Pandora Report: 5.1.2020

Launching The Coronavirus Chronicles 
It has been three months since the World Health Organization declared that the novel coronavirus now known as SARS-CoV-2 posed a public health emergency of international concern. Not since the “Spanish Flu” of 1918 has the world experienced a pandemic of the scope and severity caused by the SARS-CoV-2 coronavirus. Since SARS-CoV-2 first emerged, the faculty, students, and alumni of the Biodefense Graduate Program at the Schar School of Policy and Government have been working on the front lines, behind the scenes, and on the home front to respond to this unprecedented pandemic. After we heard some amazing stories from Biodefense students and alumni about how the COVID-19 pandemic had presented new personal and professional challenges and how they had been able to contribute, in ways large and small, to the pandemic response, the editors of The Pandora Report decided that these stories needed a wider audience. The Coronavirus Chronicles is a collection of stories, based on the personal and professional experiences of the faculty, students, and alumni of the Biodefense Graduate Program, about life during the pandemic. We hope these stories help the public better understand the challenges posed by COVID-19 and how current and former members of the Biodefense Graduate Program have responded to these challenges and contributed to the pandemic response at the local, national, and international levels. The first installment of The Coronavirus Chronicles features three stories by Biodefense students and alumni. Biodefense PhD alumna Jennifer Osetek explains how she juggles multiple roles from working for the Coast Guard to teaching public health emergency preparedness to being a mom and Saskia Popescu discusses the challenges of infection prevention on the frontlines in hospitals. Finally, master’s student Madeline Roty highlights the importance of protecting your mental health as well as your physical health during the pandemic. New stories will be added to The Coronavirus Chronicles on a regular basis and new installments will be featured in future issues of The Pandora Report. If you are a student or alumni of the Biodefense Graduate Program and would like to contribute a story, please email us at biodefense@gmu.edu.

In Memoriam – Julian Robinson
The CBW world got a bit dimmer with the loss of Julian Perry Robinson on April 22. Julian was an avid researcher and contributor to the world of CBW nonproliferation, inspiring generations to study and work in biodefense. “A chemist and lawyer by training, Julian was a member of the SIPRI research staff during 1968–71 and the focal point of the work on CBW, which included the excellent six-volume series of books The Problem of Chemical and Biological Warfare (1971–76). During this period he was also responsible for groundbreaking reports on CBW issues published by the UN Secretary-General and the World Health Organization.  All of these provided essential inputs into the negotiation of the Biological Weapons Convention which was opened for signature in 1972.”

Health Security Articles by Our Editorial Team
The latest issue of Health Security includes two articles by the Pandora Report’s managing editor Saskia Popescu and associate editor Rachel-Paige Casey. Both articles can be found here. Popescu co-authored the article “Restricted and Uncontained: Health Considerations in the Event of Loss of Containment During the Restricted Earth Return of Extraterrestrial Samples” with Betsy Pugel and Syra Madad. Currently, the scope of a satisfactory public health response to the release of biological material is limited to biological vectors with known pathogenicity and virulence; however, the scope should be expanded to include the release of biological material with unknown pathogenicity and virulence. The recent return of extraterrestrial samples from Mars, a planet which may harbor life, instigates the renewed framing of a public health response, particularly for an accidental release of a such novel and mystifying material. The article poses a set of question relating to the initial public health and healthcare response in the event that extraterrestrial samples are accidentally released from failures in biological containment mechanisms. These questions ask how the public health community prepares for such an event; what can be done to confine, decontaminate, and collect the material; and how will the public be prepared. Casey co-authored the article “Conflict and Cholera: Yemen’s Man-Made Public Health Crisis and the Global Implications of Weaponizing Health” with Christine Crudo Blackburn and Paul E. Lenze, Jr. The 2016-17 cholera epidemic in Yemen was, prior to COVID-19, the largest disease outbreak in modern history. Conservative estimates found that the number of suspected cases exceeded 1 million and, within the first 8 months of the outbreak, there were over 2,000 confirmed deaths. Although cholera is an ancient disease that continues to plague many countries, Yemen’s outbreak had several unique features. The outbreak, which disseminated at an unprecedented pace, was directly linked to the country’s ongoing armed conflict. This article assesses what the cholera outbreak in Yemen reveals about the connection between infectious disease and conflict, the targeting of healthcare infrastructure as a modern warfare tactic, and the implications of a strategy of infrastructure destruction have for global health security.

Spore Wars
The COVID-19 pandemic has increased fears of both another naturally-occurring disease event and a bioweapons attack. The Trump administration released a National Biodefense Strategy in 2018, but it also dismantled directorate of the National Security Council that focused on health security and biodefense, and it proposed budget cuts to the laboratory network that tests for biological threats. between FY2015 and FY2019, funding for civilian biosecurity dropped 27% to a number $1.61 billion lower than the bill for buying Black Hawk helicopters. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, spoke to how the pandemic has, frighteningly, showcased that the US public health infrastructure is comprehensive broken or overtaxed. In other words, we have now exposed a critical vulnerability that may be provide incentive for a bioterrorist. This vulnerability extends beyond public health and the beyond the US borders; the US and global economy may now have targets on their backs.

The Saga Continues: Disinformation and Conspiracy Theories about the Origins of COVID-19
As the COVID-19 pandemic continues and the nations of the world still struggle to stop the spread and protect their people and economies, the desire for a boogie man persists. Conspiracy theories abound about the suspected surreptitious origins of the SARS-CoV-2 virus that plagues the world. Despite a bevy of experts denying the possibility that the coronavirus is the result of biological warfare and genetic analyses showing that this virus is not human-made, the shoddy hypothesis has a following of believers. In the Washington Post, Dan Kaszeta, a specialist in chemical and biological defense, provides further insight into the illegitimacy of the theories that the pandemic is the product biological warfare. Beyond the lack of evidence of human tampering, the inducement of a pandemic threatens the safety and security of the perpetrator’s own people, thereby disincentivizing the release of a pandemic-inducing bioweapon. There is no therapeutic or vaccine against this coronavirus that would engender protection of one’s own or a friendly population to the releaser. Further, the spread of disinformation relating to the pandemic is now being coined as a concurrent “infodemic.” One of the newest conspiracy theories is that the 5G network either transmits the coronavirus directly or weakens the immune system to imbue susceptibility to the virus. What will be tomorrow’s half-baked coronavirus conspiracy hoax?

