Coronavirus: how AI identified the outbreak and alerted people before the UN

On New Year’s Eve a team of medics and computer scientists in Toronto had their digital ear to the ground and passed on vital information about a new viral outbreak developing in China

Hong Kong Chief Executive Carrie Lam speaks during a press conference about the coronavirus outbreak, in Hong Kong. EPA

A member of Mexico's Baja California state Health Secretary epidemiology brigade waits at the lobby in preparation for the arrival of China's Hainan Airlines flight HU7925 from Beijing, at the Abelardo L. Rodriguez International airport in Tijuana, Mexico. AFP

Passengers are seen on a thermal screen upon their arrival at the Tribhuvan International Airport after Nepal confirmed the first case of coronavirus in the country, in Kathmandu, Nepal. Reuters

Chinese tourists wearing protective masks to help stop the spread of a deadly virus which began in Wuhan, look on at a train station in Colombo. AFP

Tourists wear protective face masks as they walk in Red Square near the Kremlin in Moscow, Russia. Bloomberg

A security guard wears a protective mask at the entrance gate of the National Institute of Infectious Diseases, commonly called the Infectious Diseases Hospital (IDH), where one Chinese citizen has been placed in isolation and is being closely monitored after testing positive for coronavirus, in the suburbs of Colombo, Sri Lanka. EPA

Thai technicians wearing protective suits spray disinfectant on passenger seats aboard a Thai Airways International aircraft. EPA

A medical worker in protective suit and police officers wait for drivers at a checkpoint in Yunxi county, Hunan province, near the border to Hubei province. Reuters

A police officer looks at a clinic map of the Klinikum Schwabing, after Germany has declared its first confirmed case of the deadly coronavirus that broke out in China, in Munich, Germany. Reuters

A security person wearing protective clothing to help stop the spread of a deadly SARS-like virus which originated in the central city of Wuhan is seenseen at the entrance of subway station in Beijing. AFP

Employees disinfect escalator handrails in hopes to prevent transmission of the coronavirus at a subway station in Seoul, South Korea. AP Photo

Chinese Premier Li Keqiang wearing a mask and protective suit speaks to medical workers as he visits the Jinyintan hospital where the patients of the new coronavirus are being treated following the outbreak, in Wuhan, Hubei province, China. Reuters

A Transmission Electron Microscopy image of the first isolated case of the coronavirus. Reuters

Zhang Changchun shows a CT scan image of the lungs of his mother, 53-year old patient Yang Zhongyi, who is a highly suspected case of the new coronavirus yet is unable to get tests to confirm due to local hospitals' lack of testing equipment or beds, in Wuhan, Hubei province, China. Reuters

Students sanitize hands to avoid the contact of coronavirus before their morning class at a high school in Phnom Penh, Cambodia. AP Photo

A medical worker in protective suit checks the body temperature of car passenger at a checkpoint outside the city of Yueyang, Hunan Province, near the border to Hubei Province that is on lockdown after an outbreak of a new coronavirus, China. Reuters

A hospital in Torrevieja, Alicante, Spain has ruled out that the 66-year-old Icelandic tourist that entered hospital the previous day along with her partner, an Icelandic 52-year-old national, is infected with coronavirus. EPA

On New Year’s Eve 2019 at 10.00am EST, an artificial intelligence company in Toronto, Canada sent out a communication about more than 20 reported cases of a severe respiratory syndrome in Wuhan, China associated with the Wuhan South China Seafood Market “with no cause yet identified”.

The notification landed in the inboxes of healthcare workers in Canada and the US, as well as clients in South-East Asia and some airlines, about a week before public warnings from the UN World Health Organisation about a novel coronavirus that had been identified in the massive capital of central China’s Hubei province.

"We didn't know it was going to turn into a global outbreak," Dr Kamran Khan, an infectious disease physician and founder and chief executive of BlueDot, told The National.

His company, made up of a team of about 40 physicians, veterinarians, epidemiologists, statisticians and computer scientists, determined that what they were seeing from the data they gathered on December 31 looked a lot like the origins of Severe Acute Respiratory Syndrome (Sars) in 2002: a new pneumonia-like virus linked to an animal market in China. 
How did they know that? By listening.

BlueDot uses machine learning and natural language processing methods (two subsets of AI) to monitor about 100,000 websites in 65 different languages from all over the world. The AI algorithms are trained to pick up chatter on infectious diseases from official local news channels, physicians' public web forums and government and NGO communications. BlueDot scans for this information every 15 minutes, 24 hours a day, every day of the year.

Infectious diseases pose a growing threat in an increasingly interconnected world as booming global travel, urbanisation and climate change make cases more frequent and severe.

The company, founded in 2013 and with nearly $10 million (Dh36.7m) in venture capital to date, is part of a new breed of public health response that relies on technology and open-source information to inform front-line responders and help them heal patients.

BlueDot is helping its clients like public health workers and airlines “anticipate rather than react”, according to Dr Khan. He recalled that St Michael’s Hospital in Toronto, where he still works, “didn’t really know what Sars was until it showed up” in 2003. The outbreak “crippled the city” for four months, and killed 44 people there.

Since BlueDot first picked up on the emerging coronavirus, China has sealed off millions of people near the centre of the outbreak in an unprecedented quarantine effort as the death toll climbed to more than 100 and the number of confirmed cases jumped to almost 6,000 by Wednesday.

Part of BlueDot's work is predicting where outbreaks are likely to go internationally by looking at commercial air-traffic data.

Since most outbreaks happen halfway around the world, BlueDot assesses “if there is a sufficiently large amount of people coming to your backyard, in the 'pathway of the epidemic’, we would notify you that that is something you should pay attention to”, Dr Khan said.

In the days after the Wuhan coronavirus emerged but before the mandatory quarantine issued by Chinese authorities, BlueDot accurately said that the virus would travel from Wuhan to Bangkok, Seoul, Taipei and Tokyo, based on air-travel patterns from the Chinese province. They published their findings and a list of 20 destinations receiving the most passenger traffic from Wuhan, alongside a readiness score for a given city to cope with an outbreak, in the Journal of Travel Medicine.

Sydney and Victoria in Australia, and Dubai, were the only three destinations in the top 20 that are outside of East Asia, but every country on the list that received high volumes of passenger traffic from Wuhan had high readiness scores, “corresponding to relatively strong public health and healthcare capacity,” they found.

“The UAE has grown a lot in the last 15 years and is a very important traffic hub,” Dr Khan said. “Places that have that level of inter-connectedness are places that it’s pertinent to have these kinds of insights to understand these kinds of threats.”

The challenge is to not overwhelm healthcare workers or front-line responders with a deluge of information.

Location-specific insights are vital, according to Dr Khan. “So that a person in Dubai versus Singapore versus London is getting different information that is relevant to them and how they are connected to any outbreak.”

John Oxford, emeritus professor of virology at the University of London and co-author of the textbook Human Virology, told The National on Sunday: "I think it could reach that [level of Sars], but not more," he said. "With all this attention and quarantine, and we have the experience of Sars so we know the public health measures – quarantine, social distance, hand washing – that should knock it on the head."

Dr Khan is putting his faith in healthcare workers as "the rubber hits the road in emergency departments”. Although most clinicians only receive a day or two of tropical medicine training in school, their access to information as it is occurring day to day has never been better. BlueDot is helping them to “think global but act local”. But they have their work cut out.

“It is an easy adage and far more difficult to operationalise,” Dr Khan said.

But progress, he feels, is certain.

“When Sars was happening in Toronto back in 2003 I had my first BlackBerry. We've come a long way."