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Oura and other fitness-tracking companies, like Garmin and Whoop, think body temperature, breathing, and heart data from their devices might help users know when they鈥檙e getting sick days before they do.
Oura and other fitness-tracking companies, like Garmin and Whoop, think body temperature, breathing, and heart data from their devices might help users know when they鈥檙e getting sick days before they do. (Photo: Courtesy Oura)

Your Fitness Tracker Might Be Able to Predict COVID-19

The pandemic is prompting activity-tracking companies to pivot from personal to public health

Published: 
Oura and other fitness-tracking companies, like Garmin and Whoop, think body temperature, breathing, and heart data from their devices might help users know when they鈥檙e getting sick days before they do.
(Photo: Courtesy Oura)

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Despite some initial hesitations, Petri Hollm茅n had a hell of an Austrian ski trip. He and nine friends spent a textbook mountain weekend in St. Anton in early March, hammering the slopes by day, enjoying lagers and schnitzel by night. Sure, coronavirus听飞补蝉 a thing听in Europe听then. But the data showed that听infections听were mostly centered in northern Italy. There were supposedly only 20 or so cases in Austria鈥檚听entire 750,000-person Tyrol region. So why not ski?

鈥淚 didn鈥檛 notice anyone sneezing or coughing on my flights or on the chairlift. I used hand sanitizer and washed my hands like never before,鈥 says Hollm茅n, a fit听40-year old听Finnish entrepreneur. (Picture Bode Miller with a Finnish accent.) 鈥淚 got home Sunday evening, and by Tuesday, I heard that the area inTyrol I was in was declared .鈥

Hollm茅n worked from home the next day out of precaution, even though he 鈥渇elt totally fine,鈥 he says. Thursday, too. But that morning, his 听fitness tracker鈥攚hich gives wearers a daily听鈥渞eadiness鈥 score听based on their level of recovery鈥攄isplayed an oddity. 鈥淢y score was 54,鈥 he says. 鈥淔or me听that is very, very low. I鈥檓 usually in the eighties听and nineties.鈥 Part of the reason Hollm茅n鈥檚 score was so low was听that his body temperature, which the ring measures along with听other biometrics like heart-rate variability听and respiratory rate to formulate that readiness score, was about two degrees higher than usual throughout the night.听

鈥淚 still felt fine, and I tested myself with a thermometer in the morning, and my body temperature was normal,鈥 he says.Hollm茅n听飞补蝉 going to shrug the听temperature anomaly听off,听but听his wife, a medical researcher,听told him to check in with his doctor. 鈥淭hey had me come in for a test. The doctors came out with these space suits on and stuck a cotton stick up my nose,鈥 he says. 鈥淎nd they called me back after an hour or two and said I was COVID positive.鈥澨

Experiences like Hollm茅n鈥檚听are leading some wearables companies to partner with research institutions around the world. Eleven days after Hollm茅n received his test results, as states were locking down and 43,000 Americans tested positive, Oura ring users were posed听a question on the company鈥檚 app: Would you like to participate in a University of California at San Francisco (UCSF) study using Oura ring data to predict COVID-19?听Over 40,000 users and 3,000 frontline health care workers have since signed up (the health care workers received Oura听rings for free as part of the study). Each day听they report any symptoms and whether they鈥檝e knowingly come in contact with an infected person.听

Oura and other fitness-tracking companies, like 听and听, think body-temperature, breathing, and heart-rate data from their devicescan do more than assess听recovery and improve听fitness鈥攖hey听might also help users know when they鈥檙e getting sick听days before they do. And with that information, perhaps they wouldn鈥檛 go out to the grocery store and get close to others. Or visit an older relative. Or decide to go for a long run, which could potentially dampen their immune system enough to give the virus听an upper hand. If enough people were using trackers, public-health institutions could even use the data to create a sort of infectious disease 鈥渨eather map鈥 that alerts the public about trends in diseases like the coronavirus.

Many of the study鈥檚听scientists were already using trackers in other research projects, but the focus shifted as COVID-19 tipped into a pandemic. 鈥淭he early data is very encouraging,鈥 says Benjamin Smarr, a professor of data science and bioengineering at the University of California at听San Diego, who is leading the Oura study along with UCSF colleagues. 鈥淲e鈥檙e noticing things change at least a few days ahead of a fever in most cases. The data is听very clear.鈥 In fact, the data is so encouraging that both the听 and the听 having players wear fitness-tracking devices鈥擶hoop bands for the former, Oura rings for the latter鈥攖o help detect COVID-19听symptoms as they听start to resume their seasons.听

On April 8, West Virginia University鈥檚 Rockefeller Neuroscience Institute launched a similarstudy. It鈥檚听analyzing Oura data from over 1,000 hospital workers in New York City, Philadelphia, and Nashville, Tennessee, and听asking听the workers to enter psychological and cognitive information听about听their stress, anxiety, memory, and more听into a separate app created by researchers. The lead researchers of the听study recently announced that the ring, paired with their app鈥檚 algorithm, could predict COVID-19 symptoms three days before they start to manifest.听

