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The Pivot Point

Molly Wood Jul 31, 2020
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Dr. Paul McKay, who is working on an vaccine for COVID-19, looks at bacteria containing the coronavirus' DNA fragments at Imperial College School of Medicine in London on Feb. 10. Tolga Akmen/AFP via Getty Images
Specials

The Pivot Point

Molly Wood Jul 31, 2020
Dr. Paul McKay, who is working on an vaccine for COVID-19, looks at bacteria containing the coronavirus' DNA fragments at Imperial College School of Medicine in London on Feb. 10. Tolga Akmen/AFP via Getty Images
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Marketplace has been reporting on how the pandemic and protests against systemic racial inequality will change our economy. As part of our series, “The Economy: What Now?” we’ve reported on technological innovations in health care, the workplace, education and how the key to almost all of it is the internet.

First though, if you’re talking about the future, get a futurist. Amy Webb is one. She’s the founder of the Future Today Institute. She advises businesses on how to shift their thinking to ensure a better long-term future. Webb says the key to that is flexibility.

Amy Webb: I believe that catastrophe can be a great catalyst for positive change. And part of the reason for that is because when we are looking for certainty, we continue to sort of lock ourselves into our cherished beliefs. And sometimes the best inventions are born in those moments where you couldn’t control for every possible variable and you had to make different types of decisions.

Molly Wood: Is there a certain type of thinking then or a certain type of leadership that allows you to set aside that fear?

Webb: So the organizations that I think have always thrived under tenuous circumstances where there is a lot of uncertainty are those organizations that have a very strong idea of what the future should look like, but are flexible in their approach to achieving that desired future state. So a leader that is curious about the future rather than cautious, a leader that is more interested in creating a state of preparedness than predicting exact outcomes is going to create the type of organization that doesn’t just survive this current situation that we’re in, but thrives.

Wood: We’re now several months into this pandemic. And it’s clear it’s going to last a while. What innovations do you see happening now that will help us get to a better post-pandemic future?

Webb: So somebody in the United Kingdom developed something called the hygiene hook. This is a handle with a little hook on the end so that you can open up doors without touching them. We’re also starting to see all different types of form factors for masks and gloves. And even my daughter, who was totally obsessed with “Spider-Man: Into the Spider-Verse,” built herself this little wristband. She put a little pump on it so she can squirt out hydrogen peroxide on a surface about 6 inches in front of her, which is good. Turns out hydrogen peroxide also is a bleaching agent, which I guess we didn’t think through in advance. But my point is this: There’s innovation coming from everywhere.


Let’s begin with health. Scientists are working all over the world to develop treatments and vaccines for COVID-19 and to figure out how to make testing for the virus cheaper, easier and faster. One of those scientists is James Collins. He’s a professor of bioengineering at the Massachusetts Institute of Technology who specializes in synthetic biology, an area of science that applies engineering principles to living cells. Or in this case, to parts of the cells to create a different kind of virus test.  

James Collins: We showed, going back about six years ago, that you were not limited to using living cells to take advantage of the power and diversity of biology. We showed that you could take what are called cell-free extracts — so, that is you can open up a living cell, take the machinery of that living cell out, which would be DNA, RNA proteins, and we showed you could freeze-dry them onto paper, along with engineered components, to make inexpensive paper-based diagnostics. What we’ve been doing to address the pandemic, among others, is now using synthetic biology to create highly sensitive, low-cost diagnostics, some that are now approved for use in clinical diagnostics labs, and now we’re moving towards point-of-care diagnostics, as well as at-home diagnostics.

Wood: So testing, as the normals put it, right? It’s being used to create faster tests, more accurate tests?

Collins: It’s being used to create both faster and considerably cheaper [tests]. And the last point is really very instrumental as we as a community and we as a world are considering return to work and return to school in the fall. There’s going to be a dramatic increased need for both rapid and critically inexpensive tests.

Wood: What else, as we look toward the next six to nine months, and maybe just beyond, this sort of near future of this technology and the COVID-19 pandemic — what else is going to be possible? I understand you’re actually working on a mask that detects whether the wearer has COVID-19?

