COVID-19 called for drastic innovations in technology. The health-care field stepped up to the plate.
When Dr. Marjorie Bessel, Banner Health’s chief clinical officer, drives by the Arizona State Fairgrounds, it’s difficult for her to hold back tears.
Two years ago, driving down 17th Avenue would not have constituted a particularly emotional experience for Bessel, but the pandemic made it significant. It was where Bessel administered the first COVID-19 vaccine on the site, one of the first in the entire state.
That’s just one in a flurry of virus-related flashbulb memories for Bessel. She sometimes thinks back to the very first time she heard about the virus. She also remembers when the first case hit Arizona. Along with her colleagues in the health-care industry, Bessel was at the epicenter of a slow-moving seismic event that completely rocked the foundation of their field.
“Nothing could have prepared me for this,” Bessel says, even though she is a hospitalist and well-versed in emergency management. “Nothing has ever come close to this in my lifetime.”
The pandemic backed the health-care industry into a corner. There was inadequate and limited equipment, crimps in the nursing pipeline and weak links in clinical service. Bessel and her colleagues were pushed to extremes. But instead of crippling the progress of public health technologies, COVID-19 did just the opposite.
In a twist of irony, it accelerated a movement of medical innovation that will be felt far beyond the confines of the pandemic.
At the peak of the pandemic, Bessel would look at her hands. They were cracked and pruney from constant hand-washing and glove-wearing. When she wasn’t at work, she was trying to sleep, and usually failing. Her mask would be muggy and uncomfortable against her face. She’d have been using it for days.
Before COVID-19 hit the hospitals, reusing masks was unorthodox in the health-care industry, Bessel says. If health-care workers went into a room where a patient had tuberculosis, they would toss their mask once they stepped out – even for short visits of 30 seconds or less. Even if it was a particulate-filtering N95.
During the early days of the pandemic, the vast stores of masks that hospital personnel took for granted vanished on a dime. The shift from disposing of hundreds of masks a day to desperately trying to preserve them for weeks was extreme, Bessel says. Eventually, Banner joined other hospitals and facilities in experimenting with an innovative new way to disinfect masks – by cooking them.
An early study by the Department of Pathology at Stony Brook University experimented with dry-heat ovens and N95 masks in an attempt to disinfect them so they could be used again for health-care workers. Researchers arrived at an effective protocol: Masks would be treated for 30 minutes at 212˚F. Equipped with ovens, medical facilities could disinfect thousands of masks a day.
Mask disinfecting and steaming were a relief to hospitals at the beginning of the pandemic, including Banner. Prior to the success of cleaning personal protective equipment (PPE) like masks for reuse, health-care workers had to face the possibility that supplies across the world would be exhausted. Some hospitals ran out of masks altogether.
It didn’t happen at Banner, but even the possibility, Bessel says, was appalling.
“Nothing, for me, would have been more tragic than running out of masks that we needed for nurses,” she says. “We saw some nurses [in American hospitals] with literal coffee filters on their faces. Just to even think of that being a reality in the United States was beyond my comprehension.”
The mask and equipment shortage eventually eased, and Banner moved away from the need to disinfect masks. But Bessel credits the practice for hospitals making it through that tough stretch without resorting to more desperate options.
The pandemic also demanded heavier protection for health-care workers, beyond masks. After a thorough wash of the hands, which could happen more than 100 times in one day, COVID-19 unit nurses and doctors would have to gear up in full PPE. The plastic suits would crinkle when Bessel pulled them on, and she could feel her breath on her face shield. It wasn’t that health-care workers weren’t used to the process, but it had never been needed for this many people, this tediously.
For each room in the COVID-19 unit, health-care workers would have to remove all their equipment just to put on a new set several minutes later. The incessant process was draining, Bessel says, and it revealed the need for another option, one less hands-on. But how would they be able to give people care if they weren’t even in the same room?
Telemedicine: The COVID Trump Card
Between the two of them, Rick Hall and Dr. Steven Lester had little if any doubt. For the health-care industry, COVID-19 meant war.
In a field that had been so focused on competition, suddenly every institution and company involved in health were working together to save lives. It was terrifying, but also an opportunity to take a hard look at what needed to change in the world of public wellness.
Hall, assistant dean of Arizona State University’s Edson College of Nursing and Health Innovation, and Lester, a cardiologist from the Mayo Clinic, are part of the leadership team at the Mayo Clinic and ASU MedTech Accelerator program. This budding initiative works with next-generation medical technology and service startups to build new tools and methods of service for the health-care industry. Some of the initial cohort participants had a direct hand in adapting technology to respond during the COVID-19 pandemic.
There were several major concerns for health care organizations when the world shut down, Hall says. They needed to figure out how to administer health care when people weren’t able to come to the hospital, and how governments and institutions would be able to track
SAFE Health, a company that participated in the Mayo Clinic and ASU MedTech Accelerator, was responsible for creating the tracking app for ASU that allowed students to update their health status on a daily basis in order to help track cases of the virus in the college. The startup has also pursued virtual diagnostic and treatment care options for the public.
