Pandora Report 3.3.2023

Happy end to yet another very eventful week! Today we are covering the Department of Energy’s updated assessment on the start of the pandemic, the subsequent discourse, the IC’s assessment on Havana syndrome, the newly-signed NSM 19, and Iran’s investigation into alleged poisonings of schoolgirls.

Spy Agencies Gone Wild RE: COVID-19 Origins? Not Quite…

This week, the Department of Energy (DOE) and Federal Bureau of Investigation (FBI) provided assessments and statements indicating that they believe the initial spread of SARS-CoV-2 was the result of a lab leak in Wuhan. The initial firestorm was kicked off by a Wall Street Journal article with a less-than-helpful headline regarding DOE’s delivery of an assessment to the White House. In the following days, the FBI director provided statements indicating his agencies reached the same conclusion. Subsequent discussion has been rife with poor understandings of the Intelligence Community (IC) and intelligence itself, in addition to flawed claims about what these assessments actually mean. This section aims to break down what all has happened in this area this week and highlight the intrinsically interdisciplinary nature of intelligence and national security more broadly.

What Actually Happened This Week

As previously mentioned, the Wall Street Journal published an article on Sunday entitled “Lab Leak Most Likely Origin of COVID-19 Pandemic, Energy Department Now Says” to much uproar from all matter of folks. The assessment referenced by the article stemmed from analysis conducted by Z-Division at Lawrence Livermore National Laboratory, which led DOE to conclude “as part of a new government-wide intelligence assessment that a lab accident was most likely the triggering event for the world’s worst pandemic in a century.”

As the Washington Post explains, “…other intelligence agencies involved in the classified update — completed in the past few weeks and kept under wraps — were divided on the question of covid-19’s origins, with most still maintaining that a natural, evolutionary “spillover” from animals was the most likely explanation. Even the Energy Department’s analysis was carefully hedged, as the officials expressed only “low confidence” in their conclusion, according to U.S. officials who spoke on the condition of anonymity to describe a classified report.”

“U.S. officials confirmed that an updated assessment of covid-19’s origins was completed this year, and said the document was based on fresh data as well as new analysis by experts from eight intelligence agencies and the National Intelligence Council.” Furthermore, the IC remains firm in its view that SARS-CoV-2 was absolutely not developed as a biological weapon.

Of course, this news sparked a lot of conversation from lab leak and natural origin proponents alike. As NPR notes:

…at the end of the day, the origin of the pandemic is also a scientific question. Virologists who study pandemic origins are much less divided than the U.S. intelligence community. They say there is “very convincing” data and “overwhelming evidence” pointing to an animal origin.

In particular, scientists published two extensive, peer-reviewed papers in Science in July 2022, offering the strongest evidence to date that the COVID-19 pandemic originated in animals at a market in Wuhan, China. Specifically, they conclude that the coronavirus most likely jumped from a caged wild animal into people at the Huanan Seafood Wholesale Market, where a huge COVID-19 outbreak began in December 2019.

Virologist Angela Rasmussen, who contributed to one of the Science papers, says the DOE’s “low confident” conclusion doesn’t “negate the affirmative evidence for zoonotic [or animal] origin nor do they add any new information in support of lab origin.”

“Many other [news] outlets are presenting this as new conclusive proof that the lab origin hypothesis is equally as plausible as the zoonotic origin hypothesis,” Rasmussen wrote in an email to NPR, “and that is a misrepresentation of the evidence for either.”

The FBI also re-iterated its moderate confidence assessment that the virus originated in a lab, with FBI Director Christopher Wray highlighting this in an interview with Fox News. To summarize, the FBI maintained its moderate confidence assessment that the COVID-19 pandemic began with a lab accident, DOE changed its view to that above, and the CIA and another agency remain undecided as they did in the 2021 unclassified assessment. The others continue to favor a natural origin. So where does that leave us?

The Breakdown

As this discussion has been fraught with confusion about the IC, we will cover some brief basics about the IC’s structure and work. First, the IC is broad and diverse. It is composed of 18 organizations, including the Office of the Director of National Intelligence (ODNI) and the 17 constituent organizations that report to ODNI. ODNI and the Central Intelligence Agency are independent organizations. Nine others are Department of Defense elements (including the Defense Intelligence Agency, the National-Geospatial Intelligence Agency, the National Reconnaissance Office, and the DoD service intelligence elements). Seven other organizations are elements of other departments and agencies. These include the “Department of Energy’s Office of Intelligence and Counter-Intelligence; the Department of Homeland Security’s Office of Intelligence and Analysis and US Coast Guard Intelligence; the Department of Justice’s Federal Bureau of Investigation and the Drug Enforcement Agency’s Office of National Security Intelligence; the Department of State’s Bureau of Intelligence and Research; and the Department of the Treasury’s Office of Intelligence and Analysis.”

Naturally, each of these agencies has its strong suits and purposes, though there is intentional overlap. The intelligence failures in the lead up to the events of September 11, 2001, significantly changed the IC, bringing the abolition of the Director of Central Intelligence, the establishment of ODNI and the Director of National Intelligence position, creation of new agencies and restructurings of existing ones, and an overall effort to improve coordination, collaboration, and communication in the community. The main failure in the case of 9/11 was in not “connecting the dots”, so there have been strong efforts to make agencies share information in a timely, useful manner. Of course, this has not made the IC immune to failures, but it has been a positive step in improving coordination and creating appropriate overlap that can help provide more comprehensive intelligence to decision makers.

Furthermore, far from simply being “spy stuff”, intelligence draws on broad expertise and knowledge sources in a cycle of evaluation and feedback. In fact, it is estimated that about 80% of intelligence relies on open information, including news and academic sources. Information gaps and limitations may require further collection, but the bulk of information is often times openly available. Furthermore, the community is simply not full of a bunch of spies. For example, in 2003, it was estimated that just 10% of the CIA’s workforce were clandestine officers-the ones that recruit sources and go on covert missions like you might see in the movies. The rest are all kinds of analysts, mission management and admin folks, and even all kinds of scientists, physicians, public health experts, and so on. Agencies oftentimes have entire directorates dedicated to S&T work, and there are entire sub-organizations dedicated to specific S&T-related topics, including the National Center for Medical Intelligence.

There is also confusion about how analysts conduct their work. The 2011 IC Consumers Guide referenced by many news outlets and scholars discussing these assessments and their confidence levels explains how analysts conduct their work. It reads in part “Intelligence analysts are generally assigned to a particular geographic or functional specialty area. Analysts obtain information from all sources pertinent to their area of responsibility through information collection, processing, and forwarding systems. Analysts may tap into these systems to obtain answers to specific questions or to generate information they may need.”

“Analysts receive incoming information, evaluate it, test it against other information and against their personal knowledge and expertise, produce an assessment of the current status of a particular area under analysis, and then forecast future trends or outcomes. The analyst also develops requirements for the collection of new information…Analysts rarely work alone; they operate within a system that includes peer review and oversight by more senior analysts.“

With this information in mind, it is clear that statements that paint the IC as a hive mind that produces assessments on political whims without oversight, methodologies, or internal review processes are unhelpful and untrue. Though it is not publicly known who specifically wrote these assessments, it is reasonable to believe they were made in good faith and in accordance with the above information. In addition to personal knowledge and expertise, importantly, IC analysts do have access to classified information-a fact seemingly overlooked by many in the last week.

One of the main points of confusion in public discussion of this has centered on why the Department of Energy is making an assessment on the origins of a virus. It is true that the Department of Energy, as the name implies, oversees national energy policy and manages nuclear power and weapons, but that is not its only tasking. In fact, the idea that eventually led to the Human Genome Project was conceived in the Department’s Office of Science. DOE has an intelligence element (as referenced above) and also oversees the National Laboratories, a broad system that aims to address critical scientific challenges “from combating climate change to discovering the origins of our universe”. Three of these laboratories (Lawrence Livermore, Los Alamos, and Sandia) are National Nuclear Security Administration labs, meaning they do work related to nuclear weapons in addition to other kinds of research-including global security research. The labs do work in conjunction with other organizations and, in some cases, support the IC. Lawrence Livermore National Laboratory, for example, has its Laboratory Intelligence Program, which has been at the heart of this frenzy and provides “critical science and technology support to the intelligence community’s foundational intelligence missions in strategic intelligence and anticipatory intelligence, as well as mission objectives in counterproliferation, cyber intelligence and counterterrorism.” The point is-DOE is not just a bunch of physicists working on the nuclear weapons stockpile. The Department is as large and diverse as its taskings, including those requiring expertise in the life and social sciences.

Much attention has also been paid to the confidence levels of the assessments. WSJ noted later in its piece that the assessment was made with low confidence, a term used by analysts when “…information used in the analysis is scant, questionable, fragmented, or that solid analytical conclusions cannot be inferred from the information, or that the IC has significant concerns or problems with the information sources.” Unfortunately, this information is not particularly helpful for the general public as the assessment itself is classified, so it is not known what information led to the assessment and why specifically it was rated low confidence. Analytical confidence can be influenced by several factors, including analyst expertise (which is likely limited given the nature of this specific assessment), time constraints, source reliability and corroboration, and more.

As ODNI identified in its unclassified October 2021 Intelligence Community Assessment on COVID-19 Origins, at the time, four elements and the National Intelligence Council also assessed with low confidence that initial SARS-CoV-2 infection was likely caused by natural exposure to an infected animal. One agency (the FBI) was noted to assess that the first human infection with SARS-CoV-2 most likely was the result of a laboratory-associated incident. This assessment was made with moderate confidence, which “…generally indicates that the information being used in the analysis may be interpreted in various ways, or that the IC has alternative viewpoints on the significance or meaning of the information, or that the information is credible and plausible but it is not sufficiently corroborated to warrant a higher level of confidence.” At that time, three other IC elements remained unable to coalesce around either explanation. Again, however, these assessments are classified, so there is no way of knowing why they were judged this way in the open source.

Others have taken aim at a low confidence assessment finding a lab origin “very likely”, arguing that these terms are mutually exclusive. Analytic confidence is separate from the estimative language employed by the IC. Estimative language (“very likely”, “almost certainly”, “unlikely”, etc.) expresses an assessment or judgement. Assessments are oftentimes based on incomplete information, which is why analysts use estimative language to express the likelihood or probability of something given what information is available. Because information gaps are inherent to this work, these products include declarations of underlying assumptions and judgements analysts made in their processes. Confidence levels “reflect the scope and quality of the information supporting its judgements.” In fact, to avoid confusion, the ODNI indicates that a confidence level and degree of likelihood should not be included in the same sentence. Again, as these assessments are classified, we do not know what assumptions were made nor what sources were used. However, it is possible and okay to judge that something is very likely with low confidence, particularly when dealing with something as complex as the origin of this virus.

The Bottom Line

Flashy news headlines aside, what have we really learned from these reports? Well…not much. It was well-established in late 2021 that the IC is unclear on the origins of SARS-CoV-2, and the events of this week have not settled that debate. As the NSC Coordinator for Strategic Communications, John Kirby, told the press this week, “There is not a consensus right now in the U.S. government about exactly how covid started…That work is still ongoing, but the president believes it’s really important that we continue that work and that we find out as best we can how it started so that we can better prevent a future pandemic.”

Furthermore, it is important to address the question of to what extent we can know this and what it would change at this point. China is clearly not going to cooperate on any kind of investigation into COVID-19’s origin. That has been clear since the early days of the pandemic and is part of a pattern of behavior on the part of the CCP. Irrespective of where this virus actually came from, it is clear that China did cover up its initial spread in the population, censoring netizens and healthcare professionals until it was impossible to conceal further. While an in-depth investigation into the start of this pandemic has always been needed, hyper focusing on this runs the risk of diverting attention from other critical issues we have much more information readily available on. China did cover up the initial spread of this virus and has been disingenuous in its reporting and handling of it ever since. The United States failed to adequately respond to this pandemic for a variety of reasons, a fact that does not depend on how the virus initially spread. It is vital to balance desires to find the truth of COVID-19’s origins, something that is indisputably important, with using the information that is available and can reasonably be acquired to address these problems before the next pandemic. This information could inform debates on laboratory safety and oversight, though, as Biodefense Graduate Program Director Dr. Gregory Koblentz demonstrated in his interview with the New York Times this week, there is a wealth of information available already driving these discussions.

Finally, this all demonstrates the intrinsically inter/multidisciplinary and cross-sectoral nature of these problems. False dichotomies pitting national defense against public health, particularly in terms of funding, are not helpful, particularly as it is increasingly clear that public health threats are critical national security threats. As the IC learned in the early years of this century, siloing information is incredibly dangerous-a lesson we cannot afford to have to re-learn at the intersection of public health and national security. While respect for expertise and experience is an absolute necessity, understanding the need to collaborate, work across lanes, and recognize what unique capabilities others can offer is equally vital. These threats are not going anywhere, so learning to understand how different disciplines approach these problems and how best to work together is of the utmost importance.

New ICA-Havana Syndrome Very Likely Not Caused by Foreign Adversary

Director of National Intelligence Avril Haines released a statement this week regarding the Intelligence Community’s assessment of the mysterious “Havana syndrome”, indicating the IC finds it very unlikely a foreign adversary is responsible for the phenomenon. The Washington Post writes “The new intelligence assessment caps a years-long effort by the CIA and several other U.S. intelligence agencies to explain why career diplomats, intelligence officers and others serving in U.S. missions around the world experienced what they described as strange and painful acoustic sensations. The effects of this mysterious trauma shortened careers, racked up large medical bills and in some cases caused severe physical and emotional suffering.”

The DNI Statement reads in part “Today we are sharing key judgments and investigative efforts from our Intelligence Community Assessment (ICA) on Anomalous Health Incidents (AHIs). This assessment builds on the Intelligence Community’s (IC) interim findings released last year, which described the IC’s judgment that U.S. adversaries, including Russia, were not engaged in a global campaign resulting in AHIs, but indicated that we continued to investigate whether a foreign actor was involved in a subset of cases. Since then, we continue to surge resources and expertise across the government to explore all possible explanations.”

“Based on the latest IC-wide effort, which has resulted in an ICA that will be issued today, I can share with you that most IC agencies have now concluded that it is “very unlikely” a foreign adversary is responsible for the reported AHIs. IC agencies have varying confidence levels because we still have gaps given the challenges collecting on foreign adversaries — as we do on many issues involving them.”

President Biden Signs National Security Memorandum to Counter Weapons of Mass Destruction Terrorism and Advance Nuclear and Radioactive Material Security

This week, President Biden signed National Security Memorandum (NSM) 19 to Counter Weapons of Mass Destruction (WMD) Terrorism and Advance Nuclear and Radioactive Material Security. According to the White House, “This comprehensive new strategy advances several of President Biden’s most enduring national security priorities: protecting our nation and the international community from the existential threats posed by WMD terrorism and preventing non-state actors from using chemical, biological, radiological, and nuclear weapons.”

Among its central aims is that of keeping radioactive materials used in industry out of terrorists’ hands, notes the New York Times. The same article explains that “Details of the new memorandum are classified. Previous versions of the policy focused on securing fissile material commonly used in nuclear weapons such as the ones the United States used against Hiroshima and Nagasaki in 1945. The effort focuses on specific radioisotopes that terrorists could potentially use in so-called dirty bombs — improvised weapons that use explosives to blast radiological materials into the surrounding area, potentially sickening or killing people and causing environmental harm.”

President Biden’s Homeland Security Advisor, Elizabeth Sherwood-Randall, explained the impact of NSM 19 on the medical field at an event at the Nuclear Threat Initiative: “In her remarks, the homeland security adviser said that medical devices for treating blood with X-rays — a process that makes transfusions safer — have traditionally used cesium-137 as the radioactive source to produce those rays, but that alternatives that use less dangerous materials now exist…The Department of Veterans Affairs, which manages the largest public health care network in the country, recently removed all cesium-based blood irradiators from its hospitals, she said, and transitioned in October to machines that produce X-rays though different processes.”

This comes just over a month after a small quantity of cesium-137 went missing in Western Australia, prompting a large search for the tiny cylinder that lasted six days.

Iran Investigating Reports of Schoolgirl Poisonings

Iran announced this week it is investigating reports that several schoolgirls were poisoned as revenge for the role of young women in recent protests in the country. The Guardian explains “Iran’s deputy education minister, Younes Panahi, told reporters yesterday: “After the poisoning of several students in [the city of] Qom … it was found that some people wanted all schools, especially girls’ schools, to be closed.” He added: “It has been revealed that the chemical compounds used to poison students are not war chemicals … the poisoned students do not need aggressive treatment and a large percentage of the chemical agents used are treatable.”

Dan Kaszeta, author of multiple well-known works on chemical weapons, discussing Iran’s investigation

“Report: A Summary on Ending Biological Threats-Event Summary”

From the Council on Strategic Risks: “This report summarizes discussions held during a workshop hosted by the Council on Strategic Risks (CSR) on September 26, 2022, focused on ending extreme risks from biological threats. For several years, CSR has convened diverse experts who agree that it is more feasible than ever to halt the spread of infectious disease threats from all sources before they cause significant damage. After several years of virtual discussions during the heights of the COVID-19 pandemic, this in-person, invitation-only event brought together experts from government, academia, industry, and non-profit organizations to discuss how to use technological advances, policy, and other tools to gauge progress, identify open questions and ongoing challenges, and think strategically about what steps must be done next.”

“Conversations and panels held during “The Summit on Ending Biological Threats” were held under the Chatham House Rule. This report does not represent consensus among participants, nor does it assign specific perspectives to any individual participant. Though many topics were covered throughout the Summit, conversation centered around a few core subject areas: pathogen early warning, public-private collaboration, interagency efforts and collaboration, and strategic communications. This summary report will discuss these central topics and provide a general overview of discussions.”

“A Bipartisan Approach to Pandemic Security? It’s Within Reach”

Beth Cameron, Gary Edson, and J. Stephen Morrison recently published this opinion piece with STAT News in which they discuss the findings of the “Democracy and Pandemic Security” roundtable convened by their respective organizations. They write in part “Covid-19 laid bare persistent inequities across America. Polarization, a comorbidity that made the pandemic worse, continues to impede a unified and effective response to public health threats, and not just those caused by viruses. When the next threat emerges — and it will — it is uncertain if most Americans will adhere to public health measures.”

“That is why our organizations — the Brown University School of Public Health Pandemic Center, the Covid Collaborative, and the Center for Strategic and International Studies Global Health Policy Center — recently convened a diverse group of leaders to discuss how to better protect Americans from pandemic threats while at the same time reinforcing American values of freedom and democracy. The group included former governors and mayors; officials from red, blue, and purple states and from the Biden, Trump, Obama, and Bush administrations; as well as experts in incident management and pandemic inequity.”

“Prevention of Zoonotic Spillover”

From the WHO: “The devastating impact of COVID-19 on human health globally has prompted extensive discussions on how to better prepare for and safeguard against the next pandemic. Zoonotic spillover of pathogens from animals to humans is recognized as the predominant cause of emerging infectious diseases and as the primary cause of recent pandemics.”

“This spillover risk is increased by a range of factors (called drivers) that impact the nature, frequency and intensity of contact between humans and wild animals. Many of these drivers are related to human impact, for instance, deforestation and changes in land use and agricultural practices. While it is clear that the triad of prevention-preparedness-response (P-P-R) is highly relevant, there is much discussion on which of these three strategic activities in the field of emerging infectious disease should be prioritized and how to optimally target resources. For this, it is important to understand the scope of the respective activity and the consequences of prioritization. “

Read this position paper here.

“WHO Warns of Worsening Health Situation in Ukraine”

This Devex Inside Development piece discusses the WHO’s data on health care in Ukraine since Russia invaded the country last year. It reads in part “About 44% of people in liberated areas are seeking health care for chronic conditions, such as kidney and heart disease. One in 3 people can no longer afford to buy medicines. An estimated 10 million people may have a mental health condition. All this is happening against a backdrop of continued attacks on health care in the country. Since the war started, WHO has recorded more than 800 attacks on health care, a huge majority of which damaged or destroyed facilities, including hospitals and pharmacies.”

Third International Summit on Human Genome Editing

The Royal Society will host this hybrid summit March 6-8, 8:30- 6 pm GMT. “Building on previous events held in Washington, DC (2015) and Hong Kong (2018), the London meeting will continue the global dialogue on somatic and germline human genome editing. Major themes for discussion include developments in clinical trials and genome editing tools such as CRISPR/Cas9, as well as social, ethical and accessibility considerations these scientific developments entail.”

“The three-day Summit is being organised by the Royal Society, the UK Academy of Medical Sciences, the US National Academies of Sciences and Medicine and The World Academy of Sciences. Find out more about the Summit’s Organising Committee, chaired by Professor Robin Lovell-Badge FMedSci FRS.”

Register here.

Report Launch– Preparing for Success at the Fifth Review Conference of the CWC: A Guide to the Issues

“The United Nations Institute for Disarmament Research (UNIDIR) is pleased to invite you to the in-person launch of a new report on Preparing for Success at the Fifth Review Conference of the Chemical Weapons Convention: A Guide to the Issues. This is the first in a series of events the Institute is hosting in preparation for the Fifth CWC Review Conference, which is scheduled to take place from 15 to 19 May 2023.” One version will be hosted in The Hague on Monday, March 6 from 12:30-14:30 CET and another in Brussels on Tuesday, March 7 from 12:30-14:30 CET. Both will also be broadcast via Zoom.

Penetrate, Exploit, Disrupt, Destroy – with Dr. Craig J. Wiener

From the Alperovitch Institute: “Join us on Wednesday, March 15th at 5pm at the SAIS Hopkins Kenney Auditorium. Dr. Craig J. Wiener is recognized as an expert in major foreign adversary espionage, sabotage and strategic capabilities that pose threats to the U.S. Government (USG) and North Atlantic Treaty Organization. Dr. Wiener’s previous position was as the Senior Technical Analyst for the Department of Energy’s (DOE) Office of Intelligence and Counterintelligence where he fulfilled a role as DOE’s lead all source cyber threat analyst, the Department’s representative to the National Security Council for Cyber Operations, a key member of National Intelligence Council Special Analytic Groups, and a government briefer and/or advisor for Defense Science Board studies on Cyber as a Strategic Capability, Homeland Defense, Strategic Surprise and the future of US Military Superiority among other topics. Additionally, Dr. Wiener initiated and led studies for special nuclear weapons related threat and vulnerability analyses and advanced technical security threats to USG equities by foreign adversaries and engaged in the development, planning and operationalization of counter-adversary strategies across multiple domains of operations. Dr. Wiener joined the MITRE Corporation as a Technical Fellow in early-2020, where he supports key U.S. Government (USG) national security initiatives. He was recently appointed by the Secretary of Energy to the Electricity Advisory Committee to advise DOE on current and future electric grid reliability, resilience, security, sector interdependence, and policy issues.”

Dr. Wiener is an alumnus of the Biodefense PhD Program! Learn more and register for this event here.

Intelligence Studies Consortium

“On March 24, 2023, the Intelligence Studies Consortium is convening its third symposium, entitled New Perspectives in Intelligence Studies. This year, George Mason’s Schar School of Policy and Government is hosting. The symposium will be from 8 AM to 4 PM in Rooms 125-126 Van Metre Hall, 3351 Fairfax Drive, Arlington, VA. The closest Metro is Virginia Square/GMU on the Orange and Silver lines.

