Pandora Report: 4.3.2020

Not even a pandemic can stop your weekly dose of biodefense news. We’d like to take a moment to thank all who are working in COVID-19 response – from healthcare workers to those in lab, public health, and everyone working in essential services, thank you for all you do!

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security 
Are you registered for the summer workshop yet? From July 13-16, 2020, GMU Biodefense will be hosting a three and a half-day workshop on all things global health security. Leaders in the field will be discussing hot topics like COVID-19, pandemic preparedness, vaccine development, medical countermeasures, synthetic biology, and healthcare response to COVID-19. This is also a great networking opportunity as past participants come from a range of government agencies, NGOs, universities, think tanks, and foreign countries. Don’t miss out on the early-bird discount for this immersive workshop – you can register here.

Updating the CWC: How We Got Here and What is Next
Make sure to check the April 2020 edition of Arms Control Today as GMU Biodefense Graduate Program Director (and CW/BW guru) Dr. Gregory Koblentz has a new article with Stefano Costanzi. Russia’s attempted assassination of Sergei Skripal in Salisbury, United Kingdom with a Novichok nerve agent in March 2018 triggered the first-ever update of the Chemical Weapons Convention (CWC). In November 2019, parties to the CWC agreed to add Novichok agents, as well as carbamate nerve agents, to the Schedule 1 list of chemicals subject to the treaty’s most stringent declaration and verification requirements. The article describes the process that led to the first ever modification to the treaty and offers some recommendations for strengthening the treaty’s coverage of these nerve agents. For more detailed technical information on Novichok agents and further background on the Schedule 1 revision process, please refer to our article, “Controlling Novichoks After Salisbury: Revising the Chemical Weapons Convention Schedules,” which was published in The Nonproliferation Review in September 2019.

An Infected Economy: Acute & Chronic Economic Considerations of COVID-19
GMU Biodefense doctoral student Rachel-Paige Casey is tackling the painful economic and financial aspects of COVID-19 in her commentary, An Infected Economy, which you can read here. “The commonly recited statement that COVID-19 knows no bounds is not confined to its effects on individual or population health; it is also the instigator of our current and growing economic woes. Prior to COVID-19, it was well-established that an outbreak of a reemerging or novel disease with high communicability would ravage the US economy, along with global economy. A combination of industry shut downs to reduce disease transmission and panic-induced risk averse behavior among consumers and producers turns a pandemic into a pestilence for the economic health of countries and their people. Just as the high probability of a pandemic was foreseen so to were the economic effects of such an event. As the Washington Post stated, COVID-19 is no black swan, nor is it an event for which we were not given warning shots.” Keep reading here.

ASPR TRACIE COVID-19 Resources 
ASPR has now released a Novel Coronavirus Resource Page which provides people with vetted resources to tackle the ongoing pandemic. Within the site, people can find planning resources, federal websites, technical assistance requests, ASPR TRACIE-developed resources, and more. This is a great resource for preparedness efforts and can help a wide range of people looking to enhance preparedness across multiple sectors. They also encourage sharing of info – “If you have any COVID-19 promising practices, plans, tools, or templates to share with your peers, please visit the ASPR TRACIE Information Exchange COVID-19 Information Sharing Page (registration required) and place your resources under the relevant topic area.”

A Frontline Guide for Local Decision-Makers
To help unwind the web of confusion and chaos, a COVID-19 Frontline Guide for Local Decision-Makers was drafted by experts from the Nuclear Threat Institute, the Center for Global Health Science and Security at Georgetown University, and Talus Analytics. The Guide outlines 7 key objectives for local decisionmakers:

  1. Activate Emergency Operations Center and establish a whole-of-community incident management structure
  2. Understand the real-time spread of COVID-19 in your community
  3. Slow and reduce transmission
  4. Focus protection on high-risk groups
  5. Reinforce and expand health system surge capacity to sustain healthcare operations and avoid high mortality
  6. Expand risk communication and community engagement
  7. Mitigate economic and social consequences

They also provide several questions regarding progress to track an area’s improvement in response measures. The contributors for the Guide encourage and welcome feedback. The Guide is available here.

Policy vs. Pandemics: Polarization and Public Health Emergency Preparedness
Did you miss the virtual event last week? Check out our YouTube channel here for the recording. Last week, Dr. Nathan Myers, author of Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies, gave a virtual presentation at GMU. Dr. Myers’ book was written to be a wakeup call about the politicization of preparedness crippling our efforts to prepare for and respond to pandemics. The book focuses on surveillance, coordination, and countermeasures as key tools for pandemic preparedness and response. Dr. Myers’ book is available here in hardcover and Kindle formats.

Cautionary Results from the Dark Winter Simulation
In 2001, the now-called Center for Health Security at Johns Hopkins University and the Center for Strategic and International Studies designed and hosted a tabletop exercise, “Dark Winter.” Participants in the simulation included US officials and senior policymakers, and it was conducted to assess how senior leaders would respond to a biological weapons attack. The agent in Dark Winter is smallpox. The lessons drawn from the simulated pandemic foreshadowed the struggles we are currently facing with COVID-19. Participants questions and concerns from the exercise ran the gamut. How many Americans are infected? How many are exposed? Where are they located? What health resources are available to treat them? Should any health resources be voluntary or required? Should these resources be provided by local, statewide, or national entities? How should they be enforced? Who will staff pop-up clinics and hospitals? retired Air Force Col. Randall Larsen, one of the designers of the exercise, described as “uncannily accurate.” Exercises like Dark Winter are valuable tools that illuminate important gaps for when an event occurs in reality. Similar to Crimson Contagion, a USG-organized pandemic exercise held last year, which we covered here, these events are indicators for overall pandemic preparedness and response. Hopefully, these lessons will be better heeded as we continue to respond to COVID-19 and as we prepare for the next outbreak. The full article is available here.

BioD Student Spotlight: HyunJung Kim
HyunJung Kim, a BioD PhD student, was recently quoted in a Vox article about the resurgence of COVID-19 cases in Japan. Kim spoke to the importance of personal hygiene and social responsibility in disease prevention. He also pointed out his concerns regarding Japan’s border control approach. Japan limited the entry of foreigners from virus-infections regions; however, many loopholes exist to and foreigners are not the only risk factor for introducing the disease to a population. In South Korea, the majority of cases were introduced by its own citizens returning from trips abroad. The full article is available here.

COVID-19 PPE Challenges and Hard-hit Cities 
New York City is being hit hard by the COVID-19 pandemic with over 42,000 cases and 1,096 fatalities. There have been reports of patients lining the hallways, staff working tirelessly to take care of people, and many of the critically ill patients being of younger age. For many, this is an early warning of what’s to come and how we need to prepare for a surge of patients. In the past week, there has also been a renewed focus on community use of masks and conversations on “airborne” transmission. Ed Yong of The Atlantic recently discussed the controversy and how changing guidance left many confused. “A handful of studies have offered preliminary answers. One team of researchers blasted virus-laden fluids into a rotating cylinder to create a cloud of aerosols. They found that the virus remained stable for several hours within that cloud, raising fears about its ability to persist in ambient air. But as the researchers have noted, the study’s experimental setup was artificial. It doesn’t reflect ‘what’s occurring when you’re just walking down the street,’ says Saskia Popescu of George Mason University, who specializes in infection control and who was not involved in the study. ‘It’s more akin to medically invasive procedures like intubation, which run the risk of aerosolizing the virus, and are unique to the health-care setting.'” These questions have become even more prevalent as mask shortages continue to plague healthcare facilities. Many are reviewing decontamination and reuse efforts for respirators, which the CDC recently provided guidance and communication on. Unfortunately, masks are just the tip of the iceberg when it comes to supply chain issues across the U.S. – from ventilators to gowns, and even disinfecting wipes, things are increasingly becoming strained. These needs go beyond items though and it’s important that we also look to the workforce that supports not only healthcare and public health efforts, but also essential services.

Thoughts on Reopening America from a BioD Alumnus
Daniel M. Gerstein, a graduate of the Biodefense PhD program, is a senior policy researcher at the RAND corporation. This week, Dr. Gerstein and Dr. James Giordano from Georgetown University published an op-ed about the criticality of quick and reliable diagnostic testing in the COVID-19 pandemic. Most experts agree that a vaccine or effective antiviral for COVID-19 is unlikely to be developed for 12-18 months. This is quite a complication as we try to flatten the curve and return to normal life. The authors suggest focusing on diagnostics and grouping populations. Accurate and reliable testing is crucial to containing disease transmission and protecting especially susceptible sub-populations. Current tests take too long to yield a result; we need a real-time, point-of-care diagnostic tool that quickly provides doctors and patients with accurate results. In terms of categorization, they identify three groups: currently infected individuals, vulnerable individuals (such as the elderly), and individuals exposed to or infected with coronavirus and recovered. This grouping will help determine the possibility of reinfection, enable risk-based approaches, and better prioritize testing. Gerstein and Giordano’s full article is available here.

Acute & Chronic Economic Considerations of COVID-19

Rachel-Paige Casey

An Infected Economy

The commonly recited statement that COVID-19 knows no bounds is not confined to its effects on individual or population health; it is also the instigator of our current and growing economic woes. Prior to COVID-19, it was well-established that an outbreak of a reemerging or novel disease with high communicability would ravage the US economy, along with global economy. A combination of industry shut downs to reduce disease transmission and panic-induced risk averse behavior among consumers and producers turns a pandemic into a pestilence for the economic health of countries and their people. Just as the high probability of a pandemic was foreseen so to were the economic effects of such an event. As the Washington Post stated, COVID-19 is no black swan, nor is it an event for which we were not given warning shots.

Predictions

In September 2019, mere months before the arrival of the novel coronavirus in Wuhan, the Council of Economic Advisers published a report, which estimated the substantial health and economic losses the US would face as a result of pandemic influenza, another highly communicable virus. In 2018, the Worldwide Threat Assessment of the US Intelligence Community found that a “novel strain of a virulent microbe that is easily transmissible between humans continues to be a major threat,” and listed pathogens H5N1 and H7N9 influenza and MERS-CoV as potential culprits. Until bureaucracy-fueled abandonment in 2017, the Department of Homeland Security maintained annually updated models that estimated the infrastructural damage wrought by a pandemic. Beyond predictions, the 2019 Global Health Security Index forewarned the US, as well as the rest of the world, that pandemic preparedness is lacking. Continue reading “Acute & Chronic Economic Considerations of COVID-19”

Pandora Report: 3.27.2020

Welcome to your weekly source for all things health security! While Italy is struggling with a high COVID-19 death rate, here’s a bit of good news- the last Ebola patient was discharged in the DRC. In need of a good laugh and a fan of the show The Office? Check out this video on pandemic response as an episode.

