News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include the on-going work of strengthening the Biological Weapons Convention; growing highly pathogenic Eurasian H5 avian flu outbreaks in the U.S.; wartime chemical and radiological toxicology preparedness; and the challenges of shaping a future pandemic treaty.
POLICY + GOVERNMENT
Happening This Week: Biological Weapons Convention Ninth Preparatory Committee
“We urge States Parties to welcome the Tianjin Biosecurity Guidelines at the 9th Review Conference and consider mechanisms to raise awareness of them among global stakeholders, from national policymakers to frontline scientists. Formal acknowledgement of the Tianjin Biosecurity Guidelines would signal the importance of these topics and encourage all States Parties to recommit to domestic efforts to reduce risks associated with advanced life science research and technology development.
We further encourage States Parties to think critically about their goals for the upcoming 9th Review Conference, including what they hope to gain from the BWC. The treaty offers a broad scope of benefit, from bioweapons nonproliferation to international cooperation and assistance. Debate on core BWC issues, including verification and compliance assessment, have been mired in fundamental disagreements regarding the scope and purpose of those capacities. States Parties should think beyond these terms and identify their respective purposes to identify mechanisms that increase assurance regarding States Parties’ compliance with their treaty obligations.” Center for Health Security Statement, UN Supporting Documents
BWC PrepCom Report – Tuesday 5 April
The geo-political situation entered the room during the first statement delivered when Russia called for a point of order twice during the Global Partnership statement. On both occasions, Russia suggested that the statement, which included a condemnation of the war in Ukraine, described as a ‘serious breach of international law’, was not about preparations for the Review Conference but was a political statement.
Overseas laboratory allegations – A number of statements connected the allegations made by Russia to potential retrospective claims for justification for military action. Terms such as ‘false’, ‘spurious’ and ‘disinformation’ were used to describe the allegations. Russia denied this, claiming the allegations were ‘well founded’ and that the alleged activities constituted breaches of Articles I and IV. Russia said it reserved the right to raise the allegations through Article V or Article VI of the Convention. Izumi Nakamitsu, the UN High Representative for Disarmament Affairs, was quoted by some delegations. Speaking of Ukraine to the UN Security Council on 11 March, she had said: ‘The United Nations is not aware of any biological weapons programmes’. A side event was convened by Germany, Ukraine and the USA in response to the allegations.
Verification and compliance – a number of delegations suggested the Convention would be strengthened by the addition of verification measures, most of these referred to a legally binding instrument of some form. Some suggested that verification arrangements might have been useful to deal with the Russian allegations. The USA, criticised by some as the country stopping progress on verification, referred back to the Jenkins statement at the MSP that specific measures to strengthen the Convention should be adopted by the Review Conference at the same time as forming a temporary expert working group to enhance confidence and promote compliance. CBW Events
Shanghai Covid Lockdown Extended to Entire City
Chinese authorities have extended their lockdown of Shanghai to cover all its 25 million people after a fresh surge in Covid cases. Initially, there had been separate measures for the eastern and western sides, but the whole city is now subject to indefinite restrictions. Reported cases have risen to more than 13,000 a day, although the numbers are not high by some international standards. Residents reported difficulties in ordering food and water online, with restrictions on when customers are able to place their orders, because of a shortage of supplies and delivery staff. BBC News
Six Paths Forward to a “Pandemic Treaty”
At a special meeting of the WHO’s World Health Assembly last December, country representatives agreed to kick off reforms when they voted for negotiating an international agreement or pandemic treaty. While an international pandemic organization sounds important in theory, organizations like the UN Security Council can’t necessarily solve the problems they were intended to solve. Creating a new pandemic response system will likely require years of difficult negotiations and could still result in a structure unable to forcefully respond to an outbreak, or an agreement supported by only some countries and perhaps not all of the key global leaders. Bulletin of the Atomic Scientists
