Proceedings of a Workshop—in Brief

Assessing and Improving Strategies for Preventing, Countering, and Responding to Weapons of Mass Destruction Terrorism: Biological Threats

Proceedings of a Workshop—in Brief

Bioterrorism has been a significant concern of the United States for more than three decades, with development of numerous policies and programs in the late 1990s and early 2000s for preventing, deterring, detecting, responding to, and attributing biological threats from non-state actors. In December 2020, Congress passed the National Defense Authorization Act for Fiscal Year 2021, which includes a request for a National Academies of Sciences, Engineering, and Medicine (National Academies) effort to address the adequacy of strategies to prevent, counter, and respond to weapons of mass destruction (WMD) terrorism, and identify technical, policy, and resource gaps. The assessment encompasses both state-sponsored and non-state actor terrorism and acquisition or misuse of technologies, materials, and critical expertise involved in conducting WMD attacks. In response to this request, the National Academies held a virtual workshop on July 25, 26, and 27, 2022, focusing on attribution, threats of mis- and disinformation campaigns, and policy and programmatic gaps critical for countering biological terrorism. This Proceedings of a Workshop—in Brief provides the rapporteurs’ high-level summary of the topics addressed at the workshop. Although the proceedings highlights potential gaps and suggestions to address the gaps, these statements should not be viewed as consensus conclusions or recommendations of the National Academies.

BIOTERRORISM THREATS AND RISKS

Bioterrorism experts in the United States characterize biological threats differently, reflecting organizational and individual variation in the perception and existence of threats. One set of agencies, specifically those focusing on counterterrorism, view biological threats as comprising non-state actors conducting bioterrorism. These agencies assess the risk of non-state actor use of biological information, materials, and technologies for terrorism. Examples of non-state actors include domestic and foreign organized terrorists, apocalyptic groups, criminals, and lone actors, each with varying motivations for considering bioterrorism. Participants discussed threats presented by insiders, who may take advantage of their access to biological information and materials, knowledge, and skills (i.e., “rogue scientists”), as distinct from lone actors, who may not have the knowledge, skills, or access to well-equipped laboratories. Participants also expressed concerns about individuals who join laboratories with the intention of passing information to terrorist organizations. Insider threats may be motivated by grievances, greed,

or extremism. Ronald Schouten (District of Columbia Department of Behavioral Health) suggested that the greatest risk of terrorism results from polarization and extremism. In addition, Schouten, Yong-Bee Lim (Council on Strategic Risks), and Lauren Richardson (Merrick and Company) further indicated that the normalization of eccentricity contributes to the risk of bioterrorism. Though no evidence was provided, participants mentioned that in countries with facilities that have inadequate personnel reliability programs (i.e., programs that assess and monitor personnel to reduce security risks), terrorist organizations may recruit scientists more easily.

Within the context of insider threats, participants discussed the Do-It-Yourself Biology (DIY-Bio) community and its motivations for working with biology. Participants stated that DIY-Bio practitioners are not necessarily motivated by money or publication record. However, the DIY-Bio community is not a terrorist organization or entity.

Another set of agencies, including those focusing on nonproliferation, describes biological threats as natural, accidental, and deliberate use of pathogens and biological information, materials, and technologies. This definition includes concerns about biological agents that exist naturally but could be exploited for terrorist use (sometimes referred to as dual-use biological agents), use of gene editing and genomic sequencing for malevolent purposes, layered use of biological agents, covert delivery systems, and combinations of lethal and non-lethal agents. In addition, participants highlighted concern about the use of biological agents to target individuals, ethnicities, crops, and livestock and to take advantage of weakened populations.

Participants highlighted the merging of biological threats with information and cyber-enabled risks, including mis-, dis- and malinformation about biological incidents and facilities, as part of biological threat. Participants indicated that biological capabilities have become more accessible and distributed, which raises concerns about their use by non-state actors interested in bioterrorism.

Internationally, Wendin Smith (North Atlantic Treaty Organizations [NATO]) mentioned that NATO recognizes terrorism as a direct threat and anticipates the growth of threats involving chemical, biological, radiological, and nuclear (CBRN) agents as described in its strategic plan. Furthermore, NATO recognizes threats from the use of multiple techniques, which effectively blur the lines between attack types (e.g., use of disinformation with a kinetic attack). Additionally, the commercial availability of biotechnologies suggested to participants the importance of focusing on developments in the commercial sector as potential sources of tools for non-state actors. Accordingly, NATO recognizes several strategic enablers for addressing advancing biotechnologies in an integrated manner: capacity building for military and civilian personnel; intelligence and information sharing; partnerships and outreach; strategic communications and public diplomacy; scientific and technical collaboration; and medical support. Although Smith suggested that early component intervention (i.e., the points of intervention as new components are developed) as part of nuclear nonproliferation efforts may be analogous, using the same approach for addressing bioterrorism may be difficult given the dual-use nature of biotechnology. Integration of these cross-cutting capacities for addressing bioterrorism may be difficult.

