“No one can say we weren’t warned. And warned. And warned. A pandemic disease is the most predictable catastrophe in the history of the human race, if only because it has happened to the human race so many, many times before.” – Bill Gates
Infectious diseases claimed more lives than all wars, noninfectious diseases, and natural disasters put together. Infectious diseases were our oldest, deadliest foe in the pre-antibiotic era and is has now rapidly become a major threat to humanity. Year after year, we hear about infections killing people in thousands and spreading from one country to another but not many have developed a strategy to stop this happen, WHY?
In 2014-15, it was the Ebola infection, which killed more than 10,000 people. In 2015 a particularly infectious form of bird flu has ripped through 14 states, forcing public healthcare workers forcing the slaughter of 39 million birds in USA. The result of such callous act has made viruses and bacteria mutate and reassembled itself into a form that can now infect humans. It isn’t just the news that carries warnings but the fear of infectious disease exists in every persons mind, Until now no one has come forward to join hands and help us develop strategies to educate, share knowledge to help people identify and prevent the spread of infection in their family and community. Majority of stakeholders have been obstructive to disruptive technologies we developed to help reduce spreading of these infections.
Various hypothesis and strategy to fight infections were discussed but they still think vaccination is the only option that can help prevent infections and reduce spreading. Knowing there are hundreds of bacteria, viruses and fungi requiring drugs to kill, how can we even contemplate to fight the threat from an army of microorganisms that we have not yet encountered? The microbiologists and pharmacologist said it would take at least ten years before one antibiotic (Phase I trial) can reach the market and cost $Billions with no guarantee of developing and marketing treatments to fight infections. Group formed European Commission are not spending time or money to help develop methods to identify infected individuals or managing infected patients and reduce spread.
In 1980s “AIDS” was given more importance because this affected some rich and famous people. Spreading MRSA in hospital was ignored. We anticipated bacterial threat will bring us on our knee and kill millions of people worldwide, but device and equipment manufacturers and pharmaceutical companies ignored our concern. They continued to highlight needle phobia and spread of HIV infections to healthcare workers and ignored the fact about thousands of patients dying in hospital due to MRSA.
Antibiotic resistant infection in hospital went from an obscure hospital problem to a global pandemic. This is along with emerging infections has become the most common cause of death in the world. One bacteria has now shared its knowledge and technical know how with other bacteria, viruses and even fungi.
The CDC has released a document titled “Preparedness 101” Zombie Apocalypse. They said they do not expects a zombie apocalypse around the corner; but say educating people to avoid becoming a zombie will help make people aware of spreading pandemic of infectious disease. When we discuss this topic, doctors, nurses and people shut down, and so no one is planning for an actual crisis because it is just too scary, too paralyzing to think about.
Pandemic disease is something we talk about when it happens, not before and forget it as soon as the threat wanes off. The healthcare professionals thinks about, knows about and are afraid. As doctors, this is in our minds and haunts us in our nightmares that we cannot even talk to people who work in healthcare because they are too scared to talk about it. We think about it so much, it seems almost ridiculous that we aren’t ready and still not even contemplating the “Threat to humanity and our profession is real” and so we’re not ready, and not even close to even start thinking. Ebola infection has now made some healthcare workers understand what we are talking about and so its getting easier but we feel this will not get us far.
Countries will not admit they have a problem and request help because of financial implications they don’t want to admit they have a problem because in terms of investors and travel, it’s a death sentence Guinea did not declare Ebola epidemic, Chinese leaders, worried about trade and tourism, lied about the presence of the virus for months in 2002. In 2004, when avian influenza first surfaced in Thailand, officials there displayed a similar reluctance to release information.
Hospitals in countries like India are managed and often owned by doctors. They refuse to share information about existing infections and categorically deny and accept they have a problem. Reporting infections to public health authorities is not mandatory. Doctors and hospitals who fail to report are not penalized. Even now the WHO or CDC do not have information about spreading E coli or other infections. Countries like Syria or Yemen are weak and fragmented to effectively coordinate and hostile to the organizations that would need to come in and offer relief.
