A thing won't save us, systems will - a thread co-sponsored by @nitanother : A collective 2.5 decades of studying measles in LMICs has shown us that individual things (vaccines/tests/drones) are not sufficient to eradicate a virus nor provide for the health of populations 1/
Measles has had a highly effective vaccine for over 50 years; has had effective serological tests (with a meaningful correlate of immunity) for decades, but that has not been enough to eliminate a virus that kills 100s of children a day worldwide 2/
Individual things (technological solutions) are exciting and provide hope. We anxiously await their discovery, praise the discoverers. But things alone, without plans for scale-up, equitable distribution, and sustainability are operationally useless 3/
It is critical that as we develop new things we begin to look at how they will be incorporated into existing health delivery and financing systems (in the US this is especially the case as preventive care and monitoring is not easily incorporated in our model) 4/
Despite the existence of a safe and effective vaccine for measles, global coverage has stagnated at ~85% because of challenges production supply chain, delivery cold chain, and access to remote/marginalized groups. 5/
Despite the existence of good diagnostics for measles, most suspected measles cases (febrile rash with cough/conjunctivitis/coryza) are never tested because of difficulties in collection, insufficient lab capacity, and cost and supply-chain stability issues 6/
Thus, while the things exist to eradicate measles, the systems to use them effectively remain the largest barrier. We can already anticipate that this will be the challenge for implementation of novel technology to combat #COVID 7/
Technological solutions for #COVID without a plan for scale-up, equitable distribution, and sustainability may not only fail to be effective, they may waste resources that could be otherwise applied to tested, scalable, conventional solutions 8/
Technological solutions for #COVID w/o a plan for equitable distribution may reinforce existing health disparities, not only failing to reach marginalized groups, but distracting funding/support from conventional approaches with known effectiveness 9/
