News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include a federal review of research oversight on enhanced Potential Pandemic Pathogens (ePPPs); the public health crisis in Ukraine; medical saline shortage across the U.S.; approval steps for Sanofi, GSK protein-based COVID vaccine; and revisiting the story of the Cape Ray mission to neutralize Syria’s chemical weapons stockpile.
POLICY + GOVERNMENT
Spurred By Pandemic, U.S. Government Will Revisit Federal Policies on Risky Virus Research
White House officials and the National Institutes of Health tasked an expert advisory board to undertake a swift, broad review of the agency’s policies that aim to make sure federally funded studies of viruses and other microbes that could cause a pandemic are undertaken safely, and to bar funding for experiments deemed too risky. Some NSABB members are concerned the review’s tight timeline will lead to recommendations to impose overly restrictive rules. Science
Don’t Let Finger-Pointing Doom This Key Treaty Against Bioweapons
Few doubt that the Biological Weapons Convention is languishing at a critical time. Major world powers are accusing each other of maintaining bioweapons programs and the fast pace of the global scientific enterprise is making it harder for countries to find balance between technological advances and risky biological research. Meanwhile, efforts to strengthen the convention have been in a holding pattern for over 20 years since the United States scuttled negotiations meant to give the treaty a means of verifying compliance. Bulletin of the Atomic Scientists
CDC Overview and Scientific Rationale for Changing to ‘Community Level’ Indicators for Implementing COVID-19 Prevention Strategies
Presentation from the CDC to explain their new thresholds for COVID-19 Community Levels (Low, Medium, High) focused on minimizing the impact of severe COVID-19 illness on health and society; minimizing burden on the healthcare system; and protecting the most vulnerable through vaccines and therapeutics. CDC
We Need an Operation Warp Speed for Clean Indoor Air
One of the most important and needed tools to combat COVID-19 has been ignored: enhanced ventilation, better filtration in mechanical systems, in-room portable air cleaners as supplements. It’s a mistake that hurt us throughout the pandemic and will continue to hurt us in the future if we don’t act now. The standard that governs ventilation rates in offices, schools, lecture halls, local coffee shops and hair salons is a bare minimum not designed for health. The Hill
Maryland Man Pleads Guilty to Bribing Army Researcher
John R. Conigliaro owns a company that provides general construction services, including fixed and portable biochemical laboratories. From 2012 to 2019, he bribed a research biologist at the U.S. Army Combat Capabilities Development Command Chemical Biological Center at Aberdeen Proving Ground, according to the guilty plea. APG is the nation’s principal research and development center for non-medical chemical and biological weapons defense. Washington Post
MEDICAL COUNTERMEASURES
FDA Will Limit Use of Sotrovimab in Geographic Areas with Omicron Subvariant BA.2 Prevalence
When the omicron variant first emerged, sotrovimab was one of the few antibody treatments that was shown to be effective against it. With the emergence of the omicron subvariant, BA.2, Vir originally said sotrovimab retained its neutralizing activity. But a recent study suggests the subvariant is resistant to nearly all available monoclonal antibody treatments. Fierce Pharma
Microneedle Patch as a New Platform to Deliver Inactivated Polio Vaccine and Inactivated Rotavirus Vaccine
Study in rat model investigated the feasibility of manufacturing a combined IRV-IPV dissolving microneedle patch, assessing its compatibility and immunogenicity. This study is the first to show that a combined IRV-IPV dMNP is highly stable, immunogenic, and well-tolerated in rats and will move on to IND-enabling studies. NPJ Vaccines
After Raking in Billions with Its COVID Shot, Moderna Faces Patent Infringement Suit Related to Vaccine Delivery Tech
Late last year, Moderna lost a legal bid to invalidate two Arbutus Biopharma patents tied to the delivery of its COVID-19 vaccine. At the time, it wasn’t so much a question of whether Arbutus would sue the messenger RNA vaccine giant for infringement, but when. Now, the other shoe has dropped. Fierce Pharma
Sanofi And GSK to Seek Regulatory Authorization for Protein Based Vaccine
