TABLE 2.

Pandemic response and preparedness research related to SARS-CoV-2 associated with dual-use potential

Work	Proposed benefits	Potential risks	Reference(s)
Identification of mutations that make SARS-CoV-2 more transmissible, virulent, and immune evasive	Informing genomic surveillance and countermeasure design such as vaccines or monoclonal antibodies	May enable engineering of more concerning variants of SARS-CoV-2 or other viruses	Starr et al. (2021) (16)
Publication of detailed SARS-CoV-2 engineering protocols	Increased access to recombinant SARS-CoV-2 for response research	May inform malicious or careless actors on how to create SARS-CoV-2 variants	Xie et al. (2021) (20)
Engineering immune evasion for viral vectors	Improve effectiveness and reusability of viral vector vaccines	Can create transferable insights on engineering immune evasion for pathogens	Sandbrink and Koblentz (2021) (23), Roberts et al. (2006) (25)
Creation of transmissible vaccines	Use for vaccination of animal reservoirs for eradication of zoonotic viruses at risk of spillover	Safety risks; ethical and ecological concerns; may create insights on engineering transmissibility, genetic stability, and immune evasion	Nuismer et al. (2018) (31), Nuismer and Bull (2020) (30), Sandbrink et al. (2021) (32)
Increased gain-of-function work on future potential pandemic pathogens, not limited to coronaviruses	Prediction of zoonotic epidemics, possibility to inform biosurveillance targeting, and design of countermeasures	Risk of accidental exposure and lab release of engineered pathogens; risk of informing the creation of pathogens with enhanced lethality and transmissibility	Herfst et al. (2012) (34), Imai et al. (2012) (35), Casadevall and Imperiale (2014) (74)
Large-scale viral collection and characterization	Prediction of zoonotic epidemics, possibility to inform biosurveillance targeting, and design of countermeasures	Risk of accidental exposure and release; risk of informing viral engineering by creating large-scale data sets connecting sequence and function	Carroll et al. (2018) (40), Monrad and Katz (2020) (41), Carlson et al. (2021) (42)