Pandora Report: 5.29.2020

Exploring the Frontiers of Innovation to Tackle Microbial Threats

The National Academies of Sciences, Engineering, and Medicine (NASEM) released proceedings from a workshop, dubbed Exploring the Frontiers of Innovation to Tackle Microbial Threats, help in December 2019. The workshop occurred, fittingly, in the same month as the birth of SARS-CoV-2, the viral agent of the COVID-19 pandemic the world is currently besieged by. This 1.5-day workshop of the Forum on Microbial Threats examined key developments in scientific, technological, and social innovations against microbial threats: diagnostics, vaccine development, antimicrobial therapies, nonpharmaceutical interventions, and disease surveillance tools. The proceedings outline important lessons learned, particularly regarding spurred innovations, from the poliovirus eradication campaign as well as the the on-the-ground work to quell Ebola virus disease outbreaks in West Africa and the Democratic Republic of the Congo. Dr. Rick Bright, the former director of the Biomedical Advanced Research and Development Authority (BARDA), moderated the panel on incubating R&D through novel ecosystems. The output also includes content from panels regarding systematic approaches to motivate innovations in antimicrobial resistance R&D, barriers to access and use of innovations, and strategies to overcome barriers to innovation uptake. The full report can be found here.

FAS Announces the COVID-19 Rapid Response Task Force

The Federation of American Scientists (FAS) announced the launch of its COVID-19 Rapid Response Task Force, an amalgamation of dozens of scientists and experts from across the United States. The Task Force is being established as a resource for federal and state legislators as well as other policymakers seeking sound scientific information regarding COVID-19 related topics. Such topics span biomedical research needs, diagnostic test development, and contact tracing challenges, all of which are important to reopening while containing the virus. The Task Force provides an open channel of communication to experts in numerous areas of need.

Student Spotlight: Laura Schmidt Denlinger

Schar School Biodefense PhD student Laura Schmidt Denlinger was promoted to the role of Deputy Team Chief for Counterproliferation Programs in the State Department Bureau of International Security and Nonproliferation‘s Office of Cooperative Threat Reduction (ISN/CTR). As such, she coordinates CTR capacity-building programs that strengthen foreign partners’ ability to implement United Nations Security Council Resolutions regarding WMD proliferation by North Korea and Iran, as well as the Chemical Security Program, Partnership for Nuclear Threat Reduction Program, and other lines of effort to counter emerging WMD proliferation threats.

GHSA Chair COVID-19 Statement

Dr. Roland Driece, Chair of the Global Health Security Agenda, recently provided a statement on the ongoing COVID-19 pandemic and the role of the GHSA2024. Emphasizing the role of international coordination and unification of efforts from governments to NGOs, Driece noted that this event should not be seen as an indicator that our efforts to prepare have failed, but rather that “Because of the work of GHSA, we have more information than in any previous outbreak about which countries have the most prepared systems, and where the international community needs to direct assistance. As countries and partners work to respond to spread of COVID-19, national plans supported by the International Health Regulations and Joint External Evaluations are guiding action and providing resources for decision making, prioritisation, and actions.” Through the extraordinary efforts of everyone ranging from lab to information systems, this naturally occurring event coordinated to respond and it will require the continued investment in preparedness to response and prevent future pandemics.

New Evidence on Disease Dynamics

The raging pandemic has spurred a deluge of interesting new and early release articles in Emerging Infectious Diseases, a journal published by the Centers for Disease Control and Prevention (CDC). A study transmission examining a cluster of COVID-19 cases associated with a shopping mall in Wenzhou, China indicated indirect transmission of the causative agent, likely via contaminated objects, virus aerosolization in confined spaces, or spread from close contact with asymptomatic infected persons. Another research team collected information on individual case reports and domestic travel across China to estimate important epidemiological measures, such as the disease’s incubation period and R0. Specifically, they found that in the early days of the outbreak, the doubling time was 2.3-3.3 days and the median R0 could hit 5.7, numbers that support the criticality of surveillance, contact tracing, and social distancing to slow transmission. A third study confirmed asymptomatic and human-to-human transmission via close contacts in family and hospital settings, information useful for practice in clinical diagnosis and treatment. Relatedly, further research found evidence supporting the transmission of SARS-CoV-2 while an infected patient was presymptomatic or asymptomatic. Transmission of the virus from presymptomatic and asymptomatic cases impacts the types of public health interventions needed to contain the virus. An analysis of coronavirus patients from Vietnam indicated that the virus was transmitted from a traveler from China. Additionally, an asymptomatic patient showed viral shedding, more evidence that transmission can occur in the absence of clinical signs and symptoms. An article examining transmission from a presymptomatic attendee at a meeting in Germany found evidence that the disease was further transmitted via handshaking and face-to-face contact. Read all these articles here.

