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Rethinking U.S. Biosecurity Strategy for the Decade Ahead

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Rethinking U.S. Biosecurity Strategy for the Decade Ahead RETHINKING U.S. BIOSECURITY STRATEGY FOR THE DECADE AHEAD Annotated Bibliography October 27-29, 2020 Center for Global Security Research LAWRENCE LIVERMORE NATIONAL LABORATORY Annotated Bibliography RETHINKING U.S. BIOSECURITY STRATEGY FOR THE DECADE AHEAD Center for Global Security Research Livermore, California, October 27-29, 2020 Prepared By: Lauren J. Borja, Marigny Kirschke-Schwartz, Ryan Swan Key Questions: What lessons should be drawn from the COVID 19 crisis for the future of U.S. biosecurity strategy? What bio-related threats, risks, and dangers must be accounted for in the decade ahead? How can the coherence of national and international responses be improved? Panel Topics: 1. The Challenge of Anticipating Emerging Threats 2. The Challenge of Responding to an Emergent Threat 3. Biological Warfare 2030 4. Public Health Risks 2030 5. Balancing Pandemic Preparedness and Biodefense 6. Balancing Oversight and Execution The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States government or Lawrence Livermore National Security, LLC, and shall not be used for advertising or product endorsement purposes. 1 Panel 1: The Challenge of Anticipating Emerging Threats What methodologies and toolkits were used to characterize pandemic risk? Can they be improved? How? What preparations are appropriate for Black Swan events? Do we have adequate means to “connect the dots” between information source divided between public health and national security domains? Cameron, Elizabeth; Nuzzo, Jennifer B.; Bell, Jessica A.; et al, “2019 Global Health Security Index: Building Collective Action and Accountability,” Nuclear Threat Initiative and Johns Hopkins, Bloomberg School of Public Health, Center for Health Security, October 2019, https://www.ghsindex.org/wp-content/uploads/2020/04/2019-Global-Health-Security-Index.pdf The Global Health Security (GHS) Index serves as a comprehensive assessment and benchmarking of health security and related capabilities across the 195 states parties to the International Health Regulations. It notes an increasing risk of high consequence and globally catastrophic risks, magnified by a rapidly changing and interconnected world in which increasing political instability, urbanization, climate change, and rapid technology advances make it easier, cheaper and faster to create and engineer pathogens. The Index considers the broader context for biological risks, including a country’s geopolitical considerations, health system and whether it has tested its capacities to contain outbreaks. Morse, Stephen S.; Mazet, Jonna A.K.; Woolhouse, Mark; et al. “Prediction and prevention of the next pandemic,” The Lancet, 2012, https://doi.org/10.1016/S0140-6736(12)61684-5 The authors review the research literature of zoonoses, or infectious diseases caused by pathogens that have jumped from animals to humans. The authors discuss a model for zoonotic events and describe characteristics of places where an event might occur. They assess the current state of public health research efforts toward developing the ability to better predict infectious pathogens that could crossover from animals to humans. The authors also call for increased collaboration across different public health entities to better predict or reduce the impact of emerging pathogens. Schoch-Spana, Monica; Cicero, Anita; Adalja, Amesh; et al, “Global Catastrophic Biological Risks: Toward a Working Definition.” Health Security, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576209/pdf/hs.2017.0038.pdf The authors present their working definition of global catastrophic biological risks (GCBRs), which they see as a subset of global catastrophic risks. They enumerate some defining characteristics and elements of GCBRs and apply them to past and future biological risk scenarios. The authors conclude that while GCBRs represent a small portion of biological threats in the world and should not distract from work to prevent and respond to other vital disease priorities, GCBRs pose such extraordinary potential consequences for humanity that they deserve their own high-level attention, risk assessment, resources, and strategic planning. 