When I was diagnosed with Lyme disease recently, it explained a lot of things. (see www.ico-consulting.com/blog) It explained why it was so hard to push my business or anything forward; it explained the aches, pains, fatigue, and mind fog I have been experiencing for the last year. As I looked into the disease and its progression I ran into multiple systems that interweave in a complex tangle of embedded interactions.
Environmental Systems Change
One of the primary systems impacting the increase in tick-borne diseases is the environment. When we think of climate change and global warming, the first things that may come to mind are glaciers melting and seas rising, or unpredictable weather patterns. Now I have added tick and deer population growth to my short list. As people have moved into the countryside, they have eradicated predators and opened up roads, and deer populations have exploded. Tick populations have also increased—they like the warmth of longer summers, and the deer populations can support the increase in population. There are many kinds of bacteria that live in ticks, waiting for the tick to connect with a warm-blooded mammal so they can transfer to a larger host and proliferate. Here’s Dr. Daniel Cameron’s thinking about the environmental connection.
Unfortunately, there is mounting evidence that the increase in risk for exposure to tick-borne diseases is a consequence of the ways humans modify the environment we live in,” says Brian F. Allan, Ph.D., assistant professor of entomology at the University of Illinois at Urbana-Champaign. For starters, Allan says, we’re seeing more contact between ticks and people, possibly because we’re moving farther into woody areas. And ticks and the wildlife they feed on are thriving because we’ve created appealing backyards for them to live in.
As populations of ticks increase in endemic areas, there are more ticks to be dispersed outward, like cups of ticks spilling over,” Tsao (an epidemiologist) explains. “Deer have a particularly high capacity to spread ticks because they can carry adult females that can lay 1,000 to 3,000 eggs. Similarly, though one bird might not carry many ticks, it’s possible that thousands of migrating birds could pick up ticks from one area and drop them off in another.” Climate change might also be helping some tick species move northward, she adds, as warming causes summers to grow longer.
Lyme disease affects an estimated 35,000 people annually, infecting them with a bacteria that produces a neurological toxin that attacks nerves and the cerebrospinal fluid. There is controversy about diagnosis, testing, and treatment around Lyme disease. The controversy is the subject of an informative and well-researched book: Cure Unknown: Inside the Lyme Epidemic, by Paula Weintraub (2008) St. Martin’s Press: NY.
Governmental Health Systems
Some of the controversy around tick-borne disease diagnosis and treatment comes from another system involved with health care treatment: governmental departments of health. The controversy came to light when I read this recent article about how the Massachusetts Department of Health limited their financial support of research and education.
Without more research and education, the people infected with Lyme and the doctors who are trying to help them run into roadblocks when long-term treatment is needed. When organizations like the Massachusetts DOH or the CDC close down open investigation and research into Lyme disease (or any other disease), people suffer. A highly-regarded doctor who treats Lyme with long-term antibiotics, herbs, and vitamins, meticulously documented over 20 cases encountered during a 12-month period in rural Georgia and submitted the findings to the CDC. The CDC refused to acknowledge the cases claiming, there is no Lyme disease in Georgia. For anyone in Georgia who has been infected with tick-borne bacteria, this equates to very real physical suffering.
Other Complex Systems: A Healthcare Industrial Complex
The other big systems involved in this complexity are insurance organizations, physicians, pharmaceutical companies, and academic institutions. It is a complex that is what I would call a healthcare industrial complex, where insurance companies pay doctors and researchers for testimony, pharmaceutical companies pay researchers to skew test design and results, and academics and physicians earn top dollar to support insurance and pharmaceutical organizations.
As a social scientist and systems thinker, the complexities behind diagnosis and treatment of Lyme disease seem formidable. As we struggle with increasing costs for healthcare in the United States, we are also receiving less than optimal outcomes. Lyme disease is only one manifestation of how the complexity of the healthcare industrial complex is impacting people’s lives.