Could smartwatches combat the next pandemic?

In recent times, smartwatches have been shown to be able to detect the onset of viral infections some considerable time before obvious symptoms of illness appear, even to the victim. This is reflected in subtle changes to the way that heart rhythm varies, for instance. But now new research suggests that beyond just alerting the individual about the impending problem, these devices might be able to help stop a pandemic. I’ve been speaking with Märt Vesinurm from Aalto University in Finland…

Märt - We already knew from research that wearable devices and specifically smartwatches are able to detect infection before any sort of symptoms, so sneezing or coughing, start. We sort of asked ourselves how much of an impact can it have if we were to use these devices in pandemic management and people were to sort of change their behaviour given a smartwatch alert.

Chris - And what are the smartwatches that are responding to? When we look at them and we can say, ah yes, this person is infected with something, what's the giveaway that the watch is able to pick up on?

Märt - Yeah, so I guess the most common ones, of course, are the body temperature, heartbeat, heart rate variation, and then blood oxygen level. So those are like the most common ones, I would say.

Chris - And that, crucially, changes before a person may even be aware that they've got something.

Märt - Yeah, so likely even with the most basic devices, you would see an increase in your heart rate, for example, just before you start showing symptoms.

Chris - Because one of the things that caught us out with the pandemic was, initially we assumed that if you weren't symptomatic, you weren't infectious. Obviously, if we get prior warning that someone might be infected with something before they realise, you could take action sooner. Is that where you're coming from with this?

Märt - Yeah, exactly. And actually, we also know that a significant amount of the sort of infections to other people come from before you actually show any symptoms. So that was especially problematic with COVID, for example, because the incubation all of the time between you getting infected and actually showing symptoms was so long that you had quite a while to infect other people before you actually realised that you yourself were infected. So if we can really hit that mark, we could have a huge impact on how pandemics develop.

Chris - So take us through what your parameters were. What fraction of the population would have to be using a smartwatch, did you assume? And what sort of a difference, if they did, would it make to the trajectory of a problem like COVID?

Märt - The proportion of people using the smartwatch was actually sort of merged together with a parameter we called reduction in social contact. So if you get the prompt, how much would you reduce your social contacts? And that's essentially very similar to saying if you don't get the prompt because you don't have a smartwatch, you just wouldn't reduce contacts at all with the smartwatch. You know, there's some other parameters that we used for the development of the viral load. So the amount of the virus in the human body for these different diseases. We also looked at previous research on how early wearable devices can detect certain diseases. One very important part of the study was also that these smartwatches can catch people who are also asymptomatic completely. So there's 20 something percent plus or minus something in many diseases where people infect other people but show no symptoms at all. And those are also something that is possible to catch with wearable devices.

Chris - Taking all that into account then, if we did have COVID Mark 2 tomorrow and smartwatches in the population, what sort of a difference could this sort of intervention make, do you think, based on your simulations?

Märt - I think it would be a really big, big difference, but it of course depends. For example, we looked at three different variants of COVID. The very first one, for example, we could have almost eliminated in sort of a very realistic context. If we were very optimistic, we could eliminate almost everything, but, you know, keeping realism in mind. But on the other hand, then we looked at Omicron, which was really infectious. And so for that case, the most likely, likely outcome would be sort of flattening the curve, as to say.

Chris - It's going to make a difference, though, on the demographic of the country and also the living conditions, isn't it? Because one of the arguments made was that in countries like Sweden, where the approach was a bit different to countries like the UK, people said, well, hang on a minute, the density at which people live in Sweden is very different than, say, the density at which people live in London. And so if you're wearing a smartwatch, it makes no difference whatsoever if you go home and infect all your housemates.

Märt - That's of course true. But then again, assuming that if you get the alert even one day before, you know, you could make the decision to stay at home and not, you know, follow up with a visit to your grandma, for example, or the store, or if that's an option to you, you could work from home. So there's a lot of these decisions that you yourself could make given that extra information. You could still reduce the amount of extra infections by making, you know, more better decisions, or at least more well informed decisions.

Chris - So do you think policymakers should be listening to you and saying, well, this should be part of our pandemic planning for the future?

Märt - I definitely think that policymakers should consider it part of their toolbox, because that could have a huge impact on how we manage pandemics. I think that there are, of course, ethical considerations always when any kind of government or also centralised data collection even crosses someone's mind. But even say, you know, in a situation where I voluntarily go out and buy myself some sensors or a smartwatch, have that go to my phone, and based on that infect less people, I think that policymakers should be at least aware of this possibility.