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Is Twitter Even Twitter If You Can't Make Fun Of Ted Cruz To His Face? - Gizmodo Australia
Yesterday, Twitter announced that it was testing a new feature that allows users to limit who can and can’t reply to their tweets. While this will make it more difficult for people to harass others on the platform, this feature could prevent constituents from…
Yesterday, Twitter announced that it was testing a new feature that allows users to limit who can and cant reply to their tweets. While this will make it more difficult for people to harass others on the platform, this feature could prevent constituents from replying to publicly elected officials. A Twitter representative confirmed to Gizmodo that while major politicians and political candidates wont have access to the new feature during the testing phase, they will get to use it if Twitter decide to roll it out to all users. Major politicians and political candidates will not have access to this feature during the testing period in order to prevent unequal treatment, a Twitter spokesperson told Gizmodo via email. The feature would be available to everyone on Twitter if it does fully launch. But it doesnt seem like there are any measures in place at this time that would prevent politicians and political candidates from using the feature to run their mouths without consequences (or snarky replies). Given how powerful of a tool Twitter has become for politicians to influenceor completely wreckinternational diplomacy, it can easily be used for more harm than good. Twitter noted that its intention is to give people more opportunities to weigh in while still giving people control over the conversations they start. But with the controls as they are now in testingeveryone can reply, only people you follow can reply, and only the people you mention in your tweet can replyit seems like the feature will give people fewer opportunities to express their thoughts, especially if those thoughts happen to disagree with, say, the president of the United States. Heres an example of the new reply feature in action: reply if you want to be verified! — Twitter Comms (@TwitterComms) May 20, 2020 Because the @TwitterComms account didnt mention anyone in its tweet, no one could reply to it. Its sort of like turning off the comments section on an online article. However, people were still able to retweet it with their own comments. As you can see, the new feature wouldnt totally prevent harassment or prevent people from expressing their opinions. People can still retweet your tweet and add a nasty comment of their own (or debunk wild conspiracy claims, whichever!). Youll receive a notification if someone retweets and adds a comment about your original tweet, if you choose that setting. With that in mind, this new feature could also make it harder to stop the spread of misinformation, something that Twitter has recently put more of a focus due to the global pandemic. Another example: too bad he didnt use your new reply feature — u221e (@hdevalence) May 21, 2020 Here, @TwitterComms was able to reply directly and efficiently to the original post to debunk his claim that Twitter lets you transfer your verification badge to another user. But if the same guy who posted that false information was able to keep people from directly replying, it would be harder for Twitter to address everyone in the thread at once. (You can see the number of people who already retweeted the false information here.) If replies had been limited, the @TwitterComms account couldve just retweeted with comment on its own feed, but its unclear if that would be just as effective, better, or worse than the current system. But the larger concern is giving political figures and politicians a powerful social media tool to potentially misuse for their personal gain. Public officials would be violating the First Amendment if they were to use this tool to block speakers on any accounts theyve opened up for public conversation in their roles as government actors, Vera Eidelman, staff attorney with the ACLUs Speech, Privacy, and Technology Project, previously told Gizmodo. If Twitter does roll out this feature and follows through with giving politicians access to it, it will likely create the same problems that Eidelman describes. In the past, Twitter has come under fire for consistently not removing content from President Trumps Twitter account that violates its own rules, one of which was a video altered to make to look like House Speaker Nancy Pelosi ripped up Trumps printed speech during specific moments of his State of the Union address. The tweet, which was first published on February 6, 2020 is still live. Dell Cameron contributed to this article.
Why Saliva Tests Could Offer A Better Alternative To Nasal COVID-19 Swabs - Gizmodo Australia
Saliva is one of our biggest foes in the COVID-19 pandemic, because of its role in spreading the virus. But it could be our friend too, because it potentially offers a way to diagnose the disease without using invasive nasal swabs....
