With Theaters Closed, The Trailer For Christopher Nolan's 'Tenet' Debuts In Fortnite Instead

from the more-than-a-game dept

With the explosion of the video game industry and the technology that has come along with it, it's starting to get really fun to see what creative minds can do inside of the gaming realm. It's turning games into something much more than they would have been 20 years ago. Back then, games were singular in purpose: play the video game. Today they can be so much more when done right. They can be a social ecosystem. They can be economies onto themselves.

Or they can be a place to premier top tier movie trailers, in the case of Fortnite.

Tonight, a new trailer for Christopher Nolan’s upcoming film Tenet aired in Fortnite. The trailer was introduced by Geoff Keighley, because he’s the only consistency we have left in this topsy-turvy world.

Keighley introduced the trailer, shown at Fortnite’s new Party Royale hub’s movie theater. He spoke with Tenet star John David Washington about his gaming history and his role in the film. The trailer itself featured some clips we’ve seen before, but it didn’t reveal all that much more about the movie, which seems to involve time travel and Robert Pattinson.

While the trailer is now widely available, its first showing was in Fortnite. And that strikes me as both rather strange and very, very cool. There is something about layering entertainment inside other entertainment that just clicks with me. Those Minecraft builds where folks build a working computer inside the game? That's amazing to me. Those people who band together in the latest version of Skyrim just to produce a reproduction of previous Elder Scrolls games in the new engine? I love that stuff. And forward thinking media executives who want to have a little fun during a pandemic and show off a new movie trailer in a movie screen inside a popular video game? I mean, that's just cool.

And it would appear that either Nolan himself or someone on his team is interested in keeping these experiments running, given the closure of most movie theaters in the country.

The Tenet trailer ended with the words “Coming to theaters,” which seems like an awfully ambitious declaration due to, you know, the world. But just as each day brings new horrors, it also brings new possibilities to imagine, as well as Geoff Keighley telling us new things about games.

Keighley ended by announcing that there will be a screening of “an iconic Christopher Nolan film” in Fortnite this summer. (I haven’t seen a Nolan film since Memento, but it’s probably not that.)

Whatever it is, screening an entire movie inside a video game? Sounds cool to me!

Filed Under: christopher nolan, community, covid-19, crisis, debuts, fortnite, movie trailers, tenet, video games

Doctor With Rare Disease Crowdsourced His Own Cure, And Is Now Using That Network To Work On COVID-19

from the the-internet-to-the-rescue dept

A recent episode of NPR's Fresh Air ran an amazing interview with Dr. David Fajgenbaum, who was diagnosed years ago with the rare Castleman's Disease, about which very little information was known (and the general prognosis was grim). Fajgenbaum talks about how he ended up in hospitals believing that he was about to die five separate times (he even had his last rites read to him), but then set up his own organization to try to crowdsource a cure. He details the full story in his book that was published last fall, called Chasing My Cure.

The good news is through that crowdsourcing effort, called the Castleman Disease Collaborative Network (CDCN), they at least found a treatment that (for now...) appears to work for Fajgenbaum himself:

The biggest difference between this fifth time I nearly died and the previous four times is that, at this stage, I was engaged. And I had the ultimate date in mind, which is our wedding date, May 24, 2014 - in mind as the driver to say, I need to find something. I failed to respond to all these drugs. There's nothing left for me. But I have to make it to May 24, 2014. And so thankfully, this combination of seven chemotherapies saved my life.

And when I got out of the hospital, I was able to go back to all those samples I'd been storing on myself and performed a series of experiments where, from within my experiments, I found this pattern that suggested this one communication line in the immune system called the mTOR pathway was highly activated. And what was so exciting about finding this communication line turned on is that there is a drug that was developed 30 years ago that's really good at turning it off. It's called sirolimus.

And just knowing that this pathway was on did not guarantee that blocking it would work and that taking this drug would save my life. In fact, the immune system is a very finicky system. And basically, turning off this communication line could have actually caused even more problems. No one knew because this drug had never been given to a Castleman disease patient before.