When speakers were asked about why terrorists would prefer biological agents rather than other agents such as chemicals or explosives, one individual mentioned the potential terror caused by a biological attack. Multiple speakers, including Courtney Crooks (Georgia Institute of Technology), Richardson, and Schouten mentioned that biological threats may be chosen by adversaries because of their psychological aspects. These psychological effects may be influenced by individuals’ perception of actual threat and response to perceived threats, which include bioterrorism. This terror potential derives from the attack appearing without warning because biological agents are invisible and communicable agents have the potential to affect large population sizes. Furthermore, participants mentioned that anxiety may arise from both actual and imagined consequences.

The CBRN threat environment is becoming more complex, especially with the war in Ukraine and associated disinformation campaigns. Smith suggested that norms against the development and use of WMD are eroding, blurring the current understanding of WMD use, attacks, and war. An example discussed included the use of chemical weapons in various situations and environments, including the use of chemical weapons by Syria against civilians and targeted chemical attacks in the United Kingdom.

MIS-, DIS-, AND MALINFORMATION

Misinformation is the unintentional spread of false narratives and disinformation is the deliberate spread of false narratives. Both types of narratives can feed into each other where misinformation can be used deliberately and disinformation can be spread unintentionally. Incorporating real with false information (e.g., posting fake news stories on real news sites) helps to increase the credibility and acceptance of the mis- and disinformation. In addition, participants discussed the risks associated with malinformation, which is misrepresented or misleading information. In this case, the information itself is not false but without the appropriate context, it could be misinterpreted and misunderstood. Some participants referenced a significant erosion of norms against the development and use of biological warfare and a strong movement toward information warfare, particularly the use and dissemination of mis-, dis-, and malinformation.

Participants recognized that facts and images can be distorted rapidly, particularly in this age of massive information sharing, resulting in a discussion about the importance of immediate response and assessment when false stories emerge. As an illustration of the rapid spread of disinformation, Kimberly Glasgow (Applied Physics Laboratory, Johns Hopkins University) described an example in which approximately 250 articles connected Hunter Biden to the biological laboratories in Ukraine. These 250 seemingly independent articles all linked to and referenced each other. The volume of articles gave the appearance of more information and more corroboration than actually existed. By studying the flow of information in these articles, researchers revealed a different picture of the situation, specifically that Russia was involved directly in the articles about Hunter Biden. Orchestrating the creation of a large number of linked articles can result in false information being shared by credible media sources. Other techniques for disinformation that were discussed included conflating and collapsing nuances for a particular topic, debunking the fact-checking results and discrediting fact-checkers, depositing false information (i.e., priming) of preprint and other information repositories, discrediting real information, and manipulating public perceptions of information sources. Participants observed that ubiquitous electronic communications has transformed mis- and disinformation into complex problems. With the emergence of deep fake technology (a method of replacing a person’s image in an existing image or video with another person’s likeness) and other new means of spreading mis- and disinformation, concerns were raised about the seriousness of threats and the ability to counter false information. Many participants stated that countering lies with lies is counterproductive and instead, supported efforts toward educating the public about how to recognize deep fakes and understanding where fakes, particularly deep fakes, originate.

Mis-, dis-, and malinformation contribute to expanding challenges for countering biological threats, leading participants to suggest further study toward identifying mechanisms for countering the influence of false information. Indeed, several participants indicated the need for more research on effective methods for countering mis-, dis-, and malinformation, observing that existing research suggests that current approaches to countering such information are not as effective as previously anticipated. The unintentional spread of inaccurate information provides opportunities for the intentional spread of false claims about biological weapons, resulting in these claims being viewed as believable by a majority of the public. Therefore, participants suggested addressing both mis- and disinformation and recognizing that misinformation derives from a poor understanding of biological weapons. These perceptions may result, at least in part, from misinformation about the ease of acquiring biological weapons, specifically that acquisition of biological

weapons and expertise are easy, knowledge gained through scientific literature is easy, and new technologies make access to biological weapons easier. This narrative creates a sense of high vulnerability to biological threats. However, some participants said that few states have been able to produce biological weapons and no terrorist groups have created biological weapons successfully.