Saliva is one of our biggest foes in the COVID-19 pandemic, because of its role in spreading the virus. But it could be our friend too, because it potentially offers a way to diagnose the disease without using invasive nasal swabs. Our research review, published in the journal Diagnostics, suggests saliva could offer a readily accessible diagnostic tool for detecting the presence of SARS-CoV-2, the virus that causes COVID-19, and might even be able to reveal whether someones immune system has already encountered it. COVID-19 testing is a crucial part of the pandemic response, especially now countries are gradually lifting social distancing restrictions. This requires widespread, early, accurate and sensitive diagnosis of infected people, both with and without symptoms. Our review looked at the results of three different studies, in Hong Kong, the nearby Chinese mainland city of Shenzhen, and Italy. All three studies found SARS-CoV-2 is indeed present in the saliva of COVID-19 patients (at rates of 87%, 91.6%, and 100% of patients, respectively). This suggests saliva is a potentially very useful source of specimens for detecting the virus. Saliva spreads the SARS-CoV-2 virus via breathing, coughing, sneezing, and conversation, which is why guidelines suggest we maintain a distance of at least 1.5 metres from one another. We also know SARS-CoV-2 can survive in tiny droplets of saliva in an experimental setting. Saliva is an attractive option for detecting SARS-CoV-2, compared with the current tests which involve taking swabs of mucus from the upper respiratory tract. Saliva is easy to access, which potentially makes the tests cheaper and less invasive. Saliva can hold up a mirror to our health, not just of our mouth but our whole body. For this reason, saliva has already been widely investigated as a diagnostic tool for chronic systemic diseases, as well as for oral ailments such as periodontal disease and oral cancers. But less attention has been given to its potential usefulness in acute infectious diseases such as COVID-19, perhaps because researchers and clinicians dont yet appreciate its full potential. What a mouthful When we get sick, much of the evidence is present in our saliva from the germs themselves, to the antibodies and immune system proteins we use to fight them off. Saliva also contains genetic material and other cellular components of pathogens after we have broken them down (for the full biochemical breakdown of the weird and wonderful things in our saliva, see pages 51-61 of our review). Saliva is also hardy. It can be stored at 80 for several years with little degradation. This means it would be relatively straightforward to track the progression of COVID-19 in individual patients, by collecting saliva at various times during the disease and recovery. Saliva tests from recovered patients could also tell us if they have encountered the disease for a second time, and how strong their immune response is. However, there is no research yet available on using saliva to monitor immune responses. This will be well worth investigating, given the pressing need for a reliable and cost-effective way to monitor the population for immunity to COVID-19 as the outbreak continues. Could saliva testing replace nasal swabs? An ideal saliva test would be a disposable, off-the-shelf device that could be used at home by individuals, without exposing them or others to the risk of visiting a clinic. One drawback with the research so far is that it has involved small numbers of patients (each of the three studies we reviewed involved no more than 25 people), and there is little published detail on exactly how these studies collected the saliva whether from the mouth or throat, whether by spitting, drooling or swabbing, and whether collected by the patient or by a clinician. Nevertheless, based on the modest amount of research done so far, saliva looks like a promising candidate for COVID-19 testing. More research is now needed, in larger groups of people, to learn more about how to confidently test for SARS-CoV-2 in the saliva of both symptomatic and non-symptomatic people. Earlier this month the US Food and Drug Administration approved the sale of saliva-based COVID-19 test kits that will allow people to collect their own samples and send them to a lab for analysis. A reliable test would offer a cheaper, less invasive and potentially even more accurate way to detect the virus, which would also reduce the risk posed by routine COVID-19 checks to both patients and front-line medical professionals. Pingping Han, Postdoctoral Research Fellow, The University of Queensland This article is republished from The Conversation under a Creative Commons license. Read the original article.
Why You're Anxious About Coming Out Of Isolation, According To Experts - Gizmodo Australia
Restrictions are lifting and establishments are reopening slowly across the country. While this is a cause for celebration for many, some may be worried about venturing back out into the 'real world' -- and not just because of health fears. While many of us …
Restrictions are lifting and establishments are reopening slowly across the country. While this is a cause for celebration for many, some may be worried about venturing back out into the 'real world' — and not just because of health fears. While many of us have spent months declaring that we can't wait to get out of isolation, now we may feel like we're not quite ready to re-enter society. We might even be feeling anxious about seeing people in our regular social circles. We spoke to some experts to find out why. We're living through a complicated and scary time in human history, so there's no single or simple reason as to why you might not be as excited to rejoin the world as you thought you would be. Individuals will have different concerns, perhaps several in some cases. These are just some of them. The New Normal Australia has been in various forms of isolation for a couple of months, and that has been enough time for some people to get used to the decrease in social interaction. Jayashri Kulkarni, a