Pandora Report: 9.24.2021

This week we have a new student writer, Lauren Eichberger (Reynolds), a Biodefense Certificate student, shares her summary and takeaways a virtual event held by from the Association of State and Territorial Health Officials (ASTHO). Progress has been made over the last several days toward bringing justice to victims of the Kremlin’s campaign of assassination on British soil. A former US ambassador to the OPCW explains how the body is the “epicenter of a global chemical weapons crisis and a front line in a broader confrontation between the West and Russia.”

Commentary – Two Decades After 9/11: What We’ve Learned About Public Health Preparedness and Leadership

September 11th, 2001 is a date the United States will never forget. Following this tragedy, there were calls to improve our national security against “physical” attacks and amend preparedness plans. Now, in 2021, two years into the COVID-19 pandemic, the nation finds itself in a comparable situation with a call for greater biosecurity and health care preparedness. The Association of State and Territorial Health Officials (ASTHO) held a virtual event, “Two Decades After 9/11: What We’ve Learned About Public Health Preparedness and Leadership” that discussed these two calls-to-action. Lauren Eichberger (Reynolds), a Biodefense Certificate student, shares her summary and takeaways from the event. Read Lauren’s commentary here.

Worldwide Threats to the Homeland: 20 Years After 9/11

Christopher Wray, Director of the Federal Bureau of Investigation (FBI), made a statement before the House Homeland Security Committee about the threats facing the US. Director Wray shared that the FBI is currently investigating over 100 types of ransomware, has recently arrested over 600 gang members in a single month, and that the Bureau is opening a new China counterintelligence investigation every 12 hours. According to Wray, the greatest terrorist threats to the US are lone actors, largely because they move quickly from radicalization to action. In the wake of 9/11, 20 years ago, the FBI underwent a transformation that dramatically expanded national security operations, and changed the focus to “disrupting attacks before they occur and on working with and through our partners around the world and at every level of government here at home.” His testimony covers the violence and destruction of property at the US Capitol building on 6 January, top terrorism threats, cyber attacks, foreign malign influence, and lawful access. Read Wray’s testimony here.

New Book – Denying the Obvious: Chemical Weapons and the Information War Over Syria

Brian Whitaker, a former Middle East Editor of the Guardian newspaper, wrote a new book, Denying the Obvious: Chemical Weapons and the Information War Over Syria. In 2011 mass demonstrations broke out in Syria calling for an end to the regime of President Bashar al-Assad. The regime responded brutally and within months what had begun as political unrest turned into a full-scale war between government forces and a variety of armed groups. In the midst of that turmoil, the regime began using chemical weapons – banned under international law. The regime’s guilt was beyond reasonable doubt though it denied responsibility and Russia, as its chief ally, weighed in with vigorous support. So, too, did a number of small groups and individuals in the west – apparently sincere people who convinced themselves that one of the Middle East’s most oppressive regimes was the innocent victim of a plot to discredit it. Among them were an assortment of university professors, retired spies, “independent” journalists, “anti-imperialists” and more than a few habitual conspiracy theorists. They accused rebel groups of faking the chemical attacks – a claim that became the starting point for a disinformation campaign stretching far beyond Syria. This is the story of that campaign: how it originated, the ideas that drove it, and how it was choreographed with assistance from Russia. Read the new book here.

Progress Towards Accountability for Putin’s Use of Poison

On 21 September, two announcements brought justice a little bit closer to victims of the Kremlin’s campaign of assassination on British soil. The first announcement, from the European Court of Human Rights (ECHR), dealt with the case of Alexsandr Litvinenko, the former Russian spy, who was poisoned in London with the radioactive substance polonium-210 in 2006. The British government has accused two Russian citizens, Andrey Lugovoy and Dmitriy Kovtun, of being responsible for the poisoning. The ECHR ruled 6-1 that “there was a strong prima facie case that, in poisoning Mr. Litvinenko, Mr. Lugovoy and Mr. Kovtun had been acting as agents of the Russian State.”  Furthermore, the court noted that the Russian government had “failed to provide any other satisfactory and convincing explanation of the events or counter the findings of the UK inquiry” and that “the Russian authorities had not carried out an effective domestic investigation capable of leading to the establishment of the facts and, where appropriate, the identification and punishment of those responsible for the murder.” The court granted the plaintiff, Maria Anna Carter aka Marina Litvinenko, payment from Russia – 122,500 euros in non-pecuniary damages and costs – but rejected her claim for punitive damages. The same day, the BBC reported that the British authorities were ready to charge a third person, Denis Sergeev, in the use of Novichok nerve agent in the attempted murder of Sergei Skripal, another former Russian spy, and his daughter Yulia. This botched attack led to the poisoning of two police officers and two civilians, one of whom, Dawn Sturgess, died. Sergeev had been previously identified by Bellingcat as a high-ranking GRU officer who oversaw the Skripal operation. According to the Crown Prosecution Service, there was “sufficient evidence to provide a realistic prospect of conviction” and that it was in the public interest to charge Sergeev even though Sergeev is in Russia and Russia refuses to extradite its citizens. Also, this week, a third man known as ‘Sergey Fedotov’ was identified and prosecutors from the Crown Prosecution Service (CPS) concluded that available evidence is sufficient “to provide a realistic prospect of conviction and that it is clearly in the public interest to charge Sergey Fedotov.” Authorized charges against Fedotov include: conspiracy to murder Sergei Skripal; attempted murder of Sergei Skripal, Yulia Skripal and Nick Bailey; causing grievous bodily harm with intent to Yulia Skripal and Nick Bailey; and possession and use of a chemical weapon, contrary to the Chemical Weapons Act 1996.

Syria, Russia, and the Global Chemical Weapons Crisis

Kenneth D. Ward, former US ambassador to the Organisation for the Prohibition of Chemical Weapons (OPCW), explains how the OPCW is the “epicenter of a global chemical weapons crisis and a front line in a broader confrontation between the West and Russia.” Indeed, he emphasizes that the “world is now precariously perched on the knife’s edge of a new era of chemical weapons use.” In August 2013, the Syrian military launched sarin attacks against the opposition-controlled town of Ghouta, killing 1,400 people. By the end of the next month, “the international community had legally anchored the US-Russian joint framework in a decision of the OPCW Executive Council and in a UN Security Council resolution, which included measures to address any Syrian failure to comply with the resolution’s provisions or with the prohibitions of the CWC.” In 2014, Syria’s declared stocks of chemical weapons were being removed for destruction, but signs emerged that the regime would not “comply fully with its commitments under the CWC and the UN resolution.” It was around this time that the joint framework began to unravel. In the following years, attacks with chemical weapons continued, both by the Assad regime against the Syrian people and by other nations, such as Russia’s use of nerve agents in attempted assassinations. After Russia used a chemical weapon in the United Kingdom, the UK initiated a special session of CWC states-parties to forge an international response, which resulted in the adoption of the decision, “Addressing the Threat from Chemical Weapons Use.” This decision “dealt with Syria’s continued possession and use of chemical weapons,” “clarified the mandate of the OPCW Technical Secretariat in the context of the CWC,” and “authorized the release of OPCW information to any entities established under the auspices of the UN investigating chemical weapons use in Syria.” Ward states that the “United States must accord high priority to defending the CWC and lead an international effort to hold perpetrators accountable in all relevant forums.” He also emphasizes that “to successfully weather the assault on the convention and the norm, diplomacy must be paired with concerted international investment in the OPCW.” Read Ward’s full article here.

Terrorist Attacks Against Vaccinators: A Review

Vaccinators fulfill an important role in a nation’s public health by reducing the burden of disease on the population. Understanding patterns of attack employed against vaccinators is important to determine how to protect them. A new study conducted a search of the Global Terrorism Database for terrorist attacks against vaccinators that occurred between the years 1970 and 2018. Using the search terms “hospital,” “healthcare,” “clinic,” “doctor,” “nurses,” “vaccinators,” and “vaccinations,” 2,322 healthcare-related entries were identified. The researchers then manually searched the dataset for incidents related to attacks on vaccinators, which resulted in the identification of 133 attacks against vaccinators. The majority (128 out of 133) of attacks occurred during or after 2010. Every attack except one has occurred in the Middle East, South Asia, or sub-Saharan Africa. Pakistan has seen the most attacks against vaccinators, with 112 incidents recorded. Vaccinators continue to be vulnerable to terrorist attacks. Protection of healthcare personnel during mass vaccination efforts is critical so that they can continue their life saving mission. Read the article in Health Security here.

The Future of Zoonotic Risk Prediction

In the light of the urgency raised by the COVID-19 pandemic, global investment in wildlife virology is likely to increase, and new surveillance programmes will identify hundreds of novel viruses that might someday pose a threat to humans. To support the extensive task of laboratory characterization, scientists may increasingly rely on data-driven rubrics or machine learning models that learn from known zoonoses to identify which animal pathogens could someday pose a threat to global health. A new article synthesizes the findings of an interdisciplinary workshop on zoonotic risk technologies to answer the following questions. What are the prerequisites, in terms of open data, equity and interdisciplinary collaboration, to the development and application of those tools? What effect could the technology have on global health? Who would control that technology, who would have access to it and who would benefit from it? Would it improve pandemic prevention? Could it create new challenges? Read the article here.

Here’s What We’ve Learned About COVID-19—An Update

The Science and Technology Directorate (S&T)’s Master Question List (MQL) is a resource that consolidates recent and accurate COVID-19 information, and is regularly updated with the latest results and data relevant to the pandemic. The latest MQL update includes answers to some new questions covering the efficacy of the COVID-19 vaccines, the Delta variant of SARS-CoV-2, and the long-term symptoms of COVID-19 infection. According to the Centers for Disease Control and Prevention (CDC), the vast majority of US COVID-19 hospitalizations and deaths are occurring in unvaccinated individuals, at 95-99.9% and 94-99.8%, respectively. The Pfizer/BioNTech and Moderna vaccines were found to be 88% effective overall in a study published by the US National Library of Medicine. Long-term infections persist for more than four weeks, and affects 5-10% of patients. The most common chronic symptoms include fatigue, loss of taste or smell, shortness of breath, and headache. Find the current MQL here.

Leader of WHO’s New Pandemic Hub: Improve Data Flow to Extinguish Outbreaks

Chikwe Ihekweazu, an epidemiologist and former leader of the Nigeria Centre for Disease Control (NCDC), talks about his exit from NCDC and shares his hopes and fears for the new Hub for Pandemic and Epidemic Intelligence in Berlin. Upon his departure, the NCDC staffed about 700 people, included two emergency operation centers, and maintained surveillance teams to detect and respond to infectious disease incidents. In his new leadership role at the Hub, Ihekweazu says that he wants to “make the mechanics of reporting disease-related information easier, and also demonstrate that the World Health Organization can use that data to help countries that share it.” His main source of anxiety is that “expectations are so high that people will expect us to demonstrate results immediately — to, you know, identify a single case of a new virus anywhere in the world and stop it.” The aim of the Hub is to “offer [its] leadership, knowledge, systems for data sharing and analytics to help countries be more confident in the decisions they have to make.” Though Ihekweazu has physically left Nigeria, the country is always in his heart, and he is “always thinking about how to make Nigeria better, and how to make the continent work better.”

The Latest COVID-19 Figures

As of 23 September, worldwide, there have been 230,351,063 COVID-19 cases; 4,723,172 deaths; and 6,012,794,821 vaccine doses administered. According to STAT’s COVID-19 Tracker, COVID-19 deaths have now exceeded 675,400 in the US. To put that figure in perspective, in 1918, the Spanish flu caused a pandemic that claimed the lives of an estimated 675,000 Americans across about two years. At present, deaths in the US account for about 14% of the 4.7 million losses worldwide from the pandemic; the US population accounts for only 4.2% of the global population. In the US, 99% of new COVID-19 cases are of the Delta variant. Dr. Saskia Popescu, an assistant professor in the Biodefense Graduate Program as well as an alumna, said the fact that new cases are overwhelmingly caused by the Delta variant is “not unexpected, because it’s more transmissible, but it is also a strong reminder that we need to have continuous vigilance.” Popescu emphasizes, “don’t let your guard down,” because we still need “continuous surveillance, genomic sequencing, access to testing and public health interventions.” For everyone, this includes wearing a mask to curb transmission.

COVID-19 Cited in Significant Increase in Healthcare-Associated Infections in 2020

New data from the Centers for Disease Control and Prevention (CDC) show that there were significant increases in healthcare-associated infections (HAIs) during 2020, the first year of the COVID-19 pandemic. This surge is “quite troubling and must serve as a call to action.” Ann Marie Pettis, President of the Association for Professionals in Infection Control and Epidemiology (APIC), emphasizes that “as a nation we must take significant efforts to bolster our infection prevention and control programs throughout the healthcare continuum.” A new report from the CDC, COVID-19 Cited in Significant Increase in Healthcare-Associated Infections in 2020, analyzes data collected through the National Healthcare Safety Network (NHSN), the country’s largest healthcare-associated infection surveillance system. According to the report, “major increases were found in 2020 compared to 2019 in four serious infection types: central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated events, and antibiotic resistant staph infections.” This analysis “highlights the need for healthcare facilities to strengthen their infection prevention programs and support them with adequate resources so that they can handle emerging threats to public health, while at the same time ensuring that gains made in combatting HAIs are not lost.”

Mental Health and Social Support for Healthcare and Hospital Workers During the COVID-19 Pandemic

The Johns Hopkins Center for Health Security recently published a new study, “Mental Health and Social Support for Healthcare and Hospital Workers During the COVID-19 Pandemic,” that aims to identify the issues most critical to healthcare workers’ mental health, wellbeing, and motivation during the COVID-19 pandemic. Healthcare and hospital workers providing care and support to infected patients during a pandemic are at increased risk for mental distress. Factors impacting their mental health include high risk of exposure and infection, financial insecurity due to furloughs, separation from and worries about loved ones, a stressful work environment due to surge conditions with scarce supplies, traumatic experiences due to witnessing the deaths of patients and colleagues, and other acute stressors. Finding ways for institutions to support the mental wellbeing of healthcare and hospital workers in an acute pandemic-related crisis situation is of critical importance. The factors affecting mental health are deeply connected to work-related motivation and attendance. Willingness to come to work is multifactorial and is dependent upon an individual’s self-perception of risk, as well as having the skills and resources necessary to perform work tasks given the nature of the public health emergency. Social and material support for healthcare workers in a variety of high-stress and high-risk settings is important for supporting workers’ mental health and in maintaining their commitment in challenging conditions. The impact of the COVID-19 pandemic on healthcare workers has been profound, characterized by death, disability, and an untenable burden on mental health and well-being.

The study was conducted using a cross-sectional survey (1,189 responses) and 73 semi-structured interviews with individuals currently employed at the Johns Hopkins Health System (JHHS) and Johns Hopkins Medicine (JHM) hospitals located in Maryland and the District of Columbia. The study population included healthcare providers and direct support services staff, including workers in frontline environmental services, food services, and security. The responses from the survey and interviews revealed that the trauma of witnessing COVID-19 death was exacerbated by the general stress of working during the pandemic and that the significant mental health burden created by the pandemic/infectious disease environment itself was characterized by the ongoing uncertainty and ambiguity about the scientific understanding of the virus. Additionally, stressors negatively impacting employee mental health stemmed from the workplace, resulting in reduced trust of and increased perceptions of betrayal in the institution. Read the full study here.

In 2020, Maddie Roty, recent graduate of the Biodefense MS program, discussed the psychological effects of the pandemic on healthcare workers in her piece, “Heroes are Human Too: The Toll of COVID-19 on the Mental Health of Healthcare Workers.” Read Maddie’s article here.

Charting a Strategic Path Forward for DHS in an Evolved Threat Landscape

Dr. Daniel Gerstein, alumnus of the Biodefense PhD Program and an adjunct professor at the Schar School, discusses why the upcoming Quadrennial Homeland Security Review (QHSR) and Department of Homeland Security (DHS) strategic plan should take on new importance given the challenges the nation and DHS are facing. The QHSR is due to Congress by the end of calendar year 2021 and the Strategic Plan by February 2022. Together, they will articulate DHS’ missions and goals, the strategies to achieve each goal, and long-term performance measures to evaluate the progress. There are two possible paths for DHS with these documents. The first approach is to “dust off and update the 2014 QHSR and the DHS Strategic Plan for Fiscal Years 2020-2024. The core values and guiding principles could be revalidated and minor changes made to the five operational missions and enterprise support functions.” Gerstein offers a second approach for developing the QHSR report and DHS Strategic Plan: “recognize that fundamental and profound changes have occurred in the threats and risks confronting our nation and are continuing to stretch the department in its key mission areas.” The second approach recognizes the “need for charting, or at least considering, a new operational and organizational path forward.” Gerstein argues that the latter approach is most prudent to follow given the length of time that has passed since the establishment of the Department and the changing threats and risks. Read the article here.

