Dr. Jim Watson has been thinking about avian flu for a long time. When he first took on the role of Mississippi’s state veterinarian in 1998, the virus was as novel a threat to humans as any other. Only one year earlier, the first known human transmission of H5N1, often commonly referred to as “bird flu,” occurred in the confines of poultry markets in Hong Kong, killing six.
H5N1, a type of “highly pathogenic avian influenza,” or HPAI, would evolve dramatically over the course of Watson’s career.
“For many years, we did not have avian influenza in the United States,” Watson told the Mississippi Free Press in a Feb. 27 interview. “It was sort of an exotic disease. In 2014, that changed—and then in 2021, everything changed.”
The dimensions of the fight against HPAI have evolved with the virus itself. Dr. Ranu Dhillon, a public health expert at Brigham & Women’s Hospital and Harvard Medical School, has watched the growing threat with increasing alarm.
“It’s a big change from the sporadic outbreaks in poultry in South China. Now it’s jumping into a lot of new species,” Dhillon told the Mississippi Free Press on Feb. 28. From sea lions in South America to cattle across the United States, the territory the virus encroaches upon expands and expands.
“ The fact that it’s circulating among dairy cows is particularly important. Cows are, of course, mammals. They’re much closer to us humans,” Dhillon said.
HPAI’s incursions into the realm of human health are still limited to less than 1,000 fully confirmed cases since the outbreak in Hong Kong 27 years ago. But half of those identified infections have been fatal. As it passes between species and brushes up against the tangled web of global human society, infectious disease specialists worry that continued spillover could lead to a variant of HPAI that transmits easily between humans, triggering a pandemic with the capacity to kill more effectively than even the COVID-19 pandemic.
And just as the virus is reaching unprecedented levels of spread among poultry and cattle in the U.S., an upheaval in the federal government instigated by the Trump Administration is paralyzing many key agencies and offices meant to coordinate and direct a unified national response to just such a threat. Mass firings and across-the-board cuts to the federal budget have many public health officials in Mississippi watching Washington with growing concern.
Mississippi State Health Officer Dr. Daniel Edney is the man who would lead Mississippi’s pandemic response if HPAI grew into such a threat. He lamented the lack of support for public health outside of immediate catastrophes in a March 6 interview with the Mississippi Free Press, saying he was concerned that the chainsawing of the federal state could directly impact the Mississippi State Department of Health’s mission, including its surveillance and response to pandemic threats like HPAI.
“We have got to get to the point where we fund public health reasonably and stably in this country,” Edney said. “Now it’s feast and famine. We’re starved until there’s a public health crisis, and then they dump money on us.”
Since then, the Trump administration has begun mass layoffs in the U.S. Department of Health and Human Services that ultimately affect up to 10,000 employees tasked with tracking outbreaks, health research, and monitoring the safety of foods and medicines. The cuts include the Food and Drug Administration’s chief medical officer, who was among those leading the avian flu response.
On April 2, MSDH Director of External Affairs and Media Relations Greg Flynn told the Mississippi Free Press that Elon Musk’s Department of Government Efficiency has rescinded $230 million in COVID-19 funds from the department that remained unspent as of March 24.
But he said that neither that nor other changes at the federal level have harmed MSDH’s efforts against HPAI so far.
“No, not right now,” Flynn said. “Thankfully, that is not affecting our H5N1 preparations at the moment.”
‘Bullets Raining From the Sky’
While poultry and then cattle are the most significant targets of the newer strains of HPAI, perhaps the most challenging development is how the family of viruses has firmly established itself in a massive reservoir of wild waterfowl, like migratory ducks, outside of the strict surveillance and control of poultry farms. And these birds are bombarding farms across the U.S. with infectious material, feces and corpses.
“We’re just getting these bullets raining from the sky,” Dr. Jim Watson said. “Over 80% of the farms in the United States that have gotten infected—it wasn’t from another farm. They were infected by migratory waterfowl, dying geese and vultures.”
“It’s a highly contagious disease, and it spreads rapidly. It’s highly pathogenic: it kills 99% to 100% percent of all the birds it infects. There’s no cure for it. And so we have a very dramatic, draconian response to it. We stamp it out within 24 hours, if at all possible,” Watson said.
If the struggle against HPAI is analogous to a war, the response to an outbreak is best envisioned as a nuclear strike: picture a map, painted with overlapping concentric circles of mass destruction. In both cases, the innermost circle is an all-consuming fireball.
