The nation is critically underprepared to confront transnational biological threats ranging from DIY bioterror agents to natural pathogens that outpace current pharmaceuticals and overwhelm medical facilities, the Blue Ribbon Study Panel on Biodefense heard at the Hudson Institute. James Lawler, a retired Navy commander whose experience includes serving as director for medical preparedness policy on the National Security Council and director for biodefense policy on the White House’s Homeland Security Council, warned that the country is “woefully unprepared for these biological threats” in an increasingly interdependent world. “Events halfway around the world have rapid effects,” he said, and the nation suffers from a “lack of threat awareness and poor situational awareness as it comes to biological threats.”
The chairman of the Senate Intelligence Committee said a critical challenge in confronting the threat of pandemics or biological attacks is acknowledging that “the architecture of government is not designed in a way that allows innovation to happen and for it to be deployed quickly.” In an address to the Texas A&M University and the Scowcroft Institute of International Affairs Pandemic & Biosecurity Forum in Washington, Sen. Richard Burr (R-N.C.) characterized the state of pandemic research and response in this country as “a lot of people jumping up saying ‘why the hell won’t you let me try’… When we talk about Washington stovepipes, we’ve got a stovepipe when it relates to pandemics.”
A HCI virus strain emerges suddenly on a rural poultry farm west of an Asian city. Numerous cages of infected chickens shipped from that farm arrive at several legal and illegal live markets within the dense urban districts of the city. A child wanders about the market climbing and peering into cages as his mother barters for a chicken to boil that evening. The merchant butchers the chicken and sells it to the woman, who leaves with her son. This process repeats itself numerous times. The merchant’s direct contact with live and butchered birds results in his infection and within days he starts to show symptoms. His symptoms worsen, but he continues to work in the market selling his infected birds so he can provide for his family. The air in the market is stagnant as chickens and ducks move about their cages, kicking up contaminated dust and flapping their wings. The merchant is ignoring his growing aches and cough, thinking that the dust, cool mornings, and cigarette smoking are causing his asthma to flare up.
A committee studying the funding process for America’s defenses against naturally spreading and weaponized pathogens warned that as “disease outbreaks, other emergencies, and disasters continue to affect public health security, the nation must take a more businesslike approach to biodefense budgeting.” Leadership begins with the executive branch, the Blue Ribbon Study Panel on Biodefense report argued, from the vice president’s office to the National Security Council and Office of Management and Budget to an “allied Biodefense Coordination Council that prioritizes interagency biodefense activities and spending.” In previous recommendations, the panel said the president should establish the council with deputy secretaries from all departments and agencies with biodefense responsibilities, along with non-federal stakeholders.
The battleground has been evolving gradually and the balance of power has shifted. The germs with which we have had a “relative détente” have been mutating below our radar screen and are now in position to literally threaten our lives. Today, what were once pathogens over which we had control have become resistant to our antibiotics and become deadly MRSA (“Methicillin-resistant Staphylococcus aureus“) or VRE (“Vancomycin-resistant enterococci “), for instance. Outside the body, similar mutations are occurring and those germs we dealt with on our hands and surfaces are now evolving with the ability to survive our once-effective cleaning and disinfecting protocols.
The United States is “in worse shape than we were 15 years ago” in the ability to respond — particularly at the critical community level — to a potential pandemic that could be foreshadowed by a pattern of new influenza strain outbreaks, biodefense expert Steven Hatfill warned. Hatfill, a onetime biodefense researcher at Fort Detrick, was wrongly accused of sending the 2001 anthrax letters and subsequently received a multimillion-dollar settlement from the U.S. government and official public exoneration from the Justice Department. He is currently an adjunct assistant professor in the Department of Microbiology, Immunology, and Tropical Medicine at George Washington University, and emphasized that rapid detection of emerging outbreaks is useless without an effective rapid-response plan — and in terms of the pandemic influenza threat, “we’re stuttering.”
We have been fortunate not to suffer the re-emergence of a killer flu in human populations. However, a natural flu outbreak is far from our only biothreat. In recent decades, the likelihood of a new pandemic caused by the intentional release of a dangerous biological agent has increased. In this regard, we potentially face dual-threat scenarios – namely, international conflict and terrorism. The deliberate use of biological agents for terror and warfare dates back nearly 1,000 years. In recent history, the Japanese waged biowarfare against China during WWII using plague, cholera and typhus. The U.S. initiated a bioweapon development program in 1960 and terminated it in 1969.
