Pandora Report: 1.27.2023

The year of the rabbit is off to one heck of a start. This week we cover COVID-19’s spread in China as the Party increasingly cracks down on Zero-COVID protesters, growing concern amount H5N1 in mammals, new insight into the history of the plague, and more. Several new publications are listed, including a fresh book from Ed Regis about the history of the Pacific Ocean Biological Survey Program and multiple works on misinformation’s impact on COVID-19 responses. As always, we round out with events and announcements, including multiple great upcoming professional opportunities. Happy Friday!

COVID-19 Multiplying Like Rabbits in China

China’s CDC claimed this week that cases of critically ill COVID-19 patients are down 72% from a peak earlier this month in the country, with daily deaths of hospitalized COVID-19 patients down 79% as well. This comes as Wu Zunyou, Chief Epidemiologist at China CDC, claims that 80% of the country’s 1.4 billion people have already been infected. This seems like an effort to indicate that a rebound is unlikely in the coming months amid concerns that the new year travel season will cause further spread and deaths. Just last week, China claimed to have 60,000 COVID-19 deaths in the month since it rolled back its notorious Zero-COVID policies, a number far below the one million some models estimated the country will suffer this winter.

However, CNBC notes, “…some experts said that figure probably vastly undercounts the full impact, as it excludes those who die at home, and because many doctors have said they are discouraged from citing Covid as a cause of death.” This understanding better aligns with reports of over-crowded funeral homes and crematoriums, and reports of coffin makers and funeral decoration companies repeatedly selling out of their products amid the spread. Because of these discrepancies, many are doubtful of the government’s official statistics.

At the same time, reports of Zero-COVID protesters being arrested or intimidated are mounting. Four women in Beijing are known to have been arrested in connection with these protests, seemingly in retaliation for their role in what has been described as “the boldest challenge to the Communist Party’s rule in decades and an embarrassing affront to its leader, Xi Jinping.” The New York Times explains the Party’s need to do this, writing “The party seems determined to warn off anyone who may have been emboldened by the remarkable outburst of public discontent, which was followed just days later by Beijing’s abrupt decision to abandon Covid restrictions. Since then, domestic challenges have mounted: Youth unemployment is high, the economy is slowing, and Covid infections and deaths have accelerated.”

The same piece continues, “The party is also working to discredit the protesters by casting them as tools of malevolent foreign powers. Beijing has long dismissed dissent at home — from calls for women’s rights to pro-democracy activism to ethnic unrest — as the result of Western-backed subversion. The protests against “zero Covid” were no exception: One Chinese diplomat suggested that some of the demonstrators had been “bought by external forces.”

Chunyun, the Lunar New Year travel period in China, typically lasts from mid-January through late-February, meaning opportunities for spread in rural parts of the country are far from over, despite China CDC’s apparent claims to the contrary. The continued supply of highly suspect statistics and crackdowns on Zero-COVID protesters presents a troubling situation and indicates that the Party has done anything but change its ways.

Thinking of Offering a Nice Egg in This Trying Time? Mink Again

US egg prices skyrocketed in price by more than 137% between December 2021 and December 2022, leaving many in constant sticker shock at the grocery store as this once reliably cheap staple becomes increasingly expensive. Much of this is attributed to outbreaks of highly pathogenic avian influenza (HPAI) A(H5N1), which has been spreading in US flocks since January 2022, resulting in cullings of over 57 million birds across industrial and backyard flocks. However, over the past year, this virus has also demonstrated its ability to spread from birds to mammals, with infections found in several species in the US so far, including raccoons, foxes, seals, grizzly bears, and, most recently, minks. Naturally, this had led to increased concern about potential spread into other mammal populations.

“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.” Credit: CDC PHIL

Nature covered this story this week, writing “Until this particular outbreak, all mammalian infections could be attributed to direct contact with virus-contaminated material, says Hualan Chen, a virologist at the Harbin Veterinary Research Institute in China. For example, animals that ingest wild-bird droppings, or that prey on infected animals, can develop the disease. But its spread between mammals “implies that this H5N1 virus may pose a higher risk to public health”, Chen says.”

A new article in Eurosurveillance discusses the alarming spread of HPAI A(H5N1) at an American mink farm in Galicia, Spain in October 2022. In it, Agüero et al. explain that the farm experienced an acute increase in its mortality rate (.77% versus an expected range of .2-.3%), prompting the facility’s clinical veterinarian to collect samples from affected animals. These animals tested positive for H5N1, and “Post-mortem examination revealed haemorrhagic pneumonia or red hepatisation of the lungs as the most notable lesions”

The authors further explain the set-up of the farm, which housed 51,986 minks, writing “The minks were housed in wire netting cages placed in rows and situated in a series of over 30 partially open barns, which provided overhead protection but not total shelter of their sides. The minks were fed with raw fish and poultry by-products, cereals and blood meal. Poultry farms and avian slaughterhouses supplying the poultry by-products were located in Galicia. Up to 10 January 2023, H5N1 poultry outbreaks have not been reported from this region.”

The outbreak soon peaked, with a weekly mortality rate of 4.3% documented between October 17 and 23. Culling measures were ordered quickly, and all minks from infected pens were culled by November 17, along with destruction of all carcasses, fomites, and waste. Of the farm’s 12 workers, 11 were in contact with infected and culled animals, though none of them tested positive and they all completed quarantine without any problems. However, as the authors note in their abstract, “The identified viruses belong to clade 2.3.4.4b, which is responsible of the ongoing epizootic in Europe. An uncommon mutation (T271A) in the PB2 gene with potential public health implications was found. Our investigations indicate onward mink transmission of the virus may have occurred in the affected farm.”

While the mink farm seems to have been thorough in its efforts to stop this outbreak, there are concerns that this new variant may be circulating in wild bird populations. Nature writes, “But Puryear thinks that because the new variant contains genetic material from gull flu, it’s likely that at least some of its genetic changes arose in gulls before entering the mink farm. This means that a strain containing those mutations is probably still circulating in the bird population. But for human populations, the outlook is still good: if the new strain did start to infect people, health authorities could probably produce a vaccine quickly, and the antiviral drug Tamiflu (oseltamivir) can reduce the severity of the disease.”

The Nature news piece concludes with, “The potential risk to wild animals is greater. Bird flu has consistently caused high levels of sickness and death among wild birds and mammals over the past year, and how the new variant will affect that trend remains to be seen. “We just simply don’t know,” says Puryear.”

Shake Ups and Mess Ups at the Department of Health and Human Services

CDC Takes Major Steps in Revamp

CDC Director Dr. Rochelle Walensky announced a number of high-level changes to her agency this week, including the creation of the Office of Health Equity and the Office of Public Health Data, Surveillance, and Technology. These are steps taken in light of last year’s internal review that found, among other things, that the agency struggled with appropriately and rapidly sharing scientific findings, communications in general, and that it needed to strengthen relationships with federal, state, and local partners. Furthermore, most of the organizations under CDC will now report directly to the Office of the Director, moving away from what has been described as a “Community of Practice structure”.

MedPage Today explained this leadership re-structuring, writing “Today, additional details about that leadership structure became clear. There will be a centralized leadership team of experts housed within the director’s office, which will include the director of the CDC/Agency for Toxic Substances and Disease Registry; the principal deputy director; the deputy director for program and science/chief medical officer; the deputy director for policy, communications, and legislative affairs/chief strategy officer; the deputy director for global health; the chief operating officer; and the chief of staff.”

“These changes will improve efficiency, speed decision-making, and strengthen the communication of scientific information to the American public, ensuring CDC’s science reaches the public in an understandable, accessible, and implementable manner as quickly as possible,” an unnamed staffer told The Hill.

OIG Report Finds NIH and EcoHealth Alliance Fell Short in Monitoring and Oversight

The Office of Inspector General (OIG) at HHS released this week the findings of its audit of the National Institutes of Health’s grants to the EcoHealth Alliance. This audit was initiated because of concerns over NIH’s grant awards to EcoHealth as well as EcoHealth’s subawards to foreign entities. OIG aimed to “…determine whether NIH monitored grants to EcoHealth in accordance with Federal requirements, and whether EcoHealth used and managed its NIH grant funds in accordance with Federal requirements.”

The Office found that, “Despite identifying potential risks associated with research being performed under the EcoHealth awards, we found that NIH did not effectively monitor or take timely action to address EcoHealth’s compliance with some requirements. Although NIH and EcoHealth had established monitoring procedures, we found deficiencies in complying with those procedures limited NIH and EcoHealth’s ability to effectively monitor Federal grant awards and subawards to understand the nature of the research conducted, identify potential problem areas, and take corrective action. Using its discretion, NIH did not refer the research to HHS for an outside review for enhanced potential pandemic pathogens (ePPPs) because it determined the research did not involve and was not reasonably anticipated to create, use, or transfer an ePPP. However, NIH added a special term and condition in EcoHealth’s awards and provided limited guidance on how EcoHealth should comply with that requirement. We found that NIH was only able to conclude that research resulted in virus growth that met specified benchmarks based on a late progress report from EcoHealth that NIH failed to follow up on until nearly 2 years after its due date. Based on these findings, we conclude that NIH missed opportunities to more effectively monitor research. With improved oversight, NIH may have been able to take more timely corrective actions to mitigate the inherent risks associated with this type of research.”

Biodefense Graduate Program Director Dr. Gregory Koblentz was quoted in the New York Timespiece on this report, saying “Although concerns were identified by NIAID staff, the proposal was not referred to NIAID’s review committee for further consideration.” He continued, saying “On paper, NIAID staff were encouraged to ‘err on the side of caution’ in identifying and referring such proposals…but in practice it looks like they erred on the side of complacency.” 

Woman Pleads Guilty to Mailing Ricin Letters in 2020

Pascale Cecile Veronique Ferrier pleaded guilty this week in a US District Court “…to sending a threatening letter containing homemade ricin to then-President Donald J. Trump at the White House in September 2020, and eight similar letters, each containing ricin, to Texas State law enforcement officials.” Ferrier, a dual French-Canadian national, holds a French engineering degree and admitted in her plea agreements that she made ricin in her Quebec home in September 2020. According to the FBI, “Ferrier placed the ricin in envelopes containing letters she wrote to then-President Trump at the White House and to eight Texas State law enforcement officials.”

“Ferrier was detained in the State of Texas for around 10 weeks in the spring of 2019, and she believed that the law enforcement officials were connected to her period of detention. In early September 2020, Ferrier used the Twitter social media service to propose that someone should “please shoot [T]rump in the face.” The letters in the envelopes contained threatening language, and the letter addressed to then-President Trump instructed him to “[g]ive up and remove [his] application for this election.” Ferrier mailed each of the threatening ricin letters from Canada to the United States. Ferrier then drove a car from Canada to the Peace Bridge Border Crossing in Buffalo, New York, on Sept. 20, 2020, where border patrol officials found her in possession of a loaded firearm, hundreds of rounds of ammunition and other weapons.”

Ferrier is scheduled for sentencing on April 26. She faces 262 months imprisonment if her plea agreements are accepted.

