Pandora Report: 5.13.2022

Happy Top Gun Day to all those that feel the need for speed! Continuing the theme of “things you thought you left in the Cold War,” we’re covering news from Pyongyang, Beijing, and Moscow in this edition. This week we discuss the official emergence of COVID-19 in North Korea, China’s new 14th Five-Year Plan for the Development of the Bioeconomy, and a WHO European Region proposal to condemn Russia’s attacks on Ukrainian healthcare facilities and even shutter the WHO European Office for the Prevention and Control of NCDs in Moscow. The new Statement of the G7 Non-Proliferation Directors Group and updates on avian influenza in the United States are also discussed. We have included a number of great new publications, including a report from the Bipartisan Commission on Biodefense discussing the resources land-grant universities can offer US biodefense and the WHO’s first global report on infection prevention and control. Upcoming events, including one offered by Issues in Science and Technology featuring Biodefense Graduate Program alumnus Dr. Yong-Bee Lim as a panelist, are included. Finally, check out the announcements section for a special One Health funding opportunity and more new works combatting Russian WMD disinformation.

“Maximum National Emergency” in the Impossible State- First COVID-19 Outbreak Announced in Pyongyang

The Democratic People’s Republic of Korea (DPRK, or North Korea) announced via the Korean Central News Agency that it is in the midst of a COVID-19 outbreak this week with multiple people testing positive for the BA.2 subvariant in Pyongyang. At least 187,000 were quarantined due to a “fever” of unknown origin and Kim Jong-un declared a “maximum national emergency” in response. According to the New York Times, “North Korea said 350,000 people had been found to have a fever since late April, including 18,000 on Thursday. It added that 162,200 people had completely recovered.” Six are reported dead (one specifically from Omicron) and Kim has ordered all cities and counties in the country of 25 million to lock down. This is the first admission to having any cases from the regime and, in typical fashion, Kim took the opportunity to admonish his health officials, claiming that the outbreak in the capital “shows there is a vulnerable point in the epidemic prevention system.” As of late February this year, the DPRK had reported 54,187 COVID-19 tests to the WHO since the pandemic began, all of which it claimed were negative.

The announcement was made the same week the South inaugurated its new president, Yoon Suk-yeol on May 10. Yoon is a conservative who brings a harsher stance on the North than his predecessor, Moon Jae-in, which many think will heighten tensions over the North’s nuclear weapons. While major political events in the South often bring provocations from the North, including nuclear tests, some wonder if this new revelation might temper this tendency. However, former UK Ambassador to the DPRK, John Everard, believes this is unlikely to stop the North’s weapons testing for now. However, it may impact Kim’s promise to rapidly expand his nuclear arsenal, according to some analysts, a promise which he made at last month’s military parade featuring new ICBMs.

Irrespective of what happens in terms of nuclear testing, the public health situation is critical in the DPRK. Like China, it has implemented a Zero COVID-19 policy, which includes lockdowns at the border and strict quarantines. However, it has not yet started a COVID-19 vaccination campaign, making it the only other country to have not done so apart form Eritrea. This is despite multiple offers and refused deliveries from COVAX, including an offer that would have covered 20% of the population. As of February this year, COVAX had just 1.29 million doses allocated to North Korea, a number many organizations are calling for increases in amid the outbreak. The country previously expressed concerns about the safety and efficacy of the AstraZeneca vaccine COVAX had allocated for the country (citing concerns about rare blood clotting following vaccination), though it also rejected over 3 million doses of China’s Sinovac in September of last year, saying they should be sent to severely impacted countries. The DPRK also rejected multiple offers from South Korea and Russia to provide vaccines to the country in 2021. As a result, this is an unvaccinated population in a country plagued by malnutrition and other health crises facing a highly transmissible and contagious subvariant, all while lockdowns make accessing what healthcare is available difficult if not impossible.

Korea experts at CSIS think that the North is probably interested in receiving vaccines, though they specifically want mRNA ones. AstraZeneca’s vaccine is, like Johnson and Johnson’s offering, a viral vector vaccine. Sinovac’s CoronaVac is an inactivated vaccine found to be less effective than mRNA vaccines, like those offered by Pfizer and Moderna. Remember, the PRC has not produced nor authorized any mRNA vaccines, despite its initial claims that it had one domestic mRNA vaccine offering at its reach. The PRC does have some mRNA candidates in phase three clinical trials and review and approval processes, including the vaccine developed by Abogen Biosciences, Walvax Biotechnology, and the PLA Academy of Military Science that is currently in extensive trials in China, Mexico, and Indonesia. However, as China struggles with case counts in places like Shanghai, this is unlikely to be of much help to the DPRK any time soon.

The North has likely been concerned about the monitoring requirements that come with accepting COVAX shipments, which might be mitigated by reframing this as technical support while highlighting the differences between vaccines and other fungible forms of aid. De-linking COVID-19 aid from progress on other strategic goals is another potentially useful tool if the North remains committed to its current approach. Again, however, this is an incredibly serious situation, so the DPRK may be more open to less desirable terms than it normally would be.

Furthermore, the Zero COVID approach has contributed to secondary health and food crises as supplies of medication and access to care evaporate and the food shortage drags on. In fact, “The Great Year of Victory 2021”, the most recent version of the annual, near-two-hours-long documentary praising Kim and recapping the regime’s achievements for that year, even admitted there is a food crisis. According to the Washington Post, “The narrator described a meeting where Kim expressed his concern that “what is urgently needed in stabilizing the people’s livelihood is to relieve the tension created by the food supply,” and he called on emergency measures for the “food crisis,” noting that the country had dipped into its emergency grain supply. In June, Kim called the country’s food situation “tense.”” Border closures blocked shipments of grains, fertilizers, and farming equipment, adding to the pain of a population wherein the UN estimates at least 43% are food insecure. This was all even further exacerbated by severe flooding followed by 2020’s typhoons, contributing to continued low crop yields. Kim Jong-un even remarked at a 2021 Worker’s Party meeting that the “people’s food situation is now getting tense.” Finally, an October 2021 report from South Korea’s National Intelligence Service revealed that Kim ordered an all-out farming campaign, calling for all citizens to “devote every effort to farming, and to secure “every grain” of rice.”

China has indicated it is “ready to go all out” in its support for the DPRK during the outbreak. Zhao Lijian, Deputy Director of China’s Ministry of Foreign Affairs Information Department, told South Korea’s Yonhap News Agency this week, “China and the DPRK are friendly neighbors linked by mountains and rivers. The two sides enjoy the fine tradition of mutual assistance. Since the onset of COVID-19, the DPRK side has been firmly supporting China in the fight against the coronavirus. China very much appreciates that. We feel deeply for anti-COVID situation in the DPRK. As the DPRK’s comrade, neighbor and friend, China is ready to go all out to provide support and assistance to the DPRK in fighting the virus.”

However, this aid is likely to be slow moving, with the PRC and DPRK having re-suspended overland trade last month. The suspension was previously lifted in January 2022 after the border was closed in 2020 to prevent COVID-19 from spreading into the country. This lack of movement impacted what aid was sent, with a 2020 UNICEF aid bundle sent to North Korea in 2020 sitting idle at a quarantine facility in China until January of this year. Furthermore, trade between the countries dropped over 90% between March 2020 and March 2021, with the DPRK economy contracting 4.5% in 2020, the steepest decline for the country since it endured the massive North Korean Famine of the 1990s. South Korea’s Ministry of Unification announced too this week that the ROK is willing to provide medical assistance and other help North Korea during this crisis.

In February 2021 the CSIS Korea Chair’s podcast, The Impossible State, covered what was then known about lockdowns and the severity of COVID-19 in the North. This is a great source for context on this situation and, in it, Dr. Victor Cha (Senior Vice and Korea Chair at CSIS,  D. S. Song-Korea Foundation Chair in Asian Studies at Georgetown University, and former Director for Asian Affairs at the National Security Council), Dr. Kee Park (Lecturer on Global Health and Social Medicine at Harvard Medical School), and Dr. J. Stephen Morrison (Senior Vice President and Director of the Global Health Policy Center at CSIS) discussed issues like a lack of ventilators in the country and, perhaps most interestingly, greater government control of private markets.

These markets gained momentum during the days of the great famine in the 1990s when the regime’s public distribution system failed. According to some estimates pre-pandemic, up to 72% of North Koreans get all of their daily resources from these markets, not from the government. These are also avenues for media from the rest of the world to enter the country, however they also offer the regime and easy resource for hard currency. This was seen in 2009 when the regime redenominated the won and placed restrictions on how much of the old currency could be converted, helping reconsolidate its power from the growing markets. In an effort to recentralize and recoup some of its losses in 2021, the government “..reclaimed control over all foreign trade and domestic markets.” “During the 8th Party Congress, North Korea announced its new five-year economic plan (2021–25). It stresses centralised management in all sectors and advocates greater political control in day-to-day economic planning and management,” according to East Asia Forum. While this indicates the regime feels threatened by the pandemic, it also means that food insecure people’s access to resources was further limited, which will be even worse now with the entire country in lockdown.

China’s 14th Five-Year Plan Gets Boost to Its Bioeconomy Focus

In March 2021, the PRC’s National People’s Congress passed the country’s 14th Five-Year Plan, covering 2021-2025. China’s five-year plans are collections of social and economic development initiatives that the Party issues to help guide policy making. They help the Party outline what each facet of government should be working towards by doing everything from outlining what Chinese communism looks like in a given era to launching comprehensive reforms. Drafted in October 2020, the 14th Five-Year Plan was written amid economic shrinkage (the first in four decades) and worsening US-China relations during the COVID-19 pandemic. It sets forth a strategy of the “domestic and overseas markets reinforcing each other, with the domestic market as the mainstay,” focusing heavily on the economy, environment, energy, transportation, research and development, and urbanization.

China Daily reported this week that the National Development and Reform Commission released a new document outlining a plan to “spur the bioeconomy during the 14th Five-Year Plan period (2021-25), in a bid to promote high-quality development of the sector,” called “The 14th Five-Year Plan for the Development of the Bioeconomy.” This is similar in nature to the 14th Five-Year Plan for National Informatization released in December 2021, which seeks to further the country’s digitization during the period covered by the 14th-Five Year Plan. The 29-page bioeconomy plan, available here (no English translation was available at the time of writing) outlines steps “to promote innovative development of the bioeconomy, accelerate the development of healthcare, bio-agriculture, bioenergy, biological environmental protection and bioinformatics, improve the biosecurity risk control, prevention and governance system, and create a better environment for the innovative development of the bioeconomy.”

It begins by explaining broad objectives and indicating it was crafted “according to the 14th Five-Year Plan of National Economic and Social Development of the People’s Republic of China and the Outline of Vision 2035.” It then continues to define goals across 28 sub-topics, ranging from development areas to calls for improved epidemic management and biosecurity. The document outlines a number of basic principles including “Adhere to the innovation-driven”, “Adhere to win-win cooperation”, and “Adhere to risk control.”

The promise of win-win cooperation is a key way China promotes its aid and infrastructure deals with other countries, contrasting its supposedly mutually beneficial offerings with those of the United States. In a statement before the UN in 2015, Xi Jinping took this even further, saying “Major countries should follow the principles of no conflict, no confrontation, mutual respect and win-win cooperation in handling their relations. Big countries should treat small countries as equals, and take a right approach to justice and interests by putting justice before interests.” This echoes many claims and promises the PRC makes to differentiate itself from the United States on the global stage. In reality, the PRC is not really interested in win-win situations just as it is only interested in its core principle of non-interference when it is convenient. To achieve this “win-win approach”, the plan calls for, “a higher level of openness to the outside world and greater reform initiatives to gather global bio-innovation resources.” It also calls for China to “Actively participate in global biosafety governance, promote bilateral and multilateral international cooperation in life sciences and biotechnology, and promote the rational flow of innovation factors to achieve mutual benefit and win-win bio-economic benefits.”

Zhou Jian, Deputy Director of the Consumer Goods Industry Department at the Ministry of Industry and Information Technology said, “The ministry will work with relevant departments to implement moves to modernize the biomedicine sector, including building a modern innovative ecosystem deeply integrating the industrial, innovation, value and supply chains, shoring up weak chains, promoting intelligent and green development of the pharmaceutical industry, driving innovative transformation of large enterprises and supporting the development of small and medium-sized enterprises that specialize in niche sectors.”

According to China Daily, “Under the plan, the bioeconomy-a model focusing on protecting and using biological resources and deeply integrating medicine, healthcare, agriculture, forestry, energy, environmental protection, materials and other sectors-will become a key driving force to boost high-quality development by 2025.

By 2025, the proportion of the bioeconomy’s added value in GDP will increase steadily, and China is set to witness a significant increase in the number of enterprises engaged in the bioeconomy with annual revenues of at least 10 billion yuan ($1.5 billion) each. By 2035, China aims to be at the forefront globally in terms of the comprehensive strength of its bioeconomy.”

This is of concern, particularly given the strategy’s interest in things like precision medicine (which uses genomic, physiological and other data to tailor treatments to individuals), as US officials continue to warn of China’s interest in Americans’ health data – including DNA information. In 2020, as US states struggled to build their testing capacity, Chinese biotech firm BGI Group (formerly known as Beijing Genomics Institute) offered at least six states help with building and managing COVID-19 testing labs. This would have given the company access to Americans’ health data, former Director of the National Counterintelligence and Security Center William Evanina said during a January 2021 CBS 60 Minutes report. BGI was also scrutinized for its connection to the PLA as it gave pregnant patients’ genomic data from NIFTY prenatal tests to the Chinese military to conduct research on population traits. The Pentagon warned service members in 2019 not to take at-home DNA test kits, stating they create security risks and could impact service members’ careers, following similar concerns. China’s interest in competing in biopharmaceuticals and medical device manufacturing further indicate the country is in it for personal gain, not improving and saving lives- a dangerous prospect in a world threatened by high chronic disease burdens and threats of emerging infectious diseases.

Europe Pressuring the WHO to Isolate Russia

Many members of WHO’s European region are pushing the organization to remove experts at its office in Moscow. The 53-member region includes Ukraine, Russia and the entirety of the EU. It will meet on Tuesday and Wednesday to consider passing a resolution condemning Russia’s attacks on healthcare facilities in Ukraine, which could set into motion the removal of WHO experts in Moscow. Politico explains, “If agreed, the resolution would force the WHO’s hand on taking a more political stance on the war. The health organization has in the past been criticized for taking overtly apolitical positions, including for its caution at publicly calling out China in the early days of the pandemic.” The WHO did announce, however, this week that it has begun gathering evidence for a potential war crimes investigation into the more than 200 attacks it has documented by Russia on Ukrainian healthcare facilities on its Surveillance System for Attacks on Health Care platform.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus visiting Ukraine last week

The draft resolution is sharply worded and demands that the Russian Federation “ensure respect for international humanitarian law, including protection of all medical personnel and humanitarian personnel exclusively engaged in medical duties, their means of transport and equipment, as well as hospitals and other medical facilities.” It also asks WHO Regional Director for Europe Hang Kluge “to safeguard the technical cooperation and assistance provided by the WHO European Office for the Prevention and Control of Noncommunicable Diseases, including the possible relocation of the aforementioned office to an area outside of the Russian Federation.” It also asks Kluge to “consider temporarily suspending all regional meetings in the Russian Federation.” The suspension in the region would be in place until there is a peaceful resolution in Ukraine, according to Politico

However, some argue it will do very little in practice. Lawrence Gostin at the O’Neill Institute for National and Global Health Law called it a “weak rebuke that won’t bother Putin,” continuing on to say that the WHO could remove Russia’s voting rights at the World Health Assembly and that the assembly should pass a resolution condemning attacks on healthcare facilities. He also argued that the WHO should take make multiple steps regarding this at the World Health Assembly, including 1) suspending Russia’s WHA voting privileges, 2) passing resolutions condemning Russian attacks on healthcare and blocking humanitarian aid, 3) inviting Ukrainian doctors and human rights NGOs to speak at WHO, and 4) reforming surveillance system for attacks targeting healthcare facilities.

Ukraine’s Ministry of Health has been even less subtle about its view of the matter, tweeting “Due to #Russianinvasion, Ukraine insists on the closure of WHO’s European Office for the Prevention and Control of Noncommunicable Diseases, located in Moscow. We are talking about moving the office outside of russia. Ukraine has already submitted a request to the @WHO_Europe.”

Statement of the G7 Non-Proliferation Directors Group

The G7 Non-Proliferation Directors Group recently released this statement outlining directions for strengthening the G7’s desires to improve non-proliferation, regulate conventional weapons and ammunition, and secure the sustainable use of outer space. It begins by reiterating “the G7´s profound condemnation of Russia’s premeditated, unprovoked, and unjustifiable war of choice against Ukraine, enabled by the Belarusian government.” It covers topics like strengthening the NPT ahead of the 10th Review Conference in August 2022, support for the restoration and full implementation of the JCPOA, upholding the global norm against the development and use of biological weapons, honoring the 20th anniversary of the Global Partnership against the Spread of Weapons and Materials of Mass Destruction, defending the norm against the use of chemical weapons and countering impunity, countering the proliferation of missiles and other critical technology, saving lives by preventing illicit transfers and destabilizing accumulation of conventional weapons and ammunition, and addressing state threats to the secure, safe, sustainable, and peaceful uses of outer space.