GHSA Next Generation Network – Responding to Wuhan
Formed in 2014, this group of global health security researchers and professionals is working across the globe to combat the outbreak. Curious about how to participate? There are some simple things you can do right now to help. The first is to help NextGen with its social media communications. NextGen members are in a unique position to serve as trusted sources of information. “You can follow us on Twitter (@nextgenghs) and retweet or tag us in your #COVID19 tweets. You can also use the hashtag #VirtualHighFivesSaveLives to help campaign for social distancing. The next thing you can do is listen to and spread our podcast, especially our COVID-19 Special, to help people understand what is happening and how we can work together to address the issue.” Check out the NextGen mentorship program or learn about what members are doing in the field of COVID-19 response via the COVID-19 Survey and join the Working Group and WhatsApp group.

Learning from Previous CoV Outbreaks
GMU Biodefense doctoral student HyunJung (Henry) Kim is shedding some light on how we can learn from South Korea’s COVID-19 efforts, but also how South Korea learned strategies from previous MERS-CoV outbreaks. “Korea’s response to Covid-19 is highlighting a strong public health approach to reigning in the outbreak, one that provides a lesson for the rest of the world. For the country’s health officials, however, it’s a lesson they learned the hard way. Korea’s traumatic experience with a 2015 outbreak of Middle East Respiratory Syndrome, or MERS, paved the way for many of the successful strategies the government is deploying this time around.” Kim also discussed how the United States can learn from South Korea and Japan – “It seems evident that South Korea gives more weight to actively searching for and diagnosing coronavirus cases in order to break the chain reaction of disease transmission. At the same time, Japan has focused on building the public health equivalent of a firewall around the country to prevent the influx of coronavirus from overseas. Close scrutiny reveals that both pandemic prevention strategies—South Korea’s active search and Japan’s firewall approach – have advantages and disadvantages.”

Assessing Trump’s COVID-19 Approach – Q&A With Public Health Expert Saskia Popescu 
From the frontlines of healthcare and epidemiology response, GMU Biodefense alum Saskia Popescu discusses how hospitals are responding and what the real implications of poor pandemic response look like. “The harder aspects of disease mitigation and response are having those tough conversations with people about how it’s really important for you to stay home when you’re sick. People don’t like being inconvenienced. And that’s why it’s so challenging and frustrating sometimes, because if people were really good about staying home when they’re sick and engaging in social distancing and infection control measures like hand hygiene and not touching their face, that would be very, very impactful to outbreak response at this point. I think focusing on that travel ban, that travel association is a moot point now. The disease is pretty much everywhere.”

Operation 50/50: List of Women Health Security Experts Now Available 
Women in Global Health (WGH), and Women of Color Advancing Peace and Security (WCAPS) have partnered to crowdsource a list of female health security experts, intended to address the glaring lack of women represented in the global response to the current coronavirus (COVID-19) outbreak. The list, dubbed “Operation 50/50”, is now available on the WCAPS and WGH websites for organizations seeking leadership for outbreak response efforts, as well as press members seeking outbreak-related commentary. Check out the list and you might see some familiar GMU Biodefense names.

 U.S. Government COVID-19 Response Plan and How An Exercise Should’ve Been The Writing On The Wall 
The recently released USG COVID-19 Response Plan via HHS is now available online. The plan includes a risk assessment, critical considerations, roles and responsibilities, and a ton of information on sustainment and communication/coordination. On March 11, the reported noted that – “For the majority of people, the immediate risk of being exposed to the virus that causes COVID – 19 is thought to be low. There is not widespread circulation in most communities in theUnited States.” More interesting, it notes that a pandemic will last 18 months or longer and could include multiple waves of illness. Check out the report and how it utilizes a pandemic severity assessment framework, but also the approach the U.S. is taking to mitigate further spread. The irony though, is that an exercise last year actually shed light on some of the vulnerabilities we are currently experiencing. You might have seen a few recent reports on the Crimson Contagion exercise hosted by the National Biodefense Science Board however, we actually wrote on this late last year in the Pandora Report, which you can read here. “The exercise was intended to deal with a virus outbreak that starts overseas and migrates to the US with scant allocated resources for outbreak response and management, thereby forcing the Department of Health and Human Services (HHS) to include other agencies in the response.” The truth is that this exercise should’ve been an indicator of what was to come. As we noted in our report, one of the findings was that “The medical countermeasures supply chain and production capacity are currently insufficient to meet the needs of the country in the event of pandemic influenza”. Exercises like these are particularly important as they bring together key stakeholders to identify critical vulnerabilities and opportunities for improvement, which is why so many are frustrated by the fact that DHS opted to stop updating its annual models of pandemics in 2017.

DHS Pandemic Models Sidelined Since 2017
In 2017, the Department of Homeland Security (DHS) shelved the program that maintained annual models of how a pandemic could disrupt America’s critical infrastructure. These models were the foundations of reports drafted to direct policymakers toward areas that would require immediate attention and help in the event of a pandemic. Such areas include transportation and hospital systems. According to Politico, the models consisted primarily of computer simulations that estimate the interactions among millions of Americans and the US infrastructural systems. The parameters of the models were varied to simulate the impacts based on losses in the workforce due to illness or isolation; a valuable consideration given the situation we are currently facing with over 3 million Americans out of work and COVID-19 illness spreading across those in our health workforce and other critical areas. Reportedly, this program, operational from 2005 to 2017, was halted due to a bureaucratic dispute over its utility. In the midst of the COVID-19 pandemic, the value of this program is indisputable. Resources like the DHS pandemic models and analyses may have provided greater insight and enabled swifter decision-making in our current predicament. Perhaps now, the value and criticality of preparedness will be appreciated so that we may better plan for the next biological event.

A New Kind of Domestic Terrorism
As panic and fear abound with the COVID-19 pandemic, pettiness and folly are amplifying into acts that may soon be considered criminal offenses and subject to terrorism laws. A Wegmans shopper in New Jersey was just charged with making a terroristic threat in the third degree – a felony offense – after he deliberately coughed toward grocery staff and claimed to be infected with coronavirus. This act was reported to be the shopper’s response to the request that he move further away from the employee, respecting the social distancing recommendation. Later, a different man in New Jersey coughed at policy and medical personnelwhile being arrested for domestic violence. In response to such behaviors, US Deputy Attorney General, Jeffrey A. Rosen, sent a memo to law enforcement and federal prosecutors warning them to monitor threats to spread the coronavirus. The memo stated that these acts could be prosecuted under federal terrorism laws given that the virus is a biological agent. Rosen explicitly stated that threats or efforts to use COVID-19 as a weapon in any way will not be abided. The memo also addresses other potential crimes related to the pandemic, ranging from advertisement and sales of fake therapeutics and tests to illegally stockpiling scarce products like medical supplies. The full memo can be found here.

US COVID-19 Outbreak Updates
This week the White House COVID-19 task force had to ask those who recently left New York City, to quarantine for 14 days due to the high infection rate within the city. The WHO recently stated that the U.S. could be the new global epicenter of the pandemic, just as India was announcing a nationwide lockdown. More cases are being reported every day, but according to the CDC, there were over 68,440 cases as of Thursday. The U.S. has now surpassed Italy and China as the viral hotspot. New York is especially being hit hard and as the healthcare infrastructure continues to struggle with PPE challenges, many industries are working to donate and manufacture additional supplies. There is worrisome news from New York City that many of the hospitalized COVID-19 patients requiring intensive care are less than 50 years of age. In addition to the growing epidemiological data shedding light on clinical manifestations and case counts, the magnitude of supply chain challenges has been astounding. As the U.S. works to respond to growing case counts, limited testing, and a nervous healthcare infrastructure, many wonder about the true ability for the country to respond to a pandemic. “They also underscore long-standing problems with the health-care system and the lack of preparedness that has resulted from years of governmental neglect, said Saskia Popescu, an epidemiologist with Honor Health, a Phoenix hospital system (and GMU Biodefense alum). ‘This outbreak has revealed systemic weaknesses, but also the challenges of national preparedness built on private industry and how that often means some hospitals are more prepared than others and the desperate need to really strengthen national health-care biopreparedness,’ she said.” Despite quarantine and shutdown efforts only occurring recently, President Trump wants to open the U.S. back up, which counters much of what public health experts have voiced, especially since outcomes due to recent interventions won’t be seen in the case counts for weeks.

COVID-19: Where Are We and Where Do We Need to Go?
Despite only being three months in 2020, it seems like the COVID-19 pandemic has made this feel like the longest year yet. There’s still much work to be done though and it is often important to take a moment and look back at what’s happened and how we got to this point. The New York Times created this extremely detailed visual story of how the virus got out despite travel restrictions. By analyzing the movement of people, it shows out the SARS-CoV-2 pandemic occurred. Ed Yong recently wrote on how the pandemic will end and some of the most surprising roadblocks that have occurred-  like testing. For many in global health security, there are inherent challenges we identify when doing simulations, but the considerable lack of testing was not one ever considered. Pulling from many experts (you’ll see a few familiar names), Yong addresses the very complexities of this pandemic and a hard truth in that we should’ve seen this coming. “A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk. In 2018, I wrote a story for The Atlantic arguing that America was not ready for the pandemic that would eventually come. Hypotheticals became reality. ‘What if?’ became ‘Now what?'” Helen Branswell from STAT also recently wrote on what we’ve learned and what we still need to know. “The world has been warned about this over and over again. In the mid-2000s, when it looked like a very dangerous bird flu virus, H5N1, might trigger a pandemic, experts including Michael Osterholm, of the University of Minnesota’s Center for Infectious Diseases Research and Policy, warned of the possibility of disaster when it comes to the supply of protective equipment for health workers, essential drugs, and other goods. And here we are.”

Developing Medical Countermeasures (MCM)
There’s been a lot of talk regarding the use of malarial drugs, hydroxychloroquine and chloroquine, as treatments for COVID-19 following President Trump’s comments in recent press conferences. Unfortunately, this isn’t aligning with medical experts. “The study referenced by Trump, and other studies done so far of potential treatments for Covid-19, are small and hastily designed even by the standards of Phase 1 studies.” The comments/tweets by President Trump have been concerning many as supplies of the drugs, often used to treat lupus, are starting to take a hit and the suggestion of efficacy encourages misuse, which resulted in the death of a man in Arizona taking a form of chloroquine. In terms of developing treatment and prevention MCMs, SynBioBeta has recently partnered with Leaps by Bayer to develop a great visual timeline for what this process looks like.

