Pandora Report 4.12.2019

Biodefense Summit: Implementation of the National Biodefense Strategy                                                                                                                     Don’t miss this April 17th event at the National Academies of Science Building, hosted on behalf of the Federal Government. “Biological threats are among the most serious threats facing the United States. In today’s interconnected world, biological incidents have the potential to cost thousands of American lives, cause significant anxiety, and disrupt travel and trade. The Strategy sets the course for the United States to combat the serious biothreats our country faces, whether they arise from natural outbreaks of disease, accidents involving high consequence pathogens, or the actions of terrorists or state actors. Engagement with non-governmental organizations and the private sector is critical to prevent the spread of disease and respond to the next outbreak before it becomes an epidemic. Preparing for biothreats is a critical aspect of our national security, and the Strategy encompasses five goals for strengthening the biodefense enterprise including: enabling risk awareness to inform decision-making across the biodefense enterprise, ensuring biodefense enterprise capabilities to prevent bioincidents, ensuring biodefense enterprise preparedness to reduce the impacts of bioincidents, rapidly responding to limit the impacts of bioincidents, and facilitating recovery to restore the community, the economy, and the environment after a bioincident.The meeting will also be webcast; information about registering for the webcast is available at https://www.phe.gov/Preparedness/biodefense-strategy/Pages/summit-2019.aspx. Given the importance of the Nation’s biodefense to every American, the public is encouraged to submit written comments on questions on the meeting agenda, on which the U.S. Government would specifically like to solicit comment. Comments should be submitted to ASPRBIO@hhs.gov or the address above by May 1, 2019.”

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security 
Come spend 3.5 days with some of the top minds in the biodefense field this July at our summer workshop. From vaccine development to biosecurity as a wicked problem, we’ll be having frank conversations regarding the toughest issues in health security. Register before May 1st for an early discount and get another discount if you’re a returning student, GMU alum/current student/professor, or registering with a large group.

Richard Cupitt Joins GMU Biodefense                                                                We’re excited to announce that Richard Cupitt is joining the GMU Biodefense program as an adjunct professor. Cupitt will be teaching Nonproliferation and Arms Control this fall and “his areas of expertise include WMD nonproliferation, export controls, and foreign policy. Prior to joining Stimson, he served as the Special Coordinator for U.N. Security Council resolution 1540 in the Office of Counterproliferation Initiatives at the U.S. State Department from 2012 through 2016. As such, he led U.S. government efforts to further implementation of the more than two hundred legally binding obligations and recommendations of the resolution, which aims to combat proliferation of WMD and their means of delivery, especially to non-state actors such as terrorists and criminal organizations.”

A Guide to Training and Information Resources on the Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences
Have you read the latest guide from ASPR? This informative new resource includes not only helpful definitions of biosafety, biosecurity, and responsible conduct, but it also discusses the building blocks of organization culture, courses and education resources (worldwide opportunities as well!), DURC, ethics and codes of conduct, contributing organizations, and more. “If you are interested in finding out more about the culture of biosafety, biosecurity, and responsible conduct, this guide is for you. A U.S. interagency Working Group was established in 2015 to implement the recommendation of the Federal Experts Security Advisory Panel to ‘create and strengthen a culture that emphasizes biosafety, laboratory biosecurity, and responsible conduct in the life sciences… characterized by individual and institutional compliance with biosafety and laboratory biosecurity regulations, guidelines, standards, policies and procedures, and enhanced by effective training in biorisk management’. This group morphed into an International Working Group, a Community of Practice comprised of representatives of governments, academia, industry, professional and international organizations from across the globe. We are using crowdsourcing to develop educational materials and promote learning. From the U.S. perspective, we are guided by the 2018 National Biodefense Strategy which tasked us to ‘support and promote a culture of global biosafety, biosecurity, ethical, and responsible conduct in the life sciences’. Per our 2019-2022 National Health Security Strategy, ‘we must ensure the benefits of scientific research are effectively realized, while the potential for misuse is minimized by…supporting responsible conduct in the life sciences through promoting a culture of responsibility, effective oversight of dual-use research, and engagement with nontraditional and amateur research communities…” Bonus: there is a great biosecurity crossword puzzle on page 81!

