Back in 1980, the world attained a major victory. Smallpox, a destructive and often lethal infectious disease that had plagued humanity for centuries, was declared eliminated.
Things have evolved since then. Rigorously engaging, the only officially known stock of the virus that triggers smallpox is secured in two high-security biosafety labs in the US and Russia. Unofficially, however, it’s a different account.
In 2017, scientists in Canada triggered an uproar when they tailored together a synthetic version of an extinct horsepox virus in the lab, applying mail-order scraps of cloned DNA.
This controversial chimera wasn’t smallpox, but it – and the methods used to spawn it – were comparable enough that critics cautioned the world was now more susceptible to a reemergence of the smallpox scourge.
Over these kinds of fears, the US government went as far as authorizing a drug last year to treat smallpox – a disease that doesn’t even currently exist – in case it ever does come back again through some kind of bioterrorist attack.
To check out what this kind of hypothetical threat could look, scientists in Australia a short while ago led a complex international simulation of such an attack, called “Exercise Mataika”.
“Using mathematical modelling of smallpox transmission, we simulated a worst-case, large scale bioterrorist attack,” points out infectious disease epidemiologist Raina MacIntyre from UNSW in Sydney.
The ruse, carried out in August last year and currently reported in two separately published scientific reports (here and here), anticipated what might occur if an engineered smallpox attack happened in the Asia Pacific region.
The scenario begins in Fiji.
“A first case of hemorrhagic smallpox occurs in a private hospital in Fiji, but the diagnosis is missed, as clinicians are not familiar with the disease,” researchers reveal, in a overview of the exercise.
“It is not until multiple cases are reported to the Ministry of Health and Medical Services that smallpox is considered as a diagnosis.”
As a result of modelling applied to underpin epidemic projections, the hypothetical outbreak spreads to 200 individuals, with a fatality rate of about 40 percent.
The local health system becomes stressed, and media reports produce a mass freak out. It takes 13 days for the smallpox virus – variola major – to be discovered.
The World Health Organisation (WHO) declares an emergency and starts deploying vaccines, while Interpol pinpoints the outbreak as a bioterrorism attack.
Airports and ports set out to close, but with over 2,000 cases and numerous doctors now dying, nurses call a strike. Then, as 32,000 vaccine doses get to Fiji, a greater scale attack happens in a much larger and more populous country in Asia.
“In a worst-case scenario, at the peak of the epidemic, worldwide, only 50 percent of smallpox cases are isolated… and only 50 percent of contacts are tracked and vaccinated, causing a catastrophic blow-out in the epidemic,” the researchers reveal.
“Under these conditions, modelling shows it will take more than a billion doses and 10 years to stop the epidemic.”
Issues get worse.
“In the final phase of the epidemic, which becomes a pandemic, the workforce is decimated, leaving critical infrastructure, transport, power, communications and food supplies compromised,” the authors compose.
“Trust in government and authority structures has disappeared, and legitimate attempts at communication by authorities are viewed with suspicion and fuel conspiracy theories.”
Fortunately, this catastrophic scenario remains strictly hypothetical for the moment, but experts claim we need to run tests like this – particularly since they reveal how unprepared we are for what could one day materialize for real.
“We must recognise the challenge that this situation presents to society,” details biosecurity expert Michael Osterholm, the director of the Centre for Infectious Disease Research and Policy (CIDRAP) at Minnesota University, in a commentary on the exploration.
“The results of the exercise are sobering… the results and lessons learned should be considered by every country in the world.”
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