Pandora Report: 7.10.2020

The Pandemic Experts Are Not Okay

A recent article in The Atlantic sheds light on the risk of burnout that US public health specialists face as the coronavirus surges. The public-health experts who advise policy makers, monitor the pandemic, and prepare hospitals for cases are suffering from the physical and emotion exhaustion of their work, but also from the “wrath of a nation on edge” as Americans lash out after months of stay-at-home orders and response blunders. The burnout could leave the US in a “drought of expertise.” Dr. Saskia Popescu, alumna of the Biodefense PhD Program and an epidemiologist at the University of Arizona, is among the numerous experts who have been dedicated round-the-clock to fighting the pandemic since early this year. As Arizona was reopening, the intensive care unit of Popescu’s hospital was packed with COVID-19 patients, making those in the public health arena very nervous for a flood of new cases against which they may not be adequately equipped. Popescu also touched on the threats and harassment she experiences as an expert in the public’s eye, “I can say something and get horrendously attacked, but a man who doesn’t even work in this field can go on national TV and be revered for saying the exact same thing.” Despite the many struggles and barriers, public health experts are determined to continue their work against COVID-19.  

US Imprudently Initiates Withdrawal from the WHO

The latest miscalculation of the Trump administration is its formal notice of withdrawal from the World Health Organization (WHO). The withdrawal will not be official until 6 July 2021, so there is a window of opportunity, should Trump lose the election, for the decision to reversed. US withdrawal from the WHO would leave global health governance in a state of uncertainty by bringing up concerns about the economic viability of the WHO, the polio eradication program, the reporting system for infectious disease outbreaks, and other programs such as those combating the spread of antimicrobial resistance. Fears have arisen about the demise of US global health leadership and the future health of Americans. A letter signed by 750 scholars and global public health experts pleads for Congress to block the withdrawal, and argues that Trump lacks the unilateral legal authority to cancel the country’s membership. Given that the US funds the largest portion of the Health Emergencies Program, the letter also points out that the withdrawal will likely cost lives, both American and foreign. Also, the US will lose access to the WHO’s global system for important health data, a severe disadvantage as the US is still struggling with COVID-19. The withdrawal will lessen the capacity of the US and other nations to detect and control future outbreaks, heightening the risk of another pandemic in the not-so-distant future. The American Medical Association (AMA) issued a statement as well, calling on Congress to reject the administration’s withdrawal decision and fight to protect the relationship between the United States and the WHO. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, epitomizes this misstep in one of his recent tweets: “Withdrawing from the WHO in the middle of a pandemic is like shooting yourself in the foot during a marathon because your shoelaces are untied.”

COVID-19 Risk Index

Dr. Saskia Popescu, alumna of the Biodefense PhD Program and an epidemiologist at the University of Arizona, Dr. James P. Phillips, Chief of Disaster Medicine at GWU Emergency Medicine, and Dr. Ezekiel J. Emanuel, Vice Provost for Global Initiatives and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, developed a COVID-19 Risk Index to help you decide what you are comfortable doing as reopening continues. The Index is based on four key factors: (1) enclosed space; (2) duration of interaction; (3) crowds; and (4) forceful exhalation.

Medical Countermeasures for COVID-19

Though the scientific community has quickly designed 1,200 clinical trials for testing treatment and prevention strategies against the novel coronavirus, the data show that panic and disorganization are diluting these efforts. Robert Califf, the head of clinical policy and strategy at Verily Life Sciences and Google Health and a former commissioner of the Food and Drug Administration, stated that studies are often too small to provide valid answers, lack suitable control groups, and overemphasize certain potential treatments, such as hydroxychloroquine. An analysis found that 39% of studies are enrolling or planning to enroll fewer than 100 subjects, so they are unlikely to produce sound results. In short, much energy and money are being wasted on fruitless endeavors. On an encouraging note, the RECOVERY trial has returned three very important findings: (1) dexamethasone, a cheap steroid, reduced the death rate of COVID-1 patients on ventilators by a third; (2) hydroxychloroquine does not benefit hospitalized patients with Covid-19; and (3) lopinavir and ritonavir, a pair of HIV drugs, have also not benefited hospitalized patients. Clinical trials cost anywhere from $10 million to hundreds of millions of dollars, so providing resources for poorly designed or theorized studies is extremely wasteful. The fixation on hydroxychloroquine, an antimalarial drug, was the result of research enterprise becoming “lopsided and unfocused.” Hydroxychloroquine showed promise in cell cultures; however, many of the studies testing the drug’s efficacy in patients were poorly designed. The WHO conducted a large study and found that neither hydroxychloroquine nor lopinavir-ritonavir combination therapy were found to benefit patients. Walid Gellad, Director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, considers the lack of leadership for the clinical trial agenda of the US as one of the key failures of this pandemic response.

