Apple will emerge from the COVID-19 pandemic as an even more powerful and important company. Indeed, COVID-19 may prove to be Apple’s finest hour. During the first 30 days of the pandemic’s escalation in the United States, Apple stepped up in significant ways, the most notable example being the formation of a relationship with Google to contain the virus with contact-tracing technology. In addition, Apple has, among other actions:
- Launched a new website and app that helps people screen themselves for the existence of COVID-19 symptoms.
- Mobilized its resources to design new plastic face shields to protect healthcare workers.
- Made it possible to ask the Siri voice assistant, “How do I know if I have coronavirus?” to access guidance and resources from the CDC and a curated collection of telehealth apps available on the App Store.
Moreover, Apple products are taking on renewed importance. Years ago, Apple set out to create a healthcare data backbone that consists of hardware (the Apple Watch and iPhone) and software. The world needs that data backbone urgently.
A New Response Ecosystem Is Emerging
Responding to the COVID-19 outbreak requires unprecedented levels of cooperation among businesses, academics, medical providers, and governments. Lena H. Sun, William Wan, and Yasmeen Abutaleb of The Washington Post summarized the magnitude of the effort succinctly in an April 10 article, “A plan to defeat coronavirus finally emerges, but it’s not from the White House”:
. . . a collection of governors, former government officials, disease specialists and nonprofits are pursuing a strategy that relies on the three pillars of disease control: Ramp up testing to identify people who are infected. Find everyone they interact with by deploying contact tracing on a scale America has never attempted before. And focus restrictions more narrowly on the infected and their contacts so the rest of society doesn’t have to stay in permanent lockdown.
As The Washington Post noted, one of the three pillars of disease control consists of contact tracing. With contact tracing, an app uses Bluetooth to monitor a person’s proximity to other cellphones. People then receive a message if they've been in close contact with someone who has tested positive for COVID-19.
This kind of technology conceivably makes it possible for people to emerge from lockdown, knowing they have a safety net app to warn them if they’ve been exposed. Contact tracing in and of itself is not the answer to freeing people from lives of social distancing, but it’s an important step.
Outside the United States, technology experts and scientists around the world, with the support of national governments, are actively working on contact tracing solutions. As Derek Thompson of The Atlantic reports, these efforts are achieving breakthroughs:
. . . test and trace seems to work—period. Singapore and South Korea are very different countries from each other and from the U.S. But they have learned from previous outbreaks. Through tracing, both countries have reduced COVID-19 deaths much more successfully than many similarly dense U.S. cities.
Germany and France are among the European governments planning to launch contact-tracing apps, too. But the United States lacks a national effort to coordinate this kind of research. And, the White House’s response to COVID-19 has been widely criticized. For instance, on March 13, President Trump falsely claimed that Google was building a nationwide COVID-19 screening website. That’s but one example of a statement or action that has sharpened public criticism of the White House’s response to the pandemic.
The criticism of the White House underscores why businesses, regional governments, healthcare academics, and others are figuring out a way forward on their own. An example: the April 10 announcement from Apple and Google to accelerate the development of contact tracing. According to the announcement, “Apple and Google will be launching a comprehensive solution that includes application programming interfaces (APIs) and operating system-level technology to assist in enabling contact tracing.” They plan to take two near-term steps:
First, in May, both companies will release APIs that enable interoperability between Android and iOS devices using apps from public health authorities. These official apps will be available for users to download via their respective app stores.
Second, in the coming months, Apple and Google will work to enable a broader Bluetooth-based contact tracing platform by building this functionality into the underlying platforms. This is a more robust solution than an API and would allow more individuals to participate, if they choose to opt in, as well as enable interaction with a broader ecosystem of apps and government health authorities.
Here's how the technology would work, per information Google published April 10:
Contact tracing is by no means a solution in and of itself. As The Washington Post pointed out, contact tracing needs to be complemented by ramped up testing nationally. Moreover, citizens must be willing to report a COVID-19 diagnosis on their devices, which they might not be willing to do especially at a time of heightened concerns about safeguarding user privacy.
In a nod to concerns among privacy watchdogs, the brief announcement mentioned privacy five times. “Privacy, transparency, and consent are of utmost importance in this effort, and we look forward to building this functionality in consultation with interested stakeholders,” the companies said. “We will openly publish information about our work for others to analyze.’”
Even though Apple and Google got out in front of the privacy issue, the announcement triggered immediate criticisms and caveats from privacy activists in context of a larger debate about how much personal privacy we should be willing to sacrifice to protect our personal health during these extraordinary times.
Why Apple?
As imperfect as the Apple/Google alliance is, it portends an even bigger role for Apple in particular. Why Apple, though? Because Apple is already a strong healthcare tech player.
