Introduction to the Global Catastrophic Biological Risks Special Feature

The COVID-19 pandemic has caused approximately 20 million deaths worldwide (0.25% of the world's population) and brought health systems in many places to the brink of collapse. As tragic and consequential as this has been, future pandemics could be worse. As devastating as the health, economic, and societal effects of the COVID-19 pandemic continue to be, there are pathogens—naturally occurring and otherwise—whose impact could be much more severe than COVID-19. Examples include avian influenza strains that acquire the potential to spread efficiently between humans, or deliberately engineered biological weapons. Infectious disease pandemics are a very serious public health concern, and their impact can be so widespread and pervasive that society-wide preparedness efforts and plans for a coordinated response are needed to mitigate their harm.

In the years preceding the COVID-19 pandemic, the study of global catastrophic biological risks (GCBRs) emerged but was not prioritized or fully integrated with pandemic preparedness policy and practice. As the COVID-19 pandemic continues and other possibly more severe infectious disease threats could appear at any time, there is a need and an opportunity to integrate and advance GCBR awareness, prevention, and preparedness across national governments, international institutions, industry, and academia to save lives and protect humanity from future threats.

In this special feature, 4 papers respond to the following strategic question: “What lessons from the response to the COVID-19 pandemic should be captured and institutionalized and what other policy or technology advances are required to better prepare for a significantly more severe globally catastrophic infectious disease pandemic?”

In the COVID-19 pandemic, there were many breakdowns in international cooperation, including determining the basic facts about the origin of the virus. These challenges, including rampant misinformation and disinformation, are a wake-up call about how difficult attributing the source of future infectious disease outbreaks or bioweapons attacks could be. If strategic actors know that the world will be unable to determine the origins of a certain pathogen, then those pathogens become much more attractive tools. In their commentary, “Guarding Against Catastrophic Biological Risks: Preventing State Biological Weapon Development and Use by Shaping Intentions,” ¹ Jaime M. Yassif, Shayna Korol, and Angela Kane discuss mechanisms for strengthening transparency, attribution, and accountability so that the world of the future is less likely to have this problem.

Because no medical countermeasures had been designed for COVID-19 when it emerged, aspects of the response involved trying to repurpose existing countermeasures. In the future, the ability to quickly repurpose an existing treatment could be the difference between a catastrophe and a manageable situation, especially in the early days when no specific countermeasures are available. In “Lessons Learned From Limited Overlap of 15 In Vitro COVID-19 Drug Repurposing Screens,” ² Phillip J. Tomezsko, Cassandra W. Phillipson, and Matthew E. Walsh discuss proactive mechanisms that can be implemented now, to speed up the repurposing of drugs in a future emergency.

The start of the COVID-19 pandemic was marked by widespread and crippling shortages of personal protective equipment (PPE). In their commentary, “Innovate and Stockpile: Respiratory Protection for Essential Workers in a Catastrophic Pandemic,” ³ Nadia X. Montazeri and Jonas B. Sandbrink discuss mechanisms that would improve the quality and quantity of PPE in a future pandemic. Many thousands of lives could have been saved if we had better PPE stockpiles, and innovative work in this space is essential to pandemic resiliency.

One of the major success stories of the COVID-19 pandemic was Operation Warp Speed, ⁴ which delivered highly effective vaccines in record time. Is Operation Warp Speed a program that should serve as a standard for future infectious disease emergencies? In “Maintaining Warp Speed: Policy Requirements for a Just-In-Time, Capability-Based, Scalable Medical Countermeasure Research and Development Enterprise,” ⁵ Colin N. O'Leary, Julia Barnes-Weise, Kendall Hoyt, and Margaret Bourdeaux discuss the lessons learned from this successful policy and how they can be extended into the future to enable rapid production of novel medical countermeasures in a pandemic.

In the time ahead, the threat of infectious disease emergencies, pandemics, and GCBRs will not recede, and dedicated efforts to assess and meet these threats should be a policy and planning priority. This special feature provides clear examples of the kinds of assessments and innovative planning efforts that are needed to meet this task.