Pandora Report: 4.15.2022

This week we tackle online claims that Russia used CW in Mariupol, continued attacks on Ukrainian healthcare infrastructure and personnel, Shanghai’s continued lockdown and COVID-19’s spread to other Chinese cities, and the trillions climate change will likely cost US taxpayers annually in the not-so-distant future. We have listed a number of new publications, including one Biodefense PhD student’s new article covering the military history of sulfur mustard and new work on hurdles to establishing international biosecurity rules.

Managing Editor’s Note: Last week, some readers encountered issues with how the font for the weekly report displayed in their browsers and email. This looks to have been a technical issue as the font size of the Pandora Report was not actually made smaller on our site or editing platforms. Thank you so much to those who took the time to write and bring this to our attention- it is much appreciated! The weekly issue from April 8 is available here on our site for anyone who had the viewing issue last week and would like to see it on the website.

Did Russia Use Chemical Weapons in Ukraine? Vague Reports of Drones and Poisonous Substances Does Not a CW Attack Make

Following social media reports on Monday that Russia used “a poisonous substance of unknown origin” in Mariupol near the Azovstal iron and steel works, the internet has been full of debate about whether or not this was a chemical weapons attack. The widely circulating post claims that victims suffered “respiratory failure”, “vestibulo-atactic syndrome” (which many have noted is an oddly specific term to include with such little evidence), inner ear issues causing dizziness, and vomiting, eye twitching, and loss of coordination. BBC reports that, “One injured man described a “sweet-tasting” white smoke covering an area of the plant after an explosion. Another said he felt immediately unable to breathe and had collapsed with “cotton legs”.” The reports indicated that three people were ill as a result, though severe illness and injuries were not reported. While Ukrainian President Volodymyr Zelensky, British Foreign Secretary Liz Truss, and Pentagon Spokesman John Kirby all expressed that the claims are being taken seriously and investigated, experts have cast significant doubt on these claims’ legitimacy. This also comes amid continued concerns about use of white phosphorus bombs, which are not considered incendiary or chemical weapons under Protocol III and the CWC respectively, in civilian areas of Mariupol.

The key problems with these CW claims are that there is a lack of solid reporting, it is difficult (if not impossible) to make confident assessments about an event like this remotely and over social media, and the reports spark more questions than they answer, including: Why is the reported illness being attributed to chemicals specifically? What kind of drone was used? Are there videos or photos of it? What height was the drone at when the agent was delivered? How is it known that it was there to deliver an agent and not for another purpose? How much and what kinds of agent could that drone deliver? What were the weather and environment like at the time? What industrial chemicals are at the plant where this occurred? What was happening at the time of the attack? Was there active combat occurring where fires and explosions are expected? Was the agent persistent? Can environmental and biomedical samples be taken? What would such a small-scale CW attack provide the Russians right now? This is not to accuse anyone of lying, to say this did not happen, or to pretend the threat of CW use in this war is not real (though it is generally considered low), but these are questions that need to be answered to substantiate these reports. Claims that a state used CW are very serious and should not be made or spread haphazardly. It is also incredibly important to recognize that different agents behave in very different ways, so it may be impossible to ever verify that this happened, especially as heavy fighting continues.

Dan Kaszeta, author of numerous works on chemical weapons and a current fellow at the UK’s Royal United Services Institute, was quick to outline a number of the facts about what we do (and don’t) know about this incident and the dangers of trying to define this event via social media. Among these problems is that the reported symptoms are not agent-specific and do not point specifically to chemical agents as their cause. There have been vague descriptions of the chemical used in the supposed attack and, even with some claims indicating it was colorless and odorless, this is still going to be an issue without environmental samples. Important to note too is that this occurred in an industrial area several weeks into a war; a number of industrial materials could have caused this, particularly amid fires and explosions caused by combat near the plant. Kaszeta also pointed out how varied CW agents are, so any chance of finding evidence of an attack will depend on a myriad of factors like how persistent the supposed agent is. He also explained that it is dangerous to jump to conclusions on matters such as these, so it is important to wait for more definite information to come out, particularly as many of the initial reports were authored by Azov, a Ukrainian nationalist group associated with the far right and neo-Nazism.

