John Hancock Has a Not-So-Secret Weapon for Tracking COVID-19

Because of those factors, the program participants take about twice as many steps per day as the non-participants, and are more likely get preventive screenings, he said.

The average age of a John Hancock Vitality Program participant is only about 42 to 44, and one encouraging sign is that, as of early December, no program participant had died from COVID-19, Tingle said. (Most people who die from COVID-19 tend to be over 65 years old.)

Tingle said he thinks a life insurer like John Hancock is the natural sponsor of a program like the Vitality program, because it forms relationships with policyholders that often last for many decades.

"We're not trying to turn our customers into marathon runners," Tingle said. But, in the long run, he said, persuading insureds to eat better, move more and get their health screenings is bound to pay off.

John Hancock presents the Vitality Plus program to agents as something that can appeal to affluent prospects, who tend to place a high value fitness and may enjoy some of the travel-oriented discounts and perks the program offers, such as hotel discounts.

The Internet of Bodies

John Hancock and Vitality have not been using Apple Watch blood oxygen data or Apple Watch cardiogram data to run the health incentive program.

But, because the companies are using heart rate data from digital devices to verify exercise levels, they are part of the "Internet of Bodies" — efforts to connect people's bodies to the internet through biometric sensors and other devices.

Andrea Matwyshyn, a professor at Penn State University's law school, used the term "Internet of Bodies" in a widely cited paper published by the William & Mary Law Review in 2019. She focused mainly on the legal issues involved with connecting human bodies to the Internet

Xiao Liu of McGill University and colleagues then wrote in another widely cited paper, for the World Economic Forum, that the Internet of Bodies could lead to insurers discriminating against people in unfair ways.

Vitality says the kinds of internet-powered health incentive programs it runs help people and society as a whole, not just insurers.

In South Africa, Vitality has about 400,000 active participants in its exercise incentive program, and those participants have increased their number of physical activity days by 39%, Vitality says.

But the sensitive nature of the Internet of Bodies may put constraints on what insurers can do with digital devices and health incentive programs.

Vitality has focused mainly on talking about what its program can do for the well-being of the health incentive program participants themselves.

COVID-19 Uses

Oracle Corp., the business software company, reported in June 2020 that some insurers were already collecting streams of COVID-19 data from wearable devices. Those insurers are hoping to use the data to manage future COVID-19 risk, Oracle said.

If insureds agree to send wearables data to insurers, the firms could warn the insureds when they seem to be suffering from early COVID-19 symptoms, Oracle said.

Conor Heneghan and other researchers at Fitbit — the maker of one brand of the devices available to John Hancock's Vitality Plus program participants — reported in August 2020 that they could use Fitbit data to detect about half of COVID-19 cases one day before participants reported the onset of symptoms.

"This is important because people can transmit the virus before they realize they have symptoms or when they have no symptoms at all," Heneghan wrote in a summary of the research published by Fitbit. "If we can let people know they should get tested a day before symptoms begin, they can isolate and seek care sooner, helping to reduce the spread of COVID-19."

Another team, led by Tejaswini Mishra of Stanford University, reported in Nature Biomedical Engineering in November 2020, that it had analyzed wearable device heart rate, step count and sleep data for about 5,300 people, including 32 people who had COVID-19.

The team said 22 of the 32 people who developed COVID-19 had changes in their heart rate, step count or time asleep before COVID-19 symptoms showed up, according to Mishra's team.

Wearables Observatory

Vitality USA's Gilbert has not been using health incentive program participants' heart rates to create COVID-19 forecasts, but he can use a community or employer's underlying Vitality population health statistics to predict how hard the pandemic will affect that group of people, he said.

One simple protective step an insurer or employer can take is to send $30 pulse oximeters, or blood oxygen measuring tools to plan members who appear to be at high risk of developing severe COVID-19, Gilbert said.

If people know their blood oxygen levels, that reduces the odds that they'll go to the hospital emergency room simply because they have an annoying cough, and increases the odds that they'll seek appropriate care if they're have serious problems with breathing, Gilbert said.

Something else Gilbert has noticed is that Vitality participant activity levels and shopping patterns change in roughly the same way when COVID-19 begins to surge in a community, no matter the location.

Program participants in communities with surging COVID-19 tend to eat out less, cook more at home, stop exercising at outside fitness facilities and spend more on home exercise equipment, Gilbert said.