Interview with Andrew Kimball on the Ralph Nader Radio Show
Ralph Nader Radio Hour Episode 332
July 18, 2020
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Steve Skrovan: It's the Ralph Nader Radio Hour.
[Music] Stand up, stand up, you've been sitting way too long.
Steve Skrovan: Welcome to the Ralph Nader Radio Hour. My name is Steve Skrovan along with my co-host David Feldman. Hello, David.
David Feldman: Hello, everybody.
Steve Skrovan: And the man of the hour, Ralph Nader. Hello, Ralph.
Ralph Nader: Hello, everybody.
Steve Skrovan: Ralph, you wanted to open the show. You got a few things to say.
Ralph Nader: Yeah. Boeing has lost more than 800 orders by airlines for the 737 MAX so far this year. Still moving ahead to try to, by September, give it the okay to fly. There are more defects being documented in the 737 MAX that haven't been investigated by congressional committees yet, or openly by the FAA. So I just wanted to bring all this up to date. There will be more cancellations, analysts predict. And Boeing is discounting the price to try to hold its existing orders.
The second news was a sad one. Edward Kleinbard, a corporate tax lawyer who worked for corporate tax firms for years and then turned against what they were doing--getting loopholes from multinational corporations like Apple and Google and international banks and so forth--went to teach at the law school at the University of Southern California. The New York Times, where he was a regular contributor before he lost his struggle with cancer, [July 10, 2020] said of him, "Most tax policy discussions were backward. Policymakers should identify their spending priorities, ideally to invest in the country's citizens and then discuss the proper tax policies to pay for them." And I'm quoting him again in an article he wrote. "The starting point in every case should not be determined by establishing an arbitrarily small amount of tax to collect and then treating government like an institutional Procrustes, whose only responsibility is to amputate the welfare of our fellow citizens to suit that amount." And one of his friends who is also a tax lawyer, said that "Edward Kleinbard, by being in academia, that is free to speak out, and by being a good writer, he was able to bring all that to the public attention." All that meaning incredibly clever tax loopholes that often bring the tax rate in reality down to 1%/2%, if that, for these giant corporations that are making billions of dollars of profits every year. So the public has lost a champion, Edward Kleinbard.
Steve Skrovan: Well, that's a great tribute, Ralph. Thanks for that. There's also another piece of business we want to get to before we get to the main part of our show today. A few weeks ago, as many of you recall, we talked to Dr. John Geyman. We said if you emailed him, he would send his book on healthcare reform to your congressperson in your name. And the response was great. So far he's gotten 95 requests; we want to re-up that. If you would like to join in on this effort, you could still email John Geyman with your name and who you want the book sent to. That'll be at jgeyman@uw.edu. That's J-G-E-Y-M-A-N @uw.edu. And we'll also link to it at the Ralph Nader Radio Hour website if you didn't catch that.
Ralph Nader: And a few more suggestions, how to make it more effective with your senators and representative. Give your full contact; add a couple of sentences about why you think full Medicare for All should be reflected in your senators’ and representative’s votes, and ask the senators or representative to acknowledge receipt of the book and to give you a call, because you have other points you want to make and other experiences you want to reflect. If you do all that very concisely, you will triple the likelihood that this is going to get attention in the Washington, D.C., offices of those members of Congress in your state.
Steve Skrovan: There you go, people. You’ve got your marching orders. We're very pleased with the response so far. Let's keep it going. Our first guest on the show today is Andrew Kimbrell. He has been on the show twice before to talk about why GMOs help corporations and not consumers. And this time, though, he isn't here to talk about genetically modified crops, but rather genetically engineered viruses and how the risks of reckless genetic engineering could potentially lead to more novel viruses. And that's just the first half of the show. In the second half, we’re welcoming back Dr. Michael Carome. He is the director of Public Citizen's Health Research Group. We're going to talk to him about the letter Public Citizen released a few days ago directed at President Trump and Vice President Pence. The letter in question lays out the ways this administration has mishandled the coronavirus crisis. The letter is asking for Trump and Pence to step aside and allow public health experts to take charge. In between, we'll take a short break and check in with our corporate crime reporter Russell Mokhiber. But first, let's talk about genetically engineered viruses. David?
David Feldman: Andrew Kimbrell is an internationally recognized public interest attorney, bioethicist and NGO [non-governmental organization] leader. Mr. Kimbrell has been at the forefront of efforts to strictly regulate biotechnology, ensure responsible bio-medical research and eliminate biological weapons research. He is the founder and executive director of the Center for Food Safety, the author of Your Right to Know: Genetic Engineering and the Secret Changes in Your Food, and the editor of Fatal Harvest: The Tragedy of Industrial Agriculture. Welcome to the Ralph Nader Radio Hour, Andrew Kimbrell.
Andrew Kimbrell: Thanks, Dave. Appreciate the intro.
Ralph Nader: Yeah, welcome indeed, Andy. Before we get to the coronavirus COVID-19 aspect of our discussion, let's start with your point about lack of public knowledge or debate about what researchers around the world are genetically engineering.
