Hype and hope: Wearables in the covid era

Put a ring on it.

Illustration by Koren Shadmi

The NBA’s strategy of using luxury wearable devices to detect and prevent COVID-19 among basketball players looks awfully good on paper. It also torments us by both suggesting a techno-silver bullet as well as offering a view on how the rich and famous enjoy an elite level of safety during a devastating pandemic.

Because this is a story taking place in our year of hell, 2020. It is a story about coronavirus capitalism, Orwellian surveillance, and being abandoned so brutally by the federal government to die that in order to survive we must use every tool at our disposal, no matter how suspect, in order to save ourselves.

Enter the ring

When players arrive to Disney World’s “Life inside the Bubble” — tentative date July 30 — to restart the NBA basketball season, they’ll be met with a buffet of futuristic gadgets they can voluntarily use to prevent and detect the deadly coronavirus.

These gadgets include wearable proximity alarms that beep when you’ve been within six feet of someone too long, pulse oximeters, thermometers, and that hot $300 titanium smart ring everyone’s talking about, the Oura. The ring tracks and analyses data like sleep, heart rate, body temperature, respiratory function, and more. The NBA reportedly bought over 1,000 Oura rings for the season restart.

Players will also have plentiful at-will testing, too, making them the envy of most Americans.

Yet it’s Oura in all the headlines, the sci-fi wearable everyone suddenly wants. The ring’s hype in press is that it detects coronavirus symptoms up to three days in advance with 90 percent accuracy. That claim comes from a May press release basically promoting an app made by Oura, The West Virginia University Rockefeller Neuroscience Institute (RNI), and WVU Medicine. The app came out of a study between Oura and RNI about the ring’s potential to predict coronavirus among front-line healthcare workers. It’s a pretty cool idea, but my point is that it’s the app making the claim, and not necessarily the ring.

Oura, to its credit, has also been partnering with other teams at the forefront of COVID-19 research, like the USCF TemPredict study.

There are so many caveats here. For one, these studies are funded by the company selling the product. You could play buzzword bingo with every Oura press release until your eyes cross. Plus all the questions people like me have about Oura’s technical implementation and security implications (especially regarding Bluetooth), false positives, what Oura means by data sharing for in-app advertising, why they seemed to let their Android app languish, is it watching us masturbate like Ceiling Cat, and just how buggy is this magical wearable anyway? And, of course, what they think about making one for poor people. Because thanks to COVID-19, we’re going to have a lot more of those, too.

So we have questions. Lots of them. But we’re also really, truly in a life or death situation. So the deeper question is, are wearables finally getting to the point where they could detect COVID-19 symptoms before they appear (or provide a form of confirmation at the onset)?

Meet the biohacker who survived COVID-19

Biohacker Mikey Sklar had an unfortunate opportunity to find out for us when he contracted COVID-19 in the second week of March while using two fitness trackers: the Garmin Venu watch and Oura Ring.

“On the evening of March 16th, some anomalies started showing up even though I was not yet symptomatic,” Sklar wrote. “I would proceed to sweat through the night and wake up with a killer headache, terrible body aches, chills and a diminished sense of smell.” He then detailed some pretty obvious differences in his biometrics on the Garmin between his “normal” and “sick” states.

His testing ordeal was intense, though Sklar told Engadget via email “Getting tested was more complicated at that time.”

Mikey Sklar / Adafruit

If you use a sleep tracker like the Garmin or Oura, and you want to know what to look for regarding possible COVID-19 symptoms, Sklar noted his differences between “normal” and “sick” as:

  • Resting Heart Rate increased by 15 BPM (lower is better)

  • Heart Rate Variability decreased 30 BPM (higher is better)

  • Average Overnight Body Temperature increased by 3.3 degrees fahrenheit

  • Respiratory Rate increased by 2.7 breaths per minute

Sklar was one of the lucky ones. “My symptoms were limited and pretty much just being uncomfortable for a little over a week,” he wrote. Even so, he connected with developers of sleep app Bioloop, “who had been working with Stanford and Oura Ring data to find anomalies in a persons biometric history. They were looking for the same sort of jumps in biometrics I mentioned above RHR, HRV, body temperature and respiratory rate,” he added.

