How Robotic Technologies Have Impacted The Management Of COVID-19
By
Adewumi Oluwatobi (RN, DHA)
This article was originally presented as a lecture in one of our virtual classes at Carecode Digital Health Hub.
Delivered by one of our facilitators, it packs within its lines, some very interesting thoughts on the interesting topic of Robots In Healthcare, especially as it relates to the present situation–our struggle with the ongoing pandemic.
I left a short note at the end of the article. I know you are going to enjoy it.
Ayinla Daniel
Editor Care City
On Sunday, March 29, 2020, I, like any other healthcare professional – a registered nurse to be precise. I woke up to the noisy sounds of combustion engines from cars and motorcycles and the filtered ray of the sun as it passed through my window blinds. I checked my phone for the time – it was about 9:30 AM. Just another day at Lekki, Lagos, a metropolitan in Africa’s most populous country – Nigeria. Well, not any typical day…
I had to resume a 14-hour shift later that evening. As part of my daily routine, I got up and grabbed something to eat (after freshening up of course) before reaching out for my smartphone to check the trending news for the day. As I mindlessly combed through the headlines, there was one that caught my attention: a notification that the president would be addressing the nation later in the evening concerning the covid-19 pandemic.
Only a couple of days prior, some of us were joking about the “clairvoyance” one of my colleagues provided when he said that COVID-19 might shut down the entire world in the next few weeks.
It’s not that I thought his prediction was preposterous. The lockdown of some other countries earlier in the same week gave an ominous foreshadowing of events to come. Coupled with the above, the World Health Organization officially declared COVID-19 a pandemic on March 11th, 2020.
Could his predictions be accurate? Can a virus that I downplayed its severity a few weeks back actually shut down the activities of all nations of the world? What exactly does this virus look like?
How has artificial intelligence contributed to the management and prevention of the further spread of the virus? These questions will be addressed briefly in the subsequent paragraphs.
A pandemic is described as a large-scale outbreak of infectious disease that can greatly impact morbidity and mortality over a wide geographic area and cause significant economic, social, and political disruption (Madhav, 2017).
COVID-19 fits this description. It has spread rapidly throughout the world, infecting millions and killing hundreds of thousands since it was first discovered in WUHAN, China in December 2019 (WHO, 2020).
The virus has created a global economic downturn of a magnitude that has not been seen since the Great Depression of the 1930s (United Nations Department of Economic and Social Affairs [UN DESA], 2020) while also inducing fear, worry, and panic from the public.
Amid the increasing list of deleterious effects associated with the pandemic, there has been some positive news. It has proven again that tough times have a way of unveiling hidden potentials, sharpening our innovative skills, as we look for ways, methods & techniques of survival.
As the world continues to make technological advances amidst this pandemic, the field of robotics is becoming more popular, as intelligent automation is becoming a vital part of the industrial structures of most economic sectors, if not all.
Robotics is a term used to refer to the science and technology of robots: machines that can carry out tasks. Some robots are controlled by humans, while others are driven by intelligent algorithms (artificial intelligence).
Robotic innovations continually spring up from all corners of industries – exploring the depths of our oceans and reaching for the stars in the cosmos.
In parts of Asia, robots have taken up jobs such as cooking in restaurants. Within our homes, some vacuum cleaners can memorize the layout of each floor. But the presence of robots in our lives goes far beyond space exploration and futuristic vacuums; the field of robotics has become so integral to the functioning of our society that many common products and services involve the use of these machines – agriculture, manufacturing of goods, and even the delicate field of healthcare practice.
With social distancing measures in place to prevent too many humans from being in close contact, the importance of robots has increased even further.
By the time the next pandemic approaches (we don’t pray for one), robots will likely play an even bigger role due to scientific advancements.
Artificial intelligence (AI), which is also called machine intelligence, may be the most compelling concept in robotics. It has already made huge strides in medicine, as a study from 2019 found that the diagnostic performance of deep learning (a form of AI) was equivalent to that of healthcare professionals (X. Liu, 2019).
However, this raises a different question; one that not only affects the medicine industry. If artificial intelligence continues to advance, it could revolutionize the workforce and leave many unemployed.
Where do we draw the line between employment and automation? The possibilities with robotics are seemingly endless, and it is important to ensure that we reap its benefits to make the world a better place, but also remain aware of its downsides.