Andrew Kimbrell: Yeah, Ralph, I think this is really just an absolutely critical issue that's been lost -- the forest has been lost for the trees, if you will. We have talked on your show, and you've worked on this a lot, about the dangers of genetic engineering of plants, animals, or humans. But we haven't talked much about the danger of genetically engineering viruses. And I think far away from public debate, a small group of scientists over the last 10 or 11 years have used synthetic biology, synthetic virology, to be able to do something which is breathtaking. What they've done is they've taken the most dangerous viruses known to man -- these are H5N1, bird flu, Marburg, Ebola, SARS -- and instead of trying to find vaccines, or to make these viruses less lethal, they have actually spent millions and millions of our taxpayer dollars, tens of millions of our taxpayer dollars, trying to make these viruses more dangerous, by mixing and matching various parts of these viruses with other viruses, genetically engineering them, and then using animal experimentation, and human cell line experimentation, to make them more transmissible, to make them more lethal, to make them more infectious.
Ralph Nader: Scientifically, why would they want to do this?
Andrew Kimbrell: Well, I do have a master's degree in psychology, and I think I have to sort of rely on that to try and figure out why anybody would want to do this. One prominent virologist has called it the definition of insanity. I think there is a temptation, and this probably goes back, Ralph, to the creation of nuclear weapons, the early experimentations that we all saw with genetic engineering, putting human genes into pigs, and doing all sorts of crazy things. There's this problem with some of our scientists that just because you can do something, they think that you should do it. There really is no end. Marc Lipsitch from Harvard, and Thomas Inglesby, a prominent health security expert at Johns Hopkins, they've gone to great lengths to show there's no value, that we've actually gotten zero value from these experiments. The [scientists] say, "Hey, if we create these novel, brand new pandemic viruses, maybe nature will create them later, and we'll have some kind of intervention strategy for them." But that makes no sense, of course, because nature has a million different variations that we would never be able to predict. So the idea that we can somehow predict in the laboratory, and then spend tens of millions of dollars trying to find an intervention strategy when there could be millions of other combinations out there in nature, makes no sense.
Occasionally an epidemic of avian flu spills over to humans and can give rise to hundreds of H7N9 infections in man in a matter of months. Fortunately, these viruses are almost never transmitted from human to human. This is the same as with the rabies virus. Such dead end infections are not new in virology. The question is could these viruses become transmittable between humans and if so how? In modern virological parlance, what mutations are necessary to convert such a virus into a highly transmissible virus between ferrets, the animal of choice in influenza biology. This is the basis of the H5N1 projects of Fouchier and Kawaoka. As is now well known, they succeeded in doing this for the H5N1 virus and it involved a handful of mutations.
It should be emphasized that the conditions in a laboratory differ enormously from those in nature. Influenza virus evolution takes years, while in a laboratory there is a massive acceleration thanks to the selection of mutants by the virologist. To illustrate this, suffice to say that for some reason nature has not yet succeeded in morphing any influenza virus into a major human pathogen other than H1N1, H2N2 and H3N2 in 100 years. Even the resurrection of the Spanish flu HIN1 virus did not help us to predict or prepare for the H1N1 flu pandemic of 2009.
This is one of the major scientific weaknesses in the so-called gain-of-function influenza research. We do not know if the experiments reflect what happens in nature. As an HIV expert he can say this because the lab is not a good template for what happens in the clinic. There are hundreds of possible trajectories and only a few can be tested in laboratory. One can never know which are the “right ones” -– that can only be appreciated as being “right” once the pandemic has struck. As for obvious ethical reasons these experiments cannot be done in humans, an important objection to this work is that it is not falsifiable. This constitutes a real issue as science tries to solve problems, not to create them.
-- Gain-Of-Function Research: Report of a Debate between Prof. Giorgio Palù and Prof. Simon Wain-Hobson, 25 June 2014, Trippenhuis, Amsterdam, by Koos van der Bruggen
There is one unfortunate place where this kind of research could be useful, and that would be the creation of biological weapons.
Ralph Nader: I was going to say, Andy, and we spoke about this before, that before Richard Nixon put an end, at least officially, to biological warfare research by the US government, the government was funding scientists in ways that would really startle people. For example, there was a page one story many years ago, before the research was officially stopped, by the Wall Street Journal, which described a University of Wisconsin scientist on a government contract, Department of Defense contract, working in the lab to discover a more virulent form of Dengue fever; basically to develop a more virulent form of Dengue fever. So in the biological warfare context, they do all these things. Do you think this was sort of a precursor for this scientific curiosity [COVID-19]? And by the way, the scientists who do this do give us scientific justification. But how do you connect the two events here, the biological warfare . . .
Andrew Kimbrell: Well, first of all, you're absolutely right. Now that you mention it, I do feel compelled to mention Caspar Weinberger, who we all remember as the Secretary of Defense under Ronald Reagan. Caspar Weinberger, pretty much singlehandedly rejuvenated the entire biological weapons program in the United States, called the Biological Defense Research Program. I litigated against this about five times, because these experiments were so dangerous. He felt that since there was sort of a stand-off with nuclear weapons, why doesn't the United States get ahead on biological weapons? This happened throughout the 1980s and into the early '90s. We were successful in closing down experiments in Dugway, Utah and in Fort Detrick, Maryland, and actually ordering, through the National Environmental Policy Act, programmatic environmental impact statements on the entire program. And it was eventually shut down after the first Persian Gulf War because of their failure to come up with an anthrax vaccine. And that infuriated Senators John Glenn and Carl Levin who helped close down that program.