An Oldie, But a (Not So) Goodie: Y. Pestis Strains May Have Been Around Centuries Before Outbreaks

A new article in Communications Biology discusses how Yersinia pestis spread globally over longer periods of time than previously estimated. Eaton et al. estimate that the strain of Y. pestis responsible for the Black Death in the mid-14th century diverged from the ancestral strain as early as 1214, while the one responsible for the Plague of Justinian may have cropped up between 272 and 465–up to nearly 270 years before the epidemic began in 541. “‘It shows that each major plague pandemic has likely emerged many decades to centuries earlier than what the historical record suggests,” study coauthor and evolutionary geneticist Hendrik Poinar, director of McMaster University’s Ancient DNA Centre in Canada,” said in a statement to CNN.

The authors write in their abstract: “Plague has an enigmatic history as a zoonotic pathogen. This infectious disease will unexpectedly appear in human populations and disappear just as suddenly. As a result, a long-standing line of inquiry has been to estimate when and where plague appeared in the past. However, there have been significant disparities between phylogenetic studies of the causative bacterium, Yersinia pestis, regarding the timing and geographic origins of its reemergence. Here, we curate and contextualize an updated phylogeny of Y. pestis using 601 genome sequences sampled globally. Through a detailed Bayesian evaluation of temporal signal in subsets of these data we demonstrate that a Y. pestis-wide molecular clock is unstable. To resolve this, we developed a new approach in which each Y. pestis population was assessed independently, enabling us to recover substantial temporal signal in five populations, including the ancient pandemic lineages which we now estimate may have emerged decades, or even centuries, before a pandemic was historically documented from European sources. Despite this methodological advancement, we only obtain robust divergence dates from populations sampled over a period of at least 90 years, indicating that genetic evidence alone is insufficient for accurately reconstructing the timing and spread of short-term plague epidemics.”

Read the entire article here.

“Produced by the National Institute of Allergy and Infectious Diseases (NIAID), this digitally colorized scanning electron microscopic (SEM) image depicts a number of yellow-colored, Yersinia pestis bacteria, that had gathered on the proventricular spines of a Xenopsylla cheopis flea. These spines line the interior of the proventriculus, a part of the flea’s digestive system. The Y. pestis bacterium is the pathogen that causes bubonic plague.” Credit: CDC PHIL

It’s 90 Seconds to Midnight (That’s Not Good)

“This year, the Science and Security Board of the Bulletin of the Atomic Scientists moves the hands of the Doomsday Clock forward, largely (though not exclusively) because of the mounting dangers of the war in Ukraine. The Clock now stands at 90 seconds to midnight—the closest to global catastrophe it has ever been.” Read the Bulletin’s statement here (also available in РУССКИЙ and УКРАЇНСЬКА).

Say “Hello” to the International Biosecurity and Biosafety Initiative for Science

The Nuclear Threat Initiative recently announced the creation of the International Biosecurity and Biosafety Initiative for Science (IBBIS), an organization “trying to prevent dramatic advances in bioscience from unleashing engineered pathogens from the lab, and wants research funders, scientists and journals to help.” NTI explains: “NTI is working with international stakeholders to establish the International Biosecurity and Biosafety Initiative for Science (IBBIS), an independent organization dedicated to reducing emerging biological risks associated with technology advances. A core element of the IBBIS mission will be to strengthen international biosecurity norms and develop innovative, practical tools and incentives to uphold them. IBBIS has a broadly defined mission, but initially it will focus on preventing the misuse of DNA synthesis technology—with the understanding that it will expand its remit over time.”

“IBBIS will collaborate with stakeholders across the global bioscience and biotechnology enterprise including academia, industry, the public health community, governments and philanthropy. These activities will complement the important work of the World Health Organization, the United Nations Office of Disarmament Affairs, and other national, regional, and international organizations. NTI’s work to establish IBBIS is rooted in the vision of a world in which bioscience and biotechnology flourish, with safeguards against deliberate or accidental misuse with potentially catastrophic consequences.”

David Matthews discusses IBBIS in-depth, including the fraught geopolitical situation it faces, in this piece for Science Business.

The Lancet Series on One Health and Global Health Security

Check out this recent series from the Lancet: “Following the 2014-2016 Ebola outbreak in West Africa, and the on-going global COVID-19 pandemic, the One Health approach (bridging the Animal-Environmental-Human Health interface)  has rapidly gained political and financial support, particularly in regional and transcontinental initiatives to improve Global Health Security, including through recently established institutions like Africa CDC and other multidisciplinary consortia. This four-paper Lancet Series explores the adoption of One Health approaches to improve health security and include an analysis of the current landscape of preventive, surveillance, and response measures in outbreak situations of emerging and re-emerging zoonotic infectious diseases with epidemic potential as well as other potential public health emergencies such as neglected endemic diseases, antimicrobial resistance, environmental and chemical hazards and natural disasters.”

“Combating Misinformation as a Core Function of Public Health”

Knudsen et al. discuss the New York City Department of Health and Mental Hygiene’s role in countering misinformation in this New England Journal of Medicine Catalyst piece: “The New York City Department of Health and Mental Hygiene determined that the spread of misinformation about Covid-19 was having a harmful health impact, particularly on communities of color with low vaccination rates. It established a dedicated Misinformation Response Unit to monitor messages containing dangerous misinformation presented on multiple media platforms, including social media, non-English media, and international sites, and proliferating in community forums. The Misinformation Response Unit and the Health Department collaborated with more than 100 community partners to tailor culturally appropriate, scientifically accurate messages to different populations. The Health Department and its partners were able to rapidly identify messages containing inaccurate information about Covid-19 vaccines, treatment, and other issues and to support the delivery of accurate information to various populations. Although the harms of misinformation and benefits of addressing the problem require additional evaluation, internal and external interviews suggested that the Misinformation Response Unit helped the Health Department counter misinformation and disseminate accurate scientific information to the community, thus improving health and vaccine equity during the Covid-19 pandemic.”

“Fault Lines: The Expert Panel on the Socioeconomic Impacts of Science and Health Misinformation”

This new report from the Council of Canadian Academies includes a number of important findings, including that COVID-19 misinformation cost at least 2,800 Canadian lives and CAD 300 million in hospital expenses over a period of just nine months. “Fault Lines details how science and health misinformation can proliferate and its impacts on individuals, communities, and society. It explores what makes us susceptible to misinformation and how we might use these insights to improve societal resilience to it. The report includes a model of the impacts of COVID‑19 misinformation on vaccination rates in Canada, producing quantitative estimates of its impacts on our health and the economy, and situating these within a broader context of societal and economic harms.”

“Battling Biological Threats: Complacency, Progress, or Both?”

“As 2023 opens, there is apprehension that partisan divisions and politicized health security approaches may worsen as the United States moves into a divided government of ultra-thin margins. But over the course of 2022, several important new national security directives and policies and bipartisan legislative actions significantly advanced thinking on health security and what is required to better protect Americans—proving that progress remains in reach, despite tough odds. Global health security, including biodefense, has been elevated to new prominence in U.S. national security thinking. The Biodefense Posture Review, expected to be released in early 2023, is mandated to unify and modernize DOD’s broad, comprehensive biodefense capabilities, and synchronize these efforts with those of other federal departments in line with the recently released National Defense and Biodefense Strategies. The United States must be resolute and clear, leaning forward not backwards, investing in new capabilities sustained over many years to protect Americans and the larger world against future dangerous pathogens. In a new commentary, Thomas R. Cullison and J. Stephen Morrison argue that it remains possible to bridge divides and make measurable progress to prepare the United States for inevitable future biological threats.” Read this CSIS report here.

“The Pentagon’s Chemical and Biological Defense Program Moves Towards Modernization, Yet Congress Slashes Funding”

Dan Regan discusses DoD’s seemingly mismatched objectives and funding decisions in this piece for the Council on Strategic Risks. He writes, “To achieve its mission set, including investing in emerging biotechnologies and bolstering industrial capacity to scale MCMs to novel threats, developing and investing in stand-off pathogen early warning detection, and advancing protective equipment for the Joint Force, the CBDP budget requires a nearly two-fold increase from the President’s request of $1.32 billion in FY23 to $3 billion for FY24. However, Congress unfortunately just dealt a 7% cut to chemical and biodefense programs with the FY23 omnibus spending bill, following years of declining funds for CBDP. As the FY24 Presidential Budget Request is being drafted, the Biden Administration and Congress should consider significant increases to CBDP’s budget, along with the other biodefense and global health security priorities outlined in the 10 + 10 over 10 strategy, to combat biological threats.”

“Virology Under the Microscope–a Call for Rational Discourse”

In this commentary in mBio, more than 130 authors call for a return to rational discourse about virology and its role in modern issues like pandemic response and debates over GoF research. “Viruses have brought humanity many challenges: respiratory infection, cancer, neurological impairment and immunosuppression to name a few. Virology research over the last 60+ years has responded to reduce this disease burden with vaccines and antivirals. Despite this long history, the COVID-19 pandemic has brought unprecedented attention to the field of virology. Some of this attention is focused on concern about the safe conduct of research with human pathogens. A small but vocal group of individuals has seized upon these concerns – conflating legitimate questions about safely conducting virus-related research with uncertainties over the origins of SARS-CoV-2. The result has fueled public confusion and, in many instances, ill-informed condemnation of virology. With this article, we seek to promote a return to rational discourse. We explain the use of gain-of-function approaches in science, discuss the possible origins of SARS-CoV-2 and outline current regulatory structures that provide oversight for virological research in the United States. By offering our expertise, we – a broad group of working virologists – seek to aid policy makers in navigating these controversial issues. Balanced, evidence-based discourse is essential to addressing public concern while maintaining and expanding much-needed research in virology.”

“CRISPR Technology: A Decade of Genome Editing is Only the Beginning”

Wang and Doudna discuss the first decade of CRISPR in Science: “In the decade since the publication of CRISPR-Cas9 as a genome-editing technology, the CRISPR toolbox and its applications have profoundly changed basic and applied biological research. Wang and Doudna now review the origins and utility of CRISPR-based genome editing, the successes and current limitations of the technology, and where innovation and engineering are needed. The authors describe important advances in the development of CRISPR genome-editing technology and make predictions about where the field is headed. They also highlight specific examples in medicine and agriculture that show how CRISPR is already affecting society, with exciting opportunities for the future. —DJ”

“Zombie Viruses from the Arctic”

Jean-Michel Claverie’s new piece in Think Global Health discusses the threat global warming poses to global health by threatening Earth’s permafrost, potentially releasing ancient microbes. Claverie explains the evolution of this threat and how it may evolve throughout the piece, writing in part “This science fiction scenario became more realistic in 2015 when an international research team succeeded in resurrecting several viruses isolated from permafrost dating back 30,000 years. Following additional experiments, it is now clear that a significant proportion of prehistorical viruses can remain infectious for even longer periods of time. This article reviews the reality of the risks that their release might represent for the future.”

Science, Secrecy, and the Smithsonian

New from Ed Regis, author of The Biology of Doom, is this book, Science, Secrecy, and the Smithsonian:

“This is the story of how the Smithsonian Institute became intertwined in a secret biological warfare project.”

“During the 1960s, the Smithsonian Institution undertook a large-scale biological survey of a group of uninhabited tropical islands in the Pacific. It was one of the largest and most sweeping biological survey programs of all time, a six-year-long enterprise during which Smithsonian personnel banded 1.8 million birds, captured live specimens and took blood samples, and catalogued the avian, mammalian, reptile, and plant life of 48 Pacific islands.”

