With the H1N1 Pandemic still fresh in our minds, the Winter Olympics have zeroed the spotlight on Vancouver. With 70,000 visitors per day, 5,000 athletes and staff, 1,350 Paralympic athletes, 10,000 media, 25,000 volunteers, and 8,000 security personnel, a single disease outbreak can become catastrophic. Historically, mass gatherings have been particularly sensitive to vector outbreaks. The 2006 Turin games, for example, were no exception – respiratory syndrome with fever (influenza) and gastroenteritis (Norovirus) were the most common pathologies.¹ Unlike Turin however, Vancouver is ready. We are at the forefront of Technology-Enabled Knowledge Translation (TEKT) in practice.

TEKT refers to the strategic deployment of modern information and communication technologies to help individuals and organizations accelerate the incorporation of research and new knowledge into clinical practice.² For the Olympics, Vancouver Coastal Health (VCH) is responsible for deploying one of the most intricate public health surveillance systems ever designed for a planned mass gathering.³ As a medium of dissemination and performance evaluation by the system, technology is the modus operandi in the integration of fourteen data sources which allow for continuous assessment, monitoring, and public health response. Table 1 (below) displays the data sources, including both existing and enhanced data resources created for solely for Olympic surveillance by VCH. The intricacy doesn’t stop there however. All components of data collection are also congruent with the Olympic Movement Medical Code,⁴ the document which describes the rules and medical practices for Olympians and prevents positive doping tests resulting from medical treatment.

Table 1: Surveillance System Components

Existing Data	Data Enhancements
Emergency Room Data Reportable Communicable Diseases Laboratory data Facility Outbreaks Foodborne illness complaints Sentinel physician surveillance for influenza-like illness Poison control data BC Nurse Line data (coded by nature and location of call) BC Ambulance dispatch data Police dispatch centre data	Expanded ER Data VANOC Polyclinic Diagnostic Code Data Hotel medical service data Mountain injury surveillance data Illicit drug overdose data from Insite, BCAAS, St. Paul’s Hospital, and the BC coroner’s office.

As you can see from the table, data is vast and the stakes are high! The “crash” room where this data is analyzed is located at Vancouver General Hospital and staffed 24 hours a day. The Olympic surveillance team conducts real time geospatial analyses and is capable of sending blackberry-push instant notifications to all IOC medical personnel. Figure 1 displays a publicly available crowdsourced version of what the protected crash-centre map may look like. This map features the 25 cities where 75% of Olympic visitors reside and the corresponding germs these people may bring with them. In the “crash” room, data access statistics are also geo-coded by IP address allowing disease prevention and management personnel, whom are central to the system, to evaluate the effectiveness of TEKT. Daily reports with the current state of public health affairs can be downloaded directly from the “crash room”,6 should you interested.

In regards to personnel, the two polyclinics, the Olympian-only treatment facilities, are staffed with public health nurses with on-the-spot communicable disease, rapid flu, enteric, and point of care HIV testing and management resources. Cluster and outbreak investigation teams are also situated in each of the Olympic venues, all equipped with laboratory sample-collection equipment for expedited testing. For the treatment and management of disease, the Polyclinics have stockpiles of antivirals (e.g., Tamiflu), well-established outbreak protocols, and set processes for isolation, including those for security personnel, athletes and other VIPs.

While you soak in the festivities during these 27 days of sport and 60 days of celebration, don’t only walk proud of your Canadian heritage. Show your pride with a smile on your face, because you know that the 21st Winter Olympic Games have featured Vancouver as a leader of public health surveillance and TEKT in action.

References:

[1] Henry, B. Planning for the 2010 Olympics in the midst of a pandemic: a provincial perspective.

[2] Ho et al. Technology-enabled knowledge translation: frameworks to promote research and practice. J Contin Educ Health Prof (2004) vol. 24 (2) pp. 90-9

[3] Daly, P. Public Health Surveillance for Vancouver 2010.

[4] Olympic Medical Commission. Olympic Movement Medical Code.

[5] Health Map. Global Disease Alert Map for the Olympics.

[6] Vancouver Coastal Health. 2010 Helath Watch.

Acknowledgements

I would like to thank @roboethics for reviewing the first few drafts of this post.

Editorial Note:

This article was written for the column “The 2.0 Factor: Musings of a Hyperconnected world” in the TICr.

February 25th, 2010 | Articles by me, e-Public Health, English

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