Dr. Jean-Pascal Zanders contextualized these concerns and reports in The Trench, explaining that sensationalizing this reported event based on limited, “extremely sketchy” information is dangerous. He also explained in this piece when industrial chemicals and their precursors are considered chemical weapons which, again, is important to consider given the setting in Mariupol. He also notes some of the eerie similarities to previous events in Syria, including Russia’s ultimatum to Mariupol’s defenders, demanding that they surrender the city. He writes, “In and of itself, the incident is unrelated to possible CW use. However, it carries echoes of military operations in Syria where defenders of encircled cities or positions were offered the option to withdraw or face serious consequences. The insurgent groups and civilians who decided to retreat could leave the area; those who continued resisting faced chlorine attacks until they too abandoned their positions. The chemical attacks caused, relative to conventional operations, few casualties but with time psychological pressure increased. Once confronted with the demand to withdraw, the consequences of refusal became increasingly obvious.”

What is not in question is that the West is publicly decrying any threat or actual use of chemical weapons in the conflict. The CWC Coalition released a statement decrying this threat, highlighting Russia’s use of Novichoks in assassination attempts in recent years and its close allying with the Syrian Arab Republic, which has used CW throughout its civil war. The CWC Coalition also called out unsubstantiated claims about CW use, writing “We call upon Russia, in the strongest possible terms, to respect its solemn obligations under the Geneva Protocol and the CWC not to contemplate, let alone use or threaten to use, these globally banned weapons of mass terror. We also call on all parties to refrain from making unsubstantiated CW allegations for political advantage.”

On a related note, the European Commission announced recently that the EU has developed strategic reserves for chemical, biological, and radio-nuclear emergencies under the EU Civil Protection Mechanism. This measure includes a €540.5 million rescEU strategic stockpile, established in close collaboration with the Health Emergency Preparedness and Response Authority (HERA). According to the Commission, this stockpile will consist of equipment and medicines, vaccines and other therapeutics to treat patients exposed to CBRN emergencies agents, as well as of rescEU decontamination reserve to provide decontamination equipment and expert response teams. The Commission explains that, “Extreme weather conditions and emerging threats, such as the coronavirus, but also CBRN incidents may overwhelm the ability of EU Member States to help each other, especially when several European countries face the same type of disaster simultaneously,” and that “People may be exposed to CBRN agents as a result of unintentional disasters (eg. a chemical plant leak, nuclear power plant incidents, the spread of an infectious disease) or intentional incidents (eg. a terrorist attack). Being prepared to address the risks of such threats is a key part of the EU CBRN stockpiling strategy.” The rescEU medical reserve has been mobilized to procure potassium iodine tablets (which can be used to help protect against the effects of radiation by saturating the thyroid, helping stop it from absorbing radioactive iodine if taken at the right time), 3 million of which have already been delivered to Ukraine through the EU Civil Protection Mechanism.

Another Grim Milestone: WHO Records 100th Attack on Healthcare in Ukraine

The WHO announced on April 7 that, since Russia started the war in Ukraine on February 24, over 100 attacks on healthcare facilities and personnel were recorded in the country. The release reads, ““We are outraged that attacks on health care are continuing. It took just 42 days to reach this grim milestone, the announcement noted. Attacks on health care are a violation of international humanitarian law, said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, at a press conference. “Peace is the only way forward. I again call on the Russian Federation to stop the war.”” As of today, since the start of this year, the WHO’s Surveillance System for Attacks on Health Care has tracked 125 attacks on healthcare in Ukraine, resulting in at least 73 deaths and 51 injuries. These primarily consist of violence with heavy weapons, obstruction to healthcare delivery, and militarization of healthcare assets. Furthermore, 111 of these attacks have impacted facilities, 14 impacted medical transports, and 24 impacted supplies.