During this discussion, participants discussed Russia’s exploitation of disinformation about the United States funding biological weapons development in Ukraine as an example of the convergence of mis- and disinformation and biological threats. Russian disinformation cannot be countered without first refuting the misinformation that is in the public domain. This example provided an opportunity to discuss approaches for countering misinformation about biological weapons, including the development of a bio-dissuasion policy to help deter terrorist groups from pursuing biological weapons, and changing the public narrative about ease of acquisition and use of many biological agents from easy to acquire to hard to produce. This latter approach builds on a viewpoint that contrasted with other views shared during the workshop about the difficulty of designing, creating, and using biological weapons. Two policy options for combating misinformation were discussed, including (1) exploiting adjacent truth, which is real information that is unfavorable to the source of disinformation; and (2) turning disinformation against the source. Participants suggested using a state’s disinformation campaign against itself.

Participants indicated that more mis- and disinformation exists about biological weapons than nuclear or chemical weapons, perhaps because of the lack of reliable arbiters of the truth about biological weapons. Because the United States has a nuclear weapons program, authoritative experts exist to clarify technical points and serve as arbiters of the truth. However, because the United States ended its offensive biological weapons program in 1969, experts have little analogous expertise. In addition, participants compared fear from nuclear threats (e.g., Cuban Missile Crisis) and biological threats, which can result in sickness, a consequence about which they understand, fear, and respond.

U.S. POLICY LANDSCAPE FOR COUNTERING BIOLOGICAL THREATS

The U.S. policy framework for addressing bioterrorism is complex and fits within a general policy framework for countering terrorism. Participants stated that the current policy landscape for addressing bioterrorism focuses primarily on preventing, deterring, preparing for, detecting and monitoring (i.e., surveillance), mitigating, responding to, attributing to, and recovering from biological agents, specifically selected pathogens and toxins and their delivery means. Policies and programs include counterproliferation, which is a prerequisite for international cooperation, response exercises, detection and response capabilities, and other measures. Participants stated that for many of these policies one or more federal agencies are responsible. As an illustration, participants mentioned that the surveillance of unusual biological agents is not part of any specific program. Several participants highlighted the importance of greater coordination across federal, state, and local agencies and international partners given the complexity involved in addressing bioterrorism. Participants suggested better coordination between national security and intelligence agencies and the U.S. Department of Agriculture to address agriculture and food-related threats. The Biden administration is working within this complex policy framework to formulate a new biodefense policy that includes addressing bioterrorism and is based on a National Security Council review of biological preparedness policies. At the time of the workshop, the new biodefense policy and associated implementation plan were in development.¹ The administration’s view is that a comprehensive approach is critical for building trust and strengthening preparedness against known biological threats, including bioterrorism. In addition, participants discussed the need for advanced detection, response, and countermeasures against biological threats.

Participants restated long-standing concerns that addressing threats involving biological agents sometimes is viewed as less important than nuclear and chemical threats, even though biological agents are considered a WMD. Unlike chemical, radiological, and nuclear

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agents, biological agents are complex and multi-faceted. Most biological agents exist in nature and a majority can infect animals or plants in addition to humans. Therefore, assessing and addressing threats involving biological agents involve several unique approaches, including (1) accounting of human, animal, plant, and ecosystem health (often referred to as “one health”); (2) distinguishing between a deliberate attack with a biological agent and natural or accidental exposures with the same agent; (3) integrating inter- and multi-disciplinary expertise from diverse scientific disciplines (i.e., life, data, medical, physical, social sciences); and (4) sharing and integrating data and knowledge across various communities, including scientific and engineering, medical, veterinary sectors, and security. The diversity of sectors involved in countering bioterrorism prompted participants to discuss simultaneously encouraging innovation and support for the reporting of unusual events. Some participants who focused on food security described a general lack of appreciation about the risks and vulnerabilities that exist among educational, research, and commercial entities working in this sector. More broadly, participants highlighted the importance of more complex and creative approaches for scenario planning and integrated exercises to prepare various sectors more effectively.

The primary international mechanism for governing the offensive use of biological weapons is the Convention on the Prohibition of the Development, Production, and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on their Destruction (also called the Biological Weapons Convention [BWC]), of which the United States is a States Party. The BWC includes several provisions for preventing development, production, stockpiling, and acquisition or retention of biological weapons (defined as “microbial or other biological agents or toxins … in types and quantities not justified for prophylactic, protective, or peaceful purposes” and “weapons, equipment, or means of delivery designed to use such agents and toxins for hostile purposes or in armed conflict”) and for coordinating activities among States Parties. However, the BWC lacks the means to verify compliance. Although the BWC primarily is focused on state-level threats, it holds states responsible for prohibiting biological weapons–related activities within its borders.

