Pandora Report: 11.18.2022

Well Pandora Report readers, it’s that time of the year where we load our US audience up with plenty to bring up at the Thanksgiving table. 🦃 This week we start on a positive note with updates about what some of our students have been up to. We then dive into discussion of how avian influenza is likely to affect our US readers this Thanksgiving, the Biden administration’s newest National Security Memorandum on food and agriculture security, and a new study on Hendra virus that helps confirm what we already knew-man-made climate change is making infectious disease threats worse. We also cover a number of new publications, including several discussing the upcoming Biological Weapons Convention Review Conference.

Biodefense Program Students Take Atlanta and Milwaukee

When we aren’t buried in the books, enjoying our incredibly unique curriculum and world class faculty, or getting inside looks at exclusive facilities, we do get to spread our wings at professional conferences, trainings, and other trips all over the world.

Just recently, Biodefense MS Student Sophia Hirshfield traveled to Atlanta to attend the National Association of County and City Health Officials 2022 Preparedness Summit. There she learned from experts about what it takes to make us safe at the local level. As she wisely summarizes it, “We cannot say we are prepared for an emergency unless even the most vulnerable among us have preparedness resources available to them.”

Last month, Biodefense PhD Student Omar Mukhlis went to Milwaukee to attend the 65th Annual Biosafety and Biosecurity Conference offered by the American Biological Safety Association. When he wasn’t chowing down on cheese curds, he attended panels on biorisk management, public health’s intersection with law enforcement, and this year’s Eagleson Lecture delivered by Virginia Commonwealth University’s Dr. Richard Marconi-“The Growing Threat of Lyme Disease: Where Do We Stand?”

You can read about Sophia’s trip here and Omar’s here.

It’s Giving…One Health

The seventh annual One Health Day may have already come and gone this month, but there is still plenty to talk about. In case you don’t know, One Health is an approach that recognizes the synergy between human, animal, and environmental health and, as a result, emphasizes collaborative and interdisciplinary approaches to addressing health issues. It certainly isn’t a new concept but, as we’ll discuss below, it is one that is becoming increasingly important in today’s world.

Nothing to Gobble At…Turkey is ≈73% More Expensive This Year

Right now, according to the US Department of Agriculture, the average price per pound for whole turkeys is $1.99. This time last year, it averaged about $1.15, meaning the US is experiencing a 73% increase in price ahead of turkey day. However, this isn’t just a symptom of the general inflation we are experiencing. Remember the spread of highly pathogenic avian influenza we discussed earlier this year?

While avian influenza normally spreads in the colder months, the world saw a number of outbreaks earlier this year and late last year. This continued into the summer months, when commercial farmers typically are preparing for the demanding holiday season. As of November 17, more than 50 million birds in 46 states from commercial and backyard flocks have either died from bird flu or have been culled after exposure to infected birds since early 2022. 47 states have detected avian influenza in about 3,700 wild birds this year as well. While there has only been one reported human case in the US this year, people all over have felt the effects as prices for staples like eggs skyrocketed. The holidays will be no exception with price increases and large numbers of flocks impacted across Europe too.

However, if you (correctly) prioritize sweet potato casserole and cranberry sauce at your Thanksgiving dinner, you’re in luck. The price of sweet potatoes have gone up just about 3¢ a pound, while 12 oz. of cranberries went up about 1% (or 2¢) to $2.24, making them some of the most minimally affected Thanksgiving staples.

President Biden Signs NSM-16 on Strengthening the Security and Resilience of United States Food and Agriculture

This week the Biden administration released National Security Memorandum-16 (NSM-16) which aims to strengthen the resilience of US food and agriculture. This memo includes portions dedicated to threats posed by climate change and cybersecurity in response to recent events like a June 2021 ransomware attack that halted operations at one of the world’s largest meat suppliers’ North American base, the spread of HPAI this year and its impacts on poultry supply and safety, and the threats to global food security and grain supply caused by Russia’s war in Ukraine. NSM-16 provides guidance to help identify and assess threats of greatest consequence, strengthen partnerships and enhance workforce resilience, coordinate interagency efforts more effectively, and enhance preparedness and response capabilities. Among its priorities are “Redefining the way that chemical, biological, radiological, and nuclear (CBRN) threats are defined, in relation to the food and agriculture sector specifically,” and “Enhancing threat and risk assessments, disseminating needed information with relevant Federal, State, local, Tribal, and territorial (SLTT) governments and private sector partners.”

Deforestation is Driving the World Batty

A bat carrying a virus loses its habitat and, as a result, moves away towards other animals. In the process, it sheds viral particles in its feces and saliva, eventually spreading the virus on to another animal that can, in turn, spread it to human populations. Those infected typically will first experience fever, cough, sore throat, headache, and malaise. Later, they can develop meningitis or encephalitis, bringing on worsening headaches and fever, drowsiness, and even convulsions and coma. Up to 70% of people infected with the virus die, while about 80% of infected members of the intermediate species die. No, it’s not the ending of Contagion. It’s Hendra virus (HeV), a very real member of the same genus (Henipavirus) as Nipah virus, the also very real virus that inspired the film’s fictional virus, MEV-1. While it’s not quite time for EIS officer Kate Winslet to valiantly try to save us all just yet, a new study offered by Nature as an accelerated article preview indicates we might be a little closer to that point than we would like to think.

It started in 1994 in Queensland, Australia. In Hendra, a suburb of Brisbane, a pregnant mare became sick and died two days after arriving from a paddock somewhere else in Brisbane. Eleven days later, 17 more horses in the large racing stable also became ill. Fourteen of those 17 were euthanized. Between five and six days after the mare’s death, a stable-hand and a trainer, both of whom had contact with the mare’s mucous secretions, developed flu-like illnesses. The hand recovered, but the trainer developed pneumonitis and arterial thrombosis before going into respiratory and renal failure and dying from cardiac arrest seven days after hospital admission. As explained in the Medical Journal of Australia, “A morbillivirus cultured from his kidney was identical to one isolated from the lungs of five affected horses. The two affected humans and eight other horses were seropositive for the infection, which was reproduced in healthy horses following challenge by spleen/lung homogenates from infected horses. There was no serological evidence of infection in 157 humans who had had contact with the stables or the sick horses or humans.” That was how HeV made its first appearance, and it hasn’t become any less terrifying since.

Since then, HeV disease has killed over 100 horses, though just seven humans are known to have been infected, all through close contact during care or necropsy of sick or deceased horses. There has been no documentation of human-to-human transmission. The natural host has been identified as fruit bats of the Pteropodidae Family, Pteropus genus, also commonly known as flying foxes. To date, serologic evidence for HeV infection has been found in all four species of flying foxes in Australia, but spillover to horses has been limited to coastal and forested regions in Queensland and New South Wales. Furthermore, late last year, a study identified a novel HeV variant that was discovered in Australian flying foxes after a heat stress mortality event in 2013. This variant was compared to published HeV genomes and it was 84% similar. As it belongs to the HeV species but is part of a distinct lineage, it was designated HeV genotype 2 (HeV-g2). Last October, an equine case of HeV-g2 was detected near Newcastle, NSW outside of the winter season typical for HeV and further south than any previous equine detection, highlighting the expanded geographical area at risk for spillover. Updated diagnostic tests are now available in Australian states and territories to be able to test for all known HeV variants.

There is a registered subunit vaccine available for horses (Equivac), though there is no vaccine for humans. However, as a survey in PLoS One revealed, 43% of horse owners in Queensland have not vaccinated their horses, with that number rising as high as 70% in some parts of the state. The Atlantic spoke with some of these owners, with one telling them “I don’t believe in injecting chemicals into horses, especially if it’s not tested,” Carloss said, referring to the fact that regulators, citing the danger posed by an outbreak, initially allowed the vaccine to be sold under a provisional license. “More people get hit by cars or shark attacks.” This has caused tension with equine veterinarians and broader concerns about low vaccination rates increasing the risk of spread to humans who work closely with unvaccinated animals. This is especially worrisome given recent findings that indicate flying foxes are increasingly crossing paths with horses and humans as they lose their natural habitats.

Source: CDC Public Health Image Library

The New York Times explains that the new Nature study, “…based on 25 years of data from Australia, suggests that environmental changes have been driving these spillovers by radically altering the ecology of black flying foxes. Deforestation, coupled with climate-linked food shortages, has driven the bats into human-dominated habitats like farms, where food is readily available but may be of poorer quality…” Furthermore, a second study published in Ecology Letters suggests that flying foxes may demonstrate more pronounced viral excretion as a result of recent food shortages, meaning they are shedding more virus when they arrive at human-dominated habitats in search of food.

Worse yet-they aren’t leaving like they used to once the seasons change. The Nature article notes that, in the past, the bats would normally break up into smaller groups to seek out food sources like urban gardens and agricultural areas during winters or events like El Niño that limit their supply. Typically, these behavioral changes would last only for those periods of acute food stress, and then the bats would return to nomadism and nectivory once their food sources were available. Beginning in about 2003, however, flying foxes often still break off into smaller groups during periods of food shortages, but they now permanently remain in their new habitats near farms and cities instead of returning to nomadism in the forests. The authors suspect this is because of rapid deforestation, with about 1/3 of the bats’ winter foraging habitat having been lost between 1996 and 2018. Between 2003 and 2020, the number of flying fox roosts in the sampled area tripled, the average size of groups shrunk, roosts were increasingly close to one another, and, as a result, the bats foraged in smaller areas.

The authors think the animals may no longer find benefit in trying to maintain their nomadic lives as deforestation has made it more convenient to rely on the low-quality food they can get near farms and cities, rather than expending much more energy trying to search for dwindling supplies of the food they once relied on. This means that these bats are shedding more virus than normal, staying in human-dominated areas, and living in closer proximity to horses, all of which increases the likelihood of HeV transmission. It’s important to note too, as Dr. Cara Brook of the University of Chicago highlighted, that this is not a dynamic unique to Australia. Wild bat populations are reservoirs for different diseases all over the world in many different ecosystems that are also at serious threat. The Pteropus genus also includes the known reservoir for Nipah virus, which first emerged in Malaysia in 1998, devastating the local pig industry and causing fatal disease in humans. In the last few decades, their habitats in Southeast Asia have been reduced by deforestation caused by industrial plantation. In fact, between 1990 and 2010, Malaysia lost nearly 9% of its forest cover, in large part due to logging and clearing for the palm oil industry.

In the end, human, animal, and environmental health are inextricably linked. This new study does a great job of showing change over time and the role of climate change in changing animal behaviors and worsening infectious disease threats. However, it is important to not just absorb this information, but to consider the broad ramifications of these findings across all fields.

What Have We Learned from COVID-19? Apparently Not Much

This week has had a lot of more of the same old frustrating updates and conclusions in terms of COVID-19 and our preparedness for future global health threats. The WHO’s Global Vaccine Market Report for 2022 found that, “Despite progress in recent decades, global market vaccine dynamics are not fully conducive to the development, supply and access for vital vaccines for public health,” limited profit potential continues to hamper investment in vaccines labeled priorities, and (you guessed it) “Lower-income countries have struggled to access critical vaccines – such as against COVID-19 in 2021 and cervical cancer vaccine – that are in-demand by wealthier countries.” While countries like the US have had the luxury to hold onto excess vaccine doses throughout the pandemic, others have gone without. However, as most are keenly aware, this has been far from indicative of a stable situation in the US health system.

Kaiser Health News reported this week that the roughly 4,000 epidemiologists, communication specialists, and public health nurses hired by the CDC Foundation to augment local and state health departments nationally will lose their jobs as the foundation’s $289 million in COVID-19 relief funding runs dry. Pierce Nelson, a spokesperson for CDC Foundation (an independent non-profit that supports CDC), indicated that no more than 800 of these 4,000 hires would remain in their positions. This means many local and state health departments are facing serious staffing shortages as we face a potential winter surge in COVID-19 cases, a concerning start to flu season coupled with lagging vaccination rates, exploding STI rates, and growing calls for a health emergency declaration with more than 3/4 of US pediatric hospital beds occupied in large part because of this year’s explosion of RSV cases.

While the administration has largely moved on from treating COVID-19 like an active emergency, leaving a slim chance of 4,000 professionals hired using COVID-19 emergency funds keeping their jobs, this points to a much large problem-public health is chronically underfunded in the United States. Those 4,000 are dwarfed by the at least 80,000 new public health employees estimated to be required nationally to allow state and local department to consistently offer a minimal level of services. In 2020, just 28% of local health departments had an epidemiologist or statistician on staff. Furthermore, public health workers left the field in large numbers during the pandemic, citing burnout and public abuse related to COVID-19 rules and economic downturn. Though $3 billion is expected to come to state and local departments this month to help support building a public health workforce, another one-off lump sum is not enough, especially after thousands like those hired by CDC Foundation will have already had to move on with their lives.

Today, at least 1,072,285 people in the US have lost their lives to COVID-19, with 555 of those reported yesterday alone. COVID-19 is the third leading cause of death in the US, behind two noncommunicable diseases-heart disease and cancer. Even if it were true that COVID-19 is no longer a major part of our lives, the fact still remains that these numbers are as high as they are because of how poorly the US responded to the pandemic. This boom and bust funding cycle clearly does not work for public health. Consistent, yearly, secure funding is needed to make sure we have a competent, stable public health workforce that is well-supplied and able to handle whatever we have to deal with next. Dr. Katie Schenk, who served as a Senior Epidemiologist on CDC Foundation COVID-19 emergency fund contracts at the Illinois and District of Columbia Health Departments, was quoted by KHN on this subject, saying “How do you explain that there is no funding for employment in our field when there is clearly so much work to be done?” she asked. “It’s to the detriment of the public health system, which is shedding staff like there’s no tomorrow.”

Tossing a bucket of water towards the neglected, dry, wooden house that is already engulfed in flames is never going to work. Pre-COVID-19, just 3% of healthcare expenditures in the United States were for public health. In 2019, US the National Health Expenditure sat at $3.8 trillion, or $11,582 per capita, accounting for 17.7% of GDP. That number grew nearly 10% in 2020 to $4.1 trillion, or $12,530 per person, accounting for 19.7% of GDP. Of course, in the middle of surging hospital occupation and the rush to find a vaccine, the US spent a lot on health care and related activities like research and insurance. And, to be fair, public health funding accounted for 5.4% of NHE in 2020, but it was in the middle of a pandemic.

Furthermore, in August, Brookings estimated that around 16 million working-age Americans have long COVID. In a longitudinal survey conducted by the US Federal Reserve Bank of Minneapolis, 24.1% of people who contracted COVID-19 experienced symptoms for three months or longer. At that point, 70% of Americans had contracted COVID-19, meaning if that 24.1% holds roughly true in the broader population, about 34 million working-age Americans had long COVID at some point. As many as 4 million workers are likely out of work because of long COVID too, according to Brookings. The annual cost of those lost wages is estimated to be between $170 and $230 billion annually and it is likely to rise in absence of substantial policy changes like expanded sick leave, improved employer accommodations, and wider access to disability insurance in addition to improved prevention. To be sure, this all costs a lot of money. However, it would not have cost nearly as much if we had invested more in things like public health way before COVID-19 even emerged.

This highlights two very important points: 1) Americans spend much more than comparable countries on healthcare, but they have poorer outcomes, and 2) much like it is cheaper to invest in preventative care and social services that improve quality of life rather than pay for medical care down the line when someone is seriously sick, it is cheaper to invest in public health way before a crisis comes. In fact, Academy Health found in 2018 that “Every $1 invested in public health yields improved health outcomes equivalent to as much as $88 in expenditures saved by county public health departments.” One study found that other OECD country spent on average about $2 on social services for every $1 of health care spending, compared to the United States 55¢. The US spends nearly twice as much as the average OECD country on health care as a share of the economy, yet it has a lower life expectancy than comparable high-income countries like Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. The US also has among the highest chronic disease burden in the OECD, and its obesity rate is two times higher than the OECD average. Finally, according to the Commonwealth Fund, the US has the highest rate of avoidable mortality among its peers because Americans do not receive timely, high-quality care. All this points not only to problems in efficiency and delivery in healthcare, but also to major risk factors that make the US much more vulnerable to health security threats.

Tackling healthcare spending, insurance issues, and broadening access to care are objectively difficult to accomplish in the current US political environment. Public health has similarly suffered from partisan politics over the course of the pandemic, from the national level all the way to rural county commissions. However, at the end of the day, this is national security at stake. The US is suffering major economic hardships because of the impacts of COVID-19, including the loss of millions from the workforce on top of global inflation. Lack of equitable access to quality, timely care, lack of funding for community and state-level public health, and an overall reactionary system create a population that is bogged down by high chronic disease burden and slim options for healthcare. That population by definition is not secure. Patchwork and crisis-dependent funding is not cutting it and if we do not do something about it now, we will be in a similar or much worse situation not long from now when the next global health crisis strikes.

“A Plan B to Strengthen Biosafety and Biosecurity”

Dr. Gregory Koblentz (Director of the Biodefense Graduate Program) and King’s College London’s Dr. Filippa Lentzos recently published this piece in CFR’s Think Global Health. In it they discuss what Russia’s invasion of Ukraine likely means for the upcoming BWC RevCon, challenges posed by spoiler states in international negotiations, and the potential for “minilateralism”-“a collective action strategy that brings together the smallest number of countries that can have the greatest impact on an issue”-to help overcome these challenges. They conclude, “Given these stakes, the geopolitical constraints on multilateralism, and Russia’s abuse of the BWC, a concerted effort to harness minilateral strategies offers the best chance to advance collective action on ensuring that life sciences research globally is conducted safely, securely, and responsibly. This effort can begin by fostering the widespread adoption and implementation of the ISO laboratory biorisk management standard, but minilateralism has the potential to take cooperation well beyond this first step too.”

CBWNet Working Papers

CBWNet recently released multiple working papers ahead of the BWC RevCon, including “International Biosecurity Governance Evolution within the Biological Weapons Convention” and “The Legal Effect of the BWC Review Conferences”. These papers offer great background ahead of RevCon on the evolution of the BWC, recent developments like the 2015 Tianjin Biosecurity Guidelines, and the international legal consequences of review conference agreements versus actual changes to the BWC itself.

“Russia (Again) Peddles Its Debunked US-Ukrainian Bioweapons Claims at the United Nations”

While on the topic of the drama we have endured in the lead up to RevCon this year, we (again) could not skip out on more of Russia’s masterful wasting of everyone’s time with its nonsense biological weapons claims. This time Dr. Lentzos and Jezz Littlewood tackle Russia’s fourth time taking these claims to the UN Security Council this year for the Bulletin of the Atomic Scientists. In it their piece, they discuss state abstentions on the vote, highlighting that eight of the 10 non-permanent members of the UNSC made it clear that they abstained from voting because they wanted to make it clear they support the right of any state to invoke Article VI, which may have been muddied if they had outright rejected Russia’s claims that they argue have no merit. They also discuss the absurdity of going to the UNSC with an Article VI complaints after the BWC consultative meeting previously failed to get Russia more support. In fact, they explain, “Of the 15 Security Council members Russia would be making its complaint to, six had rejected Russia’s allegations at the consultative meeting (Albania, France, Ireland, Norway, United Kingdom, and the United States), while six others had been silent (Ghana, Kenya, and the United Arab Emirates) or had supported the process of the consultative meeting but without supporting Russia’s specific claims (Brazil, India, and Mexico). Only China supported the claims in September. (Gabon was absent from the September meeting.)”

