OPINION — On August 6, 2020, an unusual, two-year, $870,000 contract for artificial intelligence (AI) in medicine imaging related to COVID-19 was awarded to Bunkerhill Health Inc., of Palo Alto, Calif., for work to be performed for the Department of Defense’s Joint Artificial Intelligence Center (JAIC).
The contract called for “the development of an algorithm that will detect, quantify, and predict outcomes of the novel coronavirus disease of 2019 (COVID-19) for use by the Department of Defense” over a 24-month base period.
What was unusual about the contract was that it was announced by the Air Force and was a no bid affair, done because JAIC’s need for the services required “such an unusual and compelling urgency that the Government would be seriously injured unless the agency is permitted to limit the number of sources from which it solicits bids or proposals,” according to the “Justification for Other than Full and Open Competition” announcement that accompanied the award announcement.
“Due to this rapidly growing global emergency [meaning the pandemic], it is not anticipated that another capable and qualified source could be identified and vetted in the short term that would be able to respond to the Government’s needs,” the announcement said.
Strangely, although the award announcement was made public August 6, the background to it laid out in the Justification for Other than Full and Open Competition was only made public last Saturday, October 31.
The justification announcement went on to describe the future of the coronavirus pandemic in somewhat different terms than President Trump and his most recent top spokesman, Dr. Scott Atlas have been using.
While Trump has claimed the virus is “rounding the corner” and will eventually vanish as the country opens up, the justification announcement said, “Despite aggressive control measures, COVID-19 is expected to cause frequent violent outbreaks in populations throughout the world for years to come, including within the U.S. military.” It called the virus “clinically unpredictable and shows significant potential to rapidly overwhelm the existing healthcare infrastructure. The inability to detect outbreaks, mobilize resources, and predict which patients will have a mild case and who will need advanced life support presents a significant challenge.”
It said because “the U.S. military faces sustained outbreaks around the world, investment into new technologies for COVID-19 detection, management, and prediction will be critical to reduce impact to national security and ensure armed forces personnel readiness.”
Describing AI as key to this effort, it said “One category of AI, deep learning, has proven very effective for image recognition in medical images. The development of an algorithm that can detect, quantify, and predict outcomes of COVID-19 outbreaks in support of the DoD in this worldwide pandemic would be a force multiplier.”
It should be noted that it was on August 10, that Trump announced the arrival of Dr. Atlas as a new member of the COVID-19 Task Force. Atlas, a senior fellow at Stanford’s Hoover Institution, from 1998 to 2012 had been a professor and chief of neuroradiology at Stanford’s Medical Center.
Another unusual contract aspect was that Bunkerhill, a startup last March, was teamed up with Stanford University’s Artificial Intelligence in Medicine & Imaging Center (AIMI) as part of the contract.
David Eng and Nishith Khandwala, listed as the two principals of Bunkerhill, received Master’s degrees in computer science from Stanford and were associated last year with AIMI where on April 18, 2019 they jointly gave a lecture on “Bone Age AI [Artificial Intelligence].”
AIMI’s Co-Director, Matthew Lungren “will be helping to spearhead this extremely important effort,” according to the announcement. Dr. Lungren is an Assistant Professor of Radiology at Stanford and also a shareholder and advisor to Bunkerhill. There is no public indication that Dr. Atlas has a connection to AIMI or Bunkerhill.
The justification document said, “Bunkerhill Health, Inc. and Stanford University have already deployed these AI-based systems to analyze chest images to accurately detect diseases in legions of untested patients. By employing this same technology for this requirement, the coronavirus disease is providing the first opportunity to create reliable algorithms on the fly. These same algorithms, with slight variations, are needed by the Government to meet the requirements of this contract.”
The government-written document followed statements in line with those of Dr. Anthony Fauci in summing up the pandemic situation as it existed in August.
It said, “All 50 states have begun to reopen in some way after the coronavirus thrust the country into lockdown. While there has been immense pressure weighing on the nation’s governments to reopen the economy, epidemiologists, as well as the Surgeon General warn of the potential for a second wave of cases.” It referred to protests like those associated with Black Lives Matter occurring and suggested “these activities, due to lack of social distancing, will result in resurgence in the spread of this potential deadly virus, which has already claimed over 100,000 lives.”
It then said, “Leading health officials, including the National Institute of Allergy and Infection Disease Director [meaning Dr. Fauci] has predicted the number of deaths in the United States will rise from 154,471 to over 182,000 (18%) between August 3, 2020 and August 22, 2020.” It went on to say, “Based on current projections, it is forecasted that 230,000 Americans could be dead by November 1, 2020. These numbers are expected to increase exponentially for the unforeseeable future.”
On the other hand, Trump’s new COVID-19 advisor, Dr. Atlas, has encouraged the President to move in a new direction which Atlas described in some detail last Saturday during an interview on RT, the Moscow-controlled, English language television channel which then posted it on YouTube.
In Atlas’ view, “The case number is not the most important metric. What’s important to understand is that the vast majority that are getting these cases are lower risk, healthier people, and we are doing a better job of protecting the elderly and the high-risk people.”
He quoted, as Trump has done during campaign speeches, “that 99.997 percent of people do fine” after showing signs of the virus. However, Atlas added that statistic covers only those age zero to 18. He also pointed out that the fatality rate now is much lower than it was at the beginning. “Even for people 85 and over, 75 to 84, 65 to 74 rates are decreasing so even if when they get sick they have a less chance of dying…We see a lot of cases, but we do not see an explosion of deaths and dying.”
Atlas’ policy, and the one he advised for the President, is only “wear a mask when you cannot socially distance, particularly when you are high risk or near a high-risk person.”
On the other hand, Atlas belongs to the group that believes in so-called “herd immunity,” which means most people have either been previously infected or had a vaccine. As he said on RT, “The lockdown will go down as an epic failure of public policy by people who refused to accept that they were wrong.”
He said, “The lockdowns are not impactful even to people like me, middle upper class because they still have their jobs and their children are underfoot and that’s an inconvenience…What we see in lower class and working class, lower socioeconomic class where they’ve lost their jobs, suicides have gone way up, drug abuse has gone way up. We’re creating a generation of neurotic children, forcing them to wear masks and be six feet apart from their friends or not even have school in person.”
He added, “We see in the U.S., people 18 to 24, 25 percent, college age students, one in four thought of killing themselves in the month of June because of the lockdown. This is a tragedy of epic proportions and the data is coming out.”
Atlas also took issue, as has the President, with the number of deaths. In the interview he called filling out death certificates “an art rather than a science,” implying not all the deaths attributed to COVID-19 should be.
Last September, more than 80 Stanford physicians, researchers, epidemiologists and health policy experts issued a letter critical of Atlas. They said, “Many of his opinions and statements run counter to established science and, by doing so, undermine public health authorities and the credible science that guides effective health policy.”
For his part, Atlas on Sunday apologized for appearing on RT, saying in a Tweet he "was unaware they are a registered foreign agent." He regretted doing the interview and “allowing myself to be taken advantage of.”
It remains to be seen how successful the Bunkerhill-Stanford AIMI contract will be in “development of an algorithm that will detect, quantify, and predict outcomes of the novel coronavirus.”
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