Re-Introduction of the Global Health Security Act
“Today, Congressman Gerry Connolly (D-VA), Chairman of the U.S. Delegation to the NATO Parliamentary Assembly, and Congressman Steve Chabot (R-OH) reintroduced the bipartisan Global Health Security Act, which reaffirms the United States’ commitment to promoting global health security. The legislation is cosponsored by Representatives Brian Fitzpatrick (R-PA), Ami Bera (D-CA), Ann Wagner (R-MO) and Rick Larsen (D-WA). Republican and Democratic presidents alike have recognized the critical importance of global health security – from President Obama’s role in launching the Global Health Security Agenda (GHSA) to President Trump’s National Security Strategy and National Biodefense Strategy. The Global Health Security Act codifies U.S. investments in the ability to prepare for and respond to public health threats and reduce or prevent their spread across borders. In particular, this bill bolsters U.S. commitments under the Global Health Security Agenda, which is a multilateral initiative to build countries’ capacity to manage infectious disease threats and elevate heath security as a global priority.” Rep Connolly noted that “Saving lives from the next global pandemic starts with investing in preparedness before it strikes,. As we’ve seen time and time again, diseases do not respect borders, and global health crises have immense security, economic, and humanitarian consequences. Unfortunately, almost 70% of the world’s nations are underprepared to manage or control outbreaks. Our legislation recognizes the critical role of U.S. leadership in international health security, enshrines U.S. global health security policy in statute, and ensures that there is a permanent designated official responsible for coordinating these efforts in a strategic way.”

Why You Should Be Paying Attention to Candida Auris and How There’s Too Much Secrecy Around Outbreaks of Resistant Infections

We love talking germs but the truth is that there are some that tend to be neglected when it comes to important conversations. A recent article by Matt Richtel is calling us out on the lack of attention we’ve given the fungus Candida auris. In his quest to discuss drug-resistant infections, Richtel stumbled upon one that was causing significant infections and requiring considerable medical interventions but no one seemed to want to sit down and have a conversation about it… “From this germ of an observation grew one of the most curious aspects of our series: The rise in resistant bugs is cloaked in widespread and chronic secrecy. As our reporting continued, we discovered it was common for hospitals, doctors and public health agencies to clam up when it came to talking about their troubles with resistant bugs, though they widely acknowledged the existence of the problem and even encouraged our efforts. This disconnect was at its most extreme when the issue turned to the subject of the first article in our series, which was published online on Saturday — Candida auris. C. auris is a drug-resistant fungus that has emerged mysteriously around the world, and it is understood to be a clear and present danger. But Connecticut state officials wouldn’t tell us the name of the hospital where they had had a C. auris patient, let alone connect us with her family. Neither would officials in Texas, where the woman was transferred and died. A spokeswoman for the City of Chicago, where C. auris has become rampant in long-term health care facilities, promised to find a family and then stopped returning my calls without explanation.” Beyond the discussion of this resistant and rising infection, Ritchel started looking into the secrecy that exists in healthcare and why outbreaks of these infections weren’t being reporting. “‘They might not get up and go to another hospital, but patients and their families have the right to know when they are at a hospital where an outbreak is occurring,’ said Lisa McGiffert of the Patient Safety Action Network. ‘That said, if you’re going to have hip replacement surgery, you may choose to go elsewhere.’ Kevin Kavanagh, board chairman of the advocacy group Health Watch USA, contrasted the C.D.C.’s handling of the infections in Tijuana with a 2016 outbreak of a different drug-resistant pathogen, known as carbapenem-resistant Enterobacteriaceae, or CRE, at a rural hospital in Kentucky. It was not until early 2018 that the C.D.C. issued a report on that outbreak — and even then, the agency did not name the hospital where it occurred.” From the viewpoint of this infection preventionist – this is just skimming the surface in terms of hospital secrecy and drug-resistant infections, and there are considerable issues in hospital transparency.

