How Ava is attempting to solve the Covid-19 testing crisis

As the world is engaged in a battle of life and death with the novel coronavirus, wearables could have a vital role to play.

Hot on the heels of the Oura Ring, which went into testing for detecting Covid-19 last month (we’ll be covering that very soon), the Ava Bracelet is also looking to enter clinical trials in Europe.

Companies have long promised that wearable devices could cross the divide into consumer medical tech – but beyond heart rate tracking and the odd ECG reading, few have become crucial parts of our healthcare.

But now some could have a role to play and there are theories that wearables could be used as early warning systems for Covid-19 infections.

Ava Bracelet has had success as a fertility tracking wearable, but it’s the sensors inside that could make it a powerful weapon in the fight against coronavirus. It tracks skin temperature, as well as heart rate, breathing rate and heart rate variability – making it somewhat unique in the wearable tech world.

Solving the testing crisis

Maureen Cronin, Chief Medical Officer at Ava, outlined why Ava could have a role to play – and it comes down to a word we’re hearing a lot about: testing.

“The unique opportunity here is to have remote continuous monitoring during this outbreak. It will be very interesting to combine that with symptomology, to see if you can triage who may be a more likely candidate for testing,” she told Wareable.

With so many people isolated and having symptoms, which could or could not be Covid-19, any government looking to test and isolate those with symptoms will quickly be overwhelmed. Just look at the numbers in the UK – as of 1 April 2020, 152,979 people have been tested with just 29,474 of those positive.

With a finite amount of tests available, remote monitoring wearables could, in theory at least, help identify candidates for testing.

“At the moment people are tracking clinical symptomology using an app – and there’s a call centre where medical students are filtering people and physicians are making recommendations on who should be tested. We know there’s a finite amount of tests," Cronin told Wareable.

“The overall question is: can you combine symptomology with changes in sensor data and use machine learning data to automate that process and put less burden on the system?

“If we can get people who are unlikely, or less likely, to be symptomatic out of situations where they could be infectious, that would be a huge thing for the overall burden of the heathcare system."

So how could the study work?

So why is Ava suited to this process, when there are tens of millions of Apple Watches, Fitbits and other devices out there in the field?

“Based on what we know based on single patient reports, we’re seeing that a combination of breathing rate, heart rate and temperature could signal an infection,” Cronin said. “And we’re actually seeing indication in patients that the heart is also a factor for COVID-19. We use all of these parameters to track post ovulatory temperature increases and to look at the beginning and the end of the fertile window.”

With breathing, heart rate and temperature key elements of Covid infection, Ava is uniquely placed to track infection – in a way that other wearables cannot. But this must be tested in a clinical study.

Ava is part of a consortium that has put together a proposal for a grant from the Innovative Medicines Initiative (IMI). There’s a $45m fund up for grabs, and Ava would be working with Data Scientists from University College London, University of Utrecht, and a number of companies that provide SARS-CoV-2 related testing expertise in the project.

“The idea is to screen for triage and testing – and then test for antibodies to see how many false positives at the end of the project,” Cronin said.

“We proposed to evaluate the use and performance of our wearable, which uses sensors to measure breathing rate, pulse rate, skin temperature, and heart rate variability. At the same time, a mobile application will be used to track participant-reported symptoms."

The study will follow 30,000 people from the general population and 10,000 exposed, vulnerable patients and first responders wearing the device and responding to participant self-report parameters via a purpose-designed app.

Based on this data, an algorithm will indicate which individuals likely require general practitioner (GP) care (for COVID-19 diagnostic testing, further vital signs assessment, and/or treatment) and/or hospital care.

Fighting the future

“When you read what the Chinese researchers reported, they said that remote monitoring was great for reducing cross contamination,” said Cronin.

And once the world has the virus under control, the real battle to begins to ensure it doesn’t come back. Efficient testing, isolating and tracing cases will be crucial in stamping out future infections and second waves.

And as the world hunts for a vaccine, perhaps wearable monitoring will be ready for the next pandemic.