Pandora Report 5.11.2018

Have you registered for the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security? Don’t miss out on the early registration discount if you sign up before June 1st! Wondering if it’s safe to go back to romaine lettuce? Make sure to check the farm location as officials are saying this E. coli outbreak has a bigger footprint than that of the 2006 spinach outbreak.

White House Nixes Global Health Security in NSC
Just as Ebola hits the DRC, the National Security Council team responsible for global health security has been disbanded. “The top White House official responsible for leading the U.S. response in the event of a deadly pandemic has left the administration, and the global health security team he oversaw has been disbanded under a reorganization by national security adviser John Bolton. The abrupt departure of Rear Adm. Timothy Ziemer from the National Security Council means no senior administration official is now focused solely on global health security.” Following comments from Bill Gates about our lack of pandemic preparedness and Michael Osterholm’s on the challenges of predicting the next pandemic, a lack of health security coverage in the NSC is extremely worrisome. “Two members of Ziemer’s team have been merged into a unit in charge of weapons of mass destruction, and another official’s position is now part of a unit responsible for international organizations. White House homeland security adviser Tom Bossert, who had called for a comprehensive biodefense strategy against pandemics and biological attacks, is out completely. He left the day after Bolton took over last month.” Global health security threats, whether it be outbreaks, bioterrorism, or laboratory incidents, are only growing in complexity, which makes this particular shake-up deeply concerning for many in the biodefense world.

 New Ebola Outbreak in the DRC
Unfortunately, Ebola is rearing its head again in the DRC. Over the past five weeks, there have been reports of 21 suspected cases and 17 deaths. Two cases have been laboratory confirmed as Ebola and there are dozens of people under observation and contact tracing. “The DRC has become very good at controlling Ebola. The INRB in Kinshasa is more than capable of doing diagnostic tests without having to ship samples out to the United States. Its director, Jean-Jacques Muyembe Tamfum, was the first scientist to encounter Ebola at a time when he was the DRC’s only virologist, and has been involved in every outbreak response since. He and his colleagues have also trained a crack-team of researchers and disease detectives. ‘We’re advanced in public health,’ said Gisèle Mvumbi, a CDC-trained Congolese epidemiologist at the INRB, whom I met when I visited the DRC earlier this year. ‘If you compare us with Europe or the United States, eh, but here in Africa, we are high. We have experience’.” The WHO has officially declared the DRC cases as an outbreak, so now many are wondering if the vaccine will be deployed. The timing of the outbreak though, coincides with Trump’s plans to rescind $252 million that was set aside for Ebola response, citing that the outbreak was declared over in 2016 and that it is excessive spending.

The Characteristics of Pandemic Pathogens
The Johns Hopkins Center for Health Security has just released their new report on the characteristics of naturally occurring microorganisms that could cause a global catastrophic biological risk (GCBR). “The overarching aim of the study was to provide an inductive, microbe-agnostic analysis of the microbial world to identify fundamental principles that underlie this special category of microorganisms that have potential to cause global catastrophe. Such principles could refine pandemic preparedness by providing a new framework or lens through which to survey the threat landscape of infectious diseases in order to better anticipate, prepare for, and respond to GCBR threats.” Within the report, they compile information from 150 experts to discuss modes of transmission, host population dynamics, how human factors and/or complex disasters can elevate pathogens to GCBR, etc.

The Slow Death of Nonproliferation Norms
Charles Blair is taking a hard look at the global shifts in norms regarding the possession and use of chemical weapons. Blair, a GMU biodefense adjunct professor, points to two specific events over the span of just under two weeks, that challenged how the U.S. responds to foreign leaders who take a relaxed approach to CW. Trump’s congratulations to Putin on his re-election and the willingness to meet Kimg Jung-un are “in line with a broad, ominous shift in international attitudes toward chemical weapons and their use. The shift is alarming enough in its own right—but changes in norms that stigmatize chemical weapons directly affect other, and collectively far more important, pillars of the nonproliferation regime.” The rapid international degradation within the nonproliferation regime is surprising, notes Blair, but there were signs starting in 2012 that may have given us a heads up as to the future fissures. Telling moments for norms erosion has been repeatedly seen in the use of chemical weapons in the Syrian civil war and how the international community handles the continued possession and utilization of chemical weapons by the Assad regime. Russia, especially, has been an enabler for Assad and whose actions have been corrosive to the nonproliferation regime. Blair’s interviews include “Gregory Koblentz—director of the Biodefense Graduate Program at George Mason University— (who) discussed ‘just how little Russia cares about these norms and treaties.’ As evidence he cited Russia’s willingness to discount Syrian violations of international norms and to actively shield Damascus from the consequences of violations—by, for example, undermining the Joint Investigative Mechanism, the Fact-Finding Mission, and the overall investigative process in Syria. Koblentz said that because of Russia’s willingness to undermine the chemical weapons regime, he is concerned that Moscow might also be willing to undermine the International Atomic Energy Agency and the Nuclear Non-Proliferation Treaty. Russia, Koblentz said, is ‘the principle vector for the erosion of norms across all the nonproliferation regimes’.” Lastly, Blair underscores the important role the United States has in enforcing nonproliferation norms and the potential for Trump’s recent withdrawal from the Iran nuclear deal, to become a trigger for proliferation. “The irony, of course, is that any US military action against Iran, North Korea, or both would come wrapped in the cloak of norm enforcement—when, quite likely, Trump’s own pursuit of non-normative policies would cause North Korea to keep its nuclear weapons program and Iran genuinely to pursue a program of its own.”

