As the economy re-opens we should be aware of tools which may allow us the freedom to move out of lockdown with an awareness of the risks we face. I wanted to look at what we can do as individuals to reduce the risk of spread of Covid-19. The aim is not to undermine government directives, nor to replace the work being done by businesses but show what we can add to the effort as individuals.
The first part of the problem is understanding the level of risk, this is an enormous challenge. We have a new virus and although we know vastly more about it than we did a month or two ago, there is still a lot we don’t know. Everyone’s risk will be made up of a whole range of different factors from their personal demographics such as age, ethnicity, and underlying health conditions; who they need or want to be in contact with, and the demographics of those people; the jobs they do; and our personal risk appetite. For some a 1:100 risk of contracting Covid-19 may feel safe, and to others that may feel like an unacceptable risk. All that being said there is no perfect way of calculating these levels of risk. A variety of calculators have been developed, for example, Covid-19 Personal Risk calculator (https://www.covidodds.com/) which give an indication of individual risk; and articles such as “The risk levels of everyday activities…” give some clarity to relative risks (https://www.businessinsider.com/riskiest-to-least-risky-activities-during-coronavirus-pandemic-ranked-2020-5?r=US&IR=T ) of various activities. We then need to balance these risks with the prospect of remaining in lockdown. From a health perspective it is essential to open the economy, as recession and poverty have well-documented negative health outcomes.
What tools does healthtech provide to help us navigate this challenging situation?
The following are suggestions of 6 groups of tools we can use to manage and modify our risk on an individual basis.
1. Self-monitoring
We all need to take some responsibility for our own health and how we are feeling on a daily basis. There are many tools available to help us to do this, from the specific, for example, the tool developed by health science company Zoe in conjunction with analytics from King’s College London (https://covid.joinzoe.com/data), to those that either track symptoms of other health conditions or more general health monitoring tools. We should all be aware of the main symptoms of Covid-19 by now, a new continuous cough, fever, and loss of smell and taste, but we are also aware that it can present in a multitude of less obvious ways. By tracking our health we become aware of changes. We can act to alert those whom we have been in contact with, modify our behaviour to reduce contact, and by doing so reduce the risk of spread.
2. Temperature monitoring
Alongside monitoring general health symptoms monitoring our own temperature is a sensible step. Offices, schools, healthcare settings and transport hubs are likely to introduce temperature checks. To reduce the risk of spread further we can monitor our own temperatures and stay at home if we have even minor increases in our temperature. If we monitor our own temperatures regularly we will become aware of our own normal range and become more aware of any variation. There are multiple precision digital and infrared thermometers on the market suitable both for home use and use in workplace settings.
3. Long-term condition management
Following on from the first point if we have a long-term condition using digital tools to monitor our condition can reduce the risk of relapse. By self-monitoring, noticing trends and making adjustments to management, with support from our clinician, the risk of the conditions worsening and the risk of emergency hospital admissions are reduced. The risk of suffering a more serious illness with Covid-19 is higher in those with long-term conditions, so the ability to manage these conditions safely without unnecessary visits to healthcare facilities is key.
4. Well-being, diet and exercise monitoring
I see this situation as an opportunity to embed healthy behaviours, the government advice to go for daily exercise has led to more people get out walking than pre-Covid. Let’s continue this. By tracking exercise, diet and using tools to support our mental health we can modify our behaviours and improve our health and mental resilience in ways that can benefit us both now and into the future.
5. Masks
Wearing masks in public has been a controversial subject in the UK and is yet to gain widespread acceptance despite the acknowledgement that they do reduce spread. Any face covering is likely to reduce the risk of someone with the virus from spreading it as widely. There are new masks using smart material coming on to the market that can provide additional benefit to the users. For example, Wear and Care have developed reusable cloth masks with an embedded antimicrobial function for use in the community which should reduce risk of spread further (https://wearandcaretextile.com/).
6. Self-testing
Personal self-antibody tests have been in the news this week as multiple providers have been asked to withdraw them from sale due to concerns about accuracy. The concerns focus on the accuracy of tests developed to be used in a healthcare setting when using a fingerprick sample. Further, the incomplete understanding of the immune response to Covid-19 complicates interpretation. It is still unclear whether having Covid-19 antibodies confers protection; or whether a negative antibody test in an individual equates to a lack of immunity, even when the individual is highly likely to have been infected. We can infer from the behaviour of other corona viruses that presence of antibody probably implies immunity in at least the short to medium term. Based on this testing is likely to be of benefit and on an individual basis could be used to add to the overall risk profile. It remains to be seen if these personal self-tests will come back on the market.