Collins: Our lab at MIT and Harvard’s Wyss Institute is working, for example, on a face mask that could also function as a diagnostic. We showed in addition to having the capability of freeze-drying cell-free extracts along with synthetic biology, diagnostic sensors, onto paper, that you could also freeze-dry them onto textiles, onto cloth, to make so-called wearable diagnostics. And the idea there would be you put on the face mask, it would have this insert that would have the capability to collect viral particles that we give off, process it and if you were infected, would produce a fluorescent signal that you could detect. I’m happy to announce that we have made outstanding progress in the lab and are in the final stages of the integration steps for what would be a pre-prototype or academic prototype pulling this all together.


Now, of course, while scientists and companies are working on better testing and diagnostics for COVID-19, many other scientists and companies are working toward a vaccine. And they’re building upon work that goes back a long time.

“For hundreds of years, a vaccine was like, well, let’s take a dead piece of the bug and put it inside the body and the body’s immune system will figure out what to do,” said Safi Bahcall, a biotech investor and author of “Loonshots: How to Nurture the Crazy Ideas That Win Wars, Cure Diseases, and Transform Industries.”

The technique he’s talking about is how the first measles vaccines were created in the 1960s. 

“The body’s immune system is sort of like sniffer dogs. You give a little taste of the virus, a little piece of the sweater or an old shoe, like a little fragment of the protein of the virus,” Bahcall said. “And then those antibodies go hunting around your blood, and they start policing the blood for anything that smells like it and then attack it as soon as it comes into your blood.”

So that’s one method of creating a vaccine. Then, about 40 years ago, scientists added a different technique, where they would genetically engineer those virus proteins in a lab. That meant better quality control and a faster, safer, cheaper process.

These days, scientists are using both of those methods to attempt to create a COVID-19 vaccine, along with another, much newer approach. It’s a little complicated. 

“Suppose instead of manufacturing all these viruses, or protein fragments, or dead viruses and using that as a vaccine, suppose we skip that step,” Bahcall said. “And just take the code, the instructions, the [messenger] RNA or DNA for making that fragment and give it to the body’s cells. So instead of having a giant lab in a warehouse cranking out these proteins that we then put into lots of vials and deliver billions of doses around the world, your own cells will be the manufacturing plant.”

While this technique has been around for 10 years, it hasn’t yet led to a successful vaccine for any disease. And that’s partly for lack of trying — or more precisely, lack of funding for vaccine research on viruses of all kinds. That’s holding us back and could impact our ability to develop vaccines for future viruses, too.

“The problem is there hasn’t been enough incentive to work in infectious disease. SARS-CoV-1, which came out 18 years ago, the first sort of version of the SARS virus, is 80% genetically identical to the current SARS-CoV virus,” Bahcall said. “We had started some promising work and promising drugs and promising vaccines against that first SARS virus, some of which may have been enormously helpful.”

These days, there is plenty of incentive to both cure and treat COVID-19. And those efforts are happening in parallel, so that even by the time we get a vaccine, we might have much better success at preventing deaths from the virus. Bahcall likened it to HIV, where there’s no vaccine, but drug development has turned the virus from a fatal condition into a chronic one.

“Every month, we get more data about what drug works. It’s not just the exciting stuff of, hey, a scientist in the lab came up with this awesome new molecule that nobody ever saw before, and it eradicates the virus on first contact. That’s not how it works,” Bahcall said. “Sometimes it’s like, well, a pretty boring old drug that none of us thought mattered very much actually works. Or the right combination: by itself, it’s OK, but if you combine A and B, it’s really amazing. Those don’t make sexy headlines, but they’re really important.”

So, despite all the very bad headlines, Bahcall said he’s feeling positive.

“One of the reasons that I’m optimistic is just the number of shots on goal that we have. And for most diseases, maybe you develop five drugs or 10 drugs in clinical trials. Today, we have over 300 treatments in development for COVID-19. Those of us working in the industry, we’ve never seen anything like this,” Bahcall said.

As these innovative technologies are developed, like diagnostic masks and new kinds of vaccines, the big question is: Who will get access to them? And who won’t? 