Pandemics, while unwanted, are inevitable. Just over a decade ago, the H1N1 pandemic was making the headlines. A few years before that, SARS was the main concern. We are not even past the COVID-19 surge yet. There is still much to do to save lives and rebuild our systems that have been ravaged by this scourge. But it is not too early to start learning, especially with the possibility of another pandemic being certain.
Failures in healthcare systems and policy have not helped the fight against COVID-19, and governments need to start making the necessary adjustments and improvements so that we can be as prepared as possible to handle what comes next. Even if the next big health threat is decades away, working to improve our existing systems will still benefit the public. COVID-19 has raised many questions about how different sectors operate. It is now up to us to address these questions as we move into the future.
With the rapid advancement of modern-day technology, robots and artificial intelligence are no longer theoretical concepts actualized in science fiction, but real inventions employed in everyday life.
Although people have often raised concerns over job losses and privacy issues with regards to the incorporation of robots into society, betwixt a global epidemic, these risks are largely outweighed by the potential benefits which robots can bring.
During the 2015 Ebola outbreak, robots made a significant contribution to three broad areas of disease management: clinical care, logistics, and surveillance (Yang et al., 2020).
In terms of clinical care, robotic use was engaged in various ways throughout each stage of the process, from disease prevention to screening and diagnosis, to patient care. Within logistics, robots also played an active role in the handling and transport of contaminated waste. By synthesizing the data collected during this process, these robots altogether allow us to closely monitor the progression of the outbreak, thus contributing to surveillance.
In each of these areas, robots proved to be an advantageous addition to the healthcare system. Each of these advantages will be further examined as they apply to our present challenges (and future).
Given the highly contagious nature of COVID-19, the most effective means of preventing the spread of the infection is to limit human-to-human interaction. This is where the advantages of adopting modern-day technology such as robots and telemedicine come to light.
Whether robots are programmed to perform tasks entirely on their own or through manual control, the application of these machines considerably reduces the need for human personnel to interact directly with those infected, which consequently reduces the rate at which the infection is transmitted.
Robots are also found to be effective in screening and testing. Regardless of the type of test conducted, both testing processes involve collecting nasopharyngeal or oropharyngeal specimens—or in simpler terms, nose and mouth swabs.
The act of swabbing directly exposes the person conducting the test to the respiratory droplets of the patient, putting them at a higher risk of contracting the virus. As swabbing is a relatively mechanical action, robots can instead be employed to collect samples from patients in an automated process. Not only would this reduce the chance of infection of the clinical staff, but it would also free them up to complete other, more technically complex, tasks required for the testing process. (Who wouldn’t like to have a mechanical robotic arm stick a swab up into their nostrils?)
Sample collection is followed by handling, transfer, and laboratory testing, all of which further expose clinical staff to the virus. Luckily, the use of laboratory robots for the transport and delivery of lab samples is already prevalent in several healthcare facilities across the world. During an infectious outbreak, these robots can be operated similarly to deliver medications to infected patients in quarantine, which once again reduces risks of transmission by allowing hospital staff to maintain distance.
Even laboratory testing, the final step of the diagnostic process, can be automated. Given the proficiency of artificial intelligence nowadays, automated real-time assays can be integrated with robot-administered swabbing to allow for rapid in-vivo detection of pathogens.
Another notable challenge of containing an outbreak of this extent is the inability to conduct tests at a larger scale. A shortage of available COVID-19 test kits has been a recurring issue in multiple countries across the world, mainly due to the diminishing supply of global resources as a result of increased demand.
With these challenges, scientists once again look to robots and artificial intelligence in finding an alternative solution to the problem. As of May 2020, Imran and colleagues developed and tested an AI-powered screening solution for COVID-19 that is deplorable via a smartphone app named AI4COVID. This app is designed to closely analyze the cough sounds of the user and produce a corresponding diagnosis within 2 minutes (Imran et al., 2020). Although the technicalities and accuracy of this app are still being refined, the results of the initial trial indicated a promising outlook for the potential incorporation of AI in large-scale screening.
Aside from cough detection in COVID apps, scientists are looking to use mobile robots for temperature measurement in public areas, by equipping them with thermal sensors and vision algorithms. Automated camera systems can also be installed to screen multiple individuals simultaneously in crowded areas.
