Rethinking the epidemic in Wuhan: What can blockchain do for disease control and early warning?

The generations of fathers always called the Spring Festival the "year pass". In the past, we did not understand the taste, but as the Wuhan epidemic continued to ferment and spread, an unprecedented "year pass" was placed in front of all Chinese children.

Up to now, a total of 9,692 people have been diagnosed with new coronavirus pneumonia nationwide, 15,238 suspected cases, 171 cured, and 213 deaths.

The World Health Organization also announced that new coronavirus pneumonia constitutes an international public health emergency.

At this moment, the tragic melody of "Lang Lao Qin, going to the country together" sang on the land of Huaxia. Our country is "ill", and it is the critical period for our whole generation to work together to overcome suffering.

There is no doubt that the economic losses and social impact of the new coronavirus have far exceeded SARS 17 years ago. What's more frightening is that because the new coronavirus has a certain incubation period, the publicly available data is far from its peak, and it is still unknown when the epidemic will end.

Like the virus, it is the emotions of hundreds of millions of people who have nowhere to rest in their homes, including anxiety, panic, rumors, accountability, blessings, and so on.

One of the most turbulent is the accountability of the relevant departments for failing to provide early warning and effective control before the outbreak occurred.

At the beginning of December 2019, some medical institutions in Wuhan appeared pneumonia patients of unknown cause one after another. Until about January 20, many news about the new coronavirus pneumonia appeared on Weibo, and this round of infectious diseases broke out. Public opinion really started to ferment.

On November 16, 2002, the first SARS-infected patient appeared in Guangdong Province, and it was only in February that the "atypical pneumonia" epidemic began to spread on the Internet.

There are empty window periods of about 1-2 months. Questions of doubt and accountability also came from this.

I did n’t join the media army of online accountability crusade. Although 100,000+ is indeed tempting, this is because there are many conspiracy theories and unproven rumors spreading. On the other hand, it is mainly because of viruses. The epidemic is the common enemy of the people of the whole country. It cannot give the enemy an opportunity to disrupt us from the inside, and be mischievous.

I only care about one point:

Why has the SARS epidemic passed over 17 years, and our various medical standards have also made leaps and bounds, but the level of prevention and control of sudden virus outbreaks does not seem to have made much progress.

This is surging behind the media's accountability, hiding a fact that everyone must face:

It is time for our CDC "hardware + software" to upgrade.

01

Yesterday I saw a very hard-core article, the author proposed that the blockchain technology could be used to improve the national infectious disease surveillance and early warning network. I saw a lot of inspiration after seeing it, and then added some of my thoughts and suggestions.

I mentioned earlier in several articles that the development of human science and technology (productivity) has reached a staged ceiling. At this moment, the shortcomings in production relations should be filled in time.

The upgrade of the blockchain technology to the international infectious disease surveillance and early warning network seems to be only a help on the hardware layer "tool" services, but behind it is the software layer "organization reporting relationship" iteration.

Before the SARS epidemic in 2003, the Internet was also only a platform for obtaining information for a small number of people. After the SARS epidemic, people obtained and passed various messages through Internet portals, forums, and social platforms. The Internet led the government to open an online platform, which provided space for people to discuss public affairs, directly promoted the popularization of online political affairs, and promoted the progress of social governance.

In the face of each natural disaster, in addition to uniting one's common tribulations, people should also "introspect" themselves, which link has a problem.

Just like everyone re-examines the Internet after SARS, the new coronavirus pneumonia epidemic in 2020 will most likely open a skylight to the "blockchain" technology.

The reason is simple: Blockchain technology is a systematic upgrade of "hardware + system".

02

As early as 2008, our country launched the “Automatic Early Warning System for Infectious Diseases” nationwide. This system can automatically analyze the surveillance data of dozens of known infectious diseases and provide emergency response.

