USAID is pouring $125 million into collecting dangerous viruses in the wild. What could possibly go wrong?

 

Bushmeat market in Africa. Photo by Alexandra
Mannerings / BBC, 2014.

I just learned that the US Agency for International Development, USAID, is pouring $125 million into an effort to seek out novel viruses in remote areas of the world. This is pretty much exactly what many scientists, including me, have been warning against for years.

How did I miss this? It was announced last October, along with articles about how excited Washington State University was to lead the project, and how pleased the University of Washington was to go out and hunt down animals that were carrying dangerous new viruses.

In any case, I know about it now, and I’m joining the voices (here and here, for example) that are warning that this is a truly terrible idea.

The USAID’s announcement seems utterly oblivious to the enormous dangers posed by this program. Their own headline says they want to find viruses that could cause pandemics! The program, called DEEP VZN (”deep vision,” get it?) is funding scientists in the US and in Africa, Asia, and Latin America to venture (”deep”) into unpopulated areas of the jungle, and to find animals carrying viruses that might infect humans. They’re particularly interested in viruses that could cause the next pandemic.

What could go wrong? Oh nothing, says USAID and the scientists who are happily taking the $125 million in funding. They’ll be super careful! So we should all be pleased with how the government is preparing for the next pandemic.

Uh, no. As I wrote last year:

It’s also time to ask, very critically, whether anyone should be venturing out into remote areas to collect animals that are infected with possible pandemic-causing microbes, and bringing those animals [or just the viruses] back to densely populated areas. Rather than preventing pandemics, these activities are more likely to cause them.

The only tiny nod to risk in the USAID announcement is that they will “safely discover and understand new viruses from animals at high risk locations” (emphasis mine). They make no mention of how they will guarantee this is safe–because they simply can’t guarantee any such thing. 

Oh wait, isn’t this how some people think the Covid-19 pandemic started? Because humans were collecting bats from remote caves? Oh, but perhaps that was different, because some of those bats were being collected for food, and the people collecting them weren’t careful enough.

Never mind that the debate about whether Covid-19 was caused by a lab leak has never been fully resolved. And never mind that the debate itself has made it clear that lab leaks happen all too often, and that it’s clearly possible that a lab leak could cause a pandemic.

(For more on the risks of lab leaks, see my previous articles, from March 2022, June 2021, October 2021, or January 2015 (when the threat was from influenza), or this New Yorker story from 2021.)

The details of DEEP VZN are even more alarming: they plan to collect over 800,000 samples from animals in the wild, and they hope (!) to discover 8,000 to 12,000 new viruses, any one of which might have the potential to start a worldwide pandemic. They’ll focus especially on coronaviruses (the family that includes the Covid-19 virus), Ebola-like viruses, and a group called paramyxoviruses.

Great, so maybe they’ll cause a novel Ebola outbreak too. I’m feeling very comforted now!

I have to note here that USAID, the funder for DEEP VZN, also funded EcoHealth Alliance to collect coronaviruses from bats in China, and EcoHealth partnered with the Wuhan Institute of Virology in that project. As I and many others have written over the past two years, the Wuhan Institute of Virology is a possible source, through a hypothesized lab leak, of the Covid-19 pandemic. We may never know if WIV was involved, because China shut down all access to the lab early in the pandemic.

But it seems USAID didn’t learn any lessons at all from the many publicly expressed concerns about whether it was wise to go into caves in remote areas of China and collect coronaviruses from bats. On the contrary: with DEEP VZN, they are doubling down.

Why do USAID and the scientists at Washington State and UW think this is a good idea? Well, here the story is very familiar. They are making the same pie-in-the-sky claims we’ve been hearing for years: “The hope is that this improved understanding will lead to prevention of future pandemics,” said a UW scientist in their press release. Or “to make sure the world is better prepared for these infectious disease events, we need to be ready” according to a Washington State scientist.

