Tag Archives: healthcare
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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New drug therapies for a range of chronic diseases. Defenses against various cyber attacks. Technologies to make cities work smarter. Weather and wildfire forecasts that boost safety and reduce risk. And commercial efforts to monetize so-called deepfakes.
What do all these disparate efforts have in common? They’re some of the solutions that the world’s most promising artificial intelligence startups are pursuing.
Data research firm CB Insights released its much-anticipated fourth annual list of the top 100 AI startups earlier this month. The New York-based company has become one of the go-to sources for emerging technology trends, especially in the startup scene.
About 10 years ago, it developed its own algorithm to assess the health of private companies using publicly-available information and non-traditional signals (think social media sentiment, for example) thanks to more than $1 million in grants from the National Science Foundation.
It uses that algorithm-generated data from what it calls a company’s Mosaic score—pulling together information on market trends, money, and momentum—along with other details ranging from patent activity to the latest news analysis to identify the best of the best.
“Our final list of companies is a mix of startups at various stages of R&D and product commercialization,” said Deepashri Varadharajanis, a lead analyst at CB Insights, during a recent presentation on the most prominent trends among the 2020 AI 100 startups.
About 10 companies on the list are among the world’s most valuable AI startups. For instance, there’s San Francisco-based Faire, which has raised at least $266 million since it was founded just three years ago. The company offers a wholesale marketplace that uses machine learning to match local retailers with goods that are predicted to sell well in their specific location.
Image courtesy of CB Insights
Funding for AI in Healthcare
Another startup valued at more than $1 billion, referred to as a unicorn in venture capital speak, is Butterfly Network, a company on the East Coast that has figured out a way to turn a smartphone phone into an ultrasound machine. Backed by $350 million in private investments, Butterfly Network uses AI to power the platform’s diagnostics. A more modestly funded San Francisco startup called Eko is doing something similar for stethoscopes.
In fact, there are more than a dozen AI healthcare startups on this year’s AI 100 list, representing the most companies of any industry on the list. In total, investors poured about $4 billion into AI healthcare startups last year, according to CB Insights, out of a record $26.6 billion raised by all private AI companies in 2019. Since 2014, more than 4,300 AI startups in 80 countries have raised about $83 billion.
One of the most intensive areas remains drug discovery, where companies unleash algorithms to screen potential drug candidates at an unprecedented speed and breadth that was impossible just a few years ago. It has led to the discovery of a new antibiotic to fight superbugs. There’s even a chance AI could help fight the coronavirus pandemic.
There are several AI drug discovery startups among the AI 100: San Francisco-based Atomwise claims its deep convolutional neural network, AtomNet, screens more than 100 million compounds each day. Cyclica is an AI drug discovery company in Toronto that just announced it would apply its platform to identify and develop novel cannabinoid-inspired drugs for neuropsychiatric conditions such as bipolar disorder and anxiety.
And then there’s OWKIN out of New York City, a startup that uses a type of machine learning called federated learning. Backed by Google, the company’s AI platform helps train algorithms without sharing the necessary patient data required to provide the sort of valuable insights researchers need for designing new drugs or even selecting the right populations for clinical trials.
Keeping Cyber Networks Healthy
Privacy and data security are the focus of a number of AI cybersecurity startups, as hackers attempt to leverage artificial intelligence to launch sophisticated attacks while also trying to fool the AI-powered systems rapidly coming online.
“I think this is an interesting field because it’s a bit of a cat and mouse game,” noted Varadharajanis. “As your cyber defenses get smarter, your cyber attacks get even smarter, and so it’s a constant game of who’s going to match the other in terms of tech capabilities.”
Few AI cybersecurity startups match Silicon Valley-based SentinelOne in terms of private capital. The company has raised more than $400 million, with a valuation of $1.1 billion following a $200 million Series E earlier this year. The company’s platform automates what’s called endpoint security, referring to laptops, phones, and other devices at the “end” of a centralized network.
