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App Shows Promise in Tracking New Coronavirus Cases, Study Finds App Shows Promise in Tracking New Coronavirus Cases, Study Finds
(3 days later)
In the absence of widespread on-demand testing, public health officials across the world have been struggling to track the spread of the coronavirus pandemic in real time. A team of scientists in the United States and the United Kingdom says a crowdsourcing smartphone app may be the answer to that quandary.In the absence of widespread on-demand testing, public health officials across the world have been struggling to track the spread of the coronavirus pandemic in real time. A team of scientists in the United States and the United Kingdom says a crowdsourcing smartphone app may be the answer to that quandary.
In a study published Monday in the journal Nature Medicine, researchers found that an app that allows people to check off symptoms they are experiencing was remarkably effective in predicting coronavirus infections among the 2.5 million people who were using it between March 24 and April 21.In a study published Monday in the journal Nature Medicine, researchers found that an app that allows people to check off symptoms they are experiencing was remarkably effective in predicting coronavirus infections among the 2.5 million people who were using it between March 24 and April 21.
The study, which tracked people in the United States, the United Kingdom and Sweden, found that the loss of taste and smell was the No. 1 predictor of whether a person was going to get sick with Covid-19, the illness caused by the coronavirus, followed by extreme fatigue and acute muscle pain.The study, which tracked people in the United States, the United Kingdom and Sweden, found that the loss of taste and smell was the No. 1 predictor of whether a person was going to get sick with Covid-19, the illness caused by the coronavirus, followed by extreme fatigue and acute muscle pain.
Using a mathematical model, the researchers were able to predict with nearly 80 percent accuracy whether a person was likely to have Covid-19 based on their age, sex and a combination of four symptoms: loss of taste or smell, persistent cough, fatigue and loss of appetite.Using a mathematical model, the researchers were able to predict with nearly 80 percent accuracy whether a person was likely to have Covid-19 based on their age, sex and a combination of four symptoms: loss of taste or smell, persistent cough, fatigue and loss of appetite.
Two-thirds of those who later tested positive for the virus — about 15,000 people — had self-reported the loss of taste and smell, the study found. Fever and cough — symptoms that have been considered the most reliable indicators of infection — ranked fourth and fifth on the list.Two-thirds of those who later tested positive for the virus — about 15,000 people — had self-reported the loss of taste and smell, the study found. Fever and cough — symptoms that have been considered the most reliable indicators of infection — ranked fourth and fifth on the list.
“It’s just such a weird symptom that doesn’t occur with most other diseases so it’s rarely wrong,” said Dr. Tim Spector, a professor of genetic epidemiology at King’s College London and a lead author of the study.“It’s just such a weird symptom that doesn’t occur with most other diseases so it’s rarely wrong,” said Dr. Tim Spector, a professor of genetic epidemiology at King’s College London and a lead author of the study.
Because loss of smell and taste is often associated with mild cases of Covid-19, Dr. Spector said health officials could act on information provided by a surveillance app to encourage participants to isolate themselves until they were able to get tested.Because loss of smell and taste is often associated with mild cases of Covid-19, Dr. Spector said health officials could act on information provided by a surveillance app to encourage participants to isolate themselves until they were able to get tested.
“The more we collect this stuff and the more we document it properly, the better we can deal with new outbreaks,” he said.“The more we collect this stuff and the more we document it properly, the better we can deal with new outbreaks,” he said.
The researchers said they hoped the findings might persuade the World Health Organization and other health agencies to modify guidelines that currently rank fever and cough well above loss of taste and smell as symptoms for determining who to screen for Covid-19.The researchers said they hoped the findings might persuade the World Health Organization and other health agencies to modify guidelines that currently rank fever and cough well above loss of taste and smell as symptoms for determining who to screen for Covid-19.
Dr. Andrew T. Chan, a professor at Harvard Medical School and the lead investigator on the study, said a surveillance app could help health authorities identify people at the early stage of the disease who are unknowingly spreading the virus to others.Dr. Andrew T. Chan, a professor at Harvard Medical School and the lead investigator on the study, said a surveillance app could help health authorities identify people at the early stage of the disease who are unknowingly spreading the virus to others.
“At the moment, we’re mostly gathering data on the tip of the iceberg from those who are really sick and show up at the hospital. But there is a huge iceberg below of people with mild symptoms who we know are major culprits for community spread,” said Dr. Chan, who is also chief of clinical and translational epidemiology at Massachusetts General Hospital. “We have no ability to track these people at home and that’s a real problem.”“At the moment, we’re mostly gathering data on the tip of the iceberg from those who are really sick and show up at the hospital. But there is a huge iceberg below of people with mild symptoms who we know are major culprits for community spread,” said Dr. Chan, who is also chief of clinical and translational epidemiology at Massachusetts General Hospital. “We have no ability to track these people at home and that’s a real problem.”
If more widely adopted, the app could provide public health authorities an inexpensive tool for detecting outbreaks in cities, states and even individual neighborhoods. Given that the loss of taste and smell appears to be an early indicator of Covid-19, the information, the researchers said, would allow health officials to prepare for a spike of infections and help guide the allocation of scarce resources like ventilators for the most seriously ill, and the personal protective gear needed by medical workers.If more widely adopted, the app could provide public health authorities an inexpensive tool for detecting outbreaks in cities, states and even individual neighborhoods. Given that the loss of taste and smell appears to be an early indicator of Covid-19, the information, the researchers said, would allow health officials to prepare for a spike of infections and help guide the allocation of scarce resources like ventilators for the most seriously ill, and the personal protective gear needed by medical workers.
As local outbreaks subside, the app can also guide decisions about the easing of lockdowns and social distancing measures.As local outbreaks subside, the app can also guide decisions about the easing of lockdowns and social distancing measures.
The researchers said the app did not prompt significant privacy concerns because participants are not required to provide their names and any other personal information, only their ZIP codes.The researchers said the app did not prompt significant privacy concerns because participants are not required to provide their names and any other personal information, only their ZIP codes.
John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital, said the study added to the growing body of evidence that highlights the value of smartphone apps as real-time disease surveillance tools. Dr. Brownstein, who was not involved in the coronavirus app study, has a decade of experience using crowdsource symptom apps, starting with an influenza app called Flu Near You, and more recently, Covid Near You, an app that has already drawn more than 600,000 users in the United States.John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital, said the study added to the growing body of evidence that highlights the value of smartphone apps as real-time disease surveillance tools. Dr. Brownstein, who was not involved in the coronavirus app study, has a decade of experience using crowdsource symptom apps, starting with an influenza app called Flu Near You, and more recently, Covid Near You, an app that has already drawn more than 600,000 users in the United States.
Surveillance apps, he said, can detect an outbreak well before people begin showing up at hospitals. “Because we have such a lack of testing, this kind of data is going to give us insights into symptomatology, hot spots and the impact of social distancing,” he said. “Without this information, how are communities supposed to know we’re on the other side of this pandemic and whether we can reopen?”Surveillance apps, he said, can detect an outbreak well before people begin showing up at hospitals. “Because we have such a lack of testing, this kind of data is going to give us insights into symptomatology, hot spots and the impact of social distancing,” he said. “Without this information, how are communities supposed to know we’re on the other side of this pandemic and whether we can reopen?”
But crowdsourcing apps do not provide a complete snapshot of the coronavirus pandemic. Because users tend to be younger, they are less than ideal for charting its progression among the elderly.But crowdsourcing apps do not provide a complete snapshot of the coronavirus pandemic. Because users tend to be younger, they are less than ideal for charting its progression among the elderly.
Updated June 5, 2020Updated June 5, 2020
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
And they are also not a replacement for testing, which is the most effective means for tracking the spread of the disease. The data can also be muddled by people who report symptoms shared by other illnesses.And they are also not a replacement for testing, which is the most effective means for tracking the spread of the disease. The data can also be muddled by people who report symptoms shared by other illnesses.
“It’s a sort of real-time experiment done on a massive scale that couldn’t have been done a couple of years ago,” Dr. Spector said.“It’s a sort of real-time experiment done on a massive scale that couldn’t have been done a couple of years ago,” Dr. Spector said.
The app he helped develop piggybacks on technology that King’s College London has been using to track health outcomes among 14,000 twins in the United Kingdom. When the coronavirus outbreak temporarily idled the project, Dr. Spector realized their app could be easily repurposed to track the pandemic.The app he helped develop piggybacks on technology that King’s College London has been using to track health outcomes among 14,000 twins in the United Kingdom. When the coronavirus outbreak temporarily idled the project, Dr. Spector realized their app could be easily repurposed to track the pandemic.
“It was a crazy idea, but four days later we launched the app and it went viral,” he said. Within three days, more than a million people had downloaded the app, a number that has since grown to 3.3 million.“It was a crazy idea, but four days later we launched the app and it went viral,” he said. Within three days, more than a million people had downloaded the app, a number that has since grown to 3.3 million.
Dr. Cristina Menni, a research fellow at King’s College and another lead author of the study, said the researchers continued to refine the app. Among their goals is finding a way to gauge whether pre-existing conditions or genetic factors might magnify the health risks for people infected with the virus.Dr. Cristina Menni, a research fellow at King’s College and another lead author of the study, said the researchers continued to refine the app. Among their goals is finding a way to gauge whether pre-existing conditions or genetic factors might magnify the health risks for people infected with the virus.
But for now, she said, crowdsourcing apps may be a useful public health tool to help contain the pandemic.But for now, she said, crowdsourcing apps may be a useful public health tool to help contain the pandemic.
“Because there hasn’t been widespread testing, monitoring for symptoms of the coronavirus is a very cheap and simple way of doing it,” she said. “At the very least, anyone who reports a loss of taste and smell should self-isolate until they can get tested.”“Because there hasn’t been widespread testing, monitoring for symptoms of the coronavirus is a very cheap and simple way of doing it,” she said. “At the very least, anyone who reports a loss of taste and smell should self-isolate until they can get tested.”