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Taking the pandemic’s temperature

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thermometer


Last March, as covid-19 ripped through communities across the country, Inder Singh, MBA ’06, SM ’07, realized he had information that could help officials respond.

For years Singh’s company, Kinsa Health, had tracked fevers using data from its network of thousands of smartphone-­connected thermometers. As the potential scope of the covid-19 outbreak became clear, Singh subtracted the typical cold and flu numbers gathered in years past from the company’s graphs.

“What’s left over are unusual fevers, and we saw hot spots across the country,” Singh says. “We observed six years of data and there’d been hot spots, but nothing like we were seeing in early March.”

Kinsa’s team realized that the data offered a more immediate view of illness than test results. Within days they made it publicly available. Then on Saturday, March 14, Singh got on a call with the former head of the US Food and Drug Administration, the physician-researcher responsible for Taiwan’s successful covid-19 response, and Nirav Shah, a physician who is the former New York state health commissioner.

“Inder showed us this map, and he said, ‘I think this is covid-19 in the community,’” recalls Shah, who now sits on Kinsa’s board of directors. “All three of us were like, ‘It’s lighting up in Texas and Florida—we don’t see any covid [hot spots] there. Obviously your stuff is wrong.’” Two weeks later, the first surges in cases started being reported out of Texas and Florida.

Since then, Kinsa has been working to help US efforts to understand and contain the virus. Its data is being used by officials in at least five states and five cities, thousands of research groups, prominent media outlets, and organizations including the NBA, which used Kinsa’s thermometers during the isolation of its players and coaches to finish the 2019-2020 season. 

Kinsa’s FLUency Program, an initiative started in 2013 to help schools combat the seasonal flu, laid the foundation for Kinsa’s data collection. Today the company is working with more than 4,000 schools, accounting for about 5% of the nation’s public elementary schools.

“By the time the CDC [US Centers for Disease Control] gets the data, it has been processed, deidentified, and people have entered the health system to see a doctor,” says Singh, who is Kinsa’s CEO. “There’s a huge delay from when someone contracts an illness to when they see a doctor. The current health-care system only sees the latter; we see the former.”

Finding a path

Singh, who earned undergrad degrees in economics and engineering at the University of Michigan, was introduced to the world of infectious disease during graduate studies at the Harvard Kennedy School of Government. Although he’d started college intent on becoming an astronaut, as a grad student he spent time in different parts of Africa working on initiatives to prevent the spread of diseases like malaria and AIDS.

Singh’s first exposure to MIT came while he was back in Cambridge.

“I remember I interacted with some MIT undergrads. We brainstormed some social-impact ideas,” he recalls. “A week later I got an email from them saying they’d prototyped what we were talking about. I was like, ‘You prototyped what we talked about in a week?’ I was blown away, and it was an insight into how MIT is such a doer campus. It was so entrepreneurial.”

Soon Singh enrolled in the interdisciplinary Harvard-MIT Program in Health Sciences and Technology, earning his master’s and MBA degrees while working with leading research hospitals in the area. He then got what he describes as a dream job at the Clinton Health Access Initiative (CHAI), brokering deals between pharmaceutical companies and poor countries to lower the cost of medicines for AIDS, malaria, and tuberculosis. The role opened his eyes to several shortcomings in the global health system.

“The world tries to curb the spread of infectious illness with almost zero real-time information about when and where disease is spreading,” he says. “The question I posed to start Kinsa was ‘How do you stop the next outbreak before it becomes an epidemic if you don’t know where and when it’s starting and how fast it’s spreading?’”

Thermometers for change

With the insight that better data was needed to control infectious diseases, Singh founded Kinsa in 2012. In order to get that data, the company needed a new way of providing value to families when someone was ill.

“The behavior in the home when someone gets sick is to grab the thermometer,” Singh says. “We piggybacked off of that to create a communication channel to the sick, to help them get better faster.”

A year later, the company launched the FLUency Program, which became the vehicle for Kinsa to get millions of thermometers into communities around the country. The company relies on donations and government grants to hand out its thermometers to schools that serve primarily poor families.

