1. Potential impact of COVID-19 on the adoption of
healthcare, smart homes, and Hospital
Dr. R. Periyasamy M.Tech (IITM) & PhD (IITD)
Assistant Professor
Department of Instrumentation & Control
Engineering,
National Institute of Technology, Tiruchirappalli,
Trichy-620015
periyasamyr@nitt.edu
3/4/2023 1
2. CHECKOUT
THE LATESTGLOBAL SITUATION
2
* Data are incomplete for the current week. Cases depicted by bars; deaths depicted by line
WHO
Coronavirus
Disease (COVID-19)
Dashboard
Current global situation
Casesreported toWHO asof28 February2021
⢠> 113 million cases ⢠> 2.5 million deaths
3/4/2023 2
3. THE COVID-19 PANDEMIC
Stage 1
An unknown virus
emerges
3
Stage 2
A pandemic
unfolds
Stage 3
The pandemic
accelerates
Stage 4
A multi-faceted
pandemic
Overview of the COVID-19 pandemic
A high-level overview of emerging issues
As the COVID-19 pandemic evolves, several distinct questions and challenges arise...
Stage 5
Medical counter
measures
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4. AN UNKNOWN VIRUS EMERGES
Stage 1
An unknown virus emerges
An unusual cluster of severe
pneumonia cases is identifiedin China
raisingquestions about a possiblenew
disease (December 2019)
Source:WHO 21 January 2020
⢠Some cases are linked to a sea food market, in
Wuhan, Hubei province, China
⢠Some patients die, especially older people and
those with other medical conditions
⢠The new disease is caused by a novel coronavirus,
a family of viruses known to infect animals &
humans
⢠The infection causes respiratory disease ranging
from mild to severe disease
Following advice from the IHR Emergency
Committee for COVID-19, on 30 January 2020 â
with around 7700 confirmed cases in China and
82 cases outside of China â WHO declares the
outbreak to be a Public Health Emergency of
InternationalConcern.
At that time, no death relatedto COVID-19 is
recordedoutside China
4
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5. AN UNKNOWN VIRUS EMERGES
Stage 1
5
Initial response to the virus
31st Dec 2019: Cluster of pneumoniadetectedin Wuhan
1st Jan 2020: WHO activates Incident Management T
eam
5 Jan: WHO issues firstDisease OutbreakNews
23 Jan: First IHR Emergency Committee meeting
23 Jan: Restrictions in Wuhan,all transportin & out of Wuhansuspended
30 Jan: WHO declares Public Health Emergency of InternationalConcern
4 Feb: Strategic Preparedness & Response Plan issued
11 Mar: WHO describes COVID-19as a pandemic
3/4/2023
6. AN UNKNOWN VIRUS EMERGES
Stage 1
Research for diagnostics,vaccinesand therapeuticsbegan immediately
⢠After the West Africa Ebola outbreak in
2014-2016, the World Health Organization
(WHO) adopted a plan for research and
development (R&D) â this is known as the
R&D Blueprint
⢠The R&D Blueprint is a global strategy to
enable rapid activation of research during
epidemics and fast-track development of
diagnostics, vaccines and medicines.
⢠WHO convened the first global COVID-19
Research and Innovation Forum in Geneva
on 11-12 February 2020.