Brexit Threatens Biosecurity                                                                           What are the biosecurity implications of Brexit? How will safeguards for diseases be managed with this new separation? “Biosecurity is likely to be seriously compromised by the United Kingdom’s exit from the European Union. Common rules and safeguards, backed by a common judicial system, have for decades protected human, animal and plant health against biological hazards. Even so, ash dieback still threatens 60 million UK trees, and African swine fever has spread to Europe (see I. Capua and M. Monti Nature 566, 326; 2019). Despite the rush to pass the huge volume of secondary legislation required by the EU Withdrawal Act before the end of this month, it is almost certain that the mechanisms and operational capacities to replicate these protective systems nationally will not be in place (see, for example, go.nature.com/2tislyv). Establishing such mechanisms will take time — and, meanwhile, hazards will persist.”

Is it Time to Declare the DRC Ebola Outbreak a PHEIC?                               On Wednesday, 18 new cases were reported in the DRC, which was been the biggest jump in a single day since last August – bringing the total to 1,186 cases and 751 deaths. In the wake of this alarming news, the WHO is re-evaluating if the outbreak should be declared a Public Health Emergency of International Concern (PHEIC). The panel of experts will meet today (Friday). “This will be the second time an emergency committee has been asked to advise WHO Director-General Tedros Adhanom Ghebreyesus on whether this outbreak meets the criteria to be declared a Public Health Emergency of International Concern, known in global health circles as a PHEIC. The committee met in October and though it described the outbreak as very worrying, it recommended against declaring a PHEIC at that time.”

Dr. Matthew Meselson Wins 2019 Future of Life Award for Efforts Against Bioweapons           Dr. Meselson has been fighting the good fight since the 1960s and we’re glad to see him as the recipient of the Future of Life award, recognizing his role in biodefense. “In 1963, he was an academic working on arms control issues, and it was then that he learned the US was working on developing anthrax. ‘I asked why would we do that? [My boss] said it would be a biological weapon a lot cheaper than nuclear weapons,’ Meselson recalls. ‘I don’t think it hit me immediately. But by the time I got back to the office, it dawned on me that we don’t want a weapon of mass destruction that is cheap. We don’t want to save money to the point where anybody could have a cheap weapon of mass destruction’.” Meselson has been discussing the need to disarm biological weapons since he first found they were being developed and hasn’t stopped since. “Daniel Feakes, chief of the Biological Weapons Convention Implementation Support Unit, said in a statement, ‘Through his work in the US and internationally, Matt Meselson was one of the key forefathers of the 1972 Biological Weapons Convention. The treaty bans biological weapons and today has 182 member states. He has continued to be a guardian of the BWC ever since’.” You can watch this great video on Dr. Meselson and his work here                                   

A Scary Shortage of Infectious Disease Physicians                                        In a time of increasing antimicrobial resistance, emerging infectious diseases, and concern surrounding synthetic biology, the ability to diagnose and treat infectious diseases is pivotal. Unfortunately, those specialized physicians we rely on are becoming scarce. “Infectious diseases is one of just two medicine subspecialties that routinely do not fill all of their training spots every year in the National Resident Matching Program (the other is nephrology). Between 2009 and 2017, the number of programs filling all of their adult-infectious-disease training positions dropped by more than 40 percent.” You might wonder why this is occurring if infectious disease physicians are so critical…”The problem is that infectious-disease specialists care for some of the most complicated patients in the health care system, yet they are among the lowest paid. It is one of the only specialties in medicine that sometimes pays worse than being a general practitioner. At many medical centers, a board-certified internist accepts a pay cut of 30 percent to 40 percent to become an infectious-disease specialist.” The issue lies in both the way insurance reimbursement occurs for these providers, but also that they don’t really perform procedures, which are big sources of revenue for hospitals (i.e. incentive to have them) and there’s not much to bill. “The Infectious Diseases Society of America and other professional organizations have devised aggressive recruitment and advocacy strategies, but there is far more work to be done. It begins with the recognition that infectious-disease doctors are overworked and underpaid. Our insurance system needs a better way to measure the value of diagnoses and treatments so that we can fairly reimburse doctors in cognitive specialties. We must hurry. Superbugs are coming for us. We need experts who know how to treat them.”

