Pandora Report: 2.12.2021

Happy Valentine’s Day from the Pandora Report! For a safe celebration, the CDC recommends gathering virtually or with the people who live with you. Take a walk outside with your Valentine, enjoy an outdoor picnic, or prepare a special meal or dessert at home. As COVID-19 vaccines continue to be rolled out, the need for equitable distribution has never been more apparent or critical. Alumnus Dr. Daniel Gerstein shares a unique perspective on the role of DHS in economic recovery after the pandemic.

Appreciation and Report for the 6th GHSA Ministerial Meeting 2020

The 6th Global Health Security Agenda (GHSA) Ministerial Meeting was held in November of 2020. The main objectives of the meeting were to “exchange experiences on disease prevention and control among various sectors and countries, update the progress of action packages implementations, enhance the engagement of multisectoral cooperation, identify gaps in implementation and fill them with through concrete action as well as jointly address means and ways forward to improve the GHSA mechanism and collaboration on the global health concern issue.” The meeting highlighted several issues but also several recommendations. The COVID-19 pandemic revealed that the world remains ill-prepared to counter pandemic threats, despite several red flags with previous outbreaks. The negative impacts of the pandemic reverberated beyond public health – severe supply shocks, heightened food prices, widespread layoffs, and compromised education. The meeting report emphasizes that the economy and health are integrated and interdependent. New policies should be tailored to support health care systems and improve the socioeconomic situation to aid the recovery of the economy. Also, “health is not a cost, but an investment.” Given that health security is a global issue, a multi-government approach including all nations is needed. In case you missed it, Maddie Roty, a Biodefense MS student, attended one of the Ministerial Meeting events and shared her takeaways here.

Biodefense Graduate Program Alumni Join NextGen Leadership

Kate Kerr, an alumna of the Biodefense Graduate Program, was elected as the Deputy Coordinator of External Development for Global Health Security Agenda NextGen. As the Deputy Coordinator, she manages the mentorship program. The mentorship program entails pairing new and mid-career professionals with mid and late-career professionals for the purpose of career development and networking. During a nine-month long research program, individuals work with their partner and the rest of the group to perform research that promotes global health security. At the end of the iteration, pairs present their work to the network at large and may use their work to advance their careers. Kerr graduated from the Biodefense program at the Schar School of Policy and Government in 2017, and earned a powerful education while there. During that time, she also served as a graduate researcher at the Terrorism, Transnational Crime and Corruption Center. She is currently an analyst with Booz Allen Hamilton and now examines the intersection of health and transnational crime. Kerr shares her insights and plans for NextGen:

“The past several years, NextGen has grown aggressively, thanks to the support and outreach of our current Coordinator, Dr. Taylor Winkleman. Not only has participation risen exponentially, but we continue to expand our global participation. As a graduate from the Biodefense Graduate Program at the Schar School, I recognize the importance of global cooperation and will continue to build the solid foundation contributed by past leadership while ensuring that all stakeholders have a seat at the table. Promoting the next generation of scientists is important now more than ever before, especially in light of the challenges this year has exposed. During this election, we have greatly expanded the leadership structure to boost global capacity, and I will continue to build that structure. I am proud to take the helm, and feel the importance of this position now more than ever.”

Additional alumni of the Biodefense Graduate Program elected into GHSA NextGen leadership include Anthony Falzarano and Jessica Smrekar.

Equity in Vaccination

The COVID-19 pandemic has underscored inequality, with the virus having a tragic and disproportionate adverse effect on Black, Indigenous, and People of Color (BIPOC) communities across the United States. The number of cases, hospitalizations, and deaths related to SARS-CoV-2 is considerably higher in these groups. It is critical that the COVID-19 vaccination campaign deliver vaccines fairly and equitably. The Center for Health Security at Johns Hopkins University shares a plan that provides the tools to create, implement, and support a vaccination campaign that “works with BIPOC communities to remedy COVID-19 impacts, prevent even more health burdens, lay the foundation for unbiased healthcare delivery, and enable broader social change and durable community-level opportunities.” The plan comprises five key principles: iteration, involvement, information, investment, and integration. With the same goal, CommuniVax is a coalition dedicated to strengthening the community’s role in an equitable COVID-19 vaccination campaign. CommuniVax relies on efforts from three groups: local teams, a central working group, and national stakeholders. Local teams include resident researchers, grassroots leaders, and public health implementers located in Tuscaloosa, AL; San Diego, CA; Bingham and Power counties, ID; Baltimore, MD; and Prince George’s County, MD. The Central Working Group is comprised of experts in public health, public policy, medical science, anthropology, and public involvement. National stakeholders include groups with political, technical, cultural, and social justice perspectives on vaccine delivery and uptake. Together, these three groups are listening to Black, Indigenous, and Latino/Latinx individuals about how best to promote awareness of, access to, and acceptability of COVID-19 vaccines in their respective communities; and developing longstanding, local governance systems that enable underserved groups to exercise collective agency over their own health and wellness, during this pandemic and going forward.