鈥淲e haven鈥檛 really known whether wearables are useful in the field to inform public-health efforts or to inform individuals,鈥 says Smarr. 鈥淭hey absolutely are.鈥

Smarr鈥檚 study, in contrast, mainly tracks temperature data. 鈥淵ou tend to see daily temperature oscillations destabilize as the body begins to fight an infection,鈥 says Smarr. Such听changes usually occur at night and are comparable to skirmishes鈥攖he body鈥檚 early, imperceptible warning shots as it begins to fight a virus. 鈥淎 fever is not the start of the fight,鈥 says Smarr. 鈥淔ever is when things have gotten serious and your body is going to total war.鈥澨

If a tracker could flag those skirmishes a few days in advance鈥攚hich is听when unaware carriers听are听likely to infect others,听because they have yet to be diagnosed with听COVID-19 but are still contagious鈥攗sers could change their behavior to avoid spreading the virus. 鈥淲e haven鈥檛 really known whether wearables are useful in the field to inform public-health efforts or to inform individuals,鈥 says Smarr. 鈥淭hey absolutely are.鈥澨

Previous studies have noted that activity trackers can beirregularwhen it comes to听certain metrics. Researchers at Stanford, for example, that calorie-burn data was in some cases off by as much as 93 percent听in the seven different trackers they tested. But more straightforward measurements, like temperature and heart and breathing rates, seem to be more reliable.听That same Stanford study, for example, showed that heart-rate data in six of the seven trackers was听accurate to within 5听percent. And a recent small study conducted by researchers at Oura and the University of Oulu in Finland found that Oura鈥檚听data on resting heart rate and heart-rate variability听飞补蝉听accurate to within 0.01 to 1.6 percentwhen compared to readings from a medical-grade ECG听machine. Another small , this one published in May by Arizona State听University researchers, found that the Whoopdevice听assesses breathing rate nearly as well听as hospital devices.听

In early April, Whoop听partnered with CQUniversity听in Australia and the Cleveland Clinic to launch a study looking听to determine if听changes in respiratory rate could predict the infection. 鈥淐OVID-19 is known to impair lung function and cause respiratory symptoms (shortness of breath, hypoxia, tachypnea), so respiratory rate was a pretty obvious target for us to base a study on,鈥 Emily Capodilupo, vice president of data science and research at Whoop, wrote听in an email. Respiratory rate may be听a particularly good indicator to help detect the virus, Capodilupo says, because few things can cause a person鈥檚听respiratory rate to increase.听Whoop that the 271-patient听study听found that its听devices were able to detect 20 percent of COVID-19听cases two days prior to the onset of symptoms听and 80 percent of cases by the third day of symptoms. (While encouraging, it鈥檚 worth noting that the study has yet to be peer-reviewed.)Both Duke and Stanford Universities are also currently conducting independent research to learn if they can predict COVID-19 through Garmin heart-rate data.

What makes thesetrackers compelling to researchers is that they constantly measure your body鈥攄ay and night. This is different than, say, going to a doctor, who takes one measurement at one point in time.听鈥淵ou can think of it as analogous to your radio being on for one second a day versus all day,鈥 says Smarr. 鈥淲ith just a second, all you know is that a signal is coming through. Leave it on all day, and you can hear music.鈥 This means you can also notice an oddity that indicates an oncoming illness.

The field is promising, but don鈥檛 count on public-health salvation quite yet. Smarr says there won鈥檛 be one magic metric that will detect COVID-19 in anyone who has it. Human biology is intricate, and all data points must go through an intricate听set of algorithms. Those algorithms aren鈥檛 standardized and are still being figured out and tweaked by researchers.听It鈥檒l take time鈥攁nd lots of thinking on the part of Smarr and other researchers鈥攖o develop ones that can learn听how different individuals react to a virus. 鈥淯nfortunately, the 鈥榯here鈥檚 an app for that鈥 culture makes everyone think machine learning is magical. And it definitely struggles in the face of complex human biology,鈥 says Smarr.

Oura will soon听send participants antibody tests to confirmwhether or not they鈥檝e had COVID-19 during its听study with UCSF. (Whoop will also release its preliminary data soon.) The results听won鈥檛 guarantee the researchers completely accurate data鈥攖he that antibody tests can render false positives.听Still,听Oura鈥檚 CEO says the virus has forced his company to pivot from personal fitness and recovery to personal and public wellness.听

All the fitness-tracker companies mentioned in this story say they鈥檙e going to continue conducting more, bigger studies on different public-health topics,听even when COVID-19 is no longer a worldwide threat.听Says Smarr: 鈥淭his is a whole new way of approaching public health that we鈥檝e never had before, that we now get to contemplate.鈥

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