But really, knowing that I needed to try something if I wanted to make it to our wedding date, I decided to take the leap of faith and to start taking this drug as the first patient with my disease ever to take sirolimus back in early 2014. And amazingly, thankfully, I was able to make it to Caitlin and I's wedding date. And you wouldn't think this is too important, Dave, but my hair grew back just in time.

He admits that the treatment that works for him has not been shown to work for everyone with Castleman's -- in fact, it appears to help only about 1/3 of those treated with it. But just the fact that it's been helping some is worth noting.

And here's the really interesting part: as we've gone into this whole pandemic thing, many of the participants in the CDCN have noticed some similarities between the issues with Castleman's disease, and with what people are reporting about COVID-19. So they've been repurposing the crowdsourcing effort to work on COVID-19:

DAVIES: So the collaborative that you formed to try and share information and leads about treating Castleman is now focused on COVID-19. I mean, this is obviously an urgent public health matter. Did you see similarities between Castleman disease and COVID-19 that made this a good fit?

FAJGENBAUM: That's right. So early on in this pandemic, it became clear that the most deadly aspect of COVID-19 is actually the cytokine storm that the virus ignites. And the cytokine storm that it ignites is almost identical.

While there are lots of different groups working on different ideas -- from vaccines to antibodies -- the CDCN is focused on what it does best: looking to see if there are FDA approved drugs out there that might have some useful effect here, and recognizing that the only way to really figure that out was to actually get the data (something very few others seemed set up to do):

And so with this similarity between - at the very basic mechanism, what drives the deadliness of COVID-19 is almost identical to what makes Castleman disease so deadly, it's these - the cytokine storm. That was one aspect of it. The second is that we know that drug repurposing is our best shot at identifying a drug that can help patients in the short-term, so a drug that's either already FDA-approved or a drug that is maybe experimental but is not yet approved for anything that could be repurposed for COVID-19. We knew that was our best shot.

And, Dave, I found myself, in early March, thinking to myself, I really hope that some research group out there that has experience studying cytokine storms and has experience doing drug repurposing will follow our blueprint and search for drugs that can be repurposed against this cytokine storm. And I was sitting there hoping that someone would do it.

And then I realized that I needed to listen to my own advice, and that if I'm going to hope that some research lab out there that has experience with cytokine storms and repurposing would turn their effort towards this, then I would need to turn my effort towards this. This is what we've been doing to chase my cure for these years. And we felt like we needed to do what we could in the fight against COVID-19.

The really incredible part here is that he notes that there's no official tracking of the various tests that doctors are doing, and that's a key aspect of what they've set up for doctors around the world:

I mean, you can basically think about the state that we're in right now is that doctors are trying all kinds of things - hydroxychloroquine, remdesivir and many other drugs. Yet there's no system in place to track what's working and what's not working. And so recognizing that this wasn't being done, we decided to build a database, what we called the CORONA database - COVID-19 Registry of Off-label & New Agents. So it's a database to track all of the drugs that have been used against COVID-19 to date 'cause we want to know everything that's been tried, and we want to see what's working and what's not working. And amazingly, almost 150 different drugs have already been tried against COVID-19. And of course, we hear about a handful of them, but there are a lot of others that have already been tried as well. And so we've created this giant database from - right now it's over 11,000 patients and growing - to collect data on every drug that's been used and so that we can really dig into what's working and what's not working.

And the second part of this equation is that you want to track what's being used, but then you also want to piece together all of the data that's emerging from labs around the world to try to map out what are maybe some new drugs that we could start trying to use? What are some new pathways from all of this data that we should start going after? And interestingly, from the state of - we're finding signals that are Castleman-like, basically. A number of the features that we're seeing in the COVID-19 data, these same features we see in Castleman disease.

Think about that first part for a second. In the past, if you wanted to have a database of how certain drugs were used to treat different diseases, and what the impacts of those treatments were, you'd probably need a government to set up a program -- with lots of bureaucracy and mess. But here, a doctor and some other interested researchers were able to set up their own such database on the fly and get a massive amount of data piped into it, from which they can do all sorts of (hopefully!) useful analysis.