After-Action Findings and COVID-19 Response Revealed Opportunities to Strengthen Preparedness

The COVID-19 pandemic shows how catastrophic biological incidents can cause substantial loss of life, economic damage, and require a whole-of-nation response involving multiple federal and nonfederal entities. The 2018 National Biodefense Strategy outlines specific goals and objectives to help prepare for and respond to such incidents. The CARES Act includes a provision for GAO to conduct monitoring and oversight of federal efforts to prepare for, respond to, and recover from COVID-19. GAO’s report, After-Action Findings and COVID-19 Response Revealed Opportunities to Strengthen Preparedness, addresses: (1) interagency plans key federal agencies developed, and exercises they conducted, to help prepare for biological incidents; and (2) the extent to which exercises and real-world incidents revealed opportunities to better achieve National Biodefense Strategy objectives. GAO reviewed biological incident plans and after-action reports from exercises and real-world incidents from calendar years 2009 through 2019, including a non-generalizable sample of 19 reports selected based on threat scenario and other factors. GAO interviewed federal and state officials to obtain their perspectives on plans, exercises, and the COVID-19 response. GAO outlines 16 recommendations to the Secretaries of Homeland Security, Defense, Health and Human Services, and Agriculture. These recommendations center largely around the secretaries working through the Biodefense Steering Committee to define the set of capabilities that each agency needs to prepare for and respond to nationally significant biological incidents, and to periodically assess and communicate exercise priorities among the capabilities they identify. Read the report here.

European Health Emergency Preparedness and Response Authority (HERA): Getting Ready for Future Health Emergencies

On 16 September, the European Commission launched the European Health Emergency preparedness and Response Authority (HERA) to prevent, detect, and rapidly respond to health emergencies. HERA will anticipate threats and potential health crises, through intelligence gathering and building the necessary response capacities. When an emergency hits, HERA will ensure the development, production and distribution of medicines, vaccines and other medical countermeasures – such as gloves and masks – that were often lacking during the first phase of the coronavirus response. It will be fully operational early 2022. Its functioning will be reviewed and adapted on an annual basis until 2025, when a full review will be carried out. HERA is a key pillar of the European Health Union announced by President von der Leyen in her 2020 State of the Union address and will fill a gap in the EU’s health emergency response and preparedness.

Event – The US Food and Drug Administration’s Emergency Use Authorization: Lessons Learned from the Past to Guide the Future

The National Academies of Science, Engineering, and Medicine is offering a workshop on 5-6 October that will look at the past, present, and possible future of the FDA’s Emergency Use Authorization. The workshop will examine the US Food and Drug Administration’s historic and recent use of the Emergency Use Authorizations (EUAs) for diagnostics, therapeutics, and vaccines. It will also provide an overview of the current regulatory framework for EUAs and discuss whether any possible revisions would help to ensure that EUAs are based upon the best and most reliable scientific evidence or enhance public confidence and trust in the EUA process and products.  The workshop will also examine EUAs and similar mechanisms used by other entities within the global health regulatory system, lessons that US and global regulatory and public health partners can learn from one another, and ways to enhance international cooperation between the FDA and its global partners. Register here.

Event – 2021 BSL4ZNet International Conference

The Biosafety Level 4 Zoonotic Laboratory Network (BSL4ZNet) invites you to attend the 2021 BSL4ZNet International Conference, a four-day, online event that will be held virtually on 23 and 29 September as well as 7 and 14 October. 
The conference will convene under the overarching theme of Preparing and Responding to New Post-Pandemic Challenges. The conference aims to enhance knowledge and best practices, and promote collaboration and cooperation with participants from around the world.

The 2021 BSL4ZNet International Conference will be organized into four thematic sessions focused on the post-pandemic era and driving science forward.

  1. Emerging and re-emerging pathogens, on September 23, 2021
  2. BSL3 and BSL4 biosafety and biosecurity: international perspectives, on September 29, 2021
  3. One Health perspectives, on October 7, 2021
  4. Zoonotic outbreaks and pandemics: science policy and science diplomacy perspectives, on October 14, 2021 

The diverse line-up of international keynote speakers and panelists include scientific experts and leading science professionals from government, academia, industry, and non-profit organizations, working in the areas of research, emerging and re-emerging bio-threats laboratory management, biosafety and biosecurity, science diplomacy and policy. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, will be speaking on the “Science policy perspectives in the future of biodefense and biosecurity” panel on 14 October. Expect to hear and engage in discussions on how to leverage the experience of the COVID-19 pandemic, and other zoonotic outbreaks, through reflections and lessons learned to navigate a post-pandemic era.

Register here.

Upcoming Meeting of the National Biodefense Science Board

The National Biodefense Science Board (NBSB or the Board) is authorized under Section 319M of the Public Health Service (PHS) Act, as added by Section 402 of the Pandemic and All-Hazards Preparedness Act of 2006 and amended by Section 404 of the Pandemic and All-Hazards Preparedness Reauthorization Act. The Board is governed by the Federal Advisory Committee Act, which sets forth standards for the formation and use of advisory committees. The NBSB provides expert advice and guidance on scientific, technical, and other matters of special interest to the Department regarding current and future chemical, biological, nuclear, and radiological agents, whether naturally occurring, accidental, or deliberate.

The NBSB will meet in public (virtually) on September 28, 2021, to discuss high priority issues related to national public health emergency preparedness and response. A more detailed agenda will be available on the NBSB meeting website.

Event – Africa CDC Inaugural One Health Conference

The Africa CDC, a specialized technical agency of the African Union (AU), is working to strengthen Africa’s public health institutions to detect and respond quickly and effectively to disease threats and outbreaks on the continent. Africa CDC recognizes that a One Health approach is critical to this mission and for the accelerated implementation of the International Health Regulations (IHR 2005) and to achieve the AU Agenda 2063: The Africa We Want.

Increasing globalization, urban density, ease of travel, animal movement, environmental changes and habitat overlap between humans and animals, all provide opportunities for the emergence and spread of diseases that adversely impact both human and animal health, prosperity, and food security. COVID-19 and Ebola virus disease are two recent examples of how these various factors have directly impacted Africa. To combat these current outbreaks and get ahead of the next, a One Health approach must be taken.

One Health is a collaborative, multisectoral and transdisciplinary approach used to attain optimal health outcomes for people, animals, plants, and their shared environment. Practically, One Health involves the collaboration between human, animal, and environmental health sectors as well as other relevant stakeholders, in the design and implementation of programs, policies, legislation, and research intended to achieve better health outcomes for all.

To celebrate and share the various One Health work taking place on the continent, the Africa Centres for Disease Control and Prevention (Africa CDC) is hosting a 3-day virtual One Health Conference from 1-3 November 2021. Presenters will include representatives from Africa Union Member States, RECs, Africa Union technical agencies, Africa CDC RCCs, research institutions and technical partners. Register here.

Commentary – Two Decades After 9/11: What We’ve Learned About Public Health Preparedness and Leadership

By Lauren Eichberger (Reynolds), Biodefense Certificate Student

September 11th, 2001 is a date the United States will never forget. Following this tragedy, there were calls to improve our national security against “physical” attacks and amend preparedness plans. Now, in 2021, two years into the COVID-19 pandemic, the nation finds itself in a comparable situation with a call for greater biosecurity and health care preparedness. The Association of State and Territorial Health Officials (ASTHO) held a virtual event, “Two Decades After 9/11: What We’ve Learned About Public Health Preparedness and Leadership” that discussed these two calls-to-action.

The first session was a keynote address by Dr. Philip Zelikow, former Executive Director of the 9/11 Commission, who provided his unique insight on the preparedness of the United States for both 9/11 and COVID-19. Dr. Zelikow recalled the events of 9/11 and his role as the director of the 9/11 Commission. He stated, “[the] best learning comes from rigorous investigation.” He envisions a COVID-19 commission tasked with assessing how the United States responded, and identifying what can be improved in future responses.

As a nation, this is not our first pandemic. In the United States alone, 743,452 “excess” (potentially preventable) deaths occurred from COVID-19 between February 2020 and September 4th, 2021, according to the CDC National Center for Health Statistics. Dr. Zelikow stated this figure exceeds the number of excess deaths that occurred during the 1918-19 influenza pandemic, which was caused by an even deadlier virus. Amid our medical and technological advancements, Dr. Zelikow noted that, “our net outcomes are comparable to 100+ years ago!” He also notes that this may be, in part, due to the science being ahead of our ability to apply it in practice. Even so, our science was able to produce a vaccine faster than ever before, yet we are still “losing” to this virus.

The bones of our current health care system, which is employer sponsored, can be dated as far back as the late 1800s and early 1900s when employers of lumberjacks and those who lived in rural settings hired doctors to be on-site (Emanuel, 2020). In the 1930s and 1940s, states began offering health care via Blue Cross Blue Shield with no change in policy until the 1950s when Medicare and Medicaid were introduced at the federal level (Emanuel, 2020). Since then, the healthcare system has not made the sweeping changes needed to best care for the population, which has changed over the last several decades. As Dr. Zelikow stated, we need to redesign our health care system by focusing on “What worked, what is needed, and how do we make the US stronger and safer, besides just terrorist attacks?” A rigorous investigation of the choices the United States made is needed. As Dr. Zelikow put it, “without hindsight; it blinds!”

After 9/11, the nation came together and painfully learned what they could do to prevent a major terrorist attack on the homeland from happening again. Now, scientists, politicians, and the public have a “generational opportunity” to come together and learn from our mistakes with COVID-19.

A Q&A session moderated by ASTHO President Dr. Nirav Shah focused on the preparedness of the Department of Human and Health Services (HHS), which houses the Assistant Secretary for Preparedness Response (ASPR). Answers were provided by two former ASPRs, Dr. Craig Vanderwagen and Dr. Nicole Lurie. Dr. Vanderwagen started the session by addressing the challenges that ASPR faces today, such as adding emerging infectious diseases to the ASPR Health Care Preparedness and Response Capabilities document, which guides hospitals and health care providers on how to properly train and respond to emergencies that stress their systems, such as a mass casualty shooting or infectious disease outbreak. Dr. Vanderwagen also noted that requiring more responsiveness from HHS would improve preparedness by health care providers. Indeed, the ASPR document is updated every few years, with the current document covering 2017-2022. Dr. Lurie agreed, stating that the COVID-19 pandemic was predicted and that, as a nation, we can learn from this pandemic to better prepare for the next.

“Where did we go wrong?” Dr. Shah asked. Answers ranged from policy to science to public opinion. Dr. Lurie first explained how many scientists and leaders forgot that Mother Nature could produce such a horrific virus, even one that could be worse than a biological weapon. For that reason, the world did not take the virus as seriously as it should have. Secondly, she called out scientists for their own pride and ownership of data. In general, science is not published unless every fact has been substantiated. Also, scientists are often prone to competitiveness rather than collaboration. Dr. Lurie opposed this mindset and explained how in dire emergencies, such as a global pandemic, scientists need to work collaboratively with the information available, even if the information is not deemed perfect. However, she also noted that scientists have been under extreme pressure from politicians, leaders, and the public, and may fear backlash. As a trained immunologist and research scientist herself, Dr. Lurie highlighted her concern that science is being silenced.

Where can our nation go from here? Dr. Lurie and Dr. Vanderwagen agreed that our nation’s healthcare system needs to be redesigned with preparedness in mind, starting with an Emergent Infectious Disease Fund. In case of a future pandemic or infectious disease outbreak, this fund could immediately be used when a disease strikes. Perhaps such a fund could have decreased the excess deaths Dr. Zelikow mentioned.

Another Q& A session, moderated by Dr. Leonard J. Marcus, focused on what the 9/11 attacks taught us about preparedness. Panelists Sherry Adams, a registered nurse and Director of the Office of Preparedness and Response for the Maryland Department of Health; Dr. Georges Benjamin, Executive Director of the American Public Health Association; and Dr. Howard Zucker, the Commissioner of Public Health for New York state, provided their unique perspectives on the topic.

The discussion started with a focus on whether or not there was a failure of imagination in the public health system. As Dr. Benjamin pointed out, there is a complacency born of the belief that “the feds [Federal Government] have our back.” Ms. Adams added that she believes the problem stems from the lack of knowledge the current generation has in how the government operates, a lack of acceptance of science, and emotional responses to the pandemic that overwhelmed thoughtful responses.

The panel also addressed the importance of public communication. The 9/11 attacks taught us how important communication is without the “noise” of misinformation and disinformation. Fast forward 20 years and the information overload in this country means there is even more noise that clutters the facts. This led to another important point: tell the truth to educate the public and be coherent. According to Dr. Zucker, in order to tell the truth, we need to start with better education (and the funding to do so) to rebuild the public health workforce. With a solid foundation and understanding across all healthcare workers, the truth can be told.

When asked what will become of public health preparedness, Dr. Zucker recalled that after 9/11, the nation became more focused on security but failed to update our public health system accordingly. Ms. Adams pointed out that strengthening public health is a long-term strategy, but “society is used to a magic bullet, magic pill, etcetera.” Dr. Georges agreed, reminding everyone that, “Prevention works! We can get ahead of these things.” He also asserted that “we must normalize health security.” In order to do so, the panel stressed that the public must take interest in public health to improve our nation’s preparedness.

This ASTHO event highlighted the common challenges faced after 9/11 and during the current pandemic to identify the right lessons to be learned. While this conference featured the perspectives of health policy experts and former public health officials, the issue of improving health security needs to become an everyday conversation if we are going to put in place the right policies to implement these lessons. Just as our nation became stronger after 9/11, the United States can emerge stronger and more resilient after this pandemic.

Pandora Report: 9.17.2021

Dr. Yong-Bee Lim, Biodefense PhD ’21, was just named to the inaugural class of Editorial Fellows at the Bulletin of the Atomic Scientists! The COVID-19 pandemic has spurred calls to “revamp” the Biological Weapons Convention. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, will be speaking on the “Science policy perspectives in the future of biodefense and biosecurity” panel of the 2021 BSL4ZNet International Conference on 14 October.

Dr. Yong-Bee Lim: Inaugural Editorial Fellow at the Bulletin of the Atomic Scientists

Yong-Bee Lim, Biodefense PhD ’21, was just named to the inaugural class of Editorial Fellows at the Bulletin of the Atomic Scientists, where he will be writing a regular column on disruptive technology. He is a fellow at the Council on Strategic Risks, focusing on biosecurity, biodefense strategy, and emerging and converging technologies. Dr. Lim is one of seven fellows who will “publish articles regularly on nuclear risk, climate change, and disruptive technologies—key areas in the Bulletin’s mission to inform the public, policymakers, and scientists about man-made threats to human existence.”

HDIAC Webinar: Critical Infrastructure Protection: Assessing the Risk in the Post Pandemic

The Homeland Defense and Security Information Analysis Center (HDIAC) hosted a webinar, “Critical Infrastructure Protection: Assessing the Risk in the Post Pandemic,” earlier this week. The pandemic has posed new challenges for critical infrastructure protection (CIP), including identifying decision-makers and executing organizations’ responses to incidents. Additionally, many institutions are facing emerging threats and hazards as they return to regular operations. This session reviewed emerging and traditional risks and discuss the steps needed to safely manage the overall change in risk paradigm. Further topics include the changes in asset management, risk trends, and tools to support the new normal of CIP risk resilience. The webinar’s slides are available here, and the recording is available here.

New Book: Emerging Threats of Synthetic Biology and Biotechnology

Synthetic biology is a field of biotechnology that is rapidly growing in various applications, such as in medicine, environmental sustainability, and energy production. However, these technologies also have unforeseen risks and applications to humans and the environment. Emerging Threats of Synthetic Biology and Biotechnology is an open access book that presents discussions on risks and mitigation strategies for these technologies including biosecurity, or the potential of synthetic biology technologies and processes to be deliberately misused for nefarious purposes. The book presents strategies to prevent, mitigate, and recover from ‘dual-use concern’ biosecurity challenges that may be raised by individuals, rogue states, or non-state actors. Several key topics are explored including opportunities to develop more coherent and scalable approaches to govern biosecurity from a laboratory perspective up to the international scale and strategies to prevent potential health and environmental hazards posed by deliberate misuse of synthetic biology without stifling innovation. The book brings together the expertise of top scholars in synthetic biology and biotechnology risk assessment, management, and communication to discuss potential biosecurity governing strategies and offer perspectives for collaboration in oversight and future regulatory guidance. Download a copy here.

COVID Heats Up Debate Over Biological Weapons Convention

The COVID-19 pandemic has spurred calls to “revamp” the Biological Weapons Convention (BWC). Negotiations for the BWC concluded 50 years ago, but experts are currently “grappling with how to make the convention fit for the future – a need that COVID-19 has thrown into sharp relief.” There is an institutional deficit between the BWC and the Chemical Weapons Convention (CWC), treaties both aimed at banning their respective category of weapons; however, the CWC is “much stronger.” The BWC critically lacks a “strong implementation support unit, clear investigative powers, and frequent reviews of the convention and scientific developments.” Another major issue with the BWC is the lack of transparency, evidenced by the fact that less than half of its member states submit confidence building measures. Though the BWC grants investigatory powers, the details are “blurry,” especially regarding how an investigation should be conducted. Additionally, the BWC’s review conference is held every five years, making it difficult to keep up with the pace of scientific developments. The threat of terrorism is likely growing as technology and access to it grow.

