War With North Korea: Smallpox and Bioweapons Are the Real Threat, Not Nukes

The good news is, despite threats last week that American targets would be "reduced to ashes and flames the moment the first attack is unleashed," it is doubtful that North Korea can strike the United States with a missile. We should be safe from their nukes, at least as long as they don't atomize one of our cities with a nuclear weapon on board a midget submarine.

Yet though we may learn to ignore their threats of nuclear and artillery and cyber attack, perhaps we should listen to the threats they do not make. North Korea is not a signatory to the Chemical Weapons Convention. It is a signatory to the Biological Weapons Convention, but that treaty, lacking verification mechanisms, is little hindrance to even the most responsible of states. Working with "dual use" technologies in secret, North Korean researchers could have developed a great many things.

For example, working entirely within the BWC framework, researchers in the United States were able to infect a series of ferrets with avian flu, observing the precise mutations that are needed to make the virus dangerous to mammals. Security considerations nearly led to the decision not to publicly release the data obtained. Meanwhile, biodefense preparations include stockpiling avian flu vaccine. The combination of breeding new viruses, stockpiling vaccines against them, and doing so under a policy of secrecy is nearly all that is really needed to unleash a new and terrible plague on the world, save the final step of popping the cork in some faraway airport.

There are nonetheless a few luxuries that could help to ensure a bioweapon's success. Because biology is an experimental science, a nation would desire ready access to human subjects who can be exposed to the disease, tested, and safely disposed of. Such a pool might be found in North Korea's concentration camps, where the deaths of 50 inmates from biological warfare experiments were reported by Yi Sun Ok in the 1980s. It might also be helpful if the nation routinely conducts forced vaccination campaigns that would give it an opportunity to surreptitiously protect all of its personnel. Lastly, it could be helpful if the nation were entirely isolated from international commerce and transportation, so that after a "natural" outbreak of disease, the lack of infection among its citizens could be plausibly ascribed to efficient quarantine.

There are few more fertile outlets for the creativity of man or malign deity than the art of devising bioweapons, and it is difficult to check the veracity of claims concerning them. Did North Korea really create hybrids of smallpox and Ebola virus or Venezuelan equine encephalitis, as Ken Alibek, former head of the Russian bioweapons agency Biopreparat, has described? According to Vanity Fair, his colleagues find the claim unlikely, but nothing is impossible in biology. The goal of the Ebola modification would have been to make smallpox consistently hemorrhagic ("black pox") to increase its lethality. It is also possible to pseudotype a virus, genetically modifying its outer shell to prevent a conventional vaccine from affecting it.

Even if no modifications were really made, it is terrifying enough that U.S. and Russian intelligence services have found "medium" grade intelligence that North Korea may have acquired smallpox, and that some of the Biopreparat scientists may have moved to North Korea after the breakup of the Soviet Union. Frequently lethal and often disfiguring, smallpox might be stopped cold by 300 million stockpiled doses of vaccine in the Strategic National Stockpile, provided the North Koreans have done nothing to alter the virus. There are also antiviral drugs that may help to combat infections if a vaccine fails. But with each case of smallpox infecting, on average, 20 more people, the logistics of distribution will be critical, and the effect on any nation less prepared would be devastating.

Even the most mundane of the threats, tactical chemical and biological munitions for achieving short-term goals on the battlefield, would be more than terrifying enough for the soldiers whose duty it is to face them. According to the International Institute on Strategic Studies, North Korea may be able to produce nerve, blister, blood, and choking agents, anthrax, bubonic plague, and cholera, with South Korea estimating its overall stockpile at 2,500 to 5,000 tonnes. But all this data is wildly uncertain.

We should consider that North Korea could have strategic advantages on its side.  According to Bruce Bennett of the RAND Corporation, "no U.S. president would kill 10 million innocents" by targeting Pyongyang with a nuclear weapon. The U.S. is limited by the political and literal fallout of its arsenal. By contrast, biological agents can be anonymous. North Korea does not need a working missile to deliver a sputum sample, and our first warning could be the cough down the hall.

To defend us against these threats we have resources such as the CDC, still reeling from an 8% ($450 million) additional cut under the sequester, and this week's coincidental deployment of the 250-man 23rd Chemical Battalion to South Korea. Considering our failure to develop better vaccines to stop the yearly flu outbreaks that can kill tens of thousands of people, or to offer basic public health precautions like guaranteed sick days and free vaccinations, it remains uncertain whether we are capable even of attempting to stop a new highly infectious disease before it spreads out of control. It is a tenuous basis for a national defense.

It is time for America to reevaluate its defense priorities.  Money spent on maintaining battleships and a doomsday nuclear arsenal should be tapped to double the National Institutes of Health and double and redouble the CDC. We should be able to identify DNA sequence from every infection that lands in a hospital the day it presents. We must be fully prepared to apply a much wider range of therapies — including DNA vaccination, interferons and other cytokines, and bacteriophages — to any outbreak. We ought to treat the seasonal flu as a biopreparedness exercise and not be satisfied until we stop it at the airport. We must greatly accelerate the pace of vaccine development and deployment against things like dengue, West Nile virus, and Lyme disease. We need better ways to stimulate the private pharmaceutical development of antibiotics and other useful drugs.

We need to understand that we are not always able to monitor, control, or prevent bioweapons research in any nation, even heavily sanctioned North Korea. That means our only hope to prevent disaster is to genuinely be able to defend ourselves against both natural epidemic and deliberate biological attack.