Operation Warp Speed (OWS), the federal government’s newly-minted initiative to fast-track the development of a COVID-19 vaccine, is an attempt to provide leadership and direction for vaccine development. Despite its objective of transparency, OWS is under fire for its opaqueness about selected COVID-19 vaccine candidates. At a Senate subcommittee hearing about OWS, scientists with the initiative were rather mum when asked about the vaccine candidates that were chosen as frontrunners and the selection criteria used to make those choices. The names of the companies developing these candidates and a scientific review of 50 candidates are not available to the public. Another concern is the hypocrisy surrounding vaccine development with China. General Gustave Perna, co-leader of OWS, stated that he would not work with China; however, 4 of the 18 candidates that have entered clinical trials are made in China and 3 of these are set to start phase III trials. The triad of panic, disorganization, and opaqueness is undermining the ability of the US to quickly develop a safe and effective COVID-19 vaccine.

Lecture: Political Implications of COVID-19

Dr. Jennifer Victor, Associate Professor of Political Science at the Schar School, was a featured presenter this week for the COVID-19 and the Mason Impact virtual course. Victor’s lecture, Political Implications of COVID-19, covers why the US is struggling to contain the virus, how the virus affects existing political dynamics in the US, and how the virus may impact upcoming elections. In summary, the pandemic has worsened politics and exacerbated existing systemic inequalities in the US. Watch Victor’s lecture here.

Bipartisan Group of Former Government Officials Demand Science-Based Approach to Pandemic

This week, 57 former government scientists and public health officials released a statement calling for a science-based approach to guide pandemic response, a clear point of failure of the response. They encourage “independent and sound science” as the foundation for response decisions and efforts. Additionally, this bipartisan group criticized the administration for marginalizing the importance of science and expertise. The statement also acknowledges the need for coordination of scientists around the world, a likely reference to the unpopular decision of the Trump administration to withdrawal from the World Health Organization. Signers included officials from the Trump, Obama and George W. Bush administrations. A June article written by Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, and Dr. Saskia Popescu, alumna of the Biodefense PhD Program – “Hear, see, speak no COVID: Why the Trump administration is bungling the response to the pandemic” – spotlighted the Trump administration’s failure to utilize scientific expertise as the heart of its botched response. Koblentz and Popescu pointed out that the administration has enlarged the gap between science and policy, blighting the efficacy of the US response to COVID-19.  

The Blame Game

Some people don’t know when to give up. Ted Postol, a former MIT professor, has long claimed that the Syrian government was not responsible for a sarin attack on the town of Khan Sheikhoun in April 2017 despite the conclusions of investigations conducted by the UNOPCWUS and French intelligence agencies, New York TimesBellingcatHuman Rights Watch, and a variety of Syrian NGOs. His failed effort to publish an article promoting his CW denialism in a prestigious peer-reviewed journal  were recently recounted in the online magazine Undark. Gregory Koblentz, Biodefense Graduate Program director, played a role in blocking publication of Postol’s article. In retaliation, Postol filed a complaint of “academic misconduct” against Dr. Koblentz with George Mason University. Although the complaint did not allege any behavior that meets the definition of academic misconduct (such as plagiarism, fraud, or falsification of data), George Mason University convened an independent committee of senior faculty members to review the complaint. The committee found that the complaint had no merit. 

While Postol was busy complaining, Dr. Koblentz published a peer-reviewed article on the status of international efforts to attribute CW attacks in Syria, including the work of the OPCW’s Investigation and Identification Team (IIT). On April 8, the IIT published its first report which found that the Syrian Arab Air Force “pursuant to orders from the highest levels of the Syrian Arab Armed Forces” was responsible for three chemical attacks on the town of Ltamenah in March 2017. Two of these attacks, on March 24 and 30, were conducted the same way as the April 4 attack on Khan Sheikhoun: all three chemical attacks involved a Syrian Su-22 airplane taking off from Shayrat airbase and dropping an M4000 binary chemical bomb filled with sarin produced using a recipe unique to the Syrian CW program.  The IIT examined several alternative scenarios, including that the attacks on Ltamenah had been staged, but “the IIT could not identify any other plausible explanation for the concurrence of information before it.” The IIT report has established yet again that the Syrian regime has engaged in the systematic use of chemical weapons against its own people. It’s time to stop debating what happened at Khan Sheikhoun and focus instead on how the Assad regime can be held accountable for its heinous and illegal acts.

