U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF THE SURGEON GENERAL In re: Ban of Live Animal Markets Docket No. __ PETITION FOR RULEMAKING SUBMITTED TO VADM Jerome M. Adams, MD, MPH Office of the Surgeon General U.S. Department of Health and Human Services 200 Independence Avenue SW Humphrey Building, Suite 701H Washington, DC 20201 [email protected] RESPOND TO Physicians Committee for Responsible Medicine 5100 Wisconsin Avenue NW, Suite 400 Washington, DC 20016 [email protected] DATE April 7, 2020 INTRODUCTION Recurrent worldwide infections—seasonal influenza, SARS, MERS, and now COVID-19— cause massive mortality and economic damage. These epidemics have specific causes that have remained neglected. Poultry flocks are breeding grounds for influenza A viruses, and live animal markets are the source of coronavirus. Because these pathogens and others like them will continue to cause massive health challenges unless urgent action is taken, the director of the National Institute of Allergy and Infectious Diseases (NIAID) now calls for a ban on live animal markets.1 Therefore, we petition the Surgeon General to “prevent the introduction, transmission, or spread of communicable diseases”2 by prohibiting the operation of live animal markets in the United States and working with international bodies to harmonize this policy worldwide. FACTUAL BACKGROUND Influenza A is an avian virus. Beginning with the 1918 H1N1 “Spanish influenza” (if not before), all influenza A outbreaks have come originally from bird viruses that have found their way into domesticated animal populations and, from there, into farmworkers, their contacts, and the broader community. The H1N1 virus killed millions of people. It later combined with an H2N2 avian virus to create a new H2N2 virus capable of infecting humans, leading to the 1957 “Asian influenza.” In 1968, an H3 avian virus combined with the H2N2 human virus to create yet another virus, causing the “Hong Kong influenza.” Of the eight genetic segments found in the 1957 and 1968 viruses, five persisted from the original 1918 virus, while three came from the new avian viruses.3 In each case, poultry flocks have served as reservoirs breeding new influenza viruses. Pig farms have also contributed. Coronavirus outbreaks come from animals sold in live markets. A live animal market is a retail food market where, in the regular course of business, animals are housed alive in close proximity and then sold, often to be immediately slaughtered on site, to consumers for the purpose of human consumption or use other than as companion animals.4 The Severe Acute Respiratory Syndrome (SARS) epidemic of 2002–2003 originated in horseshoe bats in China’s Yunnan province, passing through civets sold for meat to humans. Middle East respiratory syndrome (MERS-CoV) is caused by a coronavirus from bats. COVID-19 appears to have originated in bats and passed to humans via live animal markets. In lay terms, “the virus jumped first to the people working with these animals in the market, and then began another process of evolution, which allowed it to spread from human to human, adapting to its new host species and becoming more effective at that adaptation all the time.”5 1 Interview by Brian Kilmeade with Anthony S. Fauci, MD, Director, National Institute of Allergy and Infectious Diseases (Apr. 3, 2020), available at https://news.grabien.com/story-dr-fauci-they-should-shut-down-chinese- markets-bats-and-monk. 2 42 U.S.C. § 264(a). 3 Belshe RB. The origins of pandemic influenza — lessons from the 1918 virus. N Engl J Med. 2005;353:2209– 2211. 4 See, e.g., Cal. Penal Code § 597.3(b)(2). 5 Wendy Orent, Op-Ed: This New Coronavirus Was Preventable. But We Never Seem to Learn the Lessons of Former Outbreaks, L.A. TIMES, Jan. 26, 2020, https://www.latimes.com/opinion/story/2020-01-26/new-and- dangerous-coronaviruses-will-keep-emerging-until-we-focus-on-preventing-them. -2- Live animal markets persist in many countries due to cultural beliefs, lack of refrigeration, and other factors. In the United States, birds (e.g., spent laying hens, ducks, guinea fowl, turkeys, geese, and pigeons), pigs, cows, sheep, goats, and rabbits are the animals most often commonly sold at live animal markets.6 Some also sell wildlife, such as frogs and turtles.7 In 2004, a U.S. Department of Agriculture (USDA) official estimated that “more than 20 million birds of various species pass through as many as 150 known storefront slaughter facilities in the Northeast metropolitan areas each year.”8 By 2009, there were “about 90 live-poultry markets in the [New York] metropolitan area” alone.9 The New York Senate described the markets this way: Businesses and residents complained regularly about the unbearable odor that emanated from the markets, odor that became virtually intolerable during the hot summer months. Often, markets