OPINION article

The population health effects from 5g: controlling the narrative.

\nFrank de Vocht

  • Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom

Introduction

The development and implementation of the fifth-generation wireless technology (5G) are currently ongoing and have largely been met with enthusiasm from the telecommunication industry, applications industries, national governments, and the public. However, 5G has also been met with resistance from anti-5G campaigning organizations supported by pockets of the general public. Concerns relate to the perception that 5G might increase total exposure to radiofrequency (RF) radiation, with further concerns around the fact that in addition to the frequency bands used in 3G and 4G, 5G will (and in some places already does) also use frequencies of >6 GHz including a new ~ 30–300 GHz “high band” with wavelengths from 10 to 1 mm [millimeter waves (MMWs)] ( 1 ). Further concerns relate to the use of multiple-input multiple-output (MIMO) technologies and beamforming, and to the implications on infrastructure as 5G requires many additional new small cells. A cursory read of popular and social media provides interesting reading and illustrates how different interpretations of the same information can result in widely varying interpretations, not least compounded by 5G-related conspiracy theories ( 2 ). Competing narratives around 5G are also described around geopolitical debates ( 3 ). Ideally, the peer-reviewed evidence synthesis literature should be free of these and other non-scientific influences, but in practice, this is rarely, if ever, the case. To explore the narrative that formed the basis for the evaluation of health risks in the peer-reviewed scientific literature, the publications on the topic published during the first critical period of discussion are briefly reviewed and discussed.

PubMed, Ovid Medline, and Web of Science databases of peer-reviewed literature were searched for reviews, commentaries, and opinion articles related to 5G and health. Inclusion was limited to these publications as these provide overviews of the evidence and/or initiate, drive, or direct the scientific debate, and primary research studies were excluded. Only publications in English language were included, and an a priori cutoff of the first 3 years from the first publication was assumed to describe the initiation and direction of the debate. Included articles were ranked based on the month and year of online publication (often “ahead of print”) to provide a chronological timeline of when information would have become available. Articles were assigned as “industry” or “activism” depending on whether the articles report links between the authors and either industry or campaigning organizations related to 5G in particular or mobile phones more broadly, or as “independent” otherwise. In case no such links were reported, a basic internet search was performed to identify unreported links.

An overview of the 15 articles included in this review is provided in Table 1 . The set of articles covered the period of 2018–2021, thus providing an overview of the first 3 years of publications on 5G and health.

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Table 1 . Overview of included publications.

The first review was published in February 2018 by Di Ciaula ( 4 ) and was based on a systematic search of epidemiological, in vivo , and in vitro studies identified in the PubMed database. Di Ciaula reported no funding or conflict of interest (CoI), but an internet search identified membership of the International Society of Doctors for Environment (ISDE), which published a 5G appeal for a moratorium on the development of 5G ( https://www.isde.org/5G_appeal.pdf ). Di Ciaula discussed the evidence for cancer, reproductive effects, neurologic effects, and microbiological effects and specifically addressed evidence in relation to MMWs. No formal assessment of the quality of the studies was included, and the author concluded that “[the evidence] clearly point to the existence of multi-level interactions between high-frequency EMF and biological systems, and to the possibility of oncologic and non-oncologic (mainly reproductive, metabolic, neurologic, microbiologic) effects” and further raises concerns regarding the increased susceptibility of children. The main aim of the review was to provide the rationale to invoke the precautionary principle, which is mentioned both in the Conclusion section and Abstract.

