Happy Friday! This week we discuss the release of the Biden administration’s National Security Strategy and new findings about the prevalence and challenges of long COVID. We also cover a number of new publications, a German podcast episode on the 1979 anthrax outbreak in Sverdlovsk (featuring our own Dr. Sonia Ben Ouagrham-Gormley!), and upcoming events.
Biden Administration Releases National Security Strategy
The Biden administration released its National Security Strategy (NSS)this week, building on the 2021 Interim NSS. This iteration of the NSS re-incorporates climate change as a national security threat, continues to define the threats China and Russia pose to the US, and includes “Triad” with a capital “T” to make sure there’s plenty of discussion about the document here in the Beltway. As the NSS has in the past, this version includes a section dedicated to pandemics and biological threats, which estarts by explaining that “COVID-19 has killed nearly 6.5 million people around the world, including more than 1 million Americans, but the next pandemic could be much worse—as contagious but more lethal. We have a narrow window of opportunity to take steps nationally and internationally to prepare for the next pandemic and to strengthen our biodefense.”
This section also discusses the notion that “no one is safe until everyone is safe,” and acknowledges that “some of our international institutions have fallen short in the past and need to be reformed.” It concludes with a paragraph discussing the need to address risks posed by deliberate and accidental biological risks “including through our ability to rapidly detect, identify, and attribute agents, and to develop medical countermeasures,” by working to strengthen the BWC, prevent terrorist acquisition of BW, and reinforcing “norms against biological weapons’ development and use.”
This comes on the heels of statements released this week by the US State Department and German Federal Foreign Office on the need to better cooperate to reduce biological threats globally. Both statements discuss the multi-faceted nature of these problems, including challenges created by mis- and disinformation and the need for increased global cooperation in the face of these threats, again highlighting the increasing importance of these issues.
Long COVID Gaining Recognition…Finally
This week, Hastie et al.’s article in Nature Communications discussing long COVID made waves in the media and online. The authors conducted a study in a Scottish cohort consisting of 33,281 laboratory-confirmed SARS-CoV-2 infections and 62,957 never-infected individuals. Participants were issued questionnaires at 6, 12, and 18 months. The authors found that “Of the 31,486 symptomatic infections,1,856 (6%) had not recovered and 13,350 (42%) only partially.” They also found that “Asymptomatic infection was not associated with adverse outcomes. Vaccination was associated with reduced risk of seven symptoms.” Notably, participants with previous symptomatic COVID-19 infections reported long-lasting symptoms like breathlessness, heart palpitations, difficulty focusing, and confusion at rates more than double that of those who were not previously infected. They also reported other related symptoms, like muscle aches and other heart problems.
There were some challenges in the study, however. For example, approximately 90% of participants were white, which is not helpful in trying to better understand risks and burdens of long COVID in other groups. Furthermore, only 4% were vaccinated (most with just one dose) before they were infected. However, this study does more concretely demonstrate the breadth of this problem and what it could mean for future pandemics.
A German study was also published this week in BMJ that found a “considerable burden of long-COVID symptoms, especially fatigue and neurocognitive impairment (“brain fog”), at 6 to 12 months—even among young and middle-aged adults who had mild infections,” according to CIDRAP. This study found that women were at higher risk for developing long COVID and “The researchers said the study revealed long-COVID symptom clusters with individually and societally relevant implications that also affected younger adults with mild initial infections. “Given the individual and societal burden of post-covid sequelae, the underlying biological abnormalities and causes need urgent clarification to define adequate treatment options and develop effective rehabilitation measures,” they concluded.”
Other studies have also linked long COVID to conditions like postural tachycardia syndrome (POTS). In the case of POTS, 41% of people diagnosed with the syndrome already reported a viral infection preceding the onset of POTS symptoms pre-pandemic. Because of this connection, the UK’s National Institute for Health and Care Excellence now even recommends testing for POTS in patients with long COVID. These studies build on mountains of anecdotal evidence from patients and providers alike, demonstrating that long COVID is a very real and serious danger that has already impacted many of us.
The WHO Director General, Dr. Tedros Adhanom Ghebreyesus, recently authored a piece in The Guardian discussing long COVID, what WHO is doing about it, and what countries around the world should do to support those suffering with it. He explains, “Mostly data is only available from high-income countries, which means that we don’t currently have a clear picture on how many people are actually suffering. Current estimates suggest that tens of millions, and perhaps more, have contracted long Covid, and about 15% of those diagnosed with the condition have experienced symptoms for at least 12 months.”