Fellow AI 100 cybersecurity companies include Blue Hexagon, which protects the “edge” of the network against malware, and Abnormal Security, which stops targeted email attacks, both out of San Francisco. Just down the coast in Los Angeles is Obsidian Security, a startup offering cybersecurity for cloud services.
Deepfakes Get a Friendly Makeover
Deepfakes of videos and other types of AI-manipulated media where faces or voices are synthesized in order to fool viewers or listeners has been a different type of ongoing cybersecurity risk. However, some firms are swapping malicious intent for benign marketing and entertainment purposes.
Now anyone can be a supermodel thanks to Superpersonal, a London-based AI startup that has figured out a way to seamlessly swap a user’s face onto a fashionista modeling the latest threads on the catwalk. The most obvious use case is for shoppers to see how they will look in a particular outfit before taking the plunge on a plunging neckline.
Another British company called Synthesia helps users create videos where a talking head will deliver a customized speech or even talk in a different language. The startup’s claim to fame was releasing a campaign video for the NGO Malaria Must Die showing soccer star David Becham speak in nine different languages.
There’s also a Seattle-based company, Wellsaid Labs, which uses AI to produce voice-over narration where users can choose from a library of digital voices with human pitch, emphasis, and intonation. Because every narrator sounds just a little bit smarter with a British accent.
AI Helps Make Smart Cities Smarter
Speaking of smarter: A handful of AI 100 startups are helping create the smart city of the future, where a digital web of sensors, devices, and cloud-based analytics ensure that nobody is ever stuck in traffic again or without an umbrella at the wrong time. At least that’s the dream.
A couple of them are directly connected to Google subsidiary Sidewalk Labs, which focuses on tech solutions to improve urban design. A company called Replica was spun out just last year. It’s sort of SimCity for urban planning. The San Francisco startup uses location data from mobile phones to understand how people behave and travel throughout a typical day in the city. Those insights can then help city governments, for example, make better decisions about infrastructure development.
Denver-area startup AMP Robotics gets into the nitty gritty details of recycling by training robots on how to recycle trash, since humans have largely failed to do the job. The U.S. Environmental Protection Agency estimates that only about 30 percent of waste is recycled.
Some people might complain that weather forecasters don’t even do that well when trying to predict the weather. An Israeli AI startup, ClimaCell, claims it can forecast rain block by block. While the company taps the usual satellite and ground-based sources to create weather models, it has developed algorithms to analyze how precipitation and other conditions affect signals in cellular networks. By analyzing changes in microwave signals between cellular towers, the platform can predict the type and intensity of the precipitation down to street level.
And those are just some of the highlights of what some of the world’s most promising AI startups are doing.
“You have companies optimizing mining operations, warehouse logistics, insurance, workflows, and even working on bringing AI solutions to designing printed circuit boards,” Varadharajanis said. “So a lot of creative ways in which companies are applying AI to solve different issues in different industries.”
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We’re in the midst of a public health emergency, and life as we know it has ground to a halt. The places we usually go are closed, the events we were looking forward to are canceled, and some of us have lost our jobs or fear losing them soon.
But although it may not seem like it, there are some silver linings; this crisis is bringing out the worst in some (I’m looking at you, toilet paper hoarders), but the best in many. Italians on lockdown are singing together, Spaniards on lockdown are exercising together, this entrepreneur made a DIY ventilator and put it on YouTube, and volunteers in Italy 3D printed medical valves for virus treatment at a fraction of their usual cost.
Indeed, if you want to feel like there’s still hope for humanity instead of feeling like we’re about to snowball into terribleness as a species, just look at these examples—and I’m sure there are many more out there. There’s plenty of hope and opportunity to be found in this crisis.
Peter Xing, a keynote speaker and writer on emerging technologies and associate director in technology and growth initiatives at KPMG, would agree. Xing believes the coronavirus epidemic is presenting us with ample opportunities for increased automation and remote delivery of goods and services. “The upside right now is the burgeoning platform of the digital transformation ecosystem,” he said.