The symposium will feature student presentations in four panels:

  • Russia and China
  • Violent Non-State Actors
  • Emerging Technologies
  • Transnational Challenges

There will be an 8:30 AM keynote address from the Assistant Secretary of the Treasury, Shannon Corless, and a lunchtime conversation with General Michael V. Hayden.

We encourage students to attend in person. We have also provided a livestream option for those not in the Washington DC area.”

Learn more and register here.

Charity Entrepreneurship 2023 Charity Ideas

Charity Entrepreneurship currently has a call open to support the launch of a nonprofit in Biosecurity and Large-Scale Global Health. Possible organizations includes: “An organization that addresses antimicrobial resistance by advocating for better (pull) funding mechanisms to drive the development and responsible use of new antimicrobials,” and “An advocacy organization that promotes academic guidelines to restrict potentially harmful “dual-use” research.” Learn more and apply for these grants here.

Sustainable Diagnostic Containment Laboratories – Request for Expressions of Interest

“This Expression of Interest (RFEI) is seeking bold ideas that will reinvent the diagnostic laboratory, making it fit-for-purpose in resource-limited contexts globally. These innovative solutions are expected to reimagine the physical laboratory in order to reduce ongoing operational and maintenance costs and allow sustainable presence of safe and secure handling of high-consequence pathogenic materials, whilst maintaining and/or optimizing core functions of a diagnostic laboratory in low- and middle- income countries.”

“This RFEI represents Phase I of a dual-phase approach to development of a Grand Challenge for Sustainable Diagnostic Laboratories. The pool of Expressions of Interest received will be used to inform the scope of a full Grand Challenge program in Phase II, under which Grand Challenges Canada will award funding. Submission of an Expression of Interest does not constitute an application for funding; however, Expressions of Interest will receive feedback from an external review process designed to improve the quality of full proposals submitted for an open call for funding applications in Phase II. Most promising Expressions of Interest may also be shortlisted for direct invitations to submit full proposals for funding in Phase II.”

Learn more 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). This week, we are throwing it back to middle school English class: This chemical agent features in Roald Dahl’s famous short story, The Landlady, in which the main character is given a tea that tastes of bitter almonds. What is the name of this agent?

The correct answer to last week’s question, “What is the first multilateral disarmament treaty that banned an entire category of WMD?” is the Biological Weapons Convention.

Pandora Report: 2.17.2023

Happy Friday! This week we are tackling reporting on the WHO’s investigation into COVID-19’s origin, estimates that counter China’s official COVID-19 death count, new insight into the death of Pablo Neruda, and more. New publications listed in this issue include Rolf Ekéus’ book discussing his time leading UNSCOM and a recent CBWNet working paper authored by Ralf Trapp. New professional opportunities are also included in this week’s announcement section alongside our weekly trivia question.

Biodefense Alumnus Named 2023 Emerging Leader in Biosecurity Fellow

Matthew Ferreira (Biodefense MS ’22) was recently selected as a 2023 Emerging Leaders in Biosecurity Initiative (ELBI) fellow by the Center for Health Security at Johns Hopkins University. Ferreira joins a class of 31 fellows selected from a pool of more than 227 applicants. He told the Schar School, “I am so excited to be accepted into the ELBI Fellowship program…I am looking forward to meeting and connecting with the others in the Fellowship class as well as alumni of the program. Many of the professionals and scholars that I have had the pleasure to work with have participated in ELBI, so I’m honored to have the chance to meet and learn from this cohort of diverse and talented people in the coming year.”

Read more about Ferreira and his time in the Biodefense Graduate Program here.

Confusion Over Nature WHO COVID-19 Investigation Reporting

This week, Nature published a news article indicating the WHO had abandoned the planned second phase of its investigation into the origin of COVID-19. In it, Smriti Mallapaty began by writing “The World Health Organization (WHO) has quietly shelved the second phase of its much-anticipated scientific investigation into the origins of the COVID-19 pandemic, citing ongoing challenges over attempts to conduct crucial studies in China, Nature has learned. Researchers say they are disappointed that the investigation isn’t going ahead, because understanding how the coronavirus SARS-CoV-2 first infected people is important for preventing future outbreaks. But without access to China, there is little that the WHO can do to advance the studies, says Angela Rasmussen, a virologist at the University of Saskatchewan in Saskatoon, Canada. “Their hands are really tied.”

Naturally, this caused quite the ruckus. However, the WHO was quick to pushback and clarify that it has no plans to abandon this investigation. Dr. Maria Van Kerkhove released a statement denying the claims. In Nature‘s reporting, Van Kerkhove is quoted saying “There is no phase two,” to the investigation and that “the plan has changed,” as “The politics across the world of this really hampered progress on understanding the origins.” However, on Wednesday, she clarified-“I think we need to be perfectly clear that WHO has not abandoned studying the origins of Covid 19. We have not, and we will not.” As Health Policy Watch explains, she elaborated with “In a sense, phase two became the Scientific Advisory Group for the Origins of novel pathogens (SAGO),” she clarified. SAGO held its first meeting in November 2021 and was established as a permanent advisory group to work on drawing up a framework to understand the origins of not just COVID-19 but any future outbreaks. “So the creation of SAGO was in effect, our best effort to move this work forward.”

On issues with the PRC’s cooperation (or lack thereof), she added “Studies that were recommended from the March 2021-WHO report, from the June 2022-SAGO report and studies that we’ve been recommending at the animal human interface and markets, on farms need to be conducted in China. We need cooperation from our colleagues there to advance our understanding…”

The WHO is not the only one investigating COVID-19’s origin either, with House Republicans launching their investigation into whether the pandemic began with an accident at the Wuhan Institute of Virology. AP reports “The Republican chairmen of the House Oversight Committee and the Subcommittee on the Coronavirus Pandemic are seeking information, including from Dr. Anthony Fauci, concerning the idea that the coronavirus leaked accidentally from a Chinese lab.”

China-From CRISPR to COVID

China’s Post-Zero-COVID Wave

As China rolled back its Zero-COVID policies in early December, estimates and concerns about the deadly wave of infections the country faced abounded. This was particularly true as the new year travel season approached, as millions were set to travel from urban centers to their hometowns in rural areas across the country. Soon, reports of overflowing crematoriums and funeral parlors, sold out coffin makers, and sweeping infections coincided with continuously relaxing COVID-19 control policies. However, as of February 9, China has reported just 83,150 COVID-19 deaths, and leaders just declared a “decisive victory” against the virus. Of course, this is a number particularly difficult to believe in a country that has struggled so much with acquiring and delivering effective vaccines, relying instead on harsh lockdown and testing requirements.

As the New York Times explains, “The question of how many people died has enormous political relevance for the ruling Communist Party. Early in the pandemic, China’s harsh lockdowns largely kept the coronavirus at bay. Xi Jinping, the top leader, has portrayed that earlier success as evidence of China’s superiority over the West, a claim that would be hard to maintain with a high death toll.”

“The differences between China’s figures and researchers’ estimates are dramatic. The official numbers would give China the lowest death rate per capita of any major country over the entirety of the pandemic. But at the estimated levels of mortality, China would already have surpassed official rates of death in many Asian countries that never clamped down as long or as aggressively.”

So what gives? As we have discussed in the posts linked above, China is using much more narrow definitions of COVID-19 deaths, counting only those who died from respiratory failure and excluding those who died of liver, kidney, and even cardiac failure. Worse, the government quit counting COVID-19 deaths that occurred outside of hospitals which, coupled with the sudden absence of required testing and reporting, certainly had a major contribution to these suspicious numbers.

This piece from the New York Times discusses the numbers below and how experts at different institutions calculated them, including factors like China’s less effective vaccines, elderly populations, and more.

Source: The New York Times

The He Jiankui Saga Continues

Biodefense Graduate Program Associate Professor Dr. Sonia Ben Ouagrham-Gormley recently hosted an event along with her colleagues, titled “Looking Back into the Future: CRISPR and Social Values-BioGovernance Common’s Open Discussion with Chinese Academics.” Among other things, they highlight in their event summary that “We’ve exposed that there is little substance behind the ambitious Duchenne muscular dystrophy (DMD) gene therapy that Dr. Jiankui He, the scientist behind the illegal heritable human genome editing, has been boasting about to global patients. We were concerned that he might endanger another vulnerable population if his new venture remains unchecked,” and “Our event nudged Chinese media to publicly challenge Dr. He for the first time on his DMD research. As a result Dr. He has announced that he will prioritise research rather than social media promotion.”

Nature also covered the event, highlighting He’s refusal to discuss his past work and potential challenges this will create in understanding other important ethical issues. The article explains “On Saturday, He spoke at a virtual and in-person bioethics event that was promoted as “the first time that Dr. He has agreed to interact with Chinese bioethicists and other CRISPR scientists in a public event”. But during the talk, He did not discuss his past work and refused to answer questions from the audience, responding instead that questions should be sent to him by email.”

It continues later with “Some researchers worry that interest in He Jiankui is diverting attention away from more important ethical issues around heritable genome editing. “This event puts the spotlight on He Jiankui — Will he apologize? Is he displaying remorse?,” says Marcy Darnovsky, a public interest advocate on the social implications of human biotechnology at the Center for Genetics and Society in Oakland, California. Instead, she thinks researchers should focus on discussing whether there is a medical justification for heritable genome editing.”

He, who was recently released from prison and is now working in Beijing, garnered sharp criticism in 2018 when he announced that a woman had given birth after He implanted into her uterus two embryos he had used CRISPR-Cas9 to edit the CCR5 gene to make them resistant to HIV infection. It was later revealed that a second woman carried a third child whose genome He edited.

Was Pablo Neruda Murdered by a Physician Acting on Behalf of General Pinochet?

In late September 1973, the famed Chilean poet Pablo Neruda died in a clinic in Santiago, having checked out of a hospital earlier that day. The Nobel laureate was hospitalized with prostate cancer earlier that month, just as the coup d’état led by US-backed Augusto Pinochet ousted Chile’s socialist president, Salvador Allende. Neruda, a member of Chile’s Communist Party and close advisor to President Allende, checked out of the hospital after he claimed a physician injected him with an unknown substance. He reportedly died that evening of heart failure. In the decades since, his family and many members of the public have insisted he was murdered on the orders of Pinochet. This was spurred by reports from Manuel Araya, Neruda’s driver, that he witnessed Neruda tell his wife he believed the physician was ordered by Pinochet to kill him and the belief that Neruda was flying to Mexico to counter Pinochet in exile.

In 2013, a Chilean court ordered the launch of an investigation into Neruda’s death in light of these allegations and concerns. Neruda’s body was exhumed that same year, allowing scientists to test samples to better understand the poet’s death. This Wednesday, following a ten-year investigation by scientists in Chile, Canada, and Denmark, Chilean Judge Paola Plaza received the findings of an international report on the matter. The report indicates Pablo Neruda may have been killed by botulinum toxin-producing bacteria. The New York Times reports “The scientists found in Mr. Neruda’s body a potentially toxic type of bacteria that would not naturally occur there, and confirmed that it was in his system when he died, according to a two-page summary of the report shared with The New York Times. But they could not distinguish whether it was a toxic strain, and they could not conclude whether he was injected with the bacteria or if, instead, it came from contaminated food.”

The same article continues, “Yet the scientists conceded that other circumstantial evidence supported the theory of murder, including that in 1981, the military dictatorship poisoned political prisoners with bacteria possibly similar to the strain found in Mr. Neruda. (However, that method of poisoning stemmed from a chemical-weapons program the dictatorship began in 1976, three years after Mr. Neruda’s death.)”

While definitive answers remain out of reach in this case, Neruda’s is not the only contested death from this period. As the same article also explains “Yet Wednesday’s report and Ms. Plaza’s eventual conclusion may never sway some of the Chilean public. Karen Donoso, a Chilean historian, compared the uncertainty over Mr. Neruda’s death to some people’s lasting questions over the death of the leftist President Salvador Allende, who shot himself rather than fall into the hands of the military as it overthrew his government.”

“World’s Largest Collection of Viruses: Inside the Massive Biodefense Lab in Houston Area”

Houston’s ABC13 recently got an insider’s look at Galveston National Laboratory, located at the University of Texas Medical Branch. Their reporting offers an overview of the work that goes on at the facility, including in the BSL-4 area. As the station explains, “The Galveston National Laboratory is one of 14 U.S. facilities with BSL4 labs built by the National Institutes of Health in the years following the 2001 Anthrax attacks as a network of biodefense laboratories to “study viruses of pandemic potential and to develop medical countermeasures…The team is proud that in its 15 years, there has never been a “major laboratory incident resulting in the transmission of a disease” at the facility. This may be why most of us know little to nothing about their work.”

You can learn about the other 13 BSL-4 labs in the US and more around the world at globalbiolabs.org.

“Chemical and Microbiological Forensics in Investigations of Alleged Uses of Chemical and Biological Weapons – A Preliminary Analysis”

New from CBWNet: “In the latest CBWNet working paper, Ralf Trapp discusses the mechanisms for investigating the use of chemical and biological weapons and the development of scientific capacity for such investigations. The author highlights the importance of investigations in determining if a chemical or biological weapon was used, the type of agent used, and the origin of the weapon. The OPCW and the UN Secretary General’s Mechanism have set up systems with designated laboratories to investigate such allegations. However, there are still significant scientific challenges to be addressed, including validation of methods, agreed acceptance criteria, and distinguishing between natural and deliberate events. The paper emphasizes the need for continued investment and attention from governments to make progress in this field.”

“A Notorious Syria Conspiracy Theory is Definitively Debunked”

Brian Whitaker tackles the OPCW IIT’s newest report on the Assad regime’s use of CW in Douma and its debunking of disinformation surrounding the attack in this piece for New Lines Magazine. He writes in part, “The essence of the disinformation campaign was a refusal by its purveyors to accept that the Bashar al-Assad regime was conducting chemical warfare in Syria. Instead, they claimed all such attacks were “staged” by rebels to frame the regime and trigger a Western intervention. There was never any evidence for this, but it became the deniers’ standard response to reports of chemical attacks. The main reason the Douma attack in particular became a cause celebre for the deniers is it was one of only two chemical attacks (out of a total of over 300) that did in fact result in punitive airstrikes by Western powers. In addition, for the deniers, the emergence of two dissenters from within the OPCW and a series of leaked documents kept the issue alive longer than might otherwise have been expected. Meanwhile, Russia’s attempts to shield its Syrian ally led to political divisions in the OPCW, which threatened to undermine the global prohibition against chemical weapons.”

Iraq Disarmed: The Story Behind the Story of the Fall of Saddam

Rolf Ekéus, Chair of the UN Special Commission on Iraq from 1991-97, recently published his book covering his tenure and the organization’s struggles in disarming Iraq of its WMDs-Iraq Disarmed:

“The quest to disarm Iraq took place between two wars—one justified and right, the other a dreadful mistake, a violation of international law that led to hundreds of thousands of deaths.”  With these unvarnished words, Rolf Ekéus begins his political-thrilleresque story of the disarmament of Iraq—and the machinations that ultimately led to the fall of Saddam Hussein and the rise of ISIS.”

“After Saddam’s invasion of Kuwait and the war that followed, the UN Security Council ruled that Iraq must rid itself of all weapons of mass destruction. The difficult, politically sensitive, and dangerous task of accomplishing this rested with the UN Special Commission (UNSCOM), led by Ekéus, one of Sweden’s most seasoned diplomats. This was a radical experiment in UN governance—essentially conveying to one individual the power to conduct a disarmament program, with oversight only by the Security Council.”

“What followed were a succession of tense conversations with the Iraqi leadership, often-dangerous inspections, complex destruction processes, negotiations with Security Council representatives, and diplomatic maneuvering by world leaders. The recounting of these events lies at the heart of Ekéus’s personal narrative of disarmament history in the making, a narrative that adds substantially to the evidence that UNSCOM’s mission was successful and the 2003 war clearly illegal.”

“Crafted not in the interests of a political agenda, but rather for the sake of historical accuracy, Iraq Disarmed serves today as a sobering cautionary tale.”

“Private-Sector Research Could Pose a Pandemic Risk. Here’s What To Do About It”

Dr. Gerald Epstein, Distinguished Fellow at the Center for the Study of Weapons of Mass Destruction at the National Defense University, recently published this piece in the Bulletin of the Atomic Scientists. In it he discusses biosecurity issues in the private sector, using the 2018 synthesis of horsepox in a Canadian academic lab and Larry Wayne Harris’ attempt to order freeze-dried Y. pestis as touch points. He writes in his conclusion, “With the growth of the bioeconomy and increasing amounts of privately funded life sciences research, restricting biosecurity policy only to government-funded institutions creates an ever-growing gap. Even though research with enhanced potential pandemic pathogens constitutes an extremely small fraction of the overall life science and biotechnology enterprise—and the fraction of that work done with private funding even smaller—the potential global consequences of such work make it increasingly important to develop governance approaches that go beyond attaching strings to US government dollars. Closing this gap within the United States is not sufficient, given the global extent of the life science enterprise and the global consequences of any lab-caused pandemic—but it is a necessary start.”

Strategic Trade Review, Winter/Spring 2023

The 10th issue of the Strategic Trade Review covers a number of timely topics. Dr. Andrea Viski, Schar School Adjunct Professor and editor for the Review, writes in here introduction “The role of the Strategic Trade Review is to empower readers from all stakeholder communities with the powerful tool of rigorous and consummate scholarship from some of the top experts in the world on this and other questions. From discovering the ways that North Korean nuclear researchers acquire sensitive technology through international collaborations to how companies implement R&D compliance, this 10th issue of STR holds a mirror to today’s most important trade and security concerns.”

“MCMi Program Update”

“This newly released annual report provides an update on the US Food and Drug Administration’s work to support medical countermeasure-related public health preparedness and response efforts:

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

Personal Protective Equipment and Personal Protective Technology Product Standardization for a Resilient Public Health Supply Chain

“The National Academies will convene a public workshop, March 1-2, to examine standards gaps related to personal protective equipment (PPE) and personal protective technology (PPT). The event will explore innovative approaches and technologies needed to update and streamline the U.S. standardization system for PPE and PPT in support of supply chain resiliency. Policymakers, manufacturers, users, and relevant technical contributors will discuss ways to improve the effectiveness, safety, supply stability, and accessibility of PPE and PPT in health care settings and increase usage by critical infrastructure workers and the general public.” 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 Applications: Fellowship for Ending Bioweapons (2023 – 2024)

From the Council on Strategic Risks: “In a time of rising geopolitical tensions and the continued emergence of biological events, the devastation that biological threats can cause is clearer than ever. Whether biological threats arise naturally, by accident, or through a deliberate effort to weaponize infectious diseases, they pose grave risks to international security and stability, and significantly impact the welfare and health of people around the globe. The urgency for mitigating this area of catastrophic risks is further driven home by Russia’s ongoing invasion of Ukraine and concerns that its leaders might consider using weapons of mass destruction in conflict, which includes biological weapons, and continued misinformation and disinformation related to biological weapons threats.”

“The Council on Strategic Risks (CSR) is continuing to develop and cultivate creative solutions to help address biological threats, including a particular focus on reducing risks of the deliberate weaponization of infectious diseases. As part of this work, CSR is announcing a call for applications for the 2023–2024 class of our Fellowship for Ending Bioweapons. Applications are due by 5pm Eastern Daylight Savings Time on March 24, 2023. Four to six Fellows will be selected.” Learn more and apply here.

IFBA Launches New Professional Certification in Cyberbiosecurity

From the International Federation of Biosafety Associations: “The IFBA is pleased to announce the launch of their new Professional Certification in Cyberbiosecurity which identifies individuals with demonstrated competencies in the mitigation of cybersecurity risks within biological laboratories. This includes Information Technology (IT) and Operational Technology (OT) risks in order to protect sensitive biological research, data, databases, and laboratory facilities and equipment against illicit or unauthorized access, theft, tampering, or other forms of misuse.” Read more 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: This viral disease is primarily spread by Aedes aegypti mosquitoes and was first detected in humans through a serological survey conducted in Uganda in 1952. What is its name?

Shout out to Scott H. for winning last week’s trivia! The correct answer to “This disease, named for a Brazilian physician, is caused by the Trypanosoma cruzi parasite, and is commonly spread by kissing bugs. What is it?” is Chagas disease.

Pandora Report: 2.3.2023

Happy Friday! This week we are covering President Biden’s announcement that the national and public health emergency declarations for COVID-19 will terminate on May 11, recommendations to expand federal oversight of biosecurity and risky research, and the OPCW Investigation and Identification Team’s third report on the 2018 Douma chemical attack. We also have a number of new publications and a podcast episode featuring Dr. Glenn Cross, an alumnus of the Biodefense PhD Program, discussing Rhodesia’s CBW program during its counterinsurgency in the 1970s.

Biden Administration to End COVID-19 Emergency Declarations in May

In September of last year, President Biden declared in an interview on “60 Minutes” that “The pandemic is over,” drawing swift backlash for seemingly endorsing the sentiment that the pandemic is over because Americans want to behave like it is. He continued, saying “We still have a problem with COVID. We’re still doing a lot of work on it…but the pandemic is over. If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape. And so I think it’s changing.” We wrote then, “Everybody” is definitely not “in pretty good shape.” With developments announced this week, this has potential to become even more true later this year with the end of pandemic protections.

President Biden notified Congress this week that he plans to end the national emergency and public health emergency declarations for the COVID-19 pandemic on May 11, a move that will shift the federal response to one designed at managing an endemic threat and end several protections and benefits. It comes as many have pushed for a “return to normal” and House Republicans threaten to end the national emergencies themselves. The end of these emergencies will likely mean that many Americans will have to pay for COVID-19 testing, vaccinations, and treatments out of pocket that were previously free to them. Zeke Miller explains this further in AP News, writing in part “It comes as lawmakers have already ended elements of the emergencies that kept millions of Americans insured during the pandemic. Combined with the drawdown of most federal COVID-19 relief money, it would also shift the development of vaccines and treatments away from the direct management of the federal government.”

Congress has refused to authorize additional funding for COVID-19 vaccines, prompting the federal government to begin preparations to move this care to the commercial market last year. Pfizer and Moderna have indicated that their prices for COVID-19 vaccines will likely be between $82 and $130 per dose. This amount is between three and four times what the federal government has paid for them through bulk purchasing programs, according to the Kaiser Family Foundation. The same Kaiser analysis found that, “If payers end up paying those prices for one dose per adult, the analysis estimates that the total cost of purchasing booster shots commercially would run between $6.2 billion and $29.7 billion a year, depending on price and how many people nationally get the vaccine or booster.”

The federal government spent over $30 billion on these vaccines to “…encourage their development, guarantee a market, and ensure that the public can access them at no charge.” Insurers may be able to negotiate discounted prices, but as Kaiser also points out, “…they will have limited leverage because they will generally be required to cover all recommended vaccines and boosters.” While those with public or private insurance may not personally bear this cost, this could drive up insurance premiums. Worse, those who are uninsured will lose their guaranteed access to these vaccines and, given the prices announced per dose by Pfizer and Moderna, paying out-of-pocket will likely be out of reach for many.