In some cases, algorithms and artificial intelligence might be making those decisions. A paper published in June in the New England Journal of Medicine looked at how artificial intelligence is used to determine treatments and care. It found that many of the algorithms used in medicine use race as a variable.

Here’s an example. It’s hard to test directly how well a person’s kidneys are working. So instead, many doctors use an algorithm to estimate kidney function. The algorithm uses several factors, including race, to make these guesses, which can ultimately affect who gets a kidney transplant and who doesn’t. And that is a problem.

“Race is a social and not a biological construct,” said Leo Eisenstein, a physician at New York University and Bellevue hospitals and one of the authors of the paper. “We’re seeing differences in outcomes, not because people who are Black have essentially different bodies, but their experience of being Black in this country is essentially different.”

But encoded in the world of health care is the idea that Black and brown bodies are different. As a result, “there’s an excuse for why there are any inequalities of health in the notion that these are produced naturally by racial differences,” said Dorothy Roberts, a professor at the University of Pennsylvania who wrote a book about race in science and medicine.

“People will say Black race predicts for some bad outcome, when it’s actually structural racism that’s operating to put people in a vulnerable position where they are at risk,” she said.

Roberts talked about one study that examined why Black women in Chicago started dying from breast cancer at a much higher rate than white women beginning in the 1990s.

“The researchers concluded it was not because Black women’s health got worse. It was because there had been huge advances in breast cancer detection and treatment over those 20 years, and the best machines are located in private hospitals, where more advantaged people go,” Roberts said.

Roberts said that history makes her deeply worried about government and hospital rules that could determine who gets lifesaving technology to treat or prevent COVID-19.

“There are ways in which racism is built into these rationing guidelines, which are based on a premise that scarce resources shouldn’t be wasted on someone who might die at the hospital,” Roberts said. “Now, because we live in a society that is structured by racism and racial capitalism, this tool is systematically going to discriminate against Black patients because they have already experienced a society that is set up in a way to produce lower life expectancy for them.”

A handful of hospitals around the country have stopped incorporating race into the algorithm that predicts kidney function and can affect who gets a kidney transplant. But Roberts said changing algorithms is just one part, and the solutions need to be systemic. 

“One way of addressing this is not just to tinker with the algorithm,” she said. “Just because you’re good at math and tech doesn’t mean you understand the social context and inputs that are going to make a difference in the algorithm. And I always say, if scientists are going to get into the business of social policy, they cannot just rely on what’s in their heads.”

Across the United States, Black people are dying from COVID-19 two times more often than white people. Pacific Islanders, Latinx and Indigenous people are also more likely to die from the virus.


I’m Molly Wood.  You’re listening to “The Pivot Point” from Marketplace. We’re talking about the technology that could help us transition to a post-pandemic future. 

Part of that future will involve going back to work. Ideally, not if you’re sick. So in addition to plexiglass, air filtration systems or fewer desks, some companies have spent tens of thousands of dollars for thermal cameras, which promise to spot someone with an elevated temperature from a distance. Do these cameras work, or is this just a form of health security theater? Meghan McCarty Carino, who covers workplace culture for Marketplace, explains. 

Meghan McCarty Carino: I always think about “Predator” vision when we talk about thermal cameras. This kind of allows for a big, industrial camera that does automated, instant temperature taking by mapping infrared radiation from people’s skin. It’s a lot faster than having a person standing out there with one of those temperature guns taking everyone’s temperature.

Molly Wood: But I understand that it’s not as good as “Predator” vision.

McCarty Carino: I guess it depends what the objective is. If the objective is to stop sick people from coming into your workplace, maybe no, not as successful. There’s a question of accuracy with just how well the devices work. These are generally not medical devices. They are made, by the most part, by security companies. They can be influenced by lots of different things. They take the temperature of the skin on the face — cold or hot weather, that can affect the temperature of one’s skin, or if someone is wearing glasses, or if they have some dampness on their skin, some sweat. All those things can affect the accuracy of the devices.

But the Food and Drug Administration has allowed these devices to be marketed on a temporary basis without any kind of verification of their medical veracity. The companies can basically say whatever they want. The FDA does suggest that if someone is determined to have a temperature taken with one of these devices, that they get some other secondary verification using an internal temperature taker, just your regular thermometer. But there’s really nothing requiring these workplaces to do so.

