Pandora Report: 6.18.2021

Michelle Grundahl, a Biodefense MS student, shares her take on the recent meeting of the National Biodefense Science Board. A new report highlights the compound security threats caused by the “convergence of climate change with other global risks,” such as the COVID-19 pandemic. The Pandora Report is taking a short break, but we will be back soon with news and analysis for all things biodefense!

Biodefense Board Discusses Future of US Pandemic Preparedness

On May 26, 2021, the National Biodefense Science Board (NBSB) held a (virtual) public meeting that discussed actions that the United States needs to take to be better prepared for the challenges posed by public health emergencies such as pandemics, “Disease X,” and other biological threats. NBSB is the federal committee that advises the office of the Assistant Secretary for Preparedness and Response (ASPR) in the US Department of Health and Human Services (HHS). During the meeting, the NBSB presented their recommendations to ASPR from its new report on ‘filling critical gaps’ in health emergency preparedness, response, and recovery. In addition, NBSB was briefed on the CDC’s new initiative to improve its data collection and analytical capabilities to improve information sharing and situational awareness during a public health emergency. Michelle Grundahl, a student in the Biodefense MS Program, shares her insights on the event. Read Grundahl’s article here.

Emergency Use Authorization (EUA) and the Future of the Korea Bioscience Industry

HyunJung Kim, PhD candidate in the Biodefense Program, published an article – Emergency Use Authorization (EUA) and the Future of the Korea Bioscience Industry (written in Korean) – in Monthly Chosun magazine. After the presidential summit between the United States and South Korea last month, Samsung Biologics, based in Seoul, and Moderna, based in Massachusetts, concluded an agreement for Samsung Biologics to produce Moderna’s COVID-19 vaccine in Korea. While Korea has developed the second biggest biologics production capacity in the world, next to the United States, Korea lags in the development of new vaccines and therapeutics. Kim reviews the expansion of Korea’s Emergency Use Authorization (EUA) policy from in-vitro diagnostic kits to medical countermeasures. He points out that the new EUA policy contains provisions that hamper the development of Korea’s biopharma industry by encouraging the Korean government to import medicine from abroad instead of investing in innovation at home by small and medium-sized biotech companies. Read Kim’s article here.

Reading the Nuclear Tea Leaves: Policy and Posture in the Biden Administration

Joseph Rodgers, a Biodefense PhD student, and Rebecca Hersman, Director of the Project on Nuclear Issues (PONI) at CSIS, released a report regarding nuclear policy in the Biden administration. The nuclear policy community is once again in the grips of pervasive anxiety that US nuclear policy -encompassing force modernization decisions, declaratory policy, and perceptions of adversary nuclear threat and risk – is either about to dramatically change or fail to change as dramatically as it should. In a polarized community characterized by mistrust and a highly politicized discourse, it is not surprising that the public conversation is filled with competing perspectives that seek to ensure that their voices are heard before the policies are set. As such, the current discourse appears particularly noisy. The greatest controversy centers on the modernization of the nuclear force, in particular the future of the Intercontinental Ballistic Missile (ICBM) force and commitment to the full triad of nuclear delivery systems, the role and primacy of nuclear weapons in our overall deterrence declaratory policy, the relative threat posed by Russia and China as drivers of US nuclear policy, and the relevance and utility of arms control in managing and reducing these threats. Read the report here.

Iraq National Pathogens List

Iraq has published a new national pathogens list that will guide the country’s approach to biorisk management. The list of human, plant, animal and zoonotic pathogens was produced by the interagency National Biorisk Management Committee. The national pathogen list will become part of Iraq’s system for regulating the import, export, and transfer of dual-use materials. In addition, the list will be used to determine appropriate biosafety and biosecurity measures that laboratories will need to implement. The Iraq National Monitoring Authority played a key role in the development of the list. Mahdi Al Jewari, senior chief biologist at INMA, was a visiting fellow with the Biodefense Graduate Program at George Mason University in 2015. He and Biodefense program director Dr. Gregory Koblentz described Iraq’s effort to develop a comprehensive national biorisk management system in a 2016 article.

The World Climate and Security Report 2021

The Expert Group of the International Military Council on Climate and Security (IMCCS) released its second annual World Climate and Security Report, which highlights the compound security threats caused by the “convergence of climate change with other global risks,” such as the COVID-19 pandemic. The report shows that the growing pace and intensity of climate hazards will stress military and security services as they are deployed to climate-driven crises, while also handling direct climate threats to their own infrastructure and readiness. The authors urge security institutions around the globe to act as “leading voices urging significantly reduced greenhouse gas emissions, given recent warnings about the catastrophic security implications of climate change under plausible climate scenarios.” Key risks outlined in the report include overstretched militaries, escalating climate security risks across all regions, and insufficient climate security adaptation and resilience solutions. Key opportunities outlined in the report include embracing predictive modeling and climate risk assessment methodologies as well as updating and developing international laws and mechanisms to include environmental and climate security impacts. Read the report and summary here.

The Ruthless Hackers Behind Ransomware Attacks on US Hospitals: ‘They Do Not Care’

A string of ransomware attacks on hospitals has been carried out in recent months. These attacks have forced some medical facilities to suspend surgeries and delay medical care. They are also costing hospitals millions of dollars. The Wall Street Journal tracked the major attacks conducted by a specific group, a gang of Eastern European cybercriminals known as the “Business Club” previously and Ryuk more recently, that has ties to Russian government security services. It is the “most prolific ransomware gang in the world,” responsible for one-third of the 203 million attacks in the US in 2020. It is estimated that the group accrued at least $100 million in paid ransoms last year. Bill Siegel, CEO of the ransomware recovery firm Coveware, plainly stated: “They do not care. Patient care, people dying, whatever. It doesn’t matter.” The assaults launched specifically at hospitals during the pandemic exposed concerning gaps in cybersecurity for the nation’s health systems. In this day in age, hospitals are highly dependent on computers, especially given the push to digitize patient records.

Carbis Bay G7 Summit Communique

The leaders of the G7 – Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States – met in Cornwall on 11-31 June with the primary aims of beating the pandemic and building back better. The group released a communique outlining its agenda for global action. First, they will work to end the pandemic and prepare for the future by driving an intensified international effort, starting immediately, to vaccinate the world by getting as many safe vaccines to as many people as possible as fast as possible. Additionally, they will work to reinvigorate our economies by advancing recovery plans that build on the $12 trillion of support put in place during the pandemic. Efforts will be made to secure future prosperity by championing freer, fairer trade within a reformed trading system, a more resilient global economy, and a fairer global tax system that reverses the race to the bottom. Further, the group seeks to protect the planet by supporting a green revolution that creates jobs, cuts emissions, and seeks to limit the rise in global temperatures to 1.5 degrees. Finally, the members aim to strengthen partnerships with others around the world and embrace its values as an enduring foundation for success in an ever-changing world. Read the full announcement here.

Exploring Science and Technology Review Mechanisms under the Biological Weapons Convention

The United Nations Institute for Disarmament Research (UNIDIR) published a study that “seeks to inform discussions on establishing a dedicated and systematic S&T review process under the BWC through an examination of existing S&T review-type mechanisms employed in different regimes beyond the BWC, a survey of States Parties views on a possible review mechanism and a study of past and present discourse on this issue in the Biological Weapons Convention (BWC).” Study methods included assessing review-type mechanisms employed in regimes beyond the BWC; semi-structured interviews with experts; review of past BWC proposals; and a survey of the views of BWC States Parties. Though not all States Parties support the idea of a BWC science and technology review mechanism, and even those who desire such a mechanism differ in the details, two types of potential models became evident. The first is a limited-participation model that would loosely resemble mechanisms used in organizations such as the OPCW, and would draw from a group of 20–30 qualified geographically-representative technical experts nominated by States Parties. The second is an open-ended model that would allow any interested State Party to send (and fund) a maximum of one or two expert participants in the review process. Read the study here.

Event – Pandemics and Global Health Security Workshop

COVID-19 has exposed just how unprepared governments, corporations, and societies are for a global pandemic. While the SARS-CoV-2 virus is only the most recent threat to global health security, it will certainly not be the last. Threats to global health security continue to evolve due to the emergence of new infectious diseases, globalization, advances in science and technology, and the changing nature of conflict. Pandemics and Global Health Security is a three-day virtual, non-credit workshop designed to introduce participants to the challenges facing the world at the intersection of pandemic preparedness and response, public health, national security, and the life sciences. Over the course of three days, participants will discuss how the biology and epidemiology of SARS-CoV-2 contributed to the emergence of that virus as a global pandemic, lessons learned from Operation Warp Speed about the development of medical countermeasures, obstacles to hospital biopreparedness, challenges to science communication during a pandemic, the bioethics of resource allocation during a public health emergency, the future of global health security, and the role of science and technology in preventing and responding to pandemics. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved in research and policy-making on public health, biodefense, and security issues. Live, interactive sessions will include Dr. Rick Bright, The Rockefeller Foundation; Dr. Nicholas G. Evans, University of Massachusetts-Lowell; Dr. Andrew Kilianski, Department of Defense; Dr. Gregory D. Koblentz, George Mason University; Dr. Jennifer Nuzzo, Johns Hopkins Center for Health Security; Dr. Saskia Popescu, George Mason University; Dr. Angela L. Rasmussen, Vaccine and Infectious Disease Organization-International Vaccine Centre; and Jessica Malaty Rivera, COVID Tracking Project. The workshop is organized by the Biodefense Graduate Program at the Schar School of Policy and Government at George Mason University and will be held virtually on July 19-21, 2021. Each day will run from 9am to 12:30pm ET. The course fee is $500. Register here.

Let Scientific Evidence Determine Origin of SARS-CoV-2, Urge Presidents of the National Academies

A statement from the Presidents of the National Academies of Science, Engineering, and Medicine (NASEM) strongly encourages the use of scientific evidence in the investigation of the origin of SARS-CoV-2. Marcia McNutt, President of the National Academy of Sciences; John L. Anderson, President of the National Academy of Engineering; and Victor J. Dzau, President of the National Academy of Medicine write:

“The origin of SARS-CoV-2, the virus that causes COVID-19, and the circumstances of the first cases of human infection, remain unknown.  Science is our best tool to ascertain, or to understand to the extent possible, the origins of SARS-CoV-2 and COVID-19, which could help prevent future pandemics.  However, misinformation, unsubstantiated claims, and personal attacks on scientists surrounding the different theories of how the virus emerged are unacceptable, and are sowing public confusion and risk undermining the public’s trust in science and scientists, including those still leading efforts to bring the pandemic under control. 

We urge that investigations into the origins of SARS-CoV-2 and COVID-19 be guided by scientific principles, including reliance on verifiable data, reproducibility, objectivity, transparency, peer review, international collaboration, minimizing conflicts of interest, findings based on evidence, and clarity regarding uncertainties.  In the case of SARS-CoV-2, there are multiple scenarios that could, in principle, explain its origin with varying degrees of plausibility based on our current understanding.  These scenarios range from natural zoonotic spillover (when a virus spreads from non-human animals to humans) to those that are associated with laboratory work. Scientists need to be able to evaluate all of these scenarios, and all viable hypotheses, with credible data.  Data accessibility, transparency, and full cooperation from China, of course, will be essential for a proper and thorough investigation. 

Although much still needs to be done to stop the pandemic, particularly in developing nations, science has made remarkable headway, especially through the rapid development of effective vaccines. The same scientific robustness, rigor, and cooperation should be applied to examining important questions about how the pandemic began.”

We May Never Know Where the Virus Came From. But Evidence Still Suggests Nature.

Dr. Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan, and Dr. Stephen Goldstein, a virologist at the University of Utah, emphasize that we may never uncover the origin of the novel coronavirus that has wreaked havoc on the world. At present, however, the evidence still suggests that SARS-CoV-2 is the product of nature. For instance, the genome sequence of the virus was analyzed by a group of prominent evolutionary virologists who assessed that it was “overwhelmingly unlikely” that there was laboratory manipulation. The worry that the virus could have come from a high-containment laboratory, specifically the Wuhan Institute of Virology (WIV), has surged in recent weeks. The two scientists assert that the work of laboratories and institutions like WIV are critical to preparing for and responding to pandemics. Additionally, they “agree that researchers should continue to study whether the virus could have emerged from a lab, but this cannot come at the expense of the search for animal hosts that could have transmitted SARS-CoV-2 to humans.” Rasmussen is among the distinguished faculty for the upcoming Pandemics and Global Health Security Workshop hosted by the Biodefense Graduate Program.

It’s Time to Talk About Lab Safety

Dr. Filippa Lentzos, a senior lecturer in science and international security at King’s College London, and Dr. Gregory Koblentz, Director of Biodefense Graduate Program, launched GlobalBioLabs.org, an interactive web-based map of global Biosafety Level 4 facilities and biorisk management policies. Lentzos shared that the aim of the project is to “increase public knowledge about Biosafety Level 4 labs, and importantly, to strengthen national and international virus management policies.” In their research, the two scholars found that there is “significant room for improvement in the policies in place to ensure that these labs were operated safely, securely and responsibly.” Regardless of the origin of SARS-CoV-2, the risk of laboratory accidents and incidents rises as the number of laboratories in the world expands. The new map includes 59 laboratories, the majority of which are in Europe with a total of 25 labs. Only 17 of the 23 countries that house BSL-4 laboratories have national biosafety associations or are members of international partnerships. About 60% of BSL4 labs are government-run public-health institutions, leaving 20% run by universities and 20% by biodefence agencies. Only three of the 23 countries with BSL4 labs – Australia, Canada and the US – have national policies for the oversight of dual-use research. The primary concern is that an accident could trigger the next pandemic. At a national level, Koblentz and Lentzos recommend that “countries with BSL-4 labs should have whole-of-government systems that can conduct multidisciplinary risk assessments of proposed research for safety, security and dual-use activities, such as certain gain-of-function research, that have significant potential to be repurposed to cause harm.” At the international level, they recommend that “structures be put in place to systematically oversee maximum containment facilities.”

