In pandemic preparedness work, scientists like to focus on the technical challenges: identifying pathogens, diagnosing infections, understanding their effects and developing vaccines and treatments. Each step promises progress through human innovation, investment and planning. The World Health Organization (WHO), for example, brings experts together to identify and prioritise emerging disease threats and collect the evidence needed to prepare for them.
But preparedness depends on more than scientific innovation. As the past week has shown, politics is the elephant in the room in all of this. No one could have predicted we would be talking about pneumonic plague, and that the death of a single lab worker in Russia would cause global headlines.
It might feel like an overreaction: the WHO deals with thousands of potential disease signals worldwide every month. But the circumstances of this case are unusual given the lack of transparency from Russian authorities on what happened – and ongoing concern about biological weapons research. The 28-year-old lab worker died after developing severe pneumonia.
She worked at the Irkutsk Anti-Plague Research Institute, established in 1934, which studies plague and other dangerous pathogens including anthrax and cholera, and is rumoured to be involved in biological weapons research. Prof Ashish Jha, who was the US White House Covid-19 response coordinator, and who co-chaired an Ebola commission with me, wrote on social media: “US intelligence assess that Russia’s scientists continue developing biological weapons capabilities. Those programmes operate in secret.
Nobody outside inspects them and nobody inside has much incentive to admit when something goes wrong.” On top of that, initial local media coverage suggested that she had died from pneumonic plague after a lab accident, possibly a broken test tube. Pneumonic plague is caused by a bacterium (Yersinia pestis), and can spread through respiratory contact and is always fatal if untreated. If antibiotics are given in the first 24 hours after symptoms, or even before onset of symptoms post-exposure, it is largely treatable.
If she knew she had been exposed, why was treatment not given in time? (Pneumonic plague is a different disease to the more common bubonic plague, which transmits through flea bites.) Despite Russian health authorities denying that it was a case of plague and insisting it was pneumonia of unknown origin, they quickly placed about 200 contacts of the lab worker under quarantine. The authorities reported that no high-threat pathogens were detected and monitoring had ended. The WHO released a statement noting a potential second linked case, but Russia denied this.
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