Category: Commentary

By Rachel-Paige Casey

Throughout April, strategies regarding the reopening of the US economy and its associated public health factors were published by the White House with the Centers for Disease Control and Prevention (CDC), the Center for Health Security at Johns Hopkins University, the Rockefeller Foundation, and the Edmond J Safra Center for Ethics at Harvard University. The four strategies discussed here either outline phases for resuming activity or describe systems to enable and assist safe reopening. All these plans consider the importance of testing to continue slowing the spread of COVID-19 as normal life gradually resumes. Other nations, such as South Korea, have successfully built high-capacity testing and tracing infrastructures in the wake of COVID-19. Unfortunately, the US has failed to develop its own robust testing and tracing system. At present, US testing capacity has plateaued at about 150,000 tests per day, equating to a little over 1 million tests per week, a figure deemed insufficient by experts in public health and medicine. Continue reading “COVID-19 Reopening and Recovery: Proposed Plans for the US” →

Jomana F. Musmar, MS, PhD, Public Health Advisor in the Office of Infectious Diseases and HIV/AIDS Policy within the Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services.

Disclaimer: This narrative does not represent the views of the U.S. Department of Human Health Services. They only represent Jomana Musmar’s personal perspectives and experiences.

Daniel Tiger sings about handwashing in the background while tiny hands covered in peanut butter attempt to give mommy a new hairstyle, all while I’m taking a 1-hour conference call and typing out action items to work on the following day. This is our new normal, multitasking at its finest. When chatter about a novel coronavirus in Wuhan first began in late 2019, the numbers didn’t make sense and my biodefense training immediately triggered the notion that any day now, it’s going to be in our backyard. We’ve learned about preparedness and resilience from SARS, H1N1, Amerithrax, and the tragedies of 9/11, but the transmissibility, high rate of infection, and unpredictable mortality rate for this particular pathogen make it scarier than these past experiences. While my training and expertise prepared me for the tsunami of response activities nationwide, I wasn’t prepared for the impact it would have on our daily lives, especially on my family. My husband, an ER physician who has been on the front-lines seeing COVID-19 patients in 18-hour shifts, my 81-year old mother who is in the highest risk category for COVID-19 and my fun-loving, 24-hour it’s-circus-time kids, all need my attention and all the time. We are the definition of a full-on frontline responder, high-risk of infection-type home. My mother needs frequent grocery deliveries to circumvent her urge to drive out and do her own shopping. Because of the possibility that my husband might bring home an unwanted biological ‘guest,’ my fear that one of us might get infected but be asymptomatic until the dreaded symptoms emerge keeps me up every night. Did my daughters just cough? Was it wet or dry? Is that a fever? Is my throat dry or is it allergies? Can I drop off my mother’s groceries or should I wipe down every single item I touched? The questions are endless. The juggle to sustain a daily ‘norm’ for all of us while realizing the reality of where we are and what’s to come has been a struggle, but we’re figuring it out day by day.  Continue reading “Groundhog Day 2020” →

By Travis Swaggard

I am a Senior Biologist working for a Repository in Manassas VA that stores and handles various microorganisms, media products, and cell lines. We also grow and culture viruses, that now include SARS-CoV-2, to develop products that can be sold to clinical laboratories, academia, and pharmaceutical companies for biomedical research and diagnostic testing.  My work since COVID-19 became a pandemic and a serious threat to global health has focused almost entirely on testing different regions of the SARS-CoV-2 genome from synthetically derived sections of the virus. This is done using the same technique used to screen clinical samples in hospitals and laboratories, known colloquially in our field as qPCR, or quantitative polymerase chain reaction. This is the same methodology used in the testing kits provided by the CDC. Most undergraduate molecular biology students (and, perhaps even high schoolers specializing in AP biology coursework) should understand this technique fairly well: using the same principles of traditional PCR, a region of DNA (or RNA, in the case of SARS-CoV-2) is targeted using specialized primers that complement the RNA sequence. From there, under specific temperatures, a polymerase enzyme will add nucleotides using the primers as a guide. A special molecular probe is also included that will emit fluorescence, but only when the enzyme has completed polymerization of the target region of RNA. Continue reading “A Day in the Life of a Molecular Biologist” →