The Deterioration of USAMRIID
Since the Cold War era, the US Army Medical Research Institute for Infectious Diseases (USAMRIID) has been the nation’s premier biodefense laboratory. RIID’s remarkable history includes its roles in subduing several outbreaks since its inception: Venezuelan equine encephalitis virus in South Texas in 1971, Rift Valley Fever in Egypt in 1977, Hantavirus in the southwest in 1993, and Ebola in Reston, Virginia in 1990, as well as in Africa in 1995. In contrast, RIID has not been considered especially active in the efforts to thwart the ongoing pandemic, likely as a result of bad blood from Amerithrax, inconsistent leadership, recent budget cuts, and dissatisfaction with external micromanagement by the Defense Threat Reduction Agency (DTRA). Though the lab contributed to the analysis of the mailed letters and contaminated areas from the 2001 anthrax attacks, the accusation by the FBI that the Amerithrax culprit was one of RIID’s scientists sunk its status and morale. This accusation cascaded into the closing of high-containment labs, dismissal of experienced employees, and the departure of senior scientists across Fort Detrick. Since the Amerithrax accusation, mismanagement and underfunding further deteriorated the status and outputs of RIID. Over the last decade, RIID has been through five commanders, most of whom were not research scientists equipped with the knowledge to fully understand the lab’s work. For many scientific research entities, funding has become unstable and RIID suffers from this as well. DTRA is responsible for chemical and biological defense research under the Department of Defense (DoD), and it provides a third of RIID’s budget. As a primary funder for RIID, DTRA has gradually micromanaged the lab through actions such as abolishing a research unit that developed medical countermeasures against toxins commonly used by domestic terrorists. Beyond the aforementioned issues, RIID is no longer luring young scientists for employment and almost 40% of its staff consists of contractors, who are especially reliant on stable funding streams to maintain projects. According to National Defense Magazine, Army medical experts are working in partnership with public and private organizations on several potential vaccines for COVID-19. A vaccine would protect both our soldiers and out civilian population from the novel virus. As of 20 March, the Army has 21 soldiers, 6 government civilians, 10 contractors, and 8 family members confirmed with COVID-19 infection; thousands of lives have already been lost across the world and over 1,000 lost in the US. It is most unfortunate that an infectious disease research entity that was once one of nation’s most experienced and erudite is in such a state of disarray that its ability to contribute to the ongoing crisis is weakened. We are in an emergency that requires scarce expertise and capabilities to aid in the swift development of efficacious and safe medical countermeasures. USAMRIID is yet another example of the failure to maintain and utilize some of our most productive and successful resources that could have helped the US prepare for and better respond to the COVID-19 pandemic.

 

Pandora Report: 3.20.2020

Policy vs. Pandemics: Polarization and Public Health Emergency Preparedness
Could there be a better time to discuss partisanship in pandemic response? Join us virtually on March 26th from 6-7:30pm EST. Due to the COVID-19 pandemic, this event will be held as a live webinar instead of an in-person talk. Blackboard Collaborate Ultra works best with Google Chrome and does not work with Internet Explorer. Participants will be able to use the “Raise Hand” function in Blackboard Collaborate to ask questions at the end of Dr. Myer’s prepared remarks. Everyone who registers for the webinar will receive a 30% discount on his book. This webinar will be recorded and the video will be posted to the YouTube channels for The Pandora Report and the Schar School of Policy and Government. Event info -The sweeping effects of the COVID-19 pandemic on the social, economic, and political framework of the United States highlights the vital importance of a resilient public health infrastructure. In the aftermath of this pandemic, the United States will need to reconsider its approach to biosurveillance, public health emergency preparedness, intergovernmental coordination, and the development of countermeasures in advance of the next health crisis. In the past, such efforts have been hindered by partisan polarization between Republicans and Democrats, even as some crucial public health emergency policy was only made possible through bipartisan cooperation. While considering lessons from the past, this discussion will address bipartisan efforts to move forward on approaches to protect the American people in the future, such as the implementation of the National Biodefense Strategy. Dr. Nathan Myers is an associate professor of political science and public administration at Indiana State University. His research interests include public health policy, U.S. executive branch politics and administration, emergency planning and preparedness, and regulation of biotechnology. He is the author of Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies(Lexington Books, 2019). Register for the event here. Keep reading for an in-depth interview with Dr. Myers.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
From July 13-16, 2020, GMU Biodefense will be hosting a workshop on all things global health security. Leaders in the field will be discussing hot topics like vaccine development, medical countermeasures, synthetic biology, and healthcare response to COVID-19. This is also a great networking opportunity as past participants come from a range of government agencies, NGOs, universities, think tanks, and foreign countries. Don’t miss out on the early-bird discount for this immersive workshop – you can register here.

Modeling SARS-CoV-2
A model for the spread of the SARS-CoV-2 virus for the Eclipse Spatio-Temporal Epidemiological Modeler (STEM) framework has been produced Dr. James Kaufman of IBM Research Almaden. The model divides the population into four compartments: people susceptible to the disease, those who have the disease but don’t show symptoms, people infected and showing symptoms, and those who have recovered or died, from the population. When plugged into STEM, various hypothetical scenarios can be generated using the modeling framework. For example, the model could allow researchers to study the effect of the presence of pre-symptomatic infectious individuals on the spread of the virus. In particular, the model, which can be downloaded for free from the STEM website, comes with a pre-built scenario of SARS-CoV-2 global outbreak which includes a travel shutdown in or out mainland China after 60 days of the pandemic. Additional scenarios can be built using the framework to model other public health interventions, including quarantine, global travel restrictions, and the implementation of various vaccination policies.

Risks, Trade-offs, and Responsible Science
Dr. Gregory Koblentz, GMU’s Biodefense Graduate Program Director, and Dr. Fillipa Lentzos, Senior Research Fellow at King’s College London, published an article in 2016 showcasing the heightening safety and security risks as the number of laboratories and scientists working on dangerous pathogens and toxins increases substantially. These risks are greater today than even three years ago as technological innovations and improvements in synthetic biology continue at a record rate. Beneficially, leaps in synthetic biology enable quicker and deeper research into pathogens in order to reduce their collective risk to humanity. But this comes at a cost that must be balanced. Recent articles in The New Yorker and the Bulletin of the Atomic Scientistsdebate the benefits and risks associated with increasing laboratory facilities and capabilities, and reference the expertise of Koblentz and Lentzos.  The “biodefense boom,” ongoing since the turn of the century, increases risk in four primary areas: biosecurity, biosafety, dual-use research of concern (DURCs), and compliance with the Biological Weapons Convention (BWC). These risks must be weighed into any decisions regarding new or advanced laboratories, especially those for extremely virulent pathogens that require stringent safety and security to prevent misuse, theft, or accidental release. The authors urge biodefense policymakers to regularly evaluate the risk trade-off as they make decisions about prevention, preparedness, and response to existing and emerging biological threats. To that end, Koblentz and Lentzos encourage responsible science, recommend forming a BWC science advisory group to develop well-defined international guidelines managing DURC, establish a Confidence Building Measures working group, guarantee that biodefense activities are subject to strict biosafety and biosecurity regulations supported by

COVID-19 Pandemic Updates
Every day feels a bit longer during the midst of the COVID-19 pandemic especially as so many are working remotely or actively quarantining to help prevent the spread of SARS-CoV-2. For many in healthcare, the overwhelming amount of people coming into emergency departments is stressing the system even more – New York City public health syndromic surveillance data found that ED visits for adults seeking care for influenza-like-illness is 50% higher than the last three years of flu, however this is likely “care-seeking behavior – not all COVID.” As many cities initiate restaurant and bar limitations, there has been increased focus on the role of the CDC and how their messages and efforts have been somewhat sidelined. “The CDC, which has come under fire because of protracted delays in the rollout of agency-developed test kits, has not conducted its own telephone briefings for reporters in more than a week. Recent CDC recommendations on school closures and mass gatherings were overtaken by different guidelines issued by the coronavirus task force, creating confusion, experts and officials said.” Tom Inglesby of the Johns Hopkins Center for Health Security noted that “It is confusing for the public to have CDC say no gatherings of more than 50 people, and the next day, the task force says no gatherings of more than 10 people If the information has changed, tell everyone why. Let’s make sure everyone is on the same page.” Many are underscoring though, that the continued funding cuts to critical agencies, like the CDC, and the disbanding of the White House’s National Security Council Directorate for Global Health Security and Biodefense, created a perfect storm that would leave the United States vulnerable to biological threats and limited response. NTI’s Dr. Beth Cameron discusses the impact here, noting that “When President Trump took office in 2017, the White House’s National Security Council Directorate for Global Health Security and Biodefense survived the transition intact. Its mission was the same as when I was asked to lead the office, established after the Ebola epidemic of 2014: to do everything possible within the vast powers and resources of the U.S. government to prepare for the next disease outbreak and prevent it from becoming an epidemic or pandemic. One year later, I was mystified when the White House dissolved the office, leaving the country less prepared for pandemics like covid-19. The U.S. government’s slow and inadequate response to the new coronavirus underscores the need for organized, accountable leadership to prepare for and respond to pandemic threats.” In response, National Security Advisor Bolton has been quick to defend his decision though, claiming streamlining, while many feel that this was just poor prioritization of global health security. The truth is that that there have been several warnings of what might happen in this situation, including government exercises. One in particular was the “Crimson Contagion” exercise, held last year by DHHS, which simulated an influenza pandemic. If that name sounds familiar, it’s because we reported on the event late last year. In an effort to tackle the pandemic and community-level response, experts are working to commit to COVID-19 efforts, like the biomedical meeting held this week in Boston. In building response, should we look to those countries that have already dealt with COVID-19? GMU Biodefense student HyunJung (Henry) Kim asks what lessons we can learn from Japan and South Korea for the coming cases. “For example, Japan and South Korea have taken very different approaches to restrictions on travelers from China. Since February 1, Japan has denied entry to foreign nationals who had visited China’s Hubei province, which includes a home of Wuhan city, and later, on February 13, expanded that travel ban to eastern provinces including Zhejiang province. In contrast, South Korea does not prevent the entry of any foreigners who had visited China.” Lessons learned will be critical now, as hospitals in the United States struggle with supplies and additional cases are identified via growing testing capabilities. The capabilities of our healthcare system are limited and now is the time, as so many have pointed out, to reinforce social distancing, staying home when you’re sick, and engaging in infection prevention basic. Flattening the curve can help preserve hospital capacity and capabilities. “Just 11 weeks into a pandemic crisis expected to last months, the nightmare of medical equipment shortages is no longer theoretical. Health-care workers, already uneasy about their risk of infection amid reports of colleagues getting sick and new data showing even relatively young people may become seriously ill, are frustrated and fearful.” Despite a need to start developing strategies for vaccines, facilities previously funded to help rapidly develop medical countermeasures are sitting it out. Having $670 million invested into these four sites, none of the locations though (Florida, Maryland, North Carolina and Texas) “have developed or are close to delivering medicines to counter the outbreak, according to records, government officials and others familiar with the facilities. Instead of leading the rush to find and mass manufacture a vaccine or lifesaving treatment, two of the sites are taking no role, while the other two expect to conduct small-scale testing of potential coronavirus vaccines.” Don’t miss the Global Health Security Agenda’s COVID-19 Chair, Roland Driece’s statement on the role of GHSA2024 in the pandemic, here.

