Pandora Report: 5.13.2022

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Europe Pressuring the WHO to Isolate Russia

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

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

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

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

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

Statement of the G7 Non-Proliferation Directors Group

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

Bird Flu Updates- US States Confirm Cases in Wild Mammals

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

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

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

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

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

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

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

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

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

“Want to Prevent Pandemics? Stop Spillovers”

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

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

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

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

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

“The Department of Defense Contributions to Pandemic Response”

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

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

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

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

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

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

“The Coronavirus Vaccine Manufacturing Failures of Emergent Biosolutions”

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

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

“Global Report on Infection Prevention and Control”

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

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

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

Patrono et al. write in Nature Communications,

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

Influenza Milestones, Source: CDC

New York Times- The Daily: “One Million”

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

What Is Biosecurity for the Twenty-First Century?

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

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

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

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

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

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

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

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

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

Russian WMD Disinformation Resources

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

“Russia Targets Azerbaijan, Others With Fake Bioweapons Claims”

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

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

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

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

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

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

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

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

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

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

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

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

Pandora Report: 5.6.2022

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

The Birds, 2022 Edition

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

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

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

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

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

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

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

Our Evolving Understanding of COVID-19 and Its Impacts

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

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

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

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

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

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

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

“Building a Sustainable Biopreparedness Industrial Base”

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

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

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

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

From the National Academies:

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

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

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

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

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

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

Student Features

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

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

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

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

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

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

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

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

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

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

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

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

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

Chemical and Biological Weapons Net Launched

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

Russian WMD Disinformation Resources

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

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

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

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

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

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

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

EUvsDisinfo Now Available in Mandarin Chinese

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

Pandora Report 3.2.2018

Happy Friday! We’ve got a full plate of biodefense news this week, so we hope you’re hungry for everything from ASM Biothreats 2018 coverage to Gain of Function research, and a side of pandemic budgeting.

ASM Biothreats 2018 – GMU Biodefense Coverage
We’re excited to present our annual coverage of the ASM Biothreats conference from some of GMU’s very own biodefense graduate students. Our overview is a great way to catch up on some of the hot topics and captivating breakout sessions from the conference. You can find a landing page for all the reviews here, which will have links and a brief synopsis for each section the students wrote. GMU biodefense graduate students covered a variety of sessions – from artificial intelligence in biosecurity to the GHSA, future DoD programs in biodefense policy, and BARDA/DARPA projects- we’re reporting it all!

New Pathogen Research Rules: Gain of Function, Loss of Clarity
GMU Biodefense professor and graduate program director Gregory Koblentz is teaming up with Lynn Klotz (co-managing director of Bridging BioScience and BioBusiness LLC), to evaluate the December 2017 release of the latest Gain of Function (GoF) research rules. The DHHS release finally lifted the funding moratorium on GoF research following the controversial projects involving H5N1 in 2011. While the DHHS policy (or “Framework for guiding funding decisions about proposed research involving enhanced potential pandemic pathogens”) is similar to the Office of Science and Technology Policy guidance that was released in January 2017 (the “P3C0 Framework”), it came with the bonus of restoring funding for such research. Unfortunately, there are still considerable concerns with how GoF research is evaluated and if these frameworks have really addressed the gaps. “We, the authors, harbor concerns about adequate oversight of potentially dangerous research, and the framework incorporates several elements that address those concerns. The framework is thorough. It does a good job of laying out the principles and processes through which the Health and Human Services Department will make funding decisions regarding research that involves enhanced potential pandemic pathogens. The framework’s approach to dual-use research of concern is not based on lists of experiments or on specific pathogens, but instead takes a risk-based approach that focuses on the attributes of modified organisms. While the identity of starting organisms is central to existing oversight policy for dual-use research of concern, the framework emphasizes the importance of organisms’ properties once the experiment is over. This more comprehensive approach to dual-use research is a welcome change. Some elements of the new framework, however, remain worrisome.” Koblentz and Klotz point to several limitations of the new framework – it’s too narrow and not broad enough in that it only applies to research funded by DHHS, the terminology and definitions are lacking (especially in the definition of a potential pandemic pathogen), and the review process that was created is a limited. The framework also has new criteria for risks and benefits, which is “inherently problematic” and agreement is often never achieved. “The criteria used to judge which experiments involving enhanced potential pandemic pathogens warrant review by the Health and Human Services Department—and how the risks, benefits, and ethical aspects of such experiments are measured and weighed—are ambiguous enough to provide departmental reviewers wide latitude in their funding decisions. The process and outcomes must be transparent in order to demonstrate that the process is conducted in good faith and that policy is implemented appropriately. The framework, though it recognizes the importance of transparency for maintaining public trust in science, does not go far enough in actually providing the requisite level of transparency.” Lastly, Koblentz and Klotz point to the international considerations as a considerable weakness within the new framework. Sadly, it only applies to research done within the United States and the truth is that this is an international issue and needs global consideration and collaboration.

 2018 NASPAA Student Simulation – Global Health Security
How did you spend your Saturday? Battling a virtual pandemic? We were fortunate to participate as judges at an international collaboration and simulation to test students on their response during a pandemic. The NASPAA-Batten simulation (Network of Schools of Public Policy, Affairs, and Administration) involved a total of 563 students in 117 teams, from 159 universities across 27 countries. Teams represented approximately 336 million fictitious people in 4 fictitious countries per 1 fictitious world and were battling 1 seriously tough outbreak. GMU’s Schar School and the biodefense program were represented in both participants and judges. Professor and graduate program director Gregory Koblentz and PhD student Saskia Popescu were judges while six Schar students participated (four of which were biodefense students!) at the Carnegie Mellon University site in DC – Alexandra Williams (Biodefense MS), Annette Prietto (Biodefense MS), Stephen Taylor (Biodefense MS), Justin Hurt (Biodefense PhD), Fleciah Mburu (MPA), and Ryan Kennedy (MPP). The two finalist teams from the CMU site included biodefense MS students Alexandra and Justin, which means they’ll now move on to the global round where they are competing for the $10,000 prize. GMU biodefense students know how to battle a pandemic – whether it’s simulated or real! From a judge’s perspective, this was a great experience to not only observe how people respond to the complexities of a global outbreak, but also pose questions that help them see all the moving pieces in response.

Blue Panel Study Panel on Biodefense Calls For Strategic Budgeting Tied to New National Biodefense Strategy
The Blue Ribbon Study Panel has released a statement on the desperate need for decision-makers to commit to biodefense funding and recognize it as an imperative component to national security.  “We would do well to remind ourselves that we are really just as vulnerable now as we were then. In addition to the enormous potential toll on human health that intentional or natural outbreaks can inflict, the cost of the relentless rise of outbreaks is also entirely unsustainable based on current funding approaches. Emergency appropriations reach into the billions in direct outlays to the U.S. government. Economic impacts of a catastrophic outbreak could reach into the trillions.” You can also read the OpEd by Sen. Joe Lieberman and Former Gov. Tom Ridge, stating that American lives are worth budgeting for biodefense. “We call upon the president to release the National Biodefense Strategy soon and ensure that his next budget request to Congress conforms to the priorities in this strategy, showing how money requested for biodefense programs support the National Strategy’s goals and objectives.”

CDC Plans for New High Containment Lab
The CDC is asking congress for $350 million to start building the high containment continuity laboratory on their main campus to replace the existing one that has been used since 2005, but requires replacement by 2023. “The existing facility contains a number of BSL4 labs and labs that are one step down the biosafety and biosecurity ladder, BSL 3 enhanced. That’s where research on dangerous avian influenza viruses like H5N1 and H7N9 is conducted. Buildings that house these types of labs simply require a lot of maintenance, explained Dr. Dan Jernigan, head of the CDC’s influenza branch. ‘We’re just faced with the realities of what it takes to maintain something as complex as the high containment lab,’ he said.” The complex design of high containment labs makes them both expensive to build and maintain.

Battelle Takes On Biological Threats With New Software
Between naturally occurring outbreaks, bio-error, and bio-terror, there are a lot of ways infectious diseases can pose a threat to human life and safety. Battelle is seeking to change this through a new software for the U.S. government that “would screen small bits of DNA and assess whether they belong to potentially dangerous genetic sequences.The local research institution is one of six groups awarded an $8.7 million, two-and-a-half-year grant by the Intelligence Advanced Research Projects Activity (IARPA), an organization within the Office of the Director of National Intelligence.” The growing application of CRISPR and other genome editing technologies has underlined the gaps in DNA sequence screening for biosecurity concerns, especially when one considers the recent horsepox synthesis. “In the absence of national or international policy that would monitor bioengineering activity — and the technological gap for keeping an eye on never-before-encountered organisms — Battelle and the other groups awarded the federal contract are trying to figure out how to stay a step ahead. ‘At first I thought it would be too big of a lift for us,’ Dickens said. At the end of January, Battelle researchers completed a first version of the software, which they are now testing and optimizing. It can, for example, analyze a small fraction of an influenza virus’ genetic code and identify or predict whether it has the potential to make people, animals or the environment sick. The tool then assigns the genetic scrap a threat level: dangerous, potentially hazardous or safe. The tool is artificially intelligent enough to detect whether the sample is related to any known specimens, such as botulism or anthrax, and predict the function of never-seen-before DNA sequences.”

Workshop on Women’s Health In Global Perspective
GMU Schar School is hosting this free workshop on March 7-8th in Arlington,VA – don’t miss out! “The Workshop on Women’s Health in Global Perspective seeks to contribute to understanding and improve policy on women’s health and wellbeing around the world. The program includes panels on Communicable and Non-Communicable Disease; Health and Wellbeing; Maternal Health; and Reproductive Technology and Family Planning. It will cover topics such as HPV Vaccine Awareness, Maternal Mortality, and Cross-border Reproductive Care.”