Russell published a similar review in April 2018 ( 5 ). Despite being the Executive Director of Physicians for Safe Technology, the author reported no affiliation, funding, or CoI. Russell does acknowledge support from Smernoff and Moskowitz; an internet search identifies the latter as being on the Advisory Board of Physicians for Safe Technology as well as being an advisor to the International EMF Scientist Appeal (and its spokesperson for the United States). The review reported effects on cancer, dermal effects, ocular effects, effects on reproduction and neurology, microbiological effects, and effects on the immune system. It further reports specific effects from MMWs, electrohypersensitivity [or, more accurately, idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF)], and effects on children, and discusses how industry bias has obscured these facts. Scientific uncertainty is only mentioned in passing and is largely attributed to industry distortion. Russell concludes that “current radiofrequency radiation wavelengths we are exposed to appear to act as a toxin to biological systems” and “although 5G technology may have many unimagined uses and benefits, it is also increasingly clear that significant negative consequences to human health and ecosystems could occur if it is widely adopted.” It further makes specific policy recommendations that “public health regulations need to be updated to match appropriate independent science with the adoption of biologically based exposure standards prior to further deployment of 4G or 5G technology” and that “a moratorium on the deployment of 5G is warranted, along with the development of independent health and environmental advisory boards that include independent scientists who research biological effects and exposure levels of radiofrequency radiation.”

McClelland and Jaboin, who do not seem to have published on the topic of mobile phones and health before, published a commentary in August 2018 ( 6 ). They reported no CoIs, the commentary was supported by a few references to in vivo studies, and the sole aim of the commentary was to bring a 5G moratorium to the attention of the journal's readership.

Miller et al. published their review on August 2019 ( 7 ). The manuscript was initially developed as a Position Statement of the International Network for Epidemiology in Policy (INEP), but after its board voted to abandon its involvement, the authors decided to publish it regardless. They reported affiliations to universities as well as the campaigning organizations the Environmental Health Trust and the Environment and Cancer Research Foundation, but did not, for example, report their involvement in the Physician's Health Initiative for Radiation and Environment (PHIRE) (Miller, Hardell, Davis) and Oceania Radiofrequency Scientific Advisory Association (ORSAA) (Hardell, Morgan, Davis). No information is provided on the methodology of this narrative review, and no quality assessment of included references is conducted, but scientific uncertainty is discussed. Carcinogenic and reproductive effects are reported as a specific susceptibility of children to RF. Particularly in relation to 5G, skin effects, oxidative stress, altered gene expression, immune function, and other biological endpoints are mentioned. The authors make several policy recommendations, but not specifically in relation to 5G.

In September 2019, Simkó and Mattsson published a pragmatic review of in vivo and in vitro evidence for health and biological effects in relation to 6 to 100 GHz frequency range ( 8 ). Both authors were from SciProof International and reported that their review was funded by Deutsche Telekom Technik GmbH. Although described in opaque language, the review seems to be based on a systematic approach to evidence synthesis and includes an assessment of study quality. Scientific uncertainty is discussed in detail, and the authors conclude that “regarding the health effects of 6–100 GHz at power densities not exceeding the exposure guidelines, the studies provide no clear evidence due to contradictory information from the in vivo and in vitro investigations.” They further highlight that “regarding the quality of the presented studies, a few studies fulfill the minimal quality criteria to allow any further conclusions.”

Hardell and Nyberg published a commentary in January 2020 ( 9 ). Both reported university affiliations and reported that neither funding was received for the work nor do they report any CoIs. However, in addition to unreported associations already mentioned above, it has also been documented that Hardell has previously received direct industry funding as well as funding from pressure groups, while he has also acted as an expert witness for the plaintiff in hearings around brain tumors and mobile phones ( 10 ). He is the spokesperson for the International EMF Scientist Appeal for Sweden and also runs a charity, the Environment and Cancer Research Foundation, which accepts direct donations and is heavily involved in appeals. The commentary includes several strong claims, including that “RF radiation may now be classified as a human carcinogen, Group 1” and that “experience with the EU, and the governments of the Nordic countries suggest that the majority of decision-makers are scientifically uninformed on health risks from RF radiation”, and interestingly and without basis that “they [the EU and governments of Nordic countries] seem to be uninterested to being informed by scientists representing the majority of the scientific community.”