Rise of AMR During COVID-19

A physician treating hospitalized COVID-19 patients is seeing how resistant secondary infections are complicating care and the pandemic response. Antimicrobial resistance (AMR) is the characteristic in which microorganisms – viruses, bacteria, and fungi – change over time and exposure in ways that that render antimicrobial medicines futile against them. Globally, about 700,000 people die from these types of infections annually. According to Dr. John B. Lynch, an infectious diseases doctor at Harborview Medical Center and professor of medicine at the University of Washington in Seattle, “the simultaneous COVID-19 and antibiotic-resistant bacteria pandemics weaken our ability to prepare for and respond to the next public health threat.” A recent study examined 148 hospitals across 17 states from March through September 2020 and found increases across several types of healthcare-associated infections (HAIs). Additionally, there were 24% more cases of hospital-acquired multidrug-resistant infections than expected without SARS-CoV-2, including a 30% increase in hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections. These infections are especially difficult to treat and require an “arsenal of safe and effective antibiotics.” Unfortunately, this arsenal is currently lacking. The antibiotic pipeline is waning as many large drug companies have moved away from R&D into antibiotics, which are not a good financial return on investment. The overuse and misuse of antimicrobials is contributing to growing resistance. Lynch strongly recommends that the US “prioritize its response to antibiotic resistance to ensure we are better prepared for future threats.” The bipartisan Pioneering Antibiotic Subscriptions to End Upsurging Resistance (PASTEUR) Act, Lynch asserts, is a “strong step forward.” The PASTEUR Act “would fundamentally change the way the federal government pays for the most critically needed new antibiotics — a shift from paying for volume to paying for value.”

A Strategy to Assess Spillover Risk of Bat SARS-Related Coronaviruses in Southeast Asia

Emerging diseases caused by coronaviruses of likely bat origin (e.g., SARS, MERS, SADS and COVID-19) have disrupted global health and economies for two decades. Evidence suggests that some bat SARS-related coronaviruses (SARSr-CoVs) could infect people directly, and that their spillover is more frequent than previously recognized. Each zoonotic spillover of a novel virus represents an opportunity for evolutionary adaptation and further spread; therefore, quantifying the extent of this “hidden” spillover may help target prevention programs. The authors derived biologically realistic range distributions for known bat SARSr-CoV hosts and quantify their overlap with human populations. This research then used probabilistic risk assessment and data on human-bat contact, human SARSr-CoV seroprevalence, and antibody duration to estimate that ∼400,000 people (median: ∼50,000) are infected with SARSr-CoVs annually in South and Southeast Asia. These data on the geography and scale of spillover can be used to target surveillance and prevention programs for potential future bat-CoV emergence. Read the article here.

1 in Every 500 US Residents have Died of COVID-19

As of 14 September, 663,913 people in the US have died of COVID-19. This toll equates to 1 in 500 Americans having died from the novel coronavirus. The Pfizer COVID-19 vaccine was granted approval by the Food and Drug Administration on 23 August, and two other vaccines – one from Moderna and another from Jansen – are available to the public under emergency use authorizations. Despite these shot options, little more than half of the population is fully vaccinated. Though vaccinations are the “best source of protection against the virus,” the rate of vaccination is slowing. With Pfizer approved, mandates are underway that require certain workers to get the COVID-19 shot, but many are against these measures. For example, in August, New York issued an order that required all health care workers be vaccinated against the virus by 27 September, but several Catholic and Baptist medical professionals filed a federal complaint in hopes of preventing enforcement of the mandate for religious reasons.

A Science in the Shadows

The Washington Post investigated the US support for gain-of-function experiments with potentially dangerous pathogens and the secrecy around it. Gain-of-function experiments are used to enhance certain aspects of a pathogen, often conducted using a combination of gene editing and serial passage of the pathogen between animal hosts. The controversy surrounding this realm of research stems from the concern that this work could cause a terrible outbreak. This concern has been a major topic of discussion as the origin of the COVID-19 pandemic remains a mystery. There are suspicions that SARS-CoV-2 was an escaped virus from a high-containment laboratory in Wuhan, China. This theory has shone a light on gain-of-function research, and its risks and benefits. View the interactive here.

The Grave Risk of Lab-Created Potentially Pandemic Pathogens

In 2012, the research work of Ron Fouchier and Yoshihiro Kawaoka “renewed the debate over whether potential pandemic virus research is too dangerous to conduct.” These researchers published “studies on making avian influenza contagious through the air among mammals.” At the time of publication, highly pathogenic avian influenza, or H5N1, was already known to transmit human-to-human, if only rarely. This debate on developing pathogenic threats for research purposes led the US government to implement a moratorium on funding gain-of-function research. Dr. Lynn Klotz, PhD, a Senior Science Fellow at the Center for Arms Control and Non-Proliferation, shares his “grave concern that the probability of a pandemic caused by a lab incident or accident is much too high.” Klotz’s calculation demonstrated the “high likelihood of release into the community from at least one of the 14 facilities that now create airborne-transmissible potential pandemic viruses and made estimates of the probability that a release will seed a pandemic with potentially millions of fatalities.” These 14 facilities conduct research with avian and human pandemic influenza viruses. This calculation supports his “grave concern that the probability of a pandemic caused by a lab incident or accident is much too high.” Klotz estimates that the chance of a release from a laboratory for an estimated five years of research producing and studying mammalian airborne transmissible H5N1 avian influenza and human flu viruses is 15.8%. Human error can cause accidents that result in the release of a dangerous pathogen into the surrounding community. Given the risks, Klotz recommends a strong level of precaution, specifically a moratorium on this mammalian airborne transmissible avian influenza research.

On the China COVID Investigation, Take the Virus-Hunter Approach

The high-profile publication of the US intelligence community’s investigation into the origins of the COVID-19 pandemic highlighted how little progress has been made on that front. The report reiterated two leading theories: the virus emerged in nature or the virus escaped from a laboratory. Much of the continued uncertainty is the result of the Chinese government obscuring the events around the early days of the SARS-CoV-2 outbreak and withholding important information to outside investigators. The World Health Organization (WHO) is initiating a second global investigation into the origins of COVID-19, which is to be led by more qualified investigators, but China continues to reject further inquiries. Pressure is mounting on the White House to “play hardball with China,” as in to compel cooperation via new penalties like sanctions on China’s laboratories. Dr. Michael Callahan, an infectious disease doctor, is the former biosafety physician for the US Department of State’s BioIndustry Initiative in the former Soviet Union and Bio-Engagement Program in Asia. Dr. Callahan offers a more promising method than force, one based on a “little-known 30-year US government effort to root out bioweapons in dangerous parts of the world, and to secure dangerous pathogens in foreign laboratories.” After the fall of the Soviet Union, Congress supported the idea of a “special forces” for laboratory biosecurity, and the Cooperative Threat Reduction (CTR) program was created. Under CTR, US biosecurity experts – infectious disease doctors, veterinarians, and microbiologists – were deployed in a “dispersed, field-based approach.” These field scientists “built partnerships in each country not just with governments, but with vaccine companies, local physicians and public health officials.” The CTR model was based on building trust through collaboration and doctor-to-doctor contacts. Callahan emphasized that “biosafety is built on collaboration, positive incentives and strong scientific and public health alliances.” Focusing on collaboration instead of “hardball tactics” could better open a line of communication with China regarding the origins of COVID-19.

Poisons & Pestilence Podcast: Shoot that Poison Arrow

A new podcast, Poisons and Pestilence, is debuting with an episode that covers the pre-history of poison arrows. Poisons and Pestilence is produced by Dr. Brett Edwards, an expert on chemical and biological weapons at the University of Bath. Listen to the podcast here.

Frontiers of Computing in Health and Society Symposium

George Mason University is organizing a two-day virtual symposium as part of the kick-off of a new thematic initiative to enhance diverse multidisciplinary research in computing, society, and healthcare, aligned with GMU’s new School of Computing. The two-day virtual “Frontiers of Computing in Health and Society” symposium will feature keynote talks, moderated panels, and lightning talk sessions organized around the broad themes of “AI, Social Justice, and Public Policy” (September 20) and “Computational Systems Biomedicine” (September 21). The conference is open to students, faculty, and the general public. The symposium will also be putting together “lightning talk” sessions on each of the two themes. Participants are encouraged to submit a short abstract on the registration page describing their research area for consideration for inclusion in one of these sessions. More information can be found here. Register here.  

Towards a Post-Pandemic World: Lessons from COVID-19 for Now and the Future

This public workshop is the second of a two-part series about what we’ve learned from a year and a half of living through a pandemic. Presentations will broadly examine responses to COVID-19 in the US and abroad and will host discussions on the long-term impacts of the pandemic on human health and society. The workshop will also examine the role of social sciences in pandemic response, including efforts to reinforce social capital through community engagement and partnerships, and the implications on improving health equity. Each session will highlight successes, missed opportunities, and emerging data in order to extract key understandings that leaders in government, public health systems, the private sector, and communities can incorporate into their ongoing pandemic responses right now – with a view towards enhancing resilience and preparedness for the future. The workshop will be held 21 – 24 September from 10:00 AM – 2:30 PM ET.

Each day of the workshop will take on a different genre of critical understandings from the pandemic to date:

  • September 21 (Day 1): Anticipated Long-Term Effects of COVID-19 – Impacts on Health Equity
  • September 22 (Day 2): Addressing Uncertainties during a Pandemic – Establishing Trust and Engagement, Managing Misinformation
  • September 23 (Day 3): Systematizing Recovery Efforts to Mitigate the Next Pandemic
  • September 24 (Day 4): Potentials for a Post-COVID World – Scenario Planning Exercise

Register here.

2021 BSL4ZNet International Conference

The Biosafety Level 4 Zoonotic Laboratory Network (BSL4ZNet) invites you to attend the 2021 BSL4ZNet International Conference, a four-day, online event that will be held virtually on 23 and 29 September as well as 7 and 14 October. The conference will convene under the overarching theme of Preparing and Responding to New Post-Pandemic Challenges. The conference aims to enhance knowledge and best practices, and promote collaboration and cooperation with participants from around the world.

The 2021 BSL4ZNet International Conference will be organized into four thematic sessions focused on the post-pandemic era and driving science forward.

  1. Emerging and re-emerging pathogens, on September 23, 2021
  2. BSL3 and BSL4 biosafety and biosecurity: international perspectives, on September 29, 2021
  3. One Health perspectives, on October 7, 2021
  4. Zoonotic outbreaks and pandemics: science policy and science diplomacy perspectives, on October 14, 2021 

The diverse line-up of international keynote speakers and panelists include scientific experts and leading science professionals from government, academia, industry, and non-profit organizations, working in the areas of research, emerging and re-emerging bio-threats laboratory management, biosafety and biosecurity, science diplomacy and policy. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, will be speaking on the “Science policy perspectives in the future of biodefense and biosecurity” panel on 14 October. Expect to hear and engage in discussions on how to leverage the experience of the COVID-19 pandemic, and other zoonotic outbreaks, through reflections and lessons learned to navigate a post-pandemic era.

Register here.

Preparing for the Next Pandemic: A Preview of Bipartisan Congressional Action

On 22 September at 1 PM ET, join the Capitol Hill Steering Committee on Pandemic Preparedness and Health Security webinar: Preparing for the Next Pandemic: A Preview of Bipartisan Congressional Action.

Congressional leaders on the Senate HELP Committee and House Energy & Commerce Committee have long supported bipartisan legislation to improve and sustain domestic pandemic preparedness. This session will feature senior health policy staff representing Senator Patty Murray (D-WA) and Senator Richard Burr (R-NC), Chair and Ranking Member of the Committee, and Representatives Frank Pallone (D-NJ) and Kathy McMorris Rodgers (R-WA), Chair and Ranking Member of the House E&C Committee.

The Health Policy Directors will discuss their plans and policy priorities for working together on bipartisan legislation to improve the nation’s public health and medical preparedness and response, by implementing lessons learned from COVID-19.

Register here.

US Chemical Weapons Stockpile Elimination: Progress Update

As part of its treaty obligations to the Chemical Weapons Convention (CWC), the United States must finish destroying all of its declared chemical weapons stockpiles by September 2023. With two years remaining before the stockpile elimination deadline, the CWC Coalition seeks to discuss what has been accomplished, what still lies ahead, and the importance of meeting the 2023 deadline. Since becoming a signatory to the Chemical Weapons Convention in 1997, the United States has worked steadily to destroy its declared chemical weapons stockpiles. As of May 2021, the United States has destroyed 96.52% of its Category 1 chemical weapons stockpile and all of its Category 2 and Category 3 chemical weapons. The United States is the last of eight declared stockpile possessor states to complete its safe and permanent demilitarization of chemical weapons. Catch up with progress updates on 23 September at 10 AM EST.  

Speakers include Dr. Brandi Vann, Deputy Assistant Secretary of Defense for Chemical and Biological Defense; Irene Kornelly, Chair of the Colorado Citizens’ Advisory Commission; and the moderator, Paul Walker, Coordinator, CWC Coalition. Register here.

Upcoming Meeting of the National Biodefense Science Board

The National Biodefense Science Board (NBSB or the Board) is authorized under Section 319M of the Public Health Service (PHS) Act, as added by Section 402 of the Pandemic and All-Hazards Preparedness Act of 2006 and amended by Section 404 of the Pandemic and All-Hazards Preparedness Reauthorization Act. The Board is governed by the Federal Advisory Committee Act, which sets forth standards for the formation and use of advisory committees. The NBSB provides expert advice and guidance on scientific, technical, and other matters of special interest to the Department regarding current and future chemical, biological, nuclear, and radiological agents, whether naturally occurring, accidental, or deliberate.

The NBSB will meet in public (virtually) on September 28, 2021, to discuss high priority issues related to national public health emergency preparedness and response. A more detailed agenda will be available on the NBSB meeting website.

Africa CDC Inaugural One Health Conference

The Africa CDC, a specialized technical agency of the African Union (AU), is working to strengthen Africa’s public health institutions to detect and respond quickly and effectively to disease threats and outbreaks on the continent. Africa CDC recognizes that a One Health approach is critical to this mission and for the accelerated implementation of the International Health Regulations (IHR 2005) and to achieve the AU Agenda 2063: The Africa We Want.

Increasing globalization, urban density, ease of travel, animal movement, environmental changes and habitat overlap between humans and animals, all provide opportunities for the emergence and spread of diseases that adversely impact both human and animal health, prosperity, and food security. COVID-19 and Ebola virus disease are two recent examples of how these various factors have directly impacted Africa. To combat these current outbreaks and get ahead of the next, a One Health approach must be taken.

One Health is a collaborative, multisectoral and transdisciplinary approach used to attain optimal health outcomes for people, animals, plants, and their shared environment. Practically, One Health involves the collaboration between human, animal, and environmental health sectors as well as other relevant stakeholders, in the design and implementation of programs, policies, legislation, and research intended to achieve better health outcomes for all.

To celebrate and share the various One Health work taking place on the continent, the Africa Centres for Disease Control and Prevention (Africa CDC) is hosting a 3-day virtual One Health Conference from 1-3 November 2021. Presenters will include representatives from Africa Union Member States, RECs, Africa Union technical agencies, Africa CDC RCCs, research institutions and technical partners.

Register here.

Pandora Report: 9.10.2021

Tomorrow is the 20th anniversary of the 9/11 attacks on the World Trade Center in New York City and the Pentagon in Arlington, Virginia. The Biden administration proposed a sweeping pandemic preparedness plan. US-Russian cooperation on nuclear nonproliferation has come to an inflection point, and each state must decide whether the challenges in their bilateral relationship make it impossible to collaborate.

20th Anniversary of 9/11 & Amerithrax

Tomorrow, 11 September 2021, marks the 20th anniversary of the attacks on the World Trade Center and the Pentagon, which cost the lives of nearly 3,000 people and injured 6,000 more. The following weeks in 2001 were plagued by the anthrax letter attacks that killed five people and sickened another 17.

Michael Morrell, former Acting Director and Deputy Director of the Central Intelligence Agency (CIA) and current Distinguished Visiting Professor at the Schar School of Policy and Government, served as President Bush’s CIA briefer during the 9/11 attacks. It was during that morning’s briefing that the attacks began, which were initially suspected as accidental due to severe weather conditions. Morrell remembers realizing that al-Qa`ida and bin Laden were behind these acts of terrorism once the second plane hit the Twin Towers. Morrell’s 9/11 story continued until the death of bin Laden under the Obama administration. Returning to the present, Morrell shared that his greatest worry remains weapons of mass destruction (WMDs), which could be deployed by a nation or non-state group, such as a terrorist organization. Biological weapons are among the WMDs for which Morrell fears could wreak terrible havoc.

Trust for America’s Health (TFAH) released an analysis on the response and limitations of the public health system, Public Health Preparedness: Progress and Challenges Since September 11, 2001. A component of this report “highlights the urgent need for federal, state, and local policymakers to prioritize the nation’s health security as we work toward ending the COVID-19 pandemic and preparing for extreme weather, the health impacts of climate change, future pandemics, and other emerging threats.” The President and CEO of TFAH stated, “The 20th anniversary of September 11th is an important milestone to mark the progress we have made in the past two decades: we have built a public health preparedness enterprise from the ground up, including a dedicated public health emergency workforce. But we must make additional and sustained investments in public health infrastructure and workforce, and we must ensure equity is at the center of preparedness, response, and recovery efforts.” TFAH recommends several policy actions, such as investment in modernizing public health data systems and equipping public health and government leaders to deliver effective public communications and counter misinformation.

