How Next Generation Technology Can Stop Ebola Today And Future Pandemics … – Forbes
Guest post written by Anita GoelDr. Goel is the chairman and CEO of the Nanobiosym Research Institute and Nanobiosym Diagnostics.
Today, even the world’s best hospitals rely upon a thermometer, a 400-year old technology, to decide who to quarantine for Ebola. The ambiguity in our current approaches to diagnosing Ebola has resulted in over 1400 Ebola suspects in the U.S. today who still have not received a definitive diagnosis.
Congress is poised to commit up to $6 billion to fight Ebola. I believe that the United States can win this global war on Ebola, but we must invest our resources wisely to significantly upgrade our diagnostic technologies and capabilities, bolstering the heroic efforts of those fighting this viral enemy on the front lines, whether in African villages or in American hospitals.
There are hi-tech solutions available today (leaving the thermometer behind) that can revolutionize how we stop the spread of Ebola and provide a quantum leap in our current capabilities for responding to such global pandemic threats. I have made this case directly to top officials in recent weeks at the Departments of Defense, State, Health and Human Services and CDC, as well as CEOs and CMOs of our nation’s leading hospitals.
Problem with using thermometers to triage Ebola cases
First, it typically takes 10-21 days after a person has been infected with Ebola for fever to show up. Meanwhile, the Ebola virus continues to replicate in the blood during this “incubation period” so that by the time the fever manifests, the patient has between 50,000 and 100,000 copies of Ebola virus infecting every milliliter of his/her blood. The thermometer thus has low sensitivity for detecting Ebola, resulting in a high rate of false negatives. An unfortunate case in point: Thomas Eric Duncan—the first domestic Ebola case, showed no feverish symptoms when he entered the country from Liberia.
With the current Ebola protocol, individuals can wait in limbo for as long as three weeks without a definitive diagnosis. During this time individuals are neither quarantined nor treated. Recent findings in monkeys and humans have shown that providing even supportive therapy to an Ebola infected individual early in the incubation period significantly increases the likelihood of survival.
Further, without a quick and accurate way to rule out the virus, any new Ebola cases coupled with the flu season could cause panic and overwhelm our healthcare systems. For worried patients experiencing Ebola-like symptoms of fever, headache, diarrhea or vomiting, a thermometer will have low specificity and not be able to distinguish between Ebola and the flu.
The costs of false positives and negatives are too high to bear. Dr. Craig Spencer’s case alone reportedly cost New York taxpayers $20 million. A flare-up of a critical number of suspect Ebola cases could exhaust our already fragile healthcare system.
Disrupting the centralized paradigm in healthcare
In a perfect world, pandemic response would use the gold standard for medical diagnoses. Based on 20-year-old Nobel Prize-winning polymerase chain reaction (PCR) technology, this method measures the Ebola virus’s ribonucleic acid (RNA) in the blood. But, this method requires centralized labs with expensive overhead infrastructure, trained personnel, large machines, running water, electricity and complex sample transport logistics.
This centralized lab paradigm does not work in West Africa due to the lack of basic infrastructure. Even in the U.S., we can see this model breaking down as the leading centralized lab testing companies—Quest Diagnostics, LabCorp, ARUP Laboratories and Mayo Medical Laboratories—have all refused to accept blood suspected of Ebola.
The holy grail is point-of-care (POC) testing. Unfortunately, the current generation of such POC tests—primarily ELISA or immunoassays—suffer from a high rate of false positives and false negatives and hence require gold standard PCR confirmatory testing in centralized labs.
This is where emerging technologies form nanobiophysics and (ICT) information communications technologies provide next generation tools and infrastructure to decentralize, mobilize, and personalize the delivery of healthcare. Such hi-tech solutions are already available today and with the right resources and collective consciousness can be promptly deployed to combat the current global Ebola crisis. For example, by precision controlling nanomachines that read and write DNA, it is now possible to rapidly and affordably detect and quantify genetic fingerprints of various pathogens like Ebola, HIV, and the Flu at the point-of-care with gold standard accuracy.
Quantifying the viral loads of viruses before symptoms appear will radically change how we stop the spread of diseases and prevent future pandemics. This will lead to early quarantine; stop the spread to others; and enable early onset of supportive and experimental therapies.
Our healthcare industry still operates on a paradigm of centralized infrastructure that was developed in the Industrial Revolution of the 1700s. The result is that today billions of people worldwide lack access to adequate healthcare infrastructure and we have a multi-trillion dollar healthcare dilemma here in the US. The urgent crisis we face with Ebola today might just be the catalyst needed to disrupt this old centralized paradigm and pave the way for the next generation of global healthcare infrastructure.
