(CNN) - The administration of US President Donald Trump is facing difficulty in obtaining clear answers regarding the death of an employee in a Russian laboratory at an institute dedicated to studying the plague, as Russian officials continue to procrastinate and refuse to provide information about the mysterious circumstances surrounding the incident.
The death of the employee - who was working at the Irkutsk Plague Research and Control Institute in Siberia - sparked a state of immediate concern within the US administration, prompting it to work urgently to gather intelligence information and plan a possible public health response, according to multiple sources familiar with the matter.
But Russia's reluctance to share information about the incident has hampered these efforts, leaving officials uncertain about the broader risks that might ensue, and specifically how to protect the United States from them.
An informed source told CNN that the United States is considering sending an official diplomatic note known as a "démarche" to Russia to demand more information.
Secretary of State Marco Rubio said on Tuesday: “Russia has a duty to share more information with the world. It may be bigger than we thought. We don’t know, but I think it would be reckless at this moment - and given the limited information we have - to resort to speculation.”
A US State Department official said that officials have been communicating with the Russian government since Friday, including communications between health experts at the department and the Russian Foreign Ministry.
An administration official indicated that this communication is still ongoing, while Rubio expressed Tuesday his hope that the situation regarding the sharing of limited information will change “in the next few hours and days.”
Trump also told reporters outside the White House on Tuesday that he was "scheduled to have a call" to speak with Russian President Vladimir Putin about the issue "very soon," and added that US agencies would have more information to report on "possibly tomorrow."
However, the United States has received only limited cooperation so far; The little information coming out of Russia has been met with great skepticism, as officials are not convinced that the Kremlin is revealing the full facts, according to people familiar with the situation.
However, until the administration has more information through intelligence gathering and diplomatic outreach, officials are not taking steps — such as imposing travel restrictions — to prevent any potential spread of the disease, according to a U.S. official.
It is worth noting that the United States already advises against traveling to Russia for several reasons, including the possibility of arbitrary detention and the ongoing war with Ukraine.
Among the crucial questions that remain unanswered: Did the 28-year-old employee who died last week contract pneumonic plague (a serious but treatable infection) or another unknown infectious disease? It is noteworthy that workers at the Plague Control Institute are studying a group of other dangerous diseases, including cholera and anthrax, according to the institute’s website.
US officials also sought details about whether the disease had undergone any modification - a process known as “gain of function” that could fundamentally change the nature of the US and international response.
Rubio and other Trump administration officials have publicly downplayed the immediate threat facing Americans, stressing that the administration is closely monitoring the situation and that pneumonic plague is a disease treatable with antibiotics.
However, sources familiar with the situation reported that there is deep concern within the administration due to the continued absence of clear information.
These fears are exacerbated by Russia's exaggerated response, which included imposing a quarantine on the hospital where the female employee was treated, according to the mayor of Shelikhovsky District. A regional media outlet reported that nearly 200 people are under medical observation.
An American official said: “We do not currently know much about what actually happened, but there is one thing we are fairly certain of: the Russians will act as the Chinese did during the Covid crisis; they will not be transparent or cooperative in disclosing information.”
However, Trump described the situation on Monday as a “big problem” for Russia, indicating that the United States may need to provide an unspecified level of assistance.
In a statement issued by her, a State Department spokeswoman said that several federal agencies are “closely monitoring the death resulting from suspected pneumonic plague,” but noted that many details surrounding the incident remain unconfirmed, and she also reiterated that the long-standing advice to Americans is not to travel to Russia for any reason.
“We urge the Russian authorities to share accurate information quickly and openly,” the spokesman said.
In the days after the lab employee's death, officials at the National Security Council and State Department led the administration's efforts to gather information, build a picture of what happened, and assess potential risks, officials and other sources familiar with the matter said.
Federal health agencies, including the US Centers for Disease Control and Prevention and the Strategic Preparedness and Response Administration, participated in the joint government effort.
A source familiar with the outreach said Trump officials also reached out informally to the World Health Organization — the international health body whose funding Trump withdrew shortly after taking office, but with which the government continues to communicate in emergency situations.
The World Health Organization said on Monday that it is in contact with the Russian authorities to verify the details of the employee’s death, but so far it has received only a little information.
“If they are not transparent, if they are not open to independent accountability, how can we trust that the Kremlin is sharing full and accurate information with us,” said Lawrence Gostin, a professor of global health law at Georgetown University who has worked closely with the WHO.
“It is clear, on the face of it, that the laboratory was conducting extremely risky research and using poor biosafety procedures,” he added.
The Plague Control Institute's relatively remote location in eastern Russia, coupled with pneumonic plague's limited ability to spread rapidly, gave health experts some reassurance that any immediate threat could be contained.
Pneumonic plague is a bacterial infection, unlike the highly contagious coronavirus strain that caused the 2020 pandemic, and although plague is fatal if untreated, there are now effective and widely available antibiotics to treat it.
While there is little indication that this incident will lead to another global health crisis, officials and independent experts have confirmed that it has nonetheless reinforced how difficult it is to monitor and prepare for potential biological threats.
These officials and experts indicated that the Department of Health and Human Services may have the medical stock needed to combat classic pneumonic plague.
But there is little certainty about whether it can do the same against a modified version of it, or how long it will take to develop a treatment for it when needed.
Jennifer Nuzzo, professor of epidemiology and director of the Center for Epidemiology at Brown University School of Public Health, said that this incident comes at a time when health response capabilities in the United States and the world have declined due to funding cuts and pressure resulting from responding to other crises.
The World Health Organization proposed cutting its budget after a US$600 million deficit resulting from the US withdrawal.
She added that America's ability to handle a new public health response has been "severely diminished" amid its efforts to combat the measles outbreak.
“We are talking about a very exhausted system,” Nuzzo said. “God forbid another pathogen is added to the already difficult and exhausting work of measles control. That would be a nightmare.”
