Are we thinking of the next pandemic?

“The real way for the long haul to make outbreaks less serious is to build the global health system to support core health care functions in every country in the world so that all countries, even poor ones, can rapidly identify and treat new infectious diseases as they emerge.” (Alanna Shaikh, 2019)

I see three elements in mitigating future outbreaks - (1) science, (2) leadership and (3) human resources.

In Science

ZZDog MD (a.k.a. Dr. Zubin Damania) summed up my #1 response to Alaina Shaikh's quote - "science the crap outta ___________ (fill-in with the next virus)"

Dr. Damania laid out three actions that helped Iceland minimize the effect of COVID : (1) public-private partnerships; (2) genomic epidemiology, and (3) a national EMR.

In Damania's analysis, Iceland's Directorate of Health immediately collaborated with the private sector (deCODE) and deployed the technologies in genomics to understand the makeup of the novel virus. The openness of the public-private partnership allowed for the sharing of resources. Human resources were mobilized, they opened spaces and locations where labs can be established to the private sector and vice-versa.

In a feature written by Scudellari (2020) deCODE and Iceland’s Directorate of Health worked hand-in-hand, sharing ideas, data, laboratory space and staff. She further describes the depth of the high-powered partnership that provided valuable insights about the virus and can effectively track every move the virus has made. This involved the tracking of the health of every person who has tested positive for SARS-CoV-2, sequenced the genetic material of each viral isolate and screened more than half of the island’s 368,000 residents for infection.

They made the technology that tied all the data together possible because Iceland had a robust national EHR system that truly embraced interoperability. The biggest obstacle facing EHR interoperability in the US is not technological, but cultural (Reisman ,2017).

According to Andrew Gurman, MD, “The future of EHR and its ability to be an important tool in care coordination and team-based care will depend on the action taken by the EHR vendor industry and the federal government to ensure interoperability is a major focus,” (Reisman ,2017).

This further illustrates how disconnected the private from the public is.

In Leadership and Mental Toughness

I highly recommend reading The Great Influenza: The Story of the Deadliest Plague in History by John Barry. The book analyzed the 1918 flu pandemic, one of the worst pandemics in history, and tells a cautionary tale for similar kinds of large-scale outbreaks. Barry wrote the book in 2004, but its relevance today only serves as an indictment of how woefully unprepared the US and the world are from the Pandemic.

Some quotes from John Barry:

Human Resources

We have used the term "frontliners" many times during this pandemic. Frontline is defined as the military line or part of an army that is closest to the enemy. (Wikipedia contributors, 2021, February 26).

Health administrators were given the task of ordering the healthcare workers to the frontline - the closest to the enemy. And this takes tremendous sacrifice by the leadership and the organization. To willingly embrace the dangers of contracting a deadly virus. We have lost countless healthcare workers to COVID. And we laud them heroes, they deservedly must be considered as. While the front liners are at "war" the administrators are close behind supporting their every effort. The logistical requirements are enormous, the personnel, the regulations, the compensations, the benefits and the aftermath are all handled by the health administrators.

So, what are we going to do with the next pandemic?