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



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.

Expert Opinion

Craig Settles: And a Little Child Shall Lead Them — Digitally

How many communities are leveraging their teen populations in the pursuit of broadband and digital equity?



The author of this Expert Opinion is Craig Settles, who leads telehealth-broadband integration initiatives.

In 2011 at the MoBroadbandNow Summit in Missouri, I listened to the CIO of the City of Springfield explain why his city included teenagers in important broadband needs assessment and planning meetings. “In your home, who do you call when you’re trying to figure out how to use the VCR?”

His point? Springfield learned a valuable lesson: Teens push the edges of technology, and understand how to use technology better than many adults do. Therefore, it is imperative to include teenagers in the planning of what is and will be their main future technologies. The brain power and the creativity alone will lead to the success of tapping this demographic.

Fast forward to 2023. How many communities are leveraging their teen populations in the pursuit of broadband and digital equity? “Kids want to get a look into the future,” said Kevin Morris in a video. “That’s the thing that drives many of them in school.” Morris talks to many students as the director of college, careers and community services for the Duarte Unified School District.

What about their future in broadband, I wondered, when a friend talked to me about her efforts to recruit internship positions for the K12 Foothill Consortium? Many of the high school students in the Consortium are anxious to intern remotely or in-person near their homes in Southern California. It hit me — take the Springfield model of teen engagement to the rest of America!

Imagine the possibilities for local broadband or digital equity teams, local government and nonprofits if they can channel bright, tech-savvy, energetic, inquisitive teens on a mission to help bring the digital equity solutions to communities. Remote or in person interns can help with focus groups, town halls logistics, preparing and writing newsletters, usability testing and Affordable Connectivity Program enrollments.

The K12 Foothill Consortium is recruiting internship hosts for the June through August period and for at least 60 hours total. Those groups and organizations engaged with broadband and digital inclusion projects get the benefit of interns’ prior training in coding, health care, web design, engineering and other related disciplines. Since interns prefer paid internships, the Consortium also raises money for organizations that may be too cash-strapped to offer a stipend but can offer meaningful internships.

Photo of Career Technical Education students courtesy of the K12 Foothill Consortium

Internship hosts view the relationships as a win-win for everyone involved. Ivan Ayro, director of adult and career technical education at Charter Oak Unified School District, agrees. “Students are able to connect the educational experience they’re getting from Career Technical Education classes with real-life experience from workplace learning. Through the internships, many of our students are able to realize in high school if this is something that they want to do for the rest of their lives.”

A recent US News & World Report article states that, although internships are traditionally for college students, high school students increasingly are participating in them. Benjamin Caldarelli, co-founder of Princeton College Consulting, a New Jersey-based educational consulting company, said, “High school students want to work somewhere that interests them and potentially make what they feel is a more meaningful contribution. They see internships as an enrichment activity and opportunity to make an impact rather than simply trading time for a little money.”

More than 205,000 new jobs will need to be created to complete the Broadband Equity, Access and Deployment expansion plans, many of them skilled workers. “There is a lot of focus placed on building broadband networks, but we cannot build them without a proper workforce,” Fiber Broadband Association CEO Gary Bolton said in a press release. “Failure to ensure the availability of high-skilled labor will result in workforce bottlenecks, which will ultimately lead to higher costs and project delays.”

The National Telecommunications and Information Association is requiring every state to have a five-year workforce development strategy. FBA published a guidebook to help states develop that strategy. Broadband and digital inclusion teams need to pencil in “internships” as part of their plans.

High school broadband and digital inclusion interns may not be considered skilled workers, obviously, but the interns should be considered the beginning levels of workforce development campaigns in every community. Start people thinking about broadband and all things digital in high school and use internships to shape their college or post-high school plans. Don’t forget that Gen Z can be an important part of broadband discussions, even if they’re not interns.

Amy Foell, principal of Amy Foell Consulting LLC, heads the K12 Foothill Consortium for Azusa, Charter Oak, Duarte and Monrovia Unified School Districts’ CTE. Their mission is to educate and train students to provide a community-sourced talent pool to sustain a healthy, balanced, local economy. Foell also supports workforce development programs across the San Gabriel Valley, including Pasadena Unified School District.