This is not to say they're ignoring other approaches -- because these things work together. In the interview, it's mentioned that the crowdsourcing team at CDCN has combed through over 2,500 published papers to look for potential promising treatments.

Also important: they're being very open about all of this. While some keep insisting that we need to lock up successful treatments and ideas, Fajgenbaum recognizes the power of sharing information widely (the very root of crowdsourcing, after all):

You know, what we really want to do with this corona project is to map out everything that's being tried, to put in one place all of the studies that are being published, all of the data on every drug that's being tried so that other people can go to it and they can kind of decide for themselves what looks promising and what doesn't. We didn't build this to say this is the drug and that's not the drug; we built this to say this is where all the data is. If anyone wants to use the data, we have this very data-first approach. Anyone can use the data.

And from our perspective, we want to use the data to determine and to prioritize what drugs should go on to clinical trials. So the fact is, is that this drug is already being studied in randomized controlled trials, and that's all that we can really ask for. We want to use the database to say what's being given, what looks really promising and what should go forward to randomized controlled trial. We don't want to use the database to say this drug should be given or that drugs should not be given. So we're hopeful.

And actually, we put together a paper based on our first pass of analyses of the data and recently received favorable reviews. So hoping that that'll get published in peer-reviewed journal shortly and that we will be able to get the word out about this database. But the goal is not to say this is the drug that everyone should be on; the goal is to say these are the promising drugs. Let's make sure that we don't forget anything along the way because you're right - I think that we all have a tendency to jump on every major drug or every major headline. But we need to keep an eye on all the drugs that are being tried and make sure that we're doing this really systematically.

Once again, the ability for anyone to just setup and build something on the internet, without needing to ask for approval or go through some big bureaucratic process, may be helpful yet again, and hopefully the very open process of bringing in data, and sharing it outward, will lead to real breakthroughs.

Filed Under: castleman's disease, covid, covid-19, crowdsourcing, cytokine storm, david fajgenbaum
Companies: cdcn

More Than A Game: The COVID-19 Pandemic Has Turned Esports Into An Economy Of Its Own

from the jobs-jobs-jobs dept

One of the dangers when we talk about esports and its rapid growth, particularly during this pandemic, is that those not in the know can see this as hobbyists touting their own hobby. It's understandable to some degree, what with this industry being both in its infancy stage and growing exponentially in speed. Still, while we've had several posts lately focusing on how esports is happily filling the void of traditional live sports during the COVID-19 pandemic, it is worth remembering that this isn't just a hobby any longer. It's an economy in and of itself.

And that, to put a fine point on it, means jobs. Lots and lots of jobs, actually, and economic growth going along with it. NBC has an illuminating post on just how fast streaming companies are expanding to keep up with the esports demand.

Viewership on Amazon’s Twitch, YouTube, Facebook and other streaming platforms has spiked tremendously in the past couple of months, owing to the fact that esports was born and exists online and competitors can play remotely in its virtual realm during the crisis. And although the millions of Americans suddenly unemployed include tens of thousands of people who work for the shuttered traditional sports leagues’ offices, ballparks and stadiums, as well as the ancillary businesses that support and supply them, the esports workforce is relatively intact.

“Yes, we are still hiring,” said a spokesperson for the streaming website Twitch, a unit of Amazon that enjoyed a 23% surge in viewership in March. In mid-May its jobs page listed more than 115 positions, from a senior software engineer at its San Francisco headquarters to an advertising sales director in Singapore.

It's not just that esports is now a billion dollar industry. It's also that it's an industry somewhat uniquely positioned to not just weather this pandemic, but to thrive during it. And, as more and more people adopt esports for entertainment while traditional sports are shutdown, there is no reason to think that all of those new adopters are suddenly going to disappear if and when life goes back to something relatively normal. But above, you're talking about the primary players in the industry: leagues, teams, streaming platforms. Of course those have all grown.

But the real power in esports becoming a fully fleshed out industry is, just like with real sports, all of the jobs and industry that come along for the ride. Industry that, again, is well crafted for the very young people that suddenly find themselves without opportunities for jobs in more traditional workplaces.