In a thought-provoking talk at Singularity University’s COVID-19 virtual summit this week, Xing explained how the outbreak is accelerating our transition to a highly-automated society—and painted a picture of what the future may look like.
You’ve probably seen them by now—the barren shelves at your local grocery store. Whether you were in the paper goods aisle, the frozen food section, or the fresh produce area, it was clear something was amiss; the shelves were empty. One of the most inexplicable items people have been panic-bulk-buying is toilet paper.
Xing described this toilet paper scarcity as a prisoner’s dilemma, pointing out that we have a scarcity problem right now in terms of our mindset, not in terms of actual supply shortages. “It’s a prisoner’s dilemma in that we’re all prisoners in our homes right now, and we can either hoard or not hoard, and the outcomes depend on how we collaborate with each other,” he said. “But it’s not a zero-sum game.”
Xing referenced a CNN article about why toilet paper, of all things, is one of the items people have been panic-buying most (I, too, have been utterly baffled by this phenomenon). But maybe there’d be less panic if we knew more about the production methods and supply chain involved in manufacturing toilet paper. It turns out it’s a highly automated process (you can learn more about it in this documentary by National Geographic) and requires very few people (though it does require about 27,000 trees a day—so stop bulk-buying it! Just stop!).
The supply chain limitation here is in the raw material; we certainly can’t keep cutting down this many trees a day forever. But—somewhat ironically, given the Costco cartloads of TP people have been stuffing into their trunks and backseats—thanks to automation, toilet paper isn’t something stores are going to stop receiving anytime soon.
Automation For All
Now we have a reason to apply this level of automation to, well, pretty much everything.
Though our current situation may force us into using more robots and automated systems sooner than we’d planned, it will end up saving us money and creating opportunity, Xing believes. He cited “fast-casual” restaurants (Chipotle, Panera, etc.) as a prime example.
Currently, people in the US spend much more to eat at home than we do to eat in fast-casual restaurants if you take into account the cost of the food we’re preparing plus the value of the time we’re spending on cooking, grocery shopping, and cleaning up after meals. According to research from investment management firm ARK Invest, taking all these costs into account makes for about $12 per meal for food cooked at home.
That’s the same as or more than the cost of grabbing a burrito or a sandwich at the joint around the corner. As more of the repetitive, low-skill tasks involved in preparing fast casual meals are automated, their cost will drop even more, giving us more incentive to forego home cooking. (But, it’s worth noting that these figures don’t take into account that eating at home is, in most cases, better for you since you’re less likely to fill your food with sugar, oil, or various other taste-enhancing but health-destroying ingredients—plus, there are those of us who get a nearly incomparable amount of joy from laboring over then savoring a homemade meal).
Now that we’re not supposed to be touching each other or touching anything anyone else has touched, but we still need to eat, automating food preparation sounds appealing (and maybe necessary). Multiple food delivery services have already implemented a contactless delivery option, where customers can choose to have their food left on their doorstep.
Besides the opportunities for in-restaurant automation, “This is an opportunity for automation to happen at the last mile,” said Xing. Delivery drones, robots, and autonomous trucks and vans could all play a part. In fact, use of delivery drones has ramped up in China since the outbreak.
Speaking of deliveries, service robots have steadily increased in numbers at Amazon; as of late 2019, the company employed around 650,000 humans and 200,000 robots—and costs have gone down as robots have gone up.
ARK Invest’s research predicts automation could add $800 billion to US GDP over the next 5 years and $12 trillion during the next 15 years. On this trajectory, GDP would end up being 40 percent higher with automation than without it.
This is all well and good, but what do these numbers and percentages mean for the average consumer, worker, or citizen?
“The benefits of automation aren’t being passed on to the average citizen,” said Xing. “They’re going to the shareholders of the companies creating the automation.” This is where policies like universal basic income and universal healthcare come in; in the not-too-distant future, we may see more movement toward measures like these (depending how the election goes) that spread the benefit of automation out rather than concentrating it in a few wealthy hands.
