Pandora Report 8.26.2016

A new report by the Organization for the Prohibition of Chemical Weapons (OPCW) is pointing to a harsh reality that despite incomplete and inaccurate Syrian disclosures, there are traces of nerve agents in their laboratories. While they promised to destroy their entire arsenal, there is a growing concern that Damascus has not followed through on commitments to destroy all of its armaments.   Feel like a biodefense arts and crafts project?  You can learn to make a plague doctor’s mask here. Chem-Bio warfare suits may be getting a fashionable upgrade as companies like Lululemon and Under Armor are competing to revolutionize the protective equipment. 

UN Security Council – Calls for Eradicating WMD’s  689139
On Tuesday, GMU Biodefense Graduate Program Director and Professor, Dr. Gregory Koblentz, briefed the UN Security Council on how terrorists could exploit advances in science and technology to acquire weapons of mass destruction. He delivered the briefing as part of a Security Council open debate on WMD nonproliferation that is part of the comprehensive review currently being conducted of Resolution 1540. You can read the summary of the meeting here, but the focus was on the evolving threat of WMD’s falling into the hands of non-state terrorists and actors. Emphasizing the threat of biological weapons, Secretary-General Ban Ki-Moon “questioned the international community’s ability to prevent or respond to a biological attack.  He also suggested giving a closer look at the nexus between emerging technologies — such as information and communication technologies, artificial intelligence, 3-D printing and synthetic biology — and weapons of mass destruction.” Dr. Koblentz (27 minutes into the broadcast of the meeting here) pointed to the Fourth Industrial Revolution as a source for huge gains in both productivity and prosperity, but also a darker potential for mis-use by non-state actors. Within his talk, Dr. Koblentz noted the five advances in science and technology that “increase the risk of CBRN weapons proliferation to non-state actors”. The advances include unmanned aerial vehicles (UAVs), 3D printing, accessibility of illicit items on the Dark Web, malicious software and cyber attacks, and genetic engineering tools like CRISPR-Cas9. While these advances reveal the diverse technology, there are also seven deadly traits within these emerging technologies – dual-use, disruptive, diffusion, reliance on a digital component, decentralization, deskilling, and the DIY (do-it-yourself) movement. Simply put, these seven characteristics make emerging technologies that much more challenging to prevent mis-use. “The international community faces a continuous challenge of encouraging innovation and maximizing the benefits of such innovation with the need to mitigate the security risks posed by these new technologies. I hope the Security Council will take advantage of the Comprehensive Review of Resolution 1540, which this open debate is an important contribution to, to update the resolution to take into account the impact of scientific discoveries and technological breakthroughs on the proliferation of weapons of mass destruction to non-state actors.” There was substantial discussion regarding the strengthening of Resolution 1540, especially to consider the implications of a biological attack in light of recent outbreaks like Ebola, MERS, and SARS.  During her remarks, Ambassador Michele J. Sison, U.S. Deputy Representative to the United Nations, described Dr. Koblentz’s briefing as, “a very interesting, but also very sobering intervention.” Hopefully, with the focus on these evolving threats, the current review of Resolution 1540 can be further strengthened and focused to reduce the risk of terrorists acquiring WMD’s.

A Tribute to D.A. Henderson
There are few times in the history of public health that we can say we’ve eradicated a disease. D.A. Henderson, smallpox guru and disease detective, led such efforts within the WHO and his absence has been felt throughout the health community. A legend among public health and biodefense students, his dedication to the field inspired generations. As an epidemiologist, his work in both infectious diseases and bioterrorism gave me hope that such a career was not only possible, but also filled with the kind of adventure that many only dreamed about. Having just read Scourge (and I would highly encourage you to read it), the dedication to the smallpox eradication efforts is still an inspiration. After conquering what many considered impossible, Henderson worked as Dean of the Johns Hopkins School of Public Health, founding director of the Johns Hopkins Center for Civilian Biodefense Strategies (now UPMC Center for Health Security), and following 9/11, led the Office of Public Health Preparedness. Described as a “Sherman tank of a human being- he simply rolled over bureaucrats who got in his way”, Henderson’s death is truly felt throughout the international community. In the wake of his death, we take a moment to truly applaud and appreciate all he’s given and inspired within global health security.

