COVID-19 Pandemic may be the Biggest MegaTrend of All
The coronavirus pandemic adds new perspective to an article I read in Inc. I responded to 4 MegaTrends Expected to Change Everything by 2050 to say the COVID-19 pandemic is the Biggest MegaTrend of All, and Baddest. It has significant social, economic, and political implications, and the impact will likely be profound, broad, and very rapid. Here at Modern Health Talk, I’ve published other articles on healthcare megatrends with my unique perspective as a retired IBM technologist, market strategist, and futurist, including 101 MiniTrends in Health Care. I sure hope I’m right in my predictions here.
What Changes Might the Coronavirus Pandemic Bring in the Near Future?
The pandemic caused us to focus more attention on long standing societal issues like extreme inequality and health disparities, systemic racism, and the importance of mental health and family caregiving.
These social issues will gain increased public support as we rethink the proper role of government and how to fund it. They start with Universal Healthcare, Universal Broadband, Telemedicine, Telework, and Distance Learning, as voters see real threats to their personal health and finances. This will almost certainly result in a political sea change in Washington, with Democrats regaining power in November and possibly in landslide victories.
The trickle-down effects will disrupt every industry and market segment, bankrupting many but creating opportunities for others. It’s time to think creatively as we respond to this pandemic and prepare for a new future. The optimist in me sees this as very positive in the long run, because the dark uncertainty of today can lead to a brighter tomorrow if we’re ready to accept and prepare for it.
Besides the social programs mentioned above, I expect increased support for public investments in a healthy, skilled, well paid, and productive workforce to drive demand for goods & services, as well as other engines of long-term economic growth. That includes public education, research, infrastructure, immigration reform, the environment, and strengthening foreign relations as opposed to continuous wars. We must also address the underlying issue of political corruption from extreme inequality. I also hope this pandemic will help close the hyper partisan divide and give us the public support and political will needed to do that. It’s up to each of us and how we respond and vote.
Telemedicine interest sparked by Coronavirus Pandemic
According to this Parks Associates white paper, “between 2019 and 2020, the percentage of consumers who had a remote [doctor] visit in the previous twelve months rose from 15% of US broadband households to 41%.”
That’s nearly a three-fold increase in telehealth visits, and the patients reported positive experiences and high levels of satisfaction. Consumers aged 65 and older showed even higher levels of satisfaction than younger people.
Among those with both broadband and connected medical devices, 64% report that services that let them share device data are “appealing” (rating 5-7 on a 7pt scale), vs. 43% of non-owners of such devices.
What follows echos my comment on Virtually Perfect: Telemedicine for Covid-19, a recent article in the New England Journal of Medicine.
Let’s hope the Coronavirus pandemic becomes the spark that finally changes people’s attitudes about Universal Healthcare, Telework, Telemedicine, Telehealth, and Distance Learning. As schools close and we worry about the safety of healthcare professionals, or that patients coming to hospitals can spread the disease, people are beginning to rethink the benefits of telehealth (often used synonymously with telemedicine). At least temporarily regulators are relaxing restrictions that were put in place to protect incumbent medical practitioners from competition from this new type of service, including requiring a license in each state served and a face-to-face visit before any online telehealth services.
But even if we make major changes in public policy to support these long-overdue innovations, large swaths of the population can’t benefit. Sadly, many rural and underserved (low-income) communities still lack access to the necessary broadband Internet services, or the devices and training to use them.
At Modern Health Talk, I’ve published dozens of articles on different aspects of telehealth, as well as broadband telecommunications and various other digital health technologies. I expect and hope that, with this health scare impacting the 2020 election and progressive policies, we will finally see these advanced technologies and services implemented in mass, because the potential is truly immense.
Beyond Remote Doctor Visits
The NEJM article describes many telemedicine benefits, including the ability to remotely triage patients before sending them somewhere for testing. But put on your thinking cap and imagine the potential if telehealth were combined with electronic medical records, remote monitoring of medical sensors, and the ability to possibly track patient travel. So much more becomes possible with centralized (i.e. government controlled or incentivized) coordination of tech innovation.
