Correct my H5N1 research

The following is an incorrect and incomplete post about the recent bird flu, H5N1. I am offering rewards to anyone who helps me improve it. My total budget is up to $5,000, and I commit to spending at least $1,000.*

[ETA: 1/​13: bounty no longer available, although reach out if you think you have something especially good]

Payouts are a judgement call. I’ve marked some bullet points below with what I would have awarded them if they’d been suggested here (and would pay out if someone proved incorrect).

  • Spread

    • The virus has been found in livestock and wild birds across all 50 states, and every continent.

    • H5N1 has been found in 600+ dairy cow herds in CA, which is 45% of all CA herds. This is the first flu known to infect cows.

    • There are 58 confirmed human cases in the US. of those, 2 do not have a known source; the remainder are from poultry and dairy cows.

    • Spread appears to be primarily or exclusively through fluids, at least from cows.

    • A new paper says that H5N1 only needs a single point mutation to switch to human receptors.

      • However given flu’s mutation rate and the number of virons produced by each infection, this should already happen at least once per infected cow, so clearly it’s not sufficient.

      • What does it need to get airborne? ($300)

    • The flu virus taxon has something similar to chromosomes- instead of one strand of RNA it has 8 separate segments. If a cell is co-infected by two different strains it can mix and match segments. If those strains are from different species (e.g. bird and human flu mixing in pigs), this can result in virulent hybrids. ($250 to quantify this)

  • Reference Class

    • Past major epidemic scares in the US:

      • 1976 Swine Flu Scare (small)

      • 2002: SARS (774 deaths worldwide)

      • 2009: Swine Flu H1N1 (151,700 to 575,400 deaths worldwide)

    • Past major epidemics in the US (death count):

      • 1910s-1950s: Repeated Polio epidemics

      • 1918: Spanish Flu (675,000)

      • 1957: Asian Flu H2N2 (116,000)

      • 1968: Hong Kong Flu (100,000)

      • 1980s: AIDS

      • 2020: covid (1,219,48)

  • Treatment

    • Tamiflu

      • … is most effective when taken within 12-48 hours of symptom onset. Starting treatment within 12 hours can reduce illness duration by over 3 days compared to starting at 48 hours

      • When used prophylactically, Tamiflu reduced the risk of developing influenza by 89% in household contacts of infected individuals

    • Xofluza is more effective than Tamiflu but I can’t find anywhere to buy it online

    • Traditional vaccines

      • This year’s flu vaccine contains an H1N1 but not an H5N1

      • For years with good antigenic match between the vaccine and circulating strains, effectiveness estimates are typically around 49% to 60%. However, in years with poor matches, such as the 2014-2015 season, effectiveness dropped to as low as 19% (source)

    • The US does not have over the counter tests available, however you can import Fluorecare tests (flu A and B, RSV, and covid on one cartridge) from Europe for a fraction of the cost of an American covid test.

  • Specific requests:

    • Additional major epidemics or scares that didn’t pan out ($50 for first few, $25 for later).

      • ETA: must have confirmed human cases.

    • Detailed report on the usefulness of tamiflu ($500)

    • How good is national flu monitoring? Should I take comfort in the low prevalence? ($100-$500)

    • How did H5N1 spread from bird to cow if it requires fluids? ($500)

    • What percent of cows in infected dairy herds were actually sick?($50)

    • Is there something better than tamiflu? ($100 for a credible suggestion, $500 for details)

    • Detailed report on cross immunity ($500)

    • Any information that updates my estimates of mortality or human-to-human spread.

*Details on payment: awards will be given over paypal or to a 501c3 of your choice. If you receive >$500 you will need to fill out a 1099 on tax1099.com. This means I won’t have your SSN but tax1099 will.

If the awards total to less than $500, I will double all awards given. If the total comes to between $500 and $1000, I will donate the excess to Lightcone.

To add legibility without cluttering up the comments, I’m responding to comments with rewards <=100 with