Pandora Report: 1.28.2022

This week we bring you a number of updates from the chemical warfare world, including Navalny’s surprise premier at the Sundance Film Festival and the OPCW’s findings on the use of chemical blistering agents in Syria. We continue our coverage of Omicron, including a startling new graphical representation of the latest surge and what this variant means for China as we approach the 2022 Winter Olympics. We also bring more events, new information about antimicrobial resistance globally, and a special feature about the United States’ greatest nuclear defenders- bottlenose dolphins and sea lions in the US Navy Marine Mammal Program.

Navalny Makes Waves at Sundance

The Sundance Film Festival’s mysterious tenth competitor in the US Documentary section, originally known only as “Untitled LP9,” made headlines this week when it turned out to actually be a 90-minute film from Daniel Roher using fly-on-the-wall footage of the Russian opposition leader, Alexei Navalny, healing for several months in Germany after surviving an attack using a Novichok nerve agent in 2020. The film, which included a sequence in which Navalny made a prank call from the Black Forest to someone he believed to be a member of the hit squad that targeted him, convincing the individual to reveal several details about that attack by pretending to be an irate security services boss, drew shock and instant attention across the world. The Guardian explains how people at the festival reacted, with many panicking and wondering if they should get rid of the footage or call the police. Roher, working with Bulgarian investigator Christo Grozev, originally intended to make a film on another subject, but decided to focus on the Navalny poisoning after it made headlines in 2020. The pair sough out information about who may have perpetrated the attack, purchasing telephone and flight records from Russia on the dark web, allowing them to locate a group of eight men from the FBS security services who appeared to have followed Navalny around Russia for several years. Grozev then contacted Navalny in Russia, arranging to meet with him and share what they had found with Roher tagging along to film. The article explains that Navalny was already considering making a film and agreed to work with the pair. The film, which has since sold out subsequent screenings, concludes with Navalny’s January 2021 return to Russia, during which he was detained upon arrival at the airport and promptly sentenced to nearly three year’s in prison for supposedly violating the terms of his sentencing for a prior conviction largely thought to be politically-motivated.

Japan’s COVID-19 Successes

Dr. Hitoshi Oshitani, a virologist at Tohoku University Graduate School of Medicine in Japan, recently published an op-ed, “What Japan Got Right About COVID-19,” in The New York Times. Oshitani begins with the country’s struggle as cases first appeared on the Diamond Princess cruise ship, drawing international attention as repatriation flights form Hubei Province in China continued amid historic lockdowns. Nine healthcare workers and quarantine officials who responded to the cruise ship outbreak became infected, though Oshitani contests the official reason provided for them becoming infected (via infectious droplets and contaminated surfaces) and instead contends that each actually failed to wash their hands properly. He goes on to discuss the initial discovery of asymptomatic transmission internationally and what this looked like at the Japanese Ministry of Health, as well as how the country was unique in that it used retrospective contact tracing, an approach where tracers identify an infected person and look back to determine when and where they were infected and who might have been infected simultaneously with them. He explains that this approach allowed the Japanese to determine that it was a small number of infected individuals largely spurring the spread by causing super-spreader events, mostly in closed, indoor environments, all before the end of February 2020. This, he writes, became the basis of Japan’s COVID-19 strategy, even before the WHO declared the novel coronavirus a pandemic. He then discusses how containment was not possible with this disease, unlike with SARS which tends to cause pneumonia, making it easier to identify cases. This led the Japanese to adopting the “Three Cs,” which means “avoid…closed spaces, crowded places, and close-contact settings,” a phrase which was declared buzzword of the year in Japan for 2020. He argues that Japan never implemented lockdowns (which Japanese law prohibits) or went beyond giving strongly-worded warnings to citizens because the country’s strategy from the onset was to find ways to live with COVID-19. He explains that he thinks others have misunderstood Japan’s response, arguing that it was successful despite its challenges and economic and livelihood costs. However, others argue that Japan’s response was fragmented or that it relied too heavily on barring cases from entering the country instead of actively seeking out cases via aggressive testing like that implemented in South Korea, as highlighted by our own HyunJung (Henry) Kim (Biodefense PhD graduate) in early 2020. Oshitani’s advice for learning to live with COVID-19 globally is to embrace the Three Cs whenever there is a surge, which is good advice in general when dealing with an infectious disease, though it does not necessarily solve the problems countries like the United States have with high rates of unvaccinated individuals- especially for a country where the COVID-19 vaccines are readily available- causing them to continue to struggle with hospitalization rates and their downstream effects.

