This article was written by Curt Hopkins and originally appeared on the Snowflake Blog here: https://www.snowflake.com/blog/the-case-for-disease-surveillance/
The fact that COVID-19 is a pandemic, not an epidemic, shows us why a global immune system is necessary. The radically interactive2 nature of the present world means any epidemic is much more likely now than ever before to go global before it’s stopped. Rapid detection now means more than just improved treatment for the individual—with the right kind of data sharing, it can also mean outbreaks can be caught early and limited or stopped.
Data is the key. By 2025, International Data Corporation (IDC) anticipates a global datasphere of 175 zettabytes generated per year.3 Health and wellness–related issues are a big contributor. MRIs alone, as they’ve grown in sophistication, have increased the number of images they take of a head, for example, from 2,000 to 20,000, according to the IDC report.
As The Journal of Big Data has said, “Healthcare (is) a big data repository.”4
Picture a world in which you exhale into a Breathalyzer, perhaps some simple device that syncs with your phone, each morning to analyze your health. You receive an alert if you turn out to have been infected with a contagious disease. These are some things biological science is working on and that could flip global health from a treatment system to a prevention ecosystem.
The Past Is Prelude
According to Todd Crosslin, Global Head of Healthcare and Life Sciences Strategy at Snowflake, the most important technological developments in the healthcare field over the last several years are virtual health, health devices, and genomics. Each of these areas can contribute toward building a global health early-warning system.
“Telehealth is something that’s been around for five to 10 years already,” Crosslin said, but the COVID-19 pandemic accelerated people’s embrace of what is now called hybrid care. A fusion of online doctor visits for issues of moderate concern and in-person visits for those issues that cannot be diagnosed without hands-on examination is quite common now.
“We have also moved from reliance on big and bulky machines for imaging and diagnostics to being able to do the same things on much smaller devices, right down to health assessments you can do on your iPhone,” Crosslin said.
Wearable devices that help measure, communicate, and advise you on your health are the second big health technology innovation. (See some of these devices in this illustrated patient’s journey.)
What Crosslin calls the “third wheel” of our triskelion of medical innovation is genomics. When having your DNA mapped transitioned from science fiction to possible, it also moved from imaginary to expensive. Since then, however, it’s become downright cheap, to a point where there are a number of for-profit companies who do it for you over a combination of the internet and the mail.
“Because the price has gone down so much, there is massively more screening and sequencing that’s happening, which is contributing to the explosion of data,” Crosslin said.
Faster and more-effective treatments are also advancing steadily. For John Ellithorpe, President of DNAnexus, one key development in recent years is the ability to leverage the human immune system to treat disease, especially cancer.
“This is just the tipping point or the very start of a whole world of understanding the mechanisms of the body,” said Ellithorpe. This is a model for using the way a body works to provide its own cures. He also notes innovations such as the machinery used to produce mRNA vaccines, including for COVID-19, and CRISPR5 gene-editing technology.
The architectures of innovation that both of these experts describe have one thing in common: They set the stage for a future in which this imagined global immune system is possible.
What’s Next: The Collaborative Cloud
What the future holds, according to Crosslin, is even more data, leading to data-fueled breakthroughs. So-called edge technologies6 that gather and sometimes process data at the point of collection are increasing. Medical technologies and sensors will gather more information, and advances in artificial intelligence and machine learning will mean faster and better recognition of trends and patterns.
All this together means that even more than now, data will be the vehicle through which we understand medicine, even if it is behind the scenes for most patients.
To tame and employ this data in a way that makes for a healthier population requires one thing above all, according to Crosslin: a supercharged collaborative cloud.
“You have an ability with modern cloud data platforms to collaborate on live data that is a configuration, not a software or hardware build,” he said. Public health systems will be able to use such a platform to share alerts and respond to emerging patterns earlier, while researchers could work on larger shared data sets to strengthen clinical trials or accelerate drug development.
Ellithorpe believes healthcare by subscription is a likely development that will contribute toward this type of collaboration.
“The promise is about moving further and further away from calling the doctor when you’re sick to a model like a subscription software service,” said Ellithorpe.
“You subscribe to your health, you subscribe to provide information to services that look at lab results and your medical records every time you visit.” This sort of service dovetails with Fitbits and other personal health devices and the data it gathers, communicates, and processes.
Data will continue to mount and continue to hold out the promise of diagnosis and treatment. The technologies that have led up to the present and the technologies that will likely evolve from them make it likely that we will be able to create the global immune system Reid imagines.
The Privacy Challenge
While the necessary technologies are advancing rapidly, patient privacy is an obvious hurdle that needs careful consideration. The U.S. Health Insurance Portability and Accountability Act7 (HIPAA) protects patients with the Privacy Rule,8 which “creates national standards to protect individuals’ medical records and other personal health information.” It secures the privacy of patients’ medical information, keeping it from being passed around by insurance companies and medical corporations. In the U.K., the Data Protection Act has similar protections.
Aggregate data, not attached to individuals, isn’t subject to the same restrictions. Any attempt to gather and share personal health information digitally on a large scale will require software and systems with a neurosurgical precision and transparency.
Such an enormous undertaking as a global immune system will require profound transparency, a level of standardization that ensures interoperability across the world, an almost absolute level of security, and enough give in the system that it will not break. The collective intellect of the world certainly seems adequate to the task. But can it find the political will to prioritize health over fear, and trust over self-interest?