Kinsa’s thermometers link to an app that considers age, temperature, and symptoms to help users decide if they should seek medical attention. The app also incorporates community illness levels into its guidance—informing parents, for instance, if other students in their child’s grade have come down with the flu. 

“That’s important because parents question what’s going around,” Singh says. “For the most part everything starts the same way: a cough, maybe a spike in fever. But what is it? Strep throat? Common cold? Flu? Covid-19? Now you have more context.”

Kinsa’s HealthWeather website lets anyone check real-time covid risk by zip code; it draws from fever data collected by the company’s smart thermometers, symptoms entered on its app, and covid case data collected by Johns Hopkins University.

CHRISTIE HEMM KLOK (DEVICE); KINSA (SCREEN)

The data generated by the thermometers is also anonymized and aggregated for officials like school nurses, who can help prevent the spread of disease in classrooms by reminding parents to keep their kids home if they are sick or by encouraging teachers to disinfect surfaces more often.

In California, Fresno began equipping families in each of its 60 elementary schools with thermometers in 2019. Kinsa looked at the number of student absences in schools with more and less participation in the program and found that students missed 8% fewer days in schools where more families had thermometers, a pattern school officials also noticed.

“Students miss less school because we’re not exposing as many kids to illness,” says Jane Banks, the head of school nurses for the Fresno public schools. “We’re educating and intervening in real time when we see any outbreak, or anything that’s off.” In the fall, she was talking with Kinsa about how Fresno might use the thermometers to help bring students back to the classroom in phases once schools got the green light. 

In Laguna Niguel, California, the Community Roots charter school distributed the thermometers to all students’ families after beginning the school year with online instruction. When the school shifted to in-person learning, it required students arriving on campus each day to show school officials their negative fever results through the Kinsa app. While of course being fever-free can’t guarantee that a student is covid-free, the daily temperature readings at home at least made it possible to keep symptomatic students away from healthy students. As of the beginning of December, Community Roots was the only elementary school open for five-day classroom instruction in Orange County. 

“I interacted with some MIT undergrads. We brainstormed some social-impact ideas. A week later I got an email from them saying they’d prototyped what we were talking about. I was like, ‘You prototyped what we talked about in a week?’ I was blown away.”

Singh says the only thing holding the FLUency Program back is funding: an additional 13,000 schools have applied to participate, but Kinsa hasn’t found enough donors. “We are adamant that we don’t charge the public schools,” he says.

Kinsa’s fever data has proved useful beyond school settings as well. In the Orlando “bubble” the NBA used to finish its 2019-2020 season, every player, ref, media person, and staff member began each day with a reading from Kinsa’s thermometer. If someone showed a higher temperature than average, the NBA’s health and safety team, which included doctors and epidemiologists, would call the person to do an assessment. John DiFiori, the NBA’s director of sports medicine, told USA Today the daily temperature check was “really the foundation” of the league’s approach to keeping everyone safe.

Kinsa has also made information about local outbreaks available to anyone—not just those with the app. In November, the company launched a tool on its HealthWeather website that lets anyone in the US view a real-time risk score for the level of contagious illness in a given zip code. The idea is to make checking local illness levels as easy as viewing local weather forecasts.

Fever data is not a perfect proxy for covid-19 infection. It can do only so much to help authorities contain the virus because people can be asymptomatic but still contagious, cautions Joseph Frassica, a professor of the practice at MIT’s Institute for Medical Engineering and Science (IMES) as well as the head of Philips Research North America. Younger populations are more likely to be asymptomatic if infected, he says, which particularly limits the usefulness of student testing systems that rely on temperature data alone.

That said, he thinks that combining fever data with the questionnaires on Kinsa’s app is a great way to track symptomatic covid-19 cases, and Kinsa’s widespread thermometer distribution means that its maps are a fairly good indicator of covid-19 in communities. Kinsa says that between March 1 and November 1 of 2020, it captured nearly 15 million fever readings and 1.7 million symptom inputs.

