The 9th TEPHINET Global Scientific Conference: Ending Pandemics in our Lifetime Initiative

From August 7th-11th, The Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) held its 9th Global Scientific Conference and the 23rd National Epidemiology Seminar in Chiang Mai, Thailand. I had the opportunity to listen to a panel presentation on Global Influenza Surveillance as well as the following presentation on Ending Pandemics. The overview I have provided below summarizes Mark Smolinski’s (Director of Global Health Threats at Skoll Global Threat Funds) presentation on innovations in surveillance for personal, national, and global health security. Feel free to listen to the entire presentation (1:17:00-2:16:28)!

  • Epi curves generally focus on human disease but human disease and animal outbreaks coincide or trigger one another. Additionally, bioterrorism can play a role in outbreaks and should be included in epi curves.
  • There are six main opportunities for epidemiologists/public health practitioners to intervene and reduce risk from pandemic threat:
    • Stop the threat in the animal population
    • Reduce the epi curve in the animal population
    • Find the first human cases (quickly)
    • Limit human infections and stop the epi curve in the animal population
    • Ensure strong surveillance/warning systems are in every country so disease doesn’t spread beyond country borders
    • Know and work directly with neighbors across borders so that regional security exists to stop any outbreak/prevent pandemics
  • It costs 3.4 billion dollars to prevent a pandemic by ensuring that developing countries have baseline capacity/public health systems that meet international standards. The return of investment is 10 fold. We are currently at ~450 million dollars.
  • Innovations in Surveillance – Researchers in tech as well as universities are involved in innovative surveillance methods, not necessarily epidemiologists/public health practitioners:
    • Google Flu Trends –predictive of flu and comparable to CDC flu reports (visits to providers), which were delayed by two weeks (80% of ill individuals did not visit a provider)
    • Twitter – University of Rochester developed an algorithm that can predict flu with 90% accuracy and gives an 8-day notice of when someone will get the flu (based off of tweets of others in your community/social circle)
    • HealthMap/Flu Near You – Participatory surveillance system that allows people to check off symptoms, see results on a map, and find where the closest vaccines are; correlates very well with the CDC influenza-like illness surveillance (over 5 years)
    • Epi Hacks – the idea is to bring together human, animal, and environmental health experts for one week to work with developers to come up with open source products for countries to use (for surveillance purposes); at least one has been conducted on each continent
    • PODD – uses a One Health approach as people in villages are tasked with helping find outbreaks quickly and reporting animal morbidity/mortality in real-time
    • KIDENGA – CDC and the University of Arizona are working together on vector-borne surveillance on the U.S/Mexico border, an epi hack will take place to see if they can create a sustainable way to address vector-borne diseases
    • Guardians of Health app – asked attendees to report health issues or symptoms during the World Cup, attendees received health information and program updates/information in return
    • EPICORE – retrospective analysis of public health information related to outbreaks; an automated system that epidemiologists follow-up on (after requests for information have been sent out)
  • When there are no outbreaks, public health gets no credit…
  • All countries cannot meet the International Health Regulations, even if they agree that they SHOULD be met
  • Skoll Global Threats Fund teamed up with Google and examined publicly available data at the World Health Organization (WHO) to determine how long it takes to detect, report, and respond to outbreaks; found that the global community is improving but has plateaued (due to limited data)
  • Research Paper – Finding Outbreaks Faster – Smolinski MS, Crawley AW, Olsen JM. Finding Outbreaks Faster. Health Security. 2017;15(2):215-220. doi:10.1089/hs.2016.0069.
    • There are epidemiologists in 28 countries looking at data from each outbreak to determine 6 metrics that all countries can follow (over past 5-10 years)
    • Countries had never looked closely at this issue and were able to see their strengths and weaknesses in investigating different types of outbreaks
    • Hot Spots of Emerging Infectious Disease – CORDS
      • Build friendship and trust across borders
      • Helps regional disease investigation networks share best practices, scale innovations, optimize informal networks
      • South Asia and West Africa are the most concerning for emerging infectious diseases, in a few years they may have stronger regional networks
  • Ending Pandemics Collective
    • 14 foundations and leaders of companies concerned about social responsibility want to invest in global health, share ideas, coordinate funding for projects, break down barriers in the foundation world
      • Smithsonian Museum of Natural History wants to do a 2-year exhibit called outbreaks, collectively a great chance to improve the knowledge base of people that visit the exhibit (~7 million people)
      • In 10 years the collective sees a world where:
        • Every outbreak is detected within 3 incubations periods of the index case or cluster
        • Every country’s Emergency Operations Center is utilizing an integrated, event-based detection system being used simultaneously by the WHO and G20
        • Human, animal, and environmental health volunteers are verifying rumors or suspected threats within 24 -48 hours through EpiCore
        • Participatory surveillance is engaging communities directly to detect and respond to outbreaks in every disease hotspot across the globe
        • Field epidemiologists in every country are using the latest technology to detect, verify, and respond to outbreaks faster
  • At the end of the day, pandemics can be prevented because “no community is too hard to reach, no community is too poor to innovate, and curiosity outshines fear!” 

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