Bird flu could jump to humans any day. A former surgeon general says it feels like 2020 again.

• The H5N1 bird flu virus is spreading through US cattle herds for the first time.
• The mammal-to-mammal transmission has scientists worried the virus could mutate to spread between humans.
• Former surgeon general Jerome Adams fears the US is making the mistakes of 2020 all over again.

Bird flu is flying wild. In recent months the highly pathogenic H5N1 virus has been spreading through US cattle herds for the first time ever.

The cow-to-cow transmission is the latest escalation in a global outbreak that began when the virus reemerged in Europe in 2020. It has since killed tens of millions of birds and more than 40,000 sea lions and seals in South America.

World Health Organization chief scientist Jeremy Farrar called this an "animal pandemic" on April 18.

Genetic fragments of the virus, discovered in grocery store milk on Tuesday, suggest the cattle outbreak is more widespread than officials believed, The Washington Post reported.

Experts told the Post that drinking pasteurized milk is probably still safe. Pasteurization deactivates pathogens, probably including H5N1, according to the Food and Drug Administration. However, no studies have specifically tested whether pasteurizing milk deactivates H5N1. According to the New York Times, the FDA is testing that now.

One human in Texas has tested positive for the virus after exposure to dairy cattle. According to the US Centers for Disease Control and Prevention, that person's only symptom was eye redness.

There has been no known human-to-human transmission. Still, future mutation could allow the virus to spread more easily to and between humans — a possibility of "great concern" to Farrar.

Dr. Jerome Adams, a former surgeon general and the director of health equity at Purdue University, is getting deja vu.

"If it keeps spreading in animals, then it is eventually going to cause problems for humans, either because we don't have food because they've got to start exterminating flocks, or because it starts to make a jump in humans," Adams, who served under former President Donald Trump and was on the administration's initial COVID-19 task force, told Business Insider. "The more it replicates, the more chances it has to mutate."

Though he agrees with the CDC's assessment that the current risk to humans is low, Adams fears the US is repeating many mistakes it made in the early days of COVID-19.

Weak messaging with no clear leaders

Who is in charge of an animal pandemic in the US? The CDC? The US Department of Agriculture? The FDA?

The answer is, sort of, all of them. That decentralized responsibility could be behind the lack of widespread, clear public messaging so far.

For example, Adams says he hasn't changed anything about his diet, since pasteurization and proper cooking procedures should kill any live virus present. But he isn't sure everyone is getting the message.

He compared it to the development of COVID-19 vaccines, when people distrusted a process they didn't understand.

"The public needs good consistent communication from the White House, from the USDA, helping reassure them what the process is to keep them safe," Adams said.

Rather than consumers, the people most at risk are agricultural workers or anyone with close or prolonged exposure to chickens or cattle. It's those groups who need strong, targeted guidance right now, Adams said.

Only testing the sick

So far, the USDA has only been testing cattle herds when an animal appears sick. That means asymptomatic spread could be flying under the radar.

"An animal can't tell you, 'Hey, I feel a little under the weather today.' So they're literally waiting until an animal is collapsing or showing fatigue or showing severe symptoms," Adams said. "We need a testing strategy that is proactive and allows true surveillance, and not reactive."

The USDA took a step forward on Wednesday, ordering that all lactating dairy cows must be tested for H5N1 before they're moved across state lines and that all positive test results must be reported.

New York Times columnist Zeynep Tufekci reported that same day that, until now, the USDA has not been keeping track of positive test results in cattle.

Election distraction

In late 2019 and early 2020, the big news story was the impeachment, and later acquittal, of President Trump. Now a different Trump trial is dominating the news.

And, as in 2020, this is an election year.

"The Biden administration, particularly the White House, has been incredibly quiet on this bird flu situation. Why? To me, it looks like they very much don't want to scare the public and spook the economy in an election year," Adams said.

Business vs. public health

Just like the lockdowns of COVID-19 were devastating for the restaurant and hospitality industries, a crackdown on avian flu can be devastating to the chicken industry.

The treatment for a bird flu outbreak is to kill all the chickens. Even before that, just testing the flock can slow down production.

"We're seeing the same tension between business interests and public health interests," Adams said.

What's more, many of the workers who handle chickens and cattle are undocumented immigrants. That can make them and their bosses hesitant to call in authorities over diseased animals.

Many vulnerable groups were hesitant to report illness in the early COVID days, too, including migrant workers and people who didn't have sick leave from work.

"My concern is we keep making the same mistakes over and over again," Adams said. "Because we keep focusing on the wrong things instead of focusing on the root causes."