Two experts offer insights on what seems to be a particularly troubling time for public health, both in the US and internationally.

The first US case of polio in ten years was diagnosed in New York. There have been a number of unexplained cases of hepatitis in children. Tuberculosis cases are on the rise. And there’s been an uptick in cases of scarlet fever in the United Kingdom. What’s going on? And what can we do about it?

Julie Swann is a systems engineer with expertise in public health whose work focuses on making health care more efficient, effective, and equitable. Swann is the department head and professor in the industrial and systems engineering department at North Carolina State University. Matt Koci is a virologist and immunologist whose work focuses on host-microbe interactions; he is a professor in NC State’s poultry science department.

Here, Swann and Koci answer questions about overlapping crises and best responses:

It feels like we’re seeing an increase in both the emergence of new diseases, such as COVID-19, and a re-emergence of diseases that many people associate only with history books, such as polio and scarlet fever. What’s contributing to this apparent increase in public health problems?

Swann: I think there are a couple of things going on. We may have more attention from the media on reporting disease, and we could have more awareness from the public about the potential of a new outbreak to impact our lives. Those are generally positive.

On the other hand, I do think that we are seeing disease trends that matter, in terms of new diseases (e.g., from Zika virus), diseases affecting new populations or transmitting in new ways (e.g., monkeypox), and diseases reoccurring that were almost eradicated (e.g., polio). I expect these to continue over the coming years. We have almost 8 billion people in the world, and that is projected to grow to almost 10 billion by 2050. We have an increase in natural disasters that can lead to displacement of people and animals, bringing them in critical contact. Compared to previous centuries, the level of global travel and connectivity is astounding. Science has delivered us effective vaccines for some diseases like polio, although the (unneeded) rise in vaccine hesitancy is leaving communities vulnerable to preventable disease. We also do not focus enough of our resources on preventing disease in the US and globally, and we find ourselves scrambling to respond to new, preventable, or neglected diseases. Unfortunately, I expect this to be the “new normal.”

Koci: The answer depends on which disease you’re talking about. The new diseases are the hardest to know for sure. Some of it is just really bad luck. The wrong person comes in contact with the wrong wild animal infected with a strain that just happens to be well suited for jumping to humans. The more humans move into previously wild areas, the more the numbers of these interactions go up, the more the likelihood of that happening goes up year after year.

Read the full article about public health crises by Matt Shipman at Futurity.