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AMU students hold protest march, demand offline classes

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A section of Aligarh Muslim University students took out a protest march on Sunday demanding the university to be reopened after the COVID-19 pandemic without delay. The university was closed in March 2020 after the government shut down educational institutions because of the pandemic.

In December 2019, AMU was shut down and students were asked to vacate the hostels after anti-Citizenship (Amendment) Act protests on the campus turned violent. Later, students protested against the university administration for allowing the police to enter the campus.

‘Career suffering’

A female research scholar, requesting anonymity, said their career was suffering. “Many of us could not afford electronic gadgets necessary for online classes. Also, lab and other practical work are not possible online. Research work could not be done with proper access to the university library. As the number of COVID-19 cases has come down considerably, we demand the administration to open the university and hostels as soon as possible or at least give us a timeline,” she said.

Sources said around 1,000 to 1,200 students, mostly males, were staying in hostels without permission. As the women’s hostels were strictly locked, they were forced to stay in PG accommodation.

Some teachers said if the Aligarh Numaish (exhibition), a popular annual event of the city, could be held, why a central university could not be opened in phases. Ali Nadeem Rezavi, professor of History, asked, “If cinema halls, political rallies, Numaish and absolutely anything could be allowed, why this obsession with having the doors of educational institutions closed.”

Talha Mannan, a final year student of post-graduation, said, it seemed the university administration “deliberately” wanted to keep students out of the university.

“Ours is a different case as after the university was shut down in December, it opened only in February for a few days. At least other universities such as the BHU and JNU have come up with a schedule. The University administration can open the faculties and the hostels in a phase-wise manner.”

Tough SOPs

University spokesperson Shafey Kidwai said the government’s COVID-19 SOPs stipulated that only 50% of students could attend offline classes and that only one student should stay in a hostel room. “It is not possible to conform to these SOPs in a residential university. We have four students in one hostel room. What would we say to the other three,” he asked.

He admitted that the COVID cases had come down considerably in Aligarh and that there was no active case in the corona ward of the university hospital.

Prof. Kidwai said the University Academic Council had met and the administration would soon come out with a plan.

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Livestream Shopping Goes Global

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Her face colored by red neon lights, Anastasiia Kanshina grooved quietly, her phone on the table in front of her, alongside pages of notes and an unopened box holding a wireless speaker. Eight seconds later, she burst into laughter as she realized that the camera in front of her had already started rolling. 

“Ah, I can’t see myself [in the camera monitor],” she said in Chinese, before regaining her composure and switching to Russian. “Hello everyone! Welcome to the channel Blooming Show. My name is Nastya, and today our broadcast is in Russian. Today my broadcast is all about a brand that’s already pretty well-known.” 

From a studio in Shenyang, a city in northeastern China, Kanshina, a 29-year-old from the Russian city of Irkutsk, is broadcasting to thousands of viewers in Russia and Ukraine. Today, she is selling wireless speakers and chargers manufactured by Anker. But since she started livestreaming in 2019, she has hawked everything from smartphones to baby toys. Her three hour-long shows each week are a reboot of the TV shopping programs that emerged in the 1980s and have since proliferated worldwide, but with live interactions and mobile payments processed through an app made by AliExpress, the international arm of the Chinese e-commerce giant Alibaba.

“I didn’t expect livestreaming to become my job,” said Kanshina, who arrived in Shenyang in 2013 for a master’s degree in international trade. She stayed in China to work in customer service for Neusoft Cloud Technology, a company that operates multi-language call centers for AliExpress. When Neusoft reached out to its Russian-speaking employees to bootstrap an experiment in livestreaming in 2018, Kanshina was initially reluctant. “But my previous manager said, ‘Her! She wants it! She likes to talk!’” Kanshina told Rest of World. “And I said, ‘OK, I can give it a try.’” 

She hosted her first independent show in March 2019 and since then has been regularly broadcasting every week. Her audiences are mostly from Russia, but some viewers tune in from Ukraine, Kazakhstan, Belarus, and other Russian-speaking countries. This past March, she broke a personal record, attracting over 20,000 viewers at once in a live show for Xiaomi, the Chinese phone manufacturer.

In 2019, live shopping shows on mobile screens completely changed the trillion-dollar Chinese e-commerce market, becoming a major marketing channel for everything from small farms to global luxury brands. Leading livestreamers attract millions of viewers nightly. But the domestic market is becoming increasingly saturated. In search of new sources of growth, China’s e-commerce giants and influencer agencies are now trying to export their model overseas, recruiting foreigners like Kanshina to expand into markets in Eastern Europe. 

