Decisive Point Podcast – Ep 4-11 – Diane DiEuliis and James Giordano – “Responding to Future Pandemics: Biosecurity Implications and Defense Considerations”

In an evolving and expanding biothreat landscape caused by emerging biotechnologies, increases in global infectious disease outbreaks, and geopolitical instability, the Department of Defense now faces challenges that alter its traditional approach to biothreats and prompt the need for modernized, improved preparedness for—and response to—potential biothreat scenarios. These challenges further complicate specific weaknesses revealed by the COVID-19 pandemic, including the Department’s inability to sustain the military mission while meeting intragovernmental expectations to assist with civilian public health resources and services.

Read the article: https://press.armywarcollege.edu/parameters/vol53/iss2/8/

Episode Transcript: “Responding to Future Pandemics: Biosecurity Implications and Defense Considerations”

Stephanie Crider (Host)

You’re listening to Decisive Point, a US Army War College Press production focused on national security affairs. The views and opinions expressed in this podcast are those of the authors and are not necessarily those of the Department of the Army, the US Army War College, or any other agency of the US government.

Decisive Point welcomes Drs. Diane DiEuliis and James Jordano, authors of “Responding to Future Pandemics: Bio Security Applications and Defense Considerations,” which was published in the Summer 2023 issue of Parameters.

DiEuliis is a distinguished research fellow at the National Defense University, and Giordano holds several distinguished titles, including the Pellegrino Center professor in the departments of neurology and biochemistry.

Thank you for joining me today, Drs. DiEuliss and Giordano.

Dr. James Giordano

Thank you.

Dr. Diane DiEuliis

Thank you. It’s great to be with you today.

Host

Your article addresses three primary factors that have complicated the evolving landscape of biodefense threats. What are they?

Murray

Giordano

Murray

Let me take the first. The first one that we mentioned is emerging biotechnologies across a spectrum of potential applications in recent developments. These include, but certainly aren’t limited to, things such as gene editing. Probably the one most people are most currently familiar with is the use of a particular gene scissoring tool called CRISPR CAS9. But realistically, what that does is that just adds to our current armamentarium and makes our current armamentarium more facile and far easier to both acquire and use with regard to the existing techniques and technologies for gene editing to modify the genome and perhaps direct various phenotypes (expressions of physical characteristics). Going right along with that is the vast field of synthetic biology. Synthetic biology ranges everything from the molecular to the mass effect to the subcellular all the way to those things that can produce social change and a variety of different applications.

Certainly, we’re concerned about those things that directly affect humans, but realistically, there’s a number of things in synthetic biology that can disrupt and affect the ecologies and the environments upon which humans are dependent and interact. And this can then have ripple effects. And, really, I think the potentiator, and as Diane and I both have argued in print, the force multiplier for these is the use of big data coupled with forms of machine learning that are iteratively becoming forms of artificial intelligence. You put all these things together and you got yourself a juggernaut of biotechnological capability with a broad, broad range and field of different applications and uses and potential misuses. Diane?

DiEuliis

Thanks, Jim. Tagging on to that as a second concern is the fact that we may be looking in future at an increasing incidence of emerging infectious disease. And as the world’s population grows, we see more and more infringement of human populations into natural habitats. And as you know, much of emerging infectious diseases that appear in human beings comes from what are called zoonotic jumps, or a jump from a disease pathogen in an animal that then becomes adapted to human populations. And then we could see pandemics resulting from that. As we move into the future, we may see more incidences of zoonotic jumps, but also, we see things like people living in more close spaces in urban environments, which in some cases could just be an incubator for spreading diseases in a pandemic fashion. So, this is also a reason for why we need to reexamine the biothreat landscape. Jim, did you have more to add to that?

Giordano

If you take a look at the second and the first, in other words, the increased incidence and perhaps prevalence of infectious diseases, both in humans and in other species upon which humans are dependent—and the use of biotech—one thing is not mutually exclusive from the other. As the COVID crisis brought into stark relief, many of our emerging biotechs are prompted by, if not in direct response to what may be seen as biological risks and/or threats such as COVID. But more than that, I think, what tends to happen is that you do get this march along, whereby the biotechnology is beginning to address more and more areas that are so representative of human susceptibilities and vulnerabilities. And in so doing, that interface between those things that are environmental, from the microbial level all the way to the geopolitical level, become the targets of those things that we can use biotechnologically to assess those risks and threats, and to engage those risks and threats, in a variety of different ways. Diane?

DiEuliis

Those are really interesting points, and one of the things that we talk about in the paper is this sort of irony in emerging biotech in that some of these tools and the emerging capabilities that are offered by biotechnology are sort of the same tools that we want to use in order to mitigate things like pandemics, things like COVID-19. The goal is going to be moving forwar how to balance that how to balance the potential emerging threats that can come from these expanded capabilities while at the same time safely leveraging these technologies for the benefits that we can get out of them. And there’s a wide swath of benefits that could be used both by DoD and the community writ large that could be used to combat bio threats into the future.