In the meantime, though, some people are benefiting from automation in ways that maybe weren’t expected. We’re in the midst of what’s probably the biggest remote-work experiment in US history, not to mention remote learning. Tools that let us digitally communicate and collaborate, like Slack, Zoom, Dropbox, and Gsuite, are enabling remote work in a way that wouldn’t have been possible 20 or even 10 years ago.
In addition, Xing said, tools like DataRobot and H2O.ai are democratizing artificial intelligence by allowing almost anyone, not just data scientists or computer engineers, to run machine learning algorithms. People are codifying the steps in their own repetitive work processes and having their computers take over tasks for them.
As 3D printing gets cheaper and more accessible, it’s also being more widely adopted, and people are finding more applications (case in point: the Italians mentioned above who figured out how to cheaply print a medical valve for coronavirus treatment).
The Mother of Invention
This movement towards a more automated society has some positives: it will help us stay healthy during times like the present, it will drive down the cost of goods and services, and it will grow our GDP in the long run. But by leaning into automation, will we be enabling a future that keeps us more physically, psychologically, and emotionally distant from each other?
We’re in a crisis, and desperate times call for desperate measures. We’re sheltering in place, practicing social distancing, and trying not to touch each other. And for most of us, this is really unpleasant and difficult. We can’t wait for it to be over.
For better or worse, this pandemic will likely make us pick up the pace on our path to automation, across many sectors and processes. The solutions people implement during this crisis won’t disappear when things go back to normal (and, depending who you talk to, they may never really do so).
But let’s make sure to remember something. Even once robots are making our food and drones are delivering it, and our computers are doing data entry and email replies on our behalf, and we all have 3D printers to make anything we want at home—we’re still going to be human. And humans like being around each other. We like seeing one another’s faces, hearing one another’s voices, and feeling one another’s touch—in person, not on a screen or in an app.
No amount of automation is going to change that, and beyond lowering costs or increasing GDP, our greatest and most crucial responsibility will always be to take care of each other.
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As Covid-19 continues to spread, the world has gone digital on an unprecedented scale. Tens of thousands of employees are working from home, and huge conferences, like the Google I/O and Apple WWDC software extravaganzas, plan to experiment with digital events.
Universities too are sending students home. This might have meant an extended break from school not too long ago. But no more. As lecture halls go empty, an experiment into digital learning at scale is ramping up. In the US alone, over 100 universities, from Harvard to Duke, are offering online classes to students to keep the semester going.
While digital learning has been improving for some time, Covid-19 may not only tip us further into a more digitally connected reality, but also help us better appreciate its benefits. This is important because historically, digital learning has been viewed as inferior to traditional learning. But that may be changing.
We often think about digital technologies as ways to reach people without access to traditional services—online learning for children who don’t have schools nearby or telemedicine for patients with no access to doctors. And while these solutions have helped millions of people, they’re often viewed as “second best” and “better than nothing.” Even in more resource-rich environments, there’s an assumption one should pay more to attend an event in person—a concert, a football game, an exercise class—while digital equivalents are extremely cheap or free. Why is this? And is the situation about to change?
Take the case of Dr. Sanjeev Arora, a professor of medicine at the University of New Mexico. Arora started Project Echo because he was frustrated by how many late-stage cases of hepatitis C he encountered in rural New Mexico. He realized that if he had reached patients sooner, he could have prevented needless deaths. The solution? Digital learning for local health workers.
Project Echo connects rural healthcare practitioners to specialists at top health centers by video. The approach is collaborative: Specialists share best practices and work through cases with participants to apply them in the real world and learn from edge cases. Added to expert presentations, there are lots of opportunities to ask questions and interact with specialists.
The method forms a digital loop of learning, practice, assessment, and adjustment.
Since 2003, Project Echo has scaled to 800 locations in 39 countries and trained over 90,000 healthcare providers. Most notably, a study in The New England Journal of Medicine found that the outcomes of hepatitis C treatment given by Project Echo trained healthcare workers in rural and underserved areas were similar to outcomes at university medical centers. That is, digital learning in this context was equivalent to high quality in-person learning.
