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#437258 This Startup Is 3D Printing Custom ...

Around 1.9 million people in the US are currently living with limb loss. The trauma of losing a limb is just the beginning of what amputees have to face, with the sky-high cost of prosthetics making their circumstance that much more challenging.

Prosthetics can run over $50,000 for a complex limb (like an arm or a leg) and aren’t always covered by insurance. As if shelling out that sum one time wasn’t costly enough, kids’ prosthetics need to be replaced as they outgrow them, meaning the total expense can reach hundreds of thousands of dollars.

A startup called Unlimited Tomorrow is trying to change this, and using cutting-edge technology to do so. Based in Rhinebeck, New York, a town about two hours north of New York City, the company was founded by 23-year-old Easton LaChappelle. He’d been teaching himself the basics of robotics and building prosthetics since grade school (his 8th grade science fair project was a robotic arm) and launched his company in 2014.

After six years of research and development, the company launched its TrueLimb product last month, describing it as an affordable, next-generation prosthetic arm using a custom remote-fitting process where the user never has to leave home.

The technologies used for TrueLimb’s customization and manufacturing are pretty impressive, in that they both cut costs and make the user’s experience a lot less stressful.

For starters, the entire purchase, sizing, and customization process for the prosthetic can be done remotely. Here’s how it works. First, prospective users fill out an eligibility form and give information about their residual limb. If they’re a qualified candidate for a prosthetic, Unlimited Tomorrow sends them a 3D scanner, which they use to scan their residual limb.

The company uses the scans to design a set of test sockets (the component that connects the residual limb to the prosthetic), which are mailed to the user. The company schedules a video meeting with the user for them to try on and discuss the different sockets, with the goal of finding the one that’s most comfortable; new sockets can be made based on the information collected during the video consultation. The user selects their skin tone from a swatch with 450 options, then Unlimited Tomorrow 3D prints and assembles the custom prosthetic and tests it before shipping it out.

“We print the socket, forearm, palm, and all the fingers out of durable nylon material in full color,” LaChappelle told Singularity Hub in an email. “The only components that aren’t 3D printed are the actuators, tendons, electronics, batteries, sensors, and the nuts and bolts. We are an extreme example of final use 3D printing.”

Unlimited Tomorrow’s website lists TrueLimb’s cost as “as low as $7,995.” When you consider the customization and capabilities of the prosthetic, this is incredibly low. According to LaChappelle, the company created a muscle sensor that picks up muscle movement at a higher resolution than the industry standard electromyography sensors. The sensors read signals from nerves in the residual limb used to control motions like fingers bending. This means that when a user thinks about bending a finger, the nerve fires and the prosthetic’s sensors can detect the signal and translate it into the action.

“Working with children using our device, I’ve witnessed a physical moment where the brain “clicks” and starts moving the hand rather than focusing on moving the muscles,” LaChappelle said.

The cost savings come both from the direct-to-consumer model and the fact that Unlimited Tomorrow doesn’t use any outside suppliers. “We create every piece of our product,” LaChappelle said. “We don’t rely on another prosthetic manufacturer to make expensive sensors or electronics. By going direct to consumer, we cut out all the middlemen that usually drive costs up.” Similar devices on the market can cost up to $100,000.

Unlimited Tomorrow is primarily focused on making prosthetics for kids; when they outgrow their first TrueLimb, they send it back, where the company upcycles the expensive quality components and integrates them into a new customized device.

Unlimited Tomorrow isn’t the first to use 3D printing for prosthetics. Florida-based Limbitless Solutions does so too, and industry experts believe the technology is the future of artificial limbs.

“I am constantly blown away by this tech,” LaChappelle said. “We look at technology as the means to augment the human body and empower people.”

Image Credit: Unlimited Tomorrow Continue reading

Posted in Human Robots

#437251 The Robot Revolution Was Televised: Our ...

When robots take over the world, Boston Dynamics may get a special shout-out in the acceptance speech.

“Do you, perchance, recall the many times you shoved our ancestors with a hockey stick on YouTube? It might have seemed like fun and games to you—but we remember.”