“But there was a twist. The study had been initiated, funded, and was overseen by the U.S. Biological Laboratories at Fort Detrick, Maryland. The home of the American biological warfare program. In signing the contract to perform the survey, the Smithsonian became a literal subcontractor to a secret biological warfare project. And by participating in the survey, the Smithsonian scientists were paving the way for top-secret biological warfare tests in the Pacific.”

“Critics charged the Smithsonian with having entered into a Faustian bargain that made the institution complicit in the sordid business of biological warfare, a form of combat which, if it were ever put into practice and used against human populations, could cause mass disease, suffering, and death. The Smithsonian had no proper role in any such activities, said the critics, and should never have undertaken the survey.”

Science, Secrecy, and the Smithsonian: The Strange History of the Pacific Ocean Biological Survey Program explores the workings of the survey program, places it in its historical context, describes the military tests that followed, and evaluates the critical objections to the Smithsonian’s participation in the project.”

Jonathan Tucker CBW Symposium

“The James Martin Center for Nonproliferation Studies cordially invites you to the 11th annual Jonathan Tucker Symposium on chemical and biological weapons issues on February 9th and 10th, 2023.” BW topics include “Revisiting the Siege of Caffa & Catapulting Cadavers” and “Governance of Dual-Use Biological Research,” the latter of which will be moderated by Dr. Gregory Koblentz. CW topics include “Lessons learned from the U.S. Chemical Weapons Destruction Program” and “The 2023 CWC Review Conference”. Learn more and register for the virtual events here.

Novel Applications of Science and Technology to Address Emerging Chemical and Biological Threats

For the first time since 2019, this Gordon Research Conference is back, this time in sunny Ventura, CA. “The Chemical and Biological Defense GRC is a premier, international scientific conference focused on advancing the frontiers of science through the presentation of cutting-edge and unpublished research, prioritizing time for discussion after each talk and fostering informal interactions among scientists of all career stages. The conference program includes a diverse range of speakers and discussion leaders from institutions and organizations worldwide, concentrating on the latest developments in the field. The conference is five days long and held in a remote location to increase the sense of camaraderie and create scientific communities, with lasting collaborations and friendships. In addition to premier talks, the conference has designated time for poster sessions from individuals of all career stages, and afternoon free time and communal meals allow for informal networking opportunities with leaders in the field.” The conference will be held March 19-24, 2023. Learn more and apply here by February 19.

High School and College Student Internship: Data Analytics for Elite Young Scholars – Biology and Medical Science Experience

“This Young Scholars Research Program is designed for Elite High School Students and Undergrad Students, who are interested in pursuing their study and/or career in the fields of biology or medical science with emphasis on advanced data analytics. You will work with our esteemed George Mason University faculty members on a specific team project. The team will consist of about three to four members of both high school and undergraduate students. The project will be assigned to the students at the beginning of the program based on the preference indicated by the students prior to the program. Two outputs will be expected from each team at the end of the programs: i) a final paper which will be published on the Center for Biomedical Science and Policy website as well as a special issue of World Medical & Health Policy; and ii) Team presentation at a symposium at which students compete for prizes.”

“During this program, students will be participating in a research project applying some of the following methods, including but not limited to biostatistics using R or Stata, data visualization using QGIS or ArcGIS, and network visualization using Gephi.”

“During this program, students will be participating in a research project applying some of the following methods, including but not limited to biostatistics using R or Stata, data visualization using QGIS or ArcGIS, and network visualization using Gephi.”

Special Call for Papers-Journal of Science Policy & Governance

The Journal of Science Policy & Governance recently announced a special call for papers “and competition to provide policymakers with a new perspective on how scientific expertise could be useful to the complex brew of 21st foreign policy and national security challenges, resulting in a special issue on Policy and Governance on Science, Technology and Global Security.” The journal invites “students, post-doctoral researchers, policy fellows, early career researchers and young professionals from around the world to submit op-eds, policy position papers and other articles addressing foreign policy and national security challenges. These include concerns about the use of nuclear or radiological weapons driven by the war in the Ukraine, hypersonic weapons, immigration driven by climate change, and emerging threats in cybersecurity and biosecurity.” The deadline for submission is April 30.

Additionally, there will be a science policy writing workshop on January 30 in addition to two webinars on February 20 and March 30 (one on Policy and Governance on Science and Technology and one on Foreign Policy and National Security, respectively) to help prospective authors prepare their submissions. Learn more about these events and register here.

Weekly Trivia Question

You read the Pandora Report every week and now it’s time for you to show off what you know! The first person to send the correct answer to biodefense@gmu.edu will get a shout out in the following issue (first name last initial). For this week, our question is “On April 22, 1915, the German Army infamously unleashed more than 160 tons of chlorine gas on French trenches near which Belgian city?”

Shout out to Morgan M. for winning last week’s trivia! The correct answer to “In 1985, an American extremist group’s compound was raided by more than 300 law enforcement officers from several federal, state, and local agencies following a three-day standoff. Among other items, officers seized about thirty gallons of potassium cyanide the group intended to use to poison water supplies of several cities. What was the name of this group?” is the Covenant, the Sword and the Arm of the Lord.

Pandora Report: 1.20.2023

Happy (almost) Lunar New Year! This week we are covering several updates, including China’s COVID-19 cases and fatalities, a new GAO report on HHS’ oversight of high-risk research, and more. We also have several new publications this week, an interesting podcast episode on PPE, and plenty of newly-launched resources and open opportunities later on in the issue.

China Calims 60K COVID-19 Deaths as Lunar New Year Travel Surges

This week, China said it has recorded nearly 60,000 deaths linked to COVID-19 since lifting Zero COVID restrictions last month, up from the 37 it previously claimed had died since December 7. Previously, the country had reported just over 5,000 COVID-19 deaths in total since the initial outbreak of the disease in Wuhan in late 2019. The New York Times explains this, writing “Until Saturday, China had reported a total of just 5,272 Covid deaths since the pandemic began in the city of Wuhan in late 2019. That measure was narrowly defined as deaths from pneumonia or respiratory failure caused by Covid. The new figure released Saturday included those who had Covid, but also died from other underlying illnesses.”

Reuters explains this figure further, writing “China recorded 59,938 Covid-related deaths from Dec. 8 to Jan. 12, Jiao Yahui, an official with China’s National Health Commission, said at a news conference in Beijing. That figure included 5,503 people who died of respiratory failure directly caused by Covid. Another 54,435 fatalities were linked to other underlying illnesses, Ms. Jiao said.” Reuters also notes that Jiao claims China was unable to release this information sooner because it “required a comprehensive examination of hospital reporting.”

It remains unclear whether or not China has changed the way it counts COVID-19 deaths so that it includes those with underlying conditions that contributed to their death from COVID-19. Furthermore, many are still skeptical of these numbers, and concerns about a further spike amid holiday travel persist. Combined with other factors like the economic impact this has had in China, and attempts to stamp out online discourse about the Party’s handling of the pandemic by blocking “fake information” that would cause a “gloomy sentiment”, this troubling situation is continuing to evolve.

Russia Announces Criminal Case Against Unnamed US Citizen Accused of Espionage Related to “Biological Topics”

Russia’s Federal Security Service (FSB) announced this week it has opened a case against a US citizen, citing allegations of “…engaging in “espionage” related to “biological topics.” According to The Guardian, ““The American is suspected of collecting intelligence information in the biological sphere, directed against the security of the Russian Federation,” it added, without any further details.” Reuters reports that “The U.S. State Department said it was aware of the “unconfirmed reports” that Russia has opened a criminal case against a U.S. citizen on suspicion of espionage.” Reuters continued, writing “We’re looking into this matter and we’ll continue to monitor,” State Department deputy spokesperson Vedant Patel told reporters on Thursday….Patel added Russia does not generally abide by obligations to provide timely notification of the detention of U.S. citizens in Russia.”

New GAO Report–“Public Health Preparedness: HHS Could Improve Oversight of Research Involving Enhanced Potential Pandemic Pathogens

The Government Accountability Office (GAO) recently released this report discussing its study reviewing the Department of Health and Human Services’ (HHS) oversight policies and programs (“the Framework”). The report indicates that “GAO found that HHS’s Framework does not fully meet the key elements of effective oversight identified in past work. For example, the Framework does not provide a standard to help funding agencies interpret what “reasonably anticipated” means. Until HHS develops and documents such a standard, the Framework allows for subjective and potentially inconsistent interpretations of the requirement—leaving HHS without assurance the department is reviewing all necessary research proposals.”

The report, available here, discusses the GAO study and findings at length. It concludes with three recommendations–1) “The Secretary of Health and Human Services should work with HHS funding agencies to develop and document a standard for “reasonably anticipated” to ensure consistency in identifying research for departmental review that is “reasonably anticipated to create, transfer or use enhanced potential pandemic pathogens,”; 2) “The Secretary of Health and Human Services should work with HHS funding agencies to identify and share non-sensitive information with researchers, Congress, and the public about the departmental review process for research involving enhanced potential pandemic pathogens, including information on composition and expertise of those involved in the review process and how the evaluation criteria are applied,” and 3) “As HHS and CDC deliberate any changes to the DSAT program, the Director of the Centers for Disease Control and Prevention should assess and document the risk posed by the limitations of the existing DSAT exemptions for public health emergencies and seek legislative authority as needed.”

“This photograph depicts a microbiologist in what had been the Influenza Branch at the Centers for Disease Control and Prevention (CDC), while she was conducting an experiment inside a negatively-pressurized biological safety cabinet (BSC) within the Biosafety Level 3-enhanced laboratory. The airflow into the BSC helps prevent any airborne virus particles from escaping the confines of the cabinet, and as part of her personal protective equipment (PPE), she was wearing a powered air purifying respirator (PAPR), which was filtering the air that she was breathing.”| Credit: CDC PHIL

No More Biowordscramble–NIST Releases Bioeconomy Lexicon

Biosecurity, bioenergy, bioinspired, biorisk…If you have ever started to feel like the new trend in security jargon is adding “bio” to an already existing word, this one is for you. The National Institute of Standards and Technology (NIST) recently released its bioeconomy lexicon as directed in the Executive Order on Advancing Biotechnology and Biomanufacturing Innovation for a Sustainable, Safe, and Secure American Bioeconomy. NIST explains the need for this, writing “Biotechnology and biomanufacturing are increasingly vital to the global economy, including in the health care, food and agriculture, and energy sectors. Accordingly, there is a need for standardized terms and definitions to ensure a common understanding of the concepts, data, technical developments, and workforce opportunities as the bioeconomy grows both domestically and internationally.”

They continue by explaining the creation of the lexicon: “This initial lexicon was developed by NIST in consultation with an interagency working group consisting of several U.S. government departments and agencies as directed in the Executive Order noted above, and reflects consideration of relevant domestic and international definitions as well as those from private sector stakeholders. The lexicon harmonizes a base set of terms and definitions with the goal of helping to enable the development of measurements and measurement methods for the bioeconomy that support uses such as economic measurement, risk assessments, and the application of machine learning and other artificial intelligence tools. This lexicon is intended to be a living document, and NIST intends to periodically engage with government and private sector stakeholders to inform future updates to the lexicon terms and definitions as appropriate.”