The protein-based vaccine can be kept at refrigerator temperatures, making it easier to store and transport than some of the other vaccines. In a phase 3 trial in which more than 10,000 adults were randomized to receive two doses of the vaccine or placebo, 21 days apart, researchers found it to have 100% efficacy against severe disease and hospital admission. The protein-based vaccine showed 57.9% efficacy against any symptomatic disease, the companies have reported. In a separate trial, the vaccine was tested as a booster dose for people who had previously had two doses of an mRNA or adenovirus vaccine (such as Oxford-AstraZeneca). The booster dose was found to increase neutralizing antibodies 18-fold to 30-fold across different vaccine platforms and age groups. The BMJ
BIOSECURITY + BIOPREPAREDNESS
Experts Urge US Cities and States to Prep for Future Outbreaks as Omicron Slows
With only 65% of the population fully vaccinated, the US was buffeted by Omicron. It is now seeing an average of 54,000 cases and 1,300 deaths each day. Large swaths of the population have some form of protection from Covid, through vaccination or prior infection or both. The US should continue investing in masks, tests, ventilation, vaccination campaigns, wastewater monitoring and other measures to prevent and respond to the next surge. And when the next wave begins rising, communities should pay careful attention to changing levels of risk. The Guardian
Another Casualty of Russia’s Invasion: Ukraine’s Ability to Contain the Coronavirus
Ukraine is reporting an average of about 26,000 new cases a day, or 63 new cases per 100,000 people. Only about one-third of Ukraine’s 44 million people are fully inoculated against SARS-CoV-2. The fighting in Ukraine’s east is forcing a mass migration to the west that is crowding mass transit centers and trains and crowding people into makeshift bunkers. Health care workers will be caring for wounded and COVID cases simultaneously under strained conditions. “They’re going to be understaffed because of the war, and it’s going to harm their chances of keeping patients in isolation or have social distancing. It’s going to be a mess.” NY Times
False Claims of U.S. Biowarfare Labs in Ukraine Grip QAnon
Pro-Russian channels and QAnon conspiracy theorists think Moscow is launching airstrikes on Ukraine to destroy bioweapon-manufacturing labs to prevent the American infectious disease expert Anthony Fauci from creating a sequel to the COVID-19 virus. The theory is now being actively contributed to, and promoted, by one Russian embassy, an official Russian state propaganda outlet, and media channels in Serbia and China. Foreign Policy
Russia’s Invasion of Ukraine May Cause Polio, Covid-19, Public Health Crises
Ukraine has been going through a Winter Covid-19 surge with an average of over 21,000 cases and 210 deaths per day over the past seven days. To date, only 34.29% of their population has been fully vaccinated against Covid-19. Low vaccination rates in general have been a continuing problem for Ukraine, long before the Covid-19 pandemic. Last year, Ukraine had at least 20 cases of polio with one child suffering paralysis. The polio outbreak prompted the Ministry of Health of Ukraine to sign a national polio control plan on December 30, 2021. Now these efforts are disrupted by the Russian invasion and diaspora of the population. Forbes
When Antibiotics Stop Working: The Next Pandemic Is Already Here
A new study estimates that 1.3 million people die each year from bacterial infections that are resistant to antibiotics. Such infections kill more people annually than do HIV/AIDS, diarrhea, and malaria. Antibiotic resistance could well become the leading cause of death by infectious disease in the coming years. The consequences of inaction are serious. With antibiotics rendered ineffective, societies would return to a world of greater death and deteriorating life expectancy in which common surgeries, transplants, and chemotherapy become much more dangerous. Foreign Affairs
Bioterrorism: An Analysis of Biological Agents Used in Terrorist Events
The reported use of biological agents as a terrorist weapon is extremely rare and accounts for 0.02% of all historic terrorist attacks. Despite its apparent rarity, however, bioterrorism can inflict mass injuries unmatched by conventional weapons. 33 terrorist attacks involving biological agents were recorded between 1970 and 2019, registering 9 deaths and 806 injuries. 21 events occurred in the United States, 3 in Kenya, 2 each in both the United Kingdom and Pakistan and a single event in Japan, Columbia, Israel, Russia and Tunisia. The American Journal of Emergency Medicine
