In this COVID-19 era, the need for health and care systems to become agile and change is very real.

As COVID-19 sweeps around the world, we are starting to see countries exit from lockdown, others introducing more stringent lockdown and others relying on the resilience of their health and care systems to allow them to make changes which are more discreet and focused on trying to avoid the economic and political effects of more stringent approaches.

The explosion of data points

Health and care systems are having to adopt to this new world and suddenly, the old ways of working which relied largely on an analogue world and the bricks and mortar of the ‘office visit’ are starting to look more outdated and out of step with the environment they are working within.

There is an interesting parallel here. Human Coronavirus are a group of viruses that change small parts of their genetic code as part of their life cycle. Thus, they mutate as a matter of course. The challenge is for our health and care systems to also be able to “mutate” at pace and scale. We have never seen this happening before but happening it is, with digital transformation, the use of medical technological devices, the application of AI in the care of people becoming more commonplace.

This is also being accompanied by other significant changes, particularly around the deployment of a whole gamut of new devices and products including wearables which together with the dissemination of a 5G infrastructure and the very sudden increase in take up, are leading to a veritable explosion in the number of data points which are going to become available to different health and care systems globally.

It is now accepted that these changes are here to stay. Not only is COVID-19 a pandemic which is unlikely to vanish with the summer sun in the northern hemisphere, but there is a real urgency to develop the insights we need to deploy AI and improve and personalise the care of people who will be affected on the second wave of contagion which is likely to creep up on us in the autumn above the equator. This means that the reliance on medical technological solutions will increase and increase at a pace and scale we have not witnessed before. This has many potential entry points in the best management of COVID-19 pandemics. From the monitoring of mild cases at home, to the personalised care of patients post discharge from hospitals, at both ends of the COVID-19 journey. To this can be added the better management of contact tracing, and more systematic and technologically enabled monitoring of workforce which is already a scarce resource.

There is also another and often forgotten, dimension. The monitoring of existing non-communicable diseases, largely displaced as the central activity of health systems who are totally focused on managing the pandemic, will require new solutions and the potential here for technology and digital solutions to enable better self-care is considerable.

It is therefore really unlikely that this is a temporary phase. The post COVID-19 world in the 2020s is going to be very different to what came before it.

Deploying technology at scale

So, what are some attributes which will make some devices stand out?

Obviously, they need to fulfil a tangible need and be “good enough” in terms of accuracy, reliability, safety and reproducibility to be deployed at scale. This is largely self-evident but there are five other aspects of how they are deployed which may appear to be less obvious but in fact are equally important.

1. They need to fit within a governance structure so there is clarity around who is responsible for monitoring and action when required. This has in the past been all too often an afterthought. It is all too easy to get enticed by exciting technological advances and deploy them, because it is possible without spending the requisite time ensuring they fit within a clinical workflow and that the workforce implications around their deployment is managed with the same rigour as any other aspect.

2. They need to be built into existing clinical pathways and flows – the technologies that succeed will be the ones that assist clinical decision support and preferably are “baked into” EMRs.

3. They need to be personalised. Ideally, they need to incorporate existing data to provide data which is relevant to the individual and also relevant to the consultation. The age of metadvice is upon us now in this era of precision health and precision medicine.

4. They need to have interoperability built into them via open APIs. Unless one can easily and effortlessly integrate them within an EMR, it is unlikely they can form part of the system into which AI can work its magic and develop the insights we are desperate for to better manage subsequent waves.

5. They must be secure. Cybersecurity takes on an even greater importance and prominence in the age of pandemics.

Thus, the future for med tech is rosy. First movers and fast followers will reap the benefits of easier adoption and incorporation into the mainstream as long as they are true to these principles.

Read the article here: The future of medical technology devices in the time of COVID-19

Smart cities can help us combat the coronavirus pandemic. In fact, in a growing number of countries, smart cities are doing just that. Governments and local authorities are using smart city technology, sensors and data to trace the contacts of people infected with the coronavirus. At the same time, smart cities are also helping in efforts to determine whether social distancing rules are being followed.

On the one hand, such applications of smart technology are exciting and invaluable, particularly in nations that have managed to keep Covid-19 case numbers relatively low, such as South Korea.

But on the other hand, the use of masses of connected sensors makes it clear that the coronavirus pandemic is–intentionally or not–being used as a testbed for new surveillance technologies that may threaten privacy and civil liberties. So aside from being a global health crisis, the coronavirus has effectively become an experiment in how to monitor and control people at scale.

One recent example of this comes from the University of Newcastle, which last week reported on how they’ve been using an array of smart city technology to monitor the effectiveness of the UK government’s social distancing measures.

In particular, the team at the Newcastle University Urban Observatory have analysed more than 1.8 billion pieces of observational data collected in the city of Newcastle over the last few years, including since the UK nationwide lockdown began. Much of this data comes from pedestrian sensors, which monitor pedestrian flows in two directions every hour, and which the team compares against data from 2019.

Analysing this data, the Newcastle University team found that pedestrian traffic has fallen by a massive 95%, in comparison to the usual annual average. Likewise, they’ve also made use of automatic number plate recognition (ANPR) cameras, and discovered that vehicle traffic has declined by around 50%.

The researchers have also produced models capable of measuring the distance between pedestrians. Making use of a traffic light indicator system, their algorithm is able to anonymously identify and label people who maintain safe distances, while flagging violations.

