SARS-CoV-2 and Research Funding: Do No Harm.

Abstract

Health SecurityVol. 18, No. 3 Letter to the EditorFree AccessSARS-CoV-2 and Research Funding: Do No HarmGeorge W. ChristopherGeorge W. ChristopherAddress correspondence to: George Christopher, MD E-mail Address: georgechristopher4@gmail.comGeorge W. Christopher, MD, is the retired Chief Medical Officer, Medical Countermeasure Systems Program Management Office, Ft. Detrick, MD. The views expressed herein are the personal opinions of the author.Search for more papers by this authorPublished Online:17 Jun 2020https://doi.org/10.1089/hs.2020.0053AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail The origin of the COVID-19 pandemic is controversial. The overwhelming consensus of the scientific community is that SARS-CoV-2 was introduced to the human population via zoonotic transmission in a live animal food market, possibly through an intermediate amplifying host1 in a pathway reminiscent of the 2002 emergence of severe acute respiratory syndrome. An alternative hypothesis is that the pandemic began with an accidental laboratory-acquired infection at the Wuhan Institute of Virology (WIV),2 a recipient of US government funding from the National Institutes of Health and the US Agency for International Development, to conduct research on enzootic bat coronaviruses.3 US State Department cables have expressed concerns regarding biosafety at the WIV.4 Whether the pandemic began from a laboratory-acquired infection or an unrelated zoonotic introduction, this sequence underscores the value of quality assurance as a prerequisite for funding by government and nongovernment organizations (NGOs).In the aftermath of COVID-19, prerequisites for funding of studies in biosafety level-4 (BSL-4) laboratories by international partners, either as direct recipients or as subcontractors, should include quality assessments using standards similar to those of the US Select Agents Program; periodic reassessments for the duration of the funded project; and robust capacities for outbreak response. Going beyond intramural laboratory occupational health programs and adherence to the reporting obligations of the World Health Organization International Health Regulations, capacities should include integration of containment laboratories, health departments, and clinicians and transparent reporting of pathogens being studied to local health departments and clinicians; provision of clinical case definitions and promotion of a high situational awareness and index of suspicion for laboratory-acquired infections to local medical communities; and anticipatory placement of diagnostic assays for potential laboratory-acquired infections. Effective response begins at the grassroots level.Proactive research on enzootic viruses before their potential introduction to the human population is a rational component of pandemic preparedness. Research by international partners in geographic “hot spots” is a logical step for the prevention and mitigation of emerging diseases. However, such research must be conducted safely. The US Department of State Biological Engagement Program,5 the US Department of Defense Cooperative Biological Engagement Program,6 and NGOs7,8 build international partnerships to enhance biosafety, occupational health, and personal reliability in containment laboratories. While it will be important to learn in retrospect the concerns raised in the State Department cables and the extent of quality assurance programs in the University of Texas-WIV collaboration,7 it will be consequential to apply lessons learned to future planning. Containment laboratories are regulated by national authorities. However, pandemics abrogate international borders. International risk management of BSL-4 laboratories could be based on precedents of the nuclear energy industry initiated by the United Nations International Atomic Energy Agency after the Chernobyl disaster. Safeguards to consider include inspections of BSL-4 laboratories by the World Health Organization.Transparent international collaborations to enhance biosafety and the strengthening of public health programs in regions that host BSL-4 laboratories can reduce the risk of outbreaks due to contagious laboratory-acquired infections. Furthermore, these measures can obviate future controversies regarding the origins of epidemics due to select agent pathogens as either laboratory accidents or natural emergence. Whether the COVID-19 pandemic originated from a laboratory-acquired infection, zoonotic transmission at the Huanan Seafood Wholesale Market, or another zoonotic introduction, laboratory safety at high-containment laboratories is in both national and international interests of global health.