Indian Health Service: Relief Funding and Agency Response to COVID-19 Pandemic
Indian Health Service provides health care to 2.6 million American Indians and Alaskan Natives. Outdated facilities, few inpatient beds, and health care provider shortages make IHS’s pandemic response especially challenging. IHS took steps to mitigate these challenges by using its $9 billion in COVID-19 relief funding to address immediate and longstanding needs, e.g., covering vaccine- and testing-related costs and implementing a video telehealth system. U.S. Government Accountability Office
Russia’s Lies About Bioweapons in Ukraine Make the World Less Safe
The conspiracy theories worry experts because they are false and could provide cover for Russia deploying biological weapons of its own. But the least speculative and most sinister threat is that the lies endanger the Cooperative Threat Reduction Program, a long-standing international effort that actually prevents bioweapons labs from operating—while allowing countries to develop the capacity to respond to other threats, from destructive livestock and crop pathogens to deadly diseases such as Ebola and Covid. Wired
The DoD Releases the President’s Fiscal Year 2023 Defense Budget
The Department recognizes the vital importance of addressing dangerous transboundary threats:
- Defense Health Program for continued COVID-19 clinical testing and public health efforts – $188 million
- Expanded surveillance activities, including wastewater surveillance Whole Genomic Sequencing of COVID variants
- Chemical and Biological Defense Programs – $280.4 million (20% increase)
The C.D.C. Will Undergo a Comprehensive Re-Evaluation, Says Director Walensky
The move follows an unrelenting barrage of criticism regarding the agency’s handling of the pandemic over the past few months. The review will be conducted by Jim Macrae, who served as acting administrator of the Health Resources and Services Administration for two years and has held other senior positions at the federal Department of Health and Human Services, of which the C.D.C. is a part. Mr. Macrae will start his assignment on April 11. New York Times
Why Has It Taken So Long to Add More Covid Symptoms to NHS List?
With little fanfare, a further nine potential symptoms have now been added to the official list on the NHS website. So why has the UK taken so long? British scientists have long called for a broadening of the official symptoms list. According to research published in February 2021, the inclusion of fatigue, sore throat, headache and diarrhoea in the criteria to qualify for a PCR test could have enabled 96% of symptomatic cases to be detected – a third more than relying on the “classic” three symptoms alone (high temperature, persistent cough and loss of sense of smell and taste). Some scientists suspect it’s precisely because access to free testing has been scrapped for most people in England that the government has updated the list. The Guardian
Senate Leaders Close in on Covid Funding Deal That Halves White House Request
If passed in its current form, the $10 billion deal (pulled from unspent funds in previous stimulus packages) would represent a significant disappointment for the White House, which had publicly campaigned for at least $22 billion in new funds and would probably be forced to scale back elements of its planned response. But lawmakers are facing a rapidly approaching deadline, with Congress soon taking a two-week break, and administration officials warning that they are effectively out of cash for urgent coronavirus needs. The federal government has already begun to wind down a program to cover the costs of health-care providers that give coronavirus tests, treatments and vaccinations to uninsured Americans, an initiative that officials said has cost about $2 billion per month. Washington Post
Summary of the COVID deal:
FUNDING: $10 billion for the Department of Health and Human Services, all in the Public Health and Social Services Emergency Fund (PHSSEF).
- $9.25 billion for the Biomedical Advanced Research and Development Authority (BARDA). Of which, not less than $5 billion to research, develop, manufacture, produce, purchase, and administer therapeutics
- Not less than $750 million for research and clinical trials for emerging coronavirus variants and to support the sustainment and expansion of vaccine manufacturing capacity.
PAYFORS: $10 billion in dollar-for-dollar offsets, provided by repurposing unspent COVID funds, will supply $10 billion in funding for therapeutics and urgent COVID needs. CBO has scored each of the offsets as a savings in outlays.