“The first order of business is to completely eliminate the birds on that farm because they’re generating virus,” Watson said. Factory farming crams tens of thousands of chickens into metal longhouses, capable of generating a staggering viral load in an outbreak. “ We have fans that blow it out into the environment and a lot of chicken farms that are close to each other,” he continued. Indeed, some studies have suggested that HPAI may even be transmitted on the wind.
The second circle encompasses the entire facility. Every surface is sprayed down and disinfected, purging the environment of any trace of the virus. A much wider circle tracks contacts: individuals who work on the farm and their families. Other chicken farms are surveilled for cross-contamination. Finally, a zone of control: all poultry and all their products in a broad area are locked down, only allowed to leave their farms after receiving a permit from the Board of Animal Health.
Mississippi’s cattle industry is comparatively smaller than many other states; the state’s entire herd is not much larger than those of the most productive individual counties in places like Texas and California. But in November, as HPAI’s spread into U.S. farms grew, Watson ordered a testing program for Mississippi’s dairies. “ We’ve been testing every dairy in the state pretty much weekly at our diagnostics lab,” he explained. Elsewhere, the strong influence of industry has allowed opting out of surveillance testing.
In the contemporary outbreak of HPAI, Mississippi has had to engage its purge protocol only twice, both right at the end of 2024. On Dec. 20, a small poultry farm in Greene County had to purge 34,000 birds. Just a week later, in Copiah County, a large commercial farm destroyed over 200,000 birds. Both times, Mississippi’s protocols worked: the virus was stamped out.
“You hear a lot of the news today about how the Biden Administration let this thing get out of control, that the Trump administration is gonna come in and save the day and we’re not gonna kill all these birds,” Watson said. “ Well, unfortunately, killing all these birds is what stops the spread of disease.” The depopulation of infected flocks, no matter the size, is the only realistic
way to exterminate the virus.
That approach has been effective at preventing the unmitigated spread of HPAI for decades now, but with the mass extermination of poultry, the price of eggs in America has skyrocketed—leading the Trump administration to eye relaxing those policies in light of infuriated consumer sentiment.
Late in February, the administration announced a significant investment in HPAI biosecurity measures, as well as hundreds of millions in financial relief for affected farmers. This financial relief, Watson said, is critical; compensating farmers for the massive economic losses caused by purges is how the U.S. convinces producers to comply with strict monitoring and reporting policies.
“We’re going to pay you for your birds that we’re going to kill, pay you for the eggs we’re gonna destroy. We will pay for the cleaning and disinfecting, that sort of thing,” Watson said, adding that where such compensation is not practiced, the concealment of outbreaks is far more common.
In Mississippi, the two outbreaks in Greene and Copiah were resolved at a cost of roughly $100,000. Watson explained that the Board of Animal Health maintains a Legislature-appropriated emergency fund of $250,000.
Increased biosecurity is an important component of hardening poultry farms against the constant barrage of viral exposure from the outside world. But when it comes to the idea of pulling back on the culling of chickens, Watson is skeptical at best.
“If you don’t depopulate those farms, even the big four and five million-layer operations—which is what is causing our egg problem—if you don’t do that, if all you try to do is take out the infected animals, within 10 days to two weeks, all the rest of them are infected anyway. And, by the way, you’ve let people spread it to other farms during that time,” he concluded.
On March 12, the Board of Animal Health announced that it had identified another avian flu outbreak among poultry from a broiler breeder chicken flock in Noxubee County. Days later, on March 17, the board said the strain of HPAI identified was H7N9, which had not been identified in any commercial poultry flocks since 2017. The announcement noted that MBAH was “actively working with federal partners and the poultry industry to increase monitoring of flocks statewide.”
‘So Much is About Speed’
Every month, a familiar group gathers to discuss the state of public health in Mississippi. The circle is informal, pieced together during the chaos of the COVID pandemic, but among the group are some of the most influential medical experts in the State of Mississippi, from the state health officer to the leadership of the Mississippi State Medical Association. Once, this group was called the COVID-19 Clinical Operations Committee; now, it is the Public Health Priorities Committee.
At the committee meetings, discussions range from updates on the simmering threats of infectious diseases, like HPAI or measles, to frank conversations about the structure of health insurance. Those present speak across agencies and specialties, a comforting, if all too rare, relic of the pandemic’s early heights, when some notion of national unity against the virus, however faint, pervaded.
