A Rapid Warning System for Risk of Pathogen Spillover Events

Through adaptation of SMART technology and monitoring, we can efficiently and effectively bolster identification of pathogen spillover risks globally.

Diego Montecino-Latorre, Wildlife Health Data Scientist & Manager, Wildlife Conservation Society (WCS)

Beyond Ebola virus and SARS-2-CoV, there are estimated to be over 600,000 as yet unidentified zoonotic viruses in wildlife. Despite these threats to global health, effective and timely identification and reporting of Wildlife Disease Events (WDEs) are major bottlenecks in our ability to properly respond and mitigate pathogen spillover risks. The causes are worldwide limited monitoring mandates and lack of technological and human resources.

Under current global capacities, several dead gorillas alongside a protected area in Central Africa may be observed by someone but go unreported. Consequently, public health authorities and nearby communities would be unaware of this potential Ebola virus threat. If reporting occurs, expedited communication channels to managers who can initiate a timely public health response and the safe collection of valuable field specimens are likely non-existent. As a result, the identification of these dead gorillas would not yield early warnings to mitigate the risk of pathogen spillover. Moreover, the lack of specimens to determine the cause of mortality impedes the assessment of emergent disease risk. Similar limitations repeat across spillover frontlines globally.

Our solution robustly leverages modified worldwide-distributed technology and trained field sentinels to improve identification and reporting at the frontlines of disease emergence and spillover.

Our primary target audience is active SMART users in biodiverse regions considered higher-risk for disease emergence. This audience is globally distributed and actively patrolling protected and remote areas where human-livestock-wildlife interfaces are prevalent. SMART is currently deployed in ~1,000 sites globally, including 150 WCS sites and 16 national-scale systems. Our solution recruits this target audience to identify, record, and process WDEs during patrols, leveraging their SMART expertise to smoothly roll-out SMART Health. WCS will also train users to safely process WDE specimens. SMART Health, combined with associated specimen collection, will generate an unparalleled worldwide network of WDE sentinels collecting and sharing data. 

The secondary target audience is managers responsible for SMART Health data administration, aggregation, assessment, and notification of decision-makers to activate a response if necessary (high-risk scenario). Managers will be proficient in SMART and SMART Health, and training to successfully fulfill this role and communicate with government-level One Health platforms will be provided.

To refine this technology and understand the needs of our target audiences, WCS field veterinarians and WDE data managers are currently piloting the development, training, and implementation of SMART and SMART Health with forest rangers in Cambodia, Laos, and Vietnam. 

SMART Health sets new standards for wildlife health monitoring post COVID-19, including the professionalization of data collection, standardization, safety, security, and efficient communication channels. This benefits global public health and well-being, facilitating rapid identification and response to WDEs, and reducing the threat of emerging zoonotic diseases. SMART Health also provides curated data to develop useful models aiming to predict and prevent spillovers.

The SMART platform is free to access and use. SMART Desktop is downloadable from the SMART website and SMART Mobile is installed from typical App Stores. The SMART website also provides information on how to launch SMART Connect, including contacting WCS/SMART IT teams. SMART Health follows SMART’s accessibility approach, with features and capabilities readily and freely available, and globally accessible without restrictions. Like SMART, the SMART Health website will host the SMART Health - Ranger module so it can be merged into their current SMART data model. The website will also host the standalone SMART Health - Comprehensive module which can be freely loaded into SMART Desktop and then installed on smartphones. An online open-source dashboard to facilitate SMART Health data visualization is currently being developed and will be ready and freely accessible to users later this year.

Our solution involves the recruitment and training of staff to identify and process WDEs and roll-out technology that supports data collection, data management, and real-time reporting of these events. The expected outputs of these activities are: i) the improved identification of WDEs and their processing and ii) the establishment of timely responses. Based on these outputs, our solution can protect the health of local communities living in remote areas which are usually underserved and where nutrition and economic income is dependent on wildlife hunting or healthy livestock. Indeed, our solution represents a key step to protect the health of the livestock and wildlife that these communities rely on. Reporting WDEs will empower these communities with data and information on risks needed to address conservation, public health, and livestock disease concerns.

Further, our solution equips local managers, national surveillance, and One Health government platforms with data on zoonotic and other emerging disease threats in wildlife at high-risk interfaces for spillover, that is rarely, if ever, collected. In our pilot countries, identification of high consequence pathogens in protected areas (e.g., Avian Influenza and African Swine Fever) have resulted in greater local community awareness, collaboration across previously siloed sectors, and improved monitoring.