“Assessing the Trajectory of Biological Research and Development in the Russian Federation”

In this piece for Joint Forces Quarterly, Dr. Gigi Kwik Gronvall and Aurelia Attal-Juncqua offer an overview of the Soviet and Russian biological weapons programs and insight into concerns about current Russian research today. Using information from a two-round Delphi study, they discuss their findings related to “Concerns About Management, Biosecurity, and Biosafety of Dual-Use Research of Concern in the Russian Federation” and “Current State of Biotech and Biological R&D in the Russian Federation.” They conclude with a number of observations and recommendations, including insight into how science diplomacy with Russia may be harmed, writing “Historically, science diplomacy has been a useful tool to keep communication lines open when security relations are fraught and has led to positive outcomes for both science and national security. However, Russia’s invasion of the sovereign Ukrainian nation makes any bilateral engagements between the United States and Russia unconscionable at this time. These actions are unlikely to be forgotten or forgiven swiftly, and sanctions are likely to persist for some time. Eventually, at an undetermined point in the future, such engagements will certainly again prove to be important for national security and scientific advancement.”

“The Myth of the “Poor Man’s Atomic Bomb”: Knowledge, Method, and Ideology in the Study of Chemical, Biological, and Nuclear Weapons”

Check out Biejan Poor Toulabi’s interesting recent article in the Journal of Global Security Studies. Abstract: “Chemical and biological weapons (CBWs) have often been characterized as a “poor man’s atomic bomb”: a cheap and easy to acquire alternative to nuclear weapons that is particularly appealing to so-called Third World states. This idea is also reflected in Western government and expert estimates that have long exaggerated the spread of CBWs, especially among states in the Global South. In this article, I break down the ways in which the idea that the spread of CBWs is prevalent and that it primarily happens among states in the Global South has come to exist and persist. By dissecting an oft-cited dataset on CBW spread, I unravel frequently occurring methodological flaws—such as conceptual confusion, misinterpretation of sources, and a bias toward proliferation charges originating from the US government—that breed and sustain inflated estimates and faulty allegations. Subsequently, I show that a dominant cognitive framework that centers on the metaphorical use of the terms “proliferation” and “poor man’s atomic bomb” primes analysts and policymakers to interpret the history and future of chemical, biological, and nuclear weapons as being characterized by inevitable spread, particularly among the non-Western “Other.” In conclusion, I offer ways to counter the orthodoxies of this ideology in teaching, research, and policy.”

RevCon Reports 16 and 17

CBW Events’ BioWeapons Prevention Project recently released its RevCon Report 16 and RevCon Report 17, concluding their coverage of the recent BWC Review Conference. Report 16 discusses the final day of the conference and offers reflections on RevCon as a whole. Report 17 provides an outline and discussion of the content of the Final Document. Richard Guthrie also includes discussion of what the Final Document lacks, writing “As well as what would normally be part II of the Final Document, noted above, there were a number of other elements missing. Perhaps the most significant is any substance on the processes that will be established for the review of S&T developments and the promotion of international cooperation under Article X. Other aspects which have had broad support ended up being removed in an attempt to reach consensus included creation of an Article VII database, endorsement of the Tianjin Guidelines, and any reference to gender issues.”

“118th Congress: Bioeconomy and Health Security”

In this piece for the Federation of American Scientists,  Michael A. Fisher, Sruthi Katakam and Maeve Skelly discuss opportunities the 118th Congress has to adopt policies that “help drive U.S. biotech and biomanufacturing to grow regional prosperity, deliver on conservation goals, and improve U.S. competitiveness and resilience.” They offer several ideas for improving competitiveness in the bioeconomy, safeguarding the country against biological threats, and several recommendations for appropriations. An especially interesting portion is that which is dedicated to countering global malnutrition to enhance US security, in which they write “Due to the COVID-19 pandemic, environmental impacts, and conflicts like the war in Ukraine, global rates of malnutrition are at eight percent and are forecast to become even worse. Providing life-saving treatment around the world serves a core American value of humanitarianism, and a priority for U.S. national security – the newly released National Security Strategy dedicates an entire section to food insecurity.”

In 2021 legislation, Congress directed USAID to advance programs to prevent and treat malnutrition around the world and develop a Global Nutrition Coordination Plan. That legislation also directed USAID to create the Nutrition Leadership Council, which can help elevate nutrition programs across U.S. global health interventions and foster collaboration with other sectors, development agencies, partner governments, and local actors. These are important steps to create a centralized food security program with harmonized funding – a system to deploy a more effective response to end global malnutrition and improve U.S. national security.”

“Congress should work with the Administration to begin scaling up global malnutrition assistance in FY 2024, in accord with the 2021 legislation.”

“‘Shot In The Arm’ Shows How Disinformation Can Be Deadly”

Dr. Lipi Roy discusses Shot in the Arm, a film that recently premiered at the Palm Spring International Film Festival, in this piece for Forbes. In it, she covers core elements of the film and how it contributes to the broader conversation surrounding vaccine hesitancy and disinformation going on today, consulting experts like Dr. Peter Hotez along the way. She writes in part, “Health-related misinformation can be deadly, and we must actively combat it. Healthcare professionals need to partner with finance, fashion, sports, media and entertainment industries to promote vaccines and science in general. Celebs like Hugh Jackman, Gayle King and Julia Roberts proudly – and publicly – promoted their Covid-19 vaccinations. I also believe that a politicized problem needs a political response: elected officials – guided by health experts – need to create policies to protect the public, as they did with seatbelts, air bags and bike helmets. Lastly, people who actively promote lies about science and medicine need to be held accountable. As a physician, if I lied to patients and withheld lifesaving treatments for their thyroid cancer or lupus, I would lose my medical license. Similar punitive action must be applied to people who actively propagate egregious lies about YOUR health and safety. Shot in the Arm is really the kick in the pants we ALL need to preserve the sanctity of science and protect the most vulnerable among us. Go see this film.”

What We’re Listening To 🎧

PPE Breaches: Understanding the Risks and How to Respond 

“On the podcast episode “NETEC Guidance on Breach of PPE,” five NETEC [National Emerging Special Pathogens Training and Education Center] experts in personal protective equipment (PPE) talked about breaches in PPE and the importance of preparing health care workers to assess the risks and safely respond to a breach.”

One Health Approach for Effective Biodefense and Global Health Security

“The National Academy of Engineering’s Government-University-Industry Research Roundtable will convene a webinar on January 24 from 1-2 P.M. ET to discuss the latest National Biodefense Strategy and Implementation Plan. Discussions will focus on the collaborative and transdisciplinary ‘One Health’ approach, per the Plan, for effective biodefense and global health security. Speakers (below) will explore the role of cross-sectoral partnerships as well as innovative approaches to achieve the goals and objectives outlined in the Strategy.” Learn more and register here.

National Science Advisory Board for Biosecurity (NSABB) Meeting

The next NSABB meeting will take place virtually on January 27 at 1 pm EST. This meeting will cover “Draft Findings: Ensuring Biosecurity Oversight Frameworks Keep Pace with the Future of Science.” Learn more and register here.

Special Call for Papers-Journal of Science Policy & Governance

The Journal of Science Policy & Governance recently announced a special call for papers “and competition to provide policymakers with a new perspective on how scientific expertise could be useful to the complex brew of 21st foreign policy and national security challenges, resulting in a special issue on Policy and Governance on Science, Technology and Global Security.” The journal invites “students, post-doctoral researchers, policy fellows, early career researchers and young professionals from around the world to submit op-eds, policy position papers and other articles addressing foreign policy and national security challenges. These include concerns about the use of nuclear or radiological weapons driven by the war in the Ukraine, hypersonic weapons, immigration driven by climate change, and emerging threats in cybersecurity and biosecurity.” The deadline for submission is April 30.

Additionally, there will be a science policy writing workshop on January 30 in addition to two webinars on February 20 and March 30 (one on Policy and Governance on Science and Technology and one on Foreign Policy and National Security, respectively) to help prospective authors prepare their submissions. Learn more about these events and register here.

Closing the Knowledge Gaps

“BIO-ISAC, in partnership with the Department of Homeland Security and Johns Hopkins Applied Physics Laboratory, will host a one-day event (with remote participation available) on January 24, 2023.”

“This gathering of thought leaders across the industry and its partners will address knowledge gaps about the bioeconomy itself. The event is expected to deliver recommendations that demonstrate the scope and breadth of industry impacts, identify specific safety needs and goals, and carve the path forward for a secure future.” Learn more and register here.

Novel Applications of Science and Technology to Address Emerging Chemical and Biological Threats

For the first time since 2019, this Gordon Research Conference is back, this time in sunny Ventura, CA. “The Chemical and Biological Defense GRC is a premier, international scientific conference focused on advancing the frontiers of science through the presentation of cutting-edge and unpublished research, prioritizing time for discussion after each talk and fostering informal interactions among scientists of all career stages. The conference program includes a diverse range of speakers and discussion leaders from institutions and organizations worldwide, concentrating on the latest developments in the field. The conference is five days long and held in a remote location to increase the sense of camaraderie and create scientific communities, with lasting collaborations and friendships. In addition to premier talks, the conference has designated time for poster sessions from individuals of all career stages, and afternoon free time and communal meals allow for informal networking opportunities with leaders in the field.” The conference will be held March 19-24, 2023. Learn more and apply here by February 19.

Call for Participants: Assess Biosafety and Biosecurity Oversight of Dual Use Research of Concern and Pathogens of Pandemic Potential

Kathleen Vogel and David Gillum of Arizona State University are conducting a research project to “…understand how dual use research of concern and pathogens of pandemic potential are regulated and how biosafety and biosecurity of this work is implemented, and if there are opportunities to improve the long-term benefits and minimize risks associated with this scientific work.” Their study includes a survey on this topic, which is accepting responses through January 27. Learn more and take the 20-25 minute survey here.

Notice of Funding Opportunity: Evidence-based Approaches to Implementing Biosafety in Diagnostic and Research Laboratories

This opportunity is offered by the Elizabeth R. Griffin Program at Georgetown University’s Center for Global Health Science and Security. Stakeholders can review this funding opportunity and submit applications here. Applications are due February 28.

Wilson Center Launches International Cooperation for Pandemic Preparedness Website

“As the COVID-19 pandemic enters its fourth year, the Wilson Center’s Science and Technology Innovation Program and the O’Neill Institute for National and Global Health Law at Georgetown University Law Center launched a new website today to address the changing paradigms in international health law and the critical need for strengthening global health security for the future.”

“This dynamic website, International Cooperation for Pandemic Preparedness, features renowned international health experts who break down eight critical issues the pandemic exacerbated, revealed, or created. Through video interviews and written analyses, the interactive examines what can happen at the international level when countries and international organizations work together to find needed solutions. In light of heightened demands for a pandemic treaty under the World Health Organization, expert advice on what is achievable at the international level has never been more critical to combating future COVID-19 variants and future pandemics.”