SARS-CoV-2 Variants of Interest and Concern Naming Scheme Conducive for Global Discourse

The Virus Evolution Working Group of the World Health Organization convened a group to determine a naming system that will “enable clear communication about SARS-CoV-2 variants of interest and concern.” SARS-CoV-2 is the causative agent of coronavirus disease 2019 (COVID-19), and, as with all viruses, it continuously adapts to changing environments via random genome mutations. There have been several mutations of SARS-CoV-2 since its emergence, and the naming of them has been based on three nomenclature systems, each of which has its own scientific method to classify and name lineages. This means that one variant could have multiple names. To simplify communication and information sharing, a new system was developed for the naming of Variants of Concern and Interest. The new labels use the Greek alphabet. The tables below show the new labels of Variants of Interest and Variants of Concern, respectively.

The US Has Hit 600,000 COVID Deaths, More Than Any Other Country

It has been 15 months since the first confirmed death due to SARS-CoV-2 was reported in the US, and the novel virus has now taken the lives of 600,000 people across the nation. The vaccines have slowed the trend from thousands to hundreds of deaths per day. At present, there are about 375 deaths per day on average, a major decline since January with an average of 3,000 per day. Many Americans are vaccinated or in the process of becoming so, helping to further overcome COVID-19; however, an alarming number of people are reluctant to get vaccinated.

Biodefense Board Discusses Future of US Pandemic Preparedness

By Michelle Grundahl, Biodefense MS Student

On May 26, 2021, the National Biodefense Science Board (NBSB) held a (virtual) public meeting that discussed actions that the United States needs to take to be better prepared for the challenges posed by public health emergencies such as pandemics, “Disease X,” and other biological threats. NBSB is the federal committee that advises the office of the Assistant Secretary for Preparedness and Response (ASPR) in the U.S. Department of Health and Human Services (HHS). During the meeting, the NBSB presented their recommendations to ASPR from its new report on ‘filling critical gaps’ in health emergency preparedness, response, and recovery. In addition, NBSB was briefed on the CDC’s new initiative to improve its data collection and analytical capabilities to improve information sharing and situational awareness during a public health emergency.

The NBSB’s All-Hazards Science Response Working Group draft report, Filling Critical Gaps: Comprehensive Recommendations for Public Health Preparedness, Response, and Recovery from the National Biodefense Science Board, is the result of a September 2020 request from ASPR to NBSB to review the 2007 Homeland Security Presidential Directive 21 (HSPD-21). HSPD-21 is the national strategy for ‘Public Health and Medical Preparedness’ that was formulated during the George W. Bush Administration as part of its strategy to protect the health of Americans during disasters. ASPR asked NBSB to answer three questions:

1) What, if any, of the 2007 focus areas (biosurveillance, countermeasures stockpiling and distribution, mass casualty care, or community resilience) should remain as highest priorities for capacity development by HHS? 

2) How might those focus areas be modified, updated, or expanded to promote additional advances in public health and medical preparedness in the United States? 

3) What should be new HHS focus areas for public health and medical preparedness, if any?

The key finding of the NBSB report is that the United States should always be prepared to “implement an immediate, effective, and coordinated public health response that is guided by scientific knowledge and protected from undue political influence…insulated from political considerations, with the ability to independently develop, directly distribute, and frequently update public health messages with scientific principles in mind, guided by analysis of available data, with inputs from the nation’s leading experts.” To achieve that objective, NBSB made five recommendations to enhance the country’s disaster preparedness and response based on strengthening One Health biosurveillance and situation awareness, enhancement of medical countermeasures, reinforcing health workforce readiness, increasing health facility resilience, and improving communication with the public during health crisis.

The NBSB’s first recommendation is to use a One Health threat assessment for biosurveillance and situational awareness. One Health is holistic approach that considers the systems involved in achieving optimal health outcomes for humans, animals, plants and their shared environment. NBSB recommended that federal departments, public and private research institutions, and private sector organizations should engage in One Health collaborations to protect against emerging human and animal disease risks. A One Health approach would continuously assess emerging human and animal disease risks by using research and predictive data capabilities (based on artificial intelligence) to assess patterns of animal, agricultural, and human health. Proactively discovering biothreats, including zoonotic or arthropod-borne disease, would create improved situational awareness about high consequence risks.  

The board specifically suggests the enhancement of medical countermeasures (MCM), manufacturing, and supply chain. The report provides detailed examples of this approach, and advises that the production of vaccines, drugs, personal protective equipment, and diagnostics should all be “on-shored” inside the United States for quick production and scale-up. For example, active pharmaceutical ingredients, as well as finished products, can be made in the United States instead of imported from foreign suppliers. In addition, assessment of emergency medical countermeasures and diagnostic tools, as well as readiness for manufacturing them, should be an ongoing process. Also, mechanisms for infectious disease, vector-borne and zoonotic disease research and related drug development require investment in computer modeling, in-vitro models, and better animal models. To support these goals, NBSB recommend that incentives should be provided to support private sector innovation. The board also suggests improving the transparency of the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) to increase information sharing among relevant Federal agencies and private sector partners.  The PHEMCE – led by ASPR – consists of coordinated federal preparedness activities and medical countermeasures for natural, accidental, and intentional threats. Federal interoperable capabilities should be ready to be deployed systematically to proactively manage zoonotic and infectious diseases, climate change, supply chain shortages, workforce shortages, and additional threats to health security.

The health workforce is another focus area for achieving readiness and resilience during a public health crisis. The nation’s workforce needs more infectious disease specialists who are the first responders during an outbreak or a pandemic. The NBSB suggested that the training curriculum for health professionals should include disaster preparedness, emergency response, epidemic control, and training to use personal protective equipment. Likewise, first responders and incident commanders would benefit from additional emergency response education related to health threats and disasters. A critical point identified by NBSB is the need to review  Emergency Support Function (ESF)-8 of the National Response Framework which coordinates of public health and medical services in response to a natural disaster, terrorist attack, or other incidents of national significance. Another astute point is the consideration of the need for childcare, eldercare, and pet care to be available for health workers and first responders during disasters.

NBSB also identified health facility readiness and resilience (and the general soundness of healthcare systems) as having room for improvement as well. Some examples of improvements that are desperately needed are stronger health facility cybersecurity, better hospital collaborations for resource sharing (including staff), and planning for weather disasters overlapping with simultaneous health threats. As a lesson learned from COVID-19, telehealth and health license portability should continue post-pandemic. During COVID-19, health appointments could be held remotely online, and health professionals could work outside of their licensed jurisdictions. Since electronic health records are available over the internet, health professionals could see patients from anywhere.  

The NBSB also recommended improving public communication by developing and disseminating “timely, accurate, consistent, and trusted advisories, public health messages, and clinical guidelines” during a health crisis. Clear, consistent scientific messages should not be influenced by political concerns. Their communication recommendation noted that there should be an alignment of information using social media and local organizations. The goal is to provide accurate information to everyone; no one in society should be left out of receiving crisis communications.

The recommendations contained in this report build on previous reports by NBSB on how to “accelerate research and develop goals to prevent infectious diseases disasters.” For example, the May 13, 2020 report, Medical Countermeasure Research and Development Goals to Prevent Infectious Disease Epidemics, recommended nine items for the early detection and identification of pathogens, including early activation of MCM, coordination mechanisms, rapid MCM development pathways, adequate infrastructure and emergency funding – and the management of public trust. Another May 2020 report, Integrating Clinical Disaster Response Training with Community and State-Based Emergency Planning, recommended continued collaborations between clinical practitioners and disaster management authorities. That previous report focused on medical recommendations for healthcare organizations, local health departments, incident commanders, and emergency medical services to improve their capacity for disaster response, recovery, and mitigation.

The NBSB also heard from Dr. Daniel B. Jernigan, Deputy Director for Public Health Science and Surveillance, about the Centers for Disease Control and Prevention (CDC) Data Modernization Initiative. The CDC now has greater capacity to use electronic data and centralized laboratory reporting. They can receive and share massive data through the cloud. The CDC is still aiming for an even more modern, integrated, real-time public health surveillance data.  This initiative involves four core areas for strengthening core surveillance capabilities: 1) syndromic surveillance, 2) electronic case reporting (eCR), 3) electronic laboratory reporting, and 4) vital records. Syndromic surveillance can reveal local symptom trends by comparing hospital and health reports. Dr. Jernigan discussed real-time data surveillance during COVID-19, which used county-level monitoring of COVID-like Illness (CLI). Anomaly detections and syndromic surveillance programs, such as BioSense, are cloud-based.  Electronic case reporting is the real-time automated information exchange of electronic health records between public health agencies. Reporting laboratory results electronically reduces the turn-around time of waiting for results, allowing for faster intervention. Electronic lab reporting existed before COVID-19, but it was not automated or truly robust. Also, having up-to-date information on vital records, such as death certificates, is important for public health decision-making.

The goal of the CDC’s data modernization plan is to collect accurate data, including from non-traditional sources that can forecast health threats, that can be shared easily with partners. Under this model, data would flow through the same data hubs, where a single data upload would inform various partners in a hub and spoke model. Faster access to larger data sets will allow for interoperability and dashboards that inform forecasting and decision-making. Combined data-set platforms can be used to create pandemic dashboards. Timely, high-quality data sharing is now scalable and the process can be used during future outbreaks to reduce the burden of manual reporting. Data standards for electronic data exchange and electronic data linkage, using databases such as the National Notifiable Diseases Surveillance System (NNDSS), will bolster the mapping of notifiable diseases.

Together, the draft report by the NBSB’s All-Hazards Science Response Working Group and the CDC’s data modernization plan can help strengthen public health emergency preparedness and response in the United States so that we can prevent pandemics – and be ready for unknown threats.  

Pandora Report: 6.11.2021

June is National Pet Preparedness Month! The FDA approved a new drug for the treatment of smallpox. The SARS-CoV-2 virus is here to stay.

Pet Preparedness Month

June is National Pet Preparedness Month! Pet parents should include animals in emergency plans: have an evacuation plan, microchip your pet, and develop a buddy system. You can also build a kit for your pet with food, water, medicine, a first aid kit, grooming items, and a photo of you with your pet. As the summer heat sets in, remember to keep your pet hydrated and do not leave them in a hot car. Also, mind hot pavement for their paws!

A new article in Disaster Medicine and Public Health Preparedness explores the evidence regarding the use of trained dogs to detect COVID-19 infections. Detection dogs are a promising non-invasive, efficient, and cost-effective screening method for SARS-CoV-2 infection. Read the article here.

Science & Tech Spotlight: Digital Vaccine Credentials

Digital vaccine credentials can confirm that a person has been vaccinated or tested negative for COVID-19. They can be a tool to reduce the disease’s spread, and allow travel and other activities to resume safely. Users of such credentials can provide their COVID-19 information on a mobile device through a secure, digital code for fast and contactless scanning. Airports and other venues could process larger numbers of people more quickly with these credentials than with paper vaccine cards. However, challenges that may limit the use of these credentials include concerns about the security and privacy of users’ health data. Read the full report from the US Government Accountability Office (GAO) here.  

HHS Launches First Venture Capital Partnership to Develop Transformative Technologies to Combat Future Pandemics, Other Health Emergencies

Through the BARDA Ventures program, the Biomedical Advanced Research and Development Authority (BARDA – part of the HHS Office of the Assistant Secretary for Preparedness and Response – is launching a partnership with the nonprofit organization Global Health Investment Corporation (GHIC) to accelerate development and commercialization of technologies and medical products needed to respond to or prevent public health emergencies, such as pandemics, and other health security threats. Through this partnership, BARDA intends to provide GHIC with a minimum of $50 million over five years with potential for up to $500 million over 10 years. GHIC will launch a global health security fund with matching capital from other investors. This partnership will allow direct linkage with the investment community and establish sustained and long-term efforts to identify, nurture, and commercialize technologies that aid the US in responding effectively to future health security threats.

FDA Approves Drug to Treat Smallpox

The Food and Drug Administration (FDA) approved Tembexa (brincidofovir) to treat smallpox. Though smallpox was eradicated in 1980, there are worries that it could be deployed as a bioweapon. The disease spreads via direct contact among humans and symptoms arise 10-14 days after infection. Symptoms include fever, exhaustion, headache, backache, and the telltale rash consisting of small, pink bumps progressed to pus-filled sores before it crusts over and scars. As an eradicated disease, the efficacy of Tembexa was evaluated in animals infected with viruses that are closely related to the variola virus, and was determined by measuring animals’ survival at the end of the studies. Efficacy and safety were adequate for FDA approval. The most common side effects are diarrhea, nausea, vomiting, and abdominal pain.

Gene Drives Are What’s Next

The next meeting of the Novel and Exceptional Technology and Research Advisory Committee (NExTRAC), a federal advisory committee that provides recommendations to the NIH Director and a public forum for the discussion of the scientific, safety, and ethical issues associated with emerging biotechnologies, will be held on 25 June 2021. The meeting will discuss a Draft Report of the Gene Drives in Biomedical Research Working Group, which was prepared in response to the charge given by the NIH Director at the December 2019 NExTRAC meeting to “consider whether existing biosafety guidance is adequate for contained laboratory research utilizing gene drive technology” and “outline conditions (if any) under which NIH could consider supporting field release of gene drive modified organisms.”

Review of Recounting the Anthrax Attacks

Dr. R. Scott Decker is a retired supervisory special agent for the Federal Bureau of Investigation (FBI) and he published the book, Recounting the Anthrax Attacks: Terror, the Amerithrax Task Force, and the Evolution of Forensics in the FBI. Al Mauroni, director of the US Air Force Center for Strategic Deterrence Studies, wrote a review of the book, dubbing it “a valuable book for understanding how the FBI developed its case for the Amerithrax investigation, not just for the legal community that engages in bioterrorism cases, but for the defense community that engages in the policy aspects of this issue.” The FBI eventually attributed the anthrax attacks to Bruce Ivins, a research scientist working at the Army’s Fort Detrick laboratories. Read the review here.

