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Bird Flu Leaves the World With an Existential Choice – by Jacob Stern for The Atlantic - 17.02.23

To prepare for future outbreaks, we’ll have to decide which is the greater danger: nature or ourselves.

After three bleak years, the coronavirus pandemic is finally drawing to a close, but pandemics as a general threat very much are not. At the moment, the most pressing concern is H5N1, better known as bird flu. Public-health experts have worried for decades about the virus’s potential to spark a pandemic, and the current strain has been devastating global bird populations—not to mention spilling over into assorted mammalian hosts—for more than a year. But those worries became even more urgent in mid-October, when an outbreak of the virus on a Spanish mink farm seemed to show that the mink were not only contracting the disease but transmitting it.

Occasional spillover from birds to mammals is one thing; transmission among mammals—especially those whose respiratory tracts resemble humans’ as closely as mink’s do—is another. “I’m actually quite concerned about it,” Richard Webby, an influenza expert at St. Jude Children’s Research Hospital, told me. “The situation we’re in with H5 now, we have not been in before, in terms of how widespread it is, in terms of the different hosts it’s infecting.”

What’s hard to gauge at this point, Webby said, is the threat this spread poses to humans. That will depend on whether we can transmit the virus to one another and, if so, how efficiently. So far the risk is low, but that could change as the virus continues to spread and mutate. And the kind of research that some scientists say could allow us to get a handle on the danger is, to put it mildly, fraught. Those scientists think it’s essential to protect us from future pandemics. Others think it risks nothing less than the complete annihilation of humanity. Which way you feel—and how you think the world should approach pandemic preparedness as a whole—comes down to which type of pandemic you think we should be worried about.

The point of the research in question is to better understand pandemic threats by enhancing deadly viruses. This is done in a highly controlled laboratory setting, with the aim of better preparing for these pathogens out in the world. This type of science is often referred to as gain-of-function research. If that term sounds familiar, that’s probably because it has been invoked constantly in debates about the origins of COVID-19, to the point that it has become hopelessly politicized. On the right, gain-of-function is now a dirty term, inextricable from suspicions that the pandemic began with a lab leak at China’s Wuhan Institute of Virology, where researchers were doing experiments of just this sort. (Solid evidence points toward the competing theory: that the coronavirus jumped to people from animals. But a lab leak hasn’t totally been ruled out.)

As a category, gain-of-function actually encompasses a far broader range of research. Any experiment that genetically alters an organism so that it does something it didn’t before—that is, gains a function—is technically gain-of-function research. All sorts of experiments, including many of those used to produce antibiotics and other drugs, fall into this category. But the issue people fret about is the enhancement of pathogens that, if released into the world, could conceivably kill millions of people. When you put it that way, it’s not hard to see why this work makes some people uncomfortable.

Despite the inherent risks, some virologists told me, this sort of research is crucial to preventing future pandemics. “If we know our enemy, we can prepare defenses,” the Emory University virologist Anice Lowen told me. The research enables us to pinpoint the specific molecular changes that allow a virus capable of spreading among animals to spread among humans; our viral surveillance efforts can then be targeted to those adaptations in the wild. We can get ahead on developing countermeasures, such as vaccines and antivirals, and ascertain in advance how a virus might evolve to circumvent those defenses.

This is not merely hypothetical: In the context of the bird-flu outbreak, Lowen said, we could perform gain-of-function experiments to establish whether the adaptations that have allowed the virus to spread among mink enhance its ability to infect human cells. In fact, back in 2011, two scientists separately undertook just this sort of research, adapting H5N1 to spread among ferrets, whose respiratory tract closely resembles our own. The research demonstrated that bird flu could not only spill over into mammalian hosts but, under the proper circumstances, pass between mammalian hosts—just as it now seems to be doing—and perhaps even human ones.

The backlash to this research was swift and furious. Critics—and there were many—charged that such experiments were as likely to start a pandemic as to prevent one. Top flu researchers put a voluntary moratorium on their work, and the National Institutes of Health later enacted a funding moratorium of its own. With the imposition of stricter oversight regimens, both eventually lifted and the furor subsided, but researchers did not race to follow up on the two initial studies.

The article ends with these words:

Regardless of who’s right, Esvelt’s broader point is a good one: How you feel about this research—and which kind of pandemic worries you most—is, in the end, a question of how you feel about human nature and nature nature and the relation between the two. Which should we fear more—our world or ourselves?

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Jacob Stern is a staff writer at The Atlantic.

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