Exploring Invisible International with Dr. Nevena Zubcevik

Education and innovation using a One Health approach to vector-borne diseases.

Dr. Nevena Zubcevik joins Looking at Lyme on episode 65.

In this podcast, we speak with Dr. Nevena Zubcevik, a Harvard trained and board certified physical medicine and rehabilitation physician, and Chief Medical Officer of Invisible International. Dr. Zubcevik talks about some of the challenges that doctors and Lyme patients face within the medical system, including time constraints and the “syndromizing” of symptoms rather than addressing their cause. 

She also discusses the One Health perspective, including what we can learn from veterinary medicine and the ways that Invisible International is addressing these issues through their education platform and other innovative initiatives.

The evolution of physical and rehabilitation medicine

Dr. Zubcevik explains that physical medicine and rehabilitation medicine began as a way to provide rehabilitative medicine to people with strokes, developmental disabilities and those who were recovering from accidents. Over time the field grew to include pain management, cancer therapy and most recently, recovery from vector-borne infections. One of the foundations of this line of work is to first understand the underlying mechanisms.

“For medical professionals, you know, when we study medicine, and we open up a medical book, and we read, you know, strep throat, okay, so you have (symptoms)… then you do a test… Lyme patients, unless you actually stratify, and start explaining what they look like and develop the recipe to understand… they’re very confusing. They walk into a clinic, and they have every symptom that you present them with, and in busy primary care practices where physicians are limited… it’s a very isolating experience for both the patient and the physician.”

Dr. Nevena Zubcevik

Neuroinflammation in brain injury and infection

In the case of brain injury, those mechanisms include inflammation which in turn restricts the flow of glucose into neurons in the brain. With increased research around COVID and neurologic inflammation, Dr. Zubcevik explains that we’re gaining insights that will lead to a better understanding of Lyme disease and other infections. 

Caring for complex patients requires time

Dr. Zubcevik points out that although some infections are easier to address using a recipe based approach to diagnosis and treatment, Lyme patients are often much more complex and require more of a doctor’s time to really figure out what’s going on and how to treat it. Doctors that want to help their patients can suffer from burn out when they’re expected to see so many patients in a day, many of whom have complex health issues.

“So almost every bug that we’re exposed to, from birth on, has a place to hide in our system and then in an event where our immune system is reduced, it can kind of manifest itself again. And so Lyme isn’t that much different, except that, because of our lack of knowledge and inability to identify it early enough and treat it for long enough, we miss the window of opportunity to really protect the nervous system from getting completely obliterated by this disease. And then the recovery is very long.”

Dr. Nevena Zubcevik

Is infection “cured” or dormant?

One of the other challenges in treating infections such as Lyme is knowing whether a patient is “cured”. Dr. Zubcevik explains that, like other infections, the microbe that causes Lyme disease could still be present after their symptoms have subsided. Under certain conditions, the pathogen can become active again, leading to a resurgence of symptoms.

The GSQ-30 Lyme questionnaire

Dr. Zubcevik’s approach with Lyme patients has been to do a full assessment which includes the use of a validated questionnaire called the GSQ-30. Dr. Zubcevik helped to develop this questionnaire alongside a team of researchers that also included Dr. Brian Fallon from Columbia University and Dr. John Aucott from Johns Hopkins. It can be used to help make a diagnosis and track symptoms during treatment and recovery. 

“It’s a huge movement in the direction of improving the physician force, making it easier for those Doc’s that are stranded for time and having 10-15 minutes with this questionnaire, taking one look at it and saying… let’s figure this out… And so when you can not only find the reason of why they’re sick, but also prevent future, risk exposure and future tools that can aid them in having a healthy life is really the ultimate reason why all of us want to be doctors and, you know, to offer somebody that good quality of life.” 

Dr. Nevena Zubcevik

Why dogs aren’t diagnosed with fibromyalgia

Dr. Zubcevik explains that Invisible International grew out of a desire to change the landscape around Lyme disease. Early on they started working with veterinarians, who are also dealing with vector-borne and other zoonotic diseases. She explains that veterinarians have a more direct approach to these diseases where they are more focussed on finding and treating the infections, rather than applying a diagnosis like fibromyalgia. 

Syndromes describe symptoms, not causes

She highlights the fact that in human medicine, there are many “syndromes” that describe symptoms without understanding the underlying cause of those symptoms. Oftentimes this pathway includes medications to try to alleviate symptoms, but the effects and side-effects of these medications can sometimes create new symptoms which a patient then has to deal with. 

