The coronavirus and ONiO.temp fever monitoring

Before you read on, please consider that ONiO.temp is a medical device that is not yet medically approved and thus cannot be directly applied in the worldwide viral outbreak that we are witnessing in 2020 as of yet.

Safe monitoring of patients at home can be facilitated by ONiO.temp lowering the strain on the medical professionals and hospitals. They should be a safe haven for those who really require professional help. Plainly put, most of us are best monitored at home as we let our own immune system handle the siege.
 

But let us get the nomenclature in order first.

The foreign agent that is causing the pandemic we are watching unfold in 2020 is a newly found virus, the SARS-CoV-19 virus that in turn results in the COVID-19 illness. You might recognize the first part of its name, Severe Acute Respiratory Syndrome or SARS. So safe to assume COVID-19 will involve some level of reduced respiratory function for those infected.

The virus itself is a member of the Coronavirus family and not surprising siblings with SARS-CoV (SARS) and Middle East respiratory syndrome Coronavirus (MERS-CoV or MERS). The reader may have some remembrance of these outbreaks in 2003 or SARS and 2012 for MERS respectively. At least the frequent flyer will remember thermal border scans - thermal cameras would typically be installed at airports to detect travellers with a skin temperature of 38 degrees Celsius or more - indicating that they were febrile and thus could be infected with SARS virus. In fact, the current COVID-19 pandemic is the 7th time humans are fighting the coronas. Save the thermal border scans to local memory until the end of the article when we have a look at ONiO.temp.

Being the seventh bout in the ring with one of the Coronavirus family members is a fierce one. As of middle March 2020, it is safe to say that there is a global spread of the viral contagion and that it will pass through sizeable numbers of the world population. Elders and other risk groups are specifically targeted.

It seems that the origin of the pandemic is the wet markets of the Wuhan province in China. In such outdoor markets, narrow lanes of cuts of meat and ripe produce are sold side by side. People and live and dead animals — dogs, chickens, pigs, snakes, civets, and more in constant close contact. It creates an ideal environment for the virus that is usually spread between animals to come in contact with humans. It is generally accepted that the SARS outbreak in 2003 also was from such wet markets (Perpetrator being bats). The first confirmed case of COVID-19 in China was December 12th 2019.

“Luckily for most, COVID-19 can be managed at home. Out of 44000 confirmed cases in China only 15% were admitted to hospitals and 5% in intensive care.” 
 

The COVID-19 by the numbers

The origin of the viral pandemic is really one for the history books. But it is clear that with the great spread of SARS-CoV-19 and the COVID-19 illness must be handled by each individual in their home. The problem is simply that since the number of infected people will double every six days - or thereabouts the toll on the health system becomes too high. The US had 500 confirmed cases of COVID-19 on March 8th 2020. This number is probably vastly underrepresented as testing for coronavirus is still not well developed, so in fact the real number for sake of argument is 2000. That means at the beginning of April there will be about 1 million US cases and so forth until reaching some 1% of the population if one is to believe modern epidemiological studies. That is a grand total of 3.3million Americans infected. With 2.8 hospital beds per 1000 inhabitant and each infected requiring weeks of care - the health system will grind to a halt quickly. Especially given that around 70% of the beds are already occupied with regular hospital patients. So for the case of maintaining a manageable load on hospitals it is critical to slow down the initial spread of the virus in a population - and make it as long tail as possible. The total number of infected is believed to be the same but the longer an outbreak lasts the more manageable load on the hospitals and greater chances of a vaccine.

Luckily for most COVID-19 can be managed at home. Out of 44000 confirmed cases in China only 15% were admitted to hospitals and 5% in intensive care. The numbers are a bit worse in Italy where 50% of the infected require hospitalization and 10% found themselves at intensive care. This is an enormous additional burden on hospitals nationwide as they are already busy treating their regular patient loads. Even considering the Italian case where 50% until now has required hospitalization it is more plausible that the number is lower and more people have mild symptoms that can be managed at home.

Symptoms for COVID-19 are similar to those of the flu and typically involve fever to some extent and as well as sore throat and diarrhea. Low to moderate symptoms that can be linked with the levitation of the core body temperature, a mechanism used to literally make the living conditions for a virus inhospitable. Antibiotics are harmless to viruses and short of a vaccine there is little left to do than prevent spreading of the contagion in general and specifically to those at risk. Additionally ensure that those infected do not get secondary infections such as Pneumococcus bacteria causing pneumonia.

“ONiO.temp can allow comfortable fever monitoring and control at home at the convenience of wearing a simple batteryless skin patch sensor.”
 

