Bird Flu, Bioterror, and Bioerror

This week the prestigious science journal, Nature, published the methods and results of a groundbreaking new experiment in biotechnology, reigniting a firestorm that has been raging on and off for nearly a year. The reason for the controversy is the ghastly topic of the research paper: How to genetically engineer the avian influenza virus (H5N1) to make it more communicable.

Although H5N1 (i.e. “bird flu”) has existed in bird populations for decades, it entered the public consciousness in 2004, when human cases began surfacing in China and Southeast Asia. The cases were quickly linked to contact with poultry – mostly slaughterhouse workers or chicken farmers, who directly worked with chickens in insanitary conditions. H5N1 was far more virulent than the seasonal strains of influenza which have been circulating since 1918; over 60% of people who have contracted H5N1 in the past eight years have died from it. Fortunately, there has been no pandemic. Only 600 people worldwide are known to have had avian influenza. Although it appears that humans can acquire the disease directly from birds, there have been no known cases of human-to-human transmission – a prerequisite for a global pandemic. Although influenza viruses mutate very quickly, the lack of human-to-human transmission caused some complacency. Some epidemiologists even went so far as to state that human-to-human transmission of H5N1 might be impossible.

The new research blows that theory out of the water. Scientists at the University of Wisconsin and Erasmus Medical College succeeded in taking the H5N1 virus and combining it with the H1N1 (“swine flu”) virus. Swine flu is known to be easily communicable between humans but relatively mild; bird flu is known to be extremely deadly but difficult to transmit. By combining the two into a hybrid and making other modifications to the genes of the virus, scientists developed a “super-strain” of flu. They tested the virus on ferrets, which have an immune system very similar to humans. Not only did many of the ferrets die, but the disease was easily transmitted to other ferrets who were not directly exposed to the virus themselves.

The research has horrified many scientists. Governments remain gravely concerned about its publication in Nature. In the United States, the National Science Advisory Board for Biosecurity requested that Nature not publish the findings in the interest of national security. Although academia typically does not view censorship kindly, many scientists found themselves agreeing with the government. Biologist and Nobel-laureate Sir Richard Roberts said, “Someone is trying to make the most dangerous virus we can think of. I don't understand how one can justify that, unless there is no other way of getting the data that you're interested in.” The risks are huge: Nature published the methodology that the scientists used to create their super-strain of flu, potentially providing a blueprint for terrorists to replicate their efforts. Additionally, there is the concern that if research like this isn't shunned, it will continue apace and may one day escape the laboratory through simple error.

Other scientists believe that publishing the research is necessary, in order to prevent future outbreaks. They argue that if we can learn more about how influenza mutates and infects new people, we will be better prepared to deal with a future pandemic. They acknowledge the dangers of the research, but argue that there is no avoiding the fact that it will soon be possible to create bioengineered diseases, and it is better to be prepared for them when they do occur. Additionally, there is the possibility that H5N1 may eventually evolve into a more communicable form on its own, for which epidemiologists should prepare. Last month, the US government finally relented. The National Science Advisory Board for Biosecurity reversed itself, voting 12-6 to allow the publication of the research to proceed.

As it stands, I find myself on the side of those urging extreme caution with this type of research. Bioterrorism will be the greatest security threat of the early 21^st century; unlike nuclear weapons, biological weapons will soon be available to many people. Futurist Michio Kaku warns that in the not-too-distant future, creating new viruses may be as simple as typing base letters into a piece of software and having a computer assemble the DNA strand. When that happens, we may have no choice but to fund research to prevent diseases that do not yet exist in nature. But until then, it seems that the risks greatly outweigh the rewards.

Black Swan Events: Bioterrorism

The Genomic Revolution is a double-edged sword. As I mentioned previously, the benefits will be enormous. Genomics will allow us to have personalized, preventative health care, instead of mass-market sick care. However, there is also a ghastly dark side to the Genomic Revolution. We will soon face the truly horrifying prospect of bioterror (or bioerror.) When any college student has access to pathogens and the capability to modify them to make them even more virulent or transmissible, someone almost certainly will.

Within a few years, the genomes of nearly all human pathogens will be publicly available. This will be necessary in order to better understand these diseases and develop cures. However, those who wish to use this information to commit acts of mass murder will have access to it as well. Some diseases may not require very much modification to become even more deadly. The 1918 Spanish flu pandemic, which killed more people than World War I, is very genetically similar to many of the strains of flu that are still circulating to this day. Soon it will be possible for an individual to create a virulent flu strain like the Spanish flu by genetically modifying other strains.