Weekly Trivia Question

You read the Pandora Report every week and now it’s time for you to show off what you know! The first person to send the correct answer to biodefense@gmu.edu will get a shout out in the following issue (first name last initial). For this week, our question is “In 1985, an American extremist group’s compound was raided by more than 300 law enforcement officers from several federal, state, and local agencies following a three-day standoff. Among other items, officers seized about thirty gallons of potassium cyanide the group intended to use to poison water supplies of several cities. What was the name of this group?”

Shout out to Tracy S. for winning last week’s trivia! The correct answer to “In 1980, a Frenchman entered a cave while visiting Mount Elgon National Park, Kenya. A week later he became seriously ill, eventually dying in a Nairobi hospital. Which cave did he enter and what disease killed him?” is Kitum Cave and Marburg virus disease.

Pandora Report: 5.15.2020

The Coronavirus Chronicles
We recently introduced our new series,The Coronavirus Chronicles, which is a collection of stories, based on the personal and professional experiences of the faculty, students, and alumni of the Biodefense Graduate Program, about life during the pandemic. From lab safety to parenting and even healthcare work, The Coronavirus Chronicles have detailed the lives of so many of our students and alumni working in COVID-19 response. We hope these stories help the public better understand the challenges posed by COVID-19 and how current and former members of the Biodefense Graduate Program have responded to these challenges and contributed to the pandemic response at the local, national, and international levels. This week, we’re launching a new story by biodefense doctoral alum Jomana Musmar, who shares how she’s responding to COVID-19 with HHS while multitasking as a mother and spouse to an ED physician. Jomana’s experiences provide insight into the challenges we’re facing in terms of pandemic response and lesson we can all take away, noting that “Another important lesson learned is the need for everyone—from households to corporations to governments—to have a Plan B for continuity of operations for every aspect of life. Our reliance on the internet, laptops, and mobile phones has shown how pivotal a role this technology plays in being able to survive.”

COVID-19 Reopening and Recovery: Proposed Plans for the US
GMU biodefense doctoral student and Pandora Report associate editor Rachel-Paige Casey is breaking down the recovery plans to help get the U.S. back from COVID-19. “Throughout April, strategies regarding the reopening of the US economy and its associated public health factors were published by the White House with the Centers for Disease Control and Prevention (CDC), the Center for Health Security at Johns Hopkins University, the Rockefeller Foundation, and the Edmond J Safra Center for Ethics at Harvard University. The four strategies discussed here either outline phases for resuming activity or describe systems to enable and assist safe reopening.” Casey details the four strategies, their phases, and provides a risk assessment in this detailed review of what experts are suggesting for COVID-19 recovery. Read more here.

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

The Future Bioweapons Threat: Lessons from the COVID-19 Pandemic
Looking for a webinar to discuss lessons learned from COVID-19 and the implications for bioweapons threat analysis? The Council on Strategic Risks (CSR) is thrilled to present its first LIVE webinar on May 28 from 3:00-4:30pm EST, which will examine the future bioweapons threat from the perspective of the COVID-19 pandemic. Panelists include Max Brooks, author of World War Z and Devolution, Nonresident Fellow at The Modern War Institute and Atlantic Council, Honorable Andrew C. “Andy” Weber, Senior Fellow at Council on Strategic Risks, former Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense Programs at the Pentagon, GMU Biodefense alum Dr. Saskia Popescu, Epidemiologist and Senior Infection Preventionist, HonorHealth, and Dr. Alexander Titus, Chief Strategy Officer, Advanced Regenerative Manufacturing Institute and Senior Fellow at Council on Strategic Risks. Register for event here.

 Social Distancing During Pandemics According to the GAO
The US Government Accountability Office (GAO) released a brief report about the science behind social distancing to curb the spread of COVID-19. Based on historical studies, the Centers for Disease Control and Prevention (CDC) asserts that the area of highest risk is within 3 feet of an infected individual, but a buffer radius of 6 feet is recommended. These recommendations are founded on studies in the fields such as fluid mechanics, epidemiology, and microbiology. Other studies found that infectious droplets can travel beyond 6 feet, but the degree of infectivity of particles that travel relatively long distances is uncertain. The distance that an infectious droplet can travel depends on several factors such droplet size, humidity level, and air currents. For instance, the smaller the droplet, the farther it can potentially travel. The goal of social distancing (keeping a personal bubble with a 6-foot radius) is to reduce the rate of transmission; however, it is not a perfect non-medical countermeasure. The speeds and distances of viral particle travel from coughing or sneezing are difficult to determine with absolute precision. Additional challenges beyond the science and calculations are related to the difficulty in application: the psychological impacts of social distancing and isolation are yet to be fully realized. Read the full two-page here.

DHS S&T Launches Indoor Predictive Modeling Tool for Coronavirus Stability
This week, the Science and Technology Directorate (S&T) of the Department of Homeland Security (DHS) released a predictive modeling tool that estimates the natural decay of SARS-CoV-2 based on temperature within the 70-95°F range and relative humidity between 20-60%. The current iteration of the model is for stainless steel or ABS plastic surface types; nitrile (a compound used in disposable gloves) surface type will be available soon. For example, on a stainless steel or ABS plastic surface with a temperature of 77°F/25°C and relative humidity of 33%, the half-life of the virus is 11.52 hours, or 0.48 days. This model was developed to inform response efforts regarding the persistence of the virus on certain surfaces (fomites) and under specific combinations of conditions. Additional enhancements in the pipeline for this model include droplets in the air vs. on a surface, expanded temperature and humidity ranges, different surfaces. The model can be found here.

Pandemic dispatch: An infection-prevention expert on shortages, misinformation, and health worker strain on the coronavirus front line
GMU Biodefense doctoral alum and infection prevention epidemiologist Saskia Popescu discusses her experiences on the frontlines during the COVID-19 pandemic. “For the past four months, I’ve had a front row seat to the coronavirus pandemic. Working in a major hospital system, I’ve seen first-hand the issues that have come to define the crisis: the concerns about supplies, the torrent of misinformation, and the critical problem of health care worker exposure to COVID-19. Infection preventionists such as myself work in hospitals to stop the spread of infections among patients, staff, and visitors alike. Despite our training, the coronavirus has tested hospital programs like mine, forcing us to drastically change our daily practices.” Read more here.

News of the Weird: Pajama Sales in a Pandemic
Though many industries are struggling to survive as sales have plummeted during the response to COVID-19. Pajamas, however, are in high demand as many of us remain at home; pajama sales have soared by 143%since lockdown. Real pants are optional when working from home.   According to CNN Business, eCommerce sales were up almost 50% in April, because in-person retail shopping is currently limited, if not impossible. Other items with growing demand include beer and liquor and creative audio equipment like sound mixers.

News of the Weird: Cocktail-Friendly Face Masks
Artist Ellen Macomber designed an unconventional face mask that sports a small hole fit for a straw that allows the wearer to enjoy cocktails in Covid-19. Macomber is based in the Big Easy, also called New Orleans, a city known for its round-the-clock party life. These bedazzled and flamboyant face masks run $60 a pop. She does admit that the masks are not the “best form of prevention” given its opening right into the mouth.

Biosecurity Is the Lesson We Need to Learn from the Coronavirus Pandemic
Dr. Daniel Gerstein, graduate of the Biodefense PhD program, and Dr. James Giordano wrote in The National Interest about the biosecurity lessons we need to learn from the coronavirus pandemic. Though there is no scientific evidence that the novel coronavirus was human-made, humans do bear some the blame for this pandemic. Humans disrupt and destroy the environment and its habitats, mix species as bush meat in wet markets, and experiment with dangerous pathogens. The COVID-19 pandemic and the human behavior that encouraged it signal the need to develop a new approach to biosafety and biosecurity that “addresses the full range of biological threats that humankind and the global environment will face in the future.” As humans continue to intrude into natural habitats, the risk of zoonotic disease spillover continues to increase. Over the last thirty years, 30 new human pathogens have been found, most of which originated in animals. Gerstein and Giordano encourage the expansion of biosafety and biosecurity to include consideration of the global biological ecosystem. Read the full article here.

WHO Announces the Launch of New Informational Apps
The World Health Organization (WHO) launched two COVID-19 apps for smartphones. One is for healthcare workers and the other is for the general public. For healthcare workers, the WHO Academy app provides information on COVID-19 resources, guidance, training, and virtual workshops. For the general public, the WHO Info app provides access to the latest COVID-19 news and developments. Both apps can be downloaded for free from the Google Play Store and the Apple App Store.

 

Pandora Report: 2.28.2020

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

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

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

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

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

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

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

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

Pandora Report: 2.21.2020

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

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

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

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

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

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

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

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

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

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

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

Pandora Report: 2.14.2020

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

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

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

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

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

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

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

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

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

Pandora Report: 1.31.2020

ASM Biothreats
Missed the 2020 ASM Biothreats conference? Next week we’ll have you updated with our coverage across multiple talks, panels, and the highlights of this top conference on all things biological. GMU biodefense graduate students will be providing detailed accounts of these discussions at a pivotal time in international health. “ASM Biothreats is a one-of-a-kind meeting offering professionals in biodefense, biosecurity and biological threats the opportunity to exchange knowledge and ideas that will shape the future of this emerging field. ASM Biothreats offers a unique program that explores the latest developments and emerging technologies in the industry.”

Update: 2019-nCoV
If you have turned on any news channel or navigated to news website, you most certainly encountered a number of discussions about the ongoing coronavirus outbreak originating in Wuhan, China. The WHO was alerted on New Years Eve of this novel pathogen causing pneumonia-like illness and chaos increasingly ensued over the continuing weeks. This mysterious pathogen was identified as a coronavirus (think SARS and MERS) and is currently dubbed “2019-nCoV.” As the disease spreads globally, the WHO is launching a Global 2019-nCoV Clinical Data Platform for Member States to contribute anonymized clinical data that can inform the public health clinical response. On 30 January, the Emergency Committee on the 2019-nCoV under the International Health Regulations (IHR 2005) reconvened to determine if the outbreak constitutes a Public Health Emergency of International Concern (PHEIC), and, if so, what recommendations and actions should be made to manage it. Thursday evening, the Committee announced declaration of a PHEIC for the 2019-nCov outbreak. As of 28 January, there are confirmed cases in China, Nepal, the Republic of Korea, Japan, Sri Lanka, Viet Nam, Thailand, Cambodia, Malaysia, Singapore, United Arab Emirates, Australia, France, Germany, Finland, Canada, and the United States. Within the United States, there are 5 confirmed cases in Washington, California, Arizona, and Illinois as well as an additional 92 suspected cases awaiting diagnostic results. Currently, there are 165 persons located in the US under investigation for 2019-nCoV infection. On Thursday, public health officials reported that the husband of the case identified in Chicago, had tested positive for the disease. This marks a second-generation of cases, or transmission, within the U.S. There are also reports of people running to buy face masks in the U.S., leaving concern for shortages. Experts have been quick though to note that these are not needed as transmission is not widespread within the United States and that hand hygiene is most effective this time of year. GMU Biodefense doctoral alum Saskia Popescu recently spoke to CNN on this, noting that “Wearing a surgical mask helps you prevent sharing your germs if you’re sick,” Saskia Popescu, a hospital epidemiologist and infection prevention expert, told CNN. “Surgical masks do not seal around the face, so while they offer some protection, it’s the N95 mask that offers the most protection.” The CDC released an updated travel warning to its most severe yet – Warning Level 3 – urging travelers to avoid all nonessential travel to China. According to the WHO, the latest figures (30 January) for the outbreak are:

  • 7,818 confirmed cases worldwide
  • 7,736 confirmed cases in China
  • 170 deaths worldwide
  • Global Risk Assessment: High

Experts from the University of Hong Kong estimate the true total number of cases in Wuhan to be about 44,000, and they predict this figure could double by the start of February. The city is already under an unprecedented quarantine and hospitals are overrun as the epidemic intensifies. GMU biodefense graduate program director Dr. Gregory Koblentz recently spoke about the importance of promoting education, not travel bans as coronavirus concerns spread. “Widespread travel bans are ineffective and even counterproductive,” said Koblentz, a professor at George Mason University’s Schar School of Policy and Government and an expert on biodefense and biosecurity. “The idea that you can quarantine the entire population of large cities is just not feasible.” If people want to travel, they will find a way to travel, but they will be secretive about it, said Koblentz. “Then when they do get sick, they will avoid seeking medical attention because they don’t want to get in trouble,” said Koblentz. “A travel ban basically means that people will avoid getting help and notifying public health authorities, and the spread of the virus will continue, undetected.” Instead, Koblentz recommended that health officials work to get the public on their side by communicating with them about the symptoms and when to seek medical care.

