Wearable tech shows promise for early COVID-19 detection

Scott Tong Feb 22, 2021
Heard on:
A Stanford University COVID-19 study is tracking people with Apple Watches, Fitbits and other trackers. Above, an Apple Watch from 2014. Justin Sullivan/Getty Images

Wearable tech shows promise for early COVID-19 detection

Scott Tong Feb 22, 2021
Heard on:
A Stanford University COVID-19 study is tracking people with Apple Watches, Fitbits and other trackers. Above, an Apple Watch from 2014. Justin Sullivan/Getty Images

Fitness trackers and other wearable tech devices have steadily attracted a growing audience of exercise buffs and step counters, but now the technology may be deployed for an entirely different use: predicting COVID-19 cases.

Based on promising early data suggesting predictive patterns of heart rates, respiratory rates, heart rate variability and body temperature from consumer fitness devices, academic researchers have begun clinical trials to assess whether wearables and big data algorithms can provide warning signals long before a person’s symptoms.

This reporter’s Oura Ring biometric data: sleep, activity, heart rate, temperature, etc.

Early studies began once the pandemic hit. At the University of California, San Francisco, Osher Center for Integrative Medicine, researcher Ashley Mason was studying a different condition, hyperthermia, tracking patients’ temperatures with consumer fitness devices known as Oura Rings.

Starting at $300, the ring is a chunky metal band with sensors in the middle to monitor body temperature, calories burned, sleep and other biometric data.

When the pandemic came, Mason got thinking.

“And I said, ‘Gosh, it’s really neat that these things measure temperature. And fever seems to be such a prominent symptom in COVID. What if we could measure this?'” Mason said. “And we thought, ‘Sheesh, why don’t we do this?’ And the company said, ‘Hey, we’ll provide rings.'”

The Oura, along with a separate donor, provided more than 3,000 rings for medical professionals in several states to look for patterns of biometric signals in subjects who contracted the virus. Subjects also include tens of thousands of willing Oura Ring owners.

Normally, getting a study like this approved and funded takes months.

“Things happened with unbelievable lightning speed like I have never seen in my life as a researcher,” Mason said. “I believe that the conversation where we conceived of this idea was on a Wednesday night. I think that we had a contract by Sunday night.”

Oura Rings are more convenient and far less invasive than temperature trackers often used in other medical studies.

“I don’t really think I could convince people to wear an indwelling rectal probe for a week,” Mason said. “I think that’d be pretty difficult. But getting them to wear an Oura Ring for a week is a piece of cake.”

Her team found that, out of 50 study subjects diagnosed with virus, 45 showed early warning signs from their rings in advance, Mason said.

“This work shows the feasibility of gathering fever-related information from distributed populations using wearables,” states the research group’s paper, which was published in December in the journal Scientific Reports. “This work is only the proof of concept to support a great deal of future work.”

The use of the fitness ring device for research purposes turned out to be “a beautiful historical accident,” said Benjamin Smarr, lead author of the study and assistant professor of bioengineering at the University of California, San Diego. “They put in this temperature sensor not knowing fully what it would uncover, but it was just a new source of information. And it was very prescient, because the finger turns out to be a great place for looking at your pulse.”

For this story, the Oura company sent me a ring to try out, assessing not only my exercise and sleep patterns, but also something called “readiness” — a composite score of all the measurements to score my overall health every morning. For one wearer, an out-of-whack readiness score turned out to be critical.

“I woke up my, readiness was 68, and I’m like, ‘That’s a little weird.’ My normal is like 80 or 92,” Renee Belz, an Oura Ring wearer based in Las Vegas, said, recalling an episode in June. At the time, Belz and her husband, Ryan, were taking a staycation at a local resort. She was tired, but had no fever.

Oura Ring owner Renee Belz’s heart rate variability dipped before her COVID-19 diagnosis. Courtesy: Oura

“I’m walking around a casino, passing through all the temperature checks just fine,” Belz said. “But I knew, ‘OK something’s up.’ We checked out. We went home.”

Days later, she and her husband tested positive for COVID-19.

Ryan Belz’s respiratory rate jumped before his COVID diagnosis. Courtesy: Oura

This promise of early detection has some organizations trying wearables on their own. At Oakland University in Michigan, hundreds of students began wearing BioButtons, digital coin-size fitness tracking patches that tape to the chest, just after Thanksgiving.

The hope is to catch any outbreak early.

“We were thinking of students in residence halls,” David Stone, Oakland University health science professor, said. “And trying to limit that one case from becoming 50 cases, and from having to shut down the campus. Or shut down a dorm.”

The BioButton can also help with contract tracing.

“If you were wearing the button and I was wearing the button,” Stone said, “and I was positive and you came within Bluetooth range, 15 or 20 feet of me, and stayed there for a half an hour, your data would know that.”

Not all students chose to wear the button, and data privacy is a question wearables makers and researchers have to address. And for now it’s still unclear how convincing the results of current studies will be.

Stanford genetics professor Michael Snyder’s TED talk on wearables and medical data.

Stanford University genetics professor Michael Snyder is running his own COVID-19 study, tracking people with Apple Watches, Fitbits and other trackers. Snyder said the potential breakthrough here is not just fighting the current pandemic, but having the medical community take wearables and sensors seriously.

“The average human has a total of zero sensors, whereas your car has maybe up to 400 sensors,” Snyder said. “And that drives me nuts. I think that, you know, people are more important than cars.”

Down the road, consumer wearables may be able to predict other viral infections, as well as bacterial infections, heart ailments, lung disease and diabetes, Snyder said.

“We want it to be like a car dashboard,” Snyder said, “where your engine light goes on when something is off.”

Both the UCSF study and the Stanford study are actively recruiting volunteers.

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