First, let me say that for many reasons, those with experience with Hantavirus outbreaks feel at this time that it is highly unlikely to turn into something like Covid.
Yes, in the aftermath of the pandemic, it’s only reasonable to feel a bit gun shy. But unlike Sars-CoV2, this virus has not appreciably mutated in years. Current specimens are reported to be exactly the same as those seen in Argentina in 1996 and 2018 outbreaks.
Its ability to survive and adapt depends heavily on the rodent species it inhabits, a species only present in southern South America.
There are other hantavirus strains in the U.S., but they depend on different rodent species. This particular hantavirus can spread person to person, and evidence suggests by respiratory transmission. This outbreak has emerged in a very contained environment, making it easy to identify those at risk, even though some people left the ship before it became apparent what was happening.
Most significantly, previous outbreaks have been contained by close monitoring, quarantine of close contacts, and isolation for those with symptoms. Every day, we will learn more about how this virus is behaving in this outbreak. No, the reason to pay attention has far greater implications than the medical risks of an outbreak. It’s a chance to evaluate our preparedness, and how fast systems in place are ready to respond quickly to an outbreak. In Western North Carolina, how quickly systems are in place to respond to weather-related disasters is top of mind as we enter hurricane season. It is also an opportunity to see if the current administration’s desire to shrink the federal government is working — DOGE, restrictions on the ability of agencies to act independently and quickly, responsibilities and associated funding needs pushed down to states and then local communities (as we are well aware of in Haywood County, with proposed tax increases to cover the shortfalls) and cuts to healthcare insurance, food availability and research to name a few.
Has this created a gap in adjusting to these new realities that endanger health and safety now? Is this really saving us any money? In short, everyone supports a government that spends our tax dollars wisely and on what is deemed necessary and important. But has this current experiment in how to go about that served you well? Focus on this hantavirus outbreak provides a great opportunity to take the time to decide what are the “valuable” services our government should provide, at what level of government should these services be provided and what we are willing to pay in taxes to fund these services.
And with the upcoming elections all over the country, who are the candidates focused on providing services and support that meet what we need to be prepared? After all, we don’t wait for houses and businesses to burn down to only then decide we need adequate numbers of fire fighters and fire trucks. Specifically with this outbreak, are we being adequately served by a pared down workforce at CDC, given that it took a month for CDC to communicating with us? Are we being hampered by not being in the World Health Organization with ready access to information/ data sharing and coordination that comes with being a member, given that these health-related issues are not confined by borders? Are the resource sharing and support through agencies like USAID a benefit to us, by helping others in far-off places be healthier and thus less susceptible to diseases that are only a plane flight away? And do we benefit here at home when there are people on the ground in those far-away places to monitor, provide early detection and thus early intervention before an outbreak spreads too far too fast.
As Supreme Court Justice, Ruth Bader Ginsburg said, You don’t throw ‘away your umbrella in a rainstorm because you are not getting wet.’ Andes Hantavirus has a case fatality rate or around 30%, meaning that 30% of those diagnosed as infected die. For comparison, in April 2020 at the onset of Covid outbreak, New York City had a case fatality rate of around 8%. So, it is nothing to be complacent about.
We cannot tell or control when the next risky pathogen will emerge. (And just last Friday, we all became aware of an Ebola outbreak in the Congo — now that’s something to be very concerned about.) But we can be prepared to respond when it does. How well our current pared down workforce can utilize its pared down resources to manage this hantavirus outbreak can be a helpful gauge for how well-positioned we actually are. It is an opportunity to hold our elected officials accountable to make sure the necessary pieces are in place. And it gives each one of us an opportunity to participate and fulfill the role that comes with being a citizen.
Mark Jaben, MD
Medical Director, Haywood County Health Department