Flattening the curve

The current pandemic is a battle of technologies. On the one side is a complex, non-living biomolecular compound – a virus – capable of the archaic yet highly sophisticated genetic technology of data storage, host infection, and parasitic replication. On the other side, there’s us, who, too, have a vast technological arsenal at our disposal that builds on age-old societal strategies, such as refraining from physical greetings, physical distancing, and quarantining. Our medical technologies, including drugs, genetic testing, and artificial respirators continue to improve year on year. And since the dawn of the digital era, we’ve had a new category of technologies: digital technologies and, subsequently, data. These, we’re rolling out and testing for the first time against a global pandemic.

What the post-pandemic world ends up looking like will depend to a large degree on how successfully we wield this newest arrow in our quiver. To understand its importance, simply imagine the pandemic without the internet and the myriad innovations it spawned: smartphones, the cloud, the Internet of Things (IoT). Without instant messaging, video calls, and social media, lockdown would have been more socially isolating, and home office far less productive, perhaps even pointless. And on the medical front, we would have had to make do without our growing knowledge base and our ability to tease out insights in real-time from statistics that health authorities put out. Our ability to manage scarce resources, develop treatments, and bring a viable vaccine to market would be handicapped.

One thing is certain: for all the benefits they’ve so far brought to our fight against COVID-19, we’re still far from using digital technologies to their full potential. For one, the gains they can deliver are tied to their levels of adoption. And while they are sufficiently widespread to enable many applications, such as digital contact tracing, adoption is still too low for these applications to play any more than a supporting role. At the same time, scaling up adoption to sufficient levels will quickly use up available wireless bandwidth. And because the data that the digital technologies capture and process are stored in separate systems that interface poorly with each other, much of the insights they hold remain out of reach. Connecting datasets would, however, increase their value to hackers, raising the demands on data security and privacy.

“For all the benefits they've brought to our fight against COVID-19, we're still far from using digital technologies to their full potential.”

Still, the promise digital technologies have shown so far is clear, as is their potential for helping us combat the pandemic and adapt to the new reality that awaits us once we’re over the hump. From optimizing detection, diagnosis, and follow-up to enforcing social distancing and enabling contact tracing, all the way to helping us keep the economy and our social lives going, digital technologies could become a saving grace in this pandemic. And, if we play our cards well, lessons learned this time around could prove invaluable in future calamities that befall us.

Detection, diagnosis, and monitoring

It’s a little-known fact that artificial intelligence was the first to send out an alert that something was brewing in the Chinese Wuhan region, and that it could spread from there. As reported in WIRED, a Canadian health monitoring platform, BlueDot, beat both the World Health Organization and the US Centers for Disease Control and Prevention to the punch by about a week. Fast-forward almost a year, and dozens of technological applications to detect, diagnose, and monitor the disease have emerged.

the first sign of symptoms, patients have multiple communication channels at their disposal to seek advice on next steps. While the precise mix of channels depends on their location, they typically include standard telephone helplines, virtual video consultations, and AI-powered chatbots. National health authorities and local healthcare providers, media outlets, and tech giants have also set up online information portals presenting official recommendations and up-to-date information on the outbreak. In short, thanks to the abundance of communication channels, those seeking information can find what they are looking for.

Countries that had been exposed to highly contagious and lethal viruses in the recent past were quick to respond by setting up countrywide detection, diagnosis, and monitoring infrastructure. A number of Asian countries that had set up contingency plans in the wake of the SARS outbreak in 2003, the H1N1 influenza outbreak of 2009, or the MERS outbreak in 2015, mounted a fast response. In Korea, for instance, drive-thru COVID-19 testing centers were quickly set up across the country, delivering results only hours after the nose swab was conducted. Transparent communication and an online tracking system of those infected helped contain the virus. The successful responses in Singapore, Hong Kong, and Taiwan are rife with lessons for Western countries.

“Countries that had been exposed to highly contagious and lethal viruses in the recent past were quick to respond by setting up countrywide detection, diagnosis, and monitoring infrastructure.”

To assess the virus’s impact at the city-level, researchers have turned to a foul-smelling proxy. Sewage, which has previously been analyzed to estimate such things as recreational and medicinal drug consumption, contains genetic sequences stemming from the coronavirus. The concentration detected can then be used to estimate the actual infection rate of the local population. These data can be fed into epidemiological models to make predictions of where the next hotspots might be and help to efficiently allocate medical resources.

But now that millions of people have contracted and largely recovered from the disease, an alarming trend is coming to light: a significant percentage of recoverees continue to show symptoms long after the peak of the infection has passed, from fatigue to headaches to shortage of breath. Mobile health applications present a valuable tool to follow the progression of the disease once the initial acute phase of the virus is over. And in August, the MIT Technology Review reported on a group of “COVID long haulers,” people with lingering health problems stemming from COVID-19 infection, who got together using electronic messaging platforms to collect data and study their condition themselves.

