Here's What Concerns Me Most About The Russian Plague Lab Death: Former White House Official

0:02Hi, everybody. I'm Brittany Lewis, a breaking news reporter here at Forbes. Joining me now is Dr. Raj Panjabi. He's the former White House Bioscurity Director and the author of Safer, a playbook turning fear into action and crisis into community. Dr. Panjabi, thanks so much for coming on. Thanks for having me on, Brittany. We have a wide range of conversation in store today, and I'm really grateful for your expertise. I first want to start with a developing story out of Russia. An employee at an anti-plague lab in Siberia died last week, and her suspected cause of death has been cause for concern around the globe.

0:37There have been reports that she died after allegedly developing pneumonic plague. But Russian officials have said that the researcher died after contracting pneumonia from an unknown origin. To start off the conversation, as the former biosecurity director at the White House, what's your reaction to the news and what we know so far? Well, I'm concerned, and I would say we should take this seriously. I would not panic, but I would demand the data. Right now, as you noted, the Russian authorities have said that this individual researcher died of pneumonia of unknown origin or unknown etiology. What they haven't said is what piques my curiosity.

1:19They haven't said what the cause is. And it's been days now that she has died, unfortunately. And she worked in a lab that is very capable of sequencing the pathogen, telling us what the genetic code, which would tell us whether this is truly a natural pathogen or something that might have been engineered in a lab. I think those questions are going to be critical to answer. And so that's why we have to demand the data. I think before we even get into the responses and how dangerous this is, if we could take a step back here, what exactly is, if this is a case of pneumonic plague, what is that?

1:57How possibly could this worker could have contracted that? And how dangerous is this all? The things that would keep me up at night in the situation room at the White House would be not the clear emergencies, but the ones that had ambiguous signal. And so when that happened, and I write about this in my new book, Safer, we would actually articulate three very simple questions. So let's walk through them here. Number one, how fast is this threat moving? There's been one death. There's been nearly 200 contacts being observed for about a week. And there's thankfully, at least as far as we know, no secondary cases, meaning those contacts, no one's fallen sick as far as we know.

2:39The second question we ask is, who is it most likely to harm? Now, right now, it would be the clinicians who cared for that initial patient who died and the colleagues who work with her at the lab. Of course, without an independent lab-confirmed diagnosis, I'd say the risk to the wider public is uncertain. I underscore uncertain. Some will say low, high, medium. I don't think we know the risk without knowing the pathogen. So the last thing is, what can we do now? I'd say the most useful, that's the third question we often ask to protect people. And I'd say, number one, if this is pneumonic plague, it is treatable with common antibiotics if caught early.

3:18So that's the good news if it is pneumonic plague. If it is an engineered pneumonic plague or it's a drug-resistant pneumonic plague, all bets are off on that. However, I would say the most useful step for all of us is to call on Russia's authorities to publish the diagnostic results and share them openly. Russia, as we know, isn't exactly known for their transparency. And what they've said here is essentially, hey, there's no cause for panic. This researcher died from pneumonia from an unknown origin. And I'm curious, though, what the response from Russia indicates, if anything, to you. because Russian health officials, they claimed to have implemented a host of anti-epidemic measures here in the wake of this researcher's death.

4:05And they quarantined the hospital where she passed away. They said that there was not any evidence she got sick from the pathogens she worked with in the lab. And the people that this deceased researcher came into contact with, they're being monitored. And Russia's top public health official, she went to the region where this all happened, and she met with officials there. The Washington Post also noted there were unconfirmed reports that Russia's Federal Security Service has been escorting ambulances to the hospital. Russian officials publicly, they're essentially saying don't worry. But I'm curious, could you read the tea leaves here for us from your expertise from being at the White House?

4:44Does the evidence that I just laid out here that has been reported, does that suggest to you that perhaps they are worrying more than they're letting on? Well, when words and actions diverge, Brittany, people fill the gap with fear. And saying pneumonia of unknown ideology, saying what this is not, but not sharing what it is, while locking down hospitals, erodes trust, especially when the risk is uncertain. And that is, you know, I've been writing and researching on this topic in addition to working as a physician and in the White House. This is what plays out everywhere. When words and actions of authorities diverge, people fill the gap with fear.

5:24So that's what's concerning about the way this response has played out. And then from the White House, I know you have some experience in the White House. I'm curious what you make of the administration's response. And perhaps if it were you during your time there, what you would have done, because according again to The Washington Post, a U.S. health official said we don't have a lot of intel. But they did add that it's in Siberia unless someone gets on a plane and gets to the U.S. It's low risk. We should be alert, but not panicked. And then President Trump, he was asked about the potential pneumonic plague death.

6:01And he said this. They call it pneumonia. pneumonia. You know, years ago, you could treat pneumonia easier. The microbes and the germs have gotten stronger disproportionately. And he also added that the United States would help Russia. What do you make of all of that? What do you think's next here? What could that potential help look like? Well, the critical thing is to watch what would raise your concerns. So rather than assessing risk as high, medium, low, what would be important is actually to set some triggers that would tell us concern is elevating and more action needs to be taken. What would triggers look like, Brittany, in this situation?

6:42Number one would be if any of the secondary cases, new people get sick amongst those close contacts of this first patient. Number two, are there additional contacts being listed given the lack of transparency. Number three is the quarantine or workplace transportation or school restrictions expanding. So if you see those signs, now you want to escalate your response. And the critical thing I learned in the situation room, and I write about this in Safer, is you want to set the threshold for this in advance of actually meeting the threshold. And I believe that's what the White House could be doing at this time and what other nation states should be doing at this time as well.