Bird Flu Updates- US States Confirm Cases in Wild Mammals

Building on last week’s update on Highly Pathogenic Avian Influenza (HPAI) cases in the US, H5N1 HPAI is now impacting more than 2/3 of US states, and multiple states in the Midwest have reported cases in fox kits. 37.55 million poultry in the US have died as a result of the virus’s spread. In Michigan, three fox kits have died in Macomb, St. Clair, and Lapeer counties, with the Michigan State Veterinary Diagnostic Lab finding them “non-negative” for HPAI. Minnesota’s Department of Natural Resources (DNR) reported on Wednesday that a wild fox had tested positive. Two kits were also confirmed to have died from H5N1 in Ontario, Canada earlier this month, with one displaying “severe neurologic signs before dying at a rehabilitation center, according to the DNR.” An estimated 1.7 million farmed birds in Canada have been killed by H5N1 this year. A turkey vulture in Dundas was recently found to be infected, indicating it is spreading even further in Canadian wild bird populations. Wild red foxes in the Netherlands tested positive in 2021 during outbreaks of avian influenza in multiple European countries as well. These cases in the US and Canada represent the first cases reported in wild mammals in North America.

“Testing in Minnesota has confirmed HPAI in nearly 200 wild birds, including 19 species of birds, primarily waterfowl and raptors,” said Michelle Carstensen, the Minnesota DNR’s wildlife health program supervisor. Washington state confirmed Thursday that it has seen six outbreaks in just one week, adding two to that count yesterday. “With so many suspicious cases in domestic flocks and wild birds pending investigation, I can’t emphasize enough how important it is to avoid exposing your flock to wild waterfowl, shorebirds, and other domestic flocks,” Washington state veterinarian Dr. Amber Itle said. The CDC still says the risk of H5N1 to humans remains low, but it advises the public to avoid handling sick or dead birds, cautioning them to use a plastic bag or shovel to do so if necessary.

In related news, China recently detected the first human case of H3N8 in a young boy who had close contact with chickens and crows raised at his home. While a single case is not particularly concerning, increases in transmission in birds increases the opportunities for these viruses to mutate, potentially gaining the ability to spread easily from person-to-person eventually. The WHO said of the case, “Currently, limited available epidemiologic and virologic information suggests that this avian influenza A(H3N8) virus has not acquired the ability of sustained transmission among humans. Therefore, the risk at the national, regional and international level of disease spread is assessed as low.”

“Boots on the Ground: Land-Grant Universities in the Fight Against Threats to Food and Agriculture”

The Bipartisan Commission on Biodefense recently released this report discussing how universities receiving benefits through Morrill Acts of 1862, 1890, and 1994 and Equity in Education Land-Grant Status Act funds offer unique resources to identifying and rectifying critical biodefense gaps. The Commission writes:

The food- and agro-biodefense challenge is different from, but as daunting as, biodefense of human public health due to the diversity of targets (e.g., livestock, crops, soil); spectrum of potential pathogens and pests; and different geographies, ecosystems, and infrastructures at risk. Land-grant universities are uniquely positioned to help defend the United States against biological threats to food, livestock, crops, wildlife, biofuels, pharmaceuticals, textiles, the environment, the bioeconomy, and the food and agro-economy, valued at more than $1 trillion annually. In serving the states, localities, tribes, and territories in which they reside, the land-grant universities have their boots on the ground in the fight against threats to food and agriculture.

The Commission makes a number of recommendations across the subjects of coordination, early warning, research and development, and preparedness, response, and mitigation. These include “Incorporate all land-grant universities in national food and
agro-biodefense activities,” “Expand the role of land-grant universities in international
surveillance and interdiction for food and agriculture defense,” “Establish land-grant university biodefense research coalitions,” and “Establish a cooperative extension preparedness and response framework that extends the capabilities of the Extension
Disaster Education Network,” among others.

Today, the US has 112 Land-Grant Colleges and Universities, ranging from Ivy League Cornell to major state agriculture universities like Kansas State and Texas A&M, both of which have strong backgrounds in biodefense work. “The original mission of these institutions, as set forth in the first Morrill Act, was to teach agriculture, military tactics, and the mechanic arts as well as classical studies so members of the working classes could obtain a liberal, practical education,” according to the Association of Public and Land-Grant Universities. The Association also explains, “A key component of the land-grant system is the agricultural experiment station program created by the Hatch Act of 1887. The Hatch Act authorized direct payment of federal grant funds to each state to establish an agricultural experiment station in connection with the land-grant institution there. The amount of this appropriation varies from year to year and is determined for each state through a formula based on the number of small farmers there. A major portion of the federal funds must be matched by the state.”

Map depicting land-grant universities across the nation. Source: USDA

“Want to Prevent Pandemics? Stop Spillovers”

Vora et al. discuss how just $20 billion per year in investments could greatly reduce the likelihood of future spillovers in their recent Nature Comment. They write that, “Spillover events, in which a pathogen that originates in animals jumps into people, have probably triggered every viral pandemic that’s occurred since the start of the twentieth century.” They continue, explaining “What’s more, an August 2021 analysis of disease outbreaks over the past four centuries indicates that the yearly probability of pandemics could increase several-fold in the coming decades, largely because of human-induced environmental changes.” They identify four specific actions based on “decades of research from epidemiology, ecology and genetics,” including protecting tropical and subtropical forests, banning or strictly regulating (both domestically and internationally) “commercial markets and trade of live wild animals that pose a public-health risk,” improving biosecurity where dealing with farmed animals is concerned, and improving people’s health and economic security, particularly in “hotspots for the emergence of infectious diseases.” They go on to discuss other measures, like incorporating these actions into the WHA pandemic agreement currently under negotiation and improvements in preventative health care.

“Zero Draft Report of the Working Group on Strengthening WHO Preparedness and Response to Health Emergencies to the Seventy-Fifth World Health Assembly”

Speaking of the WHA, a working group tasked with finding ways to strengthen WHO’s preparedness and response to health emergencies just released this draft report for the Assembly. In their 56-page report, they provide insight and recommendations for boosting the implementation and compliance of parties to the International Health Regulations and a potential timeline for amending them. According to Devex, “To strengthen equity, the report says member states should establish and scale up national and regional manufacturing capacities for the development and delivery of vaccines, therapeutics, diagnostics, and other essential supplies during emergencies. It also asks them “to consider processes for transfer of technology and know-how, including to and among larger manufacturing hubs in each region.””

Much of the report’s proposals are not new, owing to the fact that the working group was tasked with reviewing existing recommendations for pandemic preparedness. Other recommendations, as Devex explains, include “…for the WHO Secretariat to consider a different acronym when referring to so-called public health emergencies of international concern, as the abbreviation “PHEIC” is sometimes pronounced like the word “fake” in English. The report also suggests that WHO publish information on disease outbreaks with pandemic potential “on an immediate basis” and that member states discuss the feasibility of developing an intermediate and/or regional alert systems for health emergencies.” It also recommends the 75th WHA adopts any amendments to the IHR that are ready, while also suggesting the director-general convenes a review committee to “make technical recommendations for proposed amendments submitted to the WHO Secretariat by June 30 of this year.” The group also recommends that the IHR review committee provides a report to the director-general by October. Meanwhile, a member state-led process should finalize their proposed amendments and then submit them to the director-general by January of 2023. If necessary, the report indicates this process can continue until the 76th World Health Assembly, expected to take place in May 2023.

The United States has already submitted proposals for IHR amendments for consideration by the 75th WHA. They are primarily focused on requiring states parties to provide early notification to WHO regarding any events that might become PHEICs. The WHO would also have a 24-hour window to work with states parties to verify reports and determine a disease’s potential to spread abroad. Another US-proposed amendment includes a provision on deliberations of the IHR emergency committee, specifying that if the group “is not unanimous in its findings, any member shall be entitled to express his or her dissenting professional views in an individual or group report, which shall state the reasons why a divergent opinion is held and shall form part of the Emergency Committee’s report.” The US has also proposed creation of a compliance committee for implementation of the IHR.

“The Department of Defense Contributions to Pandemic Response”

CSIS Global Health Policy Center’s Drs. Thomas Cullison and J. Stephen Morrison recently authored this report discussing the Department of Defense’s (DOD) future in the US government’s work on international health security. They write, “A process of strategic planning that encompasses a spectrum of valuable DOD contributions to contain the global Covid-19 pandemic should begin right away. DOD has broad capabilities that have consistently proven their high value in addressing the current Covid-19 pandemic and other historical disease outbreaks, in support of the U.S. civilian-led response. The knowledge and experience gained in crisis response at home and overseas contribute to military readiness and improved coordination of all actors involved in preventing, detecting, and responding to infectious disease events.”

They also provide four recommendations to strengthen DOD’s contributions overseas that advance US global health security interests:

  • Identify a lead federal agency for U.S. international Covid-19 response and future health security crises. DOD should have permanent, sustained involvement in integrating and planning from the beginning.  
  • More closely coordinate and synchronize DOD capabilities dealing with biological threats within DOD and with external partners. 
  • Align funding authorities with desired outcomes. 
  • Maintain military, medical, and scientific expertise. 

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

The National Academies recently published this proceedings of a workshop summarizing discussions and findings from the Forum on Microbial Threats’ two virtual 2021 workshops. The first workshop focused on what it means to frame the response to COVID-19 through a “syndemic” approach, and what the implications would be for global recovery. The second workshop focused more broadly on key lessons and emerging data from ongoing pandemic response efforts that can be incorporated into current health systems to improve resilience and preparedness for future outbreaks.

This workshop explored the long-term effects of COVID-19 on health equity, including considerations for mental health and social determinants of health. It also addressed uncertainties during a pandemic, such as trust, communication, and engagement and explored approaches to systematize recovery efforts to improve the ongoing responses and prepare for the next pandemic. Experts discussed possibilities for a post-pandemic world and a response strategy for stakeholders that ensures sustained community partnerships and prioritization of health equity. This Proceedings of a Workshop summarizes the presentations and discussions from the second workshop.

“The Coronavirus Vaccine Manufacturing Failures of Emergent Biosolutions”

This week, Rep. Carolyn B. Maloney, Chairwoman of the Committee on Oversight and Reform, and Rep. James E. Clyburn, Chairman of the Select Subcommittee on the Coronavirus Crisis, released a staff report on their joint investigation into coronavirus vaccine manufacturing failures of Emergent BioSolutions, Inc. (Emergent). These failures occurred under a contract awarded by the Trump administration despite warnings about the company’s history of serious deficiencies.

According to the Committee on Oversight and Reform, “New evidence shows that nearly 400 million doses of coronavirus vaccines—significantly more than previously known—were destroyed because of Emergent’s failure to meet or maintain quality standards at its Bayview manufacturing facility. Internal communications reveal efforts by Emergent executives to hide evidence of contamination in an attempt to evade oversight from government regulators.” The report also found that Emergent executives promoted their manufacturing capability despite being warned for years by their then Executive Vice President of Manufacturing and Technical Operations that the company’s quality systems were deficient. Furthermore “FDA, Johnson & Johnson, and AstraZeneca identified multiple deficiencies at Bayview, which Emergent failed to remediate despite urgent warnings.” The report also determined that inexperienced staff and high rates of staff turnover at Emergent contributed to the vaccine contamination. HHS, under the Biden administration, terminated its contract with Emergent because the company failed to follow federal manufacturing standards. The report notes, “According to HHS, Emergent received $330 million in taxpayer dollars before the Biden Administration terminated the company’s contract in November 2021.  This action saved taxpayers $320 million that remained on the contract and came after the Committees launched an investigation and released preliminary findings about Emergent’s troubling conduct.”

“Global Report on Infection Prevention and Control”

The WHO has launched the first ever global report on infection prevention and control (IPC), revealing that “good IPC programmes can reduce health care infections by 70%.” The WHO explains, “Today, out of every 100 patients in acute-care hospitals, seven patients in high-income countries and 15 patients in low- and middle-income countries will acquire at least one health care-associated infection (HAI) during their hospital stay. On average, 1 in every 10 affected patients will die from their HAI.” This report finds that high-income countries are more likely to be further progressing in improving their IPC, and “are eight times more likely to have a more advanced IPC implementation status than low-income countries.” The report also notes that “…little improvement was seen between 2018 and 2021 in the implementation of IPC national programmes in low-income countries, despite increased attention being paid generally to IPC due to the COVID-19 pandemic.” WHO calls on all countries to increase their IPC investments to help improve quality of care and patient and worker safety.

“Archival Influenza Virus Genomes from Europe Reveal Genomic Variability During the 1918 Pandemic”

In the decades since the 1918 flu pandemic, improvements in technology have allowed researchers to learn more about the H1N1 virus that killed an estimated 50 million globally. However, questions have still remained regarding how and why the virus changed as time progressed, especially since its first wave was relatively tame compared to later waves. However, Patrono et al. recently published their research helping answer some of these questions. Dan Robitzski with The Scientist explains, the “researchers managed to extract viral genomes from tissue samples of people who caught the 1918 pandemic flu in different years to show how the virus mutated over time to adapt to the human immune system. They conclude that the virus may have evolved into the pathogen that circulated as a seasonal flu after the pandemic ended.”

Patrono et al. write in Nature Communications,

The 1918 influenza pandemic was the deadliest respiratory pandemic of the 20th century and determined the genomic make-up of subsequent human influenza A viruses (IAV). Here, we analyze both the first 1918 IAV genomes from Europe and the first from samples prior to the autumn peak. 1918 IAV genomic diversity is consistent with a combination of local transmission and long-distance dispersal events. Comparison of genomes before and during the pandemic peak shows variation at two sites in the nucleoprotein gene associated with resistance to host antiviral response, pointing at a possible adaptation of 1918 IAV to humans. Finally, local molecular clock modeling suggests a pure pandemic descent of seasonal H1N1 IAV as an alternative to the hypothesis of origination through an intrasubtype reassortment.

Influenza Milestones, Source: CDC

New York Times- The Daily: “One Million”

Today’s episode of The Daily podcast discusses the impending one millionth confirmed COVID-19 death in the United States, providing stories of some of the lives lost and the impact this has had on the living. “One million empty chairs around the dinner table. Each an irreplaceable loss,” President Biden said in a statement Thursday. “Each leaving behind a family, a community, and a nation forever changed because of this pandemic.” The podcast producers write, “We asked listeners to share memories about loved ones they have lost — and about what it’s like to grieve when it seems like the rest of the world is trying to move on. “Time keeps moving forward, and the world desperately wants to move past this pandemic,” one told us. “But my mother — she’s still gone.”” One million people is a number difficult to comprehend, but humanizing this massive number can help one process the gravity of the loss the country has suffered during this pandemic.

What Is Biosecurity for the Twenty-First Century?

After September 11 and the anthrax attacks in 2001, the United States adopted a top-down governance structure for bioterrorism that famously employed “guns, gates, and guards” to prevent attacks, while keeping track of suspicious “insiders” who might cause harm. But today, after the emergence of the novel coronavirus and its variants, society’s idea of what constitutes biological security and safety is changing. Looking toward a future in which gene editing can be done by do-it-yourselfers, biological engineering is common, and environmental changes shape new biorealities, the old top-down model of biosecurity will not be up to the task.

On May 23 at 3:00 PM ET, join Melissa Haendel (University of Colorado Anschutz Medical Campus), David Gillum (Arizona State University), Sam Weiss Evans (Harvard Kennedy School), and Yong-Bee Lim (Council on Strategic Risks) for a discussion moderated by Bryan Walsh (Vox Future Perfect) on how to reimagine biosecurity and biosafety—and even the relationship between biological research and society—for a new era. Register for the event here.

The Danger of Disinformation: Understanding Russia’s Propaganda Campaign Against Ukrainian Biological Facilities

Join NTI for a conversation with Dr. Gregory Koblentz, one of the world’s foremost biodefense scholars working at the nexus of health, science, and security, to discuss the ongoing Russian disinformation campaign against biological research facilities in Ukraine.

As part of an effort to justify its invasion of Ukraine, Russia has sought to sow doubt and confusion around the purpose of public health and research labs in the country, spreading disinformation that these facilities are conducting covert, offensive bioweapon development operations. This tactic is a longstanding favorite of the Russian government, going back decades. Koblentz will explore the true aims of Russia’s disinformation campaign in Ukraine and what the international community should do to counter it. This seminar will be held on May 17 at 11 am EST. Register here.

Lessons from COVID-19 for the Public Health Emergency Enterprise: What Happened to the Plans? – A Workshop

The National Academies of Sciences, Engineering, and Medicine Forum on Medical and Public Health Preparedness for Disasters and Emergencies is hosting a workshop exploring the nation’s Public Health Emergency (PHE) preparedness enterprise, through the lens of COVID-19 in the US. The workshop will be hosted on May 17 and 18, and will explore key components, success stories, and failure points throughout the entire PHE preparedness and response enterprise. Participants will also identify opportunities for more effective catastrophic disaster, pandemic, and other large scale PHEs planning at the federal, state, local, tribal, and territorial levels. Speakers include Dr. Deborah Birx (former Coronavirus Response Coordinator at the Office of the Vice President) and Dr. Gigi Gronvall (Senior Scholar at Johns Hopkins Center for Health Security). Register here.

Dr. Gregory D. Bossart Memorial One Health Scholarship Call for Applicants

A $5,000 USD Dr. Greg Bossart Memorial Scholarship is available to a graduate student in wildlife biology, epidemiology, veterinary, medical, public health, basic or social sciences or other post-graduate program focusing on the interconnection between people, animals, plants, and their shared environment using a One Health framework. The application deadline is July 1, 20022, at 11:59 pm EDT. Learn more about Dr. Bossart and the scholarship here.

