Not Everything Is Bad: 3 Good Things about COVID-19
Finally, people are realizing that Blockchain and Healthcare makes sense
Little did I know when visiting Kibera, a 120-year-old, 1 million people urban slum in the outskirts of Nairobi, that a month later I would be locked down in a deserted, dystopian urban settlement called New York City, the epicenter of the COVID-19 pandemic. (special thanks to Norman Friedland, for introducing me to the SHOFCO leadership)
While in Kibera, speaking with community leaders, clinic administrators, social workers, teachers and vocational trainers, led by the Kiberian social entrepreneur Kennedy Odede and his non-profit organization SHOFCO (Shining Hope for communities), I couldn’t stop admiring the amazing achievements of this community. A community who decided to replace dirty puddles with clean water through their Water, Sanitation, And Hygiene (WASH) program, to build girl’s leadership and education through schools and shelter homes that target by design the most vulnerable and create community-based free health services that include primary care, HIV, TB, vaccination, nutrition, family planning, and prenatal care.
But SHOFCO is not about providing services for free. SHOFCO is about community, transparent governance, financial inclusion and building social capital. Through their self-governance council called SUN (SHOFCO Urban Networks), they have eliminated tribal tensions, and their vocational training program called Sustainable Livelihoods has allowed Kiberians to start their journey from destitute poverty to economic independence and prosperity.
It was therefore not surprising that my hosts immediately understood the concepts of a transparent, distributed, decentralized society, built on trust, monetary and non-monetary incentives and peer-to-peer economic activity, or in their own words:
We don’t need corrupt middlemen or politicians who bring nothing to the community. We need trust, transparency, fairness. If that is what your technology does, we want it right now… we are ready!
Why is it then that a community with little-to-no infrastructure is ready for a cash-less, trust-less, peer-to-peer society that intuitively speaks “blockchain”, while we here in the US and Europe still cannot see the need to add distributed ledger technology to our own legacy structures, assuring digital resilience, computational trust, and economic inclusivity?
Perhaps COVID-19 is changing all this and as our public health system, health IT, economic vulnerability, as well as populism and selfish streak are exposed, “blockchainizing” our social fabric is starting to make sense.
With that said, I do feel 3 good things are happening to us thanks to COVID-19:
Thing #1: We are becoming even more creative:
(thank you, Dr. Samantha Nazareth, for your extensive research)
As we are trying to study from previous pandemics and the current one (also here, here and here) most developments are intent to triage, test and treat COVID-19.
Triage: Particle Health, Carbon Health, Rimidi and Verily have built APIs that scrub data on existing EMRs to help identify high-risk individuals. Tytocare, Kinsa Health, KroniKare are adding internet-connected thermometers to track fever and help detect patients in real-time. Eko Health developed a digital stethoscope with AI-powered cardiac and lung auscultation capabilities, SenseTime is using facial recognition to promote contactless identification and MayaMD.ai is offering clinicians an AI engine to help their decision making.
DAMO and Infervision use AI to radiologically diagnose and monitor suspected cases, while Alibaba is using NLP to skim online media sources to detect clusters of infection with BlueDot.
Test: Although testing in the US still remains limited, solutions like EverlyWell for home testing, SightDiagnostics for point of care testing and Veredus Laboratories lab-on-chip are being developed.
Treat: Telemedicine and virtual visits are attracting new solutions like MeMD and Datos, and the increased interest by incumbents like RO and InTouch Health from TelaDoc, may well represent a tipping point for blockchain-driven telemedicine solutions in the future.
Sonovia has upgraded face masks with anti-pathogen material for increased protection, Italian researchers have repurposed scuba diving masks for ventilation (below), a Canadian anesthesiologist rigged a ventilator to serve nine patients at once, and UVD Robots, Blue Ocean Robotics, and XAG robots have built robotic systems to disinfect rooms and emit UV light over infected areas.
The race for finding a vaccine is a priority for Gilead Sciences, AbbVie, Moderna, Regeneron, Inovio, Vir Biotechnology, Sanofi Apeiron Biologics, CureVac, GSK, MIGAL, and half a dozen more pharmaceuticals, and once these vaccines are available MicroMultiCopter and Terradrone have promised drones to transport these supplies while conducting thermal imaging in quarantined communities.
Finally, BrightMD, Phreesia and Duration Health are developing education platforms to help the public comply with COVID-19 mitigation and suppression strategies.
Thing #2: We finally can seriously rethink our healthcare system design:
I have previously published about the shortcomings of our healthcare system, the poorest performer among the OECD countries for over a decade. As the pandemic has overwhelmed our hospitals and brought the economy to a halt, we now have the opportunity to seriously rethink our healthcare system design.