7:32What then specifically from your experience here are you looking out for next? Because I know that this facility, apparently during the Soviet era, it was reportedly used to engineer biological weapons. The State Department said back in the Biden administration that Russia continues to maintain an offensive biological weapons program. Should people be concerned that this could be a potential biological weapon? Was this just an accident? Is this even the plague? Are those hyperbolic concerns from your point of view? What are you looking out for next? Well, to level set at this particular time, there's no evidence that this is an engineered pathogen.

8:17We don't know whether this current facility is continuing to be involved as it had historically in offensive biological weapons research, though, as you know, the U.S. maintains an assessment that offensive research continues in Russia. And so, of course, it's a fair question to ask. It's also an answerable question. A genome sequence of this pathogen that killed this young women in the lab, a genome sequence would show within days whether this is a natural pathogen, a lab strain, or something that's been altered. And that's another reason that Russia should share it openly. I do want to pivot just a little bit, but stay on the topic of biological weapons.

8:59And I want to turn to another issue, and that's artificial intelligence. Because over the past couple of weeks, we have seen renewed concerns about AI safety. People who have worked at these frontier companies have voiced concerns about the existential threats to humanity the technology could pose. And one researcher even warned that there's a real chance that AI could kill us all in the next decade. And one way people fear that could happen is bad actors using the technology to create and deploy a biological weapon. So to start off this part of the conversation, how concerned are you about that?

9:33Well, you know, I am, I think the Russia incident, sort of gives us a backdrop for this or some context. When something strange happens, as is happening with a dangerous pathogen in Russia at the moment, the questions become, can we detect it fast? Can we figure out where it came from and respond in the open? AI is about to make that question and those questions harder and also easier to answer. And what I mean by that is we have, on the one hand, AI that I see every day at my work at Flagship Pioneering, where we create life science companies, being used to develop the next vaccine and the next treatment against infectious diseases, against cancer.

10:16And it turns out some of the same AI and biology tools we use to develop those innovations that benefit humanity can be used to harm humanity if AI is used to design a biological weapon. And, of course, you point out some of the AI models in this past month did report that there may be some biological misuse of their AI model. So I think we're in a moment, again, a decisive moment where the critical question becomes, can we minimize the risks of AI so that we can maximize its benefits? And from your experience in the White House and in the Situation Room, let's say once again you were in that position right now, what do you think and how would you advise the administration to go about implementing an AI biosecurity strategy?

11:13Well, if you look at the AI accord that was put forward from the White House last week on superintelligence, as it's called, it commits each company to robust internal controls to monitor the capabilities and alignment of its models. And one of the areas includes biosecurity. They also add outside evaluators and a board committee to check that those controls work. And that's what it says. It says what we should watch. It doesn't say what to watch for. And I think that's where the gap needs to be closed. It doesn't say, for instance, what the controls are monitoring for. Nowhere does the accord name what would count as a model crossing a biosecurity line, who would decide if it did, or what would happen next.

12:04And the key point here is an auditor must audit against something. And so we need to work to establish what those thresholds are. And there's some, we can talk about this if you'd like, Brittany. There are some pretty clear thresholds that we could be looking at at this moment. Yeah, dive a little deeper into what exactly those thresholds are, because you are the science brain, not me. So I know a lot of people, when they're asking me about AI and the safety concerns and risks, they don't even know what to look out for, me included. So you tell us. Well, and this comes up in times of uncertainty, especially around technological uncertainty.

12:45And again, in the book, Safer, I dig into this. What do we do when there is uncertainty and how could we respond? And so here with AI and the link with potential biosecurity incidents, when people see a frightening report, such as there were researchers outside the United States, as was noted by one of the AI companies last month and to their credit publicly reported, We're using the AI models to design more efficient influenza to spread between people to figure out how it may evade our vaccines and treatments. And then when it gets reported like this, people who read a disclosure like that come to one of two conclusions.

13:40Either AI has made biological weapons frighteningly accessible, or the safeguards worked and there's nothing to worry about. And my argument would be that rather than swinging the risk pendulum between panic and denial, we should ask a much more calibrated question. What could the AI help this person do, and what could it not do? And that immediately points you to the threshold that matters next, Brittany. And that is whether AI can carry a design from the digital world into the physical one. And quite simply put, a model that can write a research protocol to create a pathogen is not a person who can create it.

14:21You still need synthesized DNA. You need equipment. You need a lab with four walls to grow a virus in. AI has not yet dissolved those barriers. That's not a reason to relax. what we should be doing is to prevent it from dissolving the capability of taking AI, designing biological threats from the digital world into the physical one. And my last question to you is, let's say we were at a dinner party right now. We were seated next to each other. We're having this conversation, the same one we're having right now. I'm curious, from your perspective and with all of your expertise, what else would you include in this conversation?

15:01What else do you think at all? Are we missing anything? What does that look like to you? Well, I think it's critical. I see AI getting better every day at helping scientists do advanced biological work, from predicting heart disease to detecting cancer and accelerating vaccines and treatments for infectious disease. These same tools can be used by a bioterrorist to cause us harm. So we have to get really serious about, yes, continuing to maximize AI's benefits. But to do that, we've got to actually minimize its risks. So that's what I would argue. And we have to be a lot more clear about the thresholds.

15:43If we set those triggers in advance, we can, I think, get there where we can minimize risks and maximize benefits. And your book, Safer, is coming out later this month. Where can people get it and when? Well, it comes, a Safer playbook for turning fear into action and crisis in the community. Safer comes out on October 13th, and you can get it wherever you get your books, from your local independent bookstore to online retailers. Dr. Panjabi, I really appreciate you coming on here, you making sense of this moment we're in. Thank you so much. You're welcome back anytime. Thank you, Brittany.

16:32Thank you.