He also discussed the shift in investment strategies this requires of countries, writing “Early in the pandemic, it was important for overwhelmed health systems to focus all of their life-saving efforts on patients presenting with acute infection. However, it is critical for governments to invest long-term in their health system and workers and make a plan now for dealing with long Covid. This plan should encompass, providing immediate access to antivirals to patients at high risk of serious disease, investing in research and sharing new tools and knowledge as they’re identified to prevent, detect and treat patients more effectively. It also means supporting patients physical and mental health as well as providing financial support for those who are unable to work.”
WHO/Europe also issued a factsheet discussing the need for rehabilitation, recognition, and research focused on lingering COVID symptoms that is available here.
“COVID Prompts Global Surge in Labs That Handle Dangerous Pathogens”
Smriti Mallapaty’s recent article in Nature News discusses the growing number of BSL-3 and 4 certified facilitates globally and rising concerns about the costs and risks they present. This article covers new facilities across Asia as well as Russia’s promise that it will build 15 new BSL-4 facilities. Mallapaty also quoted GMU’s Dr. Greg Koblentz in the article, writing “Since the COVID-19 pandemic began, plans to build 27 BSL-4 labs have been announced worldwide, say Gregory Koblenz, a biodefence researcher at George Mason University in Arlington, Virginia, and Filippa Lentzos, a biosecurity researcher at King’s College London, who have tracked the number and distribution of BSL-4 facilities globally. “These will likely take several years to design, build and commission,” says Lentzos.”
“Pandemic Origins and a One Health Approach to Preparedness and Prevention: Solutions Based on SARS-CoV-2 and Other RNA Viruses”
In this recent Proceedings of the National Academy of Sciences article, Keusch et al. discuss the importance of One Health in improving and integrating biosafety and biosecurity. Their abstract explains “COVID-19 is the latest zoonotic RNA virus epidemic of concern. Learning how it began and spread will help to determine how to reduce the risk of future events. We review major RNA virus outbreaks since 1967 to identify common features and opportunities to prevent emergence, including ancestral viral origins in birds, bats, and other mammals; animal reservoirs and intermediate hosts; and pathways for zoonotic spillover and community spread, leading to local, regional, or international outbreaks. The increasing scientific evidence concerning the origins of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is most consistent with a zoonotic origin and a spillover pathway from wildlife to people via wildlife farming and the wildlife trade. We apply what we know about these outbreaks to identify relevant, feasible, and implementable interventions. We identify three primary targets for pandemic prevention and preparedness: first, smart surveillance coupled with epidemiological risk assessment across wildlife–livestock–human (One Health) spillover interfaces; second, research to enhance pandemic preparedness and expedite development of vaccines and therapeutics; and third, strategies to reduce underlying drivers of spillover risk and spread and reduce the influence of misinformation. For all three, continued efforts to improve and integrate biosafety and biosecurity with the implementation of a One Health approach are essential. We discuss new models to address the challenges of creating an inclusive and effective governance structure, with the necessary stable funding for cross-disciplinary collaborative research. Finally, we offer recommendations for feasible actions to close the knowledge gaps across the One Health continuum and improve preparedness and response in the future.”
Science published a news article discussing this paper, writing “‘Our paper recognizes that there are different possible origins, but the evidence towards zoonosis is overwhelming,” says co-author Danielle Anderson, a virologist at the University of Melbourne. The report, which includes an analysis that found the peer-reviewed literature overwhelmingly supports the zoonotic hypotheses, appeared in the Proceedings of the National Academy of Sciences (PNAS) on 10 October.”
The article continued with “The panel’s own history reflects the intensity of the debate. Originally convened as a task force of the Lancet COVID-19 Commission, a wide-reaching effort to derive lessons from the pandemic, it was disbanded by Columbia University economist Jeffrey Sachs, the commission’s chair. Sachs alleged that several members had conflicts of interest that would bias them against the lab-origin hypothesis.”
“WHO’s Response to COVID-19 – 2022 Mid-Year Report”
“This mid-year report provides a consolidated update on WHO’s response to the COVID‐19 pandemic between January and July 2022, against the objectives laid out in the Strategic Preparedness and Response Plans (SPRP) for 2021 and 2022.”
