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    Biodefense Headlines – 29 November 2020

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    News highlights on health security threats and countermeasures curated by Global Biodefense

    This week’s selections include COVID-19 vaccination strategies; a history of nerve agents; bioethics of ‘supersoldier’ pharmacological enhancements; and digital warm-start CRISPR diagnostics.

    Article Contents

    POLICY + GOVERNMENT

    Coronavirus Pandemic Stands to Force Changes in U.S. Spy Services

    Preparing for biological outbreaks and climate change will become higher priorities for intelligence services under the Biden Administration. Intelligence tends to focus on terrorism, weapons, and military enemies – most notably China, Russia, Iran, and North Korea. “If those are one, two, three, four, this is 372” on the list of priorities, a senior Biden official told the WSJ about pandemic threats. “It’s that far away.” Biden vowed to bring the directorate for global health and biodefense back to the NSC with “a full-time, dedicated coordinator.” Wall Street Journal

    The Advisory Committee on Immunization Practices’ Ethical Principles for Allocating Initial Supplies of COVID-19 Vaccine

    In addition to ethical considerations, ACIP’s recommendations regarding receipt of the initial allocations of COVID-19 vaccine during the period of constrained supply will be based on science (e.g., available information about the vaccine’s characteristics such as safety and efficacy in older adults and epidemiologic risk) and feasibility of implementation (e.g., storage and handling requirements). MMWR

    Congress Braces for Biden’s National Coronavirus Strategy

    Congress is expecting a Biden move beyond the Trump administration’s state-by-state approach to build out a national strategy to fight the pandemic and distribute the eventual vaccine. Republicans largely rejected the $2 trillion-plus House bill from Democrats as excessive. They prefer their own $500 billion Senate effort, saying states and cities can tap funding from previous relief legislation. Senate Democrats blocked that bill twice as insufficient. Associated Press

    Public Health Agency of Canada Quarterly Financial Report

    When compared to the second quarter of the previous fiscal year, the authorities available for spending for the year have increased by $20,257.3 million or 3,154 percent, from $642.3 million to $20,899.6 million. This change in authorities is related to initiatives funded under the Public Health Events of National Concern Payments Act to address the COVID-19 pandemic. Government of Canada

    Biden’s Plan for an Army of Disease Trackers Faces Long Odds

    A raging pandemic and a gridlocked Congress could upend President-elect Joe Biden’s plan to hire 100,000 public health workers to trace COVID-19’s spread. Contact tracing will be essential even after vaccines become widely available, because not everyone will get shots and scattered outbreaks will continue to ripple across the country. Politico

    MEDICAL COUNTERMEASURES

    Why Emergency COVID-Vaccine Approvals Pose a Dilemma for Scientists

    Competition between a clinical trial for a vaccine and emergency use of it is new for vaccine development. Once a vaccine has been shown to work, it becomes harder to ask participants to remain in the placebo arm unprotected. If too many people cross over, the trials might not have sufficiently large control groups to gather statistically significant results for some long-term goals. Nature

    Vaccination of Contacts of Ebola Virus Disease Survivors to Prevent Further Transmission

    Transmission events associated with survivors have hampered outbreak containment and highlight the urgent need to incorporate vaccination into survivor programs as standard practice. It is time to develop, implement, and standardize a protocol for vaccination of contacts of survivors during Ebola outbreaks to prevent survivor-related infections in the future. The Lancet

    CHEMICAL AND BIOLOGICAL WEAPONS

    Pandemic Preparedness: A U.K. Perspective on Overlaps with Countering Terrorism

    In response to the COVID-19 pandemic, a government-in-crisis mode has drawn on the counterterrorism playbook. The severity of the crisis, however, was partly explained by the UK’s failure to treat national health as a top-tier national security concern. Linking national health and national security issues, however, carries both risks (to civil liberties, for example), as well as potential rewards (by enabling better resourcing and coordination efforts to counter pandemics and bioterrorism simultaneously. CTC Sentinel

    Toxic: A History of Nerve Agents, From Nazi Germany to Putin’s Russia

    There are few heroes and lots of villains in this history of chemical nerve agents. Toxic is a comprehensive book covering all these events. Although it contains some professional reminiscences, it is accessible for non-specialists alike. Chemistry World

    SURVEILLANCE + DETECTION

    Evidence Builds That an Early Mutation Made the Pandemic Harder to Stop

    There is no evidence that a coronavirus with the 614G mutation causes more severe symptoms, kills more people or complicates the development of vaccines. One study found that outbreaks in communities in the UK grew faster when seeded by the 614G variant than when seeded by its Wuhan ancestor. Another reported that hamsters infected each other more quickly when exposed to the variant. And in a third, the variant infected human bronchial and nasal tissue in a cell-culture dish far more efficiently than its ancestor. NY Times