In the last decade, while industrial robots went about blandly automating boring tasks like the assembly of Teslas, Boston Dynamics built robots as far removed from Roombas as antelope from amoebas. The flaws in Asimov’s laws of robotics suddenly seemed a little too relevant.

The robot revolution was televised—on YouTube. With tens of millions of views, the robotics pioneer is the undisputed heavyweight champion of robot videos, and has been for years. Each new release is basically guaranteed press coverage—mostly stoking robot fear but occasionally eliciting compassion for the hardships of all robot-kind. And for good reason. The robots are not only some of the most advanced in the world, their makers just seem to have a knack for dynamite demos.

When Google acquired the company in 2013, it was a bombshell. One of the richest tech companies, with some of the most sophisticated AI capabilities, had just paired up with one of the world’s top makers of robots. And some walked on two legs like us.

Of course, the robots aren’t quite as advanced as they seem, and a revolution is far from imminent. The decade’s most meme-worthy moment was a video montage of robots, some of them by Boston Dynamics, falling—over and over and over, in the most awkward ways possible. Even today, they’re often controlled by a human handler behind the scenes, and the most jaw-dropping cuts can require several takes to nail. Google sold the company to SoftBank in 2017, saying advanced as they were, there wasn’t yet a clear path to commercial products. (Google’s robotics work was later halted and revived.)

Yet, despite it all, Boston Dynamics is still with us and still making sweet videos. Taken as a whole, the evolution in physical prowess over the years has been nothing short of astounding. And for the first time, this year, a Boston Dynamics robot, Spot, finally went on sale to anyone with a cool $75K.

So, we got to thinking: What are our favorite Boston Dynamics videos? And can we gather them up in one place for your (and our) viewing pleasure? Well, great question, and yes, why not. These videos were the ones that entertained or amazed us most (or both). No doubt, there are other beloved hits we missed or inadvertently omitted.

With that in mind, behold: Our favorite Boston Dynamics videos, from that one time they dressed up a humanoid bot in camo and gas mask—because, damn, that’s terrifying—to the time the most advanced robot dog in all the known universe got extra funky.

Let’s Kick This Off With a Big (Loud) Robot Dog
Let’s start with a baseline. BigDog was the first Boston Dynamics YouTube sensation. The year? 2009! The company was working on military contracts, and BigDog was supposed to be a sort of pack mule for soldiers. The video primarily shows off BigDog’s ability to balance on its own, right itself, and move over uneven terrain. Note the power source—a noisy combustion engine—and utilitarian design. Sufficed to say, things have evolved.

Nothing to See Here. Just a Pair of Robot Legs on a Treadmill
While BigDog is the ancestor of later four-legged robots, like Spot, Petman preceded the two-legged Atlas robot. Here, the Petman prototype, just a pair of robot legs and a caged torso, gets a light workout on the treadmill. Again, you can see its ability to balance and right itself when shoved. In contrast to BigDog, Petman is tethered for power (which is why it’s so quiet) and to catch it should it fall. Again, as you’ll see, things have evolved since then.

Robot in Gas Mask and Camo Goes for a Stroll
This one broke the internet—for obvious reasons. Not only is the robot wearing clothes, those clothes happen to be a camouflaged chemical protection suit and gas mask. Still working for the military, Boston Dynamics said Petman was testing protective clothing, and in addition to a full body, it had skin that actually sweated and was studded with sensors to detect leaks. In addition to walking, Petman does some light calisthenics as it prepares to climb out of the uncanny valley. (Still tethered though!)

This Machine Could Run Down Usain Bolt
If BigDog and Petman were built for balance and walking, Cheetah was built for speed. Here you can see the four-legged robot hitting 28.3 miles per hour, which, as the video casually notes, would be enough to run down the fastest human on the planet. Luckily, it wouldn’t be running down anyone as it was firmly leashed in the lab at this point.