I and others have pointed out the flaws in these claim before, but it’s worth re-stating a few of them:

1. First, there’s not a shred of evidence that collecting these viruses will help prevent a pandemic, and we now have evidence providing the opposite. Scientists have been collecting coronaviruses since the first SARS outbreak, in 2003, and that work didn’t prevent the Covid-19 pandemic, even though both outbreaks were caused by coronaviruses.
2. Second, the act of going into remote areas and looking for viruses is highly likely to bring deadly new viruses back into human cities, creating opportunities for a lab leak that could easily cause a new pandemic. And despite some protests to the contrary, lab leaks can and do happen, even from the most secure facilities.
3. Third, having viruses in labs, even if they’re secure, will do little to help anyone design vaccines against future pandemic viruses. As expert virologists have pointed out, we simply can’t predict what viruses will cause the next pandemic: there are far too many of them, among other reasons.

There’s one more threat I have to mention. DEEP VZN proudly proclaims that it’s going to make all of its data public, including the genome sequences of the viruses that it collects. This strategy blithely ignores the fact that it’s now possible for hostile actors to use these sequences to create deadly new bioweapons. An MIT engineer estimates that some 30,000 people around the world already have this capability. Even if that is a bit alarmist (and I tend to think it is), it’s not so far-fetched to believe that generating all of these sequences greatly increases the risk that someone will create a rogue virus.

If USAID wants to help prevent the next pandemic, there are far, far better ways to spend $125 million of taxpayer money. Here are a few ideas:

1. Use the money to reduce the consumption of “bushmeat” in countries where this is still practiced. This could be done in many ways, such as training people in better farming methods, or even just providing food directly.
2. Put a halt to the use of wild animals for ineffective “traditional” medicines, which don’t cure anything and which are one of the main incentives for hunting exotic animals. This would have the additional benefit of saving a number of animal species from extinction.
3. Use the money to develop faster ways to produce and deliver vaccines, so we don’t have to wait months or years from the time a pathogen starts spreading until we have a vaccine.

Look, I know that some scientists are very excited about going out and finding new viruses, and some of them truly believe this will help prevent future pandemics. But they’ve been saying this for years, and the evidence is now overwhelming that this is a pipe dream. Sending humans out into the wild to gather viruses that would otherwise never make their way into population centers is just a terribly dangerous plan.

Or let’s put this another way: if you discovered that a research facility in your home town were working with hundreds of deadly viruses, would you have any concerns? Any at all? I know I would.

Are you "vaccine hesitant"? You may be in a cult

Edward Jenner, who pioneered vaccination, and two colleagues
 (right) seeing off three anti-vaccination opponents, with the dead
lying at their feet (1808). I Cruikshank/Wellcome Images/Wikimedia
Commons, CC BY-SA

The World Health Organization recently declared that "vaccine hesitancy," as they called it, was one of the top 10 threats to global health. That's right: it was up there with air pollution, climate change, influenza, Ebola, and other threats.

For the WHO, "vaccine hesitancy" is a polite phrase designed to engage the public and highlight how serious the problem is, without angering those who are guilty of it. I'm not going to be quite so polite here: "vaccine hesitant" means anti-vax. The anti-vax movement, which aggressively spreads fear and misinformation about vaccines, has become a major, worldwide threat.

It also resembles a cult, as I'll explain.

The most recent anti-vax nonsense centers on the new coronavirus that originated in China, and that has led the Chinese government to impose a massive quarantine affecting millions of people. This is a genuine public health crisis, and it has nothing to do with vaccines. Nonetheless, some anti-vaxxers are claiming, without evidence, that the new virus originated from a failed effort to create a coronavirus vaccine. I don't have time to get into that here, but Orac has a lengthy, detailed takedown of that bogus claim.

"Vaccine hesitancy" sometimes refers to parents who are just learning about vaccines for the first time, and who rely on the Internet to search for information. Unfortunately, these new parents are likely to be flooded with anti-vax messages, especially on Facebook. (In recent years, Google has taken steps to lower the priority of anti-vax sites, which has improved things considerably. Sites such as healthychildren.org now appear near the top of searches for "vaccine safety.") It's entirely reasonable to ask your doctor about the benefits and risks of vaccines.

But the answers that parents hear should be clear: vaccines work. As physician ZDoggMD (a pseudonym, obviously) explains in this video:

"Anti-vaccine sentiment is a poisonous scourge.... There's no debate about vaccines. Let's get over that nonsense that the media and celebrities have created, okay? There is nobody in the medical community of any actual reputation who believes that there are two sides to this."

The problem is that anti-vaxxers are continuously creating new websites, Facebook groups, and even movies to spread misinformation about vaccines, particularly the long-debunked claim that vaccines cause autism.

