COVID-19 Blame and Shame on Duke NUS Medical School

This is a very long read but since we are all sheltering in place, take the time to read it in full as it is jammed with fascinating facts. We have learned minute by minute due to media reporting all kinds of things about coronavirus but some REAL key facts have been omitted. Gotta ask why. We should start with Duke NUS Medical School/Singapore and domino from there. Doctors, scientists, lab techs, researchers and hunters all know very well the genesis of all potential 5000 strains of coronavirus and they collaborate and read published reports and discuss in seminars and educational events.

Lil Miss Shi knew as she is known as the bat-hunter in Wuhan. Beijing knew and kept quiet but Miss Shi did not. She warned for years and years and Duke University collaborated and likely the CDC and John Hopkins did also. Domestic biolabs and pharma all participate in the volumes of published reports and research.

Okay, read slowly and even take notes and list your questions.

Here we go.

Wuhan-based virologist Shi Zhengli has identified dozens of deadly SARS-like viruses in bat caves, and she warns there are more out there

By Jane Qiu

How China's "Bat Woman" Hunted Down Viruses from SARS to the New Coronavirus Shi Zhengli, known as China’s “bat woman” for her virus-hunting expeditions in bat caves, releases a fruit bat after taking blood and swab samples from it in 2004. Credit: Wuhan Institute of Virology

BEIJING—The mysterious patient samples arrived at Wuhan Institute of Virology at 7 P.M. on December 30, 2019. Moments later, Shi Zhengli’s cell phone rang. It was her boss, the institute’s director. The Wuhan Center for Disease Control and Prevention had detected a novel coronavirus in two hospital patients with atypical pneumonia, and it wanted Shi’s renowned laboratory to investigate. If the finding was confirmed, the new pathogen could pose a serious public health threat—because it belonged to the same family of bat-borne viruses as the one that caused severe acute respiratory syndrome (SARS), a disease that plagued 8,100 people and killed nearly 800 of them between 2002 and 2003. “Drop whatever you are doing and deal with it now,” she recalls the director saying.

Shi—a virologist who is often called China’s “bat woman” by her colleagues because of her virus-hunting expeditions in bat caves over the past 16 years—walked out of the conference she was attending in Shanghai and hopped on the next train back to Wuhan. “I wondered if [the municipal health authority] got it wrong,” she says. “I had never expected this kind of thing to happen in Wuhan, in central China.” Her studies had shown that the southern, subtropical areas of Guangdong, Guangxi and Yunnan have the greatest risk of coronaviruses jumping to humans from animals—particularly bats, a known reservoir for many viruses. If coronaviruses were the culprit, she remembers thinking, “could they have come from our lab?”

While Shi’s team at the Chinese Academy of Sciences institute raced to uncover the identity and origin of the contagion, the mysterious disease spread like wildfire. As of this writing, about 81,000 people in China have been infected. Of that number, 84 percent live in the province of Hubei, of which Wuhan is the capital, and more than 3,100 have died. Outside of China, about 41,000 people across more than 100 countries and territories in all of the continents except Antarctica have caught the new virus, and more than 1,200 have perished.

The epidemic is one of the worst to afflict the world in recent decades. Scientists have long warned that the rate of emergence of new infectious diseases is accelerating—especially in developing countries where high densities of people and animals increasingly mingle and move about.

“It’s incredibly important to pinpoint the source of infection and the chain of cross-species transmission,” says disease ecologist Peter Daszak, president of EcoHealth Alliance, a New York City–based nonprofit research organization that collaborates with scientists, such as Shi, around the world to discover new viruses in wildlife. An equally important task, he adds, is hunting down other related pathogens—the “known unknowns”—in order to “prevent similar incidents from happening again.”

Tracing the Virus at Its Source

To Shi, her first virus-discovery expedition felt like a vacation. On a breezy, sunny spring day in 2004, she joined an international team of researchers to collect samples from bat colonies in caves near Nanning, the capital of Guangxi. Her inaugural cave was typical of the region: large, rich in limestone columns and—being a popular tourist destination—easily accessible. “It was spellbinding,” Shi recalls, with milky-white stalactites hanging from the ceiling like icicles, glistening with moisture.

But the holidaylike atmosphere soon dissipated. Many bats—including several insect-eating species of horseshoe bats that are abundant in southern Asia—roost in deep, narrow caves on steep terrain. Often guided by tips from local villagers, Shi and her colleagues had to hike for hours to potential sites and inch through tight rock crevasses on their stomach. And the flying mammals can be elusive. In one frustrating week, the team explored more than 30 caves and saw only a dozen bats.

These expeditions were part of the effort to catch the culprit in the SARS outbreak, the first major epidemic of the 21st century. A Hong Kong team had reported that wildlife traders in Guangdong first caught the SARS coronavirus from civets, mongooselike mammals that are native to tropical and subtropical Asia and Africa.

Before SARS, the world had little inkling of coronaviruses—named because, seen under a microscope, their spiky surface resembles a crown—says Linfa Wang, who directs the emerging infectious diseases program at Singapore’s Duke-NUS Medical School. Coronavirues were mostly known for causing common colds. “The SARS outbreak was a game changer,” says Wang, whose work on bat-borne coronaviruses got a swift mention in the 2011 Hollywood blockbuster Contagion. It was the first time a deadly coronavirus with pandemic potential emerged. This discovery helped to jump-start a global search for animal viruses that could find their way into humans.