The burgeoning esports workforce — largely comprised of millennials and Gen Zers — also includes software engineers, content creators, data analysts, game designers, social media specialists, broadcasters, journalists, marketers, partnership managers, advertising and sponsorship salespeople, event managers, venue operators, concessionaires, accountants, lawyers and office staff. There are private chefs and house managers employed at the digs where teams live together, and there are counselors who wrangle kids at esports summer camps.

“You see a lot of mirroring of the traditional sports industry in terms of employment opportunities, but the roles have a twist on them,” said Remer Rietkerk, head of esports at Amsterdam-based Newzoo, a market research firm specializing in esports and gaming. “You have a different set of challenges due to esports being digital and attracting a different audience,” he added, alluding to the worldwide fan base of 443 million, according to Newzoo’s latest Global Esports Market Report.

And the trend lines are all rising. All of this is to say a couple of things. First, esports isn't some fad that's going away any time soon. Second, it's long past time we stop talking about esports as though it were this niche entertainment choice enjoyed by very few via a few odd and hard to navigate internet platforms.

No, esports is big business. And big entertainment. Even the traditional broadcasters are paying attention and turning to esports in this time of crisis. Before the pandemic, esports was finding itself on larger and larger platforms and on more and more traditional networks. This crisis only supercharged that trend.

And finally, if you care about jobs and economic growth, that is all very welcome news in times like these.

Filed Under: covid-19, e-sports

The Case For Contact Tracing Apps Built On Apple And Google's Exposure Notification System

from the tradeoffs dept

Apple and Google have now released their update to their mobile operating systems to include a new capability for COVID-19 exposure notification. This new technology, which will support contact tracing apps developed by public health agencies, is technically impressive: it enables notifications of possible contact with COVID-positive individuals without leaking any sensitive personal data. The only data exchanged by users are rotating random keys (i.e., a unique 128-digit string of 0s and 1s) and encrypted metadata (i.e., the protocol version in use and transmitted power levels). Keys of infected individuals, but not their identities or their locations, are downloaded by the network upon a positive test with the approval of a government-sanctioned public health app.

Despite being a useful tool in the pandemic arsenal and adopting state-of-the-art techniques to protect privacy, the Apple-Google system has drawn criticism from several quarters. Privacy advocates are dreaming up ways the system could be abused. Anti-tech campaigners are decrying “tech solutionism.” None of these critiques stands up to scrutiny.

How the exposure notification API works

To get a sense for how the Apple-Google exposure notification system works, it is useful to consider a hypothetical system involving raffle tickets instead of Bluetooth beacons. Imagine you were given a roll of two-part raffle tickets to carry around with you wherever you go. Each ticket has two copies of a randomly-generated 128-digit number (with no relationship to your identity, your location, or any other ticket; there is no central record of ticket numbers). As you go about your normal life, if you happen to come within six feet of another person, you exchange a raffle ticket, keeping both the ticket they gave you and the copy of the one you gave them. You do this regularly and keep all the tickets you’ve exchanged for the most recent two weeks.

If you get infected with the virus, you notify the public health authority and share only the copies of the tickets you’ve given out—the public health officials never see the raffle tickets you’ve received. Each night, on every TV and radio station, a public health official reads the numbers of the raffle tickets it has collected from infected patients (it is a very long broadcast). Everyone listening to the broadcast checks the tickets they’ve received in the last two weeks to see if they’ve “won.” Upon confirming a match, an individual has the choice of doing nothing or seeking out a diagnostic test. If they test positive, then the copies of the tickets they’ve given out are announced in the broadcast the next night. The more people who collect and hand out raffle tickets everywhere they go, and the more people who voluntarily announce themselves after hearing a match in the broadcast, the better the system works for tracking, tracing, and isolating the virus.