China’s Winter Olympics Woes

With the Olympics starting just one week from today, the pressure has been on for China to stick to its promise of “zero COVID.” While the PRC has claimed to have had just over 150,000 cases total since the novel coronavirus’s initial emergence in Wuhan, many have called into question whether or not the country’s case count is at all accurate. This is especially true as the Omicron variant proves to spread more easily than prior variants, though China’s reporting on case counts of the variant remain questionable at best. The current official story offered by China is that the Omicron variant entered the country on a piece of mail originating in Canada. This claim has been alluded to in news media published around the anniversary of Wuhan’s 2020 lockdown, such as on this cover of the Wuhan Evening News showing an employee in a hazmat suit fumigating a postal office. The Olympics represent an opportunity for Xi Jinping, the most powerful leader of the country since Mao Zedong himself, to demonstrate that his country is the world-class superpower he claims it is, using the prestige and abundance hosting an Olympiad brings to further legitimize the CCP and his rule. Creating a COVID-19-free bubble for the Olympics, too, allows the CCP to further propagate the idea that they have effectively managed COVID-19 and are continuing to manage it well, even as the games bring an influx of foreign athletic delegations to the capital. This COVID-free image is likely to be especially critical for the Chinese to maintain as several countries, including the US, UK, Australia, and Canada, make a diplomatic boycott of the games, citing China’s human rights violations against the minority Uyghur population in Xinjiang and its actions in Tibet and Hong Kong as some of the reasons for the boycott. Even major companies like Coca-Cola find themselves under increasing pressure to withdraw their sponsorship from the games, a sticky situation for foreign companies working hard to appease China’s sensitive nature. Talk of the Olympics has somewhat overshadowed the attention previously afforded to Chinese tennis player, Peng Shuai, a mainstay on the women’s tour who disappeared after accusing a CCP official of sexually assaulting her. After mounting pressure from the Women’s Tennis Association (WTA) came down on China, a mysterious email, which the WTA insisted was not from Peng, was sent claiming Peng was safe and well. This was just the latest demonstration of how swiftly any challenging of the Party, even from an internationally-loved tennis star, can be silenced. All this to say- the Olympics represent a huge opportunity for Xi and the CCP to further legitimize themselves and present an attractive image to countries in the developing world China is currently targeting for things like debt traps or switching their diplomatic recognition to the PRC from Taiwan. However, this could be disastrous if the games bring a spike in cases while international press is present en masse, though the Party likely would still not acknowledge the scope if that were to happen. We will keep you posted on how this develops over the next couple of weeks.

Beijing National Stadium, popularly referred to as the Bird Nest, was originally constructed for the 2008 Summer Olympics in Beijing. It will be used this year as well to host events for the 2022 Winter Olympics. The stadium holds 80,000, though Beijing announced ticket sales to the general public would be halted in an effort to limit the number of people inside the games’ bubble this year.

ASPR TRACIE: 2021 At-a-Glance and Looking Forward

The Assistant Secretary for Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (TRACIE) has just released their Year-in-Review report, featuring more than 100 resources they published in calendar year 2021. The have also released their At-a-Glance and Looking Forward video which highlights how the program’s partnerships have supported their work over the last several years. The report explains how TRACIE supported over 1.2 million site visitors and responded to nearly 10,000 technical assistance requests (3,000 of which pertained to COVID-19) in 2021 alone. The organization is looking forward to offering resources on issues like climate change and healthcare system resilience in the year ahead. They also are creating tools to assist hospital planners better prepare for disasters and learn from challenges faced during the COVID-19 pandemic.