Outreach 2.0: Emerging Technologies and Effective Outreach Practices

Drawing upon existing best practices, risk assessments, surveys, interviews, and stakeholder feedback, a new report from the Strategic Trade Research Institute (STRI) aims to empower governments with tools, in the form of good practices, with which to conduct outreach to emerging technology sectors that could be targeted by non-State actors for malicious purposes. Andrea Viski, an adjunct professor at the Schar School who teaches a course on strategic trade controls, and Scott Jones have identified an advanced outreach model, Outreach 2.0, that can be used by countries to enhance compliance with United Nations Security Council resolution 1540. Outreach 2.0 consists of a more customized, targeted, creative, real-time, and collaborative communication strategy between regulators and technology holders that builds trust, support, knowledge-sharing, and inclusion. Read the report here.

8 Tools that Helped Us Tackle the Coronavirus

Over the last year, scientists have worked diligently to understand, diagnose, treat, and prevent SARS-CoV-2 infection, and eight technologies were critical to their successes. Adenoviral vectors, derived from the adenoviruses that cause the common cold, are engineered viruses designed to transport a gene from SARS-CoV-2 into the body so that cells will make coronavirus spike proteins. The creation of these spike proteins is intended to teach the body to quickly detect and kill actual SARS-CoV-2. Another example is Johnson & Johnson’s adenoviral vaccine against Ebola virus disease, which was approved in Europe last year. Clustered regularly interspaced short palindromic repeats (CRISPR) is a powerful gene editing tool that enables impressive precision. This technology is being used to detect SARS-CoV-2. Cryogenic electron microscopy (CRYO-EM) is a technique that enables scientists to observe how biomolecules move and interact by flash-freezing solutions of proteins then bombarding them with electrons to produce microscope images of individual molecules. CRYO-EM has helped researchers visualize over 150 SARS-CoV-2-related structures. Loop-mediated isothermal amplification (LAMP) is a method of copying genetic material for diagnostics. This diagnostic technique is a key component of the first at-home product granted emergency use authorization from the FDA. Messenger RNA (mRNA) is the “universal language” in nature, because all living organisms use it as an “intermediary between the DNA code of their genomes and the amino acid sequences that compose proteins.” In December 2020, the FDA authorized the first two mRNA vaccines to fight COVID-19. Rapid monoclonal antibody development has dramatically shortened the timeline for developing antibody drugs. Indeed, two antibody drugs to treat mild cases of SARS-CoV-2 were granted emergency use authorization only nine months after the drugs were discovered. Single-cell genomics is used to “analyze which genes are active or silent under infectious conditions.”  These studies helped several discoveries such as which cells SARS-CoV-2 infects. In 2020, a protein-engineering trick, the 2P mutation, keeps the coronavirus’ spike protein static in form instead of shape-shifting. The 2P mutation is used in COVID-19 vaccines made by Moderna, Pfizer and BioNTech, Johnson & Johnson, and Novavax.

Landmark Report from Security Experts Identifies Ecological Disruption as the 21st Century’s Most Underappreciated Security Threat

The Council on Strategic Risks released a landmark report, The Security Threat That Binds Us, which “identifies ecological disruption as a major and underappreciated security threat and calls on the United States to reboot its national security architecture and doctrine to better respond to this evolving threat.” The major stresses on our planet include threats to water, food, wildlife, forests, and fisheries, which amplifies the risks of pandemics, conflict, political instability, loss of social cohesion, and economic harm. The report outlines eight pillars of recommended actors by the US: (1) promote international mechanisms that aim to reverse and reduce the drivers of ecological disruption; (2) promote methods that protect and expand critical systems and services; (3) build and strengthen international alliances; (4) treat environmental crimes as serious crimes; (5) reduce pandemic risk at point of origin; (6) amplify ecological and natural security issues in the US government; (7) initiate an ecological and natural security agenda; and (8) engage the public on ecological and natural security issues. Read the report here.

The Essential Role of DHS in the Economic Recovery from COVID-19

Dr. Daniel Gerstein, alumnus of the Biodefense PhD Program and senior policy researcher at the RAND Corporation, released an op-ed about the critical role of the Department of Homeland Security (DHS) in the economic recovery from the pandemic. Gerstein emphasizes that DHS can help “set the conditions for a more rapid recovery, reduce the human suffering and stimulate the development of a more resilient and ‘built back better’ US economy.”  Though indirect, DHS can aid economic recovery by exercising its “vital roles in areas such as emergency management, infrastructure protection and law enforcement that promote economic vitality and security.” In regard to infrastructure resilience and mitigating risks from disasters, the Cybersecurity and Infrastructure Security Agency (CISA) “examined the COVID-19 implications on the 55 national critical functions and sought to minimize the disruption to these functions.” Law enforcement stopped illegal activities related to COVID-19, such as the distribution of counterfeit pharmaceuticals and medical equipment. Read Gerstein’s article here.

