The COVID-19 pandemic highlights the importance of GIS and spatial analysis to public health. We have seen a variety of analyses and use of spatial platforms to monitor and assess how to address the viral pandemic. However, what this crisis highlights are the needs and deficiencies in how GIS is used in public health and where GIS and public health will be in the future.
Trends in public health and GIS started before the COVID-19 pandemic, although the current crisis may catalyze some change to happen faster. For instance, perhaps the greatest contribution that GIS will likely make in public health is a better optimization of care. We can think of hospitals and health workers as supply, while patients are demand. The COVID-19 crisis has shown imbalances between the two has led to a variety of crises, with some areas having more health workers and medical supplies than patients and other regions having vast demand for care and inadequate provisioning. Hospitals and healthcare providers will likely need to increasingly use online and real-time GIS monitoring of communities that forecast spatial change in how communicable diseases may spread.[1] Forecasting that looks at infection rates, analyzes vulnerable populations in an area, and then provides a probability of spread of an infection could provide a way for care workers to anticipate where health needs are likely to be. Such tools are, of course, available now, although data perhaps might be limited to make very accurate predictions. For instance, the National Health Service (NHS) in the UK has applied a tool, HealthGIS, to provide forecasting capabilities of healthcare needs. This tool can provide forecasting capabilities but the speed of data capture may need to improve to allow more rapid response to changes in public health.[2]
There are, of course, lessons learned that have helped the next generation of tools to be thought about based on needs. For one, it is clear that spatiotemporal modeling and analysis will be critical to the healthcare system, allowing real-time tracking of infections and forecasting. A second need is also to allow systems to be interactive and enable data sharing. This may require healthcare facilities to use cloud-based GIS systems, rather than only tools made specifically for their institutions, as the sharing of data that allows real-time interaction to occur is critical to enable healthcare workers to better plan across multiple regions and coordinate activities. Tools that apply GIS-based Multicriteria Evaluation (GME), as an example, is a likely direction for platform application to address this need.[3] In India, researchers have called for the healthcare system there to develop a national GIS database for health data, which is particularly important during a pandemic when national-level coordination is so critical to limit the spread of infections.[4]
Using GIS for healthcare takes us back to the origins of spatial analysis, such as John Snow’s famous use of spatial mapping and analysis in 1854 to map the source of cholera in London’s urban water infrastructure. Researchers have also called for particular focus by the GIS and healthcare communities to create coordinated GIS databases that are not only relevant for one country but multiple countries in particularly vulnerable regions such as sub-Sahara Africa. Researchers have taken a first step in assembling data for healthcare facilities across sub-Sahara Africa, but efforts will need to go much further so that real-time data sharing and monitoring are even possible.[5]
GIS will certainly be critical to healthcare in the future. The question is how do countries and regions begin to develop systems that can better prepare us not only for the next pandemic but also for other public health events or crises. Some regions and countries, such as in the UK, have made good efforts towards this through a developed GIS system at a national level, but other countries and regions, such as India and in sub-Sahara Africa, far more effort is needed. What is clear is coordination, data sharing, and real-time data provisioning and forecasting will be critical for health professionals to better deal with major crises.
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References
[1] For more on future forecasting needs using GIS for public healthcare, see: Wang, F. (2020). Why public health needs GIS: a methodological overview. Annals of GIS, 26(1), 1–12. https://doi.org/10.1080/19475683.2019.1702099.
[2] For more on the NHS and its use of a GIS forecasting tool, see: https://www.healthgis.nhs.uk/.
[3] For more on how GIS systems could change and evolve for healthcare providers, including the use of GME-based tools, see: Jelokhani-Niaraki, M. (2020). Collaborative spatial multicriteria evaluation: a review and directions for future research. International Journal of Geographical Information Science, 1–34. https://doi.org/10.1080/13658816.2020.1776870.
[4] For more on national-level needs for a coordinate GIS database in India, see: Ranga, V., Pani, P., Kanga, S., Meraj, G., Farooq, M., Nathawat, M. S., & Kumar Singh, S. (2020). National Health-GIS Portal-A Conceptual Framework for Effective Epidemic Management and Control in India(preprint). MEDICINE & PHARMACOLOGY. https://doi.org/10.20944/preprints202006.0325.v1.
[5] For more on an effort to coordinate heathcare across sub-Sahara Africa, see: Maina, J., Ouma, P. O., Macharia, P. M., Alegana, V. A., Mitto, B., Fall, I. S., et al. (2019). A spatial database of health facilities managed by the public health sector in sub Saharan Africa. Scientific Data, 6(1), 134. https://doi.org/10.1038/s41597-019-0142-2