The Apple-Google exposure notification system works similarly, but instead of raffle tickets, it uses low-power Bluetooth signals. Every modern phone comes with a Bluetooth radio that is capable of transmitting and receiving data over short distances, typically up to around 30 feet. Under the design agreed to by Apple and Google, iOS and Android phones updated to the new OS, that have their Bluetooth radios on, and that have a public health contact tracing app installed will broadcast a randomized number that changes every 10 minutes. In addition, phones with contact tracing apps installed on them will record any keys they encounter that meet criteria set by app developers (public health agencies) on exposure time and signal strength (say, a signal strength correlating with a distance up to around six feet away). These parameters can change with new versions of the app to reflect growing understanding of COVID-19 and the levels of exposure that will generate the most value to the network. All of the keys that are broadcast or received and retained are stored on the device in a secure database.

When an individual receives a positive COVID-19 diagnosis, she can alert the network to her positive status. Using the app provided by the public health authority, and with the authority’s approval, she broadcasts her recent keys to the network. Phones download the list of positive keys and check to see if they have any of them in their on-device databases. If so, they display a notification to the user of possible COVID-19 exposure, reported in five-minute intervals up to 30 minutes. The notified user, who still does not know the name or any other data about the person who may have exposed her to COVID-19, can then decide whether or not to get tested or self-isolate. No data about the notified user leaves the phone, and authorities are unable to force her to take any follow-up action.

Risks to privacy and abuse are extremely low

As global companies, Google and Apple have to operate in nearly every country around the world, and they need to set policies that are robust to the worst civil liberties environments. This decentralized notification system is exactly what you would design if you needed to implement a contact tracing system but were concerned about adversarial behavior from authoritarian governments. No sensitive data ever leaves the phone without the user’s express permission. The broadcast keys themselves are worthless, and cannot be tied back to a user’s identity or location unless the user declares herself COVID-positive through the public health app.

Some European governments think Apple and Google’s approach goes too far in preserving user privacy, saying they need more data and control. For example, France has indicated that it will not use Apple and Google’s API and has asked Apple to disable other OS-level privacy protections to let the French contact tracing app be more invasive (Apple has refused). The UK has also said it will not use Apple and Google’s exposure notification solution. The French and British approach creates a single point of failure ripe for exploitation by bad actors. Furthermore, when the government has access to all that data, it is much more likely to be tempted to use it for law enforcement or other non-public health-related purposes, risking civil liberties and uptake of the app.

Despite the tremendous effort the tech companies exerted to bake privacy into their API as a fundamental value, it is not enough for some privacy advocates. At Wired, Ashkan Soltani speculates about a hypothetical avenue for abuse. Suppose someone set up a video camera to record the faces of people who passed by, while also running a rooted phone—one where the user has circumvented controls installed by the manufacturer—that gave the perpetrator direct access to the keys involved. Then, argues Soltani, when a COVID-positive key was broadcast over the network, the snoop could be able to correlate it with the face of a person captured on camera and use that to identify the COVID-positive individual.

While it is appropriate for security researchers like Soltani to think about such hypothetical attacks, the real-world damage from such an inefficient possible exploit seems dubious. Is a privacy attacker going to place cameras and rooted iPhones every 30 feet? And how accurate would this attack even be in crowded areas? In a piece for the Brookings Institution with Ryan Calo and Carl Bergstrom, Soltani doubles down, pointing out that “this ‘decentralized’ architecture isn’t completely free of privacy and security concerns” and “opens apps based on these APIs to new and different classes of privacy and security vulnerabilities.”

Yet if “completely free of privacy and security concerns” is the standard, then any form of contact tracing is impossible. Traditional physical contact tracing involves public health officials interviewing infected patients and their recent contacts, collecting that information in centralized government databases, and connecting real identities to contacts. The Google-Apple exposure notification system clearly outperforms traditional approaches on privacy grounds. Soltani and his collaborators raise specious problems and offer no solution other than privacy fundamentalism.

Skeptics of the Apple-Google exposure notification system point to a recent poll by the Washington Post that found “nearly 3 in 5 Americans say they are either unable or unwilling to use the infection-alert system.” About 20% of Americans don’t own a smartphone, and of those who do, around 50% said they definitely or probably would not use the system. While it’s too early to know how much each component of coronavirus response contributes to suppression, evidence from Singapore and South Korea suggests that technology can augment the traditional public health toolbox (even with low adoption rates). In addition, there are other surveys with contradictory results. According to a survey by Harris Poll, “71% of Americans would be willing to share their own mobile location data with authorities to receive alerts about their potential exposure to the virus.” Notably, cell phone location data is much more sensitive than the encrypted Bluetooth tokens in the Apple-Google exposure notification system.