“Kinsa’s approach of collecting data from connected thermometers is an important one and actually very useful for detecting geographies where there’s an increase or decrease in the incidence of fever—and, in the year of covid-19, the incidence of covid-19,” says Frassica, who has worked on building predictive models for covid-19 through IMES and is not affiliated with Kinsa Health.

Filling a void

Last spring, New Orleans city officials were working overtime in a struggle that was playing out across the US. The city had organized a covid-19 response team to establish community testing sites, procure protective equipment, educate the public, and take other steps to curb the spread of the disease.

Unfortunately, like the rest of the country, New Orleans had to rely on testing data to track the virus. That made it more likely that people would spread the disease before they knew they were infected.

The mayor’s office had been in touch with Kinsa about the company’s thermometers, but the city was in no position to buy them anytime soon.

Then a Kinsa employee called the mayor’s office to say the company had found a donor, and 25,000 thermometers were coming free of charge. They arrived at city hall on June 24. Over the next few weeks, the thermometers were given out to low-income families, who are generally more vulnerable to the worst symptoms of covid-19. Many of the recipients didn’t previously have a thermometer in their home. Kinsa’s app gave the families information about the spread of the disease in their communities and helped them take steps to mitigate its spread. It also gave city officials new, real-time information about community health.

“If I know what’s going on in the community, I can respond better as a parent, I can respond better as a school leader, I can respond better as a school nurse,” Singh says. “When you know where and when symptoms are starting and how fast they’re spreading, you can empower local individuals, families, communities, and governments.” 

Tech

The Download: Algorithms’ shame trap, and London’s safer road crossings

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This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.

How algorithms trap us in a cycle of shame

Working in finance at the beginning of the 2008 financial crisis, mathematician Cathy O’Neil got a firsthand look at how much people trusted algorithms—and how much destruction they were causing. Disheartened, she moved to the tech industry, but encountered the same blind faith. After leaving, she wrote a book in 2016 that dismantled the idea that algorithms are objective. 

O’Neil showed how every algorithm is trained on historical data to recognize patterns, and how they break down in damaging ways. Algorithms designed to predict the chance of re-arrest, for example, can unfairly burden people, typically people of color, who are poor, live in the wrong neighborhood, or have untreated mental-­health problems or addictions.

Over time, she came to realize another significant factor that was reinforcing these inequities: shame. Society has been shaming people for things they have no choice or voice in, such as weight or addiction problems, and weaponizing that humiliation. The next step, O’Neill recognized, was fighting back. Read the full story.

—Allison Arieff

London is experimenting with traffic lights that put pedestrians first

The news: For pedestrians, walking in a city can be like navigating an obstacle course. Transport for London, the public body behind transport services in the British capital, has been testing a new type of crossing designed to make getting around the busy streets safer and easier.

How does it work? Instead of waiting for the “green man” as a signal to cross the road, pedestrians will encounter green as the default setting when they approach one of 18 crossings around the city. The light changes to red only when the sensor detects an approaching vehicle—a first in the UK.

How’s it been received? After a trial of nine months, the data is encouraging: there is virtually no impact on traffic, it saves pedestrians time, and it makes them 13% more likely to comply with traffic signals. Read the full story.

—Rachael Revesz

Check out these stories from our new Urbanism issue. You can read the full magazine for yourself and subscribe to get future editions delivered to your door for just $120 a year.

– How social media filters are helping people to explore their gender identity.
– The limitations of tree-planting as a way to mitigate climate change.

Podcast: Who watches the AI that watches students?

A boy wrote about his suicide attempt. He didn’t realize his school’s software was watching. While schools commonly use AI to sift through students’ digital lives and flag keywords that may be considered concerning, critics ask: at what cost to privacy? We delve into this story, and the wider world of school surveillance, in the latest episode of our award-winning podcast, In Machines We Trust.

Check it out here.

ICYMI: Our TR35 list of innovators for 2022

In case you missed it yesterday, our annual TR35 list of the most exciting young minds aged 35 and under is now out! Read it online here or subscribe to read about them in the print edition of our new Urbanism issue here.