Shi was an early recruit of that worldwide effort, and both Daszak and Wang have since been her long-term collaborators. But how the civets got the virus remained a mystery. Two previous incidents were telling: Australia’s 1994 Hendra virus infections, in which the contagion jumped from horses to humans, and Malaysia’s 1998 Nipah virus outbreak, in which it moved from pigs to people. Both diseases were found to be caused by pathogens that originated in fruit-eating bats. Horses and pigs were merely the intermediate hosts.

In those first virus-hunting months in 2004, whenever Shi’s team located a bat cave, it would put a net at the opening before dusk—and then wait for the nocturnal creatures to venture out to feed for the night. Once the bats were trapped, the researchers took blood and saliva samples, as well as fecal swabs, often working into the small hours. After catching up on some sleep, they would return to the cave in the morning to collect urine and fecal pellets.

But sample after sample turned up no trace of genetic material from coronaviruses. It was a heavy blow. “Eight months of hard work seemed to have gone down the drain,” Shi says. “We thought coronaviruses probably did not like Chinese bats.” The team was about to give up when a research group in a neighboring lab handed it a diagnostic kit for testing antibodies produced by people with SARS.

There was no guarantee the test would work for bat antibodies, but Shi gave it a go anyway. “What did we have to lose?” she says. The results exceeded her expectations. Samples from three horseshoe bat species contained antibodies against the SARS virus. “It was a turning point for the project,” Shi says. The researchers learned that the presence of the coronavirus in bats was ephemeral and seasonal—but an antibody reaction could last from weeks to years. So the diagnostic kit offered a valuable pointer as to how to hunt down viral genomic sequences.

Shi’s team used the antibody test to narrow down locations and bat species to pursue in the quest for these genomic clues. After roaming mountainous terrain in the majority of China’s dozens of provinces, the researchers turned their attention to one spot: Shitou Cave on the outskirts of Kunming, the capital of Yunnan—where they conducted intense sampling during different seasons throughout five consecutive years.

The efforts paid off. The pathogen hunters discovered hundreds of bat-borne coronaviruses with incredible genetic diversity. “The majority of them are harmless,” Shi says. But dozens belong to the same group as SARS. They can infect human lung cells in a petri dish, cause SARS-like diseases in mice, and evade vaccines and drugs that work against SARS.

In Shitou Cave—where painstaking scrutiny has yielded a natural genetic library of bat viruses—the team discovered a coronavirus strain in 2013 that came from horseshoe bats and had a genomic sequence that was 97 percent identical to the one found in civets in Guangdong. The finding concluded a decade-long search for the natural reservoir of the SARS coronavirus.

Viral Melting Pots

In many bat dwellings Shi has sampled, including Shitou Cave, “constant mixing of different viruses creates a great opportunity for dangerous new pathogens to emerge,” says Ralph Baric, a virologist at the University of North Carolina at Chapel Hill. And in the vicinity of such viral melting pots, Shi says, “you don’t need to be a wildlife trader to be infected.”

Near Shitou Cave, for example, many villages sprawl among the lush hillsides in a region known for its roses, oranges, walnuts and hawthorn berries. In October 2015 Shi’s team collected blood samples from more than 200 residents in four of those villages. It found that six people, or nearly 3 percent, carried antibodies against SARS-like coronaviruses from bats—even though none of them had handled wildlife or reported SARS-like or other pneumonia-like symptoms. Only one had travelled outside of Yunnan prior to sampling, and all said they had seen bats flying in their village.

Three years earlier, Shi’s team had been called in to investigate the virus profile of a mineshaft in Yunnan’s mountainous Mojiang County—famous for its fermented Pu’er tea—where six miners suffered from pneumonialike diseases (two of them died). After sampling the cave for a year the researchers discovered a diverse group of coronaviruses in six bat species. In many cases, multiple viral strains had infected a single animal, turning it into a flying factory of new viruses.

“The mineshaft stunk like hell,” says Shi, who went in with her colleagues wearing a protective mask and clothing. “Bat guano, covered in fungus, littered the cave.” Although the fungus turned out to be the pathogen that had sickened the miners, she says it would only have been a matter of time before they caught the coronaviruses if the mine had not been promptly shut.

With growing human populations increasingly encroaching on wildlife habitats, with unprecedented changes in land use, with wildlife and livestock transported across countries and their products around the world, and with a sharp increase in both domestic and international travel, new disease outbreaks of pandemic scale are a near mathematical certainty. This had been keeping Shi and many other researchers awake at night—long before the mysterious samples landed at the Wuhan Institute of Virology on that ominous evening last December.

About a year ago, Shi’s team published two comprehensive reviews about coronaviruses in Viruses and Nature Reviews Microbiology. Drawing evidence from her own studies—many of which were published in top academic journals—and from others, Shi and her co-authors warned of the risk of future outbreaks of bat-borne coronaviruses.