Wood: What other concerns are there around scanning workers constantly in this way?

McCarty Carino: One of the biggest is the fact that these devices generally also come with facial recognition software as part of the deal. If you’re scanning everybody’s temperatures as they walk in the door, you need to have a way to identify who the people are that are triggering the system so you can identify who to send home. There could be some thorny legal issues. A number of states have started passing these biometric data laws, privacy laws having to do with collecting information about individuals’ fingerprints or their voice. This is something where these systems could kind of become part of a greater surveillance infrastructure. Groups like the American Civil Liberties Union are up in arms about having these installed at, say, all airports and hospitals and all kinds of businesses all over the place.

Wood: If this thermal scanner says that you’re sick and you are sent home, you can’t come to work, will you still be compensated for that time?

McCarty Carino: That is a bit of a question mark. The Coronavirus Aid, Relief and Economic Security Act did provide for two weeks of paid sick leave, but it excluded a lot of people. We’re talking about gig workers. We’re talking about people who work for companies with more than 500 employees or less than 50 employees. So there are a lot of workers who may get sent home and not be able to collect any pay.


Companies are also going to want to know when someone’s infected and who they’ve been in contact with. Enter digital contact tracing. The global consulting firm PwC, also known as PricewaterhouseCoopers, is selling a suite of health-tracking products to companies, including this type of app.

“What it does is using Bluetooth signals and also other ambient signals within a building, identifies when two employees are coming close to one another,” said David Sapin, with the connected solutions division of PwC.

Then, if one of those employees gets sick with COVID-19, the employee will tell human resources, which will notify any co-workers who were in contact with that person. Yes, there are privacy questions. Sapin said only HR will know if you’ve been in contact with someone who’s been sick and will notify you, but not identify the person.  

PwC told us the app is being used by more than 30 clients in Europe, Asia and the U.S. 

“People are beginning to realize you’re going to need to have something like this in order to come back into the workplace,” Sapin said. “I think this is one thing that if you want to work from home and continue to work from home, and that’s OK with your job responsibilities, that’s fine. But if you’re going to come back into the workplace, you need to accept having this type of app on your phone.”

PwC said colleges and universities are also interested in using the app as a part of their return-to-campus strategy.

But what about when it is just too dangerous for humans to do certain kinds of jobs? Maybe robots can help. Ayanna Howard is a roboticist and professor at Georgia Tech. She said the pandemic has been a boost for the U.S. to get more robots into the workplace. 

Ayanna Howard: One of the things, if you think about human and people’s relationship to robotics, it’s been kind of a love-hate relationship. Most people, they might buy a Roomba, for example, but a lot are like, “No, I’m not doing that. Robots? Please.” But what we’ve seen now is there’s this adoption of robots in the home, in the workplace, in the hospitals and clinics, because it fulfills a need that cannot be filled by people anymore.

Wood: It seems like there are lots of different aspects to this. Maybe someone can’t have their cleaning lady come and they just need help because we’re cooking at home all the time, making a bigger mess. But there’s also robots in the context of medicine and robots in the context of companionship. Talk a little bit about these various roles that we’re seeing become more necessary.

Howard: Yes. So I would categorize them into buckets. So there’s the set of robots that are being used for addressing issues with a pandemic. So it’s robots that are being used in the hospitals and in stores to clean and disinfect, right? So that’s a needed attribute that robots are able to fill. But then there are also robots for the home environment that provide us a little bit of the social interaction. There are robots, and we design them, that … understand humans, and so they can be emotional, they can be reactive. And because we are not able to interact with those outside of our home as much, the robot, it’s a replacement. It’s not the best replacement, but it gives us a little bit of humanity that we can touch with and interact with. And so there’s an increase in these types of devices and development and products.

Wood: As you kind of look ahead at the next, say, six to 18 months, what do you think is going to happen in this field? How fast are companies going to move and pivot and adopt?