The must-reads

I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.

1 There’s now a crazy patchwork of abortion laws in the US
Overturning Roe has triggered a legal quagmire—including some abortion laws that contract others within the same state. (FT $)
+ Protestors are doxxing the Supreme Court on TikTok. (Motherboard)
+ Planned Parenthood’s abortion scheduling tool could share data. (WP $)
+ Here’s the kind of data state authorities could try to use to prosecute. (WSJ $)
+ Tech firms need to be transparent about what they’re asked to share. (WP $)
+ Here’s what people in the trigger states are Googling. (Vox)

2 Chinese students were lured into spying for Beijing
The recent graduates were tasked with translating hacked documents. (FT $)
+ The FBI accused him of spying for China. It ruined his life. (MIT Technology Review)

3 Why it’s time to adjust our expectations of AI
Researchers are getting fed up with the hype. (WSJ $)
+ Meta still wants to build intelligent machines that learn like humans, though. (Spectrum IEEE)
+ Yann LeCun has a bold new vision for the future of AI. (MIT Technology Review)
+ Understanding how the brain’s neurons really work will aid better AI models. (Economist $)

4 Bitcoin is facing its biggest drop in more than 10 years
The age of freewheeling growth really is coming to an end. (Bloomberg $)
+ The crash is a threat to funds worth millions stolen by North Korea. (Reuters)
+ The cryptoapocalypse could worsen before it levels out. (The Guardian)
+ The EU is one step closer towards regulating crypto. (Reuters)

5 Singapore’s new online safety laws are a thinly-veiled power grab
Empowering its authoritarian government to exert even greater control over civilians. (Rest of World)

6 Recommendations algorithms require effort to work properly
Telling them what you like makes it more likely it’ll present you with decent suggestions. (The Verge)

7 China’s on a mission to find an Earth-like planet
But what they’ll find is anyone’s guess. (Motherboard)
+ The ESA’s Gaia probe is shining a light on what’s floating in the Milky Way. (Wired $) 

8 Inside YouTube’s meta world of video critique
Video creators analyzing other video creators makes for compelling watching. (NYT $)
+ Long-form videos are helping creators to stave off creative burnout. (NBC)

9 Time-pressed daters are vetting potential suitors over video chat
To get the lay of the land before committing to an IRL meet-up. (The Atlantic $)

10 How fandoms shaped the internet
For better—and for worse. (New Yorker $)

Quote of the day

“This is no mere monkey business.”

—A lawsuit filed by Yuga Labs, the creators of the Bored Ape NFT collection, against conceptual artists Ryder Ripps, claims Ripps copied their distinctive simian artwork, Gizmodo reports.

The big story

This restaurant duo want a zero-carbon food system. Can it happen?

September 2020

When Karen Leibowitz and Anthony Myint opened The Perennial, the most ambitious and expensive restaurant of their careers, they had a grand vision: they wanted it to be completely carbon-neutral. Their “laboratory of environmentalism in the food world” opened in San Francisco in January 2016, and its pièce de résistance was serving meat with a dramatically lower carbon footprint than normal. 

Myint and Leibowitz realized they were on to something much bigger—and that the easiest, most practical way to tackle global warming might be through food. But they also realized that what has been called the “country’s most sustainable restaurant” couldn’t fix the broken system by itself. So in early 2019, they dared themselves to do something else that nobody expected. They shut The Perennial down. Read the full story.

—Clint Rainey

We can still have nice things

A place for comfort, fun and distraction in these weird times. (Got any ideas? Drop me a line or tweet ’em at me.)

+ A look inside the UK’s blossoming trainspotting scene (don’t worry, it’s nothing to do with the Irvine Welsh novel of the same name.)
+ This is the very definition of a burn.
+ A solid science joke.
+ This amusing Twitter account compiles some of the strangest public Spotify playlists out there (Shout out to Rappers With Memory Problems)
+ Have you been lucky enough to see any of these weird and wonderful buildings in person?