Why do I suggest that anti-vaxxers resemble a cult? Because they have several of the key features of cults, such as:

1. Members of the cult have special insights that outsiders cannot comprehend. With anti-vaxxers, this means they are completely convinced that they know that vaccines cause harm, despite mountains of evidence to the contrary.
2. The group and its leaders are the exclusive means of knowing "truth" or receiving validation, and no other process of discovery is credible. The anti-vax movement has had several prominent leaders, whose followers flock to their speeches and events. These include Andrew Wakefield, the disgraced former doctor who lost his medical license after it was revealed that he had committed fraud. His followers, though, either don't know or ignore his fraudulent past, and regard him as a hero. He makes a living from his books, a movie, and speaking fees, all based on spreading fear about vaccines. An even more prominent anti-vax leader is Robert Kennedy, Jr., who also sells books and gives speeches proclaiming the harms of vaccines. Thanks to his famous name, and despite the fact that he has no medical or scientific training, some people believe him.
3. Unreasonable fear about the outside world, such as impending catastrophe, evil conspiracies and persecutions. Conspiracy theories are the core of many anti-vax arguments. The most common version holds that the "medical establishment" (whoever that is) are hiding the dangers of vaccines so that they can make money. This is utter nonsense. All of doctors I know in the infectious disease community are motivated by a wish to cure disease. In any case, most doctors make little or no money from the vaccines they administer.
4. No meaningful financial disclosure regarding budget or expenses. Some anti-vaxxers profit handsomely by selling bogus, ineffective supplements as alternatives to vaccines. (I'm looking at you, Joe Mercola.) Because supplements are largely unregulated, they get away with it. They'd prefer you to think they're "just in it for the children."

I've no doubt that anti-vaxxers like Wakefield, Kennedy, and others would deny that they are conspiracy theorists, because that's how conspiracy theorists operate. If you question them (they argue), you must be part of the conspiracy. By their own reasoning, they can never be wrong.

So if you encounter someone, either on the sidelines at your kid's soccer game, on Facebook, or elsewhere, who is spreading claims that vaccines are harmful, pause for a minute and ask: what is the source of this information? Is it coming from someone who is profiting from this fear-mongering? There's a good chance the answer is yes.

It's ironic that when the world is faced with a true health emergency, such as the Ebola virus or the Wuhan coronavirus, the first thing that public health experts start to work on is a new vaccine. That's because vaccines provide our best protection against infections. We now have effective vaccines for 16 diseases that used to harm and even kill children in large numbers around the world. We've eliminated smallpox worldwide, and we've nearly eliminated polio, thanks to vaccines. Their very effectiveness is what has allowed the anti-vax message to take hold: many people are no longer frightened of dying from infectious diseases.

We're still a long way from conquering infections, but there's no reason for the world to slip back in time to an era when large numbers of people died from preventable infections. Vaccines work, if we'll let them.

NIH opens the floodgates to creating super-viruses

Some scientists really want to earn their "mad scientist" label. Ever since Mary Shelley's Frankenstein, novelists and screenwriters have shown us the dangers of letting mad scientists pursue their dreams without any controls. Of course, those stories are fiction.

In the microbial world, though, technology has caught up with fiction. Scientists today can create viruses from scratch, as they've already done with the polio virus, back in 2002. Using the tools of modern genomics, virologists and microbiologists can make pathogens much, much more deadly. But would anyone really want to do this? The answer, it turns out, is yes.

A few years ago, some virologists had the clever idea of modifying the bird flu virus to make it more deadly to humans. What would it take, they wondered, to turn the bird flu into a human flu? They decided to give it a try, and they announced their plans to the world. Then, just a few months later, they published results showing that they had succeeded, at least partially, using a bird flu called H7N9.

That wasn't even their first try. Only a year earlier, they did the same thing using a different flu virus (H5N1). Both of these bird flu strains have killed people, but the wild-type version of the virus rarely infects humans. The scientists running these experiments aimed to create a strain that could get into humans much more easily.

Many scientists were mortified. 18 leading microbiologists and infectious disease experts, including Nobel laureate Sir Richard Roberts, formed the Cambridge Working Group to oppose efforts to create super-viruses in the lab. Hundreds of other scientists, including 3 more Nobel laureates, joined the group as charter members.

