Friday, March 15, 2024

ODNI 2024 Annual Threat Assessment: Health Security


#17,950

While this blog is normally narrowly focused on emerging infectious diseases - with a smattering of individual and community preparedness - from time to time we take a look at (mostly governmental) reports on wider threats. 

In the past we've looked at such diverse topics as:

FEMA: Preparing the Nation for Space Weather Events




Every year the Office of the Director of National Intelligence (ODNI) releases an unclassified report on threats to our national security, which covers a wide range of scenarios.  One of the threats mentioned every year has been that of a pandemic, although prior to 2020 it was given fairly short shrift.

The only mention of the word `pandemic' in the 2019 edition, was limited to:

Global Health 

We assess that the United States and the world will remain vulnerable to the next flu pandemic or large scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support. 

Although the international community has made tenuous improvements to global health security, these gains may be inadequate to address the challenge of what we anticipate will be more frequent outbreaks of infectious diseases because of rapid unplanned urbanization, prolonged humanitarian crises, human incursion into previously unsettled land, expansion of international travel and trade, and regional climate change.

In light of the events of the past 4 years, it is no surprise that in the latest edition - published last week by the ODNI - the issue of global health threats is given more attention.  

Some of the issues discussed include increased risks for future pandemics, failures of nations to report outbreaks in a timely fashion (as required by international law), and the potential risk from lab leaks. 

In the report's forward, the agency warns:

The accelerating effects of climate change are placing more of the world’s population, particularly in low- and middle income countries, at greater risk from extreme weather, food and water insecurity, and humanitarian disasters, fueling migration flows and increasing the risks of future pandemics as pathogens exploit the changing environment

 

Health Security 

National health system shortfalls, public mistrust and medical misinformation, and eroding global health governance will impede the capacity of countries to respond to health threats. Countries remain vulnerable to the introduction of a new or reemerging pathogen that could cause another devastating pandemic. 

  • The predicted shortage of at least 10 million healthcare workers by 2030 will occur primarily in low- and middle-income countries. 

  • Global health governance and adherence to UN health protocols may be eroded during the coming year by continued disregard by governments of international health institutions and norms and adversary interference in global health initiatives. 

  • Drivers for infectious disease emergence are on the rise, including deforestation, wildlife harvesting and trade, mass food production, and lack of international consensus on biosafety norms. These drivers are compounded by factors that facilitate global spread, such as international travel and trade, inadequate global disease surveillance and control, weakened health systems, public distrust, and medical misinformation. 

  • Significant outbreaks of highly pathogenic avian influenza, cholera, dengue, Ebola, monkeypox, and polio have stretched global and national disease detection and response systems further straining the international community’s ability to address health emergencies.

The origins of the SARS-CoV-2 virus remains murky, as China continues to resist sharing information: 

 

While much of this 41-page report is focused on state actors (China, Russia, Iran, North Korea, etc.), it also covers growing technological concerns which include the proliferation of AI, Cyber threats, and synthetic biotechnologies (see National Academy Of Sciences: Biodefense in the Age of Synthetic Biology).

Disruptive Technology 

New technologies—particularly in the fields of AI and biotechnology—are being developed and are proliferating at a rate that makes it challenging for companies and governments to shape norms regarding civil liberties, privacy, and ethics. 

The convergence of these emerging technologies is likely to create breakthroughs, which could lead to the rapid development of asymmetric threats—such as advanced UAVs—to U.S. interests and probably will help shape U.S. economic prosperity. 

• For example, stealth technology has significantly impacted conventional defense systems and has driven the efforts of varying countries to start a new round of research on detection systems and guided weapons. A key trend is the development of advanced materials with enhanced stealth properties with reduced reflection and absorption properties. 

Advances in AI and new machine learning models are moving AI into its industrial age, with potentially huge economic impacts for both winners and followers and unintended consequences— from rampant deepfakes and misinformation to the development of AI-generated computer viruses or new chemical weapons. Generative AI is a means for discovering and designing novel technologies and advanced system-level processes that could strengthen a country’s technological, economic, and broader strategic competitiveness. 

• China is pursuing AI for smart cities, mass surveillance, healthcare, drug discovery, and intelligent weapons platforms. Chinese AI firms are already world leaders in voice and image recognition, video analytics, and mass surveillance technologies. 

• PRC researchers have described the application of generative AI to drug discovery as “revolutionary.” On average, it takes more than 10 years and billions of dollars to develop a new drug. AI can make drug discovery faster and cheaper by using machine-learning models to predict how potential drugs might behave in the body and cut down on the need for painstaking lab work on dead-end compounds.

• Russia is using AI to create deepfakes and is developing the capability to fool experts. Individuals in warzones and unstable political environments may serve as some of the highest value targets for such deepfake malign influence.

Innovators in synthetic biology probably will control new military and commercial applications and hold trillions of dollars in production capacity, including supply chains for products that vary from disease-resistant crop seeds to metals to pharmaceuticals. 

• Countries, such as China and the United States, that lead biotechnological breakthroughs in fields such as precision medicine, synthetic biology, big data, and biomimetic materials, will not only drive industry growth, but also international competition and will exert substantial influence over the global economy for generations 

Admittedly this report makes for sobering reading, and while there isn't much any of us can to mitigate most of these threats, we can be better prepared if, and when, the next crisis occurs. 

Each year FEMA conducts a nationwide poll on preparedness, and they released their 2023 survey last December. Even though these are self-reported assessments, and `being prepared' means different things to different people, they report some small progress over the past 12 months.

It is a mixed bag, however.  More people have assembled supplies, but fewer people report practicing emergency drills or habits More have learned their evacuation routes, but fewer have made a plan.  And while more have tested a family communication plan, fewer report having signed up for alerts or warnings. 

While you can't be prepared for every eventuality, there are some basic goals one should strive for.

So . . . if a disaster struck your region today, and the power went outstores closed their doors, and water stopped flowing from your kitchen tap for the next 7 to 14 days . . . are you ready with:

  • A battery operated NWS Emergency Radio to find out what was going on, and to get vital instructions from emergency officials
  • A decent first-aid kit, so that you can treat injuries
  • Enough non-perishable food and water on hand to feed and hydrate your family (including pets) for the duration
  • A way to provide light when the grid is down.
  • A way to cook safely without electricity
  • A way to purify or filter water
  • A way to handle basic sanitation and waste disposal. 
  • A way to stay cool (fans) or warm when the power is out.
  • A small supply of cash to use in case credit/debit machines are not working
  • An emergency plan, including meeting places, emergency out-of-state contact numbers, a disaster buddy, and in case you must evacuate, a bug-out bag
  • Spare supply of essential prescription medicines that you or your family may need
  • A way to entertain yourself, or your kids, during a prolonged blackout

If not, you've got some important work to do. A good place to get started is by visiting Ready.gov.