Racing against a Deadly Pathogen

On the train back to Wuhan on December 30 last year, Shi and her colleagues discussed ways to immediately start testing the patient samples. In the following weeks—the most intense and the most stressful time of her life—China’s bat woman felt she was fighting a battle in her worst nightmare, even though it was one she had been preparing for over the past 16 years. Using a technique called polymerase chain reaction, which can detect a virus by amplifying its genetic material, the first round of tests showed that samples from five of seven patients contained genetic sequences known to be present in all coronaviruses.

Shi instructed her team to repeat the tests and, at the same time, sent the samples to another laboratory to sequence the full viral genomes. Meanwhile she frantically went through her own laboratory’s records from the past few years to check for any mishandling of experimental materials, especially during disposal. Shi breathed a sigh of relief when the results came back: none of the sequences matched those of the viruses her team had sampled from bat caves. “That really took a load off my mind,” she says. “I had not slept a wink for days.”

By January 7 the Wuhan team determined that the new virus had indeed caused the disease those patients suffered—a conclusion based on results from polymerase chain reaction analysis, full genome sequencing, antibody tests of blood samples and the virus’s ability to infect human lung cells in a petri dish. The genomic sequence of the virus—now officially called SARS-CoV-2 because it is related to the SARS pathogen—was 96 percent identical to that of a coronavirus the researchers had identified in horseshoe bats in Yunnan, they reported in a paper published last month in Nature. “It’s crystal clear that bats, once again, are the natural reservoir,” says Daszak, who was not involved in the study.

In 2004, an international team of scientists takes blood and swab samples from bats at night in order to discover potential bat-borne pathogens. Credit: Wuhan Institute of Virology

The genomic sequences of the viral strains from patients are, in fact, very similar to one another, with no significant changes since late last December, based on analyses of 326  published viral sequences. “This suggests the viruses share a common ancestor,” Baric says. The data also point to a single introduction into humans followed by sustained human-to-human transmission, researchers say.

Given that the virus seems fairly stable and that many infected individuals appear to have mild symptoms, scientists suspect the pathogen might have been around for weeks or even months before the first severe cases raised alarm. “There might have been mini outbreaks, but the virus burned out” before causing havoc, Baric says. “The Wuhan outbreak is by no means incidental.” In other words, there was an element of inevitability to it.

To many, the region’s burgeoning wildlife markets—which sell a wide range of animals such as bats, civets, pangolins, badgers and crocodiles—are perfect viral melting pots. Although humans could have caught the deadly virus from bats directly (according to several studies, including those by Shi and her colleagues), independent teams have suggested in preprint studies that pangolins may have been an intermediate host. These teams have reportedly uncovered SARS-CoV-2–like coronaviruses in these animals, which were seized in antismuggling operations in southern China.

On February 24 the nation announced a permanent ban on wildlife consumption and trade except for research or medicinal or display purposes—which will stamp out an industry worth $76 billion and put approximately 14 million people out of jobs, according to a 2017 report commissioned by the Chinese Academy of Engineering. Some welcome the initiative, whereas others, such as Daszak, worry that without efforts to change people’s traditional beliefs or provide alternative livelihoods, a blanket ban may push the business underground. This could make disease detection even more challenging. “Eating wildlife has been part of the cultural tradition in southern China” for thousands of years, Daszak says. “It won’t change overnight.”

In any case, Shi says, “wildlife trade and consumption are only part of problem.” In late 2016 pigs across four farms in Qingyuan county in Guangdong—60 miles from the site where the SARS outbreak originated—suffered from acute vomiting and diarrhea, and nearly 25,000 of the animals died. Local veterinarians could not detect any known pathogen and called Shi for help. The cause of the illness, called swine acute diarrhea syndrome (SADS), turned out to be a virus whose genomic sequence was 98 percent identical to a coronavirus found in horseshoe bats in a nearby cave.

“This is a serious cause for concern,” says Gregory Gray, an infectious disease epidemiologist at Duke University. Pigs and humans have very similar immune systems, making it easy for viruses to cross between the two species. Moreover a team at Zhejiang University in the Chinese city of Hangzhou found the SADS virus could infect cells from many organisms in a petri dish, including rodents, chickens, nonhuman primates and humans. Given the scale of swine farming in many countries, such as China and the U.S., Gray says, looking for novel coronaviruses in pigs should be a top priority.

Although the Wuhan outbreak is the sixth one caused by bat-borne viruses in the past 26 years —the other five being Hendra in 1994, Nipah in 1998, SARS in 2002, MERS (Middle East respiratory syndrome) in 2012, and Ebola in 2014—“the animals [themselves] are not the problem,” Wang says. In fact, bats help promote biodiversity and the health of their ecosystems by eating insects and pollinating plants. “The problem arises when we get in contact with them,” he says.

Fending Off Future Outbreaks

More than two months into the epidemic—and seven weeks after the Chinese government imposed citywide transportation restrictions in Wuhan, a megacity of 11 million—life feels almost normal, Shi says, laughing. “Maybe we are getting used to it. The worst days are certainly over.” The institute staffers have a special pass to travel from home to their laboratory, but they cannot go anywhere else. For more than a month, they had to subsist on instant noodles during their long hours in the lab because the institute’s canteen was closed.