    Effectiveness of Routine Asymptomatic COVID-19 PCR Testing at Different Frequencies

    Routine asymptomatic testing using RT-PCR of people who interact with vulnerable populations, such as medical staff in hospitals or care workers in care homes, has been employed to help prevent outbreaks among vulnerable populations. This study estimated the probability that the PCR test detected infection peaked at 77% 4 days after infection, decreasing to 50% by 10 days after infection. Their results suggest a substantially higher probability of detecting infections 1–3 days after infection than previously published estimates. medRxiv

    The governor of Kansas issued an executive order requiring wearing masks in public spaces, effective July 3, 2020, which was subject to county authority to opt out. After July 3, COVID-19 incidence decreased in 24 counties with mask mandates but continued to increase in 81 counties without mask mandates. MMWR

    Sensitive Quantitative Detection Of SARS-Cov-2 in Clinical Samples Using Digital Warm-Start CRISPR Assay

    Digital warm-start CRISPR (WS-CRISPR) assay for sensitive quantitative detection of SARS-CoV-2 in clinical samples combines low-temperature reverse transcription dual-priming mediated isothermal amplification (RT-DAMP) and CRISPR-Cas12a-based detection in one-pot. Demonstrated to directly detect SARS-CoV-2 in heat-treated saliva samples without RNA extraction, showing high tolerance to inhibitors. medRxiv

    Removal Lists of Tests that Should No Longer Be Used or Distributed for COVID-19

    Updated list of manufacturers with COVID-19 tests flagged by the FDA for market removal (including 176 different serological tests to date). This action is done if an EUA request is not submitted within a reasonable period of time, or if significant problems are identified with the test that cannot be or have not been addressed in a timely manner. Companies may also request self-removal for any reason, and these are noted. FDA

    COMMENTARY

    Is Emergency Use Authorization the Best Way to Get a COVID-19 Vaccine to the Public?

    While an EUA may be the speediest way for public health officials to begin a vaccination campaign, it may not end up shaving that much time off more traditional routes to government approval. Using a different expedited process, the FDA cleared a novel Ebola vaccine in just six months. Such an approach may get COVID-19 vaccines to the public almost as quickly as EUA can—while providing a (by some polls) majority vaccine-hesitant public with greater reassurance that those vaccines are safe and effective. Bulletin of the Atomic Scientists

    Militaries are investing in R&D programs to enhance soldier performance in areas of strength, mental capacity, recovery, and resistance to fatigue and trauma. It can be expected that any pharmacological performance-enhancing program in the military is likely to have a security classification. Lessons from compartmentalizing medical threat information during the Gulf War, during which many soldiers had no real understanding of what the immunization  program (anthrax, plague, whopping cough) involved, or what vaccines they were given, can be applied today in considering transparent informed consent. Chatham House

    Put Nurses on Biden’s COVID-19 Advisory Board

    Nurses have always stood at the nexus of medical decisions, nursing care, patients’ needs and family concerns. Appointing nurses to the advisory board would bring a wealth of insight to high-level strategy sessions on how to fight the pandemic. It would also go a long way to helping regain the trust of burned-out healthcare workers. LA Times

    A truly effective “all-of-society” pandemic response by the incoming administration will require strategies informed by social science. Pandemic denialism has become so entrenched that, as one South Dakota nurse recently reported, some COVID-19 patients refuse to accept their own diagnosis even as they lay dying in hospital beds. We must recruit social scientists to apply their significant knowledge base to the development of a pandemic communication strategy, meeting skeptical Americans where they are and motivating them to get on board with efforts in public health. The Hill

    SPECIAL INTEREST

    Pandemic Response Challenge

    The Pandemic Response Challenge is a $500K, four-month challenge that focuses on the development of data-driven AI systems to predict COVID-19 infection rates and prescribe Intervention Plans (IPs) that regional governments, communities, and organizations can implement to minimize harm when reopening their economies. XPrize

    Career-Life Balance (CLB) Supplemental Funding Requests

    NSF’s CLB effort aims to help reduce the rate at which early-career researchers depart from the STEM workforce by offering supplemental funding to help researchers, who are confronted with a short-term increase in dependent care responsibilities, ensure that the research activities supported by an NSF award can continue. National Science Foundation

    SARS-Cov-2 Antigen Detecting Rapid Diagnostic Test Implementation Projects

    Request for proposals concerning monitored implementation of SARS-CoV-2 antigen detecting rapid diagnostic tests (Ag-RDTs) in low- and middle-income countries. Proposals should be based on the provided Master Protocol. This information will be utilized to inform the development of evidence-based policy and implementation guidance. Deadline: 8 December, 2020 World Health Organization

    COVID-19 RESOURCE UPDATE

    Courtesy of the CDC Public Health Emergency Preparedness Program Division of State and Local Readiness

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