Mobile Health Technologies: Game Changers in the Fight Against COVID-19?

Devices already in market could track the coronavirus, but privacy is a concern.

(Image courtesy of Imgix.)

(Image courtesy of Imgix.)

The deployment of mobile wireless technology for health purposes, or mHealth, may prove to be a powerful tool in the fight against COVID-19.

A major study examined 27 wearable devices—that could measure heart rate, skin temperature and other health indicators—to determine how effective they were in detecting and monitoring COVID-19 in their users. These included skin patches, sensors embedded in clothing and devices worn on the wrist.

The study found that adhesive sensors placed directly on the skin performed better than wrist-worn sensors or devices attached to clothes. Devices in consistent and direct contact with the skin are better at tracking cardiovascular functioning and could even record symptoms such as coughing and sneezing. Also, these sensors could monitor the lungs of patients with respiratory difficulties.

One limitation, however, is that they can’t collect information about the body as a whole and are limited to readings taken on just the areas where they are attached. Still, their effectiveness is encouraging to health professionals.

(Image courtesy of IEEE.)

(Image courtesy of IEEE.)

These mobile devices could be used to monitor COVID-19 patients and predict the progression of the disease. These individuals are usually told to self-quarantine at home or go to a community treatment center for monitoring. However, a recent report shows that of those patients, about 2 percent develop more severe coronavirus symptoms—and that deterioration can happen quite suddenly, requiring hospitalization. A wearable health monitor could help identify remotely when a person’s health takes a turn for the worse, allowing for earlier medical intervention when needed and improving the patient’s chance of recovery.

The same concept could be applied to health care workers and other essential personnel in hospital or clinical settings, allowing them to identify and respond to outbreaks earlier and more effectively. Wearable sensors that can detect and track resting heart rate and sleep duration could also predict flu-like infections and the progression of COVID-19 cases. And by pairing sensors with mobile network functions and contact tracing apps, that functionality could be broadened to monitor the disease at a community level—helping identify hotspots such as long-term care facilities or food processing plants.

Wearable biosensors could also be used to monitor individuals who are assumed to be free of the disease and facilitate predictions of exposure to the coronavirus, which would help focus efforts to contact trace and deploy diagnostic testing. One of the challenges with COVID-19 is that infected individuals may be able to spread the disease before they become symptomatic. However, researchers believe these individuals may display subtle physical changes—which wearable technologies could detect.

In addition, mHealth technology could be used to monitor people who recover from COVID-19, helping to track and study the long-term effects of the disease on people.

“The better data and tracking we can collect using mHealth technologies can help public health experts understand the scope and spread of this virus and, most importantly, hopefully help more people get the care they need earlier,” said Paolo Bonato, associate professor at Harvard Medical School.

Their effectiveness could also be amplified when these technologies are paired with contact-tracing apps.

Journalist tries out wearable health devices that could detect COVID-19.

Devices Already on the Market

Some of these devices are already commercially available, such as the Fitbit and Apple Watch. About 21 percent of Americans currently use wearable technologies.

Earlier this year Fitbit released the findings of a study showing that its product can detect almost 50 percent of COVID-19 cases, a day before participants showed symptoms, with 70 percent accuracy.

Fitbit and Apple are also working with the Stanford Healthcare Innovation Lab on a coronavirus wearables study, which has shown early promising results, although the findings have yet to be published. In fact, researchers were able to detect early signs of COVID-19 by studying changes in the heart rate tracked by Fitbits: they were able to detect the presence of the virus at the time of diagnosis or even sooner in 11 out of 14 patients.

These technologies are already in use in long-term care facilities and some factories—with other industries and sectors looking to follow the trend. Some large companies, educational institutions and sports teams are already using wearables to track virus outbreaks.

For example, Oakland University in Rochester, Mich. intends to distribute wearable devices that would log skin temperature about 1,400 times a day—or roughly every minute—to its students. Rent-A-Center’s headquarters in Plano, Tex. has employees wearing proximity detectors that log when staff come into close contact with each other and can warn them of possible exposure to COVID-19. The University of Tennessee’s varsity football team also uses proximity trackers—fitted under their shoulder pads—during games: the team’s doctor can then trace which players may have spent more than 15 minutes close to a teammate or an opponent.

Other sectors are showing interest in these technologies, such as resorts, schools and conference organizers.

“Everybody mostly uses them as fitness trackers,” said Michael Snyder, who studies wearables as director of the Center for Genomics and Personalized Medicine at Stanford. “But we see them as health monitors.”

Privacy Concerns

But while these developments may seem encouraging, they do have significant drawbacks in terms of privacy concerns.

“There’s going to be a lot of good medical care that comes out of this that would have been impossible otherwise,” said Benjamin Smarr, a professor of data science and bioengineering at UC San Diego who is researching these devices. “The flip side is, as a society, we have no protections for people having this kind of transparency.”

It could be easy for an employer to mandate that is employees wear these devices 24/7 as a condition of employment or use the data gathered by the devices to determine how much health insurance will cost—or even determine if someone is too much of a health risk to employ at all. An intrusive government agency could make it obligatory for COVID-19 patients to keep their trackers on even after recovery to monitor long-term effects: while the data would be useful for health officials, it could be seen as an invasion of privacy.

In a real-world example, University of Alabama football players were given Apple Watches to monitor their sleep patterns and activity levels earlier this year, prompting an investigation by the Southeastern Conference league administration.

If wearable technologies can be enlisted in the fight against COVID-19, then the devices will move from a lifestyle gadget to an important public health tool—as long as privacy and ethical boundaries are clearly established and consistently maintained.

“There’s a huge amount of promise in these new technologies,” said Dr. John Brownstein, chief innovation officer for Boston Children’s Hospital and a professor of epidemiology at Harvard Medical School.

Read more about technological tools used to combat the coronavirus at Do COVID-19 Apps Really Make a Difference?.