GMU Biodefense Alum Leads NEIC Laboratory 
We love getting to brag about the amazing things that GMU Biodefense students and alum do with their passion for health security. Biodefense MS alum Francisco Cruz was recently named the Chief of the EPA’s National Enforcement Investigations Center (NEIC) Laboratory Branch! “The branch’s primary responsibility is conducting forensics analysis on environmental samples related to criminal and civil cases. The lab is a fully accredited forensics laboratory staffed by 21 chemists who can not only conduct the lab analysis, but also testify in court regarding the science behind the analysis. Additionally, the lab is capable of developing novel analytical methods for rare and difficult matrices that most labs cannot analyze. The lab supports EPA and other federal law enforcement partners with either lab analysis or technical consultation on how to process a sample.” Biodefense alums – don’t forget to stay connected so we can recognize you for all the amazing biodefense work you do!

DARPA Names Pandemic Prevention Platform Researchers
Launched in 2017, the P3 program from DARPA hopes to stop the spread of an outbreak before it becomes a pandemic. “In contrast with state-of-the-art medical countermeasures, which typically take many months or even years to develop, produce, distribute, and administer, the envisioned P3 platform would cut response time to weeks and stay within the window of relevance for containing an outbreak.” DARPA recently announced the institutions that are contracted for the program and will hopefully make progress in the fight against pandemics – MedImmune, Abcellera Biologics Inc., Duke University, and Vanderbilt University.

 The WHO – What Went Wrong from Swine Flu to Ebola?
The WHO has struggled to find its strong foot since 2009’s H1N1 influenza pandemic and then the 2014/2015 Ebola outbreak. With new leadership, many are hoping the WHO’s abilities can be strengthened and some faith restored in their capacity to prevent and respond to international health events. One particular evaluation of this can be found in a chapter of Political Mistakes and Policy Failures in International Relations. “This chapter examines a series of mistakes and the structural, cultural, political and epidemiological factors that contributed to the WHO’s mishandling of the first pandemic of the twenty-first century and the world’s largest ever outbreak of Ebola. The chapter then concludes by examining the reforms currently being implemented to strengthen the WHO’s global health security capabilities and what these signify for the future.”

Stories You May Have Missed:

  • CDC Epidemiologist Missing – “Police investigators are bewildered as they work through the “extremely unusual” circumstances surrounding the missing-person case of Timothy Cunningham, a researcher who vanished Feb. 12, shortly after hearing why he had been passed over for a promotion at the Centers for Disease Control and Prevention (CDC). Cunningham, 35, told colleagues he was not feeling well and left work at CDC headquarters in Atlanta, not long after speaking with his supervisor about why he had not been promoted, Atlanta Police Maj. Michael O’Connor told reporters. Cunningham works in the chronic disease unit at the CDC, not in the part of the CDC that deals with infectious disease, according to authorities.”
  • Iraqi, Dutch, Vietnamese Officials Report Avian Flu Outbreaks – Several countries reported new avian flu outbreaks, including two more H5N8 events at commercial poultry farms in Iraq, an H5 outbreak at a poultry farm in the Netherlands, and the first known H5N6 detection of the year in Vietnam. In Iraq, which has reported ongoing H5N8 activity since early January, authorities reported new outbreaks in Diyala and Baghdad province that began on Feb 13 and Feb 14, respectively, according to a report yesterday from the World Organization for Animal Health (OIE). The investigation said the source of the virus was contact with wild species.”
  • 11 Fall Ill After Suspicious Letter Arrives At Military Base– “Eleven people fell ill after a suspicious letter was opened in an administrative building at Joint Base Fort Myer-Henderson Hall in Arlington, Virginia, on Tuesday, according to the Arlington County Fire Department. A law enforcement official said field tests for the letter all came back negative for any harmful substance, but the FBI is transporting it tonight to its lab in Quantico for further analysis. The law enforcement official said the text of the letter contained derogatory, at time unintelligible and ranting language, and was addressed to a commanding officer at the base. Investigators are still determining what relationship, if any, the sender had with the base. A corporal, gunnery sergeant and a colonel all exhibited symptoms of a burning sensation on their hands and face, according to Specialist Nicholas Hodges who spoke to CNN from the base.”

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

Pandora Report 1.5.2018

Welcome to our first Pandora Report of 2018! While things may have been relatively quiet over the holidays, we still have some health security gems for you to start the new year right.

 An Infection Preventionist’s Take on the 2017 Biological Weapons Convention
GMU Biodefense Phd student and infection preventionist Saskia Popescu recently attended the BWC Meeting of States Parties and is discussing the importance of civil society and why even the most unlikely participants are important for the future of the BWC. “It seems an unlikely story that an infection prevention (IP) epidemiologist would attend a Meeting of the States Parties (MSP) at the United Nations (UN), but here’s why civil society has an important role in the work that IPs do.” Highlighting the Confidence Building Measures (CBMs) and the role of NGOs, she uses communicable disease reporting as an example of how so many of us play an unsuspecting role. “In fact, I feel that there are 2 things that should underline the importance of NGOs and civil society being involved in international treaties such as the BWC: 1.) Inherently, our work plays into the CBMs. Who does communicable disease reporting at a county level? Yours truly, and that feeds into the state health departments and then up through the Centers for Disease Control and Prevention (CDC), which goes into the CBM. 2.) With the rapid pace of advancements in the life sciences—such as gain-of-function research or genome editing like CRISPR—it is critical that treaties like the BWC be modernized to maintain relevancy. This requires experts from civil society who can work across international borders.”

Enhancing BioWatch Capabilities Through Technology and Collaboration
The latest proceedings of a workshop report from the National Academies are now available online. “The Department of Homeland Security’s (DHS’s) BioWatch program aims to provide an early indication of an aerosolized biological weapon attack. The first generation of BioWatch air samplers were deployed in 2003. The current version of this technology, referred to as Generation 2 (Gen-2), uses daily manual collection and testing of air filters from each monitor, a process that can take 12 to 36 hours to detect the presence of biological pathogens. Until April 2014, DHS pursued a next-generation autonomous detection technology that aimed to shorten the time from sample collection to detection to less than 6 hours, reduce the cost of analysis, and increase the number of detectable biological pathogens. Because of concerns about the cost and effectiveness of the proposed Generation 3 system (Gen-3), DHS cancelled its acquisition plans for the next-generation surveillance system.” Within the report, you can find an overview of BioWatch priorities, collaborative planning, recommendations from the GAO and DHS responses, and future opportunities at the state and local level. Some of the GAO’s findings included failure by DHS to develop performance requirements that would allow for conclusions about Gen-2’s ability to detect attacks, and that the modeling and simulation studies that DHS commissioned had not directly and comprehensively assessed Gen-2’s capabilities.

 GMU Biodefense MS Open House
Mark your calendars for the February 21st Master’s Open House at GMU’s Arlington campus! The session will provide an overview of our master’s degree programs, an introduction to our world-class faculty and research, and highlights of the many ways we position our students for success in the classroom and beyond. Our admissions and student services staff will be on hand to answer your questions. This is a great chance to speak with biodefense faculty, learn about some of the awesome classes our students get to take, and find out why we study health security threats from anthrax to Zika.

Winter 2018 Mid-Atlantic Microbiome Meetup Biodefense and Pathogen Detection
Don’t miss out on this January 10th event at the University of Maryland College Park. The University of Maryland Institute for Advanced Computer Studies (UMIACS) is hosting this regional conference next week, the Winter 2018 Mid-Atlantic Microbiome Meetup, with a focus on biodefense and pathogen detection. The workshop is a great way to learn about the latest in synthetic biology, biodefense, and pathogen detection. Several federal agencies are sending experts, and the conference will include a keynote talk from Tara O’Toole, executive vice president of In-Q-Tel.

Three Global Health Issues To Watch in 2018
What are the biggest stories health reporters are looking to follow this year? STAT polled their reporters and predicted that the three big stories in public health would be the final push to end polio, how the WHO will do with a new Director General amidst shaken confidence, and vulnerability to pandemics as we march into the centennial of the 1918 Pandemic. “This year marks the centenary of the Spanish Flu, the influenza pandemic of 1918, which killed somewhere between 50 million and 100 million people as the H1N1 flu virus swept the globe. Many of the people who died were in the prime of life. There are unsettling reports of people who were well at breakfast and dead by dinner. This uniquely fatal outbreak haunts influenza scientists and emergency response planners to this day. The latter know health systems don’t have the capacity to cope with the huge upsurges in illness that would accompany a major disease outbreak. A regular old bad flu season can severely tax hospitals. Those who worry about these issues will use the anniversary to focus attention on the risk of ‘the next Big One’.” What do you think the big pubic health topics will be this year? Tweet us @PandoraReport and we’ll report back on what the biodefense community is saying!

Three Children Hospitalized With Dengue Following Vaccination
Three Filipino children have been hospitalized with suspected dengue infections following their immunization with Dengvaxia, the latest Sanofi Pasteur dengue vaccine. “The hospitalizations come 1 month after Sanofi recommended Dengvaxia not be used in anyone who is dengue-naive. In recipients without previous dengue infections, the vaccine can lead to more severe illness.”

Stories You May Have Missed:

  • Raw Water” Trend Sparks Public Health Concern – This is both hysterical and deadly – a new Silicon Valley obsession with untreated and unfiltered “raw” water. “When food-safety expert Bill Marler saw The New York Times’ trend piece on Silicon Valley’s recent obsession with raw water, he thought he was reading a headline from The Onion. According to The Times, demand for unfiltered water is skyrocketing as tech-industry insiders develop a taste for water that hasn’t been treated, to prevent the spread of bacteria or other contaminants.”

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

Pandora Report 12.1.2017

Are you registered for the Read-Out on the GHSA Summit in Kampala? Just a friendly reminder – we’ll be on hiatus next week as we attend the Biological Weapons Convention Meeting of States Parties. Make sure to look out for a packed newsletter on 12.15 as we’ll be covering both the Read-Out on the GHSA Summit and the BWC meeting! If you’d like real-time updates, check out our Twitter account @PandoraReport.