The researchers found that the new coronavirus enters human lung cells using a receptor called angiotensin-converting enzyme 2 (ACE2). The scientists have since been screening for drugs that can block it. They, as well as other research groups, are also racing to develop vaccines and test promising candidates. In the long run, the team plans to develop broad-spectrum vaccines and drugs against coronaviruses deemed risky to humans. “The Wuhan outbreak is a wake-up call,” Shi says.

Many scientists say the world should move beyond merely responding to deadly pathogens when they arise. “The best way forward is prevention,” Daszak says. Because 70 percent of animal-borne emerging infectious diseases come from wild creatures, “where we should start is to find all those viruses in wildlife globally and develop better diagnostic tests,” he adds. Doing so would essentially mean rolling out what researchers such as Daszak and Shi have been doing on a much bigger scale.

Such efforts should focus on high-risk viral groups in certain mammals prone to coronavirus infections, such as bats, rodents, badgers, civets, pangolins, and nonhuman primates, Daszak says. He adds that developing countries in the tropics, where wildlife diversity is greatest, should be the front line of this battle against viruses.

In recent decades, Daszak and his colleagues analyzed approximately 500 human infectious diseases from the past century. They found that the emergence of new pathogens tended to happen in places where a dense population had been changing the landscape—by building roads and mines, cutting down forests and intensifying agriculture. “China is not the only hotspot,” he says, noting that other major emerging economies, such as India, Nigeria and Brazil, are also at great risk.

Once potential pathogens are mapped out, scientists and public health officials can regularly check for possible infections by analyzing blood and swab samples from livestock, wild animals that are farmed and traded, and high-risk human populations, such as farmers, miners, villagers who live near bats, and people who hunt or handle wildlife, Gray says. This approach, known as “One Health,”, aims to integrate the management of wildlife health, livestock health, and human health. “Only then can we catch an outbreak before it turns into an epidemic,” he says, adding that the approach could potentially save the hundreds of billions of dollars such an epidemic can cost.

Back in Wuhan, China’s bat woman has decided to retire from the front line of virus-hunting expeditions. “But the mission must go on,” says Shi, who will continue to lead research programs. “What we have uncovered is just the tip of an iceberg.” Daszak’s team has estimated that there are as many as 5,000 coronavirus strains waiting to be discovered in bats globally. Shi is planning a national project to systematically sample viruses in bat caves—with much greater scope and intensity than her team’s previous attempts.

“Bat-borne coronaviruses will cause more outbreaks,” she says with a tone of brooding certainty. “We must find them before they find us.”

 

 

China Says Immoral of US Officials to Blame China for Virus

FNC: If you listened to Chinese state-run media, you’d think President Trump went to China and released vials of COVID-19 on groups of unsuspecting men, women and children.

Beijing has been bending over backward trying to convince the world that the United States is the real culprit behind the quickly spreading virus that’s already claimed more than 4,600 lives across the globe.

It’s a high-stakes strategy for the Asian nation fighting to keep its superpower status amid a national lockdown and palpable anger over claims that Wuhan, China, the epicenter of the coronavirus, at first covered it up, triggering a worldwide health and economic crisis.

The Chinese government has already published a book in English — with translations in the works in French, Spanish, Russian and Arabic — touting its handling of the deadly disease.

A Battle Against Epidemic: China Combatting COVID-19 in 2020” is a mishmash of glowing state media reports on the accomplishments of President Xi Jinping, the Communist Party and the dominance of the Chinese system in fighting the crisis.

biosafety-level-IV (P4) opened in 2017 in Wuhan

At best, China’s aggressive new campaign can be chalked up to ambitious propaganda.  At its worst, it’s a reckless display from a country that has actively misled the world while working overtime to save its own skin, foreign affairs expert Gordon G. Chang told Fox News.

Chang believes Beijing has been laying the groundwork for a PR attack against the United States for more than a month, first by throwing doubt on the origin of COVID-19 and second, by slamming America’s handling of previous diseases like the swine flu, which decimated China’s pork industry.

On Sunday, Lin Songtian, China’s ambassador to South Africa, said: “Although the epidemic first broke out in China, it did not necessarily mean that the virus is originated from China, let alone ‘made in China.’

 

Vague and misleading statements like the one from Lin are ripped right out of China’s propaganda playbook and attempt to sow doubt about the global crisis.

Chinese officials have also pushed back on the expression “Wuhan coronavirus” — saying the name used frequently by U.S. conservative commentators unfairly stigmatizes the world’s most populous country.

Chang said it’s just another tactic in China’s playbook, carefully choreographed to make Americans look petty and racist.

“This an all-out assault on the United States,” Chang said.

In December, when the coronavirus was first detected in Wuhan, many media around the world began referring to it as the “Wuhan virus.” But last month, the World Health Organization renamed the illness COVID-19 so as not to link it to a specific location or group of people.

The name change didn’t stop some, like Secretary of State Mike Pompeo, who blew past warnings and deliberately referred to it as the “Wuhan virus” after China’s foreign ministry called it “highly irresponsible” to do so.

President Donald Trump’s national security adviser, Robert O’Brien, went even further Wednesday.

“Unfortunately, rather than using best practices, this outbreak in Wuhan was covered up,” O’Brien said at the Heritage Foundation, a conservative-leaning think tank in Washington. “There’s lots of open-source reporting from China, from Chinese nationals, that the doctors involved were either silenced or put in isolation, or that sort of thing, so that the word of this virus could not get out. It probably cost the world community two months.”