Special Issue of Intelligence and National Security
The Journal of Intelligence and National Security released a Special Issue on Global Health Security, introduced with an article by Filippa Lentzos (a friend of GMU Biodefense), Michael Goodman, and James Wilson. Their article provides an overview of the health security threat spectrum: deliberate disease outbreaks, emerging infectious diseases and natural disease outbreaks at the other, and accidental disease events created by the significant scientific advances in the abilities to modify genes and microorganisms. Additionally, it traces how the perceptions about biological and health security threats have changed and expanded with outbreaks of naturally-occurring diseases, recognition of the unintended consequences of research, laboratory accidents, negligence, and emerging technologies. The authors argue that the traditional intelligence community must better engage with non-IS stakeholders and broaden its cadre to include new sources of intelligence in order to strengthen global health security and health intelligence. The Special Issue is an effort to encourage the development of a “multidisciplinary, empirically-informed, and policy-relevant approach to intelligence-academia engagement in global health security that serves both the intelligence community and scholars from a broad range of disciplines.” Read the full article here and all the articles in this Special Issue are open access.

COVID-19 MCM Update
The latest scientific study findings of potential COVID-19 therapeutics are a mixed bag of good news and bad news. Gilead’s remdesivir, an antiviral drug developed to treat hepatitis C and Ebola virus disease, shows no benefit to coronavirus patients according to a clinical trial conducted in China. This finding was accidentally revealed, but additional studies on the effects of remdesivir for coronavirus patients await their own conclusions. Conversely, Dr. Anthony Fauci, the top infectious disease expert for the US government, recently stated that data from another clinical trial is showing a positive effect from remdesivir in cutting a patient’s time to recovery. GEN’s list of front-runners for therapeutics and vaccines against COVID-19 currently includes 19 candidates; remdesivir remains on that list. In encouraging news, the COVID-19 pandemic has underscored the argument for supporting the development of a panviral drug. A panviral drug works broadly within or across viral families to incapacitate them. Such a drug is extraordinarily difficult to design because viruses hijack a host’s cellular machinery to survive and propagate; however, targeting a virus’s functions in a host cell may also negatively impact that cell’s normal function. Fortunately, researchers are starting to discover ways around that problem by refining which processes an antiviral drug targets.

The Trump Effect – International Institutions
From UNESCO to the Human Rights Council, and now the WHO, President Trump isn’t much of a fan of international institutions. “Global institutions are supposed to help facilitate cooperation during crises, but this time they’ve left nations to their own devices. That’s a departure from the past, and many experts suggest that it’s largely driven by the U.S.’s absence. ‘This makes the U.S. weaker, not stronger,‘ said Greg Koblentz, an associate professor at the Schar School of Policy and Government at George Mason University. ‘This will either lead other countries to try and use these crises to push their own agendas, or everyone will be on their own and you’re going to get a zero-sum competition among countries competing for scarce resources and hording supplies and not sharing data, because the mechanisms for facilitating cooperation and burden sharing and information sharing will have fallen apart’.” Since the news of President Trump’s plans to halt U.S. funding to the WHO, many have pointed out that his frustrations with the international institution aren’t excuses for why the U.S. has performed so poorly in responding to COVID-19. Jeremy Konyndyk noted “First off, the decision to pause funding to the organization that is coordinating the global fight against a pandemic in the middle of a pandemic is hugely damaging. If they do move forward with fully cutting off funding, that doesn’t just disrupt COVID response; it disrupts a lot of different things the U.S. government relies on WHO to do, like polio eradication, or cholera in Yemen, or extinguishing the Ebola outbreak in eastern Congo.”

The Right Way to Reopen the Economy According to GMU’s Pearlstein
Steven Pearlstein, a GMU Schar School professor and Pulitzer Prize-winning business and economics columnist, briefly outlined his recommendations on reopening the US economy. The upshot of Gerstein’s article is that getting Americans back to work after the coronavirus lockdown should not be a politicized process, but one that focuses on protecting Americans while restarting the US economy. The sooner we can safely return to normal life, the better. He outlines several general principles for reopening the economy, but points out that decisions and policies should be tailor-made to a region, industry, or institution to maximize success. For instance, regarding special funding programs, workers should be prioritized over investors and low-wage workers should be prioritized over high-wage workers. In general, lenders can afford to wait for their money, whereas workers and suppliers cannot. Given that a large chunk of white-collar workers can work from home but many blue-collar workers lack that luxury, low-wage workers should be the first to receive help as they are more likely to have lost most, if not all, of their income under the social distancing measures. No matter what decisions are made, tradeoffs are inevitable. There is no perfect solution without some hiccups or shortcomings. So, the key question is how do we reopen in a way that minimizes costs and risks to public health?

Preventing CBW Proliferation In the Age of COVID-19
How are the OPCW, BCW, and 1540 committees working to combat biological and chemical weapons during the pandemic? Richard Cupitt, Senior Fellow and Director of the Partnerships in Proliferation Prevention program at Stimson and Adjunct Faculty at GMU Biodefense, has provided a review of how each nonproliferation organization is working during this time. Cupitt notes of the BWC, “Not surprisingly, many national governments have entertained the need to adopt and implement the BWC and contribute to its strengthening.  And the requests for assistance have increased enormously according to several sources (although which requests, if any, that have gone to the BWC is confidential).” He emphasizes that for those like the OPCW, adjustments have been made to work remotely while maintaining a critical presence. Moreover, the economic recession will likely mean cuts to the budgets of many nations, which could impact the financial obligations of States parties to these international organizations.

Opportunity to support CBRN Research: The University of Maryland’s Integrated Discovery of Emerging and Novel Technologies (IDENT) Project Team Invites You to Join 
GMU Biodefense MS alum Alexandra Williams, Junior Researcher at the Unconventional Weapons Technology Division of the National Consortium for the Study of Terrorism and Responses to Terrorism (START) at UMD, is the co-research lead for the IDENT project and is inviting you to join. “This project has allowed me to apply the knowledge and experience I gained at GMU to conduct hands-on biodefense research and support US government CBRN mission space.” The IDENT Project seeks to develop a repeatable and scalable process for the discovery of emerging or disruptive technologies that may impact the Countering Weapons of Mass Destruction (CWMD) mission space. The project is sponsored by the Defense Threat Reduction Agency (DTRA) and is being designed and implemented by an interdisciplinary research team from the University of Maryland, ABS Consulting Group (ABSG), and the University at Albany (State University of New York). The IDENT Project team would like to invite rising and leading experts in the fields of biological and chemical defense to participate in the IDENT Knowledge Hub. The Knowledge Hub, a core component of the IDENT system, is a distributed, collaborative online software platform that includes broad horizon scanning and iterative-structured elicitation functionalities. The platform is also designed to incorporate additional expertise as needed through brief semi-structured probing interviews. If you would like to join the network of experts participating in the Knowledge Hub, refer a colleague, a fellow classmate, or would like more information about this effort, please reach out to Ms. Salma Bouziani at Bouziani@umd.edu and we are happy to provide you with any additional information.

