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San Diego’s economy has long been dominated by health care and technology. And for those who work in these collective spaces, the coronavirus is not merely a tragedy. It’s an opportunity.
In recent months, researchers at the University of California, San Diego, and elsewhere have quickly shifted their focus so that life might get back to normal without sacrificing the most vulnerable. In one way or another, they’re offering new digital tools to help transform the way we clean rooms, test and trace the sick and prevent the spread of infectious diseases — not just COVID-19.
The pivot occurred in a matter of days, but the research itself is looking years ahead.
Some of it is promising. Much of it is unproven. And it’s coming whether you care about the privacy and security considerations or not.
Here’s a brief guide to the tools and projects that the coronavirus is spawning. These (and others) will be on our radar as governments and major employers try to move beyond the pandemic.
These little devices sound simple, because they gather only a few points of data. But they would have big implications if they ever went to mass market.
UC San Diego Health, for instance, is piloting a wristwatch capable of monitoring people who have tested positive for COVID-19 but don’t need to be hospitalized. All day and night, it senses and collects information about vital signs, including heart rate and oxygen saturation levels, as well as sleep activity. Patients also fill out a daily questionnaire about their symptoms, using an app.
The lead researcher, Dr. Sujit Dey, a professor of electrical and computer engineering at UCSD, said the point is to alert health care professionals when they need to follow up with a patient remotely so that they don’t necessarily have to come into a hospital.
The data goes into a dashboard that health care professionals monitor. Dey, who directs the university’s Center for Wireless Communications, said his team can’t see personally identifiable information on their end.
Things get more complex in the next phase of the project, though. Dey intends to use machine learning algorithms to understand what a change in vital signs and behaviors means for a patient’s underlying condition — even before the patient is conscious of it. His hope is to develop a wristwatch capable of predicting where one’s health is headed.
It’s easier said than done, of course. But as Dey explained to me, there’s already enough research out there to make accurate predictions in blood pressure. “For infectious diseases, there is no such quantification,” he said. That’s going to require a lot more data.
So at what point should a patient be alerted to the impending change in their own health?
Dey isn’t totally sure. There’s also the possibility that the prediction is wrong — meaning you inform someone that they’re about to take a turn for the worse and they don’t.
That’s a big risk and a bigger conversation for public health professionals and governments, he said. “This is where tech policy and public policy need to come together.”
Scripps Research Translational Institute is also tinkering with wearable COVID-19 devices that can monitor and make predictions, but in a slightly different way.
It’s called the DETECT health study and it has close to 26,000 participants already. But in this case, researchers are looking for subtle changes in people before and after they come down with the coronavirus. They’ll do this with vital signs and surveys.
The goal is to eventually create a visual map of where outbreaks of the coronavirus are occurring in something close to real time, so that people know which parts of town to avoid.
Dr. Jennifer Radin, an epidemiologist and the principal investigator on the project, told me that her team published a report in January using Fitbit heart rate data to predict where influenza was headed next. As it is, the Centers for Disease Control and Prevention already release population-level data on the spread of influenza, but it’s usually weeks behind.
“We lose the opportunity to respond quickly to outbreaks,” she said. “Wearables give us the potential to collect that data on a much larger scale.”
Much like Dey, Radin insisted the platform was secure and private. She said participation was voluntary, people would be anonymized and the information was encrypted.
More than one in the works: A UCSD professor of data science and bioengineering, Benjamin Smarr, is leading the analysis on yet another wearable device that’s being tested nationwide. Relying on a ring, it also aims to identify contagious individuals before they become noticeably sick.
It launched in San Francisco and more than 30,000 people, including health care workers, are involved.
“It’s a chance for us to see how your body is changing long before you do,” Smarr told Stat News.
Also: Earth2.0 wins the prize for most utopian-sounding experiment.
A group of clinicians, engineers, designers and privacy experts at UCSD is constructing a platform where people can willingly share their case information and travel history. “Everyone can help keep themselves safe, reach potential sick contacts and help stop the spread of the virus as a collective,” the website says.
Testing and Tracing Apps
UCSD’s plan to reopen its own campus in the fall is ambitious. Administrators are planning to test some 65,000 people — student, faculty and staff — once a month. It makes sense that a major research institution would leverage its lab space.
Some students who live on campus are already participating. They pick up a clean nasal swab in a container that’s linked to a personalized number. The students then administer the test themselves. One Ph.D. candidate described the experience this way: “It wasn’t nearly as mummy-brain-removal-esque as I feared, but shoving the long Q-tip up into my sinuses wasn’t the greatest.”
