Joseph V. Micallef is a best-selling military history and world affairs author, and keynote speaker. Follow him on Twitter @JosephVMicallef.
The COVID-19 pandemic is far from over. While the United States may be at peak mortality from the pandemic, it is still raging in many of the other 180 countries infected -- many of which have not yet seen their mortality peaks.
COVID-19 is simply one battle in a longer and larger war that humankind has waged with coronaviruses for generations. This pandemic, however, has underscored the national security implications of such outbreaks.
Even with a COVID-19 vaccine, the enormous pool of potential pathogens, and the current patterns of world trade and travel, mean that it is likely that new pathogens may emerge in the future whose medical and economic consequences may be as devastating as COVID-19, or even worse.
The U.S. military has been on the frontline of the battle against the COVID-19 pandemic and played a major role in marshaling medical assistance and building emergency facilities to deal with the anticipated surge. In doing so, it reclaimed a role that it played extensively during the 19th century and the first half of the 20th century.
The legacy of the COVID-19 pandemic on national security will be manifold. Three aspects in particular stand out already: an expanded role for the U.S. military in providing the surge capacity in medical facilities and personnel in the event there is another pandemic; a rethinking of what procedures and policies are necessary for preserving force readiness in the face of disease outbreaks; and a new assessment of biological threats, whether deliberately weaponized or not, on national security.
The Military and Infectious Diseases: Past, Present and Future
An old 16th century adage declared, "Where armies march, plague follows." Disease outbreaks have long been associated with military campaigns and have often shaped their outcomes -- from the plague that ravaged Athens during the Peloponnesian War to Napoleon's retreat from the Russian campaign to the jungle warfare of World War II. Hence the long-standing military interest in the matter.
During the Revolutionary War, for example, smallpox took a greater toll on Washington's Continental Army than it did on the British. Many British soldiers, growing up in the crowded and unsanitary conditions of 18th-century British cities, developed an immunity, while American soldiers, having been spared those conditions, were more vulnerable.
Washington ordered the entire Continental Army, a first among military forces, to be immunized, a process then known as variolation, by intentionally exposing soldiers to a mild form of the smallpox virus. Both he and Martha Washington also got immunized. The first official smallpox vaccine was not developed by Edward Jenner until 1796.
Washington's timing may have had some interesting historical consequences. Military historians have suggested that, had the immunization occurred earlier, portions of eastern Canada might have ended up as part of the U.S. In 1776, a Continental Army advancing on Quebec was ravaged by an outbreak of smallpox. Half of the 10,000-man force were stricken, and the campaign was abandoned. According to John Adams, "The smallpox is 10 times more terrible than the British. ... This was the cause of our precipitate retreat from Quebec."
During the 18th and 19th centuries, military planners would routinely assume that fatalities from disease outbreaks during military campaigns would exceed combat fatalities by a factor of four to one. During the Mexican War, for example, the ratio of fatalities from disease was six to one. It fell to three to two during the Civil War, but rose to five to one during the Spanish-American War. During the Crimean War, it rose to 10 to one among French forces in theater; during the Sino-Japanese war of 1894, it was 12 to one.
Typhoid fever, for example, was the leading cause of fatalities during the Spanish-American War. Likewise, during the 20th century, the U.S. suffered more casualties due to malaria than bullets in malaria-endemic regions.
World War I was the first major war where battlefield deaths exceeded deaths from disease -- the result both of improved medical care and the killing efficiency of industrial warfare. The ratio was .82 to one among the U.S. forces deployed in Europe. During WWII, the ratio dropped to .07 to one. Only one out of every 15 deaths, 6.6%, was due to disease; 85 percent of hospital admissions, however, were disease related.
Not surprisingly, the U.S. military has, throughout its history, strived to preserve its fighting strength through, according to the Defense Department, "a broad program of vaccine development, therapeutics, and programs for vector controls." In addition, it has conducted ongoing and extensive research programs "into the structure, genome, growth, pathogenicity, and virulence" of disease pathogens.
Additionally, many civilian agencies tasked with responding to disease outbreaks had military origins. The Centers for Disease Control, for example, began in 1943 as the Office of National Defense Malaria Control Activities. The National Institute of Allergy and Infectious Diseases began in 1887 as a laboratory at the Marine Hospital Service facility on Staten Island, New York to study the link between microscopic organisms and infectious diseases. The MHS cared for disabled seamen in the U.S. Merchant Marine, Coast Guard and other federal agencies.
