Pandora Report 8.4.2017

We all know that kitchen sponges are like little densely populated germ cities, but did you know that cleaning them could make it worse?

Only Six Nations Have Evaluated Pandemic Readiness
A new report from the World Bank is calling out how little work has been done to evaluate and prepare for pandemic readiness. The report notes that only six countries have evaluated their capacity and capabilities for responding to a pandemic. Of these countries, three are wealthy (Finland, Saudi Arabia, and the U.S.) and are were poor (Eritrea, Pakistan, and Tanzania). All six countries had gone under external evaluations and developed funding plans to rectify their inadequacies. “The annual number of disease outbreaks around the globe has more than tripled since 1980, and air travel spreads contagions across oceans far more often. To convince countries that preparedness pays, the report included estimates of the economic damage various epidemics had done. For example, the viral pneumonia SARS — which ultimately killed only 774 people — shrank China’s gross domestic product by 0.5 percent in 2003.” We’re seeing an increasing emphasis on the financial aspect of pandemics and as this report points out, knowledge is power. The report includes an entire section on incentivizing countries to prioritize allocation of funds to preparedness, assessment of economic vulnerability, sovereign credit rating, etc. It was interesting to see that antimicrobial resistance was not considered a pandemic. What would happen if a fully resistant bacteria swept the world?

We Don’t Need Another Biodefense Strategy
Al Mauroni is taking a deep dive into the history of American biodefense strategies and why Thomas Bossert’s recent comments about a new one aren’t exactly promising. White House homeland security advisor Bossert announced this during a security forum in Aspen, noting that until the development of a new plan, the U.S. lacked a comprehensive biodefense strategy. When this was announced there was a collective “um….about that..” from many within the biodefense community. Mauroni points to the three recent biodefense strategies within the last fifteen years, highlighting what we’re all thinking – this won’t be the first comprehensive strategy. First, there was the Homeland Security Presidential Directive 10 in 2005, then the National Strategy for Countering Biological Threats (Presidential Policy Directive 2) in 2009, and most recently, the National Strategy for Biosurveillance in 2012. So, if we’ve had strategies for the better part of two decades, why is there a demand for a new one? Increased outbreaks and concern for biothreats have many calling for further funding of biodefense efforts, like that of the Blue Ribbon Study Panel on Biodefense. Funding is one thing though, but a whole new strategy? “A recent article on the ‘proliferation’ of national strategies suggests that strategic guidance only adds to the confusion, allowing executive agencies to pick and choose what they want to implement.” Mauroni notes that “Going back to Bossert’s statement at the Aspen Security Forum, he referenced the 2001 anthrax-filled letters, pandemic influenza outbreaks, genetic engineering research, and the Global Health Security Agenda. He didn’t reference the protection of US military forces against adversarial use of biological warfare agents. All of these fall under the area of ‘biodefense,’ and there is no one agency that comprehensively addresses all of these threats. Because US government funding, authorities, and capabilities for biodefense reside in different agencies, it is very difficult to articulate objectives and responsibilities in one single strategy. There is no single point of authority to execute the strategy, and very often, no incentive to change given an inability to redirect resources or authorities”. Biodefense is a unique term though as it is often considered in a singular context and while the DoD plays a significant role in countering biological threats, there are other players. Biosafety and biosecurity is a large component, which rests heavily on both the private and public sectors. The DHHS leads in times of public health concerns (even if some of these efforts are duplicated by the DoD) and we can’t forget the role of public health surveillance and health security efforts like that of the GHSA. Mauroni leaves us with several points – “there cannot be one national biodefense strategy because there are at least three distinct policy areas that, while overlapping, are significantly different in execution of their policy objectives.” He notes that “I am not optimistic that the US government will consider a more diverse and complex policy process that articulates these differences. Having one national biodefense strategy offers a façade of simplicity and organization that three separate strategies will not.”

Opening Statements for ASPR Nominee
The nomination hearing for Dr. Robert Kadlec as Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services began on August 1st. You can check out the transcript here, in which Kadlec highlights five priority issues he wishes to pursue if confirmed. His priorities include providing stable leadership and clear policy direction, creating a “national contingency health care” system, supporting the sustainment of robust and reliable public health security capabilities, re-invorgorating and advancing an innovative MCM enterprise, and working to reauthorize the Pandemic and All-Hazards Preparedness Act in 2018. You can watch the nomination hearings here. Reports are pointing to his likely confirmation as his nomination “lacks controversy“.

