Bioterror causes extinction---only AI solves.

Biodisaster X could result in catastrophic human and economic consequences. Yet to date, no studies have examined the potential role of information technologies in preventing and mitigating Biodisaster X, especially in the context of advanced and emerging technologies such as AI and 6G. To bridge the research gap, in this study, we sought to explore 2 fundamental research questions that could considerably enrich the literature: (1) what Biodisaster X might entail and (2) solutions that use AI and emerging 6G technologies to help monitor and manage Biodisaster X threats. In the following sections, we will detail our findings pivoting on these 2 research objectives, as well as practical and powerful strategies that have the potential to effectively control and contain Biodisaster X threats. Biodisaster X: What is in a Name? A disaster can be defined as “a serious disruption of the functioning of a community or society involving widespread human, material, economic, or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources” [47]. Based on the contributing causes, disasters are usually categorized as natural (eg, earthquakes, infectious disease-inducing epidemics, or pandemics of natural origin) and anthropogenic (eg, armed conflicts, nuclear accidents, or the release of pathogenic genetically modified organisms from laboratory settings). In the context of this study, biodisasters are defined as disasters that occur as a result of infectious pathogens with bioweapon potential, which are unleashed by state or nonstate actors accidentally and intentionally (eg, the Japanese government’s controversial decision to dump Fukushima’s contaminated water into the boundless and borderless ocean shared by all life forms on earth, including humans and sharks [48]). In the context of biodisasters, a state actor often takes the form of a nation that deliberately and systematically designs and develops infectious pathogens with its national interest in mind. In contrast, a nonstate actor is an individual or group acting independently to obtain or manufacture a pathogen either owing to misguidance or malice. Of note, although existing multilateral agreements prohibit the production and use of bioweapons by state actors (termed biowarfare) [49], the presence of signed agreements does not imply that accidental or intentional development and release of pathogens by state actors will not occur. The concept of “bioterrorism,” defined as the deliberate release of pathogens that could cause illnesses and deaths in society, is not the focus of this study because “bioterrorism” entails both deliberation and malice (eg, to elicit terror to the public) [50]; antecedents may not necessarily apply to Biodisaster X threats. Insights from behavioral science [51-53] and evidence regarding individual-caused mass casualty events (eg, indiscriminate mass shootings) [54-56] suggest that individual actors’ behaviors, potentially leading to the onset of Biodisaster X, may or may not include conscious deliberation to harm. In other words, while it is possible that individual actors’ malicious actions might cause some biodisasters, it is also possible that some individual-caused biodisasters are accidental. Furthermore, the term bioterrorism is limited, in that “terror” is the main outcome. We believe that for Biodisaster X, which could upend lives, livelihoods, and economies, “disaster” is a more appropriate description that sheds light on the scale and severity of its consequences and is more diverse than “terror.” Drawing insight from real-world examples, similar to the prevalent ransomware hacks, it is possible that state or individual actors could develop and utilize infectious pathogens as “ransomgens” for financial gain rather than merely aiming to generate terror in society. Therefore, under the current research context, we adopted the term “biodisaster” instead of “bioterrorism.” Furthermore, considering that various studies have discussed approaches to address state actor–initiated biodisasters [57-61], this study focuses on biodisasters that are infectious in nature, caused by individual actors, and can result in catastrophic human and economic consequences. Biodisaster X vs Disease X The risk of biodisasters, such as Biodisaster X, is increasing in likelihood: advances in technology, particularly the availability and maturity of biotechnology, have grown considerably in recent years. Inadvertently, these advances may resemble those of Oppenheimer [62] in facilitating the release of destructive factors. One example of the misuse of biotechnology is a microbiologist, vaccinologist, and senior biodefense researcher who worked at the United States Army Medical Research Institute of Infectious Diseases, who allegedly engineered the 2001 anthrax attacks [63-65]. While the scale of the 2001 anthrax attacks was minor, it demonstrated how easily biodisasters can occur and how unprepared society was for these events. As seen in the lack of adequate preparation and coherent responses to infectious disease–induced pandemics, including COVID-19 [66-69], Biodisaster X’s effects may be compounded to the same, if not greater, degree by incompetence across international, national, and regional agencies and organizations. The concept of Biodisaster X can be best understood in contrast with Disease X. In terms of similarities, both Biodisaster X and Disease X are driven by pathogens unknown to humans and have the potential to cause crippling effects on society. Furthermore, based on previous inadequacies in response to emergency events including pandemics [66-74], the world at large may be ill-prepared for both Biodisaster X and Disease X. In terms of unique attributes, compared to Disease X, Biodisaster X is more likely to have the following characteristics: (1) having a pathogen directly affiliated to a laboratory; (2) having distinctive and engineered attributes tailored by the capabilities and intentions of the developer; and (3) the origin, development, and history can be definitively ascertained upon identification of the developer, which is not possible for naturally occurring pathogens (eg, the 1918 influenza pandemic), where there is always uncertainty regarding the origin and evolutionary history of the disaster [75-77]. The Imperative of Preparing for Biodisaster X Some of the deadliest pandemics—the most recent ones ranging from AIDS, severe acute respiratory syndrome, Middle East respiratory syndrome, Ebola, and COVID-19—all have zoonotic origins [78]. Studies have further shown that for viruses that can transmit from animals to humans, especially those that can infect a diverse range of host species, the transmission speeds are substantially amplified once human-to-human transmission is