Howard: I will say exponentially, except that exponential is based on what the first number is. But I would say exponentially, with all the caveats that go with that. And it’s only because we still need to live, we still need to function, we still have human needs and human desires. And we still want to go to work when we can. And how do you do that safely, given that we can’t physically do a lot of these thing? Robots and artificial intelligence fill that space. That’s in at least the near future, which is, again, at least a year based on all the reports. That means it’s going to accelerate, and then once we’re on the other side of COVID, we would become accustomed to robots and AI, and so I think it will become the new norm.

Howard also said there is real fear about robots taking people’s jobs, but that new jobs will emerge, too, such as robot mechanic.


On now, to education. Millions of students switched to distance learning this spring, and millions will still be doing remote schooling this fall. Those transitions happened fast, and at first, some kids were excited. 

“What I thought was, oh, this is gonna be really fun,” said Louisa Padwe, who just finished third grade in Yarmouth, on the coast of Maine. “And I thought, oh yay, I can wake up late, really late, and just do whatever I want.”

Louisa worked from her beanbag chair in her bedroom. But she had a hard time keeping up. “It would take me a long time to complete one assignment,” she said. “And then I’d have two days’ worth of assignments, and then I wouldn’t have any time to do anything else.”

Jonathan Padwe, Louisa’s dad, noticed she was getting distracted by some of the digital tools, like the types of pens she could use to fill in a worksheet. “She eventually had, like, an overflowing inbox, basically,” he said.

He’s a college professor, so no stranger to an inbox full of assignments, but he thought it seemed too much for a third-grader. “This idea that she’s sort of like an office worker, this is not a natural way to be a kid and it’s not a natural way to learn,” Padwe said. “And I think that this classroom tech has got to figure out a way around that.”

Some educators say this is an opportunity to bring more kinds of technology into schools to see if it can help kids learn in different ways. Stacia McFadden is the director of academic technology at the Lovett School, a private school in Atlanta. Part of her job is to help teachers use new tools, like having kids create a podcast or make a video, rather than just writing a report. And she said for some kids, being remote wasn’t all bad.

“We saw kids who are typically introverted come out of their shells a lot,” she said. “So it was interesting to see kids using the chat feature or just being a little more engaged because they weren’t afraid to interact virtually, than being maybe shy in a classroom.”

Also in Atlanta is Maria Constance Pizano. She’s a media and technology consultant for private schools and knows that not all schools are able to provide students with their own computers. But for schools that do have resources, there are lots of things they can try.

“A second-grade student, instead of just turning in a worksheet or doing a Google Form assessment, would take a word problem and create a stop-motion animation,” Pizano said. “Or a third-grader would do their book report using the green-screen app.”

Green-screen apps work kind of like a television weather forecaster’s map. Kids can stand in front of a green sheet of paper and put pictures behind them.

For older kids, Pizano said, there are options like virtual field trips.

“Google Arts & Culture is the place that can kind of transport you to a museum and you have a virtual reality experience, or you can find yourself standing in the middle of an, you know, an ancient site,” she said.

Of course, to get the full experience, the kids have to own a virtual reality headset. We’ll talk more about these inequities later in the show.  And to be clear, both Maria Pizano and Stacia McFadden said technology can do a lot, but human interaction still really matters.  

“The ideal distance classroom just doesn’t exist for educators, right?” McFadden said. “You’re learning about tactile development. You’re touching, you’re feeling. Kids want to hug their teachers. But, I think there are opportunities for us in thinking about the future of education and what blended learning looks like.”

Plenty of tech companies are making tools for classrooms. Many more might jump in, and that could be a double-edged sword. Tech can help evaluate how well kids learn or engage. But that means collecting a lot of data, too. Monica Bulger thinks a lot about this. She’s a senior fellow at the Cooney Center, a research and innovation lab founded by Sesame Workshop.

Monica Bulger: Things that we know are collected, in terms of things that teachers are able to see, are timestamps, how much time spent on task. Things that are likely collected also are latitude and longitude, things like the device that they’re accessing from. Also, things like how much battery they have. Now, that’s an interesting one, because battery levels are being used now to predict whether people will pay back loans. So, there’s a lot of room here. If you think about a latitude/longitude that indicates someone’s at McDonald’s or somebody living in a hotel, or accessing from a hotel, you start to see the ways data can actually provide a lot of information about our kids that we may not have wanted to share.