At the end of it all, Sklar concluded that “fitness trackers cannot tell us what we have,” but that they “can give us a little bit of warning when our bodies start fighting.”

It’s a pretty even-handed take from someone who is really into hacking and tracking themselves. Some NBA players, on the other hand, are not cool with that at all. While using Oura rings is voluntary and the NBA is making data privacy promises to players, Los Angeles Lakers forward Kyle Kuzma tweeted, “Looks like a tracking device.”

A coronavirus panopticon (on your wrist)

Kuzma is right to be suspicious; he’s absolutely correct. Oura isn’t all that different than other sleep and wellness trackers, yet these devices gather and record a wealth of deeply personal data, they use security-problematic things like Bluetooth, anyone who knows what they’re doing can poke at the data to get more info like location, and companies get sold (as well as pressured by governments).

From every technical perspective, something like the Oura represents an elite, thorough, and worryingly accurate tracking device bar none, terrifying if it were to be used for evil (or by Palantir, or Facebook for that matter). Moreso now that one country is taking coronavirus wearables in a very Orwellian direction — and that country is Singapore.

Not everyone in Singapore is using the country’s contact-tracing TraceTogether app. Use among the population never made it past 25% saturation, partly because not everyone has a smartphone, and largely because Singapore’s app doesn’t work on iPhones. That’s because TraceTogether breaks a serious security “best practice”, namely that Apple does not allow iPhone apps running in the background to access Bluetooth.

Singapore’s new solution to this mess of its own making is to release a wearable contact-tracing tracking device to its citizens and threaten to make it compulsory for the entire population to wear.

“Whether circumstances would ever require mandatory adoption we cannot say,” said Singapore’s Smart Nation Initiative Minister-in-charge Vivian Balakrishnan on June 5th. “I am going to do my best to push participation rates up without having to go down the mandatory route.”

A petition was immediately created, with 52,000 signatures as of this week for “Singapore says ‘No’ to wearable devices for Covid-19 contact tracing.” It explains how easily the device will be able to surveil citizens, and states:

The Government looks to the Covid-19 pandemic as the perfect excuse to realise what it has always envisioned for us – this country’s populace: to surveil us with impunity, to track us without any technological inhibitions, and maintain a form of movement monitoring on each of us at all times and places. And to do so by decreeing it compulsory for all law-abiding persons to become ‘recipients’.

We – as free, independent, and lawful members of the public of Singapore – condemn the device’s implementation as blatant infringements upon our rights to privacy, personal space, and freedom of movement. We reject the notion that the non-efficacy of the Trace Together initiative be superceded by a regime that could potentially require all members of the public (regardless of their age, susceptibility to disease, or health status) to give up these rights under fear – not of infection from Covid-19 – but of prosecution by the state.

The point of showing you all of this is not to scare you. We’ve had enough of that, and we should probably brace for more. It’s also tempting to think that I’ve taken you to these vistas of dark possibilities because I get off on terrifying readers, or desire a reputation for traumatically scaring my readers. I do not.

There is a lot going on and it is more than some people can take. If you use fitness trackers, hopefully Mikey Sklar’s experience can help you (he will also tell you what he did while surviving it, all you have to do is ask him).

But I’m also looking into the face of all this injustice, unfairness, greed, madness, and unnecessary heartbreak here on this page because, well, anger is a form of hope -- and we need as much of that as we can right now. As inconceivable as it is, the US has officially unflattened the curve, so terribly that the world is readying to quarantine us to our own soil. I think we can be forgiven for being angry, being scared, and for there being just an overwhelming sadness in everything we do.

I also think it is entirely appropriate to talk about why and how we DIY our way through this, whether it’s learning from fitness tracker hackers, demanding answers for people who can’t access these technologies because of inequalities tech startups refuse to acknowledge, or seeing the people of Singapore oppose invasive digital tracking and learning from it. We are no longer bewitched by shiny gadgets that offer convenience and connectivity. It’s time to make those gadgets work for us, instead.

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