Host

How do you see these factors playing out against the changing landscape of bio threats?

Giordano

I think we’re seeing an increased ecological disruption, everything from that writ large, climate change, for example, and the total human footprint over a period of time, particularly over the 19th, 20th now to the 21st century. And, I think writ small, as Diane noted, what we’re seeing is urban and suburban spread and sprawl, but also an increased level of commercialization and technologization of various environments that then disrupt those environments in those ways that make those environmental niche factors far more feasible, viable, and, therefore, accessible to humans and human populations.

So, these two things work together, both as respective of human progress and perhaps also as intentional disruption. I mean, seeing the ecology and the environment as a battle space, whereby disruptions of that ecology can then prompt individual and collective notions of dread and threat, forced migration, and/or in some cases, various responses, I mean, true responses, particularly in the psychological operations base, can be seen very, very importantly as a domain of perhaps non kinetic engagement, which then gets us directly into kinetic engagement. The use of these bio threats and bio risks as weaponizable entities on a variety of scales, from the individual all the way to the international.

Host

So, through this lens, what should the Department of Defense consider when it comes to maintaining readiness and preparing for the next pandemic?

DiEuliis

I really have two areas of response to that, and the first one is . . . of course, we learned quite a bit in responding to COVID-19. That entire experience really highlighted a number of things that DoD needs to be concerned with moving forward. The first of which is DoD obviously does defense support of civil authorities. Sometimes we nickname that DSCA. That’s an expected role that DoD has played for a long time is supporting civilian authorities in responding to disasters, or, in this case, a pandemic of global proportion. But at the same time, DoD needs to protect the warfighting force from whatever it is that’s happening and needs to maintain readiness in the warfighting force.

So, one tension that was revealed during COVID-19 is that our civilian response to the pandemic was leaning heavily on the DoD for logistical and other kinds of support. So that may not be the ideal situation moving forward because DoD quickly learned that extending itself to support the civilian response had some drawbacks on the DoD side. We were quickly depleting some of our stockpiles of response materials in the way of PPE and other kinds of things as simple as nitrile gloves and other things that are involved in that. That is one thing that DoD will have to strike a balance. How much can they lean forward in supporting the civilian response versus how much to continue to maintain their protection of the forces internally.

The second piece of that gets to more of some of the things that we cover in more detail in the paper. And that is this sort of overlap space between the general health and welfare of warfighters versus protecting war fighters from very specific intentional bio threats. Let me describe that in a little bit more detail. It’s general purpose is keeping a healthy fighting force keeping people from getting sick, helping when they’ve been sick, get back to health and get back into the fight. These are just general considerations of health and wellness that the Department of Defense utilizes the same kind of medical advice, treatments, therapeutics that everybody else uses. And they rely on whatever is considered best practice in general public health to maintain the readiness of the fighting force. But DoD has to worry about specific biothreats.

So, by this we’re talking about things like the potential of, say, an anthrax attack or someone who may try to recreate a smallpox and infect warfighters with something like that. So, we have a program that’s devoted specifically just for nasty things that war fighters might be exposed to in their daily work or their deployments. And so Dod has full control of this latter program, the investments, and what they do to develop those kinds of therapeutics.

On the other side of it, on just the health and wellness side, they’re completely at the mercy of the public health community in the US. What COVID-19 demonstrated is that readiness was somewhat compromised because DoD had to wait for the CDC, for general public health authorities, to provide them with things like test kits and diagnostics, whereas in the other category, DoD develops their own diagnostics and their own medical countermeasures. So, looking forward, in addition to balancing this DSCA problem and how much should DoD lean forward in helping defense support of civil authorities, they’re also going to have to navigate this space in terms of how much should they rely on the public health community to provide them with what they need if they cannot provide it rapidly enough in the case of a pandemic or other kind of bio threat.

Giordano

It sort of does get into the idea of this interface between what is cooperation and what is competition, not only with regard to intranationally, in terms of what are they cooperative domains and what are the competitive domains for resources, services, and goods during these times of crisis. But more broadly, and I think as COVID, once again, has illustrated quite well, is that this is multinational. I mean, let’s face it, at its core, science and technology have a strongly cooperative bend. I mean, realistically, what we find is that these things coming together under a convergent scientific approach utilizes technology to advance science and utilizes science to advance technology, and certainly intranationally, or within allied economic and scientific groups, that’s very much, de rigueur.

But very often it’s some kind of overarching or undergirding competitiveness that provides the prompt, in other words, to get to some proverbial metaphorical finish line first—to a new cure or new treatment, some advancement. And those things can have a variety of different pay offs from the financial all the way to the idea of international power, and even perhaps military leverage. So, what we found is that when that competition gets too stripped, too dense, as COVID has shown, that can be a zero-sum equation. And no one wins because there’s not that necessary sharing of resources, knowledge, capabilities. By the same token, we do recognize both macro and microeconomic factors, and that frank openness of that level of gross cooperation can very often stultify competitive drives and, therefore, can be problematic in the same way.