Virtual Reality Simulation for Disaster Preparedness Training in Hospitals
A critical component of disaster preparedness in hospitals is experiential education and training of health care professionals. A live drill is a well-established, effective training approach, but cost restraints and logistic constraints make clinical implementation challenging, and training opportunities with live drills may be severely limited. Virtual reality simulation (VRS) technology may offer a viable training alternative with its inherent features of reproducibility, just-in-time training, and repeatability. Although the findings demonstrated the applicability of VRS to different training scenarios, these do not entirely cover all disaster scenarios that could happen in hospitals. Journal of Medical Internet Research
SELECT AGENTS + PRIORITY PATHOGENS
Highly Divergent White-Tailed Deer SARS-Cov-2 with Potential Deer-to-Human Transmission
Researchers identified a new and highly divergent lineage of SARS-CoV-2. This lineage has 76 consensus mutations including 37 previously associated with non-human animal hosts, 23 of which were not previously reported in deer. There were also mutational signatures of host adaptation under neutral selection. Phylogenetic analysis revealed an epidemiologically linked human case from the same geographic region and sampling period. The findings represent the first evidence of a highly divergent lineage of SARS-CoV-2 in white-tailed deer and of deer-to-human transmission. BioRxiv pre-print
SARS-Cov-2 Emergence Very Likely Resulted from at Least Two Zoonotic Events
Researchers show that the SARS-CoV-2 genomic diversity prior to February 2020 comprised only two distinct viral lineages—denoted A and B—with no transitional haplotypes. Novel phylodynamic rooting methods, coupled with epidemic simulations, indicate that these two lineages were the result of at least two separate cross-species transmission events into humans. The first zoonotic transmission likely involved lineage B viruses and occurred in late-November/early-December 2019 and no earlier than the beginning of November 2019, while the introduction of lineage A likely occurred within weeks of the first event. These findings define the narrow window between when SARS-CoV-2 first jumped into humans and when the first cases of COVID-19 were reported. Hence, as with SARS-CoV-1 in 2002 and 2003, SARS-CoV-2 emergence likely resulted from multiple zoonotic events. Zenodo pre-print
Structural Insight into Marburg Virus Nucleoprotein–RNA Complex Formation
These findings provide a structural basis for understanding the nucleocapsid formation and contribute to the development of novel antivirals against Marburg virus and Ebola virus. Nature Communications
The Huanan Market Was the Epicenter of SARS-CoV-2 Emergence
Geographical clustering of the earliest known COVID-19 cases and the proximity of positive environmental samples to live-animal vendors suggest that the Huanan Seafood Wholesale Market in Wuhan was the site of origin of the COVID-19 pandemic. Zenodo pre-print
Japanese Encephalitis Virus Declared ‘Nationally Significant’ as NSW Woman in Intensive Care
Australia’s chief medical officer has beefed up the nation’s response to the Japanese encephalitis virus as New South Wales reports its first case. NSW Health confirmed on Friday night a woman from the NSW-Victoria border region was in intensive care in a stable condition with the virus, marking the state’s first case after outbreaks in Queensland and Victoria. Several more patients in NSW were undergoing testing and more cases were expected to be confirmed in the state over coming weeks. The Guardian
Novel Humanized Anti-Abrin A Chain Antibody Inhibits Abrin Toxicity
Abrin, a type-II ribosome inactivating protein from the seed of Abrus precatorius, is classified as a Category B bioterrorism warfare agent. In this study, a novel anti-abrin neutralizing antibody (S008) was humanized using computer-aided design, which possessed lower immunogenicity. Like the parent antibody, a mouse anti-abrin monoclonal antibody, S008 possessed high affinity and showed a protective effect against abrin both in vitro and in vivo, and protected mice that S008 was administered 6 hours after abrin. Frontiers in Immunology
Novel Hendra Virus Variant Detected by Sentinel Surveillance of Horses in Australia
