Pandemic Raises Spectre of Bioterror

The three-year viral storm of COVID-19 circling the globe and killing millions of people has left a lingering question: Has the wholesale disruption and devastation of SARS-CoV-2 made biological pathogens a more compelling and/or attainable goal by bioterrorists?

“The implications of COVID-19 for bioterrorism appear complex and contingent,” a group of terrorism experts write for the CTC Sentinel, a U.S. Army publication.¹

“For example, terrorist ideology acts as a critical mediating factor. While the COVID-19 experience might encourage certain groups with apocalyptic goals to pursue biological weapons, it might equally discourage groups with narrower goals that recognize widespread harm might result in significant blowback both upon and from their own supporters. In general, [we] assess COVID-19 will have a limited overall effect on bioterrorism risks, though it may have greater effects on perceptions of those risks,” the authors said.

Thus, fake powders simulating anthrax and other hoax agents could be used to engender fear amplified by misinformation. Such disturbing hoaxes followed the 2001 anthrax letter attacks.

“Hospitals should prepare for a surge of the worried well,” says Sonia Ben Ouagrham-Gormley, PhD, a professor in the biodefense program at George Mason University in Washington, DC. “Bioweapons are extremely difficult to produce, and no terrorist group has been able to succeed on that front, primarily because bioagents are very unpredictable. It takes teams of scientists with very specialized expertise to stabilize, produce, and weaponize them. That expertise is weapons-specific, so general knowledge in biology would not help much.”

Yet, we still see articles warning in breathless prose that “viruses as deadly and disruptive as COVID-19, or potentially much worse, are going to be possible to produce in labs worldwide soon, if not right now.”²

In contrast, another paper takes a calming tone: “COVID’s bolstering of terrorists’ abilities to acquire biological weapons is likely modest at best. The main potential concern is the proliferation of medical and public health resources aimed at combatting COVID and whether any of these can be reappropriated to serve bioterrorism schemes. In most cases, the answer is no. Nonetheless, new laboratories might create opportunities to steal equipment or pathogens.”³

Other Bio-Agents

Bioterrorists could use more manageable agents, such as ricin, which is a poisonous byproduct of the processing of castor beans for castor oil. “If made into a partially purified material or refined into a terrorist or warfare agent, ricin could be used to expose people through the air, food, or water,” the Centers for Disease Control and Prevention (CDC) reports.⁴ There is no antidote, but someone infected with ricin is not contagious.

Probably the most famous case of fatal ricin poisoning could have been lifted from a James Bond novel during the Cold War. In 1978, a Bulgarian journalist living in London died after a man walking behind him used the tip of an umbrella to inject a pellet in the thigh of the back of his leg. A hollowed bearing the size of a pen head most likely held the poison, with all signs and symptoms preceding death leading to the consensus that ricin was the agent.

With the possible exception of airborne pneumonic plague (Yersinia pestis) and an effective system to deliver it with, the most feared biological agent probably is smallpox. This disfiguring variola virus, marks of which were found on Egyptian mummies, killed hundreds of thousands of people for centuries.

After a modern vaccine was developed and, using a “ring vaccination” technique around known cases, smallpox was eradicated in 1977. It was one of the greatest public health achievements of all time, but a devil’s bargain was struck by allowing frozen vials to be kept in the United States and Russia. As immunity wanes, most of the world’s population is now susceptible to smallpox. After 9/11 and the anthrax mail attacks, the U.S. government proposed vaccinating about 500,000 healthcare workers in 2003, but there was widespread pushback and it is not clear how many were ultimately voluntarily immunized. (See Hospital Infection Control & Prevention, February 2003.)

Building Boom

George Mason’s biodefense program put out a report in 2023 warning that the number of Biosafety Level 4 (BSL-4) labs is increasing rapidly as a result, in part, to a COVID-19 “building boom” worldwide.⁵ The report identified 51 BSL-4 labs in operation, three under construction, and 15 planned in a total of 27 countries.

In 2014, laboratory pathogenic agents, including anthrax, H5N1 avian flu, and — incredibly — vials of smallpox were found in unsecured areas at the CDC and the National Institutes of Health. (See Hospital Infection Control & Prevention, February 2014.)

“Most lab incidents are caused by human error or poor oversight and inventory management,” Ben Ouagrham-Gormley says. “As the number of high-containment labs increases, so do the risks of accidental lab release due to human error. There have been several reported lab incidents in the past few years around the world due to human error or equipment defects. Some incidents may not be reported, so we don’t really have a good inventory of cases.”

Research to prepare for emerging viral pathogens carries the “dual use” threat of a dangerous pathogen escaping from the lab. Although unproven, the theory that SARS-CoV-2 escaped from the Wuhan Institute of Virology (WIV) in China still persists. No intermediary source animal reservoir has been found. This is in contrast to the finding that civet cats carried severe acute respiratory syndrome (SARS-1), and camels are the animal reservoir for Middle East respiratory syndrome (MERS).

There are disputed reports that some Wuhan lab workers became sick in fall 2019. While conceding that origin of COVID-19 “remains uncertain,” in 2021, a U.S. State Department fact sheet gave some credence to the theory: “The U.S. government has reason to believe that several researchers inside the WIV became sick in autumn 2019, before the first identified case of the outbreak, with symptoms consistent with both COVID-19 and common seasonal illnesses. ... Accidental infections in labs have caused several previous virus outbreaks in China and elsewhere, including a 2004 SARS outbreak in Beijing that infected nine people, killing one.”⁶

The contrary view to all these fears and threats is that the pandemic actually prepared the health system for a bioterrorism attack or the next emerging pathogen.

“COVID-19 responses involved the rapid development, implementation, and refinement of public health measures aimed at containing the spread of the disease,” the Army report notes. “This included requirements for mandatory stay-at-home orders, mask mandates, and rapid vaccination development and dispersal, such as the United States’ Operation Warp Speed. Such measures would also likely be useful in combating the spread of a contagious agent spread in a bioterrorist attack.”

REFERENCES

1. Ackerman GA, Kallenborn Z, Bleek PC. Going Viral: Implications of COVID-19 for Bioterrorism. Combating Terrorism Center. Published May 2022. https://ctc.westpoint.edu/going-viral-implications-of-covid-19-for-bioterrorism/
2. Piper K. Why experts are terrified of a human-made pandemic — and what we can do to stop it. Vox. Published April 5, 2022. https://www.vox.com/22937531/virus-lab-safety-pandemic-prevention
3. Ackerman GA, Kallenborn Z, Bleek PC. Why COVID probably hasn’t helped bioterrorists, despite fears. Bulletin of Atomic Scientists. Published Aug. 11, 2022. https://thebulletin.org/2022/08/why-covid-probably-hasnt-helped-bioterrorists-despite-fears/
4. Centers for Disease Control and Prevention. Facts about ricin. https://emergency.cdc.gov/agent/ricin/facts.asp#
5. Global BioLabs Report. King’s College London and Schar School of Policy and Government at George Mason University. https://static1.squarespace.com/static/62fa334a3a6fe8320f5dcf7e/t/6412d3120ee69a4f4efbec1f/1678955285754/KCL0680_BioLabs+Report_Digital.pdf
6. U.S. Department of State. Fact sheet: Activity at the Wuhan Institute of Virology. Published Jan. 15, 2021. https://2017-2021.state.gov/fact-sheet-activity-at-the-wuhan-institute-of-virology/