Unfortunately, I think after 9/11, I have had I think credible information that they have revived some, but not all of those experiments. And they were incredibly dangerous, and mixing all [kinds of] toxins, viruses, bacteria. You can imagine how we had a lot of discovery there that was very, very frightening. But I think again, the excuse for this kind of insanity of taking viruses and creating new novel pandemic viruses in laboratories, is because that might just happen in nature, and we'd have them in a laboratory ready to study, and maybe even have a vaccine. Again, the problem with that is…
Let me just give you an example. So there's something called H5N1 bird flu. Most people have heard of it. Just a few hundred people have been infected by it, but it has a 60% mortality. Whoever gets it, 60% of the people die. Compare that to, for example, what's happening with COVID-19; some people say it's 1%, 4%, we'll see. But imagine 60%. Well, two researchers, Ron Fouchier who's up at the University of Erasmus in Netherlands, and Yoshihiro Kawaoka who is a researcher at University of Wisconsin, they said, "You know what, this isn't very infective, this bird flu. What if we were able to create a version that is airborne? You could get like the common cold. Let's try that." And they did. They actually were able to create this virus. So if this virus escapes, right, 1.6 billion people could die, 60% of the world's population. Well, this caused a huge furor. In 2014, the Obama administration actually declared a moratorium on this gain of function--gain of threat. I don't like calling it gain of function because that's euphemistic; it's gain of threat research, great threat, creating novel pandemic viruses. They said, "This is just too dangerous."
Ralph Nader: Let me ask you a connected question here. They have these labs all over the world. They're in Europe, Africa, Asia, South America, North America; they're everywhere. What has been the record of the security of these labs? Because even Fort Meade in Maryland has had problems with security for this dangerous research. I mean they have to have like 100% perfection that none of this stuff will leak out of the lab. What has been the experience?
Andrew Kimbrell: Well, there's four levels of biological safety [BLS] 1, 2, 3 and 4; 4 being the strongest and 1 being the weakest. You want some of these most dangerous experiments to be BLS 4, and of course I'm suggesting that we should never have this kind of experimentation at all; it should never happen! But the record is very poor. Every year we have over 100 accidents, and that's just the ones that are reported. There have been deaths, quarantining, and we've had numerous accidents. And then just this October, just a month or so before we began to learn about this COVID-19, the Global Health Security Index, for the first time, did a 195-country survey and said, "Exactly how much biosecurity is out there?" Exactly the question you asked, Ralph. And their answer was, and get ready for this, that out of a score of 100 on a number of different biosecurity and safety points, out of a best possible score of 100, the average country of these 195 countries was 40.1 out of 100. Even the wealthier countries were 51 out of 100. A country like China that's doing a lot of these experiments, was 51st in the world. So 50 countries were more safe than China. In other countries, the BSL 4 laboratories were even worse, such as Israel and the Czech Republic. So it is abysmal that with the billions of dollars that have gone out to the biomedical research industrial complex, if you want to call it that, for all these years and all these dangerous experiments, much less these gain of threat experiments that threaten half the world's population today as we speak, because that moratorium was lifted, and in secret the NIH [National Institutes of Health] preapproved Ron Fouchier's experiments in the Netherlands at Erasmus Medical Center and Kawaoka's experiments in University of Wisconsin. So airborne bird flu research is ongoing right now every day; and we have a 3% out of 100 % safety; that combination really should keep us up at night!
Executive Summary
Biological threats—natural, intentional, or accidental—in any country can pose risks to global health, international security, and the worldwide economy. Because infectious diseases know no borders, all countries must prioritize and exercise the capabilities required to prevent, detect, and rapidly respond to public health emergencies. Every country also must be transparent about its capabilities to assure neighbors it can stop an outbreak from becoming an international catastrophe. In turn, global leaders and international organizations bear a collective responsibility for developing and maintaining robust global capability to counter infectious disease threats. This capability includes ensuring that financing is available to fill gaps in epidemic and pandemic preparedness. These steps will save lives and achieve a safer and more secure world.
The Global Health Security (GHS) Index is the first comprehensive assessment and benchmarking of health security and related capabilities across the 195 countries that make up the States Parties1 to the International Health Regulations (IHR [2005]).2 The GHS Index is a project of the Nuclear Threat Initiative (NTI) and the Johns Hopkins Center for Health Security (JHU) and was developed with The Economist Intelligence Unit (EIU). These organizations believe that, over time, the GHS Index will spur measurable changes in national health security and improve international capability to address one of the world’s most omnipresent risks: infectious disease outbreaks that can lead to international epidemics and pandemics.
The GHS Index is intended to be a key resource in the face of increasing risks of high-consequence3 and globally catastrophic4 biological events and in light of major gaps in international financing for preparedness. These risks are magnified by a rapidly changing and interconnected world; increasing political instability; urbanization; climate change; and rapid technology advances that make it easier, cheaper, and faster to create and engineer pathogens.
Developed with the guidance of an international expert advisory panel, the GHS Index data are drawn from publicly available data sources from individual countries and international organizations, as well as an array of additional sources including published governmental information, data from the World Health Organization (WHO), the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO), the World Bank, country legislation and regulations, and academic resources and publications. Unique in the field, the GHS Index provides a comprehensive assessment of countries’ health security and considers the broader context for biological risks within each country, including a country’s geopolitical considerations and health system and whether it has tested its capacities to contain outbreaks.
Knowing the risks, however, is not enough. Political will is needed to protect people from the consequences of epidemics, to take action to save lives, and to build a safer and more secure world.
WHY IS THE GHS INDEX NEEDED?
