A common expression heard in the military is, “we’re always fighting the last war.” In the face of the global response to the COVID-19 crisis, the “last war” was the influenza pandemic of 1918.
By Diane DiEuliis, Peter Emanuel, James Giordano, and Alexander Titus
Although history provides invaluable lessons, it’s vital to re-examine the issues, problems, and solutions of the past in light of the circumstances, capabilities, and complexities of the present. The COVID-19 pandemic has created a dilemma of ensuring public safety and health, while at the same time attempting to stabilize and sustain the economy.
Meanwhile, obviously beneficial, available advanced technologies are not being fully used to maximize ethically sound, effective, and efficient approaches to reducing the pandemic effects on our societies and our economies. If there was ever a time to put such tools to use, it is now.
Platforms for disease surveillance data need to be modernized
Testing affords an understanding of disease characteristics and patterns — such as incidence, prevalence, recovery, and demography — and should have begun much earlier. Technologies for testing viral infection and exposure are mature, but they are uncoordinated and unlinked to scale-up pathways best found in the private sector. Genomic tests could reveal data on who is most at risk, and who is likely to be resilient. Thus, crucial data are absent that are needed to inform decision-making about the extent of physical distancing, implications for socio-economic revitalization, and readiness of U.S. defense forces.
Early recognition of infectious diseases like COVID-19 requires a globally distributed array of hardware and software, placed in enough locations to create a network of linked collection sites. This requires the development of biosurveillance systems through collaborative ventures that involve strategic allies and public-private partnerships as well as international competitors. Such capability and cooperation do not exist at this time — either across the U.S. federal government or with many of our global partners. Mechanisms for cooperative surveillance with global competitors, while admittedly difficult, are currently strained, and therefore tenuous. Of course, caution and considerable deftness are required to realize such “cooperative competition,” and this requires a more trusting reliance upon intelligence and diplomatic services.
Advanced computational tools should be used regularly
Artificial intelligence, machine learning, and digital health approaches should be employed for modeling the potential spread of the virus, and identification, design and development of testing and therapeutic — if not preventative — interventions. AI and digital health were not part of preparedness protocols in the event that the most concerning pathogens were to become pandemics. Such preparedness would be “ahead of the curve” if and when the pandemic began — rather than having to “jump-start” such efforts in pandemic response in the middle of a rapidly evolving crisis.
Of course, any approaches to enable and provide individuals’ real-time medical data create ethical, legal, and social concerns in both civilian and military settings. Legal measures need to be developed to prevent or mitigate potential bias in treatment and regard and to reduce the risk and possible effects of data hacking.
Supply chains also require technology modernization. The COVID-19 effects on global trade have shown us the vulnerabilities in U.S. supply chains, their foreign dependence, and have revealed the need for more flexible and expedient supply lines. That requires rigorous inspections of imports, exploring innovative manufacturing technologies, and protecting against single-point failures from abroad.
Many companies in the private sector have demonstrated that they can rapidly and flexibly steer biotechnology platforms toward the production and scaling of diagnostics and medical molecules, assisted by computational tools like the ones suggested above. These efforts should more regularly reinforce traditional supply chains.
It’s not 1918, and it doesn’t have to be again
The COVID-19 crisis should be regarded in the literal sense — a time of change. There are lessons to be learned from the pandemic of 1918 that can be applied to the here-and-now. Just as systems of medical response were threatened, prompted to respond, and changed by the pandemic of 1918, so too must those infrastructures and functions of the government, civilian and commercial sectors of today.
Current emerging biotechnologies could — and should — be engaged to develop advanced diagnostic tests and tools, create more accurate epidemiological models, innovate medical countermeasures and manufacturing platforms, and digitally engage U.S. citizens in the response. Such methods must be used within a networked biosecurity enterprise that engages a whole-of-nation system to enable a more effective and efficient response, whether or not the threats are natural or manmade. Such a system would enable capability to far better predict, prepare, if not prevent the next biosecurity issue, and not merely repeat the errors of the last.
Diane DiEuliis is a senior research fellow at the Center for the Study of Weapons of Mass Destruction, National Defense University. Peter Emanuel is a senior research scientist for bioengineering at Army Futures Command’s Chemical Biological Center. James Giordano is a professor at the Departments of Neurology and Biochemistry, and Pellegrino Center for Clinical Bioethics Georgetown University Medical Center, and a senior fellow at the Project in Biosecurity, Technology, and Ethics at the Naval War College. Alexander Titus is the chief strategy officer at the Advanced Regenerative Manufacturing Institute. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of Defense or the U.S. government.
This article on technology to fight pandemics originally appeared in National Defense.