“Russia’s Apoplexy Over Biological Research – Implications for the BTWC and Its Articles V and VI”

Dr. Jean-Pascal Zanders also took a crack at this on his site, The Trench, offering a detailed explanation of Russia’s claims, their recent moves under Articles V and VI of the BWC, and what issues this process has illuminated ahead of RevCon. In particular he notes that 1) “In both instances [when Article V was invoked], the FCM did not resolve the controversies for lack of consensus among the participating BTWC state parties.” 2) The BWC does not outline a clear procedure to trigger Article VI. Because Russia simultaneously filed a UNSC complaint and used its status as a permanent UNSC member to submit a draft resolution that would form an investigative commission, proposals aimed at strengthening Article VI at RevCon may have to address the question of if this permissible. They would also need to “…determine whether a request to act on a concurrent draft resolution amounts to the request to have the complaint considered by the UNSC as explicitly stipulated in Article VI,” and 3) Russia resubmitted the same documentation in its Article VI complaint that UNODA had questioned four times before the UNSC, and that the FCM previously did not conclude demonstrated there was a violation of the BTWC. Zanders concludes, “The question, therefore, arises whether Russia did not brutalise Article VI by submitting documents in evidence that the international community had already repeatedly judged as wanting.”

“Delay, Detect, Defend: Preparing for a Future in Which Thousands Can Release New Pandemics”

This new paper from the Geneva Centre for Security Policy written by MIT’s Dr. Kevin Esvelt discusses information hazards in pandemic research. Esvelt writes, “The world is demonstrably vulnerable to the introduction of a single pandemic virus with a comparatively low case fatality rate. The deliberate and simultaneous release of many pandemic viruses across travel hubs could threaten the stability of civilisation. Current trends suggest that within a decade, tens of thousands of skilled individuals will be able to access the
information required for them to single-handedly cause new pandemics. Safeguarding civilisation from the catastrophic misuse of biotechnology requires delaying the development and misuse of pandemic-class agents while building systems capable of reliably detecting threats and preventing nearly all infections.” You can also find the accompanying article in The Bulletin of the Atomic Scientists.

“Toward a Post-Pandemic World: Lessons from COVID-19 for Now and the Future”

From the National Academies: “To take stock of lessons learned from COVID-19 around the world and in the United States, the Forum on Microbial Threats held two virtual workshops during 2021. The first workshop focused on what it means to frame the response to COVID-19 through a “syndemic” approach, and what the implications would be for global recovery. The second workshop focused more broadly on key lessons and emerging data from ongoing pandemic response efforts that can be incorporated into current health systems to improve resilience and preparedness for future outbreaks.”

“This workshop explored the long-term effects of COVID-19 on health equity, including considerations for mental health and social determinants of health. It also addressed uncertainties during a pandemic, such as trust, communication, and engagement and explored approaches to systematize recovery efforts to improve the ongoing responses and prepare for the next pandemic. Experts discussed possibilities for a post-pandemic world and a response strategy for stakeholders that ensures sustained community partnerships and prioritization of health equity. This Proceedings of a Workshop summarizes the presentations and discussions from the second workshop.”

What We’re Listening To 🎧

“The Retort” – A History of Chemical and Biological Disarmament

The 9th Review Conference for the Biological Weapons Convention is swiftly approaching and, well, there’s a lot to know about it beforehand. Check out this episode of Dr. Brett Edward’s podcast for a concise rundown on CBW disarmament whether you need a soothing refresher or a 101 style introduction.

This Podcast Will Kill You Episode 109, Chikungunya: Not Dengue (Or Is It?)

Has it been awhile since you got really freaked out by an arbovirus? Don’t worry-there’s a new episode of TPWKY out to fix that for you! From the creators: “Somehow it’s taken us until the penultimate episode to cover this season’s first mosquito-borne virus. But we assure you, this episode is well-worth the wait. Although Chikungunya virus is often lumped in with dengue or Zika, the unique characteristics that distinguish Chikungunya virus from these other arboviruses are just as important to note as the similarities among them. In this episode, we explore these differences and similarities in the biology of Chikungunya virus before reassessing what we thought we knew about the history of this disease, a history that is presently under revision. Finally, we wrap up the episode as we always do, by taking stock of where we stand with Chikungunya virus today. Tune in for a good deal of dengue compare/contrast, a whodunnit (or whichdiseaseisit) in the history of these two diseases, and a frustrating attempt to gather present-day case numbers.”

Book Launch- Tech Wars: Transforming U.S. Technology Development

Dr. Dan Gerstein, an alumnus of the Biodefense PhD Program and current Schar School adjunct professor, is launching his latest book, Tech Wars, at an event hosted in-person by American University’s School of International Service on November 29, at 5:30 pm EST. “This book explores the evolution of the current U.S. research and development enterprise, asks whether this organization remains appropriate to the challenges we face today, and proposes strategies for better preparing for the global technology race shaping our future.” Learn more and register here.

Countering the Misuse of CBRN Materials and Related Information

“On 23 November 2022 (Wednesday) at 10:30 am the Center for the Study of Democracy is organizing an international conference on Countering the misuse of CBRN materials and related information. This event aims to provide an opportunity to consider different approaches to promote the effective management of chemical, biological, radiological and nuclear security risks.” Learn more and register here.

Other Ways to Connect with the Pandora Report

While we don’t have any zingers lingering in our Twitter drafts to release just in case we are at the end of the line, we do have a couple other places you can connect with us if you would like. If you aren’t already, you can subscribe to our newsletter here and get the weekly report straight to your inbox. You can also join our LinkedIn group-Pandemics, Bioterrorism and Global Health Security-and find us on Instagram @thepandorareport. As always, everything we post is available at https://pandorareport.org/!

Pandora Report: 11.11.2022

This week we start by sharing some fun updates from the Biodefense Graduate Program and discussing the current situation with influenza, RSV, and COVID-19 in the United States. We also discuss new publications, including ones that discuss hypothetical BW use in Ukraine, highly pathogenic avian influenza in the US, and a new episode of the Poisons and Pestilence podcast focused on the M device. This issue concludes with details on a number of upcoming and recorded events (including a virtual open house for the Biodefense PhD Program!) and announcements, including open applications for the Biotechnology Innovation & International Security Fellowship at Stanford University’s Center for International Security and Cooperation. Happy Friday and, as always, please wash your hands.

George Mason Biodefense MS Students Tour BSL-3 Facility on Science and Technology Campus

Last month, students in the Biodefense Graduate Program made the trek from Arlington to Manassas, VA to tour George Mason’s Biomedical Research Laboratory (BRL) on our Science and Technology Campus. Check out the Schar School’s article about their tour of the 52,000-square-foot, $50 million, NIAID-funded facility here. If you would like to have this and similar opportunities in the future, check out our upcoming PhD virtual open house coming up this Wednesday at 7 pm EST.

Schar School Biodefense MS Students and Adjunct Professor Scott Wollek joined by Biodefense Graduate Program Director Dr. Gregory Koblentz (center) and Drs. Rachel Pepin and Farhang Alem of the BRL (far right)

If the Time Change Wasn’t Bad Enough…We Might Have a Triple Threat On Our Hands

As the days get shorter and colder, the United States is also experiencing upticks in influenza, RSV, and (of course) COVID-19. Children’s hospitals are already struggling with the burden this is causing and there are further concerns that hospitals across the country will become overwhelmed as we head into winter. In response, some health departments have ramped up drive-thru testing for COVID-19 while also offering drive-thru RSV and flu testing at those same sites. Some suspect this convergence and uncharacteristic spikes in respiratory illnesses may be the result of an immunity gap created by lack of exposure to other illnesses during harsher COVID-19-related restrictions.

CDC reported this week the “cumulative hospitalization rate in the FluSurv-NET system is higher than the rate observed in week 44 during every previous season since 2010-2011.” The agency also estimates that in this flu season so far, there have been at least 2.8 million cases, 23,000 hospitalizations, and 1,300 deaths associated with influenza. This year was also marked by an early increase in seasonal flu activity in the US, following earlier concerns that a rough flu season in the southern hemisphere provided warning of the same coming for the north. The US notably had historically low interseasonal influenza cases in 2020 when people were much more cautious and consistently took actions such as social distancing, masking, increased hand washing, etc.

This year has also brought an increase in cases of respiratory syncytial virus (RSV) infections, with CDC reporting its surveillance “has shown an increase in RSV detections and RSV-associated emergency department visits and hospitalizations in multiple U.S. regions, with some regions nearing seasonal peak levels. Clinicians and public health professionals should be aware of increases in respiratory viruses, including RSV.” The US saw a much higher than normal rate of RSV infections over the summer that then surged throughout September and October. RSV causes mild, cold-like symptoms that most people typically recover from in one or two weeks. However, RSV can be serious in some cases, with infants and older adults at particular risk. In the US, RSV is the most common cause of bronchiolitis and pneumonia in children under the age of one. Annually, the US averages 60,000 pediatric RSV hospitalizations, but this is likely to be exceeded this year.

RSV hospitalization rates by season for children (ages 0-17) in the United States. Source: CDC RSV-NET Interactive Dashboard

While the updated, bivalent COVID-19 vaccines have proven more effective against BA.4/5 subvariants than original offerings, new concerns loom as the so-called “Scrabble variants” spread. While the BA.5 subvariant still accounts for about 40% of US cases, others like BQ.1, BQ.11, BA.4.6, and BF.7 are rising along with XBB and B.1.1.529. If this collection of subvariants is confusing to you, you’re not alone, as Dr. Peter Hotez acknowledged in initially describing them as “Scrabble variants”.

There is debate about how much the general public needs to understand about all these different subvariants. Some argue that the granular details differentiating between these is unhelpful and communication should instead focus on risk. However, others like Dr. Hotez argue it is important that people understand the differences. He points to the updated vaccines having been formulated for the BA.4 and BA.5 subvariants, the latter of which BQ.1 and BQ.1.1 are descendants. This likely means the updated vaccines do offer protection against BQ.1 and BQ.1.1, making it important to communicate these facts to the general public. Others also argue that easier names should be offered to the public so that subvariants do not blend together and cause people to underestimate new emerging strains.

While these new subvariants are new enough that there is no available vaccine efficacy data on them yet, consensus is largely that a “booster is a booster” and that it is still worth getting one if you have not already. Both the bivalent vaccines and antivirals like Paxlovid are expected to remain effective against severe outcomes with these subvariants. However, US vaccine rates with the updated versions have remained underwhelming, with rates by age groups ranging from nearly 27% in adults over the age of 65 to under 12% for adults ages 18-65.

Total population vaccine rates with bivalent booster by state, Source: CDC COVID Data Tracker

The weather is cooling and we are all increasingly spending more time inside at a time with relaxed public health measures in place. These are each viral respiratory infections, so it is important to be vigilant on measures like covering coughs and sneezes, washing hands appropriately, staying home when sick, and so on.

Important to note is that there is currently no vaccine available for RSV, though certain children may qualify to receive preventative injections of the monoclonal antibody product palivizumab during RSV seasons. Furthermore, there is no antiviral for RSV, so treatment is supportive care. There are antivirals for COVID-19 and influenza available and, of course, it is important to be vaccinated for both of these if at all possible. You can schedule appointments to get your seasonal flu shot and updated COVID-19 booster at the same at plenty of locations, many of which can be found through Vaccines.gov’s search tool.

“Les « Frankenvirus » au cœur des débats, après l’émergence du Covid-19”

In this Le Monde article on gain of function research, Biodefense Graduate Program Director Dr. Gregory Koblentz discusses the announcements of 27 new BSL-4 laboratories since the start of the COVID-19 pandemic and what these announcements, in light of loose international standards on biosafety, might mean in terms of increased risks of accidents.

“The World is Prepared for the Unthinkable”

This recent piece in CFR’s Think Global Health discusses the likely consequences of biological weapons use in Ukraine. McCloskey, Nuzzo, and Heymann write “A biological attack in Ukraine or anywhere would have profound and far-reaching political, military, and health consequences. The immediate impact would be to exacerbate the already profound human suffering that is occurring in the country and it would place further strain on already struggling health systems. Depending on the pathogen used, a biological attack could present risks beyond Ukraine. Unlike other weapons, biological agents have the potential to spread widely. Neighboring countries could be at immediate risk, but, as the ongoing COVID-19 pandemic has shown, diseases can travel widely around the globe before they are noticed.”

“Strategic Intelligence Assessment and Data on Domestic Terrorism”

This week the FBI and Department of Homeland Security released their second Strategic Intelligence Assessment and Data on Domestic Terrorism report. Overall, it details a continued increase in domestic terrorism investigations in the US, with the government opening 1,400 investigations in 2020 versus the average of 1,000 seen in previous years. It does note that this was in part because of investigations opened as a result of the January 6 attack on the US Capitol, but also that this anomaly does not fully account for the significant increase in that number. Most of these investigations were related to “…racially or ethnically driven violent extremism, anti-government or anti-authority violent extremism, and civil unrest.”

Other interesting points in the report include the that, as Lawfare explains, “…despite the increased threat, the National Counterterrorism Center (NCTC) does not employ a single analyst focused exclusively on domestic terrorism. One could argue that the NCTC is hamstrung in some respects because its mandate, or at least a narrow reading of its statute, limits its ability to focus on terrorism not related to the international variety of groups like the Islamic State and al-Qaeda. At the same time, the assessment states Homeland Security employs only ten analysts for domestic extremism threats. However, that number represents a meteoric increase from five years earlier, when there was not a dedicated domestic terrorism analyst squad.”

“Flu: When Spillovers Spill Over”

As the authors of this Think Global Health piece explain, the US is currently in the middle of one of the largest outbreaks of highly pathogenic avian influenza (HPAI) in animals in US history. At least 49 million birds from backyard and commercial flocks have been culled so far in 43 states as this year’s outbreaks continue.

The authors write “Case counts and distributions in wild birds have been equally astounding. Department of Agriculture surveillance efforts in 2022 have detected HPAI in wild birds in almost every state in the continental United States, plus Alaska. Active surveillance has found more than 3,300 infected wild birds. This extensive transmission through wild avian species is more pronounced than in previous U.S. epizootics, or animal epidemics; in the 2014-2015 outbreak, fewer than 100 wild birds tested positive for H5, primarily along the Pacific Flyway, one of four major North American migration routes for birds, especially waterfowl. Affected species in this outbreak range from the relatively abundant Canada goose and wild turkey to the more vulnerable bald eagle and snowy owl. How many of these birds are actually symptomatic is difficult to determine, as detections often occur opportunistically through the sampling of dead birds and hunter harvests. Mortality in wild species is varied with some species like gulls, terns, geese, and raptors experiencing higher than usual rates, while songbirds are relatively unaffected, even asymptomatic. The variation in morbidity and mortality makes this virus even harder to track.”

“Atoms are Local”

In this essay Elliot Hershberg, a PhD student in genetics at Stanford and the mind behind The Century of Biology, discusses the industrialization of biotech and proposes the biologization of industry as a preferable alternative. He explains this concept, writing “Biologization of Industry — Many people default to a mindset of industrialization. But, why naively inherit a metaphor that dominated 19th century Britain? Biology is the ultimate distributed manufacturing platform. We are keen to explore and make true future biotechnologies that enable people to more directly and freely make whatever they need where-ever they are.”

“Compendium of Best Practices on the Engagement and Advancement of Women in Chemical Safety and Security”

From the UN Interregional Crime and Justice Research Institute: “The Organization for the Prohibition of Chemical Weapons (OPCW) and the United Nations Interregional Crime and Justice Research Institute (UNICRI), in close cooperation with international partners, stakeholders and practitioners, recognized the asymmetric portrayal of women and men in chemical safety and security; both in global literature and policy debates. To address this gap, amplify women’s voices and promote opportunities to increase their engagement in this field, OPCW and UNICRI, with the generous funding of the European Commission, developed the Compendium on “Engagement and Advancement of Women in Chemical Safety and Security”.”

“The Compendium aims to provide policymakers and practitioners in the field of chemistry with guidance to promote gender inclusivity in the chemical safety and security sector through the identification of best practices in recruiting, training and promoting gender-inclusive careers.”

What We’re Listening To 🎧

Poisons and Pestilence-13 Bonus Episode: The M Device with Simon Jones

Dr. Brett Edwards has released a new episode of his podcast, Poisons and Pestilence, covering the M device (a canister device used to release CW agents) with historian Simon Jones. In addition to the podcast, you can find Jones’ work on the M device here where he explains, “During the closing stages of the military intervention in North Russia in 1919, British chemical munitions were improvised as effective aerial bombs for the first time in history.”

Schar School PhD Virtual Open House Session

Come learn about the Schar School’s doctoral programs (including the Biodefense PhD!) and interact with faculty at this online open house. This event will take place Wednesday, November 16, at 7 pm EST. Register here.

Applying Lessons Learned from COVID-19 Research and Development to Future Epidemics

“The National Academies of Sciences, Engineering, and Medicine’s Forum on Microbial Threats; Forum on Drug Discovery, Development, and Translation; and the Forum on Medical and Public Health Preparedness for Disasters and Emergencies will organize and conduct a public, hybrid workshop on December 7-8, 2022 to explore how innovative approaches in research sparked by COVID-19 can enhance health systems preparedness and responses to emerging infectious diseases. This workshop will consider basic scientific infrastructure and essential capabilities to support medical and behavioral countermeasures that were deployed during the COVID-19 pandemic response. Workshop participants will reflect on critical scientific infrastructure for stakeholder coordination and innovations that can facilitate rapid and effective responses to emerging infectious disease threats.” Register here.

Strategies to Reach Zero Dose Children in Fragile States and Cross-border Contexts in Africa

“CORE Group and Gavi, the Vaccine Alliance invite you to register to attend a webinar where experts will discuss the importance of reaching Zero Dose Children and how addressing the challenges in reaching communities with immunization interventions could diminish disease outbreaks and health system disruptions. The webinar will also provide a platform for discussions on innovative ways to reach zero dose children beyond traditional government partners in fragile contexts. It will be an opportunity le learn more about the Zero-Dose Immunization Programme (ZIP) and will feature speakers from Gavi, the Vaccine Alliance, International Rescue Committee(IRC), CORE Group Polio Project (CGPP) and World Vision.” This event will be hosted virtually on November 15, at 10 am EST. Register here.

ICMYI: 8th African Conference on One Health and Biosecurity

The 8th African Conference on One Health and Biosecurity concluded recently in Lagos, Nigeria. The conference aimed to “…present a unique forum to raise National, Regional and Continental awareness and engage in deep introspection and robust interactions on existing health security measures and how to strengthen them, as the first urgent step toward mitigation of emerging biological threats in Africa.” Recordings from the conference are available on the Global Emerging Pathogens Treatment Consortium (GET) Africa YouTube Channel. You can read the conference’s “Communiqué of 8th African Conference on One Health and Biosecurity themed Strengthening Health Security and Mitigating Biological Threats in Africa”.