The Forever Virus: A Strategy for the Long Fight Against COVID-19

The SARS-CoV-2 virus is here to stay. The novel coronavirus cannot be eradicated, because it infects over a dozen different species. Due to vaccine supply shortages and vaccine hesitancy, global herd immunity is “unreachable.” Even if every human on the planet could be vaccinated today, the virus would persist in various animal species. That said, vaccination must remain a primary goal in order to contain the disease. Though many hoped that the virus would be the cause of a short-term crisis, it is proving to be a chronic crisis against a very resilient pathogen. This is, in part, a result of many nations failing to heed the early warning signs and take the threat seriously, allowing grave damage to occur. “As a wealthy, powerful, and scientifically advanced country, the United States is optimally positioned to help lead the long fight against COVID-19.” And, in order to do this, the US must repair its reputation as a global public health leader. Beyond US leadership and support, the entire global framework for pandemic response needs a reboot. A recent report recommends elevating pandemic preparedness and response to the highest levels of the United Nations via the creation of a “global health threats council.” This council would be led by heads of state, separate from the World Health Organization, and “charged with holding countries accountable for containing epidemics.”  

Dr. Rick Bright, Senior Vice President of Pandemic Prevention & Response at The Rockefeller Foundation, is among the contributors of this piece. Bright is also among the distinguished faculty for the upcoming Pandemics and Global Health Security Workshop hosted by the Biodefense Graduate Program.

The “Legal Epidemiology” of Pandemic Control

The centrality of law as a public health intervention has been undeniable during the COVID-19 pandemic. In just the first half of 2020, more than 1,000 laws and orders were issued by federal, state, and local authorities in the United States in an effort to reduce disease transmission. Legal interventions include stay-at-home orders, mask mandates, and travel restrictions, as well as more particular rules for business operations, alcohol sales, curfews, and health care. Given their heavy use, importance, and obvious socioeconomic side effects, and the social and behavioral complexities of their implementation, one might have expected the National Institutes of Health (NIH), other research funders, and the research community to jump to the work of determining the right mix, intensity, and enforcement approaches of legal restrictions to control transmission with the least and most equitably distributed harms. No organized research program emerged. Funding for scientific evaluation of legal effects and public health systems research was paltry, at a time when hundreds of thousands of lives, the socioemotional development of millions of children, and billions of dollars in economic activity directly depended on questions about control measures, enforcement methods, the organization of the health system, and the many ways in which law was immediately influencing vulnerability, resilience, and social behavior. It is past time for a broad recognition in our health system that law is a ubiquitous treatment, one to which hundreds of millions of people are routinely exposed. The imperative is to scale up the infrastructure for at least three kinds of research: study of the mechanisms, effects, side effects, and implementation of laws designed to influence health, such as COVID control measures; research on how the legal infrastructure of the US health system — the allocation of powers and duties, as well as limits on authority — influences the effectiveness of the system; and perhaps most important for addressing health equity, studies of how laws that may appear to have no health purposes — such as the tax code, minimum wage, and labor rules — shape the social determinants of health.

The COVID Lab-Leak Hypothesis: What Scientists Do and Don’t Know

Most scientists say SARS-CoV-2 probably has a natural origin, and was transmitted from an animal to humans. However, a lab leak has not been ruled out, and many are calling for a deeper investigation into the hypothesis that the virus emerged from the Wuhan Institute of Virology (WIV), located in the Chinese city where the first COVID-19 cases were reported. On 26 May, US President Joe Biden tasked the US Intelligence Community to join efforts to find SARS-CoV-2’s origins, whatever they might be, and report back in 90 days. Scientists don’t have enough evidence about the origins of SARS-CoV-2 to rule out the lab-leak hypothesis, or to prove the alternative — that the virus has a natural origin. Many infectious-disease researchers agree that the most probable scenario is that the virus evolved naturally and spread from a bat either directly to a person or through an intermediate animal. Most emerging infectious diseases begin with a spillover from nature, as was seen with HIV, influenza epidemics, Ebola outbreaks and the coronaviruses that caused the SARS epidemic beginning in 2002 and the Middle East respiratory syndrome (MERS) outbreak beginning in 2012. In theory, COVID-19 could have come from a lab in a few ways. Researchers might have collected SARS-CoV-2 from an animal and maintained it in their lab to study, or they might have created it by engineering coronavirus genomes. In these scenarios, a person in the lab might have then been accidentally or deliberately infected by the virus, and then spread it to others — sparking the pandemic. There is currently no clear evidence to back these scenarios, but they aren’t impossible. Read the breakdown of knowns and unknowns here.

Biden Would Slash Pentagon Money for Pandemic Prevention

President Biden proposed halving the Pentagon’s budget for the leading US government program for preventing, detecting, and responding to global disease outbreaks – the Biological Threat Reduction Program. The Biological Threat Reduction Program “finds and fights emerging global diseases that can threaten US troops and, ultimately, the world’s population.” This is a move that “even the White House’s staunchest allies on Capitol Hill oppose as the nation continues to grapple with the COVID-19 pandemic.” The proposed cut arose despite the assessment of US intelligence agencies and scientists that “pandemics will become increasingly common and as COVID-19 still rages in many countries and hangs on in America.” “The US military has been a leader in research and development of coronavirus vaccines and in disseminating them,” and the Pentagon plans to spend $500 million in FY22 on COVID-19 response and preparedness for future pandemics, despite the funding slash.  

COVID-19 Air Traffic Visualization

The RAND Corporation released a report, COVID-19 Air Traffic Visualization: COVID-19 Cases in China Were Likely 37 Times Higher Than Reported in January 2020, which presents strong evidence that China’s reported COVID-19 caseload was undercounted by a factor of nearly 40. In this report — one of several from a RAND Corporation team examining the role of commercial air travel in the coronavirus disease 2019 (COVID-19) pandemic — researchers use RAND’s COVID-19 Air Traffic Visualization (CAT-V) tool to estimate the likely number of infections in China in early 2020. The tool combines COVID-19 case data from Johns Hopkins University with detailed air travel data from the International Air Transport Association. From December 31, 2019, to January 22, 2020, China reported a daily average of 172 cases of COVID-19 among its residents. This number of confirmed cases was equivalent to just one per 8.2 million residents in the country per day. Using the detailed flight data over that same period of time, it was determined that the five countries most at risk of importing COVID-19 from China were, in descending order of risk, Japan, Thailand, South Korea, the United States, and Taiwan. But far fewer than 8.2 million passengers flew from China to the five countries over that 23-day period. Just more than 1 million passengers flew from China to Japan and Thailand each, while slightly more than 750,000 flew to South Korea, 500,000 flew to the United States, and fewer than 400,000 flew to Taiwan (as illustrated in the map below). Thus, all of these passengers from China totaled fewer than 3.7 million, for an expected COVID-19 exportation rate of less than one case to all five of these countries combined. However, COVID-19 cases were already being reported in all five countries during this time. This trend would be exceedingly unlikely given the low reported case count in China. Read the report here.

Why Contact Tracing Couldn’t Keep Up with The US COVID Outbreak

A survey from NPR and the Johns Hopkins Center for Health Security found that many state health departments are “winding down the contact tracing programs they scrambled to grow last year.” Even though coronavirus infections are tapering off in most parts of the country, public health experts recommend maintaining a smaller workforce able to stay on top of ongoing outbreaks. This is a significant change from last winter when the US suffered from a shortage of people to respond and deliver case investigation and contact tracing. Adriane Casalotti of the National Association of County and City Health Officials likened the scramble to find these workers as “trying to build the plane while flying it.” Beyond the lack of personnel, there was an absence of federal leadership and communication from authorities (namely, the Centers for Disease Control and Prevention as well as the White House). Additionally, there did not exist a uniform approach for contact tracing programs. Low responsiveness was another challenge. An analysis of 14 contact tracing programs from June to October 2020 published in JAMA Network Open found that “no contacts were reported for two-thirds of persons with laboratory confirmed COVID-19 because they were either not reached for an interview or were interviewed and named no contacts.” A recent poll by the Harvard TH Chan School of Public Health and the Robert Wood Johnson Foundation found that only 52% of Americans trust the CDC, while the numbers for state and local health departments were even lower. Distrust also inhibited the utility of digital tools for contact tracing. For instance, in Utah, an app called Healthy Together used GPS location for contact tracing, but much of the population was uninterested in using it and unwilling to download it.  

BSL-4 Laboratories

Recently, Dr. Filippa Lentzos of King’s College London & Dr. Greg Koblentz of George Mason University launched GlobalBioLabs.org, an interactive web-based map of global Biosafety Level-4 facilities and biorisk management policies. Lentzos shared that the aim of the project is to “increase public knowledge about Biosafety Level 4 labs, and importantly, to strengthen national and international virus management policies.” Regardless of the origin of SARS-CoV-2, the risk of laboratory accidents and incidents rises as the number of laboratories in the world expands. The new map includes 59 laboratories, the majority of which are in Europe. Only 17 of the 23 countries that house BSL-4 laboratories have national biosafety associations or are members of international partnerships. The primary concern is that an accident could trigger the next pandemic. Watch a recording of the webinar launching the site here.

Pandora Report: 6.4.2021

The Biden administration has released its fiscal year 2022 budget, which includes an increase of almost $1 billion for global health programs. Syrian President Bashar al-Assad remains in power. Register for the upcoming Pandemics and Global Health Security Workshop!

Biden’s FY22 Budget

The Biden administration released its fiscal year 2022 (FY22) budget, which includes an increase of almost $1 billion for global health programs. There is also a section of the budget that provides “discretionary funding for the Centers for Disease Control and Prevention (CDC) — the largest budget authority increase in nearly two decades — to restore capacity at the world’s pre-eminent public health agency.” In regard to the fight to end the COVID-19 pandemic, the budget provides $1 billion in foreign assistance to “establish Global Health Security Agenda capacity building programs in additional nations and increase investments in crosscutting research and viral discovery programs to detect and stamp out future infectious disease outbreaks.” In total, global health security funding is $905 million, a 376% above the FY21 enacted level. Funding for tuberculosis totals $319 million and funding for malaria totals $770 million, both matching the FY21 enacted levels. Funding for neglected tropical diseases totals $103 million, also matching the FY21 enacted level. KFF outlines a detailed comparison of funding for global health efforts between FY22 and FY21 here.

Ahead of the budget release, KFF analyzed the historical trends in US funding for global health, finding that funding through regular appropriations increased by almost $10 billion since FY 2001. Most of this increase is due to the establishment of President’s Emergency Plan For AIDS Relief (PEPFAR), the Global Fund, and the President’s Malaria Initiative. Over the last decade, the US has offered nearly $12 billion in emergency supplemental funding for infectious diseases, but  90% of that funding was provided in the last year in response to the COVID-19 pandemic.

‘A Perilous Point’: Global Agencies Call for $50 Billion Investment to Combat COVID-19

A statement from the World Health Organization (WHO), the World Bank, the World Trade Organization (WTO), and the International Monetary Fund (IMF) urges investment of up to $50 billion to “boost manufacturing capacity and supplies and ease trade rules to ensure equitable distribution of vaccines and other medical products.” Additional funding to COVAX, the global vaccine distribution initiative, “could be widened to 40% and, possibly 60% by the first half of 2022.” COVAX has administered nearly 2.4 billion doses across 92 low and middle-income countries. But, an additional $8.3 billion is needed as the current resources would only cover about 30% of their populations through early 2022. According to an IMF analysis, “added investment could generate an estimated $9 trillion in additional global output by 2025.”

It’s No Joke: Borat Turns to Johns Hopkins Scientist for Serious COVID Vaccine Talk

Dr. Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, shares her vaccine expertise for British comedian Sacha Baron Cohen’s latest moviefilm. One of the topics Nuzzo addressed was the conspiracy theory that the COVID-19 vaccines are being used as vehicles to insert microchips into people. She clarifies, “a microchip wouldn’t fit through the tiny needle used to inject COVID-19 vaccines.” Nuzzo is among the distinguished faculty for the upcoming Pandemics and Global Health Security Workshop hosted by the Biodefense Graduate Program.

Operation Warp Speed and Beyond Toolkit

The Operation Warp Speed and Beyond Toolkit has been developed for cleared and uncleared industry partners working on Operation Warp Speed (OWS). It provides OWS partners with the resources they need to better protect the important work they are doing. While some of these resources were developed with cleared contractors participating in the National Industrial Security Program (NISP) in mind, the guidance and information provided apply to any industry partner working on sensitive information that is sought after by an adversary, regardless of classification level or designation.

On September 10, 2020, Operation Warp Speed industry partners were invited to participate in a webinar that provided an overview of insider risk, cybersecurity, counterintelligence threats, and industrial security best practices. In case you were unable to attend the live webinar, you may view a recording of the webinar here.

WHA74: Strengthen Global Preparedness for Health Emergencies

The 74th World Health Assembly (WHA) concluded on 31 May, and it focused on ending the COVID-19 pandemic and how to prevent the next one. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), called for beginning negotiations this year on an international treaty to enhance pandemic preparedness. Though such a treaty was not adopted at this year’s WHA, member states agreed to create a working group that would look at the benefits of a treaty, a convention, or an international agreement. In late November, the ministers from the WHO’s 194 member states are set to convene and decide whether or not to start such negotiations. To the dismay of many, the WHA did not adequately consider a very current and critical topic: “a plan to vaccinate the world and end vaccine inequity.” No resolution or strategy was put forward to achieve global equitable vaccination. Thomas Schwartz, executive secretary of Medicus Mundi International, stated, “Unfortunately, the WHA is still not [a] place for member state[s] to be challenged, and the full transparency, with all sessions being live webcast, does not provide the setup for critical self-reflection.” On a better note, the WHA did pass two resolutions “advocating for government support for the Gender Equal Health and Care Workforce Initiative to address gender inequities in the health and care workforce.”

