Senior man looking out a window

Nothing is risk free and we are all learning to balance the risk of infection by SARS-CoV-2 with the associated risk to health and wellbeing from the ‘collateral’ of lockdowns and infection control measures. 

The older generation have been particularly at risk in this pandemic as evidenced by the terrible case fatality rates in many care homes. Care homes have had to take extreme measures including restrictions on visiting which has had a profound impact on residents, many of whom already suffer from loneliness, agitation and depression. What of technology in this? 

We have found that video calls and ‘hands free’ smart speakers have played a very useful role. However, some technologies – robot companions – are meant to be touched. There is considerable research showing that robot pets such as Paro the seal and Joy for All cat and dog, may benefit care home residents by reducing loneliness, agitation, depression and improving wellbeing.

Their use is now becoming widespread and care home staff have confirmed to us that their robot pets are indeed demonstrating particular usefulness at present, in the absence of usual visitors or scheduled activities. However, robot pets are often a shared resource, passed between residents and staff. 

The plausibility of SARS-CoV-2 transmission on fomites – objects that can transfer infections to others – raises implications for such devices. Care homes are able to follow the published advice about SARS-CoV-2 persistence on various surfaces but we have not yet seen publications regarding soft, artificial fur-type surfaces, as in the case of robot pets.

So how should care homes balance the benefit of use with the risk of virus transmission? 

Along with colleagues Chris Johnson and John Lee from Microbiology at Royal Cornwall Hospital, we had previously carried out empirical work, recently published in PLOS ONE, demonstrating that robot pets could transmit bacteria between care home residents. They tested the efficacy of a cleaning procedure to stop it and found that this worked well, and concluded that, if regularly cleaned the risk from bacterial infection with shared use of robots was acceptable.

But what of SARS-CoV-2? 

Our experimental work carried out in 2019 did not test for viruses and of course not for the new virus. Nevertheless, Mar Soler-Lopez from the University’s Peninsula Medical School reviewed the cleaning products used and compared them with the USA Environment Protection Agency (EPA) List N of Disinfectants for Use Against SARS-CoV-2. One of the two cleaning agents, PDI Super-Sani Germicidal Cloths, meets the EPA criterion for use against SARS-CoV-2. 

The other agent, Ecolab spray, used in the bacteria experiment was not listed and we have doubts as to whether the strength of propanol was sufficient to be effective against SARS-CoV-2. It is possible the order of application should change from our original procedure designed to remove bacteria to account for viruses and in particular SARS-CoV-2. But we cannot confirm this without more research.

So how do we balance risks and benefits in the meantime? Robot pets may be particularly useful during this pandemic and consequential isolation, but safety must be prioritised. Used individually retains the benefits while limiting the risk, but shared use of such devices appears unsafe at present. We are aware and concerned that robot pets are still in use in care homes, and often kissed and cuddled. We are also unaware of SARS-CoV-2 advice being provided by the main robot pet producers. There is an urgent need for empirical investigation of SARS-CoV-2 transmission on robot pets.

In the meantime, on balance, shared use of robot pets should be stopped.

Hannah Bradwell

An EPIC Research Associate in eHealth, Hannah is also completing her PhD in Applied Health. Over the last few years she has investigated the use and impact of therapeutic robots for people living in care homes and with dementia as well as investigating whether they can be made affordable for small budgets. Her recent paper published in the open-access journal PLOS ONE found that the devices, used to reduce depression, isolation and loneliness in older adults and people with dementia, became unacceptably dirty after use as bacteria built up on their surface and ‘fur’.

Hannah Bradwell care robots

Professor Ray Jones

Professor Ray Jones is Professor of Health Informatics and Co-Director of the Centre for Health Technology at the University of Plymouth. 

He leads the eHealth and Productivity in Cornwall and the Isles of Scilly (EPIC) project (funded by the European Regional Development Fund), which works to create a sustainable eHealth sector in the region, supporting regional businesses and addressing the challenges faced by ageing communities in coastal and rural settings.

Find out more about Professor Ray Jones

Ray Jones

The Old Normal: Our Future Health 

The Centre for Health Technology brings together researchers with over 30 years of evidence-based research experience in health and technology. Together, they work to enable innovative healthcare solutions that reduce the pressure on services, support healthy ageing in our communities and stimulate an economy of wellbeing that benefits all. 

In this series, they share their views on the current state of health and care in the UK, and what its future could look like.

Elderly woman looking hopeful