Epic Fail: Why the US Wasn’t Prepared for the Coronavirus Pandemic
Daniel Gerstein, a graduate of the Biodefense PhD program and a senior policy researcher at the RAND Corporation, published an article in the Bulletin of the Atomic Scientists about why the US was not prepared for the coronavirus pandemic. The current administration largely failed to arrange a strong and timely response to COVID-19. The factors in this epic failure include, but are not limited to, inadequate biosurveillance systems, a disjointed emergency response network, and poor management of supply chain disruptions. Gerstein encourages a makeover for the emergency response system that lowers reliance on the federal government for a quick and effective response to outbreaks. In fact, certain state governments are already forming pacts to coordinate their responses to the outbreak and, perhaps, bypass the federal government. The pandemic has exposed the fissures in the national preparedness and response systems, which will require reconfiguring by relearning the lessons of crisis response and emergency management. Read Gerstein’s full article here.

Pandemic Pets?
First it was a sick tiger and now a new study from the CDC has reported that two pet cats living in separate ares of New York State have tested positive for SARS-CoV-2. “In the NY cases announced today, a veterinarian tested the first cat after it showed mild respiratory signs. No individuals in the household were confirmed to be ill with COVID-19. The virus may have been transmitted to this cat by mildly ill or asymptomatic household members or through contact with an infected person outside its home.Samples from the second cat were taken after it showed signs of respiratory illness. The owner of the cat tested positive for COVID-19 prior to the cat showing signs. Another cat in the household has shown no signs of illness.” No word on if hairballs are considered fomites…

News of the Weird
Got chickens? You’re in good shape against COVID-19 according to a Swedish city. The city of Lund is “spreading chicken manure in its central park in an effort to deter crowds gathering for a festival. Tens of thousands of people usually descend on southern city to celebrate Walpurgis Night, which is marked across Scandinavia. But officials want to keep people away because of the coronavirus outbreak. There is no lockdown in Sweden, where data show most people have taken to voluntary social distancing.” For residents of Lund, they have emphasized that with the stench of chicken manure, who would want to sit and have a beer?

Pandora Report: 4.24.2020

Summer Workshop Cancellation
We are so grateful for all the interest in the workshop over the years, but regretfully have decided to cancel the 2020 workshop due to the ongoing COVID-19 pandemic. In the interest of public health, George Mason University has cancelled all on-campus events through mid-August. We hope you and your family stay healthy and safe. If you are working on the response to COVID-19, we would like to thank you for your hard work and dedication to global health security. We are confident that the 2021 workshop will offer critical insights into the causes and consequences of this pandemic and a renewed passion for biodefense efforts. We hope to see you at next summer’s workshop and thanks to all for their interest.

‘Understanding and Surviving a Pandemic’ A Week of Scholarly Webinars
From April 27-May 1, 2020, you can enjoy a daily virtual event with a range of experts on the implications of the COVID-19 pandemic. Each day, a panel of experts from the Schar School of Policy and Government at George Mason University, guest practitioners, and elected officials will examine a different aspect of the coronavirus crisis, from politics to health care to intelligence. Mark J. Rozell, dean of the Schar School, will host the programs. The virtual sessions are open to the public and may be followed by a question and answer period, if time allows. See below for topics, times, and viewing information. Don’t miss the Tuesday event on infection control and surge capacity with Biodefense doctoral alum Saskia Popescu. You can read about the events and register for each webinar here.

Schar School Event- Public Policy in the Pandemic Age: How COVID-19 is Reshaping our Government, Economy, and Society
Join the Schar School Faculty, Alumni, Schar Alumni Chapter, and Dean Mark Rozell for an engaging virtual panel on the future of public policy post COVID-19 – COVID-19: How the Pandemic is Reshaping our Government, Economy, and Society. This virtual event will be held from 2-3:30pm EST on Wednesday, May 20, 2020. The COVID-19 pandemic is presenting unprecedented challenges to the United States and the rest of the world. Not since the “Spanish Flu” of 1918 have we experienced a pandemic of this scale and severity. Aside from the steep and growing human toll of the outbreak, virtually every aspect of our personal and professional lives are being affected. The sheer breadth of issues impacted by COVID-19 is overwhelming: public health, medicine, government, the economy, international trade, education, national security, politics, and technology, to name just a few. The effects of the pandemic are also magnified by existing cleavages within our society ranging from hyperpartisanship to racial disparities to socioeconomic inequalities. You can read more about our distinguished panel members and register for the event here.

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

Counting Calories in COVID-19
GMU Biodefense doctoral student Rachel-Paige Casey discusses COVID-19 implications for food shortages, American food culture, and what widespread stay-at-home orders mean for our diets. “To assuage any panic, the outlook for domestic food production – namely in cereals, meat, and dairy – remains sufficient despite reduced production. A recent announcement by Robert Johansson, USDA Chief Economist in Food and Nutrition, confirms that the United States possesses sufficient quantities of food to feed our population and maintain much of its exports. Anxiety averted and assuaged, patience is needed as our food value and supply chains adapt to abrupt changes in demand. Additionally, the agricultural and food processing sectors need time to adjust operations to increase safety measures (for its workers and customers) and to fulfill changes in consumer preferences.” Read more here.

OPCW Confirms Syrian Sarin Chemical Weapon
The Organisation for the Prohibition of Chemical Weapons (OPCW) published its First Report by the Investigation and Identification Team (IIT), which strongly linked the Syrian government to the March 2017 sarin and chlorine attacks on a rebel town. Specifically, in March 2017, three projectiles – two containing sarin and one containing chlorine – were dropped from aircraft of the Syrian Arab Air Force into Ltamenah in northern Syria. According to Dr. Gregory Koblentz, Dirrector of the Biodefense Graduate Program and member of the Scientists Working Group on Chemical and Biological Security, the IIT’s use of multiple methods provided “damning evidence” of that the sarin was developed by the Syrian government. Unfortunately, the IIT does not have the authority to issue sanctions against Syria as punishment. Kenneth D. Ward, US ambassador to the OPCW, assured that the use of chemical weapons will not be tolerated by the United States, which will seek to hold Syria accountable.

COVID-19 and International Security Podcast
Have you heard the latest Power Problems podcast episode? You can listen to Dr. Greg Koblentz of George Mason University as he joins Emma Ashford and Trevor Thrall to talk about the international security implications of the coronavirus pandemic. This is an engaging and insightful podcast that discusses national security in the age of pandemics and how we govern in a crisis, let alone reconsidering biosecurity and a recalibration of our efforts during biological threats. As Koblentz reiterates, “This pandemic should be a wake-up call to the national security community that its time to rethink its priorities. Instead of obsessing about great power competition, we should be more focused on defeating our microscopic enemies. When great powers compete over global health, the only winners are the viruses.”