6
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7. A PANDEMIC UNFOLDS
Stage 2
A pandemic unfolds
7
By 12 March 2020, there
were over 120,000 cases
and over 4,600 deaths
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8. A PANDEMIC UNFOLDS
Stage 2
In many countries, spread of COVID-19 leads to community transmission
⢠âFlatteningthe curveâ is importantas in everycountry,there are limited numbersof
hospitals, nurses and doctors
⢠The capacity of the health system can be exceeded if toomanypeopleseek healthcareat
the same time
⢠Testing,isolatingpositivecases,
contact tracing and PHSM are
important to flattening the curve
⢠Some countries manage to stop
transmission with control
measures
⢠Many countries close schools,
shops, workplaces, bars,
restaurants as well as borders
and ask people to stay home to
limit the spread of the virus
8
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9. A PANDEMIC UNFOLDS
Stage 2
Implementation of Public Health & Social Measures
Personal protective
measures
ď Hand hygiene
ď Respiratory
etiquette
ď Face masks
Travel-related
measures
ď Travel advices
ď Travel restrictions
ď Border closure
ď Entry and exit
screenings
Social distancing measures
ď Contact tracing
ďIsolation of sick
individuals
ď Quarantine of exposed
individuals
ďSchool measures /
closures
ďWorkplace measures /
closures
ď Avoiding crowding
Environmental measures
ď Surface and object
cleaning
ď Increased ventilation
WHAT HOW
9
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10. A PANDEMIC UNFOLDS
Stage 2
Health systems are under pressure even in
wealthy countries
⢠Hospitals and health workersfacerising demand to attend to a
growing number of COVID-19 patients
⢠Materials are in short supply:
ď Personal protective equipment
ď Oxygen and ventilators
ď COVID-19 diagnostic tests
š Globally aggregated weekly surveillance data based on cases notifiedto WHO
https://www.who.int/fr/news/item/17-09-2020-keep-health-workers-safe-to-keep-patients-safe-who
https://apps.who.int/iris/handle/10665/336265
Photo: WHO
10
⢠Health workersare affected,of all detailed casereportssubmitted to WHO by October2020,
14% of the cases are health workers. Capacity building and access to adequate personal
protective equipment & measureslead tothe decreaseof this percentage.š
⢠Usual health care is cancelled or postponed with a major impact on other endemic or
chronic diseases as well as on preventive activities such as routine immunization
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11. THE PANDEMIC ACCELERATES
Stage 3
The pandemic accelerates
Number of newconfirmed COVID-19 cases bydatereportedtoWHO andregion
The epicentre moves from
Europe to the Americas
By 1 July 2020, there were over
10.3 million cases and over
503,000 deaths in 215 countries
or areas and two cruise ships
Source: WHO
11
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12. THE PANDEMIC ACCELERATES
Stage 3
Beyond the health crisis: impact on
all of society
⢠National restrictions have a huge impact on businesses
and individuals lose jobs
⢠The travel sector is greatly affected by international
movement restrictions
⢠Pressure mounts to re-open societies, including schools to
minimize social and economic damage
InsideChicagoOâHareInternationalAirport,UnitedStatesofAmerica
Countries start re-opening societies
The âfirst waveâ passes in countries first affected which
see cases declining
Some country borders re-open and restrictions are
eased, in particular during holidays in the northern
hemisphere
Source: www.weforum.org/agenda/2020/06/imf-lockdown-recession-covid19-coronavirus-economics-recession/
12
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13. THE PANDEMIC ACCELERATES
Stage 3
COVID-19 spreads more easily in certain
settings
⢠Certain situations and activities (such as singing,
exercising, shouting) are identified to be at higher risk for
COVID-19 transmission:
ď Crowded places
ď Close-contact settings
ď Confined and
enclosed spaces with
poor ventilation
13
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14. A MULTIFACETED PANDEMIC
Stage 4
A multifaceted pandemic
Source: WHO 01 November 2020
There is sustained
transmission in the US
and India, a new
increase of cases in