“It’s widely accepted that China has been the proving ground for so many recent innovations in e-commerce,” said Franklin Chu, a private equity investor and retail expert. “So the fact that it’s worked in China … it’s just inevitable that it will be copied in smaller markets.”


“Livestreaming is basically television shopping plus [social networking],” said Chu, who once sat on the board of the Home Shopping Network, a U.S. TV shopping pioneer. 

Livestreaming began in earnest in China in 2016. Hundreds of apps were launched, each offering a different genre of content: e-sports, music, quiz shows, and softcore porn. 

That year, Alibaba jumped on the trend with Taobao Live, where influencers could sell products through the Taobao e-commerce platform, but it took nearly three years for the trend of mixing livestreaming with selling to break into the mainstream.

The combination of livestreaming’s real-time interactions between viewer and host and the convenience of e-commerce has been wildly successful. As of June 2020, more than 300 million Chinese citizens regularly shopped through livestreams, according to data from the China Internet Network Information Center, a government agency. The Guangzhou-based business consulting company iiMedia Research estimated that the Chinese livestream e-commerce market was worth more than $67 billion in 2019 and that it could have doubled in size in 2020. Taobao Live, now the dominant player in China, brought in $54 billion in sales for Alibaba last year, including nearly $6 billion on Singles Day, a shopping event that falls on November 11 each year.

Taobao Live’s success inspired Alibaba to overhaul the livestreaming feature of its overseas e-commerce platform, AliExpress, in 2019. Since 2013, Russia has been AliExpress’ largest market, according to the company, and now has more than 20 million active buyers and $3.5 billion in annual sales

To expand overseas, Chinese e-commerce companies need streamers who speak local languages. That inspired Neusoft to expand beyond call centers and make more use of its foreign talent. “We saw the successful applications of livestreams in China … and also the business potential of cross-border e-commerce platforms,” said Zhihao Wang, planning director of Neusoft’s Digital Social Media Marketing Center. “We decided to train foreign influencers to prepare for overseas livestreams.”

The northeast region of China, where Neusoft is based, is geographically close to Russia and has a sizable number of Russian-speaking residents, making it easy for Wang to scout potential influencers just by going to local bars.

In September, the company employed seven full-time foreign livestream influencers, after several others went home during the coronavirus pandemic. Each of them earns between $30,000 and $60,000 (200,000 to 400,000 yuan) a year, according to Wang. Neusoft also works as an agent for 300 influencers based outside of China, targeting Russian-, Spanish-, and French-speaking markets. 

Dmytro Romashko is the most popular of Neusoft’s contract influencers. Before he began writing product reviews on AliExpress in 2014, the 29-year-old, who lives in the Ukrainian capital of Kiev, had no connections to China. He sent professional photos of himself modeling products and proposed writing reviews for the company blog, which later turned into live streaming. He gave up his job as a government lawyer to become a full-time livestreamer, specializing in selling men’s clothing and tech gadgets, and now has more than 250,000 followers on AliExpress.

“I found that a lot of people come to shows to talk about the product and also to have some emotional exchanges from talking live. [It’s] like a party,” said Romashko, who sometimes spends an hour or more just casually chatting with his fans, without actually marketing anything. “So it’s not just a TV shop but also a lifestyle.”

During a three-hour marathon live show in 2019, Romashko’s stream attracted 364,000 viewers — a fraction of the millions that his Chinese counterparts receive regularly. Livestreaming in Eastern Europe may be growing quickly from a low base, but it’s still unclear when, or if, it will really break out to the extent it has in China.

Because it can be difficult to return products to China, and the dominant view is that AliExpress is a platform for low-cost goods, many customers in Russia and Ukraine are unwilling to spend as much as Chinese consumers via livestreaming. In China, users often spend hundreds of dollars; in Russia, it is only around $20, Romashko said. “If the product is expensive, they need to think. They need to come back to me with questions 20 times on my Instagram,” he explained. They usually end up buying a featured item a week or more after watching the show, making it hard to measure the success of one specific livestream.

Romashko gave up his job as a government lawyer and now has more than 250,000 followers on AliExpress.


Courtesy of Romashko

Influencers in Eastern Europe often stick to lower-price products: no more than $20 for summer clothing, $30 for a jacket, and between $200 and $300 for a mobile phone, said Zhihao Wang of Neusoft.