OPCW Decision on Chemical Weapons in Syria

It’s official. The Organisation for the Prohibition of Chemical Weapons’ (OPCW) Executive Council (EC) condemned the use of chemical weapons by the Syrian air force in Ltamenah in March 2017.  The OPCW EC adopted this decision by vote: 29 yes, 3 no, and 9 abstain. The EC’s decision shows its deep concern that the Syrian Arab Republic failed to declare and destroy all of its chemical weapons and production facilities for chemical weapons. The decision reflects the conclusion that the Syrian Arab Republic did not cooperate with, and provide access to, the Investigation and Identification Team (IIT). The EC demands that the Syrian Arab Republic immediately cease all use of chemical weapons and fully cooperate with the OPCW’s Technical Secretariat. Within 90 days, the Syrian Arab republic should complete three measures: (1) declare to the Secretariat the facilities where the chemical weapons were developed, produced, stockpiled, and operationally stored for delivery; (2) declare to the Secretariat all of the chemical weapons it currently possesses prohibited under the Convention, and the chemical weapons production facilities; and (3) resolve all of the outstanding issues regarding its initial declaration of its chemical weapons stockpile and programme. Within 100 days, the Director-General will report to the EC and all States Parties to the Chemical Weapons Convection on whether the Syrian Arab Republic has completed all measures.

UNSC Convenes on COVID-19

The United Nations Security Council (UNSC) held an open video conference about pandemics and security, taking place the day after the adoption of resolution 2532 on pandemic response. Resolution 2532, which passed unanimously, demands a general and immediate cessation of hostilities in all situations so that efforts against COVID-19 can unite to help the most vulnerable countries. The resolution is considered a compromise as it makes no reference to the World Health Organization or the topic of transparency. A COVID-19 resolution was difficult to pass largely due to the clash between the US and China over reference to the World Health Organization. At the conference, UN Secretary-General António Guterres asserted the relevance of the Biological and Toxin Weapons Convention in a pandemic, and urged considerable attention be paid to the deliberate use of diseases as weapons. In short, Guterres recommends a strengthening of the Convention and implores the 14 states that have yet to join to do so immediately. Guterres also emphasized the intersection of resilience against the threat of biological weapons and effective public health measures. He said, “the best counter to biological weapons is effective action against naturally occurring diseases.”

Community Lab in Baltimore Aims to Put Science in the People’s Hands

The Baltimore Under Ground Science Space (BUGSS) is a community laboratory, which was recently discussed in a Pandora Report Commentary by Biodefense PhD candidate Yong-Bee Lim, that provides research space for do-it-yourself biologists, hobbyists, and high school and home-schooled students. BUGGS exists to provide a learning and research environment for citizen scientists who would otherwise not have the space or tools to build their skills or work on projects. BUGGS has played host to several innovative projects in its brief lifespan. For example, Dr. Huon de Kermadec, a “biohacker,” is working with others scientists to develop an alternative to insulin as part of the Open Insulin Project. The Inner Harbor project is a collaboration between BUGGS, the National Aquarium, and the University System of Maryland’s Institute of Marine and Environmental Technology to catalogue all living species in the watershed of Baltimore.

Making BioWeapons Obsolete

The Council on Strategic Risks and Sandia National Laboratories convened thought leaders in government, academia, and the private sector to discuss the creation of a future in which the threat of biological weapons is greatly reduced. A summary of the discussions, Making Bioweapons Obsolete, covers the spectrum of topics and issues that must be addressed to reduce biothreats. Biothreats are changing due to three factors: (1) advances in technology; (2) increased concern about nation-state peer competitors; and (3) decreased focus of US on biothreats. The report considers bioterrorist and state attacks and assesses the differences in biodefense strategy dependent on the type of adversary. Read the report here.

CSHL Trustees Vote on the Future of Graduate School

The Cold Spring Harbor Laboratory (CSHL), established in 1890 as a biological teaching laboratory, voted to rename restore the original name of the graduate program to the Cold Spring Harbor Laboratory School of Biological Sciences, dissociating from James D. Watson. Though Watson made considerable contributions to CSHL and science, his views of race are incompatible with the mission and values of CSHL. Additionally, the Board of Trustees endorsed a plan by the faculty to start a new program at the graduate school about the social impact of the biological sciences.