professor of psychiatry at Monash University, said in an email to Gizmodo Australia that human being are creatures of habit. "While we can adapt to change, it takes time and effort to shift long-standing habits. Initially, there was considerable concern about isolation and there still is but over the past few weeks, we got used to having a smaller world'," Kulkarni said. "Many are now fearing an end to isolation because it is another change, a loss of control over a smaller world. Once you limit your world, the re-entry into it can be frightening after all, there are many more loud noises, bright lights, differing opinions to contend with." Some experts such as Professor Kim Felmingham, professor and Chair of Clinical Psychology at the University of Melbourne, have also stated that some people enjoy, and perhaps even thrive, working from home because it's an environment where they can live a little more flexibly and make time for themselves. "[Some people] are reporting gaining new perspective during lockdown and rethinking what wasnt good about how they were living their previous lives — with more time for reflection, more time with family, and more time to explore important activities that are meaningful," Felmingham said. "Re-engaging can lead to less time with family and loved ones, less relaxation or exercise time, and less time to follow meaningful pursuits. In this situation, there may be a fear of losing the insights and time gained during lockdown." Kulkarni has spoken to people who have had positive experiences in isolation due to being able to better control social interactions from their homes. "Many people spoke about the enhanced 'peace and quiet' of working from home, not having to commute or get dressed for work, not having to cope directly with others in the workplace — not having face to face negative workplace interactions, in particular... having control is very important to us, so limiting contact and controlling the individual environment gives comfort and reassurance to many," Kulkarni said. Some people may have found some comfort in being able to hide from the realities of COVID-19: illness, business closures, job losses. With restrictions lifting, they won't so easily be able to shield themselves physically or mentally. "When in isolation with a narrowed world, denial is easier. So, we lived in a more 'present tense' way just getting food, dealing with unusual telecommunication meetings and virtual get togethers," Kulkarni said. "It was easier to turn off the news when desired. Return to socialisation makes the world bigger, scarier and harder to deny, she said." Australia's COVIDSafe app has been out for three weeks now but despite the government's draft legislation stating the data cannot be accessed outside of coronavirus tracing purposes, some of its vague wording is causing legal experts concern over potential misuse. Read more Uncertainty In addition to the fear of contracting COVID-19 itself, concern over the unknown has become common for Australians over the past two months. Concerns such as not knowing when there will be a vaccine and uncertainty regarding jobs, restrictions and what the rules are for each state. Confusion around the COVIDSafe app and general disillusionment regarding whether things will ever truly be the same. These constant questions and a future filled with potential threats can leave a psychological mark and be a cause for anxiety — especially if there's a second wave of infection. "I think this can be attributed to an increased anxiety and uncertainty about the future, and about peoples safety — health, social and economic. Once our life is no longer predictable and following a normal course, it is confronting and challenging to engage with a new reality and way of being," Felmingham said. "There is also uncertainty about the future which is a really significant factor the knowledge that a lockdown will gradually be reduced, not knowing precise timelines or how this might happen, and importantly knowing that we might need to revert back into lockdown if there are future waves of the virus makes it hard to plan future activities/life events and makes it hard to be confident about where you will be heading into the future, she said." Felmingham also pointed out that the cause for isolation-related anxiety won't be the same for everyone. While some will be concerned about their health as the return to work, as well as just how serious the virus has become, others will be concerned with the other new realities that COVID-19 has brought to Australia in such a short period of time. "For others, I think this may be more about fear of confronting a new reality, and most particularly, a new economic reality. Needing to re-engage with a society that has fundamentally changed, with changing rules for social interaction and massive economic uncertainty can significantly raise anxiety. In some ways, this lockdown period enables people to cocoon themselves or shield themselves, but now re-engaging with our old lives can sharpen anxiety as we re-engage," Felmingham said. COVIDsafe, Australia's coronavirus contact tracing app, has just just gotten an update which addresses some bugs and privacy concerns. The update will also help with some of the background bluetooth problems that iOS devices have suffered with the app so far. Read more Fear Of Other People While it seems obvious that some may be scared that the end of isolation heightens their risk of infection, what is perhaps less considered is the toll this fear takes psychologically — especially in regards to social interaction and comfort. Due to the contagious nature of the virus, as well as some carriers being asymptomatic, anyone could be a potential threat. This includes strangers as well as loved ones. "Another unique aspect here is that inadvertently, by the very nature of the level of contagion of this virus, other people have become potential threats. We need to keep our distance, avoid people we dont know. This undermines a common coping mechanism we typically use in the face of threat, and one we saw