The Pandemic Issue

been exposed, and isolation of people who test positive. The value of at-home testing is that it can be done on the kind of broad basis that needs to happen for our country to get back to work.” Because of the pandemic, new policies have removed some of the barriers that impeded the widespread adoption of home-based diagnostics and telemedicine. Physicians can now practice across state lines, get reimbursed for telemedicine visits and use Face Time to communicate with their patients, which had long been considered taboo because of privacy issues. Doc- tors and patients are becoming more comfortable and realizing the convenience and benefits of being able to do these things virtually. Added to this, the only way to safely reopen for busi- ness without triggering a second and perhaps even more deadly wave of sickness is through large scale testing, but hospitals and doctors’ offices are no longer the safest places. “We don’t want people sitting in a waiting room who later find out they’re positive, and potentially infected everyone, including doctors and nurses,” says Dr. Kavita Patel, a physician in Washing- ton, DC who served as a policy director in the Obama White House. In-home testing avoids the risks of direct exposure to the virus for both patients and health care profession- als, who can dispense with cumbersome protective gear to take samples, and also enables people without reliable transportation or child-care to learn their sta- tus. “At home testing can be a critical component of our country’s overall testing strategy,” says Dr. Shanta- nu Nundy, chief medical officer at Accolade Health and on the faculty of the Milken Institute School of Public Health at George Washington University. “Once we’re back at work, we need to be much more targeted, and have much more access to data and controlling those outbreaks as tightly as possible. The best way to do that is by leapfrogging clinics and being able to deliver tests at home for people who are disenfranchised by the current system.”

In the not too distant future, in-home diagnostics could be a key component of precision medicine, which is customized care tailored specifically to each patient’s individual needs. Like Stanford’s smart toilet prototype, these ongoing surveillance tools will gather health data, ranging from exposures to toxins and pollutions in the environment to biochemical activity, like rising blood pressure, signs of inflammation, failing kidneys or tiny cancerous tumors, and provide continuous real time information. “These can be deeply personalized and enabled by smart phones, sensors and artificial intelligence,” says USC’s Leslie Saxon. “We’ll be seeing the floodgates opening to patients accessing medical services through the same devices that they access other things, and leveraging these tools for our health and to fine tune disease management in a model of care that is digitally enabled.”

Linda Marsa is a contributing editor at Discover whose work has been featured in Best American Science Writing . She is also a former Los Angeles Times reporter and author of Fevered: Why a Hotter Planet Will Harm Our Health and How We Can Save Ourselves.


Will COVID-19 Pave the Way For DIY Precision Medicine?


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