The “Best People” for Pandemic Response? Vaccine Expert Leaves BARDA While Labradoodle Breeder Leads HHS COVID-19 Efforts
From critical vacancies to questionable personnel choices, this week has been another shaky one for the White House. And no, we’re not referring to comments about injecting disinfectants into the body to prevent COVID-19… On Wednesday, a startling shakeup occurred- Dr. Rick Bright was removed from his position as director of BARDA. Not one to go quietly, Bright released a statement stating that leadership pressured him to look more into hydroxychloroquine despite concerns. “I believe this transfer was in response to my insistence that the government invest the billions of dollars allocated by Congress to address the Covid-19 pandemic into safe and scientifically vetted solutions, and not in drugs, vaccines and other technologies that lack scientific merit,” he said in his statement. “I am speaking out because to combat this deadly virus, science — not politics or cronyism — has to lead the way.” Unfortunately, this wasn’t the only shake-up in how the U.S. is responding to COVID-19. Despite President Trump stating that he only hires the best people, it turns out that the aide of HHS Secretary Alex Azar, was tapped to take over COVID-19 response for the agency despite his lack of experience in public health and a track record for…dog-breeding. “The aide, Brian Harrison, had joined the department after running a dog-breeding business for six years. Five sources say some officials in the White House derisively called him ‘the dog breeder.’ Azar’s optimistic public pronouncement and choice of an inexperienced manager are emblematic of his agency’s oft-troubled response to the crisis. His HHS is a behemoth department, overseeing almost every federal public health agency in the country, with a $1.3 trillion budget that exceeds the gross national product of most countries.” GMU Biodefense graduate program director Dr. Gregory Koblentz emphasized these key personnel vulnerabilities in this 2017 OpEd and the implications for biodefense.

The World vs. COVID-19: Potential Models for Stymying the Spread of COVID-19
Michael Krug, a soon-to be-graduate of the Biodefense MS program, was recently hired on by HHS’s Office of Global Affairs as a Global Health Officer for the Office of Pandemics & Emerging Threats. As a budding biodefense professional, the Pandora Report reached out to Krug for his thoughts on his upcoming career and how the GMU Biodefense Graduate Program helped him land his new role. “The Biodefense Program at GMU helped hone my policy knowledge on several topics significant to my work now, including global health policy, health security, and international norms. The program’s proximity to Washington, DC enabled me to find meaningful work experience, to go along with the robust policy-oriented curriculum. One of the reasons I joined the Office of Global Affairs (OGA) at HHS was to help support the core efforts and expertise that strengthen global health priorities. The OGA promotes coordination and partnership between all levels of governments, international and non-governmental organizations. Together these efforts highlight the importance of global health and raise awareness to the health risks around the world. In this interconnected world, I felt as though the OGA provided me the greatest opportunity to make a resounding impact on the global health field.” Krug recently published an article for GMU’s Center for Security Policy Studies about strategies and countermeasures for stymy the continued spread of COVDI-19, citing South Korea and Washington state as examples. Please read Krug’s latest article here.

Realigning the conventional routes of transmission: an improved model for occupational exposure assessment and infection prevention
GMU Biodefense doctoral alum Chris Brown is addressing the very real challenges of occupational exposure assessments, which couldn’t come at a better time as we learn about more healthcare-related COVID-19 cases. “Current recommendations for standard and transmission-based precautions in place for patients who are suspected or known to be infected or colonized with infectious agents are best suited to prevent the transfer of micro-organisms to other patients – that is, to prevent the acquisition of a healthcare-associated infection, rather than to protect the healthcare worker from self-contamination resulting in a potential occupationally acquired infection. This article reviews current recommended infection prevention and control practices and offers a framework for better protection and controls from an occupational health point of view. We offer a model with two exposure routes – contact and aerosol – resulting from work activities and environments, shifting the focus away from particular pathogenic micro-organisms’ typical methods for spreading to patients or to other non-workers in hospital and community settings.” Read more here.

ASPR’s Activities
The office of the Assistant Secretary for Preparedness and Response (ASPR) is housed in the Department of Health and Human Services (HHS) and was established by the created under the Pandemic and All Hazards Preparedness Act (PAHPA) in 2006. The ASPR manages the Strategic National Stockpile (SNS) of medical supplies, personal protective equipment (PPE), medicines, and devices for life-saving care in an emergency situation. In the COVID-19 response, the SNS has distributed PPE (N95 respirators, surgical and face masks, face shields, gloves, and disposable gowns) in all 50 states to help subdue the transmission of COVID-19; it has also provided ventilators to areas with critical need. The SNS, in conjunction with its federal partners, is coordinating logistics operations to optimize all available resources to support the COVID-19 response. HHS launched the ASPR Technical Resources, Assistance Center, and Information Exchange (TRACIE) to “meet the information and technical assistance needs of regional ASPR staff, healthcare coalitions, healthcare entities, healthcare providers, emergency managers, public health practitioners, and others working in disaster medicine, healthcare system preparedness, and public health emergency preparedness.” TRACIE covers healthcare coalitions, CBRN, health care system partners and medical surge, the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers (CMS EP Rule), hurricanes, disaster behavioral health, mass violence, infectious diseases, drug shortages and scarce resources, and emergency medical services (EMS). TRACIE’s COVID-19 page highlights the resources developed and identified to aid ongoing response and recovery operations.