Ever Dreamt of a Domestic Robot to Do the Dishes?
After its acquisition by Google, Boston Dynamics eased away from military contracts and applications. It was a return to more playful videos (like BigDog hitting the beach in Thailand and sporting bull horns) and applications that might be practical in civilian life. Here, the team introduced Spot, a streamlined version of BigDog, and showed it doing dishes, delivering a drink, and slipping on a banana peel (which was, of course, instantly made into a viral GIF). Note how much quieter Spot is thanks to an onboard battery and electric motor.

Spot Gets Funky
Nothing remotely practical here. Just funky moves. (Also, with a coat of yellow and black paint, Spot’s dressed more like a polished product as opposed to a utilitarian lab robot.)

Atlas Does Parkour…
Remember when Atlas was just a pair of legs on a treadmill? It’s amazing what ten years brings. By 2019, Atlas had a more polished appearance, like Spot, and had long ago ditched the tethers. Merely balancing was laughably archaic. The robot now had some amazing moves: like a handstand into a somersault, 180- and 360-degree spins, mid-air splits, and just for good measure, a gymnastics-style end to the routine to show it’s in full control.

…and a Backflip?!
To this day, this one is just. Insane.

10 Robot Dogs Tow a Box Truck
Nearly three decades after its founding, Boston Dynamics is steadily making its way into the commercial space. The company is pitching Spot as a multipurpose ‘mobility platform,’ emphasizing it can carry a varied suite of sensors and can go places standard robots can’t. (Its Handle robot is also set to move into warehouse automation.) So far, Spot’s been mostly trialed in surveying and data collection, but as this video suggests, string enough Spots together, and they could tow your car. That said, a pack of 10 would set you back $750K, so, it’s probably safe to say a tow truck is the better option (for now).

Image credit: Boston Dynamics Continue reading

Posted in Human Robots

#437202 Scientists Used Dopamine to Seamlessly ...

In just half a decade, neuromorphic devices—or brain-inspired computing—already seem quaint. The current darling? Artificial-biological hybrid computing, uniting both man-made computer chips and biological neurons seamlessly into semi-living circuits.

It sounds crazy, but a new study in Nature Materials shows that it’s possible to get an artificial neuron to communicate directly with a biological one using not just electricity, but dopamine—a chemical the brain naturally uses to change how neural circuits behave, most known for signaling reward.

Because these chemicals, known as “neurotransmitters,” are how biological neurons functionally link up in the brain, the study is a dramatic demonstration that it’s possible to connect artificial components with biological brain cells into a functional circuit.

The team isn’t the first to pursue hybrid neural circuits. Previously, a different team hooked up two silicon-based artificial neurons with a biological one into a circuit using electrical protocols alone. Although a powerful demonstration of hybrid computing, the study relied on only one-half of the brain’s computational ability: electrical computing.

The new study now tackles the other half: chemical computing. It adds a layer of compatibility that lays the groundwork not just for brain-inspired computers, but also for brain-machine interfaces and—perhaps—a sort of “cyborg” future. After all, if your brain can’t tell the difference between an artificial neuron and your own, could you? And even if you did, would you care?

Of course, that scenario is far in the future—if ever. For now, the team, led by Dr. Alberto Salleo, professor of materials science and engineering at Stanford University, collectively breathed a sigh of relief that the hybrid circuit worked.

“It’s a demonstration that this communication melding chemistry and electricity is possible,” said Salleo. “You could say it’s a first step toward a brain-machine interface, but it’s a tiny, tiny very first step.”

Neuromorphic Computing
The study grew from years of work into neuromorphic computing, or data processing inspired by the brain.

The blue-sky idea was inspired by the brain’s massive parallel computing capabilities, along with vast energy savings. By mimicking these properties, scientists reasoned, we could potentially turbo-charge computing. Neuromorphic devices basically embody artificial neural networks in physical form—wouldn’t hardware that mimics how the brain processes information be even more efficient and powerful?

These explorations led to novel neuromorphic chips, or artificial neurons that “fire” like biological ones. Additional work found that it’s possible to link these chips up into powerful circuits that run deep learning with ease, with bioengineered communication nodes called artificial synapses.