When President Kennedy made landing a man on the moon in a decade, we all rallied around that goal, built new universities, and invented the needed technologies. So I see no reason why the U.S. can’t surpass Singapore as the world’s leading healthcare nation, cover the entire population, and deliver superior longevity and health outcomes. Doing that would save over $2.7 trillion/year (3/4 of what we spend on healthcare now). The real obstacle to that vision is not technological; it’s political and relates to extreme inequality and corruption.
(added later)
The Increasing Threat of Novel Virus Pandemics
In this revealing interview, Kaiser Health News meets with Dennis Carroll. Carroll ran the federal Agency for International Development (USAID), which for 15 years studied the increasing threat of novel virus pandemics. The Trump administration shut down this group and closed the Global Health Security office in the National Security Council. Here’s my summary.
TRENDING CAUSES (from the interview)
- Human Population Explosion. The 2.5 billion people on earth when I was born has mushroomed to nearly 8 billion today, with serious consequences.
- Food Supply Scarcity. Globally, we converted prairies and forests to farmland to raise more livestock and grow more plant food per acre, causing humans to live closer to remaining wildlife, and even eating them too. Se saw that in China’s Wuhan province.
- Climate Change. Wetter conditions and warmer temperatures creates a better environment for bacteria and virus growth.
- Globalization. Easier travel over land, sea, and air make the world seem like a smaller place, meaning a health event anywhere can quickly become a global event everywhere.
CONTRIBUTING FAILURES (my perspective)
As implied in the body of my article above, I hope the fear caused by the COVID-19 pandemic will prompt us to rethink the role of government, how we fund it, and how we can make it serve population interests and not just wealthy special interests.
- Broadband Infrastructure. The U.S. invented the Internet but has not kept up with other nations in speed, adoption rates, and affordability. Rural and underserved (low income) communities often lack broadband access and adequate bandwidth for telemedicine, telework, and distance learning — all solutions we’re trying to rely on today with our focus on social distancing.
- Extreme Inequality. The wealthy have always had outsized political influence to elect representatives and enact laws & regulations that benefit their special interests rather than public interests. This political corruption was made worse by the Supreme Court’s Citizens United decision.
- Questioned Truth. With Cable TV, hundreds of channels, and the need to fill a 24/7 news cycle, what was once trusted “news” has largely been replaced by opinion. The ability to self-select which ever version of truth fits your world view, enhanced by social media sharing, has caused us to distrust “facts” and question truth, leading to hyper-partisanship as we seek comfort with likeminded members of our same “tribe.”
- Economic Fragility. We have not fully recovered from the 2008 global recession and are saddled with crippling debt and few tools to fight another recession. The Federal Reserve this week lowered their bank interest rate to near zero (0.25%), meaning they can’t go much further if a recession does occur.
- Overextended Consumers. 40% of families lack enough savings to handle a $400 emergency, according to The Federal Reserve.
WINNERS & LOSERS
- Big Retail & Big Tech. According to Rock Health, many big retailers made new digital health aspirations clear, including Best Buy, Walgreens, and Rite Aid, while companies like Walmart and CVS ramped up their digital health investments. And on the tech front, Amazon, Google, Apple, and Microsoft aimed much of their tech at health care.
- Purchasing Power. Just as with the 2008 recession, those with no debt and enough savings will be able to expand their wealth by buying up foreclosed properties and bankrupted businesses for pennies on the dollar.
- Political Influence. The wealthy will likely be able to use their influence to gain federal protections that the rest of us can’t. On the other hand, the political landscape could change dramatically in the Presidential election coming this November. Voters seem to be warming to policies promoted by Sanders and Warren, which are much more progressive, and they seem to support some structural changes to make government work better for the 99%.
- Natural Selection. In some ways, the COVID-19 pandemic may be nature’s way of limiting human population growth. The fact that it affects seniors so much more could have an economic benefit if the death of millions lessens future reliance on age-specific social programs like Social Security and Medicare.
WATCH THIS
Airing ironically at the global introduction of a novel SARS-CoV-2 coronavirus and COVID-19 pandemic, this Netflix docuseries introduces you to some of the heroes on the front lines of the battle against influenza. Here’s the trailer, but you can watch the full series on Netflix or YouTube to learn about their efforts to stop the next global outbreak.