In response to the concerns raised by scientists and other public health experts, NIH announced a moratorium on these so-called "gain of function" (GOF) experiments, at least in the U.S. (The scientists leading the charge for GOF experiments were based primarily in The Netherlands, although they did get some funding from NIH.) The NIH convened an expert panel, the NSABB, who commissioned a 1,000-page report and then issued their own report, which was released in May of 2016.

The NSABB panel avoids taking very strong positions, but they do raise some alarms. Here's their definition of "research of concern," for example:

"...research that could generate a pathogen that is: 1) highly transmissible and likely capable of wide and uncontrollable spread in human populations; and 2) highly virulent and likely to cause significant morbidity and/or mortality in humans." 

This does not sound like a good idea! So what does the NSABB recommend? Well, this:

"Research proposals involving GOF research of concern ... should receive an additional, multidisciplinary review, prior to determining whether they are acceptable for funding."

I can't argue that research like this doesn't need "additional" review–but the wording here suggests that at least some experiments like this might be worth funding. Mad scientists must be rubbing their hands together in glee.

And finally, just last week NIH announced it will end the moratorium on gain-of-function research. (They made this announcement just a week before Christmas, when many people are probably not paying attention. Coincidence? Perhaps.) In his statement announcing the end of the moratorium, NIH Director Francis Collins wrote:

"I am confident that the thoughtful review process ... will help to facilitate the safe, secure, and responsible conduct of this type of research in a manner that maximizes the benefits to public health."

I am not so confident. Harvard's Marc Lipsitch, one of the leaders of the Cambridge Working Group, commented that "we don't need to do these dangerous experiments. Indeed there are many ways that can (and have) been used to answer the public health question with greater generality, little to no safety risk, and much lower cost."

But just in case there is some question, let's weigh the pluses and minuses, shall we?
Pluses:

• Creating novel pathogens might lead to insights in the basic biology of viruses and bacteria.
• Creating hard-to-kill pathogens might help us develop better anti-virals and anti-bacterials, although more effective strategies already exist.

Minuses:

• The viruses could accidentally escape, and millions of people could die.
• The viruses could get into the wrong hands, and millions of people could die.

I don't know about you, Dr. Collins, but I'm leaning towards banning such research permanently.

How to stop Ebola: ban air travel from West African countries

Countries in which Ebola virus has appeared in the past.

I never thought I’d find myself agreeing with Louisiana governor Bobby Jindal. But this week, Governor Jindal called for a ban on air travel to the U.S. from the countries where the epidemic is present. He’s right: a flight ban is the best way to keep Ebola from spreading. 

In the world of infectious diseases, we often hear the phrase that the next epidemic is “one flight away” from the U.S. That’s true—but we don’t usually know where that flight will originate, so we can’t simply ban all flights to the U.S. from everywhere. With Ebola, though, we know the source: the epidemic is confined to Liberia, Sierra Leone, and Guinea. 

As the Ebola crisis has grown in West Africa, the need to stop its spread has grown ever more urgent. The number of cases is now over 20,000, and the CDC estimates that by January, Liberia and Sierra Leone will have 1.4 million people with Ebola infections. These are frightening numbers.

The Ebola virus has no treatment and no cure, although some promising research is under way (as I’ve written about previously). According to the WHO, the Ebola fatality rate is 50%. This makes it one of the deadliest diseases known to affect humans.

And now, alarmingly, Ebola has appeared in the U.S., in an airplane passenger who traveled from Liberia to Texas. This one individual has exposed as many as 114 others, all of whom are now being followed by the CDC.

In a press briefing yesterday, CDC Director Tom Frieden offered this reassurance:

“We know how to stop outbreaks of Ebola.  In this country, we have health care infection control and public health systems that are tried and true and will stop before there's any widespread transmission.  The core of that, the way to stop Ebola in its tracks is contact tracing, and follow-up.”

Dr. Frieden is correct that we can stop an outbreak, if we can find everyone exposed and quarantine those who might be infected. But he dismissed the notion of simply banning travel: 

“Although we might wish we could seal ourselves off from the world, there are Americans who have the right of return.  There are many other people who have the right to enter into this country.”