If that is possible today, with simple tools, will they surpass traditional medical centers and schools in the future? Can digital learning more generally follow suit and have the same success? Perhaps. Going digital brings its own special toolset to the table too.
The Benefits of Digital
If you’re training people online, you can record the session to better understand their engagement levels—or even add artificial intelligence to analyze it in real time. Ahura AI, for example, founded by Bryan Talebi, aims to upskill workers through online training. Early study of their method suggests they can significantly speed up learning by analyzing users’ real-time emotions—like frustration or distraction—and adjusting the lesson plan or difficulty on the fly.
Other benefits of digital learning include the near-instantaneous download of course materials—rather than printing and shipping books—and being able to more easily report grades and other results, a requirement for many schools and social services organizations. And of course, as other digitized industries show, digital learning can grow and scale further at much lower costs.
To that last point, 360ed, a digital learning startup founded in 2016 by Hla Hla Win, now serves millions of children in Myanmar with augmented reality lesson plans. And Global Startup Ecosystem, founded by Christine Souffrant Ntim and Einstein Kofi Ntim in 2015, is the world’s first and largest digital accelerator program. Their entirely online programs support over 1,000 companies in 90 countries. It’s astonishing how fast both of these organizations have grown.
Notably, both examples include offline experiences too. Many of the 360ed lesson plans come with paper flashcards children use with their smartphones because the online-offline interaction improves learning. The Global Startup Ecosystem also hosts about 10 additional in-person tech summits around the world on various topics through a related initiative.
Looking further ahead, probably the most important benefit of online learning will be its potential to integrate with other digital systems in the workplace.
Imagine a medical center that has perfect information about every patient and treatment in real time and that this information is (anonymously and privately) centralized, analyzed, and shared with medical centers, research labs, pharmaceutical companies, clinical trials, policy makers, and medical students around the world. Just as self-driving cars can learn to drive better by having access to the experiences of other self-driving cars, so too can any group working to solve complex, time-sensitive challenges learn from and build on each other’s experiences.
Why This Matters
While in the long term the world will likely end up combining the best aspects of traditional and digital learning, it’s important in the near term to be more aware of the assumptions we make about digital technologies. Some of the most pioneering work in education, healthcare, and other industries may not be highly visible right now because it is in a virtual setting. Most people are unaware, for example, that the busiest emergency room in rural America is already virtual.
Once they start converging with other digital technologies, these innovations will likely become the mainstream system for all of us. Which raises more questions: What is the best business model for these virtual services? If they start delivering better healthcare and educational outcomes than traditional institutions, should they charge more? Hopefully, we will see an even bigger shift occurring, in which technology allows us to provide high quality education, healthcare, and other services to everyone at more affordable prices than today.
These are some of the topics we can consider as Covid-19 forces us into uncharted territory.
Image Credit: Andras Vas / Unsplash Continue reading →
Penicillin, one of the greatest discoveries in the history of medicine, was a product of chance.
After returning from summer vacation in September 1928, bacteriologist Alexander Fleming found a colony of bacteria he’d left in his London lab had sprouted a fungus. Curiously, wherever the bacteria contacted the fungus, their cell walls broke down and they died. Fleming guessed the fungus was secreting something lethal to the bacteria—and the rest is history.
Fleming’s discovery of penicillin and its later isolation, synthesis, and scaling in the 1940s released a flood of antibiotic discoveries in the next few decades. Bacteria and fungi had been waging an ancient war against each other, and the weapons they’d evolved over eons turned out to be humanity’s best defense against bacterial infection and disease.
In recent decades, however, the flood of new antibiotics has slowed to a trickle.
Their development is uneconomical for drug companies, and the low-hanging fruit has long been picked. We’re now facing the emergence of strains of super bacteria resistant to one or more antibiotics and an aging arsenal to fight them with. Gone unchallenged, an estimated 700,000 deaths worldwide due to drug resistance could rise to as many as 10 million in 2050.
