Pandora Report: 10.1.2021

October marks the 20th anniversary of the anthrax letter attacks, which killed five people and sickened 17. A new article in Nature examines the resurgence of Ebola virus in Guinea this year, suggesting a new paradigm for outbreaks. In COVID-19, the health system is seeing widespread overwork and discontent among healthcare workers, causing an acceleration in the preexisting downward trend.

20th Anniversary of the Anthrax Attacks

This month marks the 20th anniversary of the anthrax letter attacks, which targeted major media outlets and members of Congress. Anthrax spores were sent in letters, killing five people and sickened several more. Bacillus anthracis causes anthrax, and its spores can “remain inactive for decades until they find a favorable environment to germinate, such as blood or tissue.” Infection can occur via inhalation, ingestion, and skin contact. Anthrax can be treated by certain antibiotics; however, inhalational anthrax is usually lethal if not diagnosed and treated very early. In 2001, before the attacks, the Armed Forces Radiobiology Research Institute (AFRRI) was studying “how to render anthrax spores harmless through irradiation.” AFRRI’s work confirmed that electron beams and X-rays, both forms of ionizing radiation, could sanitize mail. An electron beam “passes through an electromagnetic lens, which focuses the beam on the target,” but due to limited penetration, e-beams could only be used on letters and flat envelopes. X-rays penetrate deeper, making them a better option for parcels and boxes. Since the Postal Service needed to process about 1.8 million pieces of contaminated mail, e-beam and X-ray machines needed to be scaled up. Scaling up became a logistical nightmare as the processing facility could only push through about 2,000 kilograms per hour. Though it took weeks to process all the mail items and up to a few months to get the items to their intended destination, irradiation was the key to decontaminating nearly 2 million pieces of mail after Amerithrax.

Scientific Risk Assessment of Genetic Weapons Systems

For any emerging technology, defense and homeland security analysts strive to understand (1) its dual-use potential, meaning whether the same research and technology applied for peaceful purposes may be diverted to illicit ends, for example to develop a weapon; (2) the State and sub-State actors with access to that dual-use potential, whether peacefully or illicitly directed; and (3) motivational factors and indicators of intent that might suggest these actors would divert the emerging technology to illicit ends. Precision medicine represents one such emerging technical space. Precision medicine is defined as medical care designed to optimize benefit for particular groups, especially based on genetic (or molecular) profiling. A long-speculated but incompletely understood dual-use consideration of precision medicine is the possible development of a genetic weapon system, defined as a weapon system designed to optimize effect on particular groups based on genetic profiling.

This Occasional Paper assesses the potential for precision medicine to be diverted to develop a population-specific genetic weapon system, examines relevant state capabilities and motivations to pursue such an effort, and offers policy recommendations to manage the dual-use implications of this emerging biomedical field while still preserving its potential benefit for human welfare. Read the paper here.

Identifying and Prioritizing Potential Human-Infecting Viruses from Their Genome Sequences

Determining which animal viruses may be capable of infecting humans is currently intractable at the time of their discovery, precluding prioritization of high-risk viruses for early investigation and outbreak preparedness. Given the increasing use of genomics in virus discovery and the otherwise sparse knowledge of the biology of newly discovered viruses, a team of researchers developed machine learning models that identify candidate zoonoses solely using signatures of host range encoded in viral genomes. Within a dataset of 861 viral species with known zoonotic status, their approach outperformed models based on the phylogenetic relatedness of viruses to known human-infecting viruses (area under the receiver operating characteristic curve [AUC] = 0.773), distinguishing high-risk viruses within families that contain a minority of human-infecting species and identifying putatively undetected or so far unrealized zoonoses. Analyses of the underpinnings of model predictions suggested the existence of generalizable features of viral genomes that are independent of virus taxonomic relationships and that may preadapt viruses to infect humans. Their model reduced a second set of 645 animal-associated viruses that were excluded from training to 272 high and 41 very high-risk candidate zoonoses and showed significantly elevated predicted zoonotic risk in viruses from nonhuman primates, but not other mammalian or avian host groups. A second application showed that the models could have identified Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as a relatively high-risk coronavirus strain and that this prediction required no prior knowledge of zoonotic Severe Acute Respiratory Syndrome (SARS)-related coronaviruses. Genome-based zoonotic risk assessment provides a rapid, low-cost approach to enable evidence-driven virus surveillance and increases the feasibility of downstream biological and ecological characterization of viruses. Read the article here.