Any reasonable assessment of the tradeoff between privacy and effectiveness for contact tracing apps will conclude that if the apps are at all effective, they are overwhelmingly beneficial. For cost-benefit analysis of regulations, the Environmental Protection Agency has established a benchmark of about $9.5 million per life saved (other government agencies use similar values). By comparison, the value of privacy varies depending on context, but the range is orders of magnitude lower than the value of saving a life, according to a literature review by Will Rinehart.

If we have any privacy-related criticism of the tech companies’ exposure notification API, it is that it requires the user to opt in by downloading a public health contact tracing app before it starts exchanging keys with other users. This is a mistake for two reasons. First, it signals that there is a privacy cost to the mere exchange of keys, which there is not. Even the wildest scenarios concocted by security researchers entail privacy risks from the API only when a user declares herself COVID-positive. Second, it means that the value of the entire contact tracing system is dependent on uptake of the app at all points in time. If the keys were exchanged all along, then even gradual uptake of the app would unlock value in the network that had built up even before users installed the app.

The exposure notification API is part of a portfolio of responses to the pandemic

Soltani, Calo, and Bergstrom raise other problems with contact tracing apps. They will result in false positives (notifications about exposures that didn’t result in transmission of the disease) and false negatives (failures to notify about exposure because not everyone has a phone or will install the app). If poorly designed (without verification from the public health authority), apps could allow individuals who are not COVID-positive to “cry wolf” and frighten a bunch of innocent people, a practice known in the security community as “griefing.” They want their readers to understand that the rollout of a contact tracing app using this API will not magically solve the coronavirus crisis.

Well, no shit. No one is claiming that these apps are a panacea. Rather, the apps are part of a portfolio of responses that can together reduce the spread of COVID and potentially avoid the need for rolling lockdowns until a cure or vaccine is found (think of how many more false negatives there would be in a world without any contact tracing apps). We will still need to wear masks, supplement phone-based tracing methods with traditional contact tracing, and continue some level of distancing until the virus is brought fully under control. (For a point-by-point rebuttal of the Brookings article, see here from Joshua B. Miller).

The exposure notification API developed by Google and Apple is a genuine achievement: it will enable the most privacy-respecting approach to contact tracing in history. It was developed astonishing quickly at a time when the world is in desperate need of additional tools to address a rapidly spreading disease. The engineers at Google and Apple who developed this API deserve our applause, not armchair second-guessing from unpleasable privacy activists.

Under ordinary circumstances, we might have the luxury of interminable debates as developers and engineers tweaked the system to respond to every objection. However, in a pandemic, the tradeoff between speed and perfection shifts radically. In a viral video in March, Dr. Michael J. Ryan, the executive director of the WHO Health Emergencies Programme, was asked what he’s learned from previous epidemics and he left no doubt with his answer:

Be fast, have no regrets. You must be the first mover. The virus will always get you if you don’t move quickly. [...] If you need to be right before you move, you will never win. Perfection is the enemy of the good when it comes to emergency management. Speed trumps perfection. And the problem in society we have at the moment is that everyone is afraid of making a mistake. Everyone is afraid of the consequence of error. But the greatest error is not to move. The greatest error is to be paralysed by the fear of failure.

We must move forward. We should not be paralyzed by the fear that somewhere someone might lose an iota of privacy.

Filed Under: apis, contact tracing, privacy
Companies: apple, google

Emergency Room Doctor: Getting Best COVID-19 Treatment Ideas Via WhatsApp

from the don't-stop-believin' dept

The excellent podcast Radiolab has been running some shorter (from its normal fare) "dispatches" from the pandemic that have been quite interesting, but I wanted to take a quick look at one recent such episode that is mostly a discussion between host Jad Abumrad and ER doctor Avir Mitra, who, in a prior life, had interned at Radiolab, in which Mitra plays some of the voice memos he's been recording for himself as he deals with being an ER doctor on the frontlines in a hospital in NYC, where the largest number of COVID-19 cases are happening.

