Infectious Disease Specialists — Healthcare Unicorns

Infectious diseases are now at the forefront of global health concerns. Several epidemic/pandemic events occurred in the past few decades, such as the avian and swine influenza, as well as the Zika virus, whereas the West Nile virus (WNV), transmitted through mosquitos, became a planetary issue in the past years. Horrific Ebola outbreaks in central Africa, the reappearance of measles (due to a scandalous anti-vaccination movement), and the emergence of another coronavirus — SARS-CoV-2 (after SARS and MERS) has made it clear that infectious diseases are one of the most (if not the most) important challenges of global health.

The “infectious disease specialist” should logically play a crucial role in healthcare today, but what is strange that the Western medical system continuously promoted a bizarre underappreciation for this occupancy.

To quote one of the papers I read as a young MD aspiring to be an ID specialist:

“several authors have suggested that [infectious disease] specialists contribute excessively to the overall cost of care and do not provide sufficient quality to justify this expense.”

The “lack of value” of an ID specialist, bringing this occupancy to a state of “endangered species”, was expressed by the Infectious Disease Society of America just a few years ago:

“We [IDSA] are concerned by the continued decline in the number of infectious diseases trainees pursuing careers as physician-scientists and the attrition of junior and midcareer physician-scientists. The inability to replace the aging physician-scientist workforce will have a negative, long-lasting impact our biomedical research enterprise and its ability to drive the discovery of new treatments for important infectious diseases.”

Training in infectious diseases is essential for everyday work in family medicine, epidemiology, surgery, radiology, microbiology, public health, family medicine, as well as veterinary medicine and even agriculture. Unfortunately, we have fallen under the impression that infectious diseases are a “thing of the past”, and it seems healthcare systems felt there is no need for ID specialists to have such an important place in modern medicine. There has to be a connection between the depreciation of ID specialists in healthcare and our failure as a society to understand why something as simple as washing hands is so important for our health, and the health of our patients.

Turns out, infectious diseases are the biggest global health concern — and many countries were simply not prepared for an outbreak of this magnitude. Delays in interventions, shortage of doctors and nurses, and scarcity of both resources and hospital facilities show how fragile our entire healthcare system is when an infectious disease spreads and infects so many individuals, resulting in so many unfortunate deaths. Despite warnings by high-level academic professionals that something like what we are experiencing with COVID19 will occur, we fail to recognize the extent to which we are at the mercy of viruses, bacteria, parasites, and fungi.

The old models of infection prevention crumble in the era of globalization and worldwide travel, resulting in the rapid spread of pathogens within days across continents, particularly through asymptomatic carriers. Despite Infectious Diseases being a “gratifying” branch of medicine — where timely treatment can bring a person from certain death to a healthy state within days, the decreasing availability of antimicrobial agents and the absence of therapy for many infections (including COVID19) also point to a deeper issue with infectious diseases and their priority in society.

It feels fortunate to have the ability to track this pandemic through global sharing and integration of data in a visual manner, helping us get as close as possible to the actual scale of the problem. And indeed, new technologies empower us to understand these issues better, perhaps even help us develop solutions on how to prevent them or at least act earlier. More needs to be done in terms of developing new treatments and vaccines, but also incentivizing the healthtech ecosystem to develop new solutions on detection and surveillance of microorganisms — it is time we dive deeper into our interaction with this invisible world. The medical device industry, while maintaining a tight regulatory framework, needs to include these people who can explore new avenues of diagnostics, treatment, and predictive modelling.

Infectious disease specialists, but also microbiologists and public health experts should team up with designers, engineers, regulatory consultants, and software developers and create new ways to combat the inevitable battles with pathogens. This branch of healthcare has a big role to play in the coming decades. I think that it is no longer “necessary for ID specialists to articulate their value to multiple audiences” — their value has never been more obvious.

I Originally published this article on LinkedIn.

Clinician at Huma, PhD student of Public Health focusing on hospital-acquired infections in ICUs. Building medical devices.