“With the aim of ending the acute phase of the pandemic by the end of the year, WHO, in collaboration with partners, has supported countries to further strengthen their surveillance systems; ensure more equitable access to tests, treatments, and essential supplies worldwide; make health systems more resilient; and reduce exposure to the disease by empowering and enabling communities.”
“The report highlights the role of WHO at the global, regional, and local levels, and across the key elements of an effective emergency response – from implementation and operational support, to developing evidence and research, and providing strong coordination and planning. By working with partners, including multi-agency and multi-partner operational platforms, regional and national public health and scientific institutes, governments, communities, donors, UN organizations and NGOs and the private sector, WHO helped bring the world together to provide direct technical and operational support to countries implementing their national COVID-19 response plans.”
“Epidemics That Didn’t Happen”
On a much more cheerful note, check out Prevent Epidemics’ online feature, “Epidemics That Didn’t Happen”. This page explores six epidemics that were prevented thanks to solid cooperation and good public health responses, including averted epidemics of Ebola, Nipah, cholera, rabies, influenza, and dengue. As the page notes, these cases present common themes, including “Speed is essential,” “Well-coordinated action at the local level is crucial to preventing epidemics,” “Community engagement pays off,” and “Health care workers need to be trained, supported, and provided with access to resources and assistance to stop epidemics.”
“Russia’s Alleged Bioweapons Claims Have Few Supporters”
Jez Littlewood and Dr. Filippa Lentzos recently published this piece in this Bulletin of the Atomic Scientists discussing the outcome of September’s Article V Formal Consultative Meeting requested by Russia. They write “For the fourth time this year, Russia accused the United States and Ukraine of being in non-compliance with the Biological and Toxins Weapons Convention (BTWC)—and once again found little support for its allegations. At the conclusion of the Article V Formal Consultative Meeting in September, no other state formally accused these two nations of non-compliance. Russia stands alone in its allegations, with limited support from eight other states. In contrast, more than five times as many backed the United States and Ukraine in rejecting the allegations; the meeting ended with a procedural report that noted no consensus regarding the outcome.”
“Addressing Inaccurate and Misleading Information About Biological Threats Through Scientific Collaboration and Communication in Southeast Asia”
From the National Academies: “Misinformation about outbreaks, epidemics, and pandemics is a decades-old problem that has been exacerbated by the rise of the internet and the widespread use of social media. Some false claims may be addressed through sound scientific analysis, suggesting that scientists can help counter misinformation by providing evidence-based, scientifically defensible information that may discredit or refute these claims. This report explains how scientists can work collaboratively across scientific disciplines and sectors to identify and address inaccuracies that could fuel mis- and disinformation. Although the study focused on a scientific network primarily in Southeast Asia, it is relevant to scientists in other parts of the world. A companion “how-to-guide”, available in print and in digital form, outlines practical steps that scientists can take to assess mis- or disinformation, determine whether and how they should address it, and effectively communicate the corrective information they develop.”
“Counterfeit PPE: Substandard Respirators and Their Entry Into Supply Chains in Major Cities”
This recent article from Urban Crime was co-authored by the Schar School’s Dr. Louise Shelley and discusses challenges in ensuring legitimate PPE is available and what this means for definitions of threats to human life. The abstract reads “Over 58 million counterfeit respirators of substandard quality unable to protect individuals from infection have been seized globally since the start of the COVID-19 pandemic. These seizures have primarily occurred in urban warehouses and ports around the world according to analysis of public and corporate data shared with the authors. The presence of tens of millions of respirators in storage facilities prior to distribution demonstrates that urban areas are key elements of illicit supply chains. Data suggests that the concept of urban insecurity needs to be reconsidered in light of illicit supply chains for counterfeit respirators and their role in facilitating disease transmission in urban areas. The analysis presented in this article suggests that threats to human life should not be confined narrowly to violent acts or the consumption of drugs. Human life can also be threatened through the massive distribution of counterfeit N95 masks during a pandemic, a problem that has become more acute with more contagious mutations of COVID-19.”
Dr. Shelley is the Omer L. and Nancy Hirst Endowed Chair and a University Professor at George Mason University. She is in the Schar School of Policy and Government and directs the Terrorism, Transnational Crime and Corruption Center. She is a leading expert on the relationship between terrorism, organized crime, and corruption as well as human trafficking, transnational crime, and terrorism with a particular focus on the former Soviet Union. She also specializes in illicit financial flows and money laundering.