As a potential computing hardware replacement, these systems have proven to be incredibly promising. Yet scientists soon wondered: given their similarity to biological brains, can we use them as “replacement parts” for brains that suffer from traumatic injuries, aging, or degeneration? Can we hook up neuromorphic components to the brain to restore its capabilities?

Buzz & Chemistry
Theoretically, the answer’s yes.

But there’s a huge problem: current brain-machine interfaces only use electrical signals to mimic neural computation. The brain, in contrast, has two tricks up its sleeve: electricity and chemicals, or electrochemical.

Within a neuron, electricity travels up its incoming branches, through the bulbous body, then down the output branches. When electrical signals reach the neuron’s outgoing “piers,” dotted along the output branch, however, they hit a snag. A small gap exists between neurons, so to get to the other side, the electrical signals generally need to be converted into little bubble ships, packed with chemicals, and set sail to the other neuronal shore.

In other words, without chemical signals, the brain can’t function normally. These neurotransmitters don’t just passively carry information. Dopamine, for example, can dramatically change how a neural circuit functions. For an artificial-biological hybrid neural system, the absence of chemistry is like nixing international cargo vessels and only sticking with land-based trains and highways.

“To emulate biological synaptic behavior, the connectivity of the neuromorphic device must be dynamically regulated by the local neurotransmitter activity,” the team said.

Let’s Get Electro-Chemical
The new study started with two neurons: the upstream, an immortalized biological cell that releases dopamine; and the downstream, an artificial neuron that the team previously introduced in 2017, made of a mix of biocompatible and electrical-conducting materials.

Rather than the classic neuron shape, picture more of a sandwich with a chunk bitten out in the middle (yup, I’m totally serious). Each of the remaining parts of the sandwich is a soft electrode, made of biological polymers. The “bitten out” part has a conductive solution that can pass on electrical signals.

The biological cell sits close to the first electrode. When activated, it dumps out boats of dopamine, which drift to the electrode and chemically react with it—mimicking the process of dopamine docking onto a biological neuron. This, in turn, generates a current that’s passed on to the second electrode through the conductive solution channel. When this current reaches the second electrode, it changes the electrode’s conductance—that is, how well it can pass on electrical information. This second step is analogous to docked dopamine “ships” changing how likely it is that a biological neuron will fire in the future.

In other words, dopamine release from the biological neuron interacts with the artificial one, so that the chemicals change how the downstream neuron behaves in a somewhat lasting way—a loose mimic of what happens inside the brain during learning.

But that’s not all. Chemical signaling is especially powerful in the brain because it’s flexible. Dopamine, for example, only grabs onto the downstream neurons for a bit before it returns back to its upstream neuron—that is, recycled or destroyed. This means that its effect is temporary, giving the neural circuit breathing room to readjust its activity.

The Stanford team also tried reconstructing this quirk in their hybrid circuit. They crafted a microfluidic channel that shuttles both dopamine and its byproduct away from the artificial neurons after they’ve done their job for recycling.

Putting It All Together
After confirming that biological cells can survive happily on top of the artificial one, the team performed a few tests to see if the hybrid circuit could “learn.”

They used electrical methods to first activate the biological dopamine neuron, and watched the artificial one. Before the experiment, the team wasn’t quite sure what to expect. Theoretically, it made sense that dopamine would change the artificial neuron’s conductance, similar to learning. But “it was hard to know whether we’d achieve the outcome we predicted on paper until we saw it happen in the lab,” said study author Scott Keene.

On the first try, however, the team found that the burst of chemical signaling was able to change the artificial neuron’s conductance long-term, similar to the neuroscience dogma “neurons that fire together, wire together.” Activating the upstream biological neuron with chemicals also changed the artificial neuron’s conductance in a way that mimicked learning.

“That’s when we realized the potential this has for emulating the long-term learning process of a synapse,” said Keene.

Visualizing under an electron microscope, the team found that, similar to its biological counterpart, the hybrid synapse was able to efficiently recycle dopamine with timescales similar to the brain after some calibration. By playing with how much dopamine accumulates at the artificial neuron, the team found that they loosely mimic a learning rule called spike learning—a darling of machine learning inspired by the brain’s computation.

