The Challenge of Operational Response in the Era of Synthetic Pathogens and Emergent Threats

Prof. David J. Heslop, School of Population Health University of New South Wales

Decision-making surrounding the safe conduct of operations in a CBRN environment is becoming increasingly challenging. The last few decades have seen an increase in the frequency of novel and emerging biological threats, thought to be driven by rising population, encroachment onto previously isolated habitats and ecosystems, and human population pressures and impacts on animal reservoirs of disease with outbreak potential.1 While there have been significant improvements in molecular diagnostic techniques, sequencing, and industrial scales of testing, there has been a parallel rise in the potential for the negative use of synthetic biology and dual-use technologies and a lowering of the barriers to the misuse of these technologies to enable the emergence of novel biological agents through deliberate action or accident.2 Such hazards are thus no longer solely found in traditional military context, but may be present in civil-military operations, policing contexts, and humanitarian response contexts in the midst of large urban population centers where the ability to distinguish between friend, foe, and hazard is unclear.3 CBRN responders thus now find themselves contemplating hazard and risk management circumstances that render traditional Cold War considerations of CBRN risk management obsolete. For example, the historically narrow focus on certain classes of biological weapons (e.g., Bacillus anthracis and Variola major) in CBRN operational planning, preparation, and training is now inadequate to meet the modern CBRN operational landscape. The current and future landscape of CBRN operations will instead be characterized by the traditional alongside potential deliberately developed or naturally emerging biological threats that are new, have unexpected characteristics, are themselves continuously adapting to evolutionary pressures and unpredictable.4, 5, 6

Organizations and individuals responsible for the safety of first responders in these circumstances must re-consider the decisions they have made during planning, preparedness, and procurement much more frequently. This ideally involves a deeply collaborative effort between technical, medical, operational, and leadership elements in an organization, and traditionally has involved the utilization of highly specialized technical networks of scientists and medical experts who are responsible for driving the engines of innovation and analysis in relation to best practice risk management. This may include the development of novel materials, protective ensembles, respiratory protective devices, detection devices, and many other risk controls that assist the protection of the first responder. How these strategic development systems integrate properly into the CBRN operational reality is the key issue. How protective systems perform under real-life conditions and most critically, how they perform when confronted with the unanticipated or novel hazard is often inadequately addressed following development and procurement phases, but it is at this time that the operational effect is being realized and is most important. The allocation of resources into the development of revised Standard Operating Procedures (SOPs) and Tactics Techniques and Procedures (TTPs), integration into existing systems, and extensive test and evaluation during anticipated operations in CBRNE environments can be lacking. At worst, this can lead to cases where CBRN risk controls developed in isolation in technical settings and presenting excellent credentials to decision-makers “on paper” - are not fieldable in practice or not fit for purpose. The consequence of these events is the potential unnecessary sacrifice of operators when integrated systems fail. Closing the innovation and communication gap between the technical, scientific, medical, and operational stakeholders is the critical step that can minimize such possible catastrophic outcomes. Such a possibility of systemic development and strategic risk management failure can sometimes be discounted or assumed away in technical and decision-making circles. By contrast, it is precisely this possibility that crosses the mind of individual first responders who are working in the hazard zone of a modern CBRN environment; will the system of risk controls I am wearing perform well under operational conditions, particularly in conditions that are unanticipated or perhaps not previously conceived? The truth is that these new environments are more likely to be the norm in the modern CBRN operational environment than the exception. The risk analysis of hazards in potential future CBRN operational environments has traditionally relied on the approaches outlined in international and national standards, legislation, and codes of practice. Most commonly, the steps taken are derivations of current international norms,7, 8 and lead the analyst through a series of logical and evidence-based steps to the identification of appropriate risk reduction techniques and options.9 This approach has been highly successful from an operational, but also regulatory and legal perspective, for countless situations involving the interaction between humans and known hazards.

When the hazard is uncharacterized, unknown, novel, or has no historical precedent, the traditional approach to risk management begins to fail. This is particularly so in the case where the hazard has been deliberately engineered to undermine or circumvent risk controls. Certain classes of chemical and biological weapons have features that not only produce a greater effect but are designed to defeat risk controls like protective ensembles or respiratory protection.10 Major industrial accidents and events can also result in unexpected hazards, hazard mixes, or combinations of hazard classes leading to operational surprise. The recent major accidents at Tianjin, China11, 12 and Beirut, Lebanon13 are good examples and have unfortunately been associated with numerous first responder casualties and loss of life.