Wood: There are rules, federal rules, around data collection with respect to kids. It sounds like you’re saying they’re not enough, or maybe parents don’t know enough to opt out?

Bulger: No, actually, what I’m saying is that the corporations themselves aren’t transparent enough for us to even know what they’re collecting. In terms of opt out, that is a really interesting angle to all of this, because there are no options for opting out of fourth grade. Right? If the schools are using Google for education, parents don’t have a choice of whether to opt in or opt out.

Wood: What more will we see? What new kinds of metrics might be introduced here to measure student performance and engagement?

Bulger: I’d like to be positive about this for a second. I can do both, and I think we will, probably but I’d like to be positive for a minute and imagine the potential for this moment. The way edtech is designed is usually by engineers, and teachers are brought in after the fact, if at all. What might be really wonderful in this moment is if there ends up being just a wave of feedback on how data could be useful in classrooms.

Wood: Are there skills that we could see kids develop as a result of some of this technology or even some of this data? I have a 13-year-old, and things that we talk about a lot is the ability to project manage your day. I wonder if we could start to see some of those skills develop in kids earlier, as a result of some of these tools

Bulger: In terms of managing their day, an interesting finding is speaking with students about how these tools are impacting how they’re learning, and one thing is increasing quantification. So, looking at their scores, but also looking at what percentage of their grade different assignments are, and then determining what score they need to keep their GPA at the level they want it, and so then putting that much time into it accordingly.

Wood: That seems like a kind of great and dangerous thing for kids to learn. I mean, they definitely do their own decision-making around what is important and what isn’t, but maybe quantifying it could make it better.

Bulger: I’m both concerned about that and see the positives. But mostly I don’t really want learning to be reduced to numbers. Because, I wonder what books I may not have read in high school if I knew that it was only worth, you know, 5% of my grade or something, and what I might have missed out on.


Distance learning requires a functioning device, digital literacy and, of course, a robust internet connection.  A new report from Common Sense Media and Boston Consulting Group found that at least 15 million students in the U.S. lack either a device or internet access, and 9 million kids lack both.  Those disparities are worse in rural communities and in Black, Latinx, and Native American households.

Hundreds of thousands of K-12 teachers also lack hardware or internet access. Elizabeth Gettelman Galicia is vice president for policy at Common Sense Media.

Elizabeth Gettelman Galicia: We heard from students and we heard from teachers about trying to navigate learning. For example, there was a student who was trying to download a four-minute algebra video, and it took over half an hour. Or we heard from teachers who weren’t able to upload videos that they had made, or host a Zoom class, so had to drive to a parking lot where they could access free WiFi. What else do you need? You need a device. Now, data shows that nearly all U.S. households have at least a mobile phone. Now, try to do a book report or you know, navigate a chemistry lesson, on your phone. Mobile-only is not going to cut it, either, when it comes to distance learning.

Wood: How much would it cost to try to close this divide, given all those factors?

Galicia: It will take an investment. It’s a range, $6 billion to $11 billion to get students ready to learn. That range represents, so if you’re talking about just basic access for kids, they have high enough speed that they can participate in a couple of hours of interactive instruction during a day. A lot of learning may happen independently, where they’re figuring out when they can download things and there’s one device in the home. Now, the high-end accounts for, Census data right now shows that there’s an average of two kids per household, and the recommendation is to have a 1:1 ratio of student to device. So, you would allow for a device for each student, you would have an environment where you could be participating in interactive online learning throughout the day. That would allow for the kind of learning environment that I frankly think teachers are really hoping for, if they if they want students to succeed when it comes to distance learning

Wood: Where might that money—I mean, does that need to be federal investment?

Galicia: This would be something, and this is an ask out to Congress, and this is talking about putting in funding that would allow schools immediately to purchase hotspots for families to get devices in the hands of families and get reimbursed. It’s interesting, we have precedent in the past. If you think about free and reduced-price lunch, why not have something like free and reduced-price access?

Wood: Are there conversations or investments or innovations that you see happening now that do give you hope, that you think could potentially get us to a more equitable future?

Galicia: (long pause) I’m trying not to be cynical.

Wood: We all are. That’s why I’m asking you to help us.