Moving On & Up

Congratulations to Diandra Coleman and Minh Ly for starting new jobs in the areas of global health security and biosecurity. Diandra, a student in the Biodefense MS program, is starting a new job as a program coordinator with Health Security Partners, a nonprofit international development organization that is dedicated to building local capacity to improve health security around the world. As program coordinator, Diandra will report to the Executive Director and be responsible for supporting HSP’s education, collaboration and stewardship projects in Asia and the Middle East. Minh Ly, Biodefense MS ’21, has joined the DC office of the James Martin Center for Nonproliferation Studies. CNS is the largest nongovernmental organization in the United States devoted exclusively to research and training on nonproliferation issues. In his new role as a Research Associate, Minh will be focusing on the implications of advanced biotechnologies for national and international security. 

HyunJung Kim (Henry Kim), Biodefense PhD ’21, has been appointed a research fellow at the Center for Security Policy Studies Korea (CSPS-K). CSPS-K is the South Korean branch of Center for Security Policy Studies (CSPS) at the Schar School of Policy and Government at George Mason University. His work at CSPS-K will focus on the use of unapproved medical countermeasures in response to public health emergencies and the history of biological warfare.

A Weapons of Mass Destruction Strategy for the 21st Century

An article co-authored by Zachary Kallenborn, a Policy Fellow at George Mason University’s Schar School of Policy and Government, highlights the threat of weapons of mass destruction (WMDs) to the US, and points out the limited interagency collaboration and lack of a common approach across the US government to countering the development and use of WMDs. Over time, the concept of WMDs, in general, has evolved to include not only lethal chemical, biological, radiological, nuclear, and explosive weapons (CBRNE), but also non-lethal chemical and biological weapons. Today, the debate continues regarding the inclusion of nerve agents and emerging infectious diseases. Yet, the US government has yet to develop a standardized definition of WMDs, let alone a meaning that adequately accounts for 21st century challenges that do not fit into the traditional CBRNE model. For example, “the public health and WMD communities clash over the extent to which bioterrorism and natural pandemics should fall under the scope of WMD response.” Additionally, the norms against the use of WMDs are under threat in recent years with certain states deploying banned weapons, like Russia’s use of Novichok nerve agents in attempted assassinations. Technological leaps are changing the game, “making it easier for state and non-state actors to acquire, enhance, and use WMD.” Synthetic biology enables the development of bioweapons, drones offer a novel delivery system, and 3D printing makes components easier to manufacture. Today, the US government has three strategies to counter WMDs that do not adequately account for the dynamic threat landscape. The authors urge the US to develop a “guiding strategy to integrate activities aimed at ensuring non- and counter-proliferation of WMD across national security agencies.” This strategy should “recognize the common challenges WMD pose as a class — the need to reinforce international norms, identify and close off proliferation pathways, and punish egregious use of such weapons — but also appreciate the challenges unique to particular classes of weapons, such as the use of chemical weapons in assassination attacks.” Read the article here.

Progress on Biorisk Management in Iraq

On September 3, Mahdi Al-Jewari, senior chief biologist of the Iraqi National Monitoring Authority for Non-Proliferation (INMA), presented a working paper on Iraq’s National Biorisk Management Committee (NBMC) as part of a Meeting of Experts session on national implementation of the Biological Weapons Convention (BWC). The working paper describes the role, objectives and structure of the NBMC, its international partnerships, achievements so far, and remaining challenges. Mr. Al-Jewari and Gregory Koblentz, director of the Biodefense Graduate Program, described the origin and evolution of biorisk management in Iraq in this 2016 article

Call for Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health

The United Nations General Assembly in September 2021 will bring countries together at a critical time for marshalling collective action to tackle the global environmental crisis. They will meet again at the biodiversity summit in Kunming, China, and at the climate conference (COP26) in Glasgow, United Kingdom. Ahead of these pivotal meetings, the editors of health journals worldwide call for urgent action to keep average global temperature increases below 1.5°C, halt the destruction of nature, and protect health. Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades. The science is unequivocal: a global increase of 1.5°C above the pre-industrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse. Despite the world’s necessary preoccupation with Covid-19, we cannot wait for the pandemic to pass to rapidly reduce emissions. Urgent, society-wide changes must be made and will lead to a fairer and healthier world. The editors of health journals call for governments and other leaders to act, marking 2021 as the year that the world finally changes course. Read the article here.

End of an Era: The United States, Russia, and Nuclear Nonproliferation

US-Russian cooperation on nuclear nonproliferation has reached an inflection point. Policy makers in both capitals must now decide whether the risks posed by the spread of nuclear weapons are great enough to merit their renewed engagement—or whether the challenges in their bilateral relationship make it impossible to collaborate in this vital sphere. The election of President Joseph R. Biden offers the potential for a more pragmatic US approach to nuclear cooperation with Russia—one aimed at reducing the mutual threats perceived by both countries. At the same time, however, both the Biden and Putin administrations will face significant domestic political opposition should they choose to revive their joint work in the nuclear sector and attempt to isolate it from other contentious issues that have plagued their relationship.

Recognizing these challenges, End of an Era: The United States, Russia, and Nuclear Nonproliferation identifies nonproliferation challenges that merit US-Russian cooperation and provides suggestions about specific measures that might usefully be pursued. These suggestions are drawn from the seven case studies, which describe instances in which the United States and Russia previously have been able to find common ground, even during periods of considerable tension in their bilateral relationship. Building upon the editors’ 2018 publication, Once and Future Partners: The United States, Russia, and Nuclear Non-proliferation, the present volume distills this history into lessons for contemporary policy makers, scholars, and students of US-Russia nuclear policy. While not a panacea, the recommendations offer practical opportunities to adopt more constructive US-Russia nuclear relations. Read End of an Era here.  

Russia’s Novel Weapons Systems: Military Innovation in the Post-Soviet Period

This article identifies the principal drivers of Russian military innovation involving five novel nuclear, conventional, or dual-capable delivery systems—Avangard, Burevestnik, Poseidon, Kinzhal, and Tsirkon—and analyzes the interplay between these drivers over the course of the innovation process. It does so by means of a structured, focused comparison of the five systems and their progression to date, distinguishing “innovation” from concepts like “invention” and “diffusion,” and defining the stages of an innovation life cycle. The article also distills prior research on Soviet weapons innovation and investigates its continued validity. The analysis finds external factors to be central in driving innovation, specifically Russian threat perceptions around (1) US missile-defense development and (2) the development of Western conventional warfighting capabilities. It also discusses the roles of a range of internal factors, including industry and high-level political support for specific systems, the availability of Soviet-legacy research and engineering initiatives, and the appeal of anticipated industrial and ancillary benefits from the development of specific systems. Cooperation between design bureaus and other industry players is also examined, as is the role of status considerations in driving innovation. Finally, the relative importance of individual factors in explaining innovation is shown to differ across the systems. The structured comparison identifies the continued validity of certain aspects of past studies on Soviet military innovation, while also bringing to light new insights about contemporary Russian weapons innovation. Read the article here.

Strengthening Global Health Security and Reforming the International Health Regulations

Since the SARS-CoV-2 outbreak emerged in late 2019, more than 623,000 people in the US and 4.4 million people worldwide are known to have died from COVID-19. The true death count is probably many times higher. More than 200 million more people around the world have been infected. The rapid spread of highly contagious variants is a grim signal that those numbers will continue to rise. Behind the daily reports are the momentous health, economic, and security challenges this crisis poses for the US and the rest of the world. The pandemic has revealed significant weaknesses in global health security. While working to end the COVID-19 pandemic as quickly as possible, leaders around the world must also marshal the resources and commitment to look beyond this pandemic and build much stronger global health security for the future. There are 4 critical components of an effective global health security system in a post-COVID world, which US government and global leaders must come together to pursue. First, global leaders must modernize essential global institutions, starting with the World Health Organization (WHO). Second, countries and institutions must strengthen international laws and norms, and agreements written at an earlier time may need to be revised. Third, the international community must mobilize sustained financing. Fourth, global leaders must strengthen global governance, with an emphasis on transparency and accountability. The authors offer several recommendations regarding amendments to the International Health Regulations (IHR), such as establishing early warning triggers for action. Read the article here.

Apollo-Style Pandemic Preparedness Plan

Last week, the Biden administration announced a new biosecurity plan that is likened to the Apollo program of the late 1960s. This $65 billion proposal would be one of the largest investments in public health in American history and would “remake the nation’s pandemic preparedness infrastructure in the wake of Covid-19.” About $12 billion would be used to develop treatments for any known virus family and $5 billion would be for developing “diagnostics that the government would aim to make available within weeks of identifying a new biosecurity threat.” Dr. Beth Cameron describes this plan as a way to ensure that the US “has the capabilities it needs to operationalize [its response] when we see the first signs of an emerging outbreak that could have epidemic or pandemic potential.” The plan focuses on overhauling pandemic preparedness in the United States in five main areas: (1) transforming medical defenses, (2) ensuring situational awareness, (3) strengthening public health systems, (4) building core capabilities, and (5) managing the mission. Dr. Yong-Bee Lim, an alumnus of the Biodefense PhD program, and Christine Parthemore assert that a “bold and innovative re-envisioning of how the United States and the global community address pandemic threats is long overdue.”

Early this year, the Bipartisan Commission on Biodefense released a report, The Apollo Program for Biodefense – Winning the Race Against Biological Threats, that outlines a path forward to tackle biological threats. According to the Commission, “the existential threat that the United States faces today from pandemics is one of the most pressing challenges of our time; and ending pandemics is more achievable today than landing on the moon was in 1961.” The Apollo Program for Biodefense encompasses four main goals: (1) implement the National Blueprint for Biodefense; (2) produce a National Biodefense Science and Technology Strategy; (3) produce a cross-cutting budget; and (4) appropriate multi-year funding. Interviewed experts for the Apollo Program report by the Bipartisan Commission on Biodefense include Dr. Gregory Koblentz, Director of the Biodefense Graduate Program; Dr. Andrew Kilianski, an adjunct professor in the GMU Biodefense Graduate Program; and Dr. Saskia Popescu, an assistant professor in the Biodefense Graduate Program. Read the full report here.

Schar School Master’s and Certificate Virtual Open House

Prospective students are invited to attend a virtual open house to learn more about the Schar School of Policy and Government and our academic programs, including the Biodefense Graduate Program. The online session will provide an overview of the master’s degree programs and graduate certificate programs, student services, and admissions requirements. The open house will be on 14 September from 6:30-8 PM EDT. Register here.

Frontiers of Computing in Health and Society Symposium

George Mason University is organizing a two-day virtual symposium as part of the kick-off of a new thematic initiative to enhance diverse multidisciplinary research in computing, society, and healthcare, aligned with GMU’s new School of Computing. The two-day virtual “Frontiers of Computing in Health and Society” symposium will feature keynote talks, moderated panels, and lightning talk sessions organized around the broad themes of “AI, Social Justice, and Public Policy” (September 20) and “Computational Systems Biomedicine” (September 21). The conference is open to students, faculty, and the general public. The symposium will also be putting together “lightning talk” sessions on each of the two themes. Participants are encouraged to submit a short abstract on the registration page describing their research area for consideration for inclusion in one of these sessions. More information can be found here. Register here.  

Dual-Use Research Workshops

Identify biosecurity and biosafety risks in two real-world case studies! Many life sciences students graduate without ever learning the term “dual-use”. In this interactive workshop, led by iGEM alumni and members of the Safety and Security Committee, you will learn how to evaluate Dual Use Research of Concern and bring your biosecurity considerations to the next level.

Register here for 1 of 3 workshop sessions:

Wednesday September 15, 6:00-8:00 pm CEST

Thursday September 16, 12:00-2:00 pm CEST

Friday September 17, 7:00-9:00 am CEST

Pandora Report: 9.3.2021

The last couple weeks marked two important anniversaries: the first anniversary of the Novichok poisoning of Alexei Navalny and the eighth anniversary of the sarin attack on Ghouta. Dr. HyunJung Kim, a newly minted graduate of the Biodefense PhD program, published an article urging the Food and Drug Administration to authorize COVID-19 for children. Ivermectin, an anti-parasitic medication, has become a dangerous false treatment for COVID-19.

State Department & Biosecurity

Dr. Yong- Bee Lim, an alumnus of the Biodefense PhD Program, and Jackson duPont discuss the unintended consequences of the “reemerging conversation about lab safety in China.” These unintended consequences include rising violence against Asians and heightened geopolitical tensions. The authors also encourage augmenting the global infrastructure that mitigates biological threats by “entering into new partnerships with the international community to pioneer a cultural shift towards stronger biosafety and biosecurity, increased disease detection, and new pathways of communication and cooperation that can be activated when—not if—the next threat arises.” These goals will require collaboration with local health authorities, transparency, and an executable implementation plan. Read the article here.

Why the FDA Should Quickly Authorize Kids’ COVID-19 Vaccines

Dr. HyunJung Kim, a newly minted graduate of the Biodefense PhD program, published an article in the Bulletin of the Atomic Scientists urging the Food and Drug Administration (FDA) to authorize COVID-19 for children. People want the safest product possible for their children, but as the FDA seeks expanded safety data for pediatric COVID-19 vaccines, experts and parents alike are asking how much data is enough, especially in the face of a highly transmissible strain of the coronavirus.

The FDA has cited concerns that the Pfizer and Moderna trials of pediatric COVID-19 vaccines were not large enough to detect rare side effects such as myocarditis, an inflammation of the heart. But should the government be paying such close attention to a rare condition at the possible expense of quicker access to pediatric vaccines at a time when the number of cases among children is shooting up? The FDA determined that the benefits of COVID-19 vaccines exceed the risks when it issued the authorizations for adolescent use as well as for adult use.

Careful and cautious approaches to pediatric vaccine development are very important because children can respond differently to vaccines than adults. Since the delta variant has caused a surge of pediatric COVID-19 cases, however, the government’s request for bigger trials and a longer period of follow-up means the United States may miss a critical time for protecting children from the pandemic. The pediatrics group wrote a letter to the FDA asking for more urgency in approving pediatric vaccines. Read Kim’s article here.

The Bioeconomy: A Primer

The Congressional Research Service recently released a primer on the bioeconomy that delves into policy considerations for the US. The term bioeconomy refers to the share of the economy based on products, services, and processes derived from biological resources (e.g., plants and microorganisms). The bioeconomy is crosscutting, encompassing multiple sectors, in whole or in part (e.g., agriculture, textiles, chemicals, and energy). Many predict that the bioeconomy will be a key component of the future economy. Specifically, many view the development of and transition to predominantly a bioeconomy as a means to address grand challenges such as climate change, food security, energy independence, and environmental sustainability. Advancing the bioeconomy is also viewed as an opportunity to create new jobs and industries, improve human health through the development of new drugs and diagnostics, and boost rural development. Some experts estimate the direct economic impact of bio-based products, services, and processes at up to $4 trillion per year globally over the next 10 years.

US competitiveness and leadership in the future global bioeconomy is uncertain. Other countries are adopting comprehensive policies and strategies to advance their bioeconomies. Such efforts have the potential to challenge US leadership in biotechnology and other bioeconomy-related sectors that many view as critical to national security and economic competitiveness. Congress may consider a number of issues regarding advancement of the US bioeconomy, including the development and implementation of a national bioeconomy strategy, federal investments in bioeconomy-related research and development, expanding the bioeconomy workforce, promoting and furthering the development of regional bioeconomies, increasing both the market for bio-based products and services, as well as public awareness and acceptance of bio-based products and services. Conversely, Congress may decide there is no need to restructure federal activities and policies, including some long-standing efforts (e.g., bio-based fuels or agricultural biotechnology), under a bioeconomy framework. Congress may decide to pursue bioeconomy-related policies through new or existing sector-specific efforts, or it may decide current policies and activities are sufficient. Read the report here.

Ivermectin

Ivermectin is an anti-parasitic medication used to treat certain parasitic worms in humans and livestock. The drug is now the latest false cure for COVID-19. The Food and Drug Administration (FDA) has highlighted that ivermectin is not approved for use in treating or preventing COVID-19 in humans, and that taking this medication in large doses is dangerous. The Centers for Disease Control and Prevention (CDC) posted an official health advisory warning the public away from using ivermectin in any form to treat COVID-19. The forms used for humans versus animals differ in the concentrations of active ingredients and the types of inactive ingredients added to the drug. Yet, some are even taking the ivermectin paste formulated for horses. Overdoses of the medication can lead to vomiting, allergic reactions, seizures, coma, and death. America’s Frontline Doctors (AFLD) is the primary promoter of using ivermectin against COVID-19, inaccurately claiming that it is a safe and effective treatment for the viral disease. The founder of this group stormed the US Capitol on 6 January. Research Square removed a non-peer-reviewed study about the medication’s potential as a COVID-19 treatment; the research was deemed to be flawed. In effort to combat the misinformation about the anti-parasitic, Facebook is removing “any content that attempts to buy, sell, donate or ask for Ivermectin.” Reddit is reviewing the ivermectin communities on its platform for misinformation as well. Unfortunately, warnings from the FDA and CDC have yet to curtail interest for the drug on Facebook and Reddit.

Beyond the Lab-Leak Question: Focusing on Global Efforts to Address Biological Threats

Dr. Yong-Bee Lim, a recent graduate of the Biodefense PhD program, co-authored a brief about the capabilities and gaps of the Department of State for addressing biological threats. This is the fourth briefer in the Key US Initiatives for Addressing Biological Threats series. State’s critical activities regarding biological threats include: (1) leading US engagement in fora like the Biological Weapons Convention (BWC) and promoting norms against biological weapons; (2) building capacity with partner nations via the Biosecurity Engagement Program; and (3) working through more than 270 embassies, consulates, and missions worldwide to lead and support arms control and counterproliferation efforts around the world. The authors offer several recommendations to maximize the capabilities of State for addressing biological threats: (1) leverage existing and emerging technologies to assist in detection, attribution, and verification of treaty compliance; (2) expand diplomacy and programs for pathogen early warning; and (3) appoint a special envoy and increasing biorisk expertise across the US diplomatic corps. Read the briefer here.

