Canadian Space Agency astronaut Dave Williams performs a spacewalk on August 11, 2007, during Shuttle Mission STS-118. | SkyNews
Canadian Space Agency astronaut Dave Williams performs a spacewalk on August 11, 2007, during Shuttle Mission STS-118. (NASA)

Doctors in deep space — and how they’ll help on Earth

The Canadian Space Agency is set to release details for a “Deep Space Healthcare Challenge” in an effort to develop space technologies that will benefit not only astronauts, but remote communities on Earth.

The Canadian Space Agency is set to release details for a “Deep Space Healthcare Challenge” in an effort to develop space technologies that will benefit not only astronauts, but remote communities on Earth.

With the challenge not yet fully detailed to the public — you can get updates on the website above — I asked medical doctor and retired CSA astronaut Dafydd (Dave) Williams for suggestions on what to focus on. I know Williams, as we were co-authors on a book, but beyond that, I felt he would be well-positioned to offer some insight on what the challenge should consider, given his 16 years with CSA between 1992 and 2008.

Williams’ administrative roles and duties during his active astronaut years include being director of the space and life sciences directorate at the NASA Johnson Space Center, a hub of astronaut training. He flew twice in space, focusing on medical experiments during STS-90 Neurolab, and spacewalking three times during STS-118, among other duties. He also was an aquanaut for two underwater NASA Extreme Environment Mission Operations (NEEMO) multi-day excursions in Florida, NEEMO 1 and NEEMO 9, the latter as commander.

SkyNews: Why is a challenge like this important in terms of boosting Canadian research in space medicine, including what the CSA terms “medically isolated populations” on Earth?

Williams: Space medicine is unique in its goal to provide medical care to those living and working in partial and microgravity environments. To date, humans have explored low Earth orbit and the Moon, but they will become a spacefaring species as they go farther and stay longer at other destinations in our Solar System. The distances separating these astronauts from Earth will be huge, requiring the development of new technologies and clinical capabilities to provide high quality medical care at a distance.

Whether that distance is a few thousand kilometres to a remote community in northern Canada, or a few hundred thousand kilometres to a lunar habitat, the solutions developed for space medicine will assist in improving the delivery of health care to Canadians who are isolated based on living in a remote community, or due to limited mobility. This challenge helps develop innovative solutions that will both improve remote medical care on Earth and in space. It will also help create opportunities for new companies in Canada.

SkyNews: What kinds of problems should we be thinking about in deep space health care and how could the challenge help?

Williams: Broadly speaking, the goal of health care is focused on prevention, diagnosis and treatment of illness or injury. Preventive strategies can be implemented anywhere, but are often limited by the social determinants of health in disadvantaged communities that do not have the resources of other communities. Many of those communities are found in rural or remote locations, further increasing the challenge of remote medical care.

Closed-loop space habitability technologies to provide pure potable water, waterless toilets or eco-friendly heating and cooling systems are all part of potential space spinoffs that can provide solutions for remote communities. Deep space health care [also] exemplifies the challenge of isolation in diagnosing and treating clinical conditions. Unlike living on Earth, where it may be possible to communicate with isolated communities by voice and possibly video, the large distances of space increase the latency of voice communication to a point where it precludes real-time virtual care.

Enhancing the clinical autonomy of crews is critical to deep space travel. On Earth, it can prevent the need to transport sick patients long distances away from their communities to access care. Another goal is to develop artificial intelligence technologies to monitor health, detect the early onset of illness and assist with diagnosis of disease. For example, the rapidly increasing availability of body-worn smart sensors and the concept of using them to monitor health is a significant opportunity to intervene in the early stages of an illness.

Virtual monitoring of biomedical data — connecting artificial intelligence-based systems with real-time data from such sensors — could enhance the care of those in geographically isolated communities or those who are socially isolated. More broadly, augmented reality, mixed reality and virtual reality devices can improve care in isolated communities in space or on Earth, by assisting local care providers in treating ill or injured patients.

SkyNews: If you could briefly pick two to three outstanding questions in space medicine that we’ve uncovered from the International Space Station and require further study for Moon or Mars missions, what are they?

Williams: The first is health maintenance. What are the protocols needed to prevent deleterious or harmful body changes during the microgravity phase of deep-space spaceflight, and what partial gravity technologies are needed for health maintenance on other planets?

The second is inventory management of medications and clinical supplies. What approaches can be developed to provide in situ or local manufacturing as needed, or regular resupplies to ensure crew autonomy?

The third is designing for prevention — radiation protection is a good example, or dust management during surface extravehicular activities or spacewalks on the Moon and Mars. This goes along with developing new technologies to enhance autonomous clinical capability in detecting and treating illness and injury. Even physician astronauts will experience loss of clinical skills due to infrequent use.

SkyNews: How will the nature of space medicine change between ISS and Moon/Mars missions?

Williams: Lunar space medicine will be the testbed and proving ground for new technologies to enhance crew autonomy. Missions will include virtual mentoring and consultation, both of which can be used to complement new tools to enhance crew autonomy. The Moon will also give space medicine clinicians a better understanding of the range of medical issues that astronauts will face, living for longer periods of time in a partial gravity environment. Environmental factors such as radiation and dust exposure will need solutions that can be tested and validated before human missions to Mars.

SkyNews: Where do you think the Canadian community will go next in terms of researching deep space health care in say, the next five years, and how will this help with the planned Artemis human Moon-landing program?

Williams: As CEO of Leap Biosystems, I am excited about the prospect of Canadian companies participating in the development of technologies to enhance crew autonomy in space that can be used to enhance the delivery of healthcare in remote Canadian communities and improve the lives of Canadians. Space exploration historically drove development of technology in many areas of clinical care, including remote monitoring physiologic data as seen in the case of the Apollo crews and Skylab space station astronauts in the 1960s and 1970s. Many of these ideas were incorporated into critical care monitoring technologies.

SkyNews: Is there anything else you want to add?

Williams: Going to space gives us a broader perspective on living together on Earth. Scientists and clinicians throughout the world working together collaboratively helped all countries understand the challenge of the recent COVID-19 pandemic, share protocols to treat critically ill COVID patients, and find and share preventive vaccines to help reduce the impact and spread of illness. As we go forward exploring space, the need for new technologies and approaches to providing care at a distance will benefit from the same global collaborative approach — and it will be exciting to see Canada playing a leadership role in this important area.

This interview was edited and condensed.

This biweekly column by Canadian science and space journalist Elizabeth Howell focuses on a trending news topic in Canadian astronomy and space.

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