Pandora Report: 5.27.2022

Happy Friday! This week starts with a trip around the Korean Peninsula as we cover what some Biodefense Program students are doing in South Korea right now before discussing updates on COVID-19 in North Korea. Brief updates and sources for more information on monkeypox are also included, in addition to a number of new publications and upcoming events.

Biodefense Students Study Northeast Asian Security Issues in South Korea

Four students from George Mason’s Biodefense Program are studying international security issues in South Korea for two weeks with the Schar School’s Center for Security Policy Studies (CSPS). The program is headed up by the Schar School’s Professor Ellen Laipson, current Director of CSPS and President Emerita of the Stimson Center, and is sponsored by the UniKorea Foundation. Their time in Korea began at George Mason’s Korea campus, located on the Incheon Global Campus. They are currently in Seoul and will soon finish their trip in Busan. Among other things, they have completed a Korean War crisis simulation and attended the CSPS-Korea branch’s annual symposium, “Prospects for Peace on the Korean Peninsula in Northeast Asia’s Changing Security Landscape,” which has been featured in multiple Korean media outlets.

COVID-19 in North Korea

The Democratic People’s Republic of Korea’s (DPRK, North Korea) outbreak of “fevers” continues as cases surge towards 3 million and the official death count reaches 86. The country claims it has the situation under control and that it is currently seeing a downward trend in cases, though this is the subject of much skepticism. “In a few days after the maximum emergency epidemic prevention system was activated, the nation-wide morbidity and mortality rates have drastically decreased and the number of recovered persons increased, resulting in effectively curbing and controlling the spread of the pandemic disease and maintaining the clearly stable situation,” Korean Central News Agency said this week.

However, North Korea is apparently unable to maintain sufficient testing capacity, so their numbers actually reflect those confirmed to have a fever, rather than confirmed cases of COVID-19. The term “fevers” seems to have become both a euphemism for COVID-19 and an actual metric for determining who is sick in the absence of strong testing capacity. Furthermore, given the realities of the regime’s rule and party politics in the country, lower-level leaders are not incentivized to tell the truth about outbreaks in localities and provinces. Therefore, while state media is likely not telling the truth about the situation, the central government also likely does not have a great understanding of national case counts either.

North Korean poster praising the Party’s “quarantine battle” featured by Korean Central News Agency (Source: 조선중앙통신)

Furthermore, while it is doubtful that the country has been truthful in reporting cases over the last couple of years, this does pose an important question- Why did the DPRK announce it has an outbreak now? Kim Jong-un has even described this as the worst crisis since the country’s founding in the mid-20th century. For context, North Korea survived a horrific famine in the 1990s wherein 240,000 to 3.5 million died of starvation or hunger-related illnesses in a country of 22 million. The DPRK is currently struggling with food shortages driven by low crop yields and reduced trade with the PRC due to COVID-19 border restrictions. Kim has also formally acknowledged this crisis, but the admission that this outbreak is so dangerous is especially interesting. National lockdowns have also likely further exacerbated hunger issues in the chronically malnourished country, as North Koreans lose access to private markets where many acquire most of their food, instead of through the national distribution system. There are a myriad of answers swirling around right now about why Kim announced this now, ranging from the idea that he really did not know how bad it was (because, again, lower-level leaders are not likely to be entirely truthful in their reporting) to the potential for this announcement to give the regime more control during this crisis.

However, the rapid spread of fevers throughout the capital has not dampened the DPRK’s missile tests. It launched three ballistic missiles within hours of announcing there was an outbreak in Pyongyang. Furthermore, this week, as President Biden’s trip to South Korea and Japan wrapped up, the North launched an ICBM and two other ballistic missiles. Multiple high-explosive tests have been conducted in the North in recent weeks, prompting officials to warn that nuclear and ICBM tests were likely scheduled to occur within the next several weeks. President Biden promised his counterparts that he would work to deter the North’s nuclear threat, which has been a cornerstone of newly-inaugurated South Korean President Yoon’s campaign. Biden and Yoon also publicly discussed resuming military exercises between the two countries, which were paused or scaled-down under the Trump and Moon administrations in an effort to increase engagement with the DPRK. While all of this is something the North would unsurprisingly conduct tests in response to, some did express doubt that this would happen with the formal announcement that there is a major COVID-19 outbreak in the capital. This week, the UN Security Council rejected a US-led resolution to sanction the DPRK in response to these launches, due to Russian and Chinese vetoes. The Chinese Permanent Representative to the UN, Zhang Jun, gave a speech during the vote in which he argued that sanctioning the North would be inhumane given the current situation, even though countries like South Korea and the US have offered aid to the DPRK even while remaining firm on issues like the North’s nuclear program.

The North has also continued to reject other international COVID-19 aid, further signaling that this outbreak has not changed much in the DPRK’s foreign policy so far. There are no known COVID-19 vaccines or antivirals in the country either. With concerns about access to things like oxygen and other medical supplies in the country, this fact is especially concerning. State TV has advised citizens to do things like make salt gargles, drink herbal teas, take pain killers, and disinfect their homes with mugwort solutions, further indicating the regime is presently relying on these at-home “cures” even though it has been offered aid by several countries and the WHO. Kim Jong-un has personally toured several pharmacies, sporting two masks while doing so in a departure from the last two years. It has also been reported that North Koreans near the Chinese border have been observed not wearing masks, meaning masking may only be in effect in Pyongyang or there is a mask shortage. This all does not bode well as the country’s healthcare system has remained hardly functional since the 1990s and more than 42% of the population are considered malnourished.

Monkeypox Cases On the Rise

Monkeypox updates are coming in constantly so, in an effort to not provide outdated or incomplete information, this section will focus more on providing good options for more information. As of May 25, there were 219 confirmed cases globally, primarily in young men who have sex with men, according to the European Centre for Disease Prevention and Control. These have been reported in 12 WHO member states where the disease is not endemic, a fact that the WHO says is abnormal, but containable.

The CDC’s Health Alert Network recently published this report on the disease in the US and other non-endemic countries that urges clinicians to be vigilant given the rise of cases not associated with travel to endemic countries. It provides good background and descriptions of clinical presentation, in addition to advice for health departments and the general public.

This situation has also required countries to assess the preparedness of their vaccine stockpiles. The US has two vaccines in its Strategic National Stockpile for smallpox that will also work against monkeypox, for example. As there is no specific vaccine for monkeypox, demand for smallpox vaccines has skyrocketed. Bavarian Nordic‘s smallpox vaccine has proven to be 85% effective against monkeypox and the company is seeing unprecedented demand for a product it normally produces for biodefense stockpiling purposes.

“Unrelenting Violence: Violence Against Health Care in Conflict”

The newest report from Safeguarding Health in Conflict Coalition was recently released, analyzing attacks on healthcare systems in conflict zones throughout 2021. With more than 200 WHO-confirmed attacks on health care in Ukraine, “…the world’s attention has understandably focused on Russia’s invasion and its apparent strategy of targeting hospitals and ambulances,”—but the crisis is global, the Coalition’s chair, Leonard Rubenstein, said in a Physicians for Human Rights news release. While the report does acknowledge there have been some improvements in accountability for these attacks, Rubenstein also stated, “Perhaps 2022 will be an inflection point, as images and reports of attacks on health care and their consequences in Ukraine continue to go viral, accompanied by frequent and loud demands for accountability – but it won’t be if the lassitude of the international community continues.”