The specific process is as follows: Infectious cases are found in clinical work by provincial, city, district, and county hospitals, and infectious disease report cards can be filled in and submitted to the hospital information management system, and then the same type of case data from multiple hospitals will be uploaded to the district, The city, provincial and national level data exchange platform will then be unifiedly submitted to the national infectious disease network direct reporting system, and finally the case information will be uploaded to the national infectious disease automatic early warning system. (As shown below).

The advantages of this system are obvious. For known infectious cases, the country can receive bottom-up data feedback, and then be able to respond and allocate resources for prevention and control in a timely manner. But in the face of unknown cases of infection, the system's flaws were exposed:

1) Case data will be reviewed and approved at the time of submission. This is done to ensure the accuracy of the data and to avoid the irreversible impact of subsequent joint errors caused by human error in one link. However, this has also brought two side effects: 1. Too much manual intervention and review mechanism will greatly reduce the reporting efficiency; 2. The review and accountability system of the same organization will reduce the enthusiasm of clinicians for uploading cases.

Everyone knows how the butt determines the head. After the pressure on doctors to take responsibility for the results of the data, they will be extremely cautious about the new unknown virus, fearing that if they make mistakes, they will cause unnecessary trouble and impact. Most doctors may choose not to report or selectively optimistically classify it as an existing similar disease.

2) Data islands exist between the hospital and the hospital. Due to the protection of patient privacy and case data, the patient data generated by most hospitals is not shared in a timely manner. This makes the hospital blindly underestimate its destructive power and impact when unknown viruses occur, which is not conducive to bottom-up decision-making among organizations.

The reasons why hospitals are reluctant to synchronize data are complicated. On the one hand, the cost of systematically collecting data in the hospital is relatively high, including the classification of initial diagnosis, the type and amount of medication, the recovery of re-diagnosis, and various clinical CT, MRI and other medical image data; on the other hand, the data of each hospital Often there are certain chains of interest. Clinical medical data is a valuable data asset for hospitals, which can help drug research and development institutions to conduct drug research and development and potentially undescribable gray commercial value.

3) The fully centralized decision-making mechanism of the National Center for Disease Control and Prevention. Due to the qualitative nature of infectious diseases, after the data model characterizes the infectious virus, the transparent and open authority is often not in the hands of the local government, and it depends on the upper-level national disease control center to make decisions. After receiving the data feedback, the National Center for Disease Control and Prevention will send experts to further check and confirm. The set up of the entire process will sacrifice great timeliness, which is not conducive to the timely disclosure and prevention and control of dangerous new infectious diseases.

The above reasons can be summarized as three points: 1. Long review period and human intervention; 2. Data are not shared openly; 3. Fully centralized decision-making mechanism.

03

When we vent our emotions, we must also recognize the fact that the disclosure of infectious diseases is indeed a complex and systematic project that involves all aspects of the social organization structure. A little carelessness will lead to uncontrollable vicious consequences. .

As far as the relevant departments are concerned, it is necessary to be cautious, and how to avoid the occurrence of "hidden reporting" incidents becomes the key while being cautious.

In essence, this is the speed at which the epidemic is spreading and the approval efficiency of the competent authorities is racing. If the latter is a beat, we should realize that there is an institutional lack behind it. The best strategy to solve the problem is to optimize and adjust the current organizational system for reporting disease in hospitals.

As we all know, blockchain technology has many characteristics such as “distributed”, “decentralization”, “immutability”, and “transparency”. Since 1024, the country has upgraded the blockchain technology to the strategic height of the core technology breakthrough. The spring breeze of the industrial blockchain has blown up.

Since the current automatic early warning system for infectious diseases is outdated, why not upgrade it with the help of "blockchain technology"?

As a blockchain practitioner, I only know a few blockchain technologies. To avoid unnecessary trouble, I make the following statement: 1. I am not a front-line medical staff, and I have not communicated with medical staff at the moment. The transformation of the system is difficult. The following ideas may be impractical; 2. Blockchain transformation of the medical and health industry is not a new topic. There are already many more detailed solutions. The ideas I provide are for everyone to open. Brain hole.

