Some parts of remote living are here to stay
The pandemic was a stress test for many kinds of remote services. Which ones passed?
Why it matters:
The pandemic set off a global experiment in virtual living that will continue to shape our lives for years to come.
• Babyl Rwanda
• Daktari Africa
The Covid-19 pandemic shrank our world, reducing it to nothing beyond the walls of our homes. But as we sheltered in place, the world kept spinning: we sat in meetings, went on dates, celebrated holidays, and met friends for drinks. The only difference? We did it all from behind a screen.
It’s almost unimaginable to have a list of 10 world-changing technologies in 2021 without reflecting on how much of our lives have moved online. The pandemic was a crash course in how much we can get done remotely when we have to. It also revealed which aspects of life suffer most when we experience them only in a virtual way.
Though changes happened everywhere, those in two particularly important services—health care and education—had huge impacts on people’s overall well-being and quality of life. Online tools like Zoom suddenly became critical lifelines for many. But the most significant change was not in the technology itself—teleconferencing and telemedicine have long been available—but in our behavior.
What worked and what didn’t? What will stay and what won’t? And what have we learned that could help us better prepare for the future? Here we look at developments in Asia and Africa that could set an example for the rest of the world.
At its peak last April, the pandemic forced school closures in more than 170 countries, affecting nearly 1.6 billion children. As traditional schooling became virtual across most of the globe, Asia witnessed a parallel trend—a surge in demand for services such as those offered by the Hong Kong–based online tutoring company Snapask.
Snapask now has more than 3.5 million users in nine Asian countries—double the number it had before the pandemic. “What took five years to accumulate, we achieved in one year because of covid,” says Timothy Yu, who founded Snapask in 2015.
Other ed-tech companies in the region have reported similar growth. Byju’s, a learning app and the second most valuable startup in India, saw its user figures soar by a third, to nearly 70 million, when it offered its app for free following nationwide school closures in March of last year. When China’s leading online learning platform, Yuanfudao, did the same in early 2020, its system crashed under the load: more than 5 million people signed up.
Private tutoring has always been exceedingly popular in China and other Asian countries such as South Korea and Singapore, where eight in 10 primary school students receive out-of-school support. The pandemic has raised the profile of online tutoring services, which have quickly become as much a part of many students’ days as their scheduled classes.
Many schools just weren’t prepared for the switch to virtual teaching, especially in the pandemic’s early stages. Online tutors helped fill gaps in instruction and were able to focus more on students’ individual needs.
Yu built his company around the notion of “on-demand help”: students can snap a picture of a homework question they are struggling with, upload it via the popular messaging service WhatsApp at any time of day, and receive help from one of Snapask’s 350,000 tutors within 30 seconds.
Such services are often more convenient for parents than virtual schooling, says Wei Zhang, a professor at Shanghai’s East China Normal University who studies the field of private tutoring. She spent the past year looking into how the pandemic affected parents, students, and online tutoring companies in China, Japan, and Denmark.
A common complaint she heard about virtual schooling was that parents “had to help their kids check into classrooms, fix technical glitches, respond to teachers, and supervise homework.” Online tutoring services were much more straightforward.
Many tutoring platforms, including Snapask and Byju’s, also have extensive libraries of instructional videos filled with brightly colored animations, special effects, and sounds. “For kids, this makes the lessons feel more fun and interactive,” says Zhang.
All that said, inequality is a big barrier to scaling up both virtual schooling and online tutoring. Only 56% of people in Indonesia, for example, have internet access, according to statistics from 2019. And even in wealthier countries such as South Korea, where 99.5% of the population has internet access, the government had to step in and lend computers to low-income students.
At the same time, online tutoring does connect students in less developed regions with better instructors in urban areas. That’s probably why some students in China’s smaller cities have stuck with it even as schools return to normal, Zhang says. It also saves parents the hassle of shuttling their kids to and from private tutors.
Though private tutoring is not nearly as popular everywhere as it is in Asia, the covid-induced boost in online tutoring is a timely reminder for everyone: students learn best when teaching is tailored to their needs and when they take an active role in learning.