In January 2020, there was also the publication of a review of health effects of 5G under real-life conditions by Kostoff et al. ( 11 ). They reported university affiliations and declared that neither external funding was received for the work nor any CoIs. However, an internet search identified that Héroux is the spokesperson for the International EMF Scientists Appeal for Canada. There is no assessment of study quality or scientific uncertainty. They mentioned that industry influence is the cause of the lack of consensus on health effects of mobile phones. The authors claimed that “there is a large body of data from laboratory and epidemiological studies showing that previous and present generations of wireless networking technology have significant adverse health impacts”, and that, with respect to 5G specifically, “superimposing 5G radiation on an already imbedded toxic wireless radiation environment will exacerbate the adverse health effects shown to exist.”

An information statement from the IEEE Committee on Man and Radiation (COMAR) was published in relation to health and safety issues concerning the exposure of the general public to electromagnetic energy from 5G wireless communication networks in June 2020 ( 1 ). All authors report industry CoIs. The main focus of the review relates to RF exposures from 5G, but some discussion specifically on potential biological and health effects of MMWs is included. Study quality is discussed in detail, including the varying quality of narrative reviews [including ( 4 )], and research gaps regarding the bioeffects of MMWs are highlighted. The authors refer back to ( 8 ) for a discussion on bioeffects and conclude that “… while we acknowledge gaps in the scientific literature, particularly for exposures at MMW frequencies, the likelihood of yet unknown health hazards at exposure levels within current exposure limits is considered to be very low, if they exist at all.”

Hardell contributed a second commentary in this period, with Carlberg as co-author ( 12 ). In this commentary, they reported the Environmental and Cancer Research Foundation as their affiliation, but declared neither CoI nor any external funding for the work. Also, the authors discussed the involvement of certain experts in various committees related to RF health and safety in the EU and internationally and the influence of industry. In addition, they mentioned effects of RF exposure, including 5G, on cancer, reproduction, and neurology; effects on the immune system; and microbiological effects, and also mentioned the susceptibility of children to RF. The claim that “the IARC Category should be upgraded from Group 2B to Group 1, a human carcinogen” is re-iterated, referencing Hardell's earlier contribution as the basis for this claim ( 9 ). Hardell and Carlberg highlighted the appeal for a 5G moratorium sent to the EU in 2017.

Leszczynski published a review on the physiological effects of MMWs on the skin and skin cells in August 2020 ( 13 ). He reports a university affiliation, neither external funding for the work nor CoI. Leszczynski conducted a systematic review of several databases for studies of >6 GHz. The quality and uncertainty of the available evidence are specifically discussed, and he concludes that “this evidence is currently insufficient to claim that any effects have been proven or disproven”. Leszczynski addresses policy and argues that “deployment for industrial use should be the first, but the further broader deployment for the non-industrial use should preferably await for the results of the biomedical research”.

Frank published an essay on 5G and the precautionary principle in January 2021 ( 14 ). He declares neither external funding nor CoI. He is, however, a member of the PHIRE team. Frank has no previous track record in radiation epidemiology, but he has reviewed the evidence and provided support for the work by Miller et al. ( 7 ). He concluded that the precautionary principle should be applied and recommended a moratorium on 5G development.

A team from the Swinburne University of Technology and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) published two studies in March 2021: a comprehensive review of the literature for experimental studies of bioeffects of RF fields between 6 and 300 GHz and a complementary meta-analysis ( 15 , 16 ). The authors reported Australian government and National Health and Medical Research Council funding, but no CoIs. Of relevance is that Karipidis is a member of the International Commission on Non-Ionizing Radiation Protection (ICRNIRP). The included studies in these publications were identified in a systematic literature search, and the authors have explicitly discussed study quality. They concluded that many studies have low-quality methods and that experimental data do not provide evidence that low-level MMWs are associated with biological effects relevant to human health.

