The robot arrived at Christine Kiernan, an orthopedic surgeon at Tullamore Hospital in Ireland, just a few days after COVID-19 was diagnosed. She had arranged for Violet, an autonomous UV cleaning machine, to begin trials at Tullamore to help the hospital adjust to the shortage of personnel caused by the pandemic. But on the first working day of Violet, Kiernan was already in bed.
"It was terrible, I'm not going to lie," Kiernan, who has since fully recovered from the illness, told The Verge. "Fortunately, I wasn't critically uncomfortable, but you feel like crap for weeks. Your energy is gone. And I have two children, babies really, and there is no social distance that can be made from a one-year-old and a two-year-old."
Robots help to reduce the burden of staff shortages and strict cleaning regulations
Aside from the unfortunate timing of her diagnosis, Kiernan's experience with Violet was a kind of revelation. Like many healthcare workers around the world, the arrival of COVID-19 has made their work significantly more difficult. The normal hustle and bustle of hospital life was supplemented by new complications: lack of personnel, requirements for personal protective equipment and strict cleaning measures to keep the virus at bay.
But machines like Violet, says Kiernan, helped with these problems and proved themselves in times of crisis. And like other doctors The Verge spoke to, Kiernan says the robots should stay after the pandemic is over.
"The reaction of the employees and everyone who really saw it was so positive," says Kiernan of Violet. "They love that we are interested in technology, but also that the results achieved go beyond what we can do manually." We protect the staff, we protect the patients and we protect the cleaning staff. "
Violet is the foundation of Akara Robotics, a Dublin-based company that builds robots that provide social support in nursing homes. When the pandemic broke out, the company began adapting an open source machine called TurtleBot to work as a mobile disinfection unit with ultraviolet light. And in just 24 hours, it had created a working prototype for testing in hospitals like Tullamore.
Like all UV cleaning robots, Violet is essentially a giant light bulb on wheels. It whirls around and emits ultraviolet light that is strong enough to cut the genetic material in viruses apart. UV light is known to be effective against many coronaviruses, and studies suggest that it works equally well with SARS-CoV-2, the new strain of coronavirus responsible for the current pandemic. As a result, autonomous UV cleaning machines have been used not only in hospitals, but also in a variety of high traffic areas where infection poses a risk, including airports, hotels and food banks.
Ultraviolet light cuts the genetic material apart in viruses
These machines have become the avant-garde of pandemic automation, and the sale of UV cleaning robots has been booming in recent months. A U.S. robotics company, Xenex, tells The Verge that sales of UV cleaning robots have increased 600 percent compared to 2019. "We started increasing production in December when we heard reports from international colleagues about developments in China," said Morris Miller, Xenex CEO, told The Verge via email. "We have seen an increase in healthcare orders."
In Tullamore, Violet sterilized the hospital's CT scan room, a key link in the chain of coronavirus treatment. As a relatively small hospital with 250 beds, Tullamore only has two CT scanners. Since these scans are one of the most effective methods of diagnosing COVID-19, it is important that the device is always ready for use. Fast cleaning is therefore a must.
Violet uses ultraviolet light to kill viruses on potentially infectious surfaces.
Picture: Akara Robotics
According to Kiernan, it takes an hour for human cleaners to thoroughly disinfect the CT scan room and wipes the equipment and surfaces. When the pandemic broke out and the room had to be cleaned after each use, "one machine that used to be able to perform 30 scans a day is reduced to seven."
In comparison, violet can clean the room in just 15 minutes. It uses Machine Vision, which is powered by Intel's Movidius AI chips, to map and navigate the environment. As Kiernan notes, people still have to "wipe the nooks and crannies the robot can't reach, like behind the door handles". By reducing cleaning times from 1 hour to 15 minutes, the hospital's capacity for CT scans increases fourfold.
This kind of extra headroom, which at the same time reduces the risk for human cleaners, is too good to ignore, Kiernan says. Tullamore is now extending its trials with violet to cover more rooms within the hospital.
No hands, no brains, just a light bulb on wheels that emits deadly light: UV robots undoubtedly show how limited the automation of healthcare is at the moment. Machines that can actually look after patients and people are still a science fiction dream, doctors say, but there is one simple feature that makes robots well-suited to work during a pandemic: their immunity.
Machines do not cough, sneeze, or shake hands so that they cannot actively spread the coronavirus in a hospital. This means that in addition to UV cleaning, most of the work helps to minimize contact between potentially infectious people. Since the pandemic, we've seen robots deliver food and medication to isolated patients, carry test samples for diagnosis, and act as receptionists.
At the Belgian university hospital in Antwerp, for example, robots have taken positions on the literal front of the healthcare system. Patients arriving at the hospital suspected of having COVID-19 are greeted by a child-friendly robot with blunt arms and a spherical upper body.
At Antwerp University Hospital, robots are used to examine potentially infectious patients arriving at the facility.
