Rick Bright is an immunologist who was fired for being a whistleblower during the pandemic under Trump's first administration.
The article gives an overview of his concerns for public health should Trump win the (then) upcoming 2024 election. Unfortunately, we can't take advantage of Bright's warning in hindsight:
For the well-being of our nation, the safety of our loved ones and the security of future generations, we must reject Donald Trump and any other candidate who threatens to undermine our public health institutions.
However, I'm posting this article that he wrote one year ago for an important reason. Yesterday, the CDC published a review article, which reported multiple cases of confirmed asymptomatic bird flu outside of the U.S., and likely person-to-person transmission.
This finding contradicts the common belief that most human infections will be symptomatic and severe.
Bright and a public health colleague published a commentary in the same journal, warning of the dangerous implications of asymptomatic cases spread by human to human transmission.
Asymptomatic Influenza A(H5N1) Infections and Sustained Surveillance—Sustaining Surveillance Beyond the Crisis
Through rigorous review of international literature and careful molecular and serologic confirmation in 16 cases outside of the US, the authors document that influenza A(H5N1) infections among humans do not always present with severe illness, that asymptomatic infections occur, and in some settings, there is probable person-to-person transmission. This finding challenges the traditional perception that influenza A(H5N1) infection among humans is almost invariably symptomatic and severe.
The urgency of this message is underscored by recent events in the US. Since March 2024, influenza A(H5N1) clade 2.3.4.4b has spread widely among dairy cattle, with confirmed infections in more than 800 herds across at least 16 states.2 High viral titers have been detected in raw milk and viable virus has been recovered from mammary tissue and milking equipment. Spillover into, and transmission among, other mammals has been documented, including cats, dogs, mice, wild carnivores, marine mammals, and swine.2-4 Human cases have been confirmed in multiple states, and as of mid-2025, approximately 70 cases have been officially reported, most with mild illness but including at least 1 death.5 The report from Dawood and colleagues1 thus challenges the notion that there has been no human-to-human transmission related to these events. It also highlights a critical gap in many national and global surveillance systems, which tend to focus on the detection of symptomatic illness rather than infection, and underscores the importance of carefully examining clusters where limited transmission may occur.
The implications are substantial. If asymptomatic infections are occurring, transmission chains can go undetected, giving the virus opportunities to adapt and spread widely before an emerging pandemic is recognized. These silent events will not be captured by systems that rely primarily on symptom-based case finding. Dawood et al1 provide a strong evidence base for expanding the scope of influenza surveillance to include molecular and serologic testing of individuals at higher risk of exposure, whether or not they are experiencing symptoms, as well as testing of contacts of infected persons. This is particularly important for pathogens with pandemic potential, where early detection is essential for containing spread before it becomes sustained.
Given the cuts to positions and funding in science, as well as anti-vaccination rhetoric that has spread throughout the U.S. under the current Trump administration, trusting this administration will responsibly handle another pandemic the second around seems like a dangerous assumption to make.
There is no reason to use fear or incite panic. However, this is very important information, that should be made widely available to the public as early as possible.
Given the lack of straightforward communication by the current administration, preventing a potentially dangerous situation, will require public awareness and sustained public pressure to follow the suggestions for changes to the current monitoring protocol, such as the ones provided in the commentary by Bright and Lurie.