Jargin published a letter to the editor in March 2021 ( 17 ) in which he has argued that various publications claiming there are health harms related to 5G published by interest groups overestimate any health risks from RF-EMF to hamper the technological advancement of developed nations. He further argued that excessive restrictions would only be unfavorable for the economy and add difficulties to daily life. As such, it advocates a policy recommendation of no action. He has reported neither external funding for the work nor any CoI.

Hardell also contributed a third publication ( 18 ). In this opinion piece/review, Hardell argued that evaluations by the Health Council of the Netherlands, the WHO, ICNIRP, and the Swedish Radiation Safety Authority are not impartial and that a moratorium on the implementation of 5G is urgently required. He has reported both university and foundation affiliations, but has reported neither external funding nor any of the above identified CoI.

This chronological overview of the publications published during the initial critical phase of discussions around 5G and health leads to the interesting observation that publications by authors with links to anti-5G campaigning organizations dominated the early phase in which adverse effects related to 5G were discussed. Over half of the 15 publications had links to such organizations in the initial 3-year period covered here. Such patterns of efforts to control the narrative during critical periods have been studied elsewhere, for example, in the sugar-sweetened beverage research ( 19 ); although in this example, the opposite pattern was observed in which the contribution of industry-related studies was high at the start and decreased significantly with time.

With the increasing contribution from independent and industry-linked authors over the covered time period, the narrative shifts from the exclusive reporting of increased risks of all biological or health effects covered to predominantly descriptions of mixed results and conclusions not supporting increased risks. This difference in the interpretation of the same evidence depending on the affiliation in RF research has been mentioned previously, specifically in relation to the funding source of primary studies ( 20 , 21 ), but the current overview is indicative of a similar pattern in other types of peer-reviewed publications. Reviews from independent and industry-linked authors were systematic-style reviews, rather than narrative reviews, and were of higher methodological quality because they based their inferences on a more systematic approach to the identification of relevant literature and also explicitly included some forms of assessment of the quality of these studies. They also had a narrower aim in terms of exposures or health outcomes, which will have facilitated a more systematic approach. There is evidence from various industries, including the telecommunications industry ( 20 , 21 ), of a correlation between industry funding of research and null findings. However, there is much less discussion of its mirror image: the phenomenon that independently funded studies may be biased if the authors have strong a priori beliefs about the question under study. This “white hat bias” is observable in the literature as selective referencing and the acceptance of a lower standard of scientific evidence for studies supporting the authors' beliefs ( 22 ), and was first explored in obesity research ( 23 , 24 ). The non-systematic inclusion of references (or “cherry picking”) and lack of explicit assessment of study quality observed in the publications in the current work were most prominent in the narrative reviews by authors with links to campaigning organizations and likely will have resulted in biased inferences. Importantly, since these publications made up most of the earliest publications during the critical window, these inferences will have disproportionally influenced the narrative. Given that all of these articles had the specific aim to influence policy and, in most cases, advocated for a moratorium on 5G, this provides further support for the presence of “white hat bias” influencing the initial peer-reviewed and, through that, lay literature.

Given the observed differences between publications by authors with links to campaigning organizations and those with industry-linked or independent authors, the reporting of CoI becomes more important. Direct industry funding and other financial CoIs are generally considered the main sources of potential bias, and these were reported by the publications with links to industry (either as a CoI or as a funding source) and by one of the papers with links to activism. However, no other financial CoIs were reported; for example, it is recorded that Hardell, who has contributed three publications in this critical time period, has previously received direct industry funding as well as funding from pressure groups, while he has also acted as an expert witness for the plaintiff in hearings around brain tumors and mobile phones ( 10 ). Importantly, industry and other financial CoIs are not the only potential source of CoI bias ( 25 ), and a variety of non-financial CoIs have been described, for instance, originating from particular concerns, ideals, and predilections ( 26 ). Membership of campaigning organizations or their advisory or expert boards would, presumably, constitute such non-financial CoIs and, therefore, should have been reported. Despite internet searches by the authors identifying quite a number of such CoIs, only a few of these were reported by the authors (or could be inferred from affiliations). Likewise, the membership of national or international expert organizations constitutes non-financial CoIs that ideally should have been reported, and Karipidis' membership of ICNIRP is relevant in the context of these publications.

