Geospatial Hotspots Need Point-of-Care Strategies to Stop Highly Infectious Outbreaks: Ebola and Coronavirus

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Context. Point-of-care testing (POCT), diagnostic testing at or near the site of patient care, is inherently spatial, that is, performed at points of need, and also intrinsically temporal, because it produces fast actionable results. Outbreaks generate geospatial "hotspots." POC strategies help control hotspots, detect spread, and speed treatment of highly infectious diseases. Objectives. To stop outbreaks, accelerate detection, facilitate emergency response for epidemics, mobilize public health practitioners, enhance community resilience, and improve crisis standards of care. Data Sources. PubMed, WWW, newsprint, others were searched until COVID-19 was declared a pandemic, the US, a national emergency, and Europe, the epicenter. Coverage comprised interviews in Asia, email to/from Wuhan, papers, articles, chapters, documents, maps, flowcharts, schematics, and geospatial-associated concepts. EndNote X9.1 (Clarivate Analytics) consolidated literature as abstracts, ULRs, and PDFs, recovering 136 hotspot articles. More than 500 geospatial science articles were assessed for relevance to point-of-care testing. Conclusions POCT can interrupt spirals of dysfunction and delay by enhancing disease detection, decision making, contagion containment, and safe spacing, thereby softening outbreak surges and diminishing risk before human, economic, and cultural losses mount. Point-of-care tests results identify where infected individuals spread COVID-19, when delays cause death, and how to deploy resources. Results in national cloud databases help optimize outbreak control, mitigation, emergency response, and community resilience. The COVID-19 pandemic demonstrates unequivocally that governments must support POCT and multidisciplinary healthcare personnel must learn its principles, then adopt POC geospatial strategies, so that onsite diagnostic testing can ramp up to meet needs in times of crisis.

Original languageEnglish (US)
JournalArchives of pathology & laboratory medicine
DOIs
StateAccepted/In press - Apr 16 2020

Keywords

  • 2019-nCoV
  • acute respiratory distress syndrome (ARDS)
  • Coronavirus disease (COVID-19)
  • crisis standards of care
  • Ebola virus disease
  • environmental stress
  • epidemic
  • geospatial care path (GCP)
  • geospatial science
  • global emergency
  • global strategies
  • government failure
  • MERS-CoV
  • newdemic
  • novel Coronavirus pneumonia (NCP)
  • pandemic
  • panepidemic
  • point of risk
  • point-of-care testing (POCT)
  • public health crisis
  • safe spacing
  • sepsis
  • severe acute respiratory syndrome (SARS)
  • severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2)
  • small-world network (SWN)
  • social distancing
  • spatial care path (SCP)
  • temporal

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

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