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.

Islamic State Goes Old School

By Erik Goepner

Recent reports suggest that IS has employed chlorine as a weapon.  Though currently unconfirmed, these reports suggest that IS is looking to bolster its inventory of tactics, techniques and procedures. In so doing, they’ve gone old school.

IS’ first use of chlorine as a weapon may have been in September against Iraqi security forces and Shiite militias north of Baghdad.  Reports indicate the chlorine was delivered via bombs.  No one died, but approximately 40 reported difficulty breathing and heavy coughing.  One source said IS had taken the chlorine from purification plants overtaken during their advance.

Additional reports suggest that IS employed toxic gas in Kobani on October 21. Patients reportedly sought medical care for trouble breathing, burning eyes, and blisters.  A doctor on-scene ruled out chlorine as the cause, while assessing the injuries as consistent with exposure to an as-of-yet unidentified chemical.  The Guardian noted, however, there was no consensus or confidence from experts regarding potential causes of these injuries.

Five days later, an Iraqi military commander said seven chlorine filled projectiles were fired into a residential area of Anbar province, though no casualties were reported.

According to the Organization for the Prohibition of Chemical Weapons (OPCW), though, this is not new.  The implementing body of the Chemical Weapons Convention reported chlorine was already used “systematically and repeatedly” in northern Syrian villages earlier this year.  Western government officials assert Assad’s forces had employed the chlorine, though it is unclear if other groups may also have been responsible.

Historically, perhaps the most heinous and deadly precedent for chlorine-as-weapon comes from World War I, when the Germans dispersed 168 tons of chlorine during the Second Battle of Ypres in Belgium.   Approximately half of the 10,000 allied soldiers in the affected area died.  Two days later, chlorine was again used, killing an additional 1,000 Allied service members.

What might the future hold?  The Nuclear Threat Initiative, writing in 2007 about chemical weapon fears in Iraq, noted that the worst industrial accident in history was the release of 40 metric tons of methyl isocyanate at a pesticide plant in Bhopal, India.  3,000 were killed and more than 100,000 were injured.  The author concluded that a “sufficiently large release of elemental chlorine may be capable of exacting a comparable toll, particularly if discharged in a highly populated civilian area.”  However, the author also noted chlorine is typically ineffective against a “prepared adversary” because its visible color and potent odor announce its arrival and the effects of chlorine can be mitigated with “simple countermeasures,” such as gas masks or wet cloths placed across the nose and mouth.

Image Credit: Stripes

The Pandora Report 9.27.13

Highlights include MERS, more MERS, Marburg & Ebola, chemical weapons antidotes, universal vaccine. Happy Friday!

Saudi Efforts to Stop MERS Virus Faulted

Saudi Arabia is being accused both of withholding information and conducting incomplete epidemiological investigations on MERS. While health officials have been careful to collect as much information as possible from infected individuals, they have been accused of neglecting to interview healthy contacts of infected patients. Such interviews are critical to determining possible routes of transmission. Saudi officials have vehemently denied these accusations, arguing it’s impossible to withhold what they don’t know.

Wall Street Journal – “‘It’s very difficult to give all the details to the people when we don’t know all the details,’ Ziad Memish, the deputy health minister, said last week at his office in Riyadh, the Saudi capital. ‘”Where’s it coming from? We don’t know. How is it transmitted? We don’t know.'”

Middle Eastern Respiratory Syndrome Update

Speaking of MERS, the CDC has updated its epi information on the virus. According to this week’s Morbidity and Mortality Weekly Report, there are now 130 cases, of which 45% of were fatal. While cases have occured in eight countries, all infected patients had recently visited or resided in just four countries – Jordan, Qatar, Saudi Arabia, and the UAE. Also of note, just over a fifth of cases (21%) were asymptomatic. No new information on mvectors, reservoirs, or route of infection.

CDC –  “To date, the largest, most complete clinical case series published included 47 patients; most had fever (98%), cough (83%), and shortness of breath (72%). Many also had gastrointestinal symptoms (26% had diarrhea, and 21% had vomiting). All but two patients (96%) had one or more chronic medical conditions, including diabetes (68%), hypertension (34%), heart disease (28%), and kidney disease (49%). Thirty-four (72%) had more than one chronic condition (7). Nearly half the patients in this series were part of a health-care–associated outbreak in Al-Ahsa, Saudi Arabia (i.e., a population that would be expected to have high rates of underlying conditions) (8). Also, the prevalence of diabetes in persons aged ≥50 years in Saudi Arabia has been reported to be nearly 63% (9). It remains unclear whether persons with specific conditions are disproportionately infected with MERS-CoV or have more severe disease.”

New Marburg & Ebola Theraputics?

Tekmira Pharmaceuticals Corporation has developed a Marburg treatment which protects non-human primates from the virus completely (100%), even if administered 24 hours after post infection. This is very exciting. The company has also received funding to undertake a similar Ebola treatment, with Phase I clinical trials set to begin early next year.

Street Insider – “In a presentation entitled ‘Medical Countermeasures for Filovirus Infection: Development of siRNA Therapeutics Under the Animal Rule’ data were presented that showed successful anti-viral therapy with the application of Tekmira’s LNP technology to hemorrhagic fever viruses, including multiple strains of the Ebola and Marburg viruses. Newly presented data resulting from a collaboration between Tekmira and the University of Texas Medical Branch (UTMB) showed 100% survival in non-human primates infected with the Angola strain of the Marburg virus in two separate studies. In the first study, 100% survival was achieved when dosing at 0.5 mg/kg TKM-Marburg began one hour after infection with otherwise lethal quantities of the virus. Dosing then continued once daily for seven days. In the second study, 100% survival was achieved even though treatment did not begin until 24 hours after infection.

Scientists at UNC-Chapel Hill, Wake Forest work on antidotes to nerve gas

The Defense Threat Reduction Agency has awareded UNC-Chapel Hill a $4.47 million grant to develop antidotes to nerve gas. While the timing of the award may seem a little reactionary, apparently discussions on the project began over a year ago. Researchers are hoping to create an adhesive bandage, pre-loaded with the antidote which would be administered through tiny needles in the bandage itself. The advantage of a bandage over an injected serum is self-administration – no medical professional would be needed to administer it.

Charlotte Observer – “‘We can load them up with antidotes to nerve agent, including enzymes that combat nerve agent,’DeSimone [a professor of chemistry at UNC-CH and chemical engineering] said. ‘The idea was to put them directly into a dissolvable microneedle that’s painless – just a patch – and rapidly get them into the bloodstream’ Such a device could be used by the military or civilians during an attack, when poison gas can kill within minutes. The patch could be easily disseminated and transported, DeSimone said, and would have a long shelf life.

Researchers Move Step Closer to Universal Seasonal Flu Vaccine

It’s nearly flu season again, and for many of us that means shots. For scientists, it means hoping their predictions as to which strain of flu will strike are right, and that the vaccine in the shots is actually useful. Making things easier for everyone, scientists at the Imperial College of London have determined a “blueprint” for a single vaccine against all types of influenza. Scientists there have found that by boosting CD8 killer T cells, rather than trying to trigger antibody production, the vaccines are significantly more effective.

Voice of America – “’Such a vaccine would induce T cells that would be able to recognize new viruses that have not even been identified yet. In other words, future pandemic strains. In that sense, it’s a universal vaccine. And it will be different to existing vaccination where currently every year a new vaccine has to be developed, which is why we are always one step behind…'”

(image courtesy of CIDRAP)