It is likely that the world will continue to face outbreaks that most countries are ill positioned to combat. In addition to climate change and urbanization, international mass displacement and migration—now happening in nearly every corner of the world—create ideal conditions for the emergence and spread of pathogens. Countries also face an increased potential threat of accidental or deliberate release of a deadly engineered pathogen, which could cause even greater harm than a naturally occurring pandemic. The same scientific advances that help fight epidemic disease also have allowed pathogens to be engineered or recreated in laboratories. Meanwhile, disparities in capacity and inattention to biological threats among some leaders have exacerbated preparedness gaps. The GHS Index seeks to illuminate those gaps to increase both political will and financing to fill them at the national and international levels. Unfortunately, political will for accelerating health security is caught in a perpetual cycle of panic and neglect. Over the past two decades, decision makers have only sporadically focused on health security, despite concerns stemming from the 2001 anthrax attacks, the emergence of the Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome coronaviruses, and the looming threat of a pandemic caused by a novel strain of influenza.
In September 2014, the United Nations (UN) Security Council met in crisis over the growing Ebola epidemic in West Africa. Massive global assistance was needed to stop the outbreak because of insufficient national capacities in Guinea, Liberia, and Sierra Leone to quickly detect and respond to the epidemic.
As a result, the West Africa Ebola epidemic killed at least 10,000 people and infected more than 28,000.5 The three affected countries lost $2.8 billion in combined GDP, and a massive global response totaled billions of dollars before the outbreak was contained. The crisis awakened the world to the reality that pathogens can emerge unexpectedly, and when outbreaks occur in countries that are unprepared, they can spill beyond borders, threatening the peace, health, and prosperity of all countries. However, despite newly available vaccines and therapies, response to the Ebola outbreak that began in 2018 in eastern Democratic Republic of Congo has been hampered by violence and instability, community resistance to outbreak mitigation measures, hospital transmission, delays in detection and isolation, and lack of funding and resources.
Delays in the global response to Ebola in 2014 led to a restructuring of the WHO and prompted calls for measurement and transparent reporting of countries’ public health capacities, including the launch of the voluntary WHO IHR Joint External Evaluations (JEEs). Since then, health, policy, and security leaders have developed numerous high-level reviews and recommended ways to identify, finance, and fill major preparedness gaps. These recommendations are relevant for epidemic threats, such as Ebola, and high-consequence pandemic threats, such as a fast-spreading respiratory disease agent that could have a geographic scope, severity, or societal impact and could overwhelm national or international capacity to manage it.6 Some of those recommendations have been implemented, but many have been shelved owing in part to lack of financing. Nearly all recommendations pointed to a need to better understand and measure—on a transparent, global, and recurring basis—the state of international capability for preventing, detecting, and rapidly responding to epidemic and pandemic threats.
The GHS Index is designed to meet this need.
DEVELOPING THE GHS INDEX
The NTI, JHU, and EIU project team—with generous grants from the Open Philanthropy Project, the Bill & Melinda Gates Foundation, and the Robertson Foundation—worked with an international advisory panel of 21 experts from 13 countries to create a detailed and comprehensive framework of 140 questions, organized across 6 categories, 34 indicators, and 85 subindicators to assess a country’s capability to prevent and mitigate epidemics and pandemics.
The GHS Index relies entirely on open-source information: data that a country has published on its own or has reported to or been reported by an international entity. The GHS Index was created in this way with a firm belief that all countries are safer and more secure when their populations are able to access information about their country’s existing capacities and plans and when countries understand each other’s gaps in epidemic and pandemic preparedness so they can take concrete steps to finance and fill them. The indicators and questions that compose the GHS Index framework also prioritize analysis of health security capacity in the context of a country’s broader national health system and other national risk factors.
The 140 GHS Index questions are organized across six categories:
1. PREVENTION: Prevention of the emergence or release of pathogens
2. DETECTION AND REPORTING: Early detection and reporting for epidemics of potential international concern
3. RAPID RESPONSE: Rapid response to and mitigation of the spread of an epidemic
4. HEALTH SYSTEM: Sufficient and robust health system to treat the sick and protect health workers
5. COMPLIANCE WITH INTERNATIONAL NORMS: Commitments to improving national capacity, financing plans to address gaps, and adhering to global norms
6. RISK ENVIRONMENT: Overall risk environment and country vulnerability to biological threats
Among its 140 questions, the GHS Index prioritizes not only countries’ capacities, but also the existence of functional, tested, proven capabilities for stopping outbreaks at the source. Several questions in the GHS Index are designed to determine not only whether a capacity exists, but also whether that capacity is regularly—for example, annually—tested and shown to be functional in exercises or real-world events.
The GHS Index also includes indicators of nations’ capacities and capabilities to reduce Global Catastrophic Biological Risks (GCBRs), which are biological risks of unprecedented scale that could cause severe damage to human civilization at a global level, potentially undermining civilization’s long-term potential.7 These are events that could wipe out gains in sustainable development and global health because of their potential to cause national and regional instability, global economic consequences, and widespread morbidity and mortality.
FINDINGS AND RECOMMENDATIONS
This report summarizes the results of the first GHS Index, including overall findings about the state of national health security capacity across each of the six GHS Index categories, as well as additional findings specific to functional areas of epidemic and pandemic preparedness. The full report also offers 33 recommendations to address gaps identified by the GHS Index. All the findings and recommendations are summarized on pages 12–15 and described in detail throughout the full report, which begins on page 31.
Whereas every country has a responsibility to understand, track, improve, and sustain national health security, new and increased global biological risks may require approaches that are beyond the control of individual governments and will necessitate international action. Therefore, the recommendations contained in this report are made with the understanding that health security is a collective responsibility, and a robust international health security architecture is required to support countries at increased risk. As a result, in addition to the many recommendations intended for national leaders, the GHS Index also includes recommendations aimed at decision makers within the UN system, international organizations, donor governments, philanthropies, and the private sector. These are especially important in the case of fast-spreading, deliberately caused, or otherwise unusual outbreaks that could rapidly overwhelm the capability of national governments and international responders.