Europe (2nd wave); while
other countries remain
COVID-19 free (e.g. New
Zealand)
By 01 November, there
are nearly 46 million
cases and over 1.19
million deaths
Source:WHO
14
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15. A MULTIFACETED PANDEMIC
Stage 4
Global partnership
Source: WHO 06 October 2020
⢠Access to COVID-19 Tools (ACT) Accelerator is a global
collaboration end to end process, to accelerate
development, production, and access to COVID-19
vaccines, therapeutics and diagnostics
ď Vaccines in development as of 1st November 2020:
⢠154 in preclinical evaluation
⢠44 in clinical evaluation
⢠10 in phase III trials
ď Dexamethasone has been confirmed as a useful
therapeutic treatment for severe cases
ď An antigen-based rapid diagnostic test has been
approved
⢠Information on vaccines
⢠More information on the ACT Accelerator
2 billion
doses
globallyby
endof2021
245 million
therapeutic
coursesinlow
andmiddle-
incomecountries
bymid-2021
500 million
testsinlowand
middle-income
countries
bymid-2021
Health SystemsConnector
Strengtheninghealthsystemstomakesureessential
COVID-19tools reachthepeople whoneedthem
15
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16. MEDICAL COUNTER MEASURES
Stage 5
Medical counter measures available
Source:WHO
16
The increase of cases in
Europe and the USA (2nd
wave) continues;
The first COVID-19
vaccines are rolled out;
There is growing concern
about emerging variants
As of January 3rd, more
than 83 million cases and
over 1.8 million deaths
Source:WHO
3/4/2023
17. MEDICAL COUNTER MEASURES
⢠As of 2nd March 2021, there are 76 COVID-19 candidate vaccines in clinical development of
which 12 are in Phase III and 4 in Phase IV trials
⢠There are another 182 candidate vaccines in preclinical development
⢠More than 90% of all top candidate vaccines will be delivered through intra-muscular injection
⢠Most are designed for a two-doseschedule
Stage 5
COVID-19 vaccine accelerated development
Source: 2nd March 2021
https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines
17
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18. MEDICAL COUNTER MEASURES
Stage 5
COVID-19 vaccine development
As of 3rd March, more than 265 million vaccine doses have been administered:
ď Different vaccines (3 platforms) have been administered (Pfizer, Moderna, Oxford/AZ, SII,
Gamaleya, Sinopharm, Sinovac, Bharat Biotech)
From Bloomberg COVID-19 vaccines tracker on Global Distribution (28th Feb2021)
35%
30%
20%
17% 15% 13% 10% 10%
% of population given at least 1 dose
52%
Israel UAE U.K. Bahrain Chile U.S.
https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/
https://ourworldindata.org/
Serbia Malta Morocco
18
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19. MEDICAL COUNTER MEASURES
Stage 5
New emerging SARS-CoV-2 variants and their implications
⢠New SARS-CoV-2 variants:
ď Sept. 2020, a variant emerged in Denmark related to mink farming
ď Variant detected in the United Kingdom in December 2020
ď Variant detected in South Africa in December 2020
ď 9th January 2021, variant detected in Japan among persons coming
back from Brazil
⢠All these variants involve genetic mutations coding for the
spike protein
⢠The spike protein of SARS-CoV-2 is targeted by most vaccines currently
approved or in development; mutations of the spike protein are closely
monitored
⢠The mode of transmission of the virus variantshas not changed
⢠The same preventive measures continue to be effective and should continue to be implementedš
š https://www.who.int/publications/i/item/considerations-in-adjusting-public-health-and-social-measures-in-the-context-of-covid-19-interim-guidance
19
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20. MEDICAL COUNTER MEASURES
⢠Baseline analysis by the World
Bank Group estimated that
COVID-19 could push an
additional 88 million people
into extreme poverty in 2020.
In the worst case scenario, it
could be 115 million people
⢠The largest share of the ânew
poorâ are living in South Asia
and Sub-Saharan Africa
Stage 5
Extreme poverty is predictedto increasesharply
Sources: Lakner et al. (2020) (updated), PovcalNet, Global Economic Prospects
Note: Extreme poverty is measured as the number of people living on less than $1.90 per day.