exemplified in the bushfires, which is coming together and supporting each other and working together as a community," Felmingham said. Kulkarni believes this threat of others could manifest in other concerning ways. "Loss of control which comes from return to the wider world, can generate further fear of infection. This could lead to social phobia — avoiding others or social situations or having panic attacks when socialising. A sense of paranoia about others can be heightened when back in circulation and this can be expressed as racism or specific hostility to certain groups," Kulkarni said. "Increased obsessive compulsive behaviour will be seen in many with increased germ phobia, compulsive cleaning rituals and obsessive thoughts about illness and death." It's Worse For Some For more fortunate Australians, COVID-19 has been an exercise in changing our routines around a largely unseen enemy - working from home, fighting boredom and adjusting to this new normal. Perhaps it has allowed time to develop a new skill, to bake some bread and to reflect on what we want our lives and relationships to look like moving forward. If this is you, that's great and your experience shouldn't be invalidated. We're all living through history and doing the best we can. But unfortunately for some, isolation has been far more taxing, terrifying and even dangerous. "For some unfortunately it has led to significant escalation of substance use, mental health issues and family violence," Felmingham said. "Combine this with the difficulty in engaging in our usual coping mechanisms of supporting one another through family and friends and community support this can exacerbate our anxiety future." Several of our experts mentioned the 2019-2020 bushfires which devastated large chunks of the country. Australia didn't have a chance to physically, psychologically or emotionally heal before COVID-19 ravaged the country again. This is important because as a nation we have actually been dealing with collective grief, loss and a lack of normality for longer than a few months now. So it makes sense if people are feeling anxiety and a whole other range of emotions ever more deeply right now. Ferlmingham draws a comparison between this national precursor to COVID-19 with individuals who deal with prior physical or mental health conditions. "If people have been coping or living with chronic health conditions, this can lead to significant escalation in anxiety and for people already experiencing mental health issues. These may have been markedly exacerbated during lockdown," Felmingham said. "We know there has been a significant impact on mental health due to COVID 19 and the lockdown, with some developing mental health issues for the first time, but others having a major exacerbation of symptoms." So if you are venturing back into the world — whether socially, for work or otherwise — try and approach others and yourself with an extra dose of empathy and kindness. You don't know what somebody else is going through right now other than the collective COVID-19 experience. With some much uncertainty in our futures we need our humanity now more than ever. People love creating words in times of crisis its a sick (in the good sense) way of pulling through. Read more
Click Frenzy 2020: Aussie Broadband Has Some Cheap NBN Plans For You - Gizmodo Australia
Click Frenzy 2020 is still going, which is good news for anyone looking for a sweet NBN deal. Aussie Broadband has lowered the price of most of its NBN plans across multiple speed tiers and considering its one of the fastest NBN providers in Australia, now mi…
Click Frenzy 2020 is still going, which is good news for anyone looking for a sweet NBN deal. Aussie Broadband has lowered the price of most of its NBN plans across multiple speed tiers and considering its one of the fastest NBN providers in Australia, now might be the time to make the switch. In terms of average NBN speeds, Aussie Broadband was hovering near the top of the list according to the ACCC's most recent quarterly report. While it isn't quite as speedy as Optus, TPG or Exetel, it was still found to get 85.8% of its maximum download speeds during peak hours - which is still impressive. To put it into perspective, Optus came in at number one at 89.9%. Aussie Broadband Cheap NBN Deal But now onto the deal. Aussie Broadband is knocking $10 off most of its NBN plans. The only ones that are excluded are its NBN 12 plans, which we wouldn't recommend anyway, and its new NBN 250 plans. It's worth noting that the $10 off special will only last for the first six months of the plan. But there also isn't any lock in contracts so you can leave after that period if you want. To get the deal you use the promo code MAYHEM promo code before 11:59pm AEST Thursday May 21. Our pick of the litter is the $79 a month NBN 100/20 plan - it's a good price and comes with 86Mbps evening speeds. If you're still not sure, here are some other similar plans and prices currently available on market. Best NBN 50 Plans If you want something a little cheaper and don't mind a speed reduction you might want to consider an NBN 50 plan. Best NBN 100 Plans If you want the fastest speeds possible (without bumping up to NBN 250, which isn't common yet), NBN 100 is where you should be looking. In addition to making working from home more bearable during isolation, it will also help with gaming and streaming speeds. Not all internet providers are equal especially when it comes to the NBN. Buying a fast NBN plan should be simple, but there are a whole lot of factors that will affect just how fast your connection is. Read more As Gizmodo editors we write about stuff we like and think you'll like too. Gizmodo often has affiliate partnerships, so we may get a share of the revenue from your purchase.
Can A Smart Watch Detect Covid-19? - Gizmodo Australia
The notification popped up without warning just as I was syncing the Whoop tracker I was testing: The tracker had a new metric, respiratory rate. Truthfully, I almost ignored it. But the notification used the phrase covid-19, and my eyes widened....