The U.S. military played a major role in controlling Yellow Fever and other tropical diseases, a prerequisite to the successful building of the Panama Canal. During the 19th century and the first half of the 20th century, the military, especially National Guard units, would often play a major role, both medical and at times civil, in responding to disease outbreaks.
During the recent COVID-19 pandemic, the U.S. military was critical in providing the surge capacity in hospital facilities and medical personnel. The Trump administration dispatched the U.S. Navy's Mercy-class hospital ships, USNS Comfort and USNS Mercy, to New York City and Los Angeles, respectively. The Army Corps of Engineers built field hospitals in a matter of days in the five New York City boroughs, as well as Seattle, New Orleans, Philadelphia, Miami, Dallas, Denver and Detroit -- adding tens of thousands of hospital beds virtually overnight.
Future administrations will again look to the U.S. military to provide the surge capability for medical facilities in the event of future pandemics. The Trump administration has already indicated that it intends to order two additional Mercy-class hospital ships for the Navy. This is not a new role for the military, but it is a return to a historic role on a larger and more robust basis.
Force Preparedness During Disease Outbreaks
The DoD has deployments in 147 countries. There are 21 countries where U.S. deployments exceed more than 200 military personnel. Not surprisingly, the U.S. military has an active program of monitoring the incidence of infectious disease outbreaks around the world. There are more than a dozen DoD agencies -- in particular, the National Center for Medical Intelligence -- which are involved in monitoring such disease outbreaks.
In 2006, the DoD formulated the "Department of Defense Implementation Plan for Pandemic Influenza." The plan spelled out those tasks delegated to the DoD in the "National Strategy for Pandemic Influenza" plan designed by the Department of Homeland Security in 2005. Those tasks were: assisting in disease surveillance, assisting partner nations, protecting and treating U.S. forces and dependents, and providing support to civil authorities in the U.S.
During the current pandemic, the military has not figured prominently in the first two tasks and accomplished the fourth task brilliantly. Its record on protecting and treating U.S. forces and dependents, however, is mixed.
As of April 20, there were approximately 2,500 military personnel who had tested positive for COVID-19. Overall, given the size of the U.S. armed forces, that's a pretty small number. A fourth of those infections, however, were on the carrier Theodore Roosevelt.
I'm not going to delve into the controversy surrounding the Roosevelt or the firing of its captain, Brett Crozier. I don't have all the facts. I will say, however, that I visited the Roosevelt in December 2019, for several days, courtesy of the Navy. It certainly seemed like a well-run ship and Crozier, whom I met, came across as a very competent officer deeply committed to his ship and his crew.
The DoD appeared rather flat-footed in dealing with the outbreak of COVID-19 on Navy ships. Presumably, there is a protocol governing such events, if so, it certainly wasn't apparent. Notwithstanding that the DoD had formulated a plan in 2006, that the possibility of such disease outbreaks has long been recognized, as has the need for maintaining force preparedness under such circumstances, it's surprising that appropriate policies weren't immediately implemented.
Regardless of what happened on the Roosevelt and other infected Navy ships, it's likely that there will be disease outbreaks in the future, and it is essential that the U.S. military retains its ability to deploy or engage an opponent if necessary, even in the event that it is simultaneously dealing with a disease outbreak.
That point was underscored when China's People Liberation Army Navy sailed its aircraft carrier, the Liaoning, in the Taiwan Straits provocatively close to Taiwan in the middle of the pandemic.
The DoD has long gamed the ability of U.S. armed forces to simultaneously handle multiple conflicts around the world. Presumably that planning has involved doing so while also dealing with a major disease outbreak or a pandemic. If not, then some revisions are in order.
This raises a third, and even more important, issue. What does the experience with COVID-19 tell us about the nature and threat posed by biological weapons, both man-made and naturally occurring, to U.S. national security?
Biological Weapons and National Security
Biological weapons are not new. In antiquity, a range of such weapons were used, from flinging clay jars full of poisonous vipers at opposing ships to throwing disease-ridden corpses over city walls. The practice continued during the Middle Ages. In the 20th century, industrial processes came to be applied to both chemical and biological weapons.
