As contact-tracing apps prove less useful than hoped in many countries, other digital tools such as wearable fitness trackers are gaining in popularity for detecting or tracing coronavirus infection. But a reliance on such technologies comes with big questions about effectiveness and privacy.
Professional sports organizations in the United States like the National Basketball Association (NBA) and golfing’s PGA Tour are using wearable health devices to get back in the game. And they are not alone. A growing number of countries, businesses and individuals are looking to devices like fitness trackers as a solution to detect and halt the spread of the virus. The idea is to collect and monitor real-time physiological data that might point to possible infection with Covid-19.
But the temptation to grasp at what seems like an ideal solution may be premature. First, there is not enough data to substantiate the effectiveness of wearable health devices in predicting or tracing the virus. Secondly, fitness trackers already raised privacy concerns over the use of wearers’ personal health data before the pandemic. Now, at least some of that information could have much more serious consequences than monitoring routine fitness statistics if it also ends up being used by businesses for screening potential employees, targeting customers, and so on.
As an example of how fitness trackers are finding a new market, the NBA has partnered with “smart ring” creator Oura to distribute rings to players and other league staff to track and monitor their temperature and heart and respiratory rates. The device then uses the health data collected and its early-stage illness-detection and monitoring algorithm to predict whether a player or a team member might have contracted Covid-19. The NBA has said it expects this early detection system to enable swift action to self-isolate and treat – and meanwhile to continue the game.
Similarly, the Professional Golfers Association’s PGA Tour announced in June that it had acquired 1,000 WHOOP strap fitness trackers for distribution to players, caddies and other essential workers. WHOOP monitors respiratory and heart rates, among other indicators related to, for example, sleep. The PGA Tour acquired the devices in an arrangement with WHOOP after one of its players said the device helped him discover he was positive for the coronavirus because it showed elevated respiratory rates, prompting him to get tested.
Governments in the wearable tracking game
Governments are getting into the game – so to speak – too. Singapore recently handed out 10,000 TraceTogether coronavirus tracking tokens, or dongles, to its most vulnerable populations – starting with the elderly. Authorities opted for that route after they realized many people weren’t using the tracing app of the same name because they didn’t have a smartphone or because its Bluetooth-enabled functioning drained battery life.
In April, the government of the tiny principality of Liechtenstein in Europe distributed about 2,000 Ava bracelets, commercially marketed as fertility trackers for women, to citizens as part of a new study called Covi-Gappa. The research intends to develop an algorithm using physiological data from a wearable device to predict the onset of Covid-19.
That is just one of numerous clinical studies across the globe researching the use of wearable technology like Fitbit, Apple Watch, Garmin Watch, Amazfit and others to determine whether they can effectively help detect and track coronavirus cases. Duke University’s study Covidentify, the Detect study from Scripps Research’s Translational Institute, Stanford Healthcare Innovation Lab’s Covid-19 Wearables Study, and the Covid Collab led out of King’s College London’s PHIDatalab are just a few others. The fact that these trials are in their early stages illustrates the point that the effectiveness of fitness trackers to gauge coronavirus infection remains uncertain.
In the meantime, the increasing use of these devices in the struggle to contain the pandemic gives companies access to an enormous quantity of real-time health data. Even startups like the NBA’s Oura ring have funding from tech giants like Google. It isn’t news that big tech companies have always been interested in our health data; healthcare is a multibilliondollar industry and represents the next frontier for tech giants to become one-stop shops for end-to-end health solutions. By combining their artificial intelligence capabilities with Internet of Things (IoT) hardware like wearables and smartphone health devices, big tech can now analyze personalized health data to provide solutions ranging from telemedicine, remote patient monitoring, personalized medicine, remote clinical trials and drug development, to name a few.
Privacy laws lag . . . again
But governments still lack robust laws, rules, regulations and global standards that will ensure the secure and ethical use of individual health data and respect for privacy on the part of the companies involved. Citizens of the European Union and the nations of Liechtenstein, Norway and Iceland, which are united with the EU economically through the European Economic Area (EEA) agreement, fare better when it comes to the privacy of their identifiable health data than the United States or some others. Provisions such as Article 6 and Article 9 of the EU’s General Data Protection Regulation (GDPR) govern the processing of identifiable biometric data generated by wearable devices and technologies as a special category of personal data.
But across the Atlantic, the US legal landscape lacks provisions to safeguard personal health data collected by wearables. While the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) is the primary federal law governing health privacy in the United States, it does not cover data collected by wearable devices and health apps.
Even the privacy policies of research projects to gauge the efficacy of wearable devices for preventing or tracing Covid-19 are sometimes vague. Certain provisions permit, for example, the use of individuals’ stored data even after they drop out of a trial, or allow the use of de-identified data.
In Singapore, however, the TraceTogether token does not collect health data and uses encrypted data to inform the wearer of potential exposure. Singapore chose to design its own wearable device to meet the privacy expectations of its people, a decision that may inspire greater confidence in the wearer. But the device only helps trace individuals who may have come in contact with an infected person. The same cannot be said about the privacy provisions of other popular wearable devices that are being promoted as potentially predicting the early onset of infection.
So, while wearable health devices may hold potential in the battle against Covid-19, they really aren’t ready for prime time. Not only is their effectiveness in this use uncertain, individuals and governments have yet to grapple with the privacy consequences of this kind of data collection.