Pandora Report: 08.06.2021

This week, we cover Chinese nuclear missile silo construction, effective risk communication, the ethics of forensic genetics, and of course, updates on COVID-19. We also feature an article from Biodefense M.S. student Michelle Grundahl on how a Pennsylvania County Animal Response Team implemented a One Health approach to community assistance during COVID-19. And a big congratulations to HyunJung Kim, who just successfully defended his Biodefense doctoral dissertation.

Congratulations to Dr. HyunJung Kim

HyunJung Kim successfully defended his Biodefense doctoral dissertation, “Use of Unapproved Medical Countermeasures During Public Health Emergencies: Comparing the United States and South Korea,” on August 4. When the COVID-19 pandemic emerged, the United States and South Korea were among the only countries in the world with Emergency Use Authorization (EUA) policies to provide large-scale access to unapproved medical countermeasures, such as vaccines, drugs, and diagnostic kits, in the event of a public health emergency. HyunJung argues that these policies were heavily influenced by major crises that each nation suffered and that the policy domains that resulted from these crises shaped the implementation of EUA policy, even during the pandemic.

According to HyunJung, the U.S. EUA policy that emerged in the wake of 9/11 and Amerithrax was part of the new homeland security policy domain while in Korea, the EUA policy that followed the 2015 MERS outbreak was part of the disease containment domain. These different policy domains help explain why EUA policy in both countries diverged and affected each nations response to the COVID-19 pandemic. While the United States and South Korea each issued their first EUA for an in vitro diagnostic kit to detect SARS-CoV-2 on the same day (February 4, 2020), there were dramatic differences in the ability of each country to institute large-scale testing programs. While South Korea embarked on a major national campaign to ramp up testing, the United States struggled to develop a reliable test and deploy it widely. The pandemic, in effect, provided a “stress test” for the EUA policies in each country. As HyunJung’s work shows, the U.S. EUA policy was hampered by its homeland security-centric focus on post-exposure prophylaxis whereas the Korean EUA policy that evolved as part of the disease containment domain was better suited for the rapid roll-out of diagnostic tests and integration of these tests into the nations’ public health response to the pandemic. This dissertation contains valuable lessons learned from the U.S. and South Korean experiences that could be used to provide best practices to governments around the world for implementing their own EUA policies to strengthen their preparedness for public health emergencies.

A One Health Approach to Community Assistance During COVID-19

Biodefense M.S. student Michelle Grunhdal is featured in the Summer 2021 One Health newsletter from the Veterinary Public Health (VPH) Special Primary Interest Group (SPIG) of the American Public Health Association (APHA). Grundahl writes about her experience providing community assistance as part of the Pennsylvania County Animal Response Team (CART) during COVID-19. The CART worked alongside food banks to provide pet food to households experiencing food insecurity and “created new local paradigms where emergency management, human social services and local animal welfare groups came together.” This One Health approach has led to permanent changes in the community. You can read the full newsletter here.  

COVID-19 Update: Policies and Pushback

A grim statistic: the known total of global COVID-19 cases has surpassed 200 million. The CDC has updated their guidance on mask wearing and COVID-19 testing in response to the latest data on the delta variant. It is now recommended that fully vaccinated people wear a mask in public indoor settings in areas of substantial or high transmission or if they or someone in their household is at increased risk for severe disease from COVID-19, as we reported last week. Universal indoor masking is recommended for all teachers, staff, students, and visitors to schools regardless of vaccination status. Additionally, fully vaccinated people—even if they’re not showing symptoms—should get tested 3 to 5 days after exposure to someone with suspected or confirmed COVID-19 and wear a mask in public indoor settings for 14 days after exposure or until they receive a negative test result. Previous recommendations said that fully vaccinated people didn’t need testing after exposure unless they showed symptoms.

People around the world are pushing back against more restrictive public health measures as countries try to encourage vaccination through public policy. In Germany, Berlin has refused to authorize over a dozen anti-lockdown protests, citing rising infection rates and protesters’ history of flouting public health requirements, such as mask-wearing. Also in Germany, officials are planning to stop paying for rapid antigen COVID-19 tests after enough Germans have been fully vaccinated. Currently, Germans must show a negative COVID-19 test to enter offices and some shops and restaurants, and testing is free. Taking a different approach toward encouraging vaccination, Philippine president Rodrigo Duterte recently addressed the nation, telling citizens: “For those who do not want [the COVID-19 vaccine], well, for all I care, you can die anytime.”