The notification popped up without warning just as I was syncing the Whoop tracker I was testing: The tracker had a new metric, respiratory rate. Truthfully, I almost ignored it. But the notification used the phrase covid-19, and my eyes widened. At 7 a.m., I was bleary-eyed, under-caffeinated, and still adjusting to my new reality of sheltering in place. But, from what I could tell, this niche tracker was telling me that there was a possible correlation between my sleeping respiratory rate and the novel coronavirus dominating headlines. Was this real or marketing bullshit? The Whoop may have been the first wearable tech company to alert me to the relationship between metrics on a wearable and covid-19, but it certainly wasnt the last. It seemed wearable companies big and small all had the same idea: That their devices might be useful in the fight against covid-19. It looked promisinga logical progression of how wearables in the past few years have increasingly blurred the boundary between wellness tech and medical devices. Apple Watches and a fewothersmartwatches can now take electrocardiogramsa test that can measure the electrical activity of your heartbeatstraight from the wrist. But wearables have mostly focused on things like sleep, reproductive health, and heart disease. Detecting infectious diseases is newer territory, and arguably not something these devices were really designed for. For every heartwarming story of an AppleWatch or Fitbit saving someones life, theres another lurking about health tech peddling false promises and shady marketing passed off as science. With the stakes of covid-19 so high, how much of this is a genuine desire by wearables companies to lend their expertise during an unprecedented crisis? How much is a PR play meant to drum up goodwill at a time when consumers are more careful with their purse strings? And crucially, is a future where your smartwatch warns you before you get sick even possible? It might sound like science fiction, but theres reason to believe wearables could be useful in detecting infections. Whether researchers can figure it out in time to make a difference against covid-19 is another story. My Zoom chat with Michael Snyder was the first interview Ive ever done where someone other than myself was wearing multiple smartwatchesthree watches and an Oura smart ring to be exact. Theres not much reason to unless youre a tech reviewer or researching potential applications of what these devices can do. Snyder, the director of genomics and personalised medicine at Stanford University School of Medicine, is very much the latter.Snyder heads one of two coronavirus-related studies Fitbit is involved in, the Wearables Data Study, which looks to study whether wearables can predict covid-19. (The other is the DETECT study by Scripps Research Translational Institute, which aims to improve detection and containment of outbreaks.) He told me there is actually clinical evidence that wearables might be capable of detecting infectious diseases early based on a study Stanford published in 2017 that found these devices could be useful in identifying when you get sick by catching physiological abnormalities. The exact metrics that researchers are studying vary, depending on what the sensors a participants smartwatch or fitness tracker can track. Generally speaking, while wearables makers are providing access to hardware, a population for researchers to study (their user base), and data for those who opt-in, medical researchers are the ones trying to find patterns in the data. There are differences depending on the study, but the researchers I spoke with are examining a wide range of metrics that include heart rate, heart rate variability, sleep, blood oxygen saturation levels, respiratory rate, skin temperature, and even general activity to find a link between covid-19 symptoms and the data tracked by wearable devices. If that seems like a lot of metrics, its because theres a lot we dont know about the novel coronavirus, and researchers are looking for anything that might stand out. One significant metric is heart rate. Stanfords 2017 study and a more recent 2020 study from Scripps Research both note a correlation between elevated resting heart rate and infections. But where the Scripps study focused on whether data from wearables could help detect outbreaks in real-time, the earlier Stanford study posits that it might be possible to detect infections before external symptoms appear. Snyder was actually a participant in the Stanford study, which involved tracking metrics, including heart rate and SpO2 levels, across a variety of devices. At one point during the course of the study, Snyder visited his brother in rural Massachusetts. Two weeks later, he was flying to Norway through Frankfurt, and on the last leg of the flight, he noticed the blood oxygen levels reported on his fitness tracker seemed abnormally low and his heart rate abnormally high. Snyder later developed a low-grade fever and suspected that Lyme disease might be the culprita suspicion that was later confirmed via an antibody test. Because Snyder had given blood before visiting his brother, this was a clear cut casethose samples had tested negative for Lyme. The experience prompted his team to pour over two years worth of Snyders data. They discovered that in addition to the Lyme episode, hed been sick three other timesand one of those times, Snyder had actually been asymptomatic. During an infection, Snyder explained, your immune system produces something called a C-reactive protein. A serious infection, such as Lyme disease, would result in extremely high levels of this particular proteinsomething that Snyder noticed in subsequent blood tests, even though at the time he hadnt actually felt sick. The team then found every time his C-reactive protein levels rose, Snyders heart rate and skin temperature were elevated before symptoms appeared. Those results held true for three other people involved in the study. Each time they found elevated heart rates before people fell ill. Were talking tens of millions of people, all with these smartwatches that could be health protectors for infectious diseases like covid-19. News reports, social media, and government press conferences have all stressed that asymptomatic carriers can still pass on covid-19 without even knowing. Infected people can also spread the virus in the days before the coughs and fevers manifest. That said, being asymptomatic might be a misnomer if invisible metrics like heart rate, respiratory rate, or even skin temperature could possibly reveal infection. If a wearables company could build an algorithm that would alert every person with a tracker or smartwatch that