The whole episode is quite interesting, and they get into discussions about how doctors are recognizing that COVID-19 is not acting like other respiratory diseases, and they're finding all sorts of oddities -- like patients who should be passed out due to low blood oxygen levels acting like there's nothing wrong at all:

AVIR MITRA: The biggest thing that struck me is patient comes in, you measure their oxygen level with a pulse ox. And to take a step back, the pulse ox is that little thing you put on your finger with a laser light.

JAD: It shines a laser through your finger and reads the color of your blood. And from that ...

AVIR MITRA: It tells you your oxygen concentration. If normal is, you know, 97 to 100 percent, you know, we're seeing patients that are at 60, 70 percent routinely. Normally, if someone's oxygen saturation is anything close to 70 percent, they're not awake. They're -- they're out of it completely. They're grasping at anything, trying to get oxygen. But these patients we’re seeing routinely that are looking at us, talking to us, they’re wide awake, texting on their phone, and their oxygen saturations are at these super low levels.

JAD: I remember you sent me a text message of somebody who had a -- an oxygen saturation reading of, like, in the 50s and they were on their phone.

AVIR MITRA: Exactly. That one got circulated around because we were all seeing the same thing and it's like you look at someone with a 54, that's a person that you're like, "Okay ma'am, you're gonna be taking a long nap. You know, you're going on a ventilator." And they may be like, "Well, can I just finish posting on Instagram first?" You know, it's just so surreal.

But what struck me about the story -- and which made it worth posting about here -- is that Mitra discusses how he and other doctors are all using WhatsAspp to discuss theories and possible treatments. In a voice memo he recorded, Mitra first discusses how doctors are all communicating and sharing info through WhatsAspp:

AVIR MITRA: April 10, 2020. I've never in my short career seen people spreading information amongst ER doctors and ICU doctors literally by WhatsApp, texting each other images of charts that people have written, kind of really just figuring it out as it goes, which is kind of incredible because in medicine in general, we're very cautious. We'll sit in journal club meetings and debate whether we should give somebody 162 milligrams of aspirin or 325 milligrams of aspirin. We'll -- we'll literally debate that for hours.

JAD: Hmm.

AVIR MITRA: But -- but right now we're just trying different things out almost on a whim.

JAD: So these WhatsApp groups you were telling me about where you're ...

AVIR MITRA: Yeah.

JAD: ... you're exchanging information with doctors in Italy and China.

AVIR MITRA: Yeah. And a lot from Washington also.

JAD: Washington state, right.

AVIR MITRA: Their outbreak started, I don’t know. What was it? A week or two before ours?

And later in the episode, Mitra and others start exploring a completely different approach to treatment, again based on their discussions on WhatsApp:

JAD: One of the things he says that's been puzzling is just the crazy array of symptoms he's seeing in people with COVID. There's the usual cough, fever, breathing issues, but you also have people reporting neurological issues. Some people, including a few folks that I work with, lost their sense of taste and smell for a while. Others are reporting skin issues on their fingers and toes. Migraines.

AVIR MITRA: Trying to understand what's going on and more importantly what to do about it. So one hypothesis that has been kind of floating around, and I've been thinking about and a lot of people have been thinking about is this idea of a coagulopathy.

JAD: He said the idea started again on a WhatsApp group.

AVIR MITRA: I first heard about it from Washington. It may have gone back even to Italy or China, I'm not sure.

JAD: Doctor on one of these groups says, "Hey, I'm seeing these weird lab values in my COVID patients. I'm not sure what it means." Avir and his colleagues start to investigate, and ultimately notice that COVID patients often seem to have very high levels of this one enzyme in their blood. It's an enzyme that's often associated with clotting.

AVIR MITRA: If someone's making clots and breaking down clots and just going through that clotting process. So that kind of brought up this theory of could it be that this virus is somehow inducing little clots all over the body?

JAD: Thousands and thousands of these micro-clots that might be jamming up the highways and preventing the oxygen in the blood from getting where it needs to go.

