Increased vigilance in hospitals, better data sharing and training drills can help ready the world to respond to infectious-disease outbreaks.
In January 2020, news outlets around the world reported a disease outbreak in China caused by a new pathogen. For a while, the now all-too familiar disease called COVID-19 appeared to be mostly contained in China — at the start of the final week of January, there were 2,700 confirmed cases in the country and only around 40 cases elsewhere. The rest of the world scrolled past the headlines, failing to see what was coming.
Often it’s the emergency medicine physicians who make decisions about what information to gather from a person through laboratory testing, at least initially. Sorensen emphasizes that, in a pandemic-aware world, these professionals need to be meticulous about diagnosis, staying alert to symptoms that don’t fit the typical pattern for the region. “Emergency providers need to have a really high index of suspicion,” she says.
Genomic testing can be a helpful tool in these cases. Saha’s group has used a genomic sequencing facility to analyse cases of meningitis in the local community that were caused by unknown pathogens. Sequencing samples of cerebrospinal fluid from children who had meningitis showed, to the researchers’ surprise, that in some cases their condition stemmed from an otherwise unnoticed outbreak of the chikungunya virus, a mosquito-borne pathogen.
Tieble Traore, technical officer for emergency preparedness at the WHO’s regional office emergency hub in Dakar, says that after the Ebola outbreak in West Africa between 2014 and 2016, the WHO has led efforts to strengthen information-sharing practices in Africa. Under a strategy adopted in 2016, health officials now encourage robust community participation to improve data sharing about threats to public health.
In addition to being well-drilled, a good response to a pandemic also relies on having the capacity to handle a spreading disease — a particular issue in resource-limited settings. “Capacity comes from access,” says Desiree LaBeaud, a paediatric infectious-disease specialist at Stanford University in California who collaborates with researchers in Kenya. “Access to knowledge, access to diagnostics, treatments, vaccines, medical care, and then trained individuals and social capital.
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