Galicia: We’re co-sponsoring a bill in California, Broadband for All. There’s a parallel effort in California to close the digital divide that has industry involved, and we’ve seen tech companies step up with providing devices to students. We see a lot of low-cost and free broadband opportunities. Now those usually are time-bound. We want to see what are sustainable solutions. I think if industry can continue to lead the way by showing where they’re willing to step up, that really sends a message to policymakers.


So clearly, the internet is in many ways, an essential service in this economy. But as our listeners told us, access is not equal. 

“I’m a technical communication professor. That means that I am helping students learn how to write and communicate in workplace environments. Oh no, my internet connection is unstable,” said Erin Pavlak, who lives near Fort Worth, Texas, as her Zoom connection was starting to fail.

Those glitches happen to Pavlak and her family a lot. Her husband is a software engineer and their daughter is 8 years old. They have video meetings and school online, so they drew up a calendar to prioritize who could be online and when. Pavlak and her family only have one choice for internet access, and it costs them more than $100 a month.

According to a 2017 analysis by the non-profit Institute for Local Self-Reliance, 129 million Americans—about 40% of the population—have just one choice for broadband access. Frank Reid lives in southern New Jersey and has two choices.

“I’m more than willing to play them off against each other and switch providers as needed. I mean, that’s the game they’ve chosen to create, so I’m just going to play it the way they want us to play it,” Reid said.

In Atlanta, Aaron Honegan works a rotating schedule in IT. “I’m originally from Jamaica. Internet was not, it was more of a luxury item,” he said.

Now, Honegan works from home, and it’s a necessity. He has a cable connection and backups for when things drop, which did happen in the middle of a night shift. “I just switched to my hot spot. It was good enough for me to continue working for the next couple hours until the end of my shift there. But that night if it still wasn’t working, I was preparing to have to travel to the office,” Honegan said.

Ariel Smythe lives in Minnesota, just north of St. Paul. She’s retired, lives on a fixed income, has a flip phone and went months without internet when her library closed early in the pandemic. She’s thought about getting her own connection, but “I would have to somehow work that in along with the electricity and the water and the gas, etc., etc.,” she said. “Right now, there’s just not really room to do that.”

This fall, the Federal Communications Commission is planning to award up to $16 billion to increase broadband availability across the country. But the data the FCC is using to decide where broadband is most needed is wildly inaccurate, even by the agency’s own admissions. Nicol Turner Lee researches technology access as a fellow in the Center for Technology Innovation at the Brookings Institution.

Nicol Turner Lee: When you don’t know where broadband is deployed, you find yourself in the situation that we actually saw with educational institutions — 53 million school kids mandated to stay at home, [and] out of that, about 15 million to 18 million, we believe, without broadband access in their neighborhood or in their household. The fact that we cannot get accurate, clear data, you don’t even know where to start when it comes to serving individuals within their community or within their homes. This is problematic, and I would say even more amplified as part of the coronavirus outbreak, because without that data, the absence of it makes it just so topsy-turvy and so unclear on how we begin to solve the digital divide.

Wood: Do you feel like collecting accurate data has not been a priority? How did we get in this position where this information is so unhelpful in some ways?

Turner Lee: I was going through some old paperwork, and one of the papers that I actually ran across was one in the mid-2000s, when the first national broadband map was actually released. At that time, it corresponded with the National Broadband Plan, which was a federal imperative to start this process of inventorying where broadband access was and what the correct strategies were to actually close or narrow the digital divide. What that suggests to me is we’ve had the starts and stops of broadband data. It’s the fact that the United States has been somewhat lackadaisical and really paying attention to the collection and aggregation of useful broadband data that allows us to, again, map out assets of what’s existing, but also identify areas where we need to do just a better job of getting people connected.

Wood: It sounds like what you’re describing is really an underinvestment. I wonder, to what extent have we also left that up to companies to dictate and decide?

Turner Lee: That is somewhat the case, and so as a result of that, the coverage maps that we see are largely dictated by where the return of investment is. If we were to speak about this pre-coronavirus, perhaps it would be necessary and critical that we have the information, but not a priority. Right now, it’s a priority.