OVERALL FINDING: National health security is fundamentally weak around the world. No country is fully prepared for epidemics or pandemics, and every country has important gaps to address.
The GHS Index analysis finds no country is fully prepared for epidemics or pandemics. Collectively, international preparedness is weak. Many countries do not show evidence of the health security capacities and capabilities that are needed to prevent, detect, and respond to significant infectious disease outbreaks. The average overall GHS Index score among all 195 countries assessed is 40.2 of a possible score of 100. Among the 60 high-income countries, the average GHS Index score is 51.9. In addition, 116 high- and middle-income countries do not score above 50. Overall, the GHS Index finds severe weaknesses in country abilities to prevent, detect, and respond to health emergencies; severe gaps in health systems; vulnerabilities to political, socioeconomic, and environmental risks that can confound outbreak preparedness and response; and a lack of adherence to international norms.
Specific scores for the GHS Index categories are as follows:
PREVENTION: Fewer than 7% of countries score in the highest tier8 for the ability to prevent the emergence or release of pathogens.
DETECTION AND REPORTING: Only 19% of countries receive top marks for detection and reporting.
RAPID RESPONSE: Fewer than 5% of countries scored in the highest tier for their ability to rapidly respond to and mitigate the spread of an epidemic.
HEALTH SYSTEM: The average score for health system indicators is 26.4 of 100, making it the lowest-scoring category.
COMPLIANCE WITH INTERNATIONAL NORMS: Less than half of countries have submitted Confidence-Building Measures under the Biological Weapons Convention (BWC) in the past three years, an indication of their ability to adhere to important international norms and commitments related to biological threats.
RISK ENVIRONMENT: Only 23% of countries score in the top tier for indicators related to their political system and government effectiveness.
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Notes:
1. As of April 16, 2013, there are 196 States Parties to the World Health Organization (WHO) 2005 International Health Regulations (IHR), including the Holy See. The Holy See is a sovereign juridical entity under international law, but it was not included in the country-specific research for this Index in light of the Holy See’s lack of an independent health system. This report will refer to the assessed “States Parties” as “195 countries.”
2. The WHO IHR (2005) is the foundational international standards for health. The IHR (2005) is a binding legal instrument to address cross-border public health risks. The goal of the IHR (2005) is to prevent, protect, control, and respond without disrupting international trade and traffic. The IHR (2005) provided the guiding regulations behind many of the indicators included in the GHS Index.
3. High-consequence biological events are defined here as infectious disease outbreaks that could overwhelm national or international capacity to manage them. For example, although international health security has improved following the 2014–2016 Ebola epidemic in West Africa, countries and international responders are not prepared to quell outbreaks that occur in violent or insecure settings; deliberate biological events that require close coordination and investigative links between security, health, and humanitarian actors; and fast-moving respiratory diseases with high mortality that could spread rapidly to become global pandemics.
4. Global Catastrophic Biological Risks are biological risks of unprecedented scale that could cause severe damage to human civilization at a global level, potentially undermining its long-term potential. See Nick Alexopoulos, “Center for Health Security Publishes First Working Definition of Global Catastrophic Biological Risks,” Johns Hopkins Center for Health Security, July 27, 2017, http://www.centerforhealthsecurity.org/ ... ition.html.
5. Centers for Disease Control and Prevention, “2014–2016 Ebola Outbreak in West Africa,” http://www.cdc.gov/vhf/ebola/history/20 ... index.html.
6 United Nations General Assembly, “Protecting humanity from future health crises: Report of the High-level Panel on the Global Response to Health Crises,” https://www.un.org/ga/search/view_doc.a ... l=A/70/723.
7. Monica Schoch-Spana et al.,“Global Catastrophic Biological Risks: Toward a Working Definition,” Health Security 15, no. 4 (2017): 323–28, http://www.liebertpub.com/doi/full/10.1089/hs.2017.0038.
8 The GHS Index scoring system includes three tiers. Countries that score between 0 and 33.3 are in the bottom tier (also called “low scores”), countries that score between 33.4 and 66.6 are in the middle tier (also called “moderate scores”), and countries that score between 66.7 and 100 are in the upper or “top” tier (also called “high scores”)
-- 2019 Global Health Security Index: Building Collective Action and Accountability, by Nuclear Threat Initiative, Center for Health Security, Johns Hopkins Bloomberg School of Public Health, and The Economist Intelligence Unit
Ralph Nader: The obvious question is how come there have been no catastrophes? With this kind of security, and the leakage of all this lab work with virulent bacteria and virulent viruses around the world, how come there hasn't been any catastrophes?
Andrew Kimbrell: There have been catastrophes, obviously. The SARS virus leaked twice from Beijing laboratories in China, and there were deaths.
Example 4: SARS laboratory escapes outbreaks after the SARS epidemic
The SARS outbreak of 2002-2003 eventually spread to 29 countries, causing over 8,000 infections and at least 774 deaths. Because many cases were in hospital workers (1707, amounting to 21%), it had the potential to shut down health care services where it struck33. By imposing strict (sometimes draconian) quarantines on exposed persons and isolation of patients, and even more because of good fortune and dedicated (indeed, heroic) medical personnel, it was contained and extinguished by July 2003. Quarantines, closure of factories and travel restrictions caused economic losses estimated at $40 billion worldwide, with an estimated 2.6% GDP loss in China, 1.05% GDP loss in Hong Kong, and 0.15% GDP loss to Canada34.