What can ONiO do to help?

Leaving the specifics of the COVID-19 for now, it is time to talk about something we are extremely excited about and have been working on for a while and that is ONiO.temp. It is an electronic device embodied as a small self-adhesive skin patch for continuous monitoring of core body temperature. This development started almost two years ago and has been developed under the radar until now. In the video below, you can see this skin patch sensor on the little girl’s forehead. The locations are suggested to be the forehead, behind ear or torso for an accurate reading. The patch can be comfortably worn for a few days up to a week depending on its structure and adhesive used.

Tell Me - An introduction video for ONiO.temp

The patch itself is rather sophisticated in its operation - as it samples the patient’s core body temperature, grooms the measurements and wirelessly transmit the telemetry over a secure Bluetooth Low Energy link. Thus allowing for easy integration with a mobile device or to the cloud through a gateway. The patch relies on energy harvesting for its operation - no battery mess or charging required, shelf-life only limited by skin adhesive being utilised and sterilisation grade. We wanted a true stick and forget technology and the effort in deploying energy harvesting is well worth the investment. ONiO.temp also includes a batteryless microcontroller and slots to extend with other sensors.

“The patch itself is rather sophisticated in its operation - as it samples the patient’s core body temperature, grooms the measurements and wirelessly transmit the telemetry over a secure Bluetooth Low Energy link.” 
 

As mentioned above the ONiO.temp can be used by itself as a skin patch - but also included in a bigger ecosystem that offers rich benefits. ONiO.temp has a house-wide range when used with ONiO’s cloud connector. The cloud connector allows painless monitoring of up to ten patients at any time. The cloud connector also performs basic metrology of the environment that the patient is located in to guide the best care possible. For instance, if a febrile patient is kept in a warm and humid room the system will guide to lower room temperature and aerate.

Make your fever count globally

The data collected is securely sent to ONiO’s cloud backend where data is being analyzed, signal processed and stored. One unique feature of ONiO’s patient data system is that the storage of person and data is never linked in a traditional way. And it is not possible to link personal data to fever data besides the caretaker controlling the measurement. In this way, it is possible to offer true and safe big data. You do not have to worry that your fever is ever linked with you unless you or your medical team decide so.

The caretaker can set temperature alarms and event triggers so that if the fever goes above a certain level a system notification including an SMS or voice message will be issued from the backend. Patient data can be viewed online, in an app or through professional health journal systems used by medical doctors.

From an individual point of view you see your fever characteristics and can share them with your physician. However, the data in anonymous form can be used by hospitals and governmental agencies to monitor and map outbreaks of seasonal flu or more severe conditions like SARS, COVID-19 or malaria.

At ONiO we believe there is a significant benefit from being able to show your medical doctor what your core body temperature was while being ill. In most cases people do fever measurements as a spot test, measure once or twice and leave it at that. Let us face it - for most automobiles on the planet, the only universal gauge is the engine temperature - maybe it is time to make fever measurements more frequent and less painful. 

Putting it all together

With a system like ONiO.temp we want to enable patients and caretakers to be informed about fever, the benefits of fever and a safe recovery. A patient should be able to be monitored conveniently at home with the confidence of a hospital. As we have read and learnt with COVID-19 there is simply too many infected to be handled at hospitals. But it is easy to see that physicians and caretakers would enable better care and triage of patients with remote fever monitoring performed at home. This has been historically proved during the SARS outbreak in 2003 where the Taiwanese government implemented a SARS phone hotline to help triage patients based on fever measurements.

Instead of having potentially infected residents call a hotline we can apply smart sensing where an autonomous system assists the medical profession. Above is a suggested way to triage patients.

We know from SARS that it has a specific fever curve/pattern that starts with very high core body temperature. Applying big data smartness, recognizing similar fever patterns among a large population can be used to trigger pandemic alerts - something that was not done early enough for COVID-19.

What the collected fever data can be used for is limitless and for those more clever than ONiO - but the first step is to make collecting data convenient and that it is of high fidelity. We believe that ONiO.temp is one such tool and that it can make a huge difference in-home health care in general and specifically be critical when managing a pandemic.

A few closing remarks:

1. ONiO.temp is not yet a commercially available product
2. Avoid crowds of people. Keep your distance in environments where you are not in control
3. Don’t panic and engage in hoarding of food and resources
4. Stay warm and stay hydrated
5. And as always keep track of your body temperature.
6. And as always keep track of your body temperature. You are worth a better gauge than your car.

We want to give a massive shoutout to those in the medical and governmental offices that manage the viral pandemic that is hitting us right now. Keep up the awesome work.