Advertisement
Advertisement
A researcher delivers detection reagents for the new coronavirus at a company in Tianjin, China. Photo: Xinhua
Opinion
Swee Kheng Khor
Swee Kheng Khor

Doctors aren’t enough – to fight the new coronavirus, we need an all-of-science response

  • Fighting a species-level threat like Covid-19 requires the best brains from disciplines as varied as mathematics, AI, sociology and psychology
  • Learning to work together under the threat of outbreak lays the foundation for global collaboration to fight larger threats like climate change

In April 2019, humanity saw what was previously thought unseeable when Nasa released our first picture of a black hole. Black holes are so dense no light escapes from them, making them invisible and any pictures hitherto impossible. We produced that picture because a whole bunch of scientists worked together, representing the height of our species’ collaborative abilities.

Hundreds of astronomers, astrophysicists, computer scientists, engineers and mathematicians from tens of countries worked for two hard years in a symphony of human collaboration, showing how interdisciplinary work is the best work. If we can take a picture of the invisible with a coalition of the unlikely, then we can certainly do the same to beat Covid-19 today and all other outbreaks tomorrow.

Who then, are the new outbreak experts? Why do we need them? How could it work?

To cope with the coronavirus outbreak, China needs less politics and more science

When I was a medical student and then a young doctor, it was impressed upon me that doctors have the power to cure diseases, and that we alone are the most important discipline in a health system. We were wrong – doctors only have a small part of the truth. Other parts of the truth belong to scientists, scholars and experts outside medicine and the health sciences.
Fighting a species-level threat like Covid-19 requires the best brains of our species, and many of the solutions lie outside vaccines, medicines and intensive care units. They lie within the old sciences of chemistry, biology and virology, and the new sciences of big data and artificial intelligence, computer science and statistical models of disease transmission, and genomic medicine.

As outbreaks are also a psychological, political and social phenomenon, we may need sociologists, psychologists, philosophers, ethicists, media practitioners, crisis management experts, policymakers and senior civil servants in the decision-making room.

A woman wearing a face mask walks through a disinfectant-spraying device at an entrance to a residential compound in Tianjin. Photo: Reuters

These are just the more predictable ones. Others could be the software engineer who writes an algorithm or a digital health tool that gathers disease transmission data, urban planners who design cities to be more resilient to outbreaks, or anthropologists or historians who help us manage fear and panic by deconstructing our human psyche and history.

We need this new set of outbreak experts for three main reasons. Firstly, no longer can individual disciplines believe that they alone have all the answers; not doctors, not virologists, not bench scientists. The planetary commons is far too large for single disciplines to try to comprehend or conquer; we need the entire resources of our entire species to fight viruses.

Coronavirus fight is between species, not countries – we need science and solidarity to beat it

Secondly, society has become infinitely complex and outbreaks are infinitely multifactorial. Such complex interactions require a basket of solutions that simultaneously address multiple angles of the problem.

Thirdly, learning how to collaborate when our species is under the threat of outbreak lays the foundation for global collaboration to fight larger health threats like climate change and antimicrobial resistance.

The new outbreak experts will bring crucial expertise and we need them for many good reasons. However, their inclusion into decision-making processes is not guaranteed. There are vested interests keeping them out, path dependencies from past decisions or experiences, or just simply because the historian or computer scientist is afraid of irrelevance, has no connections, or is not confident enough.

These barriers can be overcome by pulling and pushing. Non-traditional but crucial outbreak experts must be pulled into decision-making processes, either as a formal participant or ad hoc adviser.

A medical staff member in protective clothing takes the temperature of a man at the Wuhan Red Cross Hospital. Photo: AFP

Traditional decision makers like doctors, public health physicians or politicians must consciously remember their limitations, and quickly ask advice for how to remove their blind spots.

This begins with the generosity and humility of individual experts to reach out and say to another human being: “I need your help.” Getting traditional outbreak experts to pull non-traditional ones into the room requires citizens to also agitate for an all-of-science approach to fighting outbreaks and building health.

The second is for non-traditional outbreak experts to push themselves into the rooms where decisions are made. They must acquire the necessary skill set to provide support, of course, and to explore intersections between their fields and that of health, public health and global health. When offering ideas, they should avoid academic and theoretical discussions and focus on hard and concrete suggestions; doctors are some of the most hyper-practical professionals in the world.

Why we might have to accept that this new coronavirus could be here to stay

Health education systems can reconfigure themselves to provide basic public health training for non-health professionals like architects, mathematicians and meteorologists. A year-long Master in Public Health may not be the most appropriate, but a week-long certificate course can be easily delivered and scaled up. This creates a critical mass of health-savvy experts in very diverse fields; who knows what palaeontology can teach us about health and outbreak responses?

Health systems are rightly predicated on all-of-government and all-of-society responses. Outbreaks are species-wide threats that should engender species-wide solutions. This means we need an all-of-science response, not just a response by the health sciences.

Dr Swee Kheng Khor specialises in health systems, health policies and global health, and is currently based at the University of Oxford

Post