Learning from History
Doctor Onstine, of the clinic operated by the Taos County cooperative health association, and Father Smith, the parish priest, at the bedside of a tuberculosis patient. Questa, New Mexico, January 1943. By John Collier Jr. Photo: Courtesy of the Library of Congress
As we continue to learn more about COVID-19 and race against time to control its spread, data scientists are crunching numbers on high performance computers, disease trackers are mapping the rapid spread of disease across the globe, and laboratories are rushing to design new treatments and a vaccine. At the same time, researchers are looking back at historical models for combatting infectious disease.
In Chasing the Cure in New Mexico: Tuberculosis and the Quest for Health, published by Museum of New Mexico Press in 2016, Nancy Owen Lewis chronicles the history of tuberculosis and New Mexico’s sanatorium industry during the late 19th century and early 20th centuries, when TB was the leading cause of death in the United States. Prior to 1882, when scientists discovered that TB was caused by infectious bacteria, doctors had no real way to prevent or treat the disease and they began to send sick people out West to recover, away from their homes in overcrowded and unsanitary industrial cities. New Mexico, with its fresh air and dry and warm climate, was believed to offer an ideal environment for the recovery of “lungers”, as TB sufferers were often called. Health seekers flocked here until the 1940s when doctors got their hands on the first effective treatment, the antibiotic streptomycin, and finally could control the spread of TB. Many who had come to New Mexico chasing the cure never left and ended up making a profound impact on the history and culture of their adopted home.
Author: Mimi Roberts, Chasing the Cure in New Mexico
Search, Treat and Prevent
Artists Carlos Vierra, Gerald Cassidy, Theodore Van Soelen, Sheldon Parsons, and Daus Myers, La Fonda Hotel, Santa Fe, New Mexico, ca. 1925. Photograph by T. Harmon Parkhurst. Courtesy Palace of the Governors Photo Archive (NHMH/DCA), Neg. No. 020786.
In a post on the NPR website on April 1, 2020, The Way The U.S. Beat TB Could Be A Boon In Battling Coronavirus, three authors advocate for replicating the community-based health care delivery model that ended the scourge of tuberculosis. Over a 60-year time span, science revealed that TB is caused by infectious bacteria, and diagnostic techniques, treatments, and preventive measures were developed. The first line of defense, Search involved tracking down and testing everyone who had had contact with an infected person. The second line of defense was Treat, and the third was Prevent. People received free access to testing, treatment, and medicines, and financial support during periods of physical distancing. The strategy was implemented by trained community-based health teams usually overseen by municipal public health authorities and funded by federal, state and private sources.
The authors argue that the best way to stop transmission of COVID-19 is not to focus on quarantine, physical distancing, and hospital care, but rather to invest in a strategy that is community-based—in people’s homes, schools and workplaces. While the history of TB might be highly relevant to a long-term strategy, there would need to be consideration given to the ways in which the world has changed and our scientific knowledge has expanded for combatting a disease that is many times more contagious than TB. Providing high-quality and equitable defense against infectious diseases now and in the future will require a coordinated response between policymakers, scientific researchers and community health providers.
Author: Mimi Roberts, The Way The U.S. Beat TB Could Be A Boon In Battling Coronavirus
Moving Knowledge, Not People
Sanjeev Arora, M.D.
It was the quest to control the spread of a different infectious disease, hepatitis C, that led Sanjeev Arora, M.D., a liver disease specialist at the University of New Mexico Health Sciences Center, to launch Project ECHO, a free, educational system for mentoring community health providers across New Mexico. Project ECHO, now reaching over 90,000 learners worldwide, is committed to addressing the needs of the most vulnerable populations by equipping communities with the right knowledge, at the right place, at the right time.
Unlike traditional telemedicine, where specialists assume remote care of patients, Project ECHO uses interactive video technology to offer telementoring, a guided practice that connects groups of community providers and specialists in regular real-time collaborative sessions designed around case-based learning and mentorship. Local providers gain the expertise, skills and self-confidence they need to provide high-quality care. Patients receive needed care from local people they know and trust. Specialists in urban medical centers learn new approaches for applying their knowledge across diverse cultural and geographical contexts.
The extensive use of telemedicine in treating COVID-19 sufferers will undoubtedly change forever the delivery of health care, especially to rural areas, after the current pandemic is over. New Mexico’s homegrown version, telementoring, is grounded in the spirt of democratizing knowledge. Project ECHO is connecting experts and healthcare professionals working on the frontlines of the pandemic through training sessions and working with partners on a coordinated response.
Author: Mimi Roberts, Project ECHO
