Influenza virus Credit: Dr Paul Digard, Department of Pathology
Author's note: In 2007 I was invited to speak at a NATO instillation near Warsaw. I delivered a talk on variola major the causative agent of smallpox and highly pathogenic disease containment. At that time, the US Strategic National Stockpile was rapidly increasing its procurement of a number of vaccines and medical counter measures, including vaccine to prevent smallpox. The US strategic stockpile was comprised of vaccine from Acambis and Bavarian Nordic. As I noted in my discussion, NATO held only a virtual stockpile and one had wonder how a real response could be mounted by NATO, not just allocated to the Member States, holding their national stockpiles, but by NATO command, when they only had a virtual stockpile. Atlantic Storm, following on from Dark Winter, was in my view a conservative and realistic table top exercise. Below is the basic introduction to Atlantic Storm, but what would happen if instead of strategic stockpiles we could use centrally located 3Dbioprinters? What if NATO had 3D bioprinters for example or even the World Health Organization? How would that change how we counter highly pathogenic and possibly deliberate outbreaks of disease? I do make a distinction between deliberate and natural outbreaks, as a deliberate outbreak is likely to increase mortality rates. So here are the basics of Atlantic Storm:
If we consider not only the time it takes to deploy a vaccine, and the US CDC estimates the time at about twelve hours, and we consider international travel, this time frame becomes critical. This photo below illustrates one aspect of what is involved in deploying medical countermeasures. If however, a state or institution such as NATO or WHO could manufacture vaccines on site, something akin to having fire hydrants strategically located throughout a city for putting out fires and easily accessible to all, containing disease would be far more efficient and effective.
While it is prudent to understand that such technology can potentially be used to manufacture biological warfare agents, I believe the benefits far outweigh this possibility. In terms of Atlantic Storm, 3D bioprinting would remove policy decision making on vaccination/containment strategy, logistical issues involved in deploying a stockpile, remove transnational issues related to supply and rapidly increase our ability to respond at the first instance. One of the issues particularly with regard to smallpox vaccine availability within EU/NATO states is inconsistent stockpiles. One can imagine if there were an outbreak of smallpox in Africa, given lengthy incubation periods, flights arriving into Schipol or Zaventem would not raise any alarm until the first cases started emerging. By this time, Belgium which holds only slightly over a 15% coverage would see citizens possibly trying to cross the boarder to the Netherlands where they hold a 100% so 1:1 stockpile. 3D bioprinting could theoretically remove all these issues possibly making bio-terrorism and warfare a less attractive option.
For an interactive view see: http://www.atlanticstorm.org/flash/