And the number of uninsured also has potential to rise with the end of expanded Medicare coverage in response to the COVID-19 pandemic. AP explains, “Medicaid enrollment ballooned during the pandemic, in part because the federal government prohibited states from removing people from the program during the public health emergency once they had enrolled. The program offers health care coverage to roughly 90 million children and adults — or 1 out of every 4 Americans. Late last year, Congress told states they could start removing ineligible people in April. Millions of people are expected to lose their coverage, either because they now make too much money to qualify for Medicare or they’ve moved. Many are expected to be eligible for low-cost insurance plans through the Affordable Care Act’s private marketplace or their employer.”

Worse yet “Food help for unemployed adults, under the age of 50 and without children, will also change after the public health emergency is lifted in May. During the emergency declaration, a rule that required those individuals to work or participate in job training for 20 hours per week to remain eligible for SNAP benefits was suspended. That rule will be in place again starting in June. SNAP aid for more low-income college students will also draw down in June.” Important to note here is that it is estimated as many as 4 million Americans are out of work because they are dealing with long COVID. The unemployment rate stayed roughly the same in January 2023 as job growth continued, but this does not address discrepancies between stagnated wages and rising costs of living. Ultimately, the end of all these expanded benefits and protections now will only harm especially vulnerable populations, more than likely threatening their overall health.

Finally, the Office of Budget and Management indicated this week that “…an abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans. During the PHE, the Medicaid program has operated under special rules to provide extra funding to states to ensure that tens of millions of vulnerable Americans kept their Medicaid coverage during a global pandemic. In December, Congress enacted an orderly wind-down of these rules to ensure that patients did not lose access to care unpredictably and that state budgets don’t face a radical cliff. If the PHE were suddenly terminated, it would sow confusion and chaos into this critical wind-down. Due to this uncertainty, tens of millions of Americans could be at risk of abruptly losing their health insurance, and states could be at risk of losing billions of dollars in funding.” If the last three years have taught us anything, it is that giving about 100 days notice for these kinds of changes is hardly helpful for those who will be the most impacted.

Of course, the end of the national emergencies does not mean the pandemic is actually over. Three years after its inaugural meeting, the International Health Regulations (2005) Emergency Committee released the report from its fourteenth meeting regarding COVID-19. While the committee and WHO Director-General Tedros Adhanom Ghebreyesus acknowledged the pandemic is likely at a transition point, the “WHO Director-General concurs with the advice offered by the Committee regarding the ongoing COVID-19 pandemic and determines that the event continues to constitute a public health emergency of international concern (PHEIC).”

Importantly, “The WHO Secretariat expressed concern about the continued virus evolution in the context of unchecked circulation of SARS-CoV-2 and the substantial decrease in Member States’ reporting of data related to COVID-19 morbidity, mortality, hospitalization and sequencing, and reiterated the importance of timely data sharing to guide the ongoing pandemic response…WHO is urging countries: to remain vigilant and continue reporting surveillance and genomic sequencing data; to recommend appropriately targeted risk-based public health and social measures (PHSM) where necessary; to vaccinate populations most at risk to minimize severe disease and deaths; and to conduct regular risk communication, answering population concerns and engaging communities to improve the understanding and implementation of countermeasures.”

Ultimately, apathy towards this ongoing emergency is driving the end of protections and needed benefits for those that need them most. The pandemic is not over, despite politicians’ interest in that being the case. No amount of political rhetoric will ever substitute making needed investments in adequately managing and preventing these kinds of public health emergencies–a lesson the United States seems destined to “re-learn” yet again.

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19).| Credit: CDC PHIL

National Science Advisory Board for Biosecurity Recommends Changes in Biosecurity Oversight

The National Science Advisory Board for Biosecurity endorsed a set of draft recommendations this past week that found, among other things, that current definitions of potential pandemic pathogens (PPP) and enhanced potential pandemic pathogens (ePPP) are too narrow and over-focused on pathogens that “…are both likely “highly” transmissible and likely “highly” virulent”. Their recommendations would expand oversight to cover work considered less risky and end blanket exclusions for “research activities associated with surveillance and vaccine development or production,” among several other measures aimed at enhancing safety and transparency. The White House will decide whether or not to adopt these recommendations.

Dr. Gregory Koblentz, Biodefense Graduate Program Director, discussed these recommendations with The New York Times, saying ““If the government implements the spirit of what they’ve written, this would be a major overhaul of dual-use research oversight in the United States,”. The article also explains his argument that the White house should go beyond these recommendations and create an independent agency to perform this oversight and streamline a system he says is too fragmented.

OPCW Investigation and Identification Team Releases Third Report on Douma Attack

The Organisation for the Prohibition of Chemical Weapons released its third report from its Investigation and Identification Team investigating a chemical weapons attack that occurred on April 7, 2018, in Douma, Syrian Arab Republic. The report indicates that “Based on the holistic assessment of the large volume and wide range of evidence gathered and analysed, and on the convergence of the outcomes of such corroborated multiple analyses, the IIT concluded that, on the evening of 7 April 2018, at least one helicopter of the Syrian “Tiger Forces” Elite Unit dropped two yellow cylinders containing toxic chlorine gas on two apartment buildings in a civilian-inhabited area in Douma, killing 43 named individuals and affecting dozens more.”

Syria’s Foreign Ministry commented on the report: “The [Syrian Foreign Ministry] statement said that the report lacks scientific and objective evidence, and no sane person or specialist can reach such misleading conclusions,” Syria’s state-run SANA news agency summarized the foreign ministry as saying….”Those who prepared this report neglected the objective observations raised by State parties, experts, academics and former OPCW inspectors, known for their expertise and knowledge.”

However, as polygraph.info explains, “That is false…The OPCW reviewed over 19,000 files, obtained and assessed 66 witness statements, and considered data related to 70 samples. It also followed up on “lines of inquiry” suggested by Syria and other state parties…Adhering to “best practices,” the OPCW reached its conclusions after collecting, scrutinizing and corroborating all the available information gathered throughout the course of its nearly two-year investigation.”

US Secretary of State Antony Blinken issued a joint statement with UK Secretary of State for Foreign, Commonwealth and Development Affairs James Cleverly, French Minister of Europe and Foreign Affairs Catherine Colonna, and German Federal Foreign Minister Annalen Baerbock discussing the OPCW report:

Today, the Organization for the Prohibition of Chemical Weapons (OPCW) released a report that found the Assad regime responsible for the deadly chemical weapons attack on Douma on April 7, 2018. The report refutes the Russian claim that it was an opposition attack.

The report concludes that there are reasonable grounds to believe that, around 19:30 local time on April 7, 2018 at least one Mi-8/17 helicopter of the Syrian Arab Air Force, departing from Dumayr airbase and operating under the control of the Tiger Forces, dropped two yellow cylinders which hit two residential buildings in a central area of the city releasing chlorine killing 43 named individuals and affecting dozens more.

This report marks the ninth instance of chemical weapons use independently attributed to the Assad regime by UN and OPCW mechanisms.

Our governments condemn in the strongest terms the Syrian regime’s repeated use of these horrific weapons and remain steadfast in our demands that the Assad regime immediately comply with its obligations under the Chemical Weapons Convention (CWC) and relevant UN Security Council resolutions.  Syria must fully declare and destroy its chemical weapons program and allow the deployment of OPCW staff to its country to verify it has done so.

The report also points out that the IIT received credible information, corroborated through multiple sources, that Russian forces were co-located at Dumayr airbase alongside the Tiger Forces. The IIT also obtained information that, at the time of the attack, the airspace over Douma was exclusively controlled by the Syrian Arab Air Force and the Russian Aerospace Defence Forces.

We call on the Russian Federation to stop shielding Syria from accountability for its use of chemical weapons. No amount of disinformation from the Kremlin can hide its hand in abetting the Assad regime. In the aftermath of Syria’s chemical attack on April 7, 2018, Russian military police helped the Syrian regime obstruct OPCW access to the site of the attack and attempted to sanitize the site.  Russian and Syrian troops also staged photographs later disseminated online in an attempt to support its fabricated narratives of this incident.

We commend the independent, unbiased, and expert work of the OPCW staff, condemn the use of chemical weapons anywhere, by anyone, under any circumstances.  We also reaffirm our commitment to hold accountable the perpetrators of all chemical weapons attacks in Syria and beyond.

Dr. Gregory Koblentz, Biodefense Graduate Program Director, said of the OPCW report: “This report documents the fifth chemical attack that can be directly attributed to the Syrian air force. The chlorine attack on Douma fits a pattern of chemical weapon use by the Assad regime and was an integral part of the brutal counterinsurgency operation the Assad regime was conducting at the time. The report is based on a thorough, multidisciplinary investigation that refutes Syrian and Russian allegations that this attack was somehow staged by the rebels.   The report breaks new ground by naming the Syrian military officer responsible for conducting this attack: Brigadier General Souheil Al-Hassan, commander of the notorious Tiger Forces, which has been responsible for a series of chemical attacks and other atrocities during the Syrian civil war.”

“Pandemic Origins: Technologies, Challenges, and Policy Options to Support Investigations”

This report from the Government Accountability Office discusses the findings of the office’s technology assessment, Pandemic Origins: Technologies and Challenges for Biological Investigations and covers “(1) key technologies available for pandemic origin investigations, (2) strengths and limitations of these tools and how researchers use them to investigate pandemic origins, and (3) cross-cutting challenges researchers face in trying to determine a pandemic’s origin.” GAO identified several challenges that can inhibit determination of a pandemic’s origin, including challenges in acquiring data and the lack of a sufficient and skilled workforce. According to the report, “GAO identified five policy options that may help address the cross-cutting challenges, including proactively establishing multilateral agreements for accessing and sharing samples and genetic sequence data, taking steps to grow an interdisciplinary workforce, and developing a national strategy targeted to pandemic origin investigations. These policy options represent possible actions that policymakers—who may include Congress, federal agencies, state and local governments, academia, industry, and international organizations—could consider taking.”

Disease X: The 100 Days Mission to End Pandemics

This new book was published this week by Kate Kelland, Chief Scientific Writer at the Coalition for Epidemic Preparedness Innovations (CEPI). “Distilling insights from health security experts, examining epidemics and pandemics of the past and present, and analysing what governments, societies and their people got right and wrong in the response to COVID-19 and other devastating disease outbreaks, Kelland explores why and how viruses—tiny as they are—can wreak enormous havoc on our way of life. But she also tells a story of hope, giving readers a glimpse of a future where the threat of pandemics has been neutralised by a prepared and collaborative world.”

Governing Pandemics Snapshot Inaugural Issue

The first issue of Governing Pandemics Snapshot is available now from the Geneva Graduate Institute’s Global Health Centre. “Welcome to the inaugural issue of the Governing Pandemics Snapshot, a publication aiming to provide a concise, periodic overview on the state of efforts to strengthen global pandemic preparedness and response (PPR). This first issue looks back at 2022 and forward to 2023, examining three topics that will recur with each issue: negotiations towards a Pandemic Treaty (or instrument), amendment of the International Health Regulations; and Financing of PPR. Each issue will also cover a rotating special topic, and we begin here with Pathogen- and Benefit-Sharing (PBS). More frequent updates are available on our timeline at GoverningPandemics.org.”

“Addressing Misconceptions About Biological and Chemical Weapons and Related Legal Frameworks”

This new report from VERTIC is available now here. “The main purpose of this resource is to disprove misconceptions about biological and chemical weapons and related international instruments. It addresses misconceptions about biological and chemical weapons and related legal frameworks that VERTIC staff have identified through interactions with states over 20 years’ work on these treaties, and from other sources such as the media. Each misconception is broken down into an explanation of the misconception and its implications, and how to address it. The misconceptions are then disproved through factual and legal discussions, supported by expert commentary.”

“New Bio-Defense Strategy to Eschew ‘One Bug, One Drug’ Programs”

This piece in National Defense covers discussion of the upcoming Bio-Defense Posture Review with USAF Col. James Harwell, deputy director for chemical, biological, radiological and nuclear defense at the Joint Chiefs of Staff’s Joint Requirements Office. The article reads in part, “Gone are the days where we take long periods of time to identify an emerging threat and build a specific countermeasure to that threat. Science is moving at a pace that allows for new threats to rapidly emerge and to undermine our ability to achieve our National Defense Strategy,” Harwell said.”

“The Doomsday Clock is Ticking on Biosecurity”

In this piece for Defense One, Suzet McKinney, Asha George, and David Relman discuss the Bulletin of the Atomic Scientists’ Science and Security Board’s setting of the Doomsday Clock’s time to 90 second to midnight. They acknowledge that it was mostly moved because of the war in Ukraine, but they also write that “The impact of this war on the global order has implications far beyond the nuclear realm and the battlefield more generally. The war thwarts international cooperation exactly when we need cooperation most—to address pressing 21st-century threats such as climate change, mis- and disinformation, and a problem we and others know quite well: the proliferation of biological threats.”  

“Managing the Risks of Biotechnology Innovation”

In this workshop policy paper for the Council on Foreign Relations, Dr. Gigi Kwik Gronvall discusses the risks posed by biotechnological progress and summarizes a November CFR workshop titled “Managing the
Risks of Biotechnology Innovation.” She identifies several gaps in global governance of these risks, including misinformation and disinformation’s influence on the progress and governance of biotechnology, writing in part “Well-funded groups have undermined the development of various biotechnologies, as seen in “golden rice,” which was developed in the 1990s to combat vitamin A deficiency. However, this intervention has not been deployed due to unjustified safety concerns, and millions of children have died from vitamin A deficiency. Misinformation about GMOs, vaccines, and therapies is common, and has intensified during the COVID-19 pandemic. In addition, Russia has recently presented the presence of public health laboratories in Ukraine as cause for suspicion of misuse of biotechnologies. Sometimes institutions, newspapers, or research groups will organize to counter specific threads of misinformation and disinformation, but it is a significant, often uncompensated, obligation for those involved.”

“The Next Generation of Coronavirus Vaccines: A Graphical Guide”

“Vaccines against the coronavirus SARS-CoV-2 have been given to billions of people to protect them from COVID-19, and have saved more than 20 million lives. But viral variants can evade some of the immunity provided by the original vaccines. As a result, vaccine developers around the world are working on dozens of ‘next-generation’ COVID-19 vaccines: not just updates of the first versions, but ones that use new technologies and platforms.” Check out this graphical guide from Nature that covers the next generation of COVID-19 vaccines.

“Could a Chatbot Teach You How to Build a Dirty Bomb?”

In this piece for Outrider, Matt Korda discusses concerns brought about by chatbots like ChatGPT and OpenAI. He writes in part, “But despite being programmed to align with human values, could ChatGPT be tricked into doing harm? To answer this question, many researchers (myself included) picked up ChatGPT’s proverbial gauntlet and went to work searching for creative ways to circumvent the AI model’s safety guardrails. The results of this collective experiment were often funny and—worryingly—occasionally successful.”

What We’re Listening To 🎧

Poisons and Pestilence “14 Bonus Episode: Dirty War with Glenn Cross”

In this latest episode, Dr. Brett Edwards discusses Rhodesia’s development of a CBW program and its use during the country’s counterinsurgency in the 1970s with Dr. Glenn Cross, an alumnus of the Biodefense PhD program and author of Dirty War, a book discussing this program in-depth that is a must read.

This Podcast Will Kill You “Episode 111 RSV: What’s syncytial anyway?”

“We’re kicking off our sixth season in the same way we ended our fifth: with another headline-making respiratory virus. But as our listeners know, not all respiratory viruses are the same, and it’s often those differences among them that play the biggest role in their spread or the symptoms they cause. This episode, we’re exploring the virus that everyone has been talking about lately. No, not that one. Or that one. The other one. Yes, we’re talking about respiratory syncytial virus, or RSV. For many people, the recent surge in RSV infections that dominated headlines this winter may have been the first time they had heard of this viral infection or realized how deadly it could be. But for others, RSV has long inspired fear and dread. In this episode, we Erins explain why this virus deserves such notoriety, how long we’ve recognized the dangers of infection, and what hope the future may hold for novel RSV treatments or vaccines. If at any point you’ve wondered what all the fuss is about this virus or how to pronounce syncytial, then this is the episode for you!”

Prosperity and Human Security: Japan and Asia’s 21st Century Governance Challenges

Join Harvard’s Program on US-Japan Relations for this symposium that includes panels on “Development and Governance Challenges in Public Health” and “Development, Climate Change, and Climate Migration”. The former will feature Dr. Yanzhong Huang, Senior Fellow for Global Health at the Council on Foreign Relations, discussing “China, Covid-19, and global health governance”. This event will take place on February 6 at 12 pm EST. Learn more and register here.

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.

Publication Launch Event-Strategic Trade Review: 10th Issue

Join the Strategic Trade Research Institute on February 15, at 9 am EST for this launch event moderated by Dr. Andrea Viski, a Schar School adjunct professor who teaches courses on strategic trade controls. Featured authors will engage in a virtual interactive panel discussion discussing the new edition. Learn more and register here.

Personal Protective Equipment and Personal Protective Technology Product Standardization for a Resilient Public Health Supply Chain

“The National Academies will convene a public workshop, March 1-2, to examine standards gaps related to personal protective equipment (PPE) and personal protective technology (PPT). The event will explore innovative approaches and technologies needed to update and streamline the U.S. standardization system for PPE and PPT in support of supply chain resiliency. Policymakers, manufacturers, users, and relevant technical contributors will discuss ways to improve the effectiveness, safety, supply stability, and accessibility of PPE and PPT in health care settings and increase usage by critical infrastructure workers and the general public.” 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.

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 February 1964, Albert Nickel, an animal caretaker at Fort Detrick, contracted and died from a disease after he was bitten by an infected rodent. What is the name of the disease and what is its causative agent?

Shout out to Pappas G. for winning last week’s trivia! The correct answer to “On April 22, 1915, the German Army infamously unleashed more than 160 tons of chlorine gas on French trenches near which Belgian city?” is Ypres. Check out the National World War I Museum and Memorial’s page on this event.

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 Times‘ piece 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.

The End of Zero-COVID in China: What’s Happening and What’s Coming Next

Shockingly low case counts, the Party’s Central Economic Work Conference concludes, thick smoke emanating from Beijing crematoriums, and a closed-door meeting of the National Health Commission…

Amid the endless stream of Tweets and headlines warning of a massive wave of COVID-19 deaths in China, there is no shortage of discussion about how serious the situation in the country might become. However, there has been some confusion, incomplete information, and countless questions circulating about what is known right now. We discussed the rollback of China’s Zero-COVID policies and growing problems like antiviral shortages in last week’s Pandora Report, so check there for more detailed discussion on those topics. This update aims to explain and clarify what is known about the current situation and analyze what might happen as a result of it, covering how China is counting cases and deaths, what vaccines are available in the country, critical threats the healthcare system is facing, and what this means in the current economic and political environment in the country.

The Basics

The current wave in China is being driven by BF.7, which is short for BA.5.2.1.7, a sub-lineage of the Omicron BA.5 variant (good luck remembering all that!). BF.7 is reported to transmit faster than other variants, have a shorter incubation period, and be better able to infect those who previously had COVID-19 or are vaccinated. Dr. Li Dongzeng, Chief Physician at Beijing YouAn Hospital’s Infectious Disease Department, reported late last month that BF.7 is thought to have an R0 between 10.0 and 18.6. For context, the original strain of SARS-CoV-2 had an R0 between 2.0 and 3.0 and it officially infected 68,150 people as it ripped through Wuhan in 2020, though estimates of the true case count are as much as three times that number. Given what we have discussed previously about China’s Zero-COVID policy, specifically its failed vaccine strategy, this is incredibly dangerous with many models predicting around one million COVID-19 deaths in China in the coming months. Furthermore, with the rollback of Zero-COVID restrictions, a massive, immunologically vulnerable population is likely to be quickly infected, causing national and global economic problems. This policy pivot is also likely to further complicate business for the Chinese Communist Party (CCP) as its credibility is challenged by this spread and as the likely economic and human costs it will bring come to fruition.

What’s Up with China’s Case and Death Counts?

The incredibly low case and death counts China is reporting currently have left many highly skeptical of the government’s truthfulness. For example, there were officially five COVID-19 deaths on Tuesday, December 20, and just two the day before-and zero in the two weeks prior. The government also reported shockingly low numbers of new cases throughout this week. Meanwhile, the World Health Organization reported that China has 26,878 new cases and 78 new deaths, causing some confusion online and in media reporting. So, what gives?

First-What Counts as China in These Numbers?

Regarding the WHO numbers, it is important to remember that they include Taiwan’s counts in the totals for China. While the WHO’s interactions with and stance on Taiwan made global headlines in early 2020, little has been done to address this issue. Taiwan, officially the Republic of China (ROC), initially represented China in the United Nations and its umbrella organizations. This was because China was one of the original UN member states during the organization’s creation in 1945. This predated the Chinese Communist Party’s defeat of the Kuomintang-led government of the ROC, which led to the establishment of the People’s Republic of China (PRC) and the exiling of the ROC to the island of Taiwan in 1949. The ROC (still under the leadership of Chiang Kai-shek) continued to represent China in the UN until the passage of United Nations General Assembly Resolution 2758, or the Resolution on Admitting Peking, in 1971. This resolution recognized the PRC as “the only legitimate representative of China to the United Nations,” giving the PRC its permanent seat on the UN Security Council and expelling “representatives of Chiang Kai-shek from the place which they unlawfully occupy at the United Nations and in all the organizations related to it.”

Though Taiwan has functioned as a self-ruled democracy since 1949, the PRC insists that Taiwan is a renegade province that will eventually be reunified to the rest of the country. As a result, Taiwan lacks proper representation in organizations ranging from those in the UN System to the International Olympic Committee (where it is listed as Chinese Taipei). While this might normally seem like a purely political issue between the countries, it has important implications, particularly in the context of global health. Taiwan is an excellent international player in pandemic response, as demonstrated in its work to support other countries during the COVID-19 pandemic. The WHO has been largely unresponsive, however, which many critics argue is because the PRC forces its view of Taiwan as a province of the PRC on international organizations, irrespective of the potential harm this carries in matters like international development and global health. Earlier this year, there was a movement to allow Taiwan to attend the WHO’s World Health Assembly as an observer, which had support from 13 member states, including the United States. However, this bid was rejected.

Important to also consider is that the WHO counts Hong Kong and Macao in its counts for China, whereas some data sources differentiate between them and the mainland. Hong Kong and Macao are special administrative regions (SARs) of the PRC with their executive, legislative, and judicial powers devolved from the national PRC government. These SARs are the subject of the “one country, two systems” policy in China which came about as Hong Kong and Macao were transferred to the PRC from the United Kingdom and Portugal respectively in the late 1990s. Under this policy, the SARs would continue to have their own governments and maintain functions like overseeing their own legal financial affairs, including foreign trade. This has allowed them to hold onto their distinct cultures and functions with, for example, both SARs maintaining their own currencies separate from the PRC’s renminbi. In recent years, China has aimed to reduce the independence of the SARs, taking aim at Macao’s famous casinos this year and implementing the Hong Kong National Security Law in 2022, which sharply reduced Hong Kong’s autonomy. Importantly, despite these changes, the SARs have separate healthcare systems and have implemented different policies to control COVID-19 than the mainland. As we will discuss later, this has made the SARs an attractive location for mainlanders to seek care and vaccinations. However, the point here is that it is important to take Taiwan and the SARs into consideration when looking at COVID-19 cases and deaths in China.