“I like to have an initial phone call and 15 to 20 Zoom sessions to ensure prospective internship sites understand the program,” said Foell. “Before we meet, it’s advisable to create a brief description of the internship project — be sure to share the organization’s purpose and mission. We’ll help hosts identify and interview candidates in May to early June, and students can start mid-June.”

Craig Settles conducts needs analyses, planning, and grant assessments with community stakeholders who want broadband networks and telehealth to improve economic development, healthcare, education and local government. This piece is exclusive to Broadband Breakfast.

Broadband Breakfast accepts commentary from informed observers of the broadband scene. Please send pieces to The views expressed in Expert Opinion pieces do not necessarily reflect the views of Broadband Breakfast and Breakfast Media LLC.

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Expert Opinion

Craig Settles: There’s a TAP for That!

Through Telehealth Access Points, we can consider broadband and telehealth as the double-edged sword of digital health.



The author of this Expert Opinion is Craig Settles, who leads telehealth-broadband integration initiatives.

By one estimate, there are over 400,000 healthcare-related apps at the App Store. But what’s a Telehealth Access Point?

TAPs are self-contained spaces that are furnished with an internet connection, a computing device equipped with a camer­­­­a, speaker and microphone, and a dedicated private room or kiosk open to the general public. It is telehealth broken down to its essential elements.

A TAP could be a blessing if a person having a mental health crisis needs a safe place. Rural residents can find TAPs are low-pressure environments to try out telehealth. TAPs at trusted places such as barbershops, hairdressers, or churches are places to go for appointments when people don’t have Internet accounts, laptops or their smart phone is data-capped out.

“The Find Telehealth app located at our webssite is a tool that helps people find TAPs if they need them, and the app will help these established TAPs become better utilized by their communities,” said Jaleen Johnson, program manager for the Northwest Regional Telehealth Resource Center and the Utah Education and Telehealth Network. “TAPs are scalable at many different levels. These typical locations you’ve described would have the basic necessities for a TAP, though some across the region have added features.”

Nicki Perisho, program director for NRTRC, continued, “Currently TAPs are live, but we have been marketing it as only being available in the Northwest Region (Alaska, Washington, Oregon, Montana, Idaho, Wyoming, Utah). Not all the regional TRC’s have the same telehealth mapping functionality. There is another mapping project being utilized by five of the other TRCs that is still in beta testing.”

Location data can be entered by NRTRC, individuals that run the TAPs and individuals independently finding TAPs after NRTRC verifies it. TAPs do not provide medical services, just access to the Internet and a device to connect to a telehealth appointment. There is no charge for that access at this time.

TAPs, strategically speaking

TAPs have a wonderful potential to impact telehealth deployments, especially if communities maximize TAPs’ public health value with a plan, some thought and a little kick-ass marketing strategy.

Every state is working feverishly to produce statewide broadband plans as well as digital inclusion plans by in Fall. Then true craziness begins as local broadband teams start jockeying for millions of federal and state dollars. Public health official and stakeholders need to leverage these planning activities with health needs assessment to determine where TAPs can play.

Poor people are in a crisis of poor health!

Right off the bat there’s a market need for TAPs because 25 percent of U.S. homes do not have internet access, often due to affordability issues. A little research will uncover that those who can’t afford broadband have trouble keeping food on the table, they don’t have insurance or regular doctors, and they have a higher propensity to be chronically sick or unhealthy. Consider broadband and telehealth the double-edged sword of digital health.

Health Affairs, a leading journal of health policy, wrote recently that “Poor adults are five times as likely as those with incomes above 400 percent of the federal poverty level to report being in poor or fair health. Low-income Americans have higher rates of heart disease, diabetes, stroke, and other chronic conditions, compared to higher-income Americans.” TAPs can or should be a part of every digital equity plan.

TAPs are ideal for trusted spaces

In Cleveland, two Urban Kutz barbershops have been screening customers’ blood pressures for 12 years. Owner Waverly Willis said, “I find at least 90 percent of my customers have high blood pressure, and many don’t know about the dangers of hypertension.” Other than the church, there’s not a more trusted place for TAPs to find sanctuary than the barbershop or hairdresser for African Americans.

