Don’t Panic. Preparation for Infectious Diseases Goes A Long Way

Dr. Tracey McNamara on West Nile Fever and COVID-19

As interviewed by Edward Borton, GIDEON

What was the experience of discovering a new and emerging communicable disease outbreak on your doorstep?

When New York City announced that people were dying of unusual encephalitis, I was struck by the timing and proximity between this event and an outbreak of crow deaths. Upon ruling out all known viruses that cause inflammation of the brain in birds in the United States: exotic Newcastle, avian influenza, and Eastern Equine encephalitis (EEE), I knew this was something new.

It wasn’t until I picked up the phone and called the U.S. Army and said, “I think it’s something new to veterinary medicine. I think it’s the same thing killing people in New York City, but no one will test my samples.” That one phone call changed everything because the military had a different mindset. When you say ‘something unusual, new, and killing people, they immediately thought of bioterrorism, and the West Nile virus is indeed a biowarfare weapon.

Was there a significant media response at the time for emerging infectious diseases? How does the response compare with what we’re experiencing today?

It was pretty crazy. We faced the same situation: a disease that we had never seen in the Western Hemisphere and knew nothing about. We didn’t know what it was going to do, who it was going to make sick, only that it had already killed people. The scientists had nothing but questions about this virus, and the public was extremely anxious.

To minimize panic, everyone was told, ‘it’s only affecting the very young and the very old.  Public health officials were telling people to wear mosquito repellent and destroy mosquito habitats if found in or near their homes. Sadly, a lot of people were saying, ‘I don’t have to worry about this’.

It seems to be an instinctive response to a novel threat, to just deny it,  but sticking your head in the sand doesn’t mean something isn’t going to walk up and bite you on the butt.

Do you feel that the technology available to the industry is sufficient right now, or does it need to improve before we start moving things forward?

I think the technology is there. There are companies using artificial intelligence and algorithms to detect anomalous events. It just hasn’t been applied to the animal science sector.

We need to improve the speed of diagnostics. When the Ebola virus outbreaks took place, that prompted scientists to look into portable deep sequencing in the field. There is a company that developed a tool that’s smaller than a lunchbox, which allows you to take a swab, stick it in the device, and in two hours, you can download the results to your laptop. In two hours, you could know what you’re dealing with, whether it’s Ebola, or another virus, bacteria, fungus, parasite, or unicellular organisms.

Another really powerful thing is a species-neutral diagnostic test. It doesn’t matter if it’s human, environmental, or animal. We’re probably talking 10 years from now, but it has been deployed in the field for Ebola, so we will eventually replace all our other methods of diagnostic tests we’re currently using.

Do you think we’ll see a new wave of people inspired to get involved in healthcare, public health systems, or public health policy as a result of the current outbreak? 

Yes, I think so. Young people, they’re so interconnected; they’re online constantly. They will make terrific advances.

There is a phrase used when teaching medical students – ‘when you hear hoofbeats in the distance, think horses, not zebras.’ None of us can afford to think that way anymore; we all have to be thinking about zebras.

We, as human beings, have to find a way to bring all of our expertise together and to respond quickly. That will prevent major mortalities, no matter what profession you’re in. We all have a different mindset but that is what we need – multi-disciplinary teams.

We truly are all in this together, and everyone has a role to play. I hope everyone keeps that in mind. Don’t panic. Prepare. Don’t get scared. Prepare. Work with the officials that are working around the clock trying to get their arms around us.

Dr. Tracey McNamara was hugely influential in the discovery of the West Nile Virus outbreak in the United States in 1999 and has been in the field of veterinary pathology for over 32 years, including Professor of Pathology at Western University of Health Sciences for almost 13 years.

Tracey gave a TedX talk at UCLA on ‘How monitoring animal health can predict human disease outbreaks’.