Researchers identified and isolated a novel Hendra virus (HeV) variant not detected by routine testing from a horse in Queensland, Australia, that died from acute illness with signs consistent with HeV infection. In silico and in vitro comparisons of the receptor-binding protein with prototypic HeV support that the human monoclonal antibody m102.4 used for postexposure prophylaxis and current equine vaccine will be effective against this variant. Genetic sequence consistency with virus detected in grey-headed flying foxes suggests the variant circulates at least among this species. Surveillance and biosecurity practices should be updated to acknowledge HeV spillover risk across all regions frequented by flying foxes. Emerging Infectious Diseases
CHEMICAL + RADIOLOGICAL THREATS
How Four Women Destroyed 1,200 Tons of Poison Gas — and Defused a Crisis
An obscure Defense Department team had nine months to make a stockpile of Syria’s chemical weapons disappear. In doing the impossible, they helped avert a global showdown and saved untold lives. Rolling Stone
Combined Trauma and CBRN Exposure: Adding Insult to Injury
Toxic industrial chemicals (TICs), biological agents with an infectious prodrome, radiological exposures from possible dirty bombs, nuclear detonation, and nuclear power plant disasters result in different forms of contamination in the setting of trauma. We only need to look at our own experience from the protracted COVID-19 pandemic and its impact on hospital operations to see how underprepared the nation is for such events. By comparison, a CBRN event would cause an even more abrupt and drastic interruption to hospital systems. A combined CBRN and trauma event would create an acute spike in patients and demand for resources without the benefit of prolonged response. Hospitals need tools and training to adequately prepare to effectively manage CBRN exposures and concurrent trauma while keeping their staff protected. One of the best mechanisms for ensuring readiness is to formulate hospital and community-based disaster plans and perform large-scale simulations as a hospital in partnership with EMS, police departments, fire departments, and local government entities. ASA Monitor
Chernobyl Plant Is Unharmed Despite Russian Invasion of Ukraine, Scientists Say
The nation’s 15 operating reactors have also been assessed as safe — at least for the moment. The IAEA noted reports of “higher radiation measurements at the Chernobyl site” and quoted Ukraine’s nuclear body as saying that the readings may have resulted from heavy military vehicles stirring up soil that the 1986 accident had poisoned. NY Times
Ukraine Reports Damage to Two Nuclear Waste Facilities
Two Ukrainian facilities containing nuclear waste suffered damage amid Russia’s now four-day-old invasion, international monitors reported on Feb 27. Missiles hit a radioactive waste-disposal site in Kyiv, and an electrical transformer was damaged in a similar depot in Kharkiv, according to an email from the International Atomic Energy Agency. Inspectors are still awaiting radiation measurements from local authorities to determine the extent of the damage. Bloomberg
Radiation Emergency Medical Preparedness in Japan: A Survey of Nuclear Emergency Core Hospitals
Based on experiences following the Great East Japan Earthquake and nuclear power plant accident in 2011, Nuclear Emergency Core Hospitals (NECHs) were designated as centers for radiation disaster management in Japan. This study aimed to investigate their current status and identify areas for improvement. Disaster Medicine and Public Health Preparedness
Remarks at a UN Security Council Briefing on Chemical Weapons in Syria
“The United States sees attempts by the Assad regime and its allies to impugn the integrity and capability of the OPCW and its staff as part of a deliberate and frankly desperate campaign to distract us from the human tragedy the Assad regime has caused and from the fact that it has flouted its obligations under both the Chemical Weapons Convention and UNSCR 2118. Indeed, the disinformation narratives issued by Russia today, are but a continuing disturbingly misguided effort to shield a regime which has used weapons of mass destruction against its people. But as we have said before, no amount of disinformation espoused by Syria or its Russian enablers can negate or diminish the credibility of the substantial body of evidence that has been presented to this Council by the OPCW.” US Mission to the United Nations
SURVEILLANCE + DETECTION
Pathogens that Cause Illness Clinically Indistinguishable from Lassa Fever