US Intelligence Community’s Investigation into the Origin of COVID-19

Following the 90-day investigation order by President Biden, the US intelligence community was unable to reach a consensus regarding the origin of the COVID-19 pandemic. In sum, the investigation was inconclusive. The investigation’s single robust conclusion is that the novel coronavirus was not a biological weapon. Dr. Robert Garry, a virologist at Tulane University, stated that the investigation’s report exceeded his expectations. This report also highlights that the “intelligence and scientific communities lack the clinical samples and other data from the earliest COVID-19 cases needed to make a conclusive assessment of the origins of COVID-19.” The granular details of the intelligence community’s investigation are not available to the public. After the results of the investigation were released, Biden made a statement that the US will continue to search for the origins of the pandemic, and he “condemned China for its lack of cooperation, and pressed Chinese officials to cooperate fully with the WHO’s phase-two investigation.”  China is not expected to cooperate with US intelligence agencies, whose goals will be perceived as political. The “Unclassified Summary of Assessment on COVID-19 Origins” published by the Office of the Director of National Intelligence is available here.

China’s Disinformation Response to COVID-19 Origin

China has launched a disinformation campaign claiming that SARS-CoV-2 originated from Fort Detrick, a US military base in Maryland that houses biomedical laboratories. This campaign is seen as a reaction to the recent investigation into the pandemic’s origin conducted by the US intelligence community. The investigation was inconclusive, leaving two leading possibilities: (1) the virus emerged naturally or (2) the virus escaped from a high-containment laboratory in Wuhan, China. The groundless accusations that the US is the source of the novel coronavirus flip the blame for the latter theory onto the US. Despite the absurdity of the claim, it will further strain relations between the US and China. A number of Chinese policy research institutes have pointed fingers at the US for “manipulating global public opinion by practicing ‘origin tracing terrorism.’” The claims are circulating widely across Chinese platforms and media. A rap song performed by a Chinese nationalist group is further spreading this false narrative to the Chinese public. Adding insult to injury, Chinese leadership aims to spread their campaign to international audiences. A Facebook post by a “Wilson Edward,” a supposed scientist from Switzerland, criticized the US for being “so obsessed with attacking China on the origin-tracing issue that it is reluctant to open its eyes to the data and findings.” The Swiss embassy in China revealed that there is no record of a Swiss citizen named Wilson Edwards.

USDA Proposed Framework for Advancing Surveillance for SARS-CoV-2

The US Department of Agriculture (USDA) is dedicating $300 million in American Rescue Plan Act funding to conduct surveillance for SARS-CoV-2 and other emerging and zoonotic diseases in susceptible animals and build an early warning system to alert public health partners to potential threats so they can take steps sooner to prevent or limit the next global pandemic. USDA’s Animal and Plant Health Inspection Service (APHIS) is the lead agency responsible for implementing the early warning system and is inviting public comment on a Strategic Framework that outlines how the Agency will focus its efforts to prevent, detect, investigate and respond to SARS-CoV-2, the virus that causes COVID-19, as well as other emerging and zoonotic diseases that could pose a threat to both people and animals. APHIS’ Strategic Framework uses the One Health approach, which embraces the idea that complex problems that affect the health of humans, animals, and the environment are best solved through improved communication, cooperation, and collaboration across disciplines and sectors. APHIS’ immediate focus will be on expanding surveillance for SARS-CoV-2 to a wider range of animal species (including domestic species and wild animals), increasing diagnostic testing capability and capacity and conducting multisectoral investigations of new animal detections and exposures. The proposed Strategic Framework is available here.

8th Anniversary of Syrian Sarin Attack on Ghouta

On 21 August 2013, the Assad regime deployed sarin on its own citizens in the Ghouta district of Damascus, killing more than 1,400 Syrians and injuring 11,000 more. The attack on Ghouta was the largest chemical weapons attack by the regime against its own people. The US continues to call upon the Assad regime to fully declare and destroy its chemical weapons program in accordance with its international obligations. The United States condemns in the strongest possible terms the use of chemical weapons anywhere, by anyone, under any circumstances.

On this anniversary of the atrocity, the Syrian Network for Human Rights released a report that “identifies some of the most notable Syrian regime individuals involved in the use of chemical weapons in preparation for exposing their crimes and placing them on international sanctions lists.” The report details the attack on Ghouta, which occurred in the early morning when most people are asleep, lessening the victims’ chances of survival. The death toll from this attack accounted for about three-quarters of the total victims killed as a result of chemical attacks carried out by the Syrian regime since December 2012. The report counts 222 chemical attacks between 23 December 2012 and 21 August 2021. Further, the document calls on the United Nations and the UN Security Council to impose economic, political and military sanctions on the Syrian regime for its use of chemical weapons.

1 Year Anniversary of Navalny Poisoning

Alexei Navalny, a Russian opposition leader, was poisoned on 20 August 2020 by a Novichok nerve agent. The US and UK issued a joint statement on the anniversary, which called on Russia to comply fully with the Chemical Weapons Convention (CWC). The statement also shares the nations’ support for sanctions, but reiterate their shared “interest in stable and predictable relations with Russia.”
On the anniversary, the US Department of the Treasury’s Office of Foreign Assets Control (OFAC) and the US Department of State joined the UK in imposing additional sanctions on Russia in response to the state-sponsored poisoning. Additionally, the US Department of State is designating two Russian Ministry of Defense scientific laboratories that have engaged in activities to develop Russia’s chemical weapons capabilities. In prior months, the Treasury Department sanctioned seven Russian government officials for their involvement in the poisoning of Navalny. The new sanctions from the US include restrictions on the permanent imports of certain Russian firearms, and additional Department of Commerce export restrictions on nuclear and missile-related goods and technology pursuant to the Export Control Reform Act of 2018.

Closing the Gaps in Chemical Weapons Nonproliferation

Dr. Stefano Costanzi is a Professor of Chemistry at American University, and he works at the “intersection of science and policy.” Costanzi analyzes the efforts related to chemical weapons nonproliferation, seeking solutions to their gaps and weaknesses. Over the last decade, there have been several violations of the Chemical Weapons Convention (CWC), including attacks against civilians and political figures. The Assad regime of Syria has released sarin on its own people. Russia has attempted assassinations using nerve agents. The half-brother of North Korea’s ruler was assassinated using a nerve agent. Costanzi monitors such events and is working with the Stimson Center’s Partnerships in Proliferation Prevention program to develop a software tool that will help export and border control agents identify controlled chemicals. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, is working with Costanzi to make this tool a reality. Costanzi’s chemistry expertise, computational skills, and international affairs knowledge give him unique and critical insight into helping nonproliferation efforts.  

BWC Meetings of Experts

The 2020 Meetings of Experts for the Biological Weapons Convention (BWC) was postponed, but commenced this week. The Meetings of Experts began on 30 August and runs through 8 September 2021. It is broadcast live in all six official UN languages via UN WebTV or the ListenLive platform. Official documents, presentations, and statements can be found here.

The Meeting of Experts on Assistance, Response, and Preparedness released a working paper, “Lessons Learned in International Cooperation and Assistance from an Agricultural Incident,” based on the several incidents in which US citizens received unsolicited seed shipments that were not compliant with import requirements. These surprise seed deliveries “demonstrated the vulnerability of agriculture and the environment, a critical economic sector, to naturally occurring or deliberate threats.” Fortunately, these events were merely a strange scam.

Enhancing International Biorisk Management

The International Federation of Biosafety Associations (IFBA) announced the launch of their new Professional Certification (PC) in Biological Risk Assessment which identifies individuals with demonstrated competencies in conducting structured and systematic biosafety and biosecurity risk assessments. The IFBA’s (PC) in Biological Risk Assessment identifies individuals with demonstrated competencies in conducting structured and systematic biosafety and biosecurity risk assessments. Individuals holding this certification possess advanced knowledge and skills in sufficient degree to implement a risk-based decision-making approach in mitigating biological risks in the clinical laboratory, public and animal health laboratory, research laboratory and healthcare setting. Candidates applying for this certification must first successfully complete the prerequisite PC in Biorisk Management before they are eligible for examination. The PC in Biological Risk Assessment is suited to a wide range of professionals working with and around biological materials in functions such as biorisk management & biosafety officers, laboratory scientists, technicians, researchers, disease outbreak response personnel, facility operations & maintenance personnel, biocontainment design engineers & architects, educators, consultants, and policy makers.

WHO Scientific Advisory Group for the Origins of Novel Pathogens

On 20 August, the World Health Organization (WHO) issued an open call for experts to serve as members of the new WHO Scientific Advisory Group for the Origins of Novel Pathogens (SAGO). The SAGO will advise WHO on technical and scientific considerations regarding the origins of emerging and re-emerging pathogens of epidemic and pandemic potential, and will be composed of a wide range of experts acting in their personal capacity. SAGO will also guide WHO on next steps for understanding the SARS-CoV-2 origins. The WHO is seeking experts in several areas, including biosecurity, ethics, social sciences, infectious disease epidemiology, medicine, veterinary medicine, environmental science, and more. The deadline to submit an application is 10 September.

Schar School Master’s and Certificate Virtual Open House

Prospective students are invited to attend a virtual open house to learn more about the Schar School of Policy and Government and our academic programs, including the Biodefense Graduate Program. The online session will provide an overview of the master’s degree programs and graduate certificate programs, student services, and admissions requirements. The open house will be on 14 September from 6:30-8 PM EDT. Register here.

Pandora Report: 6.18.2021

Michelle Grundahl, a Biodefense MS student, shares her take on the recent meeting of the National Biodefense Science Board. A new report highlights the compound security threats caused by the “convergence of climate change with other global risks,” such as the COVID-19 pandemic. The Pandora Report is taking a short break, but we will be back soon with news and analysis for all things biodefense!

Biodefense Board Discusses Future of US Pandemic Preparedness

On May 26, 2021, the National Biodefense Science Board (NBSB) held a (virtual) public meeting that discussed actions that the United States needs to take to be better prepared for the challenges posed by public health emergencies such as pandemics, “Disease X,” and other biological threats. NBSB is the federal committee that advises the office of the Assistant Secretary for Preparedness and Response (ASPR) in the US Department of Health and Human Services (HHS). During the meeting, the NBSB presented their recommendations to ASPR from its new report on ‘filling critical gaps’ in health emergency preparedness, response, and recovery. In addition, NBSB was briefed on the CDC’s new initiative to improve its data collection and analytical capabilities to improve information sharing and situational awareness during a public health emergency. Michelle Grundahl, a student in the Biodefense MS Program, shares her insights on the event. Read Grundahl’s article here.

Emergency Use Authorization (EUA) and the Future of the Korea Bioscience Industry

HyunJung Kim, PhD candidate in the Biodefense Program, published an article – Emergency Use Authorization (EUA) and the Future of the Korea Bioscience Industry (written in Korean) – in Monthly Chosun magazine. After the presidential summit between the United States and South Korea last month, Samsung Biologics, based in Seoul, and Moderna, based in Massachusetts, concluded an agreement for Samsung Biologics to produce Moderna’s COVID-19 vaccine in Korea. While Korea has developed the second biggest biologics production capacity in the world, next to the United States, Korea lags in the development of new vaccines and therapeutics. Kim reviews the expansion of Korea’s Emergency Use Authorization (EUA) policy from in-vitro diagnostic kits to medical countermeasures. He points out that the new EUA policy contains provisions that hamper the development of Korea’s biopharma industry by encouraging the Korean government to import medicine from abroad instead of investing in innovation at home by small and medium-sized biotech companies. Read Kim’s article here.

Reading the Nuclear Tea Leaves: Policy and Posture in the Biden Administration

Joseph Rodgers, a Biodefense PhD student, and Rebecca Hersman, Director of the Project on Nuclear Issues (PONI) at CSIS, released a report regarding nuclear policy in the Biden administration. The nuclear policy community is once again in the grips of pervasive anxiety that US nuclear policy -encompassing force modernization decisions, declaratory policy, and perceptions of adversary nuclear threat and risk – is either about to dramatically change or fail to change as dramatically as it should. In a polarized community characterized by mistrust and a highly politicized discourse, it is not surprising that the public conversation is filled with competing perspectives that seek to ensure that their voices are heard before the policies are set. As such, the current discourse appears particularly noisy. The greatest controversy centers on the modernization of the nuclear force, in particular the future of the Intercontinental Ballistic Missile (ICBM) force and commitment to the full triad of nuclear delivery systems, the role and primacy of nuclear weapons in our overall deterrence declaratory policy, the relative threat posed by Russia and China as drivers of US nuclear policy, and the relevance and utility of arms control in managing and reducing these threats. Read the report here.

Iraq National Pathogens List

Iraq has published a new national pathogens list that will guide the country’s approach to biorisk management. The list of human, plant, animal and zoonotic pathogens was produced by the interagency National Biorisk Management Committee. The national pathogen list will become part of Iraq’s system for regulating the import, export, and transfer of dual-use materials. In addition, the list will be used to determine appropriate biosafety and biosecurity measures that laboratories will need to implement. The Iraq National Monitoring Authority played a key role in the development of the list. Mahdi Al Jewari, senior chief biologist at INMA, was a visiting fellow with the Biodefense Graduate Program at George Mason University in 2015. He and Biodefense program director Dr. Gregory Koblentz described Iraq’s effort to develop a comprehensive national biorisk management system in a 2016 article.

The World Climate and Security Report 2021

The Expert Group of the International Military Council on Climate and Security (IMCCS) released its second annual World Climate and Security Report, which highlights the compound security threats caused by the “convergence of climate change with other global risks,” such as the COVID-19 pandemic. The report shows that the growing pace and intensity of climate hazards will stress military and security services as they are deployed to climate-driven crises, while also handling direct climate threats to their own infrastructure and readiness. The authors urge security institutions around the globe to act as “leading voices urging significantly reduced greenhouse gas emissions, given recent warnings about the catastrophic security implications of climate change under plausible climate scenarios.” Key risks outlined in the report include overstretched militaries, escalating climate security risks across all regions, and insufficient climate security adaptation and resilience solutions. Key opportunities outlined in the report include embracing predictive modeling and climate risk assessment methodologies as well as updating and developing international laws and mechanisms to include environmental and climate security impacts. Read the report and summary here.

The Ruthless Hackers Behind Ransomware Attacks on US Hospitals: ‘They Do Not Care’

A string of ransomware attacks on hospitals has been carried out in recent months. These attacks have forced some medical facilities to suspend surgeries and delay medical care. They are also costing hospitals millions of dollars. The Wall Street Journal tracked the major attacks conducted by a specific group, a gang of Eastern European cybercriminals known as the “Business Club” previously and Ryuk more recently, that has ties to Russian government security services. It is the “most prolific ransomware gang in the world,” responsible for one-third of the 203 million attacks in the US in 2020. It is estimated that the group accrued at least $100 million in paid ransoms last year. Bill Siegel, CEO of the ransomware recovery firm Coveware, plainly stated: “They do not care. Patient care, people dying, whatever. It doesn’t matter.” The assaults launched specifically at hospitals during the pandemic exposed concerning gaps in cybersecurity for the nation’s health systems. In this day in age, hospitals are highly dependent on computers, especially given the push to digitize patient records.

Carbis Bay G7 Summit Communique

The leaders of the G7 – Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States – met in Cornwall on 11-31 June with the primary aims of beating the pandemic and building back better. The group released a communique outlining its agenda for global action. First, they will work to end the pandemic and prepare for the future by driving an intensified international effort, starting immediately, to vaccinate the world by getting as many safe vaccines to as many people as possible as fast as possible. Additionally, they will work to reinvigorate our economies by advancing recovery plans that build on the $12 trillion of support put in place during the pandemic. Efforts will be made to secure future prosperity by championing freer, fairer trade within a reformed trading system, a more resilient global economy, and a fairer global tax system that reverses the race to the bottom. Further, the group seeks to protect the planet by supporting a green revolution that creates jobs, cuts emissions, and seeks to limit the rise in global temperatures to 1.5 degrees. Finally, the members aim to strengthen partnerships with others around the world and embrace its values as an enduring foundation for success in an ever-changing world. Read the full announcement here.

Exploring Science and Technology Review Mechanisms under the Biological Weapons Convention

The United Nations Institute for Disarmament Research (UNIDIR) published a study that “seeks to inform discussions on establishing a dedicated and systematic S&T review process under the BWC through an examination of existing S&T review-type mechanisms employed in different regimes beyond the BWC, a survey of States Parties views on a possible review mechanism and a study of past and present discourse on this issue in the Biological Weapons Convention (BWC).” Study methods included assessing review-type mechanisms employed in regimes beyond the BWC; semi-structured interviews with experts; review of past BWC proposals; and a survey of the views of BWC States Parties. Though not all States Parties support the idea of a BWC science and technology review mechanism, and even those who desire such a mechanism differ in the details, two types of potential models became evident. The first is a limited-participation model that would loosely resemble mechanisms used in organizations such as the OPCW, and would draw from a group of 20–30 qualified geographically-representative technical experts nominated by States Parties. The second is an open-ended model that would allow any interested State Party to send (and fund) a maximum of one or two expert participants in the review process. Read the study here.