The WHO announcement continues with, “Across Ukraine, 1000 health facilities are in proximity to conflict areas or in changed areas of control,” explained Dr Jarno Habicht, WHO Representative in Ukraine. “Health workers throughout the country are risking their lives to serve those in need of medical services, and they, and their patients, must never be targeted. Further, when people are prevented from seeking and accessing health care, either because the facilities have been destroyed or out of fear that they may become a target, they lose hope. The mental health toll wreaked by the war cannot be underestimated, affecting civilians and the health workforce alike.”

It is important to note that Ukraine was working to improve its healthcare system but had a number of challenges when it was attacked by Russia, suffering from a polio outbreak, low COVID-19 vaccination rates, and other issues when the war started. Ukraine has been making efforts to institute healthcare reforms and achieve universal healthcare coverage, having finally secured parliamentary support for the latter in recent years after 25 years of efforts to do so. Reforms included a financing mechanism under which money follows the patient, so the specific needs of a patient are funded rather than facilities and providers. The state also introduced full-coverage for primary, palliative, and emergency care as well as reimbursement for medication for cardiovascular diseases, asthma, a type 2 diabetes with online prescription filling systems in development. These were significant steps and it is important to remember that healthcare is not a resource that just immediately replenishes itself. It takes time, funding, and serious effort to build a resilient, robust healthcare system and it takes time to develop competent, experienced healthcare professionals. Debilitating a country’s healthcare and public health infrastructure also severely harms their preparedness for CBW attacks and other similar emergencies so, if Russia does in fact decide to use these kinds of weapons in Ukraine, civilian casualties will likely be higher because of this damage to healthcare in the country.

The WHO’s report concludes with another grim reminder: “Attacks on health are unfortunately seen amid conflicts globally. Since 1 January 2022 [as of April 7], WHO has verified 160 attacks on health care in 11 countries and territories resulting in 97 deaths and 74 injuries. Outside of Ukraine at this time, Sudan is also witnessing a recent increase in attacks on health care.”

“Zero-COVID” Fails to Contain Shanghai Surge Amid Record Cases and Lockdown Challenges

According to the Wall Street Journal, 45 cities accounting for 40% of the PRC’s economic output had implemented full or partial lockdowns as of Monday evening. As Shanghai enters its third week of strict lockdowns, videos have emerged of citizens and the police clashing amid growing frustrations as many households run dangerously low on supplies. As grocery deliveries and other services in the city continued to struggle to adapt and more areas of the city were turned into quarantine centers, Shanghai reported a record 27,000 cases on Thursday alone. 25,146 of these were asymptomatic, according to NBC. Despite this and partial easing of restrictions in some areas, President Xi has indicated the city must continue with its strict “dynamic Covid clearance” policy and pandemic control measures. A piece published in the Hong Kong-based South China Morning Post read, “And yet, the anxieties have been fuelled by images of pandemic prevention workers killing dogs, hungry residents looting grocery stores and drones flying over skyscrapers telling residents to “control your soul’s desire for freedom”.”

The fact that other cities are turning to lockdowns now too has many concerned China could soon face a much more serious, widespread fight with the disease even as the Party continues to stick to its Zero-COVID policies. Guangzhou, a major industrial center located near Hong Kong with 19 million people in it, recently shut itself off as other cities follow suit and close schools and factories. There are also concerns that spring planting for China’s farmers, who feed over 1.4 billion people, could be disrupted as a result. The need for these measures and the fact they are spreading and getting so much attention is also likely a major embarrassment to the Party, which has worked hard to portray an image of having the disease under control from the start of the pandemic.

