Here's something you might be interested in.
Ask a Hipster — Advice you didn't know you needed
Big Screen — Movie commentary
Blurt — Music's inside track
Booze News — San Diego spirits
Classical Music — Immortal beauty
Classifieds — Free and easy
Cover Stories — Front-page features
Drinks All Around — Bartenders' drink recipes
Excerpts — Literary and spiritual excerpts
Feast! — Food & drink reviews
Feature Stories — Local news & stories
Fishing Report — What’s getting hooked from ship and shore
From the Archives — Spotlight on the past
Golden Dreams — Talk of the town
The Gonzo Report — Making the musical scene, or at least reporting from it
Letters — Our inbox
Movies@Home — Local movie buffs share favorites
Movie Reviews — Our critics' picks and pans
Musician Interviews — Up close with local artists
Neighborhood News from Stringers — Hyperlocal news
News Ticker — News & politics
Obermeyer — San Diego politics illustrated
Outdoors — Weekly changes in flora and fauna
Overheard in San Diego — Eavesdropping illustrated
Poetry — The old and the new
Reader Travel — Travel section built by travelers
Reading — The hunt for intellectuals
Roam-O-Rama — SoCal's best hiking/biking trails
San Diego Beer — Inside San Diego suds
SD on the QT — Almost factual news
Sheep and Goats — Places of worship
Special Issues — The best of
Street Style — San Diego streets have style
Surf Diego — Real stories from those braving the waves
Theater — On stage in San Diego this week
Tin Fork — Silver spoon alternative
Under the Radar — Matt Potter's undercover work
Unforgettable — Long-ago San Diego
Unreal Estate — San Diego's priciest pads
Your Week — Daily event picks
The history of epidemiology
No money in prevention
Kimberly Brouwer
“It was surprising and very exciting,” says Professor Kimberly Brouwer, who teaches epidemiology at the UCSD School of Medicine. She’s talking about the brand-new graduate class she started last Tuesday, online. “I had 27 students sign in. Some from outside epidemiology. Some from outside the country. Interest is up.”
So how come epidemiology is suddenly hot, after being somewhat the “bean-counting branch” of medicine?
“I would say our experience with previous epidemics and pandemics has given us the [background] to accurately model things. All of those estimates of, for instance, how long we have to stay at home are based on the history of epidemiology, and of epidemics throughout the world. Advice such as ‘wash your hands’ has been informed by an evidence base of multiple [epidemics]. And it is important in the absence of cures and-or vaccines for this virus.”
“A lot of public health is quite basic,” says Brouwer. “In fact, I’d say that public health in recent years has moved from discovering new ways to prevent epidemics to finding ways to implement known solutions that we already have. Because we know how to prevent disease, but we are just not implementing. So implementation science is now hand-in-hand with epidemiology to make sure the basics we already know are put to work.”
But Professor Brouwer says epidemiology is also sprouting new wings. “We have genetic epidemiology, where we’re able to learn whether or not the virus is related between two people, or spreads by direct transmission. We’re also able to better predict where the virus will go, with what we call spatial epidemiology. We map it.”
Would it work here? “A place like South Korea, where they do widespread testing, mapping has been quite efficient. They’ve been linking mapping with cellphone alerts, authorities saying ‘You’re in an area, a shopping mall, whatever, where there was recently a diagnosed case.’ They’ll call you. ‘If you were there at a particular time, you may have been exposed...’ South Korea is the gold standard of spatial epidemiology.”
In the US, she says, we don’t have the data inputs to adequately inform infectious disease models.
“We’re using what we have, but right now the stay at home order is a kind of sledgehammer tool of control, because we’re missing a lot of the pieces of the puzzle with regards to where exactly the disease is. Is it everywhere? Or are there certain places that could have functioning economies, where people could still interact, and not have to be under a blanket stay-at-home order?”
The biggest thing we need, she says again and again, is testing. Two types: one that measures the virus itself, that can diagnose people who currently have the virus. But also testing that looks at antibodies, to determine who was previously infected, and maybe didn’t even know they’d already had it.
“If you could get blanket testing, then you could determine if we’ve built some type of herd immunity. Has it already passed through huge sections of our population? Or do we need to still have this stay at home policy?”
And after all this has hopefully passed by, are we going to have learned our lesson? Maybe, maybe not, says Professor Brouwer. “We’ll likely just go back to our old habits.”
Why?
“Because there’s no money in prevention.”
Here's something you might be interested in.
The history of epidemiology
No money in prevention
The history of epidemiology
No money in prevention
Kimberly Brouwer
“It was surprising and very exciting,” says Professor Kimberly Brouwer, who teaches epidemiology at the UCSD School of Medicine. She’s talking about the brand-new graduate class she started last Tuesday, online. “I had 27 students sign in. Some from outside epidemiology. Some from outside the country. Interest is up.”
So how come epidemiology is suddenly hot, after being somewhat the “bean-counting branch” of medicine?
“I would say our experience with previous epidemics and pandemics has given us the [background] to accurately model things. All of those estimates of, for instance, how long we have to stay at home are based on the history of epidemiology, and of epidemics throughout the world. Advice such as ‘wash your hands’ has been informed by an evidence base of multiple [epidemics]. And it is important in the absence of cures and-or vaccines for this virus.”
“A lot of public health is quite basic,” says Brouwer. “In fact, I’d say that public health in recent years has moved from discovering new ways to prevent epidemics to finding ways to implement known solutions that we already have. Because we know how to prevent disease, but we are just not implementing. So implementation science is now hand-in-hand with epidemiology to make sure the basics we already know are put to work.”
But Professor Brouwer says epidemiology is also sprouting new wings. “We have genetic epidemiology, where we’re able to learn whether or not the virus is related between two people, or spreads by direct transmission. We’re also able to better predict where the virus will go, with what we call spatial epidemiology. We map it.”
Would it work here? “A place like South Korea, where they do widespread testing, mapping has been quite efficient. They’ve been linking mapping with cellphone alerts, authorities saying ‘You’re in an area, a shopping mall, whatever, where there was recently a diagnosed case.’ They’ll call you. ‘If you were there at a particular time, you may have been exposed...’ South Korea is the gold standard of spatial epidemiology.”
In the US, she says, we don’t have the data inputs to adequately inform infectious disease models.
“We’re using what we have, but right now the stay at home order is a kind of sledgehammer tool of control, because we’re missing a lot of the pieces of the puzzle with regards to where exactly the disease is. Is it everywhere? Or are there certain places that could have functioning economies, where people could still interact, and not have to be under a blanket stay-at-home order?”
The biggest thing we need, she says again and again, is testing. Two types: one that measures the virus itself, that can diagnose people who currently have the virus. But also testing that looks at antibodies, to determine who was previously infected, and maybe didn’t even know they’d already had it.
“If you could get blanket testing, then you could determine if we’ve built some type of herd immunity. Has it already passed through huge sections of our population? Or do we need to still have this stay at home policy?”
And after all this has hopefully passed by, are we going to have learned our lesson? Maybe, maybe not, says Professor Brouwer. “We’ll likely just go back to our old habits.”
Why?
“Because there’s no money in prevention.”
Comments