SARS is particularly dangerous to handle in the laboratory because there is no vaccine, so all laboratory workers are susceptible. It can be transmitted through aerosol/droplet mechanisms: the very large (321 cases) Amoy Gardens outbreak in Hong Kong was traced to infectious aerosols created by turbulent flushing water flow in the sewer lines: this turbulent flow generated aerosols that were sucked back up into numerous adjacent apartments through dry floor drains by negative pressure generated by bathroom exhaust fans! (Abraham 2005).
Moreover, about 5% of SARS patients are “super-spreaders” who pass the infection to many (over 8) secondary cases35. One case (ZZ) spread SARS to directly to 28 persons during one 18-hour hospitalization, before transfer to another hospital, where he infected 93 additional hospital personnel. At a third hospital he infected 23 staff and 19 patients, and at a fourth 20 hospital staff (Abraham 2005). Another super-spreader in Beijing infected at least 59 secondary cases. A super-spreader originally infected by ZZ in China visited Hong Kong but fell ill and remained in his hotel room, but managed to spread SARS to 10 secondary cases whose only associations were using a common elevator or hallway. These Hong Kong hotel exposures were international tourists, however, and were responsible for spreading SARS to Canada, Ireland, the US, Singapore, and Vietnam36. A 72-year old was already ill when he boarded flight CA112 from Hong Kong to Beijing on March 15, after having visited a niece ill with SARS in a Hong Kong hospital. Besides introducing another transmission chain in Beijing, on the two-hour flight he infected 20 other passengers and 2 flight attendants, who spread the disease to Mongolia, Singapore, Taiwan, and re-introduced new infection chains back into Hong Kong37 (Abraham 2005).
The existence of SARS “super-spreaders” makes even a single laboratory infection into a potential pandemic.
SARS has not naturally recurred, but there have been six separate “escapes” from virology labs studying it: one each in Singapore and Taiwan, and in four distinct events at the same laboratory in Beijing.
The first escape was in Singapore in August 2003, in a 27-year-old virology graduate student at the National University of Singapore. He had not worked directly with SARS, but SARS was present in the virology laboratory where he worked with West Nile Virus (WNV). Investigation showed that his preparation of WNV was contaminated with SARS virus, and that this was the likely origin of his infection. After falling ill on Aug 26, he sought outpatient medical care in several venues, and was admitted to the hospital only on September 3. Fortunately he recovered and there were no secondary cases. Investigation revealed multiple shortcomings in infrastructure, training and observed procedures at the laboratory, and remedial actions were ordered38.
The second escape was in Taiwan in December 2003, when a SARS research scientist fell ill on a return airflight after attending a medical meeting in Singapore Dec 7-10. Although he felt his illness was SARS, he remained at home for 5 days, unwilling to seek medical care because he dreaded bringing disgrace to himself and his institution. He was only persuaded to enter the hospital when his father threatened to commit suicide39. Preliminary investigation implicated a laboratory exposure due to an attempt to decontaminate a bag of leaking biological waste, perhaps without proper protection and against protocol the day before he left for Singapore40. His 74 contacts in Singapore were put under quarantine for ten days, but again, fortunately none developed SARS. An expert committee from WHO investigated the laboratory and its procedures, and recommended improvements41.
This second outbreak further shook the virology communities in Asia, where many labs held and worked on SARS samples. On December 18, 2003 WHO released a new protocol for handling SARS specimens in the post-outbreak period, with special emphasis on reducing risk of and performing surveillance to detect laboratory infections42. Although this protocol was clearly created after the first (Singapore) escape, WHO chose to parse its words to avoid offending members. Perhaps distinguishing between a primary laboratory infection and secondary spread into a community “outbreak,” it chose to treat the risk as hypothetical, stating in the introduction:“The possibility that a SARS outbreak could occur following a laboratory accident is a risk of considerable importance, given the relatively large number of laboratories currently conducting research using the SARS-CoV or retaining specimens from SARS patients. These laboratories currently represent the greatest threat for renewed SARS-CoV transmission through accidental exposure associated with breaches in laboratory biosafety.”
The hypothetical outbreak was not long in coming.
On April 22, 2004 China reported a suspected case of SARS in a 20-year-old nurse who fell ill April 5 in Beijing. The next day it reported she had nursed a 26-year-old female laboratory researcher who had fallen ill on March 25. Still ill, the researcher had traveled by train to her home in Anhui province where she was nursed by her mother, a physician, who fell ill on April 8 and died April 19. The researcher had worked at the Chinese National Institute of Virology (NIV) in Beijing, which is part of China’s Center for Disease Control (CDC), and which was a major center of SARS research. The investigation at NIV also uncovered an unrelated laboratory infection in a 31-year old male laboratory researcher at the NIV who fell ill on 17 April [43]. The entire NIV institute was closed and all of its 200 employees placed in quarantine in a hotel. Subsequent investigation confirmed these first three cases as SARS, and eventually identified a total of nine cases, in three generations, including health care workers and their family contacts44. Neither of the two primary patients had worked with live SARS virus, and WHO investigators had “serious concerns” regarding biosafety procedures at the NIV45.