Russian WMD Disinformation Resources

The mountain of debunkings and academic commentary on the Russian disinformation campaign targeting DTRA’s Biological Threat Reduction Program-supported labs in Ukraine continues to grow. While a more comprehensive list and tool on the Pandora Report’s website is currently under construction, here are a couple of recent works on the matter:

“Russia Targets Azerbaijan, Others With Fake Bioweapons Claims”

Voice of America’s Polygraph.info fact-checking site published this fact-check discussing Secretary of the Russian Security Council Nikolai Patrushev’s April 27 claim that, “After the collapse of the Soviet Union, the United States and its satellites deployed a network of bio-laboratories in the space of the former Soviet republics – in Georgia, Ukraine, Azerbaijan, Uzbekistan, Kazakhstan, and Armenia, where, under the guise of scientific research, they conduct military-biological activities.” Following Russia’s claim that it “could face biological threats from lab leaks in countries on its southern borders,” Azerbaijan’s State Security Service rejected the claims such labs have never operated in the country on May 7.

“Americans Love Conspiracy Theories, and That’s Dangerous for Everyone”

Matthew A. Baum and Katherine Ognyanova with the Bulletin of the Atomic Scientists discuss some of their findings from the COVID States Project in this piece. They explain their recent national survey asking respondents to assess the accuracy of eight popular false claims, four of which were about the COVID-19 vaccine. The other four pertained to Russia’s war in Ukraine. They also asked respondents about their attitudes and behaviors regarding both crises. They write, “The results contain both good and bad news. The good news is that in both cases, most Americans did not believe false claims about either crisis…The bad news is that relatively large percentages of respondents were unsure about the accuracy of the false claims.”

Something a Little Less Serious If You Made It This Far… “Utah Plant Pest Diagnostic Lab Wins NPDN’s Rotten Tuber Award for ‘Hazmat Team Called for Bee Excrement!’”

USDA’s National Institute of Food and Agriculture announced Wednesday that the Utah Plant Pest Diagnostic Lab at Utah State University was awarded first place in the National Plant Diagnostic Network (NPDN)’s Rotten Tuber Awards for its submission – “Hazmat Team Called for Bee Excrement!” The Rotten Tuber Awards recognize unique samples that leave plant diagnosticians asking themselves, “What was this person thinking when they sent this sample?” From USDA NIFA:

“Enjoy “Hazmat Team Called for Bee Excrement!” submitted by Zach Schumm, arthropod diagnostician and urban IPM associate, and Claudia Nischwitz, plant pathologist specialist:

“In mid-August 2021, the Utah Plant Pest Diagnostic Lab received a frantic call from an individual at a local Department of Health regarding a substance that was found on school buses that were about to be sent out to pick up children. They weren’t sure what the substance was and due to safety concerns, they delayed the use of the buses. Thinking the substance could be from a plant or plant derived, they contacted us in the diagnostic lab to see if we could offer any immediate advice. But they made it abundantly clear that they had no idea what the substance could have been. And tensions were clearly high! 

“When we were contacted by the individual, Zach Schumm had them send photographs of the substance and told them we would call back immediately once we got a look. Zach identified the substance immediately as bee excrement and nothing of concern. Within a few minutes, we called the individual back and she immediately put me on speakerphone. 

“Schumm vividly remembers telling them I knew what the substance was, and they replied “Oh my god! Okay wait! I am putting you on speaker phone with others from the department of health, the local sheriff’s department and the hazmat team. We are all stationed on-site under a tent!” This was no ordinary response; it was being treated as a potential threat and public health crisis. So there Zach is, one minute just eating a bland lunch and thinking his job is to identify insects, and the next minute he’s talking to high-level officials with much more authority than himself about the simple fact that bees decided to poop on their school buses.

“To help confirm the substance identification, Zach asked them if there were any agricultural fields nearby that would result in a high abundance of bees. Sure enough, the place where the buses were parked was adjacent to agricultural fields. 

“When Zach applied to his position — arthropod diagnostician — he wasn’t aware that he was going to have to save the day by saying the word “poop” to a hazmat team and the Department of Health. We are eternally grateful about the quick response by Utah officials to keep Utah’s children safe when there was a concern, but you can’t help but laugh at the situation.”

The culprit, pictured moments after terrorizing school buses in Utah. Source: KONICA MINOLTA DIGITAL CAMERA

Pandora Report: 5.6.2022

Happy National Nurses Day to all our readers in the US and a big thank you to the countless nurses working hard always, but especially during this pandemic! Our main focus this week is on the continued spread of H5N1 influenza in the United States and current challenges and evolving knowledge of the COVID-19 pandemic as BA.2.12.1 accounts for more and more cases. We have also included several new publications, a couple of great new podcast episodes, and announcements, including the launch of CBWNet. Finally, in case you missed it, check out our May 4 special feature on bioweapons in Star Wars on our site.

The Birds, 2022 Edition

Highly Pathogenic Avian Influenza A(H5N1) continues to spread in the United States with 32 states reporting at least one confirmed infected flock as of May 5, 2022. Iowa has the most infected birds currently, with USDA reporting a total of 13,373,901 infections in that state. Minnesota has the most infected flocks currently at 69. 34 states have also reported positive samples in wild bird populations across the country. This has prompted massive poultry culling across the US in an attempt to control outbreaks in commercial and backyard flocks. For example, Rembrandt Enterprises, a large egg producer in Iowa owned by the same person as the Minnesota Timberwolves, has culled 5.3 million hens so far using what some describe as inhumane methods, prompting multiple public protests at Timberwolves games (Rembrandt also laid off most of its staff in the process as well, contributing to the backlash). HPAI spreads rapidly through bird populations and is a particularly painful disease for the birds to suffer through. Many of the H5 and H7 subtype viruses cause severe, systemic disease with near 100% mortality, prompting the culls. Amid skyrocketing grocery prices, eggs and poultry are especially more costly these days, with nearly 9% of all US hens having been culled recently. This is particularly challenging as the world, including the US, has steadily increased its egg consumption over the last decade, with many turning to chicken eggs as a cheaper source of protein compared to meat.

US states with detection of HPAI in wild birds as of May 5, 2022. Source: USDA APHIS

While large commercial flocks are easy targets for rapid infection, illegal cockfighting rings are also pressing dangers. Cockfighting is illegal in all US states and it is penalized as a felony in 42 of them, though enforcement and punishment vary. Oklahoma, a state with at least 20 documented major cockfighting traffickers, is especially at risk as it is a prime location for inter-state shipment of fighting birds who have higher chances of coming into contact with commercial birds along the way. Of the Oklahoma rings, Wayne Pacelle (President of Animal Wellness Action and the Center for a Human Economy) said, ““Cockfighting has unique potential to make the avian influenza outbreak even more deadly and far-reaching. Cockfighters are orchestrating illegal fights in state that cluster people and their animals from multiple states, creating perfect conditions for birds to contract the disease and then to spread it back home when the derbies are done.”

This comes as some in the Oklahoma legislature seek to lessen punishments for cockfighting. State Rep. Justin Humphrey’s measure would also “redefine the definition of “cockfighting.” Only when the birds are fitted with artificial spurs, knives or gaffs would it be considered a cockfight. Language would be removed from the law that currently includes “any training fight in which birds are intended or encouraged to attack or fight with one another” under the definition of “cockfight.” This bill, HB 3283, passed out of committee with a 5-0 vote before failing to be voted on before the legislative deadline, though Humphrey later amended a similar Senate bill that subsequently also passed the House committee. Oklahoma City’s Journal Record wrote, “Tropical conditions overseas, where there is a demand for cockfighting birds, makes it difficult to raise healthy birds in those climates – that’s why they buy quality birds from Oklahoma, Humphrey said. Purchasers might buy several males aged 10 months, raise them to two years and then choose best to use for breeding the next generation.”

Colorado reported a case of H5 influenza in a person who had direct exposure to poultry while culling animals with presumptive H5N1 bird flu late last month. CDC has confirmed the case and insists that the public health risk of H5N1 remains low as this person had direct exposure to infected animals. The patient experienced several days of fatigue (their only symptom) and has since recovered following isolation and treatment with oseltamivir (Tamiflu). CDC has been monitoring exposed humans for symptoms since the outbreaks were first detected in bird populations in late 2021, finding just one case so far in the 2,500 people tracked. The UK notified the WHO of a confirmed human H5 case in South West England in January of this year, bringing the human case total to two so far this round. Over 880 human infections with previous H5N1 viruses have been reported since 2003, though the predominant H5N1 viruses circulating currently in birds globally are different from previous viruses, according to CDC. 10 people who came into contact with the Colorado case or were also exposed at work are under close observation.

“Transmission electron microscopic image of two Influenza A (H5N1) virions, a type of bird flu virus Note the glycoprotein spikes along the surface of the virion and as a stippled appearance of the viral envelope encasing each virion.” Source: CDC/ Cynthia Goldsmith; Jackie Katz

Avian influenza (AI) cases have been documented in commercial flocks since at least the 1800s. However, AI became a much more troubling threat at the end of the 20th century when an H5N1 outbreak in Hong Kong resulted in 18 infections and six deaths in the human population and the culling of over 1 million chickens. Outbreaks of H5N1 naturally occur every few years, with the last one in the US occurring in 2014 and 2015. While bird flu viruses typically do not infect humans (and generally only infect those with close contact with infected animals), there is concern that these viruses might mutate and become better able to spread in human populations, potentially causing wide spread disease. There is no indication this has happened yet, but it is important to limit the opportunity for this to happen by containing the outbreak. Read more on precautions, including those for bird feeders, from the Raptor Center at the University of Minnesota.

Our Evolving Understanding of COVID-19 and Its Impacts

27 months into the pandemic, the United States reached 1 million COVID-19 deaths to on Wednesday. While not as high as they once were, the US is averaging about 600 deaths per day in its current 7-day average. Cases are continuing to climb as well across the country, with the BA.2.12.1 subvariant now accounting for 29% of new infections. The WHO also confirmed this week that the world saw 14.9 million excess deaths associated with the COVID-19 pandemic in 2020 and 2021, a grim reminder of how severe this has been.

This comes as the FDA announced this week that it is limiting the EUA on the Johnson & Johnson/Janssen COVID-19 vaccine “to individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate, and to individuals 18 years of age and older who elect to receive the Janssen COVID-19 Vaccine because they would otherwise not receive a COVID-19 vaccine.” The FDA stated this is because of the risk of developing thrombosis with thrombocytopenia syndrome associated with the J&J vaccine. Unlike the mRNA offerings from Pfizer and Moderna, the J&J vaccine uses more traditional viral vector technology, using a disabled adenovirus to deliver COVID-19’s DNA to cells, instructing them to produce the spike proteins. This prompts the body to mount an immune response by creating antigens. While the J&J vaccine was initially thought to be a game changer in terms of its potential to increase patient compliance versus that of the two dose vaccines, it only proved to be 66.3% effective in preventing lab-confirmed COVID-19 infection, despite being highly efficacious in preventing hospitalization and death in those who did fall ill. It also was later found to be less effective against the Delta and Omicron variants that emerged in late 2021. This EUA limitation comes alongside pandemic response challenges. With the prospect of more COVID-19 funding for the administration held up in Congress, it’s unclear if the Biden administration could even afford a broader push for second boosters the FDA has hinted at recently.

The recent Omicron subvariants have, in some ways, fundamentally changed how many think of the pandemic. With the federal mask mandate struck down, many, including Delta Airlines, have celebrated the “return to normal” and COVID-19’s transition “to an ordinary seasonal virus.” Megan Molteni with STAT News notes that COVID-19 has yet to find a seasonal cadence and COVID-19 is still more than capable of causing mass death and disability, as recently witnessed in Hong Kong. Omicron has brought a number of changes still, such as drastic differences in how the virus spreads among people. Whereas up to 80% of infections with the original version were caused by about 10 to 20% of those infected, Omicron is spreading much more in places like households, meaning superspreader events might be less important as key drivers of outbreaks. Given the drastic differences in variants, some scientists think it is worth turning to prior variants that never took off as much as ones like Delta and Omicron to better understand what future variants might bring, according to this new article in the New York Times.

Of course, the costs of this pandemic have not been limited to lives alone. A recent article in Nature examines the long-term health consequences of the COVID-19 pandemic on healthcare workers (HCWs). The results are not all that surprising–more front-line HCWs now show signs of PTSD than they did before the pandemic. In the article, Ouyang et al. seek to “investigate the development of posttraumatic stress disorder (PTSD) in HCWs in a longitudinal manner.” They also aim to further explore how risk perception impacts the evolution of PTSD over a longer period of time using a one-year follow-up study. Their study used HCWs in Guangdong, China (a coastal city bordering Macau and Hong Kong) and concludes, “Our data provide a snapshot of the worsening of HCWs’ PTSD along with the repeated pandemic outbreaks and highlight the important role of risk perception in the development of PTSD symptoms in HCWs over time.”

“Risky ‘Gain-of-Function’ Studies Need Stricter Guidance, Say US Researchers”

This new news piece from Nature details experts’ calls for the US government to improve its guidance on experiments that might make pathogens more deadly or transmissible. It covers the April 27 listening session offered by the National Science Advisory Board for Biosecurity (NSABB), to which Biodefense Graduate Program Director Dr. Gregory Koblentz provided a statement. The Nature article explains that, “Many at the listening session pushed for stricter oversight of risky-pathogen research, however. Some suggested that the HHS advisory-panel approach be extended to other US entities. Gregory Koblentz, a biosecurity-policy specialist at George Mason University in Arlington, Virginia, pointed out that pharmaceutical firms, philanthropic institutions and federal agencies, including the Department of Energy, the Department of Agriculture and the Department of Defense, also conduct research on potentially risky pathogens. They should adhere to the same guidelines, he said.”

While the debate about gain-of-function (GoF) testing has been strong over the last decade, it has gained renewed attention amid the COVID-19 pandemic and debates about the origin of SARS-CoV-2. In 2014, the US government announced a funding moratorium on GoF experiments that was lifted in 2017 after HHS implemented an extra review layer for such experiments. While most virologists think SARS-CoV-2 spilled-over to humans directly from animals, this has remained a political debate in the US centering on the Wuhan Institute of Virology. Regardless of COVID-19’s origin, concerns over these kinds of experiments and challenges in biosecurity standards should still be reviewed and addressed now before it is too late. Watch the NSABB listening session recording here and read the Under the NIH Poliscope blog post about it here.

“Building a Sustainable Biopreparedness Industrial Base”

The MITRE Corporation recently released this report discussing the state of the American biopharma industry and what objectives the US government should pursue within it. MITRE identifies several shortfalls across USG capabilities, the mRNA industry, and the mRNA supply chain and ecosystem. The report argues that “To counter strategic competition in this industry, the United States needs a focused approach to drive action and accountability on sustaining needed capacity and capabilities. However, a history of inconsistent priorities and funding constitutes a significant barrier to creating a strong partnership between government and industry in this sector.” The report outlines a number of courses of action the US government can take to help improve this capacity and help protect the US population from future biological threats.

“Strengthening Biological Security After COVID-19: Using Cartoons for Engaging Life Science Stakeholders with the Biological and Toxin Weapons Convention”

Novossiolova et al.’s new article in the Journal of Biosafety and Biosecurity reports on the development of an awareness-raising resource which uses the cartoon format to facilitate consideration of biological and chemical security issues. This resource takes the form of a cartoon series comprising five two-page thematic cartoons. The cartoon series was published by the London Metropolitan University, UK and is freely available online in 13 languages. Indicative facilitation notes aim to support the use of the cartoon series for outreach and training.

Critical Federal Capabilities Needed to Evaluate Real-World Safety, Effectiveness, and Equitable Distribution and Use of Medical Countermeasures During a Public Health Emergency

From the National Academies:

The COVID-19 pandemic has highlighted the importance of having access to real-world data and evidence to monitor and assess medical countermeasure (MCM) use and performance so policy makers can make more effective and rapid public health decisions, protect population health, and save lives. During public health emergencies, the use of MCMs, such as therapeutics, vaccines, and diagnostics, can be made available to the public under a range of regulatory access mechanisms.

This Rapid Expert Consultation was produced by individual members of the Standing Committee for CDC Center for Preparedness and Response. Its aim is to review and propose modifications to an initial draft list of critical federal capabilities presented by the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration that are needed to evaluate real-world safety, effectiveness, equitable distribution, access, and use of MCMs during a public health emergency. This effort draws from expert input, published literature, and lessons learned from previous public health emergencies, as well as the ongoing COVID-19 pandemic.

“Summit on Strengthening the Nation’s Early Warning System for Health Threats: A Meeting Summary”

The White House released this meeting summary covering its April 19 Summit supporting the launch of the CDC’s Center for Forecasting and Outbreak Analytics (CFA). The summit included panels on Next-Generation Public Health Data and Analytics, Enabling Local Governments, Strengthening the System for Patients, and closing remarks from Dr. Sandi Ford, Special Assistant to the President for Public Health & Science, Domestic Policy Council.

The Role of Public Health Emergency Management in Biodefense: A COVID-19 Case Study”

Incoming Biodefense PhD Student Ryan Houser recently published a new article in Disaster Medicine and Public Health Preparedness. Houser uses the COVID-19 pandemic to “explore the biodefense and public health preparedness landscape for tends in federal support and capacity building.” He identifies a number of consistent failures and concludes that, “To counter the increasing biothreats, the United States must invest in revamping the biodefense infrastructure to mimic and support public health emergency preparedness initiatives which will increase our resilience to various biothreats.”