Combatting Terrorism Center Sentinel New Edition

West Point’s Combatting Terrorism Center (CTC) recently released a new edition of its Sentinel, “The Biological Threat- Part Two,” as a follow up to the previous part one. In it, Gary Ackerman, Zachary Kallenborn, and Philipp Bleek present a bioterrorism
classification schema to evaluate the pandemic’s impact on bioterrorism, concluding that “…when it comes to bioterrorism, the pandemic probably has not moved the needle much. Although COVID-19 might encourage apocalyptic cults, some radical environmentalists, some extreme right-wing groups, and some Islamist extremist groups toward biological weapons, most other terrorist groups are more likely to be discouraged. The pandemic has bolstered some terrorists’ bio-related capabilities but in at most modest ways. At the same time, lessons from the COVID-19 experience may both help reduce the consequences of a future attack and heighten perceptions of bioterrorism risk.” Drs. Audrey Kurth Cronin of American University and Jaime Yassif of NTI also provided articles for this edition.

“When All Research Is Dual Use”

Issues in Science and Technology recently published this article by Dr. Sam Weiss Evans. In it, Weiss discusses issues with how policymakers view science and scientists, writing “The problems with the myth of asocial science, and its accompanying pantheon of lone hero scientists, are widespread and well known—but not, it seems, to policymakers, who continually reinscribe it. The myth can be found throughout US research, innovation, and governance systems, all of which fail to incentivize scientists to engage with society—or, often, even with those from other fields of study who might bring a different perspective.” He argues that science should instead be understood as a social system wherein science and scientists are questioned on the security implications of their work. He also criticizes “research security” and “research integrity”, arguing that these are part of a “fortress America” understanding of the world and that “Guards, gates, and guns only help when it’s clear what the threats are and what is to be protected. In the world of emerging biotechnology, neither is clear.” He ultimately concludes that social science approaches to understanding these threats need to be at the heart of the National Security Commission for Emerging Biotechnology’s work, writing that it will “…not be easy, as it questions some of the underlying assumptions of science—and of national security—for the last century. But the world in which those foundations were laid down no longer exists.”

“Charting a New Course for Biosafety in a Changing World”

David Gillum, Rebecca Moritz, Dr. Yong-bee Lim (Biodefense Program alumni), and Dr. Kathleen Vogel also recently released a piece in Issues in Science and Technology. They explain that “… recent events—such as the discovery of smallpox vials outside of high containment labs, the transport of inactivated anthrax around the world, and safety concerns around gene drives and a future with do-it-yourself genome editing—highlight gaps in how biosafety governance currently operates.” They argue that now is the time to amend issues in biosafety governance, but also that current proposals to do so “…largely mirror historical precedents and are reactive, overly broad, and inconsistent.” Their work provides good background information on this debate and offers an intriguing perspective on how to best balance allowing science to advance while also being realistic about the risks certain work poses.

Summary Report- “The Ethics of Protecting ‘CRISPR’ Babies: An International Roundtable”

The University of Kent recently hosted a roundtable event focused on the ethical issues posed by “CRISPR babies,” which featured Biodefense Program faculty member Dr. Sonia Ben-Ouagrham Gormley. The event’s summary report was recently published and provides background on this issue, including the recommendations of Ruipeng Lei and Renzong Qiu in China to protect the world’s first three genome-edited children, in addition to panelist comments. Dr. Ben-Ouagrham Gormley was also recently named a runner-up winner of the James Martin Center for Nonproliferation Studies’ McElvany Award for her work, “From CRISPR babies to super soldiers: challenges and security threats posed by CRISPR.”

Launching the Competence Network CBWNet: Achievements of the Chemical Weapons Convention and Future Challenges

The CBWNet recently released this working paper discussing the CWC at 25 years and the recent launch of the CBWNet project itself. The project is “a new, joint endeavour aimed at strengthening the norms against chemical and biological weapons. The four-year project is carried out jointly 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 von Weizsäcker-Centre for Science and Peace Research (ZNF) at the University of Hamburg.” This paper identifies key gaps in international norms against chemical weapons use and how these might be bridged.

Discussions with DTRA Podcast, “Episode 1: DTRA Cleans Up Vozrozhdeniya Island’s 12 Tons of Anthrax”

This episode covers the Cooperative Threat Reduction Program’s Biological Threat Reduction Program’s heavy involvement in Vozrezhdeniye Island, Uzbekistan, commonly referred to as Voz Island, where the CTR Program eliminated more than 12 tons of weaponized anthrax that was abandoned on site. It includes the personal stories and experiences of DTRA people who were on the ground as part of the clean-up crew.

Global Public Policy Institute Podcast- “Nowhere to Hide”

This new episode from GPPI, “Nowhere to Hide”, discusses use of chemical weapons in Syria using first-person perspectives to do so. GPPI writes:

The systematic use of chemical weapons in Syria is one of the most heinous crimes in modern history. These toxic attacks have claimed the lives of almost two thousand people and left thousands more profoundly scarred. Not only did the Syrian regime poison its own people – it also defied the norms that underpin our international community. Assad’s flagrant crimes in Damascus, Aleppo and elsewhere have raised weighty questions about the future of war. And they have left Syrians with a momentous mission for justice. Nowhere to Hide tells the stories of those who came closest to these events.

Investigating High-Consequence Biological Events of Unknown Origin

The Vienna Center for Disarmament and Nonproliferation and the Nuclear Threat Initiative are offering an event exploring the possibility of establishing a new “Joint Assessment Mechanism” — a concept that NTI has been developing in consultation with international experts — to strengthen UN-system capabilities to investigate high-consequence biological events of unknown origin. The event will take place on Tuesday, 7 June 2022 from 13:00 to 14:30 CEST (Central European Summer Time) in person and online. The event will feature NTI’s Dr. Jaime Yassif and Angela Kane and UNIDIR’s James Revill. RSVP here.

Stakeholder Engagement Meeting on USG Policies for the Oversight of Life Sciences Dual Use Research of Concern

NIH will hold a stakeholder engagement meeting on the U.S. Government policies for the oversight of Dual Use Research of Concern (DURC). The meeting will be held in person at Arizona State University in Tempe, AZ and it will be webcast. It is scheduled for June 29, 2022, tentatively 12:00 PM to 6:15 PM ET (9:00 AM to 3:15 PM MT). Additional information will be available soon. Please monitor this site for updates.

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:

Dr. Gregory Koblentz on The Danger of Disinformation

Dr. Koblentz recently gave this talk, “The Danger of Disinformation,” with the Nuclear Threat Initiative discussing Russia’s false claims about Ukrainian biological research facilities.

GMU’s Access to Excellence Podcast- “EP 39: Russia’s War in Ukraine is Tied to Corruption, Organized Crime”

Dr. Louise Shelley, a University Professor and director of Mason’s Terrorism, Transnational Crime and Corruption Center explains to George Mason President Gregory Washington the connections between the war in Ukraine and Russian corruption and organized crime, and how criminals and terrorists take advantage in diverse ways of the globalized world in which we live. Shelley’s center exposes that criminality and recently helped take 55 million counterfeit and sub-standard medical masks out of circulation worldwide with the takedown of more than 50,000 online marketplaces and social media posts.

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: 7.20.2018

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
This week Schar Biodefense hosted a three-day workshop on all things health security, from anthrax to Zika. Highlights from the first two days include a rousing discussion by Dr. Robert House surrounding medical countermeasures and the potential for nefarious actors to highjack the immune system, Sandy Weiner delving into the history of the 1976 influenza pandemic, GMU professor and virologist Dr. Andrew Kilianski breaking down some hard realities of biosurveillance, and Edward You of the FBI discussing the importance of working with the DIY biohacker community and protecting the bioeconomy. While the workshop continues through today, make sure to check back next week for more coverage.