I'm not arguing that we should “seal ourselves off from the world." (Nor, I suspect, is Governor Jindal.) We are arguing to seal off just three small countries in West Africa, until the epidemic passes. This would not be a difficult ban to implement and enforce. For Americans who wish to return from those countries, we can require a quarantine protocol, which the CDC already has in place at many airports. As Jindal said:

"How exactly would stopping the entry of people potentially carrying the Ebola virus be counterproductive? This seems to be an obvious step to protect public health in the United States.”

CDC Director Frieden also revealed yesterday that in the month of September, screening at airports in African countries has turned away 77 people who had signs of possible Ebola infection, including 17 in the month of September. Although Frieden used this example to illustrate the effectiveness of CDC’s screening program, it also shows that sick people are trying to board planes to the U.S. As the outbreak grows, it will grow increasingly difficult to keep all Ebola-infected passengers—who don't show signs of infection for several days—off those planes.

Director Frieden is correct that we can stop outbreaks of Ebola here, because we live in a modern country with good infection control systems. But prevention is better than control. So much as I hate to admit it, Bobby Jindal is right: we need a travel ban if we want to keep the Ebola virus out of the U.S.

A breakthrough cure for Ebola

Ebola is one of the nastiest, most frightening viruses known to man. Its victims suffer fevers, muscle weakness, and other symptoms that progress to severe bleeding, both internal and external, that eventually causes them to bleed to death. All known strains of Ebola virus have very high mortality rates, ranging from 25% to 90%, and there is no cure. Ebola virus was the subject of a dramatic and frightening 1995 disaster movie, Outbreak, starring Dustin Hoffman, Rene Russo, and Morgan Freeman.

Last week, in what may be the biggest medical breakthrough of its kind in years, a group of scientists published results in The Lancet describing a completely new type of anti-viral treatment that appears to cure Ebola. They report a 100% success rate, although admittedly the test group was very small, just 4 rhesus monkeys.

This is a breakthrough not only because it may give us a cure for an uncurable, incredibly nasty virus, but also because the same method might work for other viruses, and because we have woefully few effective antiviral treatments. We can treat bacterial infections with antibiotics, but for most viruses, we have either a vaccine or nothing. And a vaccine, wonderful as it is, doesn’t help you after you’re already infected.

The scientists, led by Thomas Geisbert at Boston University, used a relatively new genomics technique called RNA interference to defeat the virus. Here’s how it works. First, a little background: the Ebola virus is made of RNA, just like the influenza virus. And just like influenza, Ebola has very few genes - only 8. One of its genes, called L protein, is responsible for copying the virus itself. Two others, called VP24 and VP35, interfere with the human immune response, making it difficult for our immune system to defeat the virus.

Geisbert and his colleagues (including scientists from Tekmira Pharmaceuticals and USAMRIID) designed and synthesized RNA sequences that would stick to these 3 genes like glue. How did they do that? We know the Ebola genome’s sequence – it was sequenced way back in 1993. And we know that RNA sticks to itself using the same rules that DNA uses. This knowledge allowed Geisbert and colleagues to design a total of 10 pieces of RNA (called “small interfering RNA” or siRNA) that they knew would stick to the 3 Ebola genes. They also took care to make sure that their sticky RNA would not stick to any human genes, which might be harmful. They packaged these RNAs for delivery by inserting them into nanoparticles that were only 81-85 nanometers across.

In the key experiment, the scientists infected rhesus monkeys with a dose of Ebola that was 30,000 times greater than the normal fatal dose. They injected the siRNA treatments 30 minutes later, and again each day for 6 days. All the monkeys survived with no long-term effects.

When I read this story in The Lancet, my first reaction was: wow. A brand-new antiviral treatment, and against Ebola? In a commentary in The Lancet, Heinz Feldmann wrote that we are “in desperate need of approved countermeasures against Ebola-virus infections,” and called the new study a “milestone.” That’s putting it mildly.

Somehow, except for the UK Daily Mail, the major media outlets seem to have entirely missed this story, which I think is by far the biggest medical story of the week, if not the year. Ebola virus doesn’t get much attention (notwithstanding the 1995 movie about it), primarily because it occurs in central Africa. But air travel has made our world much smaller, and even a relatively isolated virus could easily get out of control.

There’s still a much work needed to turn the new Ebola treatment into an approved drug, but the prospect of a cure is suddenly very real, and the techniques used to create it are truly remarkable.