Rapid WDE identification and response will have a transformational impact on millions of lives. COVID-19 and Ebola virus disease demonstrate how a wildlife pathogen spillover event can have horrific impacts on the health and economic security of millions of people worldwide. Sustainable national wildlife disease surveillance is central to prevent disease emergence, respond rapidly to reduce risk following a spillover event, and build a data pipeline to garner greater insight on the global virome and wildlife health. Our solution saves lives by preventing and investigating pathogen emergence at the root, and supporting timely responses.

Under Trinity, our vision is to roll-out the solution to three new diverse countries, with a planning phase (6-9 months), followed by training (years 1-2), implementation (years 2-3), and evaluation (final three months) phases. From there, unlike any other platform, we are strategically positioned to recruit ~1,000 conservation sites worldwide using SMART to rapidly track WDEs at the frontlines.

With widespread global distribution of internet broadband and smartphone technology, there are no limitations in the development, adoption, and local to global scaling of these tools. The challenge now lies in identifying the right organizations to iteratively train, implement, improve, and scale for impact.

We are currently piloting the proposed solution in Cambodia, Laos, and Vietnam. To measure our progress in these countries we are quantifying the number of sentinels trained to use SMART Health and to safely collect specimens, and the number of managers trained. Identification of WDEs, data quality within SMART Health, and the communication of WDE data to managers (SMART Connect) are also part of these indicators. 

Specifically, indicators of progress include the number of WDEs identified; the number of specimens collected and transported from these WDEs to a laboratory; the quality of the data recorded such as dates, individuals observed, identification codes, and specimen properties; and the channeling and timing of WDEs data communication from the field to managers. For the past two years,  our progress and these metrics have been shared in project reports to the U.S. agency funding the pilot in the three countries. Despite the COVID-19 pandemic restrictions delaying several training activities, the agency has given the project a very positive evaluation. 

Barriers that may limit our impact in the next 1-3 years are cost, AI technology to detect WDEs beyond SMART Health, COVID-19 uncertainty, and government engagement.  

We currently do not have funding to support the continued refinement of our solution and expansion of training and SMART Health beyond three pilot countries. The Trinity award would help us overcome that barrier, but our solution is designed to be affordable and sustainable once in place.

Ideally technologies beyond SMART Health could be leveraged to detect WDE. Our solution establishes a protocol and workflow, theoretically making space for other technologies to make initial WDE observations (no sampling expectations), but we need tech-partners to reach this even bigger goal.

COVID-19 restrictions may result in delays and in-person training sessions. Remote training (e.g., Zoom) and flexible scheduling will be used to the extent possible to avoid these delays. 

While we plan to work with government partners and agencies committed to One Health approaches, our experience has been that actual implementation requires continued support. Here our established long-term relationships with the target audiences and relevant governmental management structures will be critical. Likewise Smithsonian has established a long-track record of working with Kenya’s Zoonotic Disease Unit. 

Smithsonian Institution

SMART Health is the first step to build a global network of WDE sentinels, but our vision to continue growing WDE surveillance beyond SMART users presents a technology barrier and frontier. For example, engaging with other smartphone-associated technologies that may be useful to record WDEs (adjacent WHIS, PODD, and SISS-Geo apps are not widely distributed, readily available, or popular). Furthermore, social media users post anomalies and unusual findings in Facebook, Instagram, or Twitter. These findings may involve WDEs, and despite being simple observations, their identification can be extremely valuable to guide targeted sampling patrols, establish early warning actions, and document WDEs in areas where SMART is not used.

Technology to integrate WDE data from non-SMART sources into our established identification machinery will expand our solution’s scale to unprecedented levels, involving more people, spatial coverage, languages/ethnicities, and economic resources. The Trinity Challenge provides the opportunity to connect with informal WDE data hubs (social media), with initiatives similar to SMART Health such as PODD in Chiang Mai Thailand, and with partners positioned to deliver the technological integration. Therefore, Trinity can assist us with finding the technological solutions to integrate WDE data coming from other platforms and informal data collection tools.

WCS would like to partner with Facebook, Inc. and the corresponding global subsidiaries based on the ownership of Facebook and Instagram. These two social media platforms have 2.8 and 1 billion users, respectively, distributed worldwide, including in zones of the planet identified as hotspots of disease emergence. A successful partnership of our One Health and WDE monitoring expertise with Facebook, Inc. can translate into an astonishing number of potential WDE reporters across the globe.  

Beyond partnering with Facebook, Inc. to scale our solution in terms of coverage and likelihood of WDE identification, it is essential to leverage Facebook’s AI capacities to automate the detection and prioritization of social media posts to efficiently identify or discard them as WDEs within a massive database. We also need Facebook’s support to integrate their mined data and data from other initiatives that could join forces in the identification of WDEs; and to determine ad-hoc data management and storage strategies.