Event – Pandemics and Global Health Security Workshop

COVID-19 has exposed just how unprepared governments, corporations, and societies are for a global pandemic. While the SARS-CoV-2 virus is only the most recent threat to global health security, it will certainly not be the last. Threats to global health security continue to evolve due to the emergence of new infectious diseases, globalization, advances in science and technology, and the changing nature of conflict. Pandemics and Global Health Security is a three-day virtual, non-credit workshop designed to introduce participants to the challenges facing the world at the intersection of pandemic preparedness and response, public health, national security, and the life sciences. Over the course of three days, participants will discuss how the biology and epidemiology of SARS-CoV-2 contributed to the emergence of that virus as a global pandemic, lessons learned from Operation Warp Speed about the development of medical countermeasures, obstacles to hospital biopreparedness, challenges to science communication during a pandemic, the bioethics of resource allocation during a public health emergency, the future of global health security, and the role of science and technology in preventing and responding to pandemics. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved in research and policy-making on public health, biodefense, and security issues. Live, interactive sessions will include Dr. Rick Bright, The Rockefeller Foundation; Dr. Nicholas G. Evans, University of Massachusetts-Lowell; Dr. Andrew Kilianski, Department of Defense; Dr. Gregory D. Koblentz, George Mason University; Dr. Jennifer Nuzzo, Johns Hopkins Center for Health Security; Dr. Saskia Popescu, George Mason University; Dr. Angela L. Rasmussen, Vaccine and Infectious Disease Organization-International Vaccine Centre; and Jessica Malaty Rivera, COVID Tracking Project. The workshop is organized by the Biodefense Graduate Program at the Schar School of Policy and Government at George Mason University and will be held virtually on July 19-21, 2021. Each day will run from 9am to 12:30pm ET. The course fee is $500. Register here.

Let Scientific Evidence Determine Origin of SARS-CoV-2, Urge Presidents of the National Academies

A statement from the Presidents of the National Academies of Science, Engineering, and Medicine (NASEM) strongly encourages the use of scientific evidence in the investigation of the origin of SARS-CoV-2. Marcia McNutt, President of the National Academy of Sciences; John L. Anderson, President of the National Academy of Engineering; and Victor J. Dzau, President of the National Academy of Medicine write:

“The origin of SARS-CoV-2, the virus that causes COVID-19, and the circumstances of the first cases of human infection, remain unknown.  Science is our best tool to ascertain, or to understand to the extent possible, the origins of SARS-CoV-2 and COVID-19, which could help prevent future pandemics.  However, misinformation, unsubstantiated claims, and personal attacks on scientists surrounding the different theories of how the virus emerged are unacceptable, and are sowing public confusion and risk undermining the public’s trust in science and scientists, including those still leading efforts to bring the pandemic under control. 

We urge that investigations into the origins of SARS-CoV-2 and COVID-19 be guided by scientific principles, including reliance on verifiable data, reproducibility, objectivity, transparency, peer review, international collaboration, minimizing conflicts of interest, findings based on evidence, and clarity regarding uncertainties.  In the case of SARS-CoV-2, there are multiple scenarios that could, in principle, explain its origin with varying degrees of plausibility based on our current understanding.  These scenarios range from natural zoonotic spillover (when a virus spreads from non-human animals to humans) to those that are associated with laboratory work. Scientists need to be able to evaluate all of these scenarios, and all viable hypotheses, with credible data.  Data accessibility, transparency, and full cooperation from China, of course, will be essential for a proper and thorough investigation. 

Although much still needs to be done to stop the pandemic, particularly in developing nations, science has made remarkable headway, especially through the rapid development of effective vaccines. The same scientific robustness, rigor, and cooperation should be applied to examining important questions about how the pandemic began.”

We May Never Know Where the Virus Came From. But Evidence Still Suggests Nature.

Dr. Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan, and Dr. Stephen Goldstein, a virologist at the University of Utah, emphasize that we may never uncover the origin of the novel coronavirus that has wreaked havoc on the world. At present, however, the evidence still suggests that SARS-CoV-2 is the product of nature. For instance, the genome sequence of the virus was analyzed by a group of prominent evolutionary virologists who assessed that it was “overwhelmingly unlikely” that there was laboratory manipulation. The worry that the virus could have come from a high-containment laboratory, specifically the Wuhan Institute of Virology (WIV), has surged in recent weeks. The two scientists assert that the work of laboratories and institutions like WIV are critical to preparing for and responding to pandemics. Additionally, they “agree that researchers should continue to study whether the virus could have emerged from a lab, but this cannot come at the expense of the search for animal hosts that could have transmitted SARS-CoV-2 to humans.” Rasmussen is among the distinguished faculty for the upcoming Pandemics and Global Health Security Workshop hosted by the Biodefense Graduate Program.

It’s Time to Talk About Lab Safety

Dr. Filippa Lentzos, a senior lecturer in science and international security at King’s College London, and Dr. Gregory Koblentz, Director of Biodefense Graduate Program, launched GlobalBioLabs.org, an interactive web-based map of global Biosafety Level 4 facilities and biorisk management policies. Lentzos shared that the aim of the project is to “increase public knowledge about Biosafety Level 4 labs, and importantly, to strengthen national and international virus management policies.” In their research, the two scholars found that there is “significant room for improvement in the policies in place to ensure that these labs were operated safely, securely and responsibly.” Regardless of the origin of SARS-CoV-2, the risk of laboratory accidents and incidents rises as the number of laboratories in the world expands. The new map includes 59 laboratories, the majority of which are in Europe with a total of 25 labs. Only 17 of the 23 countries that house BSL-4 laboratories have national biosafety associations or are members of international partnerships. About 60% of BSL4 labs are government-run public-health institutions, leaving 20% run by universities and 20% by biodefence agencies. Only three of the 23 countries with BSL4 labs – Australia, Canada and the US – have national policies for the oversight of dual-use research. The primary concern is that an accident could trigger the next pandemic. At a national level, Koblentz and Lentzos recommend that “countries with BSL-4 labs should have whole-of-government systems that can conduct multidisciplinary risk assessments of proposed research for safety, security and dual-use activities, such as certain gain-of-function research, that have significant potential to be repurposed to cause harm.” At the international level, they recommend that “structures be put in place to systematically oversee maximum containment facilities.”

SARS-CoV-2 Variants of Interest and Concern Naming Scheme Conducive for Global Discourse

The Virus Evolution Working Group of the World Health Organization convened a group to determine a naming system that will “enable clear communication about SARS-CoV-2 variants of interest and concern.” SARS-CoV-2 is the causative agent of coronavirus disease 2019 (COVID-19), and, as with all viruses, it continuously adapts to changing environments via random genome mutations. There have been several mutations of SARS-CoV-2 since its emergence, and the naming of them has been based on three nomenclature systems, each of which has its own scientific method to classify and name lineages. This means that one variant could have multiple names. To simplify communication and information sharing, a new system was developed for the naming of Variants of Concern and Interest. The new labels use the Greek alphabet. The tables below show the new labels of Variants of Interest and Variants of Concern, respectively.

The US Has Hit 600,000 COVID Deaths, More Than Any Other Country

It has been 15 months since the first confirmed death due to SARS-CoV-2 was reported in the US, and the novel virus has now taken the lives of 600,000 people across the nation. The vaccines have slowed the trend from thousands to hundreds of deaths per day. At present, there are about 375 deaths per day on average, a major decline since January with an average of 3,000 per day. Many Americans are vaccinated or in the process of becoming so, helping to further overcome COVID-19; however, an alarming number of people are reluctant to get vaccinated.

Biodefense Board Discusses Future of US Pandemic Preparedness

By Michelle Grundahl, Biodefense MS Student

On May 26, 2021, the National Biodefense Science Board (NBSB) held a (virtual) public meeting that discussed actions that the United States needs to take to be better prepared for the challenges posed by public health emergencies such as pandemics, “Disease X,” and other biological threats. NBSB is the federal committee that advises the office of the Assistant Secretary for Preparedness and Response (ASPR) in the U.S. Department of Health and Human Services (HHS). During the meeting, the NBSB presented their recommendations to ASPR from its new report on ‘filling critical gaps’ in health emergency preparedness, response, and recovery. In addition, NBSB was briefed on the CDC’s new initiative to improve its data collection and analytical capabilities to improve information sharing and situational awareness during a public health emergency.

The NBSB’s All-Hazards Science Response Working Group draft report, Filling Critical Gaps: Comprehensive Recommendations for Public Health Preparedness, Response, and Recovery from the National Biodefense Science Board, is the result of a September 2020 request from ASPR to NBSB to review the 2007 Homeland Security Presidential Directive 21 (HSPD-21). HSPD-21 is the national strategy for ‘Public Health and Medical Preparedness’ that was formulated during the George W. Bush Administration as part of its strategy to protect the health of Americans during disasters. ASPR asked NBSB to answer three questions:

1) What, if any, of the 2007 focus areas (biosurveillance, countermeasures stockpiling and distribution, mass casualty care, or community resilience) should remain as highest priorities for capacity development by HHS? 

2) How might those focus areas be modified, updated, or expanded to promote additional advances in public health and medical preparedness in the United States? 

3) What should be new HHS focus areas for public health and medical preparedness, if any?

The key finding of the NBSB report is that the United States should always be prepared to “implement an immediate, effective, and coordinated public health response that is guided by scientific knowledge and protected from undue political influence…insulated from political considerations, with the ability to independently develop, directly distribute, and frequently update public health messages with scientific principles in mind, guided by analysis of available data, with inputs from the nation’s leading experts.” To achieve that objective, NBSB made five recommendations to enhance the country’s disaster preparedness and response based on strengthening One Health biosurveillance and situation awareness, enhancement of medical countermeasures, reinforcing health workforce readiness, increasing health facility resilience, and improving communication with the public during health crisis.

The NBSB’s first recommendation is to use a One Health threat assessment for biosurveillance and situational awareness. One Health is holistic approach that considers the systems involved in achieving optimal health outcomes for humans, animals, plants and their shared environment. NBSB recommended that federal departments, public and private research institutions, and private sector organizations should engage in One Health collaborations to protect against emerging human and animal disease risks. A One Health approach would continuously assess emerging human and animal disease risks by using research and predictive data capabilities (based on artificial intelligence) to assess patterns of animal, agricultural, and human health. Proactively discovering biothreats, including zoonotic or arthropod-borne disease, would create improved situational awareness about high consequence risks.  

The board specifically suggests the enhancement of medical countermeasures (MCM), manufacturing, and supply chain. The report provides detailed examples of this approach, and advises that the production of vaccines, drugs, personal protective equipment, and diagnostics should all be “on-shored” inside the United States for quick production and scale-up. For example, active pharmaceutical ingredients, as well as finished products, can be made in the United States instead of imported from foreign suppliers. In addition, assessment of emergency medical countermeasures and diagnostic tools, as well as readiness for manufacturing them, should be an ongoing process. Also, mechanisms for infectious disease, vector-borne and zoonotic disease research and related drug development require investment in computer modeling, in-vitro models, and better animal models. To support these goals, NBSB recommend that incentives should be provided to support private sector innovation. The board also suggests improving the transparency of the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) to increase information sharing among relevant Federal agencies and private sector partners.  The PHEMCE – led by ASPR – consists of coordinated federal preparedness activities and medical countermeasures for natural, accidental, and intentional threats. Federal interoperable capabilities should be ready to be deployed systematically to proactively manage zoonotic and infectious diseases, climate change, supply chain shortages, workforce shortages, and additional threats to health security.

The health workforce is another focus area for achieving readiness and resilience during a public health crisis. The nation’s workforce needs more infectious disease specialists who are the first responders during an outbreak or a pandemic. The NBSB suggested that the training curriculum for health professionals should include disaster preparedness, emergency response, epidemic control, and training to use personal protective equipment. Likewise, first responders and incident commanders would benefit from additional emergency response education related to health threats and disasters. A critical point identified by NBSB is the need to review  Emergency Support Function (ESF)-8 of the National Response Framework which coordinates of public health and medical services in response to a natural disaster, terrorist attack, or other incidents of national significance. Another astute point is the consideration of the need for childcare, eldercare, and pet care to be available for health workers and first responders during disasters.

NBSB also identified health facility readiness and resilience (and the general soundness of healthcare systems) as having room for improvement as well. Some examples of improvements that are desperately needed are stronger health facility cybersecurity, better hospital collaborations for resource sharing (including staff), and planning for weather disasters overlapping with simultaneous health threats. As a lesson learned from COVID-19, telehealth and health license portability should continue post-pandemic. During COVID-19, health appointments could be held remotely online, and health professionals could work outside of their licensed jurisdictions. Since electronic health records are available over the internet, health professionals could see patients from anywhere.  

The NBSB also recommended improving public communication by developing and disseminating “timely, accurate, consistent, and trusted advisories, public health messages, and clinical guidelines” during a health crisis. Clear, consistent scientific messages should not be influenced by political concerns. Their communication recommendation noted that there should be an alignment of information using social media and local organizations. The goal is to provide accurate information to everyone; no one in society should be left out of receiving crisis communications.

The recommendations contained in this report build on previous reports by NBSB on how to “accelerate research and develop goals to prevent infectious diseases disasters.” For example, the May 13, 2020 report, Medical Countermeasure Research and Development Goals to Prevent Infectious Disease Epidemics, recommended nine items for the early detection and identification of pathogens, including early activation of MCM, coordination mechanisms, rapid MCM development pathways, adequate infrastructure and emergency funding – and the management of public trust. Another May 2020 report, Integrating Clinical Disaster Response Training with Community and State-Based Emergency Planning, recommended continued collaborations between clinical practitioners and disaster management authorities. That previous report focused on medical recommendations for healthcare organizations, local health departments, incident commanders, and emergency medical services to improve their capacity for disaster response, recovery, and mitigation.

The NBSB also heard from Dr. Daniel B. Jernigan, Deputy Director for Public Health Science and Surveillance, about the Centers for Disease Control and Prevention (CDC) Data Modernization Initiative. The CDC now has greater capacity to use electronic data and centralized laboratory reporting. They can receive and share massive data through the cloud. The CDC is still aiming for an even more modern, integrated, real-time public health surveillance data.  This initiative involves four core areas for strengthening core surveillance capabilities: 1) syndromic surveillance, 2) electronic case reporting (eCR), 3) electronic laboratory reporting, and 4) vital records. Syndromic surveillance can reveal local symptom trends by comparing hospital and health reports. Dr. Jernigan discussed real-time data surveillance during COVID-19, which used county-level monitoring of COVID-like Illness (CLI). Anomaly detections and syndromic surveillance programs, such as BioSense, are cloud-based.  Electronic case reporting is the real-time automated information exchange of electronic health records between public health agencies. Reporting laboratory results electronically reduces the turn-around time of waiting for results, allowing for faster intervention. Electronic lab reporting existed before COVID-19, but it was not automated or truly robust. Also, having up-to-date information on vital records, such as death certificates, is important for public health decision-making.

The goal of the CDC’s data modernization plan is to collect accurate data, including from non-traditional sources that can forecast health threats, that can be shared easily with partners. Under this model, data would flow through the same data hubs, where a single data upload would inform various partners in a hub and spoke model. Faster access to larger data sets will allow for interoperability and dashboards that inform forecasting and decision-making. Combined data-set platforms can be used to create pandemic dashboards. Timely, high-quality data sharing is now scalable and the process can be used during future outbreaks to reduce the burden of manual reporting. Data standards for electronic data exchange and electronic data linkage, using databases such as the National Notifiable Diseases Surveillance System (NNDSS), will bolster the mapping of notifiable diseases.

Together, the draft report by the NBSB’s All-Hazards Science Response Working Group and the CDC’s data modernization plan can help strengthen public health emergency preparedness and response in the United States so that we can prevent pandemics – and be ready for unknown threats.  

Pandora Report: 6.11.2021

June is National Pet Preparedness Month! The FDA approved a new drug for the treatment of smallpox. The SARS-CoV-2 virus is here to stay.

Pet Preparedness Month

June is National Pet Preparedness Month! Pet parents should include animals in emergency plans: have an evacuation plan, microchip your pet, and develop a buddy system. You can also build a kit for your pet with food, water, medicine, a first aid kit, grooming items, and a photo of you with your pet. As the summer heat sets in, remember to keep your pet hydrated and do not leave them in a hot car. Also, mind hot pavement for their paws!

A new article in Disaster Medicine and Public Health Preparedness explores the evidence regarding the use of trained dogs to detect COVID-19 infections. Detection dogs are a promising non-invasive, efficient, and cost-effective screening method for SARS-CoV-2 infection. Read the article here.

Science & Tech Spotlight: Digital Vaccine Credentials

Digital vaccine credentials can confirm that a person has been vaccinated or tested negative for COVID-19. They can be a tool to reduce the disease’s spread, and allow travel and other activities to resume safely. Users of such credentials can provide their COVID-19 information on a mobile device through a secure, digital code for fast and contactless scanning. Airports and other venues could process larger numbers of people more quickly with these credentials than with paper vaccine cards. However, challenges that may limit the use of these credentials include concerns about the security and privacy of users’ health data. Read the full report from the US Government Accountability Office (GAO) here.  