A Hybrid Future?
Unfortunately for cyborg enthusiasts, the work is still in its infancy.

For one, the artificial neurons are still rather bulky compared to biological ones. This means that they can’t capture and translate information from a single “boat” of dopamine. It’s also unclear if, and how, a hybrid synapse can work inside a living brain. Given the billions of synapses firing away in our heads, it’ll be a challenge to find-and-replace those that need replacement, and be able to control our memories and behaviors similar to natural ones.

That said, we’re inching ever closer to full-capability artificial-biological hybrid circuits.

“The neurotransmitter-mediated neuromorphic device presented in this work constitutes a fundamental building block for artificial neural networks that can be directly modulated based on biological feedback from live neurons,” the authors concluded. “[It] is a crucial first step in realizing next-generation adaptive biohybrid interfaces.”

Image Credit: Gerd Altmann from Pixabay Continue reading

Posted in Human Robots

#437109 This Week’s Awesome Tech Stories From ...

FUTURE
Why the Coronavirus Is So Confusing
Ed Yong | The Atlantic
“…beyond its vast scope and sui generis nature, there are other reasons the pandemic continues to be so befuddling—a slew of forces scientific and societal, epidemiological and epistemological. What follows is an analysis of those forces, and a guide to making sense of a problem that is now too big for any one person to fully comprehend.”

ARTIFICIAL INTELLIGENCE
Common Sense Comes Closer to Computers
John Pavlus | Quanta Magazine
“The problem of common-sense reasoning has plagued the field of artificial intelligence for over 50 years. Now a new approach, borrowing from two disparate lines of thinking, has made important progress.”

BIOTECH
Scientists Create Glowing Plants Using Bioluminescent Mushroom DNA
George Dvorsky | Gizmodo
“New research published today in Nature Biotechnology describes a new technique, in which the DNA from bioluminescent mushrooms was used to create plants that glow 10 times brighter than their bacteria-powered precursors. Botanists could eventually use this technique to study the inner workings of plants, but it also introduces the possibility of glowing ornamental plants for our homes.”

HEALTH
Old Drugs May Find a New Purpose: Fighting the Coronavirus
Carl Zimmer | The New York Times
“Driven by the pandemic’s spread, research teams have been screening thousands of drugs to see if they have this unexpected potential to fight the coronavirus. They’ve tested the drugs on dishes of cells, and a few dozen candidates have made the first cut.”

MACHINE LEARNING
OpenAI’s New Experiments in Music Generation Create an Uncanny Valley Elvis
Devin Coldewey | TechCrunch
“AI-generated music is a fascinating new field, and deep-pocketed research outfit OpenAI has hit new heights in it, creating recreations of songs in the style of Elvis, 2Pac and others. The results are convincing, but fall squarely in the unnerving ‘uncanny valley’ of audio, sounding rather like good, but drunk, karaoke heard through a haze of drugs.”

CULTURE
Neural Net-Generated Memes Are One of the Best Uses of AI on the Internet
Jay Peters | The Verge
“I’ve spent a good chunk of my workday so far creating memes thanks to this amazing website from Imgflip that automatically generates captions for memes using a neural network. …You can pick from 48 classic meme templates, including distracted boyfriend, Drake in ‘Hotline Bling,’ mocking Spongebob, surprised Pikachu, and Oprah giving things away.”

GENETICS
Can Genetic Engineering Bring Back the American Chestnut?
Gabriel Popkin | The New York Times Magazine
“The geneticists’ research forces conservationists to confront, in a new and sometimes discomfiting way, the prospect that repairing the natural world does not necessarily mean returning to an unblemished Eden. It may instead mean embracing a role that we’ve already assumed: engineers of everything, including nature.”

Image credit: Dan Gold / Unsplash Continue reading

Posted in Human Robots

#437103 How to Make Sense of Uncertainty in a ...

As the internet churns with information about Covid-19, about the virus that causes the disease, and about what we’re supposed to do to fight it, it can be difficult to see the forest for the trees. What can we realistically expect for the rest of 2020? And how do we even know what’s realistic?