One for All: An Updated Action Plan for Global COVID-19 Vaccination

The Rockefeller Foundation released a new report, One for All: An Updated Action Plan for Global Covid-19 Vaccination, that calls on the “G7 and other donors to step up so that COVAX closes its US$9.3 billion funding gap by June 2nd, allowing it to unlock an additional 1.8 billion doses of vaccine, enabling 92 low- and middle-income countries to vaccinate half their adult population.” The lack of equitable vaccine distribution leaves much of the global population unvaccinated, posing a threat to ending the pandemic. Thus far, about half of North Americans and over one-quarter of Europeans have been vaccinated, but only about 14% of South Americans, 5% of Asians, and 1.2% of Africans. Further, 80% of vaccines have been administered in high- and upper-middle income countries, leaving low-income countries vulnerable and unprotected. The report provides a 5-point action plan to scale equitable vaccination around the world: (1) share more sooner; (2) make more quicker; (3) build in the global South; (4) support delivery systems; and (5) close the financing gap. Dr. Rick Bright, Senior Vice President of Pandemic Prevention & Response at The Rockefeller Foundation, is among the contributors of this report. Bright is also among the distinguished faculty for the upcoming Pandemics and Global Health Security Workshop hosted by the Biodefense Graduate Program. Read the report here.

Event – Pandemics and Global Health Security Workshop

COVID-19 has exposed just how unprepared governments, corporations, and societies are for a global pandemic. While the SARS-CoV-2 virus is only the most recent threat to global health security, it will certainly not be the last. Threats to global health security continue to evolve due to the emergence of new infectious diseases, globalization, advances in science and technology, and the changing nature of conflict. Pandemics and Global Health Security is a three-day virtual, non-credit workshop designed to introduce participants to the challenges facing the world at the intersection of pandemic preparedness and response, public health, national security, and the life sciences. Over the course of three days, participants will discuss how the biology and epidemiology of SARS-CoV-2 contributed to the emergence of that virus as a global pandemic, lessons learned from Operation Warp Speed about the development of medical countermeasures, obstacles to hospital biopreparedness, challenges to science communication during a pandemic, the bioethics of resource allocation during a public health emergency, the future of global health security, and the role of science and technology in preventing and responding to pandemics. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved in research and policy-making on public health, biodefense, and security issues. Live, interactive sessions will include Dr. Rick Bright, The Rockefeller Foundation; Dr. Nicholas G. Evans, University of Massachusetts-Lowell; Dr. Andrew Kilianski, Department of Defense; Dr. Gregory D. Koblentz, George Mason University; Dr. Jennifer Nuzzo, Johns Hopkins Center for Health Security; Dr. Saskia Popescu, George Mason University; Dr. Angela L. Rasmussen, Vaccine and Infectious Disease Organization-International Vaccine Centre; and Jessica Malaty Rivera, COVID Tracking Project. The workshop is organized by the Biodefense Graduate Program at the Schar School of Policy and Government at George Mason University and will be held virtually on July 19-21, 2021. Each day will run from 9am to 12:30pm ET. Prior to June 18, the course fee is $400. Starting June 18, the course fee is $500. Register here.

The Assad Regime Continues

On Wednesday, Syrian President Bashar al-Assad voted to extend his rule, “casting his ballot in an ex-rebel bastion where a suspected chemical weapons attack in 2018 prompted Western air strikes.” Syria has been in a decade-long conflict that has killed hundreds of thousands of people and forced half of the country’s population from their homes, all under Assad’s regime. The election was held despite a peace process led by the United Nations that called for voting under international supervision. Unfortunately, this week’s vote will allow Assad seven more years in power, extending his family’s rule to nearly 60 years.

Last month, the members of the Chemical Weapons Convention (CWC) voted to suspend Syria’s rights and privileges under the treaty. The CWC prohibits the use, production, and stockpiling of chemical weapons. The suspension is a “modest step” toward holding Syria accountable for its chemical weapons attacks and reinforcing the global prohibition against chemical weapons use. In 2013, Syrian forces deployed nerve gas on neighborhoods near Damascus, killing about 1,300 people. Unfortunately, the international responses to Syria’s atrocities have been lackluster. Despite the latest vote, the “Assad regime could continue to maintain, expand, and employ its illegal chemical weapons arsenal as a terror weapon against opposition forces and civilians.” A possible next step in the event that Syria does not comply with the CWC is to refer Syria to the UN Security Council (UNSC). Another option would be to “demand a challenge inspection in Syria pursuant to Article IX of the CWC to clarify outstanding inconsistencies with its stockpile declaration.”

WHO Gives Virus Variants New Names, Drawing from Greek Alphabet

The World Health Organization (WHO) has established a less technical method for naming the new variants of the novel coronavirus using the Greek alphabet. For example, B.1.1.7 is now Alpha. The tables below crafted by Bloomberg shows the new names for the variants of concern and the variants of interest.

Fall 2021 Courses in the Biodefense Graduate Program

If you are a Schar School student looking for another interesting class to take this fall, the Biodefense Graduate Program is offering two fascinating courses: Global Food Security (BIOD 726) with Philip Thomas and Building Health System Resilience (BIOD 610) with Dr. Saskia Popescu.

Global Food Security (BIOD 726) analyzes threats to food security globally including those related to climate change and environmental degradation; animal and plant diseases; access to clean water; agricultural terrorism; and antimicrobial resistance. It explores the national and global health, economic, social, and ethical impacts of these disruptive forces. The course also examines strategies for enhancing the security of the global food production and supply system.

Building Health System Resilience (BIOD 610) will provide students with a foundation in how healthcare systems prepare and respond to pandemics, disasters, and biological events. The ability of healthcare systems to respond to biological threats will have impacts at the community, national, and international levels. Health resilience in the United States is a particular challenge given multiple stakeholders, economic factors, and regulatory fragmentation. Students will review case studies, such as Ebola, Hurricane Katrina, 9/11, and COVID-19, to examine the unique challenges of building and sustaining the resilience of the American healthcare and its role in global health security.

Schar School Open House

You’re invited to attend a virtual open house to learn more about the Schar School of Policy and Government and our academic programs. The online session will provide an overview of our master’s degree programs and graduate certificate programs, student services, and admissions requirements. Attendees will be provided with an application fee waiver for the Fall 2021 graduate application. Biodefense applicants are eligible for funding from the Diane Davis Spencer Foundation Scholarship. The fall application deadline is July 15th. The Open House will be held virtually on 9 June at 6 PM EST. Register here.

BSL-4 Laboratories

Last week, Dr. Filippa Lentzos of King’s College London & Dr. Greg Koblentz of George Mason University launched GlobalBioLabs.org, an interactive web-based map of global Biosafety Level-4 facilities and biorisk management policies. Lentzos shared that the aim of the project is to “increase public knowledge about Biosafety Level 4 labs, and importantly, to strengthen national and international virus management policies.” Regardless of the origin of SARS-CoV-2, the risk of laboratory accidents rises as the number of laboratories in the world expands. The new map includes 59 laboratories, the majority of which are in Europe. Only 17 of the 23 countries that house BSL-4 laboratories have national biosafety associations or are members of international partnerships. The primary concern is that an accident could trigger the next pandemic.

Pandora Report: 5.28.2021

The 74th World Health Assembly is underway in Geneva; you can watch the webcast here! Listen here as Dr. Saskia Popescu, an assistant professor in the Biodefense Graduate Program as well as an alumna, will be interviewed on the With Good Reason podcast today, 28 May. The lab leak theory for the origin of COVID-19 is gaining traction.

Schar School Open House

You’re invited to attend a virtual open house to learn more about the Schar School of Policy and Government and our academic programs. The online session will provide an overview of our master’s degree programs and graduate certificate programs, student services, and admissions requirements. Attendees will be provided with an application fee waiver for the Fall 2021 graduate application. Biodefense applicants are eligible for funding from the Diane Davis Spencer Foundation Scholarship. The fall application deadline is July 15th. The Open House will be held virtually on 9 June at 6 PM EST. Register here.

74th World Health Assembly

The 74th World Health Assembly (WHA) is underway until 1 June, and it is taking place virtually. The WHA is the decision-making body of World Health Organization (WHO), and it is attended by delegations from all WHO Member States. The primary functions of the WHA are to determine the policies of the WHO, appoint the Director-General, supervise financial policies, and review and approve the proposed budget. The theme of this year’s meeting is, “Ending this pandemic, preventing the next: building together a healthier, safer and fairer world.” On Monday, United Nations Secretary-General Antonio Guterres called for the “application of wartime logic in the international battle against COVID-19.” Guterres explains the pandemic as being “at war with the virus.” WHO Director-General Tedros Adhanom Ghebreyesus lamented the “scandalous inequity” of vaccine distribution that is perpetuating the pandemic. Though COVID-19 is the main topic of this year, other issues include proposals for WHO reforms and the exclusion of Taiwan. Taiwan maintains hope that it will be granted a seat at the WHA meeting. The nation’s successful handling of COVID-19 for more than a year and a half has brought renewed attention to Taiwan’s absence from the WHA.”

MCMi Program Update on FDA

The Food and Drug Administration (FDA) plays a critical role in protecting the United States from chemical, biological, radiological, nuclear, and emerging infectious disease threats. The FDA ensures that medical countermeasures (MCMs)—including drugs, vaccines and diagnostic tests—to counter these threats are safe, effective, and secure. The FDA works closely with interagency partners through the US Department of Health and Human Services (HHS) Public Health Emergency Medical Countermeasures Enterprise (PHEMCE, or Enterprise) to build and sustain the MCM programs necessary to effectively respond to public health emergencies. The FDA also works closely with the US Department of Defense (DoD) to facilitate the development and availability of MCMs to support the unique needs of American military personnel. The Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA), requires the FDA to issue an annual report detailing its medical countermeasure activities. This report responds to that requirement for the latest fiscal year available. The FY 2020 report includes a snapshot of the Agency’s COVID-19 response efforts through September 30, 2020. Read the report here.

DHS Exploring New Methods to Replace BioWatch and Could Benefit from Additional Guidance

The Department of Homeland Security (DHS) is following the agency’s acquisition policy and guidance to acquire Biological Detection for the 21st Century (BD21). This system-of-systems concept—an assembly of technologies to gain higher functionality—is intended to combine various technologies, such as biological sensors, data analytics, anomaly detection tools, collectors, and field screening devices to enable timelier and more efficient detection of an aerosolized attack involving a biological agent than the current biodetection system. The BD21 program is early in the acquisition lifecycle and DHS has not yet selected the technologies to be used. Potential technologies are still being analyzed to demonstrate that certain components of the overall concept are feasible, such as an anomaly detection algorithm.

However, BD21 faces technical challenges due to inherent limitations in the technologies and uncertainties with combining technologies for use in biodetection. For example, biological aerosol sensors that monitor the air are to provide data on biological material in the environment, but common environmental material such as pollen, soil, and diesel exhaust can emit a signal in the same range as a biological threat agent, thereby increasing false alarm rates. Program officials report that the risk of false alarms produced by biological sensor technologies could be reduced by using an anomaly detection algorithm in addition to the sensor. However, it is too early to determine whether integration of an anomaly detection algorithm will successfully mitigate the false alarm rate. Specifically, because the algorithms have never been developed and used for the purpose of biodetection in an urban, civilian environment.

BD21 program is following the agency’s acquisition policy and guidance to mitigate technological risks in acquisition programs, and plans to conduct technology readiness assessments (TRA) along the way. In 2020, DHS issued a TRA guide, but it lacked detailed information about how the department will ensure objectivity and independence, among other important best practices GAO has identified. If DHS follows GAO’s best practices guide, decision makers and program managers will be in a better position to make informed decisions at key acquisition decision events. Read the report here.

The Eroding Norms Against Chemical Weapons Use Will Need More Than Another Syria Censure to Survive

Last month, the members of the Chemical Weapons Convention (CWC) voted to suspend Syria’s rights and privileges under the treaty. The CWC prohibits the use, production, and stockpiling of chemical weapons. The suspension is a “modest step” toward holding Syria accountable for its chemical weapons attacks and reinforcing the global norm of prohibition against chemical weapons use. In 2013, Syrian forces deployed nerve gas on neighborhoods near Damascus, killing about 1,300 people. Unfortunately, the international responses to Syria’s atrocities have been lackluster. Despite the latest vote, the “Assad regime could continue to maintain, expand, and employ its illegal chemical weapons arsenal as a terror weapon against opposition forces and civilians.” A possible next step in the event that Syria does not comply with the CWC is to refer Syria to the UN Security Council (UNSC). Another option would be to “demand a challenge inspection in Syria pursuant to Article IX of the CWC to clarify outstanding inconsistencies with its stockpile declaration.”

Will Biden Blink Over Navalny?

This week, Jen Psaki, the White House Press Secretary, announced that President Biden and Russian President Putin will meet in Geneva, Switzerland on 16 June. This highly anticipated meeting comes as relations between the US and Russia plummet to a historic low since the Cold War. The US is compelled to respond to the use of chemical weapons as a result of the first round of sanctions under the Chemical and Biological Weapons Control and Warfare Elimination Act. This first set of penalties was in response to the Novichok attack on Alexei Navalny, and included “personal sanctions on seven senior Russian officials believed to have been involved in the decision to poison and later imprison the opposition leader, who was arrested upon his return to Moscow in January, as well as penalties on several entities involved in Russia’s chemical weapons program.” Thus far, Russia has not made any effort to signal its intent to not use these weapons again, so a second round of sanctions is required by law. The administration hopes that the upcoming meeting will “restore predictability and stability to the US-Russia relationship.” The Biden administration must tread carefully, however, as severe sanctions before the summit could derail the interaction but overly mild sanctions could be perceived as “too soft.” Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, explains, “There’s a tension between wanting to punish Russia for its use of chemical weapons but, at the same time, allowing for the relationship to improve between the countries on strategic issues.”

Launch of GlobalBioLabs.org

GlobalBioLabs.org has officially launched! This is an interactive web-based map of global Biosafety Level-4 facilities and biorisk management policies. An accompanying policy brief, entitled Mapping Maximum Biological Containment Labs Globally, was also released. This brief is offered by Dr. Filippa Lentzos of King’s College London & Dr. Greg Koblentz of George Mason University. The map is available here and the report is available here.