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The US Supreme Court just gutted the EPA’s power to regulate emissions

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The US Supreme Court just gutted the EPA’s power to regulate emissions


What was the ruling?

The decision states that the EPA’s actions in a 2015 rule, which included caps on emissions from power plants, overstepped the agency’s authority.

“Capping carbon dioxide emissions at a level that will force a nationwide transition away from the use of coal to generate electricity may be a sensible ‘solution to the crisis of the day,’” the decision reads. “But it is not plausible that Congress gave EPA the authority to adopt on its own such a regulatory scheme.”

Only Congress has the power to make “a decision of such magnitude and consequence,” it continues. 

This decision is likely to have “broad implications,” says Deborah Sivas, an environmental law professor at Stanford University. The court is not only constraining what the EPA can do on climate policy going forward, she adds; this opinion “seems to be a major blow for agency deference,” meaning that other agencies could face limitations in the future as well.

The ruling, which is the latest in a string of bombshell cases from the court, fell largely along ideological lines. Chief Justice John Roberts authored the majority opinion, and he was joined by his fellow conservatives: Justices Samuel Alito, Amy Coney Barrett, Neil Gorsuch, Brett Kavanaugh, and Clarence Thomas. Justices Stephen Breyer, Elena Kagan, and Sonia Sotomayor dissented.

What is the decision all about?

The main question in the case was how much power the EPA should have to regulate carbon emissions and what it should be allowed to do to accomplish that job. That question was occcasioned by a 2015 EPA rule called the Clean Power Plan.

The Clean Power Plan targeted greenhouse-gas emissions from power plants, requiring each state to make a plan to cut emissions and submit it to the federal government.

Several states and private groups immediately challenged the Clean Power Plan when it was released, calling it an overreach on the part of the agency, and the Supreme Court put it on hold in 2016. After a repeal of the plan during Donald Trump’s presidency and some legal back-and-forth, a Washington, DC, district court ruled in January 2021 that the Clean Power Plan did fall within the EPA’s authority.

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How to track your period safely post-Roe

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How to track your period safely post-Roe


3. After you delete your app, ask the app provider to delete your data. Just because you removed the app from your phone does not mean the company has gotten rid of your records. In fact, California is the only state where they are legally required to delete your data. Still, many companies are willing to delete it upon request. Here’s a helpful guide from the Washington Post that walks you through how you can do this.

Here’s how to safely track your period without an app.

1. Use a spreadsheet. It’s relatively easy to re-create the functions of a period tracker in a spreadsheet by listing out the dates of your past periods and figuring out the average length of time from the first day of one to the first day of the next. You can turn to one of the many templates already available online, like the period tracker created by Aufrichtig and the Menstrual Cycle Calendar and Period Tracker created by Laura Cutler. If you enjoy the science-y aspect of period apps, templates offer the ability to send yourself reminders about upcoming periods, record symptoms, and track blood flow.

2. Use a digital calendar. If spreadsheets make you dizzy and your entire life is on a digital calendar already, try making your period a recurring event, suggests Emory University student Alexa Mohsenzadeh, who made a TikTok video demonstrating the process

Mohsenzadeh says that she doesn’t miss apps. “I can tailor this to my needs and add notes about how I’m feeling and see if it’s correlated to my period,” she says. “You just have to input it once.” 

3. Go analog and use a notebook or paper planner. We’re a technology publication, but the fact is that the safest way to keep your menstrual data from being accessible to others is to take it offline. You can invest in a paper planner or just use a notebook to keep track of your period and how you’re feeling. 

If that sounds like too much work, and you’re looking for a simple, no-nonsense template, try the free, printable Menstrual Cycle Diary available from the University of British Columbia’s Centre for Menstrual Cycle and Ovulation Research.

4. If your state is unlikely to ban abortion, you might still be able to safely use a period-tracking app. The crucial thing will be to choose one that has clear privacy settings and has publicly promised not to share user data with authorities. Quintin says Clue is a good option because it’s beholden to EU privacy laws and has gone on the record with its promise not to share information with authorities. 

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