 Vaccine Causing Polio in Africa? Context From An Expert
GMU Biodefense PhD alum Christopher K. Brown sat down with Lucien Crowder of the Bulletin of the Atomic Scientists to discuss vaccine derived polio and the implications of these outbreaks. Brown discussed the vaccine production process, how they can cause an “infection light”, and the current outbreak in the DRC. “In the Democratic Republic of the Congo, a vaccine-derived type 2 poliovirus is responsible for the current outbreak, even though it is no longer a component of the live, attenuated oral vaccine that most countries use (when, that is, an oral, attenuated vaccine is used instead of a fully inactivated injectable formulation that is safer but potentially less effective). Despite a World Health Organization–led switch from the three-type, or trivalent, vaccine to a bivalent preparation, the vaccine-derived type 2 virus continued to spread from person to person undetected, slowly mutating to regain the neurovirulence that can cause paralysis in those who are infected. Now, to stop the current outbreak, health officials are deploying a monovalent vaccine formulated specifically for type 2 poliovirus. The key is to reach susceptible individuals—namely, those who did not receive the trivalent option previously—with the vaccine before the virulent strain of the virus does. If enough people are vaccinated, the mutated, vaccine-associated strain will not continue to infect new people and the outbreak will subside.” Brown took care to discuss how these incidents are high-jacked by the anti-vaccination movement, but that “the argument that vaccines cause injury often focuses on the myth that certain chemicals in vaccines—including preservatives, like Thiomersal, that are no longer used in vaccine formulations—cause autism. The polio outbreak in the Democratic Republic of the Congo is a case in which a strain of virus that was rendered safe for vaccinating most people has regained some of its disease-causing abilities through genetic mutation. That’s sort of similar to why bugs that are more common problems in developed countries, like staphylococcus and gonorrhea, stop responding to antibiotics: They acquire genetic mutations that make them resistant to certain drugs. What is most important here is to consider the level of risk associated with vaccine-linked outbreaks, or cases of paralysis, compared to the effects of polio in an unvaccinated population. While the attenuated poliovirus in the vaccine itself may lead to no more than four or five cases of paralysis among every million individuals vaccinated, there would likely be thousands of cases of serious disease among a million exposed, unvaccinated people.”

Why Aren’t We More Worried About The Next Epidemic?
In the past couple of months, we’ve seen outbreaks of Ebola, MERS, Zika, Nipah virus, Rift Valley fever, and Lassa fever – so why aren’t we more worried about the next epidemic? Globalization makes the movement of people and goods easier and faster – consider that 107 countries received frozen vegetables now being recalled for Listeria. The good news is that information technology allows us to know about these outbreaks and have the ability to notify necessary agencies and resources at a rapid pace. “Several major factors are to blame for why the world is seeing more of these increasingly dangerous pathogens. The combination of massive widespread urbanization, explosive population growth, increased global travel, changing ecological factors, steady climate change and the exploitation of environments is driving an era of converging risk for outbreaks, experts say.” Dr. Thomas Inglesby, director of the Johns Hopkins Center for Health Security, noted that ‘We don’t know when the next Ebola outbreak will come but we do know it will come again, and again, and again’.” Outbreaks like SARS and Ebola have shown the devastating impact outbreaks have on not only the healthcare system, but also the economy. Unfortunately, emergency preparedness and healthcare response is a tough problem to fix. The CDC director of the Center for Global Health, Rebecca Martin, stated that “Gaps in public health emergency response capabilities remain a serious vulnerability for the entire world,” she added. “While we don’t know when or where the next pandemic will occur, we know one is coming”. We know the next pandemic is coming, the unknowns are from where, when, and what it will look like. This makes response, including medical countermeasures, that much more difficult. R&D is a critical component to this, but as Dr. Inglesby noted, “The problem with public health in particular and with R&D is what we’re ultimately trying to do is prevent bad things from happening. When you succeed, it’s relatively invisible ― so the public doesn’t get to see why investment is so important.” Inglesby also recently highlighted the six ways countries can prepare for the next pandemic. From enhancing capabilities to develop new vaccines/medical countermeasures, to investing in more robust public health systems, there are several ways we can facilitate stronger national capacity to respond to pandemics.

Crucial Steps Forward: the National Academies of Science’s 2018 Study, “Enhancing Global Health Security through International Biosecurity and Health Engagement Programs”
GMU biodefense MS student Alexandra Williams recently attended the NASEM meeting regarding global health security through international biosecurity and health engagement programs. Within her recap, Williams discusses the background of CBEP (Cooperative Biological Engagement Program) and CTR (the DoD’s Cooperative Threat Reduction program), noting their efforts to strengthen health security within the U.S. and abroad. “As challenges continue to arise in timely and accurately detecting and responding to disease outbreaks—as we saw in 2014 with Ebola in West Africa, and in 2016 with Zika—U.S. health and security agencies are working to better meet these challenges, and examine how they need to evolve to meet unforeseen hurdles that lay ahead. This NASEM study is timely and critical because it addresses and examines these issues head-on, and will serve as the launch point for how the U.S. can rethink, reshape, and improve its already critical and successful work in biosecurity and global health security.”

Book Review – Dirty War: Rhodesia and Chemical Biological Warfare
Glenn Cross, GMU biodefense PhD alum, has taken great care to investigate and detail the history of Rhodesia’s chemical and biological warfare program against insurgents from 1975 to 1980. If you’re on the fence about adding a new book to your reading list, check out Ryan Shaffer’s latest review. “Organized topically, the book’s preface offers a brief overview of Rhodesia’s colonial history and demographics, discussing the ethnic and racial divisions arising from a white minority’s control of the government over a disenfranchised and mostly rural black African population. Cross describes the Rhodesian War with emphasis on “the regime’s inability to defeat decisively a growing guerrilla insurgency through conventional arms alone.” (39) He explains the conflict’s evolution in the context of post-war British decolonization and the manner in which the Unilateral Declaration of Independence was designed to maintain white minority rule, as well as the ensuing international sanctions that isolated Rhodesia. By the late 1960s, government opponents shifted strategy, believing the only way to change the country was to forcibility seize control. Meanwhile, the CIO had penetrated the opponents’ ranks, gathering intelligence and setting up the Selous Scouts to work against the guerrillas.” Shaffer notes that “the book is a well-researched study that sheds light on the reasons a government broke international norms to use CBW, a tactic more likely to target local non-state actors than foreign militaries.”

 Antibiotic Prescribing Failures in Urgent Care Centers
Disrupting antibiotic resistance is challenging due to not only the vast array of sectors that play a role, but also the cultural components. Prescribing habits are one of those culturally-engrained practices that can be difficult to alter. A new study has found that antibiotic stewardship is desperately needed in urgent care facilities. “Researchers with the Centers for Disease Control and Prevention (CDC), the University of Utah, and the Pew Charitable Trusts report that 45.7% of patients who visited urgent care centers in 2014 for respiratory illnesses that don’t require antibiotics end up with prescriptions for those conditions, followed by 24.6% of patients treated in emergency departments (EDs), 17% of patients who went to medical offices, and 14.4% of patients who visited retail clinics. The findings are based on analyses of 2014 claims data from patients with employer-sponsored health insurance. Previous estimates of outpatient antibiotic prescribing by some of the same researchers had pegged the amount of unnecessary prescribing at 30%, a number that some experts believe is conservative. Study coauthor David Hyun, MD, a senior officer with Pew’s antibiotic resistance project, said the findings suggest that could very well be the case.” The sad reality is that these numbers are likely to be higher across the U.S. as inappropriate prescribing practices are a systemic issue. This finding is one piece of the puzzle, which underscores the progress that needs to be made. Fortunately, countries are working to reduce antimicrobial resistance and while it’s slow, some movement forward is better than none at all.