COVID-19 Lab Leak Theory

On Wednesday, President Biden implored the US intelligence community to “redouble their efforts” in determining the origin of SARS-CoV-2. This is an about-face from the previous reliance on the World Health Organization to investigate the origins of the pandemic. This is a shift from the assessment that the novel coronavirus emerged naturally, jumping from an animal species to humans. The theory that the virus may have escaped from the Wuhan Institute of Virology in China is gaining traction, but is far from conclusive. The Adminsitration’s message follows a letter from 18 prominent biologists published in the journal Science that calls for a new investigation into all conceivable origins of the novel coronavirus, and implores Chinese laboratories and agencies to “open their records” for independent analysis. They write:

“As scientists with relevant expertise, we agree with the WHO director-general, the United States and 13 other countries, and the European Union that greater clarity about the origins of this pandemic is necessary and feasible to achieve. We must take hypotheses about both natural and laboratory spillovers seriously until we have sufficient data. A proper investigation should be transparent, objective, data-driven, inclusive of broad expertise, subject to independent oversight, and responsibly managed to minimize the impact of conflicts of interest. Public health agencies and research laboratories alike need to open their records to the public. Investigators should document the veracity and provenance of data from which analyses are conducted and conclusions drawn, so that analyses are reproducible by independent experts.”

On the other hand, many researchers find the tone of growing demands for an investigation to be “unsettling.” There are worries that the “volatility of the debate could thwart efforts to study the virus’s origins.” These demands are also exacerbating existing tensions between the US and China, an unfortunate development with crucial meetings about curbing the pandemic and preparing for future health emergencies underway and upcoming. Global health policy experts assert that it is critical for the world to “work together to curb the pandemic and prepare the world for future outbreaks.” Actions needed immediately include the expansion of vaccine distribution and the reform of biosecurity rules, such as standards for reporting virus-surveillance data.

Event – Pandemics and Global Health Security Workshop

COVID-19 has exposed just how unprepared governments, corporations, and societies are for a global pandemic. While the SARS-CoV-2 virus is only the most recent threat to global health security, it will certainly not be the last. Threats to global health security continue to evolve due to the emergence of new infectious diseases, globalization, advances in science and technology, and the changing nature of conflict. Pandemics and Global Health Security is a three-day virtual, non-credit workshop designed to introduce participants to the challenges facing the world at the intersection of pandemic preparedness and response, public health, national security, and the life sciences. Over the course of three days, participants will discuss how the biology and epidemiology of SARS-CoV-2 contributed to the emergence of that virus as a global pandemic, lessons learned from Operation Warp Speed about the development of medical countermeasures, obstacles to hospital biopreparedness, challenges to science communication during a pandemic, the bioethics of resource allocation during a public health emergency, the future of global health security, and the role of science and technology in preventing and responding to pandemics. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved in research and policy-making on public health, biodefense, and security issues. Live, interactive sessions will include Dr. Rick Bright, The Rockefeller Foundation; Dr. Nicholas G. Evans, University of Massachusetts-Lowell; Dr. Andrew Kilianski, Department of Defense; Dr. Gregory D. Koblentz, George Mason University; Dr. Jennifer Nuzzo, Johns Hopkins Center for Health Security; Dr. Saskia Popescu, George Mason University; Dr. Angela L. Rasmussen, Vaccine and Infectious Disease Organization-International Vaccine Centre; and Jessica Malaty Rivera, COVID Tracking Project. The workshop is organized by the Biodefense Graduate Program at the Schar School of Policy and Government at George Mason University and will be held virtually on July 19-21, 2021. Each day will run from 9am to 12:30pm ET. Prior to June 18, the course fee is $400. Starting June 18, the course fee is $500. Register here.

Pandora Report: 5.21.2021

Congratulations to Dr. Yong-Bee Lim and Madeline Roty, MS for being awarded as Outstanding Students of the Biodefense Graduate Program! Register now for the early bird rate to the Pandemics and Global Health Security Workshop. Dr. Angela Rasmussen discusses the latest changes to the CDC’s COVID-19 guidance.

Outstanding Students of the Biodefense Graduate Program

This year’s Outstanding Biodefense Master’s student is Madeline Roty, who graduated from the University of Michigan School of Nursing in May 2019. Her interests include healthcare preparedness, global health, and health education. Maddie was an active and vibrant member of the Biodefense community and served as President of the George Mason chapter of the NextGen Global Health Security Network. She was also an active contributor to Biodefense program’s blog and newsletter, The Pandora Report, and co-authored an article on Mynamar’s chemical weapons program that we published in the Bulletin of the Atomic Scientists.

Yong-Bee Lim is this year’s outstanding Biodefense PhD student. Yong-Bee earned a Presidential Fellowship when he entered the PhD program after completing his MS in Biodefense. Yong-Bee’s promise as a biosecurity expert was recognized by the Center for Health Security at Johns Hopkins University when they selected him for the prestigious Emerging Leaders in Biosecurity Initiative. Yong-Bee’s dissertation on community labs and the do-it-yourself (DIY) biology movement has generated new knowledge and insights into this important and poorly understood community. His research identified the assumptions and flaws in the narratives used by the DIYBio and biorisk communities to discuss the risks and benefits DIYBio labs. His research will play a key role in helping bridge the gaps between the DIYBio and biorisk communities.

Event – Launch of GlobalBioLabs.org

You are invited to a public webinar, held on the side lines of the seventy-fourth World Health Assembly, to launch www.globalbiolabs.org, an interactive web-based map of global Biosafety Level-4 facilities and biorisk management policies. An accompanying policy brief, entitled Mapping Maximum Biological Containment Labs Globally, will also be released. This briefing is offered by Dr. Filippa Lentzos of King’s College London & Dr. Greg Koblentz of George Mason University. Register here.

An Israeli Airstrike Damaged Gaza’s Only Lab for Processing Coronavirus Tests, Officials Said.

The only laboratory in Gaza capable of processing COVID-19 tests has been rendered temporarily inoperable due to an Israeli airstrike. The strike targeted a nearby building in Gaza City, but shrapnel and debris damaged the laboratory and the administrative offices of the Hamas-run Health Ministry. According to Dr. Majdi Dhair, director of the ministry’s preventive medicine department, the damage will force the laboratory to shut down for at least a day, and testing will be paused. This means a delay in COVID-19 testing but also other tests for diseases like HIV and hepatitis C. Based on official data, merely 1.9% of the two million people in Gaza have been fully vaccinated.

Health Systems Resilience in Managing the COVID-19 Pandemic: Lessons from 28 Countries

Health systems resilience is key to learning lessons from country responses to crises such as coronavirus disease 2019 (COVID-19). In this perspective, a new article in Nature Medicine reviews COVID-19 responses in 28 countries using a new health systems resilience framework. Through a combination of literature review, national government submissions and interviews with experts, the researchers conducted a comparative analysis of national responses. They report on domains addressing governance and financing, health workforce, medical products and technologies, public health functions, health service delivery and community engagement to prevent and mitigate the spread of COVID-19. This work synthesizes four salient elements that underlie highly effective national responses and offer recommendations toward strengthening health systems resilience globally. Read the article here.

New International Expert Panel to Address the Emergence and Spread of Zoonotic Diseases

The launch of the new One Health High-Level Expert Panel is intended to “improve understanding of how diseases with the potential to trigger pandemics, emerge and spread.” The new panel will advise four international organizations: The Food and Agriculture Organization of the United Nations (FAO); The World Organisation for Animal Health (OIE); The United Nations Environment Programme (UNEP); and The World Health Organization (WHO). The goal is to develop a “long-term global plan of action to avert outbreaks of diseases like H5N1 avian influenza, MERS, Ebola, Zika, and, possibly, COVID-19.” The panel will function under the One Health approach, which “recognizes the links between the health of people, animals, and the environment and highlights the need for specialists in multiple sectors to address any health threats and prevent disruption to agri-food systems.”

US Lags Behind Russia and China in Sending COVID-19 Vaccines to Struggling Nations in Need

At present, about 37% of Americans are fully vaccinated, but many nations are struggling to vaccinate their populations and are turning to Russia and China for more doses. On Monday, Biden announced that the US will send 20 million doses of COVID-19 doses to nations in need; this is in addition to the 60 million doses of AstraZeneca’s COVID-19 vaccine. The US has ordered enough COVID-19 vaccines to inoculate its population two-fold, but the world needs billions more doses. The World Health Organization announced that the world is at risk of “vaccine apartheid.” Dr. David Agus, a CBS News medical contributor, described worldwide vaccinations as a “moral imperative.” Agus asserts that if other countries do not or cannot vaccinate their people, new COVID variants could arise and endanger us all. In total, the US has offered to pledged to provide 80 million doses; however, China and Russia are set to deliver around 600 million doses each globally.

Event – Pandemics and Global Health Security Workshop

COVID-19 has exposed just how unprepared governments, corporations, and societies are for a global pandemic. While the SARS-CoV-2 virus is only the most recent threat to global health security, it will certainly not be the last. Threats to global health security continue to evolve due to the emergence of new infectious diseases, globalization, advances in science and technology, and the changing nature of conflict. Pandemics and Global Health Security is a three-day virtual, non-credit workshop designed to introduce participants to the challenges facing the world at the intersection of pandemic preparedness and response, public health, national security, and the life sciences. Over the course of three days, participants will discuss how the biology and epidemiology of SARS-CoV-2 contributed to the emergence of that virus as a global pandemic, lessons learned from Operation Warp Speed about the development of medical countermeasures, obstacles to hospital biopreparedness, challenges to science communication during a pandemic, the bioethics of resource allocation during a public health emergency, the future of global health security, and the role of science and technology in preventing and responding to pandemics. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved in research and policy-making on public health, biodefense, and security issues. Live, interactive sessions will include Dr. Rick Bright, The Rockefeller Foundation; Dr. Nicholas G. Evans, University of Massachusetts-Lowell; Dr. Andrew Kilianski, Department of Defense; Dr. Gregory D. Koblentz, George Mason University; Dr. Jennifer Nuzzo, Johns Hopkins Center for Health Security; Dr. Saskia Popescu, George Mason University; Dr. Angela L. Rasmussen, Vaccine and Infectious Disease Organization-International Vaccine Centre; and Jessica Malaty Rivera, COVID Tracking Project. The workshop is organized by the Biodefense Graduate Program at the Schar School of Policy and Government at George Mason University and will be held virtually on July 19-21, 2021. Each day will run from 9am to 12:30pm ET. Register here.

The Evolving Nature of China’s Military Diplomacy: From Visits to Vaccines

A new report by Meia Nouwens of the International Institute of Strategic Studies details the Chinese military’s place in China’s COVID-19-related foreign policy. The People’s Liberation Army’s (PLA) military-to-military cooperation in response to the global coronavirus pandemic signals a growing role for the military within China’s diplomatic activities. Historically, the PLA played a minor role in Chinese foreign policy. However, in the wake of a more nationalist and assertive Chinese foreign policy, the PLA’s role in national diplomacy and security strategy has grown to serve both strategic and operational goals and has reached new heights in the context of the coronavirus pandemic. Military-to-military COVID-19-related engagement has taken place within a larger context of Beijing’s expanded diplomatic efforts to improve China’s global reputation following its initial delayed and mishandled response at the start of the coronavirus outbreak in 2020. Publicly available data shows that COVID-19 military diplomacy began in March 2020, when the PLA sent protective equipment and clothing to Iran. In February 2021, the PLA began to donate COVID-19 vaccines to overseas militaries. The PLA’s vaccine assistance to 13 countries globally fits within a wider vaccine-centric diplomatic effort by the Chinese government but so far has been far smaller in scale. Geographically, the PLA mostly engaged with countries in the Asia–Pacific and Africa. The PLA’s activities were usually framed within the ‘responsible stakeholder’ narrative that China sought to promote through its civilian aid diplomacy. It is likely that the PLA sought to cooperate with militaries wherever it could and focused on countries with which it already enjoyed established friendly relations, rather than using the PLA’s military diplomacy to establish new strategic relations. The PLA’s military diplomatic activities relating to the coronavirus demonstrate that the PLA will increasingly play a greater role in China’s foreign diplomacy, in line with President Xi’s instructions. Read the report here.

Why Did the CDC Change Its Mask Guidance Now?

Last week, the Centers for Disease Control and Prevention (CDC) updated its guidance on mask wearing and social distancing such that vaccinated individuals are now able to go mask-free much more often. Though the underlying science is “solid,” the communication of these new recommendations was given with little prior notice and without satisfactory explanation to the public. Dr. Angela Rasmussen, a research scientist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization, discusses these latest changes. Animal studies, clinical trials, and real-world data are showing that the “vaccines provide exceptional protection against symptomatic COVID-19.” Indeed, vaccinated individuals are unlikely to get sick when exposed to the virus. The data are also showing that the COVID-19 vaccines are “very effective at preventing infection in the majority of those vaccinated, with the exception of older people and those who are immune compromised.” Rasmussen also points out that recent studies reveal that “most vaccinated people who do get infected are not shedding enough infectious virus to spread it efficiently to others.” Though there have been “sustained declines” in new cases, prevalence and immunization rates differ by region and community. Many states and businesses have lifted their mask requirement policies, but the lack of a vaccination verification system leaves only the honor system. The guidance is intended to incentivize vaccination, but vaccine accessibility remains low for many people. Rasmussen encourages public health leaders to improve transparency and public engagement with guidance in the future.

Opinion: Vaccines Didn’t Stop the Yankees’ COVID-19 Outbreak. But the Case Proves How Well They Work.

Dr. Zach Binney, a sports epidemiologist and assistant professor at Oxford Oxford College of Emory University, and Dr. Angela Rasmussen, a research scientist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization, examined the New York Yankees as a case showing the efficacy of the COVID-19 vaccines. Last week, nine fully vaccinated members of the Yankees tested positive for SARS-CoV-2. Among the nine cases, at least seven show no symptoms. So far, the only individual to exhibit symptoms is third-base coach Phil Nevin, and it is possible that Nevin will be the only case in which the vaccine “failed.” Put simply, Nevin may have been able to develop a high enough viral load to spread the virus to the other eight cases, but their “vaccinated bodies likely fought it off quickly before they could develop symptoms or transmit it.” Though vaccines do not eliminate the possibility of infection, they do eliminate the risk of severe disease and death. “It is likely the vaccine worked as expected on the Yankees: it prevented many more cases, only allowed the virus to spread from one person and reduced disease severity.”

