From making their own swabs to staying in constant communication across the board, Northwell Health dove headfirst into uncharted waters to take on the virus and save lives.
- Preparing for a pandemic like COVID-19 was virtually impossible. Northwell Health president and CEO Michael Dowling explains how, as the largest healthcare provider in New York, his team had to continuously organize, innovate, and readjust to dangerous and unpredictable conditions in a way that guaranteed safety for the staff and the best treatment for over 128,000 coronavirus patients.
- From making their own supplies when they ran out, to coordinating with government at every level and making sense of new statistics and protocols, Northwell focused on strengthening internal and external communication to keep the ship from sinking.
- "There was no such thing as putting up the white flag," Dowling says of meeting the pandemic head on and reassuring his front line staff that they would be safe and have all the resources they needed to beat the virus. "It's amazing how innovative you can be in a crisis."
The Defense Advanced Research Projects Agency (DARPA) recently issued $8 million in follow-up funding to a team of neuroengineers developing brain-to-brain and brain-to-machine technology.
- Brain-to-machine interfaces have existed for years, but wireless and non-invasive interfaces aren't yet precise enough to be useful in real-world applications.
- In experiments on insects, a team at Rice University has successfully used light and magnetic fields to both read and write brain activity.
- The team hopes to use the technology to restore vision to the blind, while DARPA hopes to use brain-machine interfaces on the battlefield.
Insects that have been injected with nanoparticles
Credit: Rice University<p><br></p><p style="margin-left: 20px;">"We spent the last year trying to see if the physics works, if we could actually transmit enough information through a skull to detect and stimulate activity in brain cells grown in a dish," Jacob Robinson, lead investigator on the MOANA Project at Rice University, <a href="https://www.houstonchronicle.com/news/houston-texas/houston/article/In-4-years-humans-could-don-magnetic-helmets-14432577.php" target="_blank">told</a> the university's Office of Public Affairs.</p><p style="margin-left: 20px;">"What we've shown is that there is promise. With the little bit of light that we are able to collect through the skull, we were able to reconstruct the activity of cells that were grown in the lab. Similarly, we showed we could stimulate lab-grown cells in a very precise way with magnetic fields and magnetic nanoparticles."</p><p>If rodent experiments prove successful, the team plans to conduct trials on blind patients, who would be injected with nanoparticles. Using ultrasound waves, the researchers would guide the nanoparticles to the brain's visual cortex. </p><p>There, the nanoparticles would be stimulated to activate specific neurons, which could potentially restore partial vision to the patients. For example, blind people may someday wear a camera that transmits visual data through the interface and enables them to see what the camera is looking at. </p>
Brain-machine interfaces in the battlefield<p>But while restoring vision to the blind is the near-term goal, DARPA has additional applications in mind. The MOANA Project is part of the agency's Next-Generation Nonsurgical Neurotechnology (N3) program, <a href="https://www.darpa.mil/news-events/2018-03-16" target="_blank">first announced in March 2018</a>. The Rice University team and others have been working with DARPA to develop noninvasive brain-machine interfaces that soldiers may someday use to, say, control drones in the battlefield.</p><p style="margin-left: 20px;">"If N3 is successful, we'll end up with wearable neural interface systems that can communicate with the brain from a range of just a few millimeters, moving neurotechnology beyond the clinic and into practical use for national security," Al Emondi, the N3 program manager, said in a <a href="https://www.darpa.mil/news-events/2019-05-20" target="_blank">statement</a>.</p><p style="margin-left: 20px;">"Just as service members put on protective and tactical gear in preparation for a mission, in the future they might put on a headset containing a neural interface, use the technology however it's needed, then put the tool aside when the mission is complete."</p><p>If the human trials prove successful, it could greatly accelerate the development and adoption of brain-machine and brain-to-brain interfaces. After all, even if other types of brain-machine interfaces are effective, it's likely that many people won't want to have a device implanted into their skull.</p><p style="margin-left: 20px;">"That's the big idea, this non-surgical interface," Robinson said. </p>
NASA is scrapping its Apollo-era launcher platform to make room for new infrastructure that will support upcoming Artemis missions.
- NASA's Mobile Launcher Platform-2 supported the launches of historic Apollo missions, including two crewed missions to the Moon.
- The space agency is in the process of deconstructing the platform to make space for its new Space Launch System (SLS).
- NASA's Artemis program aims to launch three missions, including a crewed mission to the lunar surface in 2024.