“So, in medicine, we have started labeling symptoms as diagnoses… you have these labels like pain as a diagnosis, that should never be a diagnosis. What’s causing the pain, oh, pain related to inflammation from infection of Lyme disease in the knee is a diagnosis, not just pain. So, you know, medicine has started accepting and also started syndromizing things like, you know, fibromyalgia. What’s that? That is an invented name of something that we don’t know what it is, and it’s a wastebasket term, when you don’t know why your patient has all over body pain.”

Dr. Nevena Zubcevik

The One Health approach

Dr. Zubcevik explains that Invisible International is founded in a One Health approach, which looks at the relationship between humans, animals and the environment. In relation to Lyme disease, this approach considers infections that are not isolated to humans alone. It also looks at the health impacts of environmental factors such as clean water. 

“This is really how we started approaching this idea of One Health. There is no human health versus, you know, primate health versus myself, dog health, whatever health, it’s all we’re all connected, we live on the same planet, we breathe the same air, we drink the same water, eat the same food, we really should be looked at holistically.”

Dr. Nevena Zubcevik

Course accreditation and funding

Courses at Invisible International are offered free of charge, cover many topics relating to vector-borne and zoonotic diseases, and are eligible for accreditation through the American Academy of Family Physicians. There is information on the AAFP website regarding transfer of credits for Canadian physicians as well.

Dr. Zubcevik explains that Invisible International supports the community of experts they work with by paying them for their work. The Montecalvo and Lovell families have helped to fund their platform; support by these families and other donors allows Invisible International to continue to better educate healthcare providers and anyone else wanting to know more about tick-borne diseases. It also allows them to continue to provide courses free of charge. 

Innovation hackathons

Invisible.International also holds “hackathons” to explore new ideas and engage the global community. This year the event is on September 7th, and will include an initiative that looks at different types of data to better understand and communicate risk of ticks and tick-borne diseases in different areas. She encourages international teams to participate so that programs such as this can become global initiatives. 

Resources available at Invisible International

Listeners can find more information about the courses and other resources, including a curated reference library on their website. Thank you Dr. Zubcevik for sharing your insights on Lyme disease, the One Health approach, and the courses and other initiatives that Invisible International has to offer.

Transcript

Catherine Kinsella: Welcome to looking at Lyme, an educational podcast of the Canadian Lyme disease foundation, designed to increase awareness, empower listeners with expert knowledge and explore solutions. I’m Catherine Kinsella.

Sofia Osborne: And I’m Sofia Osborne. 

Catherine Kinsella: In this podcast, we talk with Dr. Nevena Zubcevik. Dr. Zubcevik is Chief Medical Officer of the non-profit organization, Invisible International. She co-founded and co-directed the Dean Center for Tick Borne Illness at the Spaulding Rehabilitation Hospital, an affiliate of Harvard Medical School. Dr. Zubcevik is a Harvard-trained, and board-certified Physical Medicine and Rehabilitation physician.

Sofia Osborne: Welcome to the podcast. Dr. Zuber. 

Dr. Nevena Zubcevik: Thank you for having me.

Sofia Osborne: In your bio, it says that you’re a physical medicine and rehabilitation physician. Could you tell us a bit about what that is and how it relates to Lyme disease.

Dr. Nevena Zubcevik: So physical medicine and rehabilitation is a specialty that evolved out of the necessity for people to rehabilitate after an injury like a stroke, people that were born with developmental disabilities like cerebral palsy, and people that were struck by accidents, and then they had to recover.

And over time, the field grew so much. And they went into pain management, they went into cancer therapy, post cancer recovery, and most recently into recovery of vector borne disease. And so as a physiatrist, my interest is in, specifically in brain injury. And really understanding the pathophysiology of the brain and why people when they get either injured by an accident, or an organic injury, like an infection, such as Lyme disease, or bartonellosis affects the brain. Then how do people recover from it? What are the mechanisms of that injury? What’s involved? And you know, how do we get people to go back to their baseLyme and function again?

Catherine Kinsella: So you’re a brain injury doctor then, and how did you become interested in Lyme disease? 