Because the United States is a member of NATO, the workshop included discussions about NATO efforts toward assessing and addressing biological terrorism. NATO conducts exercises and promotes interoperability among its members and has developed a technology roadmap that created the Defense Innovation Accelerator of the North Atlantic and established an innovation fund to encourage the development of new ideas and capabilities to counter threats. In 2022, NATO released a CBRN policy that revised the organization’s balance among state and non-state threats and addressed technological challenges, including the use of “hybrid techniques,” which involve attacks across multiple domains, including mis- and disinformation. NATO has begun shifting to an anticipatory rather than reactive posture for these threats, seeking to “prebunk,” rather than “debunk,” mis- and disinformation. In addition to these efforts, NATO is addressing gaps in its defense and response to biological incidents and adding greater weight to the deterrence of biological attacks. An example discussed during the workshop related to the war in Ukraine where Russia may conduct a biological attack to avoid using nuclear weapons.

The U.S. Department of Defense’s (DoD’s) Biological Threat Reduction Program (BTRP) seeks to prevent threats involving biological agents internationally as described by its director, Ada Bacetty. Its purpose is to deny access to malicious actors by looking across sectors and protecting information. BTRP focuses primarily on pathogen-agnostic approaches for preparedness and readiness. However, BTRP has recently faced challenges from disinformation about biological laboratories with which it works, aiming to elicit concern about BTRP’s motivations and ultimately undermining cooperative agreements with partnering nations and scientists. Given these developments, BTRP no longer uses “emerging threats” terminology because threats evolve rather than emerge as new.

Because domestic and international cooperation was viewed as critical by several participants, they discussed

challenges for effective partnerships and means of assessing the effectiveness of those partnerships. One example shared involved work with China, specifically the challenges associated with the bioeconomy because of limitations on information sharing imposed by China. Participants also suggested that a risk-based cost–benefit analysis of country engagement might be helpful in assessing the effectiveness of partnerships. During the discussion, participants cautioned that approaches focused on country-to-country partnerships may not necessarily be appropriate for considering non-state bioterrorism.

At the institutional level, participants described organizational challenges that adversely affect the monitoring of insider threats. If research and security personnel typically do not interact, they may not be able to develop open lines of communication and trust that are critical to assessing and addressing potential insider threat situations. Participants acknowledged that people often have difficulty in recognizing aberrant behavior in others with whom they work daily and people often are reluctant to comment on their colleagues, emphasizing that the life sciences community is based on trust.

Participants described the mismatch between the pace of life sciences and biotechnology advances and the current regulatory structure for reducing risk. Studies involving genetic modification, analyzing ecosystem complexity using models that need to be validated, and creating organisms with specific traits have increased during the past several years. However, the regulatory landscape has not kept pace. An example shared was the lag in regulatory discussion following advances in various biotechnologies such as nanotechnology, mRNA (messenger RNA) vaccines, delivery systems that cross the blood–brain barrier, and CRISPR-based technologies. Although the accessibility of these advances to non-state actors remains undetermined, participants expressed concern if they are used to create and release something harmful, even if by accident (i.e., as a solution to an ecological problem).

Policies for countering mis- and disinformation are nascent. Participants highlighted trends that might reduce the influence of mis- and disinformation, including (1) the majority of the public and media start questioning what they hear; (2) standardization of K–12 curriculum in digital (or computer) literacy; and (3) validated methods for teaching and learning how to recognize accurate information.

ATTRIBUTION TECHNOLOGIES

Participants discussed three core questions that inform the analyses of attribution of biological incidents, including (1) who created the agent; (2) what sources of the materials were used to create the agent; and (3) what process was used to create the agent? Two major types of approaches are used in attribution: (1) threat-agnostic approaches (approaches that are independent of knowledge about the threat actor); and (2) targeted or agent-specific approaches (approaches that require knowledge about the agent). Participants thought that threat-agnostic approaches may be more effective in assessing attribution regardless of context (e.g., clinical, criminal, or military context). Although agent-specific detection (methods that detect specific biological agents) may be more sensitive, agent-agnostic detection (methods that are not specific to particular biological agents) has broader applications. Using both approaches ensures that detection is broad, sensitive, and selective.

