The current COVID-19 pandemic, which is caused by a novel coronavirus, is unprecedented in many ways. COVID-19 death rates are currently lower than those of the recent Ebola epidemic and respiratory virus epidemics such as MERS and SARS. But this infectious decease is spreading fast. In just two months, COVID-19 has spread to more countries (190 and counting), infected more people (759,800-plus), and caused more deaths (at least 36,674) as of March 30, 2020.
Pain Points in Confronting the Pandemic
Like other viruses, COVID-19 infection goes through the same notable stages: incubation in the host without symptoms, the onset of full-blown symptoms, a period during which viruses can still be released, and finally the recovered stage with no virus release. During the COVID-19 pandemic, governments and healthcare organizations must do many things to reduce the spread of the virus.
Infected patients with severe symptoms need to be hospitalized. In addition, the patients who no longer have symptoms may still be releasing the virus; therefore, they need to be quarantined for a period (typically 14 days) until the virus release ends. The rapid increase of COVID-19 cases is putting intense pressure on the healthcare infrastructure.
Tracking down any “patient zero” is time- and resource-consuming, as is quarantining patients. The number of infected patients is increasing much more quickly than hospitals can add beds, ventilators, monitors, personal protective equipment, and healthcare workers. Many of the hospital staff have become infected themselves, which is inevitable, generating even more stress on the remaining staff.
The Internet of Things (IoT), paired with artificial intelligence (AI), can be deployed to automate or scale tasks, including patient tracking, quarantining, monitoring, and in-hospital care.
Tracing Infections with the IoT
Tracing the route of an infection requires closely interviewing many patients and learning details such as where they have traveled, eaten and slept. Epidemiologists study the details of patients’ movements and then compile a list of people who have come into contact with the early patient in various locations such as airlines, restaurants, hotels and other public spaces.
All the people on the list need to be contacted, screened and monitored closely for symptoms of the infection. Right now, most of this outreach work happens by phone. Compiling a longer list of potentially infected patients requires more time and staff to complete the outreach and monitoring work.
Smart mapping, also known as geographic information system (GIS) technology, integrates data from multiple systems, enabling users to analyze, visualize and detect patterns and trends. For example, researchers have traced the origin of the Ebola virus to fruit bats, which like to live in palm trees. Therefore, they can predict the route of an Ebola outbreak by mapping areas with palm trees.
In addition, researchers can use the IoT to collect data to identify the early patients. One recent example is a study by researchers at MIT, who used aggregated IoT data from mobile phones with GIS to trace the spread of dengue virus in Singapore during 2013 and 2014.
During the current COVID-19 outbreak, the Chinese government and private companies have created apps that let citizens check if they have come into contact with infected persons. In addition, the apps help gather data for the government to track the spread of the virus.
In Singapore, there are thermal scanners in many major office buildings to check the temperatures of the passersby. In addition, residents are required to log their phone numbers and any recent travel they’ve made to the outbreak zone. IoT surveillance also played a crucial role in tracking the movement of people and identifying the connections among clusters of coronavirus infections. In Thailand, a technology company based in Germany provided a biometric screening system with fever-detecting cameras for border screening.
AI can also be used to forecast outbreaks. For example, by analyzing data from news reports, social media platforms, and government documents, a company called BlueDot was able to flag an unusual cluster of cases in Wuhan, China, days before the World Health Organization alerted the world of COVID-19.
Patient Containment and Quarantine
Once the potentially infected people have been identified, they need to self-isolate or be quarantined to minimize the probability of infecting others. In addition, the patients who have survived the COVID-19 infection must isolate for a period, since these patients can still be producing and releasing a small amount of the virus.
During the COVID-19 outbreak, there is no practical way of monitoring tens of thousands of potential cases and ensuring they comply with quarantine rules. Therefore, during the lockdown of Chinese cities, the authorities ended up stationing security guards in every residential area to monitor and control the movement of all residents. This approach was inefficient, not to mention labor-intensive and hard to scale.
Some of the ways in which the IoT has helped ensure that quarantine rules are being followed are by local government agencies flying drones over an area and telling wandering residents to wear face masks and go home. In addition, some railway stations in China have installed infrared thermal scanners to check the temperatures of the people passing through, so those with fevers can be identified and isolated. Also, alert bots, or AI-driven voice recognition bots, have been used in Shanghai to contact at-risk citizens to determine their health status and recommend personalized self-care routines.
