Jun 22, 2020 8:00 AM

There’s No Cure for Covid-19 Loneliness, but Robots Can Help

It’s hard to replace human contact. But during a pandemic, robots can help patients fight off feelings of isolation and despair.

Sandra Petersen’s patients are on the older side. “My youngest is 72,” she says. Some are centenarians. All are vulnerable to Covid-19, which disproportionately kills the elderly. Social distancing helps protect them, but it can also leave them profoundly lonely, facing a public health crisis while in isolation.

Petersen is a program director for the University of Texas at Tyler’s nursing department, but she also maintains a geriatric house-call practice in the Dallas-Fort Worth area. Her patients have been hit hard by the coronavirus and must often struggle through illness without the comfort of loved ones nearby. She has not been able to save some of them from disease, but Petersen is eagerly employing a tool for making this horrible time more emotionally bearable: robot pet therapy. Petersen’s bot of choice is Paro, an adorable, playful device from Japan that helps her patients feel less lonely. “The role of social robots like Paro is becoming more important, especially as we see this sector of our population targeted by this virus,” she says. “It's built for a time such as this.”

Paro looks more like a luxe toy than a health care tool. Modeled after a baby harp seal and deliberately scaled to the weight of a human infant, Paro coos and wiggles and blinks its unnervingly expressive eyes when it is held. But Paro isn’t just a $6,000 piece of cute overload; underneath its cuddly fur lies sophisticated artificial intelligence designed to comfort people. Invented by roboticist Takanori Shibata, the chief research scientist at Japan’s National Institute of Advanced Industrial Science and Technology, Paro may be helping Petersen’s patients, but it has also inspired some ethical hand-wringing about the role of robots in caretaking. Since its introduction in 2003, critics have feared it could supplant actual human contact—but it also demonstrably works, and in a time when social distancing is exacerbating isolation, devices like Paro can be a psychological salve. Petersen has studied the robot’s effects on people with Alzheimer’s disease, and she found that Paro reduced reliance on psychotropic drugs, improved blood pressure and oxygenation levels, and stirred the emotions of patients who otherwise often appeared disconnected.

“These people who supposedly had little short-term memory began interacting with Paro. As the study progressed, they’d see the Paro coming and recognize it,” Petersen says. “One lady who had been nonverbal for eight years, per her family’s report, started talking. And her first words were I love you—to the Paro.”

Is there something disconcerting about a woman who is unable to communicate with her family being able to form a bond with a robot? Maybe. But for humans who are able to look past the weirdness of developing emotional ties with robots, those connections can result in real benefits. Julie Carpenter, a research fellow in the Ethics and Emerging Sciences group at California Polytechnic State University, has studied the research on Paro and says that the effect the robot can have is similar to animal therapy. Carpenter also sees Paro’s artificialness as a boon to harried caregivers. “In nursing home settings where Paro has been used, the attendants have brought up the fact that it's easier for them to have Paro than an actual animal visit, because they don't need to clean or care for the animal,” she says. “They can focus on the patient.”

That doesn’t mean Paro is a perfect substitute for human interaction, but according to MIT robotics ethicist Kate Darling, it can potentially relieve distress at a time when that’s needed most. “Since we can’t have human interaction right now,” Darling says, “it’s certainly a lot better than nothing.”

During the Covid-19 crisis, Shibata has corresponded with people all over the world who have recently turned to Paro robots as a therapeutic tool. In addition to their increased prominence in elderly and memory care, Shibata says the pandemic has created some novel use cases. Workers at a high-volume call center in Tokyo who dealt with calls about coronavirus testing were given a Paro as a stress-relief tool this May. And Shibata has been emailing with a 34-year-old nurse in an Atlanta intensive care unit who started using a Paro this April as a way to cope with being isolated from his loved ones and pet. “He used to live with his family and a dog at the home, but in order to avoid any risks of infection from him to them, they moved to a different house,” Shibata says. Until he can return home, the Paro provides a semblance of companionship.

This sense of companionship doesn’t come cheap, though. Paro is predominantly used by institutions, because its price tag—around $6,000 in the United States—makes it prohibitively expensive for many individuals. “It's a very real access problem,” Carpenter says.

Paro, however, isn’t the only companion robot geared at alleviating loneliness. Sony’s Aibo—a cheerful dog equipped with a camera specifically to monitor children and the elderly—is less expensive than Paro but still costs around $2,800. There are more affordable models, like Joy for All’s stuffed animal-esque robots, which are available at places like Best Buy for around $130, although these offerings are more toylike than medical-grade. Jibo, a $900 social robot, gained devoted fans after its introduction in 2014 and looked like it could become a mainstream companion robot. But Jibo sunsetted its social robot in 2019, leaving loyal users sad that their little plastic friend no longer functioned—and highlighting the perils of bonding with an AI.

Meanwhile, the ElliQ, a “digital companion” from Israeli startup Intuition Robotics designed to help the elderly, isn’t commercially available yet, but Intuition is offering a free beta program during Covid-19. ElliQ doesn’t have the same tactile appeal as a fluffy seal, but its users have still become invested in the machine’s well-being during the pandemic. As part of the program, several users agreed to be interviewed and monitored by the company’s research team, a project that’s given the company intimate insights into how people are actually interacting with its creation, including what they say to their devices. The conversations make it apparent that people are using this type of robot as a sounding board, asking it the kind of questions they’d ask any friend. “Part of it is what you would expect, like ‘What are the symptoms for Covid? How many people are sick in my area?’ Things of that nature," says Dor Skuler, a cofounder of Intuition Robotics. "Part of it is really interesting—they're inquiring how she is doing. We’re seeing this often, like ‘How do you feel, ElliQ? ElliQ, can you get the virus? ElliQ, are you afraid?’”

While the arrangement between ElliQ’s beta testers and the company is voluntary, it underscores how this kind of companion robot does need to be closely examined for how well it safeguards its users’ information. Since many sophisticated companion robots gather data in order to customize their responses to users, they’re essentially friendly surveillance devices. “There are some privacy issues and potentially ethical ones,” Carpenter says of companion robots. “Especially if a patient is not cognizant of risks because they have dementia. Right now, a lot of these robots are designed so that, for example, data doesn't go to the cloud and lives in the robot, so that's helpful in terms of security. But people still need to ask these questions.” Many of these companies, including the makers of Paro and ElliQ, say they have considered these questions seriously and implemented protocols to protect privacy. Paro stores data locally and is not connected to the internet. ElliQ does sometimes store data in a cloud, but Skuler says Intuition has “gone to great lengths” to secure that information.

For all of the assistance and companionship that robots like Paro and ElliQ offer, though, they do raise a much larger question: Is it possible to make robots like these less necessary in a post-pandemic world? “I really hope that if there is any silver lining with Covid, it's that people will see how isolated older adults are in society,” Skuler says. “Let’s not forget about them when we’re back to work.”