ICYMI: Briefings in Preparation for the Ninth BWC Review Conference

Check out the recording for this event on UNIDIR’s YouTube channel. “This virtual event brought together the authors of the latest UNIDIR publications on BWC topics to provide short outlines of the key insights and ideas in their respective reports for State Parties to consider ahead of the Review Conference. These include verification, advances in science and technology, international cooperation, and potential outcomes of the Review Conference. The presentations was followed by a moderated interactive discussion with the participants.”

Biotechnology Innovation and International Security Fellowships at Stanford University

“Stanford is seeking Biotechnology Innovation & International Security Fellows, to be appointed for one year renewable for a second.  Fellows will join a community of scholars hosted by the Center for International Security & Cooperation (CISAC), Bio.Polis, & the Department of Bioengineering, with mentoring by one or more faculty identified by each fellow.  Applications are being accepted thru 2 December 2022.”  Learn more and apply here.

START Announces Upcoming CBRN Data Suite and Portal

The National Consortium for the Study of Terrorism and Responses to Terrorism (START)’s Unconventional Weapons and Technology division recently announced the creation of their CBRN Data Suite and Portal. The data suite is set to open in December and “…includes an event-level and an actor-level dataset. The event-level dataset is based on UWT’s Profiles of Incidents Involving CBRN and Non-state Actors (POICN) database, and is scheduled to be updated through May 2022 by the time the Data Suite and Portal goes live at the end of the year.”

“The actor-level dataset is a newly created dataset modeled after the Chemical and Biological Non-State Adversaries Database (CABNSAD) and the Radiological and Nuclear Non-State Adversaries (RANNSAD) dataset, with the new CBRN Actor dataset subsuming both CABNSAD and RANNSAD. As with the event-level dataset, the actor-level dataset is scheduled to be updated through May 2022 by the time the Data Suite and Portal launch.”

NIST Soliciting Feedback on Project Proposal to Improve Cybersecurity at Water Utility Facilities

The National Institute of Standards and Technology’s National Cybersecurity Center of Excellence (NCCoE) recently released a white paper discussing ways to improve utility management, operations, and service delivery at water utility sites. The paper explains that “The NCCoE has undertaken a program to determine common scenarios for cybersecurity risks among WWS utilities. This project will profile several areas, including asset management, data integrity, remote access, and network segmentation. The NCCoE will also explore the utilization of existing commercially available products to mitigate and manage these risks. The findings can be used as a starting point by WWS utilities in mitigating cybersecurity risks for their specific production environment. This project will result in a freely available NIST Cybersecurity Practice Guide.” Read the announcement and submit feedback here.

Biosafety and Biosecurity: The Role of Public Health, Law Enforcement, and Research

Omar Mukhlis, Biodefense PhD Student

Introduction:

Milwaukee, Wisconsin, the land of cheese curds and breweries, is no stranger to fermentation and pasteurization, making it the perfect location to host the 65th Annual Biosafety and Biosecurity (ABSA) Conference; the first ABSA conference with an in-person option since 2019. Held from October 17-19, 2022, the scientific program was three full days of keynote presentations and panels of biosafety and biosecurity best practices and hands-on skills.

The following are a select few synopses from the chock-full 3-day ABSA conference.

  • Session IX Biorisk Program Management
  • Session X Eagleson Lecture Award: The Growing Threat of Lyme Disease: Where Do We Stand?
  • Session XII: Public Health

Additional details about the ABSA 65th conference scientific program can be found here.

Session IX Biorisk Program Management:

This session on biorisk program management started with a talk by Robin Tobias, MPH (University of Minnesota) on ABSA International Biosafety and Biosecurity Month celebrated annually each October. Now in its 9th iteration, the month is used to spotlight ethical research, transparency, training, engagement, and stewardship of biosafety and biosecurity. Rather than embracing a specific theme for 2022, ABSA decided to return to the core components of biosafety and biosecurity. This portion of the session closed with a call to share your Biosafety and Biosecurity Month activities on social media using the hashtag #biosafety_biosecuritymonth.

Second on the session docket was Rachel Gamble, DrPH from Merrick & Company discussing the importance of operations and maintenance (O&M) personnel in facility biosafety. O&M are the heart of the facility, directly supporting lab functions, and without proper functioning of lab systems safe science cannot occur. This is especially true as the biosafety containment level increases, as the intersection between biosafety and O&M becomes increasingly more important. Currently, many O&M personnel only receive a sprinkle of biosafety training. This is an issue because O&M personnel need to understand how their job and biosafety intersect.

The key to addressing this is integrated facility training, which shows personnel how O&M operations directly tie into biosafety, allows for O&M personnel to step into researchers’ shoes, increases understanding of the regulatory compliance role that O&M plays, and facilitates the sharing of lessons learned. The benefits of this are numerous, to include greater cohesion in facility operations, better retention of personnel, and sharing of expertise between O&M and biosafety professionals. Most importantly, increased collaboration and integrated training with operations and maintenance personnel will improve facility management and operations, ultimately resulting in safer science.

The final speaker of session IX was Special Agent Scott Mahloch from the Federal Bureau of Investigation (FBI) providing an overview of the FBI weapons of mass destruction (WMD) investigation of Wyndham Lathem as an insider threat case study. An Associate Professor of Microbiology-Immunology at Northwestern University (2007-2017), Dr. Lathem was a leading researcher of Yersinia pestis, the causative agent of bubonic plague. Two of his research accolades include discovering a gene in Y. pestis that allows the bacterium to replicate quickly in air-filled areas causing pneumonia and research he conducted on the evolution of plague with Yersinia pseudotuberculosis and gut pathogens. In late July 2017 Lathem and an accomplice fatally stabbed Lathem’s boyfriend in his Chicago high-rise condominium, leading to his arrest by Chicago Police Department in late August 2017.

Not publicly known at the time was the fact there was a simultaneous but separate FBI WMD investigation into Dr. Lathem due to a confluence of factors including: 1) the withdrawal of an offer from the Pasteur Institute in France for Lathem to open a lab in March 2017; 2) a concerning email sent by Lathem to Northwestern’s University Select Agent Facility Responsible Official while on the run from authorities in August 2017; 3) the recovery of unknown substances in Lathem’s apartment during the homicide investigation; and 4) and a statement from Lathem to a jail staffer while incarcerated that he had ingested genetically modified Y. pestis and that millions of people would die due to his actions.  All of this led to a thorough investigation by the FBI to assess the credibility of the threat looking at the technical feasibility, adversarial intent, and operational practicality of the case. Specific details on the FBI’s conclusions were not shared during the course of the presentation, but Special Agent Mahloch assured the ABSA audience the FBI had taken the threat seriously, as evidenced by the three-pronged credibility test.

Special Agent Mahloch concluded his talk by highlighting the specific insider threat indicators within this Wyndham Lathem case study. Lathem exhibited noticeable behavioral changes in both his professional and personal life following his rejection from the Pasteur Institute. On a professional level, Lathem began exhibiting narcissistic tendencies, his colleagues noticed more frequent absences, and he appeared to be more checked out from his work.  In his personal endeavors, Latham’s relationship with his partner was described as “abusive and controlling,” he had increased his consumption of alcohol, and had stopped taking his antidepressant medication  These indicators, when combined with Lathem’s access to a select agent facility provide a textbook example of an insider threat.

Session X Eagleson Lecture Award: The Growing Threat of Lyme Disease: Where Do We Stand?

Richard Marconi, PhD, Virginia Commonwealth University Medical Center, Richmond, VA

Dr. Richard Marconi from Virginia Commonwealth University (VCU) Medical Center delivered the Eagleson Lecture to ABSA this year. The talk focused on the growing threat of Lyme disease and where we stand in regard to prevention and treatment. Dr. Marconi, who has spent nearly 30 years conducting research on Lyme Disease at VCU, started his lecture by providing an overview of Lyme disease, its causative agent (Borrelia burgdorferi), and the essential life cycle stages alternating between tick and reservoir host. Dr. Marconi stressed that the tick population is both increasing and spreading into parts of the country that previously have not seen ticks. This trend is not isolated to the United States, with similar reports coming from part of Europe and China. All of this suggests that we should anticipate seeing an increase in the rates of Lyme disease and other tick-borne diseases.

The second part of the lecture transitioned to look at Lyme disease prevention, specifically a deep dive into the work Dr. Marconi and VCU have done to successfully get a canine vaccine to market and the ongoing efforts to build on that to develop a human vaccine against Lyme disease. There are two formulations of vaccines for Lyme disease: 1) Lyme bacterin vaccines and 2) Lyme sub-unit vaccines. The former relies on whole cell lysates-“bacterial soups” as dubbed by Dr. Marconi. The issue with these vaccines is that most of the proteins present don’t provide protection, as only a small percentage actually elicit an immune response. The second category of vaccines, the type VCU works on, uses highly purified recombinant proteins that produce a protected antibody response. Vanguard® crLyme, the canine vaccine Dr. Marconi helped spearhead, uses two outer surface proteins (Osp) to generate immune response.

The first outer surface protein is OspA, which was used in predecessor vaccines including the short-lived Lyme Rix (1998-2001); the only Lyme disease human vaccine ever brought to market in the United States, but it was ultimately pulled from the market due to concerns about auto-immune reactions. The second protein, OspC, was far more difficult to develop as it is dissimilar to OspA in that there are around 30 variants of OspC. Through research they found that the use of OspC variant cocktails simply did not work. To get around this Dr. Marconi’s team worked to identify the epitopic regions of the OspC genome and identified two small parts of the genome (L5 & H5 fragments). Using these two identified epitopes they created a new protein, called a chimeritope. They tested to see if their approach worked, and it did. Fast forwarding through subsequent laboratory and field studies, Vanguard® crLyme was ultimately approved by the U.S. Department of Agriculture (USDA) for use in canines early 2016. Since then, Dr. Marconi has pivoted to the development of a human vaccine for Lyme disease, striving to use the same chimeritope approach he used for the canine vaccine. One major difference? He’s seeking to avoid the use of OspA due to the perceived human auto-immune issues associated with the protein as mentioned above.

Dr. Marconi’s Eagleson lecture closed with a question-and-answer session where most of the audience was interested in what to do if you find an 8-legged parasite. The best way to remove a tick? Patiently with a pair of forceps or tweezers. How long does it take to transmit the infection? If it is still crawling, you are good. It takes about 36-48 hours of feeding for transmission to occurs; simply put no engorgement, no transmission. In summary, this was an insightful and engaging lecture on the growing threat of Lyme disease and a peek into the groundbreaking vaccine work Dr. Marconi and his VCU colleagues are doing to counter this spirochete using protein sub-units.

Session XII: Public Health

This session on public health started with a presentation from Gabrielle Essix, MS from Nuclear Threat Initiative (NTI) on the 2021 Global Health Security (GHS) Index. The GHS Index is a joint effort between NTI ,Johns Hopkins Center for Health Security, and Economist Impact to assess security and related capabilities globally. The Index strives to clearly and transparently identify gaps in national-level capabilities to prevent and respond to high consequence biological events and drive accountability for filling those identified gaps. More specifically, the goals of the index are to 1) Accelerate progress in building capacity to prevent detect and respond to pandemics; 2) help national governments identify and address gaps; 3) provide data for evidence-based decision making by donors; and 4) set a standard for pandemic preparedness. The key finding of the report? All countries remain dangerously unprepared for meeting future epidemics and pandemic threats. NTI will publish the next GHS report in 2024 and is looking to improve the index through expert consultations and engagement with forums like ABSA.

Dana Krauss from Georgetown University Center for Global Health Science and Security was up next in the session with her talk looking at the intersections of personal scientific responsibility and public health through the lens of the SARS-CoV-2 pandemic.  Combining (lab) biosafety and public heath she defined public biosafety as “the application of biosafety principles, practices, and technologies by an informed individual and informed governing bodies in a community health setting to successfully reduce agent exposure to and continued release in the general public”. Examples of public biosafety principles, practices, and technologies include at-home and public testing, cleaning of contaminated personal items (e.g., computer keyboards, doorknobs), coughing into your coat sleeve, and general scientific fluency/comprehension. The key concept as presented by Ms. Krauss is that within public biosafety, there is a balance between responsibility and tools available. This was seen with the widespread “responsibility” to wear masks early in the pandemic when there were not tests available. Now we find ourselves in a situation where tests are widely available, and in turn masks are less prevalent here in the United States. The tool of self-testing is used, but there is now a decrease in responsibility to report and as such infection data is often not being shared with relevant public health authorities. Overall, Ms. Krauss provided an insightful presentation of her research conclusions looking at the  intersection of public health and personal responsibility.

The third speaker in session XII was Michael Marsico, MS from the Association of Public Health Laboratories (APHL) who presented on building biosafety across non-traditional testing site during covid-19 and beyond. APHL works in the intersection between policy, science, and practice and, in March 2021, they reached out to labs inquiring about biosafety training needs. The response received? More training for non-traditional testing sites was desperately needed. APHL addressed this by developing technical resources (e.g., COVID-19 Antigen Testing Biosafety Guidance, Potential Hazards and Recommended Mitigation Procedures for COVID-19) and providing training in the form of COVID-19 webinars and workshops. The delivery of these Biosafety Preparedness Workshop(s) for non-traditional testing sites was the focus of Mr. Marsico’s remarks. The workshop project was launched in July 2021 through APHL and the CDC, with the first workshop training being delivered in Colorado with the help of a contractor in June 2022. The second and final workshop was held in Michigan in late October. These trainings sought to provide biosafety preparedness training by describing biosafety and biosecurity concepts, explaining the fundamental principles of biological waste management, personal protective equipment and quality management related to point-of-care testing, and provide scenario-driven exercises to outline safer point-of-care testing. With the completion of the second workshop, APHL will continue to engage non-traditional testing sites, providing support and guidance as needed to foster safer practices and quality testing of patient specimens.

The final talk of the session was from Rocco Casagrande, PhD from Gryphon Scientific who presented on empirical studies in biosafety. Over the past 15 years Gryphon Scientific in conjunction with a plethora of academic and private sector partners have performed studies on biosafety and biosecurity to develop approaches to support critical decision making processess. Using findings from those studies they identified that most of the data available were dose-response data or stability data, and that data for accident causes and source terms were lacking in the life sciences. To address this identified gap, Gryphon received a grant from the Open Philanthropy Project to undertake critical research in biosafety along three lines of research: 1) conduct failure analysis to determine how laboratory accidents generate hazards; 2) conduct human reliability research to determine how/how frequently researchers create incidents; and 3) gather data on innovations in biosafety to learn from the measures that have already been implanted but are not widely known. Preliminary findings from these three lines of research were provided to the audience with official publication of the data and findings expected for the not so distant future. Dr. Casagrande closed the presentation by letting the audience know that if anyone is interested in continuing the research presented to reach out to Gryphon, and they will happily share all of their data.  

Closing Thoughts: This provides a select sampling of the of thought-provoking and insightful ABSA scientific agenda from the 65th conference. If interested, the 66th Annual Biosafety and Biosecurity Conference will be held from October 13-18, 2023 in Omaha, Nebraska.

NACCHO Summit Highlights a Need for Preparedness Innovation in a Post COVID-19 World

Sophia Hirshfield, Biodefense MS Student

In April 2022, I had the opportunity to attend the National Association of County and City Health Officials (NACCHO) 2022 Preparedness Summit in Atlanta, Georgia. The Preparedness Summit is an annual national conference where experts from the healthcare and emergency management industries meet to discuss current gaps in emergency preparedness. This year, the conference was dedicated to “Reimagining Preparedness in the Era of COVID-19,” and was the first in-person Preparedness Summit since the beginning of the pandemic. I listened to leaders from across the country share the challenges they have faced over the past two years, and I heard stories of incredible resilience and strength within the preparedness field. As an aspiring preparedness professional who will enter the field following the most catastrophic public health emergency in recent memory, the opportunity to learn about the future of preparedness practices directly from leaders in the field was unparalleled.

We cannot say we are prepared for an emergency unless even the most vulnerable among us have preparedness resources available to them. Several speakers at the Preparedness Summit amplified this theme, highlighting the importance of equity and inclusion in preparedness. I had the opportunity to learn about the role of disability inclusion specialists in emergency preparedness, an upcoming plan to address gaps in tribal access to the Strategic National Stockpile, and vaccination plans designed to address the needs of those experiencing homelessness. Although in my courses I have learned a great deal about how the COVID-19 pandemic exacerbated many of the already existing inequities in our healthcare system, it was enlightening to hear about the actions experts in the field are taking every day to enhance equitable preparedness. As we move forward beyond the pandemic, it is pivotal that preparedness leaders design programs and systems that equitably enhance health security and preparedness for everyone.

We cannot say we are prepared for an emergency unless even the most vulnerable among us have preparedness resources available to them.

I have often thought of preparedness for intentional and natural biological threats as separate challenges, yet leaders at the Preparedness Summit demonstrated a need for implementing mechanisms that simultaneously enhance preparedness for each of these threats. Improving laboratory testing capabilities can help improve the ability to identify what strain of influenza is most prevalent each year while also improving our ability to detect an intentional anthrax attack. Likewise, funding research for antimicrobials development can help strengthen preparedness for human-made and naturally occurring, drug-resistant pathogens. At the summit I was excited to learn about the work leaders around the country are doing to prepare for intentional and natural biological threats simultaneously and look forward to applying these learnings in my future work.

Though many of the summit attendees did not work directly in biodefense or health security, many of the speakers emphasized the importance of public health and emergency management in biodefense. I think many people have a perception that biodefense is solely associated with protecting the nation from bioterrorist attacks, yet in reality biodefense can encompass any action aimed at countering and preparing for biological threats. Speakers at the summit demonstrated that public health measures such as stockpiling PPE and creating vaccination campaigns fit within the biodefense umbrella, and it is thus critical for these sectors to collaborate in order to create comprehensive and effective preparedness mechanisms moving forward. Although I have learned about the crossover between biodefense, emergency management, and public health in my coursework, it was enlightening to hear leaders from each of these sectors discuss how to strengthen their partnerships with one another in order to bolster preparedness for the next biological threat.

Throughout the summit, I valued the opportunity to hear firsthand testimonies from healthcare and public health professionals who have been on the front lines of the COVID-19 pandemic. The Preparedness Summit featured multiple COVID-19 listening sessions, which afforded attendees the opportunity to share their experiences in the preparedness sector throughout the pandemic. Many of those who spoke at these sessions described how isolating it has been to combat the pandemic in a virtual environment, and how the in-person summit afforded them a cathartic opportunity to finally hear from others who shared similar experiences. I am humbled by the resiliency of public health practitioners who have spent over two years dedicating countless hours to make the country a safer place for everyone. I felt extraordinarily inspired by the meaningful and lifesaving work of public health and healthcare leaders at the conference and know that as I enter the preparedness field I will truly be standing on the shoulders of giants.

When I first began my master’s program a few months ago, I did not imagine I would so soon have the opportunity to engage with preparedness leaders and learn from such experienced practitioners about the ways the industry has adapted and grown since the onset of the COVID-19 pandemic. My generation, Generation Z, does not know what it was like to work in the preparedness sector prior to the pandemic. But as we now begin to enter the preparedness workforce, I am hopeful we will utilize our fresh perspectives in the post-COVID era to reimagine preparedness mechanisms and create a safer society for everyone. The Preparedness Summit was an incredible opportunity to learn about existing gaps in preparedness and innovative strategies for combatting them, and I am excited to apply these insights in my future career.