 Read-Out on the GHSA Summit in Kampala
Global health security on your lunch break? Only at the Read-Out on the GHSA Summit will you get lunch and an in-depth recap of this international health security event. Don’t miss this exciting opportunity to hear from global health practioners and young professionals who attended the 4th annual Global Health Security Agenda (GHSA) Ministerial Meeting in Kampala, Uganda in October. You’ll want to register ASAP for this exciting opportunity on December 4th, from 12-1:30pm at the George Mason University Founders Halls in Arlington. The GHSA meeting, Health Security for All: Engaging Communities, Non-governmental Organizations, and the Private Sector, was a multi-sectoral collaboration between governments, civil society, and industry dedicated to the strengthening of globaly capacity to prevent, detect, and respond to infectious disease threats. Attended by the ministers of health, finance, and agriculture and other senior officialfs from more than 50 nations, this was the first Ministerial GHSA Meeting held on the African continent. The meeting was held in late October at the same time as an unprecedented outbreak of pneumonnic plague in Madagascar and a rare outbreak of Marburg in Uganda itself. These outbreaks were timely, but unfortunate reminders, that global health security is still very much a work in progress. Our panel will include four participants who were on the ground in Kampala and actively engaged in this historical step forward for global health security. Attendees will have the opportunity to engage and hear the perspectives of esteemed public health practitioners and rising health security professionals. Lunch will also be provided. This event is free and open to the public.

Mason, Stanford Researchers Join Forces To Study The Science, Benefits And Dangers Of Genome Editing
GMU Biodefense researchers are teaming up with Stanford University to better address the complexities of genome editing and what it means for science, security, and governance. “The study is the only unclassified, independent academic project of its kind, said Gregory Koblentz, director of George Mason’s Schar School of Policy and Government biodefense graduate program and co-principal investigator. The Mason and Stanford researchers will examine scientific advances in the field of genome editing that can have benefits for human health and the bioeconomy, as well as the security aspects of preventing the misuse of this technology. They expect to deliver a suite of policy recommendations based on their research in summer 2018.” Genome editing has not been without controversy, as the technology allows the deletion and replacement of DNA within living organisms and many are concerned about the dual-use nature of such work. While there is potential to eradicate disease and strengthen agriculture, there is also worry that such technology will be misused for nefarious purposes or even poorly handled and result in negative outcomes. This collaborative effort is a huge step to ensuring we’re aware of the risks, benefits, and oversight needed for this exciting new technology.

Maintaining U.S. Investment in Global Health Security
Progress must continue on the global health security front and industrialized countries like the United States have a critical role in sustaining forward movement. “However, the work of the GHSA, including motivating and assisting countries to improve their capacities to prevent epidemics like Ebola from reoccurring, is now at a crossroad. Even though senior officials in the Trump administration have voiced support for the GHSA, and at a recent GHSA ministerial meeting in Uganda signed onto the Kampala Declaration to extend the GHSA for at least another 5 years, US funding for the initiative is ending and no commitment for future financial support has been made. Without additional funding, prospects for the next phase of the GHSA will be endangered. It is important for the United States to commit to support the GHSA to help protect the nation and the rest of the world from epidemic disease.” U.S. financial support encourages other countries to pledge funds but if our efforts waver, it may cause a domino effect. Not only does U.S. engagement encourage others to support the GHSA, but it also supports our own national security. “If vulnerable countries do not have the capacity to quickly cope with disease outbreaks, those outbreaks are more likely to spread internationally, including to the United States.” You can hear more about the importance of the GHSA from Jennifer Nuzzo (one of the authors of this paper) at the Read-Out on the GHSA Summit in Kampala event on December 4th!

Failure to Diagnose Monkeypox Highlights Nigeria’s Poor Health Infrastructure
Like most outbreaks, Nigeria’s monkeypox cases have exposed weaknesses in the country’s ability to rapidly identify and test potential patients. These inadequacies highlight gaps within their International Health Regulations compliance as there were no national labs that could test patients for the disease. “Consequently, for more than two weeks after the outbreak (from the September 22 to October 13), there was no conclusive confirmation that the suspected case was actually that of monkeypox. According to experts, the implication of this is that the country may be dealing with a dangerous outbreak, but unsure of what it is dealing with on time, thereby giving room for a lot of things to go wrong during the waiting period. For instance, during the waiting period for the monkeypox confirmation, different statistics on the actual number of cases were being bandied, even as the large number of suspected cases (94 cases) and the manifestation of the disease had already caused fright and panic.” Laboratory delays can be devastating to outbreak control as it can delay treatment, isolation, quarantine, and data collection. Public health laboratories are the early warning system in many ways. Many are drawing attention to these gaps as a way to reinforce the need to strengthen country-level laboratory infrastructure and capacity. The National Centre for Disease Control (NCDC) was established in 2011, but still is struggling to find the capacity to respond to health threats due to funding and personnel issues. As 14 more cases of monkeypox were reported in Nigeria, this services as a reminder of  why the GHSA is so vital!

The WHO Reports on Fake Drugs
This week the WHO released a report on medical products  that shed light upon the startling realities of patient safety and public health in low and middle income countries. The report, “Global Surveillance and Monitoring System for Substandard and Falsified Medical Products”, found that 1 in 10 products circulating in such countries are either substandard or fake. The findings of this report are extremely worrying as it means that people are taking medications intended to treat life-threatening ailments and they are either fake or not effective. In many cases, the individual is paying a considerable amount of money for such medications and can have severe medical complications from contaminated or expired products. “Substandard and falsified medicines particularly affect the most vulnerable communities,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Imagine a mother who gives up food or other basic needs to pay for her child’s treatment, unaware that the medicines are substandard or falsified, and then that treatment causes her child to die. This is unacceptable. Countries have agreed on measures at the global level – it is time to translate them into tangible action.” You can read the report here. The report also cites some of the work being done around this endemic issue – 17 WHO training workshops, 126 Member States and more than 400 regulatory personnel trained, 1500 product reports, etc.

How Will We Handle Contamination On An Airplane?
What would happen if you were on a plane with a patient who had a highly infectious disease like SARS or Ebola? What’s our national plan to deal with such issues? Hint: we don’t have a plan. How do flight attendants or pilots relay to ground control that a patient or entire plane needs to be quarantined? These are all the sorts of questions that need to be considered when planning and responding to such events. How would we quarantine an entire plane? On February 7, 2011, such an event occurred – a pilot issued a public health emergency to the air traffic control tower in Milwaukee, WI, for 3 (of 115) passengers with flu-like symptoms. “Airport officials soon learned something interesting about Flight 703 that could point to the presence of a communicable disease. The plane included at least 12 people who had returned from Cozumel, Mexico, on a cruise in which many of the passengers had fallen ill with flu-like symptoms. The incident revealed gaps in America’s emergency planning for communicable diseases aboard planes — gaps that were still present four years later when the U.S. Government Accountability Office investigated. ‘The United States lacks a comprehensive national aviation-preparedness plan aimed at preventing and containing the spread of diseases through air travel,’ the GAO found.” Sadly, it seems as if there’s still no plan. The creation of such a plan would require collaboration between the CDC and U.S. Department of Transportation, and while meetings have occurred, it is reported that no one has taken the lead. So, how are airports currently handling infectious disease incidents? “The lack of uniformity in dealing with communicable diseases during air travel was evident when the National Academy of Sciences asked 50 different airports in the U.S. and Canada how they expect to learn of an incident aboard a plane. They found 15 different notification procedures.” Report after report has found a gap within these response efforts and with the holiday season upon us and airline travel to be busy, it seems that should a public health emergency arise, we may be flying by the seat of our pants.

 Flu Season is Upon Us!
Flu season is starting to hit the United States as the CDC reports an up-tick is influenza positive tests. A majority of the positive specimens have been Influenza A (78% are H3, 13% have been H1N1). “Three southeastern states are reporting high or widespread flu activity, and the CDC said it received reports of five more pediatric flu deaths. In its report, which covers the week ending Nov 18, the CDC also reported one more novel flu infection, an H1N1 variant (H1N1v).Globally, flu activity in the Northern Hemisphere is rising, with H3N2 and influenza B the most frequently detected strains, the World Health Organization (WHO) said yesterday in an update.” Flu season and vaccination compliance is increasingly becoming an issue even in healthcare – in fact, many hospitals are terminating employees who don’t get their flu shot. Remember – get your flu vaccine, stay home when sick, wash your hands, and cover your cough!

Stories You May Have Missed:

  • Exclusive Interviews: Tackling Regulatory and Economic Challenges of Antimicrobial Resistance – “It is imperative for medical experts and drug discovery specialists to stay on top of the latest clinical advancements, developments and industry initiatives related to antimicrobial resistance. SMi Group will gather industry experts and government bodies to share their insights at the 20th annual conference on Superbugs and Superdrugs taking place on 19-20 March 2018 in London, UK. SMi Group recently had the opportunity to sit down with three of the event’s featured speakers to discuss some of the challenges they face in the industry and their strategies for overcoming them.”
  • Raw Flour and E. coli – this whole time we thought it was the eggs in the cookie dough that were doing it, but it seems that flour may also be a culprit for foodborne illness! “Research published today in the New England Journal of Medicine describes how raw flour, an unlikely suspect, caused an Escherichia coli outbreak in 2016. Because of its low-moisture properties, flour was not thought to be a conduit of E coli bacteria, but a multistate team of investigators discovered that flour processed in one facility was linked to the outbreak.”

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

Pandora Report 11.24.2017

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 10.27.2017

TGIF and Pandora Report day! Buckle up because we’ve got an abundance of biodefense news that covers GHSA, chemical weapons, synbio, and more.