Another important lesson to carry forward is that teachers should be encouraged to think differently and teach in new ways, says Steve Wheeler, a visiting professor at the University of Plymouth in the UK, who researches distance teaching and learning. If school systems can embrace what worked for online teaching—adopting new media and adjusting content accordingly—“there’s a silver lining in the dark cloud,” he says.
Remote health care
A decade before the pandemic began, Davis Musinguzi came up with his big idea: a system that would allow people in Uganda to text a toll-free number and have a doctor call them back for a consultation. To many, the notion seemed audacious. But Musinguzi, then a medical student in the capital, Kampala, was convinced it would work.
He cofounded the Medical Concierge Group in 2012, which he now admits was “way too early.” Fewer than half the people in Uganda owned cell phones at that time.
Over the years, the effort expanded to incorporate video and WhatsApp messages, and a fleet of motorcycle-riding health-care personnel who would visit patients’ homes to conduct blood tests and deliver meds. The group also extended into Kenya and Nigeria.
When the pandemic struck in 2020, the number of users soared 10-fold between March and November. “Covid-19 was a game changer,” Musinguzi says.
Similar spikes in telehealth usage were reported globally. “There’s no telemedicine company I know across the world that hasn’t seen a surge in demand and also a change in consumer mindset toward telemedicine,” he says.
That remote health care is having a moment isn’t surprising. Remote video and phone consultations were already on the rise. Change often happens slowly in health care, but covid-19 supercharged that trend and “made it steeper,” says Alex Jadad, founder of the University of Toronto’s Centre for Global eHealth Innovation.
The pandemic pushed hospitals worldwide to a breaking point, and patients stayed away—whether out of fear or because they had to. Many turned to telemedicine. In the US, for instance, the proportion of people using it skyrocketed from 11% in 2019 to 46% a year later, according to McKinsey.
Uganda and other developing countries have a lesson or two to share about remote health care, which has evolved out of necessity in a region where doctors are often scarce. “In Africa, you have about 10% of the world’s population and 25% of the world’s disease burden. And yet we have only about 3% of the world’s doctors,” says Musinguzi. “So I think telemedicine fits in perfectly with that conundrum.”
Like remote learning, remote health care often requires high-speed internet, which isn’t always readily available in the developing world. But cell-phone penetration is now over 80% in Rwanda, Kenya, Nigeria, and some other parts of Africa.
Ayush Mishra, cofounder of Tattvan, runs e-clinics in 18 Indian cities. Tattvan, which means “to protect the five senses” in Sanskrit, operates an unusual model of telehealth. It franchises e-clinics—one- or two-room setups in villages, equipped with computers and a big screen. Patients can walk in for a consultation with the local doctor or speak to a specialist further afield if necessary.
In response to covid, Tattvan also launched a tele-mobile operator service in October: paramedics carrying backpacks loaded with equipment travel by motorbike to visit patients in remote villages.
Mishra believes this model of telemedicine—something between traditional brick-and-mortar health facilities and a doctor-on-an-app service—will ultimately prevail over the latter. “Trust is the biggest factor” when it comes to telemedicine, he says. “A local doctor sitting there is like a seal of trust.”
Though teleconsultations have surged, Mishra expects this uptick to be temporary. Once things start opening up, he says, he anticipates a gradual decline in demand.
And telemedicine certainly doesn’t suffice in all cases. “I think we’ve learned a lot about where teleconsultations can work and make things more efficient, but also where they can’t work well,” says Ann Blandford, a professor of human-computer interaction at University College London.
Other experts are more enthusiastic. “What we have seen is that 70% of routine outpatient visits can be handled through telemedicine and last-mile lab and pharmacy delivery services,” says Musinguzi.
Where do we go from here?
There’s no doubt that the pandemic has made many people more comfortable with using both telehealth and remote education. And that probably won’t go away. The pandemic will end, but our habits and preferences have evolved since it began.
Although remote services won’t work for every checkup or lesson, they can make people’s lives easier and better in many cases. The pandemic was a stress test for these services, and they proved capable of delivering much of what we needed, when and where we needed it. As we emerge from our homes, more of our lives than we might expect will continue to be lived online.
“What covid-19 has done is to tell people that you can now rely on services finding you at home, whether it’s shopping or health care,” says Musinguzi. “I think that’s the one thing that’s going to stay with us post-covid—we’re going to center our lives around our homes.”
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