Agent-agnostic methods involve the use of standard operating procedures for data evaluation, analytic standards, and validation testing. The leading agent-agnostic methods include whole genome sequencing, metagenomics, and forensic proteomics. Speakers emphasized additional areas to develop such as lab-on-chip, data and metadata curation and access, and host-based methods. In addition, participants emphasized developing standardized methods for assessing the attribution of biological incidents. Although technological advances are challenging the current approaches for attribution, advances, particularly in biotechnology and information technology, also are being leveraged for threat detection and attribution. Participants identified several advances that could be particularly informative for attribution of biological threats, including (1) multi-omics approaches; (2) agent-agnostic detection techniques; (3) integration of multi-source datasets; and (4) bio-based computing approaches.

Participants discussed the convergence of artificial intelligence (AI), such as machine learning (ML), and life sciences data for forensic analysis, highlighting the importance of safeguarding the datasets used for training the algorithms. AI applications allow researchers experimentally to develop techniques for attribution of specific cases. Participants reinforced the concept that these algorithms are only as good as the training sets. AI and ML need to be trained on real data, but in the absence of sufficient data for training the algorithms, researchers use synthetic data. To be most effective, the datasets need to be unbiased and simultaneously have breadth and specificity. ML algorithms relevant to attribution use involve data from genomics and other -omics that are not as prevalent as genomic data, and other data such as social science dimensions of previous events. Other examples of algorithms with biological information that may be informative for attribution include the use of natural language processing (NLP) to evaluate narrative information, and of AI and/or NLP to analyze and track -omics data. Narrative tracking was described as one of several methods to forecast and anticipate events based on intelligence inputs. Data storage such as cloud storage and data communication at sufficiently high rates are necessary for the use of AI and ML algorithms for attribution purposes. However, these systems may be vulnerable to cyberattack, insider threats, and exploitation (e.g., deliberately using -omics data about people and organisms to cause harm). Other security challenges highlighted by speakers include untraceable datasets resulting from edited genes and stolen data (i.e., data from organisms that cannot easily be traced to a source using standard techniques) to enable the creation of bioweapons, gain economic advantage, and access to AI and synthetic biology tools.

Multiple speakers, including Monique Beaudoin (Applied Research Laboratory for Intelligence and Security, University of Maryland), Corey Wilson (Georgia Institute of Technology), Chris Mason (Cornell University), and Eric Merkley (Pacific Northwest National Laboratory [PNNL]), described the development of platform technologies, such as the use of biomolecular systems engineering programs, for creating next-generation biosecurity systems. This approach combines biological, chemical, electrical, and computer engineering to develop intelligent biological systems ranging from living therapeutics to advanced cells for biomanufacturing and “intelligent microbes” capable of decision-making at the molecular level. For example, one research group has constructed analog-to-digital converters, time-independent step responses, and other living devices for application to future biotic-informational technologies.

Another type of research discussed was exemplified by the creation of a genetic map of the New York City subway station identifying thousands of microbial species from 1,500 samples. This effort highlighted difficulties with sample collection and analysis techniques, and with reliably translating the scientific results to the broader public via news media. Mason suggested that the public does not necessary want scientific information, but does want information about the risks associated with biological agents. Research is ongoing to develop methods to correct the problems identified in this effort, including the development of more effective standards for metagenomics analyses such as the International Microbiome and Multi-omics Standards Alliance, MetaSub, and global k-mer index. Today, approximately 100 cities create global microbial censuses annually with the goal of enabling detection of unusual agents. Using principles of open data, these efforts seek to crowdsource the analysis of identified microbial species, building on recent interest generated by the discovery of microbe-influenced cancers.

James Stack (Kansas State University), Merkley, and Amy Kircher (University of Minnesota) also indicated that although several technologies and methodologies may exist for forensic and attribution analyses, few analytical approaches integrate results from multiple tools.

EXAMPLES OF POLICY, CAPABILITY, AND EXPERTISE GAPS

Speakers and participants highlighted several gaps in preventing, countering, and responding to biological incidents. These gaps are listed below.

Policy Gap: Poor recognition of the unique aspects of threats involving biological information and/or agents, and possibly high-impact consequences from biological

incidents often leads to policy development that is consistent with biological nonproliferation strategies rather than policies and response strategies that address the evolving threat.

Policy Gap: Several participants acknowledged that good governance is critical to managing biological threats, but highlighted challenges associated with insufficient cooperation, communication, and collaboration across government agencies and a clear determination of “who is in charge.” Several federal agencies are involved in preventing, countering, or responding to bioterrorism incidents, but no single agency has clear authority over these activities. One participant, Tracey McNamara, suggested that broad involvement of numerous federal agencies, and some foreign entities, raises challenges in sharing sensitive information, including relevant intelligence about bioterrorism threats.