Dr. Nevena Zubcevik: So during my studies of concussion, you know, it was very evident in Boston, that, you know, majority of the people who had chronic concussions had, you know there’s a protocol that was being developed concussion was much like Lyme disease in the dark ages, say about 30 years ago, when people thought, it wasn’t a real disease that people were just lazy, and, you know, would pretend that they had all these symptoms of light sensitivity, sound sensitivity after concussion that they couldn’t think, and they just didn’t want to go back to school or work because they were just lazy. 

Then it was a group out of University of Pittsburgh and other institutions that really wanted to take a deeper dive, and understand what’s the mechanism of injury and understood, oh, there was a real mechanism for a concussion, where, you know, the neurons aren’t able to absorb glucose like they normally would to process it, and glucose is the main ingredient, the main, you know, food for our brain to work. And so when there’s inflammation surrounding the neurons, and the, you know, sugar can’t make it in for to feed the neuron, then the neuron can’t function of the neuron can’t function, then you can’t think if you can’t think then you can’t perform what you normally used to do. And so when that mechanism was better understood, and people started seeing that, oh, this is a real problem, then therapies evolved around that, you know, diagnostics evolved around that protocols to get people back evolved around that. 

And so Lyme was very similar. I worked in a very endemic area of, you know, Lyme disease, which now seems like it’s, the entire world is becoming endemic for Lyme disease. And so people with chronic tick borne infections, and this goes well beyond Lyme now into long COVID as well, like these highly inflammatory, neurodegenerative diseases, that what they do is, you know, now that we’re understanding things to a huge research forces from around the world, gearing now to figure out what’s going on with COVID – understanding the mechanism of what it means to have inflammation in the brain and how it’s detrimental. 

And so, it became really interesting to kind of explore this organic cause of what you know, is like concussion, because nobody had really ever done it, there was no description of the phenotype even what does a Lyme patient look like? Because for medical professionals, you know, when we study medicine, and we open up a medical book, and we read strep throat, okay, so you have fever, and you have really sore throat, and then maybe you have no exit date on the tonsils, and then you do a test. And if it’s positive, you say, oh, okay, so we’re gonna treat you for strep throat. So it’s very recipe based. Things in medicine are very recipe based, and Lyme patients, unless you actually stratify, and start explaining what they look like and develop the recipe to understand, you know, how to identify them in clinics. They didn’t have a recipe, there was no recipe, you know, they’re very confusing, they walk into a clinic, and they have every symptom that you present them with, and in busy primary care practices where physicians are limited. You know, medicine used to be like a doctor would take a bag and come to your home and sit down with you. And know you, right, because it was the village doctor, and he’d know, like, if you were really sick, or if you were not sick, or if you were sad, or what, what was going on with you, and he would, you know, over some tea, talk to you and figure this out.

Now, we’re limited to 10-15 minute appointments, you know, it’s a very isolating experience for both the patient and the physician. You know, we all went to medical school wanting to help patients, nobody goes to medical school to burnout and to feel frustrated, because they don’t have enough time to spend with a patient. Everyone is hoping for that perfect physician patient bond, where you get to take care of someone and see them improve and get better. And that’s why we want to, when your little kid, you know, playing with your teddy bear and trying to put a bandaid on it, you’re trying to fix it. That’s what kind of gives you that drive to want to be – these people come with certain empathetic traits to become physicians. And then what happens is, is the insurance system the way it’s designed, it’s cruel, it creates pressure on doctors to quote unquote, produce. So if you’re supposed to produce 40 patients a week, you know, which, that word was always so bizarre to me and so hurtful, because we don’t work in a factory, we’re not supposed to be producing anything yet they call it production. And that spans, you know, academic centers, private hospitals, social medical systems, whatever it is, they’re all trying to produce something. And whatever they’re producing is not health, because it’s very hard to achieve, take care of someone, even if it’s just strep throat in 10 minutes, right. And so that frustration of having the Lyme patient not being heard, because they’re so sick by the time they usually see the physician – because it’s generally in the beginning Lyme presents, like the common cold, maybe or, you know, there’s some sore throat muscle aches, headache, people think, oh, I mean, I just have the cold.

 But then, as the weeks go by, similar to what long COVID is presenting like, is, you know, you start developing neurological problems, brain fog, pain, muscle fatigue, and so forth, and so forth. So by the time you see your primary care doctor, you’re overwhelmed. They look at you, they’re overwhelmed. They have no idea what’s going on with you when you have everything. So the easiest thing that you know, it is to dish it off to a psychological problem and say, well, this patient is just lazy and crazy. Okay. And so unfortunately, the burned out clinical force across globally now is exhausted, and that doesn’t help patients that are chronically sick. 