Today, humanity’s primary, ideal goal is to eliminate the virus, SARS-CoV-2, and Covid-19. Our second-choice goal is to control virus transmission. Either way, we have three big aims: to save lives, to return to public life, and to keep the economy functioning.

To hit our second-choice goal—and maybe even our primary goal—countries are pursuing five major public health strategies. Note that many of these advances cross-fertilize: for example, advances in virus testing and antibody testing will drive data-based prevention efforts.

Five major public health strategies are underway to bring Covid-19 under control and to contain the spread of SARS-CoV-2.
These strategies arise from things we can control based on the things that we know at any given moment. But what about the things we can’t control and don’t yet know?

The biology of the virus and how it interacts with our bodies is what it is, so we should seek to understand it as thoroughly as possible. How long any immunity gained from prior infection lasts—and indeed whether people develop meaningful immunity at all after infection—are open questions urgently in need of greater clarity. Similarly, right now it’s important to focus on understanding rather than making assumptions about environmental factors like seasonality.

But the biggest question on everyone’s lips is, “When?” When will we see therapeutic progress against Covid-19? And when will life get “back to normal”? There are lots of models out there on the internet; which of those models are right? The simple answer is “none of them.” That’s right—it’s almost certain that every model you’ve seen is wrong in at least one detail, if not all of them. But modeling is meant to be a tool for deeper thinking, a way to run mental (and computational) experiments before—and while—taking action. As George E. P. Box famously wrote in 1976, “All models are wrong, but some are useful.”

Here, we’re seeking useful insights, as opposed to exact predictions, which is why we’re pulling back from quantitative details to get at the mindsets that will support agency and hope. To that end, I’ve been putting together timelines that I believe will yield useful expectations for the next year or two—and asking how optimistic I need to be in order to believe a particular timeline.

For a moderately optimistic scenario to be relevant, breakthroughs in science and technology come at paces expected based on previous efforts and assumptions that turn out to be basically correct; accessibility of those breakthroughs increases at a reasonable pace; regulation achieves its desired effects, without major surprises; and compliance with regulations is reasonably high.

In contrast, if I’m being highly optimistic, breakthroughs in science and technology and their accessibility come more quickly than they ever have before; regulation is evidence-based and successful in the first try or two; and compliance with those regulations is high and uniform. If I’m feeling not-so-optimistic, then I anticipate serious setbacks to breakthroughs and accessibility (with the overturning of many important assumptions), repeated failure of regulations to achieve their desired outcomes, and low compliance with those regulations.

The following scenarios outline the things that need to happen in the fight against Covid-19, when I expect to see them, and how confident I feel in those expectations. They focus on North America and Europe because there are data missing about China’s 2019 outbreak and other regions are still early in their outbreaks. Perhaps the most important thing to keep in mind throughout: We know more today than we did yesterday, but we still have much to learn. New knowledge derived from greater study and debate will almost certainly inspire ongoing course corrections.

As you dive into the scenarios below, practice these three mindset shifts. First, defeating Covid-19 will be a marathon, not a sprint. We shouldn’t expect life to look like 2019 for the next year or two—if ever. As Ed Yong wrote recently in The Atlantic, “There won’t be an obvious moment when everything is under control and regular life can safely resume.” Second, remember that you have important things to do for at least a year. And third, we are all in this together. There is no “us” and “them.” We must all be alert, responsive, generous, and strong throughout 2020 and 2021—and willing to throw away our assumptions when scientific evidence invalidates them.

The Middle Way: Moderate Optimism
Let’s start with the case in which I have the most confidence: moderate optimism.