Figure. Forecastof number of people living in extreme poverty (From WoldBank Blogs)
20
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22. Challenges in Conventional Methods
Imaging Modalities
⢠Itâs a complex diagnostic technique
⢠Frequent exposure to radiation is harmful
to the body
⢠Not applicable for children, pregnant
women, mentally challenged people
⢠Images of the lungs are hidden by the rib
cage
⢠Its costly diagnosing technique
⢠Expertise is needed for this technique
⢠Direct contact with patients
⢠Itâs risky for technicians
RTPCR test
⢠False positive results
⢠False negative results
⢠Different steps
⢠Needing different lab tools
⢠Direct contact with patients
⢠Itâs risky for technicians
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23. Emerging of Auscultation Technique
Respiratory sounds
Vibration
Voice
Lung sounds
Heart sounds
Bowel sound
Breathing
Cough Digital Stethoscope
Diagnostic tools for
different diseases
Early
detection and
inexpensive
solutions
Technological
researchers and
medical scientists
3/4/2023 23
26. COVID-19 sounds crowdsourced dataset
⢠Approved by the Ethics Committee of the Department of Computer Science
and Technology at the University of Cambridge
⢠partly funded by the European Research Council through Project EAR
#833296
⢠enable machine learning model training and evaluation tens of thousands
of participants
⢠easy-to-use for researchers to facilitate healthcare model development
⢠53,449 audio samples (over 552 hours) from 36,116 participants
⢠62% are male, 36% are female
⢠one year from April 2020 to April 2021
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28. 2. Dataset Preparation
Data Augmentation
i) Stretching Time (ST): Increase or reduce the sample sound signal (to unchanged
running
pitch). Based on the four factors {0.80, 0.94, 1.06, and 1.24} the duration is stretched.
ii). Shift Pitch1 (SP1): Sound/audio samples can be increased or decreased (to
unchanged
running pitch), and every sample can be shifted differently by four values (-1,-2,-2,-1).
iii). Shift Pitch2 (SP2): We wanted to build a second augmentation package because our
initial tests showed that pitch shifting was an especially beneficial increase. Every
sample was pitch moved by four higher values (in different sizes and shapes) this time
(-2.5,-3.5, 3.5, and 2.5).
iv). Compression of Range Dynamically (CRD): We have compressed these 4 parameters
online, one taken from the
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29. 3. Data Pre-processing: Signal Denoising
ďś Involves removal of noise like external artifacts from original signal
3/4/2023 29
Signal
Pre-processing
Linear Filtering
Blind Source
Separation
Non Linear filtering
Adaptive filtering
Techniques
Wavelet
based
denoising
Modulation
filtering
Independent
Component
analysis
30. Linear filtering
ďź Butterworth FIR filter
ďź Butterworth IIR filter
ďź Savitzky Golay Filter
ďź Smoothing filter
ďź Moving Average filter
ďź Gaussian Filter
ďź Median Filter
ďź Rectangular window FIR filter
Adaptive filtering techniques
ďź Least Mean Square Algorithm
ďź Recursive Least Square Algorithm
ďź Adaptive Line Enhancement
ďź Adaptive Noise Cancellation
ďź Empirical Mode Decomposition
ďź Ensemble Empirical Mode
Decomposition
ďź Variation Mode Decomposition
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Non-Linear filtering
31. Wavelet-based Denoising- Heuristic
Threshold Approach
1. Continuous Wavelet Transform
2. Discrete Wavelet Transform
Input time
series
Time to frequency
Domain conversion
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Fourier
Transform
Short Time
Fourier
Transform
Wavelet
Transform
⢠Windowing
⢠Maps signals
into two
dimension
space
⢠Hanning window
⢠Hamming window
⢠Haar window
⢠Daubechies window
⢠Symlets window
⢠Multiple windows
⢠Allows coarse to fine
multiresolution
