The Year of the Sensor, round 2: COVID contact tracing + sensor wearables in LTC facilities; Ireland’s long and pivoting road to a contact tracing app

Wearables + sensors being used in long-term/post-acute care facilities for COVID contact tracing, decontamination. Historically ‘unsexy’ to digital health techies, long-term and post-acute care (LTPAC) came into sharp focus as the epicenter of COVID-19 deaths in the past four months. 45 percent of US COVID-19 deaths (over 54,000) occurred in nursing homes and assisted living residences, with the percentages being far higher in states like New Hampshire and Rhode Island (80%), Massachusetts and Connecticut (63%), Pennsylvania (68%), and New Jersey (48%). Freopp.org has a wealth of state-level information.

This created opportunities for companies that already had relationships with LTPAC to create systems to 1) contact trace individuals and residents, 2) trace locations not only of residents and staff but also contaminated areas, and 3) help focus ongoing decontamination and sanitization efforts. Featured in this surprising TechRepublic article is CarePredict, which back in March started to develop a response to COVID spread including what they dubbed the PinPoint Toolset. CarePredict already had in place a sensor-based system for residents that consolidated sensors into a wrist-worn resident ADL tracker with location and machine learning creating predictive health analytics that appear in a dashboard form. They expanded their analytics to staff and visitor contact plus locating frequently visited area by residents and staff so that decontamination efforts can be focused there. Also featured in the article are VIRI (website) and Quuppa, a real-time locating system (RTLS) repurposed from manufacturing and security. (Disclosure: Editor Donna consulted for CarePredict in 2017-18)

Ireland’s long and winding road to a national contact tracing app is the subject of an article in ZDNet. Waterford-based NearForm was called in by Ireland’s Health Services Executive (HSE) on week 1 of the lockdown and started work immediately. They had a prototype oapp running on a mobile phone by the end of the week, nonfunctioning but giving the HSE a look at the user interface. NearForm worked on a centralized model first, which was basically terminated by Apple’s insistence on blocking BTE, then in April pivoted to the decentralized Apple-Google (Gapple? AppGoo?) Exposure Notification system, once the HSE secured beta access to the new technology. By 7 July, Ireland launched and had over a million downloads in 48 hours. Germany had a similar saga and timing. Both Ireland, Germany, and other countries moved quickly to adopt Apple and Google’s APIs, when Apple blocked their original centralized app methodology. UK and NHSX did not pivot and are In The Lurch with Test and Trace [TTA 18 June, more deconstruction in VentureBeat]. Editor’s Note to Matt: go to your neighbor island, don’t be shy, and make a deal deal’ for the app. Solves that problem. 

NHS’ COVID contact tracing service started today–but where’s the app? Australia? (with comments)

To paraphrase the burger chain Wendy’s long-past spokeswoman, Clara Peller, ‘Where’s The App?’. The NHS debuted a contact tracing scheme for COVID, but it is a manual system dependent upon–people. If you test positive for the virus, you will receive a call from the NHS’ test and trace system. The person will ask for information about your recent contacts with others, and then asked to self-isolate for 14 days. Those names you provide will be contacted as well.

The NHSX-developed Bluetooth LE app remains in beta test on the Isle of Wight, which started on 5 May [TTA 5 May]. Reportedly there were 52,000 downloads in week one, which for an island with only 80,000 households is pretty impressive. 

The original rollout date set by Health Secretary Matt Hancock and NHSX chief Matthew Gould to the House of Commons’ science committee was mid-May, which has come and gone. The new date is now sometime in June. However, Baroness Dido Harding, the new director of NHS’s Test and Trace program, would not confirm that date–as we’d say, tap dancing quite hard. Digitalhealth.net, Telegraph

The US has been hiring contact tracers by state from Alaska to New York. A recent study in preprint in MedRxiv (PDF) by Farzid Mostashari of ACO management company Aledade and others found that in order to reduce the transmission rate by 10 percent, a contact tracing team would have to detect at least half of new symptomatic cases, and reach at least half the people with whom they were in close contact. MIT Technology Review 

Apps have been deployed in Australia (COVIDSafe) and Singapore (TraceTogether) and are in development in Switzerland and Germany. Most use BTE, but South Korea, India, Iceland, and some US states including North Dakota and Utah are using GPS phone location. China has been the most ruthless in using GPS data to monitor citizen locations and activity, to restrict their movements. Previously mentioned here [TTA 19 May] are UnitedHealth Group and Microsoft’s ProtectWell, PWC’s homegrown app–and Google and Apple announced in April a BTE app which hasn’t debuted yet. The Verge