In a recent development, traces of bird flu have been detected in store-bought milk, raising concerns about the potential for mass infection, including in humans. The ongoing multistate outbreak of H5N1 in U.S. dairy cows has already resulted in three human cases, highlighting the urgent need for government agencies to be prepared for a widespread infection or a pandemic.

Experts have expressed fears regarding the preparedness of government agencies to handle a potential bird flu pandemic. Rick Bright, immunologist and former director of the Biomedical Advanced R&D Authority, warns that the national antiviral supply for influenza is inadequate. He emphasizes the need to diversify the supply and develop additional treatment options to combat the virus effectively.

One of the main issues lies in the limited stockpile of antiviral drugs. Tamiflu, the antiviral with the greatest supply, has faced scrutiny not only for its path to government approval but also for its effectiveness in reducing the risk of hospitalization or serious complications of flu. The U.S. government has also approved an extended shelf life for Tamiflu, doubling the manufacturer's original request.

Although Baloxavir has shown promise in preventing the spread of flu, the U.S. Strategic National Stockpile (SNS) only includes a limited number of doses of the drug. Building up the stockpile is estimated to take 18 to 24 months, and countries that provide funding often receive priority access to supply.

It is crucial to develop alternative treatment options as viral resistance can develop quickly to existing drugs. The Centers for Disease Control and Prevention (CDC) emphasizes the importance of having multiple options for treating flu due to the frequent changes in flu viruses and their potential to develop resistance.

Recent information obtained by Fortune reveals that Tamiflu may have reduced efficacy against the H5N1 virus collected from an infected dairy worker in Texas. The CDC continues to recommend prompt antiviral treatment with Tamiflu for patients with confirmed or suspected H5N1 infections, but experts call for further testing to determine the drug's effectiveness.

Experts suggest the ideal approach would involve a multi-drug cocktail similar to the treatment for HIV. By combining multiple antivirals, the virus's ability to gain resistance would be significantly reduced. However, the current stockpile of Tamiflu, approximately 55 million treatment courses, would be inadequate to treat a large-scale H5N1 infection.

The availability of a human vaccine is another concern. Limited quantities of a candidate vaccine that could provide some level of immunity against the current H5N1 virus in cows are stockpiled. However, experts predict that the virus would mutate significantly before becoming the human pandemic strain, necessitating the rapid production and mass distribution of an updated vaccine.

The U.S. government's preparedness for a potential pandemic, like H5N1, has come under scrutiny. The House Committee on Energy and Commerce has expressed concerns over fiscal mismanagement and failed acquisitions, which have left the Strategic National Stockpile (SNS) under-resourced and likely unprepared to respond to public health emergencies.

Considering these shortcomings, experts emphasize the need to urgently place orders for fresh drugs, update outdated ones, diversify the SNS holdings, and accelerate the development of new treatment options. A proactive approach is essential to ensure effective response capabilities instead of waiting until a full-blown pandemic is looming.

The threat of a bird flu pandemic is a significant concern, making it imperative for government agencies to take immediate action to enhance the nation's preparedness and safeguard public health.