Archive for the ‘Viewpoint’ Category

The Definition of Pandemic

Monday, June 15th, 2009

Guest Post:

The word pandemic has been thrown around in recent years because of the prevalence of many major illnesses that have occurred throughout the third world nations as well as even many Western nations. However, the recent Swine Flu outbreak has caused much deliberation as to the proper terminology of the word itself.

There have been generations of widespread epidemics in the past that have included influenza, cholera, and a multitude of other diseases. However, the World Health Organization has come up with a six-tiered level in which to determine when to implement specific disease control efforts around the world, which has successfully led to many countries quarantining illnesses which could be easily spread abroad. However, the true definition of a pandemic is not delivered by the WHO nor can medical journals accurately define it as well. Rather, the general public is on its own to determine what a pandemic ensues, as it implies the “rapid spread of an infectious disease to many countries”. However, the severity of pandemics vary with each disease, and not every country is affected when an outbreak occurs.

Additionally, the variety of different illnesses affects the overall terminology of the word; scientists and doctors alike are still unsure as to how pandemics arise, how they spread, and why they vary in their lethality. The background of the originating country has a lot to do with the severity and contamination of the impending illness and helps contribute to the overall definition of a pandemic. The recent Swine Flu outbreak has increased concerns over the spread of a disease within these “Western nations” which otherwise were remarkably protected from threat of outside illnesses that could infiltrate these nations. The fact that the United States was one of the first countries to report signs of such a disease caused the WHO to scramble to upgrade their alert system in order to properly take care of this problem. It is unfortunate that it takes a Western nation to cause this much concern over an illness, while many African nations have been experiencing similar epidemics. The new limelight on these Western nations is solely due to the international trade that occurs within many of these nations, which therefore caused the disease to be spread throughout Europe, Asia, and Australia.

This new illness caused the WHO much stress as to a proper cure for the illness as well as a way in which to quarantine travelers from disease-ridden countries. While the illness can be treated with regular flu remedies, the fact that so many outside the tradition flu age group were coming down with the illness and succumbing to its side effects caused the WHO to take drastic measures and qualify it (perhaps prematurely) as a pandemic. This recent flu outbreak is vastly different from any earlier outbreaks which may be labeled as “true” pandemics, but this type of definition is forever changing and it may take another widespread illness before we can determine what is the proper scenario in which to classify as a pandemic.

This post was contributed by Meredith Walker, (Online nursing schools). She welcomes your feedback at MeredithWalker1983 at gmail.com

References: WHO Pandemic Phase Descriptions (pdf)

Food for Thought

Monday, November 17th, 2008

What if HIV mutates and can now be transmitted by sneezing and coughing - just like common cold??

What would this graph look like?

HIV/AIDS - people living with HIV/AIDS by Country

 

Electric cars and Global Warming

Sunday, October 12th, 2008

Do you think electric cars are less polluting then regular cars. Think again.

The electric car has not come of age, because more than half of the electricity in this country (USA) is currently generated with coal - the dirtiest of fossil fuels.

- Comment in Time Magazine (Oct 13, 2008 issue)

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Ten years later - we may be asking the same question. Again.

Open source scientific data sharing

Sunday, September 28th, 2008

Let’s take this scenario:-

A prominent scientist X publishes a clinical trial that Drug A is effective in a particular disease.

Another scientist Y publishes another article reinforcing that Drug A is indeed an effective treatment.

Then several small studies are done which show that Drug A has harmful side effects. Some of these get accepted in prominent journals, while others are rejected. Five years later, FDA discovers to its surprise (!!!!) that Drug A is indeed associated with harmful side effects.

This has happened, is happening and will happen!!!

The big question is - Is there any way to prevent this?

Welcome to open source scientific data sharing.

Open source data sharing is similar to open source software, where not only the end result (i.e. software) but also the source code is given away for free. Open source data sharing therefore should aim to not only have all the scientific articles available for free but should also include the raw data that was generated during the course of the experiment or clinical trial.

There are thousands of scientists in the world who can benefit from this data and come up with amazing results. Probably, if the data for Vioxx and Vytorin studies was available online, their side effect profile would be exposed much earlier by “entrepreneur” scientists.

This talk given by Clay Shirky at TED in 2005 explains why we need to move from institutionalization towards open collaboration (which can only be enabled by data sharing).


Of course, there are certain differences between his and my proposal. He is giving public the authority to generate data. I am proposing that scientists generate data by careful experiments/clinical trials and publish their results but in addition make the data available for “entrepreneur” scientists to analyze. It is better to have many eyes looking at data rather than a few.

Besides searching for potential side effects in a mountain of data, open source data sharing has bigger benefits. Consider this:

Many NGO’s are currently funding scientific research in the hope of speeding up the process of scientific research to produce results quickly. Stand up to Cancer is bringing the best scientific minds across the world to develop new medications to fight cancer. This is excellent - but it goes back to Clay Shirky’s talk - Institutionalization vs open collaboration. The best brains can generate excellent data and also probably are the best people to analyze it. But, this data generated should be made available for all other scientists on this planet to analyze and build upon.

Historically most inventions happened by accident. Entrepreneur scientists can make these accidents happen more often - only if given access to scientific data.

Gray’s Anatomy Vs Real doctors

Wednesday, September 17th, 2008

The television medical drama Grey’s Anatomy apparently has more to offer than Patrick Dempsey’s rakish smile and a good cry. A new survey reports watching the show also may increase a viewer’s health smarts.

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There is a lot of inaccurate information on television. According to this survey people remember health information imparted on TV, probably more so than given to them in their doctor’s office. Using the television media responsibly and effectively may increase public awareness of diseases and encourage healthy behavior.

The same goes for print media. Influential magazines should research medical articles before jumping to an opinion. The most recent example is an article in Time Magazine - Gastric bypass surgery less helpful for diabetics. A very catchy but misleading title. To the writer’s credit she did include this conversation with Dr. Hamdy:

I believe that the benefits of gastric bypass surgery outweigh any risk that a patient will have,” says Hamdy. “If you look at the mortality in relation to obesity itself, especially if it occurs with diabetics, that is much, much higher than the risk of mortality from the surgery.

… but it is included at the end of the article.

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In my opinion the title should have been more appropriately worded as it gives an impression that gastric bypass surgery may not help in diabetes.

A lot of furore is ongoing on controlling health blogs and their content. However, the print media has a greater reach and authority than most blogs in influencing health related decisions for patients. Therefore they should carry equal if not greater social responsibility than health blogs.

Reference: USA Today, Time, ACP Internist Blog