Do The Survey, Do The Duty

 SURVEILLANCE SYSTEM & THE ROLE OF MEDICAL DOCTOR IN PANDEMIC PREPAREDNESS

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Surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health.

(Center for Disease Control and Prevention/CDC)

"Why is surveillance needed?"

Surveillance serves as an early warning system of which it helps to identify public health emergencies. It also guide public health policy and strategies besides documenting the impact of an intervention or progress towards specified public health targets/goals. This system at most, understand or monitor the epidemiology of a condition to set priorities and guide public health policy and strategies.

The effectiveness of surveillance depends on its functions which represents by the table below:

Detection and notification About health events

Investigation and confirmation The epidemiological, clinical and/or laboratory matters of any case or outbreak.

Data collection and consolidation About the pertinent data

Data analysis Done routinely and also having the creation of reports

Feedback About the  information to those providing the data

Feed-forward The forwarding of data to more central levels reporting data to the next administrative level

A surveillance system is an information loop or cycle that involves 3 main roles which are the health care providers, public health agencies, and the public. The loop shown here is the summary to briefly explain how the things going between the 3 roles.

One of the many examples of uses of surveillance can be seen in Thailand. Thailand was host to one of the largest epidemics of avian influenza (bird flu) identified in eight Asian countries in early 2004. 

Later that year, the disease spread from birds to humans, killing almost all the infected people. Recognizing the global threat posed by such a disease, the Thai Ministry of Health, in partnership with field epidemiologists and WHO, supported laboratory studies that showed that the disease was being spread from human to human.

The Thai example was critical in raising public awareness of the possibility of a global catastrophe caused by avian flu. It also showed that the disease can be controlled with proven epidemiological methods; including rapid, on-site investigation by trained specialists and good communications.

"Medical doctor in pandemic preparedness"

One critical role of medical doctors of which may have been underplayed in importance, is to educate, manage and communicate with the public. In a survey of the public organized by the College of Family Physicians of Canada, an overwhelming majority of the respondents indicated that they should be able to turn to their family doctors for information and advice in the event of a serious medical emergency such as a widespread influenza outbreak (source: Influenza pandemic and the duties of healthcare professionals).

As trusted and credible sources of information, medical doctors play an important role in guiding the public even on mundane decisions such as whether and how to seek medical help. Public guidance increases in ethical significance during a potential or actual pandemic. Therefore, medical doctors should be well-informed about the spectrum of clinical presentations and severity of the pandemic matter. Doctors have to be one of the most up- to- date individuals ever :)

Furthermore, as primary medical care providers, doctors care for and report suspected or confirmed infectious diseases that threaten the health of their patients and the populations in which their patients reside. By identifying outbreaks through screening, diagnosis and reporting, doctors play a major role in helping to reduce the severity of outbreaks.

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References:

• "Surveillance, response and the role of public health informatics", lecture by dr Luthfan Lazuardi, M. Sc., PhD
• WHO: Public Health Surveillance
• Disease Control Priorities Project (DCPP): Public Health Surveillance