A lot of people in public health say the U.S. is better prepared for the next pandemic. But that is not the case, Michael Osterholm said at Wednesday’s APHA 2024 session “Champion Conversations XI: Infectious Disease Mitigation: A 21st Century Challenge.”

“We are in worse shape than in 2020,” said Osterholm, who is often interviewed by major media outlets on infectious disease. “We are doomed to repeat many of the mistakes we made with the last pandemic.” Osterholm is a regents professor at the University of Minnesota School of Public Health and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Michael Osterholm and Karyn Bishof sit on white chairs on a stage while Karyn, wearing a black face masks, talks to the audience and uses her hands. A major concern is that public trust in public health is worse now than it was in March 2020, when SARS-CoV-2 began its first major sweep across America, Osterholm said in his presentation “The COVID Pandemic: Lessons Not Yet learned.” 

In the past, parents rejected having their kids vaccinated because of safety concerns, he said. Now it is because they don’t want to be told what to do — a stand on individual freedom. While individual freedoms are important, Osterholm said, health officials have failed to make the case that vaccines are about population safety. Some parents are even passing on having the family dog receive a rabies vaccination.

“It is my health, not public health” is the public’s position, Osterholm said.

In addition, health officials have not yet recognized the importance of leveling with the public about communicable disease, he said. 

“What I find over and over, just tell the truth,” he said. “Tell them what you know and what you don’t know. People will hang with you. What they don’t want is when you sugarcoat things.”

This year, the H5N1 influenza virus, also known as bird flu, was detected in dairy cattle, posing a potential risk for a pandemic-causing virus. On Oct. 30, the virus was found in pigs on a small Oregon farm, the first time found in that animal, the U.S. Department of Agriculture said. Pigs, the source of the H1N1 flu pandemic in 2009-2010, could create a hybrid virus that can more easily infect humans.

Yet the response to H5N1 from the U.S. and other nations has been inefficient, Osterholm said.

“We don’t really understand yet what’s happening with H5N1,” he told Think Global Health in September. “We’ve been dealing with this since April (in America), but big questions remain about how much infection is in cattle and why it continues to spread within farms. This has been a real challenge because the dairy industry has largely not been helpful.”

Meanwhile, COVID-19 amnesia has swept America. One example is that, despite an estimated 17 million people in the U.S. showing long COVID symptoms, the condition is largely ignored by media and the public, said Karyn Bishof, founder and president of the Covid-19 Longhauler Advocacy Project.

Bishof, wearing a black face mask, said she lost her job as a firefighter and paramedic after becoming too sick to work because of long COVID. A single mom, Bishof was denied 15 months of back pay because a clinician said her case was psychosomatic.

Bishof has yet to receive compensation and continues to suffer debilitating symptoms, she said. If she catches a cold, she risks being hospitalized for a month.

“Even now we have not done justice of the long-term risks,” Bishof said.

Photo: Michael Osterholm and Karyn Bishof, courtesy EZ Event Photography.