Sophia is a second semester Biodefense M.S. student from Marlton, New Jersey. She recently graduated from The George Washington University with her B.A. in International Affairs and Global Public Health. Sophia’s research interests include enhancing emergency health services, medical countermeasure stockpiling and deployment, and improving health equity.

Pandora Report: 11.4.2022

Happy Friday! This week focuses heavily on China and Russia, covering the recent ProPublica piece on the Wuhan Institute of Virology, Shanghai’s lockdown, Russia’s failed attempt at creating a UN Security Council committee to investigate its false claims about supposed US biological weapons facilities in Ukraine, and more. We also cover new publications, a new podcast release from the University of Bath’s Dr. Brett Edwards, upcoming events, and an exciting fellowship opportunity from the WHO.

About That ProPublica Piece

Late last week, ProPublica and Vanity Fair released a piece in conjunction with the Senate HELP Committee minority’s interim report, claiming to have unveiled new information from the Wuhan Institute of Virology (WIV) supporting the lab leak theory of COVID-19’s origin. In it, Katherine Eban and Jeff Kao rely heavily on the work of a single self-proclaimed polyglottal State Department political officer to translate Chinese Communist Party (CCP) “party speak,” which he claims native speakers “can’t really follow…” Now, the piece some have described as a train wreck is being heavily criticized for having faulty translations, mis-matched dates, misrepresenting the sources of the documents discussed in it, not understanding how common VPN usage is in China-related research, and more. ProPublica is reportedly scrambling to review critical details of their piece, but is it too late? Let’s talk about some core issues with the article and what they might mean long term.

‘Party Speak’ or Just Lost in Translation?

The first half of the ProPublica piece is dominated by glowing discussion of Toy Reid, a former RAND Corporation employee and East Asia political officer at the US Department of State, covering his blue collar origins and attendance at Harvard. The authors then discuss how Reid spent over a year working for the Senate HELP Committee, using a VPN to search “dispatches” on the WIV’s website from Hart Senate Office Building and his Florida home. They write, “These dispatches remain on the internet, but their meaning can’t be unlocked by just anyone. Using his hard-earned expertise, Reid believes he unearthed secrets that were hiding in plain sight.”

Plain sight is right! These “dispatches” were updates posted to the Wuhan Institute of Virology’s (WIV) homepage on the general news tab. In fact, you can go look through this whole tab here to see mundane entries ranging from a recent day reflecting on the 20th National Congress to a July post about WIV celebrating the 101st anniversary of the Party, to general updates about different trainings and publications related to the institute. Therein lies one of the fundamental problems with this piece-these were not secretive dispatches internal to the Party. These are essentially press releases meant to face outward. Yes, they are laden with mentions of comrades, references to struggles and frontlines, and key Chinese leaders, including Xi Jinping and the recently ousted Li Keqiang. They are, after all, written by Party members in a major facility of the Chinese Academy of Sciences. They are going to have this kind of language by default, especially around times like national congresses and major anniversaries.

To be clear, the CCP does use euphemisms and round-about language at times to describe high-level concepts and goals. In fact, some scholars spend the bulk of their careers conducting political discourse analysis and understanding leaders’ officialease or government-speak. Some do focus on CCP party speak, which has become especially interesting in the Xi years. However, this is definitely not unique to the CCP as one can find scholars dissecting and analyzing any number of world leaders’ speeches and government lexicons. It is also important to recognize that this concept is not some niche or extremely esoteric concept known only to a few in China watching circles. Students studying Chinese politics overwhelmingly have to learn things like “crossing the river by touching the stones” or “socialism with Chinese characteristics” as a Chinese-specific form of Marxism-Leninism throughout the periods of Dengism, Three Represents, Scientific Outlook on Development, and now Xi Jinping Thought. It it core to understanding national agendas throughout different leadership periods.

However, with this comes the understanding that Party documents are laden with this kind of jargon and narrative furthering. This also is not unique to the CCP. In fact, Harry Hodgkinson wrote an entire guide in 1955 on Soviet jargon and unique meanings Communist parties give to particularly terms. While this jargon and overarching nationalistic narratives offer important context for the WIV posts, they do not represent some in-between-the-lines version of Chinese that “even native Mandarin speakers can’t really follow…” Rather, they help explain why the language in the posts seems so dramatic and nationalistic.

What’s in a Narrative?

In October 1949, Mao Zedong declared the official founding of the People’s Republic of China. With Chiang Kai-shek and the remainder of the KMT exiled to the island of Taiwan and the decades long civil war over, Mao was left to figure out how to actually lead the new PRC. Central to this were narratives of overcoming the century of humiliation, protecting the sovereignty and integrity of Chinese territory, bringing justice for China against those who subjugated it, and building a strong, advanced country. These ideas were central to nationalism at the time and drove pushes to modernize like the infamous Great Leap Forward. As Dr. Kerry Brown of King’s College London writes, “That self-designated task of bringing about justice for China was the main justification for the Party’s many mistakes under Mao when the second resolution on its own history was produced a few years after his death in 1981.” Themes of struggle against western imperial powers and self-determination were critical political tools wielded by the Party, even in the face of wildly unpopular, destructive policies.

Though it looks different today, narratives of national struggle and rejuvenation are still important features of CCP rhetoric, even for Party members at a CAS laboratory. Brown discusses the power of narrative in modern China, writing, “For the current dominant leader Xi Jinping, the notion that the Party is a kind of epistemic community, one uniquely placed to carry China forwards to the fulfilment of its great quest for a just outcome to history, is becoming more powerful by the day.  Seen in these terms, the Party is not so much about power per se – but power to deliver this historic outcome. That perhaps explains why, despite the many challenges and problems with its practice and its own history, it still remains so dominant in China.” Today, concepts like the Chinese dream, national rejuvenation, and the goal of becoming fully modernized by 2049 are central themes Party rhetoric uses, even in discussing day-to-day work at different lower-level organizations.

In the context of the Wuhan Institute of Virology posts, this is seen in the framing of work at the lab as some kind of grand struggle. In one of the first WIV posts referenced by ProPublica and Vanity Fair (available here in its original format), the authors claim to have found a dispatch that “…referenced inhumane working conditions and “hidden safety dangers.” On Nov. 12 of that year, a dispatch by party branch members at the BSL-4 laboratory appeared to reference a biosecurity breach: “These viruses come without a shadow and leave without a trace.”

However, as a number of Mandarin speakers and China watchers have pointed out online, this was actually a very general post about how the facility went from humble beginnings at its founding to now being a training hub and “fighting fortress” of China’s research and public health. It is written not unlike other fictional and non-fictional works describing BSL-4 facilities in other countries (The Hot Zone, anyone?)-hours are long in these space suit-like positive pressure suits, the pathogens are unimaginably dangerous, and those doing the work are brave, hardworking, brilliant scientists.

Much of Toy Reid’s interpretation of this post depends on a misinterpretation of “每当这时” (Měi dāng zhè shí, “whenever”) in the context of a description of Party members leading by example whenever handling BSL-4 pathogens. Reid instead took this as “whenever there are biosafety breaches,” and not some inspirational statement about Party members. Other portions of the article focus on visits from Chinese Academy of Sciences officials and seminars on the importance of biosafety and commonly noted issues during safety inspections. However, these were updates about high-level visitors and general efforts to ensure the facility maintained safety standards, much like those any organization anywhere might make.

James Palmer, deputy editor at Foreign Policy and author of Foreign Policy’s China Brief, discussing the normal workplace nature of the WIV posts

The Wuhan Institute of Virology boasts the PRC’s first BSL-4 (P4) facility, which opened in 2018, marking a major milestone for the country. A boastful post about how it came from humble beginnings but, through the work of very dedicated personnel, is now doing important, taxing work and striving to always be better is very par for the course. There is even a corny word play in the post about how Party members “infect” (Gǎnrǎn, “感染”) others with their practical actions and safety-conscious attitudes. As many have now pointed out, this is just the Party bragging about how dedicated their members are, how far the facility has come, and how personnel are constantly working to better themselves and their organization. In other words, it is furthering the Party narrative, not hinting at secret internal problems.

References throughout the posts cited by ProPublica to General Secretary Xi Jinping and his discussion of technology as a weapon make sense in the context of Party-authored news posts. Xi Jinping has achieved power unlike any previous leader, capturing himself a historic third term after the country removed presidential term limits in 2018. Xi Jinping Thought (“Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era”) was also formally enshrined in the Party’s constitution that year, further cementing Xi’s unique power over the Party with the CCP describing it as “Marxism of contemporary China and of the 21 century.” With this context in mind, it makes sense for Party members at WIV to frequently reference Xi and his national goals and speeches. However, Reid instead took this as literal input directly from Xi to the lab following the biosafety incident he claims a previous post references.

Zhihua Chen’s thread on translation and dating issues in the ProPublica article

Finally, even if this was all true-the WIV had a 2019 biosafety incident and Xi Jinping was personally concerned enough to send an urgent message about it to WIV himself-why would any of that be posted on the institute’s website? As was just discussed, the narrative matters a lot in Chinese politics; image is everything and the Party is very secretive as a result. As the country continues to compete internationally in all areas, including the bioeconomy, it does not make sense for the Party to air dirty laundry about a supposed biosafety incident and workers’ concerns in a public space. If the core argument is that China is covering up a lab leak, the question of “Why would the Party allow the facility in question to publicly hint at mismanagement and safety issues on its own website?” must be answered.

Implications

Ultimately, bad faith takes on China, COVID-19, and biosafety hurt us all. There is a fundamental difference between calling for an in-depth investigation, holding the PRC accountable for its failures, working towards making sure we are better prepared for the next time something like this happens, and inappropriately equating mischaracterized and poorly translated press releases to some kind of damning evidence of a lab leak origin of SARS-CoV-2. The US-PRC relationship is in a very dangerous place and, while criticism of the CCP’s handling of COVID-19 is absolutely warranted, this article is likely to become political fodder for the Party. In fact, the Chinese government has already condemned the piece, claiming that it was driven by US politics.

While ProPublica claimed to have corroborated Reid’s work with unnamed “experts” on CCP communications, the swift backlash and ProPublica’s moves to reach out to other translators cast further doubt on the caliber and motivations of those consulted initially. This is in addition to concerns about the experts they claim to have consulted on the WIV’s claims about biosafety and time researchers spend in BSL-4. In the end, one can be both critical of the CCP and its practices while not resorting to an overly hawkish view that leads to finding suspicion in the mundane.

Finally, this points to a need for interdisciplinary collaboration and competent understanding of the political realities of the PRC in assessing issues like biosafety. What may look to someone with little knowledge of Chinese political discourse as alarming messages are actually pretty par for the course in terms of statements and news updates on an official website. Outside of debates on SARS-CoV-2’s origin in the scientific community, scholars in the social sciences and humanities and experts working in all sorts of fields can offer important context that, in this case, marks the difference between recognizing standard Party rhetoric and sounding alarm bells over normal updates on the WIV’s website.

For more on this, including discussions of the scientific debate about COVID-19’s origin as discussed in the Senate report and ProPublica article, check out Michael Hiltzik’s opinion piece on this article in the LA Times and Max Tani’s work in Semafor.

It’s the Happiest Place on Earth, Until You’re Stuck There-Welcome to Shanghai Disney

As China continues to cling to its zero-COVID policy, tourists at Shanghai Disney Resort now find themselves trapped in the park until they can test negative for COVID-19 amid yet another snap lockdown. South China Morning Post explains “…new variants have tested local officials’ ability to snuff out flare-ups faster than they can spread, causing much of the country to live under an ever-changing mosaic of Covid curbs.” The city announced Monday that it was going into lockdown and that visitors to the park would not be allowed to leave “until on-site testing returns a negative result.” SCMP writes, “It added that those who had visited the park since Thursday must obtain three negative Covid tests over three successive days and “avoid participating in group activities.’ The announcement came after Disney said it was “temporarily closing with immediate effect … in accordance with disease control requirements”.”

Turns Out the PRC Is Not the Only Place with Biosafety Issues

The discovery of vials labeled “smallpox” in a Merck & Co. facility near Philadelphia last year, last month’s controversy over Boston University’s NEIDL’s COVID-19 work using chimeric viruses, that time the Department of Defense accidentally mailed live anthrax spores to a US base in South Korea…the US is no stranger to biosafety issues and scares. This is the subject of a three part series of The Intercept, “Experimenting with Disaster,” focused on undisclosed biosafety incidents in the US. The first part focuses on a university lab accident, the second on work with the 1918 flu pandemic’s H1N1 virus, and the third on risky work with avian influenza. The Schar School’s Dr. Gregory Koblentz is quoted throughout the series as he provides context to the political and oversight issues surrounding these and other incidents.

Russia Fails (Again) to Garner International Sympathy for Bogus BW Claims

On Wednesday, the UN Security Council (UNSC) squashed Russia’s attempt to create a formal inquiry into its claims that the US and Ukraine are running a biological weapons program in Ukraine. Of the five permanent UNSC members, only China voted in support of Russia’s draft resolution on the measure. The US, UK, and France all voted against it while the other 10 UNSC members abstained from voting. According to the UN “Through the draft resolution, the 15-member Council would have decided to set up a commission to investigate the complaint of the Russian Federation in the context of the activities of biological laboratories in the territory of Ukraine, as well as present to the 15-member organ a report on the issue containing recommendations by 30 November 2022 and inform the States parties to the Convention at its Ninth Review Conference to be held in Geneva on 28 November–16 December 2022 of the results of the investigation.”

“The draft would also have the Council request the Secretary-General and the Biological Weapons Convention Implementation Support Unit provide, within their respective mandates, all necessary assistance to the commission.”

Cholera Outbreaks on the rise Globally

In case more COVID-19 variants, monkeypox, polio, and Ebola weren’t enough for you this year, the New York Times reports that a “…record number of [cholera] outbreaks have been reported after droughts, floods and wars have forced large numbers of people to live in unsanitary conditions.” So far, outbreaks have been reported in the Caribbean, Africa, the Middle East, and South Asia. NYT also explains “Cholera is typically fatal in about 3 percent of cases, but the World Health Organization says it is killing at an accelerated rate in recent outbreaks, even though it is relatively cheap and easy to treat. It is most often fatal in children, who progress swiftly to severe illness and organ failure.”

However, as case counts grow, vaccine supplies are coming up short. The WHO has already suspended its two-dose recommendation in favor of a single dose regimen that can help stretch supplies. “We have never had to make a decision like this about vaccination before, that’s the severity of this crisis,” Dr. Philippe Barboza, head of the WHO’s cholera team, said.

NYT explains part of why this is an issue, writing “The bulk of the world’s cholera vaccine is made by a South Korean company called EuBiologics. Some 15 percent of the global stockpile was produced by Shantha Biotechnics, a wholly owned Indian subsidiary of the French drugmaker Sanofi, but the company decided two years ago to stop production of its cholera vaccine by the end of this year and end supply by the end of 2023. That planned exit from the market coincides with the spike in demand…Dr. Barboza said that EuBiologics was producing at capacity and working to expand its production, and that another drugmaker would soon begin to produce the vaccine.”

“A Multinational Delphi Consensus to End the COVID-19 Public Health Threat”

Lazarus et al.’s new Nature article discusses findings of a Delphi study focused on the COVID-19 pandemic response: “Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.”

“Lessons Learned from the COVID-19 Outbreak”

New from the RAND Corporation, a volume on COVID-19 that includes chapters on the need to prioritize biosafety and biosecurity, and GOF research: “The coronavirus disease 2019 pandemic that began in late 2019 and continues as of the writing of this Perspective in summer 2022 has been the cause of both tremendous tragedy—in lives lost and economic hardship—and great triumph in the rapid development of effective vaccines. Many nations around the world have scrambled to respond to a once-in-a-century event that has exposed many weaknesses in response planning and capabilities, including those of the United States. Even as the pandemic continues, it is not too early to reflect on the missteps that have been made and lessons that can be learned so that the United States and nations worldwide can be better prepared for the future.”

“This volume contains a collection of essays that explores topics of critical importance toward that aim and identifies actions that can be taken to not only improve pandemic preparedness but also help prevent the occurrence of future pandemics. The essays center on U.S. challenges and experiences, but the solutions, in many cases, require collaborative efforts that reach across national boundaries.”

“The Global Inequality in COVID-19 Vaccination Coverage Among Health and Care Workers”

Nabaggala et al. discuss COVID-19 vaccinations in HCWs in their new article in the International Journal for Equity in Health. Using WHO data, they found that “Despite being considered a priority group, more than a third of countries did not achieve 70% vaccination coverage of their HCWs at the end of 2021. Large inequities were observed with low income countries lagging behind. Additional efforts should be dedicated to ensure full protection of HCWs through vaccination.”

“Bolstering Arms Control in a Contested Geopolitical Environment”

Michael Moodie and Jerry Zhang’s recent issue brief published by the Stimson Center: “For decades, arms control has constituted one of the cornerstone frameworks for global governance and served as a critical tool for bolstering international security and stability. The global arms control regime is now under unprecedented pressure, due to heightened competition between major powers, rapidly deteriorating security environment, and emerging technologies. Nevertheless, cooperation on arms control is important in today’s contested geopolitical environment as it can encourage responsible competition broadly between great powers, avoid the proliferation of advanced weaponry, and reduce the risk of unintended military escalation. This paper recommends three measures to reinvigorate arms control: sustaining long-term engagement between major powers; adopting a multi-stakeholder approach by including smaller states and non-government entities in the process; and reconceptualizing the fundamentals of arms control.”

“Addressing the Global Shortage of Biosafety and Biosecurity Professionals through Education”

The International Federation of Biosafety Associations recently published this white paper discussing their efforts to build undergraduate degree programs designed to create competent biosafety professionals. They write: “Biosafety and biosecurity professionals provide an essential role in safeguarding infectious disease agents in clinical and research laboratories and other settings where biological materials are handled. The COVID-19 pandemic has brought into focus the significant demand on the profession and many countries face an overall shortage of these specialized individuals. Given that biosafety and biosecurity professionals work in laboratories behind the scenes of the frontline response, the profession remains largely unknown to students interested in pursuing a career in the sciences. As such, students tend to be steered towards more visible education paths in the biological and health sciences.”

“To address this gap, the IFBA is leading a multisectoral effort towards a future sustainable workforce by formalizing a biosafety & biosecurity career path within the higher education system. Now is the right time since the recent lived COVID-19 experiences of youth have motivated them to become involved. Over the past 6 months, and with funding support from Global Affairs Canada, the IFBA has been collaborating with Kenya’s Masinde Muliro University of Science and Technology (MMUST) to develop and pilot a new undergraduate BSc degree program specifically in Biosafety and Biosecurity. This new BSc program leverages MMUST’s existing programs in the Department of Medical Laboratory Sciences. All students undertake related core courses in microbiology and related disciplines in the first two years followed by specialized biosafety & biosecurity courses, practical laboratory and field experience and a capstone project in their later academic years.”