Student Features

Biodefense MS Student Theresa Hoang‘s research paper, “­­The Hidden Pandemic: COVID-19’s Impact on Antimicrobial Resistance”, was recently posted on the Pandora Report. Hoang uses a number of case studies to discuss how AMR has grown as a threat over the course of the pandemic and what might be done to help combat this mounting public health crisis, including improvements in antibiotic stewardship programs.

Biodefense PhD Student Danyale C. Kellogg recently discussed the threat Chinese failed outbreak responses pose to global health security on the Schar School’s Center for Security Policy Studies (CSPS) website. Kellogg, a current CSPS Fellow, covers prior failures of the Chinese Communist Party in the COVID-19 outbreak response in addition to its efforts to cover up the spread of HIV/AIDS in Henan Province in the 1990s and SARS in the early 2000s. She discusses the challenges of preparing for future pandemics in light of a rising China that is more interested in usurping the international order than promoting global health security.

This Podcast Will Kill You Episode 95, Tetanus: An Inhumane Calamity!

The Erins go beyond the risks of rusty nails and Tdap booster requirements to discuss the biology, clinical presentation, and historical and modern challenges posed by this disease. They provide an especially interesting discussion of how neonatal tetanus in the American South impacted the field of epidemiology on top of all the other great content packed into this episode.

Franklin Institute’s So Curious! Podcast: What is Biohacking? From Bodybuilding to Bacterial Shoes

Episode 9 of So Curious! continues this season’s theme of Human 2.0 by discussing innovations in hacking the human body. Covering everything from cyborgs and laws and ethics, this episode features Ricky Solorzano (CEO of Allevi) and Scott Shunk (a physique athlete who provides an interesting perspective on this topic). Give it a listen!

The 2021 Global Health Security Index: A Tool for Decision-Makers in Latin America

The Nuclear Threat Initiative (NTI) and the Initiative for Global Security (IGS) are offering this Zoom event on May 11 at 3:30 pm EST. The GHS Index is a comprehensive assessment and benchmarking of health security and related capabilities across 195 countries. Since the launch of the first edition of the GHS Index in October 2019, much has changed as a result of the COVID-19 pandemic. The second edition of the GHS Index considers lessons learned from this experience and expands upon the measures of national level health security. National leaders across the globe bear a collective responsibility for developing and maintaining robust global capability to counter infectious disease threats. Political will is needed to protect people from the consequences of epidemics, to take action to save lives, and to build a safer and more secure world. Register here.

The Danger of Disinformation: Understanding Russia’s Propaganda Campaign Against Ukrainian Biological Facilities

Join NTI for a conversation with Dr. Gregory Koblentz, one of the world’s foremost biodefense scholars working at the nexus of health, science, and security, to discuss the ongoing Russian disinformation campaign against biological research facilities in Ukraine.

As part of an effort to justify its invasion of Ukraine, Russia has sought to sow doubt and confusion around the purpose of public health and research labs in the country, spreading disinformation that these facilities are conducting covert, offensive bioweapon development operations. This tactic is a longstanding favorite of the Russian government, going back decades. Koblentz will explore the true aims of Russia’s disinformation campaign in Ukraine and what the international community should do to counter it. This seminar will be held on May 17 at 11 am EST. Register here.

Lessons from COVID-19 for the Public Health Emergency Enterprise: What Happened to the Plans? – A Workshop

The National Academies of Sciences, Engineering, and Medicine Forum on Medical and Public Health Preparedness for Disasters and Emergencies is hosting a workshop exploring the nation’s Public Health Emergency (PHE) preparedness enterprise, through the lens of COVID-19 in the US. The workshop will be hosted on May 17 and 18, and will explore key components, success stories, and failure points throughout the entire PHE preparedness and response enterprise. Participants will also identify opportunities for more effective catastrophic disaster, pandemic, and other large scale PHEs planning at the federal, state, local, tribal, and territorial levels. Speakers include Dr. Deborah Birx (former Coronavirus Response Coordinator at the Office of the Vice President) and Dr. Gigi Gronvall (Senior Scholar at Johns Hopkins Center for Health Security). Register here.

Chemical and Biological Weapons Net Launched

The CBWNet research project received funding from the German Federal Ministry of Education and Research, lasting April 2022 through March 2026. The project will be carried out by the Berlin office of the Institute for Peace Research and Security Policy at the University of Hamburg (IFSH), the Chair for Public Law and International Law at the University of Gießen, the Peace Research Institute Frankfurt (PRIF) and the Carl Friedrich Weizsäcker-Centre for Science and Peace Research (ZNF) at the University of Hamburg. The joint project aims to “identify options to comprehensively strengthen the norms against chemical and biological weapons (CBW).” The project includes an analysis of the normative order of these regimes and investigation of the potential consequences of certain technological developments in light of changing security dynamics. The project’s site explains, “Wherever research results point to challenges for or a weakening of CBW norms, the project partners will develop options and proposals to uphold or strengthen these norms and to enhance their resilience.”

Russian WMD Disinformation Resources

The mountain of debunkings and academic commentary on the Russian disinformation campaign targeting DTRA’s Biological Threat Reduction Program-supported labs in Ukraine continues to grow. While a more comprehensive list and tool on the Pandora Report’s website is currently under construction, here are a couple of recent works on the matter:

“People’s Republic of China Efforts to Amplify the Kremlin’s Voice on Ukraine”

The US State Department released this Disarming Disinformation piece outlining how China and its state outlets seek to influence public opinion on Russia’s war in Ukraine. It discusses the PRC’s toolbox of methods to do this and offers a detailed timeline of these attempts along with more sources on the subject.

“Ukraine’s Battlefield Is Haunted by Putin’s Chemical Weapons Legacy”

William J. Broad’s new piece in the New York Times begins with the 2017 televised destruction of what President Vladimir Putin claimed was the last of Russia’s CW stockpile before diving into current concerns about his potential to use these weapons in Ukraine. Broad discusses differences between how the Kremlin treats nuclear and conventional war versus chemical war as well as past Russian uses of CW, including during the hostage crisis in a Moscow theater in 2002.

“Are Russia’s Claims of Ukrainian Biological Weapons a Propaganda Ploy?

Deutsche Welle released this English language backgrounder on Russian disinformation focusing on BW. It includes a portion about accusations targeting modern Germany specifically, including the Bundeswehr Institute of Microbiology’s collaboration with Kharkiv’s Institute of Experimental and Clinical Veterinary Medicine.

EUvsDisinfo Now Available in Mandarin Chinese

The European External Action Service’s EUvsDisinfo is now offering articles published in Chinese to target Chinese-speaking audience with factual information about the war in Ukraine. This is in response to previous alignment of pro-Kremlin and Chinese state outlets using disinformation tactics on subjects like biological weapons and the origins of COVID-19. One report released in March (““生物武器被全面禁止,但是进行生物研究并不违法””/””Bioweapons Are Totally Banned, But It’s Not Illegal to Conduct Biological Research””) discusses the mission of the Nunn Lugar Program and the legal, important public health work it conducts in host countries.

Pandora Report 2.9.2018

Happy Friday fellow biodefense enthusiasts! The Winter Olympics are already starting off with a bang as Korean health officials have confirmed 128 cases of norovirus among security personnel, police officers, and Olympic workers.

WHO Releases List of Blueprint Priority Diseases
The WHO has just released their annual review of the Blueprint list of priority diseases, which includes a special tool for “determining which diseases and pathogens to prioritize for research and development in public health emergency contexts”. While the list includes diseases like Ebola, MERS and SARS, Nipah, and Zika, it is the inclusion of Disease X that highlights the unknowns of infectious diseases in the future.  “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown ‘Disease X’ as far as possible.”

BioWatch Documents Left Behind on Flight
Biowatch officials are doing a bit of a damage control at the moment as multiple copies of an official DHS document regarding performances during a bioterrorism simulation were left behind on an airplane prior to the Super Bowl. The errant document offered a critique of how officials performed during a simulated release of the infectious disease anthrax in Minneapolis on the day of the Super Bowl. Other sensitive material was also found, CNN said, without further description.” Ironically, it was a CNN employee who discovered the forgotten papers in the seat-back pocket of a commercial plane. “The reports were accompanied by the travel itinerary and boarding pass of the government scientist in charge of BioWatch, the DHS program that conducted the anthrax drills in preparation for Super Bowl LII in Minneapolis. The reports were based on exercises designed to evaluate the ability of public health, law enforcement and emergency management officials to engage in a coordinated response were a biological attack to be carried out in Minneapolis on Super Bowl Sunday.” CNN waited to publish the incident until after Sunday’s game, but the papers revealed significant areas for response improvement during a bioterrorism incident. While not surprising, the identification of such gaps is critical for improvement however, it is the concerning nature of which they were left behind. Vulnerabilities are always present, but that doesn’t mean we want them being aired in the open for nefarious actors to utilize.

 GMU Biodefense PhD Student Selected As ELBI Fellow 
The Biodefense Graduate Program in the Schar School of Policy and Government at George Mason University is proud to announce that PhD student Yong-Bee Lim has been selected for the prestigious Emerging Leaders in Biosecurity Fellowship (ELBI) program within the Johns Hopkins Center for Health Security. Selected from a group of over 120 international applicants, the 2018 ELBI class includes professionals and scholars with a passion for health security and biosecurity. This year-long fellowship will deepen the biosecurity expertise and broaden the network of those passionate about furthering the field. Yong-Bee was also the recipient of an internship with the Center for Global Security Research at Lawrence Livermore National Laboratory and the SB7.0 Fellowship, which supported his attendance of an international synthetic biology conference in Singapore. His selection also marks the third consecutive year that the Schar School’s Biodefense program has had graduate students named ELBI fellows. Congrats Yong-Bee!

Smallpox Signalling
It’s been a couple of weeks since PLOS One published the horsepox synthesis paper and the truth is that many are still in awe that not only such work was done, but that it was published. Where were broader discussions regarding the merits of this research? Conversations about need to publish it? Moreover, what about the importance of oversight in the private biotech arena and not just those with federal funding? One thing is for certain though, this is a critical moment for life sciences and DURC oversight. “A vaccine against smallpox already exists. The research was carried out unilaterally, without a broader discussion of the merits beforehand. There are apparently few oversight mechanisms when experiments are done with private funding. The restrictions that now cover dual-use research funded by U.S. government — which include an independent review process, and a weighing of the risks and benefits, as well as the ethics — should be expanded to private-sector research.”

Topics of Interest at the DHS Meeting on Sequences of Interest
Synthetic biology has led to the creation of new products, markets, companies, and industries. At the same time, this technology poses potential risks to biosafety and biosecurity, as recently demonstrated by the synthesis of horsepox virus, a cousin of variola, the virus that causes smallpox.  On January 29-30, 2018, the Department of Homeland Security (DHS) Science and Technology Directorate sponsored a workshop to discuss the evolving role of databases that contain genetic sequences of pathogens and toxins that pose safety or security concerns, termed “sequences of interest.” The workshop brought together stakeholders from government, industry, and academia to discuss the need for such databases, review current databases and those under development, explore potential applications and users of these types of databases, and consider the potential risks that they pose due to malicious or inadvertent misuse. The workshop provided a valuable opportunity to explore the scientific and technical aspects of constructing such databases, maintenance and sustainability challenges, and the trade-offs involving functionality, accessibility, affordability, confidentiality, and security. While the workshop did not produce a consensus on the best path forward, it played an important role in educating the participants on the most critical issues and facilitating a dialogue among a diverse range of stakeholders on this important topic.  The workshop also came at a propitious time as stakeholders grapple with the changing landscape of the biotech industry and advances in DNA synthesis technology.  For instance, the International Gene Synthesis Consortium, a group of the leading DNA synthesis companies that have adopted customer and sequence screening protocols to prevent the misuse of their products, has expanded in size and geographic scope and recently updated its biosecurity protocols. The U.S. government is also reviewing the customer and sequence screening guidance it issued in 2010 and is considering whether, and how, to update it.  Should a decision be made to proceed, stakeholder engagement would be a significant part of the review, just as it was a significant part of the guidance’s original development.

The US Can’t Afford to Reduce Public Health Funding
GMU biodefense PhD alum Daniel M. Gerstein is evaluating the decision to reduce funding for global epidemic prevention activities and just how dangerous that would be for the United States. “Recent reporting suggests that the Trump administration is preparing to downsize the Centers for Disease Control’s (CDC) global epidemic prevention activities in 39 of 49 countries starting in 2019 when funding first authorized by Congress in 2014 expires. Such a move is potentially dangerous and could place the U.S. at significant risk.” Gerstein points to the notion of shared responsibility in global health security and how important efforts like the GHSA are for global public health. He also notes that the last decade alone has revealed just how undeniable public health is as a national security issue. “Without renewed funding, the long-term outlook could include weakened global disease surveillance and response systems, less capable partner nations and an increased likelihood of global disease outbreaks that would undoubtedly threaten the U.S.” Wanting more information regarding the implications of CDC cutting back on their global health security funding? Check out this article regarding the funding cliff the CDC is about to fall off.

Biosecurity in Putin’s Russia
The latest book from Raymond A. Zilinskas and Philippe Mauger delves into the biodefense world of Putin’s Russia. “In March 2012, at a meeting convened by the recently reelected Russian president Vladimir Putin, Minister of Defense Serdyukov informed Mr. Putin that a plan was being prepared for ‘the development of weapons based on new physical principles: radiation, geophysical wave, genetic, psychophysical, etc.’ Subsequently, in response to concerns expressed both in Russia and abroad, the Russian government deleted the statement from the public transcript of the meeting. But the question remains: Is Russia developing an offensive biological warfare program?”

Global Monitoring of Disease Outbreak Preparedness
The Harvard Global Health Institute has released their new report that is “a step towards developing a shared framework and monitoring mechanism” for outbreak response and preparedness. “This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required to reduce such risks. These risks include the expected health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally.” The report focuses on strengthening public health capacity as a foundation, improving S&T, reinforcing risk analysis and incentives for action, strengthening global mechanisms, and revised shared monitoring framework and next steps.

 The Fearsome Future of Flu
This year has been rough for seasonal flu and while it has been a cold dose of reality in terms of hospital response, are we really learning our lesson or just running from fire to fire? 2018 marks the centennial of the 1918/1919 influenza pandemic and with a larger, more connected population, have we made ourselves safer? The next flu virus with pandemic potential will either enhance our response capabilities or exploit our most damning weaknesses. “And influenza viruses excel at the element of surprise. Few would have guessed Mexico as the origin of that 2009 H1N1 pandemic, for example, notes Fukuda. That outbreak was recognized in San Diego—never considered a hotspot—when a little girl happened to seek treatment at a clinic participating in a study focused on diagnosis, Adalja explains. That’s why he believes it is important to build up the diagnostic capacity for frontline clinicians, and not be satisfied with non-specific diagnoses—failing to pin down the specific microbial cause.” Unfortunately, we are still practicing the methods of frenzied response, delayed information sharing, and dangerous hysteria that can spread even faster through social media. These concerns highlight yet another reason why we need a universal flu vaccine.

Johns Hopkins Center for Health Security Event: Healthcare Disaster Resilience
Don’t miss this event at the National Press Club Holeman Lounge on Thursday, February 22nd from 8:30-10am EST. The Johns Hopkins Center for Health Security will release new policy recommendations for building a more effective disaster health system in the United States. Speakers include Dr. Luciana Borio from the White House National Security Council staff, Sally Phillips of HHS, Linda Langston from the National Association of Counties, as well as Drs.Tom Inglesby, Eric Toner, Monica Schoch-Spana from the Center for Health Security.

 Genetic Sequencing and the Dangers of DIY Genome Editing
Nebula Genomics will sequence your genome for just under $1,000 and you can even share it using a blockchain.  “Nebula is the brainchild of geneticist George Church, PhD student Dennis Grishin, and graduate Kamal Obbad, all from Harvard. Mirza Cifric, CEO of Veritas Genetics, which offers a genome-sequencing service for $999, is a founding advisor. When you pay to take a DNA test—through 23andMe, Helix, or Ancestry.com, for example—the company that does the testing owns your genetic data. Nebula wants to sequence people’s entire genomes and let them own it, allowing them to earn digital money by sharing it.” While professionals may be providing your genomic data through these companies, many are looking to actually learn to experiment with genes themselves. DIY gene therapy is becoming increasingly accessible, which has many worried and the FDA issuing a warning to the public. The FDA, on “November 21 cautioned against do-it-yourself (DIY) gene therapies. But even as the agency’s statement also warned that selling gene editing kits aimed at homemade therapeutics is illegal, CRISPR–Cas9 kits are available to buy online, and the number of providers is growing, raising concerns that DIY gene therapy enthusiasts could be putting themselves and others at risk.”

Biodefense Policy Landscape Analysis Tool
B-PLAT is a new tool from Pacific Northwest National Laboratory scientists Rachel Bartholomew and Kristin Omberg that aims to help coordinate national biodefense preparedness. It “captures and presents a slew of information about U.S. efforts to protect its citizens and others around the world from threats as diverse as the flu, diseases like Ebola, threats from terrorists, potential risks to water and food supplies, and myriad other concerns. The tool is freely available. In 2017, PNNL chartered an internally funded working group, the Policy Wranglers, to capture relevant biodefense policy directives, public laws, and corresponding sections of the U.S. Code, in a format conducive to visualization. The resulting tool can be utilized to better understand the current state of the U.S. biodefense enterprise.” A presentation on B-LAT will also be made at ASM’s Biothreats next week as part of a town hall on Tuesday.