Social distancing and contact tracing

Viruses have a host of strategies to spread from one human to another. In the case of COVID-19, the main pathway of contagion is via airborne transmission, for instance via droplets that are sprayed out with a cough. What makes it uniquely complicated to rein in, however, is its capacity to spread pre-symptomatically. Research shows that among the most effective means of slowing the spread of the disease is wearing a face mask in public. It might disappoint tech enthusiasts to learn that the combination of physical distancing, quarantining, and contact tracing using analog solutions were already relied on in some form half a millennium ago, when syphilis, the bubonic plague, and other pests ravaged continental Europe. But today’s wireless technology is making their effective implementation simpler and more efficient.

Enforcing physical distancing is up to each of us. But for employers that don’t want to take risks, technological tools can help ensure that their employees are following the rules. Polte, operating out of the US, has, for instance, developed a 4G LTE or 5G lanyard that sends out an alert when employees come too close to each other, while also giving them the possibility to report unsafe working conditions to their employers with the push of a button. According to a report by CNBC, Amazon has tested a device featuring a LED light and an audio system that signals an alert when workers are too close to each other. And companies eager to limit liabilities are using AI-powered image analytics to show that rules are being followed.

“What most contact tracing apps have in common is that they use Bluetooth technology to monitor and record the proximity and (anonymized) identity of nearby users.”

But if there is one area where IoT technology has been in the limelight, it is contact tracing. While analog contract tracing becomes impractical when too many people are affected, digital contact tracing, typically using a smartphone app, actually improves as the population size grows. In countries such as Singapore, where the use of contact tracing apps was strongly encouraged by the government, and in Korea, where private developers enhanced the functionality of the government’s official contact tracing app, adoption levels were high, potentially contributing to the more successful pandemic response when compared to many European and American countries.

What most contact tracing apps have in common is that they use Bluetooth technology to monitor and record the proximity and (anonymized) identity of nearby users. If one user is diagnosed with COVID-19, all app users having spent too much time in their proximity are informed that they are at risk of being infected, asked to self-quarantine, and requested to have themselves tested. Where the apps differ is in how the data is stored, and who has access to it. Some countries have favored a centralized approach with more control, while others have adopted a decentralized approach that gives up some control in exchange for increased privacy and confidentiality.

Keeping society and the economy going

Should we focus on stopping the virus or on saving the economy? It’s a question that cities, states, and countries have been asking themselves since the early days of the pandemic. But what if that’s the wrong question? According to a Bloomberg article published in June, countries like Sweden, and US states including Arizona, Arkansas, and South Carolina, which loosened their lockdowns in a bid to save the economy, actually fared worse than those that kept restrictive measures in place for longer. Rather than it making it a choice between one or the other, the focus should be on finding ways to rein in the pandemic while minimizing long-term harm to the economy and, ultimately, adapting to a new normal, which just might involve finding ways for the economy to thrive despite it. Here, technology will, no doubt, play an important role.

In fact, it already has. If you are reading this, it’s likely that you, too, spent several weeks or months working from home earlier this year. It turns out that, at least for white-collar workers, being physically present at the workplace is much less essential than previously assumed. By harnessing virtual meetings, online access to corporate servers, and collaborative work tools, productivity-losses have been minimized. Not only that, in many cases, remote work has led to savings, with lower occupancy in the office, less travel, and almost no conferences or other events. According to the World Economic Forum, many of us may never return to our pre-pandemic habit of driving to and from the office for our daily nine-to-fives. The office won’t fade into oblivion; its role, however, will not be the same as before.

But the situation was different for white-collar workers and medical professionals – the “essential” workers who were regularly applauded by the rest of us during the lockdown. In hospitals, factories, warehouses, supermarkets, work continued, with more or less stringent measures in place to protect workers. Anticipating the new normal, industries are moving to automate more and more of their processes to better deal with worker shortages caused by the pandemic and future crises. In a survey by McKinsey, nine out of ten questioned were planning to grow their in-house digitization talent, outlining planning challenges (e.g. in sourcing, supply chain management), operational challenges (e.g. in enabling remote work, protecting the workforce, increasing efficiencies, improving quality), and delivery challenges (e.g. in logistics, warehousing) as their main target areas. And, while the growth of IoT device shipments has slowed, unsurprisingly, shipments of IoT devices for the healthcare sector have not.

“While the growth of IoT devices shipments has slowed, unsurprisingly, shipments of IoT devices for the healthcare sector have not.”

A dress rehearsal for the next crisis

The result is a dramatic acceleration in preparedness, on all fronts, for the next waves of this pandemic – or for new pandemics that are still in store. At the time of writing, we are still fighting fires, responding to increases in cases by tightening restrictions, from limiting crowd sizes to extending the use of face masks to ever more scenarios, and then loosening them again when numbers subside. Rinse and repeat until enough people have gained immunity to stop the spread of the virus, either by having been infected or thanks to a vaccine. But moving forward, governments, healthcare workers, and businesses, who have been focused on responding to the pandemic, will be forced to direct efforts at adapting to it.

Judging based on the successful responses to the current pandemic on the part of countries that were most traumatized by past ones – SARS, MERS, H1N1 influenza, etc. – lessons learned the hard way have a good chance of
sticking.