- SBA Shuttered Venues Operators Grants—$1.93 billion
- SBA Economic Injury Disaster Loans—$900 million
- USDA ARP and CARES—$1.6 billion
- Transportation Aviation Manufacturing Jobs Protection Program—$2.31 billion
- Higher Education Emergency Relief Fund—$500 million
- Local Assistance and Tribal Consistency Fund—$887 million
- Treasury State Small Business Credit Initiative—$1.873 billion*
- Note: Rescinds $2.13 billion in budget authority to yield an outlay savings of $1.873 billion
MEDICAL COUNTERMEASURES
A Survey of Location-Allocation of Points of Dispensing During Public Health Emergencies
Poor decision-making while determining the location of healthcare facilities such as PODs results in negative outcomes. These adverse outcomes are not limited to cost and service but also increased infection numbers and deaths due to difficulty in accessing the service. In order to improve PODs location-allocation models during public health emergencies, there is a need to develop various techniques to analyze and define the demand of partial groups and provide the desired coverage to those demand points. Efforts to propose models to cover the needs of different countries, including variation in population size and density, are urgently needed. Frontiers in Public Health
Defining the Risk of SARS-Cov-2 Variants on Immune Protection
To address the public health threat caused by the increasing SARS-CoV-2 genomic diversity, the National Institute of Allergy and Infectious Diseases (NIAID) within the NIH established the SARS-CoV-2 Assessment of Viral Evolution (SAVE) program. This effort was designed to provide a real-time risk assessment of variants potentially impacting transmission, virulence, and resistance to convalescent and vaccine-induced immunity. Here researchers describe the coordinated approach used to identify and curate data about emerging variants, their impact on immunity, and effects on vaccine protection using animal models. They report the development of reagents, methodologies, models, and pivotal findings facilitated by this collaborative approach and identify future challenges. Nature
The Covid-19 Vaccine Market Is Getting Crowded — As Demand Begins to Wane
Two new players — Novavax and a Sanofi-GSK partnership — are making or about to make their way into an already crowded global Covid vaccine market. The world can now produce more Covid vaccine than it needs or can administer — more than 12 billion doses a year. For a number of existing manufacturers, purchases have plateaued; some players are already scaling back production. A company hoping to enter the market with yet another vaccine that targets the original SARS-CoV-2 strain or that offers no advantages over existing products will be hard-pressed to find buyers. Furthermore, the urgency to speed vaccines into use that permeated the regulatory and political landscape in the fall of 2020 is no longer the state of play. That’s not to say there’s no opportunity at all. Experts agree there is still a market for better vaccines. STAT
Immune Correlates of Protection for Emerging Diseases – Lessons from Ebola and COVID-19
Research topic: Correlates of Protection (CoP) are biological parameters present in vaccinated or naturally infected individuals that predict levels of protection against an infectious disease. CoP for emerging diseases is challenging since by the time new vaccines are urgently needed, immunogenicity and clinical efficacy data are still scarce. Recent epidemics of COVID-19 and Ebola viral disease exemplify this. Virus neutralising antibody (VNAb) levels predicted, reasonably likely, the degree of protection against SARSCoV-2 infection and disease. However, to date, an internationally standardised threshold of protection remains elusive and the emergence of SARS-CoV-2 variants with different clinical and antigenic properties to the ancestral Wuhan virus complicate the problem. Furthermore, data indicating that other mechanisms of adaptive immunity are likely involved in protection continuously emerge. Frontiers
BIOSECURITY + BIOPREPAREDNESS
Bats Host the Most Virulent—But Not the Most Dangerous—Zoonotic Viruses
Reservoir host groups more closely related to humans—in particular, primates—harbor less virulent but more highly transmissible viruses. Importantly, a disproportionately high human death burden, arguably the most important metric of zoonotic risk, is not associated with any animal reservoir, including bats. Our data demonstrate that mechanisms driving death burdens are diverse and often contradict trait-based predictions. Ultimately, total human mortality is dependent on context-specific epidemiological dynamics, which are shaped by a combination of viral traits and conditions in the animal host population and across and beyond the human–animal interface. Understanding the conditions that predict high zoonotic burden in humans will require longitudinal studies of epidemiological dynamics in wildlife and human populations. PNAS
Asha George: A Biological Weapons Threat to Ukraine is a Biological Weapons Threat to the World