But here’s the twist. Lyme disease may be not completely curable, I don’t think that any infection that you ever get is 100% curable, quote, unquote. But you can become asymptomatic from the burden of the symptoms because you know, even with strep, the tonsils will hide a certain amount of strep, you know, and then could relapse. Same thing with mycoplasma and same thing with many viruses, chickenpox, for instance. It’s something that lives in your nervous system, eventually, it can come out when your immune system tanks and then you have shingles. So, so almost every bug that we’re exposed to, from birth on has a place to hide in our system and then in an event where our immune system is reduced, it can kind of manifests itself again. And so Lyme isn’t that much different, except that, because of our lack of knowledge and inability to identify it early enough and treat it for long enough, we miss the window of opportunity to really protect the nervous system from getting completely obliterated by this disease. And then the recovery is very long. 

So to me, as a physician, it became a mission to really try to first describe these patients, what do they look like? So when they presented to the primary carers office, there’s a questionnaire. And the primary care physician can go through the questionnaire and clinically say, oh, maybe you have Lyme disease, to put it on the map. And so one of my first publications that came handful of years ago, and this is available, we’ll talk about our nonprofit that’s Invisible International that has a platform for physician education, that hosts this publications, validated questionnaire for clinical Lyme called the general symptom questionnaire, which is now used in clinics that know about it and we’re trying to spread word about it that was published by myself at Harvard, Dr. Brian Fallon at Columbia’s Lyme Center, and Dr. John Aucott at Hopkins Lyme Center, and we all collaborated together on developing this global symptom questionnaire so that the clinicians can have an easier way, and a tool to use that’s validated, to identify patients without a test, but clinically, okay, looking at the symptoms and saying, does this patient look like they might have Lyme disease, and we did that. And so what we want to do now is make sure that every clinic across the nation has this questionnaire available to them, because it’s free, and it’s available. And it can save patients’ lives, patient’s quality of life, and the time for the physicians to get from point A to point B when it comes to the diagnostic process and, you know, developing their differential of what is really going on with their patient.

Catherine Kinsella: Right, and we have that questionnaire posted on our website. But I’ll also add a link to it in the show notes as well. 

Dr. Nevena Zubcevik: Thank you.

Sofia Osborne: And could you tell us more about Invisible International?

Dr. Nevena Zubcevik: Yeah, so Invisible International came out of the desire to really change the landscape. So that vector borne diseases and Zoonotic diseases, kind of rose, as, you know, something physicians could have approachable and easy to digest education is in this face of changing climate. Because what we noticed, while we were working in academia, and across going to many different conferences, we started talking, that we don’t really have a lot of answers, that things are moving quickly. You know, some people like in Canada, were saying, hey, you know, we used to not have Lyme disease here, there are ticks. You know, there was less ticks, and now it’s an exploded, it’s all over the place, and you know, then they would get sick and then end up in their physician’s offices. And the doctors wouldn’t have any idea of what to do with them. 

So we, over a handful of these meetings and conferences, started talking to veterinarians. And veterinarians are amazing, you know, they’re kind of like lightyears ahead. Because, first of all, they work with patients that don’t talk. So, you know, when a dog walks in, and they’re limping or tired, you know, they don’t walk away with a diagnosis of depression and fibromyalgia. When the dog, you know, the veterinarian wants to figure out, why is this dog fatigued and limping? So then they start, they go into diagnostic mode, they want to figure out what is the reason for this dog being this way? So, in medicine, we have started labeling symptoms as diagnoses, and somehow because of insurance companies speeding things up just for the purpose of billing, and you know, spending less money on patients. What’s happened is you have these labels like pain as a diagnosis, that should never be a diagnosis. What’s causing the pain, oh, pain related to inflammation from infection of Lyme disease in the knee is a diagnosis, not just pain. So, you know, medicine has started accepting and also started syndromizing things like, you know, fibromyalgia. What’s that? That is an invented name of something that we don’t know what it is, and it’s a wastebasket term, when you don’t know why your patient has all over body pain. So then the, you know, then the doc says, Oh my gosh, how do I help my patient, I don’t have time to really go fishing for the reason here, maybe, maybe they’re just depressed, let’s give them some antidepressants. So now they put them on antidepressants. Then they say, oh, let’s put them on some, you know, other medicine maybe to reduce their neuropathic pain. So they put them on gabapentin. Gabapentin makes you gain weight, now you have a patient that used to exercise and be happy, now is tired and gaining weight. Now, they definitely can’t exercise or have a way harder time because there’s a side effect of this medication. Now they also have gained weight. So then, now they have diabetes. Now they have to be on diabetic meds because they’re and blah, blah, blah, and it just keeps snowballing into this…In the end, it costs the insurance, we move our money during this kind of sick care, instead of going back to the basics to the medical books and saying, like the veterinarians do, oh, you have pain? Well, let’s figure out why. Oh, you’re tired? Well, let’s go back to the medical books, and figure out why. This isn’t rocket science. You know, it all has a recipe in the end. And the veterinarians are very skilled at doing that. 