failed to properly dispose of animal entrails, which created undesirable conditions in the streets and on the sidewalks of the city. Floating feathers clogged sewer drains and air conditioning/heating ducts and presented asthma, allergy and respiratory hazards. Experience in local communities has shown that these markets are not monitored appropriately due to the inadequate number of state and city inspectors necessary to ensure market compliance with health, food safety and environmental laws. Lack of monitoring became especially frightening in light of Mad Cow disease and recent outbreaks of avian influenza (“bird flu”). The continued siting of live poultry markets in the midst of dense, urban and often residential areas has been found to jeopardize both residential and commercial property values as families were forced to move away from their homes and businesses were forced to close or relocate due to employee illness and a loss of customers.10 These are precisely the conditions that set the stage for further mutations of potentially deadly viruses including influenza A and coronaviruses. 6 Garber L, Voelker L, Hill G, Rodriguez J. Description of live poultry markets in the United States and factors associated with repeated presence of H5/H7 low-pathogenicity avian influenza virus. Avian Diseases. 2007;51:417–420. 7 Press Release, Animal Welfare Action, Looking at China’s Dangerous Animal-Use Practices, While Also Looking at Our Own Reckless Industries in the U.S. (Mar. 21, 2020), https://www.einnews.com/pr_news/ 512645530/looking-at-china-s-dangerous-animal-use-practices-while-also-looking-at-our-own-reckless- industries-in-the-u-s. 8 Shane S. Live-bird markets are under the microscope: as the United States battles new outbreaks of bird flu, the role and necessity of live-bird markets must be examined. National Provisioner. 2004;218(4):38. 9 Anne Barnard, Meeting, Then Eating, the Goat, N.Y. TIMES, May 24, 2009, https://www.nytimes.com/2009/05/25/nyregion/25slaughter.html. 10 N.Y. Senate Bill S7345, 2015–2016 Sess. (N.Y. 2016) (justifying, in “Sponsor Memo” section, amendment of N.Y. Agric. & Mkts. Law § 96-b), https://www.nysenate.gov/legislation/bills/2015/S7345. -3- In 2013, a Muscovy duck—a large bird native to Central and South America—tested positive for an avian influenza virus at a Brooklyn live bird market,11 resulting in a ban of exports to Taiwan and Japan of poultry products originating in the state of New York.12 Since 2010, there have been more than 450 reported U.S. cases of variant influenza A (i.e., “swine flu”), with most appearing to arise out of exposure to pigs.13 Live animals markets are known for additional problems: a 2017 lawsuit against J&B Poultry Market in Philadelphia documented the live animal market’s practice of storing recently slaughtered chickens on a shelf at temperatures ranging from 66 to 80 degrees.14 The animals in these markets travel in interstate commerce before and after sale. For example, the northeastern U.S. live bird market system “is comprised of more than 120 markets in 6 states (New York, New Jersey, Connecticut, Rhode Island, Pennsylvania and Massachusetts) with the majority of the markets being located in New York and New Jersey. Most of the birds come from adjacent states but some birds are transported several hundred miles from states as far west as Ohio.”15 The markets are popular in large cities,16 such as New York City and Philadelphia, from where the purchased animals routinely cross state lines again before they are consumed. As of 2020, conditions have worsened considerably. COVID-19 is now present in communities with live animal markets. It is a certainty that some of their workers and customers will have been exposed to this virus. This means that the existing virus (COVID-19) can easily come in contact with new coronaviruses carried by live animals, creating new, deadly strains. Just as influenza A viruses that previously caused human disease have combined with novel viruses to create new threats, the same is now likely to occur with coronaviruses, creating variants to which humans have no immunity and no vaccine, as is the case with the current COVID-19 pandemic. Live animal markets are a welcome mat to coronaviruses. The failure to close a single live animal market in China led to a pandemic that closed countless businesses worldwide and led to an enormous death toll and economic havoc. Yet despite these conditions and the dangers they pose, the Federal Meat Inspection Act and the Poultry Products Inspection Act—federal laws that regulate the slaughter, processing, and labeling of meat and poultry products respectively—exempt many live animal markets from 11 Michael Coston, Updating The New York H5N? Report, AVIAN FLU DIARY, Jan. 14, 2013, https://afludiary.blogspot.com/2013/01/updating-new-york-h5n-report.html.