The idea from SAFE Health was first intended for use to treat sexually transmitted diseases, but was applied to other infections. “If you need a test, because you were worried that you had strep throat or the flu or COVID, we’re creating tools to allow you to do that right from your home,” Lester says. “To actually take a picture of the test with your cell phone, and then upload that to our proprietary image-recognition software, which spits the result back to you.”
Patients could then connect with their health-care provider and have the proper treatment sent to them, without ever setting foot in a doctor’s office or clinic. “It provides convenience,” Lester adds. “This whole ability to create that connective tissue to telemedicine is really important.”
There are, of course, downsides to telehealth, Hall acknowledges. But in the era of a peaking pandemic, it offered a necessary alternative that allowed more people to receive care.
The adoption of telemedicine isn’t limited to people obtaining medical care from their homes. At Banner, it’s also used for patients in the hospital. The institution developed the technology to allow nurses and doctors to connect with patients virtually without stepping into contaminated rooms, offering a safer interaction for everyone involved. It also saved health-care workers much needed time, which they had spent donning and doffing PPE after entering every COVID-19-affected room during their rounds.
Telehealth reaches beyond inconvenienced populations during COVID-19, too. It opens up medical doors for the elderly, immuno-compromised folks and individuals who may typically have trouble accessing physical medical clinics, pandemic or not. The reasons the public needs access to remote health care are endless, and Bessel is sure that more people will take advantage of it moving forward.
Health-care workers and administrators across the board shared the same sentiment: Telehealth and virtual accessibility trumped all when it came to the most important adaptation during the pandemic – for hospitals and schools.
Early in the pandemic, Dr. Heather Ross stepped into the classroom to teach her course for the Edson College of Nursing and Health Innovation at ASU. The atmosphere had changed.
Many of her grad students, who were registered nurses, had already been called to work in the trenches of COVID-19 units, watching family farewells and last breaths. “I knew I had to acknowledge the dark circles under people’s eyes and the fatigue that they’ve been feeling,” Ross says. “They are completely physically and emotionally exhausted from work.”
Suddenly, deadlines were overshadowed by deaths, and homework mutated into real-life hands-on learning in pandemic units. It gave students needed experience, but was also a brutally honest introduction to their future career.
When COVID-19 was first identified as a global crisis, Ross was nowhere near her classroom. Or civilization, for that matter. She had been on vacation with her family near the Arctic Circle, and she wasn’t even sure if she’d be let back in the country.
As she flew back to the U.S., Ross prepared for the coming challenge by studying infectious disease epidemiology courses from Johns Hopkins University. Transiting through Europe, she noticed people beginning to social-distance, wearing masks and taking notice of the announced pandemic. Back in America, it was a different story.
It became clear that there were some parts of the health-care world that the public had taken for granted – including the expectation that people would take a worldwide pandemic seriously. “There was no hand sanitizer, no masks, no distancing. And it was then that I realized we might have problems here,” Ross says. “It set the tone for what we were walking into.”
By the time U.S. states established mask requirements, social-distancing advisories, lockdowns and other mitigation measures, COVID-19 already had an iron grip on society – including health-care students and their futures.
Hospitals stopped opening doors for clinical rotations during the peak of the pandemic. The number of opportunities for future doctors and nurses in clinics dwindled dramatically. As much as some facilities needed all the support they could get, supplies were sparse. “Hospitals told us, ‘Listen, we’re so sorry. We have to save all of our PPE for our staff,’” Ross recalls. “So when the hospitals and health-care facilities shut down their availability to train students, well, that puts a real crimp in the nursing pipeline.”
Across the world of commerce, the share of customer interactions that are entirely digital has exploded in the wake of the pandemic.
Average % share of customer interations (digital)
Source: McKinsey & Company
And it did. An already severe nursing shortage was exacerbated by COVID-19, Ross says, and the fact that only a few students could filter through the hospitals to complete their clinical rotations didn’t help.
One thing that helped keep the funnel open was conferencing technology, Ross says. Hospitals used virtual education and observation to help digitally resuscitate the nursing pipeline in any way necessary in Arizona. The state board of nursing and accreditation organizations made that shift possible, Ross says, by recognizing telehealth as a certified clinical space.
While students were able to continue their studies in and out of the facilities virtually, the health-care industry tapped into another resource during the pandemic – nurses and health-care workers who hadn’t worked in critical care units for years, but were willing to return at a time they were most needed.
“We had a lot of people who had been critical care nurses, but not for a really long time,” Ross says. “So we were able to use video-based education to very quickly sort of retrain and upskill nurses to be ready to take care of COVID patients.”
Every resource available had to be exploited during the peak of the pandemic, from allowing virtual observations to become a recognized clinical space to recruiting and refreshing experienced medical workers through telecommunication devices. These immediate and necessary changes while lives hung in the balance pushed the medical field further than it had ever gone before in technology, in a moment where it felt like it was drowning.