AMR On the Rise Globally

NPR released a piece this week discussing the rise of superbugs, or drug-resistant bacteria, viruses, parasites, and fungi, globally in the last several years. Superbugs now kill more people annually than HIV/AIDS or malaria, with low- and middle-income countries being hit the hardest by the rise in drug-resistant infections. Once thought to be a problem isolated to the wealthiest countries of the developed world, these drug-resistant infections directly killed 1.2 million people and contributed to the deaths of over 5 million globally in 2019 alone, though deaths were highest in sub-Saharan Africa (24 deaths per 100,000 population/yr. vs. an average of 13 deaths per 100,000/yr. in high-income countries). A new article in The Lancet discusses these numbers in great depth, providing what is thought to be the most comprehensive assessment of annual AMR-associated deaths. The higher rates of AMR-related deaths in the developing world exist partly because, as Dr. Fiorella Krapp Lopez, an infectious disease physician in Lima, discussed in the NPR article, there are a myriad of reasons these infections are on the rise in lower income countries. These include 1) antibiotics are often available to people in these countries without a prescription, increasing the chances of misuse and overuse, allowing microbes to gain resistance to them, 2) systems to flag potentially drug-resistant infections are generally not as sophisticated in these countries, 3) these countries generally have higher rates of healthcare-associated infections, which are more likely to become drug-resistant, and 4) while there are some new, more potent drugs in development, these lower income countries tend to rely on older, cheaper, and less-effective drugs. These challenges are compounded by the fact that major pharmaceutical companies often lack the financial incentives, or are not willing to take on the massive risks, needed now to create new antibiotics, which are increasingly limited in their applicability. In fact, this has been a problem since at least the 1960s, as this Nature article highlighted in 2020, and Alexander Fleming even warned of this in his 1945 Nobel Prize lecture when he accepted the prize for his role in discovering Penicillin. Worse yet, the NPR article concludes that the further rise of this throughout the developing world may be compounded by the pandemic as healthcare facilities struggle just to keep patients breathing, forcing testing for samples showing resistance to be placed on the back burner. This challenge presents a serious threat to global health, international development, and national security, demonstrating how a myriad of factors in the day-to-day operations of healthcare facilities can have grave, long-lasting implications for us all.

The Bioeconomy Revolution Can End the Panic-and-Neglect Cycle in Health Security”

Ryan Morhard’s new piece in ThinkGlobalHealth explains how progress in biotech can improve pandemic defenses drastically in the coming decades. Morhard is the director of policy at Gingko Bioworks, Inc., an affiliate of the Georgetown University Center for Global Health Science and Security, and term member of the Council on Foreign Relations. In this article, he provides two scenarios, a hypothetical one in which SARS-CoV-2 emerged in 2009 (“COVID-09”) and one in which COVID-19 as we know it exists. He highlights how the world responded to the 2009-10 H1N1 pandemic, paying particular attention to vaccines and detecting/tracking variants, contrasting the 350 million doses of influenza vaccine administered during the H1N1 pandemic to the more than 9.8 billion doses of COVID-19 vaccine administered so far following unprecedented development and deployment. He also highlights how, during the H1N1 pandemic, just 10,000 influenza samples were sequences compared to the more than 7 million SARS-CoV-2 sequences shared with GISAID Initiative, aided by the use of AI to analyze all this, something he writes “would have been science fiction in 2009.” He uses these comparisons, which are imperfect given the scope and devastation caused by the COVID-19 pandemic versus that of the 2009 H1N1 pandemic, to argue that, similar to how the advancements we have seen in the last decade improved COVID-19 response, advancements in the coming decade will drastically change future pandemic response, though he does highlight how the world failed to take the pandemic threat seriously even after H1N1. He argues that the bioeconomy, which is expanding away from purely medical applications, will allow this to take place, writing “The response to the COVID-19 pandemic has shown that, when combined with public sector leadership and support, the bioeconomy offers ready capacity for biosurveillance, environmental monitoring, and continuous development and large-scale production of diagnostics, therapeutics, and vaccines.” He concludes that adopting policies which take advantage of the growing global bioeconomy is our best shot at ending the panic-and-neglect cycle in pandemic policies by allowing us to develop better tools to detect, respond, and prevent epidemics and pandemics. His piece is very hopeful and does little to address other factors that come with this rapid advancement, including AI governance issues, privacy concerns, and ongoing challenges with mis- and disinformation that plague this era. Nonetheless, he brings valid points about the potential for rapid technological advancement to bring immeasurable good if it is complemented by policy improvements in the coming years.

The Omicron Surge Visualized

Felix Richter, a data journalist with Statista, created this graphic this week depicting how sharply the Omicron surge increased global case counts, pushing them to unthinkable levels. He writes, “According to the World Health Organization, the seven-day average of daily new cases climbed to 3.33 million on January 26, which is quite literally off the charts compared to previous waves. And while some have called Omicron a blessing in disguise, a “natural vaccine” that will bring us closer to the end of the pandemic, most health officials don’t seem to share that sense of optimism. “It’s dangerous to assume that Omicron will be the last variant or that we are in the endgame,” Dr. Tedros Adhanom Ghebreyesus, head of the WHO, said an executive board meeting of the organization on Monday. “Globally, the conditions are ideal for more variants to emerge.””

