This week will be remembered by the exciting announcement of the new Pfizer Covid-19 vaccine with a more than 90 percent efficacy.
This week will be remembered by the exciting announcement of the new Pfizer Covid-19 vaccine with a more than 90 percent efficacy.

Tech News: Life-changing medical technologies

By Opinion Time of article published Nov 13, 2020

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CAPE TOWN – Just imagine a world where we have eventually managed to significantly reduce our carbon emissions, where planes fly with electric motors and cars run on electricity of green hydrogen. A world where hereditary genetic diseases are totally eradicated and where doctors can diagnose most diseases early and accurately before treating them very efficiently with highly personalised medicine. A world where our physical world is seamlessly enhanced and augmented by a digital world.

This world will soon be technically possible. During the past number of years as the Fourth Industrial Revolution (4IR) progressed, we have seen an unparalleled rate of technological innovation in a variety of fields, from quantum computing, artificial intelligence and robotics to biotechnology, genomics, materials sciences, and nanotechnology. Many of these innovative technologies have the potential to solve our most challenging global problems.

Despite the difficult Covid-19 circumstances in 2020, some very exciting technologies have made significant progress during this time. Technological innovations have always played an important role in changing how we work, communicate and live. These technologies thus have a great potential to positively transform society and industry in the years to come.

In a special report, “Top 10 Emerging Technologies of 2020,” published on Tuesday 10 November 2020 by The World Economic Forum, leading experts discuss emerging technologies that have the potential to disrupt industry and society. Most of the technologies that are discussed offer solutions to two important issues, namely global health and climate change and is believed to be novel and will have a major impact within the coming three to five years.

Painless microneedle injections

Microneedles attached to a syringe or a patch are normally 50 to 2 000 microns in length (about the depth of a sheet of paper) and 1 to 100 microns wide (about the width of a human hair) and thus only penetrate the epidermis. They therefore prevent pain by avoiding contact with the nerve endings in the underlying dermis.

Microneedles are already used for the administration of vaccines and are being tested for the treatment of diabetes, cancer and neuropathic pain. In 2020 researchers introduced a new technique for the treatment of skin disorders such as psoriasis, warts and certain categories of cancer. The microneedles perforate the skin and thus enhances the passage of the therapeutic agent, while traditional transdermal patches struggle with diffusion through the skin.

Microneedles are also being commercialised for painless blood or interstitial fluid drawing. The tiny holes made by the needles result in a change in pressure that forces blood or interstitial fluid into a collection device. When the needles are connected to biosensors, certain biological markers indicate the health or disease status within minutes, such as glucose, cholesterol, alcohol, drug by-products or immune cells. The approved TAP blood collection device from Seventh Sense Biosystems enables ordinary people to collect a small sample of blood for self-monitoring or to send to a pathology lab.

The microneedles can also be integrated with wireless communication devices to deliver a precise drug dose in personalised medicine. The wonderful news is that microneedles are very affordable. Micron Biomedical developed a bandage-sized patch that can be applied by any person, while Vaxxas developed a microneedle vaccine patch that uses a fraction of the usual dose.

Due to these very tiny needles, the future will definitely entail fewer trips to pathology labs and more drug delivery and diagnostics through patches.

Virtual patients for medical trials

This week will be remembered by the exciting announcement of the new Pfizer Covid-19 vaccine with a more than 90 percent efficacy. Despite Operation Warp Speed and efforts to rush a vaccine to the market, the clinical trials of Pfizer’s vaccine took several months and is not even fully concluded. The problem is that clinical trials cannot be rushed and take time since it is driven by science principles.

But what if real people could be replaced by virtual humans in some stages of the Covid-19 vaccine trial? Besides being more cost effective, this can tremendously speed up the development of the vaccine and thus save the lives of many people subjected to the pandemic.

In the future “in silico medicine”, or the testing of drugs and treatments on virtual patients, will be used for quick and inexpensive first assessments of safety and efficacy, while real patients will be used in late-stage trials. In silico trials are already a reality and computer simulations instead of human trials are being used in the USA by the Food and Drug Administration (FDA) for assessing new mammography systems.

In silico medicine can also mitigate the risks when risky interventions are required for diagnosing or treatment of specific illnesses. A good example is HeartFlow Analysis, a cloud-based service that enables clinicians to identify coronary artery disease based on computerised tomography (CT) images of a patient’s heart. Based on the images, the HeartFlow system build a fluid dynamic model of blood running through the coronary blood vessels, clearly indicating any abnormal conditions, as well as their severity. This technology is much less invasive than the traditional angiogram.

Digital models are also used to personalise therapy for several medical conditions, such as diabetes care. Although the reliability of this technology must still be confirmed, and the mathematical models and Artificial Intelligence (AI) must be refined, the speed, cost-effectiveness and value of in silico medicine is already evident. In future the development of a vaccine for a pandemic may be much faster.

Digital medicine and apps

We live in a world where apps are playing an increasingly important role in our daily lives. It is therefore understandable that apps will also be integrated in the medical world. It could just be possible that in future the prescription from our doctor could be an app.

Several apps are available in the market or being developed that can detect or monitor physical and mental disorders autonomously and directly administer therapies. These apps, known as “digital medicines”, is of particular value for the support of patients when access to healthcare is rather limited as during the Covid-19 pandemic.

Mobile devices monitor users’ voices, facial expressions, exercise, sleep, heart rate, and stress levels and apply AI to indicate the possible onset or aggravation of a condition. A typical example is some smart watches that contain a sensor to detect atrial fibrillation (a dangerous, irregular and rapid heart rhythm). Similar tools are available to detect breathing disorders, depression, Parkinson’s, Alzheimer’s, and autism.

Micro bioelectronic detection devices are also available in the form of ingestible tablets with sensors that can detect cancerous DNA, gases emitted by gut microbes, ulcer bleeds, body temperature and oxygen saturation. The sensors constantly relay the data to apps for recording and interpretation.

Therapeutic apps are also becoming more popular such as Pear Therapeutics’ reSET technology for substance misuse disorder that provides 24/7 cognitive behavioural therapy (CBT) and gives clinicians real-time data on their patients’ cravings and triggers. Another app that treats insomnia is called Somryst, while EndeavorRX is therapeutic app in the form of a video game for the treatment of Attention Deficit Hyperactivity Disorder (ADHD).

Odin designed a virtual reality app to treat amblyopia (lazy eye) in early childhood. People alerted by a smart watch that they may be suffering from mild depression based on changes in their speech and socialising patterns could use Woebot, a chatbot for CBT counselling.

Covid-19 promoted the development and wide use of digital medicine. As the pandemic was spreading, numerous apps for the detection of depression and provision of counselling were created. Many hospitals, institutions and government agencies over the world implemented variants of Microsoft’s Healthcare Bot service to enable people with possible Covid-19 symptoms to chat with a bot.

Using natural language processing to determine the symptoms experienced by the person and AI analyses, possible causes are stated or alternatively a telemedicine session with a doctor is automatically initiated. Billions of inquiries were handled by the bots, greatly reducing the strain on health systems.

Although digital phenotyping or detection and therapeutic apps will not replace a doctor any time soon, it could save healthcare costs by flagging unhealthy behaviours and helping people to change risky behaviour.

The three discussed medical technologies are not currently widely used, but certainly have a great potential to positively transform the medical industry and personal healthcare in the years to come.

Prof Louis C H Fourie | Futurist and Technology Strategist

BUSINESS REPORT

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