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Last week, an employee who worked at a Russian anti-plague institute died, possibly from an unspecified form of plague. This led to the quarantine of nearly 200 people in Russia's Irkutsk region, located in eastern Siberia, according to local news outlets. Following these reports, concerns are circulating about what exactly caused the death and quarantine — and just how worried the rest of the world should be. The World Health Organization says the incident presents a low risk globally of pathogen spread, and a moderate risk for the nearby area, Dr. Nahid Bhadelia, founding director of Boston University's Center on Emerging Infectious Diseases, told CNBC's "Squawk On the Street" on Tuesday. But some infectious disease experts say it's impossible to determine the risk yet, citing a lack of transparency from Russian authorities. "The risk to the wider public is uncertain ... I wouldn't call it low, medium or high because we don't know the information to answer that," says Dr. Raj Panjabi, a Harvard University physician and former White House Biosecurity Director to President Joe Biden. Typically, when a pathogen causes a death or quarantine, local public health authorities test the pathogen and share the genetic code sequencing so it can be analyzed and risk levels can be assessed by infectious disease experts internationally. Russian authorities have not yet publicly shared those details. Allegations of a plague outbreak spread after local government official Alexei Tsydenov, head of the nearby Republic of Buryatia, said in an Oct. 2 post on Russian social media platform VK that a woman in the Irkutsk region "may" have died of plague. After initially saying on Sunday that the laboratory staffer died from "pneumonia of unknown [cause]," Russian public health watchdog Rospotrebnadzor reportedly said Tuesday that beyond Covid-19 and a virus that causes the common cold, "no other infectious disease pathogens were detected" among people tested so far. Yet the alleged size of the reported quarantine suggests an infection that could be more serious than what's being shared publicly, says Panjabi. "There's a mismatch between the words and the actions, and that's what makes us concerned. And a lack of transparency about the lab results, which is what's needed right now," he says. How worried should the rest of the world be? If Russia does have a plague outbreak, the rest of the world could have low cause for concern. Pneumonic plague, which can cause pneumonia or pneumonia-like symptoms, can lead to hospitalization or death — but it's treatable with antibiotics when identified early, Panjabi says. If a different form of pathogen is circulating in the Irkutsk region, you'd need more information than is currently available to determine your potential risk. You can track your need to worry by asking yourself three questions as data becomes available, Panjabi suggests. The answers can help you gauge the level of global concern, and gain knowledge on how the pathogen is progressing: - Is there an escalation in new cases, or are more people falling sick? - Are quarantines and restrictions being put in place for schools and workplaces? - Do lab results reveal that this pathogen is something we haven't seen before? More broadly, to embrace uncertainty during any infectious disease outbreak or concern, Panjabi suggests prioritizing your "locus of control" with an exercise he recommends in his upcoming book, "Safer: A Playbook—Turning Fear into Action and Crisis into Community." Draw a circle on a piece of paper and, inside the circle, write down everything you can't control surrounding a major global health event. You can't control the number of cases, or market volatility, for example. The goal of the activity is to remind yourself of what's out of your hands so you can shift your focus to what you actually can change, says Panjabi. "You don't need control over the whole situation to feel steadier. What we need sometimes is just control over the next meaningful step," he says. "And being able to shift the locus of control in this way is one way to do that."
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