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In her 2016 book Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond, science journalist Sonia Shah writes a chapter on flaws in the WHO’s global system for disease surveillance. Since pandemics mean a halt to the economy and capital accumulation, we will likely see business pressure applied on governments for new solutions to contain the spread of pathogens. Those involving Healthcare IT and surveillance seem to require the lowest cost and least amount of systemic change, and therefore are possibly on the horizon. This could mean a drastic reduction in privacy and freedom.

While she doesn’t put it this way, these flaws can be summed up as reliance on privilege, human judgement, and voluntary action. The current system uses a chain of reporting. When clinicians encounter symptoms that seem like a worrisome disease, word passes upwards through a series of health officials until it reaches the WHO. Problems arise within the first step of this process, which entails the infected person going to a clinician. Many people cannot afford to see a doctor, understandably don’t like to, or lack access. Even if they go, medical professionals are often in a rush and make misdiagnoses. Since many serious infectious diseases share symptoms with less serious and more common ones, it is likely that clinicians make the more common diagnosis. But even if this system functions as it should, it is not fast enough. Shah writes that epidemics grow exponentially, while our responses to them only linearly. (more…)