Health executives take out their crystal balls: Here are their predictions for 2021 (Fierce Healthcare, 12/21/20)
Each year, at the end of December or beginning of January, it’s common to reflect on past achievements and trends, and predict and plan for the future. That’s what this article does, and here’s my summary:
* The COVID-19 pandemic put healthcare under the microscope and revealed the good, the bad and the ugly of our industry. The swift disruption forced many manual processes and communications between payers and providers to become more automated.
* Payers and providers will invest more in health equity programs for black & brown communities.
* Technology will allow physicians, patients and health plans to collaborate and advance value-based care as physicians move away from fee for service, ultimately benefitting the patient.
* Government regulation in the form of the Cures Act and ONC rulings will accelerate the sharing of data and breaking down of silos across the industry.
* Since CMS permanently added telehealth and crafted new policies to expand it during the pandemic, virtual care will continue to be a focus.
* Federal and state governments are working to create true interoperability by addressing not just the ability to exchange data, but the willingness to do so.
* Physicians who previously divested their practices or accepted direct employment as the only viable path forward will begin to reverse course, having been underwhelmed by hospital-aligned partnerships.
* Payers will leverage their data and advanced analytics to improve member outcomes.
* Even as new vaccines give us hope about ending the pandemic and get back to some sort of normal, another crisis looms and is just starting to get noticed. One in three Americans is feeling the mental impacts of the pandemic in a hidden ‘fourth wave.’
* Mental health and substance abuse problems will escalate.
* Getting people help to reduce behavioral health issues has the potential to save many lives as well as avoid unnecessary healthcare costs—and we’ll see momentum grow for Medicaid programs to tackle this issue in 2021.
* Increasingly, pharmaceutical companies are leveraging digital therapeutics in tandem with drug therapy. These include clinical-grade wearables, remote patient monitoring, patient-facing apps and AI-powered analytics.
* 2021 will be marked by creative technology partnerships that could drive large-scale population health initiatives.
A detailed timeline of all the ways Trump failed to respond to the coronavirus (Vox, 6/8/2020) The federal coronavirus response shows a president dead set on avoiding responsibility for the pandemic.
“There are many reasons the US death toll is so high [>100,000 when this article was published], including a national response plagued by delays at the federal level, wishful thinking by President Trump, the sidelining of experts, a pointed White House campaign to place the blame for the Trump administration’s shortcomings on others, and time wasted chasing down false hopes based on poor science.”
In this excellent and detailed article, Vox chronicles what Trump and the federal government have — and have not — done to respond to the virus. As I often do, I question the motives and have been quite critical of Trump, even suggesting that his response is an intentional form of Political Genocide. After all, dead people don’t vote against you. And they don’t need Social Security, Medicaid, Medicare, Food Stamps, Unemployment Benefits, or other social services.
Trump’s response seems to coincide with a Libertarian viewpoint that sees the elderly, poor, and unemployed as a burden on the nation and its taxpayers. I, on the other hand, prefer to see our nation’s human resources, not our land or oil, as our most valuable asset. And with that perspective, I argue that it’s more fiscally prudent to invest strategically in a skilled, healthy and productive workforce paid well enough to generate market demand for the goods and services they create and deliver.
For more on my Political Genocide assertion, see Voter Suppression and the Modern Killing Fields.
IBM Watson Health to launch blockchain-powered Digital Health Pass (HealthcareNews.com 10/12/20)
This article is about a tool aimed at allowing users to share their verified health status without exposing the data used to generate it. It reminded me of another article. about wearable sensors, apps, and algorithms that can identify COVID-19 infections and symptoms before they occur. That other article features a sensor-filled smart ring that can assess sleep duration and quality, body temperature, and variation in pulse rate and heart function.
Both Apple and Google have announced plans to embed as a standard (but optional) smartphone feature that uses Bluetooth proximity sensing to record every contact you make with others using the same app. The contact data is encrypted and stored on the phone (not in the cloud). If COVID-19 symptoms appear, the phone alerts those previous contacts so they can self isolate.