COVID-19 Testing: Possibilities, Challenges, and Ensuring Equity (NAS)
This week, the National Academies of Sciences and the American Public Health Association hosted a webinar about COVID-19 testing and its equity issues. The presenters provides an update on the state of testing for COVID-19, explained the types of data that will be provided by different tests under development, discussed how that data can inform plans to ease social distancing, and described the equity issues that must be considered access testing and how we can ensure equal access for all. The panel experts included moderator David Relman, MD, Professor of Microbiology and Immunology at Stanford University; Jill Taylor, PhD, Director of the Wadsworth Center for the New York State Public Health Department; Ashish Jha, MD, MPH, Director of the Harvard Global Health Institute; and Georges C. Benjamin, MD, Executive Director of the American Public Health Association. Notes and slides for this and related events are available here. The panel covered situational awareness of diagnostics and surveillance, FDA-approved and EUA-approved molecular and serology assays for testing, the accuracy and reliability of existing tests, ongoing studies for new diagnostics, and, of course, the inequities of the current testing strategy. Diagnostics, using any type of test, need to provide data and insight about active SARS-CoV-2 infections, stage of infection, symptom level (or asymptomatic), contagiousness, prognosis, clinical needs, and acquired immunity.  Surveillance systems need to provide data and insight about acquired immunity, susceptibility, geographic and temporal factors for infection, and the efficacy of intervention measures. The slow and meager early response efforts of the US were seen in the lack of testing infrastructure, an insufficiency that persists weeks later. The high positive rate (about 20-22%) of US diagnostic testing signals that testing coverage is inadequate as many other nations who have expanded their testing network see positive rates under 10%. There are two camps about the number of tests per day that are needed to achieve reasonable containment of the virus in the US: 500,000/day or 10-30 million/day. The 500,00 tests per day recommendation is probably the only attainable option. Beyond reaching that figure, testing needs to be economically accessible to all subpopulations that are currently struggling to get testing or care. At present, the coronavirus test is covered by the federal government; however, the cost of the appointment and the proceeding care are not, which is a major obstacle for Americans that lack sufficient insurance coverage or a nearby care facility. Dr. Benjamin pointed out that current public health messaging campaigns are focused on television and social media platforms that are not accessible to everyone, but neglects using the radio as a platform for PSAs and information. Additionally, some of the innovations are only applicable certain groups; drive-thru testing sites are a novel option but only for those who own a car. Dr. Benjamin also recommends using locally trusted messengers, such as faith leaders, for public health communication. The aforementioned health inequities are not new occurrences but are of critical concern as we try to combat COVID-19. If we can quickly and adequately enhance our testing strategy to scale up testing and expand accessibility to underrepresented subpopulations, we should finally be able to contain the virus enough to slowly and safely start resuming “normal” life.

Cascading Economic Impacts of the COVID-19 Outbreak in China
The US-China Economic and Security Review Commission released a Staff Research Report on the economic impacts of COVID-19 in China. China’s late response to the originally-localized outbreak in Wuhan province led the Chinese government to unforce lockdowns across the country, crippling economic activity. With respect to the COVID-19 pandemic, the Commission found that China suffered, and continue to grapple with, obstructed demand in energy and retail items, stalled production and exports, supply chain disruptions. The Chinese supply chain disruptions are impacting global supply chains, and the US is seeing the effects. These interruptions in economic activity are also the result of intentional freezes by Chinese policymakers in an attempt to curtail the spread of the virus while maintaining supply-side efforts to support businesses; this attempt is largely considered a failure. The ultimate result of China’s slow yet extreme response measures is a deceleration of international economic activity. The International Monetary Fund (IMF) now forecasts a 3% global GDP contraction in 2020. The IMF estimate is somewhat optimistic as it relies on the assumptions that pandemic subsides and other support will be enacted in most countries during the second quarter of 2020 and economic activity will mostly resume in the latter half of this year. The full report is available here.

OHSS Webinar – Wildlife trade: the social, cultural, and political stakes
The One Health Social Sciences Initiative is hosting a webinar on April 30, 2020 from 11am-12:30pm EST, with two experts in zoonotic epidemics in an inter-disciplinary dialogue about the social, cultural, and political stakes of eliminating the wildlife trade and, in particular, the role of “wet markets”.  Dr. Laura Kahn and Dr. Christos Lynteris will be the speakers of this engaging event. As the potential breeding ground for the current worldwide COVID-19 pandemic, epidemiologists, public health officials, and wildlife conservationists have called for shutting down these markets. However, as a central means of sustenance for many communities around the world, the full impacts of closing the markets and necessary strategies to address them will be addressed. Register for this free event here.

Pandora Report: 4.17.2020

A Strategic Vision for Biological Threat Reduction: The U.S. Department of Defense and Beyond
The Committee on Enhancing Global Health Security through International Biosecurity and Health Engagement Programs of the National Academies of Sciences, Engineering, and Medicine (NAS) published its 5-year strategic vision for international health security programs along with its findings and recommendations regarding how to optimize the impact of the Department of Defense (DOD) Biological Threat Reduction Program (BTRP) in achieving its mission for biosafety and biosecurity. Since BTRP is just one of the many US government programs involved in international health security engagement, coordination across the government and with its international partners is critical to achieving the biosafety and biosecurity mission of improving capacity to detect, diagnose, and respond to dangerous pathogens and other biological threats. Though BTRP is not the only cog in the biodefense wheel, it is a vital one, and, as such, should be granted “as much geographic and programmatic flexibility as possible to understand and address broadly the biosafety and biosecurity needs of its partner nations as the program serves US interests.” The 5-year vision aims to develop a durable interagency mechanism, encompassing BTRP and its DOD partners, that tackles the entire set of biological threats and risks affecting US military forces, foreign interests, and homeland. The proposed interagency mechanism would work to disrupt, mitigate, or eliminate risks as efficiently and effectively as possible by the agency or agencies befitting the needs of the mission. Their seven primary recommendations for BTRP include establishing stronger relationships with the combatant commands, CDC, NIH, and other relevant governmental partners; selecting technical engagement professionals to represent the USG; and acquiring more scientific expertise within its staff to proactively engage with the broader scientific community to improve its understanding of technical and scientific developments in emerging infectious diseases. Read the full consensus study report with its detailed findings and recommendations here.

COVID-19 Updates: From WHO to Healthcare Worker Infections
There have been over 600,000 cases and 24,582 deaths in the United States, while the worldwide case count has surpassed 2 million. This week, the CDC released new research via the Morbidity and Mortality Weekly Report (MMWR) regarding healthcare worker cases of COVID-19, shedding light on data gaps and the need to understand the impact of potential healthcare exposures and PPE challenges. “Of 9,282 U.S. COVID-19 cases reported among HCP, median age was 42 years, and 73% were female, reflecting these distributions among the HCP workforce. HCP patients reported contact with COVID-19 patients in health care, household, and community settings. Most HCP patients were not hospitalized; however, severe outcomes, including death, were reported among all age groups.” Of the 315,000 cases reviewed, data on job role was only available for 16%, and of those with occupational data, 19% were healthcare workers. 55% of those healthcare worker cases reported exposure to a confirmed case in a healthcare setting, while fewer noted community exposures, which is likely due to testing gaps. As GMU Biodefense alum and infection prevention epidemiologist Saskia Popescu noted, “This data is really helpful because it’s giving us those first indicators of health care worker risks and exposures,” says Dr. Saskia Popescu, an epidemiologist at a large health system in Phoenix. “But ultimately we need to be collecting more on this because we have to understand the failures, so we can correct them in the future.” In Washington, D.C., President Trump has worked to shift blame of COVID-19 response to The WHO, noting that the administration would be halting funding for the organization. “In effect, Mr. Trump was accusing the world’s leading health organization of making all of the mistakes that he has made since the virus first emerged in China and then spread rapidly. As of Tuesday, there had been about two million cases of the virus worldwide, and nearly 125,000 deaths. In the United States, there have been over 600,000 cases and 25,000 deaths from the virus.” These announcements come just as more light is shed on the woefully inadequate testing within the U.S.