The pandemic has given e-commerce a boost in Eastern Europe, as more consumers are staying at home. However, it has also had a significant negative economic impact and reduced people’s purchasing power. In Russia, consumption is expected to contract by 4.9% in 2020, according to the World Bank.

On November 11 and 12, Kanshina streamed four shows for AliExpress’ Singles Day promotion, selling smartphones, security cameras, and jackets. The biggest difference she saw this year was that more viewers were actively demanding discounts and giveaways. “While they were waiting for the live show to begin, they would comment, ‘I wish I could get a free phone today!’” said Kanshina, who could reply with only, “I’m sorry. Next time!”

Despite these roadblocks, analysts in Russia expect that it’s only a matter of time before livestreaming becomes mainstream in the country. “In two years, maybe three years, this type of shopping will become [a] must-have for international brands, first of all, and for big Russian brands,” said Fedor Virin, a Moscow-based e-commerce analyst and founding partner of consultancy Data Insight. 

Virin expects domestic Russian e-commerce marketplaces like Wildberries and Ozon to soon invest in their own livestreaming services. “The Russian market is a very impulsive shopping market,” he said, adding that e-commerce purchases in Russia are often heavily incentivized by discounts and promotion gimmicks. “That’s why I think we will [be] very addicted to this type of shopping. But it will take time. Not a lot, but it will take time.”

Thieves Nationwide Are Slithering Under Cars, Swiping Catalytic Converters

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About 80 percent of demand for palladium and rhodium now comes from the automotive sector. At the same time, the effects of the pandemic on mining in South Africa, a major producer of rhodium, has kept supply limited. “This is why you’ve seen this very dramatic rise” in demand and prices, she said.

For automakers, the metals boom has jacked up the cost of producing gasoline vehicles. Max Layton, a London-based commodity analyst at Citi, estimates that soaring metal prices added $18 billion to the global auto industry’s production costs in 2019, gobbling up 15 percent of their total cash flow, and that those costs surged further in 2020.

At current prices, he said, the industry as a whole was set to spend more than $40 billion this year just on metals for catalytic converters. The escalating costs, Mr. Layton said, were “putting pressure on automakers to shift to battery electric vehicles as quickly as possible.”

Some owners are going to extremes to protect their vehicles.

After being hit with three converter thefts in quick succession last year, Jerry Turriff, proprietor of Jerry’s Certified Service and Towing in Milwaukee, has resorted to deflating the tires of some of his customers’ most at-risk vehicles to deter thieves from crawling underneath.

“It’s unbelievable,” Mr. Turriff said. “Now if I have a vehicle I think’s going to be targeted, I take the air out the tires, so they can’t slither underneath.”

He’s spotted the thieves on his security-camera footage — usually alone, entering his property in the dead of night, with “a big duffel bag carrying all his junk,” he said. (Stealing the converters can be treacherous for the thieves, too. Last year, a Kansas City man died after the Prius he was stealing the converter from crushed him to death.)

How Kitchens Became Trophy Kitchens, With the Help of MTV Cribs

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HGTV’s 2021 dream home is a three-story “grand coastal escape” in Newport, Rhode Island. It combines quiet, seaside charm (classic white window trim, antique-style bed frames, and countless nautical details) with loud, metropolitan aspiration, such as the European-style main bath and the open spiral staircase leading to a massive rooftop deck. But the most seductive part of this palatial home is the kitchen, which features walnut butcher block counters, massive pendant lights made of twine, and wall-to-wall windows with a water view. The striking navy-painted shelving displays, rather than merely stores, kitchen gadgets and dishware. It’s a kitchen that compels you to imagine who you could be, or become, once planted into the space: a joyful cook with the room and resources to create elaborate meals, a gracious host who truly loves to entertain, or a never-frazzled mother who gazes at the water as she wipes already-clean surfaces and helps darling children seated at the island with their homework.

Meanwhile, the kitchen in our current rental house has textured, black-and-blue laminate countertops, a 1990s white fridge, and thick-doored cupboards that don’t quite close all the way on a humid day—which, in Oklahoma, is rather often. It’s not my favorite kitchen, for both stylistic and functional reasons. But an outdated kitchen stings sharply, since kitchens are supposed to reflect who we are and desire to be. Searching “kitchen personality quiz” online returns millions of results: classic and traditional, contemporary and modern, bold, quirky, or perhaps a little bit country. Even for folks who rarely cook, a kitchen—particularly an aspirational “trophy kitchen” with high-end, well, everything—has become a must-have status symbol in the last twenty-five years. But it’s not simply the work of HGTV or Nancy Meyers—the notion of selling hyper-specific cookware to men played a part, as did MTV Cribs.