“The lessons learned from this pilot program will be used for future program roll out to additional universities across Africa and globally. This project presents a recommended solution towards a sustainable future global workforce of biosafety and biosecurity professionals. Supporting this approach are multisectoral partnerships committed to biosafety and biosecurity education and our common vision of more graduates and young scientists entering the profession.”

“A Plea for Making Virus Research Safer”

Dr. Jesse Bloom’s guest essay in the New York Times offers an overview of notable pathogen research, efforts over the years to make it more secure, and current concerns. In it she writes “The French statesman Georges Clemenceau said, “War is too important to be left to the generals.” When it comes to regulating high-risk research on potential pandemic viruses, we similarly need a transparent and independent approach that involves virologists and the broader public that both funds and is affected by their work.”

“How to Detect a Man-Made Biothreat”

This Wired piece discusses US government funding to develop test that would detect engineered pathogens: “To guard against these potential threats, the US government is funding the development of tests to detect dangerous bioengineered organisms before they have a chance to cause significant harm. The effort was announced in 2017 by the Intelligence Advanced Research Projects Activity, or Iarpa, within the Office of the Director of National Intelligence. In a livestreamed update in October, Iarpa program manager David Markowitz announced that two platforms developed under the program were both 70 percent accurate at identifying the presence of bioengineering. “We simply never know what sample is going to come through the door in a government lab, and we need to be prepared for anything,” Markowitz said during the news briefing.”

“Why Climate Change Matters for Pandemic Preparedness”

Check out this Nature Outlook piece with computational ecologist Xavier Rodó on climate change’s role in pandemic planning: “Numerous studies over more than two decades have demonstrated a robust relationship between climate and the dynamics of human diseases, such as cholera, malaria and dengue. Changes in climate, including both long-term warming trends and short-term climate variability, might affect patterns of disease. Xavier Rodó, a computational ecologist and climate dynamics specialist at the Barcelona Institute for Global Health and the Catalan Institution for Research and Advanced Studies in Spain, spoke to Nature about how climate modelling could be used to help prepare for future disease outbreaks — and the obstacles he has faced in implementing such systems.”

“Chemical Security Experts Call for Multisector Cooperation Against Terrorism”

From INTERPOL: “The devastating impact of chemical weapons and explosives used in acts of terrorism continues to affect civilian populations and is well known for its destructive and long-term harm.”

“Last year over 1,000 improvised explosive device (IED) attacks were conducted by non-state actors, injuring over 7,150 people in more than 40 countries. Many attacks come from chemicals that criminals acquired through weak points in the supply chain – from manufacturing to storage and retail– and made into weapons.”

“To counter this threat, some 220 chemical security practitioners from more than 70 countries met at INTERPOL’s 3rd Global Congress on Chemical Security and Emerging Threats (25-27 October) to find ways of reducing vulnerabilities by enhancing multisector cooperation and collaboration.” Read more here.

What We’re Listening To 🎧

THE RETORT: EPISODE 4 Gain of Function Experiments

The latest episode of Dr. Brett Edwards’ podcast, The Retort, offers “A straightforward introduction to the past decade of discussion of international oversight of gain of function pandemic research,” with Dr. Nariyoshi Shinomiya of Japan’s National Defense Medical College. This episode and previous ones are available on Dr. Edwards’ YouTube channel. His other podcast project, Poisons and Pestilence, also recently reached 7,000 listens. In celebration, he is hosting a t-shirt give away, so be sure to check that out here.

Conversations Before Midnight

The Bulletin of the Atomic Scientists is hosting its Bulletin Annual Gathering on November 9, 2022, at 5 pm CDT virtually. This is the Bulletin’s “signature event” and it aims to allow guests to engage in high-level conversations with influential voices tracking man-made threats. At the event, “Each virtual table has an expert, established and up-and-coming specialists in the fields of nuclear risk, climate change, disruptive technologies, and biosecurity. These discussion leaders include members of the Bulletin’s Science and Security Board, Board of Sponsors, and invited experts from around the world. Below are a few samples for this year’s gathering.”‘ Table experts include our own Dr. Greg Koblentz, so be sure to check out this event’s info page here.

Briefings in Preparation for the Ninth BWC Review Conference

From UNIDR: “The 1972 Biological Weapons Convention (BWC) is a cornerstone in the regime to prevent the hostile use of biology. The Ninth BWC Review Conference will take place in late November 2022 and presents an important opportunity to take stock of the past and chart a course for the future of this increasingly important agreement. In support of preparations for the Ninth BWC Review Conference and beyond, UNIDIR has recently published several reports intended to stimulate thinking on substantive issues related to the BWC.”

“This virtual event will bring together the authors of the latest UNIDIR publications on BWC topics to provide short outlines of the key insights and ideas in their respective reports for State Parties to consider ahead of the Review Conference. These include verification, advances in science and technology, international cooperation, and potential outcomes of the Review Conference. The presentations will be followed by a moderated interactive discussion with the participants.” This event will take place on November 7 at 2 pm CET, online. Learn more and register here.

Infection Prevention and Control: Incorporating Lessons Learned in Managing Special Pathogens

“After nearly three years responding to the COVID-19 pandemic, hospitals and other healthcare facilities have learned many lessons about the management of special pathogens and essential infection prevention and control practices. The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the National Emerging Special Pathogens Training and Education Center (NETEC) invite you to learn more about some of those lessons. Speakers will share their perspectives on how our approach to outbreaks has changed since the pandemic began. They will address issues such as infection prevention for healthcare workers and patients and mitigating disease spread. Speakers will also highlight newly developed tools and resources. This webinar will take place November 7 at 2:00 pm ET. Register today!”

WHO/AFRO Fellowship Programme on Public Health Emergencies in Africa

“The World Health Organization Regional Office for Africa (WHO AFRO) invites interested and eligible candidates to submit applications for a fellowship programme on improving the management of public health emergencies in Africa under the COVID-19 Incident Management Support Team (IMST).” Learn more and apply here.

Pandora Report: 10.28.2022

Happy Halloween! This week we haves lots of scares for you, including even more misuse of international organizations to further disinformation narratives! This week, we focus on Russia’s request for a UNSC investigation of its bogus BW claims and complaint lodged in accordance with Article VI of the BWC, the Senate Health, Education, Labor and Pensions minority report on SARS-CoV-2 origins, and ongoing debates about the SARS-CoV-2 experiments conducted at Boston University. We also cover new publications, upcoming events, and new announcements ahead of One Health Day.

Russia Criticized Heavily After Calling for UNSC Resolution on “Secret Biolabs in Ukraine”

In yet another massive waste of everyone’s time, Russia has continued to press its false claims that the US runs “secret military biological programs” in Ukraine with the UN Security Council, this time drafting a resolution that would establish a commission (comprised of all 15 UNSC members) to investigate the claims. This comes amid a new wave of “transparently false allegations” on the part of Moscow, most recently regarding alleged Ukrainian plans to use a dirty bomb in its own territory. In response to this latest effort at the Security Council, the UK’s Ambassador to the UN, Dame Barbara Woodward, asked the question on everyone’s mind-“How much more of this nonsense do we have to endure?”

This newest attempt includes an official complaint to the UNSC, filed in accordance with article VI of the BWC, in addition to the request for the formation of a formal commission to investigate the October 24 complaint. The complaints continue to center on efforts between the US and Ukraine, largely under the Cooperative Threat Reduction program, to support public health research and diagnostic facilities, though Russia insists these facilities are not for peaceful purposes.

In a Thursday briefing before the Security Council, the UN Office for Disarmament Affairs (UNODA) reiterated again that it is not aware of any biological weapons programs in Ukraine, echoing its previous statements on the matter made in March and May. In response, Russia’s Ambassador Vassily Nebenzia said, “Do you really think that we’re that naïve?…Do you really think that we think that the Pentagon is going to inform the high representative of the Office of Disarmament Affairs within the UN about their secret biological programs in Ukraine?”

US Ambassador to the UN, Linda Thomas-Greenfield, summarized the absurdity of Russia’s claims, explaining “We hear Russia raise alarms that biological weapons will be delivered by birds and bats and now even mosquitoes. Birds and bats. Russia knows public health laboratories routinely study migratory animal species to assess and counter animal-borne pathogens. Bear in mind, much like Russia, birds and bats don’t tend to observe or respect sovereign borders. Russia’s assertions are absurd for many reasons, including because such species, even if they could be weaponized, would pose as much a threat to the European continent and to Ukraine itself as they would to any other country.”

Thomas-Greenfield also described the meeting as a “…colossal waste of time… an attempt to distract from the atrocities Russian forces are carrying out in Ukraine and a desperate tactic to justify an unjustifiable war.” She later added, “It doesn’t matter how many meetings Russia tries to call on this subject. And it doesn’t matter how hard it ratchets up its propaganda machine. We must not divert UN resources toward a baseless investigation. And we must not allow Russia’s tactics to distract us from its brutal war of aggression.”

Senate HELP Committee Minority Interim Report Released on SARS-CoV-2 Origins

This week, the Senate Health, Education, Labor and Pensions (HELP) Committee Minority oversight staff released their interim report-“An Analysis of the Origins of the COVID-19 Pandemic”. The report makes a number of claims, including “While it remains possible that SARS-CoV-2 emerged as a result of a natural zoonotic spillover, facts and evidence found in previous documented zoonotic spillover events have not, to date, been identified in relation to this pandemic,” “Substantial evidence suggests that the COVID-19 pandemic was the result of a research-related incident associated with a laboratory in Wuhan, China,” and “This investigation’s interim report concludes that SARS-CoV-2 and the resulting COVID-19 global pandemic was, more likely than not, the result of a research-related incident associated with coronavirus research in Wuhan, China.”

The 35-page report does not completely rule out a market origin and, importantly, it does not claim that SARS-CoV-2 was engineered as a bioweapon-a popular conspiracy theory. One interesting element it does focus on is that Chinese scientists began testing their COVID-19 vaccines in humans about a month before the United States did. The report implies this means the Chinese had some sort of advanced (pre-January 11, 2020) access to genomic sequencing, though it does still ask “What additional steps, processes, or novel techniques did AMMS [PLA Academy of Military Medical Sciences] researchers take that advanced the development of their vaccine faster than the Operation Warp Speed timeline?” The report states, “While mRNA vaccine candidates were able to design their vaccine construct in two days, because mRNA vaccines only need the coronavirus’ genetic sequence to make a vaccine and no virus has to be cultivated in labs, traditional vaccine platforms take longer.” It continues, highlighting that the first Operation Warp Speed (OWS) vaccine candidates to enter human clinical trials were non-mRNA vaccines-AstraZeneca-Oxford’s offering and Johnson & Johnson’s, both viral vector vaccines.

It then contrasts the 8 months it took for OWS viral vector candidates to human clinical trials with the 67 days it took one AMMS team to do the same, writing “Given Operation Warp Speed’s success, it is unusual that the two AMMS COVID-19 vaccine development teams were able to reach early milestones in vaccine development even more quickly. The Chen AMMS team beat AstraZeneca-Oxford to phase I clinical trials by 38 days. The Zhou AMMS team built and validated the effectiveness of its COVID-19 candidate vaccine 44 days after the sequence of SARS-CoV-2 was released. The extremely accelerated vaccines development timelines achieved by the AMMS teams pose the following two outstanding questions:”

  • “What additional steps, processes, or novel techniques did AMMS researchers take that advanced the development of their vaccine faster than the Operation Warp Speed timeline?”
  • “If no additional steps were taken to speed up the development timeline, when did researchers in China have access to the genomic sequence? Was it before January 11, 2020? If so, how far in advance of January 11, 2020?”

This argument does not address differences in the regulatory environments of the US and PRC. Rather, it seems to imply that this is evidence the Chinese had advance knowledge of this outbreak with no discussion of drug and therapeutic approval reforms in recent years that aim to improve the country’s ability to compete in pharmaceutical manufacturing globally and incentivizes development of vaccines and drugs for rare diseases. The CCP has identified competition in global biopharmaceutical manufacturing as a top priority, so the implication that the faster timeline to clinical trials supports the lab leak theory is unsatisfactory as presented.

It also does not appear to have even won over prominent supporters of the lab leak theory, including Dr. Richard Ebright, a molecular biologist at Rutgers University. The New York Times explains, “Dr. Ebright, who was interviewed by the report’s authors, said he supported the argument that evidence pointed to a laboratory origin. But the only new element, he said, appeared to be questions raised about how China could have developed a vaccine so quickly, which he did not find persuasive. Otherwise, he said, “there was no information in the report that has not been publicly presented in the media and discussed in the media previously.”

“This image depicted a test tube with viral transport media that contained a patient’s sample to be tested for the presence of SARS-CoV-2, the virus that causes COVID-19.” Source: CDC PHIL

Naturally, this interim report has been heavily criticized. The conclusion reached in this report obviously differs from the two peer-reviewed Science articles published earlier this year that found 1) the Huanan Seafood Wholesale Market was the epicenter of the initial outbreak and 2) that there were at least two distinct spillovers from animals sold at the market. Scientists supporting the market origin still have not identified which animals were infected or where they came from, as no animals were tested before the market was shut down early in 2020. Of this, the report states “Critical corroborating evidence of a natural zoonotic spillover is missing. While the absence of evidence is not itself evidence, the lack of corroborating evidence of a zoonotic spillover or spillovers, three years into the pandemic, is highly problematic.”

Dr. Michael Worobey, Department Head of Ecology and Evolutionary Biology at the University of Arizona and a co-author of both the Science articles, addressed the report with Science news, with the news team writing “Michael Worobey, an evolutionary biologist at the University of Arizona who has co-authored scientific reports examining data from the early days of the pandemic that provide some of the strongest support for a jump from animals to humans, speculates that the timing of the report’s release could be “a cynical effort to try to win Republican votes” in the upcoming midterm congressional and state elections.  Or, Worobey says, “it could just be a bunch of staffers with no ability to understand the science who stumbled across a bunch of misinformation and disinformation-filled tweets.” (“Senator Burr felt enough compelling, open-source information had been gathered during staff’s comprehensive review of the facts that an interim report was appropriate,” a senior aide to the minority staff told Science.)”

After the minority interim report was released, Senator Patty Murray, Chair of the Senate HELP Committee, issued a statement on “continuing bipartisan oversight efforts into the origins of the virus that causes COVID-19” that did not address the minority report. Sen. Murray stated “COVID-19 has caused so much pain, hardship, and loss for people in Washington state, across our country, and all across the globe. As I’ve said time and again, it is absolutely critical we learn the lessons from this pandemic so that we never find ourselves in a similar situation again—and that, of course, includes undertaking a full examination of how COVID-19 first emerged.”

“That’s why I made it a top priority as Chair to craft bipartisan legislation to strengthen our public health and pandemic preparedness systems with the PREVENT Pandemics Act—which, among so many other vital steps, would establish an independent task force to conduct a comprehensive review of COVID’s origins and the federal response to the pandemic. And it’s why, in 2021, I announced a bipartisan oversight effort with Senator Burr into the origins of this virus. The HELP Committee is continuing bipartisan work on this oversight report, and I remain committed to passing the PREVENT Pandemics Act, which advanced out of Committee with overwhelming bipartisan support.”

More on the Boston University Controversy

While the controversy surrounding experiments conducted on SARS-CoV-2 at Boston University has subsided some, attention has shifted to how such research is regulated. The New York Times explains the concerns, writing “But the uproar highlighted shortcomings in how the U.S. government regulates research on pathogens that pose a risk, however small, of setting off a pandemic. It revealed loopholes that allow experiments to go unnoticed, a lack of transparency about how the risk of experiments is judged and a seemingly haphazard pattern in the federal government’s oversight policy, known as the P3CO framework.” It also notes “Even as the government publicly reprimanded Boston University, it raised no red flags publicly about several other experiments it funded in which researchers manipulated coronaviruses in similar ways. One of them was carried out by the government’s own scientists.”

“Colorized scanning electron micrograph of a cell infected with a variant strain of SARS-CoV-2 virus particles (green), isolated from a patient sample.” Source: NIH Image Library

Nature explains the issue further, writing “At issue is whether — and when — researchers modifying SARS-CoV-2 or other deadly pathogens need to keep regulators and funding agencies such as the US National Institutes of Health (NIH) informed about their work, even if the agencies didn’t fund the experiments in question. Studies that make pathogens more transmissible or virulent are sometimes called ‘gain of function’ research.”

The issue now being discussed is if federal guidance is too vague in explaining what disclosures are required after a proposal is approved and research is progressing. Dr. Greg Koblentz told The New York Times “The government should be providing the guidance to help people figure this out,” and explained to Grid that “Pandemic prevention and lab safety rules “only move in fits and starts,” said biodefense professor Gregory Koblentz of George Mason University, pointing to the long list of past controversies. “And we only make progress where there is some crisis, or perceived crisis, that grabs people’s attention.”

Koblentz also commented on the confusion surrounding “gain of function”, telling Grid “‘Gain of function’ — we should retire that term, it really doesn’t help us in that debate,” said Koblentz. “It has become shorthand for a class of research that people are worried about because of the risks it poses, but it is a term that really has outlived its usefulness.” The term garnered attention during a number of political debates, including back-and-forths between Senator Rand Paul and Dr. Anthony Fauci.

Grid also noted that, though many experts disagree on the utility of the term “gain of function, “There’s one point all of the experts who spoke to Grid agreed on — the Boston University chimera experiments do point to a need for stronger federal government oversight of potentially dangerous bugs. The fact that we are still debating whether to review genetically altering known pandemic pathogens, not even potential ones, said Koblentz, “is an indictment of both the self-governance model that the virology community largely supports and the current policy.”

NCT Magazine

In this issue focused on 4th generation chemical weapons, several experts offer their perspective on existing and emerging issues. Drs. Stefano Costanzi and Gregory Koblentz authored a piece for this issue, “Controlling Novichok Nerve Agents After the Skripal and Navalny Incidents”. They cover the history of this family of nerve agents and international disarmament and nonproliferation attempts before discussing the Skripal and Navalny incidents as evidence that both the Chemical Weapons Convention and Australia Group Chemical Weapons Precursors list need to be revised to better address Novichok agents. They conclude “The ability of the CWC and AG to adapt to the new challenge posed by these fourth-generation nerve agents demonstrates the resilience of the chemical weapon nonproliferation regime. However, further measures need to be implemented to reduce the opportunities for proliferators to develop and use Novichok nerve agents. Embracing a family-based approach to listing chemicals of proliferation concern would strengthen the nonproliferation regime and the adoption of technologies such as cheminformatics can facilitate the transition to this new approach to containing the threat posed by chemical weapons.”

“Designation of Three Syrian Military Officials Due to Involvement in Gross Violations of Human Rights”

On the topic of chemical weapons, the US State Department recently designated multiple military officials from the Syrian regime, it declared in a press release this week. The statement reads in part, “Of the atrocities committed by the Assad regime, some of which rise to the level of war crimes and crimes against humanity, few are as inhumane and abhorrent as the repeated use of chemical weapons against civilians.  In August 2013, the Syrian Artillery and Missile Directorate of the Syrian Armed Forces launched rockets carrying the nerve agent sarin, a deadly chemical, on Ghouta, a suburb of Damascus, killing at least 1,400 people, many of them children.  Today, we are taking additional action to promote accountability.”