Weapons of Mass Distraction: Foreign State-Sponsored Disinformation in the Digital Age                                                                      The US Department of State’s Global Engagement Center has aided in this new report. “If there is one word that has come to define the technology giants and their impact on the world, it is“disruption.” The major technology and social media companies have disrupted industries ranging from media to advertising to retail. However, it is not just the traditional sectors that these technologies have upended. They have also disrupted another, more insidious trade – disinformation and propaganda. The proliferation of social media platforms has democratized the dissemination and consumption of information, thereby eroding traditional media hierarchies and undercutting claims of authority. The environment, therefore, is ripe for exploitation by bad actors. Today, states and individuals can easily spread disinformation at lightning speed and with potentially serious impact. The problem of disinformation is therefore not one that can be solved through any single solution, whether psychological or technological. An effective response to this challenge requires understanding the converging factors of technology, media, and human behaviors. The following interdisciplinary review attempts to shed light on these converging factors, and the challenges and opportunities moving forward.”

Twist Bioscience Adopts Battelle’s ThreatSEQ DNA Screening Web Service for Advanced Biosecurity                                                                       “Twist Bioscience Corporation (NASDAQ: TWST), a company enabling customers to succeed through its offering of high-quality synthetic DNA using its silicon platform, today announced that it is the first to implement Battelle’s ThreatSEQ web service DNA screening platform for the detection and characterization of sequences of concern in genomic data, supplementing its internal biosecurity efforts. ‘We have spent decades working with and characterizing biothreats to support global biodefense efforts, which has resulted in the curation of a high-quality Sequence of Concern database and the development of a robust algorithm for screening DNA at production scale rapidly,’ said Matt Vaughan, President of Battelle’s Contract Research business. ‘Twist Bioscience continues its leadership in the field of biosecurity as the first to integrate the ThreatSEQ web service into its gene-length DNA screening pipeline. We look forward to expanding this service to all companies who desire standardized and sustainable screening capabilities’.”

Stories You May Have Missed:

  • World Pork Expo Cancelled As A Precaution Against African Swine Fever– “The National Pork Producers Council’s (NPPC) board of directors has announced its decision to cancel World Pork Expo 2019 out of an abundance of caution as African swine fever (ASF) continues to spread in China and other parts of Asia. The World Pork Expo, held each June at the Iowa State Fairgrounds in Des Moines, hosts approximately 20,000 visitors over three days, including individuals and exhibitors from ASF-positive regions. ASF affects only pigs and presents no human health or food safety risks. There is currently no vaccine to treat the swine disease. ‘While an evaluation by veterinarians and other third-party experts concluded negligible risk associated with holding the event, we have decided to exercise extreme caution,’ said David Herring, NPPC president and a producer from Lillington, N.C. ‘The health of the U.S. swine herd is paramount; the livelihoods of our producers depend on it. Prevention is our only defense against ASF, and NPPC will continue to do all it can to prevent its spread to the United States’.”
  • More Pediatric Antibiotics Prescribed with Telemedicine – “A study published in Pediatrics revealed that children with acute respiratory infections who are treated through direct-to-consumer telemedicine visits are significantly more likely to receive antibiotics. These children, according to the researchers, are also less likely to receive guideline-based antimicrobial treatment. Kristin N. Ray, MD, MS, assistant professor of pediatrics at the University of Pittsburgh School of Medicine, told Infectious Diseases in Children that the findings show that antimicrobial stewardship should be a priority for telemedicine programs that treat acute pediatric illnesses.”

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