10 Non-Medical Experts That Can Help Prevent Epidemics

We expect medical personnel--i.e., doctors, PAs, nurses, etc.--to play an integral part when it comes to identifying and thereby possibly preventing epidemics.  The scary truth is that people all over the world get sick with all kinds of potentially deadly communicable diseases every year.  Epidemics develop when such diseases are allowed to run rampant and out of control within a vulnerable population.

The deadliest infectious, contagious and/or communicable diseases (the Bubonic Plague, Ebola, SARS, the Flu, smallpox, malaria, anthrax, AIDS, etc.) known to man have been successfully contained in many instances.  When measures to do so, however, have failed, disastrous spread of these diseases have easily claimed the lives of millions of people. 

Knowing this, today we have in place measures that are supposed to contain a potential outbreak before it mushrooms into an epidemic.

It can be argued nevertheless that perhaps we place too much reliance on medical personnel to be the ones to identify, singlehandedly, potential epidemics.  Of course, medical personnel are best qualified to spot telling symptoms and to notify the authorities of what appear to be outbreaks of serious disease. 

This shouldn't preclude the fact, however, that there are other experts in society that can potentially play a role in identifying outbreaks that may later become epidemics.  Notwithstanding their lack of medical expertise, these people can nevertheless spot certain signs and conditions which they can then relate to medical and public health experts in the community.

Ten such experts with jobs that put them in a good position to spot trouble include:

1.  Pest/insect exterminators.  It may surprise some people to know that many (if not most) of the diseases most feared to lead to epidemics are Zoonotic in nature--i.e., the original host was an animal.  Consequently, animals can play an integral part in epidemics and pandemics.  In fact, some experts suspect that some new Zoonotic disease will probably be responsible for the next pandemic; either that or some old disease (like smallpox) may be resurrected in some way. 

We may also face a genetically-altered or mutated new strain of some thus-far-under-control Zoonotic disease.  Exterminators can help sound the alarm if, for example, they notice a suspiciously high number of dead animals of any one species or a combination of species.  Also, being called to deal with certain pests in areas where large groups of people have been reported to have gotten sick could tip exterminators as to a potential connection.

2.  Pharmacists and retailers.  Of course, pharmacists may peripherally be considered "health experts."  Then again, pharmacists are, primarily, drug experts and they can't give anyone healthcare advice.  Nevertheless, pharmacists do come in contact with many sick people.  As such, they are in an excellent position to notice patterns of symptoms or medical conditions. 

Along the same lines, retailers are in a position to notice if, for example, large numbers of customers all of a sudden start buying certain tell-tale products (antiseptics, antibiotics, cough drops, first aid kits, anti-diarrhea products, OTC Flu medicine, etc.).  Retailers could share potentially helpful information based on difficult-to-ignore shopping-behavior patterns, including greatly-increased sales of OTC medicines. 

3.  Animal control officers and animal shelter personnel.  Some people are afraid that, eventually, we may run into an epidemic-capacity strain of rabies.  This would be especially troublesome if such a strain were to mutate into a form that would make it more virulently Zoonotic and, what would be even scarier, more (human-to-human) contagious.  Some movies have been made that follow this logic; in fact, most zombie movies may be said to subscribe to this feared scenario. 

Beyond this, these people can sound the alarm if they notice that a large number of animals are succumbing to certain symptoms or conditions. 

4.  Zoologists and zoo keepers.  Like experts in the previous category, these people are in an excellent position to notice patterns of erratic behavior or disease development.  An exorbitant number of birds becoming sick or dying, for example, could provide the impetus to conduct pre-epidemic investigations.  The next pandemic-potential Flu strain, as a matter of fact, will probably come from animal hosts (i.e., pigs, birds, etc.), as they have in the past.

5.  Lab techs, especially those who work with animals or who help diagnose medical conditions.  Of course, lab techs are not expected to provide diagnoses.  Their job is simply to conduct tests, which they then forward to healthcare providers who interpret or apply their findings.  This doesn't mean, however, that these people can't play a more proactive role in helping to identify an epidemic. 

A lab tech's findings, for example, may go to 100 different doctors for essentially the same medical conditions or set of developments.  Each of those doctors can hardly be expected to see a pattern if only one (or a mere few) of his/her patients is sick with the same symptoms.  A lab tech, however, is capable of seeing a more cohesive picture. 