When examining samples from patients who met the case definition for Lassa fever but tested negative for the Lassa virus by quantitative RT-PCR, processing the samples through custom TaqMan Array Cards revealed that there was no single cause of the patients’ signs/symptoms. Instead, results were far more complex, detecting a variety of bacterial and viral pathogens (including mixed co-infections). The pathogens identified in this study could be added to the differential diagnosis for patients with Lassa fever signs/symptoms but negative Lassa virus/malaria test results during outbreaks in West Africa. Emerging Infectious Diseases
Fast Evaluation of Viral Emerging Risks (FEVER): A Computational Tool for Biosurveillance
A novel computational approach called FEVER (Fast Evaluation of Viral Emerging Risks) to design assays that simultaneously accomplish broad coverage biosurveillance of an entire group of viruses; accurate diagnosis of an outbreak strain; and mutation typing to detect variants of public health importance. The researchers demonstrate the application of FEVER to generate assays to simultaneously detect sarbecoviruses for biosurveillance; diagnose infections specifically caused by SARS-CoV-2; and perform rapid mutation typing of the D614G SARS-CoV-2 spike variant associated with increased pathogen transmissibility. PLoS Global Public Health
PUBLIC HEALTH
The Biden Administration Killed America’s Collective Pandemic Approach
In the new playbook, recommendations for individual people, not communities, sit front and center, and mitigation frequently falls under the purview of medicine rather than public health—heaping more responsibility on the already dysfunctional American health-care system. Even as the wall of immunity has built up, protection against SARS-CoV-2 isn’t spread equally. Millions of kids under 5 are still ineligible for shots. Vaccine effectiveness declines faster in older individuals and is patchy to begin with in many immunocompromised people. The chances of serious illness go up in high-exposure settings, too, and the CDC’s list of COVID-risky health conditions remains long. The pandemic has also, since its early days, disproportionately pummeled communities of color and people in low-income brackets—structural inequities that big, nationwide trends can easily obscure. The CDC’s new stance on mitigation glosses over all that. The Atlantic
C.D.C. Study Raises Questions About Agency’s Isolation Guidelines
More than half of people who took a rapid antigen test five to nine days after first testing positive for the coronavirus or after developing Covid-19 symptoms tested positive on the antigen test, according to a new study from the CDC. The finding raises more concerns about the agency’s shortened isolation guidelines, which say that many people with Covid can end their isolation periods after five days, without a negative coronavirus test. NY Times
Medical Saline Shortage Hits U.S. Hospitals Reeling from Omicron
Saline solution is used in hospitals for everything from reconstituting drugs to flushing intravenous lines to rehydrating patients. It is a routine but critically important part of taking care of cancer patients, kids suffering from the flu, or people who wind up in the hospital because of an accident. Even a small hospital can use saline thousands of times a day. But a confluence of factors, including supply-chain bottlenecks, high demand caused by the influx of omicron patients into hospitals, and virus-related worker scarcity have made these fundamental products harder to find. Saline vials and bags of all sizes are in shortage in the U.S. Bloomberg
UK: Is the Government Dismantling Pandemic Systems Too Hastily?
A particular concern is that the government’s removal of free testing at a wide scale—both PCR testing and lateral flow devices—and its stopping of payments to support people in isolation will compromise population health surveillance and people’s ability to limit any future spread of infection. The BMJ
Pakistan Has a Big Idea: Send 13,000 Teams Led by Women to Vaccinate the Hesitant
This dramatic intervention by the Sindh government aims to vaccinate a cohort they have struggled to reach: some 25% of residents who have not had their first dose, despite vaccines being widely available for the past year through supplies provided by the U.N.-backed COVAX program, the U.S. and China. “We’ve got Pfizer. We’ve got Moderna. We’ve got Sinovac,” says Dr. Kishwar Tanwir, who oversees vaccinations in the Pehlwan Goth district of the Pakistani city of Karachi. Pakistan dispatches female health workers for these sorts of public campaigns because they’re more likely to get access to women in conservative households who don’t speak to men. They have years of experience, frequently fanning out across Pakistan to administer the oral polio vaccine to millions of children. NPR