Bio surveillance: preparing for the next pandemic 


Wuhan Institute of Virology, Hubei province, China – the centre of the controversial theory that SARS-CoV-2 may have emerged from the research facility following a lab accident.

By Mr. Andy Oppenheimer, Former editor CBNW

On 28 February, FBI Director Christopher Wray stated that his organization believed Covid-19 most likely originated in a Chinese government-controlled laboratory in Wuhan – the city from where the novel coronavirus SARS-CoV-2 emanated.  

Director Wray’s statement arose out of an updated and classified 2021 US Department of Energy Report for a new government intelligence assessment. This states that a lab accident at the Wuhan Institute of Virology was most likely responsible for the deadly pandemic that has killed nearly seven million and infected 676 million worldwide, left millions more suffering long-term sickness and multi-organ consequences, continues to spread as multiple variants, and has brought many economies to a standstill during lockdowns through 2020 and 2021. 

Lab leak or from a bat? 

For much of the pandemic period many agencies – most notably the WHO and a variety of other health and other professionals – have said with a “low level of certainty” that the virus was a zoonotic pathogen. That is, it jumped from bats to humans. This in itself is hard to prove and involves comparing the viral genetics in the first infected victims with animal virus sequences to ascertain the host.  

At present, the type of animal or vector from which the virus jumped to humans has still not been confirmed. Poor husbandry, bad practices – most notably, the live animal trade in open ‘wet’ markets – are blamed as well as other contributory factors like overpopulation, increased travel, and climate change.  

Problems of bio-attribution 

As a highly controversial theory, the lab leak notion has been heavily politicized. There is even accusation from some sources that the virus was deliberately released as a bioweapon. Any hypothesis would have to be backed by verifiable scientific evidence – a tall order given the virus originated in an authoritarian and, by and large, closed vast country. All that aside, the theory cannot be ignored.  

“It could well have resulted from a natural spillover, but it could equally be the result of research-related activity, such as a lab leak or fieldwork incident. There simply is no hard evidence either way, just historical precedent, and circumstantial evidence.” 

Dr Filippa Lentzos, King’s College London 

Whichever Covid origin theory is believed, after three-plus years of this scourge there is no definite conclusion on the virus’ origins. This has proved just how difficult attribution of any biological organism spread can be made – whether the organism is man-made or proliferated among humans and animals by Mother Nature. Pathogens are basically invisible and unlike chemical and nuclear releases, are very difficult to trace back to where they started.  

A negative NHS Covid Rapid Antigen (lateral flow) test result. Two red lines signify a positive, which in the first two years of the pandemic required a patient to isolate for two weeks, then ten days. Repeat tests are often necessary to confirm an infection since the Omicron variants emerged. Photo courtesy of the author.

Previous lab leaks 

The preponderance of accidental lab leaks may indicate that this can happen, has happened before, and can happen again.  

The shocking evidence of at least 100 safety breaches have occurred in the past five years in the UK alone – in labs where invaluable research on dangerous pathogens is conducted. In one incident, live anthrax was sent from a government facility to labs across the country, which exposed scientists to the disease. In another incident, tears in isolation suits were found at a facility handling animals infected with the deadly Ebola virus. 

Elsewhere, arguably the most notorious accidental release was of anthrax spores from a Soviet military research facility near Sverdlovsk, Russia (now Yekaterinburg) in April 1979, resulting in at least 100 fatalities. 

More recently, and somewhat relevant, was when two researchers at the Chinese Center for Disease Control and Prevention contracted the SARS virus in Beijing around April 2004 then spread the infection to around six others. 

Biosurveillance: policy 

Many specialist teams and committees of experts in epidemiology, microbiology and virology have worked extensively and intensively for many years on origins of pandemics and providing advice to government on response policies.  

It should be noted that the specific body set up for this very purpose in the UK – the Threats, Hazards, Resilience and Contingency Committee – was disbanded by PM Boris Johnson only days after he was voted into office. In the US, the Global Health Security and Biodefense unit was stood down by President Donald Trump in 2018. 