So when we started talking to them, they said, Oh, finally you guys are coming to us. And we said, What do you mean? And they said, “well, when we end up needing you, because we’re the patient, you guys do a terrible job taking care of us. And we’re just a mammal. We’re just another mammal. So why are you guys so terrible at taking care of mammals, when I’ll tell you that as a doctor, when a dog walks in, and they have this and this and this, the first thing I do is I test them for Lyme disease.” Oh, and so then we realized we have to partner with veterinarians. 

And, you know, this is really how we started approaching this idea of One Health. There is no human health versus, you know, primate health versus mice health, dog health, whatever health, it’s all, we’re all connected, we live on the same planet, we breathe the same air, we drink the same water, eat the same food, we really should be looked at holistically, you know, and talking to each other because during COVID, it became evident that, you know, dog started coughing Oh, Can dogs catch COVID You know, a Tiger got COVID. So it became important that we start looking at this transfer, you know. Can animals transfer diseases to humans and vice versa? And then, how do we do a better job together? And how do we take care of everyone better. 

And so One Health also ties in environmental health as part of it. So the health of our environment is tied to our health, you can’t be drinking dirty water and expect to be healthy. And so Invisible International is a nonprofit that’s based in Massachusetts, that is really now, involving some global experts across the US and beyond, pooling the knowledge between human health clinicians and veterinarians together under the same umbrella, and providing, we’re the only nonprofit in the world that provides One Health accredited physician curriculum for zoonotic and vector borne diseases. There’s nobody else that’s doing it for free, under the umbrella of One Health, in this volume that we’re doing. So we’re accredited by the American Academy of Family Physicians, so the physicians that take our courses get free credit, that’s prescribed credit by the American Academy of Family Physicians. And, you know, which can be transferred to Canadian physicians as well, but everyone should check with their obviously their board to make sure that they’re accepted for their re-accreditation. But there is a statement on the American Academy of Family Physicians website that describes the transfer of that credit to Canadian physicians, as well. 

And so it’s a huge movement in the direction of improving the physician force, making it easier for those Doc’s that are stranded for time and having 10-15 minutes with this questionnaire, taking one look at it and saying, oh, you know, you were in a waiting room you filled this out, gosh, you know, let’s figure this out. Maybe you were exposed to you know, did you go hiking, are you a gardener, just sit on the grass, you know, these are all risk factors. You sleep with your dog. Well, is your dog wearing a tick prevention collar? Are they too taking medicine, you know, do you find dog, you know, ticks on your dog and all these questions, you know, then the doc, it helps kind of lead them into also doing preventative medicine, which is really what we all want to do as doctors, we want to teach our patients how to be healthy. And so when you can not only find the reason of why they’re sick, but also prevent future, risk exposure and future tools that can aid them in having a healthy life is really the ultimate reason why all of us want to be doctors and, you know, to, to offer somebody that good quality of life. 

So, Invisible International offers these modules we have this year is our fifth year, and we’re going to be having 50 modules on our platform that span you know, in the space of vector borne zoonotic diseases, everything from Lyme disease to leptospirosis, bartonellosis COVID. And so it’s, it’s really cool, because anyone can take these courses, you don’t have to be a physician, physicians just get the credit, but you know, anybody could come and take them for free, and it helps bridge also the communication between the patient and their doctor, because taking this these modules and saying to your doc, hey, you know, what, I’ve been having these symptoms, here’s this accredited curriculum, you know, would you please take a look at this, and, see what you think. And that bridge is really important because both validates the patient, and gives the tools to the physician to improve communication, improve diagnostic skills.