The idea of a trophy kitchen first took off after 1995, reaching a first peak of popularity around 2003, a rise some have credited to the program. MTV Cribs began airing in 2000, showcasing celebrity mansions, for an audience of fascinated older-millennial teenagers like myself. A special episode of the show in 2007 featured rapper 50 Cent’s mansion and his expansive kitchen, one of six (yes, six) in the home. Jill Notini, spokesperson for the Association of Home Appliance Manufacturers, claimed MTV Cribs contributed to increasing sales 
of high-end refrigerator brands specifically, saying, “When they showed the kitchens, it was all about the fridge.” As if on cue, 50 Cent began his kitchen tour by opening 
his refrigerator, revealing nothing but rows of Vitamin Water, for which he was a spokesman. He next opened the double wall oven, showing it full of cardboard boxes, and laughed, “No one’s touched it.”As he moved from room to room, it became clear that the kitchen was a trophy on par with the platinum records and expensive furniture throughout the home. Showing a wholly unused kitchen, as an ornamental trophy kitchen, was the ultimate display of status—a common trope on the show.

The aspirational norm for American middle- and upper-class kitchens hasn’t always been the lavish, open-concept spaces they are today—at least, on HGTV and Instagram, or in Hollywood movies and architectural magazines. For much of the seventeenth and eighteenth century, the kitchen was simply part of one large room with a fireplace for hearth cooking and home heating and a large wooden table, used for food preparation and a slew of other purposes. It was an all-purpose room for cooking, eating, working, and living. It’s not until the later eighteenth century that the kitchen became a separate space, designated specifically for cooking. In wealthier homes, this cooking room was detached, but later it was integrated into the architecture of the home, though often staffed by enslaved people or servants.

The early-twentieth century ushered in a host of kitchen changes: the decline of servants, the addition of modern conveniences like running water and electricity, and a full menu of new appliances, devices, and decor. By the middle of the century, as the white suburban ideal expanded, the walls around the kitchen increasingly came down. This put the kitchen’s specialized contents on full display to every member of the family—but also to guests. Though sometimes still divided from a living or dining area by a counter or pass-through window, many designs reintegrated the kitchen, and the house-wife, into the home. Ever since, the kitchen has become the nucleus of domestic operations, the room that sells a house (or not), and a high-stakes space for asserting status, for proving that you’re keeping up, and that you’ve made it.

But it was men cooking at home, and branding the act as a masculine endeavor, that further inspired investment in a blowout kitchen. Society still praises a man who regularly cooks to feed a partner or family as something special and laudatory, much like dads who rise to the occasion to “babysit” their own children. For women and mothers, these duties are expected, minimum standards. Despite this frustrating inequity, men’s cooking thus demands, and somehow deserves, bigger and splashier spending. In 2002, near the height of the trophy kitchen’s first cultural peak of popularity, Hugh J. Rushing, the executive vice president of the Cookware Manufacturers Association, said, “Growing male interest in cooking is one of the bright spots in the kitchen retail market. Men tend to have no problem,” he continued, “buying a special pan for paella, if the recipe calls for it, whereas women will make do with a regular skillet or pan.” That’s right, women will make do. Recognizing this, kitchen suppliers have leapt at the opportunity to court more (and male) customers, particularly with specialized equipment and gadgets with “masculine” design details like black matte finishes, not unlike cans of Coke Zero.

The phrase “trophy kitchen” makes me wince, considered in this light, because of how it echoes another phrase bandied about regarding successful men: “trophy wife,” a phrase which slightly predates the real estate term. Google Ngram Viewer, which tracks the appearance of words and phrases within a large corpus of books over time, says it first appeared in the early 1980s and steadily increased in published works until the early 2010s; The Oxford English Dictionary dates it a bit earlier, citing a mention of “Englishmen’s trophy-wives” in Anne Zoltan’s 1973 novel, Annie: The Female Experience. Other sources claim the senior editor of Fortune magazine coined the term in 1989 to name the thin, young, and beautiful, but accomplished and ambitious, second wives of prominent businessmen with cash to burn. Both terms suggest a cultural logic, where successful men both reward themselves for their status and assert it as a way of continuing to maintain it.

