Sharing tools and data will help us beat COVID-19

My patient’s voice quivered as he told me about his wife. She had COVID-19 symptoms but was too afraid to go to the hospital. By the time paramedics came to his house for another family member who fell ill, he was wracked with worry. “Please check on my wife; I don’t know if she’s ok to be at home,” he told one paramedic.

Isolated in their second floor room, his wife’s shallow breaths gave the paramedics a jolt as they realized she had an oxygen saturation level of 75% on room air and difficulty breathing at rest. She was immediately taken to the hospital and, as her condition worsened, was later transferred to the Intensive Care Unit.

As I was consoling my patient, repeating my hope that his wife recover quickly, I couldn’t help but wonder how his situation could have been different if we had an early warning system in place. What if she had a symptom tracking tool that would have told her to seek care earlier? What if she had a connected device to measure her blood oxygen level or thermometer that could have communicated early signs of deteriorating health? What if a care provider could have been prompted to touch base with her on a daily basis?

I lead a COVID-19 assessment centre near Vancouver, Canada and I daily come across cases where people present with flu-like symptoms. These range from the classic symptoms of fever, cough, and shortness of breath to less well known symptoms associated with COVID-19, such as anosmia (loss of smell) and stomach upset.

Here in the province of British Columbia, in Canada, we have restrictions on who we can test and this means that many patients who are positive are not tested but sent home to be followed up closely. Despite that close follow-up, some patients slip through the cracks. Recently, a 47-year-old COVID-19 positive patient died at home. Why he died at home and wasn’t able to seek care earlier is unclear. What is clear is that he is not alone. Every day around the world we hear about COVID-19 positive people who succumb to the disease without ever finding their way to a hospital. This happens both in places with poorly and well-resourced health systems.

It is tragic and prompts the question: could these deaths have been prevented? The hundreds of companies, universities, health authorities and government bodies that have released self-assessment apps, symptom trackers and COVID-19 specific tools would suggest that, yes, we can use technology to better understand how the novel coronavirus is spreading; what its health effects are; and how to disseminate targeted health messaging to people. Packed with geolocation, contact tracing, and self-diagnosis features – to name a few – these apps would have us believe that they can help save lives and improve health outcomes. This is true and for some more than others. Yet what this mass of innovation misses is two important points about how this pandemic can most effectively be beaten back.

First, we cannot defeat what we can’t understand. If there is one thing more important than vaccines in this pandemic, it’s data – data about transmission dynamics of the novel coronavirus, about symptoms, testing results and hospital admissions. Data that is verified, longitudinal and varied is needed to help us better understand the impact of the disease on the population and health systems. We’ve heeded this call and the COVID-19 global response is awash in exabytes of data, yet a great deal of it is trapped in walled-off databases. Just as social networks have network effects where the value of the platform becomes greater than the sum of individuals who join, so too does data gain new uses and offer novel insights when it is combined with complementary data.

Second, we need to create open-source structures that allow national and sub-national level health systems to collect and share this precious data in a timely, privacy-preserving manner. Fragile health systems around the world have already been overwhelmed with the tsunami of demand that has arisen from the spread of COVID-19. Everyone racing to create their own solutions to problems negates the need for speed we have in this pandemic. An epidemic somewhere has the potential to become a pandemic everywhere. We need to share tools – both hardware and software – openly and understand that short term gains in one area of the world are meaningless if not shared with other areas that are battling this virus.

In order to address these two points, we need a global entity with the convening power, technical acumen and financial resources to shepherd a public-private collaboration and promotion of stakeholder capitalism as the world has never seen. The World Economic Forum, World Health Organization and other UN agencies are well-positioned to form such a global, open source initiative, one that can leverage the resources of governments and the private sector to rapidly prototype open-source tools, share their blueprints and code with other locales, and help them to be customized as literal and figurative armour against this disease. Open source need not mean lack of profit. Innovative business models could be built around the use of these tools to spur further innovation and income.

When we emerge from this pandemic, we will not remember the billions that were made but the billions who suffered. Let us be proactive not just in creating more hackathons and social impact funds but a true, coordinated revolution in global, open-source data sharing that can help us all have a fighting chance against COVID-19.