HHS Launches First Venture Capital Partnership to Develop Transformative Technologies to Combat Future Pandemics, Other Health Emergencies

Through the BARDA Ventures program, the Biomedical Advanced Research and Development Authority (BARDA – part of the HHS Office of the Assistant Secretary for Preparedness and Response – is launching a partnership with the nonprofit organization Global Health Investment Corporation (GHIC) to accelerate development and commercialization of technologies and medical products needed to respond to or prevent public health emergencies, such as pandemics, and other health security threats. Through this partnership, BARDA intends to provide GHIC with a minimum of $50 million over five years with potential for up to $500 million over 10 years. GHIC will launch a global health security fund with matching capital from other investors. This partnership will allow direct linkage with the investment community and establish sustained and long-term efforts to identify, nurture, and commercialize technologies that aid the US in responding effectively to future health security threats.

FDA Approves Drug to Treat Smallpox

The Food and Drug Administration (FDA) approved Tembexa (brincidofovir) to treat smallpox. Though smallpox was eradicated in 1980, there are worries that it could be deployed as a bioweapon. The disease spreads via direct contact among humans and symptoms arise 10-14 days after infection. Symptoms include fever, exhaustion, headache, backache, and the telltale rash consisting of small, pink bumps progressed to pus-filled sores before it crusts over and scars. As an eradicated disease, the efficacy of Tembexa was evaluated in animals infected with viruses that are closely related to the variola virus, and was determined by measuring animals’ survival at the end of the studies. Efficacy and safety were adequate for FDA approval. The most common side effects are diarrhea, nausea, vomiting, and abdominal pain.

Gene Drives Are What’s Next

The next meeting of the Novel and Exceptional Technology and Research Advisory Committee (NExTRAC), a federal advisory committee that provides recommendations to the NIH Director and a public forum for the discussion of the scientific, safety, and ethical issues associated with emerging biotechnologies, will be held on 25 June 2021. The meeting will discuss a Draft Report of the Gene Drives in Biomedical Research Working Group, which was prepared in response to the charge given by the NIH Director at the December 2019 NExTRAC meeting to “consider whether existing biosafety guidance is adequate for contained laboratory research utilizing gene drive technology” and “outline conditions (if any) under which NIH could consider supporting field release of gene drive modified organisms.”

Review of Recounting the Anthrax Attacks

Dr. R. Scott Decker is a retired supervisory special agent for the Federal Bureau of Investigation (FBI) and he published the book, Recounting the Anthrax Attacks: Terror, the Amerithrax Task Force, and the Evolution of Forensics in the FBI. Al Mauroni, director of the US Air Force Center for Strategic Deterrence Studies, wrote a review of the book, dubbing it “a valuable book for understanding how the FBI developed its case for the Amerithrax investigation, not just for the legal community that engages in bioterrorism cases, but for the defense community that engages in the policy aspects of this issue.” The FBI eventually attributed the anthrax attacks to Bruce Ivins, a research scientist working at the Army’s Fort Detrick laboratories. Read the review here.

The Forever Virus: A Strategy for the Long Fight Against COVID-19

The SARS-CoV-2 virus is here to stay. The novel coronavirus cannot be eradicated, because it infects over a dozen different species. Due to vaccine supply shortages and vaccine hesitancy, global herd immunity is “unreachable.” Even if every human on the planet could be vaccinated today, the virus would persist in various animal species. That said, vaccination must remain a primary goal in order to contain the disease. Though many hoped that the virus would be the cause of a short-term crisis, it is proving to be a chronic crisis against a very resilient pathogen. This is, in part, a result of many nations failing to heed the early warning signs and take the threat seriously, allowing grave damage to occur. “As a wealthy, powerful, and scientifically advanced country, the United States is optimally positioned to help lead the long fight against COVID-19.” And, in order to do this, the US must repair its reputation as a global public health leader. Beyond US leadership and support, the entire global framework for pandemic response needs a reboot. A recent report recommends elevating pandemic preparedness and response to the highest levels of the United Nations via the creation of a “global health threats council.” This council would be led by heads of state, separate from the World Health Organization, and “charged with holding countries accountable for containing epidemics.”  

Dr. Rick Bright, Senior Vice President of Pandemic Prevention & Response at The Rockefeller Foundation, is among the contributors of this piece. Bright is also among the distinguished faculty for the upcoming Pandemics and Global Health Security Workshop hosted by the Biodefense Graduate Program.

The “Legal Epidemiology” of Pandemic Control

The centrality of law as a public health intervention has been undeniable during the COVID-19 pandemic. In just the first half of 2020, more than 1,000 laws and orders were issued by federal, state, and local authorities in the United States in an effort to reduce disease transmission. Legal interventions include stay-at-home orders, mask mandates, and travel restrictions, as well as more particular rules for business operations, alcohol sales, curfews, and health care. Given their heavy use, importance, and obvious socioeconomic side effects, and the social and behavioral complexities of their implementation, one might have expected the National Institutes of Health (NIH), other research funders, and the research community to jump to the work of determining the right mix, intensity, and enforcement approaches of legal restrictions to control transmission with the least and most equitably distributed harms. No organized research program emerged. Funding for scientific evaluation of legal effects and public health systems research was paltry, at a time when hundreds of thousands of lives, the socioemotional development of millions of children, and billions of dollars in economic activity directly depended on questions about control measures, enforcement methods, the organization of the health system, and the many ways in which law was immediately influencing vulnerability, resilience, and social behavior. It is past time for a broad recognition in our health system that law is a ubiquitous treatment, one to which hundreds of millions of people are routinely exposed. The imperative is to scale up the infrastructure for at least three kinds of research: study of the mechanisms, effects, side effects, and implementation of laws designed to influence health, such as COVID control measures; research on how the legal infrastructure of the US health system — the allocation of powers and duties, as well as limits on authority — influences the effectiveness of the system; and perhaps most important for addressing health equity, studies of how laws that may appear to have no health purposes — such as the tax code, minimum wage, and labor rules — shape the social determinants of health.

The COVID Lab-Leak Hypothesis: What Scientists Do and Don’t Know

Most scientists say SARS-CoV-2 probably has a natural origin, and was transmitted from an animal to humans. However, a lab leak has not been ruled out, and many are calling for a deeper investigation into the hypothesis that the virus emerged from the Wuhan Institute of Virology (WIV), located in the Chinese city where the first COVID-19 cases were reported. On 26 May, US President Joe Biden tasked the US Intelligence Community to join efforts to find SARS-CoV-2’s origins, whatever they might be, and report back in 90 days. Scientists don’t have enough evidence about the origins of SARS-CoV-2 to rule out the lab-leak hypothesis, or to prove the alternative — that the virus has a natural origin. Many infectious-disease researchers agree that the most probable scenario is that the virus evolved naturally and spread from a bat either directly to a person or through an intermediate animal. Most emerging infectious diseases begin with a spillover from nature, as was seen with HIV, influenza epidemics, Ebola outbreaks and the coronaviruses that caused the SARS epidemic beginning in 2002 and the Middle East respiratory syndrome (MERS) outbreak beginning in 2012. In theory, COVID-19 could have come from a lab in a few ways. Researchers might have collected SARS-CoV-2 from an animal and maintained it in their lab to study, or they might have created it by engineering coronavirus genomes. In these scenarios, a person in the lab might have then been accidentally or deliberately infected by the virus, and then spread it to others — sparking the pandemic. There is currently no clear evidence to back these scenarios, but they aren’t impossible. Read the breakdown of knowns and unknowns here.

Biden Would Slash Pentagon Money for Pandemic Prevention

President Biden proposed halving the Pentagon’s budget for the leading US government program for preventing, detecting, and responding to global disease outbreaks – the Biological Threat Reduction Program. The Biological Threat Reduction Program “finds and fights emerging global diseases that can threaten US troops and, ultimately, the world’s population.” This is a move that “even the White House’s staunchest allies on Capitol Hill oppose as the nation continues to grapple with the COVID-19 pandemic.” The proposed cut arose despite the assessment of US intelligence agencies and scientists that “pandemics will become increasingly common and as COVID-19 still rages in many countries and hangs on in America.” “The US military has been a leader in research and development of coronavirus vaccines and in disseminating them,” and the Pentagon plans to spend $500 million in FY22 on COVID-19 response and preparedness for future pandemics, despite the funding slash.  

COVID-19 Air Traffic Visualization

The RAND Corporation released a report, COVID-19 Air Traffic Visualization: COVID-19 Cases in China Were Likely 37 Times Higher Than Reported in January 2020, which presents strong evidence that China’s reported COVID-19 caseload was undercounted by a factor of nearly 40. In this report — one of several from a RAND Corporation team examining the role of commercial air travel in the coronavirus disease 2019 (COVID-19) pandemic — researchers use RAND’s COVID-19 Air Traffic Visualization (CAT-V) tool to estimate the likely number of infections in China in early 2020. The tool combines COVID-19 case data from Johns Hopkins University with detailed air travel data from the International Air Transport Association. From December 31, 2019, to January 22, 2020, China reported a daily average of 172 cases of COVID-19 among its residents. This number of confirmed cases was equivalent to just one per 8.2 million residents in the country per day. Using the detailed flight data over that same period of time, it was determined that the five countries most at risk of importing COVID-19 from China were, in descending order of risk, Japan, Thailand, South Korea, the United States, and Taiwan. But far fewer than 8.2 million passengers flew from China to the five countries over that 23-day period. Just more than 1 million passengers flew from China to Japan and Thailand each, while slightly more than 750,000 flew to South Korea, 500,000 flew to the United States, and fewer than 400,000 flew to Taiwan (as illustrated in the map below). Thus, all of these passengers from China totaled fewer than 3.7 million, for an expected COVID-19 exportation rate of less than one case to all five of these countries combined. However, COVID-19 cases were already being reported in all five countries during this time. This trend would be exceedingly unlikely given the low reported case count in China. Read the report here.

Why Contact Tracing Couldn’t Keep Up with The US COVID Outbreak

A survey from NPR and the Johns Hopkins Center for Health Security found that many state health departments are “winding down the contact tracing programs they scrambled to grow last year.” Even though coronavirus infections are tapering off in most parts of the country, public health experts recommend maintaining a smaller workforce able to stay on top of ongoing outbreaks. This is a significant change from last winter when the US suffered from a shortage of people to respond and deliver case investigation and contact tracing. Adriane Casalotti of the National Association of County and City Health Officials likened the scramble to find these workers as “trying to build the plane while flying it.” Beyond the lack of personnel, there was an absence of federal leadership and communication from authorities (namely, the Centers for Disease Control and Prevention as well as the White House). Additionally, there did not exist a uniform approach for contact tracing programs. Low responsiveness was another challenge. An analysis of 14 contact tracing programs from June to October 2020 published in JAMA Network Open found that “no contacts were reported for two-thirds of persons with laboratory confirmed COVID-19 because they were either not reached for an interview or were interviewed and named no contacts.” A recent poll by the Harvard TH Chan School of Public Health and the Robert Wood Johnson Foundation found that only 52% of Americans trust the CDC, while the numbers for state and local health departments were even lower. Distrust also inhibited the utility of digital tools for contact tracing. For instance, in Utah, an app called Healthy Together used GPS location for contact tracing, but much of the population was uninterested in using it and unwilling to download it.  

BSL-4 Laboratories

Recently, Dr. Filippa Lentzos of King’s College London & Dr. Greg Koblentz of George Mason University launched GlobalBioLabs.org, an interactive web-based map of global Biosafety Level-4 facilities and biorisk management policies. Lentzos shared that the aim of the project is to “increase public knowledge about Biosafety Level 4 labs, and importantly, to strengthen national and international virus management policies.” Regardless of the origin of SARS-CoV-2, the risk of laboratory accidents and incidents rises as the number of laboratories in the world expands. The new map includes 59 laboratories, the majority of which are in Europe. Only 17 of the 23 countries that house BSL-4 laboratories have national biosafety associations or are members of international partnerships. The primary concern is that an accident could trigger the next pandemic. Watch a recording of the webinar launching the site here.

Pandora Report: 6.4.2021

The Biden administration has released its fiscal year 2022 budget, which includes an increase of almost $1 billion for global health programs. Syrian President Bashar al-Assad remains in power. Register for the upcoming Pandemics and Global Health Security Workshop!

Biden’s FY22 Budget

The Biden administration released its fiscal year 2022 (FY22) budget, which includes an increase of almost $1 billion for global health programs. There is also a section of the budget that provides “discretionary funding for the Centers for Disease Control and Prevention (CDC) — the largest budget authority increase in nearly two decades — to restore capacity at the world’s pre-eminent public health agency.” In regard to the fight to end the COVID-19 pandemic, the budget provides $1 billion in foreign assistance to “establish Global Health Security Agenda capacity building programs in additional nations and increase investments in crosscutting research and viral discovery programs to detect and stamp out future infectious disease outbreaks.” In total, global health security funding is $905 million, a 376% above the FY21 enacted level. Funding for tuberculosis totals $319 million and funding for malaria totals $770 million, both matching the FY21 enacted levels. Funding for neglected tropical diseases totals $103 million, also matching the FY21 enacted level. KFF outlines a detailed comparison of funding for global health efforts between FY22 and FY21 here.

Ahead of the budget release, KFF analyzed the historical trends in US funding for global health, finding that funding through regular appropriations increased by almost $10 billion since FY 2001. Most of this increase is due to the establishment of President’s Emergency Plan For AIDS Relief (PEPFAR), the Global Fund, and the President’s Malaria Initiative. Over the last decade, the US has offered nearly $12 billion in emergency supplemental funding for infectious diseases, but  90% of that funding was provided in the last year in response to the COVID-19 pandemic.

‘A Perilous Point’: Global Agencies Call for $50 Billion Investment to Combat COVID-19

A statement from the World Health Organization (WHO), the World Bank, the World Trade Organization (WTO), and the International Monetary Fund (IMF) urges investment of up to $50 billion to “boost manufacturing capacity and supplies and ease trade rules to ensure equitable distribution of vaccines and other medical products.” Additional funding to COVAX, the global vaccine distribution initiative, “could be widened to 40% and, possibly 60% by the first half of 2022.” COVAX has administered nearly 2.4 billion doses across 92 low and middle-income countries. But, an additional $8.3 billion is needed as the current resources would only cover about 30% of their populations through early 2022. According to an IMF analysis, “added investment could generate an estimated $9 trillion in additional global output by 2025.”

It’s No Joke: Borat Turns to Johns Hopkins Scientist for Serious COVID Vaccine Talk

Dr. Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, shares her vaccine expertise for British comedian Sacha Baron Cohen’s latest moviefilm. One of the topics Nuzzo addressed was the conspiracy theory that the COVID-19 vaccines are being used as vehicles to insert microchips into people. She clarifies, “a microchip wouldn’t fit through the tiny needle used to inject COVID-19 vaccines.” Nuzzo is among the distinguished faculty for the upcoming Pandemics and Global Health Security Workshop hosted by the Biodefense Graduate Program.

Operation Warp Speed and Beyond Toolkit

The Operation Warp Speed and Beyond Toolkit has been developed for cleared and uncleared industry partners working on Operation Warp Speed (OWS). It provides OWS partners with the resources they need to better protect the important work they are doing. While some of these resources were developed with cleared contractors participating in the National Industrial Security Program (NISP) in mind, the guidance and information provided apply to any industry partner working on sensitive information that is sought after by an adversary, regardless of classification level or designation.

On September 10, 2020, Operation Warp Speed industry partners were invited to participate in a webinar that provided an overview of insider risk, cybersecurity, counterintelligence threats, and industrial security best practices. In case you were unable to attend the live webinar, you may view a recording of the webinar here.

WHA74: Strengthen Global Preparedness for Health Emergencies

The 74th World Health Assembly (WHA) concluded on 31 May, and it focused on ending the COVID-19 pandemic and how to prevent the next one. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), called for beginning negotiations this year on an international treaty to enhance pandemic preparedness. Though such a treaty was not adopted at this year’s WHA, member states agreed to create a working group that would look at the benefits of a treaty, a convention, or an international agreement. In late November, the ministers from the WHO’s 194 member states are set to convene and decide whether or not to start such negotiations. To the dismay of many, the WHA did not adequately consider a very current and critical topic: “a plan to vaccinate the world and end vaccine inequity.” No resolution or strategy was put forward to achieve global equitable vaccination. Thomas Schwartz, executive secretary of Medicus Mundi International, stated, “Unfortunately, the WHA is still not [a] place for member state[s] to be challenged, and the full transparency, with all sessions being live webcast, does not provide the setup for critical self-reflection.” On a better note, the WHA did pass two resolutions “advocating for government support for the Gender Equal Health and Care Workforce Initiative to address gender inequities in the health and care workforce.”