To put it simply, two principles: 1. Listen to the dispatch and scheduling of clinical data; 2. Set layered and graded early warning thresholds and corresponding precautionary measures.

1) Based on the principle of open data of the blockchain, a provincial CDC will be established as a unit to establish a "CDC alliance chain" led by the local CDC . The first members will be local and provincial hospitals. The CDC should set up a reward and punishment system to subsidize various hospitals, and encourage hospitals to actively submit cases of various infectious diseases, including existing and unknown infectious cases and suspected infectious cases.

2) Each time new data is submitted, broadcasts will be sent to the major hospitals in the entire alliance chain, and each hospital will have a special person responsible for reviewing the on-chain. Doing so can perform cross-hospital cross-validation of the on-chain data information. In this way, doctors do not need to worry about the reporting pressure in the organizational system, and are only responsible for presenting objective clinical data, ensuring the timeliness and integrity of the reported data. And the cross-validation process needs to be confirmed by more than 2/3 of the hospitals, which greatly ensures the authenticity of the data.

3) Once a new piece of data is successfully uploaded, it will be time-stamped. After that, the newly generated data will automatically be classified into a chain as long as the case similarity is as high as 95% or more (threshold value is for reference only). If a new case becomes an orphan after being chained, it can be considered that the clinical case has not formed a large infectivity, and only certain prevention and monitoring can be done. If a new case forms a data link soon after it is chained, a threshold can be set. After reaching a certain number, the CDC can coordinate local government forces to carry out matching prevention and control measures (listening of data) .

4) Similarly, on top of the local alliance chain, there will also be a national CDC alliance chain with the provincial CDC as the main unit of the alliance chain. After collecting abnormal data and taking corresponding preventive measures, the region should report the local infection data to the national disease control center and broadcast it on the chain so that other provinces and cities can attach great importance to it and do it as soon as possible. Good preventive work.

5) The data on the initial disease control chain is initially open to members of the alliance chain. Once it reaches a certain threshold of transmission, it will access the authoritative media for transparent disclosure and display, so that the public can enjoy full right to know and avoid unnecessary Suspicion and panic breed.

I admit that this is a set of possible solutions based on blockchain technology that I personally think of, but it outlines a general direction. I believe that after this epidemic, more experts will join to transform this system in the future. Just like the Internet outbreak after SARS, blockchain technology will usher in a major development.

04

As for why it is blockchain technology, because blockchain technology is essentially an upgrade of organizational production relations. Data from closed to open, fully centralized decision-making is released to the distributed weak center, the collaborative relationship that is split between each other, and more efficient optimization through benefit binding, etc.

Yes, this is the key to the "software and hardware" upgrade of the disease control early warning system by the blockchain.

1) Breaking the current situation of data islands between hospitals and allowing infectious case information to be aggregated and classified into big data as soon as possible, which has drawn great attention from CDCs in various places.

2) Assist the CDC in making early warning or prevention and control decisions through the setting of danger levels at each level. Let the data truly control the decision-making power and be assisted by institutions and people, avoiding the worry of man-made decision-making responsibility or concealment. This is like a smart contract. Thresholds and rules are still set by the CDC, but once the conditions are triggered, human intervention is minimized.

3) The hospital is the front-line window for collecting cases, allowing each hospital to be the main body of the disease control alliance chain, and can play a distributed, weak-centered community governance model, avoiding many artificial or unnecessary friction between levels.

4) The information on the chain is immutable. If the epidemic situation is not properly controlled due to non-resistance natural factors, the data is completely traceable, and it can also be transparent, which can dispel the social skepticism and conspiracy theories to the greatest extent.

What I said above is just a small brain hole in the application of blockchain technology to the prevention and treatment of infectious diseases.

There are many more categories involved in blockchain + healthcare. For example, blockchain + drug traceability traceability, blockchain + automated medical insurance, and blockchain + identity authentication, etc., each block can extend a lot of hard-core content , at least to improve the current doctor-patient relationship, to the public Better medical services and experiences.

As for the epidemic in Wuhan, the phrase "come on" is better than everything.