“Last year, the US Department of State reported that Russia and North Korea possess active biological weapons programs, with China and Iran not far behind. Even though it is a state party to the BWC, Russia never fully eliminated its biological weapons program, as the convention requires. Russia did not end its biological weapons efforts when the United States ceased its program in 1979, and to this day Russia has not granted other countries full access to its biological weapons laboratories. Russia did not destroy tons of previously weaponized smallpox, plague, anthrax, and other biological agents, choosing instead to bury them on Vozrozhdeniya Island in the Aral Sea. Accordingly, Russia will not need to ramp up efforts to produce biological agents and weapons if it decides to use them in Ukraine.” Bulletin of the Atomic Scientists
SELECT AGENTS + PRIORITY PATHOGENS
Biotechnology Firm Director Sentenced for Obstruction of Justice Relating to Attempts to Acquire Ricin
The director of advanced research at a Massachusetts biotechnology firm was sentenced last week in federal court in Boston for obstructing an investigation into his efforts to acquire the deadly toxin, ricin. Dr. Ishtiaq Ali Saaem, 37, a Bangladeshi national residing in Massachusetts, was sentenced by U.S District Court Judge Richard G. Stearns to three years of probation, six months of which will be served on home confinement. Ali Saaem was also ordered to pay a fine of $5,500. The government recommended a sentence of one year in prison. In April 2021, Saaem pleaded guilty to one count of obstruction of justice. U.S. Attorney’s Office District of Massachusetts, Washington Post
Isolation of Infectious Lloviu Virus from Schreiber’s Bats in Hungary
The filovirus Lloviu virus (LLOV), was identified in 2002 in Schreiber’s bats (Miniopterus schreibersii) in Spain and was subsequently detected in bats in Hungary. Here researchers isolate infectious LLOV from the blood of a live sampled Schreiber’s bat in Hungary. The isolate is subsequently sequenced and cultured in the Miniopterus sp. kidney cell line SuBK12-08. It is furthermore able to infect monkey and human cells, suggesting that LLOV might have spillover potential. Nature Communications
High-Path Avian Flu Strikes Texas Flock, Expands in Midwest
The USDA’s Animal and Plant Health Inspection Service (APHIS) has confirmed the presence of highly pathogenic avian influenza (HPAI) in a commercial pheasant flock in Erath County, Texas. As part of existing avian influenza response plans, Federal and State partners are working jointly on additional surveillance and testing in areas around the affected flock. The event pushed the number of states experiencing outbreaks in poultry flocks to 25 this year, with the virus linked to the loss of about 22.8 million birds so far. Iowa—the nation’s largest egg producer—is the hardest-hit state, having lost 13.2 million poultry already. The outbreaks are the nation’s worst since 2015, when highly pathogenic H5N2 avian flu struck farms in 15 states, leading to the loss of more than 50 million birds, of which more than 32 million were in Iowa. CIDRAP
Analysis of Individual-Level Data from 2018–2020 Ebola Outbreak in Democratic Republic of the Congo
The 2018–2020 Ebola virus disease epidemic in DRC resulted in 3481 cases (probable and confirmed) and 2299 deaths. Analysis suggests that an increase in the rate of quarantine and isolation that has shortened the infectiousness period by approximately one day during the epidemic’s third and final wave was likely responsible for the eventual containment of the outbreak. The authorization for emergency use of Merck experimental Ebola vaccine rVSV-ZEBOV-GP5,6 and its field deployment in 2019 has provided for better protection of those involved in monitoring efforts, as it was given to many frontline workers including doctors, nurses, and burial workers. An estimated 330,000 people living in the northern DRC provinces were vaccinated in 2019 and 2020, including frontline workers as well as ring vaccinations of the contacts of suspected and confirmed cases. Scientific Reports
Israel in Polio Vaccine Drive After Logging First Case Since 1988
Israel has launched a polio vaccination drive after its first case of the disease in more than three decades, the Health Ministry said on Tuesday, voicing concern turnout may be depressed by public fatigue over the COVID-19 pandemic. Since March a girl has been diagnosed with the disease and at least six non-symptomatic cases have been detected in the Jerusalem area, the Health Ministry said. All were unvaccinated. The virus was found in sewage from three other cities, it added. Polio vaccinations are routinely offered to Israeli children. Due to a policy change between 2005 and 2014, some received one oral dose rather than a two-dose regimen. The ministry’s focus now is on children who skipped the vaccination entirely, or those who got only one oral dose. Reuters
CHEMICAL + RADIOLOGICAL THREATS
Russian Soldiers Reportedly Sickened After Digging Trenches in Contaminated Chornobyl Soil Before Withdrawing from Site