Policy Gap: Deterrence of the malicious use of biological information and/or agents is an underdeveloped concept and is not explicitly included in current strategies for countering biological threats.

Policy Gap: Responsibility for various biodefense roles, including specific attribution policies, programs, and decision-making often are unclear.

Capability Gap: Participants discussed the paradox of having access to a large amount of data collected using modern technologies, but having no system for integrating and sharing those data and for making the data available to the broader public in a timely, understandable, and informative manner.

Capability Gaps: Speakers identified five gaps that affect threat analysis of biological incidents: (1) understanding the information environment to allow “prebunking” of mis- and disinformation; (2) assessing hybrid threats, specifically those threats that involve different vectors (e.g., biological agents and cyberattack); (3) sharing intelligence about threats across relevant agencies; (4) educating audiences about the various types of bioterrorism threats; and (5) conducting more challenging exercises to identify and address weaknesses in the evolving threat landscape.

Expertise Gap: A few participants suggested that veterinary medicine experts, who work in agriculture, with pets, and with wildlife, are not integrated sufficiently into the public health, law enforcement, and national security communities. But veterinarians play crucial roles in detecting signs of infection in animals before similar signs are identified in humans who may be exposed to and/or infected with the same pathogens.

Expertise Gap: Participants highlighted challenges in assessing and addressing plant pathogens, which is a highly diverse category of biological agent including viruses, bacteria, and fungi, which have larger genomes than bacteria and viruses. Significant natural variation among plant pathogens exists that presents challenges in analyzing these agents. Participants suggested that the low-cost methods for testing SARS-CoV-2 may serve as a model for similar methods of other pathogens. In addition, integrating epidemiological, trade, law enforcement, and intelligence information in the analysis would provide greater awareness about the potential threats and consequences posed by the plant pathogens. Participants also suggested that exclusion analysis (exclusion of one or more parameters from a model to analyze the role of that parameter in the system under study) could help to distinguish whether the origin of an outbreak is naturally occurring, accidental, or intentional.

PARTICIPANT SUGGESTIONS FOR ADDRESSING GAPS

During the workshop, speakers and participants raised several suggestions for addressing gaps in preventing, countering, and attributing bioterrorism. These suggestions are summarized below.

One speaker, Rachel Bartholomew (PNNL), and a few participants suggested that the policy approach for assessing the risks of and countering bioterrorism be broad and threat agnostic because they acknowledged that they do not know all of the potential threats that might exist. This discussion emerged when speakers and participants were asked about what risks are of the

greatest concern and how to equip biodefense policies and programs to address those risks. Furthermore, participants stressed considering which types of emerging technologies actually lower the capability bar for non-state actors. Bartholomew also stated that broadening risk assessments to consider threats at the intersection between domains (i.e., threats involving biological and cyber components) provides a more holistic approach for assessing and addressing bioterrorism.

Participants referenced one method for reducing insider threats. This method focuses more on using a “bottom up” rather than “top down” approach wherein individuals buy-in to laboratory biosecurity rules and regulations.

Some participants suggested that the DoD enhance its understanding of integrated deterrence within the biodefense context and increase warfighter preparedness against biological threats.

Participants explored challenges associated with attributing biological incidents within the agricultural and food systems. These systems are diverse and complex, and recent food crises have demonstrated adverse consequences to public health, commerce and the economy, and politics. Many food commodities, particularly grains, are traded internationally, resulting in adverse global consequences if diseases in livestock and crops occur in supplier nations. Because similar crops are grown in various countries, plant pathogens can travel through a variety of vectors. Stack discussed an example of a corn disease that was first identified in the 1970s in Kansas and since has appeared on three other continents. Pathogens can be disseminated in seeds or carried by people traveling for reasons unrelated to food trade. Although genetic sequencing of plant pathogens is useful, it can be insufficient for the determination of exact origin, which suggests that other data may be required. Farms can be breeding grounds for pathogens. Over a 5- to 10-year period, a plant pathogen has the potential to destabilize two major regions of the world, specifically South Asia and west sub-Saharan Africa. Currently, multiple agricultural pandemics quietly are ongoing, which may provide opportunities for nature to create new pathogen species according to predictions based on recent experiments. Participants highlighted the importance of understanding natural variation of agricultural pathogens because of their constant evolution and emergence. Within this context, challenges for attributing the origins of agricultural pathogens include (1) understanding about pathogens, not only their genomic sequence; (2) unanticipated variation of agricultural pathogens; (3) development of more comprehensive databases and tools such as completely validated detection tests; (4) more cooperation across government agencies with academia; and (5) enhanced laboratory capacity to analyze plant pathogens.