Rift Valley Outbreak in Uganda
Uganda has reported an outbreak of Rift Valley fever across two districts. Rwanda is also reporting cases in animals and potential cases in humans. “The WHO said the affected districts are in the ‘cattle corridor’ that stretches from the southwest to the northeast regions of the country. ‘The outbreak in Uganda is occurring at a time when Kenya is having a large RVF outbreak and Rwanda is experiencing an epizootic, with suspected human cases,’ the WHO said. In Kenya, where an outbreak has been under way since May, four more Rift Valley fever cases have been reported, raising the outbreak total as of Jul 4 to 94, 20 of them confirmed. Ten deaths have been reported. Illnesses have been reported in three counties: Wajir, Marsabit, and Siaya. The country’s agriculture ministry has reported several outbreaks in animals over the past few months, especially in areas that had experienced flooding after heavy rainfall.”

Stories You May Have Missed:

  • The Strange and Curious Case of the Deadly Superbug Yeast- Maryn McKenna discusses the latest resistant bug we’re worrying about – “It’s a yeast, a new variety of an organism so common that it’s used as one of the basic tools of lab science, transformed into an infection so disturbing that one lead researcher called it “more infectious than Ebola” at an international conference last week. The name of the yeast is Candida auris. It’s been on the radar of epidemiologists only since 2009, but it’s grown into a potent microbial threat, found in 27 countries thus far.”

Pandora Report 2.23.2018

Happy Friday fellow biodefense friends! Curious about human migrant history? Ancient DNA is giving us some insight into our ancestors movements and habits. FluMist also just got the green light for use next flu season.

 Crossing the Rubicon: Horsepox Synthesis
Julius Caesar is said to have stated “alea iacta est” (the die is cast) as he led his army across the Rubicon river, triggering a point of no return in Roman history. In many ways, the horsepox synthesis is considered a new Rubicon for synthetic biology and the life sciences. While the lead researcher of the project and the private company backing it cite desires to advance progress in the pursuit of a new smallpox vaccine and identifying gaps (“Our hope is that this work will promote new and informed public health discussions relating to synthetic biology, stimulate new evaluation of [horsepox]-based vaccines, and advance the capacity to rapidly produce next-generation vaccines and poxvirus-based therapeutics.“), many are asking if they put profits ahead of public safety. The research team claimed they chose to synthesize the virus because they could obtain it no other way, but a recent article by NPR is challenging this. “There was another possibility, NPR has learned. Evans could have done research on a specimen of horsepox collected from the wild, but he didn’t pursue that alternative. He says using the natural virus might have prevented the pharmaceutical company he is working with from commercializing horsepox as a new vaccine for smallpox. But the head of the company told NPR that he had not been aware that this stored sample of horsepox was potentially available — and would not have wanted to synthesize the virus from scratch if he had known.” So now that we’ve ventured across the river, it seems that we may be learning more about dual-use research in general. Gregory Lewis notes that “Beyond the immediate issue of whether the horsepox work should have been performed (or published), the horsepox synthesis story highlights a more general challenge facing dual-use research in biotechnology: the unilateralist’s curse.” Lewis describes the unilateralist’s curse – “imagine that 100 scientists are individually deciding whether it would be a good idea to synthesize horsepox. All of them act impartially and in good faith: They would only conduct this work if they really thought it was on balance good for humankind. Each of them independently weighs up the risks and benefits of synthesizing horsepox, decides whether it is wise to do so, and acts accordingly. The situation arises from the fact that, if synthesis of horsepox is not to occur, all 100 scientists must independently decide not to pursue it; while if any of the scientists judges the benefits to outweigh the risks, he or she acts unilaterally to synthesize horsepox. Thus there is an ‘action bias’: Horsepox synthesis is more likely to occur when scientists act independently than when they agree to a decision as a group.” Has the quest for the “first strike” in scientific discovery outweighed the risks of dual-use research? The horsepox synthesis has cast a bright light upon the challenges of DURC oversight and the gaps we are struggling to even acknowledge. 

Examining Challenges & Possible Strategies to Strengthen U.S. Health Security
The National Academies of Science have released the latest proceedings of a workshop regarding the progress that has been made in the last 15 years towards improving health security, but also the gaps that exist. “On March 8–9, 2017, the National Academies of Sciences, Engineering, and Medicine’s Forum on Medical and Public Health Preparedness for Disasters and Emergencies hosted a two-day public workshop to acknowledge these persistent issues; to evaluate past, and perhaps inadequate, approaches to addressing them; and to discuss intentional and innovative new solutions. This publication summarizes the presentations and discussions from the workshop.” The report includes proposed priorities and challenges, underlying issues in health security, and potential strategies for strengthening American health security. Such strategies include developing a shared agenda, promoting a culture of learning and sharing, building the evidence base for policy and operations, etc. “Levy called for a paradigm shift toward conceptualizing health care, public health, the business community, and other sectors as parts of a whole that need to be integrated to provide a better environment for the community at large and better care for the community on a day-to-day basis.” Optimizing the exchange of information was also discussed, as was ensuring the interoperability of data across multiple systems. Participants also examined the financial components of health security and making the business case for investment.

 Biohacker’s Remorse
Last year saw contaminated CRISPR DIY kits hit Europe, but it did little to calm the biohacking stunts of Odin CEO Josiah Zayner. In a recent article, Zayner pointed to the moment another biotech CEO dropped trouser and injected himself with an untested herpes treatment mid-conference, as a wakeup call. “’Honestly, I kind of blame myself,’ Zayner told me recently. He’s been in a soul-searching mood; he recently had a kid and the backlash to the CRISPR stunt in October had been getting to him. ‘There’s no doubt in my mind that somebody is going to end up hurt eventually,’ he said.” Zayner says his past actions were efforts to provoke people in the industry who are involved in regulation and ethics in regards to roadblocks for CRISPR and DIY kits, noting that it’s a moral and ethical dilemma. Unfortunately, his sentiments aren’t doing much for those who feel his actions were attention-seeking stunts and he has yet to prove his concern for the DIY CRISPR risks. In case anyone was wondering if Zayner is still up to his old tricks, he also provided his latest video (Gut Hack) in which he attempts to give himself a fecal transplant. While this sounds gross (and it is), what’s more concerning is that an unlicensed and untrained individual is attempting to perform a very specific task that requires a stringent infection control guidelines and procedures. For those of us who have spent years working to perfect policies and practices so this medical procedure can be used to treat patients suffering from Clostridium difficile, this is not something to be taken lightly and isn’t exactly a good indicator that Zayner has learned from his mishaps. 

When Poor Infection Control Results In A Lawsuit
Who is responsible when hospitals decide to neglect infection prevention and control? A critical component to patient safety during medical care, infection control failures can result in the spread of infection – like the transmission of Ebola to healthcare workers. A recent court decision may be setting precedent for infection control responsibility during outbreaks. A Seoul court recently ordered the South Korean government to pay compensation to a patient who acquired MERS-CoV after the government failed to implement infection control. The patient “became infected while being admitted at a hospital in Daejeon where patient 16 was staying. Patient 16 moved there not knowing that had been infected by a different person, identified as patient 1 who infected 28 others, at Pyeongtaek St. Mary’s Hospital in Gyeonggi Province. Patient 1, who had been admitted to St. Mary’s more than two weeks after returning from a trip to Bahrain, a Middle Eastern country, May 4, reported suspected symptoms of MERS with health authorities the morning of May 18. However, the Korea Centers for Disease and Prevention (KCDC) dismissed it, saying the country had no reports of a MERS outbreak.” The court notes that if quarantine would have been implemented appropriately, it could have stopped the spread.