they were potentially sick before external symptoms appeared, the benefits would be numerous. People would know when to self-isolate. Frontline workers would get a heads-up, and health care professionals could potentially have a more accurate picture of infection rates. You could triage care for vulnerable populations more effectively. Most importantly, you might be able to drastically cut the infection rate. Thats the end goal. Right now, Stanfords Wearables Data Study is looking for participantsspecifically, people whove had a confirmed or suspected case of covid-19, have been exposed to someone who had or may have had covid-19, or those who are at a higher risk of exposure, like essential workers. Once enough people have opted-in via Stanfords site and their datas been collected, the second phase involves building a personal dashboard that can tell people when theyre getting sick. And while the original Stanford studys algorithm was developed using a Basis watch and a few other discontinued devices, this new study aims to be device-agnostic. Fitbits, Apple Watches, and Oura Rings are just some of the wearables included. Were getting a ton of people enrolling who have a smartwatch and have been ill, Snyder says. Theres lots of smartwatch wearers out there. Theres 30 million active users from Fitbit, millions from Apple Watch. Were talking tens of millions of people, all with these smartwatches that could be health protectors for infectious diseases like covid-19. It almost sounds too good to be true, and truthfully, many obstacles stand in the way. Snyder told me they are working at full blast around the clock at Stanford, and he believes phase one of the study will be done in a matter of weeks. Still, wearables companies will have to win clearance from the U.S. Food and Drug Administration before rolling out covid-19 predictor features, which is an entirely different process. Take the Withings Move ECG, a watch that offers ECG capability, just like the Apple Watch, which was announced at CES 2019. Despite applying for FDA clearance and receiving a CE Mark (the European equivalent), its still not available in the U.S. Plus, theres the simple fact that medicine doesnt move as quickly as technologyfor good reason. Its true that the first human trial for a covid-19 vaccine trial is already underway, but were still several months to years away from a viable, mass-produced vaccine. Researchers may have found a potential relationship between biometric data and covid-19, but that doesnt mean by this time next year well be checking our wrists to see if were infected. While the FDA does have a pilot program to fast-track software-based medical features, its not clear whether covid-19 related software would be included as part of this program. Itll have to roll out as a research study [first] because these are not medically approved devices, Snyder concedes. As soon as you start getting into the medical side it gets very, very regulated. Youve probably never heard of Ava, a reproductive health tracker, unless you or your partner has had trouble conceiving. But in Lichtenstein, the government has already outfitted roughly 2,000 citizenseven those not trying to have a babywith an Ava bracelet to see if early covid-19 detection is possible.Among wearables companies, Ava stands out as one of the few that proactively engages in clinical research and publishes studies in peer-reviewed medical journals. The bracelet is a licensed medical product, receiving FDA approval as a Class One medical device back in 2016. As the global pandemic worsened, Ava founder Lea von Bidder was keen to put the word out that the company was seeking research partners to see if their device and clinical expertise could be put to good use. Avas commitment to scientific research makes it seem like the ideal candidate for rapidly developing a wearable solution to covid-19. The company has experience obtaining regulatory approval, employs a clinical team in addition to a data team, and already had the necessary permits in place to hit the ground running. And, like Stanford, Ava had previously looked into infectionin its case during pregnancyand already has some data. The result is the COVI-GAPP study, which will try to see if the five parameters measured by Avaskin temperature, resting pulse rate, perfusion, breathing rate, and heart rate variabilitycan be used to create an algorithm that will identify covid-19 at an early stage, even when no typical disease symptoms are present. In terms of goals, this COVI-GAPP study and Stanfords Wearable Data Study arent much different. Both will collect data, look for patterns, and, hopefully build an algorithm that can catch covid-19 before symptoms ever appear. Theres a notable difference, however, in terms of expectations. On the phone, von Bidder sounds determined, but also grounded when discussing what the study hopes to accomplish. For starters, while Snyder is hoping to develop a workable algorithmor at least a prototype of oneto help the crisis within the next few months, von Bidder is aiming to take on a potential second wave of covid-19 infections. In fact, the COVI-GAPP studys first tangible results arent expected until fall 2020. After that, the study will move onto a second phase, which would include the entire population of Lichtensteinand this is assuming that the researchers find anything to begin with. We dont even know yet how these parameters interact with covid-19, von Bidder told me. Lets start right there. This whole thing might never work. I think theres enough reason to believe it might work, but then we still dont know if it works fast enough. My assumption is that we will get there, otherwise, I wouldnt invest all this time and money in trying to figure it out, but its not that simple. You could tell people that they have covid when they dont and tell other people that they dont have it but they will. Even if researchers find a relationship between the metrics Ava can track and covid-19, theres still a question of sensitivity and specificity. Its not terribly helpful if a wearable can detect that youve got a fever when you already know you have one. Theres also the issue of how to notify someone of a potentially traumatic diagnosis. Do we tell you, You definitely have covid-19, or do we tell you, Hey, you might have covid-19, go get tested, von Bidder said. Thats a highly medical application, because youre going to really interfere, and you need to be very sure about what youre doing. You could tell people that they have covid when they dont and tell other people that they dont have it but they will. Snyder was also frank about potential limitations. Skin temperature, while one logical metric to