Currently available technologies that can enable organisations to better bridge the gap between technical, scientific, and senior decision-makers with the operators who have the tactical experience and who “wear the risk” include i) using modeling and simulation platforms to generate “digital twins” of operator-organization-system constructs and allow in silico system stress testing, and ii) using machine learning and big data techniques to more deeply and thoroughly explore how existing risk controls might perform when confronted with archetypal and imagined future hazards. Both techniques are appropriately applied during planning, preparedness, and procurement phases of organizational development, but also can be applied in real-time to support operational decision-making and tactical risk analysis. This is particularly true when such techniques are paired with data streams from forward sensors, physiological data streams, and various other data sources. CBRN operations are now confronted with a landscape that is increasingly uncertain and associated with unanticipated or novel hazards. Protective system designs that assume exposure to only narrow classes of hazards are now likely obsolete and additionally almost certainly have built-in invalid assumptions and risks in the current and future CBRNE operational environments. Future operations require more direct linkage of operators with innovators to ensure that operational needs and realities inform strategic scientific and risk decisions, and then drive well-resourced doctrinal and policy changes that enable rather than compromise the safety of the forward CBRN operator.

Notes

  1. Schmeller DS, Courchamp F, Killeen G. Biodiversity loss, emerging pathogens and human health risks. Biodiversity and Conservation. 2020;29(11):3095-102.
  2. Raina MacIntyre C, Engells TE, Scotch M, Heslop DJ, Gumel AB, Poste G, et al. Converging and emerging threats to health security. Environment Systems and Decisions. 2018;38(2):198-207.
  3. MacIntyre CR. Biopreparedness in the Age of Genetically Engineered Pathogens and Open Access Science: An Urgent Need for a Paradigm Shift. Military Medicine. 2015;180(9):943-9.
  4. MacIntyre R, Engells T, editors. Current biological threats to frontline law enforcement: from the insider threat to DIY BIO. Law Enforcement Executive Forum; 2016.
  5. Heslop DJ. Beyond traditional CBRN force protection - a future of CBRN hardened super-soldiers? Global Biosecurity. 2019;1(1):162-8.
  6. Heslop DJ. Waxing CBRNE, Waning humanity. Global Biosecurity. 2019;1(1):174-5.
  7. International Standards Organisation (ISO). ISO 31000:2018 Risk Management - Guidelines. Geneva, Switzerland: International Standards Organisation; 2018.
  8. International Standards Organisation (ISO). IEC 31010:2019 Risk Management - Risk assessment techniques. Geneva, Switzerland: International Standards Organisation; 2019.
  9. Lyon BK, Popov G. The Art of Assessing Risk. Professional safety. 2016;61(3):40-51.
  10. Heslop DJ. Beyond traditional CBRN force protection - a future of CBRN hardened super-soldiers? Global Biosecurity. 2019;1(1):162-8.
  11. Fu G, Wang J, Yan M. Anatomy of Tianjin Port fire and explosion: Process and causes. Proc Safety Prog. 2016;35(3):216-20.
  12. Zhao B. Facts and lessons related to the explosion accident in Tianjin Port, China. Natural hazards (Dordrecht). 2016;84(1):707-13.
  13. Al-Hajj S, Mokdad AH, Kazzi A. Beirut explosion aftermath: lessons and guidelines. Emergency Medicine Journal. 2021:emermed-2020-210880.

AUTHOR


Dr David Heslop is an Associate Professor at the School of Public Health and Community Medicine at UNSW Sydney. He retains military responsibilities as SO1 Public Health and Occupational Medicine at Army Headquarters. He is a clinically active Family Physician and Occupational and Environmental Physician. During a military career of over 16 years he has deployed into a variety of complex and austere combat environments, and has advanced training in Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE) Medicine with the Australian Defence Force. He now undertakes collaborative research exploring evaluation of the medical aspects of high risk and high consequence environments through a novel computational modelling and simulation effort with DST Group, and various emergency response and CBRNE related teaching and research activities with Industry and Government organisations.