So, if we’re looking more of a plus some possibility, what we’ve entertained is this idea of cooperative competition or coopetition because what it really does is it defines key areas of dependencies. One group may be dependent upon another group to establish and maintain relative dominion within a particular niche or milieu or field. But what it actually does is it leverages leverage, and in so doing, creates balance, whereby these domains of capability and power are decided upon through some process of deliberation, discourse, and dialect. And there are actually ways that we discussed both in the paper and elsewhere about how this may be entertained. But then ultimately this reaches some form of an equilibrium whereby A, whatever A may be, cannot be achieved without B, and B cannot occur and be achieved without A. So that mutuality accents and very often brings to the fore the cooperative necessity and the competitive domain. And we view that as a realistic sight picture, particularly in strategic ways, in light of the genuine and authentic risks and potential benefits that can be yielded through science and technology going forward.

Host

Do you have any final thoughts you’d like to share before we go?

DiEuliis

First and foremost, I want to thank my colleague, Jim. It’s always a pleasure to work with you and it was great writing this paper together. And thanks to Stephanie for hosting us for this podcast.

I encourage folks to take a look at the paper. And I would say that one thing to keep in mind as we are all coming out of this COVID-19 experience is that just about everybody … federal agencies, state, and local public health authorities, international forums, the WHO, the Biological Weapons Convention. Everyone is scrambling now to understand the ramifications of the COVID-19 pandemic in terms of what did we do well, what did we not do so well, and many, many efforts are going to be focused on what should we do in future to do a better job. And there’s going to be a lot of investment, a lot of churn, a lot of activity in the space. And so, I encourage people to really think carefully and to not just have sort of knee-jerk responses to the aftermath of COVID-19 but to really sort out some of these issues in a thoughtful way so that we can really carefully plan and prepare for next time.

Giordano

I agree. And thanks very much both for your interest in our work and your attention to it and providing this wonderful forum, and we would encourage the listeners of the podcast to get in touch. Our emails are available at the end of our paper and certainly has our contact information.

A lot of the work that Diane and I are engaging, both that which is funded by the DoD and other federal agencies and that which has been sort of representative of our long-standing careers in this space, address not only this issue in particular, but the broader field of issues of balancing the apparent benefits of bioscience and technology and also recognizing, appreciating, and addressing those burdens, risks, and harms that can occur if you do certain things or if you don’t do certain things. And once this begins to occur on the multicultural, multi-natural global stage of the 21st century, I mean that multinational stage by itself, I think, produces particular opportunities and challenges. And so addressing these things in that forum and it with those realities is going to be an ongoing focus of our work. So again, thanks to the listening audience for your attention and your interest. And uh, thanks to you as well, it’s been a pleasure.

Host

Listeners, I echo what my guests just said. I suggest you read the article at press.armywarcollege.edu/parameters. Look for volume 53 issue 2. You can get into so much more detail here.

This was a really great time. Thank you.

Giordano

Thank you.

DiEuliis

Thank you

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About the authors:

Diane DiEuliis, PhD, is a distinguished research fellow at the National Defense University. Her research focuses on emerging biological technologies, biodefense, and preparedness for biothreats. Specific topic areas under this broad research portfolio include dual-use life sciences research, synthetic biology, the US bioeconomy, disaster recovery, and behavioral, cognitive, and social science as it relates to important aspects of deterrence and preparedness. DiEuliis has several research grants in progress and teaches various foundational professional military education courses. Prior to joining National Defense University, DiEuliis was deputy director for policy and served as acting deputy assistant secretary for policy and planning in the Office of the Assistant Secretary for Preparedness and Response (ASPR), Department of Health and Human Ser vices. She coordinated policy in support of domestic and international health emergency preparedness and response activities, such as Hurricane Sandy and Ebola outbreaks. She was responsible for the implementation of the Pandemic All-Hazards Preparedness Act, the National Health Security Strategy, and the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE).

James Giordano, PhD, MPhil, is the Pellegrino Center Professor in the Departments of Neurology and Biochemistry; chief of the Neuroethics Studies Program; director of the Cyber-SMART Center’s Program in Biotechnology, Biosecurity, and Ethics; chair of the Sub-Program in Military Medical Ethics at Georgetown University; and senior bioethicist of the Defense Medical Ethics Center (DMEC) and adjunct professor of psychiatry at the Uniformed Services University of Health Sciences. Giordano is senior fellow of the Project on Biosecurity, Technology, and Ethics at the US Naval War College; Stockdale Distinguished Fellow of Science, Technology and Ethics at the United States Naval Academy, and senior science advisory fellow of the SMA Branch, Joint Staff, Pentagon. He has previously served as Donovan Senior Fellow for Biosecurity at US Special Operations Command (USSOCOM); as an appointed member of the Neuroethics, Legal and Social Issues Advisory Panel of the Defense Advanced Research Projects Agency (DARPA); as research fellow and task leader of the EU-Human Brain Project Sub-Program on Dual-Use Brain Science; and as an appointed member of the Department of Health and Human Services Secretary’s Advisory Committee on Human Research Protections (SACHRP).