Table 3.

Similarities and differences between Disease X and Biodisaster X.

Parameter	Disease X	Biodisaster X
Type of Disaster	Infectious diseases Natural disasters: epidemics or pandemics	Infectious diseases Anthropogenic biodisasters: initially inaccurately identified as a naturally occurring epidemic or pandemic; later identified as anthropogenic
Origin	None initially, but can be exacerbated by human action or inaction; for example, through livestock mismanagement or failure to contain early infections	Humans: state or nonstate actors
Antecedent	None	Advances in and accessibility of biotechnology; inadequacy of biosecurity measures; intent or malice of nonstate actors
Pathogen	Originated in nature, with no human engineering Unfamiliar or unknown to humans	Originated in a laboratory, mainly as a result of human engineering Unfamiliar or unknown to humans
Transmissibility	Highly transmissible, mainly as a result of naturally occurring human interconnectivity	Highly transmissible, mainly as a result of calculated dissemination and distribution of the pathogen, capitalized on naturally occurring human interconnectivity
Transmission Predictability	Initially unpredictable; predictability increases over time	Initially predictable (in principle); extremely low to extremely high predictability over time (depending on the ability of society at large to identify the risk)
Controllability and Treatability	Low	Extremely low to extremely high (based on the intent of the actor)
Nonpharmaceutical Mitigation Effort	Have an agile, evidence-based, and flexible disaster response plan Equip high-population-density areas with sufficient resources Limit social interactions; replace physical human interconnectivity with web-based social interactions when possible Integrate cost-effective technology-based surveillance systems into the emergency management systems Prepare for a secondary Disease X (potential for mutations or gene transfer, in turn leading to a new Disease X)	Have an agile, evidence-based, and flexible disaster response plan Equip high-population density areas with sufficient resources Limit social interactions; replace physical human interconnectivity with web-based social interactions when possible Integrate cost-effective technology-based surveillance systems into the emergency management systems Prepare for a secondary Biodisaster X (actors might further escalate the situation by generating a new Biodisaster X). Once accurately identified as anthropogenic in nature, there will be an urgent need prioritize the identification of the actor
Pharmaceutical Solution	Difficult and time-consuming to develop vaccines Extensive and exhaustive efforts needed to identify treatment plans	Have the potential to be developed fairly easily and time-efficiently once the nonstate actors and the pathogen manufacture process have been identified: vaccine and treatment plans
Primary Goal	Stop the spread of the pathogen; identify and deploy suitable treatments	Stop the spread of the pathogen; identify and deploy suitable treatments; locate the source of the pathogen and prevent further action
Positive Unanticipated Outcome and Negative Unintended Consequence	Physical and psychological health issues associated with the pharmaceutical and nonpharmaceutical solutions Posttraumatic stress Increased resource allocation for medicine and public health Possible economic consequences including a global recession	Physical and psychological health issues associated with the pharmaceutical and nonpharmaceutical solutions Posttraumatic stress Increased resource allocation for medicine, public health, and law enforcement Possible economic consequences including a global recession