As I wrote in Hacker Noon in February, Apple has already developed a data backbone of healthcare that encompasses:
- Hardware such as the Apple Watch (as well as the iPhone), creating an ever-present device platform for managing personal heath. Through the development of the Apple Watch, Apple has a strong head start in researching and developing ways to use technology to manage our personal health. By now, the Apple Watch has become a leading device for people to track personal wellness data such. The Apple Watch now outsells the entire Swiss watch industry.
- Software for patients and providers to monitor and share data. The Apple Watch is useless as a wellness device without healthcare apps that Apple has been developing, such as an ECG app and irregular heart rhythm notification feature that Apple released in December 2018. There’s a lot more to Apple’s software than an ECG app. Over the years, Apple has developed software such as ResearchKit (a software framework for apps that makes it possible for medical researchers to collect patient data) and CareKit (a framework for developers to build apps that let you manage your own well-being on a daily basis).
Apple develops this data backbone through relationships with healthcare providers such as Johns Hopkins that facilitate the monitoring and sharing of wellness data (more about that here); and supports the data backbone through relationships with employers and insurance providers to encourage the use of Apple products.
Apple has the expertise and knows the healthcare terrain. In addition, Apple has something else: credibility for safeguarding personal data. Apple is well known for protecting user privacy, beyond its well-publicized fights to block the FBI from getting access to iPhones. Users control which information goes into the Health app and who they share it with. Its Safari web browser blocks third-party cookies by default. The Maps app doesn’t associate your data with your Apple ID, and Apple doesn’t keep a history of where you’ve been. Apple can’t read your iMessages while they’re being sent between you and the person you’re texting. Your Apple ID isn’t connected to Siri, and your requests are associated with a random identifier.
On the other hand, even though Google has made significant efforts to become a healthcare data hub, it lacks Apple’s reputation for safeguarding user privacy – which, it could be argued, is unfair because Google has in fact put in place several measures to protect user privacy, such as blocking third-party cookies on its Chrome browser and providing an incognito option for Google Maps that does not track user behavior. But Google also recently came under fire when The Wall Street Journal reported that Google and Ascension Health were collecting patient data without informing patients. That and other privacy gaffes have dogged Google, making the company a target for privacy activists. Google’s efforts to help the White House develop a coronavirus screening site caused some senators to voice concerns about how well Google could safeguard personal data.
For the most part, Apple has escaped these controversies although the company, like Google and Amazon, suffered a black eye when it was reported that it had hired contractors to listen to conversations recorded by Siri. Apple’s reputation will serve it well as Apple and Google tackle the difficult task of winning over privacy skeptics.
To be sure, Apple faces some big challenges right now in its fight against COVID-19. They include:
- Lack of a strong partner in the White House. A better coordinated COVID-19 response from the White House would help with the uptake of contact tracing technology across the United States.
- Blowback from privacy advocates.
- Manufacturing and supply chain operations compromised by the pandemic.
- A weakened demand for its products as the world sinks into a recessionary economy.
Nevertheless, Apple’s head start creating a healthcare data backbone positions it well to lead the private sector’s fight to contain COVID-19.
A Data Backbone for Threat Detection and Management
Going forward, I expect the Apple Watch to play a more important role. It’s already possible to use the Apple Watch to monitor your response to illnesses including COVID-19 thanks to apps such as Cardiogram. Unfortunately, the Apple Watch does not monitor body temperature, which is a crucial COVID-19 symptom. Lastly, one of the diagnostic tools used for COVID-19 patients is a pulse oximeter. The Apple Watch is currently believed to have this capacity, but it is not activated as yet. There are snippets of upcoming software code that point to Apple being able to activate this feature with a software update. To be sure, the usefulness of an at-home pulse oximeter for the general population is up for debate. As a recently published Consumer Reports article states:
There is little reason for the average, healthy person to have a pulse oximeter at home, the experts said. But there are some aspects of COVID-19 that could make one useful to people diagnosed with the disease or who have symptoms of it, says Elissa Perkins, M.D., associate professor of emergency medicine at Boston Medical Center, who is treating COVID-19 patients there.
Even though the value of an at-home pulse oximeter is debatable, it’s an example of how the Apple Watch could be enriched with a functionality that could benefit segments of the population.
My prediction: Apple will turn its sights toward using the Apple Watch to monitor COVID-19 more explicitly, while relying on the iPhone for tracing. After that, as we enter a new era of personal health consciousness, Apple will make the Apple Watch become an even more useful tool for virus detection beyond COVID-19. The Apple Watch will become part of a stronger data backbone for threat detection and management.
Note: I am an investor in Apple and Alphabet, Google's parent company.