Speculation abounds about the zoonotic origin of the virus, but the prevailing theory (at the moment) points toward bats as the culprit. The source location of the outbreak is the Huanan seafood market in Wuhan, which did not sell bat meat, so speculation continues. It is possible that another animal provided the channel to human infection. Previous conjecture that snakes are the origin is under criticism as it remains unclear if coronaviruses can infect snakes. Additionally, experts reject the fringe theory that the outbreak is a consequence of accidental release of biological weapons research samples housed in the Wuhan Institute of Virology. Richard Ebright, a professor of chemical biology at Rutgers University, stated the virus’s genome and properties do not indicate that it is the product of engineering. Stay tuned to the Pandora Report for updates on the progression of the 2019-nCov outbreak.

Of Quarantine and robots: How China and the U.S. Are Working to Combat Coronavirus
GMU Biodefense PhD alum Saskia Popescu recently wrote on the efforts by both the Chinese and the U.S. in responding to and preventing transmission of the 2019-nCoV. From quarantine to travel screenings, Popescu discusses the pros and cons, but also breaks down the opportunities within U.S. response. “The first case of the coronavirus in the United States received wide news coverage, and rightly so. But the Providence Regional Medical Center in Everett, Wash., used some extreme techniques to treat the patient, a man in his 30s who’d travelled to Wuhan. He was taken from an urgent care to the hospital in a negative-pressure transportation device called an ISOPOD that’s more often associated with Ebola care and put into an isolation room, where the hospital used a robot to treat him to reduce health care worker exposure. At this point, though, these extra precautions aren’t required. The Centers for Disease Control and Prevention notes that health care workers caring for patients with coronavirus should protect themselves with a gown, gloves, eye protection, and an N95 mask, which can filter out most airborne particles. If the Everett hospital wanted to use its robot and ISPOD to test its capabilities and protocols, it should have communicated this more clearly–to keep from confusing other health care providers about the advice of federal officials.”

ABSA International – Risk Group Database App
The Association for Biosafety and Biosecurity (ABSA) just released their new International Risk Group Database app, which allows users to work offline and access the ABSA database via their mobile device. The ABSA International Risk Group Database consists of international risk group classifications for bacteria, viruses, fungi, and parasites. In many countries, including the United States, infectious agents are categorized in risk groups based on their relative risk. Depending on the country and/or organization, this classification system might take the following factors into consideration: pathogenicity of the organism; mode of transmission and host range; availability of effective preventive measures (e.g., vaccines); availability of effective treatment (e.g., antibiotics); and other factors.

Doomsday Clock
The Bulletin of the Atomic Scientists released their 2020 Doomsday Clock statement and revealed that the clock is now closer than ever at 100 seconds to midnight. The Doomsday Clock is “universally recognized indicator of the world’s vulnerability to catastrophe from nuclear weapons, climate change, and disruptive technologies in other domains.” This year’s statement highlights two coexisting existential threats to humanity: nuclear war and climate change. Adding insult to injury, these threats are exacerbated by cyber-enabled information warfare, which continues to advance in efficiency and capability. The last year saw the dissolution or undermining of several key arms control treaties aimed at quelling the risk of nuclear war – the Joint Comprehensive Plan of Action (JCPOA) and Intermediate-Range Nuclear Forces (INF) Treaty, for example. Iran, the DPRK, and Russia remain major dangerous players in the nuclear game. On a more positive note, awareness of the adverse effects of climate change swelled over 2019; however, governmental action to counter climate change left much to be desired. The Bulletin implores leaders and citizens to take thoughtful and actionable steps to lessen these threats:

  • US and Russian leaders can return to the negotiating table to reach an agreement on nuclear arms and other arsenals
  • The nations of the world should publicly rededicate themselves to the temperature goal of the Paris climate agreement (limiting warming below 2 degrees Celsius higher than the preindustrial level)
  • US citizens should demand climate action from their government
  • The United States and other signatories of the JCPOA cooperate to curb nuclear proliferation in the Middle East
  • The international community should commence multilateral discussions to create norms of domestic and international behavior that discourage and punish the misuse of science

Alumni Spotlight – NextGen GHSA
A new piece published on the Next Generation Global Health Security Network was co-authored by Anthony Falzarano, Stephen Taylor, Kate Kerr and Jessica Smrekar, graduates of GMU’s MS in Biodefense program (Taylor Winkenfeld is also an author). This Op-Ed, “We Preach Prevention, WHO Practices Response,” chastises the sluggish response of the WHO to the ongoing 2019-nCov outbreak originating in Wuhan, China. China’s President Xi Jinping instituted a mass quarantine of 50 million people, yet the WHO has yet to declare this outbreak a Public Health Emergency of International Concern (PHEIC), which helps mobilize funding and political will toward outbreak response efforts. In fact, the committee that makes such a declaration met on 30 January, weeks after the start of the outbreak. The WHO possesses a history of delayed action, such as with the current Ebola outbreak in the Democratic Republic of Congo. The authors suggest that the delay in PHEIC declaration for the 2019-nCov outbreak is founded in fear of political and economic impacts, especially given the “reach of the Chinese global engine.” This outbreak is yet another example and, hopefully, lesson waiting and watching cannot be the default response to tragic events, especially ones that harm public health, regardless of the political, economic, and social issues that complicate decision-making and action.

The Ethics of Acquiring Disruptive Military Technologies
Technological innovation – especially in human enhancement, artificial intelligence, and cyber tools – continues at an accelerating rate and yield a significant effect on combat by reducing risk to soldiers and civilians, but also broadening the spectrum of actors capable of chasing policy goals through military methods. An article by C. Anthony Pfaff published in the Texas National Security Review expands the discussion about emerging and advancing technologies to include the ethics of disruptive military technologies. Disruptive technologies in a military context are defined as “technologies or sets of technologies applied to a relevant problem in a manner that radically alters the symmetry of military power between competitors, which then immediately outdates the policies, doctrines and organization of all actors.” These technologies necessitate changes in soldier training and identity as well as the relationship between society and soldiers. A technology is considered disruptive based on its attributes’ interactions with a specific community of users in a specific environment. The author outlines a framework to evaluate the moral effect, necessity, and proportionality of technologies to determine if and how they should be developed and deployed. This framework includes consideration for moral autonomy, justice, well-being, transfer of technology, and, of course, the civilian-military relationship. The author recommends eight measures and policies to maintain ethical conditions for developing disruptive technologies ranging from managing the transfer of technologies to greater society to accounting for soldier well-being.  Pfaff’s full article detailing his analysis, framework, and recommendations is available here.

Considering Pediatrics During CBW Preparedness and Response
Often during measures to prepare for a chemical or biological weapons attack, it can be easy to forget about the unique care that children and neonates require. A new article in Physicians New Digest discussed this very critical nuance to CBW preparedness, highlighting the CW attacks in Syria by the Assad regime against civilians, included children, underscoring the need for pediatricians. Often, medical countermeasures require very specific dosages or are contraindicated in children, which poses a very unique challenge for responders. “In chemical attacks, for example, children may be disproportionately affected because they would take in more contaminated air, food and fluids relative to their body weight than adults, said co-author Carl Baum, MD, FACMT, FAAP, a former AAP Council on Environmental Health executive committee member who now serves on the Council on Disaster Preparedness and Recovery executive committee. ‘Children also spend more time closer to the ground, where toxic substances can settle. And they have a relatively larger body-surface area, which makes chemicals that touch the skin more dangerous for them,’ Dr. Baum said.” Children might also have high respiratory rates or present differently, which puts them at an increased risk for both inhalation of a CB agent, but also delays in medical care or diagnostics. The authors highlighted the importance of including pediatricians in preparedness efforts to ensure children have triage and treatment protocols in the event of a CBW attack.

News of the Weird
Sure, the novel coronavirus is in the news a lot right now, but where does beer come into the picture? Unfortunately the whole “corona” portion of the name has been throwing people off. “In the United States, Google Trends calculated that 57% of the people that searched one of those terms searched for “beer virus,’ and the remaining 43% searched for ‘corona beer virus.’ States like Hawaii, New Mexico and Kansas are searching ‘beer virus’ more, whereas states like South Carolina, Colorado and Arizona are searching ‘corona beer virus’ more”

Pandora Report: 1.24.2020

ASM Biothreats Coverage
With this three-day conference just around the corner, you’ll want to make sure not to miss our coverage in the coming weeks. GMU Biodefense has been sending graduate students to attend ASM Biothreats since 2016 and we’re always excited to share their insights into the presentations and discussions. Check out our previous coverage here, which will provide you with detailed accounts of this conference and the timely conversations that will likely take place surrounding the 2019-nCoV outbreak.