World Health Organization Executive Board 150 Convenes

The WHO’s Executive Board gathered to conduct a variety of business this week, including nominating Dr. Tedros Adhanom Ghebreyesus to continue in his role as WHO Director-General (to be confirmed at the 75th World Health Assembly in May). The Executive Board is comprised of 34 technically qualified members elected for three-years terms. At this annual meeting, the board agrees upon the agenda for the WHA and what resolutions to be considered at the assembly. This year’s Executive Board meeting runs through tomorrow and is being livestreamed and archived here.

This comes amid concerns about the United States’ commitment to the WHO, with Reuters reporting that multiple sources indicate President Biden remains skeptical of the organization and is weary of calls to make the agency function more independently. The US is the WHO’s biggest funder, though it has been resistant to proposals made to increase each member state’s standing annual contribution to the the agency, according to a WHO document dated January 4. This is part of a broader plan to reform the organization in light of issues and limitations it faced in responding to the current pandemic. The US is said to be skeptical that the agency can actually do much more, particularly when it comes to countering health threats from China, as some US officials explained to Reuters. The US is pushing instead for a separate fund to be created, directly controlled by the donors, that could finance prevention and control of health emergencies, striking to the heart of debates about how best to handle global health crises amid growing international tensions between major powers. However, HHS’ Office of Global Affairs released a tweet indicating the US successfully led efforts to build consensus on strengthening the International Health Regulations, a resolution which the Executive Board did adopt brought by the US and over 40 co-sponsors, indicating the US is still committed to improving these regulations and their enforcement.

America’s Strongest Line of Defense- Nuke-Guarding Dolphins?

Despite all the technological advancements warfare has seen in the last century, the US Navy proves that, sometimes, the natural option does the job just right. As recently reported, the Navy has trained dolphins and sea lions since 1967 for various military applications like mine clearing, force protection, and recovery missions under the US Navy Marine Mammal Program. Dolphins deployed as early as the Vietnam War and as recently as the 2003 US-led invasion of Iraq. Based at Naval Information Warfare Center Pacific, animals in the program train in San Diego Bay and have allowed the Navy to contribute more than 1,200 open scientific publications discussing the animals’ health, physiology, sensory systems, and behavior to the body of academic literature on them. They continue to serve an important mission at home, including defending the waters around Bangor, Washington, which is the largest single nuclear weapons site in the world. This stockpile contains about 25% of the United States’ 9,962 nuclear warheads and has done so since 2010. Information about the program was only declassified in the 1990s, and the US remains the only known country to have such a program currently. The Soviets trained dolphins for similar harbor protection missions, though their program status remained in limbo after the USSR collapsed, though Russia possibly sold the animals to Iran in 2000, according to The article concludes with, “Russia is said to have been looking to update its training program, and may even have used them in Syria.” The US military, particularly the Air Force, has publicly struggled with disciplinary and oversight issues at sites tasked with guarding nuclear weapons, including the 2007 incident in which six AGM-129 ACM cruise missiles were flown over the United States on a B-52H heavy bomber and the time USAF Maj. Gen. Michael Carey (then head of the 20th Air Force- the United States’ main nuclear ICBM strike force) was relieved of his duties after a drunken escapade in a Moscow Mexican restaurant while leading a high-level delegation’s trip to meet their Russian nuclear counterparts. The Navy’s marine mammals, however, remain stalwart guardians of the United States’ most sensitive weapons and vigilant companions as they continue to sniff out mines and other munitions, including a rare 19th century Howell torpedo discovered off the coast of Coronado, CA in 2013. You can check out the archived version of the Navy’s “A Brief History of the Navy’s Marine Mammal Program” here.

HT2 Christopher Burgess, assigned to EOD Mobile Unit 1, works with a bottlenose dolphin prior to a training exercise. EODMU-1 uses bottlenoses to locate and mark mines on that are present on the sea floor, tethered in the water column, or in shallow water. Source: DVIDS.

OPCW Issues Fact-Finding Mission Report on Chemical Weapons Use Allegation in Marea, Syria, in September 2015

