22 Jun 2025: Infectious Disease Update
So true story — I finished this Saturday, June 21st, before we had to leave for church, and set it to publish early this morning. Then the US bombed Iran last night. So I’m leaving the date and content of the original, but you are getting this later than intended today while the world sorts out a little bit!
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There is no new major infectious disease or mystery illness outbreak making waves. This will be another short one covering a few previous threads.
First is the dangers of journalism majors covering science. I saw some headlines about a South Korean research lab that had modified a bird flu virus to make it 100% lethal in mice exposed to the virus, even as the NIH eliminated all funding for “gain of function” research. The lay reporting on this South Korean research report suggested that the South Korean team modified bird flu to make it replicate more efficiently in mammals, leading to the virus overwhelming the lungs and even infecting the brains of the exposed mice. The implication of the lay reporting was that dangerous gain-of-function research was still happening around the world on pandemic-capable viruses, putting us all at risk. I was ready to agree — but then I read the actual paper the lay reporting was covering.
You can find it here.
The lay reports on this are some of the most egregious misreporting of the actual experiments that I have seen in a while. What the lay reporters did not tell you, or did not know to tell you, was that the only modification to flu viruses done here was to create an inactive strain for a bird flu vaccine. And they succeeded at that! The lay reporting cherry-picked a gene swap that was made to improve the vaccine virus's replication in chicken eggs, allowing it to be manufactured at scale. They did NOT mention that this same gene swap left the virus unable to replicate in mammals once it got into a cell. That’s exactly how you create an inactive virus for a vaccine! The lay reporting also cherry-picked a mutation that allowed the vaccine virus to enter mammalian (mouse) epithelial cells, but again, it could not replicate there, as demonstrated in petri dishes and mouse studies. It has to get into the epithelial cells to be an inhaled vaccine version, though! So all of this is actually good vaccine design, since the virus gets in, does nothing but die, and then lets the immune system make antibodies to its pieces! The lay reporting suggested that the virus modified to be a vaccine was the flu that killed 100% of the mice it was injected into. This is the most spectacular miss (accidental or deliberate) in these reports. What the lay reporting didn’t say, but I will, is that the two flu viruses that had 100% mortality in mice in this study were unmodified flu viruses that were the dominant strains in a couple of recent outbreaks. They were also injected into the mice in ungodly high doses, deliberately well above the expected lethal dose, and that’s why the virus was found everywhere, including the brain. Meanwhile, what the lay reporting somehow missed is that the modified virus (the one they were painting to be super scary guys!), nerfed to be a vaccine, was spectacularly successful. There were NO deaths among the mice injected with the vaccine virus — despite receiving that same super lethal dose of the regular, unmodified flu viruses. There is nothing in this that I would call gain of function. Instead, I agree with the poor South Korean researchers. They have a promising lead on a potential inactive virus vaccine that appears to be effective against a couple of recent, severe bird flu strains.
Second, some of the moves at NIH. The vaccine advisory board has, indeed, been sacked, and new appointees have been named. I can only opine on what is publicly available. The reason for replacing the board is the numerous financial conflicts of interest that prior board members had with pharmaceutical companies that manufacture vaccines, as well as their recent record of recommending every vaccine that came across their desk. The conflicts are present, and quite common for boards like this, especially with academic members named to it. That mainly comes in the form of research grants, but those grants typically include salary support, and there are also more direct pay speaker engagements. While not typically a formal requirement for academic promotions, the amount of grant support a physician or scientist receives does matter for their academic career. If you are bringing in big research grants, the chair of your department and the dean are your new bestest buddies — because the 30-60% administrative overhead tacked on to all of your grants is siphoned off by the university, and thus makes your bosses look like rainmakers too.
Now, does the source of research funding impact the impartiality of the research, especially when academics frequently have multiple industry-sponsored grants from companies directly competing with each other? Tough to say. Does this mean they are now likely to push vaccines or other solutions despite poor data because it keeps their grant money flowing? I have never seen or heard of a quid pro quo demand being laid out for one of these board members like that. But I suppose the argument is that perhaps the company doesn’t need to say it out loud. The implication is already there, and providing undue influence.
I’m not sure how often that happens, and it likely depends on the character of the potentially compromised board member. But I can’t say it doesn’t happen in the quiet of their souls during their contemplative moments, either.
Regardless, avoidance of these kinds of potential conflicts of interest is important.
So, theoretically, the new members do not have this financial conflict of interest. Some, however, have been critical of vaccines in the past. This has led to criticism that they may be too reluctant to approve vaccines, due to ideological rather than financial bias. Again, that depends greatly on the character of the board member.
The bar for minimum clinical evidence of safety and efficacy has now been significantly raised for a new vaccine seeking the recommendation of the newly constituted board. The good news is that any vaccine that receives a recommendation has even convinced some serious skeptics and is likely quite reliable. The risk, of course, is that good vaccines may not move forward if some of the skeptics are unwilling to be convinced at all. We will only get a sense of the evidentiary proof they will require once a few meetings of this board are through.
Third, I’ve gotten a couple in-person questions about the impact of NIH grant funding reductions. All is woe and despair on college campuses, with much pontificating on the collapse of science research. Wholly unrelated, I was reviewing the back pages of the mass email that morphed into this infectious disease update, at least in part. Way back in 2014, due to a budget quirk in Congress, there was a significant reduction in NIH grants that eventually got fixed some months later. There was the same consternation and prophecies of doom at the time.
Science, I observe, did not grind to a halt then. I predict that neither shall it now.
