US company Kinsa is using smart thermometers to gain knowledge about the spread of the pandemic in real-time.
More than 1.5 million of its thermometers have been sold or given away across America, including hundreds of thousands to families from low-income school districts. The thermometers link to an app that helps users decide if they should seek medical attention based on age, fever and symptoms.
At the community level, the data generated are anonymised and aggregated, and can be shared with parents and school officials, helping them understand what illnesses are going around and prevent the spread of disease in classrooms.
By working with over 2,000 schools and many businesses, Kinsa has also developed predictive models that can forecast flu seasons. In the spring of this year, the company showed it could predict flu spread 12-20 weeks in advance at the city level.
When Covid-19 came, the company was able to estimate its spread in real-time by tracking fever levels above what would normally be expected. Now Kinsa is working with health officials in five states and three cities to help contain and control the virus.
“By the time the CDC (the Centres for Disease Control) gets the data, it has been processed, deidentified, and people have entered the health system to see a doctor,” says Inder Singh, who is Kinsa’s CEO and founder. “There’s a huge delay from when someone contracts an illness and when they see a doctor. The current health care system only sees the latter; we see the former.”
In addition to its local partnerships, the company has become a central information hub for researchers with its Healthweather tool, which maps unusual rates of fevers — among the most common symptom of Covid-19 — to help visualise the prevalence of illness in communities. Singh says Kinsa’s data complement other methods of containing the virus like testing, contact tracing, and the use of face masks.
Kinsa started by selling its thermometers and creating a sponsorship program for corporate donors to fund thermometer donations to Title 1 schools, which serve high numbers of economically disadvantaged students. Singh says 40% of families that receive a Kinsa thermometer through that program did not previously have any thermometer in their house.
The company says its program has been shown to help schools improve attendance, and has yielded years of real-time data on fever rates to help compare to official estimates and develop its models.
“We had been forecasting flu incidence accurately several weeks out for years, and right around early 2020, we had a massive breakthrough,” Singh recalls. “We showed we could predict flu 12 to 20 weeks out — then March hit. We said, let’s try to remove the fever levels associated with cold and flu from our observed real time signal. What’s left over is unusual fevers, and we saw hotspots across the country. We observed six years of data and there’d been hot spots, but nothing like we were seeing in early March.”
Kinsa’s data might provide an unprecedented look into the way a disease is spreading through a community. “We can predict the entire incidence curve of flu season on a city-by-city basis,” Singh says. “The next best model is about three weeks out, at a multistate level. It’s not because we’re smarter than others; it’s because we have better data. We found a way to communicate with someone consistently when they’ve just fallen ill.”
Now the company is working on expanding its international presence to help curb infectious diseases on multiple fronts around the world, just like it’s doing in the US.
Stay at home syringe
MIT researchers have developed a simple, low-cost technology to administer powerful drug formulations that are too viscous to be injected using conventional medical syringes.
The technology makes it possible to inject high-concentration drugs and other therapies subcutaneously. It was developed as a solution for highly effective, and extremely concentrated, biopharmaceuticals, or biologics, which typically are diluted and injected intravenously.
“Where drug delivery and biologics are going, injectability is becoming a big bottleneck, preventing formulations that could treat diseases more easily,” says Kripa Varanasi, MIT professor of mechanical engineering. “Drug makers need to focus on what they do best, and formulate drugs, not be stuck by this problem of injectability.”
Leaders at the Bill and Melinda Gates Foundation brought the injectability problem to Varanasi after reading about his previous work on dispensing liquids, which has attracted the attention of industries ranging from aviation to makers of toothpaste. A main concern of the foundation, Varanasi says, was with providing high-concentration vaccines and biologic therapies to people in developing countries who could not travel from remote areas to a medical setting.
In the current pandemic, Varanasi adds, being able to stay home and subcutaneously self-administer medication to treat diseases such as cancer or auto-immune disorders is also important. “Self-administration of drugs or vaccines can help democratise access to health care,” he says.
Varanasi and Vishnu Jayaprakash, a graduate student in MIT’s mechanical engineering department designed a system that would make subcutaneous injection of high-concentration drug formulations possible by reducing the required injection force, which exceeded what is possible with manual subcutaneous injection with a conventional syringe.
In this system, the viscous fluid to be injected is surrounded with a lubricating fluid, easing the fluid’s flow through the needle. With the lubricant, just one-seventh of the injection force was needed for the highest viscosity tested, effectively allowing subcutaneous injection of any of the more than 100 drugs otherwise considered too viscous to be administered in that way.
“We can enable injectability of these biologics,” Jayaprakash says. “Regardless of how viscous your drug is, you can inject it, and this is what made this approach very attractive to us.”
Biologic drugs include protein-based formulations and are harvested from living cells. They are used to treat a wide range of diseases and disorders, and can bind with specific tissues or immune cells as desired, provoking fewer unwanted reactions and bringing about particular immune responses that don’t occur with other drugs.
“You can tailor very specific proteins or molecules that bind to very specific receptors in the body,” says Jayaprakash. “They enable a degree of personalisation, specificity, and immune response that just isn’t available with small-molecule drugs. That’s why, globally, people are pushing toward biologic drugs.”
Because the lubricated fluid passes more easily through the needle, the viscous payload undergoes minimal shear stress. For this reason, Jayaprakash says, the system could also be useful for 3D bioprinting of tissues made of natural components and administering cell therapies, both cases where tissues and cells can be destroyed by shear damage.
Therapeutic gels — used in bone and join therapies, as well as for timed-release drug delivery, among other uses — could also be more easily administered using the syringe developed by the researchers.
“The technique works as a platform for all of these other applications,” Jayaprakash says.
The researchers hope that it widens the options as different drug formulations are considered for treating Covid-19.