Several Chinese and international groups investigated the outbreak at the NIV, and identified in retrospect two additional SARS laboratory infections at the NIV that had previously gone unrecognized and had begun in February 2004 [46]. A joint China CDC and WHO investigation found many shortcomings in biosecurity at the NIV, and traced the specific cause of the outbreak to an inadequately inactivated preparation of SARS virus that was used in general (not biosecure) laboratory areas in the NIV, including the one in which the two primary cases worked. It had not been tested to confirm its safety after inactivation, as it should have been. The WHO also found more general shortcomings in the handling of live SARS virus and a lack of surveillance of laboratory personnel for laboratory infections.
Li Liming, director of the China CDC and his deputy directory, the director of the NIV and his deputy director, and the director of the division where the two index cases worked were removed from their positions and found guilty of negligence in overseeing safety at the institution47. The Chinese government also decided to move the China CDC campus from its position in a residential neighborhood to an area “more remote from downtown,” and to allocate funds for more advanced laboratory equipment and infrastructure48.
Interestingly, the virology community is still reticent to discuss laboratory escapes: despite the considerable alarm these escapes created in the public health community and the participation of US CDC personnel in their investigation, they go unmentioned in the “10 years after” historical review of SARS by the CDC.49
-- Laboratory Escapes and “Self-fulfilling prophecy” Epidemics, by Martin Furmanski MD
But here's the point: SARS, Marburg, and Ebola viruses are not highly transmissible. So what you do is you get two or three people to get sick and die. Sometimes they go home and their neighbors get sick and die. But these are not yet pandemic viruses, because they don't have sufficient transmissibility, or they don't have sufficient infectivity, having to do with the number of human cells that they can infect. So that's why.
And that's what makes this completely different. By taking pandemic viruses using this gain of threat, so-called gain of function, but gain of threat to make them transmissible, we no longer have a problem with just laboratory workers getting ill and dying, which is terrible -- we don't want that -- but now we have a huge public health threat, as we can see with COVID-19, which I think was almost certainly created in a laboratory, certainly, probably created in a laboratory, and with the potential of something as horrific as the bird flu [60% mortality]. With these novel techniques, these novel experiments, we are now not just having viruses that have low transmissibility, even though they have high fatality, but rather ones that can create a huge public health problem.
And remember, they're novel. They're creating stuff that's never been created before through genetic engineering and animal experimentation. So our immune systems are not, like with COVID-19, we're not used to them. So now even the ones we've had before that we don't have any immunity to, that [research is] ongoing right now. And there's obviously a few researchers around the world who are making hundreds of millions of dollars eventually on funding. And they represent a problem. What we need is an international moratorium or ban on all gain of threat, gain of function, gain of threat research on potentially pandemic viruses. It's insane. Whatever value that research would provide, it can't possibly equal the threat.
You know Ralph, I think the public has not been in on this debate. It has been a secret debate with the NIH and other people who funded it. I think COVID-19 is a product of this. And I know Trump wants to call it the China virus. Well, the money that went into the creation and the genetic engineering of these coronaviruses in Wuhan was supported by the NIH and the USAID. So why wouldn't it be the NIH virus, or the USAID virus?
Ralph Nader: Well, because Trump delayed facing up to it, and kind of dismissed it, and has bungled, we call it the Trump virus now. It may have come from China, but apart from that, let's focus on something very controversial.
What's the source of the COVID-19 virus? The conventional explanation is it came from bats in live meat markets in Wuhan. and the bat bit a human and then it started to spread. That's the conventional approach.
Now, before we put the framework here, and before our listeners either say, "It's a conspiracy theory," or "Yes, they did come from the Wuhan Institute," contrary conclusions, I want to refer you to an article on Dr. Daniel Lucey, who is an infectious disease specialist at Georgetown University, [who] has huge experience around the world, has advised the World Health Organization, and really knows his stuff in past epidemics. And he was the subject of an article by the science writer of the New York Times on July 14th, William Broad. And he has eight questions that he always asks scientists to ask about any kind of epidemic. He's a student of epidemics. And the paragraph that's relevant to this discussion is as follows, and I'm quoting from the Times article. "The sixth and seventh questions go to whether the deadly pathogen leapt to humans from a laboratory. Although some intelligence analysts and scientists have entertained that scenario, no direct evidence has come to light suggesting that the coronavirus escaped from one of Wuhan's labs. Even so, given the wet market's downgrading in the investigation, quote, these are Dr. Lucey's words, "It is important to address questions about any potential laboratory source of the virus, whether in Wuhan or elsewhere," end quote, Dr. Lucey wrote in his blog post. That's one to frame the discussion.
For decades, Dr. Daniel R. Lucey, an infectious disease specialist at Georgetown University, has crisscrossed the globe to study epidemics and their origins. His attention now is on the Covid-19 pandemic, which first came to public notice late last year in Wuhan, China. Its exact beginnings are sufficiently clouded that the World Health Organization has begun a wide inquiry into its roots. The advance team is to leave for China this weekend, and Dr. Lucey has publicly encouraged the health agency to address what he considers eight top questions....
The sixth and seventh questions go to whether the deadly pathogen leapt to humans from a laboratory. Although some intelligence analysts and scientists have entertained that scenario, no direct evidence has come to light suggesting that the coronavirus escaped from one of Wuhan’s labs.
Even so, given the wet market’s downgrading in the investigation, “It is important to address questions about any potential laboratory source of the virus, whether in Wuhan or elsewhere,” Dr. Lucey wrote in his blog post.
To that end, he urges the W.H.O. investigators to look for any signs of “gain of function” research — the deliberate enhancement of pathogens to make them more dangerous. The technique is highly contentious. Critics question its merits and warn that it could lead to catastrophic lab leaks. Proponents see it as a legitimate way to learn how viruses and other infectious organisms might evolve to infect and kill people, and thus help in devising new protections and precautions.