Budgeting for Medical Countermeasures
The Bipartisan Policy Center’s latest report highlights not only the growing concern for infectious disease threats, but also the role of medical countermeasures. Pointing to Project Bioshield and the procurement of 27 medical countermeasures, the white paper “will summarize the progress to date in procuring medical countermeasures and prior congressional funding mechanisms for Project BioShield. It will also discuss ways to optimize funding for medical countermeasures so that the existing public-private partnership can continue to thrive: namely, by restoring the program’s original multi-year funding structure.”

Can Nanoparticles Help Us Battle Antimicrobial Resistance?
As news emerges of an extensively drug-resistant (XDR) typhoid strain in Pakistan, it’s hard to imagine winning the battle of the resistant bug. Can nanoparticles tackle AMR? A research team led by Andrea O’Connor at the University of Melbourne is taking on antimicrobial resistance through nanoparticles and collaboration with a nearby hospital. “Together, the team found that selenium (a mineral that humans require in their diets to boost immunity and aid metabolism) in the form of nanoparticles can stop the growth of bacteria such as ‘Golden Staph’ (Staphylococcus aureus). Their findings are published in the Journal of Colloid and Interface Science. They think the nanoparticles do this by disrupting the membrane around the bacteria. ‘One of the ways that these nanoparticles can attack bacteria is by disrupting that membrane so they make the bacteria leaky, and then things can pass in and out of the bacteria in a way they normally wouldn’t’.” The team hopes that selenium nanoparticles have potential applications for when antibiotic efficiency dwindles, especially in terms of chronic wounds. Their nanoparticles have been tested against nine different kinds of bacteria and have found success against all of them.

 Tales From A Virus Hunter
With CDC and global health security funding in a dire situation, the days of virus hunters trekking through jungles and providing boots-on-the-ground support for outbreaks may be in jeopardy. Dr C.J. Peters is one of the old school virus hunters who tackled Rift Valley Fever and Bolivian hemorrhagic fever in their early days. “Peters was a virus hunter. That often meant spending time in the field, mostly in Latin America but also in Africa, where the work was interesting and the bosses far away. ‘If you’re in the shadow of the flagpole from headquarters, you’re in trouble,’ he explained. ‘Because there will be somebody poking into everything you’re doing.’ Virus hunting today is not what it used to be. There is still adventure to be had, with bold scientists seeking to uncover the mysteries of the unseen world and ultimately benefit human health. But things have also changed.”

Stories You May Have Missed:

  • Flu Vaccine Act– Last week several US senators released their proposal to invest $1 billion in research for a universal flu vaccine over the next five years. “From a total investment of $1 billion, the proposed law would direct $200 million each year over fiscal years 2019 through 2023 to universal flu vaccine research at the National Institutes of Health (NIH), according to a press release from Markey’s office. For comparison, he said the NIH’s National Institute for Allergy and Infectious Diseases (NIAID) spent about $64 million in fiscal year 2017 on universal flu vaccine research.”

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 2.9.2018

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

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

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

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 1.26.2018

In this week’s Pandora Report we’re taking a trip down the horsepox synthesis rabbit hole, looking at influenza transmission, and so much more. But first..the Bulletin of the Atomic Scientists just announced that the Doomsday Clock has been moved and is now two minutes to midnight. You can also read the full testimony from Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security, during the US Senate Committee hearing on the reauthorization of the Pandemic and All-Hazards Preparedness Act. The Senate has also just confirmed Alex Azar as the new head of Health and Human Services.

The Perilous Road of Horsepox Synthesis 
Unless you were in a state of flu-induced delirium, last Friday was a rather big day in with world of dual-use research of concern (DURC) news. The controversial publication of Dr. Evans’ synthesis of horsepox has brought about a flurry of discussion and debate regarding the implications of not only such research, but also the publication of it. Kai Kupferschmidt provided an overview of the history of this paper and what its publication means, so if you’re needing a refresher, I’d start there. As many within the biodefense and biosecurity industry read the paper, it sparked a renewed concern for how such research has exhumed a gap within DURC oversight and publication review. GMU’s biodefense guru and graduate program director Gregory Koblentz expanded upon his thoughts regarding these oversight failures. Pointing to not only the utter disaster that a smallpox re-emergence would be, he also evaluates the PLOS editorial statement and review of DURC work. “Given the serious potential risks that this research could be used to recreate variola virus, the blanket assertion by the PLOS Dual-Use Research Committee that the benefits of this research outweighs the risks is woefully insufficient. The committee dramatically understates the risks and overestimates the benefits this research presents. The U.S. government has outlined a number of factors to consider and questions to ask about dual-use research when weighing the risks and benefits of conducting and publishing such research. Although this research did not fall under current U.S. regulations on dual-use research of concern, the authors and publisher were well aware of the risks that I and others had raised and they had an ethical responsibility to carefully consider those risks before publishing the article.” NTI’s Dr. Elizabeth Cameron, VP of Global Biological Policy and Programs, weighed in on the publication and how it underlines the need for dialogue at a global level to reduce biological risks. Cameron notes that these hurdles aren’t getting smaller and the incremental approach just isn’t getting us where we need to be. “Moving forward, it’s clear that the capability to create and modify biological agents is outpacing governmental oversight and public debate. Now more than ever, scientific stakeholders, private sector actors, and biotechnology leaders should develop and take specific actions to mitigate risk and accelerate biosecurity innovation.” Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security, has also put forth commentary on the horsepox synthesis, pointing to the lack of clear-cut benefits and and that ultimately, it created a new risk. Inglesby notes that “The most important locus of control should be whether specific research is approved and funded in the first place. When scientists are considering the pursuit of research that has the potential to increase highly consequential national population-level risks, national authorities and leading technical experts on those issues should be part of the approval process. When there are highly consequential international population-level implications, international public health leaders should also be involved. When researchers put forth claims about potential benefits of this work to justify extraordinary risks, those claims ought not be accepted without discussion; those claims should instead be examined by disinterested experts with the expertise to validate or refute them.” GMU biodefense PhD student and infection preventionist Saskia Popescu also discussed the importance of this publication and why medical providers and researchers should be paying attention to the DURC debate.

ASM Biothreats
The American Society for Microbiology will be hosting their annual conference on biological threats from February 12-14 in Baltimore, MD. If you’re not able to attend, we’ve got you covered with in-depth reporting and analysis by some of GMU’s finest biodefense graduate students. Following the conference, we’ll be providing this report-out as we did with the 2017 conference, so make sure to check back for the scoop on all things ASM Biothreats.

Chemical Weapons – No Impunity
The International Partnership Against the Impunity for the Use of Chemical Weapons has just been launched! “Ringing together around 30 countries and international organizations, its purpose is to supplement the international mechanisms to combat the proliferation of chemical weapons. This intergovernmental initiative deals exclusively with the issue of impunity for the perpetrators of chemical attacks worldwide, and is a forum for cooperation in which the participating States have made several commitments that include gathering, compiling, and retaining all available information on those who use chemical weapons, etc.” Efforts like this are increasingly needed as the use of chemical weapons in Syria has been met with little adverse outcome for those at fault. GMU’s Dr. Gregory Koblentz highlighted Syria’s CW killchain, noting that “Bringing these criminals to justice, however, will be a long, slow, and difficult process. Many individuals who comprise Syria’s chemical weapons kill chain were listed in a U.N. Security Council resolution that was vetoed by Russia and China on Feb. 28.” Koblentz also points out that “So far, the only concrete steps to hold these individuals accountable for their actions are financial sanctions and travel bans imposed by the U.S. and European governments. Although the sanctions themselves are largely symbolic, by identifying these individuals and specifying their role in the chemical attacks, the United States and its European allies are laying the groundwork for future prosecutions once Assad is no longer in power.”