2 U.S. Department of Health & Human Services, “National Influenza Vaccine Modernization Strategy (NIVMS) 2020-2030”, 2020. https://www.phe.gov/Preparedness/planning/nivms/Documents/nivms-2020-2030.pdf As directed by Executive Order 12887, the National Influenza Vaccine Modernization Strategy outlines a vision for the U.S. influenza vaccine enterprise to become more responsive, flexible, resilient, scalable, and more effective at reducing the impact of seasonal and pandemic influenza viruses in line with three overarching strategic objectives: 1) strengthen and diversify influenza vaccine development, manufacturing, and supply chain; 2) promote innovative approaches and use of new technologies to detect, prevent, and respond to influenza; and 3) increase influenza vaccine access and coverage across all populations. Panel 2: The Challenge of Responding to an Emergent Threat In the local and national level responses, what should and could have been done differently? In the international responses, what could and should have been done differently? In global perspective, who got it right? How did they do so? Summary of remarks by Bentz, Julie, “Chapter 1: Capabilities for Effective Response to an International CBRN Event” in National Research Council’s An All-of-Government Approach to Increase Resilience for International Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) Events: A Workshop Summary. 2014. https://doi.org/10.17226/18814 In her remarks, Bentz offers four suggestions for responding to an international chemical, biological, radiological, or nuclear (CBRN) event, informed by the 2011 nuclear disaster in Fukushima, Japan. She first suggests the development of improved inter-government coordination for low-probability, high-impact events, asserting that traditional mechanisms are insufficient when additional layers of government are added to the process. Second, she calls improving the mechanisms for sharing technical data. Third, she advocates for new definitions of metrics for success and consequence management. Finally, Bentz calls for the structuring of procedures for evacuating U.S. personnel and citizens from foreign territories hit by a CBRN event. Currie, Chris P., “COVID-19 FEMA's Role in the Response and Related Challenges” Statement before the Subcommittee on Oversight, Management, and Accountability, and the Subcommittee on Emergency Preparedness, Response, and Recovery, Committee on Homeland Security, House of Representatives, July 2020, https://www.gao.gov/assets/710/708097.pdf Currie’s testimony focuses on FEMA’s role in managing the COVID-19 pandemic. He discusses efforts to acquire and distribute critical medical supplies as well as what these and prior efforts suggest about potential challenges going forward for the ongoing COVID crisis and future nationally significant biological incidents. Based on FEMA’s work 3 between 2003 and 2020, he highlights key challenges. These include coordination between FEMA and federal and state agencies, medical supply acquisition and distribution, deployment of disaster workforces, after-action reporting, inter-agency planning, and assessment of capabilities. Ghilarducci, Mark. “Reviewing Federal and State Pandemic Supply Preparedness and Response,” Testimony before the U.S. House of Representatives Committee on Homeland Security, Subcommittee on Oversight, Management, and Accountability, Subcommittee on Emergency Preparedness, Response, and Recovery, July 2020, https://homeland.house.gov/download/ghilarducci-testimony-oma-71420 Ghilarducci, the Director of California Governor’s Office of Emergency Services, testifies on the federal government’s procurement and distribution of personal protective equipment and testing supplies during the COVID-19 pandemic. First, he summarizes California’s response to several emerging state crises in the spring of 2020, noting interactions between the state and federal government during this time. He also summarizes efforts made by the state of California to develop its own response and address deficiencies in federal government support. He concludes with several recommendations for the U.S. government to improve its current and future pandemic response strategy. Greenberg, Karen J. and Schwartz, Amanda E., “Report #1: COVID-19 Detection and Response” for Center on National Security at Fordham Law, August 2020, https://www.centeronnationalsecurity.org/s/Biosecurity-Report-1-Aug-10-2020.pdf The authors of this report examine the experiences of six countries in confronting the COVID-19 pandemic: the United States, the United Kingdom, Germany, South Korea, New Zealand, and China. The authors discuss the successes and failures of these countries in countering COVID-19, compares their preparedness regimes and the in-time responses of each government to assess which governance-related factors are the most critical to success at the domestic level. They identify four necessary factors for countering the spread of the pandemic: 1) strong central leadership and inter-agency coordination; 2) adaptable pre-exiting pandemic strategy and implementation plan; 3) regard for societal and cultural factors; and 4) a strict lockdown and/or effective data-driven measures National Research Council 2016 “Chapter 6: Building a framework for global health security” in The Neglected Dimension
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