Safety and Security Concerns Regarding Transmissible Vaccines

Transmissible viral vaccines, also known as self-disseminating vaccines, are live vaccines with the ability to transmit between hosts. Transmissible vaccines are cost-effective in the immunization of animal reservoirs to prevent zoonotic spillovers. Nuismer and Bull (2020) endorse the development of self-disseminating vaccines, but may not adequately account for the associated safety and biosecurity risks. A correspondence piece in Nature Ecology & Evolution proposes that “efforts focus on the safer and more predictable transferable vaccine approach to achieve cost-effective vaccination of reservoir populations.” Transferable vaccines, for example, can be applied as a paste to the fur of a bat, and other bats will groom the vaccinated bat and be exposed to the vaccine as well. The authors believe that the significant safety and security risks around the advancement of transmissible vaccines outweigh potential benefits. Viral mutations are unpredictable and they may increase pathogenicity or expand the host range. The development of transmissible vaccines bears dual-use potential. Transmissible vaccine development would require heritable approaches that are applicable to infectious, potentially pandemic agents. Also, research would focus on virus traits that might be directly translated to viruses capable of infecting humans.

USAMRIID’s Biodefense Tool

The United States Army Medical Research Institute for Infectious Diseases (USAMRIID) released a new mobile app! The Biodefense Tool distils key information presented in USAMRIID’s training and education courses on biological threat agents of concern and serves as a quick reference for the identification of these agents in the field. Links to additional resources and contact information for emergency response to a suspected biowarfare or bioterrorism situation are also available through the application. Download it for free here.

‘Major Stones Unturned’: COVID Origin Search Must Continue After WHO Report, Say Scientists

The World Health Organization team investigating the origins of the COVID-19 pandemic have ruled out the possibility that the novel coronavirus came from a laboratory leak. But the hunt is not over as the team’s time in China did not produce answers to how SARS-CoV-2 started infecting humans. At present, the theory that the virus passed to humans from an animal remains the primary hypothesis. The team offered two other theories, which are supported by the Chinese government and media: (1) the virus came from an animal outside of China and (2) once the virus was circulating in people, it could have spread on frozen wildlife and cold packaged goods. These findings have been met with mixed assessments from researchers. Angela Rasmussen, a virologist at Georgetown University, said, “there are still major stones that need to be unturned, because any investigation into virus origins won’t be accomplished in two weeks.”

Exhaled Aerosol Increases with COVID-19 Infection, Age, and Obesity

Superspreading events have distinguished the COVID-19 pandemic from the early outbreak of the disease. COVID-19 transmits by droplets generated from surfaces of airway mucus during processes of respiration within hosts infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. A new study in PNAS examined respiratory droplet generation and exhalation in human and nonhuman primate subjects with and without COVID-19 infection to explore whether SARS-CoV-2 infection, and other changes in physiological state, translate into observable evolution of numbers and sizes of exhaled respiratory droplets in healthy and diseased subjects. In an observational cohort study of the exhaled breath particles of 194 healthy human subjects, and in an experimental infection study of eight nonhuman primates infected, by aerosol, with SARS-CoV-2, researchers found that exhaled aerosol particles vary between subjects by three orders of magnitude, with exhaled respiratory droplet number increasing with degree of COVID-19 infection and elevated BMI-years. The study found that 18% of human subjects (35) accounted for 80% of the exhaled bioaerosol of the group (194), reflecting a superspreader distribution of bioaerosol analogous to a classical 20:80 superspreader of infection distribution. These findings suggest that quantitative assessment and control of exhaled aerosol may be critical to slowing the airborne spread of COVID-19 in the absence of an effective and widely disseminated vaccine. Understanding the source and variance of respiratory droplet generation, and controlling it via the stabilization of airway lining mucus surfaces, may lead to effective approaches to reducing COVID-19 infection and transmission.

Event – Red Line: The Unraveling of Syria and America’s Race to Destroy the Most Dangerous Arsenal in the World

In August 2013, a massive sarin attack in the Damascus suburbs shocked the world and confronted the Obama White House with an agonizing choice: Whether to enforce the president’s “red line” threat with a military strike, or gamble on a diplomatic solution that offered the appealing prospect of the complete elimination of Syria’s strategic chemical weapons stockpile. Ultimately a deal was struck, and within days the race was on to extract and destroy hundreds of tons of lethal chemicals stashed in military bunkers across Syria, in the middle of a civil war. In his new book Red Line, journalist and author Joby Warrick draws from new documents and hundreds of interviews to reconstruct the key decision points as well as the unprecedented international effort to remove the weapons under fire and then—when no country was willing to accept Syria’s chemicals—to destroy them at sea. Warrick argues that, despite cheating by Syria—and in spite of the larger failure to end Syria’s mammoth humanitarian crisis—the disarmament mission was an important multilateral success. The historic undertaking deprived Assad of the bulk of his nerve agents and production equipment, and prevented what might have been a catastrophic leakage of deadly nerve agents to Syrian combatants and terrorist groups.

On 26 February at 11 AM EST, the Wilson Center will be hosting a live webinar about the book. Speakers include the author, Joby Warrick, Public Policy Fellow at the National Security Correspondent for The Washington Post; James F. Jeffrey, Chair of the Middle East Program, Former ambassador to Iraq and Turkey, and Special Envoy to the Global Coalition to Defeat ISIS; and Robert S. Litwak, Senior Vice President and Director of International Security Studies at the Wilson Center. RSVP here.

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