By setting up automated sensing systems at ports of entry in high-traffic, high-risk areas such as hospitals or clinics would increase both the efficiency and coverage of screening.
As hospitals scrambled to prepare for the surge in COVID-19 cases, several non-COVID-related services had to be put on pause, including non-emergent surgeries, clinical checkups, and treatments.
Although services are gradually resuming with the stabilization of COVID cases, hospitals remain high-risk environments for both patients and visitors. This brings us to the topic of robotic surgery, which has skyrocketed in popularity in recent years due to its numerous clinical advantages, from increasing efficiency to minimizing surgical invasion. In terms of its advantages in an infectious environment, the minimally invasive quality of robotics surgeries reduces the amount of open area exposed to surgical staff, effectively limiting viral transmission via blood or surgical plumes.
Robots have also provided a helping hand in other more logistical tasks in clinical settings to reduce manual labour and relieve the burdens of frontline workers. One example is implementing robot-controlled non-contact disinfection of contaminated surfaces using ultraviolet (UV) light devices (Yang et al., 2020).
The World Health Organization (WHO, 2020) stated that coronavirus can survive on inanimate surfaces for anywhere between a few hours to several days, making it all the more important for proper disinfection procedures to be practised in public places. UV light is effective in reducing contamination on high-touch surfaces in hospitals (Yang et al., 2020). Therefore, when combined with the auto-detection feature programmed in robots, this system would allow for the disinfection of contaminated spaces at a larger scale, in a timely and effective manner.
Despite the growing demand for robotics and automation in healthcare, several limitations still exist.
One of the major disadvantages of using robots stems from their technological shortcomings. Although we have made significant advancements in perfecting artificial intelligence (AI), the majority of present-day robots still exist as programmed machines that function in response to external commands.
To smoothly integrate robots into the workplace and ensure that they improve— rather than hinder workplace efficiency, the surrounding work environment must be controlled. Automated robots are especially prone to environmental discrepancies, as even a small, unexpected movement could disrupt their workflow and result in malfunction.
With this in mind, most of the current generation of robots are only assigned to complete simple and repetitive tasks to minimize the margin for error.
Selected References:
Madhav N, Oppenheim B, Gallivan M, Mulembakani P, Rubin E, Wolfe N. Pandemics: Risks,
Impacts, and Mitigation. In: Jamison DT, Gelband H, Horton S, Prabhat J, Ramanan L, Mock CN,
Nugent R, editors. Disease Control Priorities: Improving Health and Reducing Poverty. 3rd edition
[Internet]. Washington (DC): The International Bank for Reconstruction and Development / The
World Bank; 2017 [cited 2020 July 23]. Chapter 17. Available from: https://www.ncbi.nlm.nih.gov/
books/NBK525302/
World Health Organization: WHO [Internet]. Switzerland: WHO; 2020. Coronavirus disease
(COVID-19);Available from: https://www.who.int/emergencies/
diseases/novel-coronavirus-2019
Liu, X, Faes L, Kale AU, Wagner SK, Fu DJ, Bruynseels A, et al. A comparison of deep learning
performance against health-care professionals in detecting diseases from medical imaging: a systematic
review. Lancet Digital Health [Internet]. 2019 [cited 2021 Jan 26];1(6):e271-e297. Available from:
https://doi.org/10.1016/ S2589-7500(19)30123-2
Imran A, Posokhova I, Qureshi HN, Masood U, Riaz S, Ali K, et al. AI4COVID-19: AI enabled
preliminary diagnosis for COVID-19 from cough samples via an app. Informatics in Medicine Unlocked.
2020Jun26;:100378.
It may take some time, with a lot of hard work (smart work) & research, before we get to the techno-industrial era, where humans can begin to completely trust intelligent automation (or place a reasonable degree of trust) to take over most of the delicate & highly intelligent human roles.
There are promises. The science of Artificial Intelligence gradually brings us to an era where computers will begin to take over sensitive & complex human responsibilities, especially in the delicate aspect of healthcare practice. The pandemic has taught us a lot of lessons to last us a lifetime, preparing us for whatever may come at us in the future.
There are hurdles to fight, and hindrances to tackle, but that does not mean that we should not keep forging ahead. The hurdles are here to make us better in our innovative efforts, stretch our abilities and increase our capacities as a problem-solving specie.
Ayinla Daniel
Editor Care City