A new era for NASA<p>The Artemis program aims to land the first woman and the next man on the moon by 2024, and after that a voyage to Mars. While it's unclear whether President Joe Biden will change the timelines of the program, the overall goal is to establish a moon base from which astronauts can conduct long-term research and experiments. </p><p style="margin-left: 20px;">"After 20 years of continuously living in low-Earth orbit, we're now ready for the next great challenge of space exploration — the development of a sustained presence on and around the moon," former NASA Administrator Jim Bridenstine <u><a href="https://www.nasa.gov/feature/nasa-outlines-lunar-surface-sustainability-concept" target="_blank" rel="noopener noreferrer">said in a statement</a>.</u> "For years to come, Artemis will serve as our North Star as we continue to work toward even greater exploration of the moon, where we will demonstrate key elements needed for the first human mission to Mars."</p><p>In November 2021, NASA plans to launch Artemis 1, which will be the first flight using SLS and Orion. The mission aims to send the Orion spacecraft, uncrewed, to orbit the moon. In 2023, Artemis 2 aims to send a crewed mission to fly by the Moon, while Artemis 3 plans to put American astronauts on the lunar surface for the first time since 1972.</p>
Can biomaterials help finally thrust perovskite solar cells to mainstream adoption?
- Perovskite solar cells are an emerging type of solar technology that's more efficient than current photovoltaic technologies, but hasn't yet been adopted due to problems related to cost and stability.
- In a recent study, scientists treated perovskite solar cells with small amounts of capsaicin, finding that the compound improved both stability and efficiency.
- In 2022, a British startup plans to bring perovskite solar cells to market for the first time.
Using biomaterials to boost solar technology<p><br>The team needs to conduct more research to determine exactly why capsaicin boosts the efficacy and stability of perovskite solar cells, but they hypothesized that the compound increases the density of electrons on the perovskite film due to the way it interacts with lead ions in the solar cell.</p><p>Biomaterials like capsaicin could someday make perovskite solar cells economically viable, but the techniques still need to be improved.</p><p style="margin-left: 20px;">"In the future, green and sustainable forest-based biomaterial additive technology will be a clear trend in non-toxic lead-free perovskite materials," Qinye Bao, a senior author of the study from East China Normal University, said in a <a href="https://www.eurekalert.org/pub_releases/2021-01/cp-tct010721.php" target="_blank" rel="noopener noreferrer">statement</a>. "We hope this will eventually yield a fully green perovskite solar cell for a clean energy source."</p><p>The recent study isn't the first time scientists have used biomaterials to boost the performance of perovskite solar cells: <a href="https://www.osa-opn.org/home/newsroom/2019/april/a_caffeine_boost_for_perovskite_solar_cells/" target="_blank">Caffeine</a> and the protein <a href="https://optics.org/news/10/10/40" target="_blank">bacteriorhodopsin (bR)</a> have also shown benefits. The main appeal of biomaterials is that they're abundant in the environment, so they're relatively cheap and easy to obtain compared to synthetic materials.</p>
The future of perovskite solar cells<p>Since perovskite absorbers were first used in solar cells in 2006, efficiency rates have climbed from just 3 percent to over 25 percent. Research also suggests that pairing perovskite solar cells with silicon could boost efficiency levels to nearly <a href="https://newatlas.com/energy/tandem-silicon-perovskite-solar-cells-record-efficiency/?itm_source=newatlas&itm_medium=article-body" target="_blank" rel="noopener noreferrer">30 percent</a>.</p><p>Joe Berry, a senior scientist at the U.S. National Renewable Energy Laboratory, <a href="https://youtu.be/9PhovLOOtfM" target="_blank">said</a>:</p><p style="margin-left: 20px;">"The potential impact for perovskite solar cells is basically transformational," he said, adding that the long term goal is to cut manufacturing costs and make them ubiquitous. "That is to say, you can put them everywhere. You can literally paint them on the side of a building and everything then become something that can produce electricity and power."</p>
The federal government and private insurers greatly increased Americans' telehealth access during the pandemic. Will these changes be permanent?
- When telehealth visits began skyrocketing after the pandemic began, hospitals had to increase their number of virtual appointments by magnitudes. Most did it seamlessly.
- Big Think spoke to Dr. Martin Doerfler, senior vice president of clinical strategy and development at Northwell Health, about this transition and how it benefited patients.