Commentary – Public Policy in the Pandemic Age: How COVID-19 Is Reshaping Our Government, Economy, and Society

Stevie Kiesel, a Biodefense PhD Student, attended a GMU webinar featuring a discussion among a panel of experts regarding public health response strategies, economic impacts of lockdown, and potential longer-term implications of COVID-19. The panel included experts in economics, presidential leadership, emergency management, and disease transmission. Read the full commentary here.

 

Public Policy in the Pandemic Age: How COVID-19 Is Reshaping Our Government, Economy, and Society

By Stevie Kiesel, Biodefense PhD Student

On May 20th, the George Mason University Schar School of Policy and Government hosted a webinar to discuss Public Policy in the Pandemic Age: How COVID-19 is Reshaping Our Government, Economy, and Society. Moderated by Biodefense Program Director Dr. Gregory Koblentz, this panel brought together experts in economics, presidential leadership, emergency management, and disease transmission to discuss public health response strategies; the economic impact of lockdowns and physical distancing; polarization; the role of state and local governments; and potential longer-term implications of COVID-19. Panelists included GMU Professor of Public Policy Dr. Maurice Kugler, GMU Associate Professor Dr. Jeremy Meyer, GMU Director for Extramural Projects Dr. Tonya Neaves, and Aerospace Physiologist Dr. Nereyda Sevilla.

Panelists described a variety of failures in the U.S. response to COVID-19, from the late implementation of physical distancing measures to insufficient testing capacity to inconsistent messaging and a lack of a coordinated strategy at the federal level. Dr. Mayer presented data on the number of tests being conducted per million people in a variety of countries; he found that low levels of testing in the U.S. blinded policymakers and scientists to the scope of the outbreak. Testing delays combined with uncoordinated federal messaging and a lack of a coherent national strategy set the U.S. on a path to failure that would see cases skyrocket at a rapid pace.

Dr. Kruger highlighted the economic challenges and dangers associated with lockdown policies that many countries put in place because they failed to enact physical distancing measures earlier in the outbreak. Lockdowns were meant to be used as a tool to flatten the curve, prevent a catastrophic surge of patients stressing hospital systems, and give the U.S. time to ramp up testing capacity. As many parts of the country prepare to lift lockdowns, the danger that the government did not adequately prepare during this time is high. As we saw recently in Wuhan, China when they emerged from lockdown, additional cases must be met with a massive testing capacity to contain a second wave. Dr. Kugler spoke favorably of the strategies implemented by South Korea, Germany, and Switzerland that involve massive testing and targeted care and isolation. While such a strategy has fewer drawbacks, particularly economic drawbacks, than lockdowns, Dr. Kugler believes that the U.S. does not have the resources, personnel, technology, and strategic vision to successfully implement a similar course of action.

Dr. Mayer makes the interesting point that, generally, in moments of national crisis, polarization is (at least briefly) reduced and the president enjoys a significant boost in his approval rating. Yet with COVID-19, Trump has had a noticeably smaller “crisis approval surge” than other presidents. Trump himself is likely partially to blame for this effect, because he has used the pandemic as a wedge to achieve political goals. His rhetoric has generally not invoked national unity, but has stoked opposition to his rivals. Dr. Mayer argues that polarization makes us more vulnerable and less able to recover quickly from a crisis. A point Dr. Kugler made seems to reinforce this idea—lockdown measures take a much greater toll on low-income Americans who are out of work and who have very few options to fall back on. How many of you reading this are teleworking? This “digital divide” is furthering the very economic inequality that has historically increased Americans’ susceptibility to polarizing messages.

As bleak a picture of our current situation as this may have painted, the panelists suggested steps the U.S. can take starting today to improve the response. For example, Dr. Kugler describes a testing strategy that would allow physical distancing measures to be relaxed. This strategy involves testing 23 million Americans every day, so that every American is tested on a roughly biweekly basis. While there are many questions about whether the U.S. can ramp up capacity and coordinate this level of testing, Dr. Kugler identifies five key criteria that will make such a policy successful: harnessing a wide range of laboratories’ capabilities, making data open source so that the private sector can fully mobilize, implementing robust oversight capabilities, establishing clear and effective lines of communication, and developing a strategy that defines a clear, simple, and achievable target.

Testing is just one part of the strategy the U.S. needs. Dr. Neaves highlighted the importance of state and local governments to this pandemic response; these leaders have stepped in to fill a vacuum left by the absence of national strategy and coordination. Dr. Neaves praised the regional partnerships that states have developed, and she argued that state governors should write an after-action report describing their successes and challenges, as well as those of the federal government’s. Such a report developed by a bipartisan group of governors will be key for improving pandemic response in the future and rebuilding the social capital and trust that the U.S. response to COVID-19 has eroded.