The pandemic served as a setback and a catalyst in health care, Ross says. Technology and innovation were propelled forward at an outstanding rate, but under undesirable circumstances.
While technology was used on a wide scale to virtually bring more people into the room during the pandemic, there were instances where technological innovation left communities behind.
Once COVID-19 vaccines were authorized in the states, local governments and health-care departments wasted no time gearing up for protecting the public. But the mass vaccination movement didn’t fill in all the cracks.
Most of the vaccination clinics were mass clinics, and drive-thru only. Citizens had to sign up online through appointment portals where slots filled up faster than people could refresh the page. For people who didn’t have a personal vehicle or couldn’t drive, didn’t have internet access or lacked the ability to navigate the chaotic vaccination websites, the high-tech vaccination process became exclusionary, Ross says.
It called for another solution. Health-care organizations and community partners in Phoenix answered. Soon, there was a much more accessible way to reach underserved communities – by bringing COVID-19 vaccines and testing to neighborhoods on wheels.
While prepping vaccination vans to roam the streets of the city and stop in areas of need may have been a simple idea, it was effective. Targeting such neighborhoods allowed Phoenix to pursue public safety and get more individuals vaccinated, eliminating barriers that internet connectivity and transportation may have posed.
Phoenix isn’t the only area to develop a fleet of vaccination and testing vans for COVID-19. Communities in places like Virginia, Colorado and California have all hopped on the bandwagon to increase accessibility of vaccinations for communities through mobile vaccination.
But even with the great strides in telehealth, supply-chain improvement and vaccination innovation, society has revealed the mere tip of the medical innovation iceberg in a post-pandemic world.
In late October, a team of Georgia Institute of Technology and Emory University researchers released a study that offered an innovative COVID-19 vaccination device inspired by an item that’s probably stashed away near your patio grill – a barbecue lighter.
The small device was created by combining a thumb-operated electric pulser used in common household stove lighters and a microneedle that delivers a pulse to the skin, triggering antibody responses from the body. It’s a forgiving tool that could serve as a vaccination device for COVID-19 and future diseases, especially in developing countries.
“My lab figured out that you could use something all of us are familiar with on the Fourth of July when we do a barbecue – a barbecue lighter,” says Saad Bhamla, assistant professor in the School of Chemical and Biomolecular Engineering at Georgia Tech. “And these lighter components cost just pennies, while currently available electroporators cost thousands of dollars each.”
It’s not the only unorthodox, COVID-inspired innovation the medical field has conjured up in the past two years. Burgeon Group, a children’s toy and immersive learning experience company based in Phoenix, released a breakthrough piece of equipment that is used in hospitals today to minimize contamination during intubations.
The London Box was created as a tool to shield health-care workers while performing intubations on patients and hooking them up to ventilators. The shield was meant to work as an additional protective tool during operations, especially considering the supply shortage of PPE that hospitals around the country were facing.
Although Arizona isn’t currently utilizing as many ventilators as it did during its peak in January, the number of intubations has been climbing over the past six months, according to data from the Arizona Department of Health Services. Roughly 37 percent of ventilators available in Arizona were in use when this issue went to press, a testament that ventilators – and equipment supporting intubation safety – remain critical to the COVID fight.
Burgeon Group used plastics that don’t fog or haze easily while health-care workers breathe in them. The London Box’s rounded corners and sturdy surfaces ensure it won’t nick a nurse if they bump into the side of it. These practical factors in the realm of children’s play translated well to health-care theater safety.
Such innovations – the singular result of technology, entrepreneurs and monolithic medical institutions all coming together for the greater good of humanity – leave health-tech professionals like Lester in a state of amazement. “We had archrivals all working together now to find a solution for the world. All of a sudden, within a year, we had these whole new technologies, drug innovation and preventative therapies, which is remarkable,” he says. “I don’t think we’ve ever seen that before. That was only achieved because we all came together, as a community worldwide.”
COVID-19 persists, and cases continue to lap at the curbs of local medical facilities, but for health-care workers who have seen the field mature and adapt in the past two years of pandemonium, there are some victories to celebrate.
When Bessel notices tears welling in her eyes after driving by the fairgrounds, she feels them hit her cheek, not her mask.
3 Technology Realms Boosted by COVID
COVID vaccine technology – using messenger RNA (mRNA) rapidly developed by Pfizer and Moderna – gives researchers a platform for future vaccines that can be developed quickly and effectively. “This technology is easily one of the most significant medical technologies of the 21st century,” according to Forbes.
Whetted by COVID, the worldwide appetite for broadband will have extraterrestrial implications, as it will accelerate the race for satellite broadband technology. Companies like Viasat and Starlink promise speeds of 300 megabytes per second (mbps), whereas average landline speeds typically average
In addition to QR-coded menus and UV-sanitized airplane cabins, travel and hospitality will be transformed by augmented reality (AR) and virtual reality (VR), like the Xplore Petra app launched in 2020, which allowed users to “tour” Jordan’s famed archaeological site via headsets or computer screens.