Last week, on September 29th, 2021, SpaceTech Analytics hosted a virtual conference on the issues associated with health in space. Moderated by space consultant and analyst Rand Simberg, a distinguished panel of ten experts in the field, from both NASA and private industry, provided a range of viewpoints on the critical issues of keeping people not just alive, but healthy, both in orbit and on other planetary bodies.
While there were many common themes among the presentations, each speaker brought a unique perspective on the topic. Several described the hazards of flight into deep space, and specific deleterious health effects of long-term exposure to the space environment of weightlessness, radiation, and non-standard atmosphere. According to Dr. Shawna Pandya of Orbital Assembly Corporation, and as people who have been watching the television series The Expanse know, “Space is trying to kill you.” Also discussed were the psychological issues of isolation and confinement on long interplanetary missions.
A more down-to-Earth topic was dealing with motion sickness in parabolic flight, in which the aircraft doesn’t leave the atmosphere, but offers about two gees in a pull-up maneuver, then half a minute of weightlessness at the top of the trajectory, and then two gees again on the pull out. With commercial companies offering the service for both recreation and research, there has been a great deal of progress in ameliorating nausea in this experience since the old days of NASA’s “Vomit Comet” KC-135, both with drugs, and by “easing” into the weightless maneuvers with simulated reduced gravity (as on the Moon or Mars) first.
The problems of medical care millions of miles from Earth were addressed, in terms of what a space doctor should have in her medical bag, the need for better integration of AI into space medicine, the requirement for autonomy, with use of VR to help both physicians and lay people provide proper care in emergencies, and the need for a holistic, integrative approach to health in space as it should be on Earth.
With the era of space settlement perhaps on the near horizon, the problems of childbirth in orbit and on other planets were discussed by Egbert Edelbroek of Spaceborn United, an organization that is performing research on this topic. Unfortunately, because we’ve never put a centrifuge on the ISS (or better yet, actually built a rotating gravity lab in Low-Earth orbit) we don’t know if a rodent can safely conceive and gestate in the partial gravity of the Moon or Mars, let alone primates, let alone humans. This data gap will have to be filled before people should ethically attempt to create and raise families in these new gravitational environments to which we didn’t evolve.
It was noted that the lack of data is a problem beyond gestation in partial gravity. Only a few hundred humans have gone into space, and for the most part they have been excellent physical specimens in the form of selected astronauts and cosmonauts. Beyond that, the majority of them have been men. So we have a data lack for not just women in good condition, but for normal people of both sexes. But with the advent of orbital tourism, and the coming first flight of SpaceX’s Starship/Superheavy, which is expected to dramatically reduce the cost of getting to space, those are the kind of people who are going to soon be going en masse. This is both a problem and an opportunity, because we are going to soon have the potential for a lot of health data, if we can meet the challenge of harvesting it while minimizing hassle and protecting the privacy of people who are paying their own way for a thrilling space experience.
One of the most fascinating aspects are the parallels between the apparent effects of long-duration missions in orbit, and of normal aging on Earth, a theme that recurred with several speakers. That is, the space environment seems to prematurely age us though, fortunately, returning to Earth has rejuvenating effects. As Jim Keravala of Offworld put it, "One of the obvious synergies is that the pursuit of longevity medicine, and longevity strategies in particular, terrestrially, has so much overlap with the pursuit of mitigating space-medical strategies that...if we solve for long-duration space habitation, then we are a long way toward solving longevity in both terrestrial and extreme environments, and vice versa, because the pathologies and mitigation strategies are extremely coincident."
While the prospect of therapies that can help with space maladies could offer rejuvenation to earthlings is obviously almost unimaginably huge, there are other benefits of space research that can be brought back to Earth. Dr. Liz Warren, of the International Space Station National Lab, described experiments that are being performed there, with “cell chips” and “organoids,” that can mimic human organs for the purpose of rapidly researching effects of new drugs, bringing them to market much sooner than with actual human trials that can take years. 3D printing of organs goes much better in weightlessness, eliminating the need for scaffolding required to help fight the gravity of Earth. We are close to being able to make research samples by using the space environment, and ultimately, it could result in the printing of organs with an individual’s DNA in orbital factories, ending the problem of transplant rejection. The company SpacePharma is planning flights to the station in the next few months to test potential therapies for neurodegenerative diseases like Parkinson’s, Huntington’s, and even Alzheimer’s, as well as prion-based ones. There was even a presentation on taking advantage of the space environment for treating mitochondrial diseases, such as Leigh’s Syndrome, by putting the patient in a reduced-oxygen setting. Ultimately, with reduced launch costs, there may not just be factories in orbit to produce life-saving and life-improving treatments, but space hospitals.
It is an exciting period in the field of space technology, the most exciting one in fact since Apollo, and almost certain to soon surpass that. But as this conference showed, perhaps one of the most exciting sectors, and underappreciated one is space medicine. Expect to see a lot more like this.