Pandora Report: 6.12.2020

Dr. Andy Kilianski in Operation Warp Speed

Dr. Andy Kilianski, an adjunct professor in the GMU Biodefense Graduate Program, is one of the newly appointed experts leading the Department of Defense’s arm of Operation Warp Speed (OWS). Operation Warp Speed is a public-private partnership created to efficiently facilitate the development, manufacturing, and distribution of COVID-19 countermeasures. Kilianski was appointed as the subject matter expert in “security and assistance” for this fast-moving Manhattan Project-style initiative. According to Gregory Koblentz, director of the Biodefense Graduate Program, “Strengthening cyberbiosecurity is a vital element of our national effort to develop new vaccines and therapeutics against COVID-19. Kilianski’s appointment is a perfect illustration of how the biodefense program tries to bridge the gap between science and policy.” At the start of June, OWS announced five COVID-19 vaccine candidates: Moderna’s mRNA1273, AstraZeneca and Oxford University’s AZD1222, a candidate from Johnson & Johnson, a candidate from Merck, and Pfizer and BioNTech’s BNT162.

New Guidance for Decision Makers on Assessing COVID-19 Data

The newly established Societal Experts Action Network (SEAN) of the National Academies of Sciences, Engineering, and Medicine (NASEM) produced a rapid expert consultation to guide leaders using COVID-19 measurements, such as hospitalizations and number of confirmed cases, to better understand the disease’s spread in their regions. SEAN connects decision makers with researchers in the social, behavioral, and economic sciences to relay evidence-based expert guidance regarding local, state, and federal policies and responses related to COVID-19. This guide was created to facilitate insight into the strengths and weaknesses of COVID-19 data by applying 5 criteria to 7 types of data available to support decision making. The goal is to guide decision-makers toward the data type most appropriate to answer each of their questions, and then to use that data effectively. The 7 data types are the number of confirmed cases, hospitalizations, emergency department visits, reported confirmed COVID-19 deaths, excess deaths, the fraction of viral tests that are positive, and representative prevalence surveys (viral and antibody tests). The 5 criteria are representativeness; bias; uncertainty, and measurement and sampling error; time; and space. Read the full guide here.

The Military and Pandemics: Early Lessons and Future Actions

This week, the Center for Strategic and International Studies (CSIS) hosted an online event to discuss the major steps taken by the US military toward augmenting the civilian medical system while simultaneously sustaining its own operations. This discussion focused on lessons learned, the possibility of restructuring military services to improve future responses to events such as pandemics. Panelists included Lieutenant General David Barno (Ret.) from Johns Hopkins University School of Advanced International Studies, Nora Bensahel from Johns Hopkins University School of Advanced International Studies, and Melanie Marlowe from the CSIS International Security Program.

The overarching theme and point of agreement across the three panelists was the inevitability of major changes in direction, priorities, and budget of the US military. Regarding the budget, the Department of Defense (DoD) should expect a significant drop that likely requires scaling back or eliminating large legacy programs and the shrinking of active duty forces. Barno expects priorities to shift from an external focus on protecting Americans to protecting Americans at home as the cyber and space domains continue to surpass the land, air, and sea domains. The traditional defense barriers placed around the world by the US military are ill-equipped to protect those on US soil, as we are currently experiencing in the COVID-19 pandemic. Additionally, Barno anticipates that the reserve component of the military will play a bigger role now as it is essentially a dual-purpose force that helps provide food and supplies and augments civilian medical efforts in national emergencies along with its more soldierly objectives. Bensahel stressed the fact that the COVID-19 pandemic is the greatest catastrophe to hit the US since World War II; the death toll from COVID-19 now exceeds that of all US military deaths in overseas events since World War II. She also asserts that national security will now be redefined as Americans shift their notion of national security as susceptible to outside threats, like state or non-state actors, to susceptible to intangible threats. Americans will think more of their own personal security. Marlowe maintains that the military should not be the linchpin responder in a national emergency, such as a pandemic, but that the civilian sector should be the primary responder. As a support to the civilian efforts to contain the spread of the virus and treat infected individuals, the US military erected field hospitals, moved important cargo, evacuated US citizens from other nations, and provided hospital ships. In summary, the US military is about to undergo significant changes in its resources and objectives as the pandemic alters the meaning and parameters of national security. View the recording of this event here.

