Public-Private Disease Surveillance Partnerships Are What’s Needed To Stop The Next Pandemic
The SARS-CoV-2 virus, which caused the global Covid-19 pandemic, won’t be the last virus with the potential to wreak havoc on the world’s health and economy. New viruses emerge constantly — but governments, corporations and non-profit organizations are determined not to be caught off guard the next time around. To thwart the next pandemic, private organizations and governments can team up by accelerating the development of better disease surveillances. Disease surveillance is the practice of collecting massive amounts of health data to look for signs of new viruses and outbreaks.
Currently, disease surveillance in the U.S. is a patchwork of government agencies and fragmented local laws. The onus for surveillance is on individual states, and some put more effort into it than others. Even if the CDC wants to investigate a local outbreak, the agency must be invited to participate in the investigation by the state in which the outbreak occurred. And there’s no overlap between agencies that test humans for disease and those that test animals for disease. This jumbled system is bad for everyone, says Mark Smolinski, president of the non-profit organization Ending Pandemics. “If we don’t routinely and systematically monitor health, we won’t pick up things early enough to focus on prevention.”
To combat this fragmentation, federal agencies are increasingly partnering with private companies for disease surveillance. The private sector is now “playing a larger role” in helping public institutions with surveillance, says Esther Krofah, executive director of FasterCures at the Milken Institute. She cites genetic sequencing company Illumina as an example, which has been using next generation sequencing to detect new Covid-19 variants.
The Milken Institute recently released a report focusing on the importance of an early warning system to prevent future epidemics. “What our report essentially is calling for is actually embedding the private sector, much more specifically, and with intentionality, on issues like disease surveillance,” Krofah says.
Some private companies are already ahead of the game. Toronto-based BlueDot was one of the first organizations in the world to detect signs of a new infectious disease outbreak in Hubei province, China, weeks before the first Covid-19 outbreak was officially announced [CK]. The company monitors over 100,000 global sources including official government reports and news articles to create massive datasets that, with the help of AI, can determine the severity of an outbreak and where it might spread next. The company sells its services to government agencies and businesses so that they can get a heads-up if the disease is forecasted to emerge in their area.
Alex DeMarsh, senior director of outbreak science at BlueDot, says that he hopes Covid-19 will serve as a “wake-up call” for investing in disease surveillance systems. Making surveillance systems interoperable and encouraging government transparency when reporting new outbreaks is of the utmost importance, he says. Plus, countries need to be able to quickly react when a new threat emerges. The initial response to Covid-19 was unorganized, he says, but “we probably had weeks to months where there could have been a lot of preparation.”
Another disease surveillance company in a public-private partnership is MIT-spinout Biobot, which analyzes bacteria, viruses and other potential toxins or disease agents found in community wastewater. This analysis enables the company to extract lots of different types of data, such as viral infections or even illegal drug use. “What we’re talking about here is using a natural byproduct of our human activity to passively collect infectious disease data on populations, and very rapidly respond to them before they spread out and before they become epidemics,” says Biobot cofounder and CEO Mariana Matus.
In late May, the company won a contract with the U.S. Health and Human Services to spend three months collecting and analyzing samples from 320 wastewater sites in communities around the U.S. to look for detectable levels of the SARS-CoV-2 virus. Right now “it’s a test,” Matus says, but ideally this type of data will be collected in the long term and could be used to see which variants of Covid-19 are present in different regions.
Tech giant Google is also involved in disease surveillance — though not all of its forays into public health have been a success. During the early days of the Covid-19 pandemic, the company partnered with Apple and local governments to create a system of contact tracing and exposure notifications for people who came into contact with someone diagnosed with Covid-19. Unfortunately, public distrust of sharing data hampered these efforts, and the program only had limited uptake.
Google’s programs illustrate the biggest hurdle facing disease surveillance today: a lack of public buy-in. While companies like BlueDot and Biobot excel at passive surveillance, Smolinski says that to really beat back future pandemics the U.S. needs systems of active surveillance, which directly engages members of the public. He describes people voluntarily reporting how they are feeling every day, regardless of whether they are sick or not. Passive surveillance is important, but active surveillance allows agencies to immediately respond by providing useful information. “Let’s put the public back in public health,” he says, “get them to be the eyes and ears.” Once we have robust systems of both passive and active surveillance, he says, “that’s when we’ve won.”