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Welcome back to Axios' special report about the science of pandemics.

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  • Thanks for your feedback — please send more by hitting reply or email me at alison@axios.com.

This week's newsletter is 1,834 words, about a 7-minute read.

1 big thing: The coming coronavirus mental health crisis

Illustration: Sarah Grillo/Axios

The coronavirus pandemic is bringing another crisis to the U.S. — mental health impacts that will likely be felt for years to come, Axios' Miriam Kramer writes.

Why it matters: Experts are concerned the U.S. health care system isn't prepared for the potential mental health crisis that will come on the heels of the pandemic.

Driving the news: 28% of Americans reported worsening mental health, and 34% reported worsening emotional well-being at the end of April, according to the Axios-Ipsos Coronavirus Index.

  • These mental health effects are likely caused by a combination of media coverage, the economy and quarantines in place around the country.
  • Experts say this doesn't mean stay-at-home orders and social distancing shouldn't occur, but that the health system needs to be prepared for the mental health effects caused by these life-saving policies.

What's happening: Experts are now seeing waves of mental health effects from the pandemic being felt across the country.

  • "In wave one, we saw massive anxiety, and the anxiety has echoed the locations where COVID is showing up most," Nancy Lublin, CEO of Crisis Text Line, said during a webcast.

The second wave of effects from the pandemic is now breaking, according to Lublin, and she expects it to last longer than the first.

  • This wave is marked by effects from stay-at-home orders, including domestic violence, sexual abuse and economic hardship.
  • The Crisis Text Line has seen a 78% increase in texts relating to domestic violence, a 44% increase in texts about sexual abuse, and the largest group of texters are now in the 18–35 age range, who are being most disrupted by quarantines and the effects of the economy.

What's next: Experts expect the types of issues people are dealing with will shift into chronic problems like depression and PTSD.

"I think it's going to be a long journey that will not be linear, and I think that the scar of the mental health repercussions is going to burn for years," Lublin said.

Between the lines: The mental health infrastructure of the U.S. may not be up to the task of serving all the people who need help in the wake of the pandemic.

  • "We really have a very broken — and I would say disjointed behavioral health system — even on the best of days," Stuart Archer, the CEO of Oceans Healthcare, told Axios.
  • Many mental health facilities are already facing collapse due to the financial situation brought on by the virus, forcing organizations, including the American Psychiatric Association among others, to ask the Trump administration to help support struggling facilities during this time.

The big picture: These waves of need around mental health are in line with past disasters, which could help experts lay out a roadmap for how to deal with the fallout from the virus.

  • "After [Hurricane] Katrina, up to 50% of the people who lived in affected counties had a diagnosable mental illness, most of them post-traumatic stress disorder," Joshua Gordon, director of the National Institute of Mental Health, said during the webcast.

The bottom line: Extreme measures were taken to try to stave off the physical health effects of the coronavirus pandemic. Experts warn that hospitals and providers need to similarly prepare for the mental health effects expected as the crisis continues — and for years to come.

Read the full story.

2. The pandemic reawakens bioweapon fears

Illustration: Aïda Amer/Axios

The immense human and economic toll of the COVID-19 pandemic only underscores the threat posed by pathogens that could be deliberately engineered and released, Axios' Bryan Walsh writes.

Why it matters: New technology like gene editing and DNA synthesis has made the creation of more virulent pathogens easier. Yet security and regulation efforts haven't kept pace with the science.

What's happening: Along with AI, engineered pandemics are widely considered the biggest existential risk facing humanity.

  • That's in part because a pathogen could be engineered in a lab for maximum contagiousness and virulence, well beyond what would arise through natural selection.

COVID-19 has shown the vulnerability of the U.S. and the world to biological threats both natural and manmade.

  • "Anyone looking for a radical leveling approach — whether a state actor like North Korea or a motivated terrorist organization — may be influenced by COVID-19 to consider pursuing a biological weapons capability," says Richard Pilch of the Middlebury Institute of International Studies.

While earlier bioweapons fears focused on the possibility that a state or terror group could try to weaponize a known dangerous agent like smallpox — which would require somehow obtaining restricted pathogens — new technology means that someone could obtain the genetic sequence of a germ online and synthesize it in a lab.

How it works: Currently, synthetic DNA is ordered through commercial suppliers. But while most suppliers screen DNA orders for the sequences of dangerous pathogens, they're not required to — and not all do, which means safety efforts are "incomplete, inaccurate and insecure," says Kevin Esvelt, a biologist at the MIT Media Lab.

What's next: Experts agree on the need for a stronger international regime aimed at controlling bioweapons and regulating dual-use biotechnology research. But given the growing animosity between the U.S. and China over the origins of the novel coronavirus, that may be an impossible ask.

  • Esvelt has proposed the creation of a secure screening process that would use advanced cryptography to make it far more difficult for rogue actors to obtain synthetic DNA that could be used for potentially dangerous purposes.
"COVID-19 has been a catastrophe for the world, but there is a potential for even greater catastrophe. And we are not prepared for this."
— Beth Cameron, Nuclear Threat Initiative

Read the full story.