HPAI does not dominate the conversations at the committee’s meetings. But it is a constant presence all the same, an elephant in the room, reminding the state’s top doctors and administrators that the country is never that far from the potential for another pandemic. And it provides a note of necessity for the meetings; none of the experts present at the committee’s meetings want the burden of rebuilding the formal and informal networks necessary to respond to a new pandemic as it is unfolding.
So they speak candidly with one another. As they do, HPAI sweeps across the poultry and dairy farms of the United States, killing millions of animals, still just outside the purview of human health officials. But they know the threat to these industries can produce something greater: the real fear for public health officials is the prospect of human transmission of the virus.
Mississippi, on balance, has a highly functional testing and outbreak response regime, a collective of similarly-minded public health professionals with the latitude to pursue an aggressive policy of disease elimination. But Mississippi’s medical system overall is still in a deeply weakened state, still subject to the same critical personnel and hospital access shortages that pushed hospitals to the breaking point during the height of the COVID-19 pandemic.
The state may be ready for outbreaks of HPAI in its poultry farms and dairies, but a new pandemic—another serious respiratory disease capable of filling emergency rooms and ICUs—would strike at the state’s biggest vulnerabilities. This is what HPAI could one day represent.
“On the scarier end of the spectrum, in certain strains, H5N1 has shown itself to be easily transmitted: very infectious, but also very pathogenic—causing severe disease at a higher rate even than COVID,” Dr. Ranu Dhillon told the Mississippi Free Press.
Still, for now, HPAI has yet to make that leap in the U.S. Dr. Renia Dotson, Mississippi’s state epidemiologist and second in command at MSDH, confirmed that Mississippi has yet to see human infections of HPAI, even after its two most recent outbreaks on poultry farms. “ We have not seen human-to-human transmission. And in fact, in Mississippi, we have not seen animal-to-human transmission at all,” Dotson said.
But the limited detections of HPAI among humans does not mean the virus is rarely transmitted. A seroprevalence study among workers exposed to infected cattle found antibody traces of the virus in 7% of the entire group, meaning that significant exposure gives the virus an opportunity to infect human handlers even if the currently circulating strains of the virus are ineffective at causing serious illness in humans.
To that end, MSDH follows in Watson’s lead whenever there is an outbreak, activating a rapid response to aggressively test and track the virus’s spread. “Any flock where Avian Flu is present, we test all of those individuals who had any association with that flock,” Dotson said. “Then, any contacts of those people, and (finally) any immediate contacts of those (secondary contacts).”
Even without a single case of confirmed HPAI in humans in Mississippi, MSDH acknowledges that the situation is a genuine crisis. Their ability to respond is tested regularly. They meet biweekly to discuss incident reports, testing and tracing, poised for the first sign of spillover infection, or worse: human-to-human transmission.
But as strong as Mississippi’s internal networks may be, Dotson acknowledged that the mass disruption on the federal level was problematic. “Communications with CDC and other federal agencies at the moment are limited,” she said, “But the resources are still there.” As a result of the silence, state agencies are beginning, in fits and starts, to build ad hoc communication networks outside the confines of the federal government, a pragmatic approach to a national wound entirely self-inflicted.
For Dhillon, the biggest threat is simple torpor—a sluggish response to the inflection point when H5N1 or any other strain of HPAI makes the jump from human to human could be the difference between a contained regional flare-up and a global pandemic.
“ So much is about speed. That’s why rapid tests are so important. The speed of turnaround is so crucial,” Dhillon said. “Even a one-week delay in ramping up the response, with a virus that can grow so exponentially… you have to be pre-positioned to act if human-to-human transmission emerges.”
No matter how prepared Mississippi might be internally, a federal government at odds with itself and too crippled to rapidly respond to a new viral threat could render the best laid plans of state governments to waste—precisely the crisis engulfing the federal state right now.
‘We’re All Concerned’
Every node of Mississippi’s health and biosecurity network leads back to a federal partner. The Mississippi Veterinary Research and Diagnostic Lab in Pearl, Miss., is one such node—part of a constellation of animal disease investigators called the National Animal Health Laboratory Network, or NAHLN. That central lab is the repository of all the surveillance and investigation of animal diseases done by labs just like Mississippi’s.
“ The National Veterinary Services Lab in Ames, Iowa, is the mothership of them all,” Dr. Watson said.
And it’s just that network that has been the subject of crushing, confusing and perhaps even accidental cuts, a casualty of the chainsaw approach of Elon Musk’s Department of Government Efficiency, which has already laid off countless employees throughout the federal government without any visible rhyme or reason.