In such ways, the trophy status of a trophy kitchen means something different for men than for women, but this dreammaker still speaks to them both. The trophy of the dream home, coupled with the perfect family, is routinely marketed to women, especially through HGTV programming. Kitchens are stars on HGTV, especially on shows like House Hunters, which began airing in 1999. Nearly every episode features homebuyers who consider a trophy kitchen as a minimum standard, rather than aspirational. On the show, even first-time homebuyers consider granite countertops and stainless steel appliances “must-haves” rather than “wish list” items. It’s not uncommon for them to dismiss a home or expect a quick renovation if a kitchen isn’t up-to-date. Even on Tiny HouseHunters, which began airing in 2014, homebuyers often don’t fully downsize the kitchen in their quest for a simpler and more affordable lifestyle. Sometimes they choose regular-sized appliances, rather than a tiny cooktop or mini-fridge. They often maintain trophy kitchen features like significant counter space made from expensive materials.

Others credit film director Nancy Meyers’ “gracious home aesthetic” for fueling trophy kitchen design trends; the bountiful chef’s kitchen in her 2003 movie Something’s Gotta Give is purportedly one of the most requested and most copied kitchens of all time when it comes to kitchen design and remodels. The set kitchen was even featured in the July 2007 issue of Architectural Digest. For years afterward, it was one of the magazine’s most searched articles online. The phrase “trophy kitchen” declined during the Great Recession, as the housing bubble burst, but trophy kitchen’s cultural meaning didn’t wane. After 2010, the trophy kitchen’s trifecta of expensive and expansive countertops, custom cabinetry, and high-end appliances skyrocketed again.

Instagram has further stoked the cultural desire for “architecture porn,” populating feeds with light-colored, airy kitchens. The hashtag #kitchenporn brings up more than 33,000 posts, featuring gargantuan, sun-kissed rooms. There are even game apps dedicated to home renovations and design, so you can play out dream home (and kitchen) fantasies on your mobile device. Design Home came out in November 2016, and by 2019 had been downloaded more than 50 million times. Though winning proves difficult without in-app purchases, the game provides digital reverie, particularly for older millennials for whom trophy kitchens may feel (or be) financially out of reach.

Even if a trophy kitchen isn’t in your budget, you can own a piece of one. KitchenAid makes a full slew of culinary products, but the brand name primarily connotes their stand mixer — that queen of the wedding registry that retails for more than $300. Type “KitchenAid” into Google; the stand mixer pops up first, in colors like almond and avocado creme, copper pearl, and aqua sky. First launched in 1919, the stand mixer evolved into a device so purposefully pretty that it’s meant to be left upon the counter top, to be displayed rather than tucked away in a cupboard. This is particularly true on Instagram where #kitchenaid draws more than 900,000 posts and #kitchenaidmixer another 145,000.

I didn’t grow up in a family with a KitchenAid stand mixer. I recall a small handheld mixer with two humble beaters attached. My mom can mix and make anything with just a fork and some elbow grease. Notably, the KitchenAid stand mixer isn’t marketed as a labor or time-saving device. According to their website, it’s about “creating possibilities” and “unleashing creativity.” Just like a trophy kitchen, this small appliance is meant to “inspire” and “imagine.” If you’re a chef, baker, or food entrepreneur, such promises make professional sense. If you’re a home cook, and particularly a woman, this sales pitch isn’t too different from that of Weight Watchers, or, um, WW: that there is a better woman, wife, and mom within you, if only you let her out. Perhaps that’s part of the reason why the stand mixer so often dominates the registry lists of engaged couples. It’s the mechanical ingredient for the sort of wife you’re supposed to be, the life you’re supposed to want.

Some women love to cook and a KitchenAid stand mixer poses a delight that can be further enhanced with myriad attachments. For others, cooking is a chore; and the kitchen is not a space for dreams, but the site of considerable labor. It’s worth noting that some first-wave feminists campaigned for kitchenless living quarters. Dolores Hayden wrote the history of how these American material feminists sought a domestic revolution to free women from the gendered (and unpaid) burden of daily cooking, and childcare, too. They proposed making such labor collective, led and controlled by women, but performed on the neighborhood level, without the need for a kitchen in every home.

Instead, we’ve seen kitchens only grow in social status and cultural meaning. We don’t know what the future holds for trophy kitchens, but a minor kitchen renovation (costing about $15,000) remains one of the top home updates for the value it returns—and the cultural worth it creates. And this isn’t just about ROI. We haven’t quite shaken the historical view of the kitchen as a key site for producing dutiful housewives, unified families, and daily, private sustenance. Even for those who don’t cook, a kitchen remains necessary, valuable, and even inspiring. But it’s still not clear what the trophy is, or for whom it’s intended.

