WHERE WE’RE AT
As the second decade of the 21st century comes to a close, we find ourselves at the edge of a new reality. The first global pandemic in a hundred years is what brought us here — Covid-19, still killing record numbers of people every day as the first vaccines are being delivered. A year ago we didn’t know it existed. Today it has changed life for every human being on the planet.
And yet in another way — one that rings of poetic justice — Covid is also one of the things that’s pulling us across the chasm into the next world we’ll inhabit. We’ve been staring at that new world of the IoT for at least twenty years as regular readers of Harbor Research will know. Now suddenly it’s starting to come together. We’re bringing it about. Necessity is still the mother of invention, and what human beings can do under duress is always astonishing.
But what we can do is confined to the realm of the doable. There’s nothing magical about our abilities. Arthur C. Clarke is famous for saying “Any sufficiently advanced technology is indistinguishable from magic,” but note the operative phrase: “sufficiently advanced.” Similar to the confined universe of the 64-square chessboard (where AI demonstrated its earliest triumphs), the IoT has brought enormous benefits to the complex (but closed and controlled) realms of the factory floor and the supply chain, and lately even to the wild and wooly (but still rules-bound) arena of the open highway.
By contrast, in most areas of personal human life there has been little real impact on the texture of existence. Particularly in healthcare, the world still functions much as it did a hundred years ago. Listen to Bond Capital’s April, 2020, letter to investors, which is essentially Mary Meeker’s annual Internet Trends Report for this year:
“Our healthcare delivery in the U.S. hasn’t changed as much as you would think since the Spanish Flu outbreak of 1918. Technology and innovation have had little impact on the primary care patient journey. … We are awash in data, but lacking connectivity and insight. … Despite decades of investments in electronic health records, there remain hundreds of dark, unconnected pools of healthcare data. Even when the data are available, providers are overwhelmed by the workload and the sheer volume of the data, and therefore are not getting the benefits you would expect from digitization.”
Bond Capital concludes that the global crisis of COVID-19 may ironically be the impetus the world needed to jolt it out of the late 19th century. The pandemic is a problem “that technology can help solve,” their investor letter states, noting:
“Healthcare is just beginning to embrace the modern data architecture of interoperability and APIs. In the Covid-19 environment, the pressure to connect systems is greater than ever and we expect innovative companies, together with government support, to accelerate connectivity without the intensive integration requirements of past attempts.”
BLUETOOTH CONTACT TRACING
In the very same month that Bond released its letter, a prime example of what they were predicting occurred: Two singular tech giants, Apple and Google, announced a joint effort to help governments and health agencies reduce the spread of Covid-19 by enabling mobile devices to use Bluetooth connectivity for high-tech contact tracing. Dubbed the “Gapple API,” their system allows users of iOS and Android devices to anonymously track their contact with any other people using it. Built with user privacy and security central to its design, it is free, anonymous, voluntary, and completely non-monetizable.
Intended to supplement rather than replace conventional contact tracing, the Gapple API provides clear advantages to people who choose to use it. A person exposed to someone who later reports a positive diagnosis of COVID-19 will be notified almost instantly, rather than going through the convoluted pathways of conventional contact tracing. The system will also enable public health authorities to contact and provide guidance much faster than they could by manual means.
The data is carried only on the devices themselves, not stored by the application or API developers, and all applications using the API are automatically compatible with any others, regardless of developer. It will share only the day the contact occurred, how long it lasted, and the Bluetooth signal strength of that contact, as well as the type of report (such as confirmed by test, clinical diagnosis, or self-report). User identity is not shared with other users, Apple, or Google as part of this process.
One example of its use comes from the Irish enterprise software firm NearForm which initially started producing a centralized app for contract tracing. They quickly pivoted to the Gapple API when it was announced. The resulting Covid Tracker app was immediately downloaded and used by 35% of the Irish population. It was such a success story in Ireland that versions of it are now being used in multiple U.S states, including Pennsylvania, Delaware, New Jersey, and New York. New York State’s app cost $700, 000 to build and deploy, compared to the $22.5M the German government spent to fund the development of its own app, not based on the Gapple API.
GENE-BASED VACCINE TECHNOLOGY
When the pandemic first struck, most observers predicted that development of a vaccine in less than three years would be a miracle, and some commentators doubted that a workable vaccine would ever exist. Previously, the quickest vaccine development program was the four years it took to make the mumps vaccine, which was licensed in 1967.
Today, less than one year after China’s initial notification of Covid-19’s existence, two vaccines have already been approved and distributed to the most vulnerable citizens, with another dozen in the pipeline. How did drugmakers pull off this feat, cutting the typical time from more than 10 years to under one?
The answer (again) is that a global crisis spurred willingness to consider an unproven technology — in this case a “genetic code” vaccine based on synthesizing the virus’s mRNA (“messenger RNA”), the molecular couriers that deliver genetic instructions. Using whole-genome sequencing, the full sequence of Covid-19 was available on January 7, 2020, which is why some headlines have proclaimed “we had the vaccine the whole time.” Once something has been genetically sequenced, responses to it can be designed quite quickly in software because it’s all code. (The chief executive of Germany’s BioNTech, Ugur Sahin, designed 10 candidates himself in a single day, on January 25, 2020.)
Though done in desperation at lightning speed, this moon-shot approach to conquering Covid-19 with unproven technology will unquestionably lead to a new era in medicine, providing long sought-after treatments for cancer, heart disease and other infectious diseases.
IOT SENSING AND BLOCKCHAIN MANAGEMENT
Genetic code technology, combined with accelerated testing protocols, gave us usable vaccines in record time, but they would have been worthless without manufacturing and supply chains to get it to the people of the world. Pfizer, one of the winners (with BioNTech) in the race to produce a Covid-19 vaccine), didn’t have the equipment to make an mRNA vaccine, which required a new and different manufacturing process.