Keith Poulson, Director of the Wisconsin Veterinary Diagnostic Laboratory, confirmed to Politico in February that the firings had already impaired the central network’s ability to test and respond to HPAI, sapping local responders’ ability to stay ahead of the virus as it mutates and spreads.
The Mississippi Board of Animal Health is highly regarded by public health professionals across the state, but the team itself is exceptionally slim. “Inside the state,” Watson explained, “there’s really only about… well, I only have 27 people in my agency. The USDA counterpart only has about 10 or 12.” Outside of the poultry and dairy industries themselves, that’s it: Mississippi’s first line of defense against HPAI.
And the cuts extend far beyond the targeted destruction of key offices like NAHLN. Already, the Trump administration has battered critical federal health agencies like the U.S. Centers for Disease Control, the U.S. Food and Drug Administration, and the National Institutes of Health. Communications freezes have left many of these central nodes utterly silenced, leaving state and local public health agencies scrambling for guidance in the dark.
The Animal Plant Health Inspection Service, the Epidemic Intelligence Services, and other internal divisions directly related to the coordinated prevention of severe animal and human diseases have been thrown into chaos by a series of firings, freezes and occasionally confused attempts to rehire critical workers.
Lawrence Gostin, a law professor at Georgetown University and public health official at the World Health Organization, told Roll Call that “in only a few weeks in office, the United States is now less prepared for a pandemic than I can ever think of in my decades working with U.S. health agencies.”
For Mississippi’s public health leadership, the situation in Washington is a rapidly brewing storm.
“Depending on who (is fired),” Watson said, “We’re all concerned.” The cuts at NAHLN haven’t stopped the Board’s primary mission, but “ as the Trump administration talks about budget cuts and reductions—those are things that we are always concerned with … that make our ability to respond to a disease rapidly and efficiently more problematic. At this point, we haven’t seen that.”
But while HPAI is primarily the realm of the Board of Animal Health now, any human spillover falls into the hands of MSDH. And few Mississippi agencies stand to lose more from federal cuts than the health department.
When Dr. Edney took on the role of State Health Officer in 2022, roughly 80% of MSDH’s funding came directly from the federal government. After numerous efforts to reduce that all-consuming dependency, the state agency has met with some success. Now, Edney said, “that dependency is down to 70%.” It’s a significant reduction, but the department still relies on federal agencies like the CDC and NIH for a supermajority of its funding.
And Edney is particularly clear-eyed about the threat blind cuts to the federal budgets pose to the state. “Mississippi cannot afford to lose our core public health and safety programs,” he said. “Or epidemiology, syphilis and STI surveillance. Water testing, milk testing, TB testing. Genetic sequencing of COVID and flu.”
“The two most worrisome areas are the CDC and NIH,” he continued.
Already, the Trump administration has decimated the workforce at the CDC and the NIH. Across-the-board cuts to either agency could devastate the major programs that MSDH depends on for many of its critical services.
And MSDH would have to respond to such cuts by prioritizing mission critical services, severing support for other important works to ensure the baseline health and safety of Mississippians is not immediately compromised.
“It may mean we’re reigning in areas,” Edney admitted while acknowledging that it was impossible to predict what would have to be cut and how. Edney credited the Mississippi Legislature with working alongside MSDH to reduce federal reliance but admitted that in the face of massive cuts, MSDH’s work in Mississippi “would look very different.”
‘We Won’t Retreat’
None of Mississippi’s public health leadership displayed an interest in wading into the firestorm of national politics, even as they expressed the inescapable fear that the federal appetite for austerity might directly affect their in-state mission.
But a threat like HPAI, in its current form or in more dangerous variants to come, demands coordination on a higher level than any one state is capable of, Dhillon said. “ This would be a global phenomenon and challenge. You need to coordinate at least at a national level to respond as efficiently and as effectively as possible.”
The systemic deconstruction of the federal government’s public health bureaucracy, he continued, “is where you miss the opportunity to really have a coordinated national approach … the sharing of information, sharing of resources, from vaccines and diagnostics. Losing that capacity—having a government that’s silent on the issue, it’s a real loss.”
For Mississippi’s role, the leadership who spoke to the Mississippi Free Press expressed a commitment to the health of Mississippians, even in the face of silence from the federal government.
“We won’t retreat from our core work,” Edney said. “We will keep the water safe. We’ll keep the dairy safe—we will keep people safe.”