What Does the PRC Consider a COVID-19 Death?

Irrespective of all this, the low number of total deaths in mainland China is still suspicious given the sudden policy reversals and sub-pay vaccines in the country. This is made worse by reports of funeral homes and crematoriums in the country being overrun by COVID-19 victims. For starters, the Chinese government is very strict in how it identifies a cause of death, which was a point of confusion even before this pandemic in comparing things like influenza mortality rates in the United States and China. However, it is even more important right now. China is only counting deaths from pneumonia or respiratory failure in its official COVID-19 deaths. This does not include deaths of COVID-19 patients who had pre-existing conditions, and proof like evidence of lung damage caused by SARS-CoV-2 is required for confirming COVID-19 deaths. This goes against the WHO’s guidelines and helps explain the shocking discrepancies between China and other countries’ COVID-19 death counts. During the outbreak in Shanghai earlier this year, many also claimed that their elderly family members who tested positive for COVID-19 and then later died were not included in the city’s official COVID-19 death count if they had underlying diseases, for example. Essentially this means that, even without overtly concealing numbers, China will always have a lower mortality rate than countries that count deaths where COVID-19 was a factor as COVID-19 deaths.

What About the Case Counts?

Okay, so it isn’t a COVID-19 death if a person has any kind of underlying condition or did not clearly die of pneumonia or respiratory distress after testing positive for COVID-19–but why are China’s case counts still so low? In the last two weeks, China has abandoned its mass testing strategy completely and even gone so far as to stop counting asymptomatic COVID-19 cases. It has also slashed central quarantine requirements, further reducing opportunities to accurately count cases. In May this year, as hundreds of millions were forced into lockdowns, the government ordered all cities with more than 10 million people to implement routine testing requirements and to ensure that testing facilities were available within a fifteen-minute walk from anywhere in the city. Places like malls, grocery stores, and restaurants required people to show a negative PCR test from less than 48 or 72 hours ago in order to enter, meaning that people were constantly testing even if their city, neighborhood, or building were not locked down.

Large scale mandatory testing was also mandated when cities entered lockdowns after cases were detected. For example, when Shanghai shutdown in March this year, the city tested all 26 million residents as it kept them all at home or in public quarantine centers if they were positive. The disease spread widely again this fall, prompting lockdowns across the country in an effort to control outbreaks ahead of the National Congress of the Chinese Communist Party, further demonstrating that the Party’s Zero-COVID strategy was not working well even with mass testing requirements.

In mid-November, as cases soared in Guangzhou and Chongqing and discontent rose across the country, the National Health Commission announced its 20 rules for optimizing Zero-COVID, which included relaxation of quarantine measures. This coincided with cities like Shijiazhuang, Yanji, and Hefei announcing they would end their mass testing programs. Later, cities like Beijing and Shenzhen relaxed their requirements for negative tests to use public transportation on December 3, which came before the total abandonment of mass testing just days later following the State Council’s announcement of its ten-point plan on December 7. Xinhua News, an official state media outlet, reported on December 7 that the new rules indicate that, “Apart from nursing homes, medical institutions, primary and secondary schools, kindergartens and other special places, people will no longer be required to provide negative nucleic acid test results and undergo health code checks to access public venues or travel to other regions.”

Furthermore, the ten-point plan’s changes in quarantine policies and determination of high/low risk areas are impacting overall case counts. While the previous 20 rules from November cut down central quarantine facility requirements, ended many mass testing requirements, and changed testing and arrival procedures for international flights, the new ten-point plan totally cut central quarantine requirements for mild and asymptomatic cases. It also changed requirements for close contacts to just five days of home quarantine as well, in lieu of being taken to a central facility. While these new requirements are helpful in that people should not be yanked away for an unknown amount of time because they are considered a close contact, these new changes also mean it is not really possible to have a reasonable understanding of the full extent of COVID-19’s spread in the country. While other countries have dealt with similar issues as at-home testing became more common, this is a much more complicated problem as China faces a winter of overwhelming case counts.

However, as we discussed on Sunday, provinces are introducing rollbacks at different paces. Now we are also seeing cities reintroducing stricter measures on their own, with Shanghai ordering schools and childcare facilities to close this Monday as cases climb. This has created a confusing patchwork of different policies and requirements, further adding to the chaos unfolding as China exits Zero-COVID. As we mentioned last time, CSIS has a helpful map tracking where provinces are at in terms of rolling back restrictions, though it is still hard to keep track of how individual cities are responding as the situation progresses.

Finally, in perhaps the most shocking change, many in China are being encouraged to go to work still even if they are positive for COVID-19. Earlier this month, with some hospitals reporting as many as 80% of their staff were infected, healthcare workers were encouraged or required to still come into work in order to keep up with demand. Now several local governments in China have asked workers to continue going to work even if they are sick in what many view as a warning of the coming economic problems that will be discussed later in this post. These complete 180° changes are simultaneously removing virtually all precautions while also overtly encouraging further infections by encouraging or requiring those who are sick to continue going around others.

Announcement of Chengdu’s new “2+3” requirements for people arriving to the city. In this scheme, arrivals will take one nucleic acid test on arrival and one on their first day at a quarantine hotel. They will spend just two days in quarantine before staying home for three days afterwards, in contrast to the 7+3 and 5+3 arrangement previously in place. For context, Chengdu, the capital of Sichuan province, locked down entirely for four days just in September to test its 21.2 million residents after 157 cases were detected.

A Glimpse Into What’s Actually Happening?

Despite the impossibly low official counts presenting by the government, a closed-door meeting of the National Health Commission reportedly offered a much better look into how many are currently infected. Reports claim that Sun Yang, Director of the Chinese Center for Disease Control and Prevention, informed the commission that at an estimated 37 million people, or about 2.6% of the population, are thought to be recently infected. Estimates from this meeting also indicate that about 248 million Chinese were infected between December 1 and 20, making the cumulative infection rate about 17.56%. The provinces with the high single-day new infection rates are Sichuan, Anhui, Hubei, Shanghai, and Hunan. Perhaps most shockingly, both Sichuan and Beijing are thought to have infection rates over 50%. Finally, infections have spread more rapidly in the Jingjinji Metropolitan Region (the megalopolis of Beijing-Tianjin-Hebei), the Chengdu-Chongqing region, Hubei and Central China. In contrast, the Yangtze River Delta (another megalopolis incorporating Shanghai, China’s most populous city), the Pearl River Delta (yet another megalopolis in the Guangdong–Hong Kong–Macau Greater Bay Area), and the Northwest and Northeast regions of the country are less impacted thus far.

Post from popular Twitter account sharing Chinese social media posts and trends, Teacher Li is Not Your Teacher, featuring posts by netizens discussing the National Health Commission Meeting.

Though these reports indicate health officials believe Beijing is past the peak of this phase, this is still very clearly just the beginning of this disaster. Shanghai has already ordered schools to shutdown in anticipation of growing case counts, in contrast to Beijing (which rolled back essentially all of its COVID-19 policies) and Chengdu, the capital of Sichuan province and the producer of the 2+3 quarantine poster above. As we will discuss further down in this post, this situation is likely to get far worse as the disease continues to spread in other major metropolitan centers and, eventually, across rural regions of the country, especially with the country’s subpar vaccines and the approaching holiday travel season.

Don’t Shoot the Messenger(RNA): China’s COVID-19 Vaccine Problem

Earlier in the pandemic, China claimed that it was nearing production of a domestically-produced mRNA vaccine for COVID-19 (even going so far as to announce the construction of a facility to manufacture ARCoVax/AWcorna in late 2020) and that it would approve the mRNA vaccine from Pfizer/BioNTech. Today, AWcorna only has emergency use approval in Indonesia, and the only people who have access to the Pfizer/BioNTech shot in China are German expats. China’s vaccination campaign has instead depended on two domestically-produced inactivated offerings-Sinopharm BIBP and CoronaVac. The country did recently approve and rollout CanSino Biologics’ aerosol offering, Convidecia Air, a viral vector vaccine growing in popularity as more Chinese seek out booster doses.

In mid-2021, the WHO approved the initial two offerings for emergency use based on limited clinical-trial data indicating that CoronaVac was about 51% effective while Sinopharm was about 79% effective. This was alright relative to the 63% efficacy reported for AstraZeneca’s viral-vector vaccine, but it was not as effective as the 90%+ reported for the Pfize-BioNTech and Moderna mRNA offerings. Nature News explained the initial criticism of China’s vaccines, writing “Both the Chinese vaccines are inactivated vaccines, which use killed SARS-CoV-2 virus. Researchers say this type of vaccine seems to be less potent because it triggers an immune response against many viral proteins. By contrast, mRNA and viral-vector vaccines target the response to the spike protein, which is what the virus uses to enter human cells.”

These numbers sound okay, especially with a high number of fully-vaccinated individuals in the country, but these efficacy rates were for the original strain found in Wuhan in 2020 and it has been several months since most people received their last dose of vaccine. 90.3% of the population has received the entire initial protocol, but, as of December 20, just 60.5% of the population has received a booster dose. Worse, those numbers shrink to 65.8% and 40% respectively for those over the age of 80 as of November. During Hong Kong’s outbreak earlier this year, similar hesitancy in elderly people (just 20% were vaccinated at the start of the outbreak in February) contributed to widespread death in the city’s nursing facilities. China announced in late December it would push to vaccinate those over the age of 60, though this is likely too little too late now, particularly given Chinese vaccines’ even more limited efficacy against Omicron and its sub-variants.

Finally, as was hinted previously, Macao and Hong Kong have become popular destinations for mainlanders throughout the pandemic, in large part because Pfizer/BioNTech’s mRNA offering is available in the special administrative regions. The SARs have also largely sold out of cold and flu medications and painkillers after the rollback of Zero-COVID on the mainland as people rush to find these supplies where they could.

Why Isn’t There a Vaccine Mandate?

This issue naturally leads to questions of why the government hasn’t just mandated vaccines already, even if the ones they can offer are not as effective as the mRNA offerings in the West. A vaccine mandate intuitively makes sense at first look, especially as much of the discourse about China’s handling of COVID-19 in the early days of the pandemic centered on the potential benefits of authoritarian rule in pandemic response. However, if it isn’t clear yet, China is playing a unique game and even its brand of authoritarianism is not always black-and-white.

There were attempts to create a mandate, with the Beijing Municipal Health Commission announcing one this summer, for example. Dr. Yangzhong Huang at the Council on Foreign Relations explained the announcement in June, writing “On July 7, Li Ang, the deputy head of Beijing Municipal Health Commission (BMHC) announced that beginning on July 11, those who had not received COVID-19 vaccines would be denied access to public venues including libraries, museums, and cinemas. The mandate also stated that those elderly who live in military and civilian retirement and nursing homes, as well as their visitors, be fully vaccinated.”

Chinese social media was lit up with backlash over the mandate and concerns that citizens’ informed consent was being compromised. Others directly asked the municipal government to reverse the policy, which ultimately did happen the very next day on July 8. Many around the world touted this as a victory for the people, but this is bizarre event points to the difficulty in understanding China’s health policies and to a complicated vaccine hesitancy more than a purely anti-vaccine sentiment. As Huang points out, this reversal came in a city where 98% of the residents were fully vaccinated. Furthermore, that explanation does not explain why the government reversed its policy on vaccines but not on other also unpopular measures like central quarantining. This reversal was also in response to social media posts over the course of a day so, while local governments in China do make similar policy reversals in the face of opposition movements, this usually takes much more time and is the result of backlash that is much more serious in nature. While Huang’s piece focuses on fragmented authoritarianism in the CCP and friction between leaders who supported Zero-COVID and mass vaccination, it also offers very important context for understanding vaccine hesitancy in China.

While there are younger people in China who have openly avoided getting vaccinated for COVID-19, this problem is concentrated in the elderly population. Again using the example of Hong Kong this year, 20% were vaccinated at the start of the outbreak in February, in sharp contrast to the more than 60% in that same group who were vaccinated for seasonal influenza. For reasons discussed earlier in this post, it makes sense for Hong Kong’s elderly to be hesitant to take a vaccine offered by the PRC’s government. However, these low rates were true despite the Pfizer/BioNTech mRNA vaccine being available.

While some point to the initial focus on essential workers as a likely reason why vaccination rates lag in China’s elderly population, a history of scandal is likely in large part to blame. For example, in 2018, Changchun Changsheng Life Sciences was fined ¥ 9.11 billion (about $1.32 billion at the time) after an investigation by the National Medical Products Administration found the company in violation of eight drug regulations. This kind of punishment was at the very least rare and came after some had severe reactions to the company’s rabies vaccine. The incident led many netizens to express their distrust in the country’s pharmaceutical industry, prompting calls from the likes of Xi Jinping and Li Keqiang for severe punishment for the company. However, the effects of this and similar events seem to have stuck around.

John Ruwitch discussed this issue recently in a piece for NPR, writing “It wasn’t always like this, according to Mary Brazelton, an expert in the history of science and medicine in China at the University of Cambridge.​ In the months after the Communist takeover in 1949, the Chinese government launched several successful vaccination campaigns, taking on smallpox, tuberculosis, diphtheria and other diseases.”

He continues, “If you look at earlier periods in the People’s Republic of China’s history…what you see is in some ways almost the opposite in terms of really strong vaccination programs that work quite hard to convince people, particularly elderly people, to receive vaccines against infectious diseases,” Brazelton says. But lax oversight and corruption during recent decades of breakneck economic growth has led to a string of product quality scandals in China — from baby formula cut with industrial chemicals to contaminated blood thinner and tainted vaccines.​”

Now, as the government rushes to try and vaccinate more people, they seem to be pulling out every stop short of using foreign mRNA vaccines, seemingly sticking to the most flawed gun in the safe. Furthermore, this points to a complicated and sensitive situation for Chinese citizens as they try to balance the realities of heavily censored channels of communication, poor signaling and a history of mismanagement from the government, and a desire to protect themselves as best as possible. This situation, unfortunately, is likely to get much worse in the coming weeks as the healthcare system is overwhelmed.

Growing Danger for China’s Broken Healthcare System

Much of the world watched in horror in February 2020 as time lapse footage of Wuhan’s nearly overnight construction of two temporary hospitals to manage COVID-19 cases as the city’s normal hospitals became overburdened dominated news coverage. This wasn’t unique in the government’s epidemic playbook, as it had similarly erected the Xiaotangshan Hospital in Beijing amid the outbreak of SARS in 2003. However, it highlights an important flaw in the playbook. This kind of construction doesn’t really do much in the absence of an appropriately sized and prepared healthcare workforce. China faced a shortage of physicians and nurses well before the pandemic, a fact made much worse once case counts soared in 2020. Furthermore, as diseases spread across the country, Chinese rural citizens are typically left much less protected than their urban counterparts. These are central issues to the looming COVID-19 crisis unfurling in the country today.

The PRC has undergone significant healthcare reforms in the last decade or so, in large part through the Healthy China 2020 initiative, which sought to cut healthcare costs by increasing the percentage of care covered by insurance. Furthermore, as of 2020, about 95% of the population has at least some form of health insurance, though it typically covers only about half of medical costs. Coverage is split between employee medical insurance for employed urban residents, and resident medical insurance for unemployed urban and rural residents. About 75% of those insured in the country are insured by the resident medical insurance program, pointing to the sheer portion of the population that is either rural and unemployed.

This is an especially concerning fact as the healthcare system is overly reliant on urban hospitals for basic healthcare. The United States-China Economic and Security Review Commission (USCC) notes that hospitals account for 3.5% of medical institutions in China despite handling 45% of all outpatient visits. So, while the Party views quality healthcare delivery as an important part of its political agenda and there have been improvements in coverage and care, there are still serious issues in providing quality care nationally. As is often the case, corruption is a large part of this problem. As the USCC explains:

“Corruption among China’s hospitals and doctors is a widely acknowledged problem that has contributed to a low level of public trust in the country’s healthcare system and at times led to violence against Chinese doctors. In many cases, doctors accept illicit payments, known as hongbao, from patients in exchange for a higher quality of care. The practice of hongbao is widespread in China: in a 2013 survey of residents of Beijing, Shanghai, and Guangzhou, nearly one-third of respondents said they or a family member had given hongbao to physicians between 2000 and 2012. In addition to accepting these payments from patients, doctors and hospital officials also receive kickbacks for purchasing certain types of medical equipment or pharmaceutical products, a practice that has been described as “endemic” in China. In a 2010 survey of Chinese doctors, 78 percent of respondents said healthcare companies could not compete in China without paying bribes.”

This seems to bleed into patient distrust of medical clinics, interestingly, contributing to the over-reliance on hospitals to treat minor conditions. Beyond simple perceived incompetence of clinic physicians, there is a cycle of patient-physician mistrust at this level, as Nie at al. have discussed in Developing World Bioethics. They write, “Mistrust (particularly physicians’ distrust of patients and their relatives) leads to increased levels of fear and self-protection by doctors which exacerbate difficulties in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust.”

This is worse at small clinics, with providers enduring verbal and physical abuse at the hands of patients’ loved ones. There is even a recently coined term, zhiye yilao that describes a “medical mob”, or “people who support families and their relatives in demanding financial compensation from hospitals following medical disputes, as Nie et al. highlight. While many of China’s elites can afford to simply seek care at a private hospital, this is not the case for the majority of Chinese who rely on public hospitals and clinics for their care, particularly those who live in rural areas.

Rural citizens typically either use small clinics or travel to wait in lines in an attempt to get into a hospital, further burdening the system. These rural clinics are often understaffed and poorly equipped, and the national health insurance scheme creates incentives to hospitalize people with relatively minor problems, which is especially problematic for these rural populations. Socioeconomic determinants associated with rural living and resources also contribute to the stark difference in health outcomes between China’s urban and rural populations. Rural residents also are at higher risk of developing many chronic conditions like heart disease, putting them at increased risk during outbreaks of infectious diseases like COVID-19.

As cases climb in urban centers, there are distressing signs that the much better-equipped urban hospitals are becoming overrun. As we discussed, many hospitals are requiring sick staff to still come into work as individual patient loads continue to swell. We and others have also stressed, too, that China does not have the kind of ICU capacity needed to deal with what it faces. This is true in urban centers, but even more so in rural areas, where there are also 30% fewer healthcare workers available. Furthermore, retired physicians and other professionals across the country are currently being called upon to help support efforts to combat the current surge in Beijing. All these signs point to major trouble in urban centers, indicating it is likely to be much worse for rural regions of the country.

As the Spring Festival travel rush, chunyun, approaches, many will travel from urban centers to their rural hometowns, likely spreading COVID-19 to these vulnerable areas. While many are currently opting to stay home on their own and a number of universities have given students the option to finish the semester virtually to cut down on travel, these factors might not be enough to protect these places from becoming overwhelmed in the coming weeks. As a result, the Party has urged local governments to upgrade their facilities and prepare for the oncoming waves. South China Morning Post reports that, “In a directive on Sunday, the Joint Prevention and Control Mechanism of the State Council asked rural hospitals and clinics to ensure pandemic medical services and timely treatment for high-risk patients, such as the elderly and people with underlying diseases.”

The directive reads in part, “Rural areas should…improve the ability of county-level hospitals to treat severe cases, and give full play to the role of health monitoring in township hospitals and village clinics to minimise the severity rate and mortality rate.” However, there is clearly no overnight fix for the kinds of deficiencies rural healthcare facilities struggle with. Despite this, Ma Xiaowei, Director of the National Health Commission, demanded on Wednesday that hospitals address swamped emergency rooms and get patients admitted to different departments. Ma also requested that medium and large hospitals accept more severe cases while promising that regulators will not hold them accountable for increasing fatality rates, according to the Financial Times.

Imploring under-equipped rural healthcare institutions and swamped urbans ones to suddenly improve their ability to treat an onslaught of severe cases is almost an unimaginable request, even for the State Council, as the country had over two years to get ready for its Zero-COVID exit. This complete failure of policymaking and pandemic management will almost certainly cost an unimaginable number of lives, irreversibly harm many people who do survive, further damage China’s and the global economy, and leave many demanding to know why the government did not prepare for this during the years the country spent shutdown.

What Does All This Mean Long-Term?

Just a couple weeks ago, testing positive for COVID-19, even if symptoms were mild or non-existent, was an express ticket to a government quarantine center for however long it took until the government decided one could leave. Shanghai shutdown for all of April and May just months ago, wreaking havoc on the local and national economy and causing global supply chain disruptions. The Party spent the last couple years pushing the message that this “devil” virus was so incredibly dangerous that it was worth it to continue these lockdowns and economic hardships. Today, however, the government insists COVID-19 is basically a cold, that nothing much will come of being infected, and that everything from herbal supplements to canned peaches are good remedies for it. This complete turnaround has many anxiously waiting for the economic consequences and wondering what this means for Xi Jinping and the Party in the long-run.

It’s the Economy, Shagua!

The CCP and State Council recently wrapped up the annual Central Economic Work Conference (CEWC), a meeting that sets the Party’s national economic agenda and directives for the financial and banking sector for the next year. At the meeting, Xi Jinping, who has been remarkably quiet since the end of Zero-COVID, gave a speech in which he indicated that China’s economy is expected to recover and improve in 2023, a tall order given the situation. A number of other critical points were made in an attempt to address the intense downward pressure the national economy is under, explicitly recognizing that the domestic economy has weak prospects coupled with unstable supply chains and shrinking demand.

Another critical point of the CEWC was that, “The meeting urged efforts to deepen the reform of state-owned enterprises (SOEs) while improving their core competitiveness, requiring that legal and institutional arrangements must be made to ensure the equal treatment of private enterprises and SOEs.” While China’s 2001 accession into the World trade Organization was contingent on achieving predominantly “market economy conditions,” the Chinese economy never truly transformed into a market-based one. Rather, despite some reforms in the 1990s and early 2000s, the government has maintained large SOEs in strategic and financial sectors while also maintaining policies that strongly favor these companies. Nicholas Borst explained the logic behind this succinctly for the Lowy Institute, writing “Rather than allowing the private sector more space, Beijing wants a tool for the implementation of government policy.”

In 2021, China had over 150,000 SOEs, with most of its Fortune Global 500 companies under state control. In 2019, SOEs accounted for more than 60% of the PRC’s market capitalization while accounting for 40% of its national GDP. For context, in 2019, Chinese SOEs made up more than 4.5% of the global economy–and now they are going to be treated equally with private businesses in China. This marks an important change as the Party also looks to increase demand by ensuring higher quality supply, and get a better hold on the deleveraging of the country’s real estate industry, stating that bail outs will come only if companies have well-founded plans for recovery. Just last month, amid further reduced apartment sales, the cabinet urged banks (again, most of which are SOEs) to increase loans for completion of unfinished apartments, with the central People’s Bank of China going so far as to reduce “by $70 billion the money that the country’s commercial banks are together required to hold for emergencies, freeing them to lend that money instead.”