Participants highlighted the importance of developing methods for analyzing biological molecules beyond DNA such as proteins and lipids for use in attribution of biological incidents. Other scientific advances that participants thought could enhance attribution of bioterrorism include (1) single molecule sequencing methods; (2) spatial transcription technologies; (3) probe surface technologies with 25–50 micron resolution; (4) barcoding methods for tracking organisms that may be transferred between institutions; (5) new detection and analysis tools; (6) methods for connecting characteristics of an organism (e.g., DNA sequence) to effects in people, plants, and animals; (7) methods for linking characteristics with transmissibility within and between species; (8) multi-omics analyses; and (9) interactions between pathogens and commensal microbes in humans. Coupling new technology development with investment in translation for use in real-world settings and by a range of users was highlighted as critically important for realizing the potential use of these technologies for forensics and attribution. In addition, participants discussed the limitations of using speciation (methods to differentiate between and among multiple species of the same genus) and other taxonomic structures in conducting forensic analysis. They stated that species and strains be used only as anchors of the analysis rather than the primary results.

Participants supported the engagement of a variety of government (federal, state, local, and tribal) agencies and academic and private-sector organizations throughout the attribution process. Furthermore, integrating efforts by individual entities and their data could enhance attribution. For example, participants expressed the value of integrated models of public health, biosurveillance, and other data, including intelligence data, during the analytic process.

Hillary Carter described the critical steps of both detecting and monitoring when an event has occurred (e.g., through surveillance), and forecasting and anticipating events before the event has occurred. Forecasting analyses use past events, paying close attention to their context and cascading effects, as case studies to anticipate events that may not have been seen before. The context of past conditions determines their applicability to anticipatory efforts. Drawing on a variety of resources and disciplinary approaches to analyze these case studies could enhance their use in forecasting events. Examples of resources include news reports, social media communications, and micro-alerts that might not appear linked when they are released. Participants suggested that micro-alerts may be tracked, traced, monitored, and examined for triggers to counter bioterrorism incidents. They stated that waiting until people become sick to respond already may be too late. One example provided focused on agricultural events. Participants stated that certain weather conditions such as floods are known to create favorable environment for food-borne illnesses through crops. Weather events can be observed and trigger the testing of plant pathogens. In addition, information from a diversity of fields including the life sciences, medicine and public health, agriculture, veterinary medicine for domesticated animals (e.g., pets), and wildlife are necessary for addressing biological threats. Focusing on agricultural events, information may be provided by farmers and plant specialists. Information also may come from private companies and foreign partners, both of which may assist with interpreting and integrating information in a timely manner. Participants highlighted the importance of validating and exercising forecasting tools, such as risk-based models, that use this information.

When discussing risk analysis, participants highlighted the importance of accounting for uncertainty and for timeliness and consequences of actions. They suggested that these assessment methodologies account for a broad array of ways in which biological attacks may affect human life, including direct effects from person-to-person spread of infectious organisms and indirect effects. Indirect effects described by participants included the spread of infectious organisms from animals, disruption of basic services such as food and agriculture, economic consequences such as the undermining of the agricultural business sector, and political consequences such as destabilizing societies.

Participants also discussed strengthening communication about scientific results and concepts, referencing the poor communication by various groups of scientists such as epidemiologists and microbiologists. They suggested that these results and concepts be translated to ensure they are accessible to and understood by policy-makers, who are not necessarily scientific experts and may not necessarily understand how science works and evolves. Participants discussed the benefits of translators of science to enhance the communication of science. Effective communication reaches various audiences, is conveyed in a timely manner, includes uncertainties, and accounts for differences in the level of certainty needed for decision-making among government agencies. For example, decisions made by regulatory and law enforcement agencies directly affect various groups of people and consequently, necessitate a level of confidence in the information communicated, whereas preventative actions recommended during public health crises or an approaching storm may not necessitate a similarly high level of confidence. Information may be provided by members of the scientific community through various platforms, including social media. Participants stressed the importance of communicating information and analysis to decision-makers and the public even in an environment of mis-, dis-, and malinformation. The information and analyses could include other content such as the views and interests of regulatory agencies, and restrictions on various sectors (e.g., trade, commerce, and public health) and individuals.