O’Brien said if experts would have had those two months to get ahead of the spread of the virus, “I think we could have dramatically curtailed what happened both in China and what’s now happening across the world.”

Sen. Marco Rubio, R-Fla., said the Communist Party is pointing the finger at the U.S. so it can dampen discontent back home.

“The Chinese military portal Xilu.com recently published an article baselessly claiming that the virus is ‘a biochemical weapon produced by the U.S. to target China,’” Rubio said.

Arkansas Republican Sen. Tom Cotton, has frequently used the term “Wuhan virus” on the Senate floor.

Earlier this week, several social media users took House Minority Leader Kevin McCarthy, R-Calif., to task when he referred to it as “the Chinese coronavirus.”

Instead of backing down, Chang believes officials should keep calling COVID-19 the “Wuhan virus” and push back on accusations of racism.

“This isn’t a Republican thing. We all need to unite and for people to say, ‘this is racist’ is irresponsible,” Chang said. “There is no race known as Wuhanese.”

Chang also said calling COVID-19 the “Wuhan virus” or “Chinese coronavirus” keeps pressure on the Chinese government and forces it to be held accountable by the rest of the world for its initial response to the global crisis, which was widely regarded as abysmal.

China, though, is using everything in its arsenal to paint itself as a global hero, rewriting history and going so far as to demand a thank you for containing the virus as long as it did.

“We should say righteously that the U.S. owes China an apology, the world owes China a thank you,” an editorial on state news agency Xinhua read.

Also peculiar is that Beijing — which is normally quick to censor news — has refused to step in as a wave of anti-American conspiracy theories flood the internet. Among the rumors is that the U.S. created the coronavirus to make China look bad as well as one that accuses the government of covering up thousands of deaths by classifying them as the regular flu.

“It’s more than just some disinformation or an official narrative,” Xiao Qiang, an adjunct professor at the University of California at Berkeley’s Schools of Information, told The Washington Post. “It’s an orchestrated, all-out campaign by the Chinese government through every channel at a level you rarely see. It’s a counteroffensive.”

Govt Report on Prevention of Nationwide Cyber Catastrophe

A good first step for sure, however there needs to be a government-wide decision on cyber attacks being an act of war and how to respond.

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The Cyberspace Solarium Commission’s proposes a strategy of layered cyber deterrence. Our report consists of over 80 recommendations to implement the strategy. These recommendations are organized into 6 pillars:
  1. Reform the U.S. Government’s Structure and Organization for Cyberspace.
  2. Strengthen Norms and Non-Military Tools.
  3. Promote National Resilience.
  4. Reshape the Cyber Ecosystem.
  5. Operationalize Cybersecurity Collaboration with the Private Sector.
  6. Preserve and Employ the Military Instrument of National Power.

Click here to download the full report.

A much-anticipated government report aimed at defending the nation against cyber threats in the years to come opens with a bleak preview of what could happen if critical systems were brought down.

“The water in the Potomac still has that red tint from where the treatment plants upstream were hacked, their automated systems tricked into flushing out the wrong mix of chemicals,” the Cyberspace Solarium Commission wrote in the opening lines of its report.

“By comparison, the water in the Lincoln Memorial Reflecting Pool has a purple glint to it. They’ve pumped out the floodwaters that covered Washington’s low-lying areas after the region’s reservoirs were hit in a cascade of sensor hacks,” it continues.

So begins the report two years in the making from a congressionally mandated commission made up of lawmakers and top Trump administration officials, pointing to the vulnerabilities involved with critical systems being hooked up to the internet.

The report, which includes more than 75 recommendations for how to prevent the cyber doomsday it spells out, and the commission that made it were both mandated by the 2019 National Defense Authorization Act (NDAA).

The commissioners, who include co-chairmen Sen. Angus King (I-Maine) and Rep. Mike Gallagher (R-Wis.), highlight a range of issues to address, but zero in on election security as “priority.”

“The American people still do not have the assurance that our election systems are secure from foreign manipulation,” King and Gallagher wrote in the report. “If we don’t get election security right, deterrence will fail and future generations will look back with longing and regret on the once powerful American Republic and wonder how we screwed the whole thing up.”

The focus on shoring up election security, and the agreed-upon recommendations for how to do this, sets the report apart from the approach to the subject on Capitol Hill, where it has been a major issue of contention between Republicans and Democrats since Russian interference in the 2016 presidential election.

Beyond election security, the commissioners call for overarching government reform to address cyber vulnerabilities. Chief among these is calling on the White House to issue an updated national strategy to address cyber threats and to establish a national cybersecurity director position to coordinate efforts.

In terms of congressional action, commissioners recommend that Congress create cybersecurity committees in both the House and Senate, establish a Bureau of Cybersecurity Statistics, and establish an assistant secretary position at the State Department to lead international efforts around cybersecurity.

“While cyberspace has transformed the American economy and society, the government has not kept up,” commissioners wrote in calling for reforms.

The commission also zeroed in on “imposing costs” to adversaries who attempt to attack the U.S. online. In order to do so, it recommended that the Department of Defense conduct vulnerability assessments of its weapons systems, including nuclear control systems, and that it make cybersecurity preparedness a necessity.