predictive of signals
33. Denoising Evaluation metrics
ďą Signal to Noise Ratio
ďą Root Mean Square error
ďą Correlation Coefficient
ďą Normalized Root Mean Square
ďą Normalized max amplitude error
ďą Percentage distortion
3/4/2023 33
34. 4. Signal Analysis
To convert raw data to some type of parametric representation
called features
⢠Statistical analysis
⢠Discrete Fourier transform analysis
⢠Frequency Domain analysis
⢠Time-frequency analysis
⢠MFCC
⢠Wavelet and Hilbert Huang Transform
⢠Autoregressive Modelling
3/4/2023 34
35. 5. Feature Extraction
3/4/2023 35
Feature
Extraction
Time-domain
Time
frequency
domain
Frequency
domain
Statistical
features
Spectral
features
36. Time Domain Features
⢠Timing Intensity
⢠Zero crossing rate
⢠Transition ratio
⢠Power ratio
⢠Spontaneous energy
3/4/2023 36
37. Frequency Domain Features
⢠Frequency ratio-fmin/fmax
⢠Average instantaneous frequency
⢠Exchange time of instantaneous
frequency
⢠Maximum frequency
⢠Minimum frequency
⢠Peak frequency
⢠Median frequency
⢠Mean frequency
3/4/2023 37
38. Statistical Features
⢠Mean
⢠Variance
⢠Standard Deviation
⢠Skewness
⢠Kurtosis
⢠Shannon Entropy
⢠Energy
⢠Minimum and Maximum energy
⢠Entropy-based features
⢠Mean Crossing Irregularity
3/4/2023 38
39. Spectral features
ďź Spectral Centroid
ďź Spectral Decrease
ďź Spectral flatness
ďź Spectral slope
ďź Spectral spread
ďź Spectral crest
ďź Spectral entropy
ďź Spectral flux
ďź Spectral roll off
ďź Power spectral density
3/4/2023 39
41. Feature Selection
ďą Student t test
ďą Mann Whitney U test
ďą MANOVA test
ďą Perceptual Linear Predictions
ďą ROC analysis of individual features
⢠used to evaluate machine learning
models
⢠additional tool to evaluate most
relevant features
⢠highest discrimination capabilities
Statistical
Package for
Social Sciences
software-
MedCalc
software
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43. What is Machine learning?
An ML algorithm, which is a part of AI, uses an
assortment of accurate, probabilistic, and
upgraded techniques that empower computers to
pick up from the past point of reference and
perceive hard-to-perceive patterns from massive,
noisy, or complex datasets.
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44. Machine learning algorithms
4 types:
â˘Supervised and
â˘Unsupervised Learning
â˘Semi-supervised Learning
â˘Reinforcement Learning
Top 10 commonly used Machine Learning (ML)
Algorithms
â˘Linear regression
â˘Logistic regression
â˘Decision tree
â˘SVM algorithm
â˘Naive Bayes algorithm
â˘KNN algorithm
â˘K-means
â˘Random forest algorithm
â˘Dimensionality reduction algorithms
â˘Gradient boosting algorithm and AdaBoosting algorithm
3/4/2023 44
50. What is Deep Learning?
Deep learning has gained massive popularity in scientific computing, and its algorithms are widely used by
industries that solve complex problems. All deep learning algorithms use different types of neural networks
to perform specific tasks.
Deep learning uses artificial neural networks to perform sophisticated computations on large amounts of
data. It is a type of machine learning that works based on the structure and function of the human brain.
Deep learning algorithms train machines by learning from examples. Industries such as health care,
eCommerce, entertainment, and advertising commonly use deep learning.
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51. Types of algorithms used in Deep Learning
1.Convolutional Neural Networks (CNNs)
2.Long Short Term Memory Networks (LSTMs)
3.Recurrent Neural Networks (RNNs)
4.Generative Adversarial Networks (GANs)
5.Radial Basis Function Networks (RBFNs)
6.Multilayer Perceptrons (MLPs)
7.Self Organizing Maps (SOMs)
8.Deep Belief Networks (DBNs)
9.Restricted Boltzmann Machines( RBMs)
10.Autoencoders
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52. Classifier Performance Metrics
