6/30/2019 12:00:00 AM
By Brittany Segundo
I recently had the good fortune to participate in the One Health Course: Field Experience in Outbreaks, a collaborative effort between Texas A&M University (TAMU), University of Texas Rio Grande Valley (UTRGV), and University of Texas Medical Branch (UTMB). The One Health framework emphasizes the intersectionality of human, animal, and environmental health, a critical lens that leads to a more robust response. For three weeks, students from all three universities traveled to the different campuses to learn about the various roles that contribute to outbreak management.
The course predominantly drew students from the sciences: biology, epidemiology, microbiology, as well as a veterinary student. My field is operations research (a branch of applied mathematics), and my work is applied to disaster response logistics.
Outbreak science is a nuanced and multidisciplinary study, and the lectures and activities throughout the course reflected this diversity. During the first week, the students traveled to UTRGV and learned about the role ticks play in disease outbreaks. Students worked with the USDA to drag for ticks, analyze them, and protect livestock from ticks by dipping cows in liquid pesticides. Protecting animal health is a crucial part of disease response, both economically (food animals) and for human health (transmission of zoonotic disease).
At Texas A&M, we continued our study of vectors of disease, predominantly focusing on mosquitos. In cases of vector-borne disease, controlling the vector (e.g. mosquitos or ticks) is the only way to control the spread of disease. Perhaps my favorite activity that week was trapping local animals to evaluate their health and determine whether they were carrying ticks. I doubt I’ll ever be able to touch a wild raccoon again, but, more importantly, the experience highlighted the importance of animal trapping and research for epidemiological study.
While at UTMB in Galveston, we viewed the Biosafety Level 4 (the highest biosafety level for infectious organisms) laboratory and toured the hospital’s biocontainment unit. While in the biocontainment unit, we simulated the treatment of an Ebola patient by donning Ebola personal protective equipment and cleaning a medical dummy with ‘sick’ on it. Afterwards, we were taken to the morgue and observed an autopsy of human organs (except for one unnamed mathematician who got squeamish and decided to sit in the cafeteria contemplating mortality instead).
One of the most enlightening exercises of the course was a thought experiment about the ethical aspects of outbreak management based on the Haitian Asian Swine Flu Outbreak of 1978. Our class was divided into teams representing Haitian and U.S. interests, each team proposing measures to protect our respective countries from further disease spread. Even in a low-stakes classroom discussion, it was surprising how quickly the arguments devolved into an “Us versus Them” mentality. The point of the activity wasn’t that we were selfish or didn’t care about vulnerable populations, but rather that there are no quick fixes or straightforward solutions when combating disease that crosses borders, decapitalizes citizens, and risks human and/or animal health.
Throughout the course and after our activities had ended for the day, our teams worked on a case study of a potential (simulated) outbreak originating in the Rio Grande Valley with a ranch hand and the cattle he tended. Our objective was to identify the disease infecting the cattle and our patient. Solving this case necessitated a One Health Approach; we were facing an unknown emerging infectious disease for which diagnostic tools did not exist. We worked closely with medical professionals who helped us navigate our patient’s and the cattle symptoms. We relied on virologist expertise to analyze the physical properties of the virus itself. Entomologists confirmed the tick found on our patient was a carrier of the disease. After arriving at a final diagnosis, our team worked with communications specialists to hold a simulated press conference informing the public of the disease outbreak.
My most important takeaway from the course is that disease response cannot be navigated in silos. Outbreak response requires multidisciplinary collaboration. But I would argue that it needs to extend beyond the One Health framework of human, animal, and environmental health scientists. Effectively combating disease outbreak necessitates collaboration across all disciplines, not just medical and scientific scholars. It requires mathematicians that predict disease spread and effectively allocate finite resources, sociologists and anthropologists who transcend cultural boundaries with sensitivity, students of policy who develop thoughtful disaster response legislation, and communications specialists who can convey scientific findings to the public. Whatever you study, there is a role for you in outbreak science and pandemic prevention. It is my hope that scholars of all disciplines will be compelled to engage in preparedness and response efforts and that the scientific community will be open to collaboration with other disciplines.