Is This China’s Lehman Moment?

The current real estate crisis in China offers a particularly concerning look into just how damaging the sudden removal of Zero-COVID policies in the country could be both domestically and internationally. In recent years, it has been clear China’s real estate market was heading for trouble, with many people paying mortgages on apartments that are not even finished contrasting with the estimated 65 million units (1/5 of the homes available in the country) sitting completely open in China’s ghost cities. In late September last year, China Evergrande Group, China’s second largest property group, was forced to begin payments on its hundreds of billions of dollars in debt amid new regulations on developers’ debt limits. This started the current real estate sector crisis as when it caused several stock market indices to drop on September 20, 2021.

In the last year, it seemed that the Party was concerned the crisis would worsen in the absence of Zero-COVID restrictions. As Keith Bradsher explains in the New York Times, “Real estate development plays an outsize role in China’s economy, representing about a quarter of economic output and a quarter of its bank loans. Housing represents at least three-fifths of household assets in China, and many Chinese regard apartments as the only reliable way to build wealth.” This seemed to leave the Party locked into the restrictions in an effort to protect such an important but struggling part of its economy. Today, however, Zero-COVID is dead and the Party has indicated it wants less borrowing overall and that companies will only be bailed out if they present “well-founded” plans.

In the last year, the government has spent heavily on new railways and other infrastructure investments to try and help the economy amid low confidence, but that was with consistent COVID-19 policies in place. Furthermore, there have been concerns that injecting too much credit too quickly would be counterproductive to the goals of getting companies to borrow less and strengthen their balance sheets. In the real estate sector, the country has to somehow balance achieving sustainable growth and lowering prices, but that is not going to happen if sales keep falling. For example, in Shanghai this year, luxury apartment prices fell as much as 40% after the Party Congress because of concerns about the economic and political direction the country will take in Xi Jinping’s third term.

The CCP is Anything but a Party Right Now

Today, it is hard to fault those in Shanghai for selling off their multi-million dollar properties while they could. Models range in their estimated COVID-19 deaths in China in the absence of Zero-COVID, with some predicting under one million and some going over two million. This high of a number of deaths so suddenly, particularly as a result of the sudden end of virtually all precautions after years of constant testing and lockdowns, will be politically difficult to manage.

This also does not touch on how many Chinese will likely suffer from Long COVID and other long-term conditions if they do recover from COVID-19, something many other countries have had to learn the hard way. In the US, it is estimated that Long COVID costs the economy $3.7 trillion. While the US certainly has struggled with its COVID-19 response, it at least has effective vaccines. In September, Chinese state media was full of pieces talking about the “West’s hidden pandemic” of Long COVID and, now, it is nearly impossible to find any PRC official discussing this condition. The narrative has done a complete 180° on all fronts.

The threat of suddenly losing one million people completely and leaving an untold number burdened with long-lasting symptoms should be enough to make anyone reconsider their policy decisions. However, this is difficult for someone like Xi Jinping who has spent years building an image of infallibility while also championing Zero-COVID the last two years. He has often relied on rhetoric describing pandemic response as a war and continuously touted China’s unique approach as a better alternative to the “chaos of the West.” It is hard to believe what is happening in Xi’s China today is anything but complete chaos, and no amount of internet censorship and state media pieces about the supposed correctness of this new approach can keep the population totally unaware of that fact.

It still is not clear why Xi Jinping suddenly reversed course on Zero-COVID, even in the face of protests against the largely unpopular policy. Furthermore, as Xi begins his historic third term, he does so coming off a year of remarkable failure. As James Palmer recently pointed out in Foreign Policy, the once seemingly boring, safe choice in Chinese politics has proven to be anything but in the years since he took power, eliminated competition, and doubled down on state control over every facet of life in his country. Now, with mass death and further economic turmoil on the horizon, what will happen next for Xi Jinping and the CCP?

Pandora Report: 11.4.2022

Happy Friday! This week focuses heavily on China and Russia, covering the recent ProPublica piece on the Wuhan Institute of Virology, Shanghai’s lockdown, Russia’s failed attempt at creating a UN Security Council committee to investigate its false claims about supposed US biological weapons facilities in Ukraine, and more. We also cover new publications, a new podcast release from the University of Bath’s Dr. Brett Edwards, upcoming events, and an exciting fellowship opportunity from the WHO.

About That ProPublica Piece

Late last week, ProPublica and Vanity Fair released a piece in conjunction with the Senate HELP Committee minority’s interim report, claiming to have unveiled new information from the Wuhan Institute of Virology (WIV) supporting the lab leak theory of COVID-19’s origin. In it, Katherine Eban and Jeff Kao rely heavily on the work of a single self-proclaimed polyglottal State Department political officer to translate Chinese Communist Party (CCP) “party speak,” which he claims native speakers “can’t really follow…” Now, the piece some have described as a train wreck is being heavily criticized for having faulty translations, mis-matched dates, misrepresenting the sources of the documents discussed in it, not understanding how common VPN usage is in China-related research, and more. ProPublica is reportedly scrambling to review critical details of their piece, but is it too late? Let’s talk about some core issues with the article and what they might mean long term.

‘Party Speak’ or Just Lost in Translation?

The first half of the ProPublica piece is dominated by glowing discussion of Toy Reid, a former RAND Corporation employee and East Asia political officer at the US Department of State, covering his blue collar origins and attendance at Harvard. The authors then discuss how Reid spent over a year working for the Senate HELP Committee, using a VPN to search “dispatches” on the WIV’s website from Hart Senate Office Building and his Florida home. They write, “These dispatches remain on the internet, but their meaning can’t be unlocked by just anyone. Using his hard-earned expertise, Reid believes he unearthed secrets that were hiding in plain sight.”

Plain sight is right! These “dispatches” were updates posted to the Wuhan Institute of Virology’s (WIV) homepage on the general news tab. In fact, you can go look through this whole tab here to see mundane entries ranging from a recent day reflecting on the 20th National Congress to a July post about WIV celebrating the 101st anniversary of the Party, to general updates about different trainings and publications related to the institute. Therein lies one of the fundamental problems with this piece-these were not secretive dispatches internal to the Party. These are essentially press releases meant to face outward. Yes, they are laden with mentions of comrades, references to struggles and frontlines, and key Chinese leaders, including Xi Jinping and the recently ousted Li Keqiang. They are, after all, written by Party members in a major facility of the Chinese Academy of Sciences. They are going to have this kind of language by default, especially around times like national congresses and major anniversaries.

To be clear, the CCP does use euphemisms and round-about language at times to describe high-level concepts and goals. In fact, some scholars spend the bulk of their careers conducting political discourse analysis and understanding leaders’ officialease or government-speak. Some do focus on CCP party speak, which has become especially interesting in the Xi years. However, this is definitely not unique to the CCP as one can find scholars dissecting and analyzing any number of world leaders’ speeches and government lexicons. It is also important to recognize that this concept is not some niche or extremely esoteric concept known only to a few in China watching circles. Students studying Chinese politics overwhelmingly have to learn things like “crossing the river by touching the stones” or “socialism with Chinese characteristics” as a Chinese-specific form of Marxism-Leninism throughout the periods of Dengism, Three Represents, Scientific Outlook on Development, and now Xi Jinping Thought. It it core to understanding national agendas throughout different leadership periods.

However, with this comes the understanding that Party documents are laden with this kind of jargon and narrative furthering. This also is not unique to the CCP. In fact, Harry Hodgkinson wrote an entire guide in 1955 on Soviet jargon and unique meanings Communist parties give to particularly terms. While this jargon and overarching nationalistic narratives offer important context for the WIV posts, they do not represent some in-between-the-lines version of Chinese that “even native Mandarin speakers can’t really follow…” Rather, they help explain why the language in the posts seems so dramatic and nationalistic.

What’s in a Narrative?

In October 1949, Mao Zedong declared the official founding of the People’s Republic of China. With Chiang Kai-shek and the remainder of the KMT exiled to the island of Taiwan and the decades long civil war over, Mao was left to figure out how to actually lead the new PRC. Central to this were narratives of overcoming the century of humiliation, protecting the sovereignty and integrity of Chinese territory, bringing justice for China against those who subjugated it, and building a strong, advanced country. These ideas were central to nationalism at the time and drove pushes to modernize like the infamous Great Leap Forward. As Dr. Kerry Brown of King’s College London writes, “That self-designated task of bringing about justice for China was the main justification for the Party’s many mistakes under Mao when the second resolution on its own history was produced a few years after his death in 1981.” Themes of struggle against western imperial powers and self-determination were critical political tools wielded by the Party, even in the face of wildly unpopular, destructive policies.

Though it looks different today, narratives of national struggle and rejuvenation are still important features of CCP rhetoric, even for Party members at a CAS laboratory. Brown discusses the power of narrative in modern China, writing, “For the current dominant leader Xi Jinping, the notion that the Party is a kind of epistemic community, one uniquely placed to carry China forwards to the fulfilment of its great quest for a just outcome to history, is becoming more powerful by the day.  Seen in these terms, the Party is not so much about power per se – but power to deliver this historic outcome. That perhaps explains why, despite the many challenges and problems with its practice and its own history, it still remains so dominant in China.” Today, concepts like the Chinese dream, national rejuvenation, and the goal of becoming fully modernized by 2049 are central themes Party rhetoric uses, even in discussing day-to-day work at different lower-level organizations.

In the context of the Wuhan Institute of Virology posts, this is seen in the framing of work at the lab as some kind of grand struggle. In one of the first WIV posts referenced by ProPublica and Vanity Fair (available here in its original format), the authors claim to have found a dispatch that “…referenced inhumane working conditions and “hidden safety dangers.” On Nov. 12 of that year, a dispatch by party branch members at the BSL-4 laboratory appeared to reference a biosecurity breach: “These viruses come without a shadow and leave without a trace.”

However, as a number of Mandarin speakers and China watchers have pointed out online, this was actually a very general post about how the facility went from humble beginnings at its founding to now being a training hub and “fighting fortress” of China’s research and public health. It is written not unlike other fictional and non-fictional works describing BSL-4 facilities in other countries (The Hot Zone, anyone?)-hours are long in these space suit-like positive pressure suits, the pathogens are unimaginably dangerous, and those doing the work are brave, hardworking, brilliant scientists.

Much of Toy Reid’s interpretation of this post depends on a misinterpretation of “每当这时” (Měi dāng zhè shí, “whenever”) in the context of a description of Party members leading by example whenever handling BSL-4 pathogens. Reid instead took this as “whenever there are biosafety breaches,” and not some inspirational statement about Party members. Other portions of the article focus on visits from Chinese Academy of Sciences officials and seminars on the importance of biosafety and commonly noted issues during safety inspections. However, these were updates about high-level visitors and general efforts to ensure the facility maintained safety standards, much like those any organization anywhere might make.

James Palmer, deputy editor at Foreign Policy and author of Foreign Policy’s China Brief, discussing the normal workplace nature of the WIV posts

The Wuhan Institute of Virology boasts the PRC’s first BSL-4 (P4) facility, which opened in 2018, marking a major milestone for the country. A boastful post about how it came from humble beginnings but, through the work of very dedicated personnel, is now doing important, taxing work and striving to always be better is very par for the course. There is even a corny word play in the post about how Party members “infect” (Gǎnrǎn, “感染”) others with their practical actions and safety-conscious attitudes. As many have now pointed out, this is just the Party bragging about how dedicated their members are, how far the facility has come, and how personnel are constantly working to better themselves and their organization. In other words, it is furthering the Party narrative, not hinting at secret internal problems.

References throughout the posts cited by ProPublica to General Secretary Xi Jinping and his discussion of technology as a weapon make sense in the context of Party-authored news posts. Xi Jinping has achieved power unlike any previous leader, capturing himself a historic third term after the country removed presidential term limits in 2018. Xi Jinping Thought (“Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era”) was also formally enshrined in the Party’s constitution that year, further cementing Xi’s unique power over the Party with the CCP describing it as “Marxism of contemporary China and of the 21 century.” With this context in mind, it makes sense for Party members at WIV to frequently reference Xi and his national goals and speeches. However, Reid instead took this as literal input directly from Xi to the lab following the biosafety incident he claims a previous post references.

Zhihua Chen’s thread on translation and dating issues in the ProPublica article

Finally, even if this was all true-the WIV had a 2019 biosafety incident and Xi Jinping was personally concerned enough to send an urgent message about it to WIV himself-why would any of that be posted on the institute’s website? As was just discussed, the narrative matters a lot in Chinese politics; image is everything and the Party is very secretive as a result. As the country continues to compete internationally in all areas, including the bioeconomy, it does not make sense for the Party to air dirty laundry about a supposed biosafety incident and workers’ concerns in a public space. If the core argument is that China is covering up a lab leak, the question of “Why would the Party allow the facility in question to publicly hint at mismanagement and safety issues on its own website?” must be answered.

Implications

Ultimately, bad faith takes on China, COVID-19, and biosafety hurt us all. There is a fundamental difference between calling for an in-depth investigation, holding the PRC accountable for its failures, working towards making sure we are better prepared for the next time something like this happens, and inappropriately equating mischaracterized and poorly translated press releases to some kind of damning evidence of a lab leak origin of SARS-CoV-2. The US-PRC relationship is in a very dangerous place and, while criticism of the CCP’s handling of COVID-19 is absolutely warranted, this article is likely to become political fodder for the Party. In fact, the Chinese government has already condemned the piece, claiming that it was driven by US politics.

While ProPublica claimed to have corroborated Reid’s work with unnamed “experts” on CCP communications, the swift backlash and ProPublica’s moves to reach out to other translators cast further doubt on the caliber and motivations of those consulted initially. This is in addition to concerns about the experts they claim to have consulted on the WIV’s claims about biosafety and time researchers spend in BSL-4. In the end, one can be both critical of the CCP and its practices while not resorting to an overly hawkish view that leads to finding suspicion in the mundane.

Finally, this points to a need for interdisciplinary collaboration and competent understanding of the political realities of the PRC in assessing issues like biosafety. What may look to someone with little knowledge of Chinese political discourse as alarming messages are actually pretty par for the course in terms of statements and news updates on an official website. Outside of debates on SARS-CoV-2’s origin in the scientific community, scholars in the social sciences and humanities and experts working in all sorts of fields can offer important context that, in this case, marks the difference between recognizing standard Party rhetoric and sounding alarm bells over normal updates on the WIV’s website.

For more on this, including discussions of the scientific debate about COVID-19’s origin as discussed in the Senate report and ProPublica article, check out Michael Hiltzik’s opinion piece on this article in the LA Times and Max Tani’s work in Semafor.

It’s the Happiest Place on Earth, Until You’re Stuck There-Welcome to Shanghai Disney

As China continues to cling to its zero-COVID policy, tourists at Shanghai Disney Resort now find themselves trapped in the park until they can test negative for COVID-19 amid yet another snap lockdown. South China Morning Post explains “…new variants have tested local officials’ ability to snuff out flare-ups faster than they can spread, causing much of the country to live under an ever-changing mosaic of Covid curbs.” The city announced Monday that it was going into lockdown and that visitors to the park would not be allowed to leave “until on-site testing returns a negative result.” SCMP writes, “It added that those who had visited the park since Thursday must obtain three negative Covid tests over three successive days and “avoid participating in group activities.’ The announcement came after Disney said it was “temporarily closing with immediate effect … in accordance with disease control requirements”.”

Turns Out the PRC Is Not the Only Place with Biosafety Issues

The discovery of vials labeled “smallpox” in a Merck & Co. facility near Philadelphia last year, last month’s controversy over Boston University’s NEIDL’s COVID-19 work using chimeric viruses, that time the Department of Defense accidentally mailed live anthrax spores to a US base in South Korea…the US is no stranger to biosafety issues and scares. This is the subject of a three part series of The Intercept, “Experimenting with Disaster,” focused on undisclosed biosafety incidents in the US. The first part focuses on a university lab accident, the second on work with the 1918 flu pandemic’s H1N1 virus, and the third on risky work with avian influenza. The Schar School’s Dr. Gregory Koblentz is quoted throughout the series as he provides context to the political and oversight issues surrounding these and other incidents.

Russia Fails (Again) to Garner International Sympathy for Bogus BW Claims

On Wednesday, the UN Security Council (UNSC) squashed Russia’s attempt to create a formal inquiry into its claims that the US and Ukraine are running a biological weapons program in Ukraine. Of the five permanent UNSC members, only China voted in support of Russia’s draft resolution on the measure. The US, UK, and France all voted against it while the other 10 UNSC members abstained from voting. According to the UN “Through the draft resolution, the 15-member Council would have decided to set up a commission to investigate the complaint of the Russian Federation in the context of the activities of biological laboratories in the territory of Ukraine, as well as present to the 15-member organ a report on the issue containing recommendations by 30 November 2022 and inform the States parties to the Convention at its Ninth Review Conference to be held in Geneva on 28 November–16 December 2022 of the results of the investigation.”

“The draft would also have the Council request the Secretary-General and the Biological Weapons Convention Implementation Support Unit provide, within their respective mandates, all necessary assistance to the commission.”

Cholera Outbreaks on the rise Globally

In case more COVID-19 variants, monkeypox, polio, and Ebola weren’t enough for you this year, the New York Times reports that a “…record number of [cholera] outbreaks have been reported after droughts, floods and wars have forced large numbers of people to live in unsanitary conditions.” So far, outbreaks have been reported in the Caribbean, Africa, the Middle East, and South Asia. NYT also explains “Cholera is typically fatal in about 3 percent of cases, but the World Health Organization says it is killing at an accelerated rate in recent outbreaks, even though it is relatively cheap and easy to treat. It is most often fatal in children, who progress swiftly to severe illness and organ failure.”

However, as case counts grow, vaccine supplies are coming up short. The WHO has already suspended its two-dose recommendation in favor of a single dose regimen that can help stretch supplies. “We have never had to make a decision like this about vaccination before, that’s the severity of this crisis,” Dr. Philippe Barboza, head of the WHO’s cholera team, said.

NYT explains part of why this is an issue, writing “The bulk of the world’s cholera vaccine is made by a South Korean company called EuBiologics. Some 15 percent of the global stockpile was produced by Shantha Biotechnics, a wholly owned Indian subsidiary of the French drugmaker Sanofi, but the company decided two years ago to stop production of its cholera vaccine by the end of this year and end supply by the end of 2023. That planned exit from the market coincides with the spike in demand…Dr. Barboza said that EuBiologics was producing at capacity and working to expand its production, and that another drugmaker would soon begin to produce the vaccine.”

“A Multinational Delphi Consensus to End the COVID-19 Public Health Threat”

Lazarus et al.’s new Nature article discusses findings of a Delphi study focused on the COVID-19 pandemic response: “Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.”

“Lessons Learned from the COVID-19 Outbreak”

New from the RAND Corporation, a volume on COVID-19 that includes chapters on the need to prioritize biosafety and biosecurity, and GOF research: “The coronavirus disease 2019 pandemic that began in late 2019 and continues as of the writing of this Perspective in summer 2022 has been the cause of both tremendous tragedy—in lives lost and economic hardship—and great triumph in the rapid development of effective vaccines. Many nations around the world have scrambled to respond to a once-in-a-century event that has exposed many weaknesses in response planning and capabilities, including those of the United States. Even as the pandemic continues, it is not too early to reflect on the missteps that have been made and lessons that can be learned so that the United States and nations worldwide can be better prepared for the future.”

“This volume contains a collection of essays that explores topics of critical importance toward that aim and identifies actions that can be taken to not only improve pandemic preparedness but also help prevent the occurrence of future pandemics. The essays center on U.S. challenges and experiences, but the solutions, in many cases, require collaborative efforts that reach across national boundaries.”

“The Global Inequality in COVID-19 Vaccination Coverage Among Health and Care Workers”

Nabaggala et al. discuss COVID-19 vaccinations in HCWs in their new article in the International Journal for Equity in Health. Using WHO data, they found that “Despite being considered a priority group, more than a third of countries did not achieve 70% vaccination coverage of their HCWs at the end of 2021. Large inequities were observed with low income countries lagging behind. Additional efforts should be dedicated to ensure full protection of HCWs through vaccination.”

“Bolstering Arms Control in a Contested Geopolitical Environment”

Michael Moodie and Jerry Zhang’s recent issue brief published by the Stimson Center: “For decades, arms control has constituted one of the cornerstone frameworks for global governance and served as a critical tool for bolstering international security and stability. The global arms control regime is now under unprecedented pressure, due to heightened competition between major powers, rapidly deteriorating security environment, and emerging technologies. Nevertheless, cooperation on arms control is important in today’s contested geopolitical environment as it can encourage responsible competition broadly between great powers, avoid the proliferation of advanced weaponry, and reduce the risk of unintended military escalation. This paper recommends three measures to reinvigorate arms control: sustaining long-term engagement between major powers; adopting a multi-stakeholder approach by including smaller states and non-government entities in the process; and reconceptualizing the fundamentals of arms control.”

“Addressing the Global Shortage of Biosafety and Biosecurity Professionals through Education”

The International Federation of Biosafety Associations recently published this white paper discussing their efforts to build undergraduate degree programs designed to create competent biosafety professionals. They write: “Biosafety and biosecurity professionals provide an essential role in safeguarding infectious disease agents in clinical and research laboratories and other settings where biological materials are handled. The COVID-19 pandemic has brought into focus the significant demand on the profession and many countries face an overall shortage of these specialized individuals. Given that biosafety and biosecurity professionals work in laboratories behind the scenes of the frontline response, the profession remains largely unknown to students interested in pursuing a career in the sciences. As such, students tend to be steered towards more visible education paths in the biological and health sciences.”

“To address this gap, the IFBA is leading a multisectoral effort towards a future sustainable workforce by formalizing a biosafety & biosecurity career path within the higher education system. Now is the right time since the recent lived COVID-19 experiences of youth have motivated them to become involved. Over the past 6 months, and with funding support from Global Affairs Canada, the IFBA has been collaborating with Kenya’s Masinde Muliro University of Science and Technology (MMUST) to develop and pilot a new undergraduate BSc degree program specifically in Biosafety and Biosecurity. This new BSc program leverages MMUST’s existing programs in the Department of Medical Laboratory Sciences. All students undertake related core courses in microbiology and related disciplines in the first two years followed by specialized biosafety & biosecurity courses, practical laboratory and field experience and a capstone project in their later academic years.”

“The lessons learned from this pilot program will be used for future program roll out to additional universities across Africa and globally. This project presents a recommended solution towards a sustainable future global workforce of biosafety and biosecurity professionals. Supporting this approach are multisectoral partnerships committed to biosafety and biosecurity education and our common vision of more graduates and young scientists entering the profession.”

“A Plea for Making Virus Research Safer”

Dr. Jesse Bloom’s guest essay in the New York Times offers an overview of notable pathogen research, efforts over the years to make it more secure, and current concerns. In it she writes “The French statesman Georges Clemenceau said, “War is too important to be left to the generals.” When it comes to regulating high-risk research on potential pandemic viruses, we similarly need a transparent and independent approach that involves virologists and the broader public that both funds and is affected by their work.”