 Global Health Security – WHO & PATH Reports and GHSA Ministerial Meeting
As the Global Health Security Agenda Ministerial meeting in Kampala, Uganda takes place this week, several reports were released highlighting the deficiencies in global biosecurity and biosafety efforts, as well as the importance of investing in global health security. Fortunately, on the eve of the GHSA Kampala summit, the Trump administration endorsed the future of the GHSA. Don’t forget to stay tuned to our weekly reports as two GMU Biodefense graduate students are participating (as recipients of the George Mason Global Health Security Ambassador Fellowship) in the Ministerial meeting alongside NextGen GHSA and they’ll be reporting on their experiences in the coming weeks. The first report this week is from NTI, which called on countries to improve biosecurity after WHO demonstrated that there are substantial biosecurity/biosafety gaps worldwide. NTI analyzed 39 Joint External Evaluation (JEE) peer reviews and mapped the related biosecurity and biosafety related scores. Here are their findings: “74% of the assessed countries demonstrated limited or no capacity for a whole-of-government national biosafety and biosecurity system. 64% of the assessed countries demonstrated limited or no capacity for biosafety and biosecurity training and practices. 41% of the assessed countries demonstrated limited or no capacity for linking their public health and security authorities during a suspected or confirmed biological event.” The map they’ve created is also a great visualization for how truly weak biosecurity and biosafety efforts are on a global scale. NTI also used this information to track commitments and biosecurity assistance and partners. The next report comes from PATH, which just released their work: Healthier World, Safer America: A US government Roadmap for International Action to Prevent the Next Pandemic The latest PATH analysis focuses on global health security and global efforts to respond to threats. “This paper aims to examine the benefits of investments in pandemic preparedness, as well as recommends the US Administration and Congress come together behind a comprehensive US strategy, robust investments, and continued vigilance both at home and abroad. The recommendations focus on global leadership, a US plan for international action, and research and development; underpinned by the risks of unsustainable funding, with special focus given to the Ebola supplemental funding sunset set to occur in FY2019.”

Reauthorizing & Improving The Department of Homeland Security
Don’t miss the recent National Interest series by GMU Biodefense PhD alum Daniel Gerstein  on the DHS reauthorization bill. This three-part series starts with a focus on why it’s time to improve the Department of Homeland Security. Gerstein notes that “reauthorization of the Department of Homeland Security is vital to clarifying responsibilities and setting expectations for the continued evolution of the department.” The second part in the series highlights methods for fixing the fractured department. “The question is not whether reauthorization of DHS is necessary. It  most definitely is. However, we should also ask whether the bill goes far enough and what other issues should a comprehensive DHS bill encompass? This second commentary considers whether the DHS structure with  relatively weak central authorities should be reevaluated. Interestingly, each successive secretary has sought to consolidate power and authorities at the department level. Is it time to legislate this outcome? ” Lastly, Gerstein addresses why updating the DHS Acquisition System matters. “This third commentary considers how to better align the department’s requirements, research, development and acquisition processes. Currently, the processes are not synchronized and should be harmonized to better align these critical departmental systems.”

Global Health Security Forum 2017 
Don’t miss out on this November 7th event hosted by the Center for Strategic & International Studies. The all-day event will be held at the CSIS headquarters and will even include an entire session on “Hurtling Toward a Genomic 9/11”! Don’t miss out on the “CSIS’s annual flagship conference on the top challenges facing U.S. and global security. This year’s Forum will focus on national security priorities ten months into the Trump Administration and one year prior to U.S. midterm elections.”

 The Collision Of Civil War And Threat Of Global Pandemics
Infectious disease outbreaks can be challenging for even the most stable country and those experiencing civil war are even more impacted by such biological events. Currently, there are 30 civil wars going on around the world – between cholera in Yemen, polio in Syria, and yellow fever in the DRC, countries that have experienced civil war also tend to experience infectious disease outbreaks. “The Daedalus issue, “Civil War & Global Disorder: Threats and Opportunity,” explores the factors and influences of contemporary civil wars. The 12 essays look at the connection of intrastate strife and transnational terrorism, the limited ambitions of intervening powers, and the many direct and indirect consequences associated with weak states and civil wars. Barry and Wise believe there is significant technical capacity to ensure that local infectious outbreaks are not transformed into global pandemics. But those outbreaks require some level of organized and effective governance—and political will. Prevention, detection, and response are the keys to controlling the risk of a pandemic. Yet it’s almost impossible for these to coincide in areas of conflict.” Civil war impacts not only communication, but access to health resources and can challenge early detection and response of outbreaks. Moreover, the traditional hotspots for emerging infectious diseases (tropical and subtropical areas where spillover is likely) are also areas continually “plagued by civil conflict and political instability.”

Chemical Weapons and Syria
On Tuesday, Russia vetoed a vote at the United Nations Security Council that would “renew a mandate to continue an investigation into who was responsible for the use of chemical weapons during Syria’s civil war.” The Joint Investigative Mechanism (JIM) was initially set up in 2015 to help identify those responsible for chemical attacks and is currently reviewing the April nerve agent attack in Khan Sheikhoun. “But Russia could not get enough support and instead used its veto to block adoption. Russia, along with the UK, China, France and the US, have veto powers at the Security Council. It is the ninth time Russia has blocked action against its ally Syria, something rights group Amnesty called ‘a green light for war crimes’.” The United States has already released a statement through the State Department – “We are disappointed, we are very disappointed that Russia put what it considered to be political considerations over the Syrian people who were so brutally murdered,”.

The Good, The Bad, and The Ugly of Pandemic PredictionPreparation, and Medical Countermeasure Communication 
Pandemic preparedness often feels like a teetering game of picking your poison. Will we see an avian influenza like H7N9 or will it be a novel disease? The CDC “evaluates every potentially dangerous strain, and gives them two scores out of 10—one reflecting how likely they are to trigger a pandemic, and another that measures how bad that pandemic would be. At the top of the list, with scores of 6.5 for emergence and 7.5 for impact, is H7N9.” While there isn’t strong transmission capacity between humans with the H5 and H7 viruses, the H7 strains are more worrisome in that they require fewer mutations to get to that point. Our efforts against avian influenza pandemics go beyond surveillance, and also focus on vaccine responses. “In the meantime, vaccines are being developed to match the viruses seen in the fifth and current epidemic. Other control measures have waxed and waned. When the first of the epidemics struck, Chinese health ministries closed markets and slaughtered birds. But as Helen Branswell reports in STAT, some of those containment efforts became more lax in 2015 and 2016.” Preparedness and response exercises can also gives great insight into problems that may arise when dealing with a pandemic. A recent pandemic simulation was held during the World Bank’s annual meeting in Washington D.C., in which participants addressed everything from hospital closures to mass quarantine. “For the World Bank simulation, organizers looked at the impact on travel and tourism of an outbreak of a mysterious respiratory virus in a hypothetical country. Discussions during the 90-minute session were off the record. But in interviews after the event, organizers said the step-by-step scenario made the theoretical possibility seem very real for participants. In particular, it drove home the need for speedy, accurate information-sharing and strong coordination within and across governments and institutions.” These kinds of exercises are crucial to not only address gaps, but bring together a variety of people that will be critical to pandemic response and recovery. The Johns Hopkins Center for Health Security also just released their self-guided exercise scenario that focuses on communication dilemmas that occur during development of medical countermeasures. The exercise is aimed at public health communicator and risk communications researchers, and revolves around a novel coronavirus outbreak in 2025. “Over a 3-year period, the virus spreads to every US state and more than 40 countries, where case fatality rates vary depending on the capabilities of local health systems. In the United States, an existing drug is repurposed to treat SPARS symptoms while federal regulators work with a pharmaceutical company to fast-track the production of a SPARS vaccine. The response differs in other nations. What follows is a nationwide vaccination effort and lingering strains on the US healthcare sector from a steady stream of patients seeking treatment for serious post-SPARS complications.”

Security Implications of Genome Editing – Meeting of Experts in Hanover
Earlier this month, a meeting of scientists and experts on policy and security gathered to discuss the potential implications of genome editing technologies like CRISPR. GMU Biodefense professor Dr. Sonia Ben Ouagrham-Gormley attended, noting that “Over 100 CRISPR scientists form all over the world (China, India, U.S., Europe, Africa), and policy and security experts gathered in Hannover, Germany,  to discuss the security implication of the new gene-editing technique CRISPR.The group reviewed various threat scenarios and discussed potential policy responses. The meeting was particularly successful as both the scientists and security experts engaged in a productive dialogue about the importance of ensuring security without hampering the use of this new technology to promote progress in medicine and agriculture among other things.” The conference focused on establishing proactive international dialogue about genome editing and incorporating experts that range from ethics and philosophy to economics and political science. “Many workshop participants emphasised that it is vital to support and sustain a culture of responsibility and integrity in research and innovation and to engage with stakeholders. Moreover, researchers and policy makers must commit to continuing an open and inclusive dialogue that builds trust. As with other new and emerging technologies, a lack of communication about any uncertainties may undermine public confidence in science. Scientists and security experts should listen to concerns or fears regarding the misuse of genome editing, and provide their expertise on what is and is not likely.”

Synthesizing Biological Threats—A Small Leap From Horsepox to Smallpox
GMU biodefense PhD student Saskia Popescu discussed dual-use research concerns with GMU professor and graduate program director Dr. Gregory Koblentz and how these relate to healthcare and infectious disease professionals. Drawing on the recent horsepox synthesis, Dr. Koblentz emphasized how this opens Pandora’s box even wider for potential smallpox synthesis and misuse of synbio. Popescu highlighted these concerns and how important it is for healthcare workers to be aware of such events and vulnerabilities. “From the healthcare perspective, it may not seem like something we should worry about, but the direction of gene editing and dual-use research of concern is something that is intrinsically linked to public health. Nefarious outcomes of such experiments, regardless of the origin or intent, will inevitably make their way into an emergency department, urgent care, or worse, the community. Although we may not be seeing the implications today, as medical providers and healthcare workers, we must keep our ears to the ground, listening for these biotech advancements, and then thinking through what they mean for us tomorrow.”

