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Risks of Natural Pandemics/Epidemics and Biological Technologies

In 2016, the President's Council of Advisors on Science and Technology (PCAST) issued a warning concerning the risks of naturally occurring and man-made pathogens [1].  In this letter, PCAST recommended "strengthening a national laboratory network for pathogen surveillance to spot and identify these potential risks early."  The PCAST's letter noted:  "Just as rapid advances in biotechnology have increased the risk of misuse by bad actors, they have expanded the tools available to protect the public." Although DNA manipulation, CRISPR, synthetic biology and other biotech tools promise to cure diseases and improve many other aspects of our life, if used by bad actors, these powerful tools will impose imminent risks to the public [2-4]. PCAST was not alone in warning against a future pandemic, it was widely expected by many in the scientific community [5] [Bill Gates’ TED video]. 

The COVID19 pandemic has highlighted the weakness of our biodefense infrastructure. It is clear that our efforts have been  more reactive than proactive. Currently, diagnostics are in high demand and unavailable to many. Today, we wait 3-4 days to know whether we are COVID19 positive or negative. As a result, thousands of people could be infected before the results are available. The delays and the costs of testing are increasing mortality. It is up to all of us to be prepared for the future, lest we forget or ignore the next biological threat.

After 9-11 and anthrax letters attack, scientists warned the U.S. government about the necessity of massive coverage diagnostics and a knowledge-based biological safety infrastructure [1-5]. However, concerns of scientists were frequently perceived as a doomsday panic.

The number of confirmed cases for the novel coronavirus disease COVID-19 officially issued by countries and widely commented on by national and international media outlets dramatically understates the true number of infections, a recent report from the University of Göttingen suggests. Dr Christian Bommer and Professor Sebastian Vollmer from Göttingen University have used estimates of COVID-19 mortality and time until death from a recent study published in The Lancet Infectious Diseases to test the quality of official case records.

Their data shows that countries have only discovered on average about 6% of coronavirus infections and the true number of infected people worldwide may already have reached several tens of millions. Insufficient and delayed testing may explain why some European countries, such as Italy and Spain, are experiencing much higher casualty numbers (relative to reported confirmed cases) than Germany, which has detected an estimated 15.6% of infections compared to only 3.5% in Italy or 1.7% in Spain. Detection rates are even lower in the United States (1.6%) and the United Kingdom (1.2%) -- two countries that have received widespread criticism from public health experts for their delayed response to the pandemic.

In sharp contrast to this, South Korea appears to have discovered almost half of all its SARS-CoV-2 infections. The authors estimate that on 31 March 2020, Germany had 460,000 infections. Based on the same method, they calculate that the United States had more than ten million, Spain more than five million, Italy around three million and the United Kingdom around two million infections. On the same day the Johns Hopkins University reported that globally there were less than 900,000 confirmed cases, meaning that the vast majority of infections were undetected.

Sebastian Vollmer, Professor of Development Economics at the University of Göttingen, says, "These results mean that governments and policy-makers need to exercise extreme caution when interpreting case numbers for planning purposes. Such extreme differences in the amount and quality of testing carried out in different countries mean that official case records are largely uninformative and do not provide helpful information." Christian Bommer adds: "Major improvements in the ability of countries to detect new infections and contain the virus are urgently needed."

Is it rational to spend resources to study and mitigate the risks of human extinction from biological attacks? The risks of such a catastrophe are assumed to be low, so a skeptic might argue that mitigating such risks would be a waste of resources [8]. Diseases have been responsible for the greatest death tolls on humanity. In 1918, flu was responsible for more than 50 million deaths, while smallpox killed ~10 times that many in the 20th century. The Black Death plague was responsible for killing over 25% of the European population, while other pandemics, such as the plague of Justinian, are thought to have killed 25 million in the 6th century—constituting over 10% of the world’s population at the time.  It is an open question whether a future pandemic could result in outright human extinction or the irreversible collapse of civilization.

Progress of biological technologies promises of transforming the way the world produces food and portable fuels, protects the environment, and treats disease [1]. While the progress of biotechnology is a great benefit for society, it also holds serious potential for destructive use by both states and technically-competent individuals with access to modern laboratory facilities. Since 2001, the US government has spent billions of dollars annually to protect the Nation against both intentional biological attacks and emerging infectious diseases, and much has been accomplished. But, molecular biologists, microbiologists, and virologists can look ahead and anticipate that the nature of biological threats will change substantially over the coming years - in ways both predictable and un-predictable. The US government’s past ways of thinking and organizing to meet biological threats need to change to reflect and address this rapidly-developing landscape.

1. PCAST Letter to U.S.President (PCAST - President’s Council of Advisors on Science and Technology), “Action needed to protect against biological attack,” November 2016.

2. Turchin A, Green BP, Denkenberger D. Artificial Multipandemic as the Most Plausible and Dangerous Global Catastrophic Risk Connected with Bioweapons and Synthetic Biology. 2018.

3. Sotos JG, “Biotechnology and the lifetime of technical civilizations.” Cornell University Library, 2017 :1709.01149v1 [physics.pop-ph].

4. Cooper J, “Bioterrorism and the Fermi Paradox,” International Journal of Astrobiology, vol. 12, no. 2, pp. 144–148, 2013.

5.Bill Gates video .

6. University of Göttingen. "COVID-19: On average only 6% of actual SARS-CoV-2 infections detected worldwide: Actual number of infections may already have reached several tens of millions." ScienceDaily. ScienceDaily, 6 April 2020. <> <>

7. Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, Cuomo-Dannenburg G, Thompson H, Walker PGT, Fu H, Dighe A, Griffin JT, Baguelin M, Bhatia S, Boonyasiri A, Cori A, Cucunubá Z, FitzJohn R, Gaythorpe K, Green W, Hamlet A, Hinsley W, Laydon D, Nedjati-Gilani G, Riley S, van Elsland S, Volz E, Wang H, Wang Y, Xi X, Donnelly CA, Ghani AC, Ferguson NM. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. 2020 Mar 30. pii: S1473-3099(20)30243-7. doi: 10.1016/S1473-3099(20)30243-7. [Epub ahead of print] PubMed PMID: 32240634.

8. Millett P, Snyder-Beattie A. Existential Risk and Cost-Effective Biosecurity.  Health Security, 15, 4, 2017