Although the discussed timeline of publications highlights some interesting trends and areas of concern, this work has a number of limitations. Although the selected manuscripts were identified through a systematic search, it was not a systematic review of the literature, and publications that did not specifically mention 5G in the title, abstract, or keywords might have been missed. Furthermore, the search was also limited to publications in English language. Although the wider debate about health effects of 5G is much larger and also includes gray literature, popular, and social media, these were not included in this overview. It would be an interesting future exercise to evaluate similar trends in these media. Although several non-reported CoIs were identified, these were identified following cursory internet searches only and do not constitute an exhaustive list. It is likely that a more thorough systematic search would reveal additional links not reported here. It is also possible that some such CoIs did not exist yet at the time of publication.

In conclusion, the discussion around 5G as a significant human health risk in the peer-reviewed literature was initially largely driven by authors from, or with links to, various campaigning organizations and linked publications directly to appeals for a moratorium on 5G. Commentaries and letters are personal opinions and are rarely based upon a methodological appraisal of the evidence, but the narrative of the initial period covered in the current review, relied mostly on reviews of lower methodological quality compared, with the subsequently published reviews by independent researchers and researchers with links to industry. It is likely that articles in the popular media, therefore, were influenced more heavily by the initial advocacy publications than by the later higher quality contributions. Importantly, there is no clear answer (yet) whether the resulting narrative from the peer-reviewed literature describes an overestimation of risks as a result of articles with links to campaigning organizations, or whether later contributions from authors with links to industry, and possibly most independent authors, at the latter stages of the critical window describe an underestimation of true causal associations, or whether their combined evaluation will inform future evidence synthesis closer to “the truth”. It is, however, well established that not including explicit evaluation of the quality of studies included in evidence synthesis, and which was most evident in publications classified as “activism”, makes such reviews more susceptible to biased inferences. In addition to issues related to controlling the narrative and the impact of “white hat bias”, the current work further describes undisclosed non-financial CoIs that are likely to have influenced the interpretation of evidence. This was also observed particularly for those publications associated with campaigning organizations. The narrative around 5G and potential human health effects should be interpreted through this lens, in particular because many of the authors with links to various campaigning organizations in this article (Hardell, Héroux, Miller, and Moskowitz) as well as others who published works after the covered period have recently joined up formally in a new advocacy group ICBE-EMF ( 27 ).

Author contributions

FdV conceived of the study and wrote the first version of the manuscript. FdV and PA conducted the analyses. All authors contributed to the article and approved the submitted version.

Acknowledgments

The authors would like to thank Tabitha Pring, whose MSc dissertation partly informed the current work.

Conflict of interest

FdV is a member of the Committee on Medical Aspects of Radiation in the Environment COMARE, IRPA NIR Task Group, SRP EMFOR, and EMF Group of the Health Council of the Netherlands. FdV consulted for EPRI not directly related to this work.

The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: 5G, radiofrequency (RF), mobile phones, cellphones, bias, review, conflicts of interest (COI)

Citation: de Vocht F and Albers P (2022) The population health effects from 5G: Controlling the narrative. Front. Public Health 10:1082031. doi: 10.3389/fpubh.2022.1082031

Received: 27 October 2022; Accepted: 24 November 2022; Published: 19 December 2022.