Image: Kenzo Tribouillard / AFP via Getty Images
The robot is manufactured by the Chinese company Ubtech, although it is programmed and resold by the Belgian company Zorabots. A camera on top of the device checks the temperature of each visitor and makes sure that they are wearing a mask (and asks them to go away and get one if not). Then a QR code is scanned that was generated by a questionnaire that patients have to fill out before entering the hospital. It assesses whether this is a high-risk case and the robot forwards it to the appropriate ward in the hospital.
The robot started trials in Antwerp in May when the cases of coronavirus increased in Belgium, says Michael Vanmechelen, who managed the operating rooms in the hospital and oversaw the integration of the machines. However, according to Vanmechelen, the machines have actually become more useful after the hospital has resumed normal operation and the number of staff available to treat incoming patients has decreased.
The machine didn't start immediately, he says. Initially, the camera used to scan the patient's QR codes was too slow, which frustrated people and caused more problems for human staff. But a quick hardware upgrade later, and he says that the robot receptionists are now working like a dream, helping to guide patients without exposing COVID-19 to human personnel.
"It works every day from now on," Vanmechelen told The Verge. He says the bots are "magnetic" and pull people directly towards them to take them to the actual hospital. “People are very attracted to it. It's really a bit of magic. "
This sense of robotic wonder has come in handy at Phoenix Children's’s Hospital in Arizona, where OhmniLabs-built telepresence bots have been used to entertain children locked in their rooms because of the pandemic. A number of hospitals use telepresence robots (mostly iPads on wheels) so doctors can see patients without risk of infection. But in Phoenix, the robots help young patients get around.
With the telepresence robots, children could take trips outside the hospital to places like fire stations. participate in the hospital's short-circuit television channel, which broadcasts live game shows and quizzes to patient rooms; and to accommodate visitors like family members, local sports stars, and even a cartoonist who used the telepresence bots to sketch the children from a distance and then send their portraits to the hospital for printing.
The Phoenix Children's Hospital uses telepresence robots so that special visitors can spend time with children on the ward.
Image: Phoenix Children's Hospital
Having a physical avatar for these visits makes a huge psychological difference, employees say to The Verge. If there is a robot that can be controlled remotely instead of making a simple Skype call on a tablet, the children will feel more connected to the outside world.
"They were a surprising asset during that time," Matt Bryson, who maintains electronic equipment for the children's ward at Phoenix Children's Hospital, told The Verge. "If we didn't have the robots, we couldn't have had these special visits." It is a great advantage for our patients to have this experience if they are not allowed to experience many other things. "
The Phoenix hospital has actually had two telepresence robots since 2018, but since the pandemic and machines have become more valuable, they have ordered two more to add to their fleet. The robots are now in use every day, says Stephanie Smith, who coordinates the children's activities, and the feedback was enthusiastic.
"Just yesterday, when one of the kids was using the robot to scavenge our staff, her mother said," Thank you for spending the time with us, "says Smith." It's just about this connection. "
Although COVID-19 has placed a huge strain on healthcare systems around the world, doctors told The Verge that they are pleased that the pandemic has driven these new technology tests.
"We're moving at a rate five times faster than the normal rate of innovation," Tullamore's Kiernan told The Verge. “The pandemic actually made projects possible. The bureaucracy has been removed. People are more willing to take a measured risk approach that says, "Okay, let's try something." Of course in a safe environment. "
All over the world, healthcare workers had to change their type of care overnight, with new focus on telemedicine and remote diagnosis. For many, this has created an environment in which new approaches are treated with less distrust and more optimism.
In addition to the trial of Violet, Kiernan offers examples from her own orthopedic department. She says the Tullamore hospital has grown from over 100 patients on a typical morning to around 20 patients, with doctors and nurses compensating for this through online services. For example, they are now running physiotherapy sessions on Zoom and are creating a website where patients are informed about hip and knee prostheses and their consent to the operation is obtained. Doing this personally before the pandemic broke out would have taken an entire afternoon. Now it only takes minutes.
"If you tried to implement this (the website) in normal times, imagine how many people you have to approve," says Kiernan.
Vanmechelen from Belgium agrees, adding that the need to address the specific problems of COVID-19, such as reducing infections by incoming patients, has made the change process easier to manage. Instead of simply trying to “modernize” the hospital on all fronts, the managers were able to concentrate on the individual challenges.
"We developed what took three months or even a year earlier in a week."
“We had a problem that had to be solved urgently. And that's a good environment for innovation, ”says Vanmechelen. “We developed what took three months or even a year earlier in a week. Because everyone was focused. "
It is a truism that medical advances often thrive in times of crisis. When the 1918 flu devastated the world, killing an estimated 50 million people or around 2.5 percent of the world's population, the unprecedented speed and lethality of the virus drove governments to centralized health care. An illness that penetrated large parts of the public required a reaction of the same breadth. As a result, governments began offering their own health insurance and collecting medical data to better predict and track future outbreaks.
At the moment the world is facing a completely different pandemic, but there is a similar way of teaching, not only by accepting the helping hands of robots, but by creating more adaptable health services. If not for this pandemic, then for the next one.
"It's corona virus now, but it could be different in a few years," says Kiernan. "I think many of the changes that have now taken place will remain."