Department of Pathology, Medical Centre, Hungarian Defence Forces, Budapest 1134, Hungary.
Mobile Biological Laboratory, Medical Centre, Hungarian Defence Forces, Budapest 1134, Hungary.
Mil Med. 2023 Mar 20;188(3-4):531-540. doi: 10.1093/milmed/usac123.
As of early 2022, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic still represents a worldwide medical emergency situation. The ongoing vaccination programs can slow down the spread of the virus; however, from time to time, the newly emerging variants of concern and antivaccination movements carry the possibility for the disease to remain in our daily lives. After the appearance of SARS-CoV-2, there was scholarly debate whether the virus was of natural origin, or it emerged from a laboratory, some even thinking the agent's potential biological weapon properties suggest the latter scenario. Later, the bioweapon theory was dismissed by the majority of experts, but the question remains that despite its natural origin, how potent a biological weapon the SARS-CoV-2 virus can become over time.
Based on 12 bioweapon threat assessment criteria already published in 2018, we performed a literature search and review, focusing on relevant potential bioweapon properties of the virus SARS-CoV-2. Instead of utilizing a survey among experts, we tried to qualify and quantify characteristics according to the available data found in peer-reviewed papers. We also identified other key elements not mentioned in the original 12 bioweapon criteria, which can play an important role in assessing future biological weapons.
According to the international literature we analyzed, SARS-CoV-2 is a moderately infectious agent (ID50 estimated between 100 and 1,000), with high infection-to-disease ratio (35%-45% rate of asymptomatic infected) and medium incubation period (1-34 days, mean 6-7 days). Its morbidity and mortality rate can be categorized as medium (high morbidity rate with significant mortality rate). It can be easily produced in large quantities, has high aerosol stability, and has moderate environmental stability. Based on laboratory experiments and statistical model analysis, it can form and is contagious with droplet nuclei, and with spray technique utilization, it could be weaponized effectively. Several prophylactic countermeasures are available in the form of vaccines; however, specific therapeutic options are much more limited. In connection with the original assessment criteria, the SARS-CoV-2 only achieved a "0" score on the ease of detection because of readily available, relatively sensitive, and specific rapid antigen tests. Based on the pandemic experience, we also propose three new assessment categories: one that establishes a mean to measure the necessary quarantine restrictions related to a biological agent, another one that can represent the personal protective equipment required to work safely with a particular agent, and a third one that quantifies the overall disruptive capability, based on previous real-life experiences. These factors could further specify the threat level related to potential biological weapons.
Our results show that the virus can become a potent bioweapon candidate in the future, achieving a total score of 24 out of 36 on the original 12 criteria. The SARS-CoV-2 has already proven its pandemic generating potential and, despite worldwide efforts, still remains an imminent threat. In order to be prepared for the future possibility of the virus arising as a bioweapon, we must remain cautious and take the necessary countermeasures.
截至 2022 年初,严重急性呼吸系统综合症冠状病毒 2(SARS-CoV-2)大流行仍然是全球医疗紧急情况。正在进行的疫苗接种计划可以减缓病毒的传播;然而,不时出现的新出现的关注变种和反疫苗运动有可能使该疾病继续存在于我们的日常生活中。SARS-CoV-2 出现后,学术界就该病毒是自然起源的,还是源自实验室,甚至有人认为该病毒具有潜在的生物武器特性,而存在后者的可能性展开了辩论。后来,大多数专家驳斥了生物武器理论,但问题仍然存在,即尽管它具有天然起源,但 SARS-CoV-2 病毒随着时间的推移会成为多么强大的生物武器。
根据 2018 年已经发表的 12 项生物武器威胁评估标准,我们进行了文献检索和综述,重点研究了病毒 SARS-CoV-2 的相关潜在生物武器特性。我们没有采用专家调查的方法,而是尝试根据同行评审论文中发现的可用数据来定性和定量评估特性。我们还确定了原始 12 项生物武器标准中未提及的其他关键要素,这些要素在评估未来生物武器时可能发挥重要作用。
根据我们分析的国际文献,SARS-CoV-2 是一种中度传染性病原体(估计 ID50 在 100 到 1000 之间),感染率与发病率之比高(无症状感染率为 35%-45%),潜伏期中等(1-34 天,平均 6-7 天)。其发病率和死亡率可归类为中等(发病率高,死亡率高)。它可以大量生产,气溶胶稳定性高,环境稳定性中等。基于实验室实验和统计模型分析,它可以形成并与飞沫核具有传染性,并且可以利用喷雾技术有效地将其武器化。有几种预防性对策以疫苗的形式提供;然而,具体的治疗方法要有限得多。关于原始评估标准,SARS-CoV-2 仅在易于检测方面获得了“0”分,因为已经存在相对敏感和特异的快速抗原检测。基于大流行的经验,我们还提出了三个新的评估类别:一个类别建立了衡量与生物制剂相关的必要隔离限制的手段,另一个类别代表了与特定制剂一起工作所需的个人防护设备,第三个类别量化了基于以往实际经验的整体破坏能力。这些因素可以进一步确定与潜在生物武器相关的威胁级别。
我们的结果表明,该病毒未来可能成为一种强大的生物武器候选物,在原始的 12 项标准中获得了 36 分中的 24 分。SARS-CoV-2 已经证明了其产生大流行的潜力,尽管全球都在努力,但它仍然是一个迫在眉睫的威胁。为了为病毒作为生物武器出现的未来可能性做好准备,我们必须保持谨慎并采取必要的对策。