World War I saw extensive use of poison gases. During World War II, the Japanese military conducted a large-scale research program on the development of biological weapons. Such weapons were deployed against Chinese military forces. Japan also experimented with various ways of using biological weapons against civilian populations in the U.S., but never succeeded in developing a practical weapon.
During the Cold War, both the Soviet Union and the United States conducted extensive research on developing biological weapons. The Soviet Union stockpiled large quantities of pathogens, in particular smallpox, bubonic plague and anthrax, and was rumored to have worked extensively on man-made super pathogens that combined high contagion with high lethality. China is also believed to have had an extensive biological and chemicals weapons program.
The Biological Weapons Convention (BWC) of 1972 banned both the use of biological weapons and research activity to develop such weapons. The agreement, however, did leave a loophole that permitted research for defensive purposes, including vaccines. The U.S., the USSR/Russia and China are all signatories to the BWC. Worldwide, only 15 countries have not ratified the BWC.
Modern biotechnology has opened a veritable Pandora's box of biological weapons, including man-made biological weapons that combined different characteristics of several pathogens to create super pathogens. The organisms are called chimeras, a reference to Greek mythological creatures that incorporated features of several animals.
Advances in computational power, the use of sophisticated, artificial intelligence-based algorithms, as well as breakthroughs in synthetic biology, among other things, have vastly speeded up the process of developing vaccines. But even under the best circumstances, human testing still takes 12 to 18 months -- a significant vulnerability gap.
Moreover, the distinction between offensive and defensive research is a pretty subtle one. Any pathogen can be weaponized, man-made or natural, if one side has immunized its military and the other side has not.
The emergence of the SARS-CoV-2 virus underscores the challenge that even naturally occurring pathogens pose to the national security of the U.S.
There are still a lot of questions about the origins of the virus. The prevailing view among U.S. intelligence agencies is that the virus is not man-made, but that it was a naturally occurring coronavirus endemic to certain species of bats found in China.
Some believe that, while the virus was being studied at the Wuhan Institute of Virology, the virus escaped by infecting someone at the institute. Through that person, the original patient 0, it was transmitted to the general population of Wuhan, and from there elsewhere throughout China and the world.
There are thousands of coronaviruses. The full number isn't known. Just the bat species endemic to China, for example, are known to carry hundreds of different coronaviruses. Moreover, given their simple genetic structure, these viruses are highly mutable. Coronaviruses are just one of many viral pathogens in existence that can create pandemic-scale disease outbreaks.
It does not appear that the research on the SARS-CoV-2 virus was intended for weaponization. The research was part of a broader effort, in part funded by the U.S. and Canadian governments, to study coronavirus pathogens, which involved several research institutes, including the Wuhan Institute of Virology.
The enormous human and economic damage that has been caused by the SARS-CoV-2 virus, however, has underscored just how potent a biological weapon this coronavirus and other pathogens like it can be. The U.S. can survive, albeit at an enormous economic cost, the consequences of the COVID-19 pandemic. But a succession of such pandemics, even ones separated by a few years, would devastate the American economy and end the status of the U.S. as the reigning superpower. This lesson is not lost on America's enemies.
Given the enormous trade between Asia/China and the rest of the world and, more importantly, the enormous human traffic of tourists and business executives, combined with the relentless growth of international mega trade shows and sporting events around the world, it has become possible to spread pathogens globally very quickly. It took less than 100 days for COVID-19 to spread from a local outbreak in Wuhan to more than 180 countries.
The COVID-19 epidemic showcased a deep vulnerability in the U.S., indeed the whole world, to such viral pandemics. Ultimately, the U.S. needs a strategy for dealing with the incidence of such pandemics, as they are likely, whether deliberate or otherwise, to occur again. The DoD must preserve its military force readiness while simultaneously providing care for stricken personnel. At the same time, Washington needs a bipartisan strategy to deal with the economic and human consequences in a sustainable way.
Regardless of how you feel about the current U.S. response, it's clear that multiple such responses to a succession of pandemics is not sustainable. That fact, and the realization that such disease outbreaks may happen again, will have a major impact on U.S. national security concerns and will be a significant factor in defining and shaping what the post-pandemic "new normal" will be.
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