“The Department of State is designating three Syrian regime military officials involved in these airstrikes, pursuant to Section 7031(c) of the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2022.  Brigadier General Adnan Aboud Hilweh, Major General Ghassan Ahmed Ghannam, and Major General Jawdat Saleebi Mawas were involved in gross violations of human rights, namely the flagrant denial of the right to life of at least 1,400 people in Ghouta. As a result of today’s action, Hilweh, Ghannam, and Mawas as well as their immediate family members are ineligible for entry into the United States.”

“To Fix American’s Biodefense Strategy, Think Smaller”

From Breaking Defense: “It’s a natural reflex for the US government to try to develop strategies to deal with issues as broadly as possible, to handle a wide array of contingencies. But in the op-ed below, Al Mauroni of Air University’s Center for Strategic Deterrent Studies argues that the Biden administration’s biodefense strategy, expanding on past strategies, has grown too cumbersome and is in need of a cure of its own.”

ASPR TRACIE on Major Radiological or Nuclear Incidents

ASPR’s Healthcare Emergency Preparedness Information Gateway (TRACIE) recently released this updated document providing an “overview of health and medical response and recovery needs following a radiological or nuclear incident…” It also outlines resources for planners. Other relevant resources can also be found on the TRACIE CBRN page.

“Preventing and Preparing for Pandemics with Zoonotic Origins”

This piece from the Council on Foreign Relations discusses how factors that drive pathogen emergence and spread should influence decisions on investments in pandemic preparedness and response. It discusses priority pathogens, primary pandemic prevention, and secondary pandemic prevention and pandemic preparedness, concluding that “There is unprecedented support at the highest levels of government to enhance global pandemic prevention and preparedness. The recent decision to create a new fund for pandemics out of the World Bank and the ongoing negotiation for a pandemic agreement within the World Health Organization are potentially transformational. It is critical that comprehensive action be taken quickly through these efforts before the world’s collective attention moves on to the next crisis. Failure to do so means future generations will live less healthy and productive lives than we have today.”

“COVID-19 Genomic UK (COG-UK) Consortium: Final Report”

In this article from RAND Health Quarterly, Marjanovic et al. write in their abstract “The ability to sequence and understand different variants of the SARS-CoV-2 virus and their impact is crucial to inform policy and public health decisions. Soon after the UK went into its first lockdown in March 2020, the CCOVID-19 Genomics UK (COG-UK) Consortium was launched. COG-UK is a collaboration of experts in pathogen genomics including academic institutions, public health agencies, the Wellcome Sanger Institute, NHS Trusts and Lighthouse Labs. RAND Europe evaluated how COG-UK delivered against its objectives, for example how it contributed to advancing scientific knowledge about SARS-CoV-2, informing public health decisions, and providing information that can be used to evaluate the effectiveness of vaccines and treatments. The evaluation also examined the diverse factors that influenced COG-UK progress and impact, including enablers and challenges, and considered implications for the future.”

Coronavirus Vaccines R&D Roadmap

From CIDRAP: “CIDRAP, with support from the Bill & Melinda Gates Foundation and The Rockefeller Foundation, has led an international collaborative effort to develop a coronavirus vaccines research and development (R&D) roadmap (CVR). The CVR aims to serve a strategic planning tool to facilitate R&D, coordinate funding, and promote stakeholder engagement aimed at generating broadly protective coronavirus vaccines.”

“A key component of roadmap development is gathering feedback via a public comment period. The draft CVR is now available for a 4-week public comment period from October 24 – November 18, 2022. Feedback gathered during the public comment period will be used to refine the roadmap, resulting in a final roadmap made available in early 2023.”

“The draft CVR may be downloaded in PDF format. Comments should be submitted via this survey, which will be available through November 18, 2022. The survey offers the opportunity to share general and specific comments on the roadmap; the team welcomes as little or much feedback as you would like to provide.”

“The Future of Infodemic Surveillance as Public Health Surveillance”

In this recent piece from a supplement issue of Emerging Infectious Diseases, Chiou et al. write “Public health systems need to be able to detect and respond to infodemics (outbreaks of misinformation, disinformation, information overload, or information voids). Drawing from our experience at the US Centers for Disease Control and Prevention, the COVID-19 State of Vaccine Confidence Insight Reporting System has been created as one of the first public health infodemic surveillance systems. Key functions of infodemic surveillance systems include monitoring the information environment by person, place, and time; identifying infodemic events with digital analytics; conducting offline community-based assessments; and generating timely routine reports. Although specific considerations of several system attributes of infodemic surveillance system must be considered, infodemic surveillance systems share several similarities with traditional public health surveillance systems. Because both information and pathogens are spread more readily in an increasingly hyperconnected world, sustainable and routine systems must be created to ensure that timely interventions can be deployed for both epidemic and infodemic response.”

COVID Taking the Fun Out of Fungi?

The WHO recently released its first fungal priority pathogens list (FPPL)- “the first global effort to systematically prioritize fungal pathogens, considering their unmet research and development (R&D) needs and perceived public health importance.” The WHO explains that “The WHO FPPL aims to focus and drive further research and policy interventions to strengthen the global response to fungal infections and antifungal resistance. The WHO FPPL list is divided into three categories: critical, high and medium priority. The report presents these categories and proposes actions and strategies for policymakers, public health professionals and other stakeholders; targeted at improving the overall response to these priority fungal pathogens including preventing the development of antimicrobial resistance. Three primary areas for action are proposed, focusing on: (1) strengthening laboratory capacity and surveillance; (2) sustainable investments in research, development, and innovation; and (3) public health interventions.”

This comes amid a spike in certain fungal diseases during the COVID-19 pandemic. Additionally, the report found that “Currently, fungal infections receive less than 1.5% of all infectious disease research funding,” and that “most treatment guidelines are informed by limited evidence and expert opinion.”

Opinion: “To Fight Misinformation, We Need to Teach That Science Is Dynamic”

In this piece for Scientific American, Dr. Carl Bergstrom, Daniel Pimentel, and Dr. Jonathan Osborne discuss public ignorance of the scientific community, identifying ways this can be rectified. They write, “It’s easy to see why so many of us struggle to distinguish trustworthy science from what is flawed, speculative or fundamentally wrong. When we don’t learn the nature of consensus, how science tends to be self-correcting and how community as well as individual incentives bring to light discrepancies in theory and data, we are vulnerable to false beliefs and antiscience propaganda. Indeed, misinformation is now a pervasive threat to national and international security and well-being.”

They discuss the need to develop a population of competent outsiders, explaining “Giving people more facts is insufficient. Instead, we need a populace that can tell which sources of information are likely to be reliable, even if the science itself is beyond what they learned in school, so that they can identify when they need scientific information to make decisions in their own lives. Just as critically, people must understand enough about how science attempts to minimize error. In other words, every member of our society needs to be what science education researcher Noah Feinstein calls a “competent outsider.”

What We’re Listening To 🎧

This Week in Virology 948: Breathless with David Quammen

“David Quammen returns to TWiV to discuss how he wrote his new book ‘Breathless’, a story about the science and the scientists behind the race to understand the pandemic coronavirus SARS-CoV-2.” Listen here.

Conversations Before Midnight

The Bulletin of the Atomic Scientists is hosting its Bulletin Annual Gathering on November 9, 2022, at 5 pm CDT virtually. This is the Bulletin’s “signature event” and it aims to allow guests to engage in high-level conversations with influential voices tracking man-made threats. At the event, “Each virtual table has an expert, established and up-and-coming specialists in the fields of nuclear risk, climate change, disruptive technologies, and biosecurity. These discussion leaders include members of the Bulletin’s Science and Security Board, Board of Sponsors, and invited experts from around the world. Below are a few samples for this year’s gathering.”‘ Table experts include our own Dr. Greg Koblentz, so be sure to check out this event’s info page here.

Briefings in Preparation for the Ninth BWC Review Conference

From UNIDR: “The 1972 Biological Weapons Convention (BWC) is a cornerstone in the regime to prevent the hostile use of biology. The Ninth BWC Review Conference will take place in late November 2022 and presents an important opportunity to take stock of the past and chart a course for the future of this increasingly important agreement. In support of preparations for the Ninth BWC Review Conference and beyond, UNIDIR has recently published several reports intended to stimulate thinking on substantive issues related to the BWC.”

“This virtual event will bring together the authors of the latest UNIDIR publications on BWC topics to provide short outlines of the key insights and ideas in their respective reports for State Parties to consider ahead of the Review Conference. These include verification, advances in science and technology, international cooperation, and potential outcomes of the Review Conference. The presentations will be followed by a moderated interactive discussion with the participants.” This event will take place on November 7 at 2 pm CET, online. Learn more and register here.

Infection Prevention and Control: Incorporating Lessons Learned in Managing Special Pathogens

“After nearly three years responding to the COVID-19 pandemic, hospitals and other healthcare facilities have learned many lessons about the management of special pathogens and essential infection prevention and control practices. The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the National Emerging Special Pathogens Training and Education Center (NETEC) invite you to learn more about some of those lessons. Speakers will share their perspectives on how our approach to outbreaks has changed since the pandemic began. They will address issues such as infection prevention for healthcare workers and patients and mitigating disease spread. Speakers will also highlight newly developed tools and resources. This webinar will take place November 7 at 2:00 pm ET. Register today!”

From One Health Commission-World Bank Open Call

“Open Call for Experts to serve on the Technical Advisory Panel to the Governing Board of the Pandemic Prevention, Preparedness and Response Financial Intermediary Fund (“PPR FIF”)”- November 3 Deadline

“World Bank has posted a call for experts to serve on the Technical Advisory Panel (TAP) to the Governing Board of the Pandemic Prevention, Preparedness and Response Financial Intermediary Fund (“PPR FIF”).”

“The TAP will comprise a multidisciplinary pool of up to 20 experts, bringing a diverse range of independent technical and financial expertise relevant to PPR FIF-supported projects and activities. To register your interest in being considered for the PPR FIF TAP, please submit documents to ppr_fif_secretariat@worldbank.org using the subject line “Expression of interest for the PPR FIF TAP

Speaking of One Health…November 3 is One Health Day

Mark your calendars for this year’s One Health Day on November 3. One Health Day is an international campaign that was launched in 2016. The One Health Commission explains that “The goal of One Health Day is to bring attention around the world to the need for One Health interactions and for the world to ‘see them in action’. The One Health Day campaign is designed to engage as many individuals as possible from as many arenas as possible in One Health education and awareness events, and to generate an inspiring array of projects worldwide.” If you are hosting an event on this day, you can register your event here with the Commission. A list of registered One Health Day events for 2022 is also available here.

Pandora Report: 10.21.2022

It’s Friday again and this time we are kicking it off with some great news from our program. We then discuss the Biden administration’s new National Biodefense Strategy and the Boston University preprint controversy. As always, we finish the week out with new publications and upcoming events, including an entire issue supplement of Clinical Infectious Diseases dedicated to anthrax. Finally, mark your calendars, because November 3 is One Health Day (more on that in the announcements section).

First, Some Good News from the Biodefense Program!

Biodefense Faculty Member Joins Council on Strategic Risks and Wins Schar School of Policy and Government Distinguished Alumni Award…All in One Week!

This week, Dr. Saskia Popescu, an epidemiologist, prominent infection prevention consultant, an assistant professor at the Schar School, and more (No, seriously, she does all that AND more.) was named a Senior Fellow at the Janne E. Nolan Center on Strategic Weapons at the Council on Strategic Risks. In case that somehow was not enough for one week, she is also being honored today as this year’s Schar School of Policy and Government Distinguished Alumni Award winner. Read all about Dr. Popescu’s hero origin story here on the Schar School site.

Biodefense PhD Student Named Bulletin of the Atomic Scientists Editorial Fellow

Kimberly Ma, a first year Biodefense PhD student and senior analyst with the Preparedness division at the Association of State and Territorial Health Officials, was recently named an Editorial Fellow at the Bulletin of the Atomic Scientists. Over the next year, she will author a number of pieces on biosecurity for the Bulletin, so keep an eye out for her upcoming work!

The Biden Administration Releases New National Biodefense Strategy

This week, the White House announced the release of the new National Biodefense Strategy and President Biden’s intent to sign National Security Memorandum 15-“Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security”. The strategy takes a comprehensive approach, aiming to make improvements in these areas-“detect pandemic and other biological threats, “prevent outbreaks from becoming epidemics and prevent biological incidents before they can happen,” “prepare for pandemics and other biological incidents,” “rapidly respond to outbreaks when they occur,” and “recover from a pandemic or biological incident.”

Among other points about the strategy, the Nuclear Threat Initiative explains that “The new strategy’s requirement that the National Security Council and the Office of Science and Technology Policy conduct an interagency policy review regarding biosafety and biosecurity norms and oversight for life sciences research also is valuable. As the largest funder of bioscience and biotechnology research and development in the world, the U.S. Government has a responsibility to put guardrails in place to prevent laboratory accidents or deliberate misuse of the tools of modern bioscience and biotechnology. Doing so can have a profound direct impact in reducing global biological risks and serve as a valuable example for other funders around the world.”

National Security Memorandum 15, “National Security Memorandum on Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security,” directs the heads of agencies addressed to:

  1. “implement the Biodefense Strategy, as well as related strategies such as the U.S. Global Health Security Strategy, and include biodefense-related activities, including resourcing and achieving the goals of the Biodefense Strategy and the priorities, targets, and actions of its Implementation Plan, within their strategic planning and budgetary processes;
  2. in the event of the determination of a nationally or internationally significant biological incident, implement Federal response efforts in accordance with Homeland Security Presidential Directive 5 of February 28, 2003 (Management of Domestic Incidents), Presidential Policy Directive 8 of March 30, 2011 (National Preparedness), Presidential Policy Directive 44 of November 7, 2016 (Enhancing Domestic Incident Response), and Federal Government response and recovery frameworks and operational plans;
  3. coordinate their biodefense policies with other agencies that have responsibilities or capabilities pertaining to biodefense, as well as with appropriate non-Federal entities;
  4. share information and coordinate decision-making related to the biodefense enterprise; and
  5. monitor, evaluate, and hold their respective agencies accountable for the implementation of section 3(a) of this memorandum.”

The memorandum also states that “To facilitate effective implementation of the Biodefense Strategy, within 90 days of the date of this memorandum and at least quarterly thereafter, the NSC staff Directorate for Global Health Security and Biodefense shall convene lead agencies identified in the Biodefense Strategy’s Implementation Plan at the Assistant Secretary level.  These agencies shall brief the NSC staff on progress towards key milestones and timelines, as well as on critical gaps and barriers to progress.  The NSC staff Directorate for Global Health Security and Biodefense shall provide updates quarterly to the APNSA based off of these briefs, summarizing progress towards the implementation of the Biodefense Strategy by highlighting the extent to which the goals and objectives are being met, outlining major gaps and impediments to timely and effective implementation, and presenting options for overcoming these gaps.  The APNSA shall provide to the President, on an annual basis, a memorandum summarizing these updates.”

Transcripts of the background call on this new strategy are available here, and check out the Council on Strategic Risks discussion of the strategy here.

Boston University Controversy

Last week, researchers from Boston University’s (BU) National Emerging Infectious Diseases Laboratories (NEIDL) posted results from their controversial work on BA.1 variant spike proteins in preprint. As Science explains, “They took the gene for Omicron’s surface protein, or spike protein, which SARS-CoV-2 uses to enter cells and added it to the genome of a “backbone” virus—a variant of SARS-CoV-2 from Washington state that was identified soon after the pandemic first emerged in Wuhan, China, in early 2020. The objective was to tease apart whether Omicron’s spike protein explains why it is less pathogenic (meaning it causes less severe disease). The answer could lead to improved COVID-19 diagnostic tests and better ways to manage the disease, the preprint authors say.”

“This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19).”; Source: CDC PHIL

By Monday, a UK tabloid, Daily Mail, ran with the story, indicating in their headline that the lab had created a strain of SARS-CoV-2 with an “80 percent kill rate,” and had created a much more dangerous strain of the virus. While the Daily Mail piece is very clearly from a tabloid, this did spark debate online, as this preprint describes what some argue is gain of function research. This work was not approved by the National Institutes of Health, though it was approved by the institutional biosafety committee at NEIDL. Critics argue that this study lacks scientific value and that its potential risks were not properly reviewed before it was conducted. Some, including Francois Balloux, a virologist at University College London, expressed concern over the study’s relevance to human health, noting that findings in mice frequently do not carry over to humans. Others, however, are far less alarmed, generally arguing that the hybrid virus is far less lethal than the original, pointing to the extreme sensitivity of the mice used in the study, and highlighting that similar SARS-CoV-2 variants have already emerged before later fading away.

The university responded to accusations made in the Daily Mail, stating “We want to address the false and inaccurate reporting about Boston University COVID-19 research, which appeared today in the Daily Mail,” said the BU statement. “First, this research is not gain-of-function research, meaning it did not amplify the Washington state SARS-CoV-2 virus strain or make it more dangerous. In fact, this research made the virus replicate less dangerous.” BU also explained that “The animal model that was used was a particular type of mouse that is highly susceptible, and 80 to 100 percent of the infected mice succumb to disease from the original strain, the so-called Washington strain,” says Corley. “Whereas Omicron causes a very mild disease in these animals.” On the topic of funding, BU said the lab “…did not amplify the [backbone] SARS-CoV-2 virus strain or make it more dangerous. In fact, this research made the virus replicate less dangerous,” as reason for not reporting the study to NIH. They also stated this work did not need to be cleared by NIH as it was not directly funded by the agency as the lab used NIAID grants only to pay for tools and platforms.

Science reports that “Emily Erbelding, director of the NIAID division that helped fund the work, said the hybrid virus experiments weren’t described in BU’s grant proposal or progress reports. But she said if BU had informed NIAID about its plans, the institute probably would have evaluated it to determine whether it qualified for review by a special Department of Health and Human Services (HHS) committee.”

NIH also released a statement this week: “The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, did not review nor issue awards for experiments described in a pre-print article on SARS-CoV-2 research at Boston University’s National Emerging Infectious Diseases Laboratories (NEIDL). NIH is examining the matter to determine whether the research conducted was subject to the NIH Grants Policy Statement or met the criteria for review under the HHS Framework for Guiding Funding Decisions about Proposed Research Involving Enhanced Potential Pandemic Pathogens (HHS P3CO framework)…”

While the debate is sure to keep raging, it is also likely to add fuel to the ongoing review of federal oversight policies for GoF research led by the National Science Advisory Board for Biosecurity (NSABB). According to Science, “In September, an NSABB task force issued a draft report that recommended the review policy be expanded to sweep in some kinds of research, and some pathogens, that are now exempt. And experts on all sides of the GOF debate have said the criteria for review need to be clearer. The government is expected to release new rules as early as next year. (For more, see this week’s feature in Science.)”

However, as Science has also previously written, “A U.S. clampdown will have no sway over privately funded GOF research or what happens in other countries, which typically lack policies like the P3CO framework. In Japan and most of Europe, for example, oversight is limited to rules on biosafety and, sometimes, biosecurity along with voluntary self-regulation, say biosecurity experts Gregory Koblentz of George Mason University and Filippa Lentzos of King’s College London. It’s too soon to say how a 2020 Chinese biosafety law will affect PPP research, they say.”