By Current Biodefense Graduate Student (wishing to stay anonymous)

As the scientific community ramps up for more intensive research efforts in the field of COVID-19 vaccine research, the larger question of how to conduct laboratory research under social distancing conditions remains unaddressed. For example, the National Institute for Allergy and Infectious Disease has announced their strategic plans for COVID-19 research, which are heavily dependent on benchwork and animal studies.   And both basic research fields and industry are now subject to unprecedented pressure to compress established timelines for development of new medical countermeasures.  These timelines have traditionally been held as necessary for vigorous demonstration of efficacy and safety of new drugs and vaccines before licensure for use in human populations. Continue reading “Research Labs Aren’t Ready for Social Distancing” →

By Janet Marroquin

When I began my doctorate studies part-time in August 2019 while working full-time, I thought long and hard about my commitment to growing the biodefense knowledge base.  I understood the demands that the program would have on my time and mental fortitude, which were already stretched thin as a single parent of a middle schooler. Nonetheless, I felt confident in my time management skills and perseverance to overcome the cognitive barriers inherent to graduate school.  The first semester was an abrupt reminder that things never go as planned.  After struggling through all sixteen weeks of the fall semester, I was ready to implement my lessons learned to spring 2020 and start off with a clean slate.  I had a set schedule that actually worked for my son and me, I was doing group exercise classes to squeeze in social interactions with fitness, and I liked my projects at work: I had it all figured out.  A little more than a month later, I was back to square one of fall semester, a reminder that things do not always go as planned. Continue reading “Pandemic Pandemonium” →

By LCDR Jen Osetek, Ph.D.

All of us have stories of how COVID-19 changed not only the world but our individual worlds.   We have had to change our personal and professional roles and adopt new ones. For me, it has had a profound adaptation of 4 different roles in my life: Contractor for the U.S. Coast Guard (USCG), a USCG Reserve Officer, a Public Health Preparedness professor, and Mom.

As a contractor with the USCG’s Office of Specialized Capabilities, I work with the Chemical, Biological, Radiological, and Nuclear Program. Decisions about personal protective equipment (PPE) are nothing new; neither are discussions of biological threats. Coronavirus PPE quickly came to dominate a good part of our time. Working with experts across the USCG, we were involved in workgroups including those focused on protecting our members in the field, decontamination procedures, taking care of those who got sick, and deciding how to safely bring people back to work after exposures.  Instead of sitting across a conference table, our job is currently done over the phone and with screen shared documents. The logistics have changed but the dedication to our people and mission has not.

In my Coast Guard Reserve capacity, we organized a virtual drill weekend for the first time. While not the same as being together, this was a way to deliver required, position-specific training while keeping all our members healthy….and ready to deploy for the COVID response if needed. Like the other branches of the military, the USCG could not stop during a national emergency. Continue reading “A Pandemic Juggling Act” →

By Madeline Roty

The COVID-19 pandemic has had a dramatic impact on physical health, but it is also taking a less obvious toll on our mental health. Based on my background in nursing, I know that physical and mental health are interdependent, and it is difficult to promote one without the other. For example, mental health disorders have been linked with an increased risk for cardiovascular disease. While the negative impact of COVID-19 on mental health has been acknowledged in the media and scholarly literature, the pandemic represents an opportunity to normalize conversations about mental health which has been stigmatized for far too long. But as people have rushed to buy cleaning supplies and personal protective equipment to protect their physical health and the health of others, I have also witnessed friends and family neglect their own mental well-being. Masks will not protect your mental health. In fact, masking your feelings will harm your mental health.
I have been fortunate; my family and friends have been healthy and safe. Like many people, I have had classes moved online, plans cancelled, and a job restructured. I thought that if people are experiencing far worse suffering than mine, why should my problems matter? Then I got a phone call from a friend. She said she had had a really hard month, but she didn’t tell me earlier because it didn’t seem like a big deal with everything else going on in the world. Then another friend called, overwhelmed by the little stresses that had accumulated over time because she thought they weren’t important in the grand scheme of things. That’s when it struck me. Many people I know were not taking the time to acknowledge the impact of the pandemic on their mental health. Instead they were dismissing their personal feelings because other people were suffering more or because it seemed selfish. Continue reading “Masks Aren’t for Mental Health” →