The Cybersecurity and Infrastructure Security Agency, the Department of Homeland Security’s cyber agency, would be empowered as the “lead agency” at the federal level.

The report’s recommendations were debated on and pinpointed by a group of high-ranking commissioners who also included FBI Director Christopher Wray, Deputy Secretary of Defense David Norquist, Transportation Security Administration Administrator David Pekoske, Sen. Ben Sasse (R-Neb.), and Rep. James Langevin (D-R.I.).

Langevin said in a statement on Wednesday that the report is intended to shore up the nation’s cyber “resiliency for years to come.”

“Our charge in drafting this report was to prevent a cyber event of significant national consequence, and we know that the short- and long-term recommendations we crafted will better position us to realize the promise of the Internet, while avoiding its perils,” Langevin said. “The sooner our recommendations are implemented, the better positioned the country will be to prevent and respond to incidents that can disrupt the American way of life.”

The report’s recommendations may soon have real-world consequences on Capitol Hill.

Rep. John Katko (R-N.Y.), the ranking member on the House Homeland Security Committee’s cyber panel, told The Hill this week that there “definitely will be some legislation” stemming from the report’s recommendations, and that hearings would likely be held.

Katko noted that he had talked with Senate Homeland Security Committee Chairman Ron Johnson (R-Wis.) about the Senate also taking action around the report.

“This report screams of the need for bipartisan action on this, and I hope that we can leave the politics out of it, and I hope we can attack these problems quickly and effectively,” Katko said.

Rep. Cedric Richmond (D-La.), the cyber subcommittee’s chairman, opened a hearing on Wednesday by praising the report’s recommendations and saying he looked forward to working to “codifying” the ideas alongside House Homeland Security Committee Chairman Bennie Thompson (D-Miss.).

Industry groups also reacted positively to the report’s recommendations. Tom Gann, the chief public policy officer of cybersecurity firm McAfee, told The Hill in a statement that he agreed with most of the report’s findings and hoped that they are “acted upon with speed.”

Protect Our Power, a nonprofit with the goal of protecting the electric grid, also praised the report.

“These are compelling recommendations, echoing issues we have highlighted for several years now, and action is long overdue,” Jim Cunningham, executive director of the group, said in a statement. “Without a reliable supply of electricity before, during and following a disabling cyberattack, none of our critical infrastructure can function.”

While there may be legislative action soon – and praise from industry groups – both Gallagher and King emphasized in the report that their main aim was for it to open the eyes of Americans to the dangers posed by cyberattacks on critical systems.

“The status quo is inviting attacks on America every second of every day,” the co-chairmen wrote. “We all want that to stop. So please do us, and your fellow Americans, a favor. Read this report and then demand that your government and the private sector act with speed and agility to secure our cyber future.”

Taiwan More Advanced than U.S. to Deal with Coronavirus

Taiwan, while in a contentious government power struggle with China, the country has a very conservative approach on economic stability and encourages entrepreneurial strengths.

(Reuters) – China is pressuring Taiwan with “provocative” air force maneuvers near the island and spreading fake news to sow discord during the coronavirus outbreak, security sources and government officials in Taiwan say.

This sets the table for why Taiwan’s master plan to thrive during the coronavirus outbreak.

Angry Taiwan blames China for UN aviation meet snub | The ...

You can be assured corporate leaders in the United States are taking notice and are hosting some top level meetings regarding research and development across the country during this anxious time in America and across the world.

Taiwan records its first coronavirus death as global toll ...

Read on for some interesting actions Taiwan has taken given how interacted the country is with China.

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Taiwan is 81 miles off the coast of mainland China and was expected to have the second highest number of cases of coronavirus disease 2019 (COVID-19) due to its proximity to and number of flights between China.1 The country has 23 million citizens of which 850 000 reside in and 404 000 work in China.2,3 In 2019, 2.71 million visitors from the mainland traveled to Taiwan.4 As such, Taiwan has been on constant alert and ready to act on epidemics arising from China ever since the severe acute respiratory syndrome (SARS) epidemic in 2003. Given the continual spread of COVID-19 around the world, understanding the action items that were implemented quickly in Taiwan and assessing the effectiveness of these actions in preventing a large-scale epidemic may be instructive for other countries.

COVID-19 occurred just before the Lunar New Year during which time millions of Chinese and Taiwanese were expected to travel for the holidays. Taiwan quickly mobilized and instituted specific approaches for case identification, containment, and resource allocation to protect the public health. Taiwan leveraged its national health insurance database and integrated it with its immigration and customs database to begin the creation of big data for analytics; it generated real-time alerts during a clinical visit based on travel history and clinical symptoms to aid case identification. It also used new technology, including QR code scanning and online reporting of travel history and health symptoms to classify travelers’ infectious risks based on flight origin and travel history in the past 14 days. Persons with low risk (no travel to level 3 alert areas) were sent a health declaration border pass via SMS (short message service) messaging to their phones for faster immigration clearance; those with higher risk (recent travel to level 3 alert areas) were quarantined at home and tracked through their mobile phone to ensure that they remained at home during the incubation period.