Step Away From The Backyard Poultry
Do you keep poultry in your backyard? If so, you may want to rethink it as the number of Salmonella infections related to contact with backyard poultry has quadrupled since 2015. “This year, nearly every state has been pecked by outbreak strains; only Alaska and Delaware can crow about dodging them. The Centers for Disease Control and Prevention has confirmed 1,120 cases. Nearly 250 of those involved hospitalization, and one person died.But that is likely just scratching the surface of the real numbers, according to CDC veterinarian Megin Nichols. ‘For one Salmonella case we know of in an outbreak, there are up to 30 others that we don’t know about,’ she told the AP.” The issue is that chickens and other fowl can carry organisms without having symptoms and shed them in their feces. While some hatcheries will test prior to selling their birds, it’s important that owners be aware of the risks for such infections.

The Schar School of Policy & Government Presents: Strategic Trade and International Security: Policy and Practice
This Brown Bag Seminar Presentation by Dr. Andrea Viski is the place to be on Thursday, November 2nd, from noon to 1:30pm. “Dr. Andrea Viski is the founder and director of the Strategic Trade Research Institute, an independent organization dedicated to providing authoritative research on issues at the nexus of global security and economic trade. She is also the editor-in-chief of the Strategic Trade Review, a peer reviewed journal dedicated to sanctions, export controls, and compliance. She previously worked for Project Alpha at King’s College London and for the Stockholm International Peace Research Institute (SIPRI). She has published numerous articles and book chapters in the areas of strategic trade controls, nuclear non-proliferation, and international law. Dr. Viski received her Ph.D. from the European University Institute, her M.A from Georgetown University’s Institute for Law, Science and Global Security, and her B.A in International Politics from Georgetown University’s School of Foreign Service.” The seminar will be at Founders Hall 602, 3351 Fairfax Drive, Arlington, VA 22201.

Stories You May Have Missed:

  • Uganda’s Marburg Outbreak – Uganda has just confirmed the death of a 50-year-old woman as a result of the hemorrhagic fever, Marburg. “The victim, a 50-year old woman, died on October 11 at a hospital in eastern Uganda after “she presented with signs and symptoms suggestive of viral hemorrhagic fevers”, the minister said. The woman had nursed her 42-year old brother who died on September 25 with similar signs and symptoms and also participated in cultural preparation of the body for burial, she added.”
  • Big Chicken – Are you reading the latest book by Mary McKenna on antibiotic misuse in the poultry industry? “In Big Chicken, McKenna lays out in extensive detail the unintended consequences that resulted from experiments performed at Lederle Laboratories in December 1948 when scientist Thomas Jukes began adding trace amounts of the antibiotic aureomycin (later to be known as chlortetracycline) to chicken feed. The discovery that the drug could quickly fuel growth in chicks raised in confinement revolutionized the poultry industry, turning chicken into America’s favorite protein.”

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

Pandora Report 10.13.2017

What could be spookier than a Friday, 13th, in October? Actually, a few things – antimicrobial resistance, biological weapons, plague in Madagascar…..

The Trump Administration’s Misaligned Approach to National Biodefense
This recent publication from Reid Kirby is casting light upon the calamitous state of current and future U.S. biodefense efforts. Kirby points to several factors that will ultimately impact the new administration’s ability to create a new national biodefense strategy – the dysfunction rampant throughout the White House, the anti-science culture that continues to bubble up, a general inability to appoint fill key positions in a timely manner, and the disparage between the Trump administration’s ability to strategize and execute effective actions. “Again, how is the Trump administration doing so far in national biodefense? To answer this question, it is helpful to think in terms of ways, means, and ends – where the “ends” amount to security itself, the “ways” are formation of strategy, and the “means” are execution of strategy. What is concerning about the Trump administration is that the ways and means through which it pursues biodefense policy are fundamentally mismatched with the execution of meaningful biodefense ends.” Kirby highlights these failures through several examples, like the administration’s continued disrespect for science, whether it be climate change or nuclear energy. The administration’s resistance against government-sponsored research (and science in general), is in direct opposition to what a new biodefense strategy will need. “The Trump administration’s worldview, and its inability to distinguish between defense and security, may well be incompatible with a biodefense strategy. Biodefense is a scientific and technological endeavor.” Kirby states that “the administration has expressed a desire to formulate a comprehensive biodefense strategy, but the ways and means it is marshalling are not in alignment with achieving that goal. The future of US biodefense is at significant risk.

North Korea’s Biological Weapons Program – The Known and Unknown
The Harvard Kennedy School’s Belfer Center has just released a new report on North Korea’s biological weapons program. There’s been significant attention recently on their nuclear program however, there is still speculation regarding the real capacity for a biological weapons program. Bioweapon programs are always challenging to determine from the outside – so much of the equipment has dual-use capacity that makes external monitoring inaccurate at best. The new report utilizes publicly available information and interviews with experts to investigate the knowns and unknowns of North Korea’s BW program. Researchers “examine where policy on North Korea’s BW stands. We focus our analysis on the policies of South Korea and the United States, rather than at an international level, as North Korea has had limited participation in the Biological Weapons Convention (BWC).” The report also provides recommendations on how to improve assessment and surveillance efforts, not to mention current policies regarding North Korea’s BW program. Within this report, you’ll also find sections regarding means of delivery, strategic and tactical usage, gaps in current policies, how to improve nonproliferation policy, etc.

GMU Biodefense MS Open House – October 19th
Next week, GMU’s Schar School will be hosting a Masters Open house for prospective students, which means you get another chance to learn about our engaging and exciting Biodefense MS programs! You’ll be able to speak to faculty, learn about admissions, and how you can study biodefense on campus or remotely, at 6:30pm on Thursday, October 19th at our Arlington campus.

Biodefense: Federal Efforts to Develop Biological Threat Awareness
The most recent report from the U.S. Government Accountability Office (GAO) is drawing attention to biothreat awareness and how key agencies, like the DHS, DoD, USDA, HHS, and EPA, work to develop such awareness, regardless of the origin of the threat. The report highlighted three categories of efforts – intelligence gathering, scientific research, and analysis activities. “Federal agencies with key roles in biodefense share biological threat information through many different mechanisms designed to facilitate collaboration among government partners, including working groups and interagency agreements. For example, agency officials reported using collaborative mechanisms to coordinate activities and avoid duplication and overlap. However, as GAO and others have noted, opportunities exist to better leverage shared resources and inform budgetary tradeoffs. Recent legislation requires key biodefense agencies to create a national biodefense strategy that has the potential to help address these issues, by, among other things, supporting shared threat awareness. Until the strategy is developed, the extent to which it will meet this need is unknown.” Due to the variety of sources that biological threats can originate from, this report was established to review how federal agencies not only develop, but also share threat information and how this impacts future biodefense efforts. GAO utilized policies, directives, and strategies that were all related to biodefense to appropriately assess processes and the main agencies that would have critical roles within biodefense efforts.

NASA Backs Research on Evolution of Viruses in Extreme Environments Understanding how viruses adapt and infect hosts is a critical component to predicting movement and hopefully, prevention. NASA has recently funded Portland State biologist Ken Stedman to study viral evolution and how hybrid viruses work. “The study stems from a bizarre virus Stedman discovered in a hot spring at Lassen Volcanic National Park five years ago. The virus’s genetic code is derived from both DNA and its evolutionary predecessor, RNA. The vast majority of life on Earth switched its genetic code from RNA to DNA about four billion years ago, so the fact that this virus has both is highly unusual, according to Stedman.” The NASA grant will allow Stedman and his research team to study hybrid viruses, who they infect, and how they were able to adapt to such extreme environments.

Pandora Report Twitter
Feeling like you need a little extra biodefense information and humor in your life outside of our weekly reports? Check out our Twitter account (@PandoraReport) for a pretty constant stream of not only informative headlines, but also a taste of the hysterical biodefense community. The hidden world of biosecurity/biodefense twitter nerdom is pretty outstanding and probably the best thing on twitter (well, we may be a bit biased, but find out for yourself!).

Seychelles Identifies A Case of Plague
As Madagascar is struggling against a severe outbreak of plague, a nearby chain of islands, Seychelles, has just identified its first imported case. Seychelles is currently working to prophylactically treat fifteen people who were in close contact with the 34-year-old man who fell ill after returning from Madagascar. This is the first case that has spread beyond Madagascar, so officials are working diligently to avoid secondary cases. The WHO is currently sending 1.2 million antibiotics to Madagascar to fight the plague outbreak that is rapidly spreading, especially since many of the cases are pneumonic. Currently, there have been 50 deaths and 500 cases in Madagascar since the outbreak began in August.

Backing the Global Health Security Agenda
After months of speculation and concern regarding the Trump administration’s support for the future of the GHSA, Secretary of State Rex Tillerson brought forth a wave of relief. In a recent keynote speech, Tillerson “voiced support for US collaboration on global infectious disease issues, including ongoing efforts to battle threats such as HIV and malaria. He also signaled US support for extending to 2024 the Global Health Security Agenda (GHSA), a partnership of 50 nations, international organizations, and nongovernmental organizations geared toward building countries’ capacity to prevent and respond to infectious disease threats.” While discussing the importance of the President’s Emergency Plan for AIDS Relief (PEPFAR), he also highlighted that HIV/AIDS is not the only biological threat that needs addressing, commenting that the GHSA was a useful framework. Tillerson noted that “While we’ve made tremendous progress since GHSA was launched in 2014, considerable work remains. That is why the United States advocates extending the Global Health Security Agenda until the year 2024. the United States commitment to working in multi-sectoral partnerships to counter infectious diseases through the Global Health Security Agenda will remain constant,”.