6.  Funeral directors, morticians and embalmers.  Most people may not see these people are being capable of playing a role in disease identification but, in fact, they can.  If these experts, to give an example, were to notice a significant number of people who seemed to have bled out, displayed noticeable blotches, lesions, or rashes, or were rotting from within (as if succumbing to a serious, possibly contagious disease), then they could be the first to sound an alarm. 

This would be especially useful if most of these cadavers belonged to homeless people, people who were not examined by a pathologist, or people who died at home. 

7.  Coroners (who often only have a basic medical background) and medical examiners.  Coroners are supposed to certify or provide an official reason (sometimes a mere educated guess) for death, after a physician officially pronounces someone is dead.  But coroners can see patterns that individual doctors may not see, especially if the cadavers coroners preside over come from different places.  Coroners can also conduct or order inquests and autopsies (and sometimes perform them, if qualified to do so), if they believe (or are pressed into believing) that mysterious or unexplained circumstances were involved in the death. 

The case may then go to a medical examiner (ME).  Medical examiners (usually doctors) may notice suspicious circumstances that an epidemic is brewing up, depending on the severity/clarity of the evidence and whether they have up-to date training/experience in epidemics pathophysiology.  ME's, though, only see a limited number of cases and, consequently, may not be in a position to notice patterns as well as coroners.

8.  Police and other law enforcement personnel.  It's likely that the public servants who will have first contact with the "index case" (the infected person first suspected or noticed during a potential outbreak) or the "primary case" (the person suspected of having set off a human-to-human infectious disease outbreak or epidemic within a specific group of people) are law enforcement personnel.  A truly sick person who may perhaps not want medical attention (especially if they can sense that they are dying) may break the law in some way, especially if he becomes delusional or hallucinatory. 

The index (or primary) case will likely be in some institution (a prison, interment camp, a nursing home, etc.) where the staff presiding will be ill-equipped to spot (never mind properly handle) a potentially contagious/infectious patient.  If properly prepared, law enforcement personnel can help identify these individuals while their pathogenicity can be properly managed.

9.  First responders:  EMTs, paramedics, firemen, etc.  These professionals are in an excellent position to deal with those persons who will be the first to contract the disease in question.  As such, if they play their cards right, they can be the first to warn the authorities of a potential epidemic. 

This will become a reasonable reaction if, for example, they start noticing a large number of people coming down with the same symptoms, displaying classic symptoms (excessive coughing, trouble breathing, unexplained bleeding, irrational/violent behavior, vomiting, high fever, etc.), or coming from essentially the same area of town.

10.  Forensic techs and janitorial personnel.  One of the things we can say most epidemic/pandemic-worthy diseases have in common is their ability to create or bring about messes.  In the case of Ebola, for example, victims not only bleed profusely but they also have difficulty holding on to feces, urine and other bodily fluids. 

Vomiting, high-volume bleeding, high-volume-phlegm coughing, etc.--all these symptoms create messes people who clean up (including crime scene forensic techs) will surely notice, especially if they see similar messes in different places within the same community. 

Conclusion

Can these non-medical professionals help play a role in identifying and possibly thereby preventing an epidemic?

Well, that depends on the community where you live.  As a general rule, communities depend on healthcare providers to sound the alarm if they notice what could potentially turn into an epidemic.  Healthcare providers, for their part, are supposed to inform public health government agencies (including the CDC) of any fears or suspicions; as such, the final decision as to what to do (if anything) about potential epidemics rests more with politicians and heads of health agencies than it does with medical experts in the frontlines.

In other words, there is a multi-tiered system in place that has to kick into action before the process can even get started.  In essence, valuable time can be lost if the experts in these "tiers" fail to act appropriately or are simply unprepared to properly evaluate the information at hand.

Beyond that, since a politician or the head of a government agency (likely more concerned with being politically correct or cautious than being scientifically responsible) may be the one to decide what action (if any) is taken, a decision will probably be made to simply keep collecting data instead of doing the one thing that, in most cases, can stop an epidemic:  instituting mandatory isolation and quarantines. 

No politician is likely to push for mandatory isolation and quarantines of infected persons unless she can be convinced that such measures are unavoidable.  Knowing this, the more data that exists to support such drastic action, the more likely it will be that politicians will be pushed into doing the right thing, from a medical perspective. 

Medical personnel will, hopefully, do their part in conveying the seriousness of a potential epidemic--if indeed a conclusion is reached that an outbreak has gotten or may get out of control. Non-medical experts can help medical personnel reach such a conclusion.  When it comes to convincing politicians, moreover, they can help  provide additional voices of concern that will hopefully push action in the right direction.