- Telehealth has proven its value during the pandemic, but it might stop evolving unless the federal government redesigns the regulatory framework so that insurers cover it and patients can afford it.
What are the obstacles facing telehealth?<p>One of the biggest obstacles to widespread adoption of telehealth has been a lack of national legislation providing financial incentive for health centers to adopt it.</p><p>States laws vary on how practitioners are paid for telehealth visits. In some states, laws require insurance providers to cover telehealth visits at parity—at the same rate as in-person visits. But in states without parity laws, there's little incentive for health care organizations to invest in telehealth infrastructure and training.</p><p>Access is also a major obstacle. The Centers for Medicare and Medicaid Services (CMS) generally reimburse practitioners for telehealth visits only when patients live in "designated rural underserved areas."</p><p>But not all underserved areas are in small, remote places. After all, a single parent living in Brooklyn, New York, might also have trouble accessing quality health care.</p><p>"Three hours to drive 200 miles is no different than three hours to take two trains, two buses and a cab," Doerfler said. "So access is almost certainly going to be improved by the greater availability of telehealth in that direct-to-patient, in-their-home-or-office, setting."</p><p>Lack of internet access is also a problem. A <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768771?appId=scweb" target="_blank" rel="noopener noreferrer">paper</a> published by the JAMA Network in August found that 41 percent of Medicare beneficiaries don't have a computer at home with access to high-speed internet, and roughly the same number don't have a smartphone with an unlimited data plan.</p>
What is the future of telehealth?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDU1NTU1Ni9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NjA1MjkxMH0.1UuR6tky1k58rOeE9Vcgt8bUfhA2vut6yaCAXik1MEY/img.jpg?width=980" id="9f55b" class="rm-shortcode" data-rm-shortcode-id="4549f30a0347a85c7145690870cf742c" data-rm-shortcode-name="rebelmouse-image" alt="Caucasian female doctor delivering telemedicine consultation to a patient" data-width="5600" data-height="3150" />
Credit: Daniilvolkov via AdobeStock<p>Lawmakers in both parties and health care professionals have indicated a desire to make permanent some of the regulatory changes to telehealth enacted during the pandemic. That's key, because without the financial incentives to continue expanding telehealth, health care providers may revert to the pre-pandemic approach.</p><p>"One issue, which is important for health care and non-health-care folks to know, is that telehealth will continue to expand dramatically as long as there's funding and reimbursement for it," said Michael Dowling, Northwell's president and CEO. "If the insurance companies and government decide, 'We don't want to pay for telehealth going forward or virtual visits,' then it's going to slow down. If there is no delivery system, no health care system, hospital, or doctor is going to continue to expand telehealth if they don't get reimbursed for it."</p><p>Yet some of the nation's biggest insurers have already stopped waiving telehealth deductibles and copays for some customers, even though there's no clear end in sight for the pandemic.</p><p>The long-term solution, Doerfler said, is for CMS to start paying for telehealth services, a<a target="_blank" rel="noopener noreferrer"></a><a target="_blank" rel="noopener noreferrer"></a><a target="_blank" rel="noopener noreferrer"></a><a target="_blank" rel="noopener noreferrer"></a><a target="_blank" rel="noopener noreferrer"></a>t parity, up and down the chain, and passing federal legislation that requires <a href="https://www.siia.org/i4a/pages/Index.cfm?pageID=4546#:~:text=What%20is%20a%20self%2Dinsured%20health%20plan%3F&text=A%20self%2Dinsured%20group%20health,care%20benefits%20to%20its%20employees." target="_blank">self-insured health care plans</a> to pay for telehealth services as they would in-person visits.</p><p>Telehealth is proven to work for urgent care, primary care and some specialty care, and it clearly expands access to behavioral health care, according to Doerfler. "Some have said that costs of providing telehealth are lower than face-to-face care, but most of the costs are unchanged, and new ones are added with technology requirements. When the patient receives a very specific service there are billing codes used to define that service. If the service is less, the code represents that. If the service is the same, the code will represent that and needs to be paid at parity."</p><p>Doerfler added that, while telehealth can't replace all traditional health care services, it should be "<a href="https://www.northwell.edu/news/insights/how-to-have-an-effective-telehealth-visit" target="_blank">in the toolbox</a>" for patients and physicians.</p><p>"In the modern world, where this type of technology is being used for all sorts of personal and business uses, excluding something as personal as your care between you and your doctor from fitting into that modern paradigm makes no sense," Doerfler said.</p>