Many different disaster scenarios can lead to mass casualties. The largest in the last century, short of a World War, was a biological event: the COVID pandemic. I have always believed that COVID originated in a lab, and the evidence for my suspicions seem to become more justified over time. While the release of the virus may have been accidental, its potential as a biological weapon, used intentionally, shouldn’t be ignored. Biological warfare is a weapon of mass destruction, and it can be a society-breaker.
HISTORY OF BIOLOGICAL WARFARE
Biological warfare is the term given to the use of infectious agents such as bacteria, viruses, fungi or their by-products to wreak death and havoc among a target population. As a result, the attacker achieves control over an area or a people by weakening the ability to resist. Biological weapons don’t necessarily have to kill humans directly: unleashing a horde of locusts to destroy crops or an agent that kills livestock can be just as effective.
Biological weapons have been used since ancient times, even appearing in the bible as the plagues visited upon Pharaoh by a wrathful God. Medieval accounts of plague-ridden corpses catapulted into besieged cities abound; this method was used as late at 1710.
The Western hemisphere was changed forever by the inadvertent introduction of smallpox into the Native American population. In some areas, 90% died. The end result was the opening of vast swaths of land for European colonization. In addition, purposeful biological warfare was waged against Native Americans when the British presented a “gift” of infected blankets as a “peace offering” during Pontiac’s War in the mid-1700s.
New infectious agents, such as anthrax, were used in certain situations during World War I. Seeing their horrific effects, use of biological weapons was banned by the Geneva Protocol in 1925. Unfortunately, that didn’t stop research and production by both sides during World War II. Sometimes it would go awry: Work by the United Kingdom on anthrax left their laboratory in Scotland contaminated for five decades.
Eventually, the storage, production, and transport of toxic agents was banned by the Biological Weapons Convention (BWC). As of 2022, 183 countries have signed the BWC pact. Despite this, there have been a number of violations documented in the former Soviet Union and Iraq (with various others suspected).
THE IDEAL BIOLOGICAL WEAPON
To date, all biological weapons have been less than perfect. The ideal agent would have these characteristics:
- Be infectious and contagious in a large percentage of those exposed.
- Cause severe long-term debilitation or death of the infected organism.
- Have few available antidotes, preventives or cures.
- Be easily deliverable to the area or population targeted.
- Have low likelihood of causing damage to those using the agent on others.
The concerns about “accidents” affecting the aggressor have most countries reluctant to use these weapons in normal tactical situations. During the largest such accident in 1979, a Russian lab released anthrax into the surrounding area, killing 42 people, infecting sheep over 200 miles away, and causing the immediate area to be off-limits even today. There is speculation by some that the COVID pandemics effects on China are another example of such an “accident.”
DEADLY BIOLOGICAL AGENTS
Some candidates for use as biological warfare agents include coronaviruses, anthrax, smallpox, viral hemorrhagic Fevers (Ebola, etc.), and pneumonic plague.
CORONAVIRUSES
I would be remiss if I didn’t start by mentioning coronaviruses like covid-19 or SARS. Indeed, these viruses check a lot of boxes: they are contagious and infect a large number of people. They can cause serious disease; new strains may not respond to current treatment methods. The current versions, however, aren’t lethal enough to kill a significant part of the population, nor would they be easy to deliver to a specific target group. In addition, they are just as problematic for those using the weapon as those exposed to it.
The many strains of COVID have led to many victims experiencing different symptoms. Most develop:
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
Some strains of the virus cause their own particular symptoms, such as loss of taste or smell, runny nose, sore throat, nausea, vomiting, or diarrhea.
Although COVID-19 could mutate into a biological weapon-grade agent, current death and hospitalization rates are very low. Vaccines for the latest strains are widely available; treatments like Paxlovid help with the symptoms. Influenza viruses, if mutated like coronaviruses, could also pose a pandemic threat with a higher mortality rate.
ANTHRAX
Anthrax, often mentioned as a biological weapon, can be contracted in several ways: skin contact, inhalation, and gastrointestinal infection. More common in livestock than people, anthrax is not an ideal “weapon of mass destruction” in that no person-to-person contagion occurs, except in skin cases (the least lethal form). A massive “cloud” of it would be necessary to affect a large population. That said, large numbers of infected livestock could result in an epidemic of the disease in humans.
The bacterium exists as spores which, in the right environment, release toxins that cause a flu-like syndrome which eventually destroys cells in lymph nodes, spreading to the lungs and blood. Although Penicillin, Doxycycline, and Ciprofloxacin are effective against this bacterium as either a preventative or for early treatment, full-blown inhalation anthrax may be difficult to survive, as the toxins released by the spores remain active even if the spores are killed.