Germ Transmission While Flying
Dr. Nereyda Sevilla, George Mason Biodefense PhD 2017 alum, presented the results of her dissertation at the Transportation Research Board (TRB) 97th Annual Meeting held January 7–11, 2018, at the Walter E. Washington Convention Center, Washington, D.C. The information-packed program attracted more than 13,000 transportation professionals from around the world. Nereyda’s poster entitled “Germs on a Plane:  The Transmission and Risks of Airplane-Borne Diseases” was part of the Young Professional’s Research in Aviation Session.  Her research explored the role of air travel in the spread of infectious diseases, specifically Severe Acute Respiratory Syndrome (SARS), H1N1, Ebola, and pneumonic plague. She concluded that modeling showed that the spread of Ebola and pneumonic plague is minimal and should not be a major air travel concern if an individual becomes infected. On the other hand, H1N1 and SARS have higher infectious rates and air travel will facilitate disease spread across the country.

Schar School Career Fair
Schar School students and employers looking for talented graduate students – on Wednesday, February 14th from 2-5pm, GMU’s Schar School will be hosting a Career Fair at the Arlington campus. “The Schar School of Policy and Government at George Mason University, in conjunction with the School for Conflict Analysis and Resolution, will host our annual career and internship fair that attracts more than one hundred employers from federal, business, and non-profit organizations who are eager to meet our outstanding students.” For our readership – this is also a great place to recruit biodefense students who are passionate about health security!

Nonproliferation Review Call For Papers
Calling all writers of the nuclear, chemical, and biological weapons persuasion – the Nonproliferation Review is accepting manuscripts for publication in 2018! “All submitted manuscripts that are accepted for publication in Volume 25 are eligible to win the Doreen and Jim McElvany prize of $5,000, a $3,000 runner’s-up prize, or a $1,000 honorable mention prize. The deadline to submit is July 6, 2018; however, due to the limited number of pages that we can publish in a single volume, eligible articles will be accepted for publication on a rolling basis. It is therefore in authors’ interest to submit early to ensure consideration for the prize. Submissions must contribute new ideas and insights to the nonproliferation field. The Review’s editors welcome submissions on any topic related to weapons proliferation, including but not limited to chemical, biological, radiological, nuclear, and conventional weapons. Example topics include: activities and developments in international nonproliferation regimes; social, political, and economic dynamics of specific countries and regions with regard to weapons development and/or proliferation; new information on policies or weapons programs of specific countries; the spread of knowledge, materials, or technologies with potential destructive applications; the proliferation of new technologies impinging on international security; measures, either existing or proposed, to control proliferation; the causes of proliferation or nonproliferation; the consequences of proliferation, including its influence on strategic stability and its economic or environmental effects; and the relevant activities of non-state actors, such as nongovernmental organizations or terrorists.”

 Influenza Aerosols
A new study has found that influenza aerosol-spread is more common than previously thought, especially in relation to coughing and sneezing. “To measure transmission, each participant sat in a chamber for 30 minutes with his or her face in a large metal cone, part of a ‘Gesundheit machine’ that captures and measures influenza virus in exhaled breath. Patients were also asked to cough, sneeze, and say the alphabet three times. Altogether, researchers collected 218 nasopharyngeal samples and 218 breathing sample sessions. When the team analyzed the samples, they found that a significant number of patients routinely shed infectious virus—not just RNA particles—into particles small enough for airborne transmission. They were surprised to find that 11 (48%) of the 23 fine aerosol samples acquired when patients weren’t coughing had detectable viral RNA, and of those 8 contained infectious virus, suggesting that coughing isn’t a prerequisite for generating fine aerosol droplets.” The latest news points to not only the importance of staying home when sick, but also the ease of transmission of influenza viruses. While many thought transmission was limited to droplets (i.e. heavier particles that were sneezed/coughed out about three feet), this latest analysis may change the dynamics of isolation.

Stories You May Have Missed:

  • Addressing AMR in Lower-Income Countries – Fighting antimicrobial resistance (AMR) is a global challenge, but we need to ensure that our strategies account for a range of countries and the unique barriers they face. “Although traditional efforts to reduce the spread of antibiotic resistance in these countries have focused on antibiotic use in individuals, LMICs must also address the increasing roles of animal and environmental exposures in this public health crisis, write Maya Nadimpalli, PhD, University of Versailles Saint-Quentin-en-Yvelines, France, and colleagues. ‘In particular, current strategies do not prioritize the impacts of increased antibiotic use for terrestrial food-animal and aquaculture production, inadequate food safety, and widespread environmental pollution,’ the authors stress.”

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

Pandora Report 1.19.2018

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

Pandora Report 1.12.2018

 The Bright Side of Synthetic Biology and Crispr
GMU biodefense professor Sonia Ben Ouagrham-Gormley and Phd alum Shannon Fye-Marnien are looking at the realities of synthetic biology and fears of bioterrorism. Biological advances have inspired questions regarding the safety and potential for nefarious use, but are such technologies guilty until proven innocent or innocent until proven guilty? “As with previous advances in biology, Crispr is sometimes characterized as a blueprint for bioweapons development or bioterrorism, and it has elicited calls for increased control and regulation of science. But while it is important to examine the potential dangers of emerging technologies, reaching a balanced assessment of risks and benefits requires that technologies’ potential to improve human life be appreciated as well. Synthetic biology and Crispr offer a potentially enormous package of benefits, spanning from medicine to energy to agriculture and beyond. Discussions about the security and safety of synthetic biology and Crispr should not obscure these technologies’ potential to address a wide variety of complex and pressing problems.”

The United States Battles Influenza
Flu season is hitting hard in the United States as 46 states report widespread activity. 80% of cases are of the H3N2 strain, which is associated with severe symptoms and hospitalizations. “The flu is now widespread across the country and the peak of transmission probably occurred during the Christmas-New Year’s holiday week, just as many people were crowded into planes, buses and cars or in large family gatherings, said Dr. Daniel B. Jernigan, director of the influenza division of the Centers for Disease Control and Prevention. ‘H3N2 is a bad virus,’ Dr. Jernigan said. ‘We hate H3N2’.” 26 states (and New York City) are reporting high influenza-like illness (ILI) activity. The CDC has reported that “Influenza-like illness (ILI) went from 4.9% to 5.8%. ‎These indicators are similar to what was seen at the peak of the 2014-2015 season, which was the most severe season in recent years.” This tough influenza season is a helpful reminder that it could always get worse, especially in the context of the 1918/1919 influenza pandemic, which marks its centennial this year. Michael T. Osterholm and Mark Olshaker recently wrote an OpEd regarding the dismal truth – we’re not ready for a flu pandemic. Pointing to not only massive growth in population, but also challenges of supply shortages, and an outdated approach to vaccine research, they highlight the need to find a universal vaccine that can do battle against all influenza A strains with a longer immunity. “But there is no apparent effort to make these vaccines a priority in the current administration. Its national security strategy published last month cites Ebola and SARS as potential bioterrorism and pandemic threats, yet makes no mention of the risk of pandemic influenza nor any aspect of critical vaccine research and development. The next few weeks will highlight how ill prepared we are for even ‘ordinary’ flu. A worldwide influenza pandemic is literally the worst-case scenario in public health — yet far from an unthinkable occurrence. Unless we make changes, the question is not if but when it will come.”