And speaking of the church, quite a few churches of every domination worked overtime tackling COVID-19 prevention and detection. Often there were lines at the door and down the street for COVID testing and vaccinations. Thematically and logically, churches where you go to heal the sick or better yet, prevent illness and sicknesses in the first place. Move from church TAPs to telehealth in the home.

“The general principle of TAPs fits well with a specific initiative that addresses middle mile and anchor institution priorities, what we’re calling Connectivity Hubs,” said Andrew Butcher, president of the Maine Connectivity Authority. “A perfect example is a library system that will be upgrading a facility for telehealth utilization, device lending and infrastructure upgrades.” It seems logical to integrate public library systems with TAPs.

TAPs are good for the telehealth ecosystem

Digital equity needs an ecosystem that includes telehealth, and TAPs can be part of the picture. Wireless ISP Vistabeam launched their Empowerment Center in Torrington, Wyoming to foster digital inclusion among residents. The Center has a fulltime digital navigator, telehealth tools and capabilities, and remote doctor visits. Community facilities such as the Center can be added to the TAP map.

“It’s interesting to me because I can see TAPs becoming a part of an ecosystem since we recognize that telehealth is a priority,” said Brandon Carson, Executive Director of the Pennsylvania Broadband Development Authority. “We’re investing into a deployment to improve access in areas and we’re looking to future proof of these networks as well. We are developing our programming to account for new innovations like these TAPs.”

Jason Welch, Infiniti Mobile President, said, “By expanding the ecosystem beyond broadband and telehealth providers to also include healthcare organizations themselves, there’s a unique opportunity to educate as well as treat patients.” TAPs, besides giving individuals access to telehealth, can also be health education centers.

It’s time to work plans for TAPs into the fabric of digital inclusion and broadband infrastructure plans. Start your planning with the National Consortium of Telehealth Resource Centers and pick the TRC for your particular state. These centers provide consultation, resources and news at no cost.

Craig Settles conducts needs analyses, planning, and grant assessments with community stakeholders who want broadband networks and telehealth to improve economic development, healthcare, education and local government. This piece is exclusive to Broadband Breakfast.

Broadband Breakfast accepts commentary from informed observers of the broadband scene. Please send pieces to The views expressed in Expert Opinion pieces do not necessarily reflect the views of Broadband Breakfast and Breakfast Media LLC.

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Expert Opinion

Craig Settles: The Role of Telehealth in States’ Broadband Plans

Communities need a strong human element for telehealth to succeed, so digital navigators are key to the team.



The author of this Expert Opinion is Craig Settles, who unites community broadband teams and healthcare stakeholders through telehealth.

Telehealth visits were estimated to account for fewer than 1 percent of all outpatient visits before 2020. Then COVID hit. Telehealth use was off the chain!

U.S. Census Bureau Household Pulse Survey data revealed 22% of the U.S. population used telehealth services in 2022. As the 60s ad said, “You’ve come a long way, baby!” Much of the general public is now familiar with the basic virtual doctor visit.

But are state and local broadband teams on board with using telehealth to drive broadband adoption? Here are three pilot programs that address urban social determinants of health (Chattanooga Tenn.), family mental health delivery (Kansas City, Missouri), and a developing digital equity ecosystem that includes telehealth (Torrington, Wyomin). These pilots offer valuable lessons in driving ACP enrollments.

Much of digital health requires broadband infrastructure and computing devices. “When one looks at healthcare and technologies in the App Store today, there are over 400,000 healthcare-related apps, not to mention content items available on the Web” said Equiva CEO and Co-Founder Nir Altman.

Accepting that telehealth is one logical path to broadband adoption, pilot projects are one method for verify the impact on broadband adoption.

Chattanooga pushes the envelope – again

Chattanooga and their urban broadband network are a booming success story, and they are moving to the next level by distributing 1,000 free telehealth accounts in a pilot to impact the social determinants of health one of most economically blighted area in the city.

Digital equity meeting at the Enterprise Center in Chattanooga

“Our pilot project is bringing a variety of resources to a beautiful but under-resourced neighborhood called Orchard Knob,” said Deb Socia, president and CEO of the Enterprise Center, a nonprofit that works at the intersection of technology and inequality. “The neighborhood has high levels of diabetes, stroke, heart disease, asthma. We’re providing home Internet access, digital skills training, and devices.” Some homes are getting energy upgrades and smart thermostats.”