Russia’s force has fully withdrawn from the area of the Chornobyl nuclear power plant, Ukraine’s defense ministry confirmed on Friday. It cited two reasons for the exit: military losses and radiation exposure. When they left, Ukraine’s ministry added, the Russian troops looted the power plant, taking “kettles, lab equipment, and radiation.” The IAEA said on Thursday that it’s still working to determine the veracity of reports that Russian soldiers received high doses of radiation in the notoriously contaminated Chornobyl Exclusion Zone during more than a month of occupation. Russian troops left the site after digging trenches and building fortifications in the Red Forest — an area it says is the most heavily polluted in the entire zone. Early reporting indicates a panic broke out when the first signs of radiation sickness emerged. NPR, The Guardian
Wartime Toxicology: The Spectre of Chemical and Radiological Warfare in Ukraine
Despite prohibition of chemical weapons from the Chemical Weapons Convention of 1997, recent evidence has demonstrated that state actors will continue to use these agents as weapons of war and terror, despite publicly denying their use. Here researchers review chemical weapons produced and used by the Russian Federation (or its allies) to identify plausible risks in the Russian war in Ukraine, as well as a rapid assessment of treatment guidelines to recognize and manage these acute exposures. Toxicology Communications
Acute Health Effects and Outcome Following Sarin Gas Attacks in Khan Shaykhun, Syria
The aim of this study is to describe the clinical manifestations, effects management, and outcomes of sarin gas exposure in areas with poor healthcare infrastructure based on the victims of the 2017 Khan Shaykhun attack. The medical staff at al Rahman has extensive experience in wars and disasters in addition to having undergone special training in the management of chemical weapons exposure through the Chemical, Biological, Radiological, Nuclear-Taskforce (CBRN-Taskforce). Not all the necessary drugs were available in the hospital, including pralidoxime. Decontamination of the victim involves the use of bleach, soap, and water. Staff handling casualties require protection in the form of respirators and butyl rubber boots and gloves. Treatment is based on the use of large doses of atropine, a muscarinic receptor antagonist, accompanied by an oxime, an AChE reactivator, and diazepam, which may lead to practical problems of sufficient drug supplies for the average hospital. Ventilation may be necessary. Cureus
The Urgent Need to Achieve an Optimal Strategic Stock of Human Allogeneic Skin Graft Materials in Case of a Mass Disaster in Poland
A mass disaster event may involve large numbers of severely burned patients. At present, Poland does not have a sufficient supply of human allogeneic skin graft materials to meet the needs arising from a sudden and unforeseen mass disaster. This study concluded Poland has shortcomings in its tissue donation system and to better prepare for mass casualty situations the authors propose organizational, legal and systemic changes required to improve the situation in Polish transplantology, with particular emphasis on skin donation. Cell and Tissue Banking
PUBLIC HEALTH
Diabetes Risk Rises After COVID, Massive Study Finds
People who get COVID-19 have a greater risk of developing diabetes up to a year later, even after a mild SARS-CoV-2 infection, compared with those who never had the disease, a massive study of almost 200,000 people shows. Even people who had mild infections and no previous risk factors for diabetes had increased odds of developing the chronic condition, says Al-Aly. Of the people with COVID-19 who avoided hospitalization, an extra 8 people out of every 1,000 studied had developed diabetes a year later compared with people who were not infected. People with a high body-mass index, a measure of obesity — and a considerable risk factor for type 2 diabetes — had more than double the risk of developing diabetes after a SARS-CoV-2 infection. Nature
Bill Hanage: From ‘Herd Immunity’ to Today, Covid Minimisers are Still Sabotaging Our Pandemic Progress
“After almost all interventions were removed, the UK has been predictably buffeted by a wave of BA.2 infections. For now, it appears that the disease is comfortingly similar to BA.1, by which I mean readily handled by the great majority of vaccinated folks. But to insist that future variants will be similar is a gamble, not a policy. Rather than maintaining its world-beating scientific effort to understand the properties of the variants as they emerge, the UK is scaling back funding. It doesn’t end because you want it to. Every time you’ve heard a voice state it’s time to “live with the virus” remember that doesn’t mean doing nothing about it.” The Guardian
Florida’s Decision on Covid Vaccines for Healthy Kids Adds to Confusion And Distrust
Andrew Pavia, chief of pediatric infectious diseases at the University of Utah, said Ladapo’s announcement made his “blood boil.” While it’s true that children are less likely to suffer from severe disease if they contract Covid, they can still get very sick, he said, noting that at the peak of the Omicron wave, about 40,000 children a week across the country were hospitalized with Covid infections. Pavia dismissed Ladapo’s move as “political theater.”