Stories You May Have Missed:

  • US Battles IV Bag Shortage During Record-Setting Severe Flu Season – GMU biodefense PhD student Saskia Popescu is looking at the impacts of this IV bag shortage during the severe flu season. “Even prior to Hurricane Maria, the United States was already battling challenges with meeting the demand for IV fluids; however, the storm crippled Puerto Rico-based manufacturing sites for materials. In a news release on January 16, the FDA reported that they were taking additional steps to combat the shortages, such as ‘asking companies to submit data to extend expiration dates for these products.’ They noted that, ‘if expiration dates can be safety extended [for these products], it would allow some near-expiry product that remains at the hospital level to be used’.”
  • DARPA Program to Track Genetic Markers for Past WMD Material Exposure – “The program is being called Epigenetic Characterization and Observation (ECHO), and its endgame is the creation of a field-deployable system that could analyze someone’s epigenome and identify markers of whether or not–in that person’s entire lifetime–been exposed to WMD-associated materials. DARPA officials are billing it as worlds quicker than sending to a lab to test for biological or chemical agents in clothing or hair.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 1.19.2018

Happy Friday and welcome to your favorite source for all things biodefense! We hope you’re able to avoid the onslaught of respiratory viruses that are circulating right now, but on the off chance that you’re battling a bug, here’s some infectious disease new that won’t get you sick.

Fighting Influenza
Whether you’re fighting the flu or watching the mayhem unfold in the news, you can’t escape influenza right now. We’re getting hit hard with flu season in the United States and the CDC has reported that activity is still rising and we’re not out of the woods yet. You can find the latest flu data here, but what is worrying so many is the hit that hospitals are taking across the country. It’s not just that we’re facing an IV bag shortage due to the devastation Hurricane Maria wreaked upon Puerto Rico, but that hospitals are being overrun with an onslaught of ILI (influenza like illness) patients. Wait times are through the roof, staff are stretched thin, patients are being admitted into overflow areas, hospitals are having to divert patients because they’re so full, triage areas have been set up in parking lots and emergency areas, and hospitals are even struggling to ensure they have enough PPE and influenza tests. This year marks the centennial of the 1918/1919 influenza pandemic, and it seems like what’s going on is out of a history book instead of down the street. As an infection preventionist and infectious disease epidemiologist, it is not surprising or unexpected that we’re running into these issues. It’s easy for people to point to the current situation and use it as an example of why we’re not ready for a flu pandemic – and they’re right, but it shouldn’t take what’s going on to see that. These are not new issues. Infection control and hospital preparedness has been struggling for a long time and it doesn’t take a pandemic to prove it. Even after the surge of funding and focus on hospital preparedness post-Ebola, we still struggle with these issues, but throw in budget cuts and an administration that is set to pull funding away from public health…well, the outlook is dismal.

With so much attention on influenza, pandemic preparedness, and how we’re just not ready for the next great flu pandemic, what kind of household interventions can we apply in our own little ecosystems? Researchers looked at a HPAI H5N1 outbreak and estimated the reduction in primary attack rates for household-based interventions. “We show that, for lower transmissibility strains, the combination of household-based quarantine, isolation of cases outside the household, and targeted prophylactic use of anti-virals will be highly effective and likely feasible across a range of plausible transmission scenarios. For example, for a basic reproductive number (the average number of people infected by a typically infectious individual in an otherwise susceptible population) of 1.8, assuming only 50% compliance, this combination could reduce the infection (symptomatic) attack rate from 74% (49%) to 40% (27%), requiring peak quarantine and isolation levels of 6.2% and 0.8% of the population, respectively, and an overall anti-viral stockpile of 3.9 doses per member of the population.” While we all may not access to anti-virals, the use of quarantine and isolation are all effective strategies. From an infection control standpoint, it can be tough to maintain such efforts in a household where one or two people are sick. When in doubt, wash your hands, cover your cough, and clean those high-touch surfaces/objects!

GMU Biodefense MS Open House
Mark your calendars for the February 21st Master’s Open House at GMU’s Arlington campus! If you’ve been thinking about getting a MS in biodefense (who wouldn’t want to take classes on biosurveillance, historical bioweapons programs, and more?!), this is a great chance to talk to faculty and learn about the admissions process. GMU has biodefense MS programs in person and online, so even if you’re not in the DC-area, you can get your biodefense on.

Smallpox, Horsepox, And The Trouble With Poxviruses
It seems only a few months ago that news broke of a Canadian research team’s de novo synthesis of horsepox. Since then, there has been considerable discussion surrounding not only the biosafety and biosecurity behind research involving an orthopoxvirus, but also the implications of normalizing orthopoxvirus synthesis, and again, if the remaining smallpox stockpiles should be destroyed. The latest report from researchers at the University of Alberta points to the potential smallpox vaccine developments that synthetic viruses could bring. “Virologist David Evans and his research associate Ryan Noyce produced an infectious horsepox virus, which they synthetically reconstructed using a published genome sequence and DNA fragments manufactured entirely by chemical methods. The team went on to show that the synthetic horsepox virus could provide vaccine protection in a mouse model of poxvirus infection.” Unfortunately, the implications of synthesizing an orthopoxvirus aren’t so simple. GMU biodefense professor and program director Dr. Gregory Koblentz evaluated the implications of such synthesis for biosecurity and what would be needed to prevent a reemergence of smallpox. “The synthesis of horsepox virus takes the world one step closer to the reemergence of smallpox as a threat to global health security. That threat has been held at bay for the past 40 years by the extreme difficulty of obtaining variola virus and the availability of effective medical countermeasures. The techniques demonstrated by the synthesis of horsepox have the potential to erase both of these barriers. The primary risk posed by this research is that it will open the door to the routine and widespread synthesis of other orthopoxviruses, such as vaccinia, for use in research, public health, and medicine.” Koblentz notes that while there are potentially legitimate uses for synthesizing orthopoxviruses (safer smallpox vaccine development), it also means that such labs have the potential to produce smallpox from synthetic DNA and emphasized that action is needed now to avoid the misuse of synthetic biology by nefarious actors. “Unfortunately, the current legal and technical safeguards against the synthesis of smallpox virus are weak and fragmented. There is no clear international legal or regulatory framework to prevent the synthesis of smallpox virus. The WHO has a policy banning the synthesis of the smallpox and regulating who can produce and possess large fragments of smallpox DNA, but it hasn’t been widely adopted by states. Furthermore, there is no mechanism—at either the national or international level—for detecting or punishing violations of this policy.” GMU biodefense PhD student Saskia Popescu cited the importance of medical providers understanding the dual-use research of concern debate and that ultimately, biosecurity impacts us all. “From the healthcare perspective, it may not seem like something we should worry about, but the direction of gene editing and dual-use research of concern is something that is intrinsically linked to public health. Nefarious outcomes of such experiments, regardless of the origin or intent, will inevitably make their way into an emergency department, urgent care, or worse, the community. Although we may not be seeing the implications today, as medical providers and healthcare workers, we must keep our ears to the ground, listening for these biotech advancements, and then thinking through what they mean for us tomorrow.”

Blue Ribbon SLTT Ability to Respond to Large Scale Biological Events: Challenges and Solutions
If you missed the Wednesday meeting, here’s a recording to catch up on all things biodefense. “State, Local, Tribal, and Territorial Ability to Respond to Large-Scale Biological Events: Challenges and Solutions government officials, federal and academic representatives, and subject matter experts will discuss their perspectives, experiences, challenges, and recommended solutions with regard to SLTT response to large-scale biological events.”

Gene Therapy Hits a Wall With Microbial Resistance
Can gene editing trigger an immune reaction in humans? A new study is suggesting that it may be a risk. “The CRISPR-Cas9 system, which functions as a genetic scissors and tape for editing DNA, is generally derived from either Staphyloccoccus aureus or Streptococcus pyogenes bacteria.” Most of us though, have been exposed to these organisms throughout our lives. “This prior exposure could potentially render the gene editing ineffective, with the body quickly eliminating all the CRISPR–Cas9 proteins. Or worse, it could trigger the kind of immune storm that killed a young gene therapy patient named Jesse Gelsinger in 1999, derailing the field for more than a decade. ‘We share everyone’s excitement about doing Cas9 genome editing, but we want to make sure we have learned from what happened in the gene therapy world and not ignore the possibility that this could become a problem,’ Porteus says. ‘As we’re all thinking about developing Cas9-based therapeutics, we should think carefully about this potential problem’.”

Pediatric Rabies Death
A 6-year-old boy in Florida has died from rabies he contracted after being scratched by an infected bat. The boy’s father reports that he found the sick bat, put it in a bucket, and told him not to touch it however, he did and was scratched. In response, the father had the boy wash his hands thoroughly based off what he read online and opted not to take him to the hospital because the boy didn’t want to get shots. Unfortunately, within a week, the boy became ill and even after attempts at treatment, passed away. Rabies is almost always fatal once symptoms appear, which highlights the importance of seeking care immediately after exposure.

Stories You May Have Missed:

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 11.24.2017

We hope you had a wonderful tryptophan-induced holiday and are ready for your weekly dose of all things biodefense! Roughly 46 million turkeys were eaten on Thursday, but did you ever wonder if yours was antibiotic-free? (hint: we’re venturing down antimicrobial resistance rabbit hole in this week’s newsletter).

Russia Shuts Down The UN Probe Into Syrian Chemical Weapons
Despite the launch of the 2015 Joint Investigation Mechanism (JIM) by the UN and the Organization for the Prohibition of Chemical Weapons (OPCW), efforts to investigate the use of chemical weapons by President Assad in Syria, have been stalled and challenged by Russia. The latest move by Russia to kill international investigations into such attacks has come in the form of Security Council vetoes. “Russia’s actions have enraged al-Assad’s Western critics, who accuse the Syrian leader of secretly stockpiling chemical weapons in contravention of UN resolutions, and who now want to deliver accountability by other means.” This latest hurdle leaves many to wonder how we got here and if the OPCW can potentially overcome these protests. “As it happens, the OPCW’s top decision-making body, the 192-nation Conference of States Parties, is also scheduled to meet next week. Although that meeting is not directly related to the chemical weapons crisis in Syria, it ‘can’t ignore Syria’s continued non-compliance,’ says Gregory Koblentz, a nonproliferation expert at George Mason University who spoke to IRIN last week.” Not only did the vetoes do damage to inspections, but a draft Russian-Iranian decision that was circulated at the OPCW was recently obtained, in which the objectives were to overturn OPCW inspector procedures and information sharing practices. “(Russia‘s) supreme goal is to compromise the ability of the (OPCW) fact-finding mission to do its job professionally and without political interference,” said Gregory Koblentz, a non-proliferation expert at George Mason University, in the U.S. state of Virginia.“This draft resolution has to be seen as part of a Russian strategy to undermine all international investigations into the use of chemical weapons by the Syrian government,” he said.

Antimicrobial Resistance: An Underrated Biological Threat
GMU Biodefense PhD student Saskia Popescu is hoping to change the narrative for how we look at antimicrobial resistance. AMR isn’t the kind of flashy disease that gets the headlines or surges of funding, and yet it’s been wreaking havoc for decades. Popescu points to the need to address AMR as the global biological catastrophic event that it is rather than a neglected public health issue that is predominantly seen as medical or agricultural. Citing the ominous predictions of the antibiotic abyss, challenges in drug research and development, and why this is such a difficult beast to tackle, Popescu highlights just how devastating AMR is on a global level. “One of the biggest impediments to developing effective treatments is the normalization of AMR. Researchers, infection prevention and control practitioners, and medical professionals have been raising the red flag for decades. Drug-resistant infections, such as methicillin-resistant Staphylococcus aureus(MRSA), used to be rare events in health care but are now considered a common occurrence.” She notes that “AMR poses a national security threat due to its ease of transmission and its potential for a major public health crisis. Unfortunately, the spread of highly resistant diseases has received far less concern and funding than emerging infectious diseases.”

Read-Out on the GHSA Summit in Kampala Event – Save the Date!
We’re excited to announce that on Monday December 4th, GMU will be hosting a seminar on the GHSA Ministerial Meeting from several health security experts who attended. Held at the Arlington campus in Founders Hall from 12-1:30pm, guests will hear from Jamechia Hoyle, Coordinator of the Next Generation Global Health Security Network, Jennifer Nuzzo, Senior Associate at the Johns Hopkins Center for Health Security, and two GMU Biodefense MS students – Anthony Falzarano and Stephen Taylor. More details will be be provided in the coming days, but make sure to save the date as this is a great chance to hear about this critical meeting and the future of the GHSA.

Potential Role of Social Media in Combatting Antimicrobial Resistance
As we continue to see the rise of MCR-1 gene, antimicrobial stewardship and predictions of the future become increasingly important, but just how accurate is this information? GMU Biodefense MS student Janet Marroquin is fact-checking the predictions of the post-antibiotic apocalypse and how the media has portrayed this threat. “In this era of fake news, the credibility of articles circulating on social media can be dubious, particularly when citations are not readily available.  Further investigation of the statistical data used in the video yielded mixed results.” Marroquin points to a NowThis video-based news report and how antimicrobial resistance has been portrayed and introduced to the public through such venues. “Although the dissection of the data used in the NowThis video revealed a few inconsistencies, the attention that 90 seconds can bring to various aspects of AMR to the general public is much. As of November 6, 2017, the video has had 2.1M views and has been shared by 12,333 users on Facebook, retweeted by 175 users on Twitter, and has been featured on news sites. Interestingly, a few days after the release of the NowThis video, NBC News Mach published an online news article addressing the ‘post-antibiotic apocalypse’.”

Ready for a Global Pandemic?
Director of the Center for Health Security Tom Inglesby and Stanford law student Benjamin Haas are evaluating just how likely a pandemic is and how prepared we might be with the current administration. Between the rapid growth of people in densely populated areas and globalization, microbes have a sort of novel freedom that hasn’t been seen before. Biological threats go beyond pandemics to the potential for bioterrorism or even laboratory accidents. So what is the U.S. government doing to prepare? Efforts have ranged from NIH-funded research into pathogens of pandemic potential, the development of Biomedical Advanced Research and Development Authority (BARDA), reinforcing the Strategic National Stockpile (SNS), etc. “Unfortunately, President Donald Trump has not indicated so far that his administration takes this issue seriously. Initially, his 2018 budget proposed slashed funding for such programs by nine percent, or $1.25 billion, from the preceding year, which would be the largest reduction in over a decade.” “Although the civil-servant workforce has continued to make progress in important programs, it remains to be seen whether the administration’s political leadership will push biosecurity efforts forward in a meaningful way. In the months ahead, there are four elements to look for in evaluating just how seriously the Trump administration will pursue these issues: its budget priorities for the new fiscal year, its impending biodefense strategy, its approach to overseeing research on novel and highly dangerous pathogens, and its level of engagement in the Biological Weapons Convention (BWC) process.” Inglesby and Haas highlight the importance of supporting the Global Health Security Agenda (GHSA), approaching complex topics like certain kinds of scientific research, and ensuring funding for vital agencies. “The administration has opportunities to make substantial headway on pandemic risks at the national and international levels. Its budget, biodefense strategy, approach to high-consequence research, and engagement on the BWC are all key. The means exist to diminish the spread of pandemics—through science, intelligence, medical and public health preparedness, diplomacy, and smart governance.”

Bird Flu Moves Throughout Asia
China is experiencing its fifth wave of H7N9 infections since 2016 and of the 1,600 laboratory-confirmed human cases, 40% have died. While most  of the human cases have occurred due to poultry exposure, there is concern that some are related to transmission between people. Responding to the threat of avian influenza has been challenging  – wanting to avoid total alarmism and hysteria, but also ensuring the public health response is adequate and prepared. “In September, the Centers for Disease Control and Prevention summarized some disturbing developments. The H7N9 virus had become lethal to birds, which made it potentially more dangerous to people but also easier to spot. And the virus had split into two lineages — called Yangtze and Pearl, after the river deltas in which each was spreading — complicating efforts to make vaccines. In October, the World Health Organization put out an update citing new cases of H7N9 infection as cold weather set in and noting that poultry farmers were vaccinating flocks against both this virus and other strains.” Avian influenza still circulates in Egypt and Indonesia and H1N1 is now a common strain for seasonal flu, but just how close are we to continued transmission of H7N9 between humans?

Addressing Challenges in Global Health Security: Executive Program
The Geneva Centre for Security Policy will be hosting this event as a Swiss contribution to the GHSA – it’s free of charge for the representatives of GHSA member states! “Leaders are expected to formulate policies for best practices and strategies for dealing with future health contexts and crisis scenarios. This programme provides an opportunity to learn the basics of current health practices, policies, implementation schemes, and approaches for the road ahead. Throughout the programme, participants will examine emerging health challenges and their governance implications, working together to understand and devise ways to mitigate potential health threats.” This event runs January 29th – February 1st, 2018, in Geneva and applications are due November 29th, 2017.