Strategies Against Antimicrobial Resistance
We’ve been waging war on antimicrobial resistance (AMR) for decades now, but the truth is that future strategies may require thinking outside the box. Here are some of the potential avenues for helping to stop the global burden of microbial resistance – utilizing the human micro biome to help develop new antimicrobials and deploying tiny semiconductors – “A minuscule amount of drug with some light can treat some of the worst superbug infections we tested in clinical strains acquired from a Colorado hospital,” Nagpal says. “Of course, more work and extensive studies in preclinical and clinical trials need to be done before we can administer these quantum dots to patients. However, this initial study shows a lot of promising features.” Efforts also includes infection killing polymers, changing the culture of research to move away from siloing and towards efforts across multiple channels, making existing antibiotics stronger, etc. In fact, if you want to see how AMR spreads around the world, check out this graphic from Pew Charitable Trusts.

Stories You May Have Missed:

  • Puerto Rico’s Post-Hurricane Infectious Disease Woes – Following the destruction of Hurricane Maria, Puerto Rico is now working against the clock of infectious diseases. “Four deaths in Hurricane Maria’s aftermath are being investigated as possible cases of a disease spread by animals’ urine, Puerto Rico’s governor said Wednesday amid concerns about islanders’ exposure to contaminated water. A total of 10 people have come down with suspected cases of leptospirosis, Gov. Ricardo Rossello said at a news conference.”
  • The Interesting Case of the World’s First Vaccine– a recent report on a 115-year-old smallpox vaccine vile is shedding light onto the ingredients of this revolutionary medical countermeasure. “With the evolution of science and the advanced tools now used to conduct it, it has become clear that vaccinia — the virus used in modern smallpox vaccines — is neither cowpox nor horsepox. Whether it is a virus that formerly infected some species of animals — rodents, maybe — or is something that evolved in laboratories through the deliberate mingling of pox viruses isn’t clear.”

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

Pandora Report 8.18.2017

ECDC Tool for Prioritizing Biothreats
The European Centre for Disease Prevention and Control has released their tool for the prioritization of infectious disease threats. “This qualitative tool, implemented as an Excel workbook, is based on multi-criteria decision analysis. It ranks infectious disease threats in a transparent, comparable and methodologically reproducible manner. The tool enables the relative ranking of different infectious disease threats. It is intended as a supplement to other methods that also support decision-making in preparedness planning.” Part of the tool involves a scoring of diseases, in which it suggests that a multidisciplinary expert group works to establish reliable information and adequate scoring. The ECDC tool also includes a handbook and manual for users to get the most out of it.

 Long Ignored: The Use of CBW Against Insurgents
GMU Biodefense PhD alum Glenn Cross investigates the use of chemical and biological weapons in counterinsurgency campagins like that of Rhodesia, South Africa, and Syria. Cross notes that history has shown the efficacy of CBW against ill-equipped and often poorly trained insurgents. He points to the debate regarding application of use – some say that these weapons are used when conventional forces are ineffective and often a last resort, while others note that the lack of an international and effective response have given insurgents incentive. “The conclusion from these examples is that regimes in extremis — when the battle is for their very survival — seem to have little compunction about resorting to chemical and biological weapons use. The much-heralded international norms and conventions prohibiting and condemning chemical and biological development and use go out the window when a regime’s survival is at stake. The examples of Rhodesia and Syria show that the international community must be united and demonstrate the requisite political will to enforce norms if the use of chemical and biological weapons is to be prevented.” Cross highlights two case studies, Rhodesia and Syria, pointing to the use of biological weapons by Rhodesian forces as being the only example of a nation using bioweapons since the end of WWII. While the regime was aware of treaty obligations, it had no bearing on their decision to use such weapons. So what are effective constrains on the use of CBW? The case studies reveal that regimes care little about their efficacy, international norms, or international agreements, but it is really deterrence that likely prevents the use of such weapons. The credible threat of military action is the strongest deterrent and realistically, until international norms include uniform enforcement amongst nations, they won’t be as effective. “As we’ve seen in Syria, such consensus is elusive, and the international community has failed to act. As a consequence, the world faces a sad, but inevitable conclusion. The Syrian regime is unlikely to ever face justice for its use of chemical weapons.”

A View from the CT Foxhole: Edward You, FBI Weapons of Mass Destruction Directorate, Biological Countermeasures Unit
As if we need any more reasons to think Edward You is a biosecurity action hero! The Combating Terrorism Center recently sat down with Supervisory Special Agent in the FBI’s WMD Directorate, Biological Countermeasures Unit, and discussed not only his role within the FBI but also their work and coordination with partners. You notes that hisprimary mission is to support outreach and engagement, but probably most importantly it is to backstop the WMD Coordinators who are positioned in the field. They have to cover the whole broad range of modalities—chem, bio, nuke, explosives. They do the initial engagements, the partnerships, the initial response, but they can always call back to headquarters where we leverage all of our expertise as subject matter experts. We can bring in the laboratory division; we can bring in Centers for Disease Control and Prevention (CDC), if necessary, the Department of Homeland Security to support them when they run into an incident out in the field.” He emphasizes the importance of the relationship the FBI has with the private sector, not only in terms of shared interests, but also communicating security problems to help get more buy-in and coordination. When asked about the DIY biohacker, You notes that “We look at these community labs as a big positive force in the economy and engines of innovation. That has helped us overcome the natural tendency for such outfits to be a little bit anti-establishment. By engaging with them, we’re helping them to raise their level of awareness that they could potentially be targeted by malicious actors seeking to subvert their work, steal their technology, or recruit insiders on their staff. By helping them establish a form of ‘neighborhood watch,’ they will be best positioned to identify and report on instances of suspicious activity both internal and external to their community. Who better to identify threats than the community members themselves?” While the partnerships with DIY labs haven’t garnered any leads to potential threats, they help the FBI understand the direction biotech is heading, which allows them to flag areas of concern faster than if they used a top-down approach. You also addresses the 2016 Europol warning of potential ISIS experimentation with bioweapons, commenting that “With ISIS, al-Qa`ida, or any other threat actor for that matter, we are faced with two significant challenges. The first is ideology. What happens if that lone individual that becomes persuaded by their ideology happens to be a microbiologist or a biochemist? The counter WMD mission has always proceeded by identifying the actors expressing the intent to acquire, develop, or use WMDs (e.g., counterproliferation efforts). And historically, significant effort and investments have been made to counter the biological weapon threat ranging from state/non-state actors to individual level biological crimes (e.g., attempted ricin poisonings). But this introduces the second challenge. Unlike the chemical and radiological/nuclear realms where materials of concern are highly regulated and the expertise is almost arcane, biology could be classified as dual use or multi-use. The strength of the field is based on the fact that it is inherently open in nature (e.g., peer-reviewed scientific journals), which has led to significant advances in areas such as healthcare.” Lastly, You points to what he considers the greatest biosecurity threat facing the U.S. – the concerns of non-state actors, but also the role of data in terms of gene editing and other biotech, noting that “we may have have been short-sighted. Most of our legal frameworks have been focused on privacy and not on security.” “Because there’s a lack of understanding about where bio is going, we’re in danger of falling behind, and my biggest concern is that for lack of our foresight and being strategic in this space, I think China is going to become a potential biological superpower.” Did I mention that Edward You is frequently a speaker at our summer workshops?

North Korea’s Chemical Arsenal Complicates U.S. Options 
As concerns over North Korea’s nuclear weapons program grows, the threat of chemical weapons has seemingly been downplayed. Tackling nuclear threats through preemptive strikes could push North Korea to utilize their chemical weapons program and sizable stockpile, which is considered to be one of the largest. “Experts are also disturbed by Kim Jong-un’s brazen public assassination of his half-brother using the nerve agent VX, saying it demonstrates the regime’s willingness to use deadly toxins. ‘I think if people paid more attention to the chemical side, they’d be less inclined to talk about preemption and going first against North Korea,’ said Greg Koblentz, a researcher of weapons of mass destruction at George Mason University.” In the event that chemical weapons are deployed, the South Korean capitol of Seoul would surely take a hit, which is home to 25 million people. While details of North Korea’s biological weapons program have given little insight into what is actually going on, there is considerably more knowledge regarding their chemical weapons initiatives. “The exact composition and size of North Korea’s chemical arsenal is unclear, but it’s believed to include everything from antiquated chlorine gas all the way up to sarin, VX, and other highly lethal nerve agents. These weapons are distributed at facilities across the country, often tucked away in underground bunkers or other sites unknown to U.S. and allied intelligence. The weapons are also deployed along the armistice line, which sits just 35 miles north of Seoul.” While there are limits to their chemical weapons capabilities, they surely provide little comfort to South Korean citizens and those living in Seoul.

 Chatting With the WHO
New WHO Director-General Tedros Adhanom Ghebreyesus spoke with Foreign Affairs’ regarding his plans for the future of the WHO and efforts to combat global disease. Tedros notes that epidemics or pandemics keep him up at night, especially something like the 1918 pandemic and the “serious gaps we have”. He comments that “I think the world should unite and focus on strong health systems to prepare the whole world to prevent epidemics—or if there is an outbreak, to manage it quickly—because viruses don’t respect borders, and they don’t need visas.” In regards to irrational beliefs as a public health threat, Tedros highlights the role of governments (and the WHO in supporting them) to communicate with communities and use media as a tool for teaching. Tedros discussed the WHO’s response to Ebola and when asked about hesitancy governments may experience regarding raising the alarm for an outbreak, he noted that “it’s not an issue between the WHO and the member state in question; it’s about the overall implementation of the International Health Regulations [the rules that govern how states respond to outbreaks]. That involves not only the country in question but other countries, as well. For instance, a country may fear the impact on the economy if it reports a certain disease. And if the other countries, instead of banning travel or other measures, could be supportive and implement the IHR, then the country could be encouraged to report immediately.”

Book Review – Barriers to Bioweapons
As the summer winds down, you may find yourself needing a new book to delve into. GMU biodefense professor Sonia Ben Ougrham-Gormley‘s book, Barriers to Bioweapons, is a great addition to any lover of health security and the realities of biological experiments. This latest book review gives a witty and entertaining overview of her work, noting that “Barriers to Bioweapons argues that actually, we’re not all living on borrowed time – that there are real organizational and expertise challenges to successfully creating bioweapons. She then discusses specific historical programs, and their implications for biosecurity in the future.”