Resurgence of Ebola Virus in 2021 in Guinea Suggests a New Paradigm for Outbreaks

A new article in Nature examines the resurgence of Ebola virus in Guinea this year, suggesting a new paradigm for outbreaks. Seven years after the declaration of the first epidemic of Ebola virus disease in Guinea, the country faced a new outbreak—between 14 February and 19 June 2021—near the epicentre of the previous epidemic. The researchers use next-generation sequencing to generate complete or near-complete genomes of Zaire ebolavirus from samples obtained from 12 different patients. These genomes form a well-supported phylogenetic cluster with genomes from the previous outbreak, which indicates that the new outbreak was not the result of a new spillover event from an animal reservoir. The 2021 lineage shows considerably lower divergence than would be expected during sustained human-to-human transmission, which suggests a persistent infection with reduced replication or a period of latency. The resurgence of Zaire ebolavirus from humans five years after the end of the previous outbreak of Ebola virus disease reinforces the need for long-term medical and social care for patients who survive the disease, to reduce the risk of re-emergence and to prevent further stigmatization. Read the article here.

New Book – The Role of Law Enforcement in Emergency Management and Homeland Security

Keith Ludwick, Biodefense PhD alum and former FBI Special Agent, recently published a book chapter, “Terrorism Prevention: Structures and Processes,” that explains how federal, state, and local law enforcement and intelligence agencies are responsible for different aspects of counterterrorism in the United States.  The book, Role of Law Enforcement in Emergency Management and Homeland Security, is edited by Mark Landhal and Tonya Thornton, formerly of the Schar School of Policy and Government. This book is part of the Community, Environment and Disaster Risk Management series, which deals with a wide range of issues relating to global environmental hazards, natural and man-made disasters, and approaches to disaster risk reduction. As people and communities are the first and the most important responders to disasters and environment-related problems, this series aims to analyze critical field-based mechanisms which link community, policy and governance systems. This book examines the role and involvement of law enforcement agencies across the spectrum of homeland security and emergency management. The chapters, developed by expert practitioners and academics in the field, focus on the mission areas of mitigation and protection, prevention, preparedness, response and recovery. The introductory chapter sets the stage and the following content targets structures and activities specific to each mission area of homeland security and emergency management. Find the book here.

ALL THINGS COVID-19

Select Subcommittee to Hold Hearing on Challenges Facing Public Health Departments Amid Pandemic Response

This week. Rep. James E. Clyburn, Chairman of the Select Subcommittee on the Coronavirus Crisis, held a hybrid remote/in-person hearing examining challenges facing the nation’s state and local public health departments as they respond to the coronavirus pandemic. The hearing also addresses the dangerous politicization of public health and identify ways to rebuild and strengthen the country’s public health infrastructure.

For decades, state and local public health departments have been chronically underfunded and understaffed.  These challenges have impaired the government’s ability to improve the health of the US population and respond effectively when crises arise.  Compounding matters, throughout the coronavirus pandemic, the reckless politicization of public health has contributed to unprecedented levels of personal attacks against public health workers, high burnout rates and rapid turnover in the public health workforce, and recruitment challenges for many departments—all of which have threatened the success of the nation’s coronavirus response.

With the American Rescue Plan, Congress and the Biden Administration are making strong investments in the US public health infrastructure—but more must be done to ensure that state and local public health departments receive the funding and resources they need over the long term.  During the hearing, experts discussed potential solutions to these challenges, and ways local, state, and federal officials can work together to strengthen the public health system. Watch the hearing here.