Center for the Study of WMDs – Spotlight Seminar on Japanese Germ Warfare
Don’t miss this December 12th seminar “Hidden Atrocities: Japanese Germ Warfare and American Obstruction of Justice at the Tokyo Trials” from 1230-1400 at NDU’s Lincoln Hall in the Proceres Conference Room (Lincoln Hall 3212). “In the aftermath of World War II, the International Military Tribunal for the Far East, also known as the Tokyo Trials, tried 28 Japanese political and military leaders and more than 5,700 personnel with war crimes. Yet U.S. military intelligence and Washington decision makers prevented the indictment of the government leaders and scientists responsible for Japan’s secret germ warfare program, Unit 731. In an effort to acquire Japan’s biological warfare expertise to gain an advantage over the Soviet Union, the United States covered up the extent of the program, jeopardizing international justice with lasting consequences. Dr. Jeanne Guillemin, Senior Advisor in the MIT Security Studies Program, will discuss her new book, Hidden Atrocities, and its account of both the Japanese program and the subsequent collusion.” RSVP is required. All non-DOD-affiliated visitors will need to fill out the attached JBM-HH Base Access Form, even if you have attended previous Spotlight events. We ask that you send us this form to cswmd-admin@ndu.edu no later than 5 December 2017.  You may also bring the completed form with you. Please allow extra time for the new security procedures.*

Stories You May Have Missed:

  • Raw Milk Brucella Outbreak Across 4 States– The CDC has issued a warning for people “in four states—Connecticut, New Jersey, New York, and Rhode Island—who drank raw milk from Udder Milk may be infected with a rare but serious Brucella abortus RB51 bacterium and should see their doctors for antibiotic treatment.”
  •  New Malaria Parasite Discovered in Bonobos – A new malaria parasite has been found in the African animals, as researchers have confirmed the bonobos are a host. “Now, by sampling more bonobos in geographically diverse settings, scientists writing in Nature Communication show that bonobos harbor a new species of malaria parasite, called Plasmodium lomamiensis. The parasite is a previously unknown Laverania species, which are closely related to P falciparum, one of the parasites that causes human malaria infections.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

Pandora Report 6.30.2017

Happy Friday to all our amazing readers – we hope you have a lovey holiday weekend! Don’t miss the July 1st deadline for an early registration discount to the Summer Workshop on Pandemics, Bioterrorism, and Global Health Security.

Preventing Pandemics and the Necessity of Funding Prevention
Next January will mark the centenary of the 1918-1919 pandemic influenza, but what have we really learned since then? The looming threat of antimicrobial resistance is slowly surrounding us, as is the increasing biothreat of zoonotic disease. Globalization, encroachment into animal habitats, and recent models that predict a 60-day global spread for a virulent strain of airborne flu virus, all paint a rather gloomy reality for the future of health security. So what are we doing? Not enough. That’s usually the answer in public health- a field of which you can comfortably say society likes to contribute the bare minimum. A highly pathogenic influenza virus that could engulf the globe in a pandemic isn’t the storyline for a horror movie, but rather something that even UN panels note is “not an unlikely scenario”. “Pathogens are not only terrifying, they’re expensive. The 2003 SARS epidemic cost $30 billion in only four months. A flu pandemic of a severity that occurs every few decades could contract the global economy by 5 percent — some $4 trillion”. Here’s where the economics of preventative public health come into play – vaccines are expensive to make and there’s little incentive when we’re not in the eye of a disease storm. Moreover, global health security is challenging. Politics makes disease response and preparedness a sensitive topic, especially during an outbreak. The key lesson to remember though, is that an outbreak anywhere is really an outbreak everywhere. So what preparedness tactics can we start utilizing? “The project is called CEPI — the Center for Epidemic Preparedness Innovations. After the world’s failure to control Ebola quickly in 2014 and 2015 cost 11,000 lives and at least $6 billion, three global experts proposed a vaccine development organization with $2 billion in start-up funding. Harvard, the National Academy of Medicine and the United Nations all created commissions that proposed ways to avoid another catastrophe. Among other steps, all endorsed vaccine development.” CEPI aims, in the next five years, to develop vaccine candidates for Lassa fever, Nipah, and MERS. “Creating vaccines is not the same as guaranteeing that people who need them can get them. CEPI will require its awardees to sell vaccines to the poorest and lower-middle-income countries (more likely, to donors who will buy vaccine for them) at the lowest possible price.” Perhaps one of the most poignant comments from this article was that the threat to this goal is not scientific, but rather political, highlighted by short attention spans. The World Bank has initiated it’s “pandemic bond” to aid in outbreak response should there be a public health crisis like that of Ebola in 2014. “The catastrophe bond, which will pay out depending on the size of the outbreak, its growth rate and the number of countries affected, is the first of its kind for epidemics. It should mean money is disbursed much faster than during West Africa’s Ebola crisis.” The Pandemic Emergency Fund (PEF) will offer coverage to those countries eligible for financing from the IDA (International Development Agency), which is dedicated to helping the poorest countries. Head of derivatives and structured finance at the World Bank’s capital markets department, Michael Bennett, noted that “if a trigger event occurs, instead of repaying the bond in full, some or all of the principal is transferred to the PEF trust fund. So essentially the investors are acting like insurance companies. The objective of offering the risk in both forms is that the bonds and swaps appeal to different types of investors, and therefore … we are creating the broadest possible investor pool for this risk,”. The PEF would provide more than $500 million in coverage over the next five years. Efforts to provide financial support to outbreaks before they reach pandemic potential are vital. It is estimated that had the PEF been available during the 2014 Ebola outbreak, $100 million could have been mobilized as early as July 2014, which may have prevented the outbreak spreading so rapidly and costing $2.8 billion. “The annual global cost of moderately severe to severe pandemics is estimated at roughly $570 billion, or 0.7 percent of global income, the World Bank said.”

Ebola Burial Teams 
The 2014/2015 Ebola outbreak in West Africa was not only the worst in history, but taught us a great many lessons about outbreak control. One of the most extraordinary lessons learned was just how valuable burial teams could be. Funerals became a significant source for disease exposure and transmission, especially for loved ones of the deceased, as washing and handling the body was customary. In effort to combat this high-risk activity, public health responders established burial teams comprised of paid volunteers, who would collect the bodies from homes and aid in their burial. The teams would don PPE and work with families to ensure they avoided exposure. Dignified burial through these teams helped ease much of the concern for families regarding the treatment of their loved one. A recent study published in the PLOS Neglected Tropical Disease Journal evaluated the impact of these burial teams using modeling and data from 45 unsafe community burials and 310 people who were identified as having contact with the infected bodies. Researchers found that those who cared for the Ebola patient just before their death were at greatest risk, meaning that caring for an infected loved one at home was far riskier than bringing them to a healthcare facility. The study estimates that the safe and dignified burials performed by Red Cross volunteers (the burial teams) prevented between 1,411 and 10,452 cases of Ebola. “Hundreds of paid volunteers took on the grim task of collecting bodies from people’s homes in full personal protective gear, while also having to manage the grieving families and communities. They were ordinary West Africans, such as teachers and college students. Many carried out the relentless and dangerous work for months. Some were stigmatised in their communities, because people became scared they might bring the virus home with them. In reality, they were helping to stem world’s worst ever Ebola outbreak.” In the end, the Red Cross burial teams managed over 47,000 burials, carried out more than 50% of all burials during the outbreak, and consisted of 1,500 volunteers.

Instructor Spotlight – Workshop on Pandemics, Bioterrorism, & Global Health Security
We’re nearing the last few weeks before our workshop and your opportunity to get the early registration discount, so don’t miss out! This week we’re happy to show off not only the director of this workshop, but also of our GMU biodefense graduate program – Dr. Gregory Koblentz. If there was a biodefense Jeopardy, Dr. Koblentz would not only be the reigning champion, but would also have Alex Trebek doubled over in laughter. Gregory Koblentz, PhD, MPP, is an Associate Professor in the Schar School of Policy and Government and Director of the Biodefense Graduate Program at George Mason University. During 2012-2013, he was a Stanton Nuclear Security Fellow at the Council on Foreign Relations. Dr. Koblentz is also a member of the Scientist Working Group on Chemical and Biological Weapons at the Center for Arms Control and Non-Proliferation in Washington. He previously worked at Georgetown University, the Executive Session for Domestic Preparedness at Harvard University, and the Carnegie Endowment for International Peace. He is the author of Strategic Stability in the Second Nuclear Age (Council on Foreign Relations, 2014), Living Weapons: Biological Warfare and International Security (Cornell University Press, 2009) and co-author of Tracking Nuclear Proliferation (Carnegie Endowment for International Peace, 1998). He serves on the editorial boards of Nonproliferation Review, World Medical and Health Policy, and Global Health Governance. His teaching and research interests focus on international security, weapons of mass destruction, terrorism, and homeland security. He received his PhD from the Massachusetts Institute of Technology, his Master in Public Policy from the John F. Kennedy School of Government, and his BA from Brown University. For more information, see https://schar.gmu.edu/about/faculty-directory/gregory-koblentz. Don’t miss your chance to not only learn from Dr. Koblentz, but also chat with him and other experts in the field at our workshop July 17-19th!

Can CRISPR Tackle Zika?
GMU Biodefense PhD student Saskia Popescu is looking at CRISPR and its application as a vector-borne disease prevention tool. “Whether it be the latest announcement that CRISPR reversed Huntington’s Disease in mice or that it could provide rapid diagnostic improvements, the technology is being considered a breakthrough for many diseases and conditions, including vector-borne diseases.” Drawing on a recent TED Talk by famed molecular biologist, Dr. Nina Federoff, she highlights the potential for GMO mosquitoes to be used as a biological control tool. Federoff points to the public perception issues that come with GMO products, which was seen in Key Haven, Florida when GMO mosquitoes were to be trialed as a means to prevent dengue and Zika cases. “Concluding her talk with a plea to the audience, Dr Federoff emphasized the need to dig past misinformation and hype to truly look at the science of this work and the substantial benefits that can come from biological control efforts and the science of genetic modification.”

The Case of the Missing Sarin
Dugway Proving Ground is under the spotlight again for mishandling of dangerous substances. The same Army lab was responsible for mishandling Anthrax in 2015, during which they sent 575 shipments of live samples across the U.S. Unfortunately, the latest reports are looking to Dugway as the source for potentially losing a small amount of sarin. The inspector general for the DoD released a report highlighting the findings that a contractor used by the facility was not maintaining inventory properly. “Dugway stored its sarin in a two-container system. The sarin was stored in a primary container, which is then stored inside a secondary container. But officials only checked the secondary containers when doing inventory, and did not check inside the primary container, so they did not know if all the sarin was still in the containers, the inspector general found. ‘Therefore, custodians cannot identify and account for leaks, evaporation, or theft that may have occurred,’ the inspector general found. ‘Furthermore, Dugway officials did not immediately notify the chemical materials accountability officer of a 1.5-milliliter shortage of … sarin identified during an April 19, 2016, inventory nor did they properly document the results of that inventory,’.” The report found that the contractor and Dugway used varying methods for container sealing but that the amount missing is relatively small. Fortunately, sarin evaporates and degrades very quickly. Overall the report highlights the operations and procedures for handling the chemical agent put workers at an increased risk and encouraged the Army to evaluate and improve practices immediately.

The Moral Question of Bioengineering
The financial and technical hurdles for biotechnology and gene-editing have been decreasing over the years and Stanford is taking a unique approach to their budding bioengineers – asking moral questions. During their final exams for the university’s Intro to Bioengineering course, the students are asked several questions – at what point will the cost of printing DNA to create human life equal the cost of teaching a student at Stanford?  If you and your partner are planning to have kids, would you start saving for college tuition, or for printing the genome of your offspring? These questions represent much of the debate and concern regarding gene editing – the rapid decrease in cost and the morality of just how far the technology can and will take researchers. Many note that just because we can, doesn’t mean we should. Stanford professor Drew Endy emphasizes the decrease in costs, which was initially prohibitive when the technology was developing. Regarding the last question, “about 60 percent say that printing a genome is wrong, and flies against what it means to be a parent. They prize the special nature of education and would opt to save for the tuition. But around 40 percent of the class will say that the value of education may change in the future, and if genetic technology becomes mature, and allows them to secure advantages for them and their lineage, they might as well do that. There is clearly no right answer to the second question, and students are graded on their reasoning rather than their conclusion. But when both questions are considered together, they suggest, Endy says, that ‘in the order of a human generation, we’ll have to face possibilities that are much stranger than what we’re prepared for’.”

Stories You May Have Missed:

  • John Oliver Takes on Anti-Vaxxers – If you’re a fan of the HBO host, make sure to check out his recent episode of  “Last Week Tonight” in which he points out just how dangerous the anti-vaccine movement really is. “Some have even developed an ‘alternative vaccine schedule’ in which the inoculations can be delivered less frequently and over a longer period of time. ‘That sounds like a decent compromise because it’s the middle-ground position, right?”’Oliver said on ‘Last Week Tonight’ on Sunday. ‘The problem is, it’s the middle ground between sense and nonsense. It’s like saying, ’It would be crazy to eat that entire bar of soap, so I’ll just eat half of it’.”
  • Yemen’s Growing Cholera Outbreak– Yemen is currently experiencing the worst international outbreak of cholera, with 200,000 suspected cases and an average of 5,000 new cases reported daily. The WHO and UNICEF have gotten involved as there have already been 1,300 deaths in the past two months. “By calling the outbreak the “world’s worst” UNICEF and WHO hope to speed international aid efforts to the war-torn country. “This deadly cholera outbreak is the direct consequence of two years of heavy conflict,” said a press statement from UNICEF. ‘Collapsing health, water and sanitation systems have cut off 14.5 million people from regular access to clean water and sanitation, increasing the ability of the disease to spread.’ In addition to a lack of public health infrastructure, UNICEF estimated that 30,000 dedicated local health workers who play the largest role in ending this outbreak have not been paid their salaries for nearly 10 months.”

 

Pandora Report 6.16.2017

Temperatures may be soaring but we’ve got all your biodefense news, including a frosty story on frozen diseases coming to life!

Big Data Takes on Epidemics
The potential applications for big data are vast and we’re just now starting to get a taste for how it can be utilized during an outbreak. Rapid access to data sets and available personnel to handle modeling is a challenge during emergent situations however, many are pointing out just how the data science revolution can be used to fight diseases. Metabiota Senior Director of Data Science Nita Madhav has put together a list of the five ways big data analytics are changing the fight against epidemics. First, better genetic data through genome sequencing that can help speed up genetic analysis during an outbreak. Second, cell phone mobility data. This is particularly interesting as it was used during the Ebola outbreak in 2014, which allowed experts to tract contacts of cases as a means of prevention. Cell phone mobility data also provides information on movement during outbreaks. Third, social media data, which can be used to predict peaks and perform sentiment analysis (think vaccination skepticism), but also as a means of pushing public health messaging. Fourth, mapping high risk areas. “Machine learning techniques can now yield global, high-resolution maps pinpointing where epidemics are likely to emerge and take hold. These techniques make use of remotely-sensed and other geographic data about environmental, human and animal factors to estimate how many people live in the riskiest places. For example, this type of analysis helped map likely locations for Zika virus to thrive and even identified areas where the virus would later establish itself, including southern Florida.” Last but not least, large-scale simulations, which allow epidemiologists to take all the data we currently have and generate tons of simulations to reveal gaps in response mechanisms. “These simulations help fill in gaps in observed data using synthetic outbreaks and deliver novel insights into possible outcomes of outbreaks, including expected numbers of illnesses, hospitalizations, deaths, employee absences and monetary losses. Ultimately, these insights can help inform the world about epidemic risks and the best ways to mitigate them.”

Chemical Weapons & ISIS
New analysis from Conflict Monitor by IHS Market is drawing attention to a significant reduction in chemical weapons used by ISIS in Syria in 2017 as well as a concentration of the chemical attacks in Iraq. The report highlights that 71 allegations of ISIS CW attacks have occurred since 2014 (41 in Iraq and 30 in Syria) however, the only alleged use in Syria in 2017 was on January 8th at Talla al-Maqri. “The operation to isolate and recapture the Iraqi city of Mosul coincides with a massive reduction in Islamic State chemical weapons use in Syria”, said Columb Strack, senior Middle East analyst at IHS Markit. “This suggests that the group has not established any further CW production sites outside Mosul, although it is likely that some specialists were evacuated to Syria and retain the expertise.” In response to ISIS use of chemical weapons, the U.S. Department of the Treasury’s Office of Foreign Assets Control (OFAC) is taking action against ISIS leader, Attallah Salman ‘Abd Kafi al-Jaburi (al-Jaburi), who was involved in several attacks ranging from vehicle-borne improvised explosive devices (VBIEDs) to the development of chemical weapons. OFAC is also taking action against Marwan Ibrahim Hussayn Tah al-Azaw, an Iraqi ISIS leader. “As a result of today’s action, all property and interests in property of these individuals subject to U.S. jurisdiction are blocked, and U.S. persons are generally prohibited from engaging in transactions with them.” OFAC Director John E. Smith noted that “today’s actions mark the first designations targeting individuals involved in ISIS’ chemical weapons development,” and that “the Department of the Treasury condemns in the strongest possible terms the use of chemical weapons by any actor, and will leverage all available tools to target those complicit in their development, proliferation, or use.”

Pandemics, Bioterrorism, & Global Health Security Workshop Instructor Spotlight
This week we’re excited to share that Sanford Weiner will be our instructor spotlight! Sanford is a Research Associate in the Center for International Studies at the Massachusetts Institute of Technology, and a Visiting Fellow at Imperial College, University of London. For several decades he has done international comparative policy studies of public health agencies, and research on national security policies and environmental policies. He has published on policymaking at the Centers for Disease Control, the phase-out of CFCs, toxic substance control, and innovation in the Air Force. He is currently studying responses to pandemic flu in Europe and the United States, and the politics of alternative energy projects. He directs a Professional Education summer course at MIT on “Technology, Innovation and Organizations.” He has also taught in professional education courses for the Royal Society Technology Fellows (London), the National University of Singapore, UC San Diego, and in Stockholm. Before MIT he was on the research staffs of the School of Public Policy at UC Berkeley, the Health Policy Center at Brandeis, and the Harvard School of Public Health. Sanford looks to the need for organizational innovation and adaptation to address new threats, the politics of public health emergencies, and the importance of risk assessment and making evidence-based public health decisions. If you’re looking to talk about taking lessons from pandemic flu and applying them to polio, Zika, bioterrorism, and even Ebola, you won’t want to miss his lecture during our workshop!

