Are Countries Prepared for the Increasing Threat of Engineered Bioweapons?

From Harvard Business Review

Are Countries Prepared for the Increasing Threat of Engineered Bioweapons?
Ranu S. DhillonDevabhaktuni SrikrishnaDavid Beier

Amid current outbreaks of Ebola in the Democratic Republic of Congo (DRC) and Nipah virus in India, an even scarier threat looms. Last year, researchers recreated an extinct smallpox-like virus with DNA bought online for just $100,000 and published how they did it. Their feat heightens concerns that rogue regimes and terrorists could similarly modify or engineer pathogens and use them as weapons. Former U.S. Secretary of Defense Ash Carter warned that such biological artillery might come to rival the destructive power of nuclear arms. If a highly contagious agent were released in a major city, it could spread far and wide and kill thousands before it is even clear what is happening. Responding effectively to such threats will require a paradigm shift towards approaches that are faster and more agile and decentralized than what exists now.

The low cost and do-it-yourself accessibility of genomic technologies makes it possible for such weapons to be deployed by almost any aggressor. Even small changes are enough to produce dangerous effects: A single mutation was all it took to transform Zika from a relatively routine infection to one that could cause brain damage in newborns. The fact that there would be no way of knowing who launched such an attack also potentially lowers the threshold for their use. Perpetrators could even design and release several deadly pathogens at the same time, hampering our ability to respond and sowing confusion.

After an engineered agent is released, we would likely have a window of only several weeks to prevent it from causing a global catastrophe. This requires controlling transmission so that each infected person infects, on average, less than one additional person, causing the epidemic to stall and begin to contract. Our recent track record against naturally occurring epidemics, however, is troubling and doing more of what we already do better will not be enough to stop agents designed to spread and kill faster.

This type of approach would enable patients to be diagnosed in the home, school, office, or community and be isolated before they infect others. Several current and emerging technology platforms (e.g.. CRISPR, nanotechnology, nanopores, immunoassays) could improve the ability to do this. These platforms aim to detect any pathogen, including engineered microbes, with accuracy from small samples of blood and urine that do not require skilled technicians to collect or process. Such diagnostics could be evolved to the point they can run off smartphones or laptops, enabling patients to screen themselves and, like smoke detectors, continuously monitor the environment for threats.

In addition to diagnostics, more efficient ways to surge isolation and treatment capacity are also needed. Rapidly deployable tent hospitals like those used in war zones could be quickly established and, when transmission is widely spread, people could also be isolated in their homes. Self-testing approaches could be coupled with telemedicine consultations using Skype- or FaceTime-like technologies to assess patients and Amazon-like services to home-deliver medications and treatments. Mobile medical teams could be dispatched to visit patients in need of more hands-on care in their homes while precious hospital beds and the risk of transporting contagious patients could be reserved for those truly in need of intensive care.

These approaches or strategies like them and the tools necessary for their implementation should be developed and prepared. Just as advances in technology have brought us to the precipice of a merger between two of humanity’s greatest threats — disease and war — new thinking and innovations can help us be prepared to respond effectively if those threats become a reality.

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