On its website, the Newcastle University Urban Observatory says it works with “government” and “local authorities” to “make our cities smart.” Dr Luke Smith, a lecturer focusing on data-centric approaches to civil engineering, tells me that the Observatory has provided a range of data to the UK government during the coronavirus pandemic. This includes pedestrian data to the Department for Transport (prior to the nationwide lockdown), as well as vehicle flow and car park data (since the lockdown). The Urban Observatory has also had several discussions regarding using CCTV cameras to measure physical distance between people.

The UK isn’t the only country to harness smart city technology like this in the fight against the coronavirus. In South Korea, the Ministry of Land, Infrastructure and Transport, and the Ministry of Science and ICT, have been using a system called the Smart City Data Hub. The two governmental departments use this platform for the purposes of contact tracing. Essentially, it allows them to analyse and monitor data collected from cameras and other sensors, so as to identify who a known coronavirus patient had recently come into contact with.

The South Korean government has been using the Smart City Data Hub since March 16th. It’s hard to say how much of positive impact it has had on stemming the transmission of the coronavirus, but given that South Korea has witnessed a doubling of cases over the past 41 days (while the likes of the US and the UK are doubling cases every eight or nine days), the country has clearly been doing something right.

Again, other countries are turning to smart cities and smart city technology in similar ways. Various Indian cities have been making use of smart city tech to contact trace and also to monitor people under quarantine. In Pimpri-Chinchwad, Pune, where some 1.72 million people live, the local authorities have called upon Indian firm Tech Mahindra to update the capabilities of the existing smart cities infrastructure it already provides the area.

In particular, Tech Mahindra’s smart cities platform can now make use of traffic cameras to monitor people’s movements. In addition, it’s now using drones for aerial surveillance and is in the processes of rolling out a geo-fencing solution to make sure that patients are restricted to a certain area. Its platform even provides real-time info on when stores and pharmacies are open.

According to officials, such smart city solutions have helped India curb its coronavirus numbers.

“Using tech along with community-led initiatives […] has helped contain the growth in numbers,” said Pimpri-Chinchwad Municipal Corporation commissioner Shravan Hardikar, speaking today to India’s The Economic Times.

But as effective as the utilisation of smart cities appears to be (it took 21 days for the number of coronavirus cases in Pimpri-Chinchwad to double from 12), the ramping up and expansion of smart city capabilities raises some serious questions for the post-coronavirus future. Because after having developed the capacity to monitor individual and group movements, as well as the ability to trace our contacts, what’s to stop governments from using such capacities to monitor us all under more normal circumstances? What’s to stop them from using smart city technology to monitor and suppress protests and political dissidents?

Already, figures such as Edward Snowden have warned that the coronavirus pandemic could end up giving governments invasive new surveillance and data gathering powers. Speaking via video-link at the Copenhagen Documentary Film Festival a couple of weeks ago, Snowden suggested that new powers may remain in place after the pandemic has subsided.

“Five years later the coronavirus is gone, this data’s still available to them–they start looking for new things,” Snowden said. “They already know what you’re looking at on the internet, they already know where your phone is moving, now they know what your heart rate is. What happens when they start to intermix these and apply artificial intelligence to them?”

Last week, Apple and Google announced that they’re collaborating on a contact-tracing app. Meanwhile, countries such as the US, Singapore, France, China, and the UK are developing or deploying similar apps. So when combined with the emergence of smart cities capable of monitoring our movements, the long-term implications of the coronavirus pandemic for privacy and civil liberties becomes deeply worrying.

Soon enough, a significant number of nations will be harnessing smart technology to monitor vehicle and pedestrian traffic, to check whether we’re observing social distancing rules, and to trace our contacts. And after the pandemic, such technology could end up being used to monitor and nudge human behaviour in general. Needless to say, those doing the monitoring and nudging may not always have our best interests at heart.

Governments–for example, the South Korean government–have offered assurances that the smart technology being rolled out will be used only during the coronavirus outbreak. However, assurances are not legal guarantees, and it’s hard to image governments giving up new surveillance capabilities without them facing massive opposition and protest. This is particularly the case when the pre-existing surveillance activities of, for example, Britain’s GCHQ have already been found to violate human rights, yet little has been done in response to curb such activities.

However, while there are dangers, Newcastle University’s Luke Smith suggests that certain technologies will be safer than others.

“I think we should be quite relaxed about anonymous and aggregate transport statistics,” he tells me. “I’d like to see a more coherent national transport data strategy post-pandemic, where high-level data on the origins and destinations of journeys across all modes of transport are published as routine.”

Smith notes that this could require legislation to be conducted at national levels, but that it would be feasible, since much of the necessary data is already out there. That said, he does affirm that technology used to monitor individual movements should be treated with a healthy dose of caution.

“There are serious risks associated with tracking individual movements,” he says. “As the mobility reports released by Google show, mobile phone data can characterise the purpose of journeys in addition to volumes. As anyone that uses location services has probably noticed, it isn’t always accurate.”

As Smith adds, what’s needed is for a serious debate and discourse on data collection to take place once the coronavirus pandemic has ended. Indeed, because if we don’t have such a debate, we may end up replacing an overt health crisis with a more insidious privacy and civil liberties crisis.

Read the article here: How Smart Cities Are Protecting Against Coronavirus But Threatening Privacy