The Awakening of Frozen Permafrost Diseases
Climate change has an undeniably impact on infectious diseases. Whether it be the vectors that spread them, movement of animals that act as hosts, or an increasing encroachment of humans into animal habitats, we simply can’t deny that the two are wholly interconnected. Unfortunately now we get to add zombie diseases to the list. Well, maybe not a zombie virus, but a bacteria or virus that has been trapped in the icy permafrost for thousands of years and is now waking up. “Climate change is melting permafrost soils that have been frozen for thousands of years, and as the soils melt they are releasing ancient viruses and bacteria that, having lain dormant, are springing back to life.” Last year we saw anthrax cases in the Arctic Circle due to exposure from infected reindeer carcasses that were exposed due to the melting of the frozen soil and snow. “As the Earth warms, more permafrost will melt. Under normal circumstances, superficial permafrost layers about 50cm deep melt every summer. But now global warming is gradually exposing older permafrost layers. Frozen permafrost soil is the perfect place for bacteria to remain alive for very long periods of time, perhaps as long as a million years. That means melting ice could potentially open a Pandora’s box of diseases.” Nothing like a good permafrost to keep the bacteria happily frozen and alive! What is so worrying about the melting permafrost is a range of threats – buried bodies of people who died from smallpox, unknown viruses or bacteria that we’ve never seen before, or even a resistant organism that changes the course of antibiotics forever.

Angry Birds – The Flu Version
While this isn’t the title of the latest game, the projectile you should be worried about is actually avian influenza droplets. China is currently battling against HPAI H7N9  outbreaks in poultry across three provinces. “Chinese health officials detailed four outbreaks in two OIE reports. Two occurred in different locations in Inner Mongolia province in the north, one at a large layer farm that began on May 21, killing 35,526 of 406,756 susceptible poultry. The remaining birds were culled to curb the spread of the virus.The other outbreak began Jun 5 at a poultry farm in Inner Mongolia’s Jiuyuan district, which led to the loss of 55,023 birds, including 2,056 that died from the disease.” These outbreaks spark fear for a number of reasons – the mass culling of birds is always economically devastating, the risk to human life, and really, the potential for sustained human-to-human transmission due to a few genetic tweaks that could result in a pandemic. That’s right, just three mutations should switch H7N9 into a lethal human-killing virus that has pandemic potential. H7N9 is one of the more concerning avian influenza strains because it’s already been known to do damage in terms of human cases (of the 1,500 cases, 40% died). “‘As scientists we’re interested in how the virus works,’ says Jim Paulson, a biologist at The Scripps Research Institute. ‘We’re trying to just understand the virus so that we can be prepared.’ That’s why he and his colleagues recently tinkered with a piece of the H7N9 flu — a protein that lets the virus latch onto cells. It’s thought to be important for determining which species the virus can infect. ‘So it’s not the whole virus,’ says Paulson. ‘It’s just a piece — just a fragment — that we can then study for its properties’. What they studied is how different changes affected the virus’ ability to bind to receptors found on the surface of human cells.” Paulson’s group found that just three tiny mutations made it able to sustain human transmission. This brings about the dual-use research of concern (DURC) and gain-of-function (GoF) research dilemma though – while we’re using it for good, couldn’t a person with bad intentions come along and turn it into a weapon? Or a lab error that results in an outbreak? While some argue for the need of GoF research, others agree with the 2014 White House moratorium that halted federal funding for such work. Ron Fouchier of Erasmus Medical Center in the Netherlands notes that, “‘The rest of the world is moving forward with this type of experiment already,’ says Fouchier, whose genetic experiments with a different bird flu virus sparked a public outcry in 2011. And so the U. S. can either join or not join. It’s up to them, but the work will continue,’.” Topics like avian influenza, pandemics, and dual-use/GoF research are all issues we’ll be discussing in the workshop this July, so don’t miss out!

Boston University’s BioLab Nears Approval
This hotly debated BSL-4 lab has been a source of contention between researchers and surrounding neighbors for over a decade. Boston University received a $200 million federal grant nearly 15 years ago to build the regional lab as a new source for work with deadly pathogens however, neighborhood activists have been halting work since the beginning. Despite the ongoing debate, the lab is just one vote away from approval. “Supporters say it will speed the development of new vaccines and cures.  But after 15 year of fighting, the neighborhood that’s home to the lab is making a final push to keep the diseases away from the busy urban hub.”

The Scary Reality Behind WHO’S Updated Essential Medicine List
GMU Biodefense PhD student, Saskia Popescu, is taking a deeper dive into the recent announcement by the WHO regarding their reformatting of the EML list. The antibiotics sections haven’t seen an overhaul like this for 40 years, so what’s really afoot? Last week we discussed the changes- the categorization of antibiotics into three groups (ACCESS, WATCH, and RESERVE). Each list has a series of antibiotics and recommendations (i.e. for RESERVE, these are antibiotics which should be treated as the last resort of accessible antibiotics and should be used in “tailored” situations when other medications have failed. RESERVE antimicrobials should be targeted in national and international stewardship programs). While the updates make sense, they reveal a much deeper concern for developing countries and the growing threat of microbial resistance. “This extensive change to the EML highlights the dire situation that we are progressing towards in terms of microbial resistance. The EML provides the most basic medicine needed for patient care and its focus on antibiotic stewards highlights the stark reality even in the most dire of environments.”

Stacking Countermeasures for Layered Defense 
DTRA’s Joint Science and Technology Office’s (JSTO) Toxicant Penetration and Scavenging (TPS) research program is working to better defend us against chemical and biological weapons. “One such weaponized threat is the use of organophosphonates in an attack. These nerve agents inhibit acetylcholinesterase (AChE), an essential enzyme responsible for neurological function. Irreversible inhibition of AChE may lead to muscular paralysis, convulsions, bronchial constriction and death by asphyxiation. One of the projects in the TPS uses engineered DNA-enzyme nanostructures to create multi-enzyme pathway biocatalysts. These new biocatalysts are designed to process the destruction of chemical agents and their degradation compounds.”

Stories You May Have Missed:

  • MERS and Infection Control – There are endless opportunities when working in infection prevention & control to say, “I told you so” and the ongoing hospital MERS outbreaks only fuels that fire. “The World Health Organization (WHO) today provided new details on three MERS-CoV clusters in Saudi Arabia involving 32 out of the 35 cases reported between Jun 1 and Jun 10. The clusters are in three different hospitals in Riyadh. Cluster 2 is related to cluster 1, as the first case-patient in a second hospital initially visited the emergency room of the hospital implicated in cluster 1. According to the WHO, he was asymptomatic following the visit in hospital 1, and he continued to receive kidney dialysis sessions in the second hospital. The cluster involves the index case plus five healthcare workers and household contacts.The third cluster is not related to clusters 1 or 2. To date four cases are associated with this hospital; the index case involves a patient who had camel contact. Three healthcare workers have also been diagnosed.”

Pandora Report 3.10.2017

Looking for a great podcast on CRISPR? Check out RadioLab – they also have a captivating one on patient zeroes throughout history!

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security: From Anthrax to Zika 
If you’re looking to learn more about global health security, synethic biology, biosecurity, and what exactly “biodefense” entails, you’ll want to mark your calendar for the GMU Biodefense three-day, non-credit summer workshop on July 17-19, 2017! Participants will look at the challenges facing the world at the intersection of national security, public health, and the life sciences. Instructors for the workshop range from FBI special agents to biodefense professors and USAMRIID commanders. The workshop will look at the spectrum of biological threats – including naturally occurring disease outbreaks such as SARS, Zika, and Ebola, lapses in biosafety, dual-use research of concern, and the threat of bioterrorism. From now until May 1st, you can take advantage of the early bird registration discount!

Glaring Gaps: America Needs A Biodefense Upgrade
GMU biodefense PhD alum Daniel M. Gerstein is emphasizing the need to strengthen American biodefense capabilities. “Recent legislation has called for a comprehensive biodefense strategy. If carried out in a thorough and systematic way, and properly funded, this will be a great improvement for the country and the world.” Gerstein notes that while the National Defense Authorization Act for Fiscal Year 2017 called for a joint biodefense effort, there is still a desperate need for a structured and systematic approach. Perhaps one of the biggest issues Gerstein found is the current view of biodefense as a series of programs. Approaching global health security threat requires us to view biodefense as a complex system, not a series of programs. To fix the glaring gaps in U.S. biodefense efforts, he notes that any remedy will have to accept the complexity of the problem and that there is no single panacea. Internal coordination, improvement of diagnostics and treatment, and technology management are all things that must be addressed to strengthen American biodefense. “Export controls in the United States, for example, actually hinder international collaboration. Exchanging pathogen strains used in the development of medical countermeasures, diagnostics, and bio-surveillance remains difficult – even, at times, for close international partners. In one case, the United States was attempting to share a strain of the Ebola-Reston pathogen with the government of Australia, but export laws prevented this sharing, so the strain was instead acquired from the Philippines, where the strain originated.” While we’ve made great strides since the Amerithrax attacks, there is much to be done to create a systematic and resilient biodefense strategy.

Chemical Weapons Reportedly Used in Mosul
The WHO has recently activated an emergency response plan with several partners to help treat twelve people for potential exposure to chemical weapons in Iraq. “Lise Grande, the UN humanitarian coordinator in Iraq, called for an investigation. ‘This is horrible. If the alleged use of chemical weapons is confirmed, this is a serious violation of international humanitarian law and a war crime, regardless of who the targets or the victims of the attacks are,’ she said in a statement.” Many are pointing to ISIL as the likely culprit since they hold the majority of west Mosul and have a history of rudimentary use of chemical weapons.

China’s Growing Bird Flu Worries  
Despite a recent surge in human A(H7N9) cases, the WHO has stated that the risk of an epidemic remains low. Even with this release, the development of two distinct strains in a disease that has a mortality rate hovering around 30%, has many worried. “That will probably force development of a second small stockpile of emergency vaccine to be rolled out if the virus becomes more transmissible and threatens to turn into a pandemic, a scientist at the Centers for Disease Control and Prevention said. Flu specialists from around the world gathered in Geneva this week to assess the global influenza situation and discuss with vaccine companies which viral strains should be in next winter’s flu shots. China has had 460 lab-confirmed human cases of H7N9 bird flu this winter, said Dr. Wenqing Zhang, head of the W.H.O.’s global influenza program. That is the most in any flu season since the first human case was found in 2013.” Interestingly, around 7% of the new H7N9 cases were resistant to drugs like Tamiflu, which has many researchers working to make a H7N9 seed vaccine, including a secondary one due to the split strains. Coming on the heels of this outbreak, US officials have announced that highly pathogenic avian influenza (HPAI) was found in a commercial poultry farm in Tennessee. 700 birds died from infection and almost 73,000 were destroyed. The farm is a contracted supplier of chicken meat for the U.S.’s biggest supplier, Tyson, which released an announcement on March 5th regarding testing of local birds, etc.

Global Health Security Index Development
Johns Hopkins Center for Health Security recently received a grant from the Open Philanthropy Project and the Robertson Foundation to coordinate with the Nuclear Threat Initiative (NTI) and the Economist Intelligence Unit (EIU) to develop a Global Health Security Index. “The mission of the index is to encourage progress towards a world that is capable of preventing epidemics of international impact (either natural, accidental or deliberate) from arising, or, should, prevention fail, respond quickly to contain them.” The first phase of the project will aim at developing framework that can measure a country’s level of health security. While the GHSA and JEE are processes to increase transparency, preparedness, and country capabilities, the goal of this index is to fill the gaps in motivation and also the factors that are not in the hands of the health sector.

Antimicrobial Resistance in Pets: Are We Ignoring A Looming Threat? 
GMU biodefense PhD student Saskia Popescu is looking at the threat of antibiotic resistance, but from a somewhat forgotten patient population – our pets. The recent WHO list of worrisome antimicrobial resistant bugs has drawn a lot of attention to the growing threat of an antibiotic apocalypse however, sometimes it takes a personal experience to look outside the box. Pulling from experiences of dealing with drug resistance in her dog to the loss of SeaWorld’s controversial orca, Tilikum, Popescu notes the rising threat of AMR brewing in domesticated animals. Sadly, it seems that many veterinarians and infectious diseases researchers have been drawing attention to the role of household animals in antimicrobial resistance and yet, just like the human issue, it’s not getting the attention it deserves. In her article, Popescu points to the need to start addressing the full circle of microbial resistance, starting with our furry friends.

Stories You May Have Missed:

  • Constraining Norms for Cyber Warfare Are Unlikely – GMU Biodefense PhD alum, Brian M. Mazanec, is talking to the Georgetown Journal of International Affairs about the realities of norms for cyber warfare. The question of whether constraining international norms for cyber warfare will emerge and thrive is of paramount importance to the unfolding age of cyber conflict. Some scholars think that great powers will inevitably cooperate and establish rules, norms, and standards for cyberspace. While it is true that increased competition may create incentives for cooperation on constraining norms, Mazanec argues that norm evolution theory for emerging-technology weapons leads one to conclude that constraining norms for cyber warfare will face many challenges and may never successfully emerge.
  • ABSA International Webinar- Behaving Safely in the Laboratory: Understanding Complexities of Building and Sustaining a Culture of Safety–  ABSA is hosting a 2-hour webinar session for three days. “The webinar will be offered Monday, April 3; Wednesday, April 5 and Friday, April 7, 2017.  Millions of dollars on engineering.  Thousands of dollars on PPE.  Hundreds of hours spent writing SOPs – and in one instant all of these controls can be negated with one inappropriate behavior.  Behavior is the bridge between written plans and desired outcomes.  But what does it take to behave safely?  Day 1 will focus on what it takes for an individual to behave safely – as behavior requires five critical items – and without these items – sustained behavior cannot occur. Day 2 will focus on motivating behavior – the differences between leadership and management – and the motivating factors which are extrinsic, systemic, and intrinsic. Day 3 will focus on building and sustaining a ONE SAFE culture – blending the efforts of the workforce, leadership, and safety officials.”
  • High Flu Activity Throughout the U.S. – The CDC has warned that the U.S. is still experiencing high flu activity in all regions. This flu season has seen elevated pediatric mortality, with six reported last week, bringing the total to forty pediatric deaths. “The CDC said there have been more hospitalizations and clinical visits for influenza-like illness (ILI) at this point in the flu season than in 2012-13, another season when H3N2 strain predominated. The CDC said the cumulative overall rate is 39.4 hospitalizations per 100,000 people. During the 2012-13 flu season, the rate was (38.2 per 100,000).”

 

Pandora Report 12.16.2016

Sick to your stomach? Make sure to tweet about it! Seriously – the UK Food Standards Agency is using social media to track stomach bugs like norovirus. Before we venture down the biodefense rabbit hole, have you ever wondered what would happen if college students tried to hack a gene drive?

GMU Biodefense PhD Writes ‘Groundbreaking’ Thesis on Cyber Warfare– GMU Biodefense PhD graduate, Craig Wiener, is talking about his PhD experience and the amazing work he did on his dissertation. Craig’s story is pretty unique – between the commute from his position at the Department of Energy’s National Nuclear Security Administration, to his background in biodefense and research in synthetic biology, he’s a prime example of the diverse and passionate students we see in the GMU biodefense program. “Wiener’s PhD dissertation, ‘Penetrate, Exploit, Disrupt, Destroy: The Rise of Computer Network Operations as a Major Military Innovation,’ is groundbreaking, said Gregory Koblentz, director of Mason’s biodefense graduate program, and it has nothing to do with biodefense. Wiener connected some rather complicated dots in determining the origins of computer network exploitation and computer network attacks in the U.S. intelligence community. ‘I’ve established that computer network operations are a major military innovation, and it was developed by the U.S. intelligence community…. It’s the first time the intelligence community has developed a weapon system,’ said Wiener.” A labor of love, his work will significantly contribute to the history of cyber warfare and is a prime example of what makes GMU such a wonderful university to study.

FDA Review of 2014 Variola NIH Incident

screen-shot-2016-12-14-at-7-57-52-amThe newly released report, “FDA Review of the 2014 Discovery of Vials Labeled ‘Variola’ and Other Vials Discovered in an FDA-Occupied Building on the NIH Campus”, details the findings and corrective actions following the FDA’s internal investigation of the 2014 incident. The compilation includes several interviews, findings from reports and site visits, and a timeline of events leading to the discovery of the 327 vials on July 1, 2014. Some of the findings include: “There was no single individual responsible for the entire contents and operation of the shared cold storage area. FDA did not follow the CDC Select Agent Guidelines for the packaging and transfer of samples to a high containment facility for securing the materials.” There were six findings in the report, which included corrective actions, future actions, and compliance mechanisms. The report also includes the table regarding the disposition of the 327 vials. “It was noted that an internal, inward-looking investigation by the FDA had not formally started at the time of the hearing because both the CDC and FBI were in the midst of their own investigations of the incident.  However, FDA informally started an internal review and audit of the incident to understand the failure points to implement best policies and practices to prevent such incidents from happening in the future.”

