Rachel wants us to take out our mobile phones and hold them up. Virtually everyone in the room has a phone, each of which has more power than the computers which helped to put a man on the moon. And they can help provide an early warning system for viruses.
Viruses and other infectious diseases are some of the main threats to our increasingly interconnected world. Ebola highlights the threat, and the importance of public health. Doctors protect individuals. Public health protects populations. The reality is that most countries have little public health provision, so Ebola went undetected for 3 months, until it was ready to explode.
The flu pandemic in 1918-20 killed more people than World War I. Pandemic influenza is at the top of the UK government risk register, and it’s not ‘if’ but ‘when’. It’s not just a question of health, but the economy and provision of essential services. Also, antimicrobial resistance is growing, which the Chief Medical Officer describes as a ticking timebomb.
If someone is infected, there is an incubation period before symptoms arise, during which there is a risk of passing it on. There are more delays before diagnosis and intervention, which has a serious effect on PH efforts to prevent the virus spreading. So we need to pick up infections at the onset of symptoms.
Rachel’s team, across many disciplines and organisations, is using reporting of symptoms on the web to form early warning systems. There are 7bn mobile subscriptions in the world. Mobiles are the most sophisticated technology in remote villages in developing countries. The first report of SARS in China was by the public.
Many of us use our mobiles to search the web about our health. Google Flu Trends, based on anonymised searches, provides information 2 weeks ahead of official sources. Tweets also provide lots of information about symptoms. Together, they are being used to create a nowcasting service.
But symptoms don’t imply the same diagnoses, so the team is also bringing diagnostic technology to the people. It uses self-swabbing kits, which are posted back to labs. And phone sensors are now being used to do the diagnosis on the ground. Further, the team has produced bio-barcodes, readable by phone cameras, which can diagnose e.g. HIV. This is all linked to the provision of interventions.
Mobile technology was used in the fight against Ebola – text alerts, communication of test results, etc. It’s still early days, though. The challenge is to develop a means of detecting Ebola and the like 3 months earlier. And the public and public education are the main tools. Together we can fight infectious diseases.