“National Security Snapshot: Department of Defense and Intelligence Community Preparedness for Biological Threats”

The Government Accountability Office (GAO) recently released this National Security Snapshot co-authored by Dr. Brian Mazanec, an alumnus of the Biodefense PhD program. This snapshot discusses core issues like biopreparedness and the PRC’s intent to exploit US genetic data. The authors write, “We made several key recommendations to improve how DOD and the Intelligence Community prepare for and respond to biological threats. DOD is taking a number of positive steps, such as coordinating with partners to research and develop vaccines. But, DOD doesn’t have a comprehensive strategy that, for example, shows where biodefense resources are needed.”

“Public Health Preparedness: HHS Should Address Strategic National Stockpile Requirements and Inventory Risks”

GAO also recently released this report discussing the Department of Health and Human Services’ inventory planning reports and their failure to “meet most legal requirements enacted in 2019 or communicate risks associated with not meeting recommended inventory levels. This is partly because HHS hasn’t updated its processes for completing the reports and a key advisory body was inactive.” This report makes a number of recommendations while also noting that HHS’s leadership and coordination of public health emergencies is on the office’s high risk list.

“COVID-19: A Warning – Addressing Environmental Threats and the Risk of Future Pandemics in Asia and the Pacific”

From the UN Environment Programme: “This scientific review begins with the history of humans and zoonoses and provides clarity on the issues of zoonoses and emerging infectious diseases. It then presents the seven anthropogenic drivers of zoonotic disease emergence as well as the concept of viral mixing. After providing rich context, this review continues to outline solutions that address the intricate link between nature and human health and strategies to prevent future zoonotic outbreaks.”

“”It was Compromised”: The Trump Administration’s Unprecedented Campaign to Control CDC and Politicize Public Health During the Coronavirus Crisis”

The House Select Subcommittee on the Coronavirus Crisis recently released its third installment of staff reports detailing the Trump administration’s response to the COVID-19 pandemic. In the report, the committee explains its findings from its investigation into the Trump administration’s “rampant political interference with the federal public health response to the coronavirus pandemic.” Chairman Clyburn released this statement about the report: “The Select Subcommittee’s investigation has shown that the previous administration engaged in an unprecedented campaign of political interference in the federal government’s pandemic response, which undermined public health to benefit the former president’s political goals. As today’s report shows, President Trump and his top aides repeatedly attacked CDC scientists, compromised the agency’s public health guidance, and suppressed scientific reports in an effort to downplay the seriousness of the coronavirus. This prioritization of politics, contempt for science, and refusal to follow the advice of public health experts harmed the nation’s ability to respond effectively to the coronavirus crisis and put Americans at risk. As we continue to recover from the coronavirus crisis, we must also continue to work to safeguard scientific integrity and restore the American people’s trust in our public health institutions.”

Clinical Infectious Diseases “Issue Supplement 3, Anthrax Preparedness”

This issue supplement of Clinical Infectious Diseases is all about anthrax, including articles ranging from “Responding to the Threat Posed by Anthrax: Updated Evidence to Improve Preparedness” to “Risk Factors for Severe Cutaneous Anthrax in a Retrospective Case Series and Use of a Clinical Algorithm to Identify Likely Meningitis and Evaluate Treatment Outcomes, Kyrgyz Republic, 2005-2012”. So, if it has been a while since you were deeply concerned about anthrax, this issue is for you!

“How SARS-CoV-2 Battles Our Immune System”

If you like medical illustrations and interactive timelines, this one is for you. This new story available from Science walks readers visually through SARS-CoV-2’s interaction with the human immune system, offering detailed yet easily understood, general explanations along the way. Readers can even learn about the virus’s different proteins and their specific effects on the immune system.

What We’re Listening To 🎧

This Podcast Will Kill You: Episode 107: Sepsis: It’s a Mess

“Over the years of the podcast, we have often struggled with questions of why: why pathogens act the way they do, why certain people get sick while others don’t, or why we know little about some diseases. This episode is no exception – sepsis certainly inspires many “whys”. But for perhaps the first time on the pod, we find ourselves grappling not only with “why?” but also with “what?”. What, indeed, is sepsis? Ask a dozen doctors and you may get a dozen different answers. Our first goal for this episode is to sift through the various definitions of sepsis and what we know about its pathology to get a firm handle on this deadly consequence of infection. We then turn our sights to a thrilling period of sepsis history – Joseph Lister and his carbolic acid spray – before attempting to address the status of sepsis around the world today. By the end of the episode, your picture of sepsis may not be crystal clear, but hopefully the edges are a little less blurry.” Listen here on Spotify or wherever you listen to podcasts!

Project Responder 6: Evolving Response Environment Webinar

From DHS: “You’re invited to join the Department of Homeland Security (DHS) Science & Technology Directorate (S&T) for a briefing on the Project Responder 6 report, designed to document emergency response capability needs across significant changes in the operating environment. The innovative approach this data collection effort—now in its sixth generation—takes is to bring together S&T’s First Responder Resource Group (FRRG), which includes responders from traditional (fire service, law enforcement, emergency medical services, emergency management) and non-traditional (public health, public works, medical examiner/coroner, search and rescue) response agencies, to focus on identifying and validating needs across disciplines.” Learn more and register here. Download the report here. This event will take place on October 24, at 11 am ET.

Addressing Health Inequities by Strengthening Antibiotic Stewardship

From NCEZID: “Please join The National Center for Emerging and Zoonotic Infectious Disease (NCEZID) on Tuesday, October 25, 2022, at 10 a.m. EDT for the next AMR Exchange webinar on addressing health inequities by strengthening antibiotic stewardship entitled Addressing health inequities by strengthening antibiotic stewardship. The discussion will feature experts from CDC, The Pew Charitable Trusts, the Federal Office of Rural Health Policy, and Emory University School of Medicine who work to strengthen antibiotic use and prescribing and improve the quality of health care across the United States. Please register here.”

South Korea as a Global Vaccine Hub

The Korea Economic Institute of America is hosting this event October 27, at 3 pm EST virtually: “Early in the pandemic, South Korea drew widespread praise for the speed and efficiency of its response to slowing the spread of the virus and saving lives. However, despite this initial success, South Korea faced vaccine nationalism and other access challenges in its effort to secure Covid-19 vaccines. Spurred by these challenges, South Korea established a national strategic policy to become a global vaccine hub, not only to meet the current and future public health needs of its own population but also to assist low- and middle-income countries (LMICs) facing even starker obstacles in accessing safe and effective vaccines.”

“Please join KEI for a discussion with the Thomas Byrne, Claire Callahan, Irene Kyoung, and Salomé Da Silva Duarte Lepez about how global vaccine access and equity was hindered by the shortcomings of national and bilateral vaccine diplomacy and multilateral mechanisms during the Covid-19 pandemic, and how South Korea’s demonstrated capabilities to rise as global vaccine development, manufacturing and training hub will help bolster global public health capacities in the future.” Register here.

The Case for the Use of “Red Lines” in the Governance of Life Sciences Research with David Relman

From CISAC: “The nature of evolving risks in life sciences research, a brief history of risk governance, and the case for the use of so-called “red lines” in the governance of life sciences research will be presented. The goals of this presentation are to elicit discussion about the benefits and pitfalls of red lines, or guardrails, in general, including a historical perspective, and options for public policy recommendations to address concerns about the present and future risks arising from life sciences research.” This event will take place on October 27, at 3:30 pm PT. Register here.

Infection Prevention and Control: Incorporating Lessons Learned in Managing Special Pathogens

“After nearly three years responding to the COVID-19 pandemic, hospitals and other healthcare facilities have learned many lessons about the management of special pathogens and essential infection prevention and control practices. The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the National Emerging Special Pathogens Training and Education Center (NETEC) invite you to learn more about some of those lessons. Speakers will share their perspectives on how our approach to outbreaks has changed since the pandemic began. They will address issues such as infection prevention for healthcare workers and patients and mitigating disease spread. Speakers will also highlight newly developed tools and resources. This webinar will take place November 7 at 2:00 pm ET. Register today!”

ICYMI: IARPA, Gingko Bioworks and Draper Announce New Technologies to Detect Engineered DNA

This week, Gingko Bioworks, Draper, and IARPA held an event to announce the completion of IARPA’s Finding Engineering-Linked Indicators (FELIX), a program aimed at improving existing biodetection and surveillance capabilities. “The event featured a panel with Catherine Marsh, IARPA Director; David A. Markowitz, IARPA Program Manager; Joshua Dunn, Head of Design, Ginkgo Bioworks; Laura Seaman, Principal Scientist and Machine Intelligence Group Leader, at Draper; and Erin Rosenberger, Senior Member of Technical Staff, Biological Microsystems Group, at Draper. During the panel, the panelists discussed the program findings and also featured a demo of the research results.” A recording of the livestream is available here.

November 3 is One Health Day

Mark your calendars for this year’s One Health Day on November 3. One Health Day is an international campaign that was launched in 2016. The One Health Commission explains that “The goal of One Health Day is to bring attention around the world to the need for One Health interactions and for the world to ‘see them in action’. The One Health Day campaign is designed to engage as many individuals as possible from as many arenas as possible in One Health education and awareness events, and to generate an inspiring array of projects worldwide.” If you are hosting an event on this day, you can register your event here with the Commission. A list of registered One Health Day events for 2022 is also available here.

Pandora Report: 10.14.2022

Happy Friday! This week we discuss the release of the Biden administration’s National Security Strategy and new findings about the prevalence and challenges of long COVID. We also cover a number of new publications, a German podcast episode on the 1979 anthrax outbreak in Sverdlovsk (featuring our own Dr. Sonia Ben Ouagrham-Gormley!), and upcoming events.

Biden Administration Releases National Security Strategy

The Biden administration released its National Security Strategy (NSS)this week, building on the 2021 Interim NSS. This iteration of the NSS re-incorporates climate change as a national security threat, continues to define the threats China and Russia pose to the US, and includes “Triad” with a capital “T” to make sure there’s plenty of discussion about the document here in the Beltway. As the NSS has in the past, this version includes a section dedicated to pandemics and biological threats, which estarts by explaining that “COVID-19 has killed nearly 6.5 million people around the world, including more than 1 million Americans, but the next pandemic could be much worse—as contagious but more lethal. We have a narrow window of opportunity to take steps nationally and internationally to prepare for the next pandemic and to strengthen our biodefense.”

This section also discusses the notion that “no one is safe until everyone is safe,” and acknowledges that “some of our international institutions have fallen short in the past and need to be reformed.” It concludes with a paragraph discussing the need to address risks posed by deliberate and accidental biological risks “including through our ability to rapidly detect, identify, and attribute agents, and to develop medical countermeasures,” by working to strengthen the BWC, prevent terrorist acquisition of BW, and reinforcing “norms against biological weapons’ development and use.”

This comes on the heels of statements released this week by the US State Department and German Federal Foreign Office on the need to better cooperate to reduce biological threats globally. Both statements discuss the multi-faceted nature of these problems, including challenges created by mis- and disinformation and the need for increased global cooperation in the face of these threats, again highlighting the increasing importance of these issues.

Long COVID Gaining Recognition…Finally

This week, Hastie et al.’s article in Nature Communications discussing long COVID made waves in the media and online. The authors conducted a study in a Scottish cohort consisting of 33,281 laboratory-confirmed SARS-CoV-2 infections and 62,957 never-infected individuals. Participants were issued questionnaires at 6, 12, and 18 months. The authors found that “Of the 31,486 symptomatic infections,1,856 (6%) had not recovered and 13,350 (42%) only partially.” They also found that “Asymptomatic infection was not associated with adverse outcomes. Vaccination was associated with reduced risk of seven symptoms.” Notably, participants with previous symptomatic COVID-19 infections reported long-lasting symptoms like breathlessness, heart palpitations, difficulty focusing, and confusion at rates more than double that of those who were not previously infected. They also reported other related symptoms, like muscle aches and other heart problems.

There were some challenges in the study, however. For example, approximately 90% of participants were white, which is not helpful in trying to better understand risks and burdens of long COVID in other groups. Furthermore, only 4% were vaccinated (most with just one dose) before they were infected. However, this study does more concretely demonstrate the breadth of this problem and what it could mean for future pandemics.

A German study was also published this week in BMJ that found a “considerable burden of long-COVID symptoms, especially fatigue and neurocognitive impairment (“brain fog”), at 6 to 12 months—even among young and middle-aged adults who had mild infections,” according to CIDRAP. This study found that women were at higher risk for developing long COVID and “The researchers said the study revealed long-COVID symptom clusters with individually and societally relevant implications that also affected younger adults with mild initial infections. “Given the individual and societal burden of post-covid sequelae, the underlying biological abnormalities and causes need urgent clarification to define adequate treatment options and develop effective rehabilitation measures,” they concluded.”

Other studies have also linked long COVID to conditions like postural tachycardia syndrome (POTS). In the case of POTS, 41% of people diagnosed with the syndrome already reported a viral infection preceding the onset of POTS symptoms pre-pandemic. Because of this connection, the UK’s National Institute for Health and Care Excellence now even recommends testing for POTS in patients with long COVID. These studies build on mountains of anecdotal evidence from patients and providers alike, demonstrating that long COVID is a very real and serious danger that has already impacted many of us.

The WHO Director General, Dr. Tedros Adhanom Ghebreyesus, recently authored a piece in The Guardian discussing long COVID, what WHO is doing about it, and what countries around the world should do to support those suffering with it. He explains, “Mostly data is only available from high-income countries, which means that we don’t currently have a clear picture on how many people are actually suffering. Current estimates suggest that tens of millions, and perhaps more, have contracted long Covid, and about 15% of those diagnosed with the condition have experienced symptoms for at least 12 months.”

He also discussed the shift in investment strategies this requires of countries, writing “Early in the pandemic, it was important for overwhelmed health systems to focus all of their life-saving efforts on patients presenting with acute infection. However, it is critical for governments to invest long-term in their health system and workers and make a plan now for dealing with long Covid. This plan should encompass, providing immediate access to antivirals to patients at high risk of serious disease, investing in research and sharing new tools and knowledge as they’re identified to prevent, detect and treat patients more effectively. It also means supporting patients physical and mental health as well as providing financial support for those who are unable to work.”

WHO/Europe also issued a factsheet discussing the need for rehabilitation, recognition, and research focused on lingering COVID symptoms that is available here.

WHO Europe Factsheet Discussing Long COVID, Source: https://www.who.int/europe/news/item/10-10-2022-rehabilitation–recognition-and-research-needed-for-people-living-with-long-covid–new-who-europe-factsheet

“COVID Prompts Global Surge in Labs That Handle Dangerous Pathogens”

Smriti Mallapaty’s recent article in Nature News discusses the growing number of BSL-3 and 4 certified facilitates globally and rising concerns about the costs and risks they present. This article covers new facilities across Asia as well as Russia’s promise that it will build 15 new BSL-4 facilities. Mallapaty also quoted GMU’s Dr. Greg Koblentz in the article, writing “Since the COVID-19 pandemic began, plans to build 27 BSL-4 labs have been announced worldwide, say Gregory Koblenz, a biodefence researcher at George Mason University in Arlington, Virginia, and Filippa Lentzos, a biosecurity researcher at King’s College London, who have tracked the number and distribution of BSL-4 facilities globally. “These will likely take several years to design, build and commission,” says Lentzos.”

“Pandemic Origins and a One Health Approach to Preparedness and Prevention: Solutions Based on SARS-CoV-2 and Other RNA Viruses”

In this recent Proceedings of the National Academy of Sciences article, Keusch et al. discuss the importance of One Health in improving and integrating biosafety and biosecurity. Their abstract explains “COVID-19 is the latest zoonotic RNA virus epidemic of concern. Learning how it began and spread will help to determine how to reduce the risk of future events. We review major RNA virus outbreaks since 1967 to identify common features and opportunities to prevent emergence, including ancestral viral origins in birds, bats, and other mammals; animal reservoirs and intermediate hosts; and pathways for zoonotic spillover and community spread, leading to local, regional, or international outbreaks. The increasing scientific evidence concerning the origins of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is most consistent with a zoonotic origin and a spillover pathway from wildlife to people via wildlife farming and the wildlife trade. We apply what we know about these outbreaks to identify relevant, feasible, and implementable interventions. We identify three primary targets for pandemic prevention and preparedness: first, smart surveillance coupled with epidemiological risk assessment across wildlife–livestock–human (One Health) spillover interfaces; second, research to enhance pandemic preparedness and expedite development of vaccines and therapeutics; and third, strategies to reduce underlying drivers of spillover risk and spread and reduce the influence of misinformation. For all three, continued efforts to improve and integrate biosafety and biosecurity with the implementation of a One Health approach are essential. We discuss new models to address the challenges of creating an inclusive and effective governance structure, with the necessary stable funding for cross-disciplinary collaborative research. Finally, we offer recommendations for feasible actions to close the knowledge gaps across the One Health continuum and improve preparedness and response in the future.”

Science published a news article discussing this paper, writing “‘Our paper recognizes that there are different possible origins, but the evidence towards zoonosis is overwhelming,” says co-author Danielle Anderson, a virologist at the University of Melbourne. The report, which includes an analysis that found the peer-reviewed literature overwhelmingly supports the zoonotic hypotheses, appeared in the Proceedings of the National Academy of Sciences (PNAS) on 10 October.”

The article continued with “The panel’s own history reflects the intensity of the debate. Originally convened as a task force of the Lancet COVID-19 Commission, a wide-reaching effort to derive lessons from the pandemic, it was disbanded by Columbia University economist Jeffrey Sachs, the commission’s chair. Sachs alleged that several members had conflicts of interest that would bias them against the lab-origin hypothesis.”

“WHO’s Response to COVID-19 – 2022 Mid-Year Report”

“This mid-year report provides a consolidated update on WHO’s response to the COVID‐19 pandemic between January and July 2022, against the objectives laid out in the Strategic Preparedness and Response Plans (SPRP) for 2021 and 2022.”

“With the aim of ending the acute phase of the pandemic by the end of the year, WHO, in collaboration with partners, has supported countries to further strengthen their surveillance systems; ensure more equitable access to tests, treatments, and essential supplies worldwide; make health systems more resilient; and reduce exposure to the disease by empowering and enabling communities.”

“The report highlights the role of WHO at the global, regional, and local levels, and across the key elements of an effective emergency response – from implementation and operational support, to developing evidence and research, and providing strong coordination and planning. By working with partners, including multi-agency and multi-partner operational platforms, regional and national public health and scientific institutes, governments, communities, donors, UN organizations and NGOs and the private sector, WHO helped bring the world together to provide direct technical and operational support to countries implementing their national COVID-19 response plans.”

“Epidemics That Didn’t Happen”

On a much more cheerful note, check out Prevent Epidemics’ online feature, “Epidemics That Didn’t Happen”. This page explores six epidemics that were prevented thanks to solid cooperation and good public health responses, including averted epidemics of Ebola, Nipah, cholera, rabies, influenza, and dengue. As the page notes, these cases present common themes, including “Speed is essential,” “Well-coordinated action at the local level is crucial to preventing epidemics,” “Community engagement pays off,” and “Health care workers need to be trained, supported, and provided with access to resources and assistance to stop epidemics.”