Third problem majority of poor nations do not trusts the efficacy of the international institutions and will not coordinate or co-operate with agencies. The World Health Organization’s Ebola performance was a disaster. The slow response to declare a public health emergency and some five months after public warnings from Médecins Sans Frontières, whose doctors were on the front line died.
We must catch spreading infectious diseases early and implement the most effective way to protect people. It is not the basic public health infrastructure, laboratories, finding specimens, tests to discovering what’s spreading but offering a simple tool to help people share information about their clinical symptoms and use sophisticated software to monitor them. Emergency operation centers and infectious disease control centers and doctors will be informed after identifying clusters of similar symptoms. This will help mobilize service to isolate infected individuals and prevent them travel to healthcare centers or emergency room in hospitals, spreading their infection as they travel and to patients and healthcare workers in the hospitals.
The good news about our system is its not expensive and ready to go live and can be shared using internet technology. We identify local doctors with the help of people living in the area and form a net work of people, local doctors, healthcare centers to help monitor and also help organize management of infections. By allowing doctors to create a database of symptoms using their local language we hope to help protect healthcare workers and people. We have spent days and years to think, test and develop a tool that is simple to use and not expensive to implement. Basic public health infrastructure is fairly cheap – around a dollar per person, per year. Uganda, may have have motorcycle couriers picking up specimens from hundreds and hundreds of health-care centers all over the country but their life is at risk and so the system may collapse. Send specimen to centralized centers is useful if we have tests and methods to identify the organisms but we don’t have one test that can diagnose all the infectious disease. Emerging bacteria and viruses have muted and so difficult to detect.
The difficulty often isn’t money; it’s prioritizing services, communication, delegating responsibility and implementing changes in law so that people and healthcare providers report symptoms and seek help early. If we can find the disease and have a test to diagnose it, then modern technology really does help, but if we cannot diagnose infection and have no tests available to identify infecting organism, we have a major problem to manage.
Scientist believe they have can rapidly decode the basic structure and pathways of new diseases in ways that were unimaginable even a few decades ago. They claim to can come up with a response much more rapidly only but this depends on patients coming forward to say they have a symptom that may require investigating and treatment. We know from our past experience, patients with symptoms that are serious often deny and continue until its too late. The reason they do not seek help from doctors is because they do not want doctors to confirm their fear.
I was called to see a passenger during a flight. The history presented to me by a member of cabin crew was typical of infection. To tell you frankly, I was scared to see this passenger knowing all about infections like Ebola spreading in Africa. This made me worry and so developed a simple solution that could screen passengers before they board a flight. Knowing passengers travelling from a country with spreading infections that kill will not be honest to admit they have a symptom that suggest infection. We have no method that could swiftly communicate and block travelers board flight and spread the infection back in their home town. We are sure [the WHO] will not do better next time, because this organization is too big and complicated to handle future crisis. We must think and act now to avert tsunami of infection that will wipe out a generation.
By offering help to people by allowing them to download Dr Maya, FREE of cost, offering advice to help manage basic health care, we can develop a monitor that identify clusters of infection in hospitals, community, town or country. Offering a tool to help doctors communicate, manage their patients better and reduce cost of running their clinic or office will encourage them to participate. As this tool was developed and managed by doctors who was subjected to harassment for defending patient’s care in UK for ten years. He developed the tool initially to help protect fellow human and reduce medical errors, cross infections, cost and antibiotic abuse. Using the same tool and creating an APP for doctors to create their own Dr Maya, he has made it possible to initially identify infected individual and isolate them by sharing information with the doctor. Life of doctors, nurses, staff and family will be protected by preventing patients to visit them is likely to be accepted and used to help us fight a major threat to humanity.
You may download Dr. Maya App from this link: http://bit.ly/1XqxjbM
Article By Dr Kadiyali M Srivatsa
Fighting Infections Saving Lives
Harrow, United Kingdom