One for All: An Updated Action Plan for Global COVID-19 Vaccination

The Rockefeller Foundation released a new report, One for All: An Updated Action Plan for Global Covid-19 Vaccination, that calls on the “G7 and other donors to step up so that COVAX closes its US$9.3 billion funding gap by June 2nd, allowing it to unlock an additional 1.8 billion doses of vaccine, enabling 92 low- and middle-income countries to vaccinate half their adult population.” The lack of equitable vaccine distribution leaves much of the global population unvaccinated, posing a threat to ending the pandemic. Thus far, about half of North Americans and over one-quarter of Europeans have been vaccinated, but only about 14% of South Americans, 5% of Asians, and 1.2% of Africans. Further, 80% of vaccines have been administered in high- and upper-middle income countries, leaving low-income countries vulnerable and unprotected. The report provides a 5-point action plan to scale equitable vaccination around the world: (1) share more sooner; (2) make more quicker; (3) build in the global South; (4) support delivery systems; and (5) close the financing gap. Dr. Rick Bright, Senior Vice President of Pandemic Prevention & Response at The Rockefeller Foundation, is among the contributors of this report. Bright is also among the distinguished faculty for the upcoming Pandemics and Global Health Security Workshop hosted by the Biodefense Graduate Program. Read the report here.

Event – Pandemics and Global Health Security Workshop

COVID-19 has exposed just how unprepared governments, corporations, and societies are for a global pandemic. While the SARS-CoV-2 virus is only the most recent threat to global health security, it will certainly not be the last. Threats to global health security continue to evolve due to the emergence of new infectious diseases, globalization, advances in science and technology, and the changing nature of conflict. Pandemics and Global Health Security is a three-day virtual, non-credit workshop designed to introduce participants to the challenges facing the world at the intersection of pandemic preparedness and response, public health, national security, and the life sciences. Over the course of three days, participants will discuss how the biology and epidemiology of SARS-CoV-2 contributed to the emergence of that virus as a global pandemic, lessons learned from Operation Warp Speed about the development of medical countermeasures, obstacles to hospital biopreparedness, challenges to science communication during a pandemic, the bioethics of resource allocation during a public health emergency, the future of global health security, and the role of science and technology in preventing and responding to pandemics. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved in research and policy-making on public health, biodefense, and security issues. Live, interactive sessions will include Dr. Rick Bright, The Rockefeller Foundation; Dr. Nicholas G. Evans, University of Massachusetts-Lowell; Dr. Andrew Kilianski, Department of Defense; Dr. Gregory D. Koblentz, George Mason University; Dr. Jennifer Nuzzo, Johns Hopkins Center for Health Security; Dr. Saskia Popescu, George Mason University; Dr. Angela L. Rasmussen, Vaccine and Infectious Disease Organization-International Vaccine Centre; and Jessica Malaty Rivera, COVID Tracking Project. The workshop is organized by the Biodefense Graduate Program at the Schar School of Policy and Government at George Mason University and will be held virtually on July 19-21, 2021. Each day will run from 9am to 12:30pm ET. Prior to June 18, the course fee is $400. Starting June 18, the course fee is $500. Register here.

The Assad Regime Continues

On Wednesday, Syrian President Bashar al-Assad voted to extend his rule, “casting his ballot in an ex-rebel bastion where a suspected chemical weapons attack in 2018 prompted Western air strikes.” Syria has been in a decade-long conflict that has killed hundreds of thousands of people and forced half of the country’s population from their homes, all under Assad’s regime. The election was held despite a peace process led by the United Nations that called for voting under international supervision. Unfortunately, this week’s vote will allow Assad seven more years in power, extending his family’s rule to nearly 60 years.

Last month, the members of the Chemical Weapons Convention (CWC) voted to suspend Syria’s rights and privileges under the treaty. The CWC prohibits the use, production, and stockpiling of chemical weapons. The suspension is a “modest step” toward holding Syria accountable for its chemical weapons attacks and reinforcing the global prohibition against chemical weapons use. In 2013, Syrian forces deployed nerve gas on neighborhoods near Damascus, killing about 1,300 people. Unfortunately, the international responses to Syria’s atrocities have been lackluster. Despite the latest vote, the “Assad regime could continue to maintain, expand, and employ its illegal chemical weapons arsenal as a terror weapon against opposition forces and civilians.” A possible next step in the event that Syria does not comply with the CWC is to refer Syria to the UN Security Council (UNSC). Another option would be to “demand a challenge inspection in Syria pursuant to Article IX of the CWC to clarify outstanding inconsistencies with its stockpile declaration.”

WHO Gives Virus Variants New Names, Drawing from Greek Alphabet

The World Health Organization (WHO) has established a less technical method for naming the new variants of the novel coronavirus using the Greek alphabet. For example, B.1.1.7 is now Alpha. The tables below crafted by Bloomberg shows the new names for the variants of concern and the variants of interest.

Fall 2021 Courses in the Biodefense Graduate Program

If you are a Schar School student looking for another interesting class to take this fall, the Biodefense Graduate Program is offering two fascinating courses: Global Food Security (BIOD 726) with Philip Thomas and Building Health System Resilience (BIOD 610) with Dr. Saskia Popescu.

Global Food Security (BIOD 726) analyzes threats to food security globally including those related to climate change and environmental degradation; animal and plant diseases; access to clean water; agricultural terrorism; and antimicrobial resistance. It explores the national and global health, economic, social, and ethical impacts of these disruptive forces. The course also examines strategies for enhancing the security of the global food production and supply system.

Building Health System Resilience (BIOD 610) will provide students with a foundation in how healthcare systems prepare and respond to pandemics, disasters, and biological events. The ability of healthcare systems to respond to biological threats will have impacts at the community, national, and international levels. Health resilience in the United States is a particular challenge given multiple stakeholders, economic factors, and regulatory fragmentation. Students will review case studies, such as Ebola, Hurricane Katrina, 9/11, and COVID-19, to examine the unique challenges of building and sustaining the resilience of the American healthcare and its role in global health security.

Schar School Open House

You’re invited to attend a virtual open house to learn more about the Schar School of Policy and Government and our academic programs. The online session will provide an overview of our master’s degree programs and graduate certificate programs, student services, and admissions requirements. Attendees will be provided with an application fee waiver for the Fall 2021 graduate application. Biodefense applicants are eligible for funding from the Diane Davis Spencer Foundation Scholarship. The fall application deadline is July 15th. The Open House will be held virtually on 9 June at 6 PM EST. Register here.

BSL-4 Laboratories

Last week, Dr. Filippa Lentzos of King’s College London & Dr. Greg Koblentz of George Mason University launched GlobalBioLabs.org, an interactive web-based map of global Biosafety Level-4 facilities and biorisk management policies. Lentzos shared that the aim of the project is to “increase public knowledge about Biosafety Level 4 labs, and importantly, to strengthen national and international virus management policies.” Regardless of the origin of SARS-CoV-2, the risk of laboratory accidents rises as the number of laboratories in the world expands. The new map includes 59 laboratories, the majority of which are in Europe. Only 17 of the 23 countries that house BSL-4 laboratories have national biosafety associations or are members of international partnerships. The primary concern is that an accident could trigger the next pandemic.

Pandora Report: 5.28.2021

The 74th World Health Assembly is underway in Geneva; you can watch the webcast here! Listen here as Dr. Saskia Popescu, an assistant professor in the Biodefense Graduate Program as well as an alumna, will be interviewed on the With Good Reason podcast today, 28 May. The lab leak theory for the origin of COVID-19 is gaining traction.

Schar School Open House

You’re invited to attend a virtual open house to learn more about the Schar School of Policy and Government and our academic programs. The online session will provide an overview of our master’s degree programs and graduate certificate programs, student services, and admissions requirements. Attendees will be provided with an application fee waiver for the Fall 2021 graduate application. Biodefense applicants are eligible for funding from the Diane Davis Spencer Foundation Scholarship. The fall application deadline is July 15th. The Open House will be held virtually on 9 June at 6 PM EST. Register here.

74th World Health Assembly

The 74th World Health Assembly (WHA) is underway until 1 June, and it is taking place virtually. The WHA is the decision-making body of World Health Organization (WHO), and it is attended by delegations from all WHO Member States. The primary functions of the WHA are to determine the policies of the WHO, appoint the Director-General, supervise financial policies, and review and approve the proposed budget. The theme of this year’s meeting is, “Ending this pandemic, preventing the next: building together a healthier, safer and fairer world.” On Monday, United Nations Secretary-General Antonio Guterres called for the “application of wartime logic in the international battle against COVID-19.” Guterres explains the pandemic as being “at war with the virus.” WHO Director-General Tedros Adhanom Ghebreyesus lamented the “scandalous inequity” of vaccine distribution that is perpetuating the pandemic. Though COVID-19 is the main topic of this year, other issues include proposals for WHO reforms and the exclusion of Taiwan. Taiwan maintains hope that it will be granted a seat at the WHA meeting. The nation’s successful handling of COVID-19 for more than a year and a half has brought renewed attention to Taiwan’s absence from the WHA.”

MCMi Program Update on FDA

The Food and Drug Administration (FDA) plays a critical role in protecting the United States from chemical, biological, radiological, nuclear, and emerging infectious disease threats. The FDA ensures that medical countermeasures (MCMs)—including drugs, vaccines and diagnostic tests—to counter these threats are safe, effective, and secure. The FDA works closely with interagency partners through the US Department of Health and Human Services (HHS) Public Health Emergency Medical Countermeasures Enterprise (PHEMCE, or Enterprise) to build and sustain the MCM programs necessary to effectively respond to public health emergencies. The FDA also works closely with the US Department of Defense (DoD) to facilitate the development and availability of MCMs to support the unique needs of American military personnel. The Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA), requires the FDA to issue an annual report detailing its medical countermeasure activities. This report responds to that requirement for the latest fiscal year available. The FY 2020 report includes a snapshot of the Agency’s COVID-19 response efforts through September 30, 2020. Read the report here.

DHS Exploring New Methods to Replace BioWatch and Could Benefit from Additional Guidance

The Department of Homeland Security (DHS) is following the agency’s acquisition policy and guidance to acquire Biological Detection for the 21st Century (BD21). This system-of-systems concept—an assembly of technologies to gain higher functionality—is intended to combine various technologies, such as biological sensors, data analytics, anomaly detection tools, collectors, and field screening devices to enable timelier and more efficient detection of an aerosolized attack involving a biological agent than the current biodetection system. The BD21 program is early in the acquisition lifecycle and DHS has not yet selected the technologies to be used. Potential technologies are still being analyzed to demonstrate that certain components of the overall concept are feasible, such as an anomaly detection algorithm.

However, BD21 faces technical challenges due to inherent limitations in the technologies and uncertainties with combining technologies for use in biodetection. For example, biological aerosol sensors that monitor the air are to provide data on biological material in the environment, but common environmental material such as pollen, soil, and diesel exhaust can emit a signal in the same range as a biological threat agent, thereby increasing false alarm rates. Program officials report that the risk of false alarms produced by biological sensor technologies could be reduced by using an anomaly detection algorithm in addition to the sensor. However, it is too early to determine whether integration of an anomaly detection algorithm will successfully mitigate the false alarm rate. Specifically, because the algorithms have never been developed and used for the purpose of biodetection in an urban, civilian environment.

BD21 program is following the agency’s acquisition policy and guidance to mitigate technological risks in acquisition programs, and plans to conduct technology readiness assessments (TRA) along the way. In 2020, DHS issued a TRA guide, but it lacked detailed information about how the department will ensure objectivity and independence, among other important best practices GAO has identified. If DHS follows GAO’s best practices guide, decision makers and program managers will be in a better position to make informed decisions at key acquisition decision events. Read the report here.

The Eroding Norms Against Chemical Weapons Use Will Need More Than Another Syria Censure to Survive

Last month, the members of the Chemical Weapons Convention (CWC) voted to suspend Syria’s rights and privileges under the treaty. The CWC prohibits the use, production, and stockpiling of chemical weapons. The suspension is a “modest step” toward holding Syria accountable for its chemical weapons attacks and reinforcing the global norm of prohibition against chemical weapons use. In 2013, Syrian forces deployed nerve gas on neighborhoods near Damascus, killing about 1,300 people. Unfortunately, the international responses to Syria’s atrocities have been lackluster. Despite the latest vote, the “Assad regime could continue to maintain, expand, and employ its illegal chemical weapons arsenal as a terror weapon against opposition forces and civilians.” A possible next step in the event that Syria does not comply with the CWC is to refer Syria to the UN Security Council (UNSC). Another option would be to “demand a challenge inspection in Syria pursuant to Article IX of the CWC to clarify outstanding inconsistencies with its stockpile declaration.”

Will Biden Blink Over Navalny?

This week, Jen Psaki, the White House Press Secretary, announced that President Biden and Russian President Putin will meet in Geneva, Switzerland on 16 June. This highly anticipated meeting comes as relations between the US and Russia plummet to a historic low since the Cold War. The US is compelled to respond to the use of chemical weapons as a result of the first round of sanctions under the Chemical and Biological Weapons Control and Warfare Elimination Act. This first set of penalties was in response to the Novichok attack on Alexei Navalny, and included “personal sanctions on seven senior Russian officials believed to have been involved in the decision to poison and later imprison the opposition leader, who was arrested upon his return to Moscow in January, as well as penalties on several entities involved in Russia’s chemical weapons program.” Thus far, Russia has not made any effort to signal its intent to not use these weapons again, so a second round of sanctions is required by law. The administration hopes that the upcoming meeting will “restore predictability and stability to the US-Russia relationship.” The Biden administration must tread carefully, however, as severe sanctions before the summit could derail the interaction but overly mild sanctions could be perceived as “too soft.” Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, explains, “There’s a tension between wanting to punish Russia for its use of chemical weapons but, at the same time, allowing for the relationship to improve between the countries on strategic issues.”

Launch of GlobalBioLabs.org

GlobalBioLabs.org has officially launched! This is an interactive web-based map of global Biosafety Level-4 facilities and biorisk management policies. An accompanying policy brief, entitled Mapping Maximum Biological Containment Labs Globally, was also released. This brief is offered by Dr. Filippa Lentzos of King’s College London & Dr. Greg Koblentz of George Mason University. The map is available here and the report is available here.

COVID-19 Lab Leak Theory

On Wednesday, President Biden implored the US intelligence community to “redouble their efforts” in determining the origin of SARS-CoV-2. This is an about-face from the previous reliance on the World Health Organization to investigate the origins of the pandemic. This is a shift from the assessment that the novel coronavirus emerged naturally, jumping from an animal species to humans. The theory that the virus may have escaped from the Wuhan Institute of Virology in China is gaining traction, but is far from conclusive. The Adminsitration’s message follows a letter from 18 prominent biologists published in the journal Science that calls for a new investigation into all conceivable origins of the novel coronavirus, and implores Chinese laboratories and agencies to “open their records” for independent analysis. They write:

“As scientists with relevant expertise, we agree with the WHO director-general, the United States and 13 other countries, and the European Union that greater clarity about the origins of this pandemic is necessary and feasible to achieve. We must take hypotheses about both natural and laboratory spillovers seriously until we have sufficient data. A proper investigation should be transparent, objective, data-driven, inclusive of broad expertise, subject to independent oversight, and responsibly managed to minimize the impact of conflicts of interest. Public health agencies and research laboratories alike need to open their records to the public. Investigators should document the veracity and provenance of data from which analyses are conducted and conclusions drawn, so that analyses are reproducible by independent experts.”

On the other hand, many researchers find the tone of growing demands for an investigation to be “unsettling.” There are worries that the “volatility of the debate could thwart efforts to study the virus’s origins.” These demands are also exacerbating existing tensions between the US and China, an unfortunate development with crucial meetings about curbing the pandemic and preparing for future health emergencies underway and upcoming. Global health policy experts assert that it is critical for the world to “work together to curb the pandemic and prepare the world for future outbreaks.” Actions needed immediately include the expansion of vaccine distribution and the reform of biosecurity rules, such as standards for reporting virus-surveillance data.

Event – Pandemics and Global Health Security Workshop

COVID-19 has exposed just how unprepared governments, corporations, and societies are for a global pandemic. While the SARS-CoV-2 virus is only the most recent threat to global health security, it will certainly not be the last. Threats to global health security continue to evolve due to the emergence of new infectious diseases, globalization, advances in science and technology, and the changing nature of conflict. Pandemics and Global Health Security is a three-day virtual, non-credit workshop designed to introduce participants to the challenges facing the world at the intersection of pandemic preparedness and response, public health, national security, and the life sciences. Over the course of three days, participants will discuss how the biology and epidemiology of SARS-CoV-2 contributed to the emergence of that virus as a global pandemic, lessons learned from Operation Warp Speed about the development of medical countermeasures, obstacles to hospital biopreparedness, challenges to science communication during a pandemic, the bioethics of resource allocation during a public health emergency, the future of global health security, and the role of science and technology in preventing and responding to pandemics. The workshop faculty are internationally recognized experts from the government, private sector, and academia who have been extensively involved in research and policy-making on public health, biodefense, and security issues. Live, interactive sessions will include Dr. Rick Bright, The Rockefeller Foundation; Dr. Nicholas G. Evans, University of Massachusetts-Lowell; Dr. Andrew Kilianski, Department of Defense; Dr. Gregory D. Koblentz, George Mason University; Dr. Jennifer Nuzzo, Johns Hopkins Center for Health Security; Dr. Saskia Popescu, George Mason University; Dr. Angela L. Rasmussen, Vaccine and Infectious Disease Organization-International Vaccine Centre; and Jessica Malaty Rivera, COVID Tracking Project. The workshop is organized by the Biodefense Graduate Program at the Schar School of Policy and Government at George Mason University and will be held virtually on July 19-21, 2021. Each day will run from 9am to 12:30pm ET. Prior to June 18, the course fee is $400. Starting June 18, the course fee is $500. Register here.