How Far Will the U.S. Luck Run?
With the anticipation and preparations for Zika having started months before it reached U.S. soil, many are wondering if our luck with infectious disease is running out. We were lucky with Ebola- a handful of cases and once we hit the panic button, we were able to overcome the crisis. Despite insufficient funds and battling diseases we had little to no experience in handling, U.S. efforts have been fortunate in their successes. Zika may be a different kind of ball game though – mosquito control efforts are flawed at best and with a disease that is often asymptomatic, we may have finally hit a wall. Did we really learn from Ebola? Have we strengthened our surveillance and response practices? Dr. Johnathan Fielding notes that “HHS must play a greater role in coordinating the global public health response through implementation of the Global Health Security Agenda, a cooperative arrangement launched in 2014 by over 50 nations, nongovernmental organizations and other stakeholders; better coordination with other government agencies, and state, local and private sector partners; and clear delineation of roles and responsibilities within and among HHS offices.” We need both the monetary and personnel support to properly address the failures from Ebola, but also implement the recommendations that so many have made following the crisis. The contingency funding that has been pushed recently is an indication of our potentially faltering luck – have we reached such an impasse in which our politics will override our disease response capacity or capabilities?

A Lot of Zika Goes a Long Ways 
Palm Beach is seeing its second case of Zika virus, with active transmission continuing in Florida. Florida Governor, Rick Scott, has expressed frustration that the promised federal support of antibody tests and lab support has not been delivered. “In a teleconference on Wednesday, Scott made a plea for more support in fighting Zika, complaining that ‘Congress and the White House have not been good partners.’ Scott said he asked the U.S. Centers for Disease Control and Prevention for 5,000 Zika antibody tests last week, but so far had only received less than 1,200.” Johns Hopkins is opening the first multidisciplinary Zika center, the Johns Hopkins Wilmer Zika Center, which is dedicated to caring for affected patients. As of August 24, the CDC has reported 2,517 cases of Zika virus in the U.S. The CDC has also awarded $6.8 million to partners to help support Zika response. “This funding will help enhance surge capacity for Zika case identification and mosquito surveillance. It will also help improve communications to key populations, by developing focused educational materials, sharing mosquito control guidance, and refining community public awareness campaigns.”

Human Mobility and Epidemics
Tracking infectious disease cases is never an easy task – whether it be an asymptomatic patient, mosquito-spread disease, or global travel, epidemiology and case tracking is not for the faint of heart. An increasingly mobile population is only adding to this difficulty. The first few days of an infection with Dengue or Zika are often so mild that many don’t even seek medical care. How many times have you had a fever and it didn’t stop you from traveling or going about your day? Disease ecologists are now looking at the impact of a fever on human mobility and the shock this may have during an outbreak of a vector-borne disease. “We’ve found that people with a fever visit 30 percent fewer locations on average than those who do not have a fever, and that they spend more time closer to home. It may sound like stating the obvious, but such data have practical applications to understand how human behavior shapes epidemics,” says Gonzalo Vazquez-Prokopec, an assistant professor in Emory University’s Department of Environmental Sciences, and senior author of the study. “No one had previously quantified how a symptom such as fever changes mobility patterns, individually and across a population, in a tropical urban setting like Iquitos.” Not surprisingly, human mobility is a huge driver for spreading these diseases in urban settings. With the ongoing spread of Zika, researchers are continuing to learn about the impact of human behavior and mobility on the spread of these mosquito-spread diseases.

Stories You May Have Missed: 

  • Global Reaches of Antibiotic Resistance – Check out my latest comments on the global implications of antibiotic resistance for first responders and security personnel. It’s a topic we’ve so frequently cited as an international health emergency, and yet it gets so little attention. In this article, I point to the obvious implications, but also the worries that dual-use technologies of concern and genetic modification could allow for increased resistance for a more sinister reason.
  • South Sudan Crisis Calls for Additional WHO Surveillance  – the continued chaos and violence in South Sudan has translated into the WHO ramping up disease surveillance efforts. More than 1.6 million internally displaced persons (IDP) have been caught in the conflict, leaving the region more susceptible to malaria and diarrheal illnesses. “The conflict has exacerbated existing challenges with the health system and disease surveillance,” Dr Usman says. “With so many health workers and partners moving to safety, data is more difficult to collect and challenges have emerged as humanitarian access remains limited.” The WHO is coordinating with the Ministry of Health to strengthen surveillance efforts to help detect and respond to outbreaks.
  • FBI WMD Directorate Marks 10 Years – A program we’d rather have and not need than need and not have, the WMD Directorate within the FBI has been imagining worst-case scenarios for over a decade to better prepare and protect the U.S. “The Directorate has three sections: countermeasures, investigations and operations, and intelligence. In its first five years, the Directorate established itself as a central hub for WMD subject-matter expertise.” Assistant Director, John Perren, notes that while they’re intelligence driven, the things that keep him up at night aren’t what he knows, but what he doesn’t know.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s