Pfizer ended up spending more than $2 billion of its own money to buy and design the necessary equipment. They also had to make innumerable crash decisions, such as manufacturing the mRNA in disposable bags rather than in giant steel tanks to shave months off the process.
Another key decision, documented in the Wall Street Journal, came when “Pfizer wasn’t sure how long doses would last in a refrigerator before expiring, and the company didn’t have time to conduct studies to figure it out. Manufacturing staff decided to play it safe and ship the supplies at subarctic temperatures.” This is how the shipping and storage requirement of -70 degrees Fahrenheit came to be set for Pfizer’s vaccine.
In fact, all the vaccine candidates, from all companies, need to be shipped and stored cold, though not all require the ultra-cold of Pfizer’s vaccine. The temperature and shelf-life requirements, combined with the reality of massive global dosing, demand state-of-the-art blockchain-based supply chain management and real-time logistics, along with IoT solutions such as real-time temperature monitoring and asset tracking.
Much like the genetic code of the pathbreaking vaccines themselves, the use of blockchain and connected IoT data-sensors in an emergency global exercise will provide both a global proof-of-concept for these technologies as well as a hoist up to the next level of development.
The key drivers for blockchain adoption in the supply chain are increased cost savings, enhanced traceability, and greater transparency. The enterprise world is rapidly adopting blockchain strategies, with Walmart as a prime example. Because an exact copy of the ledger is created at every node in the network, with every addition validated by every node, implementation of blockchain in the COVID-19 vaccine supply chain will ensure a transparent view at every level. The use of blockchain also ensures authentication of healthcare workers’ identities, maintenance of patient records, and tracking of treatment aftereffects.
IoT integration will include the use of connected vehicles for tracking, as well as sensors embedded in vaccine cooling pallets to collect, analyze, and transmit data on light, humidity, and temperature. Temperature sensors like those from Timestrip, and tracking devices like FedEx’s new SenseAware ID, are examples of products that create real-time logistics for life-saving pharmaceuticals. Further, IoT devices can be synchronized with blockchain. Examples of this include scannable barcodes that send data to a blockchain in the cloud, or crypto seals that combine NFC chips with blockchain to track and secure the distribution of a shipment.
BACK AT THE RANCH, AIR FREIGHT IS LOSING ITS MOJO
As we describe what sounds like a budding love affair between digital innovation and the physical world, let’s remember what happens in most love stories. Romeo and Juliet were in love; their families wouldn’t let it happen. Alas, this is often the scenario with corporations and new technology.
The air cargo industry, for example, expects to play a key role in the cold-chain transport of billions of doses of COVID-19 vaccines. The problem is that it has inadequate infrastructure for both transportation and storage of something that delicate. According to the Air Transport Association, losses associated with temperature excursions in healthcare are a staggering USD $35 billion. For this reason, air freight is consistently losing market share to ocean freight:
At present in the air freight industry:
· 25% of vaccines reach their destination degraded because of incorrect shipping
· 30% of scrapped pharmaceuticals can be attributed to logistics issues alone
· 20% of temperature-sensitive products are damaged during transport due to a broken cold chain
Unless industry partners take steps to ensure quality service, air transportation may not be the choice of Covid-19 vaccine producers.
COMPARED TO WHAT’S COMING, COVID-19 IS NOTHING
The media will sometimes admit that the effects of Covid-19 will be with us for years. But “years” is an eyeblink. Eventually, the severe health impacts of Covid-19 will be stemmed by the vaccines, treatments, and delivery solutions that human ingenuity is finding ways to produce. And yet this particular virus is one of many that can leap from animals to humans. Our meat-producing industry plays a key role in that danger, but you rarely hear that discussed in mass media. Ditto for meat’s deep connection to climate change — something that could be addressed by new technologies like lab-grown meat.
Generation Investment Management’s Sustainability Trends Report 2020 captures the present moment this way: “There is no vaccine for the climate crisis. Addressing racial, gender, LGBTQ and economic inequality likewise requires both urgent and sustained actions across multiple fronts. … It feels as if the ground is shifting. Could the world be at an ‘Earthrise’ moment?”
We can’t take up that raft of social ills here, but let’s give a moment to climate change (aka “planetary heating”) because that’s the one that will destroy life as we know it the soonest, for people already living today. Consider three charts, starting with this:
Global land and ocean temperature anomalies, 1880–2020
(Relative to base period 1901–2000, downloaded 12/29/20)
Number of catastrophic events, global, 1980–2019
And finally this:
Emissions trends required for a 1.5°C pathway, 1990–2030
The only conclusion you can reach is painfully obvious: Keeping the effects of this catastrophe to a livable minimum — which will still put much inhabited land under water, create hordes of climate refugees, and kill innumerable innocent animals — would literally require us to bring the reality we currently live in to a complete halt right now.
Just as obviously, that isn’t going to happen. So where does that leave us? Where is our famous ray of hope and inspiration? What sudden magical awakening might come over humanity and lead to the social and technological force of will we need to save ourselves from certain doom?
We don’t know the answer to that question. But we’ve often said that corporations don’t exist to make money. They exist to make money by solving problems. And boy, we have no shortage of those. If our corporate leaders would join together in a Manhattan Project-like joint effort to acknowledge and address our biggest problems instead of putting their heads in the sand, not only might we escape our dreadful, self-inflicted fate, but the mountains of money they would make would literally be endless.
Bond Capital’s aforementioned investor letter, written in the early days of Covid-19, puts it as mildly and politely as possible: “None of what we are going through is comfortable, or fair. And while things will likely get worse before they get better, has America, perhaps, just gotten the wake-up call it needed to get to a better place?”