Faculty Spotlight: VOA (Korean Service)
Earlier this week, Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, was interviewed for and quoted in an article published by the Korean VOA outlet about the latest use of the Defense Production Act (DPA) to produce 39 million N-95 masks in the next 90 days. Koblentz points out that the DPA will do little to overcome the shortage in diagnostic kits because the lack is not the result of underutilized production capacity but the result of the difficulty in producing safe and reliable tests. Koblentz also acknowledges the potential abuse of the president’s powers via the employment of the DPA. Specifically, since the conclusion of the Cold War, the lawful definition of defense has been increasingly broadened to include “matters not directly related to armed conflict.” In fact, President Trump recently commented that he would stop exports of PPE based on the DPA. The full article is available here.

Global Health Security & National Security 
On Wednesday, April 15, 2020, more than 2,494 Americans died of COVID-19 according to Johns Hopkins School of Public Health. That is more deaths than occurred on December 7, 1941. Global health security is national security. Sadly, this pandemic and the U.S. response has showed how many gaps we have in national security. Oona Hathaway of Just Security noted “As devastating as the terrorist attacks of 9/11 were, the death toll of COVID-19 is already higher in New York state alone, where more than 4,000 had reportedly died as of April 5. The overall U.S. death toll from coronavirus is now close to 10,000. Estimates suggest that the final death toll could be well over 100,000. Indeed, President Donald Trump recently suggested that 100,000 American deaths would mean’“we all together have done a very good job’. If one believes, as I do, that the fundamental goal of a national security program should be to protect American lives, then we clearly have our priorities out of place. Just as the 9/11 attacks led to a reorientation of national security policy around a counterterrorism mission, the COVID-19 crisis can and should lead to a reorientation of national security policy.” As GMU professors Dr. Gregory Koblentz and Dr. Michael Hunzeker noted last week, the COVID-19 outbreak on the USS Theodore Roosevelt forced the ship’s commander to temporarily scale back operations and now, the USS Ronald Reagan is reporting positive COVID-19 cases and may have no option but to follow the lead of the Roosevelt. These events are warnings to our national security apparatus that pandemic diseases are clear and present threat to our Nation and her allies and interests. Koblentz and Hunzeker urge the US to recognize this threat and adjust to it with urgency and intensity. For more, Koblentz and Hunzeker’s article is available here.

Internal Savings from the Pentagon
According to DefenseNews, DoD identified $5.7 billion in funding – referred to as “savings found through efficiencies” – based on an internal review of the fourth-estate offices, which comprise all the defense agencies not associated with either a service or a combatant command. This funding will be reallocated to new priorities: nuclear modernization, the new US Space Force, hypersonic weapons, artificial intelligence, missile defense, 5G communications technologies, and response force readiness. Mark Esper, the Secretary of Defense, plans to find more savings by continue the review in FY22. Secretary Esper has empowered Lisa Hershman, the department’s chief management officer, to play the role of service secretary for the fourth estate offices, by overseeing their budget development process. Presently, the so-called savings and associated reallocations do not require any terminations, as retirements will free up some of that money; however, personnel reductions remain an option for FY22. Read the full article here.

Embrace Experimentation in Biosecurity Governance
A recent article in Science Magazine implores the scientific and policy communities to rethink and expand the concept of biosecurity governance with the inclusion of new assumptions about the relationships between biology, security, and society. This rethinking will enable improvements in biosecurity governance and in its implementation. Classical governance of biology concentrates on risk management and dual-use research of concern; however, as we are realizing as a global community, not all threats and risks can be precisely foreseen and, therefore, mitigated. Policy lags behind developing tools, like CRISPR, and the potential dual-use dangers they create, both of which are growing at an accelerating rate over the last decade. In an effort to close this gap, the Potential Pandemic Pathogen Care and Oversight policy was established to assess the circumstances under which such research is ethical, but there are no systematic and consistent reviews of the policy’s implications. The onus of biosecurity is increasingly falling to scientists with little training and information about how to assess safety and security concerns of their research. The authors recommend an experimental approach to biosecurity governance in which assessments of research are systematic, transparent, and flexible. Experimentation along with better data collection and sharing are critical for developing a “robust and adaptive governance system.” The full article can be found here.

Responding to COVID-19 While Reopening A Nation
As America works to “reopen” and loosen restrictions, many have warned that it must not be done too soon or too quickly. On Thursday, Present Trump announced plans to reopen the country – emphasizing criteria for relaxing restrictions in phases that did not include dates and left much to governors. The U.S. is still struggling with widespread access to rapid diagnostics, which many cite as a necessity prior to relaxing national restrictions. Focus has been of late on antibody testing and the potentially for post-infection immunity, which isn’t as easy as people might assume. “The unknowns begin with how much an immune response to SARS-CoV-2—the virus that causes COVID-19—tells us. Early studies suggest the production of IgM and IgG in COVID-19 patients typically occurs between 7 and 11 days after exposure, with IgM antibodies appearing first, followed by IgG antibodies. The presence of these antibodies, which respond to specific antigens on the surface of the SARS-CoV-2 virus, indicate that a person has been exposed and their immune system has reacted. But does that necessarily mean a person is immune to getting re-infected?” As we look to serology and the potential of re-opening efforts, experts have emphasized the incremental relaxation and that there will likely be spikes that occur, requiring contact tracing and isolation efforts. As Ed Yong of The Atlantic asked – when will things go back to normal? “The options are limited. Early inaction left the U.S. with too many new cases, and just one recourse: Press a societal pause button to buy enough time for beleaguered hospitals to steel themselves for a sharp influx in patients. This physical-distancing strategy is working, but at such an economic cost that it can’t be sustained indefinitely. When restrictions relax, as they are set to do on April 30, the coronavirus will likely surge back, as it is now doing in Singapore, China, and other Asian states that had briefly restrained it.” The truth is, and as the White House plan notes, many things need to occur prior to restrictions fully being relaxed and not just better diagnostics, but also a healthcare infrastructure that isn’t overwhelmed and without critical resources, ability to do contact tracing, and continued decline in cases and community transmission.

Good News: Vanquishing the Virus
As some much-needed good news, GEN’s tally of vaccines and treatments under development against COVID-19 has reached 161 candidates and counting. GEN divided the medical countermeasure candidates into four aptly named categories based on current developmental and clinical progress: front runners, definitely maybes, keeping an eye on, and too soon to tell. To date, there are 18 front runners, 17 definitely maybes, 70 candidates they are keeping an eye on, and 56 candidates whose efficacies are too soon to tell. The categorized lists are available here.

