I had my own little COVID-19 scare a couple of months ago. I got a stomach virus, but evidence had already emerged that some who get sick with the disease have gastrointestinal symptoms like what I was experiencing. I read up while I was laid up and discovered that a reliable leading indicator of COVID-19 symptoms is your resting heart rate. That just happens to be something that the Apple Watch already has covered.
Both my resting and real-time heat rates were much higher than normal when I got sick. However, they slowly decreased back to their normal levels over the course of the next day, both of which are ideal for my age and fitness level. This made me feel a lot better, as I had some real evidence that this was just a run of the mill stomach virus, rather than the onset of COVID-19.
That peace of mind that I got from the data that the Apple Watch collects was the main reason that I wrote an article about that whole experience. There’s no substitute for a device that tracks and records the before, during and after of an event when it comes to diagnostics and troubleshooting. I do this kind of thing in my day job all the time and wanted to pass on the fact that the Apple Watch can already give you some insight into your health in the midst of a pandemic.
I’m writing about this topic again because I read an article at ZDNet about an ongoing study at Stanford that is looking at expanding the monitoring capabilities of smartwatches to potentially recognize pre-symptomatic or asymptomatic COVID-19 cases early. Participants in this study are given access to an app to download that tracks not only their heart rate, but also skin temperature and blood oxygen saturation.
I can’t help but notice that those last two are things that aren’t currently listed features of the Apple Watch. It’s been rumored before that Apple can actually measure blood oxygen levels with the Watch’s current heart rate sensor, but that they just don’t have FDA approval for it yet. It is known that Apple and Stanford have already worked together on studies involving the Watch and it’s quite possible that they helped this team to harness some extended capabilities of the device’s sensors.
According to the article at ZDNet, the study has already met with success, catching pre-symptomatic patients as many as nine days before they recognized symptoms, with an average detection of five days before.
The first phase of the study is designed to prove that wearables can pick up a coronavirus infection by detecting changes in heart rate and other physiological parameters. The results are promising, according to Snyder: the first case the lab investigated detected physiological changes indicative of an infection through their wearable over nine days before symptoms showed up.
“You can’t miss the signal. It’s very, very clear. That person is running around for nine and a half days ill, asymptomatic or infectious and not knowing it, therefore presumably infecting many others,” he said.
On average, the system is detecting the signs of coronavirus through wearables four days before the symptoms appear in most cases.
This is really significant data that could turn our smartwatches into a major weapon against the spread of the SARS-CoV-2 virus. The study is set to go on for two years, during which Stanford will tune its detection algorithm to more accurately detect the onset of symptoms and to hopefully become accurate enough to detect cases in people who have pre-existing conditions that might skew their baseline heart and blood oxygen levels.
I am interested to see if Apple seizes on this as a huge opportunity for the Apple Watch Series 6. If they go ahead and get the approval to use the Watch to take blood oxygen level readings, that would be a huge help in both detecting the disease early and helping those who are already infected and trying to manage their symptoms at home. Many COVID-19 patients have ended up dying at home because of the fast onset of respiratory failure. Having a constant blood oxygen level reading from a device that can alert you to a decrease, and even send a 911 call for you if needed, carries the potential to save lives. The Apple Watch has already proven itself many times over in this regard, but here is another way that it can be upgraded to expand that capability in a timely way.
Skin temperature is another value that I would love to see added to the Watch’s sensor readings later this year. While reading skin temp isn’t as accurate as some other methods and isn’t a lone indicator of sickness, it can be an important piece of data when used in context. When someone scans your temp before entering a building, that data frankly has limited usefulness. It may weed out someone who is getting sick, but there is plenty of room for false positives and it doesn’t account for asymptomatic cases of COVID-19.
However, if you take that skin temp reading and expand it to track all day, every day, that’s an entirely different thing. Now you can establish a baseline for a person and weed out highs and lows based on activity and time of day. Then you can really start to pick out trends in the data, such as a rise in temperature that is out of the ordinary. Combine this reading with heart rate and blood oxygen levels and you have a powerful tool against COVID-19.
We don’t yet know the full story about how early before the onset of symptoms a pre-symptomatic patient of COVID-19 is contagious. Early reports say as little as one to two days, but it could be three to five. There isn’t a lot of certainty here yet. And we may not have hard data on asymptomatic carriers for a few years. That’s going to be a real challenge for science to nail down until more accurate testing is available everywhere. Because of all this uncertainty, a tool that can accurately alert a person who is potentially infected to go get tested has huge potential to reduce spread.
Right now, SARS-CoV-2 has an R0 of well over 1 in the United States. It is spreading rapidly as we have tried to re-open businesses here, and that is likely aided by the fact that people often spread it to others before they have any idea that they are sick. If you can get a sick person into quarantine an average of five days earlier, that is a potential gamechanger. Combine this with social distancing and pervasive use of masks indoors and in close contact with others and you have a legitimate path to getting the R0 under 1, which would allow the resumption of most of daily life and give contact tracing and quarantine a chance to work effectively to keep COVID-19 in check.
I understand that not everyone can afford an Apple Watch, especially a brand new one. However, if Apple does add these features, I wouldn’t be surprised to see more health insurance companies and employers offer them at significant discounts. I also have a feeling that the FDA will relax restrictions enough to allow older models of smartwatches to provide additional readings, such as blood oxygen levels. If so, this pandemic could push the smartwatch from being a popular mainstream gadget to becoming nearly as pervasive as smartphones.