Insights
Eric Jensen, Chief Product Officer, AVIA
During this pandemic, run-of-the-mill virus symptoms are throwing us all for a loop. I experienced that anxiety firsthand when my child exhibited symptoms that could have been caused by normal young child viruses, the flu, or, scarily, COVID-19. A fever, sore throat, and fatigue on any other day would be no big thing for us to handle at home, but amidst this crisis, the concern over her symptoms was patently higher — even for someone like me with ample healthcare experience.
The carpenter’s credo is “Measure twice, cut once.” John Doerr, a prominent venture capitalist, tells us in a recent book to “Measure What Matters.” And management guru Peter Drucker said, “If you can’t measure it, you can’t improve it.” Measurement improves our understanding of the world and allows us to make better, more informed decisions. Unfortunately, we still have huge blind spots in our ability to measure the progression of the coronavirus at both a macro and a micro level.
My family’s experience during this health crisis encapsulates this measurement challenge. To be clear, we have been incredibly fortunate and (I believe) are all in good health. There are many others who have had far more gut-wrenching experiences with their health and the ability of our health system to tackle this challenge. At the same time, as our family has experienced various symptoms of illness over the last two and a half weeks, our inability to know whether any of us has been infected has been a source of stress, anxiety, and confusion.
A quick recap of our experience follows:
March 12, 2020 (Day 0): We learn that my daughter’s school is closing for at least the next two weeks due to a single positive case identified in the school community. From this point forward, our family effectively operates under a self-imposed “shelter-in-home” edict.
Day 4: We learn that there are at least six confirmed coronavirus cases in the school community. A close colleague experiencing symptoms gets tested.
Day 5: My one-year-old son wakes up with pink eye. I take him to the pediatrician. Out of curiosity, I inquire about the availability of coronavirus tests and am told that they do not have any available nor do they know where one would get them. I later learn that pink eye can be a side-effect of the coronavirus.
Day 6: I wake up with a sore throat and sniffles.
Day 8: My symptoms disappear. If it was a cold, it was one of the shortest I’ve ever had.
Day 10: My daughter is fatigued, has the chills, and gets a fever. We call the pediatrician late in the afternoon and are told to monitor the symptoms, but to stay at home. When abdominal pains emerge as an additional symptom, we call the hotline again and are told that we should bring my daughter in the next day to test for strep.
Day 11: When we call for an appointment, we are asked the standard set of coronavirus questions: (1) Have we traveled outside of the country in the last 14 days? and (2) Have we had direct contact with someone who has tested positive for coronavirus? Both questions seem ridiculous as this point—there are plenty of cases in the US, and I don’t know whether I have had direct contact with anyone who has tested positive. My colleague has still not received test results, but is convinced they have the virus.
The pediatrician tells us to stay home and monitor symptoms. In short, if my daughter has coronavirus, the pediatrician does not want to see her unless the symptoms are severe. We are given a phone number for the State Department of Health for reference.
Day 12: My daughter’s fever breaks and she begins to feel better. My colleague tests positive for coronavirus, and another colleague tests positive on the same day. Outreach to a select set of parents in the school community confirms that about half experienced various combinations of fever, sore throat, and cough over the last week.
Day 19 (Today): Did my daughter have a virus, the flu, or COVID-19? Did my son have it? Did I have a largely asymptomatic case? If my daughter did have a mild case, are my wife and I still susceptible? In short, we don’t know whether we are susceptible, infected, or recovered. Any of us might fall into each of these three categories.
No doubt many other families across the country have had similar experiences over the last several weeks. At minimum, our experience illustrates the need for broad-based testing, not just for the virus, but also serology tests for COVID-19 antibodies. As testing ramps up nationally, it is also clear there is an opportunity to use digital solutions to track population level trends and improve individual level care.
For weeks, AVIA has been studying and sharing how digital can enable health systems to respond to COVID-19 in an efficient and safe way. What I learned in practice is that our health system is struggling under the weight of a public health crisis that changes by the hour. Where can digital help keep everyone coordinated and informed?
One example is Kinsa, a digital smart thermometer solution, which has been able to illustrate in near real-time the effectiveness of social distancing at mitigating virus transmission. Another solution, Twistle, is a text-based communication solution allowing a health system in Washington state to stay in close contact with patients remotely.
Both Kinsa and Twistle highlight the ability of digital solutions to gather symptomatic data without the need of an in-person visit. This kind of care is absolutely necessary during this period of social distancing. Once we get beyond this crisis, it is likely to be expected. Now I just need to convince my daughter’s pediatrician.
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