| Daily Briefing

Can we detect Covid-19 with smartwatches—or rings, or patches?

Amid a surge in new coronavirus cases, scientists are turning to wearable devices—including smartwatches, rings, and patches—to detect and track new cases of Covid-19, the disease caused by the virus.

Telehealth primer: Wearables 101

Here are six innovative ways researchers are employing wearables to identify and combat Covid-19.

1. A Covid-detecting patch

Northwestern University has developed a patch—designed to be placed at the dip on the front base of the user's neck—that can measure temperature, heart rate, body motions, chest wall movements, and respiratory sounds that indicate a cough.

According to John Rogers, who is part of the team that developed the patch, "irregular respiratory and cardiac activity" is common among Covid-19 patients admitted to the hospital. In addition, patients' coughing rate can help determine if a wearer has Covid-19, as well as the severity of the infection. According to Rogers, some Covid-19 patients had "coughing rates that reached an average of 100 per hour."

2. Fitbit

Fitbit has a two-fold aim with its fitness band technology: contribute to regional warning systems currently in development to detect outbreaks of Covid-19 and develop a warning feature for individuals by tracking the confluence of symptoms that may serve as an early sign of the disease.

Fitbit CEO James Park said the feature will hopefully be able to tell users to quarantine "one to three days before … symptoms start," and then, if symptoms do appear, to confirm whether they're infected with the novel coronavirus with a test. However, the feature—which may designate risk through green, orange, and red warning labels—might require regulatory approval before showing up in the Fitbit app.

But to take advantage of some of the disease-detection work the company already has in development, Fitbit added a Covid-19 tracking study into the app. So far, the study has 100,000 participants, 900 of whom have tested positive for the coronavirus—a large enough cohort to enable researchers to review the Fitbit data from before the positive test results came in and look for early warning signs of infection.

According to the Wall Street Journal, the study is already finding patterns of fluctuations in heart rate, respiration, and other key metrics days before symptoms hit.

The company also has some devices that track users' blood-oxygen levels, and it's currently working to provide a full read out of that data to users. While Eric Topol, a professor for Scripps Research, said the metric was not necessarily helpful to track Covid-19, it can be helpful for those who have Covid-19 to gauge the severity of their illness, as a blood-oxygen level in the low 90s or 80s could be a sign of severe Covid-19 symptoms.

3. Garmin

According to Scott Burgett, director of health engineering for Garmin, Garmin does not yet have a feature that warns individual users of coronavirus infection. However, he noted that Garmin is participating in several studies on how wearables can contribute to Covid-19 tracking, and users can always monitor their own health data as tracked by their Garmin devices to spot early warning signs.

"The more you know about your body and what your 'baseline' is, the more you're able to tell if something is off," Burgett said. "Because Garmin lets you see your health stats over time, it is easy to track trends and notice deviations."

For instance, Garmin has developed a few wearables that detect, among other metrics like heart rate, blood-oxygen levels—a metric for assessing the severity of Covid-19 symptoms.

4.The Oura ring

The Oura ring—a smart ring that tracks activity, sleep, temperature, pulse rate, and heart rate—is already being used by some to analyze the wearer's health data to detect if he or she is exhibiting symptoms of Covid-19.

For instance, NBA players in the Orlando, Florida, "bubble"—where they are currently living and playing in isolation—are using the ring to monitor their health for potential infection. According to the Journal, if the tracker reports that certain data points have hit key levels, authorized personnel can notify the wearer to undergo coronavirus testing.

Separately, researchers at West Virginia University Rockefeller Neuroscience Institute have been assessing whether the Oura rings can spot coronavirus infection—and early results from their research suggest the devices can detect some Covid-19-related symptoms up to three days before the user experiences other symptoms.

Oura Health CEO Harpreet Singh Rai says scientists are still running studies on the ring, but added that if it proves to be effective, the company might include a function that alerts users of potential signs of Covid-19.

5. Scripps' early detection system

Topol is developing a system—called the Digital Engagement & Tracking for Early control & Treatment (DETECT)—that relies on wearables to track and detect coronavirus outbreaks before they spread.

A trial in March found that the system successfully predicted small regional outbreaks by detecting a rise in volunteers' resting heart rates, a symptom that is often an early indication of Covid-19.

According to Topol, the system provides an alternative to mass coronavirus testing. "There's no way to get real surveillance with just testing," Topol said. "We can't do it frequently enough on a mass scale. But this you can do on that scale and you're going to get a continuous signal."

However, the system still faces one significant hurdle: It currently has only 40,000 participants—far short of the hundreds of thousands or millions needed to provide outbreak warnings nationwide. "To do it well, we need pretty dense coverage," Topol explained. And although Fitbit and pharmacy retailers, such as CVS and Walgreens, have helped promote the system, it's still not enough.

6. The SimpleSENSE health monitor

Hackensack Meridian Health and Maimonides Medical Center are collaborating with Nanowear to test a cloth-based wearable technology, called SimpleSENSE, to track Covid-19 patients' conditions.

The wearable contains nanosensors that can pick up physiological and biomarker changes that can indicate that a patients' condition is worsening and alert hospital staff accordingly. Physicians can also use the wearable to remotely track patients' vital signs, including temperature, respiration and lung volume, and blood pressure.

Overall, the wearable is able to collect 120 million data points per day for each patient and then transmit that data to clinical staff, Becker's Hospital Review reports.

Sameer Jamal, a cardiologist at Hackensack Meridian Health who is involved in the project, said the device could provide physicians with "an exponential amount of relevant data metrics about the heart and lungs … that should ultimately enable us to triage lower risk patients and stratify high risk patient" (Stern, Wall Street Journal, 7/28; Pressman, Fortune, 7/19; Drees, Becker's Hospital Review, 7/23).







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