Functioning of the International Health Regulations During the COVID-19 Pandemic

When the International Health Regulations (IHR) came into force in 2007, WHO announced that “the global community has a new legal framework to better manage its collective defenses to detect disease events and to respond to public health risks and emergencies.” The IHR aim to enable the prevention, detection, and containment of health risks and threats, the strengthening of national capacities for that purpose, and the coordination of a global alert and response system. In the prolonged and unprecedented COVID-19 pandemic, some have stated that the IHR “are a conservative instrument that constrain rather than facilitate rapid action.” The Review Committee on the Functioning of the IHR (2005) during the COVID-19 Response, found instead was that much of what is in the IHR is well considered, appropriate, and meaningful in any public health emergency. However, many countries only applied the IHR in part, were not sufficiently aware of these regulations, or deliberately ignored them, and that WHO did not make full use of the powers given to it through the wording and spirit of the IHR. Thus, the IHR are not deficient, but their implementation by member states and by WHO was inadequate. Recognizing the limited mandate of the IHR Review Committee on COVID-19, which was focused solely on the IHR-related aspects of the COVID-19 response, the Review Committee proposes that there was a collective failure in three areas: compliance and empowerment; early alert, notification, and response; and financial and political commitment. Read the article here.

COVID-19 Panel of Scientists Investigating Origins of Virus Is Disbanded

Jeffrey Sachs, a professor at Columbia University, announced that he has disbanded a task force comprised of scientists that was investigating the “origins of COVID-19 in favor of wider biosafety research.” Sachs, who is the chairman of a COVID-19 commission affiliated with the Lancet, explained that he ended the task force over concerns about its links to EcoHealth Alliance. EcoHealth Alliance is a nonprofit under scrutiny from scientists, members of Congress, along with other officials for “using US funds for studies on bat coronaviruses with the Wuhan Institute of Virology (WIV)” in Wuhan, China, where the pandemic first emerged. Peter Daszak, the president of EcoHealth Alliance, led the task force, but has recused himself from that role. Dr. Sachs said, “I just didn’t want a task force that was so clearly involved with one of the main issues of this whole search for the origins, which was EcoHealth Alliance.” Sachs also said that the “Lancet COVID-19 Commission would continue studying the origins for a report to be published in mid-2022 but broaden its scope to include input from other experts on biosafety concerns including government oversight and transparency regarding risky laboratory research.”

MENTAL HEALTH OF HEALTHCARE WORKERS

Symptoms of Depression, Anxiety, Post-Traumatic Stress Disorder, and Suicidal Ideation Among State, Tribal, Local, and Territorial Public Health Workers During the COVID-19 Pandemic

Increases in mental health conditions have been documented among the general population and health care workers since the start of the COVID-19 pandemic. Public health workers might be at similar risk for negative mental health consequences because of the prolonged demand for responding to the pandemic and for implementing an unprecedented vaccination campaign. The extent of mental health conditions among public health workers during the COVID-19 pandemic, however, is uncertain. A 2014 survey estimated that there were nearly 250,000 state and local public health workers in the United States. To evaluate mental health conditions among these workers, a nonprobability–based online survey was conducted during March 29–April 16, 2021, to assess symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal ideation among public health workers in state, tribal, local, and territorial public health departments. Among 26,174 respondents, 53% reported symptoms of at least one mental health condition in the preceding 2 weeks, including depression (32.0%), anxiety (30.3%), PTSD (36.8%), or suicidal ideation (8.4%). The highest prevalence of symptoms of a mental health condition was among respondents aged ≤29 years (range = 13.6%–47.4%) and transgender or nonbinary persons (i.e., those who identified as neither male nor female) of all ages (range = 30.4%–65.5%). Public health workers who reported being unable to take time off from work were more likely to report adverse mental health symptoms. Severity of symptoms increased with increasing weekly work hours and percentage of work time dedicated to COVID-19 response activities. Implementing prevention and control practices that eliminate, reduce, and manage factors that cause or contribute to public health workers’ poor mental health might improve mental health outcomes during emergencies. Read the article here.