Moreover, Taiwan enhanced COVID-19 case finding by proactively seeking out patients with severe respiratory symptoms (based on information from the National Health Insurance [NHI] database) who had tested negative for influenza and retested them for COVID-19; 1 was found of 113 cases. The toll-free number 1922 served as a hotline for citizens to report suspicious symptoms or cases in themselves or others; as the disease progressed, this hotline has reached full capacity, so each major city was asked to create its own hotline as an alternative. It is not known how often this hotline has been used. The government addressed the issue of disease stigma and compassion for those affected by providing food, frequent health checks, and encouragement for those under quarantine. This rapid response included hundreds of action items (eTable in the Supplement).

Recognizing the Crisis

In 2004, the year after the SARS outbreak, the Taiwan government established the National Health Command Center (NHCC). The NHCC is part of a disaster management center that focuses on large-outbreak response and acts as the operational command point for direct communications among central, regional, and local authorities. The NHCC unified a central command system that includes the Central Epidemic Command Center (CECC), the Biological Pathogen Disaster Command Center, the Counter-Bioterrorism Command Center, and the Central Medical Emergency Operations Center.5

On December 31, 2019, when the World Health Organization was notified of pneumonia of unknown cause in Wuhan, China, Taiwanese officials began to board planes and assess passengers on direct flights from Wuhan for fever and pneumonia symptoms before passengers could deplane. As early as January 5, 2020, notification was expanded to include any individual who had traveled to Wuhan in the past 14 days and had a fever or symptoms of upper respiratory tract infection at the point of entry; suspected cases were screened for 26 viruses including SARS and Middle East respiratory syndrome (MERS). Passengers displaying symptoms of fever and coughing were quarantined at home and assessed whether medical attention at a hospital was necessary. On January 20, while sporadic cases were reported from China, the Taiwan Centers for Disease Control (CDC) officially activated the CECC for severe special infectious pneumonia under NHCC, with the minister of health and welfare as the designated commander. The CECC coordinated efforts by various ministries, including the ministries of transportation, economics, labor, and education and the Environmental Protection Administration, among others, in a comprehensive effort to counteract the emerging public health crisis.

Managing the Crisis

For the past 5 weeks (January 20-February 24), the CECC has rapidly produced and implemented a list of at least 124 action items (eTable in the Supplement) including border control from the air and sea, case identification (using new data and technology), quarantine of suspicious cases, proactive case finding, resource allocation (assessing and managing capacity), reassurance and education of the public while fighting misinformation, negotiation with other countries and regions, formulation of policies toward schools and childcare, and relief to businesses.

Border Control, Case Identification, and Containment

On January 27, the National Health Insurance Administration (NHIA) and the National Immigration Agency integrated patients’ past 14-day travel history with their NHI identification card data from the NHIA; this was accomplished in 1 day. Taiwan citizens’ household registration system and the foreigners’ entry card allowed the government to track individuals at high risk because of recent travel history in affected areas. Those identified as high risk (under home quarantine) were monitored electronically through their mobile phones. On January 30, the NHIA database was expanded to cover the past 14-day travel history for patients from China, Hong Kong, and Macau. On February 14, the Entry Quarantine System was launched, so travelers can complete the health declaration form by scanning a QR code that leads to an online form, either prior to departure from or upon arrival at a Taiwan airport. A mobile health declaration pass was then sent via SMS to phones using a local telecom operator, which allowed for faster immigration clearance for those with minimal risk. This system was created within a 72-hour period. On February 18, the government announced that all hospitals, clinics, and pharmacies in Taiwan would have access to patients’ travel histories.

Resource Allocation: Logistics and Operations

The CECC took an active role in resource allocation, including setting the price of masks and using government funds and military personnel to increase mask production. On January 20, the Taiwan CDC announced that the government had under its control a stockpile of 44 million surgical masks, 1.9 million N95 masks, and 1100 negative-pressure isolation rooms.

Communications and Politics
Reassure and Educate the Public, While Fighting Misinformation

In addition to daily press briefings by the minister of health and welfare the CECC, the vice president of Taiwan, a prominent epidemiologist, gave regular public service announcements broadcast from the office of the president and made available via the internet. These announcements included when and where to wear a mask, the importance of handwashing, and the danger of hoarding masks to prevent them from becoming unavailable to frontline health workers. The CECC also made plans to assist schools, businesses, and furloughed workers (eTable in the Supplement).

Taiwan’s Outcomes so Far (as of February 24)
Interim Outcomes

The CECC has communicated to the public in a clear and compassionate manner. Based on a poll of 1079 randomly selected people conducted by the Taiwan Public Opinion Foundation on February 17 and 18, the minister of health and welfare received approval ratings of more than 80% for his handling of the crisis, and the president and the premier received an overall approval rating of close to 70%. As of February 24, Taiwan has 30 cases of COVID-19. These cases represent the 10th-highest case number among countries affected thus far, but far fewer than the initial models predicting that Taiwan would have the second-highest importation risk.

