What the Russian plague scare taught the world
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The Russian plague threat appears to have just been a fire drill, but it revealed an important lesson for pandemic preparedness: If something goes wrong in certain countries, don't expect them to be forthcoming about it.
Why it matters: The best outbreak response plans call for immediate action targeting the specific pathogen that's posing a threat. But that information may not be readily available at the onset.
State of play: When a young Russian lab worker rapidly died after contracting pneumonia, the world immediately had two fundamental questions: Which pathogen killed her, and was it spreading?
- So far, it appears the answer to the latter question is no, and that Russia's response — which included quarantines at several medical facilities and monitoring around 200 of the researcher's contacts — contained the spread, to the extent it ever was a real threat.
- But nearly two weeks after her death, the world still doesn't know what caused it, and Russia's response has raised more questions than answers.
- Many experts believe Russia knows what the pathogen was, but that it's unlikely it'll ever share with the rest of the world.
The big picture: Pathogens with pandemic potential may be natural in origin or come from a lab, either intentionally or accidentally. But all three origin scenarios come with a risk that the country of origin won't want to admit what happened.
- With that risk in mind, the U.S. must be prepared to respond to emerging biological threats without real-time information right from the start about what those threats are or how they're spreading.
- "We just have to be ready to deal with this type of unknown," said Gerry Parker, who was special assistant to the president and senior director for biosecurity and pandemic response at the beginning of President Trump's second term and is now associate dean for Global One Health at Texas A&M University.
Catch up quick: The worker who died was employed by the Anti-Plague Research Institute of Siberia and the Far East, and initial reports claimed she died of pneumonic plague following a lab accident.
- But Russia told the WHO that no case of plague had been registered recently in the region, and experts say the details surrounding her death don't add up to a normal case of pneumonic plague.
- Russian authorities also told the WHO that testing of the worker's contacts had turned up "no high-threat pathogens," and that there had been no biosecurity incidents in the lab. However, experts almost unanimously say that the Russian authorities can't be trusted to tell the truth.
- While there could be a perfectly benign explanation, and the worker's laboratory ties were just coincidental, experts worry about the possibility of a much more nefarious situation: The worker was killed by an engineered pathogen through work on bioweapons or other experimental research.
The potential tie to risky lab research recalled the debate over COVID's origins, which still aren't definitively known but may have stemmed from gain-of-function lab work.
- Though China has been widely criticized for its lack of transparency into the COVID pandemic's origins, Chinese scientists ultimately published a sequence of the virus, allowing researchers around the world to work on tests, therapeutics and vaccines.
- "Compared to Russia, China was an open book," said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health.
Between the lines: With the proliferation of high-risk labs around the world, and the rise of AI enabling more people to do such work, biosecurity threats stemming from lab accidents are becoming a much higher risk, said Ashish Jha, the Biden administration's COVID-19 response coordinator and now co-founder of BioRadarUSA.
- "We're going to see more of these kinds of accidents or these kind of lab leaks, and at this moment we're just going to hope and pray that wherever it happens that those countries are timely, open and transparent," Jha said. "That's not a great strategy if our goal is to keep Americans safe."
- The U.S. should create a coalition of countries willing to share information if there's a biosecurity incident within their borders, Jha said, which could create pressure on reluctant countries to join.
- But beyond that, "we need to shift toward biodefense," he added. "Assuming, hoping everything will work out because everybody will report is a risky endeavor."
What they're saying: Other experts echoed the need for more international diplomacy, especially with U.S. adversaries, and finding ways to create more pressure to report biosecurity incidents or events that raise alarm bells.
- "Even when there's confusion like this, there should be some kind of duty to report," Parker said.
- "This is why it is so critical for the U.S. to have health and science diplomacy efforts, because it builds bridges between and among scientists so we know what each other is working on and we know when something isn't right," Nuzzo said.
Yes, but: Diplomacy isn't enough, given its ultimate reliance on cooperation. There also needs to be a global biosurveillance network that is capable of identifying even novel pathogens.
- That way, even if the country of origin withholds information, the world will be able to track a pathogen's spread as quickly as possible.
- "It's about having multiple imperfect layers of protection," Nuzzo said.
The bottom line: Though we're unlikely to find out exactly what happened in Russia a few weeks ago, the incident is a reminder that the world needs better coordination around biosecurity threats — which are almost certainly coming.