Pandemic Preparedness & A Global Catastrophic Biological Risk By Any Other Name Would Smell As Sweet

GMU biodefense PhD student Saskia Popescu tackles the importance of pandemic preparedness and the latest publication from the Center for Health Security regarding global catastrophic biological risks. “We may think written plans and the occasional table-top exercise are making us more prepared to handle a pandemic, but true preparation goes far beyond that. The ability to prevent, detect, respond, and control outbreaks is a hefty investment that countries are still struggling to make, and as a new report recently revealed, a paltry amount of countries may be ready for a pandemic.” She highlights the latest World Bank report that only six countries have truly taken efforts to evaluate their readiness to handle a pandemic. Like many things, the devil is in the details, and often that is as simple as a real name for a problem. A recent publication from the Johns Hopkins Center for Health Security sought to fix this by establishing a working definition for global catastrophic biological risks (GCBR). “What makes this definition unique, aside from it being the first working definition for GCBRs, is that it highlights several components, such as sustained catastrophic damage, and instead of highlighting a specific number of deaths, it looks to a range of negative outcomes, such as infertility. The challenging task of defining such a globally feared, but poorly understood risk was daunting; however, the Center for Health Security has provided us with a working tool that can now be applied to policy, and future preparedness and response efforts.”

H5 Hits the Philippines and Plague in Arizona
The Philippines is reporting its first highly pathogenic H5 avian influenza outbreak. Hitting a commercial poultry farm in Luzon, the outbreak began in July and killed 36,485 of the 190,000 birds. “A report today in the Manila Times, based on a media briefing with Emmanuel Pinol, the country’s agriculture secretary, said the outbreak was confirmed in the city of San Luis and that six poultry farms were affected. Most of the poultry deaths were in layer chickens. Pinol told reporters that the outbreak may have begun as early as April when deaths were reported in quail housed above ducks. He said ducks are the likely source of the outbreak, since they had contact with migratory birds. The Manila Times report said the outbreak site is 37 miles north of Manila and is close to swamps that are stopovers for migratory birds from the Asian mainland.” Public health officials in Arizona have announced that fleas in two counties have tested positive for plague (Yersinia pestis). While plague is endemic in the southwest, public health officials still work to ensure residents are aware that there is an increased risk. Officials are warning residents to be mindful of the potential for exposure via pets. “Fleas can bite rabbits, prairie dogs and other rodents — and anything that may eat them — and transfer the disease to pets, who in turn can infect humans. Cats who get plague transmit it through their cough. Dogs typically carry the fleas on their fur. Health officials cautioned county residents and visitors to keep their pets leashed and to avoid touching dead animals. Evidence of a large die-off could indicate plague is present, they say.”

Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology
Don’t miss out on these events by the National Academies Committee on Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology:

  • August 21 – the committee’s interim report and proposed framework will be released at 11am EDT here
  • August 22 – a public release webinar and report briefing will be held from 11am-12pm EDT. Committee Chair Michael Imperiale and committee members Patrick Boyle and Andrew Ellington will be reviewing the interim report and the proposed framework. This webinar is free to attend and open to the public, but you must register to attend. You can register at the following link:  https://nasevents.webex.com/nasevents/onstage/g.php?MTID=e39277a767b1f0190db4f7ee491c01271  You will be able to submit questions and comments during this webinar through a text-based feature but will not be able to speak directly with the presenters.
  • August 23-24: The meeting will be held at the National Academies of Sciences, Engineering, and Medicine’s Keck Center at 500 5th Street NW, Washington, DC Room 208. You must register to attend the meeting in person; the Keck Center is a secure building and we will need to have your name on the guard’s list to enter the building. You can register by emailing synbiodefense@nas.edu. If you would like to attend via teleconference, you can access the conference by dialing the following: to listen, please dial 1-(866) 668-0721 and use conference code 380 454 1676.

The committee is also soliciting feedback from the public on the interim report and the associated framework. You can submit questions or comments through September 5, 2017 at the following link:  http://www.surveygizmo.com/s3/3758337/A-Proposed-Framework-For-Identifying-Potential-Biodefense-Vulnerabilities-Posed-By-Synthetic-Biology  Due to the anticipated volume of questions, the committee may not explicitly address every comment received but all comments will be considered and reviewed. PLEASE NOTE: if you submit a question, your question and any associated identifying information you provide will be added to the study’s public access file as per the National Academies’ requirements to comply with FACA.

Stories You May Have Missed:

  • Uganda Ebola-like Illness Demystified- Public health officials in Uganda are sighing with relief as results from the Uganda Virus Research Institute (UVRI) have reported the death of a 20-year-old woman in Luweero was due to carbon monoxide poisoning and not the suspected Ebola virus. “There are currently 3 female cases admitted at Bishop Asili hospital, Luweero. However, results from UVRI indicate that all cases were negative for Ebola, Marburg, Crimean-Congo hemorrhagic fever, Rift Valley fever, and Sosuga viruses. ‘The ministry of health team is working closely with the District Health Team to monitor, review, and manage these cases as well as orienting health workers on management and referral protocols of suspected cases,’ reads the statement.”

Pandora Report 6.23.2017

TGIF! Before we begin our weekly dose of all things biodefense, have you ever wondered the traits that predict animal or host spillover?

What Does A Post-Polio World Look Like?
Decades of battling diseases in eradication efforts has been a struggle throughout public health history, but what happens when you finally reach the finish line? Donors around the world have worked to eliminate polio and in the final stretch and last ditch efforts, many are asking what will happen when polio is eradicated and the donors are gone? The truth is that many polio eradication programs (which include vaccination and surveillance campaigns) actually form the foundation of public health for many countries and rural areas. These programs have been the backbone of establishing some semblance of public health for areas that many not receive it otherwise. “If and when polio is gone, however, much of the transition may fall to national governments. International funding stands to shrink dramatically. About 27 percent of WHO’s $587 million in spending in 2016 went to polio eradication efforts. The African region would also be particularly hard hit. Forty-four percent of WHO spending there went to polio efforts, and about 90 percent of all immunization staff and infrastructure on the continent are funded through the WHO’s Global Polio Eradication Initiative.” We haven’t really considered what it means to eradicate a disease like polio and how the withdrawing of funds and personnel might impact countries. Moreover, many of the polio eradication programs are closely tied to other vaccination programs (measles, tetanus, pertussis, etc.) and if funds are lost because polio is eradicated, these other vaccination programs could take a hit. Aside from vaccination initiatives, if stable public health programs are not established prior to eradicating polio, there is also a risk for loss of disease surveillance. Current polio eradication programs highlight the role of surveillance, which is also used to facilitate laboratory development, all of which could impact pandemic preparedness and global health security. It is vital that efforts to eradicate polio are also met with work from political leadership to ensure a transition occurs that maintains public health efforts. “The transition as polio is eradicated will be complex, and needs to be carefully managed, country specific and country led. Polio surveillance systems can provide an important foundation, and are tremendous assets to health care systems, said Irene Koek, the deputy assistant administrator of global health at the United States Agency for International Development. Civil society organizations will have a role to play in advocating to keep local governments and ministries on target, said John Lange, the United Nations Foundation‘s senior fellow for global health diplomacy.”

Instructor Spotlight – Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
We’re getting closer to the July 17th start date for our workshop (and the July 1st early registration discount expiration!) and this week we’re excited to show off one of our very own GMU Biodefense professors, Dr. Sonia Ben Ouagrham-Gormley. An economics and defense expert, biodefense guru, and world traveler, Dr. Ouagrham-Gormley is the kind of professor whose class you spend the entire time on the edge of your seat. Sonia Ben Ouagrham-Gormley, PhD, is an Associate Professor in the Schar School of Policy and Government at George Mason University. She holds affiliations with GMU’s Biodefense Program, Center for Global Studies, and the Department of History and Art History’s Master of Arts in Interdisciplinary Studies (MAIS) program. Prior to joining the faculty at George Mason in 2008, Professor Ben Ouagrham-Gormley was a Senior Research Associate with the Monterey Institute of International Studies’ James Martin Center for Nonproliferation Studies (CNS). While at CNS, she spent two years at the CNS Almaty office in Kazakhstan, where she served as Director of Research. She also was the founding Editor-in-Chief of the International Export Control Observer, a monthly publication focusing on proliferation developments and export controls around the globe. From 2004 to 2008, she was an adjunct professor at Johns Hopkins’ School of Advanced International Studies in Washington, D.C. She is the author of Barriers to Bioweapons: The Challenges of Expertise and Organization for Weapons Development (Cornell University Press, 2014). She received her PhD in Development Economics from the Ecoles des Hautes Etudes en Sciences Sociales (EHESS) in Paris; a graduate degree in Strategy and Defense Policy from the Ecoles des Hautes Etudes Internationales in Paris; a master’s degree in Applied Foreign Languages (triple major in economics, law, and foreign languages —Russian, and English) from the University of Paris X-Nanterre, and a dual undergraduate degree in Applied Foreign Languages and English Literature from the University of Paris X-Nanterre. She is fluent in French, English, Russian, and spoken Arabic, and possesses beginner competence in Kazakh. For more information, visit https://schar.gmu.edu/about/faculty-directory/sonia-ben-ouagrham-gormley