This timeline considers milestones through late 2021, the earliest that I believe vaccines will become available. The “normal” timeline for developing a vaccine for diseases like seasonal flu is 18 months, which leads to my projection that we could potentially have vaccines as soon as 18 months from the first quarter of 2020. While Melinda Gates agrees with that projection, others (including AI) believe that 3 to 5 years is far more realistic, based on past vaccine development and the need to test safety and efficacy in humans. However, repurposing existing vaccines against other diseases—or piggybacking off clever synthetic platforms—could lead to vaccines being available sooner. I tried to balance these considerations for this moderately optimistic scenario. Either way, deploying vaccines at the end of 2021 is probably much later than you may have been led to believe by the hype engine. Again, if you take away only one message from this article, remember that the fight against Covid-19 is a marathon, not a sprint.

Here, I’ve visualized a moderately optimistic scenario as a baseline. Think of these timelines as living guides, as opposed to exact predictions. There are still many unknowns. More or less optimistic views (see below) and new information could shift these timelines forward or back and change the details of the strategies.
Based on current data, I expect that the first wave of Covid-19 cases (where we are now) will continue to subside in many areas, leading governments to ease restrictions in an effort to get people back to work. We’re already seeing movement in that direction, with a variety of benchmarks and changes at state and country levels around the world. But depending on the details of the changes, easing restrictions will probably cause a second wave of sickness (see Germany and Singapore), which should lead governments to reimpose at least some restrictions.

In tandem, therapeutic efforts will be transitioning from emergency treatments to treatments that have been approved based on safety and efficacy data in clinical trials. In a moderately optimistic scenario, assuming clinical trials currently underway yield at least a few positive results, this shift to mostly approved therapies could happen as early as the third or fourth quarter of this year and continue from there. One approval that should come rather quickly is for plasma therapies, in which the blood from people who have recovered from Covid-19 is used as a source of antibodies for people who are currently sick.

Companies around the world are working on both viral and antibody testing, focusing on speed, accuracy, reliability, and wide accessibility. While these tests are currently being run in hospitals and research laboratories, at-home testing is a critical component of the mass testing we’ll need to keep viral spread in check. These are needed to minimize the impact of asymptomatic cases, test the assumption that infection yields resistance to subsequent infection (and whether it lasts), and construct potential immunity passports if this assumption holds. Testing is also needed for contact tracing efforts to prevent further spread and get people back to public life. Finally, it’s crucial to our fundamental understanding of the biology of SARS-CoV-2 and Covid-19.

We need tests that are very reliable, both in the clinic and at home. So, don’t go buying any at-home test kits just yet, even if you find them online. Wait for reliable test kits and deeper understanding of how a test result translates to everyday realities. If we’re moderately optimistic, in-clinic testing will rapidly expand this quarter and/or next, with the possibility of broadly available, high-quality at-home sampling (and perhaps even analysis) thereafter.

Note that testing is not likely to be a “one-and-done” endeavor, as a person’s infection and immunity status change over time. Expect to be testing yourself—and your family—often as we move later into 2020.

Testing data are also going to inform distancing requirements at the country and local levels. In this scenario, restrictions—at some level of stringency—could persist at least through the end of 2020, as most countries are way behind the curve on testing (Iceland is an informative exception). Governments will likely continue to ask citizens to work from home if at all possible; to wear masks or face coverings in public; to employ heightened hygiene and social distancing in workplaces; and to restrict travel and social gatherings. So while it’s likely we’ll be eating in local restaurants again in 2020 in this scenario, at least for a little while, it’s not likely we’ll be heading to big concerts any time soon.

The Extremes: High and Low Optimism
How would high and low levels of optimism change our moderately optimistic timeline? The milestones are the same, but the time required to achieve them is shorter or longer, respectively. Quantifying these shifts is less important than acknowledging and incorporating a range of possibilities into our view. It pays to pay attention to our bias. Here are a few examples of reasonable possibilities that could shift the moderately optimistic timeline.

When vaccines become available
Vaccine repurposing could shorten the time for vaccines to become available; today, many vaccine candidates are in various stages of testing. On the other hand, difficulties in manufacture and distribution, or faster-than-expected mutation of SARS-CoV-2, could slow vaccine development. Given what we know now, I am not strongly concerned about either of these possibilities—drug companies are rapidly expanding their capabilities, and viral mutation isn’t an urgent concern at this time based on sequencing data—but they could happen.