MITRE’s Recommendations to Stop COVID-19
The MITRE Corporation’s infectious disease analytics team published a white paper comprising recommendations of specific actions that US leaders should immediately take to quell the COVID-19 pandemic. Many of MITRE’s recommendations revolve around continuing to encourage and incentivize social distancing through non-pharmaceutical interventions (NPIs). MITRE estimates that we must reduce the human-to-human contact rate of Americans by 90% to stop COVID-19. These NPI include immediately closing all schools; incentivizing remote work among the private center enterprise; immediately closing establishments for social gatherings (restaurants, bars, theaters, concert and sports venues); and incentivizing individuals to remain at home except for those with emergent medical needs or those who are part of the maintenance of critical infrastructure. Beyond social distancing, recommendations also encompass support for sanitary maintenance of transport and logistics operations, financial support to counteract sudden losses in income and/or business revenue, and travel restrictions into and out of the US until the pandemic passes. The full white paper with its 14 detailed recommendations is available here.

Interview with Nathan Myers, PhD
Dr. Nathan Myers is an associate professor of political science and public administration at Indiana State University. His research interests include public health policy, US executive branch politics and administration, emergency planning and preparedness, and regulation of biotechnology. He is the author of Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies (Lexington Books, 2019). GMU’s Biodefense, MPA, and MPP programs are hosting a webinar with Dr. Myers focusing on his new book and the ongoing pandemic. In advance of his presentation, an interview with Dr. Myers took a number of twists and turns about preparedness politics and its role in COVID-19, in terms of US preparedness and response. Or lack thereof. Myers emphasizes the need for a One Health approach to preparedness policies and actions. Additionally, he advocated that the relationship between health and socioeconomic status be considered in preparedness policies and actions. In the thick of responding to a crisis, we must all pull together to do what is necessary to contain and mitigate the threat. Before such a crisis emerges is when political debates establish the degree to which America will be prepared. To this end, there is a long and important history of bipartisan actions on issues of public health emergency preparedness (PHEP) and biodefense: passage of the Pandemic and All-Hazards Preparedness Act (PAHPA), enactment of select reforms recommended by the Bipartisan Commission on Biodefense, and the development of the National Biodefense Strategy. An area of budding bipartisanship is the One Health movement. The One Health approach to health policy issues emphasizes the symbiosis between human health, animal health, and the environment – improving the health of one creates a ripple effect improving the health of the other two.  The COVID-19 pandemic, along with previous health emergencies over the last 20 years, have highlighted the need to recognize the public health implications of policy domains outside the traditional preparedness and response framework. This may require confronting the health security implications of some highly partisan issues. For example, the Zika virus outbreak, a vector-borne infectious disease, supports a strong relationship between climate change and human health. It is encouraging that both Republican and Democrats have been embracing the One Health framework, as it highlights the interconnectedness of several policy domains. However, Republicans and Democrats remain deeply divided on the degree to which humans affect climate change and the level at which climate change affects human health. Ebola showed that access to affordable and reliable health care can make the difference between containment and outbreak, as people may not go for treatment or be turned away. Income inequality is a driver of continuing inequities in health care and a risk factor across a range of communicable and non-communicable diseases. Zika highlighted access issues regarding contraception and abortion services around the world. It is important to keep in mind that the largest burden from caring for Zika-affected children falls on poor women in Brazil and other Latin American nations. If reproductive services are restricted, nations, including the US, must be prepared to offer economic and social assistance to help women who give birth to children with profound physical or developmental disabilities. COVID-19 is highlighting the fact that we need to provide a safety net for vulnerable groups like low-wage, working parents who are likely to experience loss of income and/or increased child care expenses during a public health emergency. Strategic bipartisan discussions need to come to grips with not only how emergency preparedness and response is funded, but also how we fund basic public health services. Population health should be regarded as not only on par with individual medical care, but as a matter of national security. Myers expects that the COVID-19 pandemic will result in bipartisan improvements in technocratic areas like disease surveillance and the development of countermeasures. Hopefully, improvements in incorporation of a One Health framework, efforts to improve population health, and measures to counteract the disproportionate burden emergencies place on out lower income households are forthcoming as well. After the immediate danger is passed, elected officials must address some tough political questions related to US preparedness and response for the next emergency. As many have noted, public health and how we address infectious disease is political. So, politicians must find a way to come together and answer hard political questions about how we avoid policy obstacles to managing public health emergencies in the future.

 

Pandora Report: 3.13.2020

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
From July 13-16, 2020, GMU Biodefense will be hosting a workshop on all things health security, from anthrax to Zika. Leaders in the field will be discussing hot topics like vaccine development, medical countermeasures, synthetic biology, and healthcare response to COVID-19. This is also a great networking opportunity as past participants come from a range of government agencies, NGOs, universities, think tanks, and foreign countries. Don’t miss out on the early-bird discount for this immersive workshop – you can register here.

Policy vs. Pandemics: Polarization and Public Health Emergency Preparedness
Curious about partisanship in pandemic response? Join us at 6pm on March 26th for this event that is now virtual (log-in instructions to follow here). Political polarization is being blamed for many areas of dysfunction in the U.S. government, and the response to infectious diseases is not immune to this concern. This presentation will discuss how a lack of cooperation between Democrats and Republicans has hindered the ability of the nation to carry out essential public health emergency response functions, such as biosurveillance and the development and deployment of medical countermeasures. Particular attention will be given to bipartisan efforts to move forward with public health preparedness efforts, such as the implementation of the National Biodefense Strategy, in light of the challenges posed by the global coronavirus pandemic.  Dr. Nathan Myers is an associate professor of political science and public administration at Indiana State University. His research interests include public health policy, U.S. executive branch politics and administration, emergency planning and preparedness, and regulation of biotechnology. He is the author of Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies(Lexington Books, 2019). Register for the event here

GMU Schar School Biodefense PhD and Master’s Open Houses – Moving to Virtual
UPDATE: While we originally had two great opportunities to learn more about GMU Biodefense graduate degrees – the PhD Open House on Wednesday March 18th at 7pm in Arlington, and the March 26th Master’s Open House, at 6:30pm, both events are cancelled and we will be providing virtual opportunities in the near future. Please stay tuned for more updates here.

COVID-19 – A Pandemic and Problems
This week the WHO finally declared the SARS-CoV-2/COVID-19 outbreak a pandemic. On Wednesday, President Trump addressed the nation regarding COVID-19 with an attempt to calm the country regarding healthcare costs and employees/businesses impacted. “The dramatic centerpiece of Trump’s speech was a ban on travelers from Europe entering the U.S. for 30 days. In theory, this might at least prevent new cases from coming to the U.S. and seeding outbreaks. But many experts think it is far too late for that.” Over 125,000 cases have been reported, and nearly 1,300 cases have been identified in the United States as of Wednesday. Several states have declared emergencies and the CDC is discouraging people of older age and with chronic conditions related to the heart, lungs, or diabetes, to stay home if there are outbreaks in their communities, as there is an increased risk for severe disease should they acquire SARS-CoV-2. The U.S. State Department has issued a Global Level 3 Health Advisory, which “advises U.S. citizens to reconsider travel abroad due to the global impact of COVID-19. Many areas throughout the world are now experiencing COVID-19 outbreaks and taking action that may limit traveler mobility, including quarantines and border restrictions. Even countries, jurisdictions, or areas where cases have not been reported may restrict travel without notice.” A new risk assessment by the European Center for Disease Control (ECDC) noted that “It advised countries to quickly shift to mitigation strategies to protect vulnerable people and prevent overwhelmed hospitals. Reports of dire conditions in hospitals in Italy’s hot spots have been circulating on social media for the past few weeks and are now appearing in medical journal and media reports. The ECDC acknowledges that high numbers of patients needing ventilation have exceeded intensive care unit (ICU) capacity in some healthcare facilities in northern Italy.” Testing for the disease is ramping up in the U.S., but still quite slowly, meaning that not all people wanting the test will get it as it depends on clinical presentation and epidemiological risk factors. The challenge though, is that this is still influenza season and for many, there is concern about what to do if you have a fever and cough. Check out guidance here and GMU Biodefense alum Saskia Popescu’s comments -“Because this is such a novel situation, people want a novel approach to handling it. They want a novel way to better isolate themselves or some crazy new hand-hygiene technique,” says Saskia Popescu, senior infection prevention epidemiologist at HonorHealth, a health system in Phoenix. “That’s just not the case. These are tried and true methods — we just need to be really vigilant with them.” Worried about dating and intimacy during the outbreak? Here are some good recommendations on love in a time of COVID-19. “It’s okay to cancel a date because you don’t feel great, and the person you’re canceling with should be happy about that. But in honesty, it’s okay to encounter other humans in the wild. We are not at a point yet where you need to lock yourself in your house and never see another human.”

Pathogens on a Plane
Airports and airplanes are dreaded areas during any kind of outbreak, endemic or novel. In light of the ongoing pandemic, researchers Christopher Robertson and Keith Joiner at the University of Arizona suggest that airlines require vaccination for all passengers or require proof of medical exemption. Unfortunately, a vaccine for COVID-19 is yet to exist and the vaccine would not counteract the exposure from unidentified cases of infection, especially given incubation periods. If a vaccine for an infectious disease of concern is unavailable to the public or nonexistent, then the vaccination requirement will serve little purpose in quelling its spread. That said, there is certainly room for improvement regarding the precautions and measures taken against infectious disease spread from air travel. Dr. Nereyda Sevilla, graduate of the GMU Biodefense PhD Program, focused her dissertation on the transmission and risks of airplane-borne infectious diseases. Sevilla’s research analyzed the impact of air travel on the spread of pneumonic plague, a disease with a high mortality rate. Her results indicate that transmission via air travel depends on the type of disease, specifically, its duration of illness. Nereyda makes the following recommendations: (1) expand the definition of close contact on aircraft, (2) require health contact information with all plane tickets purchases, (3) expand self-sanitizing measures, (4) improve travel alerts and advisory notices during the ticket sales process, (5) perform temperature checks on a limited and random basis, and (6) improve crisis communication.