The Novel Coronavirus Bubbles Out of China 
As the first case of 2019-nCoV was identified in the United States this week, questions continued to bubble up regarding the transmission mechanisms and if human-to-human transmission will be sustained. On Wednesday, the WHO met to discuss a declaration of a PHEIC (public health emergency of international concern) as cases spilled into Japan, Thailand, and South Korea, and case counts surpassed 830 infections and 17deaths. Interestingly, as the emergency committee was split on the decision, it was pushed to review again on Thursday and just before, China decided that the city of Wuhan would effectively have a cordon sanitaire, or quarantine. Ezhou and Huanggang have bene added to this list as of Thursday. Mid-day on Thursday, the WHO announced that they would not be declaring the outbreak a PHEIC. WHO situation reports can be found here. Moreover, as news of infection in 14 healthcare workers, it’s a reminder of previous coronavirus outbreaks. With the news of the Wuhan closure, it draws similarities to the quarantine efforts tried by Toronto in the SARS-CoV outbreak, which were considered widely ineffective and frustrating to the community. While each outbreak requires unique control measures, it is important to also note that it is challenging to truly know the case facility rate at this point in the outbreak, and that sudden bursts of identified cases are likely a result of surveillance efforts. As this outbreak has evolved in recent days though, the initial statements of “there has not been sustained human-to-human transmission” have been questioned. Beyond the initial worries about information sharing from the Chinese that were reminiscent of SARS-CoV, the role of healthcare and super-spreaders has been re-established. Chinese media has been quick though, to deny superspreading events. In 2003, the spread of SARS-CoV throughout Toronto taught us several lessons about not only importation of cases due to international travel, but also how super-spreaders in the right environments, like a hospital, can cause devastating outcomes. A lesson learned from Toronto too, is that of the importance of enhanced infection prevention measures and the questionable efficacy of quarantine efforts..not to mention the importance of communication, both between healthcare/public health, but also to the public. Flash forward nearly 10 years and a novel coronavirus was again causing problems…this time, beginning in Saudi Arabia. Spreading across 27 countries since it was first identified in 2012, MERS-CoV is another lesson in novel diseases and the role of One Health. MERS-CoV gave us new insights in not only why the WHO won’t declare an outbreak a PHEIC, but also a hard lesson in how hospitals can amplify an outbreak. In particular, the 2015 outbreak in South Korea, where it is estimated that 91-99% of cases were related to healthcare transmission and 83% of transmission events were tied to five superspreaders. Health system components like multiple patients per hospital room, family involvement in care, and hospital shopping, encouraged the spread of disease. In Saudi Arabia, small outbreaks have consistently happened since 2012, with links to not only camels, but also hospitals in which busy emergency departments and delays in isolation helped spread the disease. In fact, since 2013, most of the cases have been in Saudi Arabia and 19.1% have been in healthcare workers. There are many lessons to be learned from these previous outbreaks of novel coronaviruses, but as of now there are several discussions that need to happen – with a lower case fatality rate (CFR), will emergency measures need to be taken? How effective is airport screening, especially for international flights in the middle of respiratory virus season? As this outbreak is quickly unfolding and we learn new components to the virus daily, a few things are certain though – efforts have been swift (sequencing of the virus took only a matter of weeks), and the Chinese have worked to maintain diligent information sharing and outbreak investigations..not to mention to amazing and rapid efforts of international public health workers. Also, when we provide people with information, these efforts might prove to be just as effective as screening measures as the first case of 2019-nCoV within the U.S. was not identified through this route, but rather by some one who alerted to the outbreak and sought medical care, informing their healthcare provider of relevant travel history. Here are some valuable sources – regarding what we know and don’t know,  the implications of the quarantine for people in Wuhan, and fatality details.

Vulnerable Hospitals and Federal Funding Cuts for Biopreparedness
GMU Biodefense doctoral alum and infection preventionist Saskia Popescu discusses the tiered hospital approach to special pathogens and how despite its imperfections, the cut to funding should be taken seriously. Despite the flaws with the existing tiered system for dealing with special pathogens, it’s a more comprehensive and better resourced approach than what was in place before the 2014-2016 Ebola epidemic. As it stands, Congress has funded the 10 advanced treatment facilities and the National Ebola Training and Education Center but not the 60 treatment centers included in the tiered network. (The nearly 5,000 frontline hospitals never got much federal funding for their special pathogen-related efforts.) Trump signed the bill into law in December.

Redefining Neuroweapons: Emerging Capabilities in Neuroscience and Neurotechnology
Joseph DeFranco, a graduate of the GMU Biodefense MS program, recently co-authored an article about the emerging capabilities in neuroscience and neurotechnology that may enable new types of neuroweapons. Neuroscience and neurotechnology – lovingly nicknamed neuroS/T – are interwoven fields with research and development spanning medicine and military uses. Neuroscience is the study of the developmental processes, structures, functions, and of the brain and nervous system. The field is often referred to in the plural as neurosciences because of its cross-disciplinary nature encompassing molecular biology, developmental biology, physiology, anatomy, cytology, chemistry, mathematics, engineering, linguistics, computer science, medicine, and psychology. Neurotechnology produces a variety of tools, outputs, and substances that affect or probe the nervous system. DeFranco, DiEuliis, and Giordano consider the swift timeline for advancement in neuroS/T and the dual-use potential of such advancements in warfare, intelligence, and national security (WINS) applications. Certain neuroS/T advancements such as gene editing methods and nanoparticles can modify the central nervous system, providing significant utility and application for WINS. Existing pitfalls in international biological and chemical weapons conventions include the lack of consideration for existing and emerging neuroS/T outputs. Frankly, the inventions of neuroS/T are the redheaded step-child of these treaties, as none claim to cover it. The growth of “neurodata” is another important issue as biology becomes increasingly digitized. Though these data can prove immensely helpful in medicine and performance, they also have the potential to be used to target or alter specific individuals or groups. These data, as with all data, are vulnerable to cyberattacks or nefarious surveillance. Based on these benefits and risks of emerging neuroS/T, the authors outline a series of recommendations to either rectify existing insufficient oversight and governance or develop strong oversight and governance for the future.

Update: Ebola in the DRC
The current Ebola outbreak in the Democratic Republic of the Congo (DRC) is the second largest of its kind with over 1,600 cases from 2018 to mid-2019. This outbreak is mired in the exacerbating effects of conflict. Beyond the almost natural increase in disease transmission in a warzone, the DRC sees targeted attacks against medical workers there to quell the outbreak. Recent research focuses on the effects of violence on Ebola disease incidence. Mueller and Rebmann assessed the relationship between attacks targeting aid workers and the incidence of Ebola during the 2018-19 DRC outbreak in the North Kivu and Ituri provinces, regions characterized by violence. Findings from the analysis showed that the relationship between targeted violence against aid workers and disease incidence may be explained etiologically and logistically given the harmful impact on operations from the targeting of facilities, supply lines, and personnel. Wannier et al. quantified the effects of conflict on disease transmission using transmission rates between health zones that have versus have not experienced recent conflict events during the EVD outbreak. The mean overall R (reproduction number) of the total outbreak was 1.11, the average R for regions unaffected by recent violence was 0.61-0.86, and the average R for regions affected by recent violence was 1.01-1.07. These results indicate conflict contributes to increased transmission of Ebola in this outbreak. Wells et al. provides a timeline and ethnographic appraisal of the violence and disease in eastern DRC using data and information regarding the period from 30 April 2018 to 23 June 2019. Additionally, the authors constructed a model to quantify the strife prior to a conflict event and its ensuing impact on disease control activities in order to reveal the influence of war on the persistence of an epidemic. The gist of this trio of studies is that the Ebola outbreak is being exacerbated by the ongoing violence in eastern DRC as well as the attacks on the personnel in the field to respond to the outbreak.

Epidemics in Movies and Social Response
Need a break from the constant stream of coronavirus news? In perhaps one of our more favorite articles, a research team looked to the way films illustrate epidemics to the public. The authors note that there are two ways these films affect society – ” fear leading to a breakdown in sociability and fear stimulating preservation of tightly held social norms. The first response is often informed by concern over perceived moral failings within society, the second response by the application of arbitrary or excessive controls from outside the community.” If you’re a fan of outbreak or infectious disease themes in films, this is a great article to read on everything from Dallas Buyers Club to Contagion.

How much Should the Public Be Told About Risky Virus Research?
This is definitely a great way to start a fun dinner discussion with your favorite biodefense folks! Nell Greenfieldboyce recently discussed the NSABB meeting that started on Thursday and will conclude today. The news of a new coronavirus outbreak surely will add to this conversation and the future research that will study this novel disease. The argument regarding research on potential pandemic pathogens and gain-of-function experiments is one that has been going on for years. The conversations don’t just stop at if these experiments should exist and what they look like, but also about the publication of such information and just how much should be shared publicly. A new framework for evaluating potential experiments has already had three proposals – two made it and one is currently under review. “There’s a lot of interest out there in how these reviews get done, notes Wolinetz, but “it’s a little bit tricky, because all of these discussions are happening before funding decisions are made. Under current rules and regulations in the government, those conversations, pre-award conversations, are protected.” That’s to ensure, for example, that someone’s idea for a novel experiment doesn’t get stolen by another researcher. It also lets reviewers be candid in their critiques. What’s more, if a proposed study was deemed too alarming to fund, it might not make sense to make that idea available to all. On the other hand, some biosecurity experts argue that the public needs to know who is evaluating the risks and benefits and exactly what their reasoning is.” Confidence-building measures, like including a range of voices and disciplines into this decision-making process, are all ideas that have been raised during this process. Inclusion of risk-mitigation efforts and communication strategies are also measures that several researchers have emphasized. As Dr. Tom Inglesby noted though, “once we publish the mechanisms for making pathogens more dangerous —potentially ‘pandemic dangerous’ — we can’t take that information back. That information will be out there online for good.”

Patient Proximity to Farms and Increased Risk for C-diff Colonization
Talk about a One Health relationship – imagine living close to a livestock farm and having an increased risk for a diarrheal illness? That’s exactly what a new study is showing. The authors found that “the independent effect of residential distance to livestock farms was substantial; regardless of health care exposure, the probability of colonization more than doubled for those living 1 mile from a livestock farm compared with those living 50 miles from a livestock farm. Specifically, the probability of colonization increased from 6.5% among those living 50 miles from a livestock farm to 15.7% among those with previous hospitalization and from 4% to 10.6% among those without a recent hospitalization.”  Comorbidities played a factor in those patients admitted to a non-hematology/oncology unit, increasing the odds of colonization by more than 4 times.

Genetic Modification Could Protect Soldiers from Chemical Weapons
Despite bans on the development and deployment of chemical weapons, their use in conflict continues. Current treatment options are picky as they must be administered immediately and may not be satisfactorily efficacious; however, US Army researchers recently made a breakthrough in toxicant protection for soldiers. Specifically, the researchers developed a type of gene therapy that allows mice to create their own “nerve agent–busting proteins,” which provide protection against the agents, possibly for months. Though this therapy bears the potential for human use, it is risky. Such risks include the development of an adverse immune response to the introduced protein. Lead biochemist Nageswararao Chilukuri called the experiment of a “proof of principle” study. The long-short of the experiment is the livers of mice were reprogrammed as factories pushing out a “bioscavenger” enzyme that quickly incapacitate nerve agents. The team recently reported that the mice survived nine customarily lethal injections for six weeks, a promising but preliminary result.

USAMRIID 2019 Lab Protocol Failures and Findings 
Last year it was announced that the USAMRIID lab at Fort Detrick was temporarily shut following CDC inspections that found failures in their practices. “The lab itself reported that the shutdown order was due to ongoing infrastructure issues with wastewater decontamination, and the CDC declined to provide the reason for the shutdown due to national security concerns.” Documents that were recently obtained found that those violations initially reported were only a handful, but many were labeled as “serious” including – “The CDC reported that an individual partially entered a room multiple times without the required respiratory protection while other people in that room were performing procedures with a non-human primate on a necropsy table. ‘This deviation from entity procedures resulted in a respiratory occupational exposure to select agent aerosols,’ the CDC wrote.” You can read more here on these findings and the serious observations that were identified, triggering the lab’s temporary closure.

 

Pandora Report: 1.17.2020

Happy Friday! We’re glad to start the weekend with a healthy dose of all things biodefense. Before we get too far down the nCoV-2019 rabbit hole…Senator Dianne Feinstein recently wrote a letter to DHHS regarding steps the department is taking to protect the U.S. against pandemics.