Challenges

First, real-time public communications were mostly in Mandarin Chinese and sign language. Other than the Taiwan CDC website, there was not enough communication in different languages to non-Taiwanese citizens traveling or residing in Taiwan. Second, while its attention was focused on air travel, Taiwan permitted the docking of the Diamond Princess cruise ship and allowed passengers to disembark in Keelung, near New Taipei City, on January 31, before the ship left for Japan. The ship was subsequently found to have numerous confirmed infections onboard. This created a temporary public panic with concern about community spread. The government published the 50 locations where the cruise ship travelers may have visited and asked citizens who may have been in contact with the tour group to conduct symptom monitoring and self-quarantine if necessary. None were confirmed to have COVID-19 after 14 days had passed. Third, whether the intensive nature of these policies can be maintained until the end of the epidemic and continue to be well received by the public is unclear.

Conclusions

Taiwan’s government learned from its 2003 SARS experience and established a public health response mechanism for enabling rapid actions for the next crisis. Well-trained and experienced teams of officials were quick to recognize the crisis and activated emergency management structures to address the emerging outbreak.

In a crisis, governments often make difficult decisions under uncertainty and time constraints. These decisions must be both culturally appropriate and sensitive to the population. Through early recognition of the crisis, daily briefings to the public, and simple health messaging, the government was able to reassure the public by delivering timely, accurate, and transparent information regarding the evolving epidemic. Taiwan is an example of how a society can respond quickly to a crisis and protect the interests of its citizens.

Article Information

Corresponding Author: C. Jason Wang, MD, PhD, Stanford University, 117 Encina Commons, CHP/PCOR, Stanford, CA 94305 ([email protected]).

Published Online: March 3, 2020. doi:10.1001/jama.2020.3151

Conflict of Interest Disclosures: None reported.

References and footnotes found here in detail.

Operation Mega Flex

From July to September last year, Customs and Border Patrol in that 3 month period seized 1061 shipments of counterfeit goods at our cargo ports of entry. Items from Louis Vuitton bags to sports equipment with faulty parts. Other items included children’s toys, drug paraphernalia, deadly opioids, and really scary were (are) counterfeit drivers’ licenses. Recreational drugs, clothing, jewelry and even food and nutritional items (may contain toxins) are part of the counterfeit items affecting likely every American and business.

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Unlike legitimate drug manufacturers that are subject to inspections by the U.S. Food and Drug Administration, labs that manufacture counterfeits have no such oversight. According to a 2019 Better Business Bureau study, “companies based in China, Hong Kong, Singapore, and India shipped 97 percent of the counterfeit medicines seized in the U.S.”In March 2019, Europol, the European Union’s law enforcement agency, seized 13 million doses of counterfeit medicine ranging from opioids to heart medication. Europol noted that this type of counterfeiting is on the rise due to the relatively low risk of criminal detection.

Check those items in retail operations of all sorts and locations and what you purchase in the e-commerce realm, not the from the street vendor at the corner and when purchasing books, movies or music, you could be in real trouble for a transaction that violates copyright protected work.

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Watches and jewelry follow at 13 percent of total seizures. During the Mega Flex operation on August 21, 2019, for example, CBP officers seized counterfeit Rolex watches valued at over $1.4 million. Handbags and wallets represented nearly 11 percent of all seizures, including counterfeits of luxury brands such as Louis Vuitton, Michael Kors, and Gucci. Consumer electronicsrepresented 10 percent of seizures, including products such as iPhones, hover boards, earbuds, microchips, and others. Pharmaceuticals and personal care items account for only 7 percent of total seizures. However, as discussed in the next section, many of the products in these categories pose significant dangers to the consumer. Fake prescription drugs can lack active ingredients, contain incorrect dosages, or include dangerous additives. Fake personal care items such as cosmetics have been found to contain everything from harmful bacteria to human waste. Between 2017 and 2018, CBP and ICE Homeland Security Investigations (HSI) seized over $31 million in fake perfumes from China.

Law enforcement officials have uncovered intricate links between the sale of counterfeit goods and transnational organized crime. A study by the Better Business Bureau notes that the financial operations supporting counterfeit goods typically require central coordination, making these activities attractive for organized crime, with groups such as the Mafia and the Japanese Yakuza heavily involved. Criminal organizations use coerced and child labor to manufacture and sell counterfeit goods. In some cases, the proceeds from counterfeit sales may be supporting terrorism and dictatorships throughout the world.

In FY 2018, 12 percent of DHS seizures included counterfeit versions of critical technological components, automotive and aerospace parts, batteries, and machinery. Each of these industrial sectors have been identified as critical to the defense industrial base, and thus critical to national security. One example drawn from a 2018 study by the Bureau of Industry and Security within the Department of Commerce featured the import of counterfeit semiconductors or “Trojan chips” for use in defense manufacturing and operations. Such Trojan chips can carry viruses or malware that infiltrate and weaken American national security. The problem of counterfeit chips has become so pervasive that the Department of Defense has referred to it as an “invasion.” Companies from China are the primary producers of counterfeit electronics.

According to a 2019 report, Instagram and Counterfeiting, nearly 20 percent of the posts analyzed about fashion products on Instagram featured counterfeit or illicit products. More than 50,000 Instagram accounts were identified as promoting and selling counterfeits, a 171 percent increase from a prior 2016 analysis. Instagram’s Story feature, where content disappears in twenty-four hours, was singled out as particularly effective for counterfeit sellers.

For the full report, go here.