The Latest on COVID-19 Vaccines

Last week’s CDC Morbidity and Mortality Weekly Report reported that nearly three-quarters of people infected in a July COVID-19 outbreak in Massachusetts were fully vaccinated. A total of 469 patients were identified; 90% of specimens from these patients contained the delta variant. The CDC also found that fully vaccinated people who become infected carry as much of SARS-CoV-2 in their nose as unvaccinated people, and they can spread the virus to others. The media has generally reported this information with more alarmism than scientific perspective: bottom line, the majority of new COVID cases in the U.S. are among unvaccinated people, and the odds of unvaccinated people getting sick from COVID is low. Rachel L. Levine, assistant secretary for health at the Department of Health and Human Services, has stressed that this upcoming fall could be “very challenging,” but vaccination remains the best means of protection. Fortunately, U.S. vaccination rates have risen recently amidst fears over the delta variant.

A new paper from Pfizer (which has not yet been peer-reviewed) shows that the Pfizer-BioNTech COVID-19 vaccine “remained robustly protective six months after vaccination, providing nearly complete protection against severe disease.” The paper showed a slight drop in efficacy against any symptomatic cases of COVID-19 (from 96% protection in the first few months after vaccination to 84% after four months). Pfizer executives have predicted that vaccine booster shots will be needed. Israel is already offering its most at-risk citizens a third COVID-19 shot, though global health researchers are pushing back, warning that this strategy could set back efforts to end the pandemic because each booster “represents a vaccine dose that could instead go to low- and middle-income countries, where most citizens have no protection at all, and where dangerous coronavirus variants could emerge as cases surge.” The WHO just called for a moratorium for at least the next two months on COVID booster shots based on global vaccine inequity, though the Biden administration has pushed back on this idea.

Two Americans traveling to Toronto have been fined for providing fake COVID-19 proof of vaccination documents and lying about pre-departure tests. In this case, fake vaccination documents are costing roughly $20,000 in fines, while the vaccine itself is free.

In better news, the first phase of an international effort to track COVID-19 vaccines has just been launched by the Task Force on COVID-19 Vaccines, Therapeutics and Diagnostics for Developing Countries (composed of representatives from the International Monetary Fund, World Bank Group, World Health Organization (WHO), and World Trade Organization). The database and dashboard are intended to highlight specific gaps by country in obtaining and delivering COVID-19 vaccines, therapeutics, and diagnostics, building on the IMF-WHO COVID-19 Vaccine Supply Tracker.

Update on COVID-19 Origins

On July 28, the National Institutes of Health (NIH) responded to a request from Senator Grassley (R-IA) regarding SARS-CoV-2’s origins. The NIH’s view, based on the scientific literature, is that “SARS-CoV-2 infection in people most likely resulted from zoonotic transmission from animals to humans.” Current evidence does not support the assertion that the virus was engineered. However, the NIH does not rule out the possibility of a laboratory accident, such as a scenario “where a naturally occurring virus was unintentionally released during research activities such as collection of animal samples or examination of viruses in a laboratory.” This letter also addressed questions about the NIH’s grant review process (particularly a grant to the Wuhan Institute of Virology) and how the U.S. government conducts oversight of research involving enhanced potential pandemic pathogens.

A few days later, a report from Republicans on the House Foreign Affairs Committee concluded that “a preponderance of evidence proves that [SARS-CoV-2] leaked from a Chinese research facility” sometime before September 12, 2019. The report claimed that the Wuhan Institute of Virology scientists, supported by U.S. experts and Chinese and U.S. government funding, were working to modify coronaviruses to infect humans. The report’s findings are based on “new and under-reported information about safety protocols at the lab.”

The U.S. intelligence community (IC) has not come to any such conclusions; President Biden ordered the IC’s report on the virus’s origins to be submitted by the end of August. U.S. intelligence agencies just gained access to a massive trove of genetic data from virus samples studied at the Wuhan Institute of Virology. Officials hope this data will help answer the question of how the virus jumped from animals to humans, but they are facing an uphill battle. Translation of the raw data into usable information requires a great deal of computing power and manpower. The IC will be using the Department of Energy’s National Labs’ supercomputers to process the data, but there is a very small pool of scientists with the security clearance, educational background, and Mandarin-language skills necessary to work on this issue.

Interested in a former IC analyst’s perspective on the debate over COVID’s origins? Denis Kaufman, a former top infectious diseases analyst with the Defense Intelligence Agency’s National Center for Medical Intelligence, was featured on a recent SpyTalk podcast discussing the claim that China engineered COVID-19 for use as a biological weapon. In his words: “It would probably rank, in terms of monumental stupidity, as high as you could get—to release an organism that you have no countermeasures against, that was highly infectious, highly dangerous and highly lethal.”