Global Virome Project – You may remember reading  this summer about finding the next patient zero via a speaking engagement from USAID Director for Global Health Security and Development Unit, Dr. Dennis Carroll. The truth is that outbreaks like Zika and Ebola have shown us that countermeasures are invariably weak and viruses like to hide out in nature. This formidable reality has led to the development of the Global Virome Project, which looks to catalogue viruses from all over the world as a means of identifying the threats before they can identify us. “The idea has been around for a while and is supported by individual scientists and organizations including the US Agency for International Development, the nonprofit EcoHealth Alliance, HealthMap, ProMED, and the epidemic risk firm Metabiota. Now support for a global push may be picking up momentum, as scientists and health organizations find themselves repeatedly called upon whenever new threats arise.” An extension of the vision that brought about the PREDICT project, the Global Virome Project looks to make the process more efficient and effective by utilizing new methodology. While knowing the existence of a disease does not equate to preparedness, the understanding of how it interacts with humans and where it hides can help us determine risk and vaccine development. “For instance, knowing that the risk of contracting viruses carried in a species of bats is highest when their offspring are young might push ecotourism operators to avoid caves at those times. And Carroll said filling in more of the picture of the viral world will simply help scientists understand its patterns and interactions better. Right now, predictions are based on the behaviors of a few hundred known viruses, he said.”

2017-2022 Health Care Preparedness and Response Capabilities – The Office of the Assistant Secretary for Preparedness and Response has released their report outlining “the high-level objectives that the nation’s health care delivery system, including HCCs [health care coalitions] and individual health care organizations, should undertake to prepare for, respond to, and recover from emergencies.” The report further breaks down the capabilities into four sections that will, when combined and fully followed, enable full readiness. The four sections are Foundation for Health Care and Medical Readiness, Health Care and Medical Response Coordination, Continuity of Health Care Service Delivery, and Medical Surge. The report is extremely detailed and includes a wide variety of methods for identifying and coordinating resource needs during an emergency, setting up a health care EOC, implementing out-of-hospital medical surge response, and much more.

Blue Ribbon Study Panel Report on Biodefense Indicators– I remember the excitement during the Blue Ribbon Study Panel presentation on their recommendations since the Ebola outbreak. The room was packed with so many contributors to biodefense and there was a sense of fervor regarding the possibilities that could come from their 87 recommendations. Sadly, it seems that enthusiasm isn’t enough to get the work completed. It seems that an overwhelming majority haven’t been completed, according to the latest report. In fact, Tom Ridge and Joseph Lieberman have taken to TIME magazine as a means to implore the incoming administration to help protect the U.S. from bioterrorism and infectious disease threats.

Nanotherapeutics Opens Plant Near Progress Park – Nanotherapeutics opened their new $138 million 183,000-square-foot plant near Progress Park in Alachua, which was built to fulfill a DoD grant that could be worth up to $359 million. “The purpose and the capability of this facility is really fundamentally to avoid a surprise and be better prepared,” said Chris Hassell, deputy assistant secretary of defense for chemical and biological defense. “Sixty years after Pearl Harbor we were surprised again with the anthrax mailings and other events of 9/11, so this whole issue of surprise is a common area of discussion, what can we do to avoid surprise, to defend it, to respond to it more effectively and to that end this facility is very important to our capability to do that.” The DoD maintains several contracts for vaccine and treatment manufacturing, however Nanotherapeutics has tackled several of the struggles with efficiency that have plagued several other efforts. Utilizing disposable bags within stainless steel equipment allows for less clean-up and quicker transitions to help make the process more efficient and successful. The new plant follows strict NIH and military guidelines regarding waste and handling of hazardous materials, not to mention a pretty hefty security system.

czqg73pwiaacplk-png-largeUNSC 1540 Resolution – The United Nations Security Council unanimously voted on Resolution 1540 this week, which is especially prudent given the devastation in Syria and use of chemical weapons. The overwhelming adoption of the 1540 review resolution furthered the fight to keep WMD’s out of non-state actor hands. Resolution 1540 was adopted in 2004 and extended periodically through 2012 as a means of imposing binding obligations on all states to adopt legislation to prevent the proliferation of nuclear, chemical, and biological weapons. The open debate, “Preventing Catastrophe: A Global Agenda for Stopping the Proliferation of Weapons of Mass Destruction to Non-State Actors” took place on December 15th, ending the second review of 1540 implementation. “The Council is expected to adopt a resolution endorsing the review and noting the findings and recommendations contained in its report, which was agreed by the 1540 Committee last Friday”. The comprehensive review process has been somewhat challenging lately due to differences in Council member priorities and ambitions. “Russia and China made clear that they did not see the need for radical changes in the functioning or mandate of the Committee, whereas Spain, as the chair of the Committee, and other Council members, such as the UK and the US, were pushing for more substantive measures and new approaches. As a result, the discussions in the 1540 Committee on the report of the review were quite contentious, in particular with regard to its conclusions and recommendations. It took more than two months of intense negotiations after the Committee considered the first draft of the report on 27 September to reach agreement on the final document. The whole review process has taken almost two years.” We’ll make sure to keep you posted as news is released!

Avian Influenza and Global Trade Conditions– A series of avian influenza outbreaks are challenging the positive 2017 outlook for the global poultry industry. These events are especially distressing for the poultry industry as the global pork and beef production is rising. “The return of avian influenza is now shaking up global trade conditions and is especially affecting the outlook for Asia, Europe and Africa,” the report said. “It will also be a test for the U.S. industry after last year’s multiple AI outbreaks. As many European and Asian countries are exporters of meat and breeding stock, this will certainly impact the outlook for the industry and could shake up meat and breeder trade again.” The increasing protectionism and disease-related traded restrictions have caused some slowing within the poultry trade. This report comes at an auspicious time as the WHO warns of a H7N9 pandemic.

Zika Virus Updates- The most recent Florida Department of Health daily updates can be found here, which found six new travel-related cases on 12/14 and no new locally acquired cases. The CDC has issued a travel advisory for Brownsville, TX due to Zika virus. A new study has estimated the prevalence of Zika by the time a microcephaly case is detected. Saad-Roy, et al. (2016) explain, “this model gives us the probability distribution of time until detection of the first microcephaly case. Based on current field observations, our results also indicate that the percentage of infected pregnant women that results in fetal abnormalities is more likely to be on the smaller end of the 1% to 30% spectrum that is currently hypothesized. Our model predicts that for import regions with at least 250,000 people, on average 1,000 to 12,000 will have been infected by the time of the first detection of microcephaly, and on average 200 to 1,500 will be infectious at this time. Larger population sizes do not significantly change our predictions.” The CDC has reported, as of December 14th, 4,617 cases in the U.S.

Stories You May Have Missed: 

  • Biological Security Threats Situation Report – In this report from the Danish Centre for Biosecurity and Biopreparedness, you can find an assessment of current biological threats and risks. The authors note that “the overall likelihood of a major biological terrorist attack must be viewed as relatively low at the moment, but a successful attack could have grave consequences for societies.” Focusing on the capacity to respond to intentional attacks through biosecurity and biopreparedness is vital. The report looks at the risks from state, non-state terrorists, and criminals in its assessment.
  • DHS Backs Development of Livestock Disease Outbreak Readiness Program – America has a soft underbelly and it’s livestock and agriculture. The new funding for the National Agricultural Biosecurity Center (NABC) project to develop the readiness program is just over $330,000 and “will provide a clearinghouse for planning, training and knowledge products to help state, local, tribal and territorial entities prepare for transboundary livestock disease outbreaks.he program also entails extensive collaboration of academia, private industry and state governments. Faculty and staff in the Beef Cattle Institute and the College of Veterinary Medicine will provide subject matter expertise and assistance building the website, and student workers will be employed to assist with the project.”
  • ABSA International  – Don’t miss the USDA and the Agricultural Research Service’s 4th International Biosafety and Biocontainment Symposium- Gobal Biorisk challenges: Agriculture and Beyond. This symposium will take place from February 6-9th at Baltimore Convention Center. Topics will range from biorisk management challenges in one health world, arthropod containment in plant research, and much more!

Pandora Report 5.20.2016

The biodefense world was pretty busy this week – between Zika funding, cloning, and debates over dual-use technologies, we’ve got a lot to recap! Check out this great infographic on mosquitoes and the diseases they spread. The “State of Innovation” report revealed a decrease in biotech patents in 2015, with many pointing to the correlation between three U.S. Supreme Court decisions that limited patentability of some biotechnologies. If you were wondering how the sale of Plum Island is going, the House has actually temporarily halted any transactions.

Congrats GMU Biodefense Graduates!IMG_3491
We’re so happy to announce the convocation of some of our phenomenal graduate students. Earning a MS in Biodefense- Julia Homstad (also awarded the Frances Harbour Award for Community Leadership), Brittany Linkous (earning the Outstanding Biodefense MS Student Award), Francisco Cruz, Mary Dougherty, Moneka Jani, Sadaf Khan, Brittany Ferris, Michael Smith, and Robert Smith. Graduating with their PhD’s – Jonathan Gines (also the recipient of the Outstanding Biodefense PhD Student award and his dissertation was: Designing Biorisk Oversight: Applying Design Science Research to Biosafety and Biosecurity, Patricia Kehn (Flu News You Can Use? An Analysis of Flu News Quality 2008-2010), and Mittie Wallace (Emergency Preparedness in Virginia, Maryland and DC: Using Exchange Theory to Identify Government-Nonprofit Incentives and Barriers to Collaboration). Congrats to all our Biodefense graduates in the hard work and dedication they’ve put forth to contribute to such a diverse and exciting field!

Evaluation of DoD Biological Safety & Security Implementation
The Inspector General of the Department of Defense (DoD) has released their report regarding the biosafety and biosecurity policies and practices within DoD laboratories working with select agents. The report also evaluated DoD oversight of these laboratories and compliance with Federal, DoD, and Service Policy, with careful consideration to recent GAO (among others) recommendations. Several findings were reported, which include: “DoD has not maintained biosafety and biosecurity program management, oversight, and inspections of its BSAT laboratories according to applicable Federal regulations. BSAT laboratories in Military Services were inspected according to different guidance, standards, and procedures, risking dangerous lapses in biosafety practices. Lack of coordinated oversight of DoD laboratories led to multiple, missing, and duplicative inspections, and, therefore, an excessive administrative burden that could interfere with scientific research performance.” The report also noted that public health and safety was put at risk due to the poor protection of these agents. Recommendations pushed for better internal and external tracking of inspections, coordination of external technical and scientific peer reviews, standardized training for inspectors, the creation of site-specific laboratory security vulnerability assessments, etc. Overall, the report addresses several key failures within select agent laboratories that have been gaining increasing attention. While these recommendations are a necessary first step, there is definitely an up-hill battle to better secure and work with select agents.

Public Health & Emerging Disease Outbreaks – The Importance of Communication 
Outbreak prevention and response isn’t a new concept…in fact it’s something we’ve been perfecting since John Snow took off the Broad Street pump handle. Sometimes, the fastest spreader isn’t the disease, but rather poor communication and fear. In every after-action report, communication tends to be the biggest failure. Not only do people fail to talk to each other enough, but information dissemination and comprehension tends to be poorly emphasized, when in fact it could save lives. “In particular, healthcare workers may benefit from knowing about newly found transmission risks or disease findings from a novel case under intensive care. Knowledge drives behavioural change that can save lives. We live in a global community. Even if the lives saved are not citizens of our country, withholding information because it is unlikely to benefit our own countrymen, or even delaying dissemination of important information until it is published in a scientific journal is a poor choice.” Dr. Ian Mackay and Katherine Arden point to communication failures regarding the zoonotic transmission of MERS-CoV and the illness of a nurse from the UK who recovered from Ebola and was later hospitalized for meningitis. Both instances involved poor communication, especially to healthcare workers. “Good communicators and reliable communications are vital. Create a dialogue with the public now to build a partnership for later, to reduce distrust when an outbreak, epidemic or pandemic occurs. In this way, communities know which voices to trust and where to turn for their information. Leaving an information void invites others to fill it and more often than not, it is those who delight in titillation, invention, make-believe and fear-mongering.”

Weekly Dose of Zika Virus
H.R. 5243 – Zika Response Appropriations Act of 2016 is the hot topic of discussion this week, as President Obama’s Administration is opposing the act. “While the Administration appreciates that the Congress is finally taking action to address the Zika virus, the funding provided in H.R. 5243 is woefully inadequate to support the response our public health experts say is needed.  Specifically, the Administration’s full request of $1.9 billion is needed to:  reduce the risk of the Zika virus, particularly in pregnant women, by better controlling the mosquitoes that spread Zika; develop new tools, including vaccines and better diagnostics to protect the Nation from the Zika virus; and conduct crucial research projects needed to better understand the impacts of the Zika virus on infants and children.On May 17th, the Senate voted to provide $1.2 billion to fight the growing outbreak. A team from the University of Texas Medical Branch at Galveston has traveled into uncharted territory – they are the first to genetically engineer a clone of the Zika virus strain.  Their work could help speed up vaccine development and research of the virus. As the Zika outbreak rages onwards, many are pointing to the need to understand how and why it mutated from Africa to Asia and then to the Americas.  “‘Like many arboviral agents, given the appropriate environmental and human conditions, new pathogens can be easily moved around the globe,’ Ann Powers said. And that’s what Zika did. The virus began to ripple across the Pacific—and as it traveled, it seemed to change.” The Olympic Games are fast approaching and the debate about the safety of the games has been spreading (see what I did there?). Last week you read about how some are saying the games should be cancelled, while others say it poses a minimal threat. You can also find a snapshot of Zika virus here. The WHO reported that the overall risk of Zika virus moving across the WHO European region is low to moderate during late spring and early summer. Rutgers is taking the lead on an IBM-sponsored project that will utilize supercomputing resources to identify “potential drug candidates to cure the Zika virus.” The Wilson Center is hosting an event, “Zika in the U.S: Can We Manage the Risk?” on Tuesday, May 24th, at 11am. Many are also wondering why humans and not mice are susceptible to the virus. Lastly, as of May 18th, the CDC has reported 544 travel-associated cases and 10 sexually transmitted cases within the U.S.

Governance Structures for Reducing Dual-Use Technology Risks
The American Academy of Arts & Sciences has published an examination of dual-use technology governance and the state of current efforts to control the spread of potentially dangerous technologies. “Governance of Dual-Use Technologies examines the similarities and differences between the strategies used for the control of nuclear technologies and those proposed for biotechnology and information technology. The publication makes clear the challenges concomitant with dual-use governance.” The report looks at the potential objectives of these measures, what they translate to in a technical format, and if these measures are even feasible.

Global Avian Influenza A H5N1 Trends
Researchers recently looked at the epidemiology of human H5N1 cases from 1997-2015. This was the first comprehensive analysis of human cases on a global scale. The number of affected countries rose between 2003 and 2008, traveling from east Asia into west Asia and Africa. “Most cases (67·2%) occurred from December to March, and the overall case-fatality risk was 483 (53·5%) of 903 cases which varied across geographical regions. Although the incidence in Egypt has increased dramatically since November, 2014, compared with the cases beforehand, there were no significant differences in the fatality risk, history of exposure to poultry, history of patient contact, and time from onset to hospital admission in the recent cases.”

Stories You May Have Missed:

  • Health Security Available – The newest volume of Health Security is now available online. The recent issue includes pieces on Zika and microcephaly, preparing for climate disruption, adapting to health impacts of climate change in the DoD, and more!
  • Secret Genome Meeting – Last week saw a meeting hosted by Harvard Medical School’s George Church, to discuss “feasibility and implementation of a project to synthesize entire large genomes in vitro.” Initially the meeting was open to the public and media however, the decision was made to keep it private (from the media) so that researchers, lawyers, entrepreneurs, and government officials could speak freely without fear of being misquoted. “Our ability to understand what to build is so far behind what we can build,” said Jeremy Minshull, chief executive of DNA synthesis company DNA2.0, told The New York Times. “I just don’t think that being able to make more and more and more and cheaper and cheaper and cheaper is going to get us the understanding we need.”
  • Four Countries Fend Off Avian Influenza- Cambodia, Ghana, and Indonesia have been battling H5N1 and Italy has just reported its second H7N7 occurrence this month. Ghana and Cambodia have reported significant bird mortalities, with the virus killing 155 of 505 susceptible birds. “In Ghana, the H5N1 virus turned up in four commercial layer and breeding farms in three of the country’s regions: two in Greater Accra and one each in Eastern and Central regions.”
  • Bavarian Nordic Smallpox Vaccine Contract – the pharmaceutical company announced that BARDA has ordered a bulk supply of their new IMVAMUNE smallpox vaccine. The $100 million supply of the non-replicating vaccine requires Bavarian Nordic to manufacture and store the bulk supply. “The freeze-dried version of IMVAMUNE is expected to reduce the life cycle management costs based on a longer shelf life and will replace the liquid-frozen version that is currently stockpiled in the U.S. Strategic National Stockpile (SNS).”
  • Early Detection Lyme Disease Test Successful – GMU researchers have proven that their early-detection urine test works to rapidly identify Lyme diseases. “The National Institutes of Health funded the research that led to Mason’s patented technology, which traps tell-tale clues (such as the Lyme bacteria protein) that a disease is present. The Mason technology, which is licensed to Ceres, works during the earliest stages of disease and finds the tiniest traces missed by most diagnostic tests.”