Schar School Employee of the Month for July: Silva Pecini Morris

Silva Pecini Morris is the July Employee of the Month at the Schar School! Morris is the Director of Student Services and has worked at GMU for 15 years. She works hard to make the learning experience, for both graduate students and faculty, as smooth as possible. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, applauds Morris’s role in the education journey of his students:

“I have had several students express to me their gratitude for Silva’s help in navigating program requirements, scheduling, etc. Most of our students work full-time in fairly demanding jobs and some of them get detailed or deployed on short notice. Silva has been instrumental in helping these students stay on track and minimize the disruption to their graduate education.”  

Surveillance and Repression in China

The Australian Strategic Policy Institute released a report on genomic surveillance in China, which is amassing the world’s largest police-run database. Chinese authorities are intentionally enrolling millions of individuals who do not have a history of serious criminal activity, including children of preschool age, and who do not have any control over how their DNA samples are collected, stored, and used. In late 2017, China expanded its DNA data collection beyond Tibet and Xinjiang to include millions of men and boys across the country. This mass collection of DNA data violates Chinese domestic law and global human rights norms. This program will “increase the power of the Chinese state and further enable domestic repression in the name of stability maintenance and social control.” Several biotechnology companies – Thermo Fisher Scientific, AGCU Scientific, and Microread Genetics – are working with the Chinese police to create the database, despite their ethical responsibility to make sure that their products and processes do not violate fundamental human rights and civil liberties.

DARPA’s Pandemic Programs

A recent output by the Congressional Research Service (CRS) provides a summary of Defense Advanced Research Projects Agency’s (DARPA) pandemic-related programs and lists some of the considerations for maximizing biodefense research and development. DARPA established the Biological Technologies Office in 2014 to focus on the biological sciences and biotechnology and to supports programs that address pandemics. In response to COVID-19, DARPA pivoted these pandemic programs to focus on the pandemic. Current DARPA investments include the Pandemic Prevention Platform (P3) program aimed at developing methods “capable of producing relevant numbers of doses against any known or previously unknown infectious threat within 60 days of identification of such a threat.” The P3 program focuses on developing a platform to aid rapid development of new medical countermeasures (MCMs) after the identification of any known or unknown infectious threat. An awardee of DARPA funds, Fluidigm, is collaborating with a consortium of medical schools to develop and early detection test for SARS-CoV-2. All of these programs are part wider-ranging biodefense work to address threats from naturally occurring epidemics, accidental biological exposures, biowarfare, and bioterrorism. The biodefense enterprise of the US is dispersed across multiple departments and agencies with varied missions, adding another layer of difficulty to preparing for and responding to a “diverse and evolving set of biological threats.” The General Accountability Office (GAO) recommends developing processes and duties for joint decision-making across these overlapping entities within the US biodefense enterprise. Leveraging the potential of DARPA and its pandemic-related programs could significantly improve the research, development, and commercialization of innovative biodefense technologies associated with preparedness and response.

Preventing the Next Pandemic – Zoonotic Diseases and How to Break the Chain of Transmission

The United Nations released a report about stopping the transmission of zoonoses, diseases that can be transmitted from animals to humans. The report, Preventing the Next Pandemic – Zoonotic Diseases and How to Break the Chain of Transmission, considers the fundamental causes of the emergence and transmission of SARS-CoV-2 and other zoonotic diseases. The fact that diseases are emerging more frequently from animals indicates that rapid action is needed to fill the gaps in science to more efficiently develop tools to reduce the risk of future pandemics. Additionally, unsustainable human activities are contributing the increases in frequency of pathogens infecting humans from animals. The report identifies 7 human-mediated factors that are likely driving the emergence of zoonoses: (1) increasing human demand for animal protein; (2) unsustainable agricultural intensification; (3) increased use and exploitation of wildlife; (4) unsustainable utilization of natural resources accelerated by urbanization, land use change and extractive industries; (5) increased travel and transportation; (6) changes in food supply; and (7) climate change. Additionally, the adoption of a One Health approach is deemed the optimal method for preventing and responding to out zoonotic diseases outbreaks. The One Health concept is a collaborative, multisectoral, and transdisciplinary approach with the goal of achieving optimal health outcomes by recognizing the interconnection between humans, animals, plants, and their shared environment. Rad the full report and its recommendations here.

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