Yes, the pandemic is killing people, but it could (hopefully) have a positive impact on changed behaviors, technologies, and politics.
That’s the message of my MegaTrend article, but what technically is possible won’t likely happen without government encouragement; and unfortunately the Trump administration is miles away from that, even working actively to make things worse. Let’s hope the 2020 election results set us on a different path.
READER’S COMMENT ABOUT SOCIAL JUSTICE:
“When Bernie said everyone should have healthcare as a right, you called it socialism. Now you are begging for free tests and treatment and healthcare that is not tied to your job.
When Bernie said workers should be guaranteed paid leave you called it socialism, now you are begging for paid leave as places close and people are laid off.
When Bernie said every child in America should have high-quality child care and universal school meals you called it socialism, now schools are closed and you need child care and food for your kids.
When Bernie wanted to cancel all student loan debt to help millions of struggling Americans you called it socialism, now you are begging for student loan relief.
When Bernie wanted national rent control so landlords can’t jack up rent prices as high as they want and kick tenants out unfairly, you called it socialism, now you are begging for landlords to not evict tenants during this time.
When Bernie said all people should be making a living wage of at least $15/hr you called it socialism, now you are literally relying on those same people at the grocery store, food service, child care, cleaners and other min wage jobs to SURVIVE.
Bernie has been fighting for basic human rights his entire life and it took a global pandemic for you people to realize he’s been right this whole time.”
(From Jane Switchenko)
RELATED ARTICLES:
7 Digital Health Trends We’ll Keep An Eye On In 2021 (The Medical Futurist, 1/7/21)
1. At-home lab tests: this year we expect more at-home COVID-19 and Antigen test kits to be available, everywhere around the globe
2. Healthcare misinformation: in 2021, this keeps being an issue, and more misinformation will be available on social media than ever before
3. Immunity passports: we can expect to see digital health solutions being used to carry vaccination data, even in electronic passports and national identity cards
4. Telemedicine: we expect a further expansion of telemedicine, and it will become part of the new norm within the medical care
5. Tech giants: Amazon or another player from among the Tech Giants will go on transforming healthcare
6. Self-monitoring: at-home monitoring programs will be crucial for vulnerable patient populations and seniors
7. Artificial intelligence: from diagnostics to public health, I hope to see more prospective studies, more recommendations from medical associations about explainable A.I
Coronavirus Will Change the World Permanently. Here’s How. (POLITICO, 3/19/20) A crisis on this scale can reorder society in dramatic ways, for better or worse. Here are 34 big thinkers’ predictions for what’s to come.
After the pandemic: How the coronavirus will change our lives forever — from music to politics to medicine (Washington Post, 3/20/20)
How Covid-19 Will Change Aging and Retirement (Wall Street Journal, 11/23/20)
How the Pandemic Defeated America – and brought the world’s most powerful country to its knees (The Atlantic, September 2020) Ed Yong hit it out of the park with this incredibly well-written critique of what’s wrong with our healthcare system, racist policies, social safety net, divided politics, and current leadership.
Get Over It! Here’s Why There Is No Going Back To Normal After COVID-19 (LinkedIn, 5/19/20)
Can the coronavirus obliterate some Republican myths? (Washington Post, 3/23/20) Decades of demonizing government and the anti-reality mentality (enabled by a right-wing echo chamber) have seeped into the Republican psyche, leaving us in grave peril. But even Republicans must now turn to science and to government. Will this translate into a new willingness to acknowledge reality? Let’s hope so.
Coronavirus could change how we vote in the general election. That’s not necessarily bad. (Washington Post, 3/16/20) In this 5:22 min video, Democratic Party lawyer Marc Elias says states and Congress need to act now to ensure all votes count during the general election.
The Worst Is Yet to Come (NYTimes opinion, 5/20/20) Never let a good crisis go to waste. On one hand, the coronavirus pandemic provides cover for all sorts of nefarious activity for personal gain at the expense of public health and prosperity. On the other hand, it “might” galvanize public support for political reforms leading to some sort of a new New Deal designed to benefit all of us and not just the super wealthy and politically powerful. With so much at stake to so many people, the coming election in November could see record voter turnout. And Democrats tend to do best when voters are engaged and vote, rather than stay home complacent.
