Nursing

Adversary

Public health

Computer security

Computer science

Environmental health

Coronavirus disease 2019 (COVID-19)

Internet privacy

Social media

Political science

Infectious disease (medical specialty)

Biological warfare

Misinformation

Medicine

Pandemic

Terrorism

Disease

Disinformation

Pathology

Health Security

While biological warfare has classically been considered a threat requiring the presence of a distinct biological agent, we argue that in light of the rise of state-sponsored online disinformation campaigns we are approaching a fifth phase of biowarfare with a "cyber-bio" framing. By examining the rise of measles cases following disinformation campaigns connected to the US 2016 presidential elections, the rise of disinformation in the current novel coronavirus disease 2019 pandemic, and the impact of misinformation on public health interventions during the 2014-2016 West Africa and 2019-2020 Democratic Republic of the Congo Ebola outbreaks, we ask whether the potential impact of these campaigns-which includes the undermining of sociopolitical systems, the delegitimization of public health and scientific bodies, and the diversion of the public health response-can be characterized as analogous to the impacts of more traditional conceptions of biowarfare. In this paper, we look at these different impacts and the norms related to the use of biological weapons and cyber campaigns. By doing so, we anticipate the advent of a combined cyber and biological warfare. The latter is not dependent on the existence of a manufactured biological weapon; it manages to undermine sociopolitical systems and public health through the weaponization of naturally occurring outbreaks.

Disinformation and Epidemics: Anticipating the Next Phase of Biowarfare