COVID-19: Unprecedented Event or a Taste of What’s to Come?

President Biden’s science advisor Eric Lander warns that “as bad as COVID-19 has been, a future pandemic could be even worse—unless we act now.” He warns that we’re at risk not only from COVID-19’s effects but from the collective amnesia that often accompanies serious, traumatic events like pandemics. New infectious diseases have been emerging at an accelerating rate, and they spread quickly. Although everyone wants to “return to normal,” we can’t forget the weaknesses, gaps, and inequities COVID-19 exposed. Lander outlines several objectives that must be pursued, including developing the capability to design, test, and improve a vaccine within 100 days of detecting a pandemic threat; investing in early-warning systems to spot emerging biological threats anywhere in the world; and strengthening public health systems. He also says to expect a detailed plan from the White House this month describing the capabilities the United States needs to invest in now to prepare for the next pandemic.

Peter J. Hotez discusses the “troubling new expansion of antiscience aggression,” arising from far-right extremism and targeting prominent figures fighting the COVID-19 pandemic. Hotez traces the connections and consistent messaging between conservative news outlets, U.S. Congressmembers, and conservative public intellectuals teaming up to discredit scientists, policymakers, and other experts. Hotez lists several steps to begin combating this aggression; you can read more here.

Mass Resignations at Scientific Journal Over Ethically Fraught China Genetics Papers

Eight members of the editorial board of Molecular Genetics & Genomic Medicine have resigned after the journal published a series of controversial papers that “critics fear could be used for DNA profiling and persecution of ethnic minorities in China.” These papers were initially flagged by Yves Moreau, a Belgian bioinformatician with a history of pursuing the retraction of troubling or unethical scientific papers. There are several concerns with the batch of papers in question, many of whose authors have affiliations with or received funding from Chinese police agencies. First, the papers all address forensic genetics, a controversial field that applies genetic knowledge to legal issues—a problematic subject in China, “where DNA collection is part of a sustained effort to persecute ethnic minorities and other groups.” Second, there are concerns about whether the DNA samples used for some of the papers were collected with proper consent; Chinese policy have forcibly collected DNA from certain groups in the past. Concerns over the articles were raised in March, and after months of stalled progress to get more information about the journal’s stance, editorial board members began resigning. Other board members who have not resigned have expressed their disapproval but remain on the committee to push for scrutiny of the papers.

Attacks on Health Care Resources

The WHO just released an analysis of the impact of attacks on health care in fragile, conflict-affected, and vulnerable areas from 2018-2020. This data came from the WHO Surveillance Systems for Attacks on Health Care, which tracks attacks on health care, the resources that are affected, and their immediate impact on health workers and patients globally. This analysis found that health personnel are the most frequently affected resource in these attacks; such attacks were associated with a higher proportion of deaths in 2020; changing contexts are an important driver for yearly differences in the data; and reports of attacks involving psychological violence, threats of violence, or intimidations decreased in 2020. The report also makes some conclusions about COVID-19’s impact, including that attacks affecting health facilities, transport, and patients became more frequent after the onset of the pandemic.

Interested in health care facilities and resources as a terrorist target? Then you may be interested in a recent article from Studies in Conflict and Terrorism titled “Hospital Attacks Since 9/11: An Analysis of Terrorism Targeting Healthcare Facilities and Workers.” You can read the article here (access required).

China is Building a Second Nuclear Missile Silo Field

A new report from Matt Korda and Hans Kristensen uses satellite imagery to identify a second nuclear missile silo field being constructed in the prefecture-level city of Hami in Eastern Xinjiang, China. This discovery follows a recent report that China “appears to be constructing 120 missile silos near Yumen in Gansu province.” Construction on the Hami site began in March 2021, and since that time “dome shelters have been erected over at least 14 silos and soil cleared in preparation for construction of another 19 silos.” Taken together, the silo construction in Yumen and Hani “constitutes the most significant expansion of the Chinese nuclear arsenal ever.” The Federation of American Scientists estimates that China’s nuclear arsenal currently includes roughly 350 warheads, though U.S. Department of Defense officials have expressed their belief that China’s stockpile is likely to double (at a minimum) over the next ten years. However, even quadrupling China’s current stockpile would not give China near-parity with Russia and the United States, who each have around 4,000 warheads. You can read the report  on the Hami site and check out the satellite images of the site here.

