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Clade X is More than an Exercise, it is a Call to Action

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Nathan Myers
June 1, 2018

A recent New York Times article discussed the potential risks posed by gene-editing technology becoming more widely available and potentially being used as a weapon. The Johns Hopkins University School of Public Health’s Center for Health Security hosted an exercise called Clade X on May 15, 2018 which examined the possible repercussions of such an event. The exercise brought players with a broad range of government experience in the legislative and executive branches together to consider policy options and produce hypothetical recommendations in response to a global pandemic.

A number of the participants, particularly former Senate Majority Leader Tom Daschle, bemoaned the fact that throughout the exercise they were never sure who had day-to-day responsibility for managing the crisis. Daschle, a current member of the Blue Ribbon Study Panel on Biodefense, advocates that the Vice President should be given management authority over all U.S. biodefense efforts. Others advocate for a dedicated member of the National Security Council to handle those responsibilities or possibly a special coordinator, or “czar,” such as was done in the Ebola response. Regardless of which option is chosen, the individual will need the authority to convince federal, state and local officials to act in the national or even international interest in an emergency.

Another issue was the lack of a comprehensive national strategy for biodefense. According to the law, a National Biodefense Strategy should have been produced by the Trump administration last September. No one knows when legislators or the public can expect to see this document. Congress did not escape scrutiny either, as it was noted that multiple committees having jurisdiction over biodefense issues can create problems such as cabinet officials being called to testify before several committees on the same issues.

Relations between state and local governments and Washington, D.C. were another sticking point during the exercise. It was noted by participants that fusion centers have been created at the state level to facilitate more rapid intelligence sharing. There was unanimous agreement that local officials would be on the front lines of any emerging health crisis, and the federal government needs to do a more efficient and effective job of empowering them with resources and information. However, in the scenario, state officials made rash decisions like instituting quarantines or banning air travel to their state without consulting federal authorities. While these actions were hypothetical, they are certainly not outside the realm of plausibility and demonstrate how vital on-going communications is.

It was recommended by participants that the President or whomever is responsible for day-to-day management of the response maintain a daily call sheet of federal, state and local officials, both to provide and receive updated information. Federal leadership will also need to communicate regularly to the American public in order to quell any panic, fear or hysteria that may develop during a major health crisis. As travel bans were advanced in response to the Ebola outbreak in western Africa, such proposals can be expected during future events as well. Participants recommended that the federal government have a clear rationale for why travel bans are not effective ready in advance. They also noted that it is not enough to tell the public what you will not do, the government must also be ready with a proactive agenda. Representative Susan Brooks (R-IN), co-chair of the Congressional Biodefense Caucus, suggested that members of Congress receive more information from experts so that they will be knowledgeable enough to go out and help educate constituents on such issues.

On-going, effective communication will be vital to building and maintaining public trust during a pandemic emergency. One area in which public trust will be a necessary resource is vaccine distribution. In a scenario like Clade X, vaccines will take considerable time to develop, test and mass produce. This problem is exacerbated by the lack of a long-term federal funding stream for countermeasures development, which makes private industry less inclined to engage in partnership with the government. Once a vaccine is ready for distribution, federal officials will need to determine which groups will receive first priority, which could be either first responders and others with vital roles in maintaining essential infrastructure, highly vulnerable groups such as children and pregnant women, or some combination of the two. A clear and convincing rationale for why officials made their decision could help to prevent outrage at the decision.

The Clade X exercise highlighted the fact that someday a similar group may have to confront such challenges for real. And if there is not an effective chain of command or national biodefense strategy in place, the results could be as devastating for the U.S. and the world as another world war. America must build stronger operational connections between its levels of government, refine its strategy for relaying crisis information, and ramp up its ability to produce and distribute medical countermeasures in advance of a crisis. The recommendations produced from Clade X should not be written up in a report and placed on a shelf, but rather treated as an urgent call to action before a hypothetical scenario becomes all too real.

Author: Nathan Myers is an associate professor of Political Science at Indiana State University. He primarily teaches courses in the Master of Public Administration program. Myers is also a member of the Indiana State University Center for Genomic Advocacy. His teaching and research interests include organizational behavior, public health policy, and biotechnology policy associated with genomic research. He can be reached at [email protected] 

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