Current efforts to develop technology that could detect and protect the nation from biological threats “are insufficient and are going in the wrong direction,” the executive director of the Bipartisan Commission on Biodefense warned lawmakers. Asha George, a former subcommittee staff director at the House Committee on Homeland Security who now leads staff at the commission co-chaired by former Homeland Security Secretary Tom Ridge and former Sen. Joe Lieberman (I-Conn.), told the House Homeland Security Subcommittee on Emergency Preparedness, Response and Recovery that “the nation is not adequately prepared and has not been adequately prepared for more than a decade now.”
The U.S. Department of Agriculture’s point person on homeland security warned that border vigilance against Chinese pork imports — even a visitor bringing back a pack of infected jerky — is crucial to keep a pathogen from causing economic ruin here in America. “It’s a lot easier to infect animals and plants because fewer people are watching,” Stiefel said, adding that “this is something that could be attacked intentionally or unintentionally.” Sixty-one percent of diseases that affect humans have a zoonotic origin, and zoonotic diseases account for 70 percent of emerging diseases. The 2015 outbreak of Asian highly pathogenic avian influenza in the United States cost more than $800 million; the agriculture sector accounts for 5.5 percent of U.S. gross domestic product.
Several countries are screening air passengers traveling from China and Hong Kong for the deadly Novel Coronavirus, also called 2019-nCoV. In order to manage the screenings and contain the spread of the virus, all travelers flying between Wuhan and the United States will be rerouted through one of the five airports with screenings if they aren’t already scheduled to fly there. In the country of origin, China has installed 35 infrared thermometers at airports, railway stations, long-distance bus stations, and ferry terminals. Authorities initially advised against travel into and out of Wuhan, and on January 23 it was announced that all flights, trains and other public transport out of Wuhan would be suspended. Similar measures will take effect in the nearby city of Huanggang and other areas.
When the Ebola virus emerged in the United States in 2014, two of the four confirmed cases were nurses at a Dallas hospital who treated the first patient: Thomas Eric Duncan, who had contracted the virus in Liberia and later died. Those cases underscored how quick and effective response to a number of emerging diseases means protecting caregivers from first responders to hospital staff from dangerous pathogens. CDP’s Noble Training Facility includes 12 intensive care patient rooms, a fully automated nurse’s station, multiple supply and storage rooms, and a waiting room, in addition to classrooms and training rooms.
Preparedness could be the difference between a contained local outbreak and a global pandemic if there was a smallpox attack in the Pacific today, a bioterrorism exercise held at UNSW Sydney discovered. The hypothetical scenario, designed to test preparedness and response globally to a smallpox attack in our region, brought together key international representatives from departments of health, foreign affairs, defense, police, non-government agencies, vaccine manufacturers and other global stakeholders. The simulation uncovered that for a disease as infectious as smallpox, every day counts.
Declining private investment and lack of innovation in the development of new antibiotics are undermining efforts to combat drug-resistant infections, says the World Health Organization (WHO). Two new reports reveal a weak pipeline for antibiotic agents. The 60 products in development (50 antibiotics and 10 biologics) bring little benefit over existing treatments and very few target the most critical resistant bacteria (Gram-negative bacteria). While pre-clinical candidates (those in early-stage testing) are more innovative, it will take years before they reach patients.
Drones that can disperse bioweapons are a top worry for operators of venues hosting large gatherings — especially as regulations hamstring drone mitigation efforts and even knocking a suspicious unmanned craft out of the sky could inadvertently unleash a toxic payload such as anthrax spores. “Unfortunately in today’s environment, mass gathering events attended by large numbers of people may be considered a terrorist target due to a large concentration of people, symbolic nature of the event, high-profile attendees and increased media attention,” Lou Marciani, director of the National Center for Spectator Sports Safety and Security at the University of Southern Mississippi, told the Blue Ribbon Study Panel on Biodefense in Washington on Tuesday. “So terrorists and other violent criminals are placing significant emphasis on attacking soft targets.”
A new Global Health Security Index, the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries, suggests that not a single country in the world is fully prepared to handle an epidemic or pandemic. The inaugural GHS Index finds severe weaknesses in countries’ abilities to prevent, detect, and respond to significant disease outbreaks. The average overall 2019 GHS Index score is slightly over 40 out of a possible score of 100. Among the 60 highest-income countries assessed, the average score is 51.9.
The administration said the goal is “a more efficient, coordinated, and accountable biodefense enterprise” by setting up “a process to assess our capabilities and to prioritize biodefense resources and actions across the government” with an annual assessment. The National Biodefense Strategy “builds on lessons learned from past biological incidents to develop a more resilient and effective biodefense enterprise” including the 2001 anthrax attacks, the 2009 influenza pandemic, the 2014 Ebola epidemic, and the Zika epidemic. HHS said that “biological threats of a manmade, accidental, or naturally occurring nature are very real and they’re growing.”