US Public Health Workers Leaving ‘In Droves’ Amid Pandemic Burnout

Prior to the pandemic, the public health workforce was shrinking. In COVID-19, the health system is seeing widespread overwork and discontent among healthcare workers, causing an acceleration in the preexisting downward trend. By the end of last year, more than 180 public health officials were fired or resigned from their posts in 38 states, and the current number of resignations is likely much higher. Adding insult to injury, public health departments are facing significant budget cuts and challenges to their power. There is rising fear in public health that the “toll of the pandemic poses an existential threat to their line of work.”

Building Resilience and Well-Being: Keys to Avoiding the Worst of a Looming Shortage of Healthcare Workers

Nurses and other healthcare workers are facing “unprecedented levels of work stress as the world approaches two years of this global pandemic.” This is pushing our health system toward a “potentially disastrous retention crisis among nurses that will hit hard in the next five years.” The Maslach Burnout Inventory identifies several components that influence burnout, such as emotional exhaustion and low personal accomplishment. A review assessing the risk of burnout associated with the COVID-19 pandemic found that 34% of nurses reported high emotional exhaustion and 15% reported low personal accomplishment. The high rate of burnout can “directly affect nurses’ health, increase turnover, and lead to compromises in the quality of patient care.” The Department of Health and Human Services recognizes the critical levels of burnout and just announced $103 million in grant funding for reducing burnout and promoting resilience, and $29 million of this funding will go toward hospital grants for programs that enhance evidence-informed resilience. A recent analysis by Perceptyx shows that increased workload is the leading concern for healthcare workers. Along with easing workloads, resilience needs a boost. Responses from healthcare workers highlight six recommendations to boost resilience: (1) think past today to build more optimism; (2) act on employee feedback to improve feelings of control; (3) reward accomplishments, even small ones; (4) build community; (5) create a sense of fairness; and (6) live your values, increase safety.

BIOECONOMY

National Threats to the Bio-Economy with SSA Edward You

America’s hospitals and health systems are at risks of attacks that threaten the bio-economy. How do these threats affect patients and citizens and what we can do about it to help reduce risks? FBI supervisory special agent Edward You is a former colleague of John Riggi, the senior advisor for cybersecurity and risk at the American Hospital Assocation. You is a highly accomplished 17-year veteran of the FBI and one of the nation’s leading experts on threats to the bio-economy. In a new podcast, You and Riggi discuss their work defending hospitals and health systems against high impact ransomware attacks and cyber espionage campaigns. Listen here.

Another Voice: California Biosecurity Bill Safeguards Bioeconomy and Public Health

Dr. Gregory Koblentz, Director of the Biodefense Graduate Program at the Schar School of Policy and Government at George Mason University and member of the Scientists Working Group on Biological and Chemical Security of the Center for Arms Control and Non-Proliferation, recently wrote an article on the California biosecurity bill. According to Koblentz, “California Gov. Gavin Newsom now has the opportunity to reduce the risk posed by synthetic smallpox — and other novel biological threats —and keep California’s bioeconomy innovative and strong.” The California Assembly recently approved the Gene Synthesis Security bill (AB 70), which would “close this vulnerability by requiring companies that produce or sell synthetic DNA in California to have screening standards that meet or exceed those used by members of the International Gene Synthesis Consortium (IGSC).” The Scientists Working Group on Biological and Chemical Security urges the governor to sign this important legislation. If this bill is adopted, California would “establish the first legally binding biosecurity measure for the synthetic biology industry in the US – and in the world.” Koblentz emphasizes that “California has the potential to set a de facto national standard for biosecurity.” This bill will make Californians safer and “boost the state’s bioeconomy by creating a level playing field that enables companies to compete on the affordability and quality of their products without making trade-offs on security.”

NAVALNY

New Book – Navalny: Putin’s Nemesis, Russia’s Future?

