A laboratory worker in a plague research institute in Siberia died last week after developing pneumonia.
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worker → die → pneumonia
Since then, local reports suggesting that she broke a test tube containing plague bacteria have fueled speculation about how she became ill.
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she → suggest → speculation
Russian authorities disputed that account and told the World Health Organization (WHO) that plague had not been detected in her tests nor in those of her close contacts.
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plague → dispute → contacts
At the same time, Russian authorities have reportedly quarantined as many as 200 people, which public-health experts say would be an unusual response to an isolated case of pneumonia.
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experts → quarantine → pneumonia
On Tuesday evening, the WHO asked Russia for more information following media reports of a second case of pneumonia of unknown cause.
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WHO → ask → cause
Researchers who work in public-health policy and infectious diseases have been watching this rapidly evolving and opaque situation with concern.
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who → work → concern
Here’s what worries them.
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worries → ’ → them
This doesn’t look like the average lab accident
The pattern of events doesn’t fit neatly with the explanation that a lab accident with a known bacterium sickened the worker, says Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health.
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Nuzzo → look → Health
In labs that study Yersinia pestis, the bacterium that causes plague, protocols are in place to deal with accidental exposure.
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protocols → study → exposure
Wearing personal protective equipment and working under a fume hood provides some protection.
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Wearing → wear → protection
But if someone finds they’ve been exposed, they would take antibiotics, which is an effective treatment for naturally occurring plaque bacteria.
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which → find → bacteria
You don't die, typically,” says Nuzzo.
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Nuzzo → die → ?
A lab exposure “would be a regrettable accident that sometimes occurs.”
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that → occur → ?
That seems out of sync with the substantial response on the part of Russian authorities.
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That → seem → authorities
“The magnitude and severity of that response is also worth looking at,” she says, referring to reports that up to 200 people are under observation and that local hospitals have been closed.
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hospitals → look → observation
But I would feel more confident in what was going on if I knew specifically what she was tested for and what came back negative.”
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what → feel → what
By this time, Nuzzo continues, “they should have a full sequence”—meaning the pathogen that killed the lab worker should be identified.
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that → continue → worker
Much is unknown about the situation, and some experts have said it’s worth considering the possibility that an engineered pathogen, rather than a naturally occurring one, could be involved.
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pathogen → say → possibility
Dr. Ashish K. Jha, who coordinated the White House’s COVID response under President Joe Biden, wrote on X on Oct. 4 that “an accidental release from a deliberate program” was a scenario he had long worried about.
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he → coordinate → program
Russia has a long history of bioengineering pathogens.
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Russia → have → pathogens
After the fall of the Soviet Union, that nation’s programs were officially shuttered, but the current situation is unclear.
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situation → shutter → Union
“You can't help but worry that there is something more here than meets the eye,” Jha tells TIME.
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Jha → help → TIME
“What I will say from my conversations with friends in the [Trump] Administration is that they've been very worried about this…
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they → say → this
[But] they're not getting a lot of information and data.”
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they → get → information
”I'm going to say something that's going to sound incredibly naive, but I'll say it:
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I → go → it
What I hope is that the Russians will be very forthcoming and transparent about what was going on in this lab, but one can imagine that they may not be,” Jha says.
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Jha → hope → lab
“If it's plague, breathe a sigh of relief, because we know what to do about plague,” says Nuzzo.
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Nuzzo → breathe → plague
“We have a clear solution…
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We → have → solution
The worry is it's not that, it is something different, something for which we don't have easy solutions.
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we → have → solutions
No, Nuzzo and Jha agree.
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Nuzzo → agree → ?
We are in a worse situation now compared to pre-COVID times, Nuzzo says.
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Nuzzo → compare → times
“The protections we had in 2019, early 2020–there are now fewer of them, and we are more vulnerable now than we were then,” Nuzzo says, pointing to reduced monitoring and less information flow between countries.
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Nuzzo → have → countries
“This is why countries need to fund and maintain overseas scientific engagements, because then they know the actors, they know their motivations, they know what's normal.
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what → need → motivations
It's also why you want to have a strong, capable, and relied-upon WHO, because sometimes they're the best entity to have the conversations to surface the information.”
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they → want → information
Jha also flags the lack of monitoring: “The biggest weakness we have is we have almost no biodetection system in our own country.”
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we → flag → country
If someone in Siberia was infected, got on a plane, and flew to New York City, “we would not know.
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we → infect → City
We just need a much better global monitoring system on this.”
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We → need → this
Jha and a colleague from the Biden White House, Nikki Romanik, have started a public benefit corporation to build a monitoring system that draws on search and social media information, clinical information from hospitals, and wastewater sequencing.
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that → start → hospitals
Wastewater monitoring typically looks for hand-picked pathogens, such as RSV or COVID-19.
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monitoring → look → RSV
“Our strategy is you flip it, you sequence everything in the wastewater and you look for anything that doesn't belong.
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that → flip → anything
…and 22 more, not listed.
The Aporia