The more extensive use of the IoT can help doctors monitor which patients remain quarantined and which have breached quarantine. This way, doctors can track down cases potentially caused by the breach. For example, Alibaba’s Alipay and Tencent’s WeChat have developed features that help doctors track infected individuals with colored QR codes.
Patient Monitoring
The patients in quarantine usually do not have serious, or sometimes any, symptoms, so their conditions generally do not require hospitalization. However, they need to be monitored continually for any onset or deterioration of symptoms.
In China and other countries, healthcare workers going door-to-door performed many of the daily checkups of patients. This method was not only slow but also dangerous for the healthcare workers. Contrast that method with the IoT application where a healthcare worker flew a drone that carried an infrared thermometer up to apartment balconies to measure residents’ temperatures.
With a broader application of the IoT, patients can have their temperatures taken remotely and upload the data with their mobile devices to the cloud for analysis. This way, fewer healthcare workers will be needed to collect, manage and analyze more data within a short timeframe. Also, the risk level for the health workers will decrease due to them having reduced contact with potentially infected patients. Finally, remote patient monitoring will also increase the capacity of hospitals to serve patients.
In-Hospital Care
COVID-19 patients who require hospitalization present several challenges. First, hospitals need to have enough capacity to treat them. Second, these patients put the medical staff in danger of infection. Infected staffs have to leave their posts and isolate themselves; sometimes, they have to be hospitalized as well. As a result, the remaining staff must cover more cases and work longer hours, making them more stressed and more likely to become ill. The need to check equipment and tool inventories is another task that diverts medical staff from patient care. Sometimes medical staffs even perform janitorial work, because the janitors have been sent home to minimize the risk of exposure.
Remotely monitoring patients with chronic conditions such as hypertension or diabetes already depends on the IoT. In hospitals, telemetry has been used to transmit biometric data like heart rate and blood pressure from wireless, wearable sensors to the central monitoring unit, so that a small staff can monitor many patients closely.
During an escalating outbreak, the IoT can be used to reduce the workload and increase the efficiency of the medical staff—all the while reducing the exposure of healthcare workers to infection.
In hospital admitting, chatbots can be used to free doctors and nurses from repetitive and simple tasks like collecting patient information and answering general questions about the virus. For example, Japan’s Bespoke has launched a chatbot “Bebot,” which can answer queries on the coronavirus via a mobile app. In Washington State, a robot carrying a stethoscope is helping doctors diagnose patients and answer simple questions. Streamlining administrative tasks is another example of how the IoT can be used. Xiang Hu Bao, which is owned by China’s Ant Financial, offers a blockchain platform that expedites the claim process and at the same time reduces staff exposure to patients.
Diagnosis
Since the spread of COVID-19 is unusually fast, there is a great need to diagnose more patients in less time. During patient diagnosis, AI image processing and recognition capabilities can be used to analyze patient lung scans and identify infected cases.
Patients and clinicians usually have to wait for hours to get the results of CT scans. But an AI solution from Infervision reduces the waiting time significantly. The AI-based system by Alibaba can even help doctors detect coronavirus infection in CT scans with a 96 percent rate of accuracy in less than a minute.
Furthermore, AI computation power can also be useful in discovering new molecules that can be used for treating coronavirus infections.
IoT Cleaning and Robots
The IoT and robots can also relieve hospital staff from janitorial duties so that they can focus on treating patients. IoT sensors installed in bathrooms can monitor traffic and schedule additional cleaning cycles by robots in bathrooms with heavier use. Robots can also automate sterilization. For example, the Chinese company TMiRob has deployed disinfection robots to major hospitals in Wuhan. Danish company UVD is also making robots that can disinfect patient rooms.
IoT Help with Supply Chain Tasks
Medical staff can gain relief from the necessary but tedious task of checking inventory and reordering supplies by taking advantage of the IoT. IoT sensors can enable automatic restocking. In addition, the IoT can increase resource allocation transparency and efficiency, so that the neediest hospitals, not the most prominent hospitals, will receive the most help.
Autonomous vehicles can also be used to deliver medical supplies. One company in China, JD.com, has undertaken short-distance deliveries to hospitals with driverless cars. Another, Singapore’s AntWorks, has developed drones that can deliver medical supplies.
Conclusion
Healthcare systems already have components that can be connected to operate effectively in response to a viral outbreak. However, the readiness to expand existing data processing and data storage capacity will be crucial if the IoT is to successfully scale in response to a growing outbreak. In short, the system needs to build and expand its infrastructure to support large-scale data collection, processing, and storage for various applications in disease tracking, quarantine, remote patient monitoring, in-hospital care, and supply chain logistics.