Emily Contois, PhD is Assistant Professor of Media Studies at The University of Tulsa. She is the author of Diners, Dudes, and Diets: How Gender and Power Collide in Food Media and Culture and the co-editor of a book on food Instagram.

Apple Christmas sales surge to $111bn amid pandemic

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Rainbow Six Siege has already been testing a reputation system for season 6

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Rainbow Six Siege will embark on its sixth year with four new operators and several map reworks, but the big launch is a reputation system that rewards positive gameplay behavior with in-game content, which Ubisoft Montreal has been shadow testing over the past few months.

The Reputation System already has been running in the background, according to a news release, and it’s been doling out in-game rewards to good teammates while limiting access to the ranked playlist for toxic ones. It’s also been working in other, unspecified ways to curb toxicity and encourage teamwork; Ubisoft said all this will become transparent when the tool launches at some point in the next year.

The system, and everything else, was discussed in a nearly hour-long livestream on Sunday, all of which is below.

The first season starts with Operation Rainbow Heist, starting March 18. Flores, from Argentina, is the first new operator, with subsequent operators for seasons 2 through 4 coming from western Canada’s Nakoda Nations, Croatia, and Ireland. Season 1 will see a rework of the map Border, with season 2 reconfiguring Favela, season 3 getting three map reworks, and finally Outback getting a polish with season 4.

Core gameplay changes will include the always ongoing operator and weapons balancing (developers have a much more technical discussion of that) as well as some new features and capabilities. Such as:

  • Armor will be called Health, “for players to have a better understanding on how much damage they can take.”
  • Players will be able to control cameras and gadgets after their death. “This change has been made to intensify the support phase in a game,” Ubisoft said in Sunday’s statement, “and make sure players that are out can better help their team.”
  • The Attacker team will be able to change operators and their loadouts as many times as they want in the preparation phase, “making scouting even more tactical and offering many new tactical possibilities,” Ubisoft said.

These features will all arrive at an unspecified point in the coming year.

Also, Ubisoft and Capcom are teaming up to deliver two Resident Evil skins to the game. The first, coming March 2, gives Zofia an elite-level Jill Valentine look. The second is unspecified but might be coming closer to Resident Evil Village’s launch in May.

Also on March 2, Echo and Dokkaebi will get elite skins designed by Ikumi Nakamura, formerly the creative director for Bethesda Softworks’ Ghostwire: Tokyo (and famous for her E3 2019 appearance).

Rainbow Six Siege first launched in December 2015. Ubisoft said the game now has a player base of more than 70 million.

Telemedicine and chatbots are using data to transform health care

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This article is part of a VB special issue. Read the full series: AI and the future of health care


Among the many transformations accelerated by COVID-19, health care ranks at the top of the list. An industry that had been changing at a plodding pace before 2020 has been forced to rapidly embrace advances like telemedicine and health chatbots on a far greater scale to navigate the crisis.

As health care providers adopt these tools, they are receiving a wealth of new patient data that is creating new challenges and opportunities. On the front lines between patients and doctors, the companies driving these products are betting that they are part of a broader revolution that will place data at the heart of everyday treatment.

“We call it digital primary care,” said Nick Desai, CEO of telemedicine platform Heal. “There is still an irreplaceable value to the human-doctor patient interaction. What we want to do is give doctors data-driven decision support.”

Data-driven medicine

Health care was already facing pressure to reinvent itself before the pandemic. A number of trends — such as population growth, longer lifespans, more complicated health issues, and doctor shortages — were among the factors contributing to higher health care costs and strains on the system.

At the same time, a number of digital trends had begun to collide. These include telemedicine platforms, connected health and fitness-monitoring gadgets, and chatbots, which had all steadily increased the amount of digitized health data being produced.

Telemedicine and chatbots got a nice boost when the Centers for Medicare & Medicaid Services expanded reimbursement for remote services such as telemedicine in 2019.

A Stanford University 2020 report published before the pandemic explored the rise of the data-driven physician. Among the factors that seemed to help this trend was the 21st Century Cures Act, passed and signed into law in December 2016. The law set out new data-sharing rules for Electronic Health Record (EHR) systems.

However, it was only last year that the U.S. Office of Management and Budget (OMB) finished defining the rules that would expand patient access to medical records, establish data standards, and enable more interoperability between EHR systems.