Inhalation anthrax, the most feared form, appears first as a flu-like syndrome, deteriorating to shock and death in many cases; luckily, not everyone exposed will get symptoms. Because of higher risk of exposure, certain individuals, such as livestock workers, are often offered a vaccine against the disease.
PLAGUE
Signs of bubonic plaguePlague has been, well, a plague since medieval times (and, probably, much earlier). Caused by microbes known as Yersinia pestis, they make their home in the GI tract of fleas that infest rodents. There are three types, all of which can cause fever/chills, headaches, body aches, weakness, and fatigue. Many cases also suffer from diarrhea, nausea, and vomiting.
There are three types:
Pneumonic plague: Pneumonic plague is, by far, the most contagious. It is easily spread by coughing bacteria into the air. Starting off as a flu-like syndrome, this highly lethal version quickly develops into pneumonia with fever, weakness, shortness of breath, and cough (often with blood).
Unlike inhalation anthrax, which may take weeks to develop symptoms, patients with pneumonic plague may be dead in two to four days if not treated early. Tetracycline, Doxycycline, and Ciprofloxacin, and IV Gentamycin are effective treatments. Oxygen, if available, will help support the sick individual. For caregivers, protective masks like the N95, are imperative.
Bubonic Plague: Bubonic plague is different from pneumonic plague in that the sufferer develops blackish-purple swellings in the groin or armpit (called “buboes”). These are infected lymph nodes that are painful and swollen. While pneumonic plague can easily be spread from person to person, bubonic plague (if treated) cannot, and carries a low death rate. Untreated, however, bubonic plague can spread to the lungs or bloodstream and become highly lethal.
Septicemic Plague: When plague organisms infect the bloodstream, it is termed septicemic plague. Victims of septicemic plague, in addition to basic symptoms, often complain of abdominal pain, but may also bleed from the nose, mouth, or under the skin. This form is fatal if untreated.
As a biological weapon, some forms of plague would be formidable due to the historical death rate. Today, however, a simple course of antibiotics would prevent bad outcomes if started early. The same could be said for another past epidemic disease: cholera!
VIRAL HEMORRHAGIC FEVERS
There are several types of “fevers” associated with different viral organisms that infect animals like bats and some primates. Hemorrhagic fevers include filoviruses like Ebola or Marburg, mosquito-borne flaviviruses like Dengue or Yellow Fever, and a number of others. Ebola and Marburg are the most likely candidates for use in biological warfare, due to the combination of high transmissibility and death rates.
Most victims start off with flu-like symptoms like fever, headache, muscle and joint pains, and weakness. They quickly progress to diarrhea, nausea and vomiting, and abdominal pain. More serious problems relating to internal and external hemorrhaging appear in severe cases; victims may bleed from the eyes, ears, nose, mouth, or rectum. Bruising can occur from bleeding under the skin.
Viral hemorrhagic fevers are easily spread by bodily fluids, so masks, gowns, and gloves are extremely important for health care workers (who are often also victims during outbreaks). This makes it formidable due to its contagiousness, death rate, and various methods of spread.
Normal antivirals don’t seem to cure viral hemorrhagic fevers: Death rates may be as high as 90% in some types if untreated. If a virus like Ebola ever mutated to become primarily airborne, it would be a formidable biological weapon. Fortunately, vaccines are now available for some Ebola strains. Marburg vaccines are still in development.
SMALLPOX
Smallpox (also called “variola”) is another highly contagious viral illness that was responsible for the decimation of entire populations in the Americas. Related to the chickenpox (varicella) virus, smallpox differs in that all the blisters develop at the same time, rather than at varying points of development and healing like chickenpox. Also, chickenpox spreads less to the limbs than smallpox. Contact with blisters could transmit the disease to others. Fever, stomach pain, vomiting, fatigue, and weakness accompanied the illness.
Although smallpox is considered to have been eradicated in 1980, University of Alberta scientists were able to recreate an extinct horse pox virus in 2017. This suggests that it’s possible to recreate the smallpox virus. If so, a case of the “ordinary” strain is highly contagious and carries a one in three death rate, making it a formidable biological weapon. Others range from rarely fatal to always fatal.
Interestingly, the Strategic National Stockpile (SNS) still has mass quantities of smallpox vaccines in storage.
By-products released by microbes and plants walk the fine line between biological weapons and chemical weapons. Toxin released by the bacterium that causes botulism, for example, causes paralysis of muscles, and is used in small quantities as the cosmetic agent Botox. Ingredients in castor beans contain Ricin, a potent toxin that causes respiratory and circulatory failure. 3 milligrams of Ricin is potent enough to kill an average-sized adult if inhaled.
Joe Alton MD
Dr. Alton