Debate over its wisdom erupted in 2011 after researchers announced success in making the highly lethal H5N1 strain of avian flu easily transmissible through the air between ferrets, at least in the laboratory.Prompted by controversy over dangerous research and recent laboratory accidents, the White House announced Friday that it would temporarily halt all new funding for experiments that seek to study certain infectious agents by making them more dangerous.
It also encouraged scientists involved in such research on the influenza, SARS and MERS viruses to voluntarily pause their work while its risks were reassessed.
Opponents of this type of research, called gain of function — for example, attempts to create a more contagious version of the lethal H5N1 avian influenza to learn which mutations made it that way — were elated.
“Brilliant!” said Peter Hale, the executive director of the Foundation for Vaccine Research, which opposes such experiments. “The government has finally seen the light. This is what we have all been waiting for and campaigning for. I shall sleep better tonight.”
The announcement, which was made by the White House Office of Science and Technology Policy and the Department of Health and Human Services, did not say how long the moratorium would last. It said a “deliberative process to assess the potential risks and benefits” would begin this month and stretch at least into next year.
The move appeared to be a sudden change of heart by the Obama administration, which last month issued regulations calling for more stringent federal oversight of such research and requiring scientists and universities to disclose that their work might be risky, rather than expecting federal agencies to notice.
Critics at the time dismissed those rules as too weak.
The moratorium is only on research on influenza virus and the coronaviruses that cause SARS and MERS. It made no mention of Ebola or any related filovirus. Ebola is already extremely lethal, but it is not easily transmissible.
No scientist has publicly announced an attempt to make Ebola as easy to transmit with a sneeze as flu is. Given the current panic around Ebola, and congressional anger at federal health agencies, it is unlikely that federal funding for such a project would be given out.
The debate over the wisdom of “gain of function” research erupted in 2011 when the labs of Ron Fouchier of Erasmus University in the Netherlands, and Yoshihiro Kawaoka of the University of Wisconsin-Madison, separately announced that they had succeeded in making the lethal H5N1 avian flu easily transmissible between ferrets, which are a model for human susceptibility to flu.
The debate heated up further this year when the Centers for Disease Control and Prevention admitted it had suffered laboratory accidents that exposed dozens of workers to anthrax and shipped deadly avian flu virus to another federal lab that had asked for a more benign flu strain. Also this year, vials of smallpox that had been forgotten for 50 years were found in a lab at the National Institutes of Health.
The White House said the moratorium decision had been made “following recent biosafety incidents at federal research facilities.”
Dr. Kawaoka said he would not start any new gain-of-function experiments and would consult with the N.I.H. about which ones he had underway that met their criteria for the moratorium.
Many scientists were furious that such work had been permitted and even supported with American tax dollars. But others argued that it was necessary to learn which genetic mutations make viruses more dangerous. If those mutations began appearing naturally as the viruses circulated in animals and people, warnings could be issued and vaccines designed, they said.
Some scientists argued that the two scientists should not be permitted to publish all the details of their experiments, for fear that terrorists or unscrupulous scientists would duplicate them and start a fatal pandemic.
Others, like Richard H. Ebright, a molecular biologist and bioweapons expert at Rutgers University, argued that the long history of accidental releases of infectious agents from research labs made such work extremely risky and unwise to perform in the first place.
Dr. Ebright called Friday’s announcement “an important, albeit overdue, step.”
Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, called the moratorium “a wise move — I congratulate the U.S. government on taking this step.”
The new policy had to be announced now, he explained, because the National Science Advisory Board for Biosecurity is to meet later this month. It will have 11 new members, and gain of function research is a principal agenda item.
Dr. Osterholm was one of 11 previous members who were removed from the board in the middle of the controversy.
All, like him, had been on it many years past their original five-year appointments and were due to be replaced, but had routinely been asked to stay, he said.
In April, he was the author of a letter to the National Institutes of Health complaining about government pressure on the advisory board. The institutes gave grants to support gain of function work.
The explanation given was that they had outlasted their tenures, but Dr. Osterholm said that “in the same week as the anthrax accident at the C.D.C., we all got an email on a Sunday night from a junior staffer telling us we were out.”
He called that a public relations failure: “P.R. zero point zero.”
-- White House to Cut Funding for Risky Biological Study, by Donald G. McNeil Jr., NYT, Oct. 17, 2014
In his blog, Dr. Lucey asks “what, if any,” gain-of-function studies were done on coronaviruses in Wuhan, elsewhere in China, or in collaboration with foreign laboratories.
“If done well scientifically, then this investigation should allay persistent concerns about the origin of this virus,” he wrote. “It could also help set an improved standard for investigating and stopping the awful viruses, and other pathogens, in the decades ahead.”
Finally, Dr. Lucey asks the W.H.O. team to learn more about China’s main influenza research lab, a high-security facility in Harbin, the capital of China’s northernmost province. In May, he notes, a Chinese paper in the journal Science reported that two virus samples from Wuhan were studied there in great detail early this year, including in a variety of animals. It reported that cats and ferrets were highly susceptible to the pathogen; dogs were only mildly susceptible; and pigs, chickens and ducks were not susceptible at all.
-- 8 Questions From a Disease Detective on the Pandemic’s Origins: Dr. Daniel R. Lucey wants answers to pointed questions that bear on how the coronavirus leapt from bats to humans, by William J. Broad, NYT, July 8, 2020