“For an industry that has long struggled with low levels of information sharing and poor interoperability across its technology systems, in 2020 we expect to see the final rules create a seismic shift in how health care stakeholders share and interact with digital medical records,” the Stanford report reads. “The rise of the Data-Driven Physician is a sign that the entire health care market is now grappling with the practical application of data and new technologies.”

Then came the pandemic.

Digital health

Even with this forward momentum, many in the medical community were reluctant to embrace these tools. But with the onset of the pandemic, opposition melted away as hospitals became either overwhelmed or simply unsafe to visit.

Hospitals increasingly turned to companies like U.K.-based Babylon Health, which offers services such as video consultations and the ability to report illnesses to providers. The company saw usage soar at the onset of the pandemic, and in May 2020 it launched in its first U.S. market. Sweden’s video consultation platform Kry also launched in the U.S. last spring to address surging demand.

Doctolib, a Paris-based company that offered online booking for medical appointments in France and Germany, had just launched its video feature before the pandemic took hold. Doctolib saw the number of daily video consultations jump from 1,000 pre-pandemic to 100,000 in the first few months of the outbreak. The French government has now authorized it to be one of the main platforms for booking COVID-19 vaccination appointments.

After years of gradual progress, telemedicine and chatbots became overnight successes during the pandemic. According to the recent State of Healthcare report from research firm CB Insights, telehealth (which includes telemedicine and chatbots) became a centerpiece of executive discussions during earnings calls as companies considered how to provide services to employees.

And funding for telemedicine startups soared.

Chatbots

When it comes to chatbots, Ada Health’s combination of artificial intelligence and human doctors had made it a rising star even before the coronavirus began its global spread. The company had spent years developing a platform that allowed patients to input their symptoms so the AI could sort through its databases and either give responses or make a referral to a doctor.

Anyone can download the Ada app for free. To ascertain their symptoms, users are asked a series of questions Ada’s algorithm personalizes based on the responses from each user. The app then suggests possible health issues and proposes next steps, such as making an appointment or going to an emergency room. The app replaces the often tedious work of taking a patient’s history, which can be a big time-saver for doctors and nurses. Ada’s revenue comes via partnerships with health providers who integrate Ada into their early screening systems.

According to Ada cofounder and chief medical officer Dr. Claire Novorol, the company’s consumer app now has 11 million users. While Ada had already seen rapid growth prior to 2020, last year it enabled 5.5 million assessments, or about 25% of all assessments since its app launched in 2016.

Novorol said that during the first phase of the pandemic, when users needed more trustworthy health advice, Ada launched a dedicated COVID-19 assessment and screener to support individuals and health organizations. This screener has since been adopted and integrated into health organizations around the world.

According to Novorol, increased adoption is generating more transparent and consent-driven health data collection and finding ways to share that data will improve digital health services, as well as overall medical quality. This includes capturing data from a wider range of people who might not typically go to a physician.

Novorol said Ada’s access to global aggregated and pseudonymized health data holds the potential to unlock real-time insights that provide additional breadth and depth to treatments.

“In the long-term, not only can health data improve public health and medical quality, but it also has significant potential when it comes to personalization in health care,” Novorol said. “I believe personalized, tailored experiences will be essential to the future of health care — and data will be a key part of that.”

Telemedicine

Heal’s Desai is also bullish about the potential for all this data to drastically improve health care.

The company’s telemedicine platform was initially designed to allow doctors to speak with patients from home. The theory was that seeing patients in their normal setting would be more convenient and give doctors insight into any home conditions that might impact a patient’s health.

Desai outlined four levels of data that can potentially impact health care, with Heal currently delivering the first three. The first level is real-time data that can be provided by simple actions, like a parent taking their kid’s temperature and then sending it directly to the doctor via Heal’s service.

The second level is continuous monitoring of patients via those aforementioned connected devices. Along the way, Heal has developed a suite of tools that allow doctors to continually monitor chronic patients from a distance, including factors like blood pressure, blood sugar, heart rate, and pulse.

That allows physicians to monitor trends in patients’ health status, rather than recording occasional data or relying on patient reporting. Those trends are more powerful for diagnosing a patient because it’s hard to know if a single measure is typical or not. In this case, the doctor can take corrective actions when the trend line seems troubling and more urgent interventions when something seems acute.