Participants highlighted information voids as ripe environments for generating and propagating mis- and disinformation. Several fields and approaches to counter mis-, dis-, and malinformation were discussed, but participants observed that existing research suggests that current methods for countering such information may not be as effective as anticipated. Detecting, tracking, and analyzing disinformation and its spread enables both technical and social science (e.g., human behavior) approaches for countering mis-, dis- and malinformation. An approach for countering disinformation is filling information voids with factual and consistent information about a particular situation, and cultivating credible sources of accurate, factual information. Other approaches discussed included prebunking, which is countering false claims before they emerge and spread; debunking false claims soon after they emerge and spread; building trust among consumers of information (including targets of disinformation) prior to the spread of mis-, dis-, and malinformation; combating false claims actively by improving science literacy, countering false stories, and presenting consistent messages; and informing the public about the scientific process, which continuously changes as new information is obtained or emerges. Participants stated that debunking alone is not sufficient for countering mis- and disinformation. They also stressed that timely response to countering false reports is critical to prevent panic and other rapidly escalating effects. Finally, participants stated efforts to counter mis- and disinformation can be clarified by identifying individuals and offices with responsibility within the government and having procedures to avoid communicating conflicting responses from different sources.

For years, concepts about the “worried well” following a biological incident (i.e., individuals who believe they are sick but are not) have been discussed within the biodefense policy process. Studies about social contagion and sociogenic illness indicate that symptoms of disease may emerge from anxiety rather than a physical cause. Large groups of people can reinforce their fears, lead people to act in inconsistent ways, and destabilize societies because of such anxiety. Participants suggested that one solution to social contagion is through consistent messaging as Anthony Fauci had during the SARS-CoV-2 pandemic. One hallmark of social contagion is the emergence of symptoms in the absence of a causative agent, which could have significant effects on response and attribution. One example discussed was the gas attacks by the Japanese religious group Aum Shinrikyo, which led thousands of unexposed people to seek care in hospitals. Understanding the psychological basis for why and how disinformation about WMD is effective in developing tools to counter these messages, and appreciating the effects of mis- and disinformation affects individual and policy decisions. Using information to influence a population with a goal in mind is a form of social engineering. Social engineering also can be used to explore cognitive vulnerabilities. A perceived threat may be real, real but embellished, or completely fabricated. Research on the psychological effects of a nuclear threat suggests that psychoanalytic theory may help to identify means for countering disinformation about bioterrorism. Participants discussed the COVID-19 pandemic as an example of cultural trauma, which can be a type of social engineering. The pandemic generated anxiety, fear, trauma, and unconscious vulnerability in the population, which has been exacerbated by intolerable uncertainty in the presence of a perceived, unknown threat to human existence.

DISCLAIMER This Proceedings of a Workshop—in Brief was prepared by Kavita Berger, Nancy Connell, Alan Shaw, and Steven Moss as a factual summary of what occurred at the workshop. The statements made are those of the rapporteurs or individual workshop participants and do not necessarily represent the views of all workshop participants; the planning committee; or the National Academies of Sciences, Engineering, and Medicine.

REVIEWERS To ensure that it meets institutional standards for quality and objectivity, this Proceedings of a Workshop—in Brief was reviewed by Jason Middleton, Battelle Memorial Institute; Erik Prentice, 6th Floor Insights; and Kathleen Vogel, Arizona State University. Lauren Everett, National Academies of Sciences, Engineering, and Medicine, served as review coordinator.

WORKSHOP PLANNING COMMITTEE MEMBERS Jacqueline Fletcher (Chair), Oklahoma State University; Denise N. Baken, Shield Analysis Technologies; Rita R. Colwell, University of Maryland; Asha George, Bipartisan Commission on Biodefense; Margaret E. Kosal, Georgia Institute of Technology and Savannah River National Laboratory; Erik Prentice, 6th Floor Insights; Ronald Schouten, District of Columbia Department of Behavioral Health and St. Elizabeth’s Hospital.

STAFF Steven Moss, Board on Life Sciences; Nancy Connell, Board on Life Sciences; Alan Shaw, Intelligence Community Science Board; Jessica De Mouy, Board on Life Sciences; Sabina Vadnais, Board on Life Sciences; Daisha Walston, Board on Life Sciences; Kavita Berger, Board on Life Sciences.

SPONSOR This workshop was supported by the U.S. Department of Defense

SUGGESTED CITATION National Academies of Sciences, Engineering, and Medicine. 2023. Assessing and Improving Strategies for Preventing, Countering, and Responding to Weapons of Mass Destruction Terrorism: Biological Threats: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. https://doi.org/10.17226/26845.

Division on Earth and Life Studies Copyright 2023 by the National Academy of Sciences. All rights reserved.