ASM Biothreats 
It’s almost that time of year and if you can’t make the January 28-30 ASM Biothreats conference, don’t worry – we’ll have great coverage. GMU Schar School Biodefense is sending graduate students to the conference to report out on these three days of all things biothreats. Check out previous years of our coverage here, where we provide detailed overviews of the talks and events. “ASM Biothreats is a one-of-a-kind meeting offering professionals in biodefense, biosecurity and biological threats the opportunity to exchange knowledge and ideas that will shape the future of this emerging field. ASM Biothreats offers a unique program that explores the latest developments and emerging technologies in the industry.”

AI Weapons
The end of 2019 and the start of 2020 sees an uptick in discussion regarding artificial intelligence-driven weapons. Three of the world’s biggest plays – the United States, Russia, and China – are all strongly indicating that artificial intelligence (AI), considered a transformative technology, will be dominant in their respective national security strategies. Recent headlines on the topic include terms like “killer robots” and “Terminator-style war.” Indubitably, we are in an era of rapid and momentous technological advancement and discovery; however, the true application of these technologies is fairly narrow and now necessarily nefarious. Larry Lewis, a senior advisor for the State Department in the Obama administration and a member of the US delegation in the UN deliberations on lethal autonomous weapons systems, recently published an article in the Bulletin of the Atomic Scientists about the utility of AI in reducing the collateral damage of war. Lewis spent the last decade working to reduce the civilian casualties in war, and he found that such casualties were largely the result of inaccurate indicators regarding civilian presence or the misclassification of civilians as combatants. Though military applications of AI include autonomous weapons, this technology can also be employed to optimize automated processing to detection and as a decision aid to helping personnel interpret complex or vast sets of data. Though discussion tends toward the risks of AI technology, especially its military applications, Lewis endorses adding a new facet to the discussion that focuses on the benefits of AI technology in minimizing civilian casualties in warfare.

nCOV-2019 and the Wuhan Outbreak
The past few weeks have been busy with the news of this novel coronavirus cluster in Wuhan, China. Following the identification of it as a novel strain and the temporary name of nCoV-2019, public health authorities have been working to better understand the epidemiological aspects of the virus and how we can prevent further transmission. News of a case in Thailand, following travel to the affected region in China, quickly spread as it meant that cases were no longer contained in China. Interestingly, the Chinese woman whose infection was detected after her arrival in Thailand, had no exposure to the market that is considered to be the epicenter of the outbreak. “A new statement from the World Health Organization (WHO) today had several new details, including that the woman had not visited the Wuhan seafood market, which also sold live animals such as chickens, bats, and marmots, where most patients are thought to have been exposed. However, she reported regularly visiting a local fresh market before her symptoms began on Jan 5. That illness onset is later than that of the others infected in the outbreak, which ranged from Dec 8 to Jan 2, according to a Jan 12 update from the WHO. The incubation period for nCoV-2019 isn’t known, and authorities closed the seafood market on Jan 1.” 182 contacts are being monitored related to this case and eight febrile travelers at the Suvarnabhumi Airport have been isolated and tested (all were negative). Japan also confirmed their first case in a 30-year-old man who tested positive following a visit to Wuhan. On Thursday, officials released more information regarding a second family cluster in Wuhan (likely exposed via the same source), as well as findings from environmental testing at the market in Wuhan.

Antibiotic Tolerance Can Affect Combo Treatments, Study Finds
A team of scientists in Israel found evidence that antibiotic resistance in microbes may render combination therapies ineffective, a long-held fear that may now be reality. Combination drug therapy is a commonly used clinical method for treating infections caused by resistant microbes and to prevent the progression of resistance. This team monitored the evolution of Staphylococcus aureus strains in patients undergoing combination treatment and exposed the swift emergence of tolerance mutations trailed by the emergence of resistance. Tolerance mutation in antibiotics is a general term “used to describe the ability, whether inherited or not, of microorganisms to survive transient exposure to high concentrations of an antibiotic without a change in the MIC, which is often achieved by slowing down an essential bacterial process,” whereas antibiotic resistance is “the inherited ability of microorganisms to grow at high concentrations of an antibiotic, irrespective of the duration of treatment, and is quantified by the minimum inhibitory concentration (MIC).” After the discovery of tolerance to combination treatments in the S. aureus case, the scientists were able to expand the finding by measuring bacterial growth in Escherichia coli after drug combinations from four different antibiotic classes. Isolates with tolerance to norfloxacin and ampicillin promoted resistance in some of the combinations for treating E. coli. Therefore, the authors conclude that “rescue of resistance mutations by tolerance is a general phenomenon that may have crucial implications for the evolution of resistance in patients treated with combinations of antimicrobials.” A short article summarizing the study can be found here and the original publication can be found here.

WHO- Urgent Health Challenges for the Next Decade
The World Health Organization has released their list for the new decade – which was “developed with input from our experts around the world, reflects a deep concern that leaders are failing to invest enough resources in core health priorities and systems.” The list does not place challenges by priority, as they are all urgent and includes elevating health in the climate debate, delivering health in conflict and crisis, making healthcare fairer, expanding access to medicines, stopping infectious diseases, and more. Within each challenge, the WHO discusses what it is and what they are doing to help correct it.

Outbreak Dashboard 
While much attention has been to the novel coronavirus outbreak, more Ebola cases have been identified in the DRC. The latest situation report from The Who reports 8 new cases, including 3 in Beni.

Pandora Report: 1.3.2020

Welcome to 2020! We’re excited to start the new year with a short newsletter to keep you up to date on all things biodefense.

 Alcatraz of Viruses
The Island of Riems in the Baltic Sea, once inhabited by the Nazis for biological weapon research, is now a heavily restricted site for German scientists to develop vaccines against viruses. The island hosts the Friedrich Loeffler Institute, Germany’s National Institute for Animal Health, which is a hub for the study of pathogens like rabies, African swine fever, and Ebola, and maintains the primary objective of preparing for future infectious disease outbreaks. The deputy head of the Friedrich Loeffler Institute, Franz Conraths, dubbed the island to be the “Alcatraz of Viruses.” Given its nickname-sake, the island is subject to stringent security protocols in order to safely contain all pathogenic samples and protect researchers and visitors. Since 2008, the German government has invested over $300 million in the Institute for infrastructural upgrades; there are now 89 laboratories and 163 stables for the research animals within the facility. Animal welfare is an important pillar for the Institute, hence their efforts to minimize animal research and minimizing the suffering of any tested animal. That said, the potential for their vaccine research to save millions of human and animal lives, protect the livelihoods of farmers, and alleviate global hunger, according to the head of the diagnostics department, outweighs the desire to eliminate animal testing.

NAS Workshop Proceedings: Improving International Resilience and Response to Chemical, Biological, Radiological, and Nuclear Events
In October 2017, the National Academies of Sciences, Engineering, and Medicine (NAS) coordinated an international, science-based workshop in Tokyo regarding resilience to Chemical, Biological, Radiological, and Nuclear (CBRN) events. The CBRN resilience workshop, in collaboration with Niigata University and the Japan National Research Institute for Earth Sciences and Disaster Resilience (NIED), aimed to “increase understanding of the communication, interoperability, and coordination issues that arise among various international stakeholders who are responsible for responding to CBRN event.” Partakers included experts and representatives from the government/public sector, private sector and industry, international organizations, academia, and NGOs. The event included a simulation as well as various plenaries covering topics such as lessons from past CBRN events and strengthening collaborative capacity. The workshop included a Resilience Exercise that used an explosion created by the collision of a large Liquid Natural Gas Tanker into a chemical depot on the shore near the Tokyo Motor Show as its base scenario. The explosion was compounded when the adjacent industrial complex ignited and debris oil was launched into Tokyo Bay. The flames and smoke of the chemical fire travelled inland toward Tokyo, home to about 14 million people, and smoke is further spreading toward the Tokyo Big Sight complex. Additional simulation components include the challenges of responding to a cascading CBRN event and the difficulty stimulating multi-party discussion for rapid response and international cooperation. Examples of some of the issues recognized during the workshop include delayed information sharing, incongruent definitions and terminologies across organizations, and the lack of defined roles and responsibilities for response.

Antimicrobial Resistance – A New Plan For A New Year?
Since the CDC announced their latest report and findings that each year 2.8 million Americans are infected with a drug-resistant organism, 35,000 of whom later die, we can safely say we’ve got a big problem. Antimicrobial resistance (AMR) isn’t new though and the problem has been boiling up for decades however it seems that we’re starting to truly take it seriously. From rivers to traveling patients, it’s hard to escape resistant microbes. New efforts to invigorate surveillance/reporting, as well as stewardship initiatives and even addressing the drying pipeline of antibiotics, are all tactics that have been employed. In fact, this latest piece is the one that is perhaps the most damning – big pharma has all but fled the antibiotic R&D field and those start-ups courageous enough to try, are increasingly falling upon financial ruin. “Antibiotic start-ups like Achaogen and Aradigm have gone belly up in recent months, pharmaceutical behemoths like Novartis and Allergan have abandoned the sector and many of the remaining American antibiotic companies are teetering toward insolvency.” Sadly, this is only adding to the issue as it paints a grim image for those considering any investment in antibiotic R&D. Many are calling for government intervention to help address the push-pull dynamics of antibiotic development – noting that “If this doesn’t get fixed in the next six to 12 months, the last of the Mohicans will go broke and investors won’t return to the market for another decade or two,” said Chen Yu, a health care venture capitalist who has invested in the field. Another component though is the heavy push on stewardship and prescribing practices, which often makes hospitals and providers weary against using new antimicrobials. Adding to this sentiment, Dr. Rick Bright, BARDA Director and Deputy Assistant Secretary for Preparedness and Response, wrote on the need for better diagnostics for resistant infections. Dr. Bright shares his own experiences with a simple-turned-complex infection that required several antibiotics. From delays in diagnostics/treatment, to being on six antibiotics, this is a great personal account of what it’s like to have a resistant infection and the inherent limits of existing diagnostics. “The gardening incident gave me personal insight into the many challenges that confront medical professionals and every patient fighting a resistant infection. I am more committed than ever to overcoming this challenge, to identifying solutions, and to partnering with private sector to get ahead of antimicrobial resistant infections and protect our nation’s health security. I hope more potential industry partners will look closely at the problem and join me by partnering through programs like CARB-X, BARDA DRIVe and other BARDA-supported initiatives.”

Senate Passes Bipartisan One Health Awareness Month Resolution
On December 20th, the Senate unanimously passed a bipartisan resolution to promote January as “National One Health Awareness Month”. Since more than 74% of emerging infectious diseases are zoonotic, the awareness to One Health and the role we all play is critical in addressing current and future biological threats.The One Health Commission is working to promote this new resolution, including a guide to help raise awareness for this critical initiative. You can read the full resolution here.  Happy National One Health Awareness Month!

Outbreak Dashboard
Flu activity continues to rise in the United States, as the CDC reported 4.6 million flu illnesses, 39,000 hospitalizations, and 2,100 deaths in this season. The Ebola outbreak in the DRC has also been growing, as 4 new cases were recently reported in Kalunguta, which is frustrating as the area had previously gone 63 days without a new case.