Myanmar’s Chemical Weapons Program
GMU’s Biodefense Program Director Dr. Gregory Koblentz and master’s student Madeline Roty  encourage the US to help Myanmar come clean about its chemical weapons program in a new article. Myanmar’s secret chemical weapons program, now believed to be inactive, is a commonly underacknowledged topic, even by the US government. It was not until early 1988, 5 years after intelligence arose about Myanmar seeking to product chemical weapons, that the US publicly accused Myanmar of developing chemical weapons. The motivation and objective of the clandestine weapons program remains unclear, but speculation includes defense or offense measures against domestic insurgencies or neighboring countries.  Despite its continued denial of the program, Myanmar seems to be moving toward transparency with its willingness to address concerns about its adherence (or lack thereof) to the Chemical Weapons Convention. Recent reporting of chemical weapons deployment by the Myanmar military remain unconfirmed but suspected. This is especially concerning given the persecution of the minority Rohingya, likely targets of all kinds of weapons. In an optimistic turn, last month, the country hosted a US delegation of experts to discuss the CWC, an important step toward transparency. Hopefully, for both its status among the liberal international order and the safety and security of its people, Myanmar will choose a path of openness about its chemical weapons programs.

NPT’s Uncertain 50th Birthday
5 March 2020 marked the 50th anniversary of the Nonproliferation Treaty (NPT) entrance into force, and the 25thanniversary of its indefinite extension.  The NPT is an international treaty aimed at preventing the spread of nuclear weapons and related technology, promote cooperation for peaceful uses of nuclear energy, and work toward comprehensive nuclear disarmament. Advocates of the NPT can boast that only 13 states have ever possessed nuclear weapons and, of those, 4 disarmed in a nuclear reversal. Opponents of the NPT can highlight the growing threat of non-NPT nuclear weapons possessors (India, Israel, Pakistan) and states of immediate proliferation concern(Iran, DPRK, Syria). This year will also see a quinquennial Review Conference for the NPT, to be held at the United Nations in New York City and attended by representatives from the 191 states that are party to the treaty. Unfortunately, the upcoming Review is anticipated to be disastrous as members without nuclear weapons remain dissatisfied that 5 member states (US, UK, France, China, and Russia) continue to maintain their nuclear weapons stockpiles, and more members consider nuclear hedging as part of their national security strategies. The upcoming Review will provide further insight on the state of the nuclear weapons non-proliferation norms regime.

Pandemics and Podcasts
This week we’ve got two great podcasts for you – the first is from Foreign Policy and entitled (appropriately) Don’t Touch of Your Face. “On the last day of 2019, China reported an unusual outbreak in Wuhan, a port city with a population of 11 million. Within two months, the disease would spread to almost every continent on the globe and kill thousands of people. From Foreign Policy, a podcast about the extent of the COVID-19 contagion, the threat it poses, and what countries are doing to contain it. Join FP’s James Palmer and Amy Mackinnon as they track the spread of the virus and explore what it means for people’s everyday lives.” Our second podcast to share is Authors of Mass Destruction, which “focused on helping authors write great stories while getting the details right. Tune in for interviews with leading experts on weapons of mass destruction and emerging technologies, author interviews, technical modules, and reviews of what TV shows and movies get right and wrong. The podcast will help authors who write about mass destruction develop impactful ideas for their page-turning plots and provide tips for conducting research.” Don’t miss the recent podcast with GMU Biodefense alum Saskia Popescu on bioweapons, healthcare preparedness, and everything from Ebola to antimicrobial resistance.

 

 

Pandora Report: 3.6.2020

COVID-19 Continues
As of 5 March, there are 99 confirmed cases as well as 10 COVID-related deaths in the US. Among the 50 States, 13 are reporting cases: Arizona, California, Florida, Georgia, Illinois, Massachusetts, New Hampshire, New York, North Carolina, Oregon, Rhode Island, Washington, and Wisconsin. The global case count is approaching 100,000 and the death toll is just under 3,300. Now, 79 countries are presenting with coronavirus cases. As the pandemic unfolds, conspiracy theories and misconceptions persist, but financial support for the response grows and the progress made in pandemic preparedness unveils itself.

As the outbreak crests into a pandemic, the onslaught of information and advice, both accurate and baseless, intensifies at a commensurate rate. Conspiracy theories claiming that COVID-19 is the result of bioterrorism perpetrated by either the Unites States against China or by China in an effort to wage war against the United States been espoused and then rejected. These fantastic claims are unsupported given the lack of evidence within the virus’s genome that it is the product of bioengineering; COVID-19 is a zoonotic disease. Beyond its origins, the internet is overrun with faulty advice about protecting oneself from the virus. To combat these inaccuracies, the WHO published a myth busters page for COVID-19 with quick facts and clarifications for coronavirus-related topics ranging from prevention folklore to treatment misconceptions. For example, neither dousing yourself in alcohol nor submerging yourself in a hot bath are effective in killing the virus. Though delicious as an addition to whipped butter, garlic does prevent COVID-19 infection. According to NewsGuard, an online tool that assesses the credibility of news and information websites, the barrage of myths and misinformation regarding the pandemic dwarfs reliable information. For instance, Zero Hedge, a site that supported the fabrication that coronavirus was a bioweapon stolen from Canada, had 2.1 million social media engagements over the last 3 months; however, the CDC’s website had less than 200,000 social media engagements over the same time frame. NewsGuard’s Coronavirus Misinformation Tracking Centerfound almost 100 sites publishing false information about COVID-19 in the US, UK, Italy, Germany, and France.

On a cheerier note, resource support for the COVID-19 response is growing. The World Bank just announced a support package that will make immediately available up to $12 billion in financing for country response needs. This funding is intended to support response and lessen the impacts of COVID-19 as well as provide policy advice and technical assistance. Similarly, the US Congress approved $8.3 billion in emergency spending for coronavirus response, specifically for the research and development of vaccines, therapeutics, and diagnostics. Current funding will support the current response activities but also aid in the preparedness for the next big outbreak. Though it is easier to wag fingers and berate preparedness failures, impressive improvements have been made over the last 20 years toward stronger preparedness, response, infection control, and policy. Health Security is using this pandemic as a chance to reflect on the progress made toward outbreak preparedness since the turn of the century. This special release features 10 articles that span lessons from SARS, quarantine, economic impacts of infectious disease outbreaks, health information communication, public health policy, and preparedness.

News of the Weird
As the chaos and anxiety grow amidst the COVID-19 pandemic, shortages of staple items abound. As the old adage goes, desperate times call for desperate – and puzzling – measures. A newspaper outlet in Australia, NT News, published its latest issue with an additional eight pages to serve as emergency toilet paper for its subscribers. Australians are among the many people stocking up on groceries and household essentials as the pandemic continues, leaving many such items, like toilet paper, unavailable. In fact, some stores are instigating quotas on these products to prevent frenzies from shortages and price gouging by stockpilers. Similarly, the surge in demand for hand sanitizer means that stores are straining to maintain stock levels, so some customers are turning to DIY options. Unfortunately, homemade sanitizer, experts warn, must be precisely formulated to be effective. For example, an effective hand sanitizer must contain at least 60% alcohol content for efficacy, which also makes the substance quite harsh on skin. Instead of turning to Pinterest and YouTube, prevent disease transmission by thoroughly washing hands with soap and water. This is an easy yet underutilized preventive tactic given WebMD’s latest tweet stating that only 31% of men and 65% of women wash their hands after using the restroom. WYH.

Highlights from Dr. Gerstein’s Book Talk
This week, Dr. Daniel Gerstein, graduate of the GMU Biodefense PhD program, was the featured speaker in the Center for Security Policy Studies (CSPS) Speaker Series. Gerstein spoke on his new book, The Story of Technology: How We Got Here and What the Future Holds, discusses the swift proliferation and inescapable influence of technology in human societies. His lunchtime presentation illuminated the perils of technology but also the benefits. Beyond his latest publication, Gerstein talked about his career accomplishments, noting the critical role his Schar School education played in his later successes. He is currently a senior policy researcher at the RAND Corporation, and previously served in the US Department of Homeland Security (DHS) as Under Secretary (Acting) and Deputy Under Secretary in the Science & Technology Directorate. Current students in the Biodefense master’s program found the presentation informative and inspirational as they prepare to soon launch their careers as in the field.

Upcoming Event: Policy vs. Pandemics with Dr. Nathan Myers
On 26 March 2020, GMU’s Biodefense, MPP, and MPA Programs are co-sponsoring an event featuring Dr. Nathan Myers – Policy vs. Pandemics: Polarization and Public Health Emergency Preparedness. Dr. Nathan Myers is an associate professor of political science and public administration at Indiana State University. His research interests include public health policy, U.S. executive branch politics and administration, emergency planning and preparedness, and regulation of biotechnology. He is the author of Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies (Lexington Books, 2019). Political polarization is being blamed for many areas of dysfunction in the U.S. government, and the response to infectious diseases is not immune to this concern. This presentation will discuss how a lack of cooperation between Democrats and Republicans has hindered the ability of the nation to carry out essential public health emergency response functions, such as biosurveillance and the development and deployment of medical countermeasures. Particular attention will be given to bipartisan efforts to move forward with public health preparedness efforts, such as the implementation of the National Biodefense Strategy, in light of the challenges posed by the global coronavirus pandemic. Light refreshments will be served for attendees and books will be available for purchase. Register for the event at here.

 

Pandora Report: 2.28.2020

Welcome to your favorite weekly source for all things biodefense! We’ll be doing a shorter, slightly delayed newsletter next week, but rest assured, your source for global health security news will be back in full force on March 13th. Fortunately, we’ve got a registration page for you to reserve a spot (with an early-bird registration discount!) for the 2020 workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika.

Experts Examine COVID-19 and an Unsettling Response by the Chinese Government
Missed the Coronavirus and Its International Ramifications February 21st event at GMU? Here’s a great recap. While the lively discussion was even-tempered, the information imparted about the global health crisis was often staggering. No less than a longtime veteran of international health emergencies—including investigating Japan’s nuclear reactor crisis—is alarmed. “This is an astonishing outbreak,” said senior vice president of the Center for Strategic and International Studies Stephen Morrison, director of the center’s Global Health Policy Center. “What we think we know today could change tomorrow.”

International Security Crisis Reader
This week’s International Security Crisis Reader covers biosecurity and the global Covid-19 pandemic. An article by our own Dr. Gregory Koblentz, Director of the Biodefense Graduate Program at GMU, is a featured piece. Koblentz’s Spring 2010 article, “Biosecurity Reconsidered: Calibrating Biological Threats and Responses,” describes how biosecurity arose as a critical component of the international security agenda, scrutinizes the contending definitions and conceptualizations of biosecurity, and outlines a taxonomy of naturally-occurring and human-made biological threats to international security. Other featured articles cover HIV/AIDS amidst the conflict in Africa, globalization and biosecurity, and intelligence assessments for biosecurity threats. The Crisis Reader can be found here.