Many Orchard Knob residents work but not at jobs that offer medical insurance, and they earn too much to qualify for the state’s health programs. It will be difficult for residents to mitigate the negative effects of the without telehealth.

The city-owned electric power board, EPB, is critical to success. EPB was part of planning from the beginning, they contributed funding, they will power the telehealth accounts, and EPB is building out free WiFi in public spaces.

The Enterprise Center received a Tennessee Valley Authority award, and their healthcare partner is the Parkridge Medical System.

Eight steps to the pilot

Essential Families is a 501(c)3 nonprofit that conducted a telehealth pilot in one of the poorest communities in Kansas City, MO with stellar results. They delivered mental healthcare for families and also virtual parent education that enhanced parenting skills.

Their pilot has eight steps, starting with:

Step 1. Developing a database of residents who could potentially use telehealth and broadband. 69 homes participated in the pilot.

Steps 2 and 3. Their Chief of Digital Marketing, Kenneth Yancy, said, “We had to go directly to the people to educate them about FCC’s Affordable Connectivity Program (ACP). Our partners such as the school district and childcare providers were part of the needs analysis process.”

Step 4 When residents registered for the pilot and completed their forms, Essential Families gave them free laptops. The incentive motivated residents to provide data that is difficult for government agencies to collect.

Step 5. Each participant was assigned a digital navigator who walked the family through the processes leading to telehealth services, including enrolling with ACP and training for the video streaming platform, computer, and Internet.

Step 6. A minimum of 15 virtual parental education sessions and six mental healthcare services.

Step 7. An extensive follow up by the additional navigator.

Step 8 The pilot evaluation report that is helped significantly by the electronic and manual tools that execute various real-time assessments, impacts, and cost/benefits analysis.

Rural telehealth

Wireless ISP Vistabeam launched their first Empowerment Center in Torrington, Wyoming. The Center offers ACP enrollment help, digital skills training, video conferencing, and Microsoft delivers digital skill programs.

Matt Larson, owner of Vistabeam

“A fulltime digital navigator is on-site, and we are working with a telehealth company to pilot a home test suite that includes an oximeter, blood pressure monitor, and blood testing,” says Matt Larson, owner of Vistabeam. “The device will be part of the Center’s telehealth capabilities, along with remote doctor visits.”

Rural communities need a strong human element for telehealth to succeed, so digital navigators are key elements of the team. The Center draws people in by emphasizing familiarity, knowledge, no pressure, and exploration.

Larson believes digital equity is just one component of a giant ecosystem of social services to help take care of people. However, there can be a lack of coordination between many of these resources. Effectively coordinating these resources is the way to get maximum collective impact from the ecosystem. The Center staff connects people with complementary social services and other resources.

The quality of broadband infrastructure is key to telehealth success – it cannot fail customers! “The soul of a broadband deployment is in that relationship between an ISP and the customer,” says Larson.

Piloting innovation

Communities need to understand that telehealth is not connections just between doctors and patients. “It’s not up to the patient alone, but also loved ones and care providers in a collaboration that occurs in the care process,” said Altman. “There are many supports groups such as the Cancer Support Community  that supports hundreds of thousands of patients and loved ones.”

The broadband infrastructure supporting telehealth should pilot test these many-to-many connections and resources to be sure they are supported. Pilots should include tools that enables patients, urban and rural activists, and communities to do their own healthcare needs assessment as well.

Jason Welch, Infiniti Mobile president said, “By expanding the ecosystem beyond broadband and telehealth providers to include healthcare organizations themselves, there’s a unique opportunity to educate the patient. ‘Here’s your device and software, and here’s how you maximize the value of their use.’”

If a city’s telehealth pilot is driven by the creation orientation, a community builds or invents things that didn’t exist before. With the creation orientation, you reduce tunnel vision because you’re always pushing the envelope of innovation.

Craig Settles conducts needs analyses, planning, and grant assessments with community stakeholders who want broadband networks and telehealth to improve economic development, healthcare, education and local government. This piece is exclusive to Broadband Breakfast.

Broadband Breakfast accepts commentary from informed observers of the broadband scene. Please send pieces to The views expressed in Expert Opinion pieces do not necessarily reflect the views of Broadband Breakfast and Breakfast Media LLC.

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