Biodefense in the Spotlight – US Response(s) to COVID-19: The World is Watching

Oct 14, 2021

April 16, 2024

“The only thing worse than being blind is having sight but no vision.”

Helen Keller

In a recent op-ed, we argued that the rapid growth and sophistication of bioscience and biotechnology has concomitantly increased the risk and threat of bioterrorism. To be sure, as novel biotechnological tools become easier to acquire and use, many of the barriers that previously prevented effective bioterrorist activity are dissipating, creating viabilities for the development and engagement of novel threats. For example, biotechnology is being ever more democratized: with capabilities becoming available, and manifestations having greater potential effects within the public sphere.  In light of this we believe that is critically important to address ways and means to achieve and maintain balance of relatively open public science, while simultaneously sustaining ethically sound, effective, and efficient methods of surveillance, regulatory oversight, readiness, and response. Although not a bioweapon, the SARS-Cov-2 (i.e.- COVID-19) pandemic has brought awareness of biological threats to the forefront of public discourse, and exposed major vulnerabilities in the United States’ public health and biosecurity systems, many of which could be targeted by bioterrorists, unless expediently – and iteratively -addressed and rectified.

At the beginning of the pandemic, the U.S. was severely lacking in personal protective equipment (PPE). The inadequate stockpile of masks led to the CDC initially recommending that people not wear face masks in public- a message that ran contradictory to the later realization that masks are critical in the fight against COVID-19, significantly mitigating the rate of infection and spread. Ensuring sufficient PPE accessible to healthcare personnel and the public, and a readily available domestic supply chain for equipment will help reduce the potential disruptive effect(s) of a biosecurity incident. To make matters worse, deep political fractures exacerbated the vulnerability of certain populations to disinformation. Mask mandates became a symbol of government oppression, and when vaccines were developed and the push to vaccinate the population began, misinformation and partisan polarization fueled extant vaccine hesitancy to inflame vehement anti-vaccine movements.

The formation of online echo-chambers has allowed misinformation to flourish, and such patterns of partisan divide, misinformation, and fractured trust could be capitalized upon by bioterrorists. Consider that upon deploying even a mild to moderately morbid (and/or non-lethal) biological agent, malevolent actors could sow doubt about governmental attempts to respond to the outbreak: calling into question political motives and methods, rallying factions of the polis to resist seemingly imposed restrictions, and preying upon existing partisan discord to force multiply the effectiveness of their attack.

Wave surges of COVID-19 have repeatedly overloaded hospitals, as patients with non-COVID medical conditions have been forced to wait – or been unable – to receive medical care, as understaffed medical staffs work under ever-occurring triage conditions – sometimes having to choose who to save and who to let die. In a scenario of mass panic caused by a bioterrorist attack, the fearful population would likely rush to seek medical expertise, which could create similar overwhelming pressures on the healthcare system.

We have previously advocated an internationally-focused surveillance plan involving partnerships with allies and adversaries alike. Such a plan calls for greater scrutiny in monitoring scientific conduct and publications, to uphold a biosecurity-by-design approach. Yet, while essential, we see this as only a first step in learning from – and responding to – the lessons of COVID-19.

In preparation for each step, it will be important to ask how competitor, and/or hostile groups or agents might view and respond to both biosecurity vulnerabilities exposed by COVID-19, and any attempts to bridge existing gaps in pandemic (and general biosecurity) preparedness. Biological threats stoke justifiable fears in a population, in that they can render certain or all individuals vulnerable, can be hard to detect, and if new or novel in some way, can be difficult to counter – at least initially. Thus, they are very effective asymmetric weapons, requiring minimal input needed to evoke for relatively large-scale effect(s). Further, the potential unpredictability of a biological weapon- namely, difficulty in predicting the rate and extent of spread, and how significantly they will harm those affected – would not hinder terrorists in the same ways that might hamper a state or military actor. Simply put, multinational signatory treaties, and generally accepted “rules of engagement” need not necessarily apply (and/or be of deterrent value).

Terrorists seek to maximize fear and impact, and so vulnerabilities are exploitable targets. For example, a terrorist could time the release of a biological agent so as to be similar in its effects to those of a naturally occurring pathogen (e.g.- flu). Doing so would make the new agent initially hard to notice, thereby fortifying early-stage impacts. As well, disinformation campaigns could be employed in tandem with a biological attack to mislead the populace about the agent, how, why, and where it is likely to spread, and how best to mitigate or prevent its effects. Alternatively, terrorists could use online resources to veritably describe the bioweapon used and the dangers it poses, and claim credit for the attack in the name of their cause, drawing attention to themselves and spreading fear. Either way, by co-targeting the media, terrorists could ensure that their disruptive and destructive effects spread further and garner more attention. By targeting existing partisan (and/or even religious) ideologies terrorists could leverage disinformation to politicize response to their attack: casting governmental response as too weak, too harsh, or both at the same time. Bear in mind, too, that terrorist individuals and groups can also serve as relatively ideal proxies for nation states to engage clandestine or covert actions, both kinetically and non-kinetically; and in such ways, sidestep attribution for hostile engagements that could be regarded as acts of war.

As Sun Tzu noted, very often, it is the internal weaknesses of a system (whether a military, intelligence, public health system, or nation at-large) that enable the effectiveness of an external competitor and/or opponent. Thus, it is vital to shine light upon those domains and dimensions of US infrastructure and functions that are most vulnerable, so as to illuminate the view through both the lens of assessment and the mirror of (self) scrutiny. Improving access to critical medical equipment, campaigning against misinformation, improving healthcare infrastructure, and setting aside those partisan stances that divide and therefore weaken from within are each and all crucial to establishing a whole-of-nation approach to biosecurity-by-design. Without doubt, it will necessitate – and be – an endeavor of considerable proportion; which as matter of fact, may serve as a “thrown gauntlet” of challenge for malevolent actors to remain apace or ahead of any such efforts.

However, we believe that a strongly proactive posture of preparation and readiness – that meets the current and near-term level of bioscientific and technological capabilities – could disincentivize the use of bioweapons simply by making them – and those that seek to use them -less effective. Much like building an international surveillance and regulatory network to track the rise of pandemic threats, creating effective domestic detection, mitigation, and prevention of biological agents will not be simple to develop nor easy to sustain. But, given the alternative(s), we argue that the worth indubitably warrants the work.

Vikram Venkatram is a recent graduate of Georgetown University’s School of Foreign Service, where he studied Science, Technology, and International Affairs with a minor in Biology. He is also currently pursuing graduate work through Georgetown’s accelerated BSFS/Security Studies M.A. program, where he is a second-year student.

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Dr. James Giordano is Executive Director of the Institute for Biodefense Research; Professor of Neurology and Biochemistry at Georgetown University Medical Center; Senior Fellow in Biosecurity, Technology, and Ethics at the United States Naval War College; and Distinguished Fellow in Science, Technology and Ethics at the Stockdale Center of the US Naval Academy.