President’s Budget Would Leave U.S. Vulnerable to Global Health Security Threats and Why We Need An Emergency Fund For Future Outbreaks
Cuts to public health, health research, and international aid have some pretty far-reaching implications and faculty from the Johns Hopkins Center for Health Security are pointing to the inherent vulnerability that would come from Trump’s proposed budget. Health security incorporates several programs and the reality is that an epidemic anywhere means an epidemic everywhere – simply put, the outbreaks that could pose a threat to the U.S. commonly begin abroad. “The proposed budget would cut $76 million from CDC’s Global Health programs, including cuts to Global Disease Detection and other programs that train and prepare countries to diagnose and respond to emerging diseases, and to the Global Immunization Program. It would reduce by $65 million CDC’s Emerging and Zoonotic Infectious Diseases programs, which aim to prevent and control outbreaks of diseases such as Zika. It cuts by $136 million the CDC Preparedness and Response Capability budget, which includes the funding for CDC’s Emergency Operations Center and the deployment of its people abroad to emergencies such as the Ebola epidemic in West Africa.” The CDC, among other agencies with biodefense positions, has a significant volume of vacancies that haven’t been filled.  More over, the authors point to the gap within the president’s budget regarding the future work of the GHSA, which is a vital multi-lateral effort to strengthen global health security. The budget has many worried because together, these cuts paint a bleak future for health security efforts – impacting surveillance, preparedness, and response efforts across the board. Global health security is simply not an investment we can afford to ignore. Did I mention that co-author Jennifer Nuzzo is also an adjunct professor at GMU’s biodefense program? Even if you’re not worried about the impact of the budget on health security, Ebola and Zika revealed just how necessary an emergency fund for outbreaks really is. “Creating a similar ‘rainy day’ fund—and providing the Centers for Disease Control and Prevention with permission to use it in advance—could save lives and money, both at home and overseas. The idea behind an emergency fund is not to displace efforts to combat infectious disease but to ramp them up to meet a crushing temporary need. During an outbreak the CDC can call on many doctors and nurses to work without pay, but the costs of transportation, medical supplies and protective equipment still have to be covered.” While the president’s 2018 budget includes such a fund, it fails to give a specific dollar figure and is already cutting into public health funding, which may be counterintuitive. “Lawmakers need to follow through by approving one or both of the proposed measures for the president to sign to ensure that the money will be there when the next public health emergency strikes.”

North Korea & A Sea of Sarin
The threat of nuclear-armed ballistic missiles from North Korea is a growing concern and while many focus on their nuclear and ballistic missile ambition, Reid Kirby is examining North Korean chemical weapons. Looking at the Terminal High Altitude Area Defense (THAAD) missile system and South Korean capital of Seoul, which houses more than 10 million people, many worry about North Korea’s ongoing vague threats. “Proponents of preemptive military action against North Korea’s nuclear program, along the lines of Israel’s 1981 Operation Opera against Iraq’s nuclear program, typically ignore North Korea’s history of asymmetrical responses. But North Korea’s capacity to inflict mass chemical casualties on the Seoul area in a ‘sea of sarin’ attack rivals its capacity for nuclear destruction.” In 2010, it was estimated that North Korea possessed 2,500-5,000 tons of chemical weapons (mostly sarin and VX) and maintains roughly eight manufacturing facilities, which could ramp up production to 12,000 tons. Kirby addresses estimates of rounds per minute and calculations of how much sarin Seoul might receive in such an attack, noting that “a heuristic approach to estimating the total quantity of sarin required to inflict 25 percent casualties on a city such as Seoul under the specified conditions simplifies the problem into a box model of 600 square kilometers, with casualty rates integrated by area to find the necessary quantity. Using this approach, a ‘sea of sarin’ attack on Seoul would require about 400 kilograms of sarin per square kilometer”. He highlights the consequences of a 240-ton sarin attack on Seoul, noting that it would kill around 6.5% (higher lethal dosage) or potentially 25% of the population (if lower lethal dosage assumed). “If publicly stated intelligence estimates are to be believed, North Korea’s chemical arsenal represents a credible and present threat. How North Korea could apply this threat as a deterrent is speculative. But the destructive potential of the threat should give reasonable cause to hesitate regarding preemptive military options against North Korea’s nuclear weapons ambitions.”

Pandemic Flu Plan – A New Approach
The US Department of Health and Human Services (DHHS) just released their updates to pandemic flu plans. “The original plan was geared toward a more severe scenario and set a goal of delivering pandemic vaccine within 6 months of a pandemic declaration. The new document incorporates lessons learned from the 2009 H1N1 pandemic, which resulted in a less severe event. It also spells out the goal of having the first vaccine doses ready within 3 months of pandemic strain emergence, along with approved broad-spectrum antivirals.” Within the plan there are now seven domains of focus, which include objectives, goals, and key steps. The domains are: surveillance, epidemiology, and lab activities, community mitigation measures, medical countermeasures, healthcare system preparedness and response, communications and public outreach, scientific infrastructure and preparedness, domestic and international response policy, incident response, and global partnerships. You can read the plan here, in which HHS notes that they are exploring several innovative approaches to pandemic flu preparedness like re-conceptualizing respiratory protection, accelerating vaccine and antiviral development, building on emerging technologies for innovative diagnostic and diagnostic testing, etc. “Taken together, the updated domains reflect an end-to-end systems approach to improving the way preparedness and response are integrated across sectors and disciplines, while remaining flexible for the conditions surrounding a specific pandemic. This more-nuanced and contemporary approach recognizes the interdependence of domain areas, which should lead to a better understanding of how the system functions as a whole.” The updated HHS pandemic plan emphasizes that while the nature of influenza and pandemics may change, the importance of planning and strengthening critical infrastructure will always be necessary.

DoD Tick-Borne Disease Research Program
There’s been increasing attention to the threat of tick-borne diseases and the DoD is ramping up research efforts. Their Tick-Borne Disease Research Program (TBDRP) looks to help increase not only treatment efforts, but also diagnostic capacity. Created in 2016, the TBDRP works to fill the gaps within tick-borne disease research through programs like the Idea Award which encourages and supports investigators in the early stages of their career. The New Investigator aspect of this award aims at those postdoctoral fellows working to develop independent research and in the early stages of faculty appointments. “There are currently at least 16 known tick-borne illnesses, with emerging diseases being discovered all the time. In the United States, the yearly cases of Lyme disease and other tick-borne diseases, including spotted fever rickettsiosis, anaplasmosis, and ehrlichiosis, have been increasing steadily for years, currently totaling tens of thousands of people diagnosed annually, with more likely undiagnosed. Globally, the US Military prioritizes tick-borne Crimean-Congo hemorrhagic fever as an operational threat abroad. The FY17 TBDRP intends to support conceptually innovative, high-risk/potentially high-reward research in the early stages of development that could lead to critical discoveries or major advancements that will accelerate progress in improving outcomes for individuals affected by Lyme disease and/or other tick-borne illnesses.”

Health Sector Resilience Checklist for High- Consequence Infectious Diseases
Johns Hopkins Center for Health Security and the CDC jointed together to take the lessons learned from Ebola and build a checklist to strengthen the U.S. in the event of such high-consequence outbreaks. This checklist focused on high-consequence infectious diseases (HCIDs), which are novel, moderate to highly contagious, moderate to highly lethal, not easily controllable by MCM or non-pharmaceutical intervention, and cause exception public concern (think Ebola, MERS, H5N1, etc.). “The principal aim of this project was to develop evidence-based recommendations to enable communities to build health sector resilience to events involving HCIDs based on the domestic response to confirmed cases of EVD in the United States.” Aside from the checklist, their findings highlight issues with governance and coordination, communication, public health issues, health-care specific issues, EMS, and laboratories.  The general checklist itself includes sections on preparedness, leadership, creative flexibility, command structure, public trust, managing uncertainty, and crisis and emergency risk communication. There are also checklists for public health, healthcare, EMS, and elected officials, which includes things like a collaborative relationship with partners at other healthcare facilities and awareness of resources related to public health law expertise.

Stories You May Have Missed:

  • Anthrax: DoD Develops Biological Select Agents & Toxins Surrogate Solution – “The Defense Biological Product Assurance Office (DBPAO), a component of the Joint Program Executive Office for Chemical and Biological Defense, has announced the development of a Biological Select Agents and Toxins (BSAT) surrogate solution that will mitigate the risks associated with shipment and use of Bacillus anthracis. In addition to risk mitigation for Department of Defense (DoD) stakeholders and the community at large, this product demonstrates DBPAO’s commitment to providing quality reagents to the DoD and to the biodefense community. To accomplish this task, the DBPAO developed a Bacillus anthracis surrogate strain named Recombinant Bacillus anthracis with Assay Targets (rBaSwAT) using a recombinant DNA approach to create a BSL-2-level genetically modified organism that will allow continuation of operations with reduced risk. The strain is built in a novel, non-virulent Bacillus anthracis background and carries a comprehensive complement of anthrax specific molecular and immunological markers.”
  • Bioviolence- Matt Watson from Johns Hopkins Center for Health Security, is taking us through the history of bioviolence aka using infectious diseases for violent purposes. While not everyone truly sees the immediate threat of biological agents, Watson highlights the newer threats like synbio and biotechnologis that have growing potential for misuse. He also takes care to highlight the history of bioweapons to truly show the range of their application. “Of all the scourges of mankind, plagues and warfare are almost certainly the most dreaded and dangerous. Several times throughout history—and more frequently than most people are aware of—there have been attempts by individuals, organizations, and nation-states to harness the former in service of the latter.” If you want a brief overview of historical biological weapons and to truly understand the future of biothreats, don’t miss out on this great op-ed.
  • New York City Legionnares’ Cluster – Health officials are scrambling to investigate the source of a NYC Legionnaires’ cluster in Manhattan. “In a Jun 16 statement, the New York City Department of Health and Mental Hygiene (DOHMH) said seven illnesses have been confirmed over the past 11 days. Four people are recovering in the hospital, two have been discharged, and one person in his or her 90s with underlying health conditions has died. Authorities are sampling and testing all cooling tower systems within a half-kilometer radius of the affected area of Lennox Hill. The health department is urging New Yorkers who have respiratory symptoms such as fever, cough, and chills to promptly seek medical care. In a typical year, about 200 to 400 Legionnaires’ cases are reported in New York City.” Legionnaires’ can be deadly for immunocompromised patients and is often a result of water treatment issues or poor disinfecting processes with spas, hot tubs, humidifiers, condensers, etc.