This Coronavirus Is Unlike Anything in Our Lifetime, and We Have to Stop Comparing It to the Flu (Propublica, 3/14/20) Longtime health reporter Charles Ornstein says that comparing the novel coronavirus to the flu is dangerously inaccurate. Not one public health expert he trusts has called that comparison valid. Here’s why.
What America can learn from China’s use of robots and telemedicine to combat the coronavirus (CNBC 3/18/20) MY COMMENT:
Reuters Special Report: How Korea trounced U.S. in race to test people for coronavirus (3/18/20) The novel coronavirus hit the U.S. and South Korea on the same day, but why did Korea do so much better at handling it?
The Pandemic’s Geopolitical Aftershocks Are Coming (The Atlantic, 5/19/20) “Whether the pandemic brings about revolutionary change or simply accelerates the currents already working under the surface, the fact is that the epidemiological second wave isn’t the only one we need to worry about.” There’s “a slowly amassing threat that is not pathological in nature, but economic, political, and military.”
Coronavirus response could give long-awaited jolt to telehealth (Politico 3/1/20) The Trump administration’s push for virtual care to ease the crisis could establish a new normal after the pandemic subsides.
Unlocking the Potential of Physician-to-Patient Telehealth Services (ITIF 5/12/2014) Policymakers need to address several barriers before patients can fully enjoy the benefits of telehealth. (lists five)
How Artificial Intelligence is Aiding the Fight Against Coronavirus (3/13/20) AI has its limits, but it plays a vital role in allowing health experts to take full advantage of the vast amounts of data at their disposal, making accurate predictions and saving precious time in a crisis like this COVID-19 pandemic.
FDA looks to expand remote monitoring to free up hospital space (Fierce BioTech 3/20/20) Shortly after telling researchers to go virtual to keep their clinical studies going, the FDA has issued a new policy giving manufacturers some leeway in marketing their remote vital-sign-measuring devices. This includes new uses of FDA-cleared connected EKGs, electronic stethoscopes, thermometers, blood pressure monitors and other noninvasive devices. One of the agency’s goals is to expand the use of these technologies during the coronavirus outbreak to help get noninfected patients out of hospitals and clinics and free up resources.
Can Smart Thermometers Track the Spread of the Coronavirus? (NYTimes 3/18/20) A company that makes internet-connected thermometers has followed the flu more closely than the C.D.C. can. Now the devices may be turning up cases of Covid-19.
TELEWORK: Twitter CEO Jack Dorsey Tells Employees They Can Work From Home ‘Forever’ — Telework is proving itself to have economic advantages over working in offices. Companies can save on rent and office expenses; workers save gas and time commuting; and cities see less traffic congestion and wear on highway infrastructure. With the ability to hire workers wherever they are, without requiring a relocation, companies can expand their candidate pool while workers expand their employment opportunities — at least for those jobs where telework is an option.
How Consulting Will Likely Change Because of the Pandemic (Inc. 5/19/20)
10+1 Medical Technologies that Blew My Mind (The Medical Futurist) — In this video (9:58), Dr. Bertalan Mesko, MD, presents his view of the 10(+1) technologies that blew his mind and made him feel like we’re entering an era that belongs to science fiction movies!
1. 3D printed drugs
2. Smartwatch ECG
3. Portable Ultrasound
4. Mixed Reality
5. Digital Twins
6. Sleep tracking and smart sleep alarm
7. Digital Pills
8. Medical Drones
9. Genome Sequencing
10. At-home lab tests
10+1. A.I. in public health
How tech is changing healthcare (WIRED 8/8/2021) Predicting the future involves much more than just extrapolating tech trends. While the technologies mentioned in this article ENABLED disruptive change and contributed to our rapid pandemic response, many other factors also influenced the pace of change, some with even more impact. These other factors come in the form of both market accelerators and inhibitors. They include basic motivations like human survival or greed and the profit motive; governmental policy changes such as allowing telehealth across state lines; and social acceptance and market demand, which is so greatly influenced by marketing, political ideology, and disinformation promoted on social media.