ďź Sensitivity
ďź Specificity
ďź Accuracy
ďź Confusion matrix
ďź AUC/ROC
ďź Precision
ďź Recall
ďź F1 Score
ďź Kappa
ďź Mathews Correlation Coefficient
ď Cross validation
ď Leave one out cross validation
scheme
ď 10 fold cross-validation- 10
subsets
ď 9 train models, 1 test model
ď 5 fold cross-validation 5 subsets
ď 4 train models, 1 test model
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56. IEC checklist
1. Protocol discussed internally in the concerned department and obtained HODâs permission?
2. Sources of funding mentioned
3. Adequate literature review with justification for the study mentioned
4. Detailed description of methodology (Study design, number of groups, sample size, etc)
5. No mirror statement in Inclusion/Exclusion criteria
6. The Sample size calculated and mentioned
7. Consent form part
8. Validated questionnaires both in Tamil and English attached
9. Signature of all investigators (Principal & Co-investigator) and Head of the corresponding
department obtained with date
10. Ethical issues explained in detail with a level of risk
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68. The severity of the disease- varies from mild or asymptomatic to critical
patients are usually attended to on this basis.
severely ill are hospitalized as they may require external ventilation and
intensive care,
while those with milder symptoms are made to remain at home, provided
their condition does not worsen.
These measures prevent healthcare systems from being overloaded.
In this age of pervasive technology, the progress in wearable technology,
IoT, and telemedicine, make remote monitoring of patients to check if
their symptoms worsen, possible.
This can help in carrying out the strategy as mentioned above of
prioritizing healthcare resources and hospital beds for those who really
need them
This kind of monitoring is important for vulnerable groups, i.e those aged
above 60 and/or with pre-existing health issues like cardiovascular or
respiratory disorders.
Also, patients with Non-COVID-19 and Nonemergency medical problems
can be monitored remotely, which reduces the chances of cross-infection
68
70. Healthcare
Abbott Laboratories, Philips Healthcare, Life Watch, GE Healthcare, Omron Healthcare,
Siemens Healthcare and Honeywell International Inc. etc
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71. Resources
⢠E-health and wellbeing monitoring using smart healthcare devices: An empirical
investigation
3/4/2023 71
72. WHO Coronavirus Disease (COVID-19) Dashboard
https://covid19.who.int/
R&D Blueprint and COVID-19
https://www.who.int/teams/blueprint/covid-19
Global research and innovation forum to mobilize international action in response to the novel coronavirus (2019-nCoV) emergency
https://www.who.int/news-room/events/detail/2020/02/11/default-calendar/global-research-and-innovation-forum-to-mobilize-
international-action-in-response-to-the-novel-coronavirus-(2019-ncov)-emergency
Considerations for implementing and adjusting public health and social measures in the context of COVID-19
https://www.who.int/publications/i/item/considerations-in-adjusting-public-health-and-social-measures-in-the-context-of-covid-19-
interim-guidance
Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza
https://apps.who.int/iris/bitstream/handle/10665/329438/9789241516839-eng.pdf?ua=1
Keep health workers safe to keep patients safe: WHO
https://www.who.int/news/item/17-09-2020-keep-health-workers-safe-to-keep-patients-safe-who?v=4
Prevention, identification and management of health worker infection in the context of COVID-19: interim guidance, 30 October 2020
https://apps.who.int/iris/handle/10665/336265
IMF: New predictions suggest a deeper recession and a slower recovery
https://www.weforum.org/agenda/2020/06/imf-lockdown-recession-covid19-coronavirus-economics-recession/
72
Resources
3/4/2023
73. Resources (2)
73
Three factors help you make safer choices during COVID-19
https://www.who.int/teams/risk-communication/covid-19-transmission
Infodemic management
https://www.who.int/teams/risk-communication/infodemic-management
COVID-19 vaccines
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines
Fair allocation mechanism for COVID-19 vaccines through the COVAX Facility
https://www.who.int/publications/m/item/fair-allocation-mechanism-for-covid-19-vaccines-through-the-covax-facility
Draft landscape and tracker of COVID-19 candidate vaccines
https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines
Bloomberg
https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/
Our World in Data
https://ourworldindata.org/
World Bank
https://blogs.worldbank.org/voices/2020-year-review-impact-covid-19-12-charts
The World Health Organization (WHO) is not responsible for the accuracy of information provided by external sites.
The mention of specific companies does not imply that they are endorsed by WHO.
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