“Russia’s Alleged Bioweapons Claims Have Few Supporters”

Jez Littlewood and Dr. Filippa Lentzos recently published this piece in this Bulletin of the Atomic Scientists discussing the outcome of September’s Article V Formal Consultative Meeting requested by Russia. They write “For the fourth time this year, Russia accused the United States and Ukraine of being in non-compliance with the Biological and Toxins Weapons Convention (BTWC)—and once again found little support for its allegations. At the conclusion of the Article V Formal Consultative Meeting in September, no other state formally accused these two nations of non-compliance. Russia stands alone in its allegations, with limited support from eight other states. In contrast, more than five times as many backed the United States and Ukraine in rejecting the allegations; the meeting ended with a procedural report that noted no consensus regarding the outcome.”

“Addressing Inaccurate and Misleading Information About Biological Threats Through Scientific Collaboration and Communication in Southeast Asia”

From the National Academies: “Misinformation about outbreaks, epidemics, and pandemics is a decades-old problem that has been exacerbated by the rise of the internet and the widespread use of social media. Some false claims may be addressed through sound scientific analysis, suggesting that scientists can help counter misinformation by providing evidence-based, scientifically defensible information that may discredit or refute these claims. This report explains how scientists can work collaboratively across scientific disciplines and sectors to identify and address inaccuracies that could fuel mis- and disinformation. Although the study focused on a scientific network primarily in Southeast Asia, it is relevant to scientists in other parts of the world. A companion “how-to-guide”, available in print and in digital form, outlines practical steps that scientists can take to assess mis- or disinformation, determine whether and how they should address it, and effectively communicate the corrective information they develop.”

“Counterfeit PPE: Substandard Respirators and Their Entry Into Supply Chains in Major Cities”

This recent article from Urban Crime was co-authored by the Schar School’s Dr. Louise Shelley and discusses challenges in ensuring legitimate PPE is available and what this means for definitions of threats to human life. The abstract reads “Over 58 million counterfeit respirators of substandard quality unable to protect individuals from infection have been seized globally since the start of the COVID-19 pandemic. These seizures have primarily occurred in urban warehouses and ports around the world according to analysis of public and corporate data shared with the authors. The presence of tens of millions of respirators in storage facilities prior to distribution demonstrates that urban areas are key elements of illicit supply chains. Data suggests that the concept of urban insecurity needs to be reconsidered in light of illicit supply chains for counterfeit respirators and their role in facilitating disease transmission in urban areas. The analysis presented in this article suggests that threats to human life should not be confined narrowly to violent acts or the consumption of drugs. Human life can also be threatened through the massive distribution of counterfeit N95 masks during a pandemic, a problem that has become more acute with more contagious mutations of COVID-19.”

Dr. Shelley is the Omer L. and Nancy Hirst Endowed Chair and a University Professor at George Mason University. She is in the Schar School of Policy and Government and directs the Terrorism, Transnational Crime and Corruption Center. She is a leading expert on the relationship between terrorism, organized crime, and corruption as well as human trafficking, transnational crime, and terrorism with a particular focus on the former Soviet Union. She also specializes in illicit financial flows and money laundering. 

What We’re Listening To 🎧

Waffen der Wissenschaft – Die Spur der Sporen

For our German-speaking readers, a Viertausendhertz podcast episode on the 1979 outbreak of anthrax in Sverdlovsk: “Im Frühjahr 1979 sterben in der geschlossenen sowjetischen Stadt Sverdlovsk Dutzende Menschen an Milzbrand. Ein ungeheurer Verdacht kommt auf: Handelt es sich um einen Unfall mit Biowaffen? Der Forscher Matthew Meselson und der Journalist Peter Gumbel erzählen von ihren Nachforschungen vor Ort. Das Team spricht außerdem mit den Biowaffen-Experten Filippa Lentzos, Sonia Ben Ouagrham-Gormley und Andrew Weber.”

Translation: “In the spring of 1979, dozens of people died of anthrax in the closed Soviet city of Sverdlovsk. A tremendous suspicion arose: was it an accident involving biological weapons? The researcher Matthew Meselson and the journalist Peter Gumbel discuss their investigations on site. The team also speaks with bioweapons experts Filippa Lentzos, Sonia Ben Ouagrham-Gormley, and Andrew Weber.”

Event Summaries

Check out event summaries written by Geoffrey Mattoon, a Biodefense MS student, for two recent events from the Council on Strategic Risks-“Building Capacities for Addressing Future Biological Threats” and “The American Pandemic Preparedness Plan: One Year of Progress & the Path Forward”.

Schar School Master’s and Certificate Virtual Open House

Join us for next week’s Master’s and Certificate Virtual Open House on Wednesday, October 19, at 7 pm ET, to learn more about the Schar School of Policy and Government and the Biodefense Graduate Program. The online session will provide an overview of our programs, student services, and admissions requirements. Our admissions staff will be available afterward to answer any questions you may have. Register here!

Infection Prevention and Control: Incorporating Lessons Learned in Managing Special Pathogens

“After nearly three years responding to the COVID-19 pandemic, hospitals and other healthcare facilities have learned many lessons about the management of special pathogens and essential infection prevention and control practices. The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the National Emerging Special Pathogens Training and Education Center (NETEC) invite you to learn more about some of those lessons. Speakers will share their perspectives on how our approach to outbreaks has changed since the pandemic began. They will address issues such as infection prevention for healthcare workers and patients and mitigating disease spread. Speakers will also highlight newly developed tools and resources. This webinar will take place November 7 at 2:00 pm ET. Register today!”

Disinformation: An Emerging War Weapon

“Hosted by the National Defense University Foundation and Moderated by President and CEO, James Schmeling, join us for this interactive virtual discussion. Brief Talk Description: Explore how Russia, China and other entities use misinformation, disinformation, and malinformation as weapons of war and their impact on global security and American democracy.” This online webinar will be hosted on October 20 at 12 pm EST. Register here.

Reflections on Science Communication & Human Rights Amid Public Health Emergencies

“On October 20 (10:30-11:30 am ET),  join Dr. Bina Venkataraman, Editor-at-Large for The Boston Globe, and Dr. Chris Beyrer, Director of Duke University’s Global Health Institute, for a virtual discussion of science communication during public health emergencies, the role of public health researchers and journalists in advancing human rights, and emerging lessons from the COVID-19 pandemic.”

“The conversation will be moderated by Prof. Helle Porsdam, Professor of Law and Humanities and UNESCO Chair in Cultural Rights, Centre for Interdisciplinary Studies of Law, Faculty of Law, University of Copenhagen.” Register here.

Third International Summit on Human Genome Editing

The Third International Summit on Human Genome Editing will take place March 6-8, 2023, at the Francis Crick Institute, London, UK. “Building on previous events held in Washington, DC (2015) and Hong Kong (2018), this Summit will continue the important dialogue around human genome editing. It will facilitate a global discussion on somatic and germline genome editing, including developments in clinical trials and genome editing tools such as CRISPR/Cas9. Earlier this year a three-part series of online events Looking Ahead to the Third Human Genome Editing Summit discussed some of the key topics of the meeting. The three-day summit is being organised by the Royal Society, the UK Academy of Medical Sciences, the US National Academies of Sciences and Medicine and The World Academy of Sciences.”

“Find out more about the Summit’s Planning Committee, chaired by Professor Robin Lovell-Badge FRS FMedSci. Further information about the Summit agenda will be released soon, and registration to attend the event in person and online is now open.”

Event Summary: Building Capacities for Addressing Future Biological Threats

Defining Convergence

By Geoffrey Mattoon, Biodefense MS Student

On Tuesday, 20 September, the Council on Strategic Risks (CSR) hosted the “Building Capacities for Addressing Future Biological Threats” webinar, which included keynote speaker Dr. David Christian (Chris) Hassell, Deputy Assistant Secretary for Preparedness and Response at ASPR, speakers Dr. Pardis Sabeti, Professor at the Center for Systems Biology at Harvard University, and Dr. Akhila Kosaraju, CEO and President of Phare Bio, and was moderated by Dr. Yong-Bee Lim, Deputy Director of the Janne E. Nolan Center on Strategic Weapons and George Mason Biodefense Program alumni. Together they discussed the evolving biological threats landscape and the means that exist to improve preparedness and response. This event follows the previous webinar “The American Pandemic Preparedness Plan: One Year of Progress & The Path Forward,” also hosted by CSR on 8 September, and focused heavily on the need for greater cooperation, collaboration, and innovation to prepare for the next pandemic.

             Dr. Hassell began the event by highlighting the misconceptions associated with the terms “convergence” and “bioconvergence” within the field. His concern was that these terms have become buzzwords within biodefense and their use implies that the different fields and disciplines necessary for biodefense are converging or cooperating organically. Such a misconception leads those within and outside of the field to assume that unity of effort is common and effortless, which is not the case. Barriers to convergence are prevalent and numerous, both in government and private sectors. Dr. Hassell provided an example from his previous experience in the Department of Defense developing chemical detectors, comparing a lack of higher-level convergence to the lack of standardized interfaces on different detectors preventing operators from gaining competency on all systems after mastering any single system. Such stove-piping of systems and efforts prevents convergence and is common across biodefense. The solution is a greater degree of crosstalk between disciplines working towards a unified solution or goal. Providing another example of this failure of convergence, Dr. Hassell highlighted the recent Pentagon appropriations for biodefense failing to account for the need for cyber funding to be successful against future threats as that discipline becomes more critical.

            Dr. Hassell also indicated that biological threats, in addition to the biodefense, are converging. As biotechnology and other life sciences continue to advance, the line between chemical and biological threats blurs. Previous research has demonstrated this growing convergence, from opioid-producing yeast conducted by Galanie et al. published in Nature to chemical synthesis of toxins conducted by Matinkhoo et al. in the Journal of the American Chemical Society. He urges a greater convergence of chemical and biodefense disciplines to effectively overcome these threats in the future. Such efforts would come at a substantial cost and require the reorganization of numerous government agencies, but it may be necessary to respond to the evolving threat landscape and enable more efficient use of future funding to unify efforts.

            Dr. Hassell then commented on the need for greater inclusion of data sciences, data technologies, and nanotechnologies in future biodefense efforts. The necessity of greater convergence between chemical and biodefense and the inclusion of these disciplines is a key requirement identified in Biodefense in the Age of Synthetic Biology, a report prepared by the National Academies for the Department of Defense in 2018. The addition of these technology-based disciplines is indicative of a greater requirement for technology convergence in chemical and biodefense efforts to combat the rising technology integration in the threat landscape. Modern biotechnology has created significant risk of dual use to create ever greater biological threats. Dr. Hassell pointed to the recent “Dual Use of Artificial-Intelligence-Powered Drug Discovery,” published by Urbina et al. in Nature Machine Learning, that indicated how easy it may be for a machine learning system designed with the best of intentions to identify new therapeutic disease inhibitors to be reprogrammed to instead identify novel toxin molecules. In that report, the MegaSyn system was able to generate 40,000 novel VX molecules in less than 6 hours. Dr. Sonia Ben Ouagrham-Gormley, Associate Professor at George Mason University and author of Barriers to Bioweapons, indicated such results do not directly equate to actionable threats on the Radiolab episode 40,000 Recipes for Murder that covered this journal article, but they still are indicative of the evolving chemical and biological threat landscape. Dr. Hassell also indicated the convergence of other disciplines critical to future biological threats, including climate change, which is enabling greater zoonotic spillover events, generating new and often novel biological threats.

            Dr. Pardis Sabeti underscored deadly infectious diseases as an existential threat to humanity during her remarks. She agreed with Dr. Hassell’s call for greater convergence and stated we must aspire to use technology to outpace the evolution of diseases so that we can be more anticipatory and less reactionary in the face of future outbreaks. She emphasized that COVID-19, though a recent a traumatic pandemic, is not the biggest threat we have faced or could face in the future. She argued we are on the precipice of cataclysm if we do not relentlessly pursue these efforts of convergence to enhance biodefense. Infectious disease is an existential threat that we can address because the tools necessary for biodefense are not bespoke or esoteric. Effective current and future biodefense tools, she argued, must be broad spectrum, offer daily value, contain transferrable benefits and knowledge, and be embraced at a cultural level to be effective. In line with the previous CSR webinar on COVID-19, Dr. Sabeti called for a greater commitment to community engagement as a key effort to combat future biological threats.

            Dr. Akhila Kosaraju then emphasized the need to take novel technologies required for biodefense out of the lab and into the field. She also supported the need for greater convergence, stating such efforts must be intentional to be successful. Her company, Phare Bio, exemplifies such efforts, employing AI and deep learning to enable rapid antibiotic discovery to overcome rising drug resistances. This approach provides Phare Bio a strategy to overcome the drug development “valley of death” where most current pharmaceutical development fails and presents an opportunity for other organizations like it across biodefense.  Modern biodefense efforts must emphasize biotechnology, relying on computational biologists, bioengineers, and other technical experts to maximize advances in the field.  She also indicated a need for organizations like The Audacious Project, a backer of Phare Bio, to effectively unify disciplines to solve intractable problems like drug resistance. The Audacious Project is a “collaborative funding initiative catalyzing social impact on a grand scale” across a broad range of disciplines that seeks to de-risk and encourage innovation. Injection of philanthropic, grant, or even government funding sources to adequately de-risk the “valley of death” and other obstacles is essential to future preventative and treatment therapeutics. Additionally, biodefense must strive to recognize small players in the field that often offer bespoke technologies and solutions that can accelerate efforts beyond that of the usual bigger players, as demonstrated throughout the COVID-19 pandemic. Efforts like Operation Warp Speed serve as foundational examples to the benefits such efforts can provide to the future of biodefense.  

Event Summary: The American Pandemic Preparedness Plan: One Year of Progress & The Path Forward

By Geoffrey Mattoon, Biodefense MS Student

On Thursday, 8 September, the Council on Strategic Risks (CSR) hosted “The American Pandemic Preparedness Plan: One Year of Progress & The Path Forward” webinar, which included speakers Dr. Matthew Hepburn, White House Office of Science and Technology Policy (OSTP) Senior Advisor, and Dr. Carly S. Cox, CSR Fellow for Ending Bioweapons, and was moderated by journalist Janet Wu of Bloomberg. Dr. Hepburn and Dr. Cox discussed the recently released “First Annual Report on Progress Towards Implementation of the American Pandemic Preparedness Plan,” which they both played a central role in developing, and considered the current state and future goals of pandemic preparedness in the U.S. The lack of COVID-19 in the title of the event and report is intentional and the overarching message of both; do not fail to see the forest for the trees. A more apt statement in this instance may be “do not fail to see the future threats of pandemics and biological attacks for COVID-19 alone.”

This message was emphasized throughout the event, refocusing attention from COVID-19 to all pandemic response, and mirroring the call for greater broad-spectrum protection in biodefense as made by Dr. Gregory Koblentz in his book Living Weapons. Such efforts, according to Dr. Koblentz, transcend the historical “one bug, one drug” paradigm and provide a biodefense countermeasure strategy for both biological weapons and natural diseases. Broad-spectrum efforts such as these have already demonstrated their value in the response to other threats, including the adaption of existing mRNA vaccines for COVID-19 or the JYNNEOS smallpox vaccine for the ongoing monkeypox outbreak, and could prove critical in the event of any future disease outbreak or biological attack.

Dr. Hepburn opened the event with a call to action, stating all the progress we have made is good, but we still have much more work to do. He pointed to the first section of the Annual Report as a reminder of all the government has accomplished in pandemic preparedness. When asked by Ms.Wu if he believed we had learned enough from COVID-19 to prevent the next outbreak from reaching the same level, Dr. Hepburn emphatically replied “Yes.” He cautioned that the hard part is learning the right lessons and making the changes necessary to prepare. Dr. Cox stated she hoped he was right, but we also thought we were prepared for COVID-19.

Speaking on the importance of a diversified public health workforce, Dr. Hepburn highlighted the need for technologically savvy professionals. He asserted future public health workers must be trained in data analysis, program management, and human empathy to be successful. Dr. Cox then stressed the benefit of fellowship opportunities to provide professionals in the field a broader perspective to address biological threats that enhance disease outbreak prevention.

A diverse workforce is not the only ingredient needed for preparedness success. Dr. Hepburn and Dr. Cox also discussed the essential nature of interagency and private sector cooperation to overcome COVID-19 and future pandemics. This message aligns with both the 2018 National Biodefense Strategy Goal 1 and the 2021 Biodefense Vision Memo that call for greater coordination and unity of effort across all biodefense organizations in response to natural and man-made pathogens. This message is also supported by the broad range of organizations and their accomplishments throughout COVID-19 response outlined in the first section of the Annual Report. Such unity and diversity of effort is critical to maximize biodefense; including biosurveillance efforts like that of the Center for Forecasting and Outbreak Analytics, biodetection efforts from agencies like NIH RADx, and preparedness guidance from agencies like ASPR. Such multifaceted preparedness and response are essential to provide broad-spectrum protections against future threats.

A specific topic of discussion during the event was efforts in rapid production of medical countermeasures (MCM). Operation Warp Speed demonstrated we now possess the capability to produce effective vaccines within a year, enabling us to respond rapidly to emerging threats. Dr. Shulkin provides a concise summary of the essential lessons learned by Operation Warp Speed that should be applied to future vaccine development in his commentary, “What Health Care Can Learn from Operation Warp Speed.” The speakers emphasized that such efforts must become routine and require global cooperation to be effective in facing current pathogens like malaria as well as future threats. The development of vaccines is a balancing act of cost and innovation which may require government agencies to de-risk programs to incentivize innovation when the cost prohibits private sector interest. They also discussed the importance of novel vaccines that offer shelf-stable solutions as well as varied delivery methods (microneedle, oral, skin patches) to enhance distribution capabilities and capacity. Such technologies would directly benefit defensive efforts nationally and may even enhance defensive deterrence of biological weapons based on a more robust strategic stockpile.

            When asked what efforts give the panelists the greatest hope for the future, they highlighted the need to engage at the local health system and community level. Such efforts enable the establishment of trusted networks that can effectively disseminate critical health information and work to deter misinformation and disinformation. This mobilizes the population in response to threats and provides an added means of innovation that can guide future MCM and biodefense efforts. It is also critical that trust is built in advance within communities, it is not a resource you can “surge” at the time of need and COVID-19 has demonstrated the effects mistrust can have on response. Vaccine hesitancy and anti-vaccine sentiments proved to be a serious obstacle in COVID-19 response and must be addressed in a vaccine-agnostic manner to enhance current and future disease prevention and eradication.

The key messages throughout this event were consistent with those throughout the biodefense community. Interagency and international unity of effort, MCM innovation, and community involvement efforts in pandemic preparedness will enhance national biodefense. The COVID-19 pandemic is a world-changing event that may be key to reinvigorate pandemic preparedness and response efforts and, as a result, biodefense as well. As the speakers emphasized, what is critical is that the entire community applies these lessons to the whole of pandemic preparedness and response, not just COVID-19 specifically, to truly benefit from lessons learned. We cannot fail to see the forest for the trees.