Finally, Dr. Sevilla made an important point about how the lessons we learned and the precautions we put in place because of COVID-19 could benefit the U.S. in unanticipated ways. For example, physical distancing measures, increased use of masks, reduced crowding, and increased handwashing could reduce the transmission of common pathogens, such as the flu virus. This prediction emphasizes the wide range of benefits that can be realized by prioritizing public health. Whether the U.S. next faces a natural or intentionally released outbreak from an emerging or well-known pathogen, broad-based improvements in public health infrastructure can bring benefits. The U.S. should prioritize improving laboratory capacity; bolstering state and local capabilities; helping medical systems prepare for a sudden surge in patients; and training in disease recognition the doctors and nurses who will be on the frontlines of the next outbreak.

GMU Biodefense Graduate Student Awards – 2020

OUTSTANDING BIODEFENSE MS STUDENT AWARD

This year’s Outstanding Biodefense Master’s student is Michael Krug. Michael entered the program with a background in biochemistry but he quickly mastered the policy aspects of biodefense as well and graduated with an impressive GPA of 3.97. Michael also took an active leadership role in the Biodefense program and co-founded the George Mason chapter of the Next Generation Global Health Security Network which is composed of students and young professionals around the world who work on issues at the next of health and security. This group brought in outside speakers, including former Senate Majority leader Thomas Daschle, and held several social events for students. Michael was also busy off-campus with internships in the U.S. Department of Health and Human Services and with the Nuclear Threat Initiative think tank where he worked on their comprehensive survey of how well countries are prepared for pandemics and other threats to global health security. Michael is now working as a global health officer in the Office of Pandemics and Emerging Threats in the U.S. Department of Health and Human Services. Michael’s passion for bridging the gap between science and policy and strengthening global health security makes him an outstanding choice for this award.

OUTSTANDING BIODEFENSE PHD STUDENT

Saskia Popescu is this year’s outstanding Biodefense PhD student. Saskia has long been fascinated by the intersection of health and security. She entered the program with an MPH and Master’s in International Security. Saskia’s dissertation, “How Cost Containment Undermines Disease Containment: Political and Economic Obstacles to Investing in Infection Prevention and Control,” used concepts from political economy to explain why hospitals don’t spend enough on infection prevention and control programs despite their huge value to public health. Saskia also has extensive experience working in a hospital as an infection preventionist so her dissertation was able to combine both theory and practice. Unfortunately, her work was prescient in predicting the types of shortages and infection control failures we’ve seen throughout the country during the current pandemic. Saskia has also been busy with extracurricular activities. In 2017, Saskia was chosen for the prestigious Emerging Leaders in Biosecurity Initiative at the Center for Health Security at Johns Hopkins University. In 2018, she was selected to be a George Mason Global Health Security Student Ambassador and attend the 5th Global Health Security Agenda Summit in Bali, Indonesia. Saskia has also made a huge contribution to the Biodefense Program as the managing editor of The Pandora Report, our weekly newsletter which provides news and analysis on global health security issues to thousands of readers every week. Saskia has a knack for discussing complex issues in a jargon-free way and throwing in a little snark on the side. Saskia exemplifies the type of scholar the Biodefense PhD program is designed to produce: data-driven, science-based, theoretically-informed, analytically-rigorous, policy-relevant, and passionate about changing the world for the better.

FRANCES HARBOUR AWARD

The Frances Harbour Award is given to a biodefense student in recognition of his or her community leadership. Frances Harbour was an associate professor of government in the School, and a founding member and past president of the International Ethics Section of the International Studies Association. She was also a Social Science Research Council/John D. and Catherine T. MacArthur Fellow in International Peace and Security Studies

This year’s award goes to Yong-Bee Lim, who is (hopefully) in the final year of his dissertation on the do-it-yourself biology movement. Yong-Bee has been a visible and vocal part of the Biodefense program since he started as a Master’s student. Yong-Bee earned a Presidential Fellowship when he entered the PhD program and worked closely with several faculty members in the Biodefense program. Yong-Bee was a pleasure to work with and has consistently impressed the faculty with his work ethic and creativity. Along the way, Yong-Bee has worked at prestigious institutions such as the Center for Global Security Research at Lawrence Livermore National Lab and the Center for the Study of Weapons of Mass Destruction at National Defense University. In 2018, Yong-Bee was chosen for the prestigious Emerging Leaders in Biosecurity Initiative at the Center for Health Security at Johns Hopkins University. Yong-Bee has also been a fantastic ambassador for the program and was always willing to volunteer his time to help recruit new students and mentor existing ones. We can’t wait for him to finish his dissertation and graduate—but we’ll also be very sad to see him go.