“How to Detect a Man-Made Biothreat”

This Wired piece discusses US government funding to develop test that would detect engineered pathogens: “To guard against these potential threats, the US government is funding the development of tests to detect dangerous bioengineered organisms before they have a chance to cause significant harm. The effort was announced in 2017 by the Intelligence Advanced Research Projects Activity, or Iarpa, within the Office of the Director of National Intelligence. In a livestreamed update in October, Iarpa program manager David Markowitz announced that two platforms developed under the program were both 70 percent accurate at identifying the presence of bioengineering. “We simply never know what sample is going to come through the door in a government lab, and we need to be prepared for anything,” Markowitz said during the news briefing.”

“Why Climate Change Matters for Pandemic Preparedness”

Check out this Nature Outlook piece with computational ecologist Xavier Rodó on climate change’s role in pandemic planning: “Numerous studies over more than two decades have demonstrated a robust relationship between climate and the dynamics of human diseases, such as cholera, malaria and dengue. Changes in climate, including both long-term warming trends and short-term climate variability, might affect patterns of disease. Xavier Rodó, a computational ecologist and climate dynamics specialist at the Barcelona Institute for Global Health and the Catalan Institution for Research and Advanced Studies in Spain, spoke to Nature about how climate modelling could be used to help prepare for future disease outbreaks — and the obstacles he has faced in implementing such systems.”

“Chemical Security Experts Call for Multisector Cooperation Against Terrorism”

From INTERPOL: “The devastating impact of chemical weapons and explosives used in acts of terrorism continues to affect civilian populations and is well known for its destructive and long-term harm.”

“Last year over 1,000 improvised explosive device (IED) attacks were conducted by non-state actors, injuring over 7,150 people in more than 40 countries. Many attacks come from chemicals that criminals acquired through weak points in the supply chain – from manufacturing to storage and retail– and made into weapons.”

“To counter this threat, some 220 chemical security practitioners from more than 70 countries met at INTERPOL’s 3rd Global Congress on Chemical Security and Emerging Threats (25-27 October) to find ways of reducing vulnerabilities by enhancing multisector cooperation and collaboration.” Read more here.

What We’re Listening To 🎧

THE RETORT: EPISODE 4 Gain of Function Experiments

The latest episode of Dr. Brett Edwards’ podcast, The Retort, offers “A straightforward introduction to the past decade of discussion of international oversight of gain of function pandemic research,” with Dr. Nariyoshi Shinomiya of Japan’s National Defense Medical College. This episode and previous ones are available on Dr. Edwards’ YouTube channel. His other podcast project, Poisons and Pestilence, also recently reached 7,000 listens. In celebration, he is hosting a t-shirt give away, so be sure to check that out here.

Conversations Before Midnight

The Bulletin of the Atomic Scientists is hosting its Bulletin Annual Gathering on November 9, 2022, at 5 pm CDT virtually. This is the Bulletin’s “signature event” and it aims to allow guests to engage in high-level conversations with influential voices tracking man-made threats. At the event, “Each virtual table has an expert, established and up-and-coming specialists in the fields of nuclear risk, climate change, disruptive technologies, and biosecurity. These discussion leaders include members of the Bulletin’s Science and Security Board, Board of Sponsors, and invited experts from around the world. Below are a few samples for this year’s gathering.”‘ Table experts include our own Dr. Greg Koblentz, so be sure to check out this event’s info page here.

Briefings in Preparation for the Ninth BWC Review Conference

From UNIDR: “The 1972 Biological Weapons Convention (BWC) is a cornerstone in the regime to prevent the hostile use of biology. The Ninth BWC Review Conference will take place in late November 2022 and presents an important opportunity to take stock of the past and chart a course for the future of this increasingly important agreement. In support of preparations for the Ninth BWC Review Conference and beyond, UNIDIR has recently published several reports intended to stimulate thinking on substantive issues related to the BWC.”

“This virtual event will bring together the authors of the latest UNIDIR publications on BWC topics to provide short outlines of the key insights and ideas in their respective reports for State Parties to consider ahead of the Review Conference. These include verification, advances in science and technology, international cooperation, and potential outcomes of the Review Conference. The presentations will be followed by a moderated interactive discussion with the participants.” This event will take place on November 7 at 2 pm CET, online. Learn more and register here.

Infection Prevention and Control: Incorporating Lessons Learned in Managing Special Pathogens

“After nearly three years responding to the COVID-19 pandemic, hospitals and other healthcare facilities have learned many lessons about the management of special pathogens and essential infection prevention and control practices. The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the National Emerging Special Pathogens Training and Education Center (NETEC) invite you to learn more about some of those lessons. Speakers will share their perspectives on how our approach to outbreaks has changed since the pandemic began. They will address issues such as infection prevention for healthcare workers and patients and mitigating disease spread. Speakers will also highlight newly developed tools and resources. This webinar will take place November 7 at 2:00 pm ET. Register today!”

WHO/AFRO Fellowship Programme on Public Health Emergencies in Africa

“The World Health Organization Regional Office for Africa (WHO AFRO) invites interested and eligible candidates to submit applications for a fellowship programme on improving the management of public health emergencies in Africa under the COVID-19 Incident Management Support Team (IMST).” Learn more and apply here.

Pandora Report: 10.28.2022

Happy Halloween! This week we haves lots of scares for you, including even more misuse of international organizations to further disinformation narratives! This week, we focus on Russia’s request for a UNSC investigation of its bogus BW claims and complaint lodged in accordance with Article VI of the BWC, the Senate Health, Education, Labor and Pensions minority report on SARS-CoV-2 origins, and ongoing debates about the SARS-CoV-2 experiments conducted at Boston University. We also cover new publications, upcoming events, and new announcements ahead of One Health Day.

Russia Criticized Heavily After Calling for UNSC Resolution on “Secret Biolabs in Ukraine”

In yet another massive waste of everyone’s time, Russia has continued to press its false claims that the US runs “secret military biological programs” in Ukraine with the UN Security Council, this time drafting a resolution that would establish a commission (comprised of all 15 UNSC members) to investigate the claims. This comes amid a new wave of “transparently false allegations” on the part of Moscow, most recently regarding alleged Ukrainian plans to use a dirty bomb in its own territory. In response to this latest effort at the Security Council, the UK’s Ambassador to the UN, Dame Barbara Woodward, asked the question on everyone’s mind-“How much more of this nonsense do we have to endure?”

This newest attempt includes an official complaint to the UNSC, filed in accordance with article VI of the BWC, in addition to the request for the formation of a formal commission to investigate the October 24 complaint. The complaints continue to center on efforts between the US and Ukraine, largely under the Cooperative Threat Reduction program, to support public health research and diagnostic facilities, though Russia insists these facilities are not for peaceful purposes.

In a Thursday briefing before the Security Council, the UN Office for Disarmament Affairs (UNODA) reiterated again that it is not aware of any biological weapons programs in Ukraine, echoing its previous statements on the matter made in March and May. In response, Russia’s Ambassador Vassily Nebenzia said, “Do you really think that we’re that naïve?…Do you really think that we think that the Pentagon is going to inform the high representative of the Office of Disarmament Affairs within the UN about their secret biological programs in Ukraine?”

US Ambassador to the UN, Linda Thomas-Greenfield, summarized the absurdity of Russia’s claims, explaining “We hear Russia raise alarms that biological weapons will be delivered by birds and bats and now even mosquitoes. Birds and bats. Russia knows public health laboratories routinely study migratory animal species to assess and counter animal-borne pathogens. Bear in mind, much like Russia, birds and bats don’t tend to observe or respect sovereign borders. Russia’s assertions are absurd for many reasons, including because such species, even if they could be weaponized, would pose as much a threat to the European continent and to Ukraine itself as they would to any other country.”

Thomas-Greenfield also described the meeting as a “…colossal waste of time… an attempt to distract from the atrocities Russian forces are carrying out in Ukraine and a desperate tactic to justify an unjustifiable war.” She later added, “It doesn’t matter how many meetings Russia tries to call on this subject. And it doesn’t matter how hard it ratchets up its propaganda machine. We must not divert UN resources toward a baseless investigation. And we must not allow Russia’s tactics to distract us from its brutal war of aggression.”

Senate HELP Committee Minority Interim Report Released on SARS-CoV-2 Origins

This week, the Senate Health, Education, Labor and Pensions (HELP) Committee Minority oversight staff released their interim report-“An Analysis of the Origins of the COVID-19 Pandemic”. The report makes a number of claims, including “While it remains possible that SARS-CoV-2 emerged as a result of a natural zoonotic spillover, facts and evidence found in previous documented zoonotic spillover events have not, to date, been identified in relation to this pandemic,” “Substantial evidence suggests that the COVID-19 pandemic was the result of a research-related incident associated with a laboratory in Wuhan, China,” and “This investigation’s interim report concludes that SARS-CoV-2 and the resulting COVID-19 global pandemic was, more likely than not, the result of a research-related incident associated with coronavirus research in Wuhan, China.”

The 35-page report does not completely rule out a market origin and, importantly, it does not claim that SARS-CoV-2 was engineered as a bioweapon-a popular conspiracy theory. One interesting element it does focus on is that Chinese scientists began testing their COVID-19 vaccines in humans about a month before the United States did. The report implies this means the Chinese had some sort of advanced (pre-January 11, 2020) access to genomic sequencing, though it does still ask “What additional steps, processes, or novel techniques did AMMS [PLA Academy of Military Medical Sciences] researchers take that advanced the development of their vaccine faster than the Operation Warp Speed timeline?” The report states, “While mRNA vaccine candidates were able to design their vaccine construct in two days, because mRNA vaccines only need the coronavirus’ genetic sequence to make a vaccine and no virus has to be cultivated in labs, traditional vaccine platforms take longer.” It continues, highlighting that the first Operation Warp Speed (OWS) vaccine candidates to enter human clinical trials were non-mRNA vaccines-AstraZeneca-Oxford’s offering and Johnson & Johnson’s, both viral vector vaccines.

It then contrasts the 8 months it took for OWS viral vector candidates to human clinical trials with the 67 days it took one AMMS team to do the same, writing “Given Operation Warp Speed’s success, it is unusual that the two AMMS COVID-19 vaccine development teams were able to reach early milestones in vaccine development even more quickly. The Chen AMMS team beat AstraZeneca-Oxford to phase I clinical trials by 38 days. The Zhou AMMS team built and validated the effectiveness of its COVID-19 candidate vaccine 44 days after the sequence of SARS-CoV-2 was released. The extremely accelerated vaccines development timelines achieved by the AMMS teams pose the following two outstanding questions:”

  • “What additional steps, processes, or novel techniques did AMMS researchers take that advanced the development of their vaccine faster than the Operation Warp Speed timeline?”
  • “If no additional steps were taken to speed up the development timeline, when did researchers in China have access to the genomic sequence? Was it before January 11, 2020? If so, how far in advance of January 11, 2020?”

This argument does not address differences in the regulatory environments of the US and PRC. Rather, it seems to imply that this is evidence the Chinese had advance knowledge of this outbreak with no discussion of drug and therapeutic approval reforms in recent years that aim to improve the country’s ability to compete in pharmaceutical manufacturing globally and incentivizes development of vaccines and drugs for rare diseases. The CCP has identified competition in global biopharmaceutical manufacturing as a top priority, so the implication that the faster timeline to clinical trials supports the lab leak theory is unsatisfactory as presented.

It also does not appear to have even won over prominent supporters of the lab leak theory, including Dr. Richard Ebright, a molecular biologist at Rutgers University. The New York Times explains, “Dr. Ebright, who was interviewed by the report’s authors, said he supported the argument that evidence pointed to a laboratory origin. But the only new element, he said, appeared to be questions raised about how China could have developed a vaccine so quickly, which he did not find persuasive. Otherwise, he said, “there was no information in the report that has not been publicly presented in the media and discussed in the media previously.”

“This image depicted a test tube with viral transport media that contained a patient’s sample to be tested for the presence of SARS-CoV-2, the virus that causes COVID-19.” Source: CDC PHIL

Naturally, this interim report has been heavily criticized. The conclusion reached in this report obviously differs from the two peer-reviewed Science articles published earlier this year that found 1) the Huanan Seafood Wholesale Market was the epicenter of the initial outbreak and 2) that there were at least two distinct spillovers from animals sold at the market. Scientists supporting the market origin still have not identified which animals were infected or where they came from, as no animals were tested before the market was shut down early in 2020. Of this, the report states “Critical corroborating evidence of a natural zoonotic spillover is missing. While the absence of evidence is not itself evidence, the lack of corroborating evidence of a zoonotic spillover or spillovers, three years into the pandemic, is highly problematic.”

Dr. Michael Worobey, Department Head of Ecology and Evolutionary Biology at the University of Arizona and a co-author of both the Science articles, addressed the report with Science news, with the news team writing “Michael Worobey, an evolutionary biologist at the University of Arizona who has co-authored scientific reports examining data from the early days of the pandemic that provide some of the strongest support for a jump from animals to humans, speculates that the timing of the report’s release could be “a cynical effort to try to win Republican votes” in the upcoming midterm congressional and state elections.  Or, Worobey says, “it could just be a bunch of staffers with no ability to understand the science who stumbled across a bunch of misinformation and disinformation-filled tweets.” (“Senator Burr felt enough compelling, open-source information had been gathered during staff’s comprehensive review of the facts that an interim report was appropriate,” a senior aide to the minority staff told Science.)”

After the minority interim report was released, Senator Patty Murray, Chair of the Senate HELP Committee, issued a statement on “continuing bipartisan oversight efforts into the origins of the virus that causes COVID-19” that did not address the minority report. Sen. Murray stated “COVID-19 has caused so much pain, hardship, and loss for people in Washington state, across our country, and all across the globe. As I’ve said time and again, it is absolutely critical we learn the lessons from this pandemic so that we never find ourselves in a similar situation again—and that, of course, includes undertaking a full examination of how COVID-19 first emerged.”

“That’s why I made it a top priority as Chair to craft bipartisan legislation to strengthen our public health and pandemic preparedness systems with the PREVENT Pandemics Act—which, among so many other vital steps, would establish an independent task force to conduct a comprehensive review of COVID’s origins and the federal response to the pandemic. And it’s why, in 2021, I announced a bipartisan oversight effort with Senator Burr into the origins of this virus. The HELP Committee is continuing bipartisan work on this oversight report, and I remain committed to passing the PREVENT Pandemics Act, which advanced out of Committee with overwhelming bipartisan support.”

More on the Boston University Controversy

While the controversy surrounding experiments conducted on SARS-CoV-2 at Boston University has subsided some, attention has shifted to how such research is regulated. The New York Times explains the concerns, writing “But the uproar highlighted shortcomings in how the U.S. government regulates research on pathogens that pose a risk, however small, of setting off a pandemic. It revealed loopholes that allow experiments to go unnoticed, a lack of transparency about how the risk of experiments is judged and a seemingly haphazard pattern in the federal government’s oversight policy, known as the P3CO framework.” It also notes “Even as the government publicly reprimanded Boston University, it raised no red flags publicly about several other experiments it funded in which researchers manipulated coronaviruses in similar ways. One of them was carried out by the government’s own scientists.”

“Colorized scanning electron micrograph of a cell infected with a variant strain of SARS-CoV-2 virus particles (green), isolated from a patient sample.” Source: NIH Image Library

Nature explains the issue further, writing “At issue is whether — and when — researchers modifying SARS-CoV-2 or other deadly pathogens need to keep regulators and funding agencies such as the US National Institutes of Health (NIH) informed about their work, even if the agencies didn’t fund the experiments in question. Studies that make pathogens more transmissible or virulent are sometimes called ‘gain of function’ research.”

The issue now being discussed is if federal guidance is too vague in explaining what disclosures are required after a proposal is approved and research is progressing. Dr. Greg Koblentz told The New York Times “The government should be providing the guidance to help people figure this out,” and explained to Grid that “Pandemic prevention and lab safety rules “only move in fits and starts,” said biodefense professor Gregory Koblentz of George Mason University, pointing to the long list of past controversies. “And we only make progress where there is some crisis, or perceived crisis, that grabs people’s attention.”

Koblentz also commented on the confusion surrounding “gain of function”, telling Grid “‘Gain of function’ — we should retire that term, it really doesn’t help us in that debate,” said Koblentz. “It has become shorthand for a class of research that people are worried about because of the risks it poses, but it is a term that really has outlived its usefulness.” The term garnered attention during a number of political debates, including back-and-forths between Senator Rand Paul and Dr. Anthony Fauci.

Grid also noted that, though many experts disagree on the utility of the term “gain of function, “There’s one point all of the experts who spoke to Grid agreed on — the Boston University chimera experiments do point to a need for stronger federal government oversight of potentially dangerous bugs. The fact that we are still debating whether to review genetically altering known pandemic pathogens, not even potential ones, said Koblentz, “is an indictment of both the self-governance model that the virology community largely supports and the current policy.”

NCT Magazine

In this issue focused on 4th generation chemical weapons, several experts offer their perspective on existing and emerging issues. Drs. Stefano Costanzi and Gregory Koblentz authored a piece for this issue, “Controlling Novichok Nerve Agents After the Skripal and Navalny Incidents”. They cover the history of this family of nerve agents and international disarmament and nonproliferation attempts before discussing the Skripal and Navalny incidents as evidence that both the Chemical Weapons Convention and Australia Group Chemical Weapons Precursors list need to be revised to better address Novichok agents. They conclude “The ability of the CWC and AG to adapt to the new challenge posed by these fourth-generation nerve agents demonstrates the resilience of the chemical weapon nonproliferation regime. However, further measures need to be implemented to reduce the opportunities for proliferators to develop and use Novichok nerve agents. Embracing a family-based approach to listing chemicals of proliferation concern would strengthen the nonproliferation regime and the adoption of technologies such as cheminformatics can facilitate the transition to this new approach to containing the threat posed by chemical weapons.”

“Designation of Three Syrian Military Officials Due to Involvement in Gross Violations of Human Rights”

On the topic of chemical weapons, the US State Department recently designated multiple military officials from the Syrian regime, it declared in a press release this week. The statement reads in part, “Of the atrocities committed by the Assad regime, some of which rise to the level of war crimes and crimes against humanity, few are as inhumane and abhorrent as the repeated use of chemical weapons against civilians.  In August 2013, the Syrian Artillery and Missile Directorate of the Syrian Armed Forces launched rockets carrying the nerve agent sarin, a deadly chemical, on Ghouta, a suburb of Damascus, killing at least 1,400 people, many of them children.  Today, we are taking additional action to promote accountability.”

“The Department of State is designating three Syrian regime military officials involved in these airstrikes, pursuant to Section 7031(c) of the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2022.  Brigadier General Adnan Aboud Hilweh, Major General Ghassan Ahmed Ghannam, and Major General Jawdat Saleebi Mawas were involved in gross violations of human rights, namely the flagrant denial of the right to life of at least 1,400 people in Ghouta. As a result of today’s action, Hilweh, Ghannam, and Mawas as well as their immediate family members are ineligible for entry into the United States.”

“To Fix American’s Biodefense Strategy, Think Smaller”

From Breaking Defense: “It’s a natural reflex for the US government to try to develop strategies to deal with issues as broadly as possible, to handle a wide array of contingencies. But in the op-ed below, Al Mauroni of Air University’s Center for Strategic Deterrent Studies argues that the Biden administration’s biodefense strategy, expanding on past strategies, has grown too cumbersome and is in need of a cure of its own.”

ASPR TRACIE on Major Radiological or Nuclear Incidents

ASPR’s Healthcare Emergency Preparedness Information Gateway (TRACIE) recently released this updated document providing an “overview of health and medical response and recovery needs following a radiological or nuclear incident…” It also outlines resources for planners. Other relevant resources can also be found on the TRACIE CBRN page.

“Preventing and Preparing for Pandemics with Zoonotic Origins”

This piece from the Council on Foreign Relations discusses how factors that drive pathogen emergence and spread should influence decisions on investments in pandemic preparedness and response. It discusses priority pathogens, primary pandemic prevention, and secondary pandemic prevention and pandemic preparedness, concluding that “There is unprecedented support at the highest levels of government to enhance global pandemic prevention and preparedness. The recent decision to create a new fund for pandemics out of the World Bank and the ongoing negotiation for a pandemic agreement within the World Health Organization are potentially transformational. It is critical that comprehensive action be taken quickly through these efforts before the world’s collective attention moves on to the next crisis. Failure to do so means future generations will live less healthy and productive lives than we have today.”

“COVID-19 Genomic UK (COG-UK) Consortium: Final Report”

In this article from RAND Health Quarterly, Marjanovic et al. write in their abstract “The ability to sequence and understand different variants of the SARS-CoV-2 virus and their impact is crucial to inform policy and public health decisions. Soon after the UK went into its first lockdown in March 2020, the CCOVID-19 Genomics UK (COG-UK) Consortium was launched. COG-UK is a collaboration of experts in pathogen genomics including academic institutions, public health agencies, the Wellcome Sanger Institute, NHS Trusts and Lighthouse Labs. RAND Europe evaluated how COG-UK delivered against its objectives, for example how it contributed to advancing scientific knowledge about SARS-CoV-2, informing public health decisions, and providing information that can be used to evaluate the effectiveness of vaccines and treatments. The evaluation also examined the diverse factors that influenced COG-UK progress and impact, including enablers and challenges, and considered implications for the future.”

Coronavirus Vaccines R&D Roadmap

From CIDRAP: “CIDRAP, with support from the Bill & Melinda Gates Foundation and The Rockefeller Foundation, has led an international collaborative effort to develop a coronavirus vaccines research and development (R&D) roadmap (CVR). The CVR aims to serve a strategic planning tool to facilitate R&D, coordinate funding, and promote stakeholder engagement aimed at generating broadly protective coronavirus vaccines.”

“A key component of roadmap development is gathering feedback via a public comment period. The draft CVR is now available for a 4-week public comment period from October 24 – November 18, 2022. Feedback gathered during the public comment period will be used to refine the roadmap, resulting in a final roadmap made available in early 2023.”

“The draft CVR may be downloaded in PDF format. Comments should be submitted via this survey, which will be available through November 18, 2022. The survey offers the opportunity to share general and specific comments on the roadmap; the team welcomes as little or much feedback as you would like to provide.”

“The Future of Infodemic Surveillance as Public Health Surveillance”

In this recent piece from a supplement issue of Emerging Infectious Diseases, Chiou et al. write “Public health systems need to be able to detect and respond to infodemics (outbreaks of misinformation, disinformation, information overload, or information voids). Drawing from our experience at the US Centers for Disease Control and Prevention, the COVID-19 State of Vaccine Confidence Insight Reporting System has been created as one of the first public health infodemic surveillance systems. Key functions of infodemic surveillance systems include monitoring the information environment by person, place, and time; identifying infodemic events with digital analytics; conducting offline community-based assessments; and generating timely routine reports. Although specific considerations of several system attributes of infodemic surveillance system must be considered, infodemic surveillance systems share several similarities with traditional public health surveillance systems. Because both information and pathogens are spread more readily in an increasingly hyperconnected world, sustainable and routine systems must be created to ensure that timely interventions can be deployed for both epidemic and infodemic response.”

COVID Taking the Fun Out of Fungi?