Having witnessed the recent struggle with COVID-19 in Hong Kong, the PRC is pushing vaccines for the elderly (17% of whom were not vaccinated in late March) in the mainland in an attempt to control the spread amid concerns Omicron and its subvariants may overwhelm the system that, ostensibly, has held strong for so long. It is important to consider too that China’s COVID-19 vaccines are not mRNA vaccines (despite the initial claims that the country was ready to roll out two such vaccines), but rather they are inactivated vaccines that are not as effective as the mRNA ones available in dozens of other countries. While China’s ARCoV/ Walvax vaccine, an mRNA COVID-19 vaccine candidate, is approved for Phase III clinical trials in China, Mexico, Indonesia, and Nepal, this does not offer much help or hope in the current situation. Low efficacy vaccines combined with much more draconian containment measures mean the country is lagging in both natural and vaccine-induced immunity, making the next several weeks critical for the PRC’s COVID-19 response and, potentially, the global economy.

The Cost of Doing Nothing: The US Could Face $2 Trillion in Revenue Loss if Climate Change Isn’t Addressed

The White House Office of Management and Budget (OMB) released the first accounting of what unchecked climate change could spell for the federal budget and the economy overall. This is accompanied by two new assessments- the Federal Budget Exposure to Climate Risks and the Long-Term Budget Outlook focused on climate change. Written by Candace Vahlsing, Associate Director for Climate, Energy, Environment, and Science at OMB, and Danny Yagan, Chief Economist at OMB, the analysis highlights a few keypoints: 1) the economy might shrink a lot (up to a 10% reduction of GDP by the end of the century), 2) the cost of programs for various disaster responses will substantially increase, and 3) there will be consequences for things like business and public health that cannot be adequately understood or addressed by the OMB fiscal balance sheet.

Some of the shocking estimates, and what they will cost the US taxpayer, include: “Increased hurricane frequency could drive up spending on coastal disaster response between $22 billion and $94 billion annually by the end of the century,” “Over 12,195 individual Federal buildings and structures could be inundated under ten feet of sea level rise, with total combined replacement cost of over $43.7 billion,” “Rising wildland fire activity could increase Federal wildland fire suppression expenditures by between $1.55 billion and $9.60 billion annually, the equivalent of an increase between 78 percent and 480 percent, by the end of the century,” and “Federal expenditures on crop insurance premium subsidies are projected to increase 3.5 to 22 percent each year due to climate change-induced crop losses by the late-century, the equivalent of between $330 million and $2.1 billion annually.”

Climate change has attracted growing attention as a national security threat in the last decade as rising temperatures, increased severe weather, and reduced access to critical resources will likely increase geopolitical tensions and social instability globally. This was outlined in-depth in a National Intelligence Estimate from the National Intelligence Council last year, titled “Climate Change and International Responses Increasing Challenges to US National Security Through 2040”. The physical effects of climate change are judged to likely exacerbate cross-border geopolitical flashpoints, most acutely impact the developing world, and worsen tensions on the global stage as states argue over who is most responsible and should pay for how much to meet goals like those in the Paris Agreement.

These reports and analysis from OMB help further explain the threat the US faces and the far-reaching consequences of failing to address this threat. President Biden’s budget request for FY 2023 asks for $44.9 billion to help tackle climate change, an increase of almost 60% over FY 2021, after failing to pass similar funding legislation under the Build Back Better framework. The Biden administration is asking for $15 billion for clean energy investment and infrastructure and $18 billion for climate resilience. However, this is just a request that Congress has to approve, so it remains in question if it will be fulfilled. Importantly, according to the UN Intergovernmental Panel on Climate Change, it will be cheaper to reach the goal of keeping warming within 2°C than it will be to suffer the consequences of failing to do so.

“King of the War Gases: Examining the Military History of Mustard Gas”

Biodefense PhD student Chris Quillen recently published a new article titled “King of the War Gases: Examining the Military History of Mustard Gas” in the spring 2022 issue of the Georgetown Security Studies Review.  Chris’s article examines the role of sulfur mustard, commonly referred to as mustard gas, in an effort to determine why it is has become the most widely used chemical weapon in history.  Understanding why particular weapons were employed is essential to deciphering their importance and dissuading their future use. 