Just 12 People Are Behind Most Vaccine Hoaxes on Social Media, Research Shows

Research has found that 12 people – dubbed the “Disinformation Dozen” – are the sources of most of the misleading claims and falsities about COVID-19 vaccines, which have spread across Facebook, Instagram, and Twitter. It is estimated that the Disinformation Dozen are responsible for 65% of the shares of anti-vaccine misinformation on social media platforms. The group includes anti-vaccine activists, alternative health entrepreneurs, and physicians, some of whom have multiple accounts across platforms. Though these dozen culprits have not been completely ejected from the platforms, their posts have been labeled misleading and false claims have been removed. Despite the efforts to counter misinformation and disinformation, false narratives continue to take hold.  A survey of US parents found that more than 25% do not intend to vaccinate their children.

Implementation of the International Health Regulations (2005)

The Review Committee provided for in Chapter III of Part IX of the International Health Regulations 2005 (IHR) released its report on the implementation of the IHR. The main objectives of the report were to: (1) assess the functioning of the IHR; (2) assess the ongoing global response to pandemic H1N1; and (3) identify lessons learned to strengthen preparedness and response for future public health emergencies. The three overarching conclusions are: (1) core national and local capacities called for in the IHR are not yet fully operational and are not now on a path to timely implementation worldwide; (2) WHO performed well in many ways during the pandemic, confronted systemic difficulties and demonstrated some shortcomings; and (3) the world is ill-prepared to respond to a severe influenza pandemic or to any similarly global, sustained and threatening public-health emergency. The report’s recommendations include streamlining the management of guidance documents, reinforcing evidence-based decisions on international travel and trade, and developing and applying measures to assess severity. Read the report here.  

Pandora Report: 5.14.2021

The Biodefense Graduate Program will be hosting the Pandemics and Global Health Security Workshop in July! Danyale Kellogg, an incoming student to the Biodefense PhD program, highlights the security concerns related to the ending of smallpox vaccinations. Several states are devising incentives to increase their rates of COVID-10 vaccinations.

Event – Pandemics and Global Health Security Workshop

COVID-19 has exposed just how unprepared governments, corporations, and societies are for a global pandemic. While the SARS-CoV-2 virus is only the most recent threat to global health security, it will certainly not be the last. Threats to global health security continue to evolve due to the emergence of new infectious diseases, globalization, advances in science and technology, and the changing nature of conflict. Pandemics and Global Health Security is a three-day virtual, non-credit workshop designed to introduce participants to the challenges facing the world at the intersection of pandemic preparedness and response, public health, national security, and the life sciences. Over the course of three days, participants will discuss how the biology and epidemiology of SARS-CoV-2 contributed to the emergence of that virus as a global pandemic, lessons learned from Operation Warp Speed about the development of medical countermeasures, obstacles to hospital biopreparedness, challenges to science communication during a pandemic, the bioethics of resource allocation during a public health emergency, the future of global health security, and the role of science and technology in preventing and responding to pandemics. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved in research and policy-making on public health, biodefense, and security issues. Live, interactive sessions will include Dr. Rick Bright, The Rockefeller Foundation; Dr. Nicholas G. Evans, University of Massachusetts-Lowell; Dr. Andrew Kilianski, Department of Defense; Dr. Gregory D. Koblentz, George Mason University; Dr. Jennifer Nuzzo, Johns Hopkins Center for Health Security; Dr. Saskia Popescu, George Mason University; Dr. Angela L. Rasmussen, Vaccine and Infectious Disease Organization-International Vaccine Centre; and Jessica Malaty Rivera, COVID Tracking Project. The workshop is organized by the Biodefense Graduate Program at the Schar School of Policy and Government at George Mason University and will be held virtually on July 19-21, 2021. Each day will run from 9am to 12:30pm ET. Register here.

Toward A Whole-of-Society Framework for Countering Disinformation

Disinformation is the deliberate dissemination of false or erroneous information in order to discredit a person, organization, product, or notion. Disinformation is used as a tactic by actors ranging from Russia’s campaign to weaken democratic and international institutions to terrorist groups’ recruitment efforts to the growing anti-vaccine movement. JD Maddox, Casi Gentzel, and Adela Levis describe a framework for countering disinformation that would entail not only “counter messaging but also of proactive measures that use facts to inform audiences, reduce the impact of disinformation, and promote freedom of expression.” The framework categorizes efforts as communication, resilience, disruption, or regulation. Proactive communication before disinformation (or misinformation) can gain a foothold is critical and requires “implementation of the full spectrum of communication capabilities.” Further, increasing transparency and building trust in democratic values and institutions are needed. Building resilience to disinformation will include activities such as improving digital literacy; promoting independent, fact-based, investigative journalism; and leveraging public diplomacy. Disruption leverages technology to prevent the spread of disinformation through various tools and techniques such as blocking or cyberspace operations. Regulation – including legislation and international cooperation – should seek input from local and national legislators, media associations, internet platforms and the broader tech sector, and international organizations. JD Maddox will be teaching a course for the Schar School next semester on countering disinformation. Read the article here.

The Overlooked, Dangerous Nexus Between National Security and Public Health: The Case of Smallpox

Danyale Kellogg, an incoming student to the Biodefense PhD program, highlights the security concerns related to the ending of smallpox vaccinations for the civilian population after the disease’s eradication in 1980. Today, only the US and Russia maintain official samples of the variola virus that causes smallpox; however, other nations possess unofficial samples of the virus, including North Korea. This sparks concerns that a country possessing samples could deploy them as a weapon, an attack that the US is ill-equipped to combat. Additionally, there are worries regarding the use of artificial gene synthesis to recreate smallpox. In fact, in 2017, a Canadian research team synthesized the horsepox virus, which as a relative to smallpox could serve as a roadmap to recreating the eradicated scourge. Preparing for a possible smallpox attack would require “strengthening public health at all levels, ensuring the stability and efficacy of the Strategic National Stockpile, and making sure healthcare providers and private healthcare systems are prepared should they be presented with a case.”

Top Researchers are Calling for a Real Investigation into the Origin of COVID-19

Eighteen prominent biologists published a letter in the journal Science calling for a new investigation into all conceivable origins of the novel coronavirus, and imploring that Chinese laboratories and agencies “open their records” to independent analysis. They write:

“As scientists with relevant expertise, we agree with the WHO director-general, the United States and 13 other countries, and the European Union that greater clarity about the origins of this pandemic is necessary and feasible to achieve. We must take hypotheses about both natural and laboratory spillovers seriously until we have sufficient data. A proper investigation should be transparent, objective, data-driven, inclusive of broad expertise, subject to independent oversight, and responsibly managed to minimize the impact of conflicts of interest. Public health agencies and research laboratories alike need to open their records to the public. Investigators should document the veracity and provenance of data from which analyses are conducted and conclusions drawn, so that analyses are reproducible by independent experts.”

The controversial theory that the virus could have escaped from the Wuhan Institute of Virology (WIV) remains a point of contention, but the letter calls for a thorough examination of all possibilities. Dr. Shi Zhengli, chief scientist for emerging disease at WIV, said that the “letter’s suspicions were misplaced and would damage the world’s ability to respond to pandemics.”

Infographic on SARS-CoV-2 Variants of Concern with Dr. Angela Rasmussen

Dr. Angela Rasmussen, a virologist and research scientist with the Georgetown Center for Global Health Science and Security and VIDO-InterVac at the University of Saskatchewan, developed an infographic explaining the most important features of the newest SARS-CoV-2 variants.

NTI and the Next Generation GHS Network Launch 5th Annual Next Generation for Biosecurity Competition

NTI | bio is partnering with the Next Generation Global Health Security (GHS) Network to launch the fifth annual Next Generation for Biosecurity Competition to foster biosecurity professional development within the Next Generation GHS Network. We are seeking innovative and creative papers for online publication by NTI | bio and the NextGen GHS Network focused on responsible conduct of life science research. The winning team also will receive travel and lodging support to attend and present during a side-event at the 2021 Biological Weapons Convention Meeting of States Parties in Geneva.

As emerging biological risks continue to grow with the rapid pace of biotechnology advances, safe, secure, and responsible conduct of life science research is increasingly important. For this year’s competition, submissions should address the following questions and subordinate considerations: What life science research should not be conducted, if any? Should red lines in life science research be drawn? If so, by whom?

Information regarding submission criteria and eligibility can be found here. The deadline is 28 June 2021 at 11:59 PM EST.

Expert Independent Panel Calls for Urgent Reform of Pandemic Prevention and Response Systems

A panel of leading experts is calling on the global community to end the COVID-19 pandemic by immediately implementing a series of bold recommendations to redistribute, fund, and increase the availability of and manufacturing capacity for vaccines, and to apply proven public health measures urgently and consistently in every country. The Panel is also recommending that national governments and the international community immediately adopt a package of reforms to transform the global pandemic preparedness and response system and prevent a future pandemic. The Independent Panel for Pandemic Preparedness and Response was appointed by the World Health Organization (WHO) Director-General in response to a World Health Assembly resolution calling for an independent, impartial, and comprehensive review of experiences gained and lessons to be learned from the current pandemic. The review was also asked to provide recommendations to improve capacity for global pandemic prevention, preparedness, and response. The Panel released its findings and recommendations today in its main report: COVID-19: Make it the Last Pandemic. The report demonstrates that the current system—at both national and international levels— was not adequate to protect people from COVID-19. The time it took from the reporting of a cluster of cases of pneumonia of unknown origin in mid-late December 2019 to a Public Health Emergency of International Concern being declared was too long. February 2020 was also a lost month when many more countries could have taken steps to contain the spread of SARS-CoV-2 and forestall the global health, social, and economic catastrophe that continues its grip. The Panel finds that the system as it stands now is clearly unfit to prevent another novel and highly infectious pathogen, which could emerge at any time, from developing into a pandemic. Recommended reforms include: establishing a Global Health Threats Council; establishing a new global system for surveillance based on full transparency; investing in national preparedness now; and creating an International Pandemic Financing Facility.

Poll Finds Public Health Has A Trust Problem

A poll conducted by the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health surveyed 1,305 people from mid-February to mid-March of this year to examine trust in key public health groups. The survey found that merely 52% of respondents have a great deal of trust in the Centers for Disease Control and Prevention (CDC), but other agencies saw even lower figures. Only 37% said they had a lot of trust in the National Institutes of Health (NIH) or the Food and Drug Administration (FDA). Forty-one percent trust state health departments and 44% trust local health departments. This growing mistrust is unsurprising given the many missteps that have occurred in the COVID-19 pandemic including political interference, incomplete information, and confusing messaging. Interestingly, the survey showed the political divide in trust: only 27% of Republicans greatly trust the CDC, compared to 76% of Democrats.

Modeling of Future COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Rates and Nonpharmaceutical Intervention Scenarios

A recent Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention (CDC) modelled the expected COVID-19 cases, hospitalizations, and deaths. Increases in COVID-19 cases in March and early April occurred despite a large-scale vaccination program. Increases coincided with the spread of SARS-CoV-2 variants and relaxation of nonpharmaceutical interventions (NPIs). Data from six models indicate that with high vaccination coverage and moderate NPI adherence, hospitalizations and deaths will likely remain low nationally, with a sharp decline in cases projected by July 2021. Lower NPI adherence could lead to substantial increases in severe COVID-19 outcomes, even with improved vaccination coverage. High vaccination coverage and compliance with NPIs are essential to control COVID-19 and prevent surges in hospitalizations and deaths in the coming months.

What Has COVID-19 Taught Us about Strengthening the DOD’s Global Health Security Capacities?

A new report from the Center for Strategic and International Studies (CSIS) details five recommendations for “how the Biden-Harris administration and members of Congress can help steer impending deliberations over the future of the DOD’s contributions to global health security.” The COVID-19 pandemic has cost millions of lives and sickened many more, destabilizing economies and security. Though we are not yet out of the woods with this pandemic, we should prepare to face biological threats in the future. Broad US military expertise in health, biosecurity, and biosafety has contributed to the ongoing response and will continue to contribute substantially to coordinated, interagency global health security efforts. These recommendations are designed to “complement the excellent and extensive recent analysis by Mark Cancian and Adam Saxton of the CSIS International Security Program on how the US military responded to Covid-19 to guarantee the protection and readiness of US forces and how it supported the civilian pandemic response at home.” The recommendations are: (1) elevate biological threats; (2) protect and strengthen operational assets; (3) secure the future of the DOD’s medical skill base; (4) launch a military-to-military health security cooperation initiative; and (5) transition existing DOD international health engagement activities into sustainable, integrated programs. Read the report here.

Upcoming Meeting of the National Biodefense Science Board

The National Biodefense Science Board (NBSB) provides expert advice and guidance to the Secretary of the US Department of Health and Human Services and the Assistant Secretary of Preparedness and Response on scientific, technical, and other matters related to public health emergency preparedness and response. The NBSB will host a public teleconference to discuss new recommendations to HHS that address remaining public health emergency preparedness and response challenges. In light of the numerous health emergencies and disasters that have affected the United States since 2007, NBSB continues to provide recommendations related to health emergency preparedness, response, and recovery. Meetings of the NBSB are open to the public. This meeting will be held on 26 May 2021 at 11 AM EST. Register here.

Event – Get Set: Lessons Learned for The Biological and Toxin Weapons Convention Review Conference

The United Nations Institute for Disarmament Research (UNIDIR) is hosting an online discussion on Lessons Learned for the Biological and Toxin Weapons Convention (BWC) Review Conference. This is the second in a series of events the Institute is hosting in preparation for the Review Conference of the Biological and Toxin Weapons Convention. The event will contribute to enhancing understandings of BWC review conferences and identifying lessons to be learned from past experiences. Speakers for this event include Ambassador Dr. György Molnár, Special Representative of the Minister of Foreign Affairs and Trade for Arms Control, Disarmament and Non-Proliferation MFAT Hungary and President of the Eighth BWC Review Conference; Dr. Una Jakob, research associate at the Peace Research Institute Frankfurt (PRIF) in Germany; and Mr. Zahid Rastam, charge d’Affaires ad-interim, High Commissioner of Malaysia to United Kingdom. The panel will be moderated by UNIDIR researcher, James Revill and will include a question-and-answer session with the audience. The event will be held 20 May 2021 at 1 PM CEST. Register here.