Who is Alexei Navalny? Poisoned in August 2020 and transported to Germany for treatment, the politician returned to Russia in January 2021 in the full glare of the world media. His immediate detention at passport control set the stage for an explosive showdown with Vladimir Putin.

But Navalny means very different things to different people. To some, he is a democratic hero. To others, he is betraying the Motherland. To others still, he is a dangerous nationalist. This book explores the many dimensions of Navalny’s political life, from his pioneering anti-corruption investigations to his ideas and leadership of a political movement. It also looks at how his activities and the Kremlin’s strategies have shaped one another.

The book – Navalny: Putin’s Nemesis, Russia’s Future? – makes sense of this divisive character, revealing the contradictions of a man who is the second most important political figure in Russia—even when behind bars. In order to understand modern Russia, you need to understand Alexei Navalny. Find Navalny here.

MIT is hosting a virtual forum about the book on 7 October at Noon EST. Register here.

CNN’s Emmys for Navalny Coverage

At the 42nd Annual News and Documentary Emmy Awards, CNN won eight Emmys honoring news programming. CNN’s recognitions include breaking news coverage, investigative reporting, and news discussion and analysis. Two of the awards were for “Outstanding Investigative Report in a Newscast” and “Outstanding Research: News,” both in regard to CNN’s work on the poisoning of Russian opposition leader Alexei Navalny.

EVENTS

Webinar – Disinformation and the Evolving Threats of Chemical Weapon Proliferation

CRDF Global is offering a webinar, “Disinformation and the Evolving Threats of Chemical Weapon Proliferation,” on 4 October at 10 AM EST. As the chemical weapons threat evolves to include new types of chemicals used in new ways, one element of this proliferation challenge has more to do with technology and society than it does with chemical compounds and delivery systems. Proliferator states, Russia chief among them, have employed information operations to evade attribution and accountability for actions that violate global non-proliferation norms. While addressing proliferation challenges has traditionally been relegated to government professionals and academic experts, mitigating the proliferation risks posed by disinformation campaigns must be a whole-of-society effort.  

This panel will bring together leading experts Sarah Jacobs Gamberini from the National Defense University Center for the Study of Weapons of Mass Destruction and former head of the Organization for the Prohibition of Chemical Weapons laboratory, Dr. Marc-Michael Blum, to discuss how and why Russia employs disinformation campaigns that threaten non-proliferation norms. Register here.

11th Annual Global Summit on Regulatory Science

The 11th Annual Global Summit on Regulatory Science will be held virtually on 4 – 6 October from 7 – 10 AM CT. The summit is organized by the National Center for Toxicological Research (NCTR), a research campus of the Food and Drug Administration located in Arkansas. This year’s theme is “Regulatory Sciences for Food/Drug Safety with Real-World Data & Artificial Intelligence (AI).” Opening remarks will be made by FDA Acting Commissioner, Janet Woodcock. The two keynote speakers are Frank Yiannas, Deputy Commissioner for Food Policy and Response at FDA, and Stephen Quest, General Director at Joint Research Center of the European Commission. The summit will include platform presentations from scientists representing Brazil, Canada, the EU, India, Italy, Japan, Singapore, Switzerland, and the US. There will be a live debate on the topic, “Is Regulatory Science Ready for AI?” Further, there will be a workshop to showcase data-science tools currently in regulatory use by FDA, European Medicines Agency (EMA), and Swissmedic. Register here.

