In normal times, the idea behind a hackathon is simple: dozens of people gather in a conference centre or university campus for a few sleepless nights of intense, sweaty work with the goal of building something new. These tech-oriented events are the ultimate party-meets–pressure cooker, with attendees vying to create the best app, algorithm, or video game. At the end, judges declare one team the winner. Occasionally, these events spark a new company or a novel invention, but usually, they are about fun—challenge for challenge’s sake.

This spring, however, a new sort of hackathon sprang up, drawing together pools of coders and developers and thinkers and medical professionals, all taking on the world’s most pressing challenge: solving the many problems that COVID-19 has created.

One of the first of these events was the three-day Hacking Health EasterHack, held this April. The pandemic made the usual intimacy of hackathons impossible, but it allowed for something new: though originating in Berlin, the event was open to people around the world, all of whom relied on an array of platforms—Slack, Sparkboard, Mentornity—that allowed for a novel hack-from-home experience. I settled in with hundreds of others to watch the opening ceremonies via my laptop. The atmosphere was genial though distant, in that Zoom sort of way. Someone was drinking a Corona beer; another sat in front of a beach green-screened onto their apartment wall. Soon, people from Sarajevo, Toronto, São Paulo, and beyond began pitching their projects to the crowd.

The ideas put forward had names like Pandemic Helper, the Magic Mask Makeover Machine, Hey You, and Stayathome. A group of entrepreneurs was developing a website that sought to offer a free therapy video hotline, in multiple languages and via artificial intelligence, for health care workers under duress. A Montreal IT worker wanted to create a virtual immunity passport that he was hoping would help people get back into the workforce quicker. Another group was designing a machine a little larger than a microwave that, using UV rays and heat, aimed to sanitize masks so they could be reused.

Across the hackathon’s various Slack channels, waiting as potential collaborators on whichever pitch most grabbed their interest, were physicists, software engineers, biologists, oncologists, business and security experts, fashion designers, and artists. I, a writer with some experience in the world of DIY diabetes technology, signed up as a storytelling “mentor,” which was a fancy way of saying I was an ideas person. Everyone was doing whatever they could.

What struck me most, though, as we listened to the ideas being bandied about, was the conviction. From the start of the pandemic, I’d noticed that people around me all felt a need to do something in light of this unprecedented event. Here was a mix of amateurs and professionals, all seeming to share the belief that the pandemic was just another technological problem to be solved and that, with a little bit of focus and grit, we could innovate ourselves some answers. But what on earth would we actually achieve?

Katarina Braune, thirty-one, works in the paediatrics department at the Charité hospital, in Berlin. She was also one of the organizers of the Berlin hackathon and is co-chair of the city’s chapter of Hacking Health, a worldwide movement based out of Montreal. I asked her why, as a doctor at a major research hospital in Germany, she believes events like these are important in the fight against COVID-19.

Braune explained that she participated in her first health-related event back in 2017. “I found a way to make Alexa into a diabetes app that told you when your blood sugar is going low,” she said. Braune lives with type-one diabetes, and her team’s prototype was a success: she won the hackathon. But, her win aside, she was surprised by what she saw as a lack of physicians present at a health hackathon. “It made me think, Why aren’t more medical professionals involved? Also, how do you have a health hackathon with no doctors actually participating?”

She began to look for collaborators. “There was a lot of skepticism [within the industry],” she said. Eventually, Braune found a partner in Akira-Sebastian Poncette, an anesthesiologist at Charité and a board member of Hacking Health Berlin. Braune then got the hospital and a number of sponsors on board for Charité’s first health hackathon, in 2017. The event was well-attended, with far more applicants than it could accept. The winning project was a piece of hardware that could measure the jugular’s venous pulse for heart-failure diagnostics. “It was a great experience to see that you could find a common denominator of people who worked from many backgrounds: health care workers, doctors, software programmers, entrepreneurs. It’s interdisciplinary, and I’m a big believer in this kind of collaboration,” she said. Then Braune noted something that surprised me: “Health hackathons build empathy.”

I asked her what she meant.

“A lot of funding is being dumped in places ineffectively, by our governments and hospitals, because people don’t talk to one another,” she said. “A hackathon lets people talk. We have to [communicate], now more than ever. It’s the only way we will get through this pandemic.”