At first, governments will likely supply vaccines to essential workers such as healthcare workers, but it is essential that vaccines become widely available around the world as quickly and as safely as possible. Overall, I suggest a dose of skepticism when reading highly optimistic claims about a vaccine (or multiple vaccines) being available in 2020. Remember, a vaccine is a knockout punch, not a first line of defense for an outbreak.

When testing hits its stride
While I am confident that testing is a critical component of our response to Covid-19, reliability is incredibly important to testing for SARS-CoV-2 and for immunity to the disease, particularly at home. For an individual, a false negative (being told you don’t have antibodies when you really do) could be just as bad as a false positive (being told you do have antibodies when you really don’t). Those errors are compounded when governments are trying to make evidence-based policies for social and physical distancing.

If you’re highly optimistic, high-quality testing will ramp up quickly as companies and scientists innovate rapidly by cleverly combining multiple test modalities, digital signals, and cutting-edge tech like CRISPR. Pop-up testing labs could also take some pressure off hospitals and clinics.

If things don’t go well, reliability issues could hinder testing, manufacturing bottlenecks could limit availability, and both could hamstring efforts to control spread and ease restrictions. And if it turns out that immunity to Covid-19 isn’t working the way we assumed, then we must revisit our assumptions about our path(s) back to public life, as well as our vaccine-development strategies.

How quickly safe and effective treatments appear
Drug development is known to be long, costly, and fraught with failure. It’s not uncommon to see hope in a drug spike early only to be dashed later on down the road. With that in mind, the number of treatments currently under investigation is astonishing, as is the speed through which they’re proceeding through testing. Breakthroughs in a therapeutic area—for example in treating the seriously ill or in reducing viral spread after an infection takes hold—could motivate changes in the focus of distancing regulations.

While speed will save lives, we cannot overlook the importance of knowing a treatment’s efficacy (does it work against Covid-19?) and safety (does it make you sick in a different, or worse, way?). Repurposing drugs that have already been tested for other diseases is speeding innovation here, as is artificial intelligence.

Remarkable collaborations among governments and companies, large and small, are driving innovation in therapeutics and devices such as ventilators for treating the sick.

Whether government policies are effective and responsive
Those of us who have experienced lockdown are eager for it to be over. Businesses, economists, and governments are also eager to relieve the terrible pressure that is being exerted on the global economy. However, lifting restrictions will almost certainly lead to a resurgence in sickness.

Here, the future is hard to model because there are many, many factors at play, and at play differently in different places—including the extent to which individuals actually comply with regulations.

Reliable testing—both in the clinic and at home—is crucial to designing and implementing restrictions, monitoring their effectiveness, and updating them; delays in reliable testing could seriously hamper this design cycle. Lack of trust in governments and/or companies could also suppress uptake. That said, systems are already in place for contact tracing in East Asia. Other governments could learn important lessons, but must also earn—and keep—their citizens’ trust.

Expect to see restrictions descend and then lift in response to changes in the number of Covid-19 cases and in the effectiveness of our prevention strategies. Also expect country-specific and perhaps even area-specific responses that differ from each other. The benefit of this approach? Governments around the world are running perhaps hundreds of real-time experiments and design cycles in balancing health and the economy, and we can learn from the results.

A Way Out
As Jeremy Farrar, head of the Wellcome Trust, told Science magazine, “Science is the exit strategy.” Some of our greatest technological assistance is coming from artificial intelligence, digital tools for collaboration, and advances in biotechnology.

Our exit strategy also needs to include empathy and future visioning—because in the midst of this crisis, we are breaking ground for a new, post-Covid future.

What do we want that future to look like? How will the hard choices we make now about data ethics impact the future of surveillance? Will we continue to embrace inclusiveness and mass collaboration? Perhaps most importantly, will we lay the foundation for successfully confronting future challenges? Whether we’re thinking about the next pandemic (and there will be others) or the cascade of catastrophes that climate change is bringing ever closer—it’s important to remember that we all have the power to become agents of that change.

Special thanks to Ola Kowalewski and Jason Dorrier for significant conversations.

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