It’s a really phenomenal opportunity for us, we’re thrilled to be able to be doing this work and, you know, partnering with major academic institutions delivering this curriculum at conferences for CME credit to physicians. 

And, you know, we’re deeply grateful to our donor base, especially, you know, the Montecalvo family, which are CME, they, and the Montecalvo family of New Jersey have taken this as their family’s legacy to help support the development of this curriculum. And then we have the Lovell family who is helping us with outreach. So being able to fund some of our conferences that we go to, and then we have our annual donor base. So other donors that come to help us even further expand our outreach, because the sky’s the limit for our organization the more money that we’re able to fundraise more medical schools, we can go into with this credible curriculum, more ground, more conferences, and develop more modules. 

Because all of our, how our nonprofit works, which is really important, is that everybody’s paid. And our faculty are paid. A lot of the mistakes that people make when they’re working nonprofits, and they expect to kind of get really expert opinions and be able to launch different projects is they’re expecting physicians to work for free, and they’re already burnt out to the ground. And so the way we were able to engage our team, and you know, all of our consultants and our faculty is by paying them their fair price of what it costs to spend their time of the years of their education and clinical practice to now say, Okay, I will carve out these hours to be able to produce this curriculum to review it to whichever role they have within their organization, to devote that time, and that’s the only way to really work. It’s a true, you know, teamwork. 

And it’s, it’s really fun, because, having the world’s greatest experts and working together with veterinarians and human Doc’s and experts in environmental science, public health, it really energizes you, makes you feel like you know what, we’re making a difference. We’re making tractions, progress being made, which is really important when you’re doing work to feel like, yeah, you know what, this is worthwhile. And to me as a clinician, from the trenches, who has been seeing the sickest of the sick patients. Now I feel like I’m doing this for everyone. You know, I’m doing this for my own grandchildren, future grandchildren, right? Because I want them to be able to sit in the grass and enjoy environments, and by feeling safe. So what are the things I have to do in this lifetime to secure that? That happens, and that’s what I’m doing. And that’s what all of us are doing.

Catherine Kinsella: Yeah. And what you’re saying about collaborating is just so important in moving forward, in relation to all tick borne infections, and I see it a lot more nowadays than I used to. So it’s hopeful. I was going to mention that I took the tick bite Management module by Dr. Elizabeth Maloney. And I found it really very informative, because she presents all the different research, different kinds of research too on on tick bite management.

Dr. Nevena Zubcevik: At invisible, we spend an enormous amount of time referencing things, making sure that everything that we say, is credible, that it stems from, you know, an evidence based standpoint, because we, you know, to get our American Academy of Family Physician certification, and in addition to that, we’re also AC CME accredited, which which the Accreditation Council that allows you to be the CME giving body which is, we are, and that is huge. Because that is kind of, in the ultimate accreditation that you can have as an organization, to offer CME. So we have to, we’d hold these very strict standards on what we publish, how things are said and conflicts of interest the faculty might have, and making sure those are resolved before they can be on boarded as faculty and so forth. So, yeah, thank you for saying that. It really gives me joy when I hear good feedback. And also, you know, sometimes we receive creative feedback as well or constructive criticisms, and we use that feedback to improve upon our curriculum.

Catherine Kinsella: Now, you mentioned the one health framework, was there anything else you wanted to say about that and how it relates to tick borne diseases?

Dr. Nevena Zubcevik: One health is really what has bridged us to the veterinary community and really been able to engage amazing faculty like Dr. Ed Breitschwerdt, who is Bartonella expert at NC State. Dr. Erin Lashnits knits at University of Wisconsin, who’s an infectious disease expert, and specifically for cats and dogs. And, you know, spanning our outreach into the veterinary community so that we can put everybody under that same umbrella. And creating innovation events together working on projects together is a huge advancement in the right direction.

Sofia Osborne: You talked about the learning opportunities available through Invisible International. Are there any other initiatives that the nonprofit is doing that you wanted to talk about?