determine whether a person might have covid-19, isnt something that all trackers can measure. Plus, many people infected with the novel coronavirus may never have a fever. The accuracy of skin temperature readings also depends on how tightly or loosely a person wears their device. Lastly, its not yet clear whether any algorithm could distinguish between types of viral infectionsas in, could the device tell the difference between the flu, the common cold, and covid-19? Then theres the question of whether wearables will be able to even detect infection fast enough. The thing about data is that it can be very noisy. My one concern is that even among symptomatic individuals, the highest degree of viral shedding and transmission is actually in the pre-symptomatic period, Thomas Tsai, assistant professor in the Department of Health Policy and Management at Harvard T.H. Chan School of Public Health, told Gizmodo over the phone. So you know, the wearables are unlikely to be able to presage the period when theyre most infectious. Tsai went on to note that it is a good thing that this sort of research is happening. The more that we can learn about covid-19, the better public health officials can tackle the pandemic effectively. The thing about data is that it can be very noisy. Your heart rate can be elevated because youre watching a scary movie, and maybe your sleeping respiratory rate isnt ideal because your cat screams every night at 4 am. Going back to the 2017 Stanford study, Tsai is a bit sceptical about the relationship between C-reactive proteins and heart rate. A quick refresher: the study identified high C-reactive protein levels with elevated heart rate as a sign of illness. However, commercially available wearables may not even have the appropriate sensors to consistently and accurately measure C-reactive protein levels. Even if that correlation is confirmed in the current ongoing study, its not guaranteed to have an impact on how doctors treat covid-19. C-reactive protein is a very nonspecific marker for inflammation, Tsai explains. My worry is when we look backward and try to find patterns between heart rate and some markers that we see, retrospectively, patterns in the noise. They may not actually change the clinical course. But even if the signal in the noise is found, the red tape hasnt gone anywhere. The COVI-GAPP study is a bit of an outlier. Not only is Ava experienced at navigating regulatory hurdles, but Lichtensteins government was also quick, proactive, and ready to reach into its pockets to fund this type of medical wearables research. Lichtenstein also has a smaller, contained population.But the U.S. is a big, sprawling nation that was slow and ill-prepared for preventing the spread of covid-19. Back in February, the FDA did issue an Emergency Use Authorization (EUA) for medical devices in light of the pandemic. Whether the EUA has been effective or an easy process to navigate remains a mystery. Yet it has led to folks getting creative in finding new ways to use technology to help with shortages of life-saving equipment, such as ventilators and personal protective equipment. It could also theoretically be used by wearable companies roll out detection algorithms. I asked the FDA to clarify whether it would consider fast-tracking approvals for an algorithm to early detect covid-19 using software for existing wearables. In response, the FDA sent back its digital health policy for covid-19. According to the policy, most apps and software systems for public health surveillance and communication dont require clearance or approval, as theyre not medical devices. The policy also states the FDA does not intend to enforce requirements under the Food, Drug and Cosmetic Act at this time for certain lower risk softwarebut its unclear whether early detection algorithms fall under this category. They most likely do not. For higher-risk softwareany sort of diagnostic feature, for examplethe policy refers back to the EUA process. That means even with expedited processes in place, vetting this sort of experimental tech will likely take longer than anyone would like. That said, clear FDA guidance is absolutely necessary from a safety standpoint. To the average consumer, the lines between educational features and diagnostic devices might sometimes blur. Take Whoop, the sleep tracker I was testing when I saw a covid-19 notification. The FDAs digital health policy explains why Whoop can quickly roll out a respiratory rate metric: While the Whoop app itself explains the potential relationship between your breathing rate and covid-19, the company provides the metric for passive monitoring or journaling by the user. Whoop isnt going to tell you if you have covid-19, or what to do if your respiratory rate drastically changes overnight. Emily Capodilupo, Whoops vice president of data science and research, said on a recent podcast that the tracker is not a medical device and that the goal isnt to diagnose any disease or condition, especially not covid-19 or the flu. The idea is to make users aware of their baselines, with the knowledge that a sudden, drastic change could signal...something. That said, Whoop is also participating in a study with Cleveland Clinic and Central Queensland University in Australia to see if there is a potential link between respiratory rate and covid-19. It bears repeating: No wearable devices on the market can diagnose covid-19. But the research part isnt exactly the problem. Its what comes after. And theres no indication that Whoop (or Fitbit, Oura, Apple, or other big-name wearable makers) are advertising the ability to do so. But that hasnt stopped people from panic-buying anything that might give them a better chance of preventing (or surviving) illness. According to the American Lung Association, people are also snapping up pulse oximetersat the expense of hospitals and people who actually need thembecause they might early detect or quantify shortness of breath, a well-known symptom of covid-19. Fixating on pulse oximeter readings may provide a false sense of security, Dr. Albert Rizzo, chief medical officer at the American Lung Association, said in a statement. In some cases, they do catch lung problems before you struggle with shortness of breath. However, it is also possible for the device to show healthy oxygen saturation levels even when experiencing trouble breathing, which may lead some individuals to delay seeking urgently needed care. Its not absurd to worry that consumers might look at all these studies and develop unrealistic expectations that might cause more harm than intended, or leave healthcare professionals cleaning up after Big Techs mess. I wouldnt tell people to buy an Ava bracelet for