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Battling Coronavirus COVID-19, Broadband Could Provide Relief Although Telemedicine May Not Help

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Photo of President Donald Trump, joined by Secretary of Health and Human Services Alex Azar and White House Chief of Staff Mick Mulvaney, listens as Dr. Robert Redfield, Director of the Centers for Disease Control and Prevention, addresses a briefing on the COVID-19 coronavirus on Jan. 29, 2020, in the Situation Room of the White House, by Joyce Boghosian

WASHINGTON, March 6, 2020 – As cases of the novel coronavirus expand in the United States, Americans are struggling to address changes that have, or are coming, to their lifestyle.

Broadband connectivity may be an important factor in confronting the growing pandemic. However, the impact of telemedicine in dealing with the COVID-19 disease may be limited.

COVID-19 is mainly spread through person-to-person contact. As infections continue to spread in the U.S., self-isolation and growing quarantines are becoming more likely. These aspects of isolation could affect large communities of people – and perhaps until a vaccine is available in a year or more.

But in addition to being a test of medical emergency preparedness, the COVID-19 panic may also become a test of broadband access.

Indeed, while the digital divide has been a constant discussion point in Congress and at agencies like the Federal Communications Commission, an outbreak of COVID-19 could expose the harsh realities of entire communities left on the wrong side of internet access.

The impact of broadband upon confronting the COVIP-19 pandemic

Ten years ago, the National Broadband Plan was released. In 2020, many remain unconnected, creating both rural and urban digital divides.

Ironically, universal broadband could facilitate the connection and resources people need to survive and make due during quarantines that may be part of a broader outbreak of the COVID-19 pandemic.

Isolation would impact the ability to work, go to school, go to the doctor, go to church, and participate in everyday activities. Ultimately, broadband is the tool that can allow work from home, online school, telemedicine, and online worship.

While broadband can connect people to work, education and worship, without universal or widespread buildout, broadband only connects some of us.

Global response to person-to-person spread by curtaining public events and worship

The global COVID-19 death count is now more than 3,000, with more than 100,000 infested. Different countries and regions of the globe are taking different approaches to stem the spread.

BBC News reports that “France has banned all indoor gatherings of more than 5,000 people,” and even cancelled the Paris half-marathon.

Italy, the European country taking the brunt of COVID-19 so far, has organized zones depending on the situation of an area, reports Holly Ellyatt for CNBC.

Red zones are quarantined, but the “yellow zones” are engaging in preemptive cautions like closed schools, and “sports events and religious and cultural spaces have been postponed or canceled,” writes Ellyatt.

Steve Holland and Julie Harte, reporting for Sight Magazine, wrote that “churches closed in South Korea as many held online services instead, with authorities looking to rein in public gatherings.”

Tad Walch of the  Deseret News in Salt Lake City, Utah, reporting on global worship, reported that “from Italy to Singapore, congregations affected by the COVID-19 coronavirus outbreak either held virtual fast-and-testimony meetings on YouTube or Zoom or didn’t meet at all.”

Fast-and-testimony meeting refers to a service held the first Sunday of every month in the Church of Jesus Christ of Latter-day Saints. Across several countries, these worship services were either cut short or – in Italy – not held in person at all.

How telecommuting and tele-education are adapting to COVID-19

Rather than gather in large groups and risk the spread of disease, broadband technology is providing worship and connections that allow people to avoid potentially contaminated places.

For some professions, telecommuting could be a viable option to avoid infection.

Twitter announced on its blog that employees should be working from home across the world if feasible.

“We recognize that working from home is not ideal for some job functions. For those employees who prefer or need to come into the offices, they will remain open for business,” said Twitter.

However, Twitter said the company has already “been moving towards a more distributed workforce that’s increasingly remote.”

A Washington state school district cancelled school to “train employees on how to teach children remotely, should the outbreak worsen,” reports Mike Baker and Karen Weise for the New York Times.

But the “homework gap” may be exacerbated because many homes lack access to broadband. What will happen to schoolchildren in their broadband deserts?

“For families without laptops or internet access, the district was working to provide computers and internet hot spots,” report Baker and Weise.

A petition with over 10,000 signatures is calling for the University of Washington to close its campus, write Baker and Weise.