3. Sharing in pandemic times

Illustration: Sarah Grillo/Axios

Amid escalating geopolitical tensions and efforts to trace the origin of the novel coronavirus, experts say an international legal framework is needed for sharing biological samples and genetic data during pandemics.

The big picture: This pandemic is exposing legal gaps for sharing virus samples and sequencing data that could hinder responses to international health emergencies, according to a new paper in the journal Science.

Background: China published the SARS-CoV-2 genetic sequence on a public database in January and researchers around the world immediately began developing diagnostic tests for the virus and used the sequence to create an infectious clone.

Scientists interviewed by Axios say there is less need now for early samples of the virus to develop vaccines and treatments as it has spread itself around the world.

  • But it could help to understand the virus' origins and, they say, sharing of genetic information and samples is key to understanding what other viruses are out there and for responding to future outbreaks.

Where it stands: A patchwork of legal frameworks, binding and nonbinding, pertaining to some types of viruses and information but not others means access to valuable data isn't a guarantee and depends on scientific collaboration in an increasingly politicized world.

  • The World Health Organization's International Health Regulations currently require members to share “public health information” related to potential international outbreaks but that doesn't include physical samples or genetic sequencing data.
  • The Pandemic Influenza Preparedness (PIP) framework outlines nonbinding access among WHO member states, industry and others to physical samples of influenza viruses with human pandemic potential.
  • Existing UN protocols, set up to protect biodiversity, give countries the ability to determine who gets access to genetic resources within their borders and how any associated benefits of those resources are shared.

What to watch: In the future, genomic sequencing data may not be as readily shared, says Lawrence Gostin, an author of the paper and a professor of law at Georgetown University.

  • He warns that researchers that use genetic data to synthesize a virus could sidestep rules that obligate the benefits of research to be shared and, in turn, make others hesitate to share genomic data. During a pandemic, that could be "catastrophic," he and his colleagues write.
  • They propose expanding either PIP to cover other viruses and genetic sequencing data or the WHO's International Health Regulations to include sharing pathogen samples and genome sequencing data during potential international outbreaks.

Yes, but: There are barriers rooted in the divide and distrust between countries based on past experience of governments, companies and researchers cutting out collaborators in countries providing resources.

The bottom line: "If we want to survive the next pandemics, we need open scientific sharing and to find an international mechanism that allows for that," Gostin tells Axios.

Read the full story.

4. Worthy of your time

Antibiotic-resistant superbugs could be worse than COVID-19 (Eric Allen Been — OneZero)

  • This is a terrifying read about the "dual assault" of virus and bacteria in the 1918 flu, possibly with COVID-19 and beyond.

Our weird behavior during the pandemic is messing with AI models (Will Douglas Heaven — MIT Tech Review)

  • "Machine-learning models trained on normal human behavior are now finding that normal has changed, and some are no longer working as they should."

COVID-19 may permanently shutter museum devoted to vaccination pioneer (Susan Cosier — Smithsonian Magazine)

  • Edward Jenner, who developed the world's first successful vaccine and shared it far and wide even as countries were at war, wrote in 1803: "the Sciences are never at war."
5. 1 viral thing: Pandemic misinformation isn't new

Illustration: Sarah Grillo/Axios

The infodemic of misinformation and disinformation around the coronavirus is a serious threat to understanding how to deal with the pandemic — but this is nothing new, Axios' Eileen Drage O'Reilly writes.

The big picture: Whether the Black Death, smallpox or COVID-19, deadly diseases strike fear into people and, as scientific understanding is still gathered, stories and theories can start percolating into more serious finger-pointing, xenophobia or even violence.

The latest: Conspiracy theories, alarmist information, fake "cures" and scams are flooding people's news feeds and social media about COVID-19. This is happening partly due to divergent messaging leading to confusion and mistrust in the government.

This is not the first time false stories or misinformation spread as fast as the pathogen.

Flashback: The "parrot panic of 1930" started when a pet parrot died and shortly later a few members of the family fell dangerously ill.

  • There was "an outbreak of hysteria," says Lawrence Poos, a history professor at the Catholic University of America.
  • A Washington Post headline, "'Parrot Disease' Baffles Experts," captured the attention of Americans and helped foment a mass culling of parrots everywhere, per the New Yorker.
  • Parrot fever is a rare infection caused by the bacteria Chlamydia psittaci that can now be treated with antibiotics.

More serious consequences were seen in the Black Death in the 14th century, which was caused by the bacteria Yersinia pestis transmitted from rodents to humans via fleas.

The bottom line: The ability for storytelling and rumormongering to stymie efforts to stem outbreaks is not new, but with social media boosting their power, governments should make explicit efforts to address the issue via transparency on evidence-based scientific findings.

Read the full story.

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