The WHO recently released its first fungal priority pathogens list (FPPL)- “the first global effort to systematically prioritize fungal pathogens, considering their unmet research and development (R&D) needs and perceived public health importance.” The WHO explains that “The WHO FPPL aims to focus and drive further research and policy interventions to strengthen the global response to fungal infections and antifungal resistance. The WHO FPPL list is divided into three categories: critical, high and medium priority. The report presents these categories and proposes actions and strategies for policymakers, public health professionals and other stakeholders; targeted at improving the overall response to these priority fungal pathogens including preventing the development of antimicrobial resistance. Three primary areas for action are proposed, focusing on: (1) strengthening laboratory capacity and surveillance; (2) sustainable investments in research, development, and innovation; and (3) public health interventions.”

This comes amid a spike in certain fungal diseases during the COVID-19 pandemic. Additionally, the report found that “Currently, fungal infections receive less than 1.5% of all infectious disease research funding,” and that “most treatment guidelines are informed by limited evidence and expert opinion.”

Opinion: “To Fight Misinformation, We Need to Teach That Science Is Dynamic”

In this piece for Scientific American, Dr. Carl Bergstrom, Daniel Pimentel, and Dr. Jonathan Osborne discuss public ignorance of the scientific community, identifying ways this can be rectified. They write, “It’s easy to see why so many of us struggle to distinguish trustworthy science from what is flawed, speculative or fundamentally wrong. When we don’t learn the nature of consensus, how science tends to be self-correcting and how community as well as individual incentives bring to light discrepancies in theory and data, we are vulnerable to false beliefs and antiscience propaganda. Indeed, misinformation is now a pervasive threat to national and international security and well-being.”

They discuss the need to develop a population of competent outsiders, explaining “Giving people more facts is insufficient. Instead, we need a populace that can tell which sources of information are likely to be reliable, even if the science itself is beyond what they learned in school, so that they can identify when they need scientific information to make decisions in their own lives. Just as critically, people must understand enough about how science attempts to minimize error. In other words, every member of our society needs to be what science education researcher Noah Feinstein calls a “competent outsider.”

What We’re Listening To 🎧

This Week in Virology 948: Breathless with David Quammen

“David Quammen returns to TWiV to discuss how he wrote his new book ‘Breathless’, a story about the science and the scientists behind the race to understand the pandemic coronavirus SARS-CoV-2.” Listen here.

Conversations Before Midnight

The Bulletin of the Atomic Scientists is hosting its Bulletin Annual Gathering on November 9, 2022, at 5 pm CDT virtually. This is the Bulletin’s “signature event” and it aims to allow guests to engage in high-level conversations with influential voices tracking man-made threats. At the event, “Each virtual table has an expert, established and up-and-coming specialists in the fields of nuclear risk, climate change, disruptive technologies, and biosecurity. These discussion leaders include members of the Bulletin’s Science and Security Board, Board of Sponsors, and invited experts from around the world. Below are a few samples for this year’s gathering.”‘ Table experts include our own Dr. Greg Koblentz, so be sure to check out this event’s info page here.

Briefings in Preparation for the Ninth BWC Review Conference

From UNIDR: “The 1972 Biological Weapons Convention (BWC) is a cornerstone in the regime to prevent the hostile use of biology. The Ninth BWC Review Conference will take place in late November 2022 and presents an important opportunity to take stock of the past and chart a course for the future of this increasingly important agreement. In support of preparations for the Ninth BWC Review Conference and beyond, UNIDIR has recently published several reports intended to stimulate thinking on substantive issues related to the BWC.”

“This virtual event will bring together the authors of the latest UNIDIR publications on BWC topics to provide short outlines of the key insights and ideas in their respective reports for State Parties to consider ahead of the Review Conference. These include verification, advances in science and technology, international cooperation, and potential outcomes of the Review Conference. The presentations will be followed by a moderated interactive discussion with the participants.” This event will take place on November 7 at 2 pm CET, online. Learn more and register here.

Infection Prevention and Control: Incorporating Lessons Learned in Managing Special Pathogens

“After nearly three years responding to the COVID-19 pandemic, hospitals and other healthcare facilities have learned many lessons about the management of special pathogens and essential infection prevention and control practices. The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the National Emerging Special Pathogens Training and Education Center (NETEC) invite you to learn more about some of those lessons. Speakers will share their perspectives on how our approach to outbreaks has changed since the pandemic began. They will address issues such as infection prevention for healthcare workers and patients and mitigating disease spread. Speakers will also highlight newly developed tools and resources. This webinar will take place November 7 at 2:00 pm ET. Register today!”

From One Health Commission-World Bank Open Call

“Open Call for Experts to serve on the Technical Advisory Panel to the Governing Board of the Pandemic Prevention, Preparedness and Response Financial Intermediary Fund (“PPR FIF”)”- November 3 Deadline

“World Bank has posted a call for experts to serve on the Technical Advisory Panel (TAP) to the Governing Board of the Pandemic Prevention, Preparedness and Response Financial Intermediary Fund (“PPR FIF”).”

“The TAP will comprise a multidisciplinary pool of up to 20 experts, bringing a diverse range of independent technical and financial expertise relevant to PPR FIF-supported projects and activities. To register your interest in being considered for the PPR FIF TAP, please submit documents to ppr_fif_secretariat@worldbank.org using the subject line “Expression of interest for the PPR FIF TAP”

Speaking of One Health…November 3 is One Health Day

Mark your calendars for this year’s One Health Day on November 3. One Health Day is an international campaign that was launched in 2016. The One Health Commission explains that “The goal of One Health Day is to bring attention around the world to the need for One Health interactions and for the world to ‘see them in action’. The One Health Day campaign is designed to engage as many individuals as possible from as many arenas as possible in One Health education and awareness events, and to generate an inspiring array of projects worldwide.” If you are hosting an event on this day, you can register your event here with the Commission. A list of registered One Health Day events for 2022 is also available here.

Pandora Report: 10.21.2022

It’s Friday again and this time we are kicking it off with some great news from our program. We then discuss the Biden administration’s new National Biodefense Strategy and the Boston University preprint controversy. As always, we finish the week out with new publications and upcoming events, including an entire issue supplement of Clinical Infectious Diseases dedicated to anthrax. Finally, mark your calendars, because November 3 is One Health Day (more on that in the announcements section).

First, Some Good News from the Biodefense Program!

Biodefense Faculty Member Joins Council on Strategic Risks and Wins Schar School of Policy and Government Distinguished Alumni Award…All in One Week!

This week, Dr. Saskia Popescu, an epidemiologist, prominent infection prevention consultant, an assistant professor at the Schar School, and more (No, seriously, she does all that AND more.) was named a Senior Fellow at the Janne E. Nolan Center on Strategic Weapons at the Council on Strategic Risks. In case that somehow was not enough for one week, she is also being honored today as this year’s Schar School of Policy and Government Distinguished Alumni Award winner. Read all about Dr. Popescu’s hero origin story here on the Schar School site.

Biodefense PhD Student Named Bulletin of the Atomic Scientists Editorial Fellow

Kimberly Ma, a first year Biodefense PhD student and senior analyst with the Preparedness division at the Association of State and Territorial Health Officials, was recently named an Editorial Fellow at the Bulletin of the Atomic Scientists. Over the next year, she will author a number of pieces on biosecurity for the Bulletin, so keep an eye out for her upcoming work!

The Biden Administration Releases New National Biodefense Strategy

This week, the White House announced the release of the new National Biodefense Strategy and President Biden’s intent to sign National Security Memorandum 15-“Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security”. The strategy takes a comprehensive approach, aiming to make improvements in these areas-“detect pandemic and other biological threats, “prevent outbreaks from becoming epidemics and prevent biological incidents before they can happen,” “prepare for pandemics and other biological incidents,” “rapidly respond to outbreaks when they occur,” and “recover from a pandemic or biological incident.”

Among other points about the strategy, the Nuclear Threat Initiative explains that “The new strategy’s requirement that the National Security Council and the Office of Science and Technology Policy conduct an interagency policy review regarding biosafety and biosecurity norms and oversight for life sciences research also is valuable. As the largest funder of bioscience and biotechnology research and development in the world, the U.S. Government has a responsibility to put guardrails in place to prevent laboratory accidents or deliberate misuse of the tools of modern bioscience and biotechnology. Doing so can have a profound direct impact in reducing global biological risks and serve as a valuable example for other funders around the world.”

National Security Memorandum 15, “National Security Memorandum on Countering Biological Threats, Enhancing Pandemic Preparedness, and Achieving Global Health Security,” directs the heads of agencies addressed to:

  1. “implement the Biodefense Strategy, as well as related strategies such as the U.S. Global Health Security Strategy, and include biodefense-related activities, including resourcing and achieving the goals of the Biodefense Strategy and the priorities, targets, and actions of its Implementation Plan, within their strategic planning and budgetary processes;
  2. in the event of the determination of a nationally or internationally significant biological incident, implement Federal response efforts in accordance with Homeland Security Presidential Directive 5 of February 28, 2003 (Management of Domestic Incidents), Presidential Policy Directive 8 of March 30, 2011 (National Preparedness), Presidential Policy Directive 44 of November 7, 2016 (Enhancing Domestic Incident Response), and Federal Government response and recovery frameworks and operational plans;
  3. coordinate their biodefense policies with other agencies that have responsibilities or capabilities pertaining to biodefense, as well as with appropriate non-Federal entities;
  4. share information and coordinate decision-making related to the biodefense enterprise; and
  5. monitor, evaluate, and hold their respective agencies accountable for the implementation of section 3(a) of this memorandum.”

The memorandum also states that “To facilitate effective implementation of the Biodefense Strategy, within 90 days of the date of this memorandum and at least quarterly thereafter, the NSC staff Directorate for Global Health Security and Biodefense shall convene lead agencies identified in the Biodefense Strategy’s Implementation Plan at the Assistant Secretary level.  These agencies shall brief the NSC staff on progress towards key milestones and timelines, as well as on critical gaps and barriers to progress.  The NSC staff Directorate for Global Health Security and Biodefense shall provide updates quarterly to the APNSA based off of these briefs, summarizing progress towards the implementation of the Biodefense Strategy by highlighting the extent to which the goals and objectives are being met, outlining major gaps and impediments to timely and effective implementation, and presenting options for overcoming these gaps.  The APNSA shall provide to the President, on an annual basis, a memorandum summarizing these updates.”

Transcripts of the background call on this new strategy are available here, and check out the Council on Strategic Risks discussion of the strategy here.

Boston University Controversy

Last week, researchers from Boston University’s (BU) National Emerging Infectious Diseases Laboratories (NEIDL) posted results from their controversial work on BA.1 variant spike proteins in preprint. As Science explains, “They took the gene for Omicron’s surface protein, or spike protein, which SARS-CoV-2 uses to enter cells and added it to the genome of a “backbone” virus—a variant of SARS-CoV-2 from Washington state that was identified soon after the pandemic first emerged in Wuhan, China, in early 2020. The objective was to tease apart whether Omicron’s spike protein explains why it is less pathogenic (meaning it causes less severe disease). The answer could lead to improved COVID-19 diagnostic tests and better ways to manage the disease, the preprint authors say.”

“This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19).”; Source: CDC PHIL

By Monday, a UK tabloid, Daily Mail, ran with the story, indicating in their headline that the lab had created a strain of SARS-CoV-2 with an “80 percent kill rate,” and had created a much more dangerous strain of the virus. While the Daily Mail piece is very clearly from a tabloid, this did spark debate online, as this preprint describes what some argue is gain of function research. This work was not approved by the National Institutes of Health, though it was approved by the institutional biosafety committee at NEIDL. Critics argue that this study lacks scientific value and that its potential risks were not properly reviewed before it was conducted. Some, including Francois Balloux, a virologist at University College London, expressed concern over the study’s relevance to human health, noting that findings in mice frequently do not carry over to humans. Others, however, are far less alarmed, generally arguing that the hybrid virus is far less lethal than the original, pointing to the extreme sensitivity of the mice used in the study, and highlighting that similar SARS-CoV-2 variants have already emerged before later fading away.

The university responded to accusations made in the Daily Mail, stating “We want to address the false and inaccurate reporting about Boston University COVID-19 research, which appeared today in the Daily Mail,” said the BU statement. “First, this research is not gain-of-function research, meaning it did not amplify the Washington state SARS-CoV-2 virus strain or make it more dangerous. In fact, this research made the virus replicate less dangerous.” BU also explained that “The animal model that was used was a particular type of mouse that is highly susceptible, and 80 to 100 percent of the infected mice succumb to disease from the original strain, the so-called Washington strain,” says Corley. “Whereas Omicron causes a very mild disease in these animals.” On the topic of funding, BU said the lab “…did not amplify the [backbone] SARS-CoV-2 virus strain or make it more dangerous. In fact, this research made the virus replicate less dangerous,” as reason for not reporting the study to NIH. They also stated this work did not need to be cleared by NIH as it was not directly funded by the agency as the lab used NIAID grants only to pay for tools and platforms.

Science reports that “Emily Erbelding, director of the NIAID division that helped fund the work, said the hybrid virus experiments weren’t described in BU’s grant proposal or progress reports. But she said if BU had informed NIAID about its plans, the institute probably would have evaluated it to determine whether it qualified for review by a special Department of Health and Human Services (HHS) committee.”

NIH also released a statement this week: “The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, did not review nor issue awards for experiments described in a pre-print article on SARS-CoV-2 research at Boston University’s National Emerging Infectious Diseases Laboratories (NEIDL). NIH is examining the matter to determine whether the research conducted was subject to the NIH Grants Policy Statement or met the criteria for review under the HHS Framework for Guiding Funding Decisions about Proposed Research Involving Enhanced Potential Pandemic Pathogens (HHS P3CO framework)…”

While the debate is sure to keep raging, it is also likely to add fuel to the ongoing review of federal oversight policies for GoF research led by the National Science Advisory Board for Biosecurity (NSABB). According to Science, “In September, an NSABB task force issued a draft report that recommended the review policy be expanded to sweep in some kinds of research, and some pathogens, that are now exempt. And experts on all sides of the GOF debate have said the criteria for review need to be clearer. The government is expected to release new rules as early as next year. (For more, see this week’s feature in Science.)”

However, as Science has also previously written, “A U.S. clampdown will have no sway over privately funded GOF research or what happens in other countries, which typically lack policies like the P3CO framework. In Japan and most of Europe, for example, oversight is limited to rules on biosafety and, sometimes, biosecurity along with voluntary self-regulation, say biosecurity experts Gregory Koblentz of George Mason University and Filippa Lentzos of King’s College London. It’s too soon to say how a 2020 Chinese biosafety law will affect PPP research, they say.”

“National Security Snapshot: Department of Defense and Intelligence Community Preparedness for Biological Threats”

The Government Accountability Office (GAO) recently released this National Security Snapshot co-authored by Dr. Brian Mazanec, an alumnus of the Biodefense PhD program. This snapshot discusses core issues like biopreparedness and the PRC’s intent to exploit US genetic data. The authors write, “We made several key recommendations to improve how DOD and the Intelligence Community prepare for and respond to biological threats. DOD is taking a number of positive steps, such as coordinating with partners to research and develop vaccines. But, DOD doesn’t have a comprehensive strategy that, for example, shows where biodefense resources are needed.”

“Public Health Preparedness: HHS Should Address Strategic National Stockpile Requirements and Inventory Risks”

GAO also recently released this report discussing the Department of Health and Human Services’ inventory planning reports and their failure to “meet most legal requirements enacted in 2019 or communicate risks associated with not meeting recommended inventory levels. This is partly because HHS hasn’t updated its processes for completing the reports and a key advisory body was inactive.” This report makes a number of recommendations while also noting that HHS’s leadership and coordination of public health emergencies is on the office’s high risk list.

“COVID-19: A Warning – Addressing Environmental Threats and the Risk of Future Pandemics in Asia and the Pacific”

From the UN Environment Programme: “This scientific review begins with the history of humans and zoonoses and provides clarity on the issues of zoonoses and emerging infectious diseases. It then presents the seven anthropogenic drivers of zoonotic disease emergence as well as the concept of viral mixing. After providing rich context, this review continues to outline solutions that address the intricate link between nature and human health and strategies to prevent future zoonotic outbreaks.”

“”It was Compromised”: The Trump Administration’s Unprecedented Campaign to Control CDC and Politicize Public Health During the Coronavirus Crisis”

The House Select Subcommittee on the Coronavirus Crisis recently released its third installment of staff reports detailing the Trump administration’s response to the COVID-19 pandemic. In the report, the committee explains its findings from its investigation into the Trump administration’s “rampant political interference with the federal public health response to the coronavirus pandemic.” Chairman Clyburn released this statement about the report: “The Select Subcommittee’s investigation has shown that the previous administration engaged in an unprecedented campaign of political interference in the federal government’s pandemic response, which undermined public health to benefit the former president’s political goals. As today’s report shows, President Trump and his top aides repeatedly attacked CDC scientists, compromised the agency’s public health guidance, and suppressed scientific reports in an effort to downplay the seriousness of the coronavirus. This prioritization of politics, contempt for science, and refusal to follow the advice of public health experts harmed the nation’s ability to respond effectively to the coronavirus crisis and put Americans at risk. As we continue to recover from the coronavirus crisis, we must also continue to work to safeguard scientific integrity and restore the American people’s trust in our public health institutions.”

Clinical Infectious Diseases “Issue Supplement 3, Anthrax Preparedness”

This issue supplement of Clinical Infectious Diseases is all about anthrax, including articles ranging from “Responding to the Threat Posed by Anthrax: Updated Evidence to Improve Preparedness” to “Risk Factors for Severe Cutaneous Anthrax in a Retrospective Case Series and Use of a Clinical Algorithm to Identify Likely Meningitis and Evaluate Treatment Outcomes, Kyrgyz Republic, 2005-2012”. So, if it has been a while since you were deeply concerned about anthrax, this issue is for you!

“How SARS-CoV-2 Battles Our Immune System”

If you like medical illustrations and interactive timelines, this one is for you. This new story available from Science walks readers visually through SARS-CoV-2’s interaction with the human immune system, offering detailed yet easily understood, general explanations along the way. Readers can even learn about the virus’s different proteins and their specific effects on the immune system.

What We’re Listening To 🎧

This Podcast Will Kill You: Episode 107: Sepsis: It’s a Mess

“Over the years of the podcast, we have often struggled with questions of why: why pathogens act the way they do, why certain people get sick while others don’t, or why we know little about some diseases. This episode is no exception – sepsis certainly inspires many “whys”. But for perhaps the first time on the pod, we find ourselves grappling not only with “why?” but also with “what?”. What, indeed, is sepsis? Ask a dozen doctors and you may get a dozen different answers. Our first goal for this episode is to sift through the various definitions of sepsis and what we know about its pathology to get a firm handle on this deadly consequence of infection. We then turn our sights to a thrilling period of sepsis history – Joseph Lister and his carbolic acid spray – before attempting to address the status of sepsis around the world today. By the end of the episode, your picture of sepsis may not be crystal clear, but hopefully the edges are a little less blurry.” Listen here on Spotify or wherever you listen to podcasts!

Project Responder 6: Evolving Response Environment Webinar

From DHS: “You’re invited to join the Department of Homeland Security (DHS) Science & Technology Directorate (S&T) for a briefing on the Project Responder 6 report, designed to document emergency response capability needs across significant changes in the operating environment. The innovative approach this data collection effort—now in its sixth generation—takes is to bring together S&T’s First Responder Resource Group (FRRG), which includes responders from traditional (fire service, law enforcement, emergency medical services, emergency management) and non-traditional (public health, public works, medical examiner/coroner, search and rescue) response agencies, to focus on identifying and validating needs across disciplines.” Learn more and register here. Download the report here. This event will take place on October 24, at 11 am ET.

Addressing Health Inequities by Strengthening Antibiotic Stewardship

From NCEZID: “Please join The National Center for Emerging and Zoonotic Infectious Disease (NCEZID) on Tuesday, October 25, 2022, at 10 a.m. EDT for the next AMR Exchange webinar on addressing health inequities by strengthening antibiotic stewardship entitled Addressing health inequities by strengthening antibiotic stewardship. The discussion will feature experts from CDC, The Pew Charitable Trusts, the Federal Office of Rural Health Policy, and Emory University School of Medicine who work to strengthen antibiotic use and prescribing and improve the quality of health care across the United States. Please register here.”

South Korea as a Global Vaccine Hub

The Korea Economic Institute of America is hosting this event October 27, at 3 pm EST virtually: “Early in the pandemic, South Korea drew widespread praise for the speed and efficiency of its response to slowing the spread of the virus and saving lives. However, despite this initial success, South Korea faced vaccine nationalism and other access challenges in its effort to secure Covid-19 vaccines. Spurred by these challenges, South Korea established a national strategic policy to become a global vaccine hub, not only to meet the current and future public health needs of its own population but also to assist low- and middle-income countries (LMICs) facing even starker obstacles in accessing safe and effective vaccines.”

“Please join KEI for a discussion with the Thomas Byrne, Claire Callahan, Irene Kyoung, and Salomé Da Silva Duarte Lepez about how global vaccine access and equity was hindered by the shortcomings of national and bilateral vaccine diplomacy and multilateral mechanisms during the Covid-19 pandemic, and how South Korea’s demonstrated capabilities to rise as global vaccine development, manufacturing and training hub will help bolster global public health capacities in the future.” Register here.

The Case for the Use of “Red Lines” in the Governance of Life Sciences Research with David Relman

From CISAC: “The nature of evolving risks in life sciences research, a brief history of risk governance, and the case for the use of so-called “red lines” in the governance of life sciences research will be presented. The goals of this presentation are to elicit discussion about the benefits and pitfalls of red lines, or guardrails, in general, including a historical perspective, and options for public policy recommendations to address concerns about the present and future risks arising from life sciences research.” This event will take place on October 27, at 3:30 pm PT. Register here.

Infection Prevention and Control: Incorporating Lessons Learned in Managing Special Pathogens

“After nearly three years responding to the COVID-19 pandemic, hospitals and other healthcare facilities have learned many lessons about the management of special pathogens and essential infection prevention and control practices. The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the National Emerging Special Pathogens Training and Education Center (NETEC) invite you to learn more about some of those lessons. Speakers will share their perspectives on how our approach to outbreaks has changed since the pandemic began. They will address issues such as infection prevention for healthcare workers and patients and mitigating disease spread. Speakers will also highlight newly developed tools and resources. This webinar will take place November 7 at 2:00 pm ET. Register today!”

ICYMI: IARPA, Gingko Bioworks and Draper Announce New Technologies to Detect Engineered DNA

This week, Gingko Bioworks, Draper, and IARPA held an event to announce the completion of IARPA’s Finding Engineering-Linked Indicators (FELIX), a program aimed at improving existing biodetection and surveillance capabilities. “The event featured a panel with Catherine Marsh, IARPA Director; David A. Markowitz, IARPA Program Manager; Joshua Dunn, Head of Design, Ginkgo Bioworks; Laura Seaman, Principal Scientist and Machine Intelligence Group Leader, at Draper; and Erin Rosenberger, Senior Member of Technical Staff, Biological Microsystems Group, at Draper. During the panel, the panelists discussed the program findings and also featured a demo of the research results.” A recording of the livestream is available here.

