DARK WINTER

Joe Biden warned at Thursday night’s presidential debate that the U.S. was “about to go into a dark winter,” echoing the concerns of public health experts who caution about increased daily Covid-19 case counts converging with the annual flu season.

“We’re about to go into a dark winter. A dark winter,” Biden said. “And he has no clear plan, and there’s no prospect that there’s going to be a vaccine available for the majority of the American people before the middle of next year.”

On June 22, 2001, a group of well-known U.S. officials and a handful of senior policymakers gathered at Andrews Air Force Base in Maryland for a senior-level exercise that simulated a biological weapons attack—an outbreak of deadly smallpox—on the United States. Designed by the Johns Hopkins Center for Civilian Biodefense Strategies (now called the Center for Health Security) and the Washington-based Center for Strategic and International Studies (CSIS), the day-and-a-half-long “Dark Winter” simulation was conducted to gauge how senior leaders would respond to such an attack and included such high-level participants as Sen. Sam Nunn (who played the president), former White House advisor David Gergen (the national security advisor), and the retired career diplomat Frank Wisner (the secretary of state).

Dark Winter (which stipulates a smallpox attack by an unknown assailant) is not COVID-19 (a disease inadvertently spread by human contact), of course. But the fallout from the coronavirus pandemic bears an eerie resemblance to the simulation: leaders hampered by an inability to address a crisis they hadn’t foreseen (“We’d have been much more comfortable with a terrorist bombing,” Nunn later said in congressional testimony); national decision-making driven by data and expertise from the medical and public health sectors; management options limited by the swift and unpredictable spread of the disease (and a limited stockpile of vaccines); a health care system that lacks the surge capacity to deal with mass casualties; increased tensions between state and federal authorities; the rapid spread of misinformation on cures and treatments for the outbreak (the only way to treat smallpox is to not get it); the difficulty of controlling unpredicted flights of civilians from infected areas; domestic turmoil sparked by political uncertainty (with sporadic rioting—quelled by National Guard units—in large urban areas as grocery stores are shuttered); and an increasing reliance on the willingness (and unwillingness) of individual citizens to self-quarantine to stop the spread of the contagion.

The Dark Winter exercise ended on the second day of the simulation after three long sessions—and purposely without resolution.

Well. this was almost 20 years ago and, it seems, not much has changed… or has it?

Naming a new virus or disease after a location is now generally frowned upon because of the potential stigma it can create, so we’ll see if the name “Alaskapox” actually sticks to this relatively new poxvirus that was first reported in 2015 in a person in Alaska, and has now been reported for a second time in August 2020.
A genetic analysis of the Alaskapox virus showed it’s a member of the Orthopoxvirus genus, which includes a wide range of poxviruses such as smallpox, monkeypox and cowpox. Some poxviruses are very host-specific, meaning they only infect one species, like smallpox which infects only people. Some are more promiscuous, living in a reservoir species but spilling over into other species, as we see with cowpox and monkeypox that infect both animals and people.

That was the end of the story until another case of Alaskapox was identified in August 2020. It was pretty similar story to the first case: a person in Fairbanks went to their doctor because of a strange skin lesion, along with fatigue and fever, and Alaskapox was once again identified. As before, there was no apparent transmission to human contacts, and her infection resolved by itself after about a month.

Genetically the virus seems to have recombined (i.e. swapped DNA) with ectromelia virus (a mouse poxvirus) at some point in the past. All these factors suggest that an animal, most likely a rodent, is the reservoir, and that people are sporadically infected from direct or indirect contact with infected rodents.

In the grand scheme of emerging diseases, a rodent-associated virus that causes rare and mild infection in people isn’t a big deal. However, this IS 2020, things HAVE had a way of going sideways this year, there WAS a government war game that predicted a bad outcome in 2001 and the named exercise “Dark Winter” WAS used by Biden in the last debate.

Coincidence? …really…???