“If the doctor knows how your blood pressure’s been doing over the last month, or how your blood sugar has been doing over the last month, that’s very helpful to the doctor to make a more accurate diagnosis,” Desai said. “An average patient is not a good historian of their own health. This way, we keep them out of the hospital, but we’re using that data to more proactively deliver care.”

The third level is looking at the totality of all the data being captured from a patient. This allows for more contextual decisions by looking at a wide range of factors and how they are impacting each other.

However, it’s the fourth level that has Desai particularly excited. The company is currently working with university researchers to develop predictive medicine. This work involves trying to identify what data is useful, how to process it, and what conclusions can actually be made. He estimates such services are at least 12 to 15 months away.

The company is proceeding cautiously because the stakes are enormous. “The key is having it be absolutely accurate enough that the machine’s trend lines are indicative of reality,” Desai said. “Because the moment you make decisions based on machines, they’ve got to be good decisions.”

Even if the company cracks the formula, other hurdles remain. If a doctor can say with a high degree of certainty that a patient will develop a severe illness later in life, it might make sense to consider a preventive procedure. But while that decision might make sense at the time, it could lead to regret later if a treatment or cure for that same illness is developed many years later.

“Those are the kinds of things at an ethical level and at a practical level and at a cost level that become factors,” Desai said. “What is the insurance company willing to pay for the level of knowledge? It’s not just the science that has to advance, it’s also the business of health care, the insurance of health, ethical decisions, therapeutics, and treatment.”

But he added: “This is the holy grail. That machine-driven decision support, that’s the future for us.”

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Feud between Australian government and Facebook rages on with COVID campaign rollout – National Post

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‘On my watch, until this issue is resolved, there will not be Facebook advertising,’ said the health minister

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SYDNEY — Australia’s government pledged a publicity campaign for its rollout of COVID-19 vaccine on Sunday – but not in Facebook advertisements, as a feud continues over the social media giant blocking news content from its platform in the country.

Facebook Inc’s abrupt decision on Thursday to stop Australians from sharing news on its platform and strip the pages of domestic and foreign media outlets also blacked out several state government and emergency department accounts, drawing furious responses from lawmakers around the world.

Hours before Australia began inoculations with the Pfizer/BioNTech vaccine, Health Minister Greg Hunt said the government would embark on a wide-ranging communication campaign, including online, to ensure vulnerable people turned up for a shot.

But a ban on health department spending to advertise on Facebook would remain in place until the dispute between the Big Tech company and Australia – over a new law to make Facebook pay for news content – was resolved.

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“On my watch, until this issue is resolved, there will not be Facebook advertising,” Hunt told the Australian Broadcasting Corp. “There has been none commissioned or instituted since this dispute arose. Basically you have corporate titans acting as sovereign bullies and they won’t get away with it.”


Since the news blackout, Treasurer Josh Frydenberg has said he would talk with Facebook about its move over the weekend. On Saturday, Prime Minister Scott Morrison said Facebook had “tentatively friended us again” without giving further details.

Morrison got an injection on Sunday to publicize the program, saying the country would use “all the communication mechanisms available to us to reach people” without commenting specifically about Facebook advertising.

Hunt said the authorities would use every channel to encourage Australians to get vaccinated, including messages on foreign language broadcaster SBS, but “there is the capacity to do paid advertising (on Facebook) and that element is not on the cards … for now.”

Frydenberg’s office did not immediately respond to Reuters requests for comment on Sunday.

On my watch, until this issue is resolved, there will not be Facebook advertising

Morrison said Facebook Inc. has re-engaged with the government after escalating tensions.

“They’re back at the table,” Morrison told reporters on Saturday in Sydney. “That’s what we want to see. We want to work through this issue.”

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The prime minister also welcomed a report that a Facebook executive had apologized for the company mistakenly shutting down pages operated by charities and others that covered public-health and safety announcements. Morrison described the actions as “completely indefensible.”

Facebook  blocked news sharing on its platform in Australian in response to a legal standoff with the government, which is expected to pass laws next week aimed at compensating the local media industry for advertising revenue lost to digital platforms.

Facebook Chairman and CEO Mark Zuckerberg in a 2019 file photo. Photo by REUTERS/Erin Scott

Facebook’s dispute on news sharing in Australia is part of a broader battle against global regulation, with lawmakers in other countries watching the case closely.

A Facebook representative said in an email that the company was “engaging with the Australian Government to outline our ongoing concerns with the proposed law (and would) continue to work with the government on amendments to the law, with the aim of achieving a stable, fair path for both Facebook and publishers.”

With files from Bloomberg.

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