AVIR MITRA: And it also could potentially explain why we're seeing heart damage, because the blood that’s supposed to go to the heart is getting clotted before it can get there. Same thing with the brain. And as a matter of fact, we see problems with the kidneys. We're seeing problems with every end organ. Maybe it's not a problem with the organ, maybe it's a problem with the blood supply that should be getting to the organ.

As the story makes clear, they don't know any of this for sure, and some of the early tests around this haven't worked out, but it's given them a path to explore, which might have some potential.

There were a few key points that struck me about this. First is that it's yet another example of how the internet has been incredibly useful to doctors on the frontlines. A few weeks back we wrote about how oncologists were getting their best info from Twitter in how to deal with cancer patients with COVID-19, and now we hear about ER doctors on the frontlines using WhatsApp, and getting ideas and real time info from other doctors around the world (some of whom are a little further ahead in making their way through the pandemic).

The second thing that struck me about this was that for the past few years, all we've been hearing about WhatsApp have been stories about people wanting to blame the app for violence in India and elsewhere after groups spread misinformation that may have contributed to physical attacks. This, of course, is the nature of a tool that allows for communication (especially encrypted communications). Some of that communication can be for a good purpose, and some of it may be the ongoing flow of disinformation. And when we're focusing on how to deal with the latter, we should be pretty damn careful that it not cut off the possibility of the former.

The third thing that I found notable about this is how quickly these informal networks seem to have sprung up. There are, already in existence, a bunch of professional organizations and "established" channels of communication to share medical research and ideas... and none of those seem to be as useful or effective in the short term as jumping onto these social media and messaging apps to establish informal networks of experts in a hurry. That's really quite amazing and worth celebrating. For all the complaints and anger over the negative and problematic uses of social media and messaging apps, we shouldn't forget how absolutely vital they've been for many people working hard to actually save lives.

Filed Under: avir mitra, covid-19, information, information sharing, messaging, radiolab
Companies: whatsapp

Our New Blog Series Exploring Tech In The Time Of COVID

from the techdirt-in-the-time-of-covid dept

It should be no secret at all that the world is a different place than it was just a few months ago, thanks to the novel coronavirus and the disease it causes, COVID-19. We've been doing our best to deal with these trying times, as I hope you are as well. One thing we've noticed over the last few months is the role of technology in these crazy times, leading myself to often wonder what this kind of crisis would have looked like if even only a decade ago. As we were seeing more and more stories highlighting the amazing ways in which technology has been a huge (sometimes literal) lifesaver, we thought it would be worth launching a new "edition" on our site, focused on the role technology has played during this pandemic.

We're not even entirely sure what sorts of stories we'll see in this section, but the intersection of the pandemic and the technology world is something that is worth exploring. Some of the stories out there about tech and COVID may be more obvious than others (really, how many stories can there be about how much Zoom everyone is using?), but we're going to try to dig a bit deeper, and explore the perhaps more unexpected ways in which technology is playing a role in our everyday lives under lockdown, as well as how technology is changing how businesses operate, and (perhaps most importantly) the role of technology in response to the pandemic itself (mitigating, treating, and -- most hopefully -- curing the disease).

This, like so much of what we do, is an experiment and we're excited to see where it goes. The posts will appear right here on Techdirt, or you can check them out directly (as they are posted) in a new dedicated tab up top.

We're excited that the Charles Koch Institute has agreed to be our launch sponsor for this new section of the site. As its Executive Director, Derek Johnson said: "We are excited to continue our support of Techdirt, especially during this unique moment when we're likely to see significant creative destruction and experimentation with new business models in digital media. Innovation has been a force for good throughout human history, a trend especially evident today. Telling the story of how American individuals and institutions are leveraging digital tools during the coronavirus pandemic will reinforce that, as a society, we remain open to exploring creative applications of technology and ingenuity."

That perfectly sums up our general viewpoint on the importance of innovation in so many different aspects of our life -- and we expect it to be an educational journey to explore exactly how that innovative spirit plays out in helping get us through a massive pandemic.

Filed Under: covid-19, innovation, technology