Dr. Nevena Zubcevik: Yes. So we also host innovation hackathons, Those are kind of all hands on deck opportunities to innovate in the space and everyone is invited. So September 7th, we will be hosting another one of these innovation hackathons, it’s going to be bicoastal, and, you know, we hope to include the rest of the world as well, even though the locations of the physical launches will be September 7, in New Jersey, and then at UC Berkeley, in California, we’re going to be engaging the global community through our partnership with One Health Commission. And so this specific Hackathon is really a phenomenal opportunity. We are going to be using county data for those counties that have data that is easily accessible and a number of counties do in the US where they have done evaluations of their own ticks. And they know in which geo locations which ticks carry which diseases. And this information is available on a county’s websites, some counties websites. 

And so we’re going to be engaging with data scientists, software engineers to then develop software widgets to take that data and plug it into systems that exist already for folks that enable their geolocation, say when you’re hiking, or you’re going to go have a picnic or you’re just you’re gardening or whatever you’re doing in the outdoor space that you can get an alert, that it says you’re entering high tick area. These ticks are carrying these diseases, be mindful, stay in the middle of trail, don’t sit on grass, and then you can have a link that it takes you directly to the curated data portion that says, okay, these are the potential diseases you might be exposed to if you get a tick bite. And then it also gives you ideas of how to prevent that from happening. And so this is a huge, this doesn’t exist right now. But you know, if like, there’s a fire or tornado watch, you will get this kind of alert on your phone. So the mechanisms for this exist, what we’re going to do now is tie that to the county data so that people can get these alerts, so no matter you might be traveling see to Massachusetts from Texas, and you don’t know that, you know, if you sit by the river in the grass, you might get Lyme disease and more. It just looks so inviting and romantic, but you should know that you’re exposed potentially to these diseases. And that’s what we’re going to enable, is work toward that kind of alerting to prevent illness.

Catherine Kinsella: Yeah that sounds like a great program. And it would be wonderful if we could have something like that in Canada as well, sometime in the future.

Dr. Nevena Zubcevik: It’s going to be global. So what we have done in the past is teams formed, you know, we would have people from, you know, the US, Canada, Mexico, Pakistan, working together on the same team on a specific project. So because what we do is even though the launches are in person, that’s just the launch of the hackathon. There will be a three month program that then takes place onLyme. So then we have mentors that support the teams throughout this development piece of the final solution. And then at the end, there’s awards of that 12 week innovation process. So anyone can participate. Anyone can partner anyone can also support by providing financial support and sponsorship that goes to the teams to then increase the award buckets to help design products that hopefully we’ll be able to use for public health prevention.

Catherine Kinsella: And so how can people find out more about all the programs that you’ve talked about today. 

Dr. Nevena Zubcevik: So our website, invisible dot International, so is the main website that hosts all of our events, past events, future events, and the best way is to subscribe to our newsletter, which is on the bottom of our page. And then you can get information emailed to you about every new innovation event, every new module that we produce, education module, or a blog, an educational blog. So that’s the best way to do it is by going to invisible dot International and getting yourself on the mailing list, or periodically visiting our website for changes. And then our direct link to our education website is learn dot invisible dot International. So learn dot invisible dot international takes you to the physician education website.

Catherine Kinsella: That’s great. We’ll add those links as well to the show notes. So thanks very much for joining us today Dr. Zubcevik. And we certainly learned a lot about Invisible and all the initiatives that are going on there.

Dr. Nevena Zubcevik: Thank you so much for having me and thank you for the work that you’re doing to inform the public at large about everything that we’re doing.

Sofia Osborne: Yeah, that was a super interesting conversation. 

Catherine Kinsella: Yeah it was. And I learned so much about the background of Invisible. I didn’t realize they were doing other projects, other than the modules. But one of the things that really stood out for me in that conversation was why they developed, and also the way that they’re collaborating with veterinarians. I found that super interesting – in a One Health perspective.

Sofia Osborne: Yeah I thought the One Health perspective was just something that, I mean, I had never considered before. But when she was talking about it, it just made so much sense for these different types of doctors to be collaborating with each other, because it is a problem that doesn’t just affect us, it doesn’t just affect other non-human animals. But yeah, like it’s also to do with the environment, environmental health. And what she was saying too about just, how she wants people to be able to enjoy the outdoors safely, that was really powerful. Yeah, her own grandchildren and everything. Yeah you could just tell how passionate she is about it. 

Catherine Kinsella: Yeah, and the other thing that just keeps coming to mind is just how important education is for patients and for clinicians, and it’s just – the more opportunities there are to learn, the better.

Sofia Osborne: Absolutely. Well make sure to tune in next time as we engage with more experts from Canada and around the world. 

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