European Report on Drug Resistance
Is the food we eat helping antimicrobial resistance take over? A new joint report from several European public health agencies notes that “To contain antibiotic resistance we need to fight on three fronts at the same time: human, animal and the environment. This is exactly what we are trying to achieve in the EU and globally with our recently launched EU Action Plan on antimicrobial resistance. This new report confirms the link between antibiotic consumption and antibiotic resistance in both humans and food-producing animals.” The impact of consuming antimicrobial agents is increasingly becoming an area of concern. While there are many factors that contribute to the rise of antimicrobial resistance, it’s not surprising that antibiotic use in food-producing animals would become a topic of interest. “Although consumption is defined differently in humans and animals, to make the comparison as consistent as possible, the report expresses consumption in milligrams of active substance per kilogram of estimated biomass (mg/kg). Human antimicrobial consumption is typically reported as defined daily doses per 1,000 inhabitants. Overall, the report found that average antimicrobial consumption was higher in food-producing animals than in humans, although the difference was largely influenced by a handful of countries with significant animal populations.” Analysis points to a relationship between consumption and antimicrobial resistance (seen in isolates in certain species of bacteria). This latest report underscores the complexity of antimicrobial resistance and the challenges in truly addressing this hydra-like problem. Perhaps we are what we eat?

Australian Raid Finds Chemical Weapon Attempts
The Sydney police raids across four properties, which resulted in four arrests, found components for improvised explosive devices (IEDs) and construction on an “improvised chemical dispersion device”. Two men were ultimately charged with building the military-grade device and were reportedly supported by ISIS operatives but their attack plans were foiled. “Police will allege that components for an improvised explosive device (IED) were sent to Australia in air cargo from Turkey via Isis operatives in Syria. Two men, who remained in custody after facing court on Friday, then allegedly assembled the devices with instruction from ‘a senior Isis operative’, according to the Australian federal police deputy commissioner Mike Phelan.” In response to the attempt, intelligence and law enforcement agencies are working to improve screening. Fortunately, the chemical weapon was in the early stages of development.

Biothreat Worries Over Cancer Research
At last week’s DEF CON hacking conference in Las Vegas, Intel’s chief medical officer John Sotos brought forth a somewhat surprising topic – bioweapons. Building on his discussion of the cancer moonshot, Sotos discussed the same technology (DNA manipulation) having the potential for misuse and development into biological weapons. “’The reason you haven’t heard much about bioweapons is that they’ve been held back by a pretty severe limitation, which is the potential for blowback’,” Sotos said. It is hard for any attacker to use weaponised diseases because they spread beyond their initial distribution range: destroy your neighbouring nation and you destroy your own as well. Sotos noted, ‘the cancer moonshot is going to really drive new technologies to manipulate DNA because cancer is a disease of DNA. [And] the same exquisite targeting that allows it to attack only your cancer cells also overcomes the blowback potential for bioweapons’.” While this level of precision medicine isn’t available yet, it draws parallels to gene-editing tools like CRISPR, in which targeted application is becoming more real. Soto hones in on the fear that such genetic engineering capabilities will not only be possible, but used for nefarious purposes like stealing genetic codes or rewriting DNA to tamper with fertility. Soto’s points are valid and it is important to consider the full spectrum of use for biotech developments in the future however, we must not lose sight of the consistent and growing threat that is natural disease.

Stories You May Have Missed:

  • Saliva Secretions & Zika Transmission – A recent study found that rhesus monkeys, when infected with high levels of the virus, could theoretically transmit via saliva. When compared to rhesus monkeys with more common viral loads, it was possible, although extremely unlikely, that the highly infected monkey could spread via saliva “All three monkeys who were exposed to high doses of Zika virus (20-fold higher than that typically found in saliva) applied directly on their tonsils developed the disease. Another group of 7 monkeys were exposed to the virus via the saliva of monkeys who had received subcutaneous infections, representing a typical virus count. None of the monkeys exposed to doses typically found in saliva contracted the disease when their tonsils (5 animals), conjunctivae (1), or nasal passages (1) were exposed. ‘We tried to simulate sneezing, sharing utensils, and other mucosal exposures,’ said Friedrich. ‘But the amount of virus typically founding saliva was not enough to infect a monkey or suggest any seroconversion [development of detectable antibodies]’.”
  • Biodefense World Summit Coverage – Get the latest overview of the Biodefense World Summit here, with a focus on biosurveillance! Topics range from DHS work to enhancing situational awareness for global disease surveillance.

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