This study explores sulfur mustard use in a variety of conflicts over the last century.  The historical record begins with mustard’s introduction on the Western Front in World War I by the Germans followed by the retaliation in kind by the French, British, and Americans.  Between the world wars, mustard was widely used in the colonial battles in Africa by the Spanish in Morocco and the Italians in both Libya and Ethiopia.  Japan also employed mustard against the Chinese in the lead up to the Second World War.  In the 1960s Egypt utilized mustard during its intervention in the civil war in Yemen.  Iraq under Saddam Hussein repeatedly attacked both the Iranians and their own citizens with mustard during the 1980s.  Finally, the Islamic State became the first non-state actor to use mustard gas in Iraq and Syria. 

By analyzing this historical record, the impact of sulfur mustard in warfare is revealed as an effective, but not decisive, weapon of war.  While not a war-winning weapon, mustard gas is nevertheless viewed as a valuable weapon of terror for those willing to violate the taboo against the use of chemical weapons.  The lack of international reaction to the breaking of this taboo has only facilitated mustard’s continuing use.  The article concludes by determining the most effective method to limit sulfur mustard use in the future is increased willingness by the international community to enforce the taboo against chemical weapons use.

“Why the World Has No Universal Biosafety Standards”

Andrew Silver’s new article in the British Medical Journal covers pushes for the creation of international biosafety standards. To do this, he first discusses laboratory exposures to pathogens in recent years, including the case of the Academia Sinica lab worker who contracted COVID-19 while working with infected animals in late 2021, and others globally, including 56 unintended pathogen exposures in the UK between January 2020 and December 2021. The pandemic, he explains, has brought renewed interests in biosafety concerns, with China having passed a comprehensive biosecurity law in 2020 that entered into effect a year ago, and the UK announcing a call for evidence in February this year to help inform updates to its biological security strategy. The US has also recently launched reviews of its national biosecurity policy frameworks for pathogens with pandemic potential. However, there are not real international standards for this and key challenges to creating these include trying to align diverse national systems to fit a new international standard. He consulted with King’s College London’s Dr. Filippa Lentzos too, writing

In 2005, the World Health Assembly adopted the International Health Regulations, a legal instrument covering measures for preventing the spread of infectious disease transnationally. Currently, the regulations don’t have a mandate on biosafety or compliance, and Filippa Lentzos, a social scientist at King’s College London who studies biosecurity, says it’s “not realistic to get one agreed.” Instead she suggests that the International Organisation for Standardisation’s 2019 biorisk management standard for laboratories (ISO35001) could be adopted internationally with a third party responsible for certification and validation.

“BWC Assurance: Increasing Certainty in BWC Compliance”

Shearer et al. have released their article on Preprints discussing their efforts over the course of a year to interview 16 states parties’ delegations to the BWC and 20 subject matter experts to gauge their views on verification, compliance, and related concepts. They note that these views varied widely among interviewees which is not necessarily shocking as they write, “Following the 2001 end to negotiations on a legally binding protocol, Biological and Toxin Weapons Convention (BWC) states parties (SPs) developed entrenched positions about the necessity of a verification regime, hindering progress on treaty aims.” Their study is aimed at improving dialogue on verification issues outside the context of these issues, with the authors using the word “assurance” to “represent the degree of certainty that SPs are meeting their treaty obligations.” They found that there was general support for implementing assurance mechanisms, even without a comprehensive and legally binding protocol or verification regime, even among states parties who hold that as their primary goal. This is a useful study to build further discussions upon in the run-up to the 9th BWC RevCon later this year.