At the time, I worried that the reduction in NIH funding would precipitate an increase in scientific fraud, as pursuing a dwindling amount of dollars might encourage some to cheat to maintain their place in academia. The number of retractions due to fraud or errors has indeed increased. It’s likely getting worse, as AI is being used to create fake papers in bulk. I will say that, having worked in academia and industry, the amount of “foundational discoveries” that industry picks up from academia is somewhat overblown. Bluntly, no one implicitly trusts the literature. No drug is going forward based on a paper from academia that an industry lab does not first repeat. Too many of them don’t repeat, either by honest error or . . . Are there avenues of research so improbable or so distant from practical application that only the government or major private donation can provide the funding, because no for-profit industry will take that risk? Absolutely. There is still a role for NIH grants, for that exact reason, among other good ones. However, there is a lot of nonsense that gets funded as well, and if those projects are reduced to focus on better ones, that’s not a huge loss for science. There is also nothing stopping the formation of a private not-for-profit research consortium to fund important science as well. Those are pretty common and quite important. For example, the Susan G. Komen Foundation invests a significant amount of money in many important breast cancer projects. Finally, believe it or not, the industry has also made major foundational leaps forward. Probably the most famous example of this is Bell Labs. I don’t know if they still do this, but Bell Labs used to let their scientists have one day per week to work on whatever interested them. If anything popped, it was Bell’s IP, no doubt about that. But Bell Labs was wise enough to recognize that science progresses to cries of “oops!” as often as it does “eureka!”
Bell Labs has won 11 Nobel Prizes — along with 5 Emmys and 1 Grammy. I’m not making those latter two up.
Many major corporations, from Google to Eli Lilly, now have investment arms whose sole purpose is to fund innovative, tangential science and research, seeking new foundational discoveries and more useful “oops!” moments. They are also much better positioned than academia and the NIH to bring solutions to real-world problems into the real world.
I say that from direct experience. I once discovered a novel form of antibiotic during the early academic part of my career. My chemistry partner was told by his chair to drop the project because the University lacked the money and ability to bring it forward. I finally reached a point where I could no longer move the project forward myself. I spoke with infectious disease researchers at the NIH, who talked to their bosses, and were told, “We haven’t developed an antibiotic in over 30 years — find someone in industry.”
I’m not losing any sleep over the reductions in NIH grant funding. I fully expect, especially once tariffs are either fully normalized and/or trade deals restore interest rate stability, that total US spending on R&D across all sciences will increase overall. As it has for decades. More of that increase will be shouldered by non-profit and for-profit entities, rather than directly from the government, though.
Remember all the way back to this January through March, when the CDC was being re-organized, and their data reporting was frozen, right as the sporadic cases of human cross-over of bird flu among people around a lot of birds were happening? Along with lots of seasonal colds, flu, and some COVID? And that “historic” outbreak of TB in the Midwest? AND that historic measles outbreak? And we were all gonna die of those?
Notice that you did not die of those?
“Oh man, MEASLES!” I hear you say, Hypothetical “That Memory Holed From the Headlines Like It Was 1984” Reader.
Yeah, been a while since you’ve seen a measles headline, huh? And those were all over at the time.
Let me save you the Google. Here’s why:
New cases have dropped like a rock since March. We’re still at only 3 deaths in a little over 1,200 cases.
Just as some bureaucratic shuffling within CDC did NOT, in fact, precipitate waves of pestilence across the fruited plains, truly core functions of the NIH are unlikely to be affected, and this too shall pass. The larger system will adapt to the changes.
Which leads me to my closing thoughts.
I went to Chicago twice in the last couple of months for two of the major cancer research conferences. Beyond the hints and tantalizations of a possible Golden Age, what stood out was the people. It was like seeing LinkedIn CVs in suits, as far as the eye could see. In many ways, it reminded me of my business trip to Japan those years ago now. Our Japanese affiliate office was everything I had been told to expect about Japanese business culture. Professional, polite, prepared. Very formal, in everything. Rank, hierarchy, authority — all were felt, heavy with cultural weight, in this setting. Then, once the meeting was over, they took us Yankees out for drinks. One of the office managers, not even the top-ranking person at the table with us from the Japanese office, spent the night hopping up and down, ordering more appetizers, more sake, more beer, more whiskey. Alive and vibrant now, where she had been quiet, bowing, polite before the meeting. I don’t think she had said a word in the actual conference. Daimyo of the table now. Same for the others. I met the Japanese affiliate office for the first time over a cup of sake in that room. The PhD buddy and I, the only Americans in the room, were completely blown away.
But maybe Japan is just more genuine, thinking back at the same kind of “professional” masks surging all around me in the Chicago conference center. I remember thinking somewhere in this sea of suits is someone who is deeply into skydiving. Another who is leaving the conference this evening only to wind up in a walk-off against Derek Zoolander, with Neil Patrick Harris judging because Billy Zane isn’t in the Windy City tonight. He’s off somewhere with Sergio.
Amazing, isn't it, just how much the water in which you find yourself swimming matters? Much like my Japanese colleagues, they got locked into these patterns, based solely on where they were and what they were doing. You either met “Business Them” or “After Hours Them.” Meanwhile, I’m in Chicago surrounded by “Business Thems”, because swimming in the waters of “professional conference” has set an expectation to be a walking, talking LinkedIn CV.
If you’re reading this, odds are you are one of the people who can see past that. You’re one of the people who can really open up and connect with others. That makes you very special. Did you always have this ability to connect and empathize with others, even those who disagree with you, or was it something you developed over time? I bet there’s a story there, either way.
Whether you answer that in your heart, or drop a line about it, or even tag someone else who you think is good at seeing who lies beneath, do it.
Perhaps it’s your excuse to take some time away from the world today..
