By Geoffrey Mattoon, Biodefense MS Student
On Thursday, 8 September, the Council on Strategic Risks (CSR) hosted “The American Pandemic Preparedness Plan: One Year of Progress & The Path Forward” webinar, which included speakers Dr. Matthew Hepburn, White House Office of Science and Technology Policy (OSTP) Senior Advisor, and Dr. Carly S. Cox, CSR Fellow for Ending Bioweapons, and was moderated by journalist Janet Wu of Bloomberg. Dr. Hepburn and Dr. Cox discussed the recently released “First Annual Report on Progress Towards Implementation of the American Pandemic Preparedness Plan,” which they both played a central role in developing, and considered the current state and future goals of pandemic preparedness in the U.S. The lack of COVID-19 in the title of the event and report is intentional and the overarching message of both; do not fail to see the forest for the trees. A more apt statement in this instance may be “do not fail to see the future threats of pandemics and biological attacks for COVID-19 alone.”
This message was emphasized throughout the event, refocusing attention from COVID-19 to all pandemic response, and mirroring the call for greater broad-spectrum protection in biodefense as made by Dr. Gregory Koblentz in his book Living Weapons. Such efforts, according to Dr. Koblentz, transcend the historical “one bug, one drug” paradigm and provide a biodefense countermeasure strategy for both biological weapons and natural diseases. Broad-spectrum efforts such as these have already demonstrated their value in the response to other threats, including the adaption of existing mRNA vaccines for COVID-19 or the JYNNEOS smallpox vaccine for the ongoing monkeypox outbreak, and could prove critical in the event of any future disease outbreak or biological attack.
Dr. Hepburn opened the event with a call to action, stating all the progress we have made is good, but we still have much more work to do. He pointed to the first section of the Annual Report as a reminder of all the government has accomplished in pandemic preparedness. When asked by Ms.Wu if he believed we had learned enough from COVID-19 to prevent the next outbreak from reaching the same level, Dr. Hepburn emphatically replied “Yes.” He cautioned that the hard part is learning the right lessons and making the changes necessary to prepare. Dr. Cox stated she hoped he was right, but we also thought we were prepared for COVID-19.
Speaking on the importance of a diversified public health workforce, Dr. Hepburn highlighted the need for technologically savvy professionals. He asserted future public health workers must be trained in data analysis, program management, and human empathy to be successful. Dr. Cox then stressed the benefit of fellowship opportunities to provide professionals in the field a broader perspective to address biological threats that enhance disease outbreak prevention.
A diverse workforce is not the only ingredient needed for preparedness success. Dr. Hepburn and Dr. Cox also discussed the essential nature of interagency and private sector cooperation to overcome COVID-19 and future pandemics. This message aligns with both the 2018 National Biodefense Strategy Goal 1 and the 2021 Biodefense Vision Memo that call for greater coordination and unity of effort across all biodefense organizations in response to natural and man-made pathogens. This message is also supported by the broad range of organizations and their accomplishments throughout COVID-19 response outlined in the first section of the Annual Report. Such unity and diversity of effort is critical to maximize biodefense; including biosurveillance efforts like that of the Center for Forecasting and Outbreak Analytics, biodetection efforts from agencies like NIH RADx, and preparedness guidance from agencies like ASPR. Such multifaceted preparedness and response are essential to provide broad-spectrum protections against future threats.
A specific topic of discussion during the event was efforts in rapid production of medical countermeasures (MCM). Operation Warp Speed demonstrated we now possess the capability to produce effective vaccines within a year, enabling us to respond rapidly to emerging threats. Dr. Shulkin provides a concise summary of the essential lessons learned by Operation Warp Speed that should be applied to future vaccine development in his commentary, “What Health Care Can Learn from Operation Warp Speed.” The speakers emphasized that such efforts must become routine and require global cooperation to be effective in facing current pathogens like malaria as well as future threats. The development of vaccines is a balancing act of cost and innovation which may require government agencies to de-risk programs to incentivize innovation when the cost prohibits private sector interest. They also discussed the importance of novel vaccines that offer shelf-stable solutions as well as varied delivery methods (microneedle, oral, skin patches) to enhance distribution capabilities and capacity. Such technologies would directly benefit defensive efforts nationally and may even enhance defensive deterrence of biological weapons based on a more robust strategic stockpile.
When asked what efforts give the panelists the greatest hope for the future, they highlighted the need to engage at the local health system and community level. Such efforts enable the establishment of trusted networks that can effectively disseminate critical health information and work to deter misinformation and disinformation. This mobilizes the population in response to threats and provides an added means of innovation that can guide future MCM and biodefense efforts. It is also critical that trust is built in advance within communities, it is not a resource you can “surge” at the time of need and COVID-19 has demonstrated the effects mistrust can have on response. Vaccine hesitancy and anti-vaccine sentiments proved to be a serious obstacle in COVID-19 response and must be addressed in a vaccine-agnostic manner to enhance current and future disease prevention and eradication.
The key messages throughout this event were consistent with those throughout the biodefense community. Interagency and international unity of effort, MCM innovation, and community involvement efforts in pandemic preparedness will enhance national biodefense. The COVID-19 pandemic is a world-changing event that may be key to reinvigorate pandemic preparedness and response efforts and, as a result, biodefense as well. As the speakers emphasized, what is critical is that the entire community applies these lessons to the whole of pandemic preparedness and response, not just COVID-19 specifically, to truly benefit from lessons learned. We cannot fail to see the forest for the trees.