Are we prepared for the next pandemic?

In early 2020, as COVID-19 spread across the globe, Australia scrambled to respond. Protective equipment ran short, national stockpiles had dwindled, and the vaccine rollout lagged behind much of the developed world. Lockdowns became the default — not because they were ideal but because better options weren’t in place. When the dust settled, governments pledged to learn from their mistakes.

A new threat is now emerging: avian influenza, or bird flu. Unlike COVID-19, this virus isn’t a mystery. Scientists have been monitoring it for decades. In recent years, it has spread widely among birds and even jumped to mammals, raising concerns that a strain could evolve to spread easily between humans.

Australia has taken steps to prepare — investing in antiviral stockpiles, pandemic flu vaccines, and biosecurity measures. But preparedness isn’t a one-time event. Are we doing enough? Or will we once again find ourselves reacting too late?

Influenza viruses are notorious for their ability to mutate, reshuffling their genetic makeup into new and potentially dangerous strains. Of the three main types — A, B, and C — Influenza A is the troublemaker, capable of sparking pandemics.

Influenza A viruses are classified based on two key proteins: Hemagglutinin (H) and Neuraminidase (N). There are 18 H types and 11 N types, creating countless combinations. Seasonal flu is usually H1N1 or H3N2. The current concern? H5N1.

While H5N1 has yet to be detected in Australian poultry, other bird flu strains — H7N3, H7N9, and H7N8—have appeared. These viruses are what scientists call ‘highly pathogenic’ — a polite way of saying they’re deadly to birds. That’s bad news for poultry farms and potentially worse news for us if the virus mutates to spread more easily to humans.

Flu viruses have two main tricks for becoming more dangerous. The first is mutation — small genetic changes that can improve the virus’s ability to bind to human cells, making it more transmissible. The second is reassortment, which happens when two flu viruses infect the same host and swap genes. If H5N1 infects someone already carrying a seasonal flu strain, the result could be a new hybrid virus that spreads like the flu but retains bird flu’s lethality. This is how past flu pandemics, such as Swine Flu in 2009, emerged.

Right now, H5N1 struggles to infect humans and doesn’t spread efficiently between people. But the more mammals it infects, the greater the chance it will evolve into a more transmissible form.

For birds, H5N1 is devastating. The highly pathogenic strain recently detected in Australian poultry farms can wipe out entire flocks within 24 to 48 hours. Entire farms may have to be sacrificed to prevent further spread.

For humans, the picture is more complex. The World Health Organization (WHO) has reported nearly 1,000 human H5N1 cases over the past two years, with about half resulting in death. That sounds terrifying, but the real fatality rate is likely much lower. WHO data only includes severe cases — mild or asymptomatic infections almost certainly go uncounted. So far, Australia has recorded only one human H5N1 case, in 2024, from a person infected overseas. The individual made a full recovery.

In October 2024, the federal government announced a $95 million anti-bird flu package. The plan includes funding for early detection, antiviral stockpiles, pandemic flu vaccines, and biosecurity measures to limit bird-to-human transmission. By contrast, California has taken a far more aggressive approach. In December 2024, after detecting cases in farm workers and livestock, the state declared a state of emergency. Authorities distributed protective gear, expanded testing, and ramped up monitoring programs. Some experts called this a necessary precaution; others saw it as an overreaction to a virus that hasn’t yet demonstrated human-to-human spread.

Regardless of the approach, one major gap remains: tracking human infections. Most surveillance focuses on birds and animals, but we don’t know how many humans have been exposed. This is where antibody testing comes in. Antibodies are proteins the immune system produces after an infection. Testing for H5N1 antibodies in blood samples would help estimate how many people have already been infected — even if they never showed symptoms.

Large-scale antibody testing is tricky. It requires broad population sampling, and cooperation from farm workers and agricultural industries may be difficult to secure. Wastewater testing, widely used during COVID-19, can detect viral presence in communities but won’t tell us who has been infected, how sick they were, or which strain of flu is responsible. Antibody testing is essential to understanding the real human infection rate.

COVID-19 changed how governments respond to pandemics, and not always for the better. The last thing Australia should do is repeat the same mistakes. Lockdowns, mass business closures, and blanket restrictions were our only choice in early COVID-19, but they came at enormous social and economic cost.

If H5N1 remains poorly transmissible between humans, shutting down society would make no sense. If it mutates to spread more easily but becomes less deadly, it should be treated more like a severe seasonal flu than a civilization-ending catastrophe.

The key lesson from COVID-19 is that public health responses should match the actual threat—not the worst-case scenario in a headline.

Right now, the risk of an H5N1 pandemic in the next five years is low — but not zero. The virus doesn’t spread well between humans, hasn’t mutated significantly, and hasn’t reassorted with human flu strains. However, the growing number of mammalian infections increases the likelihood of future adaptation.

If H5N1 does evolve to spread more easily between people, its impact will depend on whether it weakens in the process. Historically, flu viruses that become more transmissible tend to become less deadly — but there’s no guarantee. Even a flu with a 1–2% fatality rate could cause massive disruption.

So, where does that leave Australia? Being an island helps — it buys time. Plans are being made, but preparedness must be continuous, not reactive. Expanding human surveillance, investing in large-scale antibody testing, and ensuring a proportionate response will determine whether we stay ahead of the curve or find ourselves playing catch-up once again.

The lesson from COVID-19 is clear: It’s better to prepare before a crisis than to scramble after one. This time, Australia has a chance to get it right.

Emeritus Professor Steven Schwartz AM is the former Executive Dean of Medicine, vice-chancellor of three universities, and a Senior Fellow at the Centre for Independent Studies.