Global Catastrophic Biological Risks

Transcription

1 Global Catastrophic Biological Risks

2 Working Definition of Global Catastrophic Biological Risks (GCBRs) Events in which biological agents whether naturally emerging or reemerging, deliberately created and released, or laboratory engineered and escaped could lead to sudden, extraordinary, widespread disaster beyond the collective capability of national and international governments and the private sector to control If unchecked, global catastrophic biological events would lead to great suffering, loss of life, and sustained damage to national governments, international relationships, economies, societal stability, or global security 2

3 Arguments for attention to Global Catastrophic Biological Risks Extraordinary consequences Potentially tractable problems Naming this set of risks can help us better communicate Could help us work to prevent, diminish consequences Scientists have helped drive global concern or action on other widely accepted global catastrophic risks e.g. nuclear weapons, climate change, AI 3

4 1918 Influenza Killed estimated 50M (20-100); high death rates in young adults; 1-2.5% CFR; exacerbated by troop congregation and movement involved in WWI Extreme economic and social disruption in affected cities; impact on govs, society, and economies not sustained over long run If happened now o Impact would depend on speed, character of med/ph, pharma, gov, societal response o o Antivirals, vaccine, modern medical care Global travel could spread it further and faster Global impact o High absenteeism - illness, fear, or gov policy; big interruptions to modern society o Public reaction to government response o Impact on electric grid, public safety, critical infrastructure; air traffic, commerce, military o Conflict between countries with access to meds, vaccine; vs others without access 4

5 H5N1 Starting , great alarm over the pandemic potential of the H5N1 flu; fastspreading epizootic among birds throughout Asia, Europe, and Africa. Today sporadic outbreaks of H5N1 in poultry, no sustained human to human transmission; hundreds of human cases over yrs with CFR ~50%, If virus evolves to be readily human transmissible with high CFR through natural evolution or lab manipulation would be a catastrophic event Virus with these properties would lead to great suffering & loss of life, could lead to great damage to national govs, international relationships, economies, societal stability, and global security Extraordinary actions by govs and industry to develop vax and therapies might diminish consequences, but would take time, terrible consequences in meantime 5

6 Smallpox Prior to 1977 erad, endemic in much of the world, primarily affected children, CFR ~ 30%, killing 2M /yr before erad campaign Most feared, devastating when introduced into immunologically naïve pop When smallpox, measles, and other diseases came to Western Hem in 1492, explosive epidemic killed ~ 90% over century; native societies decimated, social order and economies collapsed If smallpox reintroduced, could spread quickly in highly susceptible population. o Now, naïve population again but globally naïve, not one Hem o o Societal impact of reintroduction of smallpox would be function of efficacy of response PH measures (e.g. isolation, quarantine, infxn control, ring vaccination) could significantly slow and potentially contain spread, but would depend on a lot Depending on global response, availability of vaccine, and gov policies, reintroduction of smallpox could have global catastrophic consequence 6

7 Characteristics of Future Pandemic Pathogens Highest risks: resp transmissible RNA viruses; cytoplasmic replication cell; segmented genome, smaller host genome size, high host viremia; zoonotic relationships No perfect rules: e.g. smallpox is DNA virus that replicates in nucleus H7N9 considered to be of greatest pandemic risk by CDC Influenza Rapid Assessment Tool (IRAT); other orthomyxoviruses Other resp transmissible RNA viruses o Paramyxoviruses, esp 3 genera: respirovirus, henipavirus, rubulavirus; Pneumoviruses; coronaviruses; Picornaviruses, esp 2 genera: enterovirus and rhinovirus Transmission characteristics, Rx, Vax, etc place limits on pandemic potential of other classes of microbes, but limits may not be immutable (e.g. change in thermal range for fungi; expanding vector range; or loss of bacterial Rx options) Characteristics of Pandemic Pathogens Adalja et al, May

8 Possible Future Global Catastrophic Risks Targeted Population Threats - Biotechnology will allow targeting of pathogens against specific populations with shared genetic history Novel Strains of Known Contagious Pathogens - creation of novel strains of known viruses never detected in nature, and to which no population has prior immunity. E.g. deliberate or accidental release of novel high virulence strains (eg H5N1) engineered to become highly transmissible viral strains Widespread Eradication of Food Sources - Possible to target animal and plant vulnerabilities with precision; if plant or animal pathogens were engineered to spread widely in world in crops or herds, could be food shortages, famines, major consequences for humanity Novel or Artificial Organisms Harmful to Existing Life the design of novel organisms, novel genetic code that have capacity for harm 8

9 Economic studies on Pandemics Pike, J et al (including Daszak) Proc Natl Acad Sci U S A Dec 30; 111(52): Concludes pandemic mitigation program saves $360B over next 100 yrs Fan V, Jamison D, Summers, L. Bull World Health Organ. Pandemic Risk: How large are the expected losses? 2018 Feb 1; 96(2): Loss of $500B/yr globally, inclusive of costs of lives lost and loss of national income Jonas O, Pandemic Risk. World Bank Working paper 2013 Describes range of different economic impacts and contributors Burns, A, et al Evaluating the Economic Consequences of Avian Influenza. World Bank report 2006 Loss of $1.5T in Global GDP in 1918 like event 9

10 More economic study about Catastrophic Bio Risks Studies of pandemics with CFR >1918 influenza Studies that take into consideration economic losses in addition to national income and lives lost, w potential for: o Prolonged societal instability o Prolonged interruption of international trade o Collapse of industries o Collapse of governments Pandemics with different dynamics than influenza, o Smallpox event that leads to endemic spread again o Deliberately initiated events Take into account a new (much?) smaller global GDP Studies beyond influenza, e.g. smallpox 10

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12 HIV Since HIV pandemic s start, > 70M infected w HIV, ~ 35M died HIV started as universally fatal; now chronic treatable disease w advances in Rx & prevention, though Rx & prevention not evenly distributed between countries Is HIV GCBR? depends up perspective across time and geography In more developed countries, effective prophylactics and Rx, strong health infrastructure have led to substantial containment of HIV Vs ~ 70% of people w HIV live in sub-saharan Africa where life expectancy reduced by decades, GDP affected, high rates of orphanhood, disrupted family structures have reshaped society If HIV had happened before modern PHARMA and science? Vs. If HIV happened in world where everyone could be treated? 12