Balance and challenges of epidemiology in the third year of the pandemic


When will be the year of epidemiology? There will be those who think that it has already been. But those of us who dedicate ourselves to this branch of science know that there will never be a dedicated year because everyone has their own desire and challenges.

The year 2022, like the two previous years, has been strongly marked by covid-19 and also by its consequences on the rest of the epidemiology activities, since all efforts have been highly conditioned by the pandemic.

The impact of covid-19

Covid-19 has had a strong impact on public health surveillance of all diseases, communicable or not. Fundamentally because the saturation of the health system has slowed the notification and intervention on all of them.

Even preventive programs, such as screening for early detection of cancer , have been affected. These delays in diagnosis suggest an increase in more advanced stages in various diseases and, therefore, a worsening of survival.

Given the deficiencies that the National Health System in Spain has shown when facing this crisis, the creation of the State Public Health Agency is emerging as a crucial instrument, although we still do not know where, how and when it will materialize. It is essential to accelerate its implementation and to know what its structure and regulations will be.

Positive aspects

One of the positive aspects has been the recent publication, for the first time, of the provisional mortality data for the first half of 2022, together with the final data for 2021 , by the National Institute of Statistics, which has also reduced the deadlines. in diffusion. However, it is necessary to continue claiming the consideration of data of health interest, as well as statistical, of deaths according to cause of death. It is also necessary to implement the electronic death certificate, which would make it possible to have these data more immediately.

Another piece of good news for 2022 is the launch of the Acute Respiratory Infection Surveillance System (SiVIRA) for joint surveillance of influenza, covid-19 and respiratory syncytial virus infection, following international recommendations.

Climate change, another challenge for epidemiology

One of the great current concerns is climate change and its effects on health. For this reason, the Spanish Society of Epidemiology dedicated its Annual Scientific Meeting in 2022 to it . Extreme weather events will become more frequent and their consequences are already devastating. They have a pronounced impact on health and also affect non-communicable diseases.

In turn, the alteration of biodiversity by human activity favors the transmission of infectious and parasitic diseases and entails the risk of the resurgence of other diseases that we thought were already overcome or the appearance of new agents that could affect health.

Extreme weather events also affect population displacements and the health of those who migrate. Faced with this demanding panorama, public health services, like society, must be reorganized and strengthened with more resources to face it.

Climate change also increases social inequalities , one of the main determinants of health. Its impact on food security will increase malnutrition and diarrhea in areas with fewer resources. To make matters worse, the combination of climate change and the pandemic exacerbates vulnerability due to energy poverty.

And in 2023?

Surely the covid-19 will continue among us the year that has just started, we hope that with less incidence, although the current situation in China is worrying. But it will be necessary to limit its impact, controlling this and other possible causes of the pandemic.

In the coming months, the necessary foundations should be laid to face the health and social crises, assuming that the best preparation is to have a well-equipped, trained and well-rounded system before the crisis occurs.

Recognition for epidemiologists

In the last three years, epidemiology seems to have gained special relevance due to covid-19. But those who are dedicated to epidemiology also work and research in other fields such as cancer, addictions, social determinants of health, occupational health or nutrition. And it is that training in epidemiology is based on very diverse degrees that require a complementary effort of learning and specialization, which must be recognized professionally and professionally.

The apparent visibility of epidemiology in recent years has not been accompanied by better working conditions. Equalization with other health professionals is essential, which requires more jobs and technical resources and greater dignity and stability in the workplace.

This is how a task is recognized. That which contributes to improving people’s lives, by monitoring population health and disease prevention. That which also contributes to the promotion of community health, always trying to provide valid and equitable answers to collective health problems and influencing the development of policies and social change.

Author Bios: Oscar Zurriaga is Associate Professor. Department of Preventive Medicine and Public Health (UV). serv. Epidemiological Studies and Statistics. Sanit. (Valencian generalitat). unit Mixed Research on Rare Diseases FISABIO-UVEG. CIBER Epidemiology and Public Health at the University of Valencia, Angela Dominguez Garcia is Professor of Preventive Medicine and Public Health, Department of Medicine, CIBER Epidemiology and Public Health at the University of Barcelona, Eduardo Briones Perez de la Blancais an Epidemiologist, specialist in Preventive Medicine and Public Health at Junta de Andalucía, Federico Eduardo Arribas Monzon is
Head of Health Evaluation and Accreditation Service. General Directorate of Health Care at the Department of Health of Aragon, Juan A. Cayla Buqueras is President of the Barcelona Tuberculosis Research Unit Foundation at the Barcelona Tuberculosis Research Unit (UITB), Maria Grau works at the University of Barcelona, Maria Elizabeth Portillo is Coordinator of the Colorectal and Prenatal Cancer Screening Programs. Osakidetza-Basque Health Service at Osakidetza – Basque Health Service, Maria Joao Forjaz is a Public health Researcher at Carlos III Health Institute and Mario Fontan Vela is a Doctoral student in Epidemiology and Public Health at the University of Alcalá