COVID operations: taking a detective’s approach to the mysteries of infectious disease transmission

Published:23 April 2020

TOP: Associate Professor Olav Muurlink and Professor Andrew Taylor-Robinson. BELOW: A simple schematic of different pathways between climate and disease, highlighting how both social and vector elements interact.

Despite an intense global concentration of research effort on the coronavirus, big questions remain unanswered. How much exposure to the virus do we need to become ill? How long can you walk around incubating the virus without becoming ill? Why are men dying from COVID-19 at rates significantly higher than women?

Rather than casting the disease as the ‘criminal’ in attempting to answer these questions, two CQUniversity researchers are suggesting a social innovation approach to understanding infectious diseases: less focus on the disease and more on our vulnerability to it.

Associate Professor Olav Muurlink from the School of Business and Law and Professor Andrew Taylor-Robinson from the School of Health, Medical and Applied Sciences were working on modelling the spread of dengue fever when the COVID crisis struck, turning their attention to using the same analysis that emerged from their dengue work to the new infectious disease threat.   It all came about because of a mysterious result in complex analysis they published in late 2018.

“We found in our retrospective analysis of dengue in Bangladesh that you could use climate variables like rainfall and temperature to predict whether, where and when this mosquito-borne disease occurred, and also to gauge the scale of that outbreak,” says Professor Taylor-Robinson, “tracing a pretty obvious line between what is good for the mosquito, the vector, is ‘good’ for the development of the disease”.

What the interdisciplinary researchers found, however, was that the simple causal route didn’t work.

“The best predictor of how many people were infected was humidity six months prior to attack,” says Assoc Prof Muurlink. “And the problem with this is that six months represents a long time before the mosquitoes that bit the dengue patients even existed.”

Instead, they argued that the disease can be looked at in a different way — from the perspective that the vector, the mosquito, is the ‘only problem'.

“A social innovation perspective drills down to the grassroots level of the problem itself, and takes an inquiring mind to understanding the problem holistically,” says Assoc Prof Muurlink, who heads the Social Innovation offerings in the School of Business & Law.

“We asked ourselves, what takes place six months in the past that is reliant on rainfall — and the answer in Bangladesh is rice planting. If a rice crop is poor or fails, the result is undernourishment or malnourishment in the population dependent on it - and that leads to compromised immune systems.”

Their analysis urges scientists to look at the ‘lifecycle’ of humans rather than merely the disease itself.  This ground-breaking concept was published earlier this month in the journal Infectious Diseases of Poverty.

In another piece published online this week in Frontiers in Public Health, the duo argue that one needs to take the same 360 degree look at one of the earliest COVID mysteries to emerge: the striking gender imbalance in apparent infection rates.

“Because of our involvement in the Bangladesh sector, and how the disease may ‘operate’ within a country that at that stage had no reported cases, we began looking at how the disease might act in the kind of very different environment it would find there,” says Assoc Prof Muurlink.

“There are cultural factors at play here, such as the propensity for men to wear beards, which will make the effective use of masks more difficult, and the likelihood that, in conservative rural areas, women are going to be less likely to report to (typically male) doctors."

Taking this approach, particularly in relation to the separation between men and women in terms of living space and workspace, and the tendency of women — particularly those in conservative communities — to wear a veil that restricts facial touching when in public, the two are predicting that gender differences observed in COVID prevalence in countries like Italy and Australia are likely to be amplified in countries like Bangladesh.

“We do need to apply traditional ‘solutions’ to challenges like this,” says Prof Taylor-Robinson. “We need a vaccine and effective antivirals, but at the same time we need to better understand not just the disease, but how we relate to it."