Zika, Ebola, other public health crises — we need a better plan

Today, the United States Senate is holding hearings to respond to the potential threat of the Zika virus. This is part of a pattern that repeats every few years when an outbreak of disease occurs someplace in the world. As the media coverage increases, public panic grows and in response Congress scrambles to deal with the possible threat, appropriating billions of dollars in emergency funding. Then, as media coverage fades, public panic recedes and Avian flu, Swine flu, Ebola and the others fade from public consciousness.

This is an inefficient and dangerous way to deal with public health threats. At some point, we will have called “the sky is falling” one too many times and we will be unable to deal with a real crisis. For example, tens of thousands of people did not evacuate before Hurricane Katrina because previous evacuations were seen as false alarms. We must not let the same occur in public health.

{mosads}There have always been surprises in public health; Columbus brought syphilis back to Europe starting a continental pandemic. Cortez brought small pox to the Americas, contributing to the fall of the Aztec Empire. The problem is, hundreds of years later, every new disease still seems to catch us off-guard. 

Zika is the latest “surprise” we are scrambling to deal with. This is necessary because the data on Zika is so limited and we must take every precaution to ensure the safety of the American people. As a senator representing a Gulf State that is at a high risk for Zika outbreak, and as a doctor who has worked in public health for nearly 30 years, I am highly aware of the importance of our response. However, we can do better.

The U.S. Centers for Disease Control and Prevention, the World Health Organization and the Pan American Health Organization should know what regions have outbreaks of certain viruses and where people in those infected regions are traveling from and to. If someone is traveling from an area of intense viral infection to another similar climate that has not been previously exposed to that virus, odds are the virus will spread to the new community.

It’s intuitive that if there is an outbreak of Zika in the Pacific, and those in the Pacific are traveling to Brazil, then people in Brazil will be exposed to Zika. Big data linking travel patterns with public health data regarding virus outbreaks can tip off that an outbreak is about to occur.

The U.S. and our global partners should adopt a two-tiered preparedness strategy: proactive research and reactionary response. Predicative models of disease hotspots must be connected with travel patterns. This would allow public health officials to anticipate where the next outbreak will occur. Being able to anticipate this allows public health researchers to go to a community, do background data, and begin administering a vaccine if one is available. Ongoing funding—rather than episodic, emergency funding—is more efficient.

If we operated under this two-tiered strategy, the current Zika crisis could have possibly been avoided. Zika is not new—it was first identified in 1946 and reemerged in the Pacific around 2007, but it attracted very little research or study prior to reaching the Americas and garnering significant media attention.

Like Ebola, Zika is a tropical disease that existed off the radar of significant academic or scientific study. Given the reemergence of the disease in 2007, this should not have been the case. The link between Zika and birth defects has totally bedeviled the scientific community. The exact link between the two will take years of research to identify. Imagine if we had begun that research in 2007, we might already have those answers and be able to save lives and provide peace of mind to millions around the globe.

Much of what I’m proposing may be happening within isolated scientific organizations. We need to ensure those groups have the resources and support to collaborate on a global scale. I’ll be using my legislative role and my seat on the Senate Health, Education, Labor and Pensions (HELP) and Appropriations Committees to ensure that our federally funded scientific researchers are able to collaborate and do the work necessary to protect our nation from emerging public health dangers. 

Cassidy is Louisiana’s junior senator, serving since 2015.   na U.S. Senator for Louisiana. He sits on the Appropriations; the Energy and Natural Resources; the Health Education Labor and Pensions; and the Veterans’ Affairs committees. A physician, he has for nearly three decades provided care for uninsured and underinsured patients in Louisiana’s charity hospital system. He also created a private-public partnership to vaccinate 36,000 school children in a 10-parish area against Hepatitis B.