Braune isn’t the only doctor who has concerns with the limitations of our institutions when it comes to health research. Wes Wilson spoke to me from his apartment in Toronto. Thirty-five years old and surrounded by various computer monitors, Wilson has a PhD in tumor immunology. During the week, he works in a lab at the University of Pennsylvania, doing tests on immunotherapy. At the time, there was anecdotal evidence out of Italy that one of the drugs he was working on might provide a COVID-19 cure. He couldn’t tell me its name or disclose too many details, but he did explain that the FDA had fast-tracked it for testing and they were now neck deep in clinical trials.

It may seem surprising that, on his time off from curing COVID-19 alongside major institutions, Wilson enthusiastically joined this Berlin hackathon as a volunteer computer programmer. But, when I asked why he wanted to spend his downtime tackling the same problem in this ad hoc capacity, Wilson argued that hackathons have an important role to play too. The problems, he explained, are time and money: developing drugs normally takes years of effort and millions of dollars. Even getting the money to begin research through normal channels is a waiting game. Hackathons, meanwhile, are all about immediacy. “Governments need to change. Institutions need to change. But, in the meantime, we have hackathons, where you can rapidly prototype,” he said. “Do you get a perfect solution? No. But anything is better than nothing. Done is better than perfect.”

Wilson teamed up with Harmony Pilobello, a thirty-four-year-old entrepreneur who runs an online ethical shoe company, on her idea for the Berlin hackathon: a contact-tracing app called ReCOVer.

Pilobello lives in Queens, New York, and at the time, her business was on hold: the Brazil factory she worked with had been shut down, and not many people needed new shoes when locked inside their apartments. Pilobello studied sustainable design at Parsons School of Design, so when her sister mentioned the hackathon, she decided to give it a shot. “I’m a problem solver,” she explained on FaceTime. “I like to try to come up with solutions in my work.” This was in April, not long after the number of COVID-19 cases had peaked in New York and left its hospitals in a state of chaos. Pilobello noted there was a lot of confusion. “No one knew where to go: which hospitals were taking patients, where to get tested, even if you could get tested. ReCOVer is a response to this confusion.”

The idea seemed simple but effective. App users are given a short quiz about their symptoms. ReCOVer then determines whether the user is low, medium, or high risk and tells them whether they should get tested. That info is then added to a centralized map, where the user can see the location of other cases that are confirmed or self-diagnosed nearby. The map also indicates high-risk areas, as well as the locations where people have died or recovered from the illness—information gleaned from users, local hospitals, and health authorities. In all, it was a triage tool and contact-tracing app in one.

Contact-tracing is all the rage right now in public health, and rightly so. Singapore and South Korea managed to avert huge COVID-19 numbers this spring through their contact-tracing apps. Google and Apple collaborated to launch their own controversial version of the app this past May. In the race to eradicate the virus, tools like these are among the foremost weapons that technology has to offer: ways of ascertaining who has the virus and how to isolate and contain it. But, to date, many countries are still trying to properly roll out an effective app of their own. “When you have a system overloaded, like New York City, you don’t have enough people to manually trace the virus, so we may as well be using our smartphones,” Wilson explained. “They’re already tracking us. Having access to these data sets in a centralized app could really improve the situation.”

The issue of data ownership and surveillance remains a hot one in the world of contact-tracing. One attractive feature of ReCOVer was that it offered not only data anonymity but also a guarantee to not sell user data. “Unlike Apple or Google, we don’t present any conflict of interest,” Wilson said.

Clodagh Durkan was the security consultant on Pilobello’s ReCOVer team, and she spoke with me from her home, in Düsseldorf, Germany. “For me, the big security question for an app like this is, What happens when the pandemic goes away?” she asks. “What happens if you get corona and it scars your lungs and this information is then sent to your insurer? Will it affect your premiums? For me, there’s a lot of questions we need to resolve.”

The prototype the ReCOVer team built was admirable. They had high hopes, too, during that April weekend: they wanted to launch it in New York and, later, in Berlin and Toronto. Not only did they have what seemed like an excellently functioning and user-friendly idea, but they were working in an altruistic and health-specific capacity. However, uncertainty remained: up against companies like Apple and Google, each with billions of dollars and hundreds of thousands of employees at its disposal, the odds that a startup like ReCOVer could succeed in becoming widely adopted seemed pretty slim.