There are also a couple apps. One is a barcode reader that’s used to scan the swab container. The other links students to their health records and lab results.
Meanwhile, two teams of electrical engineers are developing their own contact tracing tools for cell phones. One will be used to record the social exposure of people who come into close contact with others who test positive for COVID-19 using Qualcomm’s Bluetooth measurement data and models. The other uses infrastructure provided by Google and Apple. It claims to use wireless signals — Bluetooth, Wi-Fi — plus infrared and motion sensors to monitor social situations and create a personalized risk profile.
Computer scientists in the region are working on other interesting apps, but this one stood out. Some undergrads have updated their ambulance tracing technology used by the Red Cross in Tijuana so that emergency responders can alert hospitals when a suspected COVID-19 patient is in transport.
Not everything is still in the research and development phase in San Diego — although its usefulness is still up for debate. Some private and public entities have begun taking temperatures to stop the feverish from entering their facilities and gambling with other people’s lives.
But they’re not all doing it the old-fashioned way.
The city of Coronado is using a so-called thermometer gun at its tennis courts, skate parks, boathouses and golf courses to gauge the heat emanating from one’s body. The device is touchless, so it only needs to be aimed at the forehead.
The Pala Band of Mission Indians had considered using thermal body scanners to take the temperatures of customers entering its casino. But Doug Elmets, a spokesman, said they wound up deploying thermometer guns at the entrance of the casino and resort near Fallbrook instead because they couldn’t get the scanners up and running in time for the reopening.
Whatever the form, heat-detecting technology has a couple major shortcomings. For starters, it doesn’t account for people who are asymptomatic. Showing a high temperature doesn’t necessarily mean you’re carrying the coronavirus. A temperature reader only helps identify people who should go get tested. It confirms nothing. And it’s not always accurate.
In China, thermometer guns have proven to be an ineffective defense mechanism against the spread of the disease. As the New York Times reported in February, the people using the devices often hold them too close or too far from a subject’s skin, which gives an unusually low or high reading. Air quality might also affect the reading, and there’s no way to know through the gun whether someone has taken medication to suppress a fever. Some manufacturers claim to have very low margins of error.
Still, it’s not hard to image how the use of temperature readers to deny people access to essential places could get messy.
The San Diego County Superior Court resumed some in-person services for people with urgent business last week, requiring everyone to wear masks and keep their distance. At the entrance, Sheriff’s deputies are also using a temperature reader — it looks less like a gun and more like a TV controller — to prevent anyone with a temperature above 100 degrees from coming inside.
“If someone had a fever, but needed a temporary restraining order, we’d have someone help them outside from a distance and then run their papers inside,” Emily Cox, a public affairs officer for the court, wrote in an email.
Deputies, she noted, have the discretion to test another time or use another device if one has been out in the sun a long time. The hope is that someone then seeks out a health care provider to know for sure whether they’ve been infected.
But what about the person who shows a high temperature and refuses to leave? It’s not yet clear how that scenario will play out.
In April, the Westport, Conn., Police Department announced a pilot program with a company claiming its technology could “accurately detect infectious conditions from a distance of 190 feet.” The public pushback was so strong that the city cancelled its plans two days later.
Locally, I know of at least one pandemic-related drone project and it’s far less creepy.
Tara Javidi, a professor at the UCSD Jacobs School of Engineering, is using a consumer drone to sterilize classrooms and offices using UV-C light — which, 10 News reports, has disinfectant properties but poses “challenges” to humans. It’s a known carcinogen that can burn one’s skin, so you shouldn’t be in the same room with it long.
Still, Javidi told the TV station, “we are curious about its effectiveness and we hope that it is effective and it’s helpful, but we want to be very careful not to misinform anybody.”
And finally, speaking of disinfectants …
San Diego has rolled out “EPA registered” technology at the Convention Center-turned-homeless shelter. That includes washable keyboards and antimicrobial tape for doors, handles and other high-touch areas, as part of a donation, Mayor Kevin Faulconer said at a recent press conference. Officials are also using UV-C light to decontaminate keys, cellphones and other items.
Sycuan Casino Resort is going on step further. It’s partnering with another San Diego-based company claiming to make “a self-cleaning antimicrobial surface coating” that is “sword-like” (whatever that means) and “destroys bacteria and viruses on contact.”