Since genomics is essentially an information technology, it is possible to swap genes from one species into another. This is what allows agronomists to copy the cold-resistant genes of Arctic fish and paste them into tomatoes (in theory.) However, the same principle could be used by bioterrorists to create a Frankenstein’s monster, combining the worst traits of many diseases. Imagine an illness with the virulence of ebola, the transmissibility of the common cold, and the evolutionary adaptability of HIV. Such a disease is the stuff that nightmares (or B-movies) are made of. Yet it will eventually be possible for malevolent individuals or groups to create them.

If a manmade disease was sufficiently different from anything found in nature, it could prove devastating. We humans have had a chance to evolve alongside influenza, the plague, malaria, and other naturally-occurring afflictions. People alive today are mostly descended from the hearty individuals who survived earlier strains of these diseases. But we would not have evolved such immunities to manmade diseases. Just as the vast majority of Native Americans were decimated by European diseases to which they had no immunity in the 16th century, we could face the same prospect with manmade superplagues.

Fortunately, we have a defensive weapon in our arsenal that the 16th century Native Americans did not have. Just as genomics can create such frightening diseases, it holds the potential to cure them. Within a few years, it will be possible to sequence a genome in a couple hours. As our understanding of how genes work continues to grow, it will take less and less time to understand the genomes we sequence. Assuming that bureaucratic procedures were waived to combat a public health emergency, a cure for a manmade disease could be on the market almost as quickly as software antivirus programs are patched when new threats are discovered. Soon, naturally-occurring diseases could be a mere minor annoyance. The real public health danger could shift to the arms race between bioterrorists and scientists racing to cure their latest concoctions.

BLACK SWAN EVENTS:

By 2040 – A disease created or modified by humans has been released into the public. Probability: 90%

By 2040 – A disease created or modified by humans has killed at least 100,000 people. Probability: 75%

(I hesitated to even call bioterrorism a “Black Swan,” since that implies that the event is at least somewhat unlikely to occur. In my opinion, the danger of manmade diseases being released onto the public is not a question of if, but when and where. Since we cannot forecast this, it is unpredictable enough to be considered a Black Swan Event in my opinion.)

Black Swans

When predictions about the future are incorrect, it is often because the predictor assumed that history wouldn’t provide us with any surprises, which it almost invariably does. Nassim Nicholas Taleb refers to these events as black swans. It is extremely difficult to predict them in advance, but they have a drastic impact on world history. Examples include 9/11, the AIDS pandemic, the Islamic Revolution in Iran, the invention of nuclear weapons, the stock market crash of 1929, the 1918 Spanish Flu pandemic, or the outbreak of World War I.

You may notice that most of the events on this list are widely considered to be disasters. As Warren Buffett has said, “Surprises are nearly always bad.” However, this isn’t universally true. There are, on rare occasions, examples of positive black swan events.

For example, in 1968 Paul Ehrlich wrote The Population Bomb, which predicted a nightmarish future of overpopulation and mass famine. Ehrlich looked at the global population trends from recent decades and saw that people were reproducing at an alarmingly fast rate. Yet within just a few years of the book’s publication, global birth rates began to decline and the global food supply increased exponentially. Ehrlich completely missed two very important “positive” black swans: The widespread adoption of the birth control pill and the Green Revolution in India.

The purpose of thinking about potential black swan events is to plan for events that are individually unlikely to occur, but would have a profound impact on the world if they do. I’ve thought of a few black swan events to think about for the next decade:

• A nuclear war between India and Pakistan
• The democratization or fragmentation of China
• Ecological collapse, followed or preceded by abrupt climate change
• Bioterror or bioerror releases a manmade super-plague
• The invention of effective anti-aging medicine offers indefinite lifespans
• The assassination of a major world leader
• An especially nasty strain of avian or swine flu results in a global pandemic
• An American state votes to secede from the union
• A global financial collapse

Depressing, huh? I tend to agree with Buffett that surprises tend to be bad (with some exceptions). Positive events tend to be much more incremental and predictable than negative events. You may believe the events on my list are all unlikely to occur in the next decade, as I do, but that’s the whole point. We must anticipate unlikely events and make contingency plans in case they occur. Life's surprises can be just as important as its long-term trends.

What do you think are some other black swan events that could conceivably occur in the next decade?