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Pandemic series: efficient human-to-human transmission of H5N1?

It would be pleasant to believe that worldwide epidemics, such as the 1346-53 black death or the 1918-19 Spanish Influenza, are a thing of the past. There is, however, no good reason to believe this is the case. While medical countermeasures and sanitation are dramatically improved, global interconnectivity and human (and livestock) population density are much higher, creating favorable conditions for the emergence of natural pandemics.

Moreover, while national militaries have for some time had the capability of weaponizing pathogens, the advent of effective genetic engineering suggests that this capability — as well as the ability to generate qualitatively new pathogens — may become much more widely available to both nations and terror groups, increasing the risk of bioterror or bioerror incidents.

Perhaps the highest risk for a natural pandemic is posed by new versions of influenza. Per a 2008 paper:

Since 1500, there appear to have been 13 or more influenza pandemics[....]; in the past 120 years there were undoubted pandemics in 1889, 1918, 1957, 1968 and 1977. In 1918, the worst pandemic in recorded history caused approximately 546,000 excess deaths in the United States (675,000 total deaths) and killed up to 50 million people worldwide.

Previous survey indicate that experts assign significant probability to such pandemics recurring. For our first question we focus on this possibility:

Will the CDC, WHO, or a published scientific paper report that H5N1 or a similar influenza virus has become an efficient human-to-human transmitter (capable of being propagated through at least two epidemiological generations of affected humans) by mid-2019?

(Notes: Here, "similar" will be taken to mean an H5N1 strain, or a strain described in the literature as a "variant", "version", etc., of the current H5N1, and in particular be believed to have a similar fatality rate. This question concerns natural mutation/variation and does not concern engineered version of H5N1, which will be considered in separate questions.)


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Use the community stats to get a better sense of the community consensus (or lack thereof) for this question. Sometimes people have wildly different ideas about the likely outcomes, and sometimes people are in close agreement. There are even times when the community seems very certain of uncertainty, like when everyone agrees that event is only 50% likely to happen.

When you make a prediction, check the community stats to see where you land. If your prediction is an outlier, might there be something you're overlooking that others have seen? Or do you have special insight that others are lacking? Either way, it might be a good idea to join the discussion in the comments.