The Organisation for the Prohibition of Chemical Weapons issued the report of its fact-finding mission (FFM) into the alleged use of toxic chemicals as a weapon in Marea, Aleppo Governorate, Syrian Arab Republic, on 1 and 3 September 2015 this week. The FFM conducted several interviews with witnesses in addition to obtaining environmental samples and digital evidence over the course of their investigation. They write, “On 1 and 3 September 2015, the town of Marea was subject to shelling with both conventional munitions as well as projectiles filled with chemicals that fell in various locations and neighbourhoods in Marea. In some of the targeted locations, a black substance was observed, and in others, a yellow powder was observed. Individuals exposed to the substances developed blisters a few hours after exposure. Affected individuals displayed similar signs and symptoms in both incidents.” This report does conclude that a chemical blister agent was used as a weapon in this case, adding to the list of agents the FFM confirmed have been used in the Syrian Arab Republic, including chlorine, sulfur mustard, and sarin. The OPCW is tasked with implementing the Chemical Weapons Convention, having overseen the destruction of 99% of declared chemical weapon stockpiles globally under its verification, receiving the 2013 Nobel Peace Prize for doing so. Our own Dr. Gregory Koblentz published an article in The Nonproliferation Review in 2020 discussing OPCW’s efforts to hold the Assad regime responsible for use of CW during the Syrian Civil War, “Chemical-weapon use in Syria: atrocities, attribution, and accountability,” which can be found here.

Johns Hopkins Science Policy Group- Impacting Policy Through Science

Gain inside knowledge about how science is communicated to policymakers, by joining JHSPG for the second session in our “Science Communication” series, with Dr. Leah Cairns, Ph.D. Dr. Cairns will discuss her current work at the National Academies, and how reports and the policy recommendations within them are produced and communicated. Cairns is a Program Officer in the Board on Health Sciences Policy at the National Academies of Sciences, Engineering, and Medicine. Her primary interests include health policy and biomedical research. Prior to joining the National Academies, she served as a AAAS Science and Technology Policy Fellow working as legislative staff for a member of Congress focusing on health policy and appropriations. Dr. Cairns also previously served as a Christine Mirzayan Science & Technology Policy Fellow at the National Academies in the Policy and Global Affairs Division. Dr. Cairns received her Ph.D. in biophysics from the Johns Hopkins University School of Medicine, and a B.A. in biochemistry and molecular biology from Hamilton College. This event will be on February 3 from 12:00-1:00 pm ET. Register here.

CSIS- Covid-19 Vaccine Confidence at One Year

The Center for Strategic and International Studies will host a livestream discussing COVID-19 vaccines’ first year on February 4 from 10:00- 11:00 am ET. A little over a year since Covid-19 vaccines became available, more than 60 percent of the world’s population has received at least one dose. But the global distribution of Covid-19 vaccines is uneven. At least 75 percent of people in the United States have received at least one dose of Covid-19 vaccine, but the same is true for just 10 percent of the population in low-income countries. As efforts to improve equity in vaccine supply and delivery advance, more countries are also now confronting the challenge of securing community trust – the final step needed to deliver shots into arms. While countries work to expand vaccine access and accelerate the uptake of vaccines, misinformation and rumors about Covid-19 vaccines crowd the information environment, politicizing vaccines, and undermining efforts to improve health security. What strategies can best equip people to make informed decisions about Covid-19 vaccines for themselves and their families? One year into the distribution of vaccines, are there still opportunities to change people’s minds?

The session will begin with a keynote presentation from Heidi J. Larson, professor of anthropology, risk, and decision science, and director of the Vaccine Confidence Project™ at the London School of Hygiene & Tropical Medicine. Her presentation will be followed by a panel discussion featuring Mollyann Brodie, executive vice president, COO, and executive director of public opinion and survey research at the Kaiser Family Foundation; James A. Lewis, senior vice president and director of the CSIS Strategic Technologies Program; and J. Stephen Morrison, senior vice president and director of the CSIS Global Health Policy Center. Katherine E. Bliss, senior fellow and director of immunizations and health systems resilience at the CSIS Global Health Policy Center, will moderate the discussion. Register here.

Biodefense PhD Student Selected for U.S.-Japan Next Generation Leaders Initiative

Danyale C. Kellogg, a first year in the Biodefense PhD program and current Managing Editor of the Pandora Report, was recently chosen to be part of Pacific Forum’s US Japan Next Generation Leaders Initiative. This program is sponsored by The US Embassy in Tokyo and Tokyo International University and selects ten cohort members annually. Members span academia, industry, military, and public policy and are chosen based on strength of application and their research proposal. Cohort members spend several months researching various facets of the US-Japan alliance, receiving mentorship from scholars and practitioners from both countries. They will have the opportunity to present their research in Tokyo later this year, travel restrictions permitting. Kellogg’s research will focus on how the US and Japan can better collaborate on global health security matters moving forward, paying particular attention to the challenge China poses regionally and globally in this area. She is interested in better understanding how the US can balance both encouraging China to improve its outbreak response and reporting record while also acknowledging its past failures, preparing for the security threat this poses, and cooperating with regional allies like Japan and South Korea appropriately.

Image shared by Pacific Forum announcing the 2021-22 cohort

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