November 3 is One Health Day

Mark your calendars for this year’s One Health Day on November 3. One Health Day is an international campaign that was launched in 2016. The One Health Commission explains that “The goal of One Health Day is to bring attention around the world to the need for One Health interactions and for the world to ‘see them in action’. The One Health Day campaign is designed to engage as many individuals as possible from as many arenas as possible in One Health education and awareness events, and to generate an inspiring array of projects worldwide.” If you are hosting an event on this day, you can register your event here with the Commission. A list of registered One Health Day events for 2022 is also available here.

Pandora Report: 10.14.2022

Happy Friday! This week we discuss the release of the Biden administration’s National Security Strategy and new findings about the prevalence and challenges of long COVID. We also cover a number of new publications, a German podcast episode on the 1979 anthrax outbreak in Sverdlovsk (featuring our own Dr. Sonia Ben Ouagrham-Gormley!), and upcoming events.

Biden Administration Releases National Security Strategy

The Biden administration released its National Security Strategy (NSS)this week, building on the 2021 Interim NSS. This iteration of the NSS re-incorporates climate change as a national security threat, continues to define the threats China and Russia pose to the US, and includes “Triad” with a capital “T” to make sure there’s plenty of discussion about the document here in the Beltway. As the NSS has in the past, this version includes a section dedicated to pandemics and biological threats, which estarts by explaining that “COVID-19 has killed nearly 6.5 million people around the world, including more than 1 million Americans, but the next pandemic could be much worse—as contagious but more lethal. We have a narrow window of opportunity to take steps nationally and internationally to prepare for the next pandemic and to strengthen our biodefense.”

This section also discusses the notion that “no one is safe until everyone is safe,” and acknowledges that “some of our international institutions have fallen short in the past and need to be reformed.” It concludes with a paragraph discussing the need to address risks posed by deliberate and accidental biological risks “including through our ability to rapidly detect, identify, and attribute agents, and to develop medical countermeasures,” by working to strengthen the BWC, prevent terrorist acquisition of BW, and reinforcing “norms against biological weapons’ development and use.”

This comes on the heels of statements released this week by the US State Department and German Federal Foreign Office on the need to better cooperate to reduce biological threats globally. Both statements discuss the multi-faceted nature of these problems, including challenges created by mis- and disinformation and the need for increased global cooperation in the face of these threats, again highlighting the increasing importance of these issues.

Long COVID Gaining Recognition…Finally

This week, Hastie et al.’s article in Nature Communications discussing long COVID made waves in the media and online. The authors conducted a study in a Scottish cohort consisting of 33,281 laboratory-confirmed SARS-CoV-2 infections and 62,957 never-infected individuals. Participants were issued questionnaires at 6, 12, and 18 months. The authors found that “Of the 31,486 symptomatic infections,1,856 (6%) had not recovered and 13,350 (42%) only partially.” They also found that “Asymptomatic infection was not associated with adverse outcomes. Vaccination was associated with reduced risk of seven symptoms.” Notably, participants with previous symptomatic COVID-19 infections reported long-lasting symptoms like breathlessness, heart palpitations, difficulty focusing, and confusion at rates more than double that of those who were not previously infected. They also reported other related symptoms, like muscle aches and other heart problems.

There were some challenges in the study, however. For example, approximately 90% of participants were white, which is not helpful in trying to better understand risks and burdens of long COVID in other groups. Furthermore, only 4% were vaccinated (most with just one dose) before they were infected. However, this study does more concretely demonstrate the breadth of this problem and what it could mean for future pandemics.

A German study was also published this week in BMJ that found a “considerable burden of long-COVID symptoms, especially fatigue and neurocognitive impairment (“brain fog”), at 6 to 12 months—even among young and middle-aged adults who had mild infections,” according to CIDRAP. This study found that women were at higher risk for developing long COVID and “The researchers said the study revealed long-COVID symptom clusters with individually and societally relevant implications that also affected younger adults with mild initial infections. “Given the individual and societal burden of post-covid sequelae, the underlying biological abnormalities and causes need urgent clarification to define adequate treatment options and develop effective rehabilitation measures,” they concluded.”

Other studies have also linked long COVID to conditions like postural tachycardia syndrome (POTS). In the case of POTS, 41% of people diagnosed with the syndrome already reported a viral infection preceding the onset of POTS symptoms pre-pandemic. Because of this connection, the UK’s National Institute for Health and Care Excellence now even recommends testing for POTS in patients with long COVID. These studies build on mountains of anecdotal evidence from patients and providers alike, demonstrating that long COVID is a very real and serious danger that has already impacted many of us.

The WHO Director General, Dr. Tedros Adhanom Ghebreyesus, recently authored a piece in The Guardian discussing long COVID, what WHO is doing about it, and what countries around the world should do to support those suffering with it. He explains, “Mostly data is only available from high-income countries, which means that we don’t currently have a clear picture on how many people are actually suffering. Current estimates suggest that tens of millions, and perhaps more, have contracted long Covid, and about 15% of those diagnosed with the condition have experienced symptoms for at least 12 months.”

He also discussed the shift in investment strategies this requires of countries, writing “Early in the pandemic, it was important for overwhelmed health systems to focus all of their life-saving efforts on patients presenting with acute infection. However, it is critical for governments to invest long-term in their health system and workers and make a plan now for dealing with long Covid. This plan should encompass, providing immediate access to antivirals to patients at high risk of serious disease, investing in research and sharing new tools and knowledge as they’re identified to prevent, detect and treat patients more effectively. It also means supporting patients physical and mental health as well as providing financial support for those who are unable to work.”

WHO/Europe also issued a factsheet discussing the need for rehabilitation, recognition, and research focused on lingering COVID symptoms that is available here.

WHO Europe Factsheet Discussing Long COVID, Source: https://www.who.int/europe/news/item/10-10-2022-rehabilitation–recognition-and-research-needed-for-people-living-with-long-covid–new-who-europe-factsheet

“COVID Prompts Global Surge in Labs That Handle Dangerous Pathogens”

Smriti Mallapaty’s recent article in Nature News discusses the growing number of BSL-3 and 4 certified facilitates globally and rising concerns about the costs and risks they present. This article covers new facilities across Asia as well as Russia’s promise that it will build 15 new BSL-4 facilities. Mallapaty also quoted GMU’s Dr. Greg Koblentz in the article, writing “Since the COVID-19 pandemic began, plans to build 27 BSL-4 labs have been announced worldwide, say Gregory Koblenz, a biodefence researcher at George Mason University in Arlington, Virginia, and Filippa Lentzos, a biosecurity researcher at King’s College London, who have tracked the number and distribution of BSL-4 facilities globally. “These will likely take several years to design, build and commission,” says Lentzos.”

“Pandemic Origins and a One Health Approach to Preparedness and Prevention: Solutions Based on SARS-CoV-2 and Other RNA Viruses”

In this recent Proceedings of the National Academy of Sciences article, Keusch et al. discuss the importance of One Health in improving and integrating biosafety and biosecurity. Their abstract explains “COVID-19 is the latest zoonotic RNA virus epidemic of concern. Learning how it began and spread will help to determine how to reduce the risk of future events. We review major RNA virus outbreaks since 1967 to identify common features and opportunities to prevent emergence, including ancestral viral origins in birds, bats, and other mammals; animal reservoirs and intermediate hosts; and pathways for zoonotic spillover and community spread, leading to local, regional, or international outbreaks. The increasing scientific evidence concerning the origins of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is most consistent with a zoonotic origin and a spillover pathway from wildlife to people via wildlife farming and the wildlife trade. We apply what we know about these outbreaks to identify relevant, feasible, and implementable interventions. We identify three primary targets for pandemic prevention and preparedness: first, smart surveillance coupled with epidemiological risk assessment across wildlife–livestock–human (One Health) spillover interfaces; second, research to enhance pandemic preparedness and expedite development of vaccines and therapeutics; and third, strategies to reduce underlying drivers of spillover risk and spread and reduce the influence of misinformation. For all three, continued efforts to improve and integrate biosafety and biosecurity with the implementation of a One Health approach are essential. We discuss new models to address the challenges of creating an inclusive and effective governance structure, with the necessary stable funding for cross-disciplinary collaborative research. Finally, we offer recommendations for feasible actions to close the knowledge gaps across the One Health continuum and improve preparedness and response in the future.”

Science published a news article discussing this paper, writing “‘Our paper recognizes that there are different possible origins, but the evidence towards zoonosis is overwhelming,” says co-author Danielle Anderson, a virologist at the University of Melbourne. The report, which includes an analysis that found the peer-reviewed literature overwhelmingly supports the zoonotic hypotheses, appeared in the Proceedings of the National Academy of Sciences (PNAS) on 10 October.”

The article continued with “The panel’s own history reflects the intensity of the debate. Originally convened as a task force of the Lancet COVID-19 Commission, a wide-reaching effort to derive lessons from the pandemic, it was disbanded by Columbia University economist Jeffrey Sachs, the commission’s chair. Sachs alleged that several members had conflicts of interest that would bias them against the lab-origin hypothesis.”

“WHO’s Response to COVID-19 – 2022 Mid-Year Report”

“This mid-year report provides a consolidated update on WHO’s response to the COVID‐19 pandemic between January and July 2022, against the objectives laid out in the Strategic Preparedness and Response Plans (SPRP) for 2021 and 2022.”

“With the aim of ending the acute phase of the pandemic by the end of the year, WHO, in collaboration with partners, has supported countries to further strengthen their surveillance systems; ensure more equitable access to tests, treatments, and essential supplies worldwide; make health systems more resilient; and reduce exposure to the disease by empowering and enabling communities.”

“The report highlights the role of WHO at the global, regional, and local levels, and across the key elements of an effective emergency response – from implementation and operational support, to developing evidence and research, and providing strong coordination and planning. By working with partners, including multi-agency and multi-partner operational platforms, regional and national public health and scientific institutes, governments, communities, donors, UN organizations and NGOs and the private sector, WHO helped bring the world together to provide direct technical and operational support to countries implementing their national COVID-19 response plans.”

“Epidemics That Didn’t Happen”

On a much more cheerful note, check out Prevent Epidemics’ online feature, “Epidemics That Didn’t Happen”. This page explores six epidemics that were prevented thanks to solid cooperation and good public health responses, including averted epidemics of Ebola, Nipah, cholera, rabies, influenza, and dengue. As the page notes, these cases present common themes, including “Speed is essential,” “Well-coordinated action at the local level is crucial to preventing epidemics,” “Community engagement pays off,” and “Health care workers need to be trained, supported, and provided with access to resources and assistance to stop epidemics.”

“Russia’s Alleged Bioweapons Claims Have Few Supporters”

Jez Littlewood and Dr. Filippa Lentzos recently published this piece in this Bulletin of the Atomic Scientists discussing the outcome of September’s Article V Formal Consultative Meeting requested by Russia. They write “For the fourth time this year, Russia accused the United States and Ukraine of being in non-compliance with the Biological and Toxins Weapons Convention (BTWC)—and once again found little support for its allegations. At the conclusion of the Article V Formal Consultative Meeting in September, no other state formally accused these two nations of non-compliance. Russia stands alone in its allegations, with limited support from eight other states. In contrast, more than five times as many backed the United States and Ukraine in rejecting the allegations; the meeting ended with a procedural report that noted no consensus regarding the outcome.”

“Addressing Inaccurate and Misleading Information About Biological Threats Through Scientific Collaboration and Communication in Southeast Asia”

From the National Academies: “Misinformation about outbreaks, epidemics, and pandemics is a decades-old problem that has been exacerbated by the rise of the internet and the widespread use of social media. Some false claims may be addressed through sound scientific analysis, suggesting that scientists can help counter misinformation by providing evidence-based, scientifically defensible information that may discredit or refute these claims. This report explains how scientists can work collaboratively across scientific disciplines and sectors to identify and address inaccuracies that could fuel mis- and disinformation. Although the study focused on a scientific network primarily in Southeast Asia, it is relevant to scientists in other parts of the world. A companion “how-to-guide”, available in print and in digital form, outlines practical steps that scientists can take to assess mis- or disinformation, determine whether and how they should address it, and effectively communicate the corrective information they develop.”

“Counterfeit PPE: Substandard Respirators and Their Entry Into Supply Chains in Major Cities”

This recent article from Urban Crime was co-authored by the Schar School’s Dr. Louise Shelley and discusses challenges in ensuring legitimate PPE is available and what this means for definitions of threats to human life. The abstract reads “Over 58 million counterfeit respirators of substandard quality unable to protect individuals from infection have been seized globally since the start of the COVID-19 pandemic. These seizures have primarily occurred in urban warehouses and ports around the world according to analysis of public and corporate data shared with the authors. The presence of tens of millions of respirators in storage facilities prior to distribution demonstrates that urban areas are key elements of illicit supply chains. Data suggests that the concept of urban insecurity needs to be reconsidered in light of illicit supply chains for counterfeit respirators and their role in facilitating disease transmission in urban areas. The analysis presented in this article suggests that threats to human life should not be confined narrowly to violent acts or the consumption of drugs. Human life can also be threatened through the massive distribution of counterfeit N95 masks during a pandemic, a problem that has become more acute with more contagious mutations of COVID-19.”

Dr. Shelley is the Omer L. and Nancy Hirst Endowed Chair and a University Professor at George Mason University. She is in the Schar School of Policy and Government and directs the Terrorism, Transnational Crime and Corruption Center. She is a leading expert on the relationship between terrorism, organized crime, and corruption as well as human trafficking, transnational crime, and terrorism with a particular focus on the former Soviet Union. She also specializes in illicit financial flows and money laundering. 

What We’re Listening To 🎧

Waffen der Wissenschaft – Die Spur der Sporen

For our German-speaking readers, a Viertausendhertz podcast episode on the 1979 outbreak of anthrax in Sverdlovsk: “Im Frühjahr 1979 sterben in der geschlossenen sowjetischen Stadt Sverdlovsk Dutzende Menschen an Milzbrand. Ein ungeheurer Verdacht kommt auf: Handelt es sich um einen Unfall mit Biowaffen? Der Forscher Matthew Meselson und der Journalist Peter Gumbel erzählen von ihren Nachforschungen vor Ort. Das Team spricht außerdem mit den Biowaffen-Experten Filippa Lentzos, Sonia Ben Ouagrham-Gormley und Andrew Weber.”

Translation: “In the spring of 1979, dozens of people died of anthrax in the closed Soviet city of Sverdlovsk. A tremendous suspicion arose: was it an accident involving biological weapons? The researcher Matthew Meselson and the journalist Peter Gumbel discuss their investigations on site. The team also speaks with bioweapons experts Filippa Lentzos, Sonia Ben Ouagrham-Gormley, and Andrew Weber.”

Event Summaries

Check out event summaries written by Geoffrey Mattoon, a Biodefense MS student, for two recent events from the Council on Strategic Risks-“Building Capacities for Addressing Future Biological Threats” and “The American Pandemic Preparedness Plan: One Year of Progress & the Path Forward”.

Schar School Master’s and Certificate Virtual Open House

Join us for next week’s Master’s and Certificate Virtual Open House on Wednesday, October 19, at 7 pm ET, to learn more about the Schar School of Policy and Government and the Biodefense Graduate Program. The online session will provide an overview of our programs, student services, and admissions requirements. Our admissions staff will be available afterward to answer any questions you may have. Register here!

Infection Prevention and Control: Incorporating Lessons Learned in Managing Special Pathogens

“After nearly three years responding to the COVID-19 pandemic, hospitals and other healthcare facilities have learned many lessons about the management of special pathogens and essential infection prevention and control practices. The U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response’s Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) and the National Emerging Special Pathogens Training and Education Center (NETEC) invite you to learn more about some of those lessons. Speakers will share their perspectives on how our approach to outbreaks has changed since the pandemic began. They will address issues such as infection prevention for healthcare workers and patients and mitigating disease spread. Speakers will also highlight newly developed tools and resources. This webinar will take place November 7 at 2:00 pm ET. Register today!”

Disinformation: An Emerging War Weapon

“Hosted by the National Defense University Foundation and Moderated by President and CEO, James Schmeling, join us for this interactive virtual discussion. Brief Talk Description: Explore how Russia, China and other entities use misinformation, disinformation, and malinformation as weapons of war and their impact on global security and American democracy.” This online webinar will be hosted on October 20 at 12 pm EST. Register here.

Reflections on Science Communication & Human Rights Amid Public Health Emergencies

“On October 20 (10:30-11:30 am ET),  join Dr. Bina Venkataraman, Editor-at-Large for The Boston Globe, and Dr. Chris Beyrer, Director of Duke University’s Global Health Institute, for a virtual discussion of science communication during public health emergencies, the role of public health researchers and journalists in advancing human rights, and emerging lessons from the COVID-19 pandemic.”

“The conversation will be moderated by Prof. Helle Porsdam, Professor of Law and Humanities and UNESCO Chair in Cultural Rights, Centre for Interdisciplinary Studies of Law, Faculty of Law, University of Copenhagen.” Register here.

Third International Summit on Human Genome Editing

The Third International Summit on Human Genome Editing will take place March 6-8, 2023, at the Francis Crick Institute, London, UK. “Building on previous events held in Washington, DC (2015) and Hong Kong (2018), this Summit will continue the important dialogue around human genome editing. It will facilitate a global discussion on somatic and germline genome editing, including developments in clinical trials and genome editing tools such as CRISPR/Cas9. Earlier this year a three-part series of online events Looking Ahead to the Third Human Genome Editing Summit discussed some of the key topics of the meeting. The three-day summit is being organised by the Royal Society, the UK Academy of Medical Sciences, the US National Academies of Sciences and Medicine and The World Academy of Sciences.”

“Find out more about the Summit’s Planning Committee, chaired by Professor Robin Lovell-Badge FRS FMedSci. Further information about the Summit agenda will be released soon, and registration to attend the event in person and online is now open.”

Event Summary: The American Pandemic Preparedness Plan: One Year of Progress & The Path Forward

By Geoffrey Mattoon, Biodefense MS Student

On Thursday, 8 September, the Council on Strategic Risks (CSR) hosted “The American Pandemic Preparedness Plan: One Year of Progress & The Path Forward” webinar, which included speakers Dr. Matthew Hepburn, White House Office of Science and Technology Policy (OSTP) Senior Advisor, and Dr. Carly S. Cox, CSR Fellow for Ending Bioweapons, and was moderated by journalist Janet Wu of Bloomberg. Dr. Hepburn and Dr. Cox discussed the recently released “First Annual Report on Progress Towards Implementation of the American Pandemic Preparedness Plan,” which they both played a central role in developing, and considered the current state and future goals of pandemic preparedness in the U.S. The lack of COVID-19 in the title of the event and report is intentional and the overarching message of both; do not fail to see the forest for the trees. A more apt statement in this instance may be “do not fail to see the future threats of pandemics and biological attacks for COVID-19 alone.”

This message was emphasized throughout the event, refocusing attention from COVID-19 to all pandemic response, and mirroring the call for greater broad-spectrum protection in biodefense as made by Dr. Gregory Koblentz in his book Living Weapons. Such efforts, according to Dr. Koblentz, transcend the historical “one bug, one drug” paradigm and provide a biodefense countermeasure strategy for both biological weapons and natural diseases. Broad-spectrum efforts such as these have already demonstrated their value in the response to other threats, including the adaption of existing mRNA vaccines for COVID-19 or the JYNNEOS smallpox vaccine for the ongoing monkeypox outbreak, and could prove critical in the event of any future disease outbreak or biological attack.

Dr. Hepburn opened the event with a call to action, stating all the progress we have made is good, but we still have much more work to do. He pointed to the first section of the Annual Report as a reminder of all the government has accomplished in pandemic preparedness. When asked by Ms.Wu if he believed we had learned enough from COVID-19 to prevent the next outbreak from reaching the same level, Dr. Hepburn emphatically replied “Yes.” He cautioned that the hard part is learning the right lessons and making the changes necessary to prepare. Dr. Cox stated she hoped he was right, but we also thought we were prepared for COVID-19.

Speaking on the importance of a diversified public health workforce, Dr. Hepburn highlighted the need for technologically savvy professionals. He asserted future public health workers must be trained in data analysis, program management, and human empathy to be successful. Dr. Cox then stressed the benefit of fellowship opportunities to provide professionals in the field a broader perspective to address biological threats that enhance disease outbreak prevention.

A diverse workforce is not the only ingredient needed for preparedness success. Dr. Hepburn and Dr. Cox also discussed the essential nature of interagency and private sector cooperation to overcome COVID-19 and future pandemics. This message aligns with both the 2018 National Biodefense Strategy Goal 1 and the 2021 Biodefense Vision Memo that call for greater coordination and unity of effort across all biodefense organizations in response to natural and man-made pathogens. This message is also supported by the broad range of organizations and their accomplishments throughout COVID-19 response outlined in the first section of the Annual Report. Such unity and diversity of effort is critical to maximize biodefense; including biosurveillance efforts like that of the Center for Forecasting and Outbreak Analytics, biodetection efforts from agencies like NIH RADx, and preparedness guidance from agencies like ASPR. Such multifaceted preparedness and response are essential to provide broad-spectrum protections against future threats.

A specific topic of discussion during the event was efforts in rapid production of medical countermeasures (MCM). Operation Warp Speed demonstrated we now possess the capability to produce effective vaccines within a year, enabling us to respond rapidly to emerging threats. Dr. Shulkin provides a concise summary of the essential lessons learned by Operation Warp Speed that should be applied to future vaccine development in his commentary, “What Health Care Can Learn from Operation Warp Speed.” The speakers emphasized that such efforts must become routine and require global cooperation to be effective in facing current pathogens like malaria as well as future threats. The development of vaccines is a balancing act of cost and innovation which may require government agencies to de-risk programs to incentivize innovation when the cost prohibits private sector interest. They also discussed the importance of novel vaccines that offer shelf-stable solutions as well as varied delivery methods (microneedle, oral, skin patches) to enhance distribution capabilities and capacity. Such technologies would directly benefit defensive efforts nationally and may even enhance defensive deterrence of biological weapons based on a more robust strategic stockpile.

            When asked what efforts give the panelists the greatest hope for the future, they highlighted the need to engage at the local health system and community level. Such efforts enable the establishment of trusted networks that can effectively disseminate critical health information and work to deter misinformation and disinformation. This mobilizes the population in response to threats and provides an added means of innovation that can guide future MCM and biodefense efforts. It is also critical that trust is built in advance within communities, it is not a resource you can “surge” at the time of need and COVID-19 has demonstrated the effects mistrust can have on response. Vaccine hesitancy and anti-vaccine sentiments proved to be a serious obstacle in COVID-19 response and must be addressed in a vaccine-agnostic manner to enhance current and future disease prevention and eradication.

The key messages throughout this event were consistent with those throughout the biodefense community. Interagency and international unity of effort, MCM innovation, and community involvement efforts in pandemic preparedness will enhance national biodefense. The COVID-19 pandemic is a world-changing event that may be key to reinvigorate pandemic preparedness and response efforts and, as a result, biodefense as well. As the speakers emphasized, what is critical is that the entire community applies these lessons to the whole of pandemic preparedness and response, not just COVID-19 specifically, to truly benefit from lessons learned. We cannot fail to see the forest for the trees.