Now, prices for internet access vary because of competition, yes, but also because of where infrastructure is built. Mignon Clyburn is a former member of the Federal Communications Commission. She said race and poverty have played a role in those investments.

Mignon Clyburn: If you were to go in rural areas where there is less infrastructure, less density, it is not uncommon for you to pay $150 per month for less-than-robust internet access. There are gross disparities when it comes to more affluent neighborhoods and more dense neighborhoods than there are for lower-income and rural communities

Wood: Is that mostly a function of infrastructure, or are there also competition constraints?

Clyburn: In urban communities, some of that is about redlining. There have been cases that have been shown where certain neighborhoods with more affluence, it has been shown that the infrastructure was not built, that robust offerings were not realized. I will say to you that in rural communities, it is partly a function of infrastructure. It costs more per square mile. You’re going to get less of a return on your investment, and so you do not see as much by way of infrastructure there, you see more satellite options out there, which cost more and oftentimes may not give you that robust coverage.

Wood: I really want to put a fine point on this because I think we have had conversations a lot that talk about last-mile problems and accessibility, and you’re saying that the disparity in internet access is also a reflection of social disparities?

Clyburn: Absolutely. You’re going to follow the money, you’re going to follow the “smart investment,” you’re going to follow the places where you’ve got mixed use or other businesses that you’re going to make most of your money from. Where those people live that work there, those are the places where the highest fees are going to go. But if you’re in a community where I sit, where I grew up, where it is definitely the working-class individual where they live, you’re not going to see as many options. You’re not going to see that investment, either on the roads or what is under the road or above attached to those power lines, because it has been assumed, by those, that the less affluent you are, the less likely you are going to use these advanced services. Honestly, the affluent part might be right, but in terms of use and need of use, that is totally incorrect.


We should note that after she left the FCC, Clyburn advised T-Mobile on its acquisition of Sprint. She said she believes the merger will bring service to underserved areas.


So, we’ve talked a lot about innovation, equity, home, work and school. But innovation alone isn’t a guarantee of success and it brings its own tradeoffs. Here’s our futurist again, Amy Webb, founder of the Future Today Institute.

Amy Webb: You know, the challenge is not necessarily inventing better technology. It’s the much more nuanced implications of all of these changes and shifts. So, if it’s the case that we’re able to test everybody [for COVID-19], and to store all of those tests, and to make sense of all of those tests, that’s great. But what are the data and privacy implications? Sometimes I feel a little bit like Cassandra. I’m the person at the party that’s like, “Hey, cool innovation. But what are the next order impacts?”

Wood: As you’ve heard throughout this hour, the next-order impacts largely lie in how evenly this future is distributed. There are questions about who will get a vaccine when it’s eventually developed, who will get a decent education and who will be left behind, who will be forced to work in dangerous conditions and who will be in their nice warm basement and who won’t be working at all.

Webb: It’s not like we’re all going to wake up this fall and the world will be back to normal. We’re going to be experiencing COVID aftershocks for quite some time. So getting around that is a matter of, if not becoming more resilient, then at least pretending like we’re all much more resilient in our tolerance for new information, new signals, how we’re making decisions and what our expectations are.

Wood: We should hope that those in charge, whether of new technologies or regulation or policy, will think like futurists, too.

Webb: The other thing to think about is: Are you objectively thinking about risk? And if the answer to that is no, then figure out what it’s going to take to move you from emotion to objectivity. And that might be data. It might be getting some close confidants to help you think through things. But assessing risk incorrectly could actually cause more harm in the future than what we’ve already been through.

Wood: It’s easy to imagine that tech is the answer to all our problems. We’ll just innovate ourselves out of this and every future crisis. And yes, in some ways, we probably will. But this pandemic is combined with incredible social change, and maybe there’s a reason for that, so that we’ll do a better job of recognizing when innovation alone isn’t enough. We still need empathy, a sense of shared responsibility and a belief that the future can be better for everyone.


“The Pivot Point” was edited by Michael Lipkin and produced by Stephanie Hughes. We also had production help from Jesus Alvarado and Matt Purdy. Scoring and engineering by Robyn Edgar, Daniel Ramirez and Bekah Wineman.

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