Ineffective Past, Uncertain Future

In 2016, in the face of relentless attacks on health care in situations of conflict, the UN Security Council adopted Resolution 2286. This committed UN member states to taking action to prevent attacks on health care and ensure accountability for perpetrators. In the five years since, they have done neither. In annual reports in the years since Resolution 2286 was adopted, the Safeguarding Health in Conflict Coalition (SHCC) and Insecurity Insight reported a total of more than 4,000 unique incidents of violence against health care in situations of armed conflict – on average more than two incidents a day. Because the reporting of such incidents is limited in many countries, this number is likely a significant undercount. The violence has taken myriad forms: airstrikes against and shelling of hospitals and clinics; kidnappings and killings of health workers; damage to, the destruction of, and looting of health care facilities and vehicles; actions that prevent those in need from accessing health care; violent interference with emergency medical responders, vaccinators and others and; arrests of health workers. During 2020, the COVID-19 pandemic resulted in more violence against health care, including in countries not at war, such as India and Mexico. Violence causes not only immediate death, injury, and destruction, but often results in an enormous psychological and physical toll on health workers and the people in the communities they serve. Hidden in each incident is the loss of family members and colleagues, livelihoods, homes, and, sometimes, a way of life. The true cost of the attacks also includes the lasting impacts on health workers’ mental health and on communities’ ability to access care for chronic illness, safe childbirth, immunization, and more. Fewer health workers are available to provide care as doctors and nurses flee the violence. The report – Ineffective Past, Uncertain Future – presents the documented threats and violence against health care between January 2016 and December 2020. An interactive map developed by Insecurity Insight and MapAction for the Safeguarding Health in Conflict Coalition shows incidents of violence and threats against health care. Read the report here and view the map here.

Incentives to Vaccinate

In effort to encourage COVID-19 vaccination, several states have devised clever incentivizes to increases their rates as demand declines. In Louisiana, the vaccine is easily accessible, but to inspire more people to join the fight against the pandemic, a vaccination event in New Orleans also offered a pound of free boiled crawfish. In Ohio, there will be five weekly lottery drawings for $1 million open to residents who received at least one dose of a COVID-19 vaccine. Similarly, there is a lottery for teenagers that offers a full, four-year scholarship to a public university in Ohio – room and board included. Maryland launched an incentive of $100 to state employees who opt to get fully vaccinated. New Jersey introduced its “Operation Jersey Summer” campaign to reach the state’s goal of vaccinating 70% of the adult population by the end of June. As part of the campaign, vaccinees aged 21 years or older can participate in the “Shot and a Beer” program that provides a free beer with COVID-19 vaccinations beginning this month.

Pandora Report: 5.7.2021

Surgeon General Dr. Vivek Murthy shared new tools to find vaccines near you! You can text ZIP code to 438829 (GETVAX) or 822862 (VACUNA). You can also visit vaccines.gov or vacunas.gov. The shot emoji gets a makeover. WHO and Germany launch the WHO Hub for Pandemic and Epidemic Intelligence.

The ‘Vaccine’ Emoji Gets a New Look This Week

This month, the most popular emoji on Twitter was the one with its mouth agape and tears streaming down, depicting the pandemic mood of being overwhelmed with either anguish or relief as the vaccines roll out. The microbe emoji has also surged in use over the last year to describe SARS-CoV-2. The face mask and shot emojis are also quite popular, promoting these countermeasures. To better represent vaccines, the vaccine emoji has been redesigned from syringe with a bright red barrel and a drop of blood coming out from the needle to a syringe with a blue-gray hue without the blood droplet.

COVID-19 Vaccine Nationalism Will Cost Lives Worldwide

Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, called the hoarding of COVID-19 vaccines by wealthy nations as a “catastrophic moral failure.” By mid-March, 14% of the global population had access to more than half of the vaccines in the world, and modeling suggests that this hoarding will lead to nearly twice as many deaths as would happen if vaccines were shared across the globe. “Vaccine nationalists” advocate for vaccinating the people in their own country by any means necessary, whereas “globalists” seek more equitable approaches for vaccine allocation that are based on need rather than payment. The US possesses an excess of the AstraZeneca vaccine that it anticipated would gain emergency authorization. After much pressure, the Biden administration decided to donate that stockpile, some 60 million doses, to nations in need. “Vaccines don’t save lives, vaccination does.” Equitable vaccination should be the default policy and action, not requiring pressure. In order to protect or strengthen the public health of a nation, we need to protect and strengthen the public health of all nations.

WHO, Germany Launch New Global Hub for Pandemic and Epidemic Intelligence

The World Health Organization (WHO) and the Federal Republic of Germany will establish a new global hub for pandemic and epidemic intelligence, data, surveillance and analytics innovation. The WHO Hub for Pandemic and Epidemic Intelligence will be a global platform for pandemic and epidemic intelligence, creating shared and networked access to vital multi-sectoral data, driving innovations in data analytics and building the communities of practice needed to predict, prevent, detect, prepare for, and respond to worldwide health threats. The Hub, based in Berlin and working with partners around the world, will lead innovations in data analytics across the largest network of global data to predict, prevent, detect prepare for and respond to pandemic and epidemic risks worldwide. It will be a new global collaboration of countries and partners worldwide, driving innovations to increase availability and linkage of diverse data; develop tools and predictive models for risk analysis; and to monitor disease control measures and infodemics.

Mitigating Future Respiratory Virus Pandemics: New Threats and Approaches to Consider

Despite many recent efforts to predict and control emerging infectious disease threats to humans, we failed to anticipate the zoonotic viruses which led to pandemics in 2009 and 2020. The morbidity, mortality, and economic costs of these pandemics have been staggering. We desperately need a more targeted, cost-efficient, and sustainable strategy to detect and mitigate future zoonotic respiratory virus threats. Evidence suggests that the transition from an animal virus to a human pathogen is incremental and requires a considerable number of spillover events and considerable time before a pandemic variant emerges. A new article in Viruses view argues for the refocusing of public health resources on novel respiratory virus surveillance at human–animal interfaces in geographical hotspots for emerging infectious diseases. Where human–animal interface surveillance is not possible, a secondary high-yield, cost-efficient strategy is to conduct novel respiratory virus surveillance among pneumonia patients in these same hotspots. When novel pathogens are discovered, they must be quickly assessed for their human risk and, if indicated, mitigation strategies initiated. In this review, the authors discuss the most common respiratory virus threats, current efforts at early emerging pathogen detection, and propose and defend new molecular pathogen discovery strategies with the goal of preempting future pandemics. Read the article here.

Insider Q&A: Ex-Biodefense Chief on Stopping the Next COVID

Dr. Rick Bright is a former director of the Biomedical Advanced Research and Development Authority (BARDA), a government office tasked with procuring and developing medical countermeasures for chemical, biological, radiological and nuclear (CBRN) threats along with emerging diseases. One year ago, Bright submitted a whistleblower complaint regarding the improper use of hydroxychloroquine, a malaria drug, to treat COVID-19; the medication was later considered ineffective and too risky. In retaliation, Bright was demoted and he ultimately resigned from his position. Bright is now the Senior Vice President of Pandemic Prevention and Response at the Rockefeller Foundation.  In a conversation with AP News, Bright explains that, in the early days of the pandemic, he wishes there had been a “reliable, nonpolitical, early warning signal.” The lack of a strong signal, transparency, and information sharing needs to change before the next biological event. He also points out there is not necessarily a lack of data or information, rather there is a need to be able to “aggregate all that information in a trusted source that’s not beholden to politics or money.”

Event – The Global Health Security Index: A Tool for Decision Makers in Latin America

The Global Health Security Index – developed by the Nuclear Threat Initiative (NTI), the Johns Hopkins Center for Health Security (JHU), and The Economist Intelligence Unit (EIU) – is the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries. On 12 May, NTI and the Cayetano Heredia Peruvian University are hosting an event, “The Global Health Security Index: A Tool for Decision Makers in Latin America.” Panelists include Javier Rodriguez Zulato, Director of the Initiative for Global Security (IGS); Luciana Vazquez, Biosecurity and Biosafety Program Coordinator at IGS; Dr. Ricardo Teijeiro, IGS Biosafety and Biosecurity Program Argentine Society of Infectology (SADI); Luis Carrerra Fox, North America Liaison IGS/PandemichTech; Jessica Bell, Senior Program Officer at NTI; and Ernesto Gozzer, Professor at Universidad Peruana Cayetano Heridia. Register here for the virtual webinar on 12 May at 2 PM EST.

Superspreaders of Malign and Subversive Information on COVID-19: Russian and Chinese Efforts Targeting the United States

The RAND Corporation released a report as part of its Countering Truth Decay initiative that examines the Russian and Chinese efforts to target the US through information manipulation. Activities to spread COVID-19-related malign and subversive information have been underway throughout the pandemic, but the report assesses evidence from the January to July 2020 period. Two types of sources were used: those formally linked to Russia and China and those shown to have indirect links to Russian or Chinese governments or networks. Using exploratory qualitative analysis, several trends were found, including: both countries falsely accused the United States of developing and intentionally spreading the virus; both countries modified their COVID-19-related messaging over time, focusing on conspiracy theories about the virus’s origins and impacts; Russia deployed wide-ranging media and targeted a variety of audiences, while China’s approach was ideologically uniform and appeared to target audiences that were less varied. Read the report here.

Virologist Angela Rasmussen on the Controversy Surrounding Russia’s Sputnik V COVID-19 Vaccine

Dr. Angela Rasmussen is a virologist and research scientist with the Georgetown Center for Global Health Science and Security and VIDO-InterVac at the University of Saskatchewan. STAT had a conversation with Rasmussen about the controversy surrounding Russia’s Sputnik V COVID-19 vaccine, which is based on technology similar to that of the Johnson and Johnson as well as AstraZeneca vaccines. According to a study published in The Lancet, the Sputnik vaccine showed 91.6% efficacy, ranking it as one of the most effective in the world. When asked why Brazil rejected the Sputnik vaccine, Rasmussen explained that with the adenovirus component, the virus could potentially replicate and cause downstream complications. Another issue is the worry about quality control of Russia’s COVID-19 vaccine, specifically, there may be “discrepancies in the manufacturing process.” In terms of soft power diplomacy, the concerns regarding the Sputnik vaccine may be dealing a blow to Russia’s attempt to assume a leadership role in the global vaccine efforts.

Listen to the full conversation here.

Event – Reinforcing the Norm Against Chemical Weapons: The April 20-22 Conference of States Parties to the Chemical Weapons Convention

At the second session of the 25th Conference of States Parties held in The Hague last month, the member states took several important steps to reinforce the norm against chemical weapons use and to hold Chemical Weapons Convention violators accountable. Foremost among these was the decision to suspend the rights and privileges of Syria under the Convention. The Chemical Weapons Convention Coalition, in cooperation with the Arms Control Association, will host a briefing to review the results and implications of the 25th Conference of States Parties for the work of the Organisation for the Prohibition of Chemical Weapons and the CWC regime. Panelists include Amb. Lisa Helfand, Permanent Representative of Canada to the OPCW (confirmed); Amb. Gudrun Lingner, Permanent Representative of Germany to the OPCW; Dr. Jean Pascal Zanders, independent disarmament and security researcher at The Trench; and Dr. Paul Walker, moderator, Coordinator, Chemical Weapons Convention Coalition. Opening remarks will be given by H.E. Fernando Arias, Director-General of the OPCW. The panel will be held on 10 May 2021 at 10 AM EST. Register here.

Cheminformatics at the Stimson Center

As recent international incidents amply demonstrate, chemical weapons remain an enduring and very real challenge to international peace and security. However, frontline officers for border security and trade controls, as well as chemical industry employees, struggle to identify whether a chemical can be utilized as a chemical warfare agent and precursor. This challenge stems from at least three sources: (1) lists of controlled chemicals identify chemicals of concern through names and registry numbers – however, the lists may not cover the specific chemical in question, given that chemicals have a multitude of synonymous names and different variants of the same chemical; (2) some lists of controlled chemicals do not identify individual chemicals only chemical families, which can make the lists difficult to interpret by non-chemists; and (3) lists of controlled chemicals are subject to change and must be kept current. The Stimson Center is developing a tool to help overcome these challenges.

The Cheminformatics tool is composed of an up-to-date database of relevant lists of controlled chemicals to help address problems inherent to the way in which the identification of such chemicals is currently conducted by converting any entered chemical name or registry number into a chemical structure, and automatically checking whether that structure matches any entry of the database. Through September 2021, the Cheminformatics team will work to lay the groundwork for the development of a database tool that will allow frontline officers for border security and trade controls as well as chemical industry employees to easily assess if a given chemical falls within the scope of a national or international control list of chemical warfare agents and precursors. A demonstration of the prototype was given in late February to showcase its ability to query a database of controlled chemicals and verify if a specific chemical is included on a control list.

A Revolution Is Sweeping the Science of Ancient Diseases

Dr. Johannes Krause, director of the archaeogenetics department at the Max Planck Institute for Evolutionary Anthropology, co-authored the book A Short History of Humanity, which synthesizes twenty years of work with ancient DNA from humans and pathogens. In the past decade, ancient DNA have been used to study diseases – the plague, syphilis, hepatitis B, and a mysterious “cocoliztli” epidemic – using techniques based on decoding the genome of the Neanderthal. This has enabled a “boom” in ancient pathogen DNA examination and revealed information of forgotten or extinct diseases. Krause explains that the teeth from ancient remains are used to collect blood samples; this is because the pathogens of interest are blood-borne. In the DNA of Yersinia pestis, the causal agent for plague, scientists found that the “Black Death is literally the common ancestor, the mother of 80% of the strains that circulate in the world today.” Krause and his colleagues have found evidence of bacteria that look like Yersinia pestis from teeth in Europe that date back almost 5,000 years. Though Krause cannot specifically identify the disease, he does describe it as likely lethal, but not transmissible via fleas. Read the full interview here.