“Operationalising BTWC Article VII – A Task For the Forthcoming Review Conference”

Dr. Jean-Pascal Zanders authored this discussion piece asking questions about issue-oriented approaches to Article VII of the BWC and highlighting the complicated relationship between BW and naturally-occurring outbreaks. The Implementation Support Unit of the Biological Weapons Convention (part of the UN Office for Disarmament Affairs) released a report, “Operationalising Article VII of the Biological Weapons Convention”, this week to delegates participating in PrepCom in Geneva ahead of the BWC RevCon later this year. Article VII of the BWC reads simply, “Each State Party to this Convention undertakes to provide or support assistance, in accordance with the United Nations Charter, to any Party to the Convention which so requests, if the Security Council decides that such Party has been exposed to danger as a result of violation of the Convention.” Dr. Zanders writes of Article VII in the The Trench,

Its clauses do not fit well together. The reference to the UN Security Council (UNSC) has its roots in the original draft Convention proposed by the United Kingdom in 1969 that outlined specific responsibilities and obligations for the body. Today, it makes little sense to wait for a decision in New York to authorise emergency assistance. Fortunately, States Parties have already clarified that ‘assistance’ as meant in the article is not military, but humanitarian. They have also agreed that humanitarian assistance may be provided before any such UNSC decision. Article VII also circumscribes the context for an assistance request, namely exposure to a danger that is the consequence of a breach of the Convention.

He also points out that much of what would fall under Article VII overlaps with global health as it pertains to naturally occurring outbreaks. Outbreaks are rarely intentionally caused by man, and there are potential dangers in not being clear about this overlap as it pertains to these international security measures. The BWC is a disarmament treaty and, as Zanders explains, states will likely invoke COVID-19 in their statements at RevCon this year, so this difference must be kept in mind. While much of the responses triggered by BW attacks would be the same as those triggered by natural outbreaks, understanding and delineating how the emergency response will differ once it is determined that the outbreak is deliberate is important and should be thought of during the upcoming review.

Systematizing the One Health Approach in Preparedness and Response Efforts for Infectious Disease Outbreaks: Proceedings of a Workshop

From the National Academies Press: A planning committee convened by the Forum on Microbial Threats of the National Academies of Sciences, Engineering, and Medicine held a virtual workshop on February 23-25, 2021, titled Systematizing the One Health Approach in Preparedness and Response Efforts for Infectious Disease Outbreaks. The workshop gave particular consideration to research opportunities, multisectoral collaboration mechanisms, community-engagement strategies, educational opportunities, and policies that speakers have found effective in implementing the core capacities and interventions of One Health principles to strengthen national health systems and enhance global health security. This Proceedings of a Workshop summarizes the presentations and discussions of the workshop.

Malaria in Africa: Translating Science Into Practice

John’s Hopkins is offering this online symposium for World Malaria Day on April 25. This year’s World Malaria Day symposium, “Malaria in Africa: Translating Science into Practice”, will feature presentations by the five NIH International Centers of Excellence for Malaria Research (ICEMRs) that are actively working in Africa (Mali, Uganda, Ethiopia, Kenya, Malawi, Mozambique, Democratic Republic of Congo, Zimbabwe, and Zambia). Confirmed speakers include Dr. Matshidiso Rebecca Moeti (WHO Regional Director for Africa), Dr. Rick Steketee (Deputy US Global Malaria Coordinator), and Professor Sheila Tlou (African Leaders Malaria Alliance Ambassador). Learn more about the symposium and register here.

Russian WMD Disinformation Resources

The mountain of debunkings and academic commentary on the Russian disinformation campaign targeting DTRA’s Biological Threat Reduction Program-supported labs in Ukraine continues to grow. While a more comprehensive list and tool on the Pandora Report’s website is currently under construction, here are a couple of recent works on the matter:

“Biological Weapons Are Banned: Biological Research Is Not”

EUvsDisinfo released this interview with Dr. Jean-Pascal Zanders, founder of The Trench, this week discussing some of the basics of history and international law surrounding biological weapons and the implications of Russia’s claims.

Programme Biologique Militaire en Ukraine, Histoire d’Une Désinformation Russe/ Military Biological Program in Ukraine, History of Russian Disinformation

This French language resource from the Fondation Pour la Recherche Stratégique (Foundation for Strategic Research) discusses Russia’s historical CBW disinformation efforts and offers updates and analysis of recent developments, including Russia’s statements at the UN Security Council last month.

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