SARS-CoV-2/COVID-19 Pandemic Updates
This week has been non-stop in terms of COVID-19 news and cases. From possible community spread in California, and  8,400 people being monitored, to a state of emergency being called in certain counties, there’s been a lot going on. On Thursday evening, the CDC revised the criteria to guide evaluation of patients under investigation for COVID-19 – this now expands to those with symptoms and travel to an affected area (China, Iran, Italy, Japan, and South Korea), as well as those with severe acute respiratory illness requiring hospitalization without a source of exposure. A whistle blower recently came forward and “is seeking federal protection after complaining that more than a dozen workers who received the first Americans evacuated from Wuhan, China, lacked proper training or protective gear for coronavirus infection control.” On Wednesday President Trump gave a press conference on the pandemic, breaking from what senior public health officials have said about the likelihood for additional cases in the United States. Vice President Pence has also been tasked with leading the COVID-19 response in the U.S., however there was concern on Thursday regarding the communication channels that are now being put in place. Shortages and communication gaps within response has been problematic in recent weeks, with comments of disruption being left to air without more guidance. Many are wondering how they can prepare though and experts have worked to dispel fear but also encourage general preparedness measures. GMU biodefense alum Saskia Popescu recently spoke on this, noting that “‘A lot of preparedness is planning ahead of time,”’ Popescu said.’“Practice makes permanent. If I have a plan, that means I don’t have to panic.’ ‘The most important thing right now is to remain calm,’ she said. ‘Remember, we don’t have that many cases in the U.S., and prevention strategies for this coronavirus are not new. We’ve been doing them for years’.” You can also hear her speak on NPR’s On Point with Jeremy Konyndyk regarding preparedness in the United States. Cases have continued to grow outside of China as Italy, South Korea, and Iran all report many infections. As COVID-19 cases spring up more and more outside of China, thoughts of containment have moved to mitigation. There has been increasing attention to the economic impact of the pandemic, and the UBS Chief Investment Office recently noted “While the situation in China appears to be improving, the next two weeks will be important in determining whether the authorities in Europe and elsewhere can quickly contain the outbreak, or whether there is a further rapid spread of the virus.The full impact on economic activity from the COVID-19 epidemic remains in a state of flux.” Moreover, they note that “In a risk case where containment in China takes much longer or the spread abroad significantly worsens, further reductions to growth would have to be made.” Realistically, how does one keep China’s economy running with 750 million in quarantine? Public trust has been hard hit and overstressed public health/healthcare systems aren’t helping. “The good news for Xi and the party at the moment is a decline in reported new cases and deaths nationwide (the vast majority in Hubei). The bad news, however, is that Hubei’s horrors have tarnished the trust many Chinese had in their officials’ ability to safeguard citizens’ lives and livelihoods.” Realistically, this also calls into attention the travel bans that despite continued use, fail to be truly effective. From discouraging transparency to the realistic issues in focusing on symptoms during respiratory virus season, these efforts appear more taxing than helpful. The economic impact of the outbreak will continue to be a topic of conversation though, as President Trump scrambles to downplay the stock market losses this week.

Synthetic Biology Surprise: Synthesis of Vaccinia Virus
Dr. Gregory D Koblentz, the Director of the Biodefense Graduate Program at Schar School of Policy and Government at George Mason University, published an article this week in the Bulletin of the Atomic Scientists about a frightening feat in biotechnology that remains unnoticed amidst the chaos of Covid-19. In January, Tonix Pharmaceuticals discreetly announced that it had successfully synthesized the vaccinia, the virus used for the smallpox vaccine, in a press release about a poster it presented at an American Society for Microbiology conference. Tonix’s “achievement” was sought after despite serious concerns from several biosecurity experts, many of whom raised criticism of the firm’s synthesis of horsepox virus in 2017. Of grave concern is the utility of synthesized vaccinia as the benefits do not outweigh the risks. In fact, synthesis is unnecessary for researching vaccinia as samples are widely available.  Any claims that Tonix’s work was intended to help develop an improved or safer smallpox vaccine are undercut by the recently licensed JYNNEOS vaccine, a 3rd generation smallpox vaccine developed by Bavaria Nordic. The resources and skills needed to synthesize even complicated viruses are becoming more readily available as synthetic biology and the flourishing bioeconomy lower costs and simplify processes. Unfortunately, the lack of regulations and oversight for DNA synthesis, whether in the name of peaceful research or otherwise, is not matching pace with its accessibility to scientists and DIY bio-users. This is yet another example of the possibilities – both beneficial and detrimental – made reality by synthetic biology, and the risks of puny safeguards for its tools and data.

Upcoming Event: The Story of Technology by Daniel Gerstein, PhD
On 4 March 2020, the CSPS Speaker Series is hosting Dr. Daniel Gerstein, a GMU Biodefense PhD alumnus, to discuss his new book, The Story of Technology: How We Got Here and What the Future Holds. The book examines the rapid proliferation and pervasive influence of technology in human societies. Dr. Gerstein is a senior policy researcher at the RAND Corporation, and he has served in the Department of Homeland Security as Under Secretary (Acting) and Deputy Under Secretary in the Science and Technology Directorate. Dr. Gerstein will be joined by Ellen Laipson, Director of the Master’s in International Security program and CSPS, and Dr. Gregory Koblentz, Director of the Biodefense Program. The event will take place at Noon in Room 113 of Van Metre Hall. Drinks and cookies will be provided. Register here.

Opportunities with the GHSA Next Gen Network
The Global Health Security Agenda’s Next Generation Network just announced its 2020 theme: Inclusive Expansion. Toward that, applications for the Next Gen Mentorship Program are open until 18 March and matches will be announced on 2 April. Apply here for the Mentorship Program. Additionally, leadership positions are available as regional coordinators; apply here. Other opportunities include helping to translate documents into multiple languages. To assist, email your name and language proficiencies to the coordinator at nextgenghsa@gmail.com. For more information on the Global Health Security Agenda click here and for more information on the GHSA Next Generation Network click here.

Covering COVID-19: What do you need to know?
Don’t miss this March 10th event hosted by the Association of Health Care Journalists. The COVID-19 outbreak story is evolving quickly and there are many unknowns about the epidemic, including how contagious the virus is, its mortality rate and whether there is undetected spread occurring outside of China. Providing accurate information to the public is more important than ever in this moment of uncertainty. Hear a panel of infectious disease experts and a journalist explain what is known, what to watch out for, where to find trusted resources and how to combat misinformation and confusion. Speakers include: Maryn McKenna, independent journalist, author; Senior Fellow of the Center for the Study of Human Health at Emory University. Michael Osterholm, Ph.D., M.P.A., director, Center for Infectious Disease Research and Policy. Saskia Popescu, senior infection preventionist at Honor Health, ELBI Fellow, and managing editor of Pandora Report.

Pandora Report: 2.21.2020

Happy Friday Biodefense Gurus! We have a packed edition of the Pandora Report this week, but before we begin – don’t forget to register and reserve your spot for the “Coronavirus & International Security” panel event this evening in Arlington, VA. The CSPS Distinguished Speaker Series event will be at 5pm and you can find more information and register here.

GMU Biodefense Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
We’re excited to announce the summer dates for the workshop: Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika. This three and a half-day workshop will be held in Arlington, VA, from July 13-16, 2020. Registration links and speaker information will be provided in the coming weeks. We hope you’ll join us for this immersive and engaging workshop with some of the top minds in the biodefense world, where we’ll discuss everything from synthetic biology to MCM, antibiotic resistance, and the current outbreak of COVID-19.

CW Use in Syria – Atrocities and Accountability 
We’ve got the scoop on a brand new article by GMU Biodefense graduate program director and professor Dr. Gregory Koblentz in Nonproliferation Review regarding Assad regime use of chemical weapons. International efforts to hold the government of President Bashar al-Assad accountable for the use of chemical weapons in the Syrian civil war have entered a new phase. For the first time, the Organization for the Prohibition of Chemical Weapons (OPCW), the international organization responsible for implementing the 1993 Chemical Weapons Convention, has been empowered to identify the perpetrators of chemical attacks in Syria. The Investigation and Identification Team (IIT), which was formed to conduct the OPCW’s new attribution mission, has announced its intention to investigate and identify the perpetrators of nine chemical attacks in Syria, including the April 7, 2018, attack in Douma. This article reviews recent efforts to attribute chemical attacks in Syria, describes what we know about the nine incidents to be investigated, discusses what to expect during the next phase of the attribution process, and offers insights into how the international community can move beyond attribution to accountability. An annex to the article summarizes what is known about the Syrian government officials, military commanders, and chemical-warfare scientists suspected of being responsible for these attacks. As Koblentz notes, “Without attribution, there can be no accountability. Without accountability, the atrocities will continue: if not by the hand of Assad, then by others emboldened by his ability to use outlawed weapons to hold onto power.” You can read the article here, which builds upon his previous research on Syria’s chain of command for the use of chemical weapons and international efforts to hold the regime accountable for these attacks.

Reaping What You Sow: The Case for Better Agroterrorism Preparedness
GMU Biodefense MS student Stevie Kiesel is pulling back the curtain on this all too forgotten aspect of biodefense – agroterrorism. “An attack on the food supply gives the perpetrating group several benefits. First, the psychological and economic effect of targeting food supplies would be substantial. Such an effect could have a powerful pull with a group such as al Qaeda, who has shown interest in biological weapons and in targeting US economic strength. Second, and related, this type of attack would be relatively low cost when compared to the economic effects it could cause. Third, similar to other forms of terrorism, agroterrorism can allow a weaker group to lessen the power imbalance between themselves and the state they are targeting. Fourth, some groups may turn to agroterrorist tactics because these attacks ‘do not harm humans directly and may therefore be more easily justified’.” Read more of Stevie’s highly engaging and relevant article here.