Image courtesy of Matt Korda and Hans Kristensen, Federation of American Scientists

Guiding Principles for Science and Risk Communicators

Syra Madad and Eleanor J. Murray with the Belfer Center for Science and International Affairs have published guiding principles for science and risk communicators to provide facts, share evidence and science-based information, and manage rumors, misinformation, and disinformation. They argue that the COVID-19 pandemic has “highlighted the critical role of scientific risk communicators and the ability to provide timely, accurate, and comprehensible guidance.” The CDC’s mantra of risk communication is: be first, be right, be credible. Madad and Murray suggest that an updated approach is needed to give a diverse range of communicators simple guidance on risk communication across different forms of media. You can read more and check out their graphic displaying the principles here.

Back to School Biosafety

Research laboratories are unique environments that present specific risks and challenges. Many undergraduates, and even graduate students, lack rigorous instruction in biological safety. Therefore, ABSA International, in partnership with the National Biosafety and Biocontainment Training Program, is offering training in biological safety for undergraduate and graduate students. The course takes place over 12 weeks, and the course content is designed to be flexible. Some of the topics covered include risk assessment; biosafety levels; personal protective equipment; lab facilities and safety equipment; disinfection, decontamination, and sterilization; and lab security and emergency response. You can learn more about the course here.

Free Resource: Handbook of Terrorism Prevention and Preparedness

Those interested in counterterrorism will find a recently released free resource incredibly helpful: the Handbook of Terrorism Prevention and Preparedness covers a diverse range of topics, from radicalization to terrorist financing to consequence management and much more. Edited by Alex P. Schmid and featuring contributions from leading experts in the field, the Handbook is divided into five parts: (1) Lessons for Terrorism Prevention from Related Fields, (2) Prevention of Radicalization, (3) Prevention of Preparatory Acts, (4) Prevention of and Preparedness for Terrorist Attacks, and (5) Preparedness and Consequence Management. The Handbook also features a chapter from Schar School professor Dr. Mahmut Cengiz, titled “Prevention of the Procurement of Arms and Explosives by Terrorists.”

Workshop: Towards a Post-Pandemic World, September 21-24

The National Academies of Sciences, Engineering, and Medicine are hosting the second of a two-part series about what we’ve learned since COVID-19 was declared a pandemic in March 2020. Presentations will examine responses to COVID-19 in the U.S. and abroad, featuring retrospective and prospective discussions on the impacts of the pandemic on human health and society and with a view towards enhancing resilience and preparedness for the future. The workshop will take place over four days and focus on a broad range of topics:

  • Sept 21: Anticipated Long-Term Effects of COVID-19
  • Sept 22: Addressing Uncertainties During a Pandemic
  • Sept 23: Mitigating the Next Pandemic through Current Recovery
  • Sept 24: Potentials for a Post-COVID World (Scenario Planning Exercise)

Each day’s session runs from 10:00 a.m. – 1:30 p.m. EDT. You can register here.

Event: Reviewing the Public Health Emergency Medical Countermeasures Enterprise, August 6 & 13

An ad hoc committee of the National Academies of Sciences, Engineering, and Medicine is conducting a study to evaluate existing Public Health Emergency Medical Countermeasure Enterprise (PHEMCE) policy and practices and make recommendations for a re-envisioned PHEMCE, particularly after COVID-19. This review will provide high-level strategic guidance to the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) on emerging issues, research, and activities relevant to the PHEMCE programs, goal, and activities. The committee will review key materials from ASPR and provide recommendations on business practices, medical countermeasure preparedness, and conduct an enterprise-wide review of programs, priorities, and harmonization across agencies.

On August 6, from 3:00 to 5:00 p.m., the committee will hear from ASPR regarding the study charge and key PHEMCE personnel to glean insights into the overall management and operations of the PHEMCE, including major outcomes, accomplishments, and recommendations for the future. On August 13, from 2:00 to 4:30 p.m., the committee will have an opportunity to engage in discussions with ASPR regarding key public documents, as well as hear from different former members of the Enterprise Senior Council, the body that provides strategic direction and policy oversight for HHS in Medical Countermeasure preparedness activities, and other key PHEMCE partners and stakeholders. Register for the April 6 session here and the August 13 session here.

Schar School PhD Virtual Open House, August 11

You’re invited to attend a virtual open house to learn more about the Schar School of Policy and Government and our academic programs. By working closely with faculty who draw on world-class research and practical experience, the Schar School prepares students for a high-powered career in the public, private, and non-profit sectors. The online session will provide an overview of our doctoral degree programs, and our Graduate Admissions team will be available to answer questions about admissions requirements, application deadlines, and materials to prepare. Register here

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