established, and the diseases can quickly evolve into global pandemics [79]. Consequently, once a pathogen is transmissible within a population, there is a low access threshold: an individual actor can “obtain” these deadly pathogens without the need for advanced laboratory skills or extensive financial resources. However, costs to physical and mental health may reveal a counternarrative. Based on available evidence, it is difficult to determine whether an individual can be a malicious “patient zero”; an individual who intentionally contracts a novel virus intending to cause infectious disease outbreaks in a society [80]. It is not impossible to purposely study and capture known or unknown deadly pathogens that can trigger infectious diseases; microbial surveys are commonly conducted to identify novel pathogens before they pose a threat to public health [81-84]. In theory, there could be individual actors, with adequate knowledge or experience (similar to the microbiologist allegedly behind the 2011 anthrax attacks [63-65]), who may take the same actions but with different motives, ranging from scientific curiosity to ill-guided intentions. Considering the rich biodiversity of wildlife, along with the large number of “missing viruses” and “missing zoonoses” that remain unidentified [85], close contacts with latent deadly pathogens are nearly impossible to control, which in turn, renders it challenging to locate or identify individual actors who might utilize them. Advances in synthetic biology may further compound the situation, especially considering the scholarly endeavors using pathogens in laboratory settings, which could amount to the level of real-world pandemics (eg, laboratory-cultured viruses such as smallpox [86-88]). The likelihood of Biodisaster X increases in proportion to these factors. Overall, considering the species diversity of wildlife, the unknown factors related to the scale and severity of viruses in animals, which have the latent potential to infect humans, and the varying degrees of competency of community health centers in detecting infectious disease outbreaks in a bottom-up manner, it could be tremendously difficult for health experts and government officials to monitor potentially emerging Biodisaster X threats. However, not all hope is lost. Technology-based solutions, especially those utilizing AI and 6G technologies, can help address these issues. The Need for Advanced Technology Solutions for Monitoring and Managing Biodisaster X The Need for Technology-Based Solutions Once Biodisaster X becomes a reality, human contact will drive transmission and become the primary fuel for exacerbating infections and deaths caused by the disaster. As seen during the COVID-19 pandemic, owing to virus spread and subsequent public health policies (eg, lockdowns), many critical societal functions could be substantially disrupted. The potential to control and contain human and economic consequences of Biodisaster X, such as the functionality of the health care systems (eg, infected health care professionals) [89-91], may also become critically undermined. In these circumstances, technology-based solutions could be the key to addressing these crises, as they are different from conventional solutions; they are not highly dependent on physical interactions and transportation. Overall, technology-based solutions require limited human resources (eg, with the ability to operate without human input), can be delivered independent of physical human contact (eg, web-based and remote deployment), and are immune to infectious diseases (eg, can function in contaminated environments). Furthermore, technology-based solutions are less vulnerable to issues ranging from physical fatigue to mental health burdens, which are health challenges that frontline workers often face amid emergency events. The Need for Advanced Technologies To effectively predict, control, and manage Biodisaster X, which is an event with a low probability (ie, difficult to detect preemptively) and a high impact (ie, difficult to control and contain), advanced technologies are needed. While many emerging technologies can address the dangers and damages associated with Biodisaster X [92,93], 2 families of advanced technology-based solutions show particular promise, namely AI techniques and 6G technologies. Unique Capabilities of AI AI is generally considered synonymous with “thinking machines” [94], or techniques that can facilitate “a computer to do things which, when done by people, are said to involve intelligence” [95]. With AI technologies, machines can identify patterns too intricate for humans to identify and process quickly. AI techniques are widely used in areas such as natural language processing, speech recognition, machine vision, targeted marketing, and health care, including efforts to combat COVID-19 [96-99]. While technologies such as virtual reality, smart sensors, drones, and robotics could play a positive role in supporting health care professionals to cope with the pandemic [100-102], AI technologies are arguably most instrumental in addressing some of the most prominent issues health experts and government officials are faced with, ranging from pandemic surveillance to COVID-19 drug and vaccine development [103-106]. AI and machine learning techniques are particularly valuable in their ability to identify trends and patterns across large amounts of data promptly and cost-effectively; for example, in identifying or searching for specific patterns. With natural language processing, for instance, data can be extracted retrospectively from clinical records or prospectively in real time and statistically processed for insights, which, in turn, can supplement existing structured data to enrich actionable information [86]. During the COVID-19 pandemic, natural language processing models have been used to analyze publicly available information such as tweets, tweet timestamps, and geolocation data, to identify and map potential COVID-19 cases cost-effectively, without utilizing testing devices or other medical resources that involve health care professional [107]. Overall, most, if not all, AI techniques are irreplaceable in regard to administering complex tasks such as extracting useful information from large data sets. Moreover, with the continuously increasing speed of its technological advancements and applications, AI technologies are often utilized as core components in other emerging technologies [108]. Smart sensors that perform advanced tasks, such as effectively identifying and recognizing captured motions and images, often need to integrate deep learning technologies (a subgroup of AI) [109-111]. These combined insights suggest that AI techniques have great potential in monitoring and managing Biodisaster X threats.[