Vladimir Putin decided to adopt tactics from the 1930s and 1940s to wage war against the Ukraine.  This meant taking territory by killing as many inhabitants as feasible and destroying whatever buildings and infrastructure existed in the area declared “captured.”  Each village, town or city taken by Russian troops was reduced to an uninhabitable wasteland as part of the pacification process. Most of the inhabitants of the captured areas left or died. All of this was done in the name of “liberation.”  As tanks were blown up and artillery shells leveled apartment buildings, the Covid-19 pandemic provided a glimpse of what will certainly replace this archaic approach to territorial gains.

Many of the citizens of our own country are eager to discard elections and restructure our fragile and imperfect democracy into a totalitarian state, complete with a national religion. This is more worrisome than most Americans realize because we are on the cusp of a new type of conflict. We and China and Russia have all witnessed the promise and feasibility of undermining nations by infection, rather than explosions. Covid-19 and the advances in viral manipulation it helped foster have demonstrated an alternative to munitions that must have certainly piqued the interest of potential rivals. It is inevitable that one or more of the nations envious of the American success story or even just extremist factions in our own country or in antagonistic nations will unleash this horrible weapon.

Unlike the warfare being conducted in the Ukraine, germ warfare is inexpensive and much less destructive.  A city with millions of people could be “liberated” from its population without the destruction of a single building or any infrastructure. This became self-evident with the Covid-19 pandemic. Millions of people died from this virus over a relatively short period of time. The part of the population most affected by the pandemic were the elderly, the immunocompromised, and people with pre-existing lung diseases. National economies were severely impacted by the various measures taken to limit the deaths and disabilities caused by the virus. Entire industries were shut down, and supply chains were disrupted. What many observers failed to appreciate was that one of the nations most affected by this killer bug, that being China, reaped several benefits from the pandemic.

China has tried and failed over the past few decades to blunt its population growth. As its economy has expanded, its immense population quickly absorbed and negated the gains achieved.  Programs to limit family size by imposing sanctions on couples who had more than one child failed. Increasing the availability of birth control materials and even encouraging abortions failed. Covid-19 succeeded in substantially increasing the excess mortality (deaths that would not have occurred without the pandemic) in China. Although the official count of deaths in the more than 5 million Chinese people infected by the virus over the past 2 years is absurdly low (less than twenty thousand), reliable estimates of deaths from the virus in China exceed two million. Because this virus targeted the aged and otherwise disabled citizens of this overpopulated nation, the Chinese government realized a reduced future need for social services while simultaneously reducing the median age of its population. With centrally mandated lock-downs, air pollution in major cities affected by the pandemic improved dramatically. The inflation rate in China went from nearly 3 % annually in 2019 to less than 1 % in 2021.  Trading partner economies, including the U.S., were crippled by supply chain disruptions. Aside from the human toll exacted by the pandemic, China is emerging from this pandemic in a more favorable position than when it entered the crisis.

The U.S. and its allies in Europe, on the other hand, are still being weakened by the repercussions of the pandemic.  America lost over a million citizens to the virus, and its healthcare system failed because of inadequate planning and incessant political bickering. Even as the general population digests a government response to the pandemic that was at best delayed, disorganized, and divisive, we are faced with another viral challenge: the monkeypox epidemic. Our healthcare system and our economy have yet to recover from the Covid-19 pandemic, and both must now deal with both a lingering Covid effect and a new challenge from the monkeypox virus. Unfortunately, our government shows no signs of having learned much from the mishandling of the Covid pandemic and seems poised to  repeat the political farce we so desperately need to avoid with this new epidemic.

Our enemies, foreign and domestic, cannot avoid recognizing the potential cost-benefit of a more targeted biological offensive. The potential weapon, a designer virus, would replicate and distribute itself without any need for manufacturing or guidance systems. It could lay waste to vast populations without damaging any structures or infrastructure. It could be tweaked to target specific populations, especially if that population lacks diversity (Note to racists: ethnic purity dooms you). Once introduced into the target population, there is no need for resupply. Logistics become irrelevant, the dream of every military leader.

This is a cautionary tale. Vaccines can be developed to protect us from many things, but our current technology has not provided protections against everything menacing us. Efforts to develop a vaccine against malaria have been underway for more than 40 years with nothing promising on the horizon. A well-organized adversary, e.g., China, could develop a vaccine against a viral agent that it developed to selectively target the population of a country like Hungary, whose leaders are openly advocating ethnic purity and white supremacy. The vaccine could be withheld from the vulnerable population unless the extortionist’s demands are met.  Our country has the advantage of a diverse population, making it much less vulnerable to this type of germ warfare.  Nonetheless, what Covid-19 should have taught us is that we must formulate coherent and comprehensive plans to manage the next viral attack from outside or within our borders.  That such an event will occur is unfortunate but inevitable.

Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan.  He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the USA, as well as in England, Germany, and France.

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