Soviet, Chinese, and North Korean False Allegations of Biological Weapons Use During the Korean War

During the Korean War, the USSR, China, and North Korea accused the US of using biological weapons against enemies. After the construction of the Richard Lugar Center for Public Health Research, the first high containment laboratory in the Republic of Georgia, the Kremlin accused Lugar Center, along with other US-backed laboratories, of producing biological weapons. Throughout the ongoing COVID-19 pandemic, mudslinging accusations that SARS-CoV-2 is a biological weapon are being flung from many China, Iran, Russia, and the United States. China has carried on a disinformation campaign against the US using unfounded claims that the US military introduced the new virus into Wuhan last fall during the Military World Games. Iranian officials have insistently promoted conspiracy theories that COVID-19 is a biological weapon created by the US to target Iran and its pharmaceutical industry. Russia has bolstered the claims of Iran by peddling their conspiracies on social media platforms. US officials have accused China of sabotaging the R&D efforts of Western nations toward developing a COVID-19 vaccine. False allegations of bioweapons use are injurious geopolitical tactics that degrade the legitimacy and authority of the Biological and Toxin Weapons Convention (BTWC). The BTWC is a multilateral arms control treaty signed by 183 countries that bans the development, stockpile, production, and transfer of biological agents and toxins. False claims of BTWC violations weaken the treaty regime by compromising the efficacy of international cooperation and collaboration against tangible threats of bioterrorism.

Coronavirus: Asymptomatic Transmission Still an ‘Open Question’

Along with numerous other uncertainties persisting in the COVID-19 pandemic, the question of the disease’s transmission from asymptomatic patients is the latest to rouse media attention. Dr. Maria Van Kerkhove is an infectious disease epidemiologist who serves as the WHO’s technical lead on the Covid-19 pandemic clarified that the actual rates of asymptomatic transmission are not yet known. Van Kerkhove’s clarification came just a day after her statement in an 8 June Press Conference that asymptomatic transmission is quite rare. At present, the data are not conclusive on the risk of asymptomatic spread. Adding insult to injury, there is confusion regarding the definition of an asymptomatic case. Though some cases of the virus are truly asymptomatic, the term is also applied to patients that have simply not begun to present with symptoms; some patients are in labeled as asymptomatic when they are actually presymptomatic. Asymptomatic cases are those that never present with symptoms, whereas presymptomatic cases are those individuals who test positive when they are symptom-free but later show them. These contradicting statements from the WHO are especially concerning given that research from different entities are finding that asymptomatic patients could be the cause of as much as half of the spread. The Office of National Statistics in the United Kingdom has been routinely testing a sample of its population, finding that of those individuals testing positive for COVID-19, less than one-third report “any evidence of symptoms” at the time of testing. The uncertainty and contradicting statements regarding asymptomatic transmission leave the public and its decision-makers in a pickle: are asymptomatic cases fueling the spread of COVID-19, and, if so, how do we adjust our response efforts?

Coronavirus Vaccine Tracker

The New York Times published a Coronavirus Vaccine Tracker that provides updates on the status of vaccine candidates that have reached human trials as well as a selection of candidates in cell or animal testing. Vaccine candidates must make it through four important stages before regulatory approval: (1) Preclinical Testing in animals, (2) Phase I Safety Trials using a small number of human subjects, (3) Phase II Expanded Trials with hundreds of human subjects, and (4) Phase III Efficacy Trials with thousands of subjects. Normally, the process to approval is quite sluggish; however, under emergent conditions, there are options to accelerate a viable candidate to approval. The Tracker categorizes vaccine candidates as genetic, viral vector, protein-based, and whole-virus. View the Tracker here.

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