The implications of closing a major university for an extended period of time with over 45,000 students at the Seattle campus are devastating, for students and employees.

The impact of telemedicine upon COVID-19 will likely be more limited

Just as many in South Korea worshiped online rather than physically gather together, telemedicine could – theoretically – limit person-to-person contact, while still facilitating health access.

Using telemedicine, patients with access to broadband can communicate directly with their health professionals from their own home. This means patients do not have to travel to their doctor or risk catching something in the doctor’s waiting room.

Unfortunately, using telehealth to cope with COVID-19 is not so cut and dry, said Craig Settles, a broadband enthusiast and telemedicine expert.

“To do any type of examination for the virus, you need to have a device that allows you to hear the sound of [your] lungs,” said Settles. He said such a Bluetooth-enabled device allowing doctors to listen to a patient’s heart or lung sounds from a remote location does exist, although is not in widespread use.

Telemedicine would be a better option for regular patients once they have already acquired telemedicine equipment that he or she will use more than once, explained Settles.

Global Telemedicine Group President Jay Sanders said telemedicine has many benefits, but conceded that as COVID-19 is a disease that can “impact the lungs,” and patients may need initial assessments completed in a hospital or medical provider’s office.

“It may be very difficult, especially if the individual is complaining of shortness of breath, for a telemedicine physician to be able to make a determination whether this is COVID-19 or just a common upper respiratory infection,” explained Sanders.

The best scenario for telemedicine would be to “keep the patient in their particular location like their home and not out in a crowd” and “monitoring their symptoms,” said Sanders.

Sanders added that “continuous care can easily be provided through telemedicine.”

Assuming that a patient has access to technology and broadband connection, “the ease of use is your smartphone or your computer,” added Sanders.

Kim Almkuist, a family nurse practitioner in North Carolina, said that she currently provides telemedicine, but her community only has access to one Bluetooth-enabled stethoscope, meaning patients have to travel to the nurse who has the device, and then she can provide care from her location. Almkuist uses TytoCare devices.

Almkuist said it wouldn’t realistic for every patient to have the device, which can cost about two to three thousand dollars. However, if more communities had access to telehealth devices or positive, quarantined COVID-19 patients had the equipment, then they could receive quality telemedicine care.

“I do think that there is still a place for telemedicine, especially in a quarantine” situation, said Almkuist.

If you can afford the devices, then telehealth is useful, said Settles. Some states do not have “consumer-friendly telehealth” because “it’s not ensured the same way in every state,” said Settles.

Telemedicine still has not be widely adopted into our healthcare system, so it is not an affordable or practical option still for many people.

If telemedicine was widespread and a viable option in the event of a pandemic, then broadband access would be the first tool to facilitate health and safety.

What are the Centers for Disease Control and Prevention saying about COVID-19?

So far, the CDC has identified three symptoms of COVID-19: fever, cough, shortness of breath.

The CDC has identified various precautions to avoid contamination. Below a few are listed:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

Although the CDC warns that infection could occur from contaminated objects, “this is not thought to be the main way the virus spreads.” Ultimately, person-to-person spread is the main form of infection.

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Health

Providers Call for More FCC Telehealth Funding as Demand Grows

‘I think obtaining funding from the Universal Service Fund would go a long way.’

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Photo of FCC Chairwoman Jessica Rosenworcel

WASHINGTON, July 26, 2022 – Health care providers in parts of America say they are struggling to deliver telehealth due to a lack of broadband connectivity in underserved communities, and recommended there be more funding from the Federal Communications Commission.

While the FCC has a $200-million COVID-19 Telehealth program, which emerged from the Coronavirus Aid, Relief and Economic Security (CARES) Act, some providers say more money is needed as demand for telehealth services increases.

“The need for broadband connectivity in underserved communities exceeds current availability,” said Jennifer Stoll from the Oregon Community Health Information Network.

The OCHIN was one of the largest recipients of the FCC’s Rural Health Care Pilot program in 2009. Stoll advocated for the need for more funding with the non-profit SHLB Coalition during the event last week. Panelists didn’t specify how much more funding is needed.

Stoll noted that moving forward, states need sustainable funding in this sector. “I am hoping Congress will be mindful of telehealth,” said Stoll.

“The need for telehealth and other virtual modalities will continue to grow in rural and underserved communities,” she added.