As we figure out optimal mitigation policies like home isolation of suspect cases, home quarantine of those living in the same household, and social distancing of the elderly and other at risk of severe disease (“flatten the curve”), it is clear we are not going back to “normal”.
So what will our post-pandemic healthcare system look like? Will we live through seasonal pandemics that regularly require huge hospitals with hundreds of ventilators on standby? Will we need “hammer and dance” surveillance programs due to herd immunity in order to mitigate future outbreaks using even more AI? How do we budget this new rapid response system and calculate the cost of human life, now estimated to be between 5–9 million US dollars per person?
One way to find out will be to see how the NYC and NYS healthcare system will function under Governor Cuomo’s emergency laws. As of March 23, NY State poses no limits on hospital size, allows no oversight for nurse practitioners, physician assistants, paramedics and medical students usually supervised by medical doctors, who will also be immune from civil liability for any alleged injury or death. Examination or recertification requirements for providers are suspended, and there will be no limits on working hours for physicians and postgraduate trainees. Providers are relieved of all record-keeping requirements which are offered absolute immunity from liability for any failure to comply.
What will this extremely deregulated environment bring? Will all regulations be reinstated automatically when this pandemic wave is over? Should they? What if the simplification of record-keeping and omission of onerous administrative requirements will improve patient outcomes? If so found, will it reduce the exaggerated physician to administrator ratio, which currently stands on 7 administrators to 1 physician and will this help decrease overall health costs? And what about healthcare data brokers, insurance brokers, pharmacy benefit managers and private equity-backed medical practices which remain profitable, while failing to deliver on their promise to reign in the spiraling cost of healthcare?
One thing this pandemic has reminded us - Healthcare needs doctors and healthcare professionals to care for patients, not a bloated non-medical administrative, financial apparatus that takes care of itself.
Thing #3: We have an opportunity to create “global intelligence” without sacrificing privacy
I am asked every day about COVID-19. Anything from how long will the pandemic go on, what are the best treatments available, how many ventilators will we need (a lot) and how many among us will die (a few).
The problem with these questions is that although they seem simple they are actually too-hard to answer because they are:
- Too big (i.e. require too much data)
- Too expensive (i.e. these data needs to be standardized)
- Too sensitive (i.e. include protected personally identifiable information)
In addition, there is a narrative that suggests that in order to remain safe and save the economy, we must sacrifice our privacy (aka the Pandemic triangle, below) and use military-grade, intrusive tools to collect data on all of us (here, here and here) without “too much” oversight.
This narrative is false.
COVID-19 tracking data and surveillance risks are much more dangerous than their rewards, and in fact, we may be facing the perfect conditions for what Yuval Harari calls “biometric surveillance”, which will strengthen predictive policing, unregulated urgent law enforcement in addition to an already existing predatory data economy (remember 23andMe selling your genetic data?).
In return, we can solve the Pandemic Triangle today via aggressive data sharing using privacy-preserving technologies (ZKP, TEE, homomorphic encryption, and secure multi-party computation) while sharing data.
Furthermore, as the COVID-19 pandemic takes hold, we are making decisions without reliable data, or data based on large, but still siloed sources. Instead of traditionally aggregating increasingly large amounts and types of data into a central location, we can now use federated analytics, followed by federated learning (FL).
FL offers a network of participants to collaboratively train algorithms on data while keeping each stakeholder’s data within its home location. Instead of sending data to a single, central repository where algorithms are trained, FL sends algorithms to the data and the updated algorithms are then shared with the participants.
Finally, blockchain-enhanced distributed networks governed by transparent smart contracts that encourage trusted data sharing, can help existing AI initiatives and startups like Benevolent AI, Cyclica, COVID tracking, Trusted Ops, and Anodot to connect to open sources like CORD-19, COVID2020, and WEF COVID Action platform.
Final Thoughts:
At Consensys Health we understand that the cure for COVID-19 is Data, and we must create an operational environment that is fit to deal with this pandemic, as well as prepare us for the post-pandemic world.
Therefore we are soliciting interested parties to join us at the global COVID-19 Hackathon: Data is the medicine we need; and help create a Federated Health Learning infrastructure, enhanced by privacy preserving technologies for distributed networks designed and incentivized to collaborate ethically and transparently.
We realize this new way of collaborating requires educating healthcare and life science professionals, as well as the web 3 developer community, and our first step in this journey is to launch April 14 our global STOP COVID-19 Hackathon. So feel free to reach out to me and see you all on April 14!
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