GET Africa Global Emerging Pathogens Treatment Consortium

The 7th African Conference on One Health and Biosecurity will take place 27 – 29 October in Lagos, Nigeria. The theme is a “Universal Approach to Addressing Biosecurity Threats: Genomic Intelligence and Vaccines.” Speakers include Sir Hilary Beckles, Vice Chancellor of the University of the West Indies; Professor akin Abayomi, Honourable Commissioner for Health of Lagos State; Professor Charles Wiysonge, Epidemiologist and Vaccinologist for the South African Cochrane Center; Dr. Valierie Oriol Matthieu, Global Medical Affairs Lead for Vaccines at Janssen Vaccines & Prevention; Dr. Sam Ujewe, Senior Research Ethics Advisor at the Canadian Institutes for Health Research; Professor Mayowa Owolabi, Dean of Faculty of Clinical Sciences at University of Ibadan; Dr. Mutiu Bamidele, Director of Lagos State Biobank; Pasquela De Blaiso, Managing Director of Integrated Systems Engineering SRL; Professor Abiodun Denloya, Professor of Applied Epidemiology at Lagos State University; Dr. Michaela Mayrhofer, Head of ELSI Services and Research; Dr. Tom Rausch, Communication Expert at Ministry of Health Luxembourg; Dr. Ayodotun Bobadoya, COO at Global Emerging Pathogens Treatment Consortium; and Professor Christian Happi, Professor of Molecular Biology and Genomics at Redeemers’ University. Register here.

2021 EPA International Decontamination Research and Development Conference

The EPA International Decontamination Research and Development Conference will be held virtually 1 – 5 November 2021. Characterization and cleanup of a site are critical challenges that the United States and EPA would face in rapidly recovering from a major chemical, biological, or radiological (CBR) hazard incident. This conference is designed to facilitate presentation, discussion, and further collaboration of EPA’s Homeland Security Research Program (HSRP), which focuses on an all-hazards approach to cleaning up contaminated buildings (both interior and exterior) and infrastructure. The conference continues to focus strongly on matters involving CBR threat agents but also include “all hazards” elements.

The virtual conference speakers and group leaders will be experts in their fields from EPA and other federal agencies, state and local agencies, tribes, academia, and NGOs and associations. This year’s conference will be a mix of pre-recorded and live sessions, including oral, poster, and Technology Café presentations. Register here.

BARDA Industry Day 2021 Virtual Event

This BARDA Industry Day 2021 Virtual Event will be held 3-4 November 2021. BARDA Industry Day is our annual conference, held to increase awareness of US government medical countermeasure priorities, interact with BARDA and ASPR staff, and network with public and private sector colleagues working in the health security space.  This annual gathering of more than 1300 stakeholders from the public and private sector provides an opportunity to increase understanding of the US government medical countermeasure priorities and funding goals; interact with BARDA and ASPR staff; and showcase innovations. Innovators may apply for limited openings to present during Lightning Talks sessions. Lightning Talks are for individuals, academic institutions, pharmaceutical companies, biotech, and other industry innovators to showcase their innovative technologies. More information is available here. Registration opening soon!

One Health: Integrating Human, Animal and Environmental Health

A virtual science conference on One Health: Integrating Human, Animal and Environmental Health will be held 3 December 2021. The One Health movement, which has come to prominence in the last decade, advocates greater cross-sectoral collaboration and communication across the human-animal-environment interface. There has been a long-standing recognition that population health is intrinsically linked to both animal and environmental health, and that issues such as population growth, changes in climate and land use, and the movement of animals and people, have a huge impact on the collective health of our world today. The Conference will examine the potential societal benefits of the multifaceted One Health methodology, analyze how successful it has been to-date, determine whether One Health could be the key to future pandemic prevention, and ascertain what steps are needed to accelerate implementation. It will explore whether the interpretation of One Health has been biased towards an anthropocentric view of “health,” and it will also seek to answer the question: will something as far-reaching as the COVID-19 pandemic be the catalyst needed to finally make the aspirational goals of One Health a reality? Register here.

Schar School Open Houses

The Schar School PhD Virtual Open House will be held 6 October 2021 at 6 PM EST. This online session will provide an overview of our doctoral degree programs – such as the Biodefense Program – and our Graduate Admissions team will be available to answer questions about admissions requirements, application deadlines, and materials to prepare. 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. Register here.

The Schar School will also be hosting virtual open houses for the Master’s and Certificate Programs! These sessions will take place on 21 October and 16 November at 6:30 PM EST. The online session will provide an overview of our master’s degree programs and graduate certificate programs, student services, and admissions requirements. Register here.

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