Pandora Report: 4.30.2021

This is World Immunization Week! The US is donating up to 60 million doses of the Astra Zeneca COVID-19 vaccine to the global vaccine effort. This week also marks the first 100 days of the Biden administration, which has already seen 200 million COVID-19 doses administered in the US.

World Immunization Week

The last week of April is World Immunization Week! World Immunization Week promotes the use of vaccines to protect people of all ages from disease. Every year, vaccines save millions of lives as one of the most successful health interventions. Despite their efficacy, nearly 20 million children worldwide are not vaccinated, leaving them vulnerable. This year’s theme is “Vaccines bring us closer,” which urges “greater engagement around immunization globally to promote the importance of vaccination in bringing people together, and improving the health and wellbeing of everyone, everywhere throughout life.” The World Health Organization’s campaign aims to increase trust, confidence, and investments in vaccines.

In great news, a vaccine against malaria, a disease that kills over 400,000 people each year, has proven 77% effective in early trials. The trial included 450 children in Burkina Faso and the shot was found to be safe and showed “high-level efficacy” over one year of follow up.

Epidemics That Didn’t Happen

In this COVID-19 era, we are constantly reminded of gaps or failures in pandemic preparedness; however, a new resource is offering examples of effective preparedness by showcasing epidemics that never hit or that were largely tempered. The examples include Yellow Fever in Brazil, Ebola in Uganda, Anthrax in Kenya, Monkeypox in Nigeria, and COVID-19 in Mongolia and Senegal.

Though anthrax is often associated with bioterrorism, it is an ancient disease that is found naturally in soil. The anthrax bacterium can infect livestock and wildlife, which, in turn, infect humans when their contaminated meat is consumed. In 2019, a local herder and two students located in a town in Kenya became very ill after eating the meat from a dead cow. All three were diagnosed with anthrax. A volunteer who had been trained by the Kenya Red Cross Society’s Community-Based Surveillance system, immediately sent an SMS alert to the system. This alert notified local health and veterinary authorities, and quickly spurred action to contain the outbreak. Ultimately, there were four human cases and one death. This and the other case studies highlight that outbreaks can be contained and epidemics can be prevented with strong preparedness and response measures, protocols, and activities.

Spillover or Endemic? Reconsidering the Origins of Ebola Virus Disease Outbreaks by Revisiting Local Accounts in Light of New Evidence from Guinea

New research published in the BMJ Global Health journal finds that the 2021 outbreak of Ebola virus disease (EVD) in Guinea originated in viral resurgence from a persistently infected survivor from the major 2013–2016 epidemic 5–7 years ago, prompting an urgent need to re-evaluate whether past EVD epidemics hitherto considered as independent zoonotic spillovers may have had similar origins. In the article, researchers reconsider local accounts from the West African epidemic that trace its origins to people, dismissed until now as implausible. The authors reinterpret existing scientific accounts of other alleged spillovers, finding that several past outbreaks probably originated in persistent infections over even longer latency. By recalibrating the balance between “spillover” and “flare-up,” they suggest that EVD manifests less as a series of discrete epidemics and more as an endemic disease in humans over long timescales and wide areas, helping to account for the increasing frequency of episodes. The authors recommend that more collaborative, respectful approaches with local communities are needed to understand the origins of outbreaks, to address them and to support rather than stigmatize sufferers and survivors. Read the article here.

India’s COVID-19 Crisis Prompts Global Response

India is currently experiencing a severe surge in COVID-19 cases, the worst in the pandemic. In fact, India broke the global daily record for the number of COVID-19 cases for a fifth straight day, with more than 350,000 new infections reported. Hospitals are facing critical shortages of oxygen and remdesivir, an antiviral used to treat hospitalized COVID-19 patients. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, said, “the situation in India is beyond heartbreaking.” President Biden spoke with Indian Prime Minister Narendra Modi about sending raw materials for its Covishield vaccine to help quell the crisis.

How COVID-19 Prepared the Military for Future Biological Warfare

Although the COVID-19 pandemic shut down much of society or transitioned it into a remote format, the vast majority of the military’s missions continued. These missions include activities ranging from air transportation to basic training. Since most of these activities cannot be conducted over Zoom, the military was forced to improvise and adapt operations to keep forces healthy, and were largely successful. According to Lt. Gen. Brian Robinson, deputy commander of Air Mobility Command, the pandemic is one of the few, if not only, times in which the military has “faced a true challenge to how it commands and controls its forces on a global scale.” The COVID-19 outbreak on the aircraft carrier Theodore Roosevelt provided important lessons about how to respond in a biological attack. The disease spread rapidly on the ship and led to the ship’s skipper pleading with Navy leadership for help, a plea that was leaked to the media. Lt. Cmdr. Brian Pike stated that the ship’s outbreak reveals the need to consider deploying technical experts in the detection and surveillance of biological threats on Navy ships to contain infectious diseases. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, asserts that improving detection capabilities on a vessel should entail monitoring the health of the crew and preparing for a situation in which the first sign of an attack is the presentation of symptoms. To do so, the Navy may need to add personnel that are skilled in disease surveillance or specially train existing personnel.  

Navalny’s Novichok Poisoning Was Putin Sending the World A Message, Experts Say

In August 2020, Alexei Navalny, an Russian opposition leader, was poisoned with a Novichok, an agent banned by the Chemical Weapons Convention. After being hospitalized in Germany, Navalny returned to Russia and was imprisoned. In response to rising international pressure, Putin gave a “fiery state of the nation speech” that warned other nations to not attempt to cross the unspecified “red lines” in regard to Navalny. Navalny’s recent court appearance saw him at the end of a three-week hunger strike, and there are fears he may be close to death. He is not the first to be poisoned with a Novichok; Sergei and Yulia Skripal were poisoned in 2018. According to Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, prior to the Skripals, the Novichok was not thought to be a weapon of assassination. Further, at that time, only about a dozen laboratories in the world were equipped to detect it. This means that the number of other enemies of the Kremlin that have been victims of a Novichok is unknown. As a clear and odorless agent, it is among the most lethal nerve agents known. Some experts are interpreting the Novichok poisonings as warnings to those who oppose Putin, but also as a message to NATO nations that “Russia is using a forbidden chemical weapon that Russia says it doesn’t have — that it can harm not only its own citizens but citizens in any city, any country outside of Russia.”

Harris to Tell UN Body It’s Time to Prep for Next Pandemic

On Monday, Vice President Kamala Harris will address the United Nations in a virtual speech to make the case that “now is the time for global leaders to begin putting the serious work into how they will respond to the next global pandemic.” This speech will come near the 100-day mark of the Biden-Harris administration. According to excerpts, Harris will provide an overview of what the administration wants to focus on: improving accessibility to healthcare; investing in science, healthcare workers, and the well-being of women; and boosting capacity for personal protective equipment (PPE) and vaccine and diagnostic test manufacturing.

Pandora Report: 4.23.2021

State Department releases its annual reports assessing arms control compliance and adherence. Dr. Brian Mazanec, an alumnus of the Biodefense PhD Program, receives the Arthur S. Flemming Awards Honor Outstanding Federal Employees. Globally, to date, there have been nearly 145 million cases of COVID-19 and over 3 million deaths from the novel coronavirus. In much-needed good news, all adults (16 years and older) in the US are now eligible for a COVID-19 vaccine.

State Department Releases Arms Control Compliance Reports

The US Department of State released its reports regarding compliance with arms control, nonproliferation, and disarmament agreements and commitments. The report assesses the adherence of the US as well as other nations, including Iran, North Korea, Syria, China, and Russia. In short, the activities of the US in 2020 were “consistent with the obligations set forth in the Biological Weapons Convention (BWC).” Additionally, the US has “provided a full and complete declaration of its chemical weapons (CW) and associated CW facilities, and continues to work toward completing the destruction of CW and associated CW facilities, in accordance with its CWC obligations.” Turning to the activities of other countries, there are concerns about BWC compliance in China and Iran. North Korea and Russia are suspected of maintaining offensive biological weapons programs, which violates Article I of the BWC.

State’s 2021 report on CWC compliance alleges that Iran and Myanmar are in violation of the CWC for failing to declare former chemical weapons facilities. GMU’s Biodefense Program Director Dr. Gregory Koblentz and master’s student Madeline Roty encourage the US to help Myanmar come clean about its chemical weapons program in an article released in March 2020. The motivation and objective of the clandestine weapons program remains unclear, but speculation includes defense or offense measures against domestic insurgencies or neighboring countries. Despite its continued denial of the program, Myanmar seems to be moving toward transparency with its willingness to address concerns about its adherence (or lack thereof) to the Chemical Weapons Convention. The State Department also raises concerns about Chinese research with pharmaceutical-based agents (PBAs) and toxins with dual-use applications. Similarly, there are worries about Iran’s work with PBAs. In August 2020, Russia violated the CWC by deploying a Novichok nerve agent in an attempted assassination of Alexi Navalny. The US also accuses Syria of being in non-compliance with the CWC due to its repeated use of chemical weapons and its failure to fully declare its CW program and destroy chemical agents and munitions. Read the reports here and here.  

Watchdog Group Votes to Punish Syria for Chemical Weapons Use

The Organization for the Prohibition of Chemical Weapons (OPCW), the entity tasked with enforcing the Chemical Weapons Convention (CWC), voted to remove the membership rights of Syria, which can no longer cast votes or hold committee positions. This determination is a response to Syria’s use of chemical weapons against its own citizens. The measure required a two-thirds majority: 87 countries approved the measure, 14 opposed, and 34 abstained. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, weighed in on the measure: “The penalties imposed today are a slap on the wrist compared to the magnitude of Syria’s egregious behavior, [but] they send a strong signal that chemical weapons cannot be used with impunity.”

Dr. Brian Mazanec Receives the Arthur S. Flemming Awards Honor Outstanding Federal Employees

Dr. Brian Mazanec, an alumnus of the Biodefense PhD Program, is among the recipients of the Arthur S. Flemming Awards Honor Outstanding Federal Employees. The award recognizes a dozen exceptional public servants for “performing outstanding service in the fields of applied science and engineering, basic science, leadership and management, legal achievement, and social science.” Dr. Mazanec serves as the director responsible for the strategic warfare and intelligence portfolio of the US Government Accountability Office (GAO). He has “demonstrated outstanding leadership, innovation, and excellence in improving the efficiency and effectiveness of the national security enterprise, particularly the intelligence community, better preparing Congress and agencies to address critical emerging threats and challenges.” Mazanec has led work in intelligence and counterintelligence, counterterrorism, building foreign partner capacity, cybersecurity, and foreign military financing and sales. Congratulations, Dr. Mazanec!

Global Health Security: USAID and CDC Funding, Activities, and Assessments of Countries’ Capacities to Address Infectious Disease Threats before COVID-19 Onset

The US Government Accountability Office (GAO) released its findings of a study about the Global Health Security funds used US Agency for International Development (USAID) and the Centers for Disease Control and Prevention (CDC). USAID and the CDC invest in global health security to help other nations build their capacities to deal with infectious diseases. The GAO study found that USAID and the CDC had dispersed roughly $1 billion as of 31 March 2020 for global health security activities. This money went to at least 34 countries, including 25 recognized as partner countries with the Global Health Security Agenda (GHSA). This support helped build capacity in 17 GHSA partner countries, which helps them address infectious disease threats. Also, by the end of fiscal year 2019, most of those 17 nations possessed some capacity in each of the 11 technical areas, but continued to face various challenges. Read the report here.

‘Building Back Better’ Requires a New Approach to US Science and Technology

Dr. Daniel Gerstein, alumnus of the Biodefense PhD Program and senior policy researcher at the RAND Corporation, discusses the need for a new approach to US science and technology (S&T). Over the last several decades, there have been organizational and process changes to the US science and technology enterprise. Such changes include the establishment of the National Science Foundation (NSF), NASA, and the Defense Advanced Research Projects Agency (DARPA), as well as new US leadership in scientific research and development. Gerstein asserts that a makeover – based on a coherent plan – of the US S&T enterprise is needed to improve economic prosperity and national security.

Billions Spent on Coronavirus Fight, But What Happens Next?

Thus far, Congress has allocated billions of dollars to help state and local public health departments respond to the COVID-19 pandemic. As the pandemic recedes, these funds may also dry up, leaving many public health departments with meager budgets yet again. Rolling back funding will leave communities – and the nation – unprepared for another health crisis, a lesson we should have learned well from the lingering pandemic. Dr. Mysheika Roberts, a health commissioner in Ohio, points out that more funding is needed consistently, not as a surge once an emergency has already started. According to Trust for America’s Health, money for public health emergency preparedness was cut nearly in half between the 2003 and 2021 fiscal years, accounting for inflation. Democratic US Senator Patty Murray of Washington leads several lawmakers aiming to “end the boom-bust cycle with legislation that would eventually provide $4.5 billion annually in core public health funding.”

How Safe Are You from COVID When You Fly?

A new interactive created by The New York Times details how air circulates in an aircraft. Dr. Nereyda Sevilla, graduate of the GMU Biodefense PhD Program, focused her dissertation on the transmission and risks of airplane-borne infectious diseases. Sevilla’s research analyzed the impact of air travel on the spread of pneumonic plague, a disease with a high mortality rate. Her results indicate that transmission via air travel depends on the type of disease, specifically, its duration of illness. Nereyda makes the following recommendations: (1) expand the definition of close contact on aircraft, (2) require health contact information with all plane tickets purchases, (3) expand self-sanitizing measures, (4) improve travel alerts and advisory notices during the ticket sales process, (5) perform temperature checks on a limited and random basis, and (6) improve crisis communication. Dr. Saskia Popescu, an assistant professor in the Biodefense Graduate Program as well as an alumna, points out that passengers may also be exposed to the virus in airport terminals, where crowding makes social distancing quite difficult.