Strategies for Improving Pandemic Preparedness

At the World AMR Congress last week, Syra Madad, DHSC, MSc, MCP, CHEP, chief bio preparedness officer for New York City Health and Hospitals, underscored the role of early surveillance systems in managing pandemic risks, and the need for integrating public health and healthcare surveillance to enhance preparedness and response.

Madad highlighted the development of an early syndromic surveillance system that monitors various conditions, including influenza-like illnesses, gastrointestinal and skin conditions, asthma, and other syndromes. “One of the tools that I've been helping develop with my team, along with other departments within NYC Health and Hospitals, is this early syndromic surveillance system. We currently track four conditions: influenza-like illness (ILI), gastrointestinal and skin conditions, and asthma. This system provides an early indicator if we see an increase in patients presenting with symptoms like influenza or rash outside of typical flu seasons or during an mpox outbreak,” Madad explained. She emphasized that these early detection tools are vital and can be complemented by methods such as wastewater surveillance for more effective outbreak detection and response.

Madad also highlighted the importance of having diagnostic tools readily available at the bedside for rapid identification of new infectious diseases. “What's even more important is having it at the bedside. When we talk about novel infectious disease outbreaks, oftentimes it's that astute clinician that suspects that this patient has this novel infectious disease. They call their local health department, and then they send samples over for testing, and many times, those samples are routed to CDC for confirmatory testing. What we need to do is bring much of that testing closer to the bedside, so that way we're not going through this very long process of sending samples to public health and sending it to the CDC at the federal level,” she said. The more we can bring better diagnostic and faster diagnostics to the bedside, the better.

She provided an example of diagnosing novel infectious diseases like bird flu or Ebola, noting the current process of sample routing to external agencies and advocating for in-house diagnostic capabilities to streamline the process. Backing up her point that bringing diagnostic testing closer to the bedside within the healthcare setting would be more effective and efficient, reducing the time involved in sending samples to external agencies for confirmation.

Madad also emphasized the need for improved preparedness strategies, including effective diagnostic tools, robust surveillance systems, and strong science and health communication. She pointed out that while COVID-19 remains a concern, its impact has lessened from being the fourth leading cause of death in the US to the tenth.

Furthermore, Madad underlined the significance of public health communication, data transparency, and cross-governmental collaboration to improve preparedness and response, drawing on insights gained from recent epidemics such as COVID-19 and the triple threat of COVID-19, RSV, and flu, “Epidemics and outbreaks are managed by people, and if the public doesn’t understand that a virus is circulating, or doesn’t know about effective vaccines or treatments, they might not take necessary precautions, like getting vaccinated or using therapeutics, which increases their risk of infection,” Madad noted.

She advocated for a holistic approach that integrates public health and healthcare responses while actively engaging the general public. “Studies show that misinformation spreads six times faster than accurate information, so we often find ourselves trying to catch up. By being proactive and educating the public, we can help them understand the value of measures like vaccines, therapeutics, and testing, and encourage them to take effective actions to reduce transmission,” Madad concluded.

In conclusion, Madad highlighted the need for advanced surveillance and diagnostic systems. Her focus on early syndromic surveillance tools and bedside diagnostics aims to improve outbreak detection and response. She emphasized the importance of effective public health communication and addressing misinformation to enhance pandemic preparedness and response.