Roadblocks to Infection Prevention Efforts in Health Care: SARS-CoV-2/COVID-19 Response
Infection prevention epidemiologist and GMU Biodefense PhD alum Dr. Saskia Popescu discusses challenges to healthcare infection prevention efforts while combatting COVID-19. ” Lessons from the 2003 SARS-CoV outbreak in Toronto and 2015 MERS-CoV outbreak in South Korea have unveiled the critical role that hospitals play in outbreaks, especially of novel coronaviruses. Their ability to amplify the spread of disease can rapidly fuel transmission of the disease, and often those failures in infection prevention and general hospital practices contribute to such events. While efforts to enhance infection prevention measures and hospital readiness are underway in the United States, it is important to understand why these programs were not able to maintain continued, sustainable levels of readiness. History has shown that infection prevention programs are primarily responsible for preparing hospitals and responding to biological events but face understaffing and focused efforts defined by administrators. The current US health care system, though, is built upon a series of priorities that often view biopreparedness as a costly endeavor. Awareness of these competing priorities and the challenges that infection prevention programs face when working to maintain biopreparedness is critical in adequately addressing this critical infrastructure in the face of an international outbreak.” Read more of her article here.

Inventions Birthed by Necessity 
GMU Biodefense PhD alum Dr. Daniel Gerstein is evaluating some of the innovations and invention that the COVID-19 pandemic is stimulating. “If necessity is the mother of invention, the new coronavirus is quickly birthing a lot of innovations. Parts of U.S. society may be forever changed by this pandemic. As of 13 April 2020, the United States had over 550,000 confirmed cases and nearly 22,000 deaths, with emergency preparedness and response agencies preparing for much more to come. Combinations of social distancing, home quarantine, closure of schools and universities, and case isolation are now being extensively practiced. Creativity is being implemented each day to overcome response barriers to those at work and meet the needs of those asked to stay at home.” Read Dr. Gerstein’s article here.

Upcoming Virtual Event: Synthetic Biology and National Security: Risks and Opportunities (Part 2 of 2)
On 21 April 2020 at 1:00 pm, Center for Strategic and International Studies (CSIS) is hosting the second part of its Synthetic Biology: The Ongoing Technology Revolution Series. The series covers several important topics within synthetic biology: present and future potential as a critical emerging technology; economic and societal implications; national security opportunities and risks; and implications for emerging technology policy. This online event features Dr. Megan Palmer, Senior Research Scholar at the Center for International Security and Cooperation at Stanford University; Dr. Alexander Titus, the Chief Strategy Officer of the Advanced Regenerative Manufacturing Institute; and Dr. Rocco Casagrande, the Founder and Managing Director of Gryphon Scientific. The event will be available to view here.

Pandora Report: 4.10.2020

National Security in the Age of Pandemics
This week, Dr. Gregory Koblentz, Director of the Biodefense Program, and Dr. Michael Hunzeker, Associate Director of the Center for Security Policy Studies, published a commentary asserting that pandemic preparedness cannot be improved if it becomes another item on the military’s infinite laundry list of missions and threats. The COVID-19 outbreak on the USS Theodore Roosevelt forced the ship’s commander to temporarily scale back operations it so that its crew could isolate themselves and later resume their duties after subduing the infection. Now, the USS Ronald Reagan is reporting positive COVID-19 cases and may have no option but to follow the lead of the Roosevelt. These events are warnings to our national security apparatus that pandemic diseases are clear and present threat to our Nation and her allies and interests. Koblentz and Hunzeker urge the US to recognize this threat and adjust to it with urgency and intensity. For more, Koblentz and Hunzeker’s article is available here.

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

Syria’s Chemical Weapons Attacks
The Organisation for the Prohibition of Chemical Weapons (OPCW) published its First Report by the Investigation and Identification Team, which strongly linked the Syrian government to the March 2017 sarin and chlorine attacks on a rebel town. Specifically, in March 2017, three projectiles – two containing sarin and one containing chlorine – were dropped from aircraft of the Syrian Arab Air Force into Ltamenah in northern Syria. In total, these weapons affected at least 106 individuals. The Washington Post reported on these findings and our own Dr. Gregory Koblentz, Director of the Biodefense Program, stated that strong evidence for attribution is the first concrete step toward punishing such violations of international laws and agreements. The OPCW is not a judicial body with the ability to determine and punish criminal acts, so action must be taken by the Executive Council and the Conference of the States Parties to the Chemical Weapons Convention, the United Nations Secretary-General, and the international community. The full report is available here.

Smartphones and Contact Tracing
Contact tracing is a vital piece to not only public health response, but also helping “reopen” the country (keep reading for more insight into this). Unfortunately, it’s quite time and resource intensive and with widespread transmission and not enough public health resources, this can limit our capabilities. Some countries though, are looking to employe technology into contact tracing – “In Singapore, a country that’s turned to cellphone contact tracing, an app called TraceTogether uses Bluetooth to log when a user’s phone encounters another phone that has the app. If someone tests positive for COVID-19, he or she can easily submit a log of all the other people (and their phones) that he or she came in contact with in the last 21 days.” GMU’s HyunJung Kim has recently discussed this approach in South Korea – noting that “The disclosure of epidemic information is very significant for disease prevention and control, because we experienced the failure of disease control and prevention during the MERS of 2015,” HyunJung Kim, a PhD student in biodefense at George Mason University who has written about Korea’s public health system, says. “Information … makes people more comfortable because they can avoid and detour the areas/hospitals where infected people visited.” On the other hand though, such tech has ethical implications. Kelly Hills, Co-Principal of Rogue Bioethics noted that “We really have to keep our guard up against surveillance technologies that could be abused with very little effort, especially since these technologies are almost always going to be used against our most marginalized communities.” Damien P Williams, PhD candidate in the Department of Science, Technology, and Society at Virginia Tech recently noted that “First and foremost, supposedly anonymized tracking data sits alongside facial recognition as technologies which, in the current formulation of Western society, have no non-oppressive, non-exploitable use. Things developed and deployed in times of heightened fear and concern will very likely become every day violations.” Williams further stated that “Such a tool simply reinforces the trend toward surveillance technologies which are both insidiously abusive and also disproportionately leveraged against already-marginalized communities, as it has been the case with technologies and research in this vein, for literally centuries.” Where do you land on the topic?

Small Groups, Big Weapons: The Nexus of Emerging Tech and WMD Terrorism
A paradigm shift in recent years has seen non-state actors enhance their capabilities to utilize WMDs. A new report from the Combating Terrorism Center at West Point, is shedding light on the changes to capital, infrastructure, and intellectual capacity that are aiding this shift. “The commercialization of emerging technologies is reducing the financial, intellectual, and material barriers required for WMD development and employment. This report surveys three emerging technologies—synthetic biology, additive manufacturing (commonly known as 3D printing), and unmanned aerial systems—and examines the nexus of each with nuclear, biological, and chemical weapons agent proliferation. It examines how non-state actors might use these emerging technologies to overcome traditional barriers against the development and employment of WMD.” You can access the report here.

