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Living with coronavirus: Where are the high-risk cases?

  • Published at 02:21 pm April 4th, 2020
tech doctor
Technology can solve a logistically impossible challenge BIGSTOCK

How mobile phone companies can step up in this battle

To fight coronavirus, we need to know where the high-risk cases are. And we need to know whom they are transferring the disease to.

People with symptoms have developed shortness of breath or have high fevers and coughs. However, according to the Centre for Disease Control and Prevention in the US, about 25% of the people carrying the virus do not present any symptoms but still transmit the disease to others.

How do we find the people with and without symptoms in a country of more than 160 million people? Certainly, the classic needle in a haystack problem.

We can test a large sample of our large population. Not possible. We don’t have the money, the huge number of test kits, and, more importantly, we don’t have the time.

We can check our 35 million households for persons with symptoms. Not possible. With the entire country in a virtual lockdown to ensure social distancing critical to slowing down the transmission of this highly contagious disease, just like almost every other country in the world, we cannot send groups of people to every household.

How can we help the Institute of Epidemiology, Disease Control and Research (IEDCR) and Directorate General of Health Services (DGHS)? 

Should we just sit idle and have coronavirus wreak havoc across the country? What other options are there to reach hundreds of millions of people in a matter of days?

Who has access to most households in the country to collect data? And that also, remotely, without any person showing up at doorsteps.

Our mobile phone companies.

Can they help us reach as many households as possible to collect data from people with coronavirus symptoms and also from people who have recently been in contact with people with the symptoms?

This is the question that prompted our government to form a consortium with all four mobile companies -- Grameen Phone, Robi, Banglalink, and Teletalk -- with facilitation by the a2i Program of the ICT Division and Cabinet Division with technical support from the National Telecommunications Monitoring Centre (NTMC).

The national information hotline 333 was repurposed to take in calls from people around the country. There is a simple triage system which automatically asks for symptoms (shortness of breath, fever, cough) of the caller and information on whether the caller has been in contact with anybody with such symptoms or anybody who has returned from abroad in the last 14 days. The Shashthya Batayon 16263 of DGHS was fit with the same IVR.

To reach out to even more people, all four telcos have launched a USSD-based system *3332# with five simple questions which capture the symptom information and the dialer’s age. Anybody above 60 years of age is considered high risk.

In a matter of days, over a million pieces of information poured in. Every day, more and more information is coming in from all corners of the country.

In the time of social distancing, we are reaching out to millions of households and getting data critical to finding the virus. Very fast, very cheap, and very efficient.

The data scientists in the four telcos, a2i, and NTMC are now working to analyze this data to locate high-risk cases who need immediate care and the possible hot zones that are forming through transmission from carriers. This will better enable the IEDCR, DGHS, and the entire health care system in the country to equip health care personnel in prioritized locations, send authorized sample collectors to households and ramp up appropriate healthcare facilities such as ventilators, ICUs, isolation units, and specialized ambulances near the hot zones. 

The administration enforcing quarantines will also be greatly benefitted through this analysis.

This is the power of crowdsourcing, big data analysis, and artificial intelligence. Combined with human intelligence which is plentiful in Bangladesh.

One callous and insensitive behaviour by the callers of 333 and 16263 and the dialers of *3332# is being observed. Many calls are coming in with spurious and frivolous information which introduces “noise” in the data, increases the load of doctors who are investigating these cases and delays critical intervention to save lives and contain disease transmission.

So, we urge the readers and our media to alert frivolous callers to be more sensitive to the national crisis and not be a roadblock to good action. Their frivolity, as much as they do not know it, may cost lives.

In a recent press conference, the question of sensitivity of this vast amount of data and privacy protection of the people providing the data were discussed. It is ensured that only anonymized data is being used, analysis is being done in a secure environment, and high-risk cases and hot zone information is restricted to authorized personnel responsible for taking proper and timely action to contain the spread of the disease and treat the patients.

This is a demonstration of how Digital Bangladesh is coming to the aid of the nation at a time of critical need. In the UN e-Governance ranking, Bangladesh has progressed from the rank of 150 to 115 between 2012 and 2018. An impressive leap when every country in the world is accelerating their efforts towards digitization. What this 35-rank jump means is that Bangladesh is accelerating faster compared to many nations. In fact, it ranked number 1 among the LDCs in 2018.

However, what is more remarkable is that, in terms of delivering public services through ICT, Bangladesh is now being compared to nations such as the UK, Denmark, Estonia, the US, and Singapore which have worked over decades to make their public service delivery more and more digitized. 

Bangladesh is leapfrogging and is catching up.

Anir Chowdhury is a US techpreneur turned Bangladeshi govpreneur serving as the Policy Advisor of a2i in the ICT Division and Cabinet Division supported by UNDP.

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