By Saskia Popescu, PhD

I knew early on that the COVID-19 pandemic would hit the United States hard. In healthcare, it’s no longer a matter of if but rather when and for how long. Thanks to globalization, every city in America is twenty-four hours away from any outbreak in the world. My role as a senior infection prevention epidemiologist has taught me that there are warning signs before cases even reach our hospital, let alone American soil. The mask shortages that began well before cases were climbing in the United States, was one such canary in the coal mine.

These lessons were burned into the brains of infection preventionists in 2014 when Ebola was spreading across west Africa and the Dallas Ebola cluster changed the face of U.S. healthcare and biodefense forever. I still remember the daily scramble to update personal protective equipment (PPE) educational tools and get enough materials to train my frontline staff. Those were 16-hour days followed by multiple pages and calls throughout the night. And did I mention that I had a wedding scheduled in the midst of it all? Fitting for an infectious disease nerd though, right? Continue reading “Relearning Forgotten Lessons About Infection Prevention” →

By Rachel-Paige Casey

As panic seized the nation, most Americans rushed to their local grocery store and saw, perhaps for the first time, bare shelves. Despite the immediate fear of food shortages, the empty shelves were the result of a suddenly overloaded food supply chain that struggled to replenish inventories at rate commensurate to the grocery (and toilet paper) stockpiling. The US boasts an exceptionally efficient food production system; indeed, 40% of all food produced and grown within our borders is never eaten. As logistics networks hustle to quicken supply chains to grocers and other food retailers, a question lingers: Will the United States run out of food if the pandemic and its countermeasures persist much longer?

To assuage any panic, the outlook for domestic food production – namely in cereals, meat, and dairy – remains sufficient despite reduced production. A recent announcement by Robert Johansson, USDA Chief Economist in Food and Nutrition, confirms that the United States possesses sufficient quantities of food to feed our population and maintain much of its exports. Anxiety averted and assuaged, patience is needed as our food value and supply chains adapt to abrupt changes in demand. Additionally, the agricultural and food processing sectors need time to adjust operations to increase safety measures (for its workers and customers) and to fulfill changes in consumer preferences. Continue reading “Counting Calories in COVID-19” →

By Stevie Kiesel

While the national focus has correctly shifted to the threat from COVID-19, other national security threats have not gone away. On the contrary, domestic and international terrorist groups view the pandemic as a chance to sow chaos and strike at their vulnerable enemies. The Voice of Hind, a magazine supportive of the Islamic State and published in India, recently called on supporters to “use this opportunity to strike [nonbelievers] with a sword or a knife or even a rope…[and] fill the streets with their blood.” Closer to home, on March 24, Timothy Wilson accelerated his plan to deploy a vehicle-borne improvised explosive device to cause mass casualties. Recognizing an opportunity to use the pandemic as a force multiplier, Wilson was on his way to his target—a crowded Missouri hospital—when he was intercepted by the FBI. Wilson had been the subject of a domestic terrorism investigation for his “violent extremist” ideology that was “motivated by racial, religious, and anti-government animus.”

The threat from white supremacist terrorism has surged in recent years, and the US has been grappling with how to address this threat. In September 2019, the Department of Homeland Security issued its Strategic Framework for Countering Terrorism and Targeted Violence, which explicitly acknowledged that “[t]here has been a concerning rise in attacks by individuals motivated by a variety of domestic terrorist ideologies, such as racially- and ethnically-motivated violent extremism, including white supremacist violent extremism [and] anti-government and anti-authority violent extremism.” And in February 2020, FBI Director Wray testified to Congress that the FBI “elevated to the top-level priority racially motivated violent extremism so it’s on the same footing in terms of our national threat banding as ISIS and homegrown violent extremism.” The FBI’s domestic terrorism investigation of Timothy Wilson, an accelerationist vehicle bomber, which thwarted a potentially devastating attack, shows that this new emphasis is not misplaced. Continue reading “Recent Developments in White Supremacist Terrorism” →