Yet, as we look into the future of global health and pandemics, hackathon apps like this show what is possible and even necessary. Maybe ReCOVer won’t be universally adopted, but it seems like the right app for our times: digital health not based on profit, a service that pays honest attention to issues of data surveillance. It’s made to improve our collective health, not line the pockets of a few corporations.

What does it mean to hack COVID-19? At the start of the Berlin event, I harboured unrealistic fantasies. I wanted N95-mask replicators and homemade ventilators that could be reproduced as efficiently as tadpoles. I wanted an app that would scan my face and tell me if I had the virus. Hell, I wanted someone to come up with a vaccine in three days flat.

Back in early March, because of my own activity in the DIY diabetes world, I was invited to join a Facebook group: Open Source Ventilators. At the time, there were thousands of members from various fields—robotics engineers, physicians, programmers—who were all worried about a lack of resources in ICUs around the world. The goal was to find a way to supply hospitals and governments in need by creating ventilators from scratch. The products may not officially be medical grade, but, the thinking went, at least they would do something. Teams were assembled and began working around the clock, building linking parts for homemade ventilators via 3D printers and automobile equipment to create prototypes. It was an initiative as extraordinary as it was hopeful.

A month later, while in the middle of the Berlin hackathon, I returned to the Facebook page to see how the ventilators were progressing. In the weeks since I’d last looked, the page had changed. Firstly, there was the name: gone was the word ventilator. It was suddenly “Open Source COVID19 Medical Supplies.” After speaking with some members, I was told that the group had been too ambitious: there were serious concerns that the lack of medical certification would mean their ventilators would never be used. What had been thought of as a last resort was deemed a place of no resort. Instead, the group had been advised by a physician to build protective equipment for health care workers: after all, without them, who was going to run the ventilators?

Crafting face shields and masks may not be as dramatic, but it was practical. Within one month, the group had swelled to over 70,000 members. An April 9 report on the Facebook page stated that over 90,000 N95 face masks had been created or received as donations and supplied to various hospitals since the end of March. (One contributing group, Maui Face Mask Project, supplied 10,000 N95 masks for Maui health care workers and volunteers by mid-May.) Volunteers from California to Croatia to Brazil to Lithuania were making face shields, gloves, intubation boxes, hard-shell respirators, and more. Some were experimenting with cleaning used N95s, others were focused on distribution tactics. The data pointed to another law of tech startups: pivots are sometimes necessary. In a pandemic, hope itself would have to mutate.

In the days after the Berlin hackathon weekend, I followed up with members of Pilobello’s ReCOVer team. The project had won an award of 1,000 euros at the end of the event—a vote of encouragement. Later, I asked Pilobello if she would continue to develop the app. She told me she was in the process of applying for government funding: “I hope to see it being used in New York sometime soon.”

A few months later, we spoke again. New York, Pilobello said, seemed set on manual contact-tracing. She lamented that a lot of funding was veering away from COVID-19 digital health development altogether. It seemed that the ReCover app envisioned during the hackathon wasn’t to be. But Pilobello and the team weren’t giving up. They had a pivot on the ReCOVer idea, featuring game-like components that would allow people to log their symptoms. The plan was to target vulnerable communities with preexisting conditions, like diabetes and cancer, and help them take back some control of their health.

As I continue to watch my health and that of those around me, I have become less interested in waiting for the perfect technological solution. If hope mutates, it also means it doesn’t die. While too many people have gotten caught up in partisan politics, and others lost in conspiracy theories, the ingenuity of individuals working on grassroots campaigns continues to astound. COVID-19 hackathons are still spreading across the world. In late April, the EU funded a pan-European event. Civic hackers in South Korea were building their own contact-tracing app—and doing it faster than Google or Apple. In Germany, the government organized a 40,000-plus-person hackathon that actually led to the creation of a contact-tracing app that got the attention of Angela Merkel and informed the program now being used by 16 million German citizens. The challenges COVID-19 present don’t just propose an end to a way of life we are familiar with—they offer an opportunity for collaboration and empathy. When the world falls apart, there is also possibility. Anything can happen.

Jonathan Garfinkel
Jonathan Garfinkel is an award-winning poet, playwright, and author. He is working on a PhD in the medical humanities at the University of Alberta.

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