Throughout our history, humankind has faced infectious disease outbreaks. Studying previous outbreaks helps us to understand, contain and treat the diseases of today — even a novel disease like COVID-19.
During our recent webinar, “Successful Outbreak Responses Depend on Reliable Data,” our conversation focused on the importance of data for pandemic preparedness and outbreak responses. We discussed epidemiological data and how it helps us understand a disease: what, how much, when, where and among whom. With this information, we can analyze a health problem and provide timely information for decision-makers, the media, the public and others to support decisions for initiating or modifying control and prevention measures. Unfortunately, a lack of reliable data has drastically hampered the world’s ability to respond to the COVID-19 outbreak.
Importance of Testing
The first step to good data is reliable testing to:
- Identify people requiring isolation, monitoring or treatment
- Understand disease spread
- Trace contacts to limit transmission
- Make decisions about isolation, quarantine and, eventually, easing of restrictions
As our featured speaker, Dr. Michelle Berrey, MD, MPH, explained, “Broad testing helps us understand disease spread and gives us more information to tell our communities when it’s safe to ease restrictions.”
But it’s not just any testing. We need validated, accurate testing to ensure we identify infected and non-infected individuals correctly. If we don’t know who is infected, we run the risk of those individuals infecting others in the community. If we don’t know how many people aren’t infected, we run the risk of exaggerating our response.
Importance of Community Surveillance
COVID-19 hotspots can occur in areas where people are in close quarters or are not willing or able to take sufficient precautions (e.g., use of personal protective equipment [PPE]). And the infections don’t stay there; they get back into our communities.
Webinar question
Georgia has started to include antibiotic testing along with PCR testing or reporting tests performed. What do you think of this?
Dr. Berrey: It depends on which assays are being used. Most of the sites reporting that data are also reporting which assay is being used, and you can see if it is one with higher sensitivity and specificity ratings. In general, these are being used by health departments but I have seen health departments reporting using serologic assays with a false negative rate of almost 50 percent. So, you really need to know which one it is.
These situations also help us understand the spread of COVID-19. For example, a peak of COVID-19 infections following a community’s choir practice helped us understand that singing, even loud talking, is very effective for disease spread. We also have a better understanding of asymptomatic shedding, with a larger percentage of asymptomatic or presymptomatic infected individuals than originally thought. “Understanding transmission dynamics helps us understand when patients may be most infectious,” says Dr. Berrey.
This and other data indicate that COVID-19 is highly contagious and has an even higher infectivity than originally thought. The reproduction number (R0), or the number of new infections that result from exposure to a single infectious individual, of COVID-19 was originally believed to be 2.5-2.7, indicating that each infected person infects two or three others. However, it is now believed to be closer to 5-6. This misunderstanding of the infectivity, which was initially believed to be similar to that of flu, led to a level of complacency regarding decisions about preparedness and the use of non-pharmaceutical interventions, such as masks and social distancing. The resulting rapid spread throughout the world has burdened the health care system and economy.
Pandemic Preparedness
Ultimately, we need to combine the data from past outbreaks with the data in the initial stages of a new outbreak to initiate a level of preparedness that includes developing, validating and implementing tests that inform our use of non-pharmaceutical interventions, and readying our health care systems with PPE and human resources to safely treat and manage infected patients. Preparedness is something we feel strongly about at FHI Clinical. Our team stays current on the epidemiology of infectious diseases and maintains our policies and procedures so that we’re ready to respond whenever there’s an issue.
Similarly, we pair our experience in the development of new vaccines and treatments with the training and development support provided by our parent company, FHI 360 — namely prevention and preparedness, detection and strengthening and enabling environments — to support local communities in their outbreak responses.
As Claudia Christian, our VP of Global Clinical Operations, says:
“We are a CRO that is 100 percent always prepared for outbreaks. Because this is our sweet spot, we know the next one is just around the corner. We keep ourselves current and ready.”
To learn more about the importance of data, view the on-demand webinar.
