COVID-19 wasn’t Google Chief Health Officer Dr. Karen DeSalvo’s first crisis. A seasoned public health leader, she worked on the health response in New Orleans following Hurricane Katrina.
During a keynote talk at CB Insights' Future of Health yesterday, she stressed that lessons learned during the hurricane can also be applied to the pandemic today.
“A lot of things that happened to us in 2005 shaped the way I think about healthcare more generally – meeting people where they are, using data to plan for the future about care needs, being more centered around the cultural and neighborhood-based needs to understand the context in which you are serving people, and do it with them and not for them … what [COVID-19] is teaching us in a very similar fashion at scale [are] the same things.”
During Katrina, outreach to patients meant going into the neighborhoods to care for patients, because the brick-and-mortar clinics had flooded or been damaged in the storm. Today, that model looks different, but the premise is similar.
“We need to be able to be flexible enough but prepared to meet people where they are –in this case it’s been digitally through telehealth, telephone services… whatever that is to be there for folks and not expect they’ll come to our brick and mortar. We need to be able to enable a system with digital tools that are lighter and nimble, but will allow us to have individual continuity of care, but also population data, to plan, to understand what is the collateral impact of [COVID-19]?”
DeSalvo took her post at Google in December of 2019 just before the pandemic began to reach large swaths of the globe. When conversations around what sort of tools would be helpful, she thought back to her days in public health in order to help inform the response.
“At the local level in New Orleans where I was health commissioner, one of the big frustrations was that I had surveillance data for chronic disease, or quality of life, or big indicators that were often pretty stale, sometimes a couple of years old, because it takes a while to get packaged. Even in these big-scale CDC-led efforts it just takes a while to have good insights,” she said.
“We were just beginning in public health at that time, this was around 2010, to start thinking about novel signals. How can we use social media or other kinds of data that could be more real-time and inform us about the public’s health and their perceptions or sentiment about the challenges they were having?”
She noted that public health agencies are often underfunded, and the technology at these institutions is subpar at times. However, her current employer, Google had neither of those issues leaving the door open for partnerships.
“So, as we started this journey with public health, I told my peers and colleagues here at Google, 'Look you take for granted a lot of what you understand about the world, and public health has many skills and things to bring to the table. But technology is not one of them. So, let’s be their partner and figure out all the ways that we can have them on that journey.'”
One of Google’s most notable efforts in the public health space, was its contact tracing effort that was created in partnership with Apple. "Exposure Notifications Express" sends device owners in participating states a push notification with the option to opt into the Bluetooth contact tracing system. If users consent, they are enrolled in the feature without the need to download a public health agency-developed app. But the efforts haven’t stopped at contact tracing.
“The rest of it is also about providing data so that public health, and medicine and science can create insights. So, we have … novel signals like search symptoms, or symptom search data, or the community mobility reports, which is about the busyness of retail, or business, or transportation sites. We would have this anonymized data. We worked out a way for it to be privacy promoting, make it available not only in reports… [but present] the data also so that the public health community, the scientific community and medical community could make use of it to make evidence-based decisions.”
Another large part of Google’s COVID-19 response is centered on getting the right information to folks at the right time.
“Google is a consumer company. People come to us for information,” DeSalvo said. “But the opportunity that we had to put authoritative information, done in partnership with the World Health Organization, the CDC [and] the National Health Service in a place where people will naturally go every day – so we don’t have to go to them, they are coming to us by the billions – and we need to make sure we can put out information that will be accessible to them and also point them to more detailed information from public health authorities.”
While we are still in the midst of the pandemic, DeSalvo said there are lessons learned that should be actionable in the future.
“I think we are also learning, and I hope it sticks that It’s not just about physical health. Context matters – where they live, learn, work and play. and their ability to access resources – sometimes we call that the social determinants of health or social health, and then of course mental health,” De Salvo said. “So, this triad – physical, emotion and social health – has become readily apparent to the world that they are all interconnected, because everyone is living it every day.”