What We’re Listening To 🎧
Waffen der Wissenschaft – Die Spur der Sporen
For our German-speaking readers, a Viertausendhertz podcast episode on the 1979 outbreak of anthrax in Sverdlovsk: “Im Frühjahr 1979 sterben in der geschlossenen sowjetischen Stadt Sverdlovsk Dutzende Menschen an Milzbrand. Ein ungeheurer Verdacht kommt auf: Handelt es sich um einen Unfall mit Biowaffen? Der Forscher Matthew Meselson und der Journalist Peter Gumbel erzählen von ihren Nachforschungen vor Ort. Das Team spricht außerdem mit den Biowaffen-Experten Filippa Lentzos, Sonia Ben Ouagrham-Gormley und Andrew Weber.”
Translation: “In the spring of 1979, dozens of people died of anthrax in the closed Soviet city of Sverdlovsk. A tremendous suspicion arose: was it an accident involving biological weapons? The researcher Matthew Meselson and the journalist Peter Gumbel discuss their investigations on site. The team also speaks with bioweapons experts Filippa Lentzos, Sonia Ben Ouagrham-Gormley, and Andrew Weber.”
Event Summaries
Check out event summaries written by Geoffrey Mattoon, a Biodefense MS student, for two recent events from the Council on Strategic Risks-“Building Capacities for Addressing Future Biological Threats” and “The American Pandemic Preparedness Plan: One Year of Progress & the Path Forward”.
Schar School Master’s and Certificate Virtual Open House
Join us for next week’s Master’s and Certificate Virtual Open House on Wednesday, October 19, at 7 pm ET, to learn more about the Schar School of Policy and Government and the Biodefense Graduate Program. The online session will provide an overview of our programs, student services, and admissions requirements. Our admissions staff will be available afterward to answer any questions you may have. Register here!
Infection Prevention and Control: Incorporating Lessons Learned in Managing Special Pathogens
“After nearly three years responding to the COVID-19 pandemic, hospitals and other healthcare facilities have learned many lessons about the management of special pathogens and essential infection prevention and control practices. The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the National Emerging Special Pathogens Training and Education Center (NETEC) invite you to learn more about some of those lessons. Speakers will share their perspectives on how our approach to outbreaks has changed since the pandemic began. They will address issues such as infection prevention for healthcare workers and patients and mitigating disease spread. Speakers will also highlight newly developed tools and resources. This webinar will take place November 7 at 2:00 pm ET. Register today!”
Disinformation: An Emerging War Weapon
“Hosted by the National Defense University Foundation and Moderated by President and CEO, James Schmeling, join us for this interactive virtual discussion. Brief Talk Description: Explore how Russia, China and other entities use misinformation, disinformation, and malinformation as weapons of war and their impact on global security and American democracy.” This online webinar will be hosted on October 20 at 12 pm EST. Register here.
Reflections on Science Communication & Human Rights Amid Public Health Emergencies
“On October 20 (10:30-11:30 am ET), join Dr. Bina Venkataraman, Editor-at-Large for The Boston Globe, and Dr. Chris Beyrer, Director of Duke University’s Global Health Institute, for a virtual discussion of science communication during public health emergencies, the role of public health researchers and journalists in advancing human rights, and emerging lessons from the COVID-19 pandemic.”
“The conversation will be moderated by Prof. Helle Porsdam, Professor of Law and Humanities and UNESCO Chair in Cultural Rights, Centre for Interdisciplinary Studies of Law, Faculty of Law, University of Copenhagen.” Register here.
Third International Summit on Human Genome Editing
The Third International Summit on Human Genome Editing will take place March 6-8, 2023, at the Francis Crick Institute, London, UK. “Building on previous events held in Washington, DC (2015) and Hong Kong (2018), this Summit will continue the important dialogue around human genome editing. It will facilitate a global discussion on somatic and germline genome editing, including developments in clinical trials and genome editing tools such as CRISPR/Cas9. Earlier this year a three-part series of online events Looking Ahead to the Third Human Genome Editing Summit discussed some of the key topics of the meeting. The three-day summit is being organised by the Royal Society, the UK Academy of Medical Sciences, the US National Academies of Sciences and Medicine and The World Academy of Sciences.”
“Find out more about the Summit’s Planning Committee, chaired by Professor Robin Lovell-Badge FRS FMedSci. Further information about the Summit agenda will be released soon, and registration to attend the event in person and online is now open.”
The Pandora Report 