“Anybody who takes care of children in a children’s hospital has seen very, very sick kids and tragic outcomes,” Pavia said. “It’s kind of unbelievable that this politically motivated surgeon general who’s taken every contrarian view on Covid from pushing ivermectin to using monoclonals for variants that are fully resistant to them is overriding the careful, transparent deliberations of dozens of real vaccine experts, public health experts, and pediatricians who have been caring for and caring about sick kids throughout this pandemic.” Stat
Opinion: The CDC is Beholden to Corporations and Lost Our Trust.
New CDC guidelines are at odds with evidence-based and equitable public health practice. By minimizing the importance of new cases and focusing instead on hospitalizations–a lagging indicator–the revamped warning system delays action until surges are well underway and the consequences of severe disease and death are already in motion. Making matters worse, at-home tests are not recorded in the US, so the only “early indicator” in the risk level calculation grossly undercounts the true number of cases. The justification for the shift is that the virus is mostly harmless– a claim which not only ignores that one million have already died in the US alone, but also completely erases the reality of Long Covid. The Guardian
The Quest to Prevent MS — And Understand Other Post-Viral Diseases
Researchers have long suspected a link between MS and the Epstein–Barr virus (EBV), but it has been hard to establish a strong connection, partly because almost everyone gets an EBV infection at some point, most of them harmless. The samples in the DoD’s freezers provided an unparalleled chance to explore the link. After analysing data and samples collected from more than 10 million Army, Navy and Air Force service members since 1993, Ascherio found that EBV infection increases the risk of MS 32-fold. Nature
SURVEILLANCE + DETECTION
Surveillance of Emerging Infectious Diseases for Biosecurity
In the effort to establish a well-integrated surveillance system for collecting, analyzing, and transforming various types of data from different partners, many practical challenges related to technology, politics, legislation, and ethics exist. Extensive and meaningful cooperation is needed to integrate the surveillance systems of various countries. An internationally united and well-integrated surveillance department should be established under the framework of the WHO for effective management, including information, techniques, expert, and resource sharing through coordinating participating countries. We can ensure global biosecurity only through effective cooperation in both biosurveillance and continuous response. Science China Life Sciences
Genome Data Gaps Could Stymie Search for Next COVID Variant
Many countries sequencing SARS-CoV-2 genomes are sharing only a fraction of them on public repositories — and many sequences are missing important information, according to a global analysis of genomic surveillance. But the study also found that despite these challenges, countries have become faster at sharing sequences over the course of the pandemic. Nature
End of Free Covid Testing Risks Creating ‘A Perfect Storm’ for UK Economy
The removal of free Covid tests in the UK is an “anti-business” measure that risks hitting the economy as it faces spiralling costs and uncertainty, ministers have been warned. Some workplaces are already seeing teams hit hard by Covid absences, after the number of infections reached its highest level on record last week. There are pleas for a rethink, with concerns that smaller businesses, as well as hospitality, could be heavily affected. Senior NHS figures are concerned that the lower Covid hospitalisation rate is creating complacency. The Guardian
Digital Plasmonic Nanobubble Detection for Rapid and Ultrasensitive Virus Diagnostics
Plasmonic nanobubbles are transient vapor bubbles generated by laser heating of plasmonic nanoparticles (NPs) and allow single-NP detection. Using gold NPs as labels and an optofluidic setup, researchers demonstrate compartment-free digital counting on homogeneous immunoassays without separation and amplification steps. Nature Communications
HISTORICAL REFLECTIONS
Project Sapphire: How to Keep 600 Tons of Kazakh Highly Enriched Uranium Safe
It was 3 a.m. on a freezing November night in 1994. Trucks carrying almost 600 kilograms of highly enriched uranium had just left a nuclear facility in an industrial town in eastern Kazakhstan. They were headed to the Ust-Kamenogorsk airport, where U.S. military planes were waiting to carry their dangerous cargo to the United States. As the weather worsened, the trucks began to slide on black ice. “I just couldn’t imagine having to report to Washington that [one of the trucks with highly enriched uranium] slid right off into the Irtysh river.” This treacherous ride was a culmination of a secret U.S.-Kazakh operation codenamed Project Sapphire. Looking back three decades later, the story of its success reveals that trust between countries can make the most challenging and high-stake cooperative security initiatives a reality. War on the Rocks