Accurate atomic model of the external structure of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), which has morphed into multiple variants since the initial outbreak at the end of 2019. 
Credit: ©Alexey Solodovnikov and Valeria Arkhipova/Wikipedia 

Tracking Infections

Also, once notification of Covid test results to the UK NHS and shielding stopped being a requirement, accurate statistics on case numbers and infectivity rates became impossible to compile accurately. In any outbreak the incubation period (when no symptoms present), variants, and false diagnoses also complicate the epidemiological picture. 

The pandemic has enhanced fears about all forms of biological threats. However, incidents of deliberate biological release are far outnumbered by disease outbreaks.  

According to a June 2022 Government Accountability Office (GAO) report, a nationwide situational awareness and biosurveillance network would facilitate early detection and rapid response at the outset of a pandemic.  

From 2006 the Department of Health and Human Services was required to take steps to improve situational awareness of public health threats, but such a capability was still not operational. 

Transmission electron microscopic image of an isolate from the first US case of COVID-19, formerly known as 2019-nCoV. The spherical viral particles, colorised blue, contain a cross-section through the viral genome, seen as black dots. Credit: ©CDC

How biosurveillance works 

Biosurveillance involves real-time reporting of communicable disease outbreaks either through individual testing (as we did with Covid), local general practitioners (GPs), pharmacies, and hospitals reporting a new infectious outbreak trend to local and national health authorities. As soon as this happens, an emergency response (such as a lockdown) can be triggered beyond towns and national borders, as epidemics often rapidly become pandemics.  

Event-based internet surveillance systems use multiple data collected from social media, lab detection, outpatient and emergency admissions, diagnoses, over-the-counter drug sales, insurance claims and absenteeism. 

Biosurveillance systems 

As with most other 21st century arenas and arising out of the Covid pandemic, biosurveillance and biohazard detection have been transformed by IT: big data and data analytics. 

In the UK, a “refreshed” biosecurity review aims to spot multiple biological risks: deliberate biological attack, infectious disease outbreaks, antimicrobial resistance, animal, and plant diseases that pose a risk to human health, and the accidental release of viruses such as foot-and-mouth disease. 

In the US, the stated goals of the CDC (Centers for Disease Prevention) are to best utilize electronic health data, integrating biosurveillance data so health-related information can be shared rapidly, and strengthening global disease detection and cooperation with global health partners. 

In the EU, the European Centre for Disease Control and Prevention (ECDC) in Solna, Sweden was set up in 2005 for the 27 Member States, Iceland, and Norway to develop surveillance systems for early warning of infectious disease outbreaks.  

The ECDC in Solna, Sweden, was established in 2005 for the 27 Member States of the EU, as well as Iceland and Norway, to develop early warning surveillance systems for infectious disease outbreaks. Credit: ©ECDC

EpiPulse is an online European surveillance portal which combines previously independent surveillance systems. The platform enables collection, analysis, and dissemination of indicator and event-based surveillance data, including global epidemic intelligence and whole-genome sequencing. 

The US SenseNet network aims to develop multi-tiered aerosol detection sensors and an information management system to provide real-time information seconds to minutes following a bio-attack or release. This includes source location, aerosol dispersion, and extent of contamination from a release and instant data to public health officials notifying an aerosol attack.  

Syndromic Surveillance 

Since 70 mostly zoonotic pathogens emerged from 1967 to 2009, a secondary system was set up in the US, called Syndromic Surveillance, focused on health-related data collection reporting from clinical laboratories, pharmacies, emergency rooms, primary care physicians, intensive care units, and hospital admission and discharge data.  

Biosurveillance and syndromic surveillance work together for early detection of deadly pathogens to lessen morbidity and mortality. Hospitals and pharmacies would have to promptly provide antidotes, antibiotics, and antitoxins in large quantities. This was found wanting during the pandemic. 

About the Author:

Andy Oppenheimer is author of IRA: The Bombs and the Bullets – A History of Deadly Ingenuity (2008) and a former editor of CBNW and Jane’s NBC Defence. He is a Member of the International Association of Bomb Technicians & Investigators and an Associate Member of the Institute of Explosives Engineers. He has written and lectured on CBRNE and counterterrorism since 2002. 

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