Increasingly, scientists warn the tide is turning, and we need a new strategy to keep pace with the remarkably quick and boundlessly creative tactics of bacterial evolution.
But where the golden age of antibiotics was sparked by serendipity, human intelligence, and natural molecular weapons, its sequel may lean on the uncanny eye of artificial intelligence to screen millions of compounds—and even design new ones—in search of the next penicillin.
Hal Discovers a Powerful Antibiotic
In a paper published this week in the journal, Cell, MIT researchers took a step in this direction. The team says their machine learning algorithm discovered a powerful new antibiotic.
Named for the AI in 2001: A Space Odyssey, the antibiotic, halicin, successfully wiped out dozens of bacterial strains, including some of the most dangerous drug-resistant bacteria on the World Health Organization’s most wanted list. The bacteria also failed to develop resistance to E. coli during a month of observation, in stark contrast to existing antibiotic ciprofloxacin.
“In terms of antibiotic discovery, this is absolutely a first,” Regina Barzilay, a senior author on the study and computer science professor at MIT, told The Guardian.
The algorithm that discovered halicin was trained on the molecular features of 2,500 compounds. Nearly half were FDA-approved drugs, and another 800 naturally occurring. The researchers specifically tuned the algorithm to look for molecules with antibiotic properties but whose structures would differ from existing antibiotics (as halicin’s does). Using another machine learning program, they screened the results for those likely to be safe for humans.
Early study suggests halicin attacks the bacteria’s cell membranes, disrupting their ability to produce energy. Protecting the cell membrane from halicin might take more than one or two genetic mutations, which could account for its impressive ability to prevent resistance.
“I think this is one of the more powerful antibiotics that has been discovered to date,” James Collins, an MIT professor of bioengineering and senior author told The Guardian. “It has remarkable activity against a broad range of antibiotic-resistant pathogens.”
Beyond tests in petri-dish bacterial colonies, the team also tested halicin in mice. The antibiotic cleared up infections of a strain of bacteria resistant to all known antibiotics in a day. The team plans further study in partnership with a pharmaceutical company or nonprofit, and they hope to eventually prove it safe and effective for use in humans.
This last bit remains the trickiest step, given the cost of getting a new drug approved. But Collins hopes algorithms like theirs will help. “We could dramatically reduce the cost required to get through clinical trials,” he told the Financial Times.
A Universe of Drugs Awaits
The bigger story may be what happens next.
How many novel antibiotics await discovery, and how far can AI screening take us? The initial 6,000 compounds scanned by Barzilay and Collins’s team is a drop in the bucket.
They’ve already begun digging deeper by setting the algorithm loose on 100 million molecules from an online library of 1.5 billion compounds called the ZINC15 database. This first search took three days and turned up 23 more candidates that, like halicin, differ structurally from existing antibiotics and may be safe for humans. Two of these—which the team will study further—appear to be especially powerful.
Even more ambitiously, Barzilay hopes the approach can find or even design novel antibiotics that kill bad bacteria with alacrity while sparing the good guys. In this way, a round of antibiotics would cure whatever ails you without taking out your whole gut microbiome in the process.
All this is part of a larger movement to use machine learning algorithms in the long, expensive process of drug discovery. Other players in the area are also training AI on the vast possibility space of drug-like compounds. Last fall, one of the leaders in the area, Insilico, was challenged by a partner to see just how fast their method could do the job. The company turned out a new a proof-of-concept drug candidate in only 46 days.
The field is still developing, however, and it has yet to be seen exactly how valuable these approaches will be in practice. Barzilay is optimistic though.
“There is still a question of whether machine-learning tools are really doing something intelligent in healthcare, and how we can develop them to be workhorses in the pharmaceuticals industry,” she said. “This shows how far you can adapt this tool.”
Image Credit: Halicin (top row) prevented the development of antibiotic resistance in E. coli, while ciprofloxacin (bottom row) did not. Collins Lab at MIT Continue reading →