GMU Biodefense Professor – Robert House
We’d like to welcome back professor Dr. Robert House to GMU biodefense, who will be teaching BioD766: Development of Vaccines and Therapeutics. Dr. House holds a PhD in medical parasitology and is a senior VP for government contracts at Ology Bioservices (previously Nanotherapeutics). The world faces a growing threat from microbiological agents in the form of terrorist weapons, pandemics (particularly influenza) and emerging/re-emerging diseases. Characteristics such as high pathogenicity/toxicity and lack of appropriate animal models, as well as lack of a viable commercial market, make it difficult to develop effective medical countermeasures for these agents. In his course, students will explore how the US Government is developing medical countermeasures (MCM) against these threats and will explore the various threat agents, the context of regulatory considerations, and the specifics of how MCMs are developed.

Infectious Disease Mapping Challenge Launched!
Do you love infectious diseases and maps? The goal of the challenge is to promote the use of geospatial mapping to address the objectives of the GHSA. The NextGen Network has partnered with the U.S. Department of State’s Virtual Student Foreign Service program to launch the 2018 challenge. You can find out more information from this engaging and informative webinar or at the page here. The deadline for signing up for the challenge is January 19, 2018. This is a great way to contribute to the GHSA goal of creating a world safe and secure from the threat of infectious diseases.

Biodefense Alum – Stay Connected! 
Are you a GMU Biodefense alum? If so, please make sure to keep your information updated in our Schar Stay Connected site. We have a strong alum community and would love to keep you up to date on future events and give shout outs for the amazing work our biodefense students accomplish.

Biopreparedness Needs to Start At the Frontlines of Disease Control
GMU biodefense PhD student and infection preventionist Saskia Popescu evaluates the attention to biopreparedness and how our focus on bioterrorism fails to address the major gaps within disease control in the United States. “The Blue Ribbon Panel report and the CNN article both highlight the bureaucratic challenges with coordination at a national level across many agencies and sectors. The crux of it all is that from a grass-roots level, we’re struggling to better prepare and respond for a host of reasons. Public health funding is always in a chronic state of too little too late and often, we don’t push out resources until we’re already in the throes of a major incident (Ebola, Zika, etc.). Preparing for biothreats, regardless of origin, requires that we strengthen the most basic surveillance and response systems within public health and health care. During the 2014–2015 Ebola outbreak, for example, there was a lot of attention on enhanced precautions. Although this was beneficial and brought attention to several gaps infection control and prevention measures, I found myself reminding staff that we can’t truly prepare and respond to rare events if we can’t get our daily practices down. The shear challenges of ensuring staff practice appropriate hand hygiene and isolation precautions in health care are indicators that we are struggling on the frontlines of disease preparedness.”

Lessons from A 2016 CRE Outbreak in A Kentucky Hospital
Hospital outbreaks are tough. The shear volume of people that go into a single patient’s room is considerable (healthcare workers, visitors, ancillary staff, etc.) and enough to spread germs throughout an entire hospital. Now imagine that the organism is a highly resistant one, such as carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE). A hospital in Kentucky experienced this very thing in 2016 and a recent CDC MMWR revealed just how difficult it can be to conquer an outbreak involving one of the worst resistant organisms you can imagine. “Over the next 4 months, scientists identified an additional 21 CRE isolates from patients at the hospital via screening and clinical cultures. The investigators believe organisms were imported into the facility and then spread among patients.” Epidemiological investigation found that five of the thirteen interviewed patients had received healthcare outside the local area and that three of the patients may have brought CP-CRE into the facility. “The authors of the report say their investigation highlights the potential role of cleaning equipment, which frequently moves between patient rooms, in CP-CRE spread. In addition, they note that although there is a low prevalence of CP-CRE in rural areas, rural hospitals should be aware that patients who’ve also accessed healthcare in areas with higher CP-CRE prevalence—primarily urban areas—can introduce these organisms into their facilities.”

Stories You May Have Missed:

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

Pandora Report 9.8.2017

Happy Friday and welcome to your weekly source for all things biodefense. Got plague? Good news – if you have some live chickens hanging around, you can try this medieval treatment.

Defense Against Biological Attacks
Biological threats come in all shapes and sizes – whether it’s an outbreak of Ebola, a biological weapon, a laboratory mishap, or even the potential for biosafety breaches following  a hurricane. Preparedness and response efforts need to be just as diverse. As Texas begins the process of rebuilding and the threat of nuclear weapons has been fresh in everyone’s mind, it is crucial we don’t forget about the importance of health security. Disease knows no borders and it’s easy to diminish the threat of it however, Laura Holgate and Elizabeth Cameron are drawing attention to the need for President Trump to prevent the next biological attack before it happens. “As Congress and the Trump administration mull a new biodefense strategy, we urge them to use this time — the time in between biological crises — to get ahead of the curve before the next major biological event inevitably comes our way.” They point to several different strategies that should to be followed – watch out for emerging threats in unstable regions, fund and renew the Global Health Security Agenda, replenish the budget to maintain global biosecurity, keep laboratory assets for attributing biological attacks, and use biosurveillance to stop outbreaks before they start. We need to take the National Bioforensics Analysis Center off the chopping block, stop slashing the biosecurity budget as programs like the Cooperative Biological Engagement Program are vital, and truly, the GHSA renewal is a no-brainer. These efforts not only defend against current threats, but work to address the next generation of bioweapons and biothreats.  Holgate and Cameron note that “We know that biological threats must remain at the top of the national security agenda, and leaders must recognize that stopping outbreaks at the source requires strong global and domestic capacity to prevent, detect and rapidly respond to naturally occurring outbreaks and biological attacks”

Health Security – Call for Papers
The Health Security journal is currently looking for papers on communication and health security: improving public health communication in response to large-scale health threats. Manuscript deadlines are October 20, 2017. “Effective communication is an essential tool in establishing an appropriate response to any large-scale health threat or disaster, such as a newly emerging infectious disease, terrorism, environmental catastrophe, or accident. Yet, public health communication is occurring in an increasingly complex world with competing messages, new platforms, and limited trust.A special feature in Health Security will be devoted to analysis of the current communication environment and efforts to effectively communicate during outbreaks of infectious diseases and other health threats. The journal seeks papers that address the wide range of policy, practice, and research issues relevant to communication in large-scale health events.” Topics might include exploration of the communication environment during recent infectious disease events or public health disasters, investigation of the role of social media and other emerging or recently emerging communication platforms, etc. Submission information can be found here.

GMU Biodefense MS – Open House on September 14th
Don’t miss out on the Master’s Open House next week for the GMU Biodefense MS program!  From 6:30-8:30pm next Thursday, September 14th, at the GMU Arlington campus, you can speak to faculty, learn about admissions, and why biodefense students have a blast while getting their graduate degrees. This is a great chance to learn about the MS program (for both online or in-person) and chat with faculty about the exciting classes and activities GMU biodefense students get to enjoy.