Reviewed by:

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  • Correspondence
  • Published: 20 May 2021

Improving patient care through the development of a 5G-powered smart hospital

  • Guowei Li 1 , 2 ,
  • Wanmin Lian 3 ,
  • Hongying Qu 1 ,
  • Ziyi Li   ORCID: orcid.org/0000-0003-1528-3931 1 ,
  • Qiru Zhou 4 &
  • Junzhang Tian 5  

Nature Medicine volume  27 ,  pages 936–937 ( 2021 ) Cite this article

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To the Editor —In 2018, Guangdong Second Provincial General Hospital (GD2H) started incorporating artificial intelligence (AI) into hospital management and operations, including patient registration and triage, diagnosis aids, health-record organization, digital payment, and the transportation of operating-room supplies 1 , 2 . Due to the limitations of big-data sharing via the current 4G hospital network, practical applications of AI cannot be closely connected throughout the hospital, which compromises efficiency and reduces patient satisfaction. For example, if a patient is waiting for emergency surgery in the operating room after a magnetic resonance imaging scan, the surgeons can proceed only until the image files and reports are transferred to the system in the operating room, which takes time and causes delays.

case study of 5g in health

To address this issue, GD2H recently announced the building of a comprehensive smart hospital in conjunction with Huawei, using 5G technology that features low latency, high capacity, increased bandwidth and a wireless nature 3 . The 5G hospital has attracted worldwide attention because of the potential for fundamentally changing how hospitals operate. By using 5G in combination with cloud storage and AI, the comprehensive 5G smart hospital will cover areas of healthcare, teaching and training, research, and management, with 5G technology applied both within and outside the hospital, including ambulance, outpatient and inpatient services, and the operating room. The 5G smart hospital has several potential benefits, as outlined below.

In 2019, GD2H started to guide complex surgery conducted in remote hospitals, connected live via 5G, that allowed the operating room to be turned into a classroom 4 . Since then, GD2H has continued to explore ways that 5G could overcome the problem of real-time data sharing due to distance and volume of data. GD2H has now equipped its ambulances with a portable computerized tomography scanner, an electrocardiogram and an echocardiogram machine, as well as first-aid supplies. Once a patient enters the ambulance, the use of 5G allows real-time data on rapid assessment, with examinations and diagnoses, monitoring, and initial treatments transmitted to the hospital system simultaneously. If necessary, a multidisciplinary team can arrive within minutes for consultation and decision-making, while the emergency room is made ready to receive the patient. The 5G-powered ambulance as a mini-hospital will shorten the time from disease onset to treatment received, which should improve the survival of patients and achieve better outcomes.

The smart hospital at GD2H has applied 5G widely in the wards, which also make use of wearable trackers, smart touchscreens, robots for supply delivery and cleaning, infusion devices, and real-time monitoring and warning systems. Infusion devices transmit data on the speed and time remaining to the monitoring system automatically, while a warning signal is sent to the operating desk and the nurse’s wearable tracker, worn on the wrist, if anything requires clinical attention (Fig. 1). This is especially appreciated by patients with sleep problems, because the nurse can handle the infusion via remote tracking, without interrupting the patient’s sleep.

Patients in the wards can also receive remote consultations and monitor their own treatment. Patients can access all the data on examinations, treatments and expenses either from bedside touchscreens or from the smartphone app DingBei Doctor, which was developed by GD2H 5 . Accessing online consultations and discussions should improve inpatients’ satisfaction, facilitate management of their own health conditions and, ultimately, improve patient-centered outcomes.

Experiences with 5G smart hospitals such as GD2H may provide lessons for internet hospitals. The internet hospital is a fully digital platform that provides healthcare services and has the potential to be a telehealth model for healthcare provision and consumption in China. Internet hospitals aim to alleviate the disparity in healthcare resources in different parts of China, and to satisfy the emerging needs of patients, who want to receive medical care through an online platform, without the need for travel 6 . The internet hospital also provides an opportunity for controlling nosocomial infections, especially during the COVID-19 pandemic 7 . Patients can receive a contactless professional consultation and medical advice before visiting a hospital and, if needed, they can request home delivery of treatments