Brian Scarpelli, senior global policy counsel at ACT, the App Association, echoed the call for FCC funding from the Universal Service Fund, which subsidizes basic telecommunications services to rural areas and low-income Americans. “I think obtaining funding from the Universal Service Fund would go a long way.”

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Artificial Intelligence in Healthcare Has Benefits, But Also Challenges That Must Be Rectified: Experts

The technology needs to be examined to ensure it doesn’t create inequities in healthcare, panel hears.

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Screenshot of the Atlantic event in late June

WASHINGTON, July 11, 2022 – While the use of artificial intelligence in healthcare has been lauded by some, experts said at an Atlantic event late last month they are concerned that inaccurate data can also hamper progress in the field.

Artificial intelligence has been used widely across the medical field to analyze relationships between medical providers and patients to improve equality of care, including providing patient risk identification, diagnostics, drug discovery and development, transcribing medical documents, and remotely treating patients.

Carol Horowitz, founder of the Mt. Sinai Institute of Health and Equity Research, argued that while AI plays a substantial role in diagnosing health problems at earlier stages, diagnosing patients more quickly, providing second opinions in diagnoses, enhancing scheduling abilities, stimulating hospital workflow, and finding drug availability for a patient as in dermatology, therapeutics, or population health, it’s not a golden ticket.

She reasoned that it “can reflect and really exaggerate inequities in our system,” negatively affecting healthcare equity among patients.

She stated that AI tools have led to inaccurate measurements in data that have proved harmful to individuals’ health. Horowitz shared the example of faulty AI technology during March 2020 meant to allow individuals to self-monitor their own oxygen levels as a precautionary method to the COVID-19 pandemic but led to inaccurate pulse readings for those with darker skin, and inaccurate data gathering, resulting in delayed treatment for many in need.

Michael Crawford, associate dean for strategy of outreach and innovation at Howard University, added that if these certain mismeasurements and flaws in the technology are not addressed, “AI could increase disparities in health care.”

Alondra Nelson, head of the White House Office of Science and Technology Policy, said when it comes to assessing AI technology innovation for the future, there are both cost and benefits, but we must find “where can we move forward in ways that don’t harm human society but that maximize human benefits.”

As we grapple with how to implement this technology, “we must do science and technology policy that always has equity at the center” for future innovation, said Nelson.

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States Lagging on Bills to Implement 988 Suicide Hotline Mandate as Deadline Approaches

As of June 7, 20 states have passed legislation to implement the 988 suicide hotline mandate, according to FCC data.

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Screenshot from the FCBA event on June 8

WASHINGTON, June 15, 2022 – Only 20 out of the 35 states that have introduced legislation for a new suicide hotline have made the legislation law as of June 7, according to information from the Federal Communications Commission, as the July 16 implementation deadline nears.

States are required to implement the infrastructure and the funding for a 988 number that will go to the National Suicide Hotline, but only four states have passed bills to finance it, Emily Caditz, attorney advisor of the Wireline Competition Bureau under the FCC, said at a Federal Communication Bar Association event last week. Those states – Colorado, Nevada, Virginia, and Washington – fund the implementation from fees on cellphone lines.

James Wright, chief of crisis center operations at the federal Substance Abuse and Mental Health Services Administration, suggested that “key partnerships between state and local governments” will be necessary to help states meet this deadline.

Laura Evans, director of national and state policy at Vibrant Emotional Health, said this funding will “make sure we have robust capacity for the anticipated 9-12 million contacts we expect to come in that first year.”

The commission ordered the adoption of the nationwide line nearly two years ago, on July 16, 2020.

According to the National Suicide Hotline Designation Act of 2020, “988 is designated as the universal telephone number within the United States for the purpose of the national suicide prevention and mental health crisis hotline system operated through the National Suicide Prevention Lifeline.”

“America’s suicide rate is at its highest since World War II,” said former FCC Chairman Ajit Pai at an FCC event in December of 2019. “A simple three-digit code for a suicide hotline can reduce the mental stigma surrounding mental health and ultimately save lives.

Caditz said the implementation of text messaging “is especially popular with groups that are at heightened risk of suicide or mental health crises, including teenagers and young adults and individuals who are deaf, hard of hearing, deafblind, or speech disabled.”

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