Clade X Table Top
The Johns Hopkins Center for Health Security will be hosting the Clade X exercise next week “to illustrate high-level strategic decisions and policies that the United States and the world will need to pursue in order to diminish the consequences of a severe pandemic. It will address a pressing current concern, present plausible solutions, and be experientially engaging. Clade X is designed for national decision-makers in the thematic biosecurity tradition of the Center’s two previous exercises, Dark Winter (2001) and Atlantic Storm (2005).” The event will run from 9am to 5pm on Tuesday May 15th and while seats are invitation only, you can livestream it on their Facebook page.

North Korean Ties with Hamas?
Following the assassination of a Palestinian academic with ties to the Hamas resistance, Malaysian police are working to find two Israeli Mossad agents who are considered the culprits.”With elections underway in Malaysia, the murder has been downplayed, but the investigation is in full-on mode. ‘If Israel is behind it, that seems to be an extension of their policy regarding Iranian nuclear scientists,’ said Sonia Ben Ouagrham-Gormley, associate professor at the George Mason University Schar School of Policy and Government’s Biodefense Program in Virginia, via email. ‘In the past few years, several Iranian nuclear scientists were killed, and many suspected Israel of being behind those killings. The problem with assassination is that it is counterproductive: it can cause the scientists to work harder at reaching a working weapon’.”

NASEM Bio, Chem, and Health Security Luncheon – May
Don’t miss out on this May 21st luncheon held by the National Academies. “May’s event will be chaired and moderated by the National Academies’ Board on Health Sciences Policy. Itfeatures Greg Measer, Regulatory Counsel in the Food and Drug Administration (FDA)’s Office of Counterterrorism and Emerging Threats. He will discuss FDA’s initiative to build a national capacity for post-dispensing monitoring and assessment of medical countermeasures. The session also builds on issues discussed at a 2017 National Academies’ workshop on Building a National Capacity of Monitor and Assess Medical Countermeasure Use in Response to Public Health Emergencies.” If you’re unable to attend the event, we’ve got you covered, as one of our GMU Biodefense graduate students will be attending and reporting out.

Stories You May Have Missed:

  • Clinical Outcomes and Trends of Patients with Carbapenem-Resistant Infections – What are the outcomes of patients with carbapenem-resistant infections? GMU biodefense PhD student Saskia Popescu discusses a recent study that evaluates similarities between those with such resistant infections. “The study was conducted in a single-center tertiary-care hospital in St. Louis, Missouri, at which researchers reviewed differences between patients with carbapenem-resistant Enterobacteriaceae (CRE) or carbapenem-resistant non-Enterobacteriaceae (CRNE). Patients with positive CRE or CRNE cultures found from January 2012 to December 2015 were analyzed. However, researchers sought to avoid inclusion of those with colonization instead of true infection, so patients without sepsis and cystic fibrosis were excluded, as were those who were discharged without having received targeted antimicrobial therapy.”

  • Experts Discuss 1918 Pandemic and Global Flu Threat – The CDC and Emory University partnered up to hold a symposium in celebration of the 100th anniversary of the 1918 pandemic, to discuss the next pandemic and how we can prepare. Michael Osterholm and Arnold Monto debated regarding a universal flu vaccine. “Nancy Messonnier, MD, head of CDC’s National Center for Immunization and Respiratory Diseases, said that despite gaps in preparedness, the CDC is better equipped to handle a flu pandemic now than it was in 2009, when a novel H1N1 flu strain first emerged. Technologies, including mobile apps that help consumers find flu shots, and antivirals are putting the power to prevent and fight flu into patients’ hands, she said.

 

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