The Biological Weapons Convention At A Crossroad
As Robert Frost once said, “Two roads diverged in a wood, and I- I took the one less traveled by, and that has made all the difference.” Which direction will the BWC take? Bonnie Jenkins investigates the uncertain future of the BWC, its current challenges, which direction it might take, and the direction it should take. Despite its relevance and capacity to endure decades of challenges, the latest RevCon was considered a monumental disappointment and left many in a state of disagreement. “Some of the major issues that were discussed at previous meetings—but at this point have no platform for discussion at the BWC—include advances in science and technology, disease outbreak preparedness and response, and national BWC implementation. Previously-held mid-year experts’ meetings have also been dropped, so there is now no chance for the exchanges with experts from relevant international organizations, including input from the World Health Organization that has been so useful in the past. These are all steps backward.” Despite a lack of Meeting of States Parties in August, there is hope that the December meeting with work towards developing an inter-sessional work program. On top of these barriers, the BWC has funding challenges, which severely impacts the Implementation Support Unit (ISU). Against these odds, the BWC ISU continues to promote universal membership and treaty implementation. Global initiatives are also beneficial to promotion of health security and prevention of biological weapons. “When global initiatives interconnect like this, it reinforces all of the initiatives. The Global Health Security Agenda, for instance, brings over 55 countries together to strengthen countries’ capacities to prevent, detect, and respond to infectious disease threats, whether natural, deliberate, or accidental.” These efforts seek to strengthen the BWC through global health security, but there is still work to be done. Jenkins suggests three tasks are crucial to maintain BWC relevancy and sustainability: “1) Sufficient and sustained funding by states parties, to include payments now in arrears; 2) Strong leadership and a successful December MSP that reaffirms the importance of the treaty to the international community and that also develops an inter-sessional work program; and 3) A vision for developing the role of the BWC as part of a larger interconnected global security architecture.”

Using Ebola Data to Fight Future Outbreaks
Learning from past outbreaks to avoid future failures is always a tough aspect of public health however, a new strategy is using data to help stop the next outbreak of Ebola. Researchers have developed a new platform to help organize and share Ebola data that was previously scattered and unable to be utilized. This was a significant issue on the ground during the 2014/2015 outbreak, which makes this project all the more important. “The information system is coordinated by the Infectious Diseases Data Observatory (IDDO), an international research network based at the University of Oxford, UK, and is expected to launch by the end of the year. At a meeting to discuss Ebola on 7–9 September in Conakry, Guinea, the team heading the platform will seek input from West African scientists, health officials and advocacy groups.” One of the most vital components to the system is the emphasis of partnership and involvement of African collaborators. Not only will this focus encourage the use of historical data, but will also allow utilization during future outbreaks. Control of the data has also been a challenging hurdle to overcome, as there are many cooks in the kitchen. “Amuasi says that he would have liked the database to be hosted and curated in Africa, rather than in Oxford, because training and paying African researchers to manage the platform would teach them how to use the information and improve their ability to respond to future outbreaks in the region. But he adds that this seems unlikely, because it would raise the cost of the project, and the infrastructure already exists at Oxford. Merson says that a copy of the database will be maintained in West Africa, although its exact location has yet to be determined. She adds that an African committee may be in charge of deciding who gets access to the data. And she says that fellowships are likely to be made available for West African students who want to work on the database.”

The Global Health Security Agenda: Public & Private Partnerships
The Global Health Security Agenda Consortium and EcoHealth Alliance will be hosting this meeting on Thursday, September 14th at 12pm. Held at the ONE UN New York Hotel in NYC, you can catch this event with speakers like Dr. Beth Cameron from the Nuclear Threat Initiative and Admiral Tim Ziemer from the US National Security Council. Make sure to RSVP here.

Launch of International Health Regulations Costing Tool
Georgetown University Center for Global Health Science & Security is launching their new open-access IHR costing tool. “In 2016, the World Health Organization adopted the Joint External Evaluation tool (JEE) to measure country-specific progress in developing the capacities needed to prevent, detect, and respond to public health threats, as mandated under the 2007 International Health Regulations (IHR). However, national governments and development partners have struggled to accurately define the costs of strengthening and maintaining critical health security systems that often depend on multi-sectoral coordination. This poses a serious dilemma for global health security and presents a compelling opportunity to improve the drafting and implementation of practical health security policies.” A joint effort with Talus Analytics, this new tool was developed to help estimate the cost to build capacity under the IHR. You can access the tool here (you may want to use Google Chrome).

IDSA Slams Budget Cuts to AMR
Biodefense budgets aren’t the only ones to be taking a beating… The president’s FY2018 budget released in May would cut the CDC’s Antibiotic Resistance Solutions Initiate (ARSI) by 14%, as well as 23% from the NIH and NIAID, which funds research on AMR. Leaders from Infectious Disease Society of America (IDSA) are rallying to oppose such efforts. “In a letter published yesterday in Annals of Internal Medicine, IDSA treasurer Helen Boucher, MD, past president Barbara Murray, MD, and current president William Powderly, MD, argue that the budget cuts for public health and research proposed by the Trump administration will not only diminish the nation’s surveillance capacity and its efforts to reduce infections and promote appropriate antibiotic use, but also undercut US leadership in global efforts to tackle the AMR threat, which is responsible for more than 700,000 deaths each year globally.” The letter emphasizes that such cut would severely impact AMR efforts, which is highly worrisome and dangerous given the severity of the global AMR threat. You can read the letter here.

An Integrated Approach to Forensic Investigation of Threat Agents
In the wake of a chemical or biological event, threat analysis is a high-stakes operation that has little room for error. Determining the substance, origin, and components all make for a stressful situation that requires effective analytical methods. “Traditional analytical methods are good at confirming the presence or absence of a particular agent or substance. If a sample is believed to contain Bacillus anthracis, standard biological analysis will quickly determine whether or not this is the case. But it will not provide insight into its virulence, origin or how it might have been manipulated. And if the sample turns out to be something other than B. anthracis, it will not tell you what it actually is. An integrated approach to CB forensics provides investigators with richer information. Integrated forensics combines advanced forensic science technologies to provide more comprehensive and timely technical intelligence.” Some of these strategies include advanced genomic analysis like massively parallel sequencing and advanced chemical analysis like gas chromatography and high resolution mass spectrometry. Currently, the extraction methods for biological analysis can render the sample unusable for chemical analysis, which make analysis problematic. A new strategy from Battelle is looking to combat these discrepancies, which involves a new process to “systematically triage samples and integrate biological and chemical forensics, as well as developing and testing new technologies to help investigators more quickly identify and characterize biological agents, including new, emerging and synthetic agents, to glean more forensic information from the samples.”

Stories You May Have Missed:

  • Zika Vaccine Efforts Slow– Sanofi recently announced they are halting work on a candidate Zika vaccine. The vaccine was a joint effort with Walter Reed Army Institute of Research however, budgetary cuts and federal efforts to scale back put the project in jeopardy. “In its Sep 1 statement, Sanofi said BARDA informed the company on Aug 17 that the agency reassessed its Zika-related projects and have decided to focus on a more limited set of goals and deliverable, and that BARDA has decided to “de-scope” its contract with Sanofi for the manufacture and clinical development of an inactivated Zika vaccine. BARDA said it would limit its funding to a case definition and surveillance study, as well as any activities needed to pause work on the vaccine until an epidemic re-emerges. As a result, Sanofi said it doesn’t intend to continue developing or seek a license from WRAIR for the Zika vaccine candidate.”
  • Australia Battles Influenza – As Australia experiences a particularly harsh flu season, many are wondering what this will mean for Europe and North America.”In general, we get in our season what the Southern Hemisphere got in the season immediately preceding us,” Fauci said. An “intelligent guess,” therefore, is that the north will probably have a bad flu season. “With influenza, it is never 100%,” he said. “So when you talk about influenza, almost nothing is absolutely precision,” Fauci said. “In general, one can say we usually see here what they see there in their season.” Schaffner agrees: “There’s not a one-to-one correlation.” Still, hearing about Australia’s high number of flu cases, he said, “I started to tighten my belt.”