Inadequate PPE Distribution & Hospital Experiences Responding to COVID-19: A U.S. Survey 
Just how well are hospitals managing the current pandemic? Not well. A survey by the HHS Office of the Inspector General (OIG) across U.S. hospitals from March 23-27, revealed some sobering insight into the challenges of COVID-19 response. 323 hospitals across 46 states chatted with the OIG on this (at least the hospital administrators did…). At a glance, the findings aren’t surprising – severe shortages of testing supplies, extended waits for results, widespread shortage of PPE, challenges maintaining adequate staffing and hospital capacity to treat patients, shortages of critical supplies and materials, and changing/sometimes inconsistent guidance. “Hospitals reported that changing and sometimes inconsistent guidance from Federal, State, and local authorities posed challenges and confused hospitals and the public. Hospitals reported that it was sometimes difficult to remain current with Centers for Disease Control and Prevention (CDC) guidance and that they received conflicting guidance from different government and medical authorities, including criteria for testing, determining which elective procedures to delay, use of PPE, and getting supplies from the national stockpile. Hospitals also reported concerns that public misinformation has increased hospital workloads (e.g., patients showing up unnecessarily, hospitals needing to do public education) at a critical time.” This is an insightful and telling report about the current challenges hospitals are facing in the U.S., not only in responding to COVID-19, but also preparing for it. Unfortunately, this isn’t the only report regarding inadequate supplies and distribution of PPE and vital medical supplies across the U.S. to various states. A new document has been released from HHS on the insufficient distribution of these critical pieces to healthcare response. “Only 11.7 million N95 respirator masks have been distributed nationwide—less than 1% of the 3.5 billion masks that the Trump Administration estimated would be necessary in the event of a severe pandemic. Only 7,920 ventilators have been distributed from the stockpile, even though a recent survey of 213 mayors—which did not include New York City, Chicago, or Seattle—identified a total estimated need of 139,000 ventilators.” Moreover, the report notes that the Strategic National Stockpile has made its last shipment of PPE for states as it now has 10% left, which will be reserved for federal workers and not distributed to states.

When Can We “Reopen” the U.S.? 
The U.S. has over 427,000 cases and 14,696 deaths related to COVID-19, but many of us have been wondering, when will we be able to go back out to restaurants and congregate in public? The answer though, isn’t so simple and frankly, contingent upon a lot of factors like rapid testing and the ability to do contact tracing. First– “Number one: any given state that’s considering relaxing social distancing should have a demonstrated downward trend in cases over the two weeks prior. And we need to get better at being able to evaluate trend data across the country. Ultimately it would be good to have more data that would allow decision makers to be able to look at neighboring states and make sure they’re congruent with others in the region.” Beyond this and a sustained reduction in cases, we need widespread availability of PPE for healthcare workers. An adequately supplied healthcare infrastructure is critical and we must support healthcare workers as they face an onslaught of cases across the U.S.

Biodefense and Pandemic Policy
With each week, we learn more about ignored messages, red flags, and exercises that shed light on the very real failures in pandemic preparedness/response we are living right now. From the disbanding of the NSC global health security team to the failures in following the 69-page pandemic playbook, there have been several missteps and delays in the administration’s response. “The playbook was designed ‘so there wasn’t piecemeal thinking when trying to fight the next public health battle,’ said one former official who contributed to the playbook, warning that ‘the fog of war’ can lead to gaps in strategies.” Pandemic preparedness is no easy task, but many are looking at previous presidential responses to biological threats as an indicator that what we’re seeing now isn’t ideal. Within the most recent International Affairs journal, there is a reading list regarding global health crises that shed light on behavior norms and response measures during such events. In this collection, you’ll see GMU Biodefense professor and graduate program director Gregory Koblentz’s review of the Obama administration’s strategy for countering biology threats. “This strategy represents a shift in thinking away from the George W. Bush administration’s focus on biodefence, which emphasized preparing for and responding to biological weapon attacks, to the concept of biosecurity, which includes measures to prevent, prepare for and respond to naturally occurring and man-made biological threats.” The current COVID-19 pandemic will be a pivotal moment in biodefense and biosecurity policy, hopefully guiding future efforts and investments into pandemic preparedness.

Student Spotlight: PREDICT-ing the Next Pandemic?
Michael Krug, a second-year student in the Biodefense MS program, November 2019 article highlights the critical need for comprehensive and quick biosurveillance tools to aid in pandemic preparedness. Last week, the decision was made to end USAID’s PREDICT project. PREDICT was established in 2009 to help develop wide-ranging detection capabilities; it was a component of the early-warning system. the project identified 1,200 viruses – including 160 novel coronaviruses – with the potential to induce a pandemic. Beyond identification, the project trained and supported staff across 60 foreign laboratories, such as the Wuhan Institute of Virology. Krug points out that the dissolution of PREDICT is an unfortunate reversal away from the US goal of slowing the emergence (or reemergence) of infectious diseases. This week, the LA Times reported on the termination of PREDICT, corroborating the echoed Krug’s sentiments and shared the announcement that the PREDICT program was just extended through September so that it can assist in the COVID-19 response.

Why Giving Americans Checks Makes Sense
In response to the March 22 column by Steven Pearlstein stating that providing funds to every American would be a bad idea, you can now read a rebuttal here. Included in this list of respondents is GMU Biodefense professor Sonia Ben Ouagrham-Gormley, who noted that “The plan to send money to every American may not be economically sound in normal circumstances, but it is an appropriate response to the economic hardships caused by this pandemic. And it could help curb the spread of the disease. True, many people will maintain their income, but what about the short-term burden people will face because of the pandemic? What about the employee who already lost her job and needs to care for her children? What about elderly people who have no one to rely on and who cannot stock up on food? These people need cash now to face the additional (temporary) economic burden caused by the epidemic. More important, they need it now to heed the Centers for Disease Control and Prevention’s guidelines: Stay home for a long enough period to break the transmission chain of the disease.”

Pandora Report: 3.20.2020

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

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

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

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

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

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

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

 

Pandora Report: 3.13.2020

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

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

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

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

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

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

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

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

 

 

Pandora Report: 3.6.2020

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

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

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

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

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

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

 

Pandora Report: 2.28.2020

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

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

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

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

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

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

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

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

Pandora Report: 2.21.2020

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

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

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

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

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

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

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

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

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

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

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

Pandora Report: 2.14.2020

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

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

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

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

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

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

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

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

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