this [purpose] tomorrow, Avas von Bidder says. We clearly tell people to not do it. In the event an accurate, thoughtfully implemented, FDA-cleared, device-agnostic algorithm is built and rolled out to fitness trackers and smartwatches the world over, privacy is a big asterisk. After all, tech companies train their algorithms with lots and lots of valuable health data. Technically, the Health Insurance Portability and Accountability Act (HIPAA) exists for protecting your medical information, but experts have been saying for years that the legislation needs to evolve with the times, particularly with regard to wearable technology.I spoke with Whoop, Fitbit, Stanford, and Ava about how theyre approaching data privacy with regard to studying covid-19. The answers across the board boiled down as follows: All ethical standards are being adhered to, all data is aggregated, none of it is being shared with advertisers, and every study is completely opt-in. Whoops Capodilupo told me that Whoop only began looking into covid-19 once users who tested positive reached out and volunteered their data. That said, Snyder mentioned that one big draw of collaborating with Fitbit is the companys expertise in managing lots of data in real-time. When I asked Fitbit about that, the company reiterated its commitment to privacy and said that no data collected is personally identifiable. And, again, everyone has to opt-in when they enroll in Stanfords study. But the research part isnt exactly the problem. Its what comes after. Who owns any potential algorithm that gets made? How do you convince wearables companies to implement tech they dont own on their devices (especially if its not clear how itll be monetized)? Who gets to see how often you get sick, and who owns that data? Does HIPAA protect that information if its not being directly shared with healthcare providers, but instead sent to users as a notification? If the FDA expedites approvals for wearable diagnostic features during the pandemic, does that set a new precedent once this is all over? While Stanford is working on a device-agnostic algorithm, its less clear whether a potential algorithm out of the COVI-GAPP study will work universally. Wearable makers are collaborating with researchers and letting them take the lead now. Yet after the research is done those makers could create their own proprietary covid-19 detection algorithms. Ideally, like Apple and Googles forthcoming contact tracing tech, any covid-19 detection algorithm for wearables would work on any available device for quick, widespread adoption, not just a specific brand. In the event of proprietary algorithms, we should all be a little wary. Fitbit and Withings are two wearables companies that have already released trends of how their users have been impacted by covid-19. All of the data is aggregated, but you get a glimpse at just how much these companies know about us. Withings, for instance, published a blog that includes a breakdown by country of how much weight people have gained (or havent) since lockdown policies began, what types of workouts people are doing, and how much sleep people are getting. Fitbit published several blogs, complete with graphs, maps, and charts about physical activity, sleep patterns, and whether people around the world are complying with lockdown orders based on step count. This data, while valuable, isnt quite on the same level as the data in your medical records. But early infection predictions? Thats more of a grey area, and its unclear whether people will trade their health data for what could be a life-saving diagnosis. The concern over privacy is warranted. Its one of the leading reasons why people will not get a fitness tracker or a smartwatch, Ramon Llamas, a research director at IDC who covers wearables technology, told Gizmodo. But if we add covid-19 to the mix and we come up with a workable solution, some people may change their tune. It should be on these vendors to get it right. Llamas said all the research points to a simple fact: Convenience trumps everything. While there are potential downsides to most new technology, a killer app or function makes the privacy trade-offs easier to bearespecially ones that could save your life. For example, the very first Apple Watch was characterised as an unnecessary luxury, but millions have since warmed up to the idea of owning oneor gifting onebased on the premise it could improve your health. If a smartwatch could reliably tell you when youre sickor about to beit might make giving up a degree of privacy more palatable for some people. Its also possible that early detection capabilities might not be convenient enough to quell privacy concerns. Instead of sparking excitement or relief, covid-19 diagnostic tools might instead conjure dystopian images of Minority Report and Black Mirror. Its impossible to judge either way until the technology is fully developed and ready for mass market. Some people might think about saying, alright, what do I have to give up in order to have this little bit of convenience and peace of mind? Llamas said. Its a matter yet to be sorted out, but if anything its going to be enough to give people pause. So, is it possible that smartwatches could help mitigate the spread of covid-19? The answer is unsatisfying. Its not all marketing bullshitthere is credible evidence that wearables might be able to help us better understand, and in the best-case scenario, early detect infectious diseases. But there are also a lot of unanswered questions and unknown variables that make it hard to say with certainty that wearables will be helpful right now. Even if a breakthrough is found, its not evident thatll change how public health officials approach this pandemic, Tsai said. Whats needed is more testingwhich is what health officials have been repeating ad nauseum since this all began.The impulse to at least try and solve the problems caused by covid-19 with wearable technology is understandable. But its also important to remember that whatever algorithms, software, or devices eventually hit the market, they wont magically restore the world back to the way it was. After all, theres no putting the novel coronavirus back in a box. Scientists say the pandemic will likely stick around until a vaccine is developed or widespread natural immunity is here. Theres a lot of potential for a wearables-based solutionand a lot of regulatory hurdles that exist to protect the public from any cut corners. If one day soon your wrist buzzes and your smartwatch asks if youd like to participate in a covid-19 study, it might be worth considering volunteering your data for science. Maybe doing so will help make a future pandemic less of a nightmare.