SARS-CoV-2/COVID-19 Outbreak Updates
As of Thursday evening, there have been 76,214 cases and 2,247 deaths related to COVID-19. From the realm of synthetic biology, many are rushing to recreate SARS-CoV-2 from its DNA code. Since it only took a few weeks to get the genetic sequence of the virus, many researchers are hoping to start ordering copies of genes to build it for efforts like diagnostic testing and vaccine development. On another front, one of the biggest topics has been that of cruise ships…One in particular, the MS Westerdam, finally docked and passengers/crew disembarked in Cambodia. Unfortunately, following the release of passengers, one was later found to have the disease, which has prompted concern as people have begun their travels home. The other, the Diamond Princess ship, finally saw its passengers allowed to leave the controversial ship-based quarantine. 621 (20% of the people onboard) of those on the ship tested positive for the virus. “Those passengers who have been declared free of the virus and are leaving the ship for the first time in two weeks face a confusing array of circumstances. Many will be forced to undergo a 14-day quarantine upon their return home — reflecting a lack of trust in the effectiveness of the ship’s quarantine. Others can remain in Japan under their own recognizance but are still barred from returning home for two weeks.” Here is a good timeline of the outbreak onboard and how the ship was initially placed into quarantine on February 4th after 10 people onboard tested positive. Passengers being flown back to the U.S. have been sharing their account of the experience, but as these two cruise ships provide unique examples of outbreak response, it sheds light on the limitations of quarantine and challenges of public health efforts during the COVID-19 outbreak. “Based on what is known so far, Cambodia’s approach is preferable to quarantining people aboard a ship where the virus is spreading, said Saskia V. Popescu, GMU Biodefense alum and senior infection prevention epidemiologist for HonorHealth, a hospital system in Phoenix. But that requires educating passengers about reporting symptoms and self-isolating if necessary, and having public health authorities in home countries closely monitor those who have returned. It includes quickly tracing the contacts of anyone who develops the infection. ‘I think we can say if you’re going to quarantine people, doing it on a cruise ship is not the best place,’ Popescu said.” In the face of these exhaustive efforts to respond to the disease, conspiracy theories have been a frustrating distraction – Chinese labs have noted that these often hurt efforts to curb the virus and scientists around the world have been working to condemn rumors and conspiracy theories regarding the origin of the virus. “A group of 27 prominent public health scientists from outside China is pushing back against a steady stream of stories and even a scientific paper suggesting a laboratory in Wuhan, China, may be the origin of the outbreak of COVID-19.” Senator Tom Cotton continues to push such conspiracy theories. The Federation of American Scientists (FAS) has a new initiative regarding the outbreak, known as the Coronavirus Project. The project focuses on debunking misinformation and providing accurate information from qualified researchers and scientists. “Since late 2019, information about the infectious Coronavirus has been trickling out from sources around the web. But not all information is created equal. Some of this information comes from science and medical professionals, who have years of experience in epidemiology. Some comes from unreliable anonymous internet accounts, bad actors, and hoaxers.” Despite these distractions, a paper in The Lancet recently emphasized the support for scientists, public health professionals, and medical professionals in China combatting the disease. “We have watched as the scientists, public health professionals, and medical professionals of China, in particular, have worked diligently and effectively to rapidly identify the pathogen behind this outbreak, put in place significant measures to reduce its impact, and share their results transparently with the global health community. This effort has been remarkable.” In times like these, the global health security community truly comes together to address common vulnerabilities and enhance strengths.

The Economic Impacts of COVID-19
The ongoing outbreak of coronavirus has already infected over 75,000 people and taken over 2,000 lives. The newly dubbed COVID-19 outbreak originated and remains strongest in China, but the economic effects of the it is already rippling across the globe. As an outbreak disseminates and intensifies, the labor force shrinks (at least temporarily), supply chains fracture, international mobility of persons and products decelerates or ceases altogether, and spending and investment decline. Though the full magnitude of economic effects from the outbreak can only be speculated upon at this point, the downward economic trends have begun. The sectors most impacted and at highest risk, thus far, are technology, oil, apparel, retail, tourism, and automobiles. The losses in production from Chinese manufacturing of key inputs and final products are critical drivers of the losses we are seeing and will continue to see across the globe. These items include iron, steel, aluminum, textiles, cement, chemicals, toys, electronics, and many more. According to the latest Statista Infographics Bulletin, global shipments of various tech products are expected to fall by 4.5 to 16% in this first quarter of the year. China is the world’s primary producer and exporter of textiles, so the fall in Chinese textile production will impact the global apparel and retail markets. Global oil demand is falling for the first time in over a decade as global transit drops from diminished trade and travel. Travel bans are, of course, squelching international tourism and costing travel hot spots to lose revenue. This is compounded as major events that attract troves of visitors are cancelled in response to COVID-19 fears. For instance, projections from the UN’s International Civil Aviation Organization expect Japan to lose $1.3 billion and Thailand to lose $1.2 billion in tourism revenue just in this first quarter. Due to the travel bans and the general disinclination to travel at the moment, US tourism from Chinese visitors will take a compounding hit in addition to the losses from the ongoing trade war with China. Relatedly, global airline revenues are predicted to drop by $4-5 billion in the first quarter of 2020 due to flight cancellations. Automobile makers are closing plants in China as the much-needed inputs such as steel and aluminum are shrinking the availability of parts. As ground zero, China is suffering the most so far. China’s growth rate is expected to drop from 6% to 4.5% in the first quarter of 2020. As the infection sweeps through the Chinese labor force, factories are shutting down or lowering output capacity, slowing the flow of parts and final products from China. Virtually all countries are and will be impacted by the break in the supply chain as a result of reduced output from China. The absence of a single small component may render a final product unachievable.  As supply falters across various sectors and products reliant on Chinese manufacturing, we should anticipate a rise in those prices. On the other hand, China is one of the largest markets for US products, especially Apple electronics and fashion items, so we should anticipate a significant decline in demand from that large consumer base as spending shrinks among the Chinese population. The Severe Acute Respiratory Syndrome (SARS) outbreak in China in 2003 provides a rough analogue on which to base predictions of the economic impacts of COVID-19. Virulence was highest from November 2002 to July 2003, and that nine month period was all the time needed for the disease to infect almost  8,500 people and kill over 800 people globally. Lee and McKibbin estimate the total economic cost of the 2003 SARS epidemic to be around $40 billion. The geographic dissemination of COVID-19 is currently akin to that of 2003 SARS with cases concentrated in China and small clusters popping up in Asia, Australia, Europe, and North America. The COVID-19 mortality rate is much lower at 2% versus 10%; however, the total number of coronavirus cases after just a couple months greatly surpasses the total case count for SARS at over 75,000. Though the loss of life may, thankfully, be much less severe with COVID-19, the adverse economic impacts of this outbreak may greatly surpass that of SARS. In 2020, we are more of a global economy than in 2003 and supply chains for a cornucopia of products are spread across nations and even continents, so a kink in one place catalyzes a domino effect across borders and industries. Unfortunately, there is no end in sight for COVID-19 as we approach March; therefore, the hits to the global economy will continue to spread across sectors and countries, as well as grow in severity. Only time will tell the full scale and spectrum of adverse economic effects instigated by COVID-19.

The 2021 Nuclear Weapons National Security Budget Proposal
The 2021 budget proposal exemplifies the continuing shift in the US nuclear posture toward a renewed nuclear arms race. This month, President Trump sent Congress a proposed Fiscal Year 2021 budget request of $740.5 billion for national security, 95% of which is for the Department of Defense. The clear priority of the proposed budget is the expansion of investment in and capabilities of US nuclear weapons. The proposal requests almost $29 billion, a 16% increase from the previous year, for the modernization of the US nuclear weapons arsenal. In addition to the $29 billion for modernization, the proposal includes other related items that would bring the total nuclear weapons budget to about $50 billion. The bump in nuclear weapons investment comes at the cost of shrinking most other security and defense programs. This should come as no surprise given Trump’s proclivity for nuclear strength as evidence by his late 2016 tweet, “must greatly strengthen and expand its nuclear capability until such time as the world comes to its senses regarding nukes.” Despite recommendations that DOD dedicate more resources on challenges from strategic rivals, namely China and Russia, the proposal outlines cuts to such programs. For example, the Navy is preparing for a significant reduction in funding for new warships. Lawrence J Korb, former Assistant Secretary of Defense for Logistics and Materiel Readiness, recommends that the administration extend the New Strategic Arms Reduction Treaty (START) with the Russians and resume negotiations. This would renew efforts toward reducing nuclear arsenals and enable the allocation of limited resources to programs that make our country and the world safer.

GAO Report – National Biodefense Strategy
The Government Accountability Office (GAO) has released a new report – “National Biodefense Strategy: Additional Efforts Would Enhance Likelihood of Effective Information”. You can access it here, but the report notes that “There are a number of challenges, however, that could limit long-term implementation success. Among other things, there was no documented methodology or guidance for how data are to be analyzed to help the enterprise identify gaps and opportunities to leverage resources, including no guidance on how nonfederal capabilities are to be accounted for in the analysis. Many of the resources that compose national capabilities are not federal, so enterprise-wide assessment efforts should account for nonfederal capabilities.” Moreover, the report points out that agency officials struggled to identify how decisions were made and there generally lacked a clear process or series of roles for joint-decision making, “As a result, questions remain about how this first-year effort to catalogue all existing activities will result in a decision-making approach that involves jointly defining and managing risk at the enterprise level.”

Pandemics and Podcasts
There are a lot of great podcasts in the infectious disease and biodefense world, so we’ll be spotlighting a few from time to time. Our first is the Next Generation GHS episode from last week, in which GMU Biodefense MS alum Jessica Smrekar sat down to discuss COVID-19. You can listen to it here. Jessica noted that “It was great sitting down with Jono and Taylor to hash out this rapidly developing COVD-19 outbreak in light of Jono’s book, The End of Epidemics: The Looming Threat to Humanity and How To Stop It. We discussed at length the weak links in local, national, and international health structures that leave us vulnerable to disease outbreaks and how we can remedy these in the future. Jono’s book outlines 7 specific actions that, if taken, could reduce these gaps and allow us to create a safer world. We explored the problems we face in developing strong, resilient health systems and how these actions work to solve those problems. Though the COVID-19 outbreak really highlights that we are not where we should be to keep our world safe, Jono expressed ‘the NextGen Group and your leadership and the fact we have such a mobilized network worldwide makes me optimistic. I think we’re building a really powerful network, both internationally and at the national level. And it’s that network of capable, informed, engaged people, who really do care about having a safer world, I think that’s what makes me feel optimistic’.”

News of the Weird
Video games and outbreaks – apparently they go hand in hand. Virus games are growing in popularity right now, in the middle of the COVID-19 outbreak, especially that of Plague, Inc. “Plague Inc. and Pandemic may have a certain morbid appeal in the time of the coronavirus. But they have more than that to offer, many experts and players agree. ‘I can certainly understand the hesitation around this — no one wants to trivialize the very real human suffering that this coronavirus has brought with it,’ said Leacock, Pandemic’s creator. ‘But the reality is that playing helps us process the world around us, and people may be turning to these games now for that reason’.”

Outbreak Dashboard 
Qatar has reported a new MERS-CoV case, marking the fourth case since December. The DRC outbreak of Ebola has now reached 3,443 cases with over 330 suspected cases under investigation.

Reaping What You Sow: The Case for Better Agroterrorism Preparedness

By Stevie Kiesel, MS

For years, interest groups, academics, and policymakers have sounded the alarm on the vulnerability of U.S. crops to a terrorist attack. This article briefly reviews the history, risks, and consequences of agroterrorism attacks targeting crop yields and suggests how the recently established DHS Countering Weapons of Mass Destruction Office could play a role in countering this threat.

Infecting a plant with disease is not always a technically challenging operation, and there are examples of this throughout history. In Alabama in the 1970s, the Ku Klux Klan poisoned black Muslim farmers’ water supplies for their cattle. Also, in the U.S., in 1989 a group calling themselves The Breeders spread medflies (an invasive species of fruit fly that has destructive effects on 22 different crops grown in California) in the Los Angeles area to protest aerial pesticide practices. Although medfly infestations are not abnormal in California, the numbers and patterns of this particular infestation raised red flags. Law enforcement also received several letters signed by The Breeders claiming responsibility for the medflies’ intentional release. A few months later, California stopped its aerial pesticide program. Elsewhere in the world, in 1978 the Arab Revolutionary Council poisoned citruses that were being exported from Israel to Europe with liquid mercury as a means of harming Israel’s economy. In 1997, Israel sprayed a chemical on grapevines in Palestinian territory, destroying hundreds of vines and nearly 17,000 metric tons of grapes.

Continue reading “Reaping What You Sow: The Case for Better Agroterrorism Preparedness”

Pandora Report: 2.14.2020

To our amazing readers, we hope you’re having a lovely Friday and a happy Valentine’s Day! Did you know the CDC estimates that every year in the United States, more than 300,000 people cope with Trypanosoma cruzi infections (Chagas disease) due to those pesky kissing bugs.

The Coronavirus and Its International Ramifications
Don’t miss this February 21st event at GMU’s Van Metre Hall in Arlington, VA at 5pm -The CSPS Distinguished Speaker Series Presents: Coronavirus & International Security featuring: Steve Morrison, Ashely Grant, and Ketian Zhang. Join CSPS for a panel discussion on the broad implications of the coronavirus crisis, the role of the international community in global health management, and the implications for China, US-China relations, and East Asian security. The panel will be moderated by Ellen Laipson, CSPS Director. The event is free to the public but please register here to reserve your spot.

2019-nCoV/COVID-19 Outbreak Updates
The outbreak of COVID-19 has been quite the whirlwind so far. Case counts are changing so rapidly, that on Wednesday evening, over 60,000 cases were reported and by Thursday, it was well over 64,000. In quite possibly some of the worst timing, the HHS Budget in Brief was released this week, which revealed proposed funding cuts to CDC’s Public Health Preparedness and Response program by $25 million, as well as ASPR’s Hospital Preparedness Program. The CDC’s Global Health Security efforts might get an extra $50 million, which might not feel like much as their Emerging Zoonotic Infectious Disease programs and funding for the Epidemiology and Laboratory Capacity program are taking a huge hit.  While many were concerned about the rapid spike in cases as China sacked a senior city health official, the rise was due to a change in reporting definition, which was broadened to account for those without lab confirmation but meeting clinical definition. The United States now has 14 confirmed cases. The second case of the novel coronavirus among the U.S. evacuees from Wuhan, China, was also confirmed on Wednesday in the San Diego quarantine site. Earlier this week, the World Health Organization (WHO) announced the naming of the disease – COVID-19. The virus, previously known as 2019-nCoV, will be referred to as SARS-CoV-2 per the International Committee on Taxonomy of Viruses, meaning that SARS-CoV-2 is the virus that causes the COVID-19 illness/disease in humans. The role of healthcare transmission has been increasingly brought up, as roughly 500 healthcare workers were diagnosed by mid-January in Wuhan. The JAMA study recently released found that 41% of the 138 hospitalized cases they studied in Wuhan, were related to healthcare transmission. As the world struggles with personal protective equipment (PPE) supplies, the CDC has provided guidance to hospitals regarding the shortages that impact healthcare worker safety. GMU Biodefense doctoral alum Saskia Popescu recently wrote on the U.S. healthcare system’s readiness during this time – “For hospital officials, preparing for cases of coronavirus infection means not only ensuring they have adequate supplies, but also the right processes put in place for the rapid identification and isolation of potential patients—which can be challenging during a patient surge.” More concerning, the CDC announced that their rollout of the COVID-19 diagnostic tests will be delayed across the U.S. Also, the cruise ship that has been quarantined for what’s felt like weeks now is finally being allowed to dock and its passengers to disembark in Cambodia.

Bipartisan Commission on Biodefense- Next Evolution: Overhauling Key Elements of Biodefense 
The Bipartisan Commission on Biodefense is hosting this March 18, 2020 event “to inform our continuing assessment of biodefense programs with structural challenges that impede the government’s ability to safeguard the Nation. Topics to be discussed at this meeting include the: Select Agent Programs, BioWatch Program, and Hospital Preparedness Program.” RSVP here by March 13. Registration is required and attendance is free. This event will also be webcast (registration for webcast is encouraged). Lunch and refreshments will be provided. WEBCAST WILL GO LIVE just before 10:00 a.m. on March 18.

News of the Weird
Have you ever wondered what an authentic plague mask looked like? Now you can get a glimpse via the German Museum of Medical History as they are showing off a 16th century plague doctor mask here. “The mask had glass openings in the eyes and a curved beak shaped like a bird’s beak with straps that held the beak in front of the doctor’s nose. The mask had two small nose holes and was a type of respirator which contained aromatic items. The beak could hold dried flowers (including roses and carnations), herbs (including mint), spices, camphor, or a vinegar sponge. The purpose of the mask was to keep away bad smells, known as miasma, which were thought to be the principal cause of the disease, before it was disproved by germ theory.”

Center for Health Security Announces New ELBI Fellows
The Johns Hopkins Center for Health Security has announced the new class of fellows for the Emerging Leaders in Biosecurity Initiative (ELBI).  “As the current novel coronavirus epidemic shows, preparing for and responding to biological threats requires talented people from a range of fields working together to take on many complicated challenges,” said Tom Inglesby, MD, director of the Center. “Our 2020 Emerging Leaders fellows are the rising leaders who will be part of preparing for and responding to biological threats in our future, and we are very excited to work with them in the year ahead.”

“The Present and Future Promise of Synthetic Biology” at CSIS
Last week, the Center for Strategic and International Studies (CSIS) launched its Synthetic Biology: The Ongoing Technology Revolution Series with an inaugural forum. The speakers included Dr. Diane DiEuliis, Senior Research Fellow at National Defense University; Dr. Gigi Gronvall, Senior Scholar and Associate Professor at Johns Hopkins Center for Health Security; and Dr. Jason Kelly, Founder of Ginkgo Bioworks. Synthetic biology, SynBio for short, encompasses the concepts, methods, and tools that enable the creation or modification of biological organisms; it traverses the fields of biology, chemistry, engineering, and computer science. Several emerging technologies, such as artificial intelligence and CRISPR, along with emerging technology companies, such as SynLogic and Evolva, were discussed as boons for a variety of sectors. Further, the exponential improvement in computers, especially in programming, bolsters other technologies and efficiencies in the field. SynBio is growing for industrial, military, personal, and amateur uses. The methods by which a variety of products – medicines, tires, makeup, and more – are made is updating to use more efficient and less extractive means thanks to these tools. Some defense specific technologies mentioned were the LALO tactical boot made from Susterra propanediol, BioBricks made from algae, and structural composite materials derived from a polymer resin matrix. Personalized medicine, such as CAR-T cell therapy cancer treatment, caters to the specific and unique set of characteristics of a patient and her/his health needs. There are a number of advantages to SynBio, but the risks cannot be ignored. As these tools and methods become more available and accessible to more people and groups, the risk of dual-use research of concern (DURC) swells. Specifically, we now must recognize that the misuse and abuse of emerging technologies is no longer limited to states and large groups as DIY biology enables virtually any individual capable of creating or modifying an organism. The sticky situation created by DURC is the continued and encouraged advancement of synthetic biology while also discontinuing and discouraging its misuse and abuse. But, how do we quantify the benefits versus the risks of a new or improved technology? And, by whom? These are questions with currently elusive answers; however, the field of SynBio will not slow so that policy can catch up. There exist some barriers and bottlenecks to the safe and appropriate use of the outputs of SynBio. There is often some level of strategic confusion around a new output, especially given that lack of a one-to-one replacement of old for new. This means that a new technology may not comprehensively replace an old one. Relatedly, best practices are yet to arise and a set of international standards and norms remains unclear. Additionally, the bioeconomy remains largely unmeasured, leaderless, and underappreciated in risk assessment and mitigation. The lack of regulatory standards for any new and incomparable product or process can cripple its advancement and adoption, a current problem for SynBio as well as the bioeconomy in general. On the bright side, there are solutions to these barriers and bottlenecks. Investments in early stage R&D for cutting-edge programming, like that for the Human Genome Project, would provide widespread support to new biotechnologies. Of the same vein, we should target investment in particularly promising innovations like advanced materials and distributed manufacturing. Most importantly, expanding the openness in the life sciences as a whole will gain us more in security than we will lose. A recording of the forum can be accessed here.

2019-2020 Flu Season: CDC Preliminary Burden Estimate
While much attention has been to COVID-19, the CDC just released their preliminary estimate for this flu season and it’s no wonder hospitals are feeling overwhelmed. 22-31 million flu illnesses, 10-15 million flu medical visits, between 210,000-370,000 flu hospitalizations, and 12,000-30,000 flu-related deaths. This data provides a good reminder for why vaccination is so important and basic infection control measures -hand hygiene, staying home when you’re sick, cough etiquette, etc.

Rogue Scientists and Deadly Pathogens?
It’s not surprising that the current COVID-19 outbreak is bringing about questions related to synbio and screening gaps that leave potentially damning vulnerabilities. What would happen if you asked a lab to send you the genetic code to the influenza strain that caused the 1918/1919 pandemic? “What if I sent them the instructions for a new disease that I have reason to believe is dangerous? What if I was doing legitimate research, but my lab didn’t adhere to modern safety standards? The answer is that a few DNA synthesis companies will send me what I asked for, with no screening to check whether they’re sending out a pathogen that ought to be carefully controlled. (Synthetic DNA is not a live virus, of course; I’d have to be a talented biologist with specialized knowledge, lots of resources, and access to expensive tools to use it maliciously.)” Screening though, presents its own challenges as DNA is a dual-use technology and tool, and we have existing policies set in place to avoid potentially dangerous events. “So new screening — and new regulations backing the international use of that screening — is needed. The aim of a new screening regime should be to ensure that requests for DNA are checked to determine whether they contain prohibited, dangerous sequences, without adding too much to the expense of screening and without slowing down legitimate researchers, who should be able to access DNA for their projects cheaply and quickly.”