New York: Over the past few years, a California-based tech startup has repeatedly made headlines for beating public health agencies at their own game.
Kinsa, which makes internet-connected thermometers, has routinely detected the spread of seasonal flu weeks before the Centres for Disease Control and Prevention. And when COVID-19 hit last year, the company saw unusual spikes in fevers about 18 days before states recorded peaks in deaths.
“The difference is not that we’re smarter,” said Kinsa founder and CEO Inder Singh. “We’ve got better data.”
Many disease-tracking efforts, including the CDC’s flu surveillance system, rely on data - patient symptoms, test results, inpatient admissions and deaths, for instance - reported by hospitals, laboratories and other health care facilities. But Kinsa’s devices provide an illness signal as soon as someone feels sick enough to use a thermometer. “In simple terms, we talk to mildly symptomatic patients,” Singh said. “The health care system misses them entirely.”
Now, the company is putting its pandemic prognostication skills to a new test in a partnership with the New York City Department of Health. Over the coming months, Kinsa will distribute as many as 100,000 free smart thermometers through the city’s elementary schools and will make the resulting data available to local health officials. The goal is to create a citywide early-warning and early-response system for outbreaks of COVID-19, the flu and other infectious diseases.
“One of the critical lessons that we have learned during the COVID epidemic is how important it is to have as accurate information as we can possibly get, in real time, about how diseases spread through communities,” said Dr. Jay Varma, senior adviser for public health to Mayor Bill de Blasio.
The Kinsa partnership, he added, is “going to help us strengthen our ability to understand new and emerging diseases that may pop up in the school community.”
This is not Kinsa’s first foray into schools. Since 2015, it has distributed thermometers through more than 4,000 individual schools across the United States as part of its FLUency program. But the New York City initiative will be its first citywide rollout.
First phase
The first phase began last month, when the company began distributing 5,000 free thermometers to teachers, staff members and families at 50 elementary schools in city neighbourhoods that had been particularly hard-hit by COVID-19. In the fall, Kinsa hopes to open the programme to all of the city’s elementary schools.
The programme is entirely voluntary, officials at both Kinsa and City Hall stress. Schools that opt into the programme will send Kinsa’s brochures home to students’ families; if parents want to participate, they can download Kinsa’s app and order a free thermometer.
“There’s nothing about this programme that is mandated,” Varma said. “Schools are not required to participate. Families are not required to participate, and of course they can kind of discontinue it at any time.”
The programme, partly funded by Lysol, will be free to schools and families.
Readings from the thermometers will be sent to the accompanying app, which also asks users to log any other symptoms they may be experiencing. Depending on what they report, the app may recommend that a child stay home from school, suggest a visit to the doctor or direct users to a nearby COVID-19 testing site. School administrators and families can view information about grade-level trends at their own schools - that there are four ailing fourth-graders, for instance.
City health officials will also have access to this aggregated, anonymized data, which they hope will help them identify unusual illness clusters earlier than is currently possible. “It’s measuring something that we’ve never really been able to measure before,” Varma said. “This is information about people’s biological measurements, being taken by somebody in their home before they’ve actually, in many situations, sought care.”
Limitations
The data has limitations. Thermometers, of course, will not catch ailments that are not accompanied by fevers, and many cases of COVID-19, especially in children, are asymptomatic. Moreover, schools and families that opt into the program may not be representative of the city’s population at large.
And then, of course, there are the inevitable privacy concerns. Kinsa emphasizes that all data provided to the city will be aggregated and anonymised. “None of the individual data is going to anyone other than to that individual,” Singh said. “They own the data, and we’re really adamant about this.”
While digital-privacy experts say that these are important safeguards, they also note that information about children and health is particularly sensitive. “It’s really important to balance the public health benefits and needs with the social or societal risks,” said Rachele Hendricks-Sturrup, health policy counsel at the Future of Privacy Forum, a think tank focused on data privacy.
Over the coming months, city officials will keep close tabs on how well the programme is working, Varma said. How do families feel about the programme? Is there enough uptake to produce useful data? Can they actually catch outbreaks earlier and slow the spread of disease?
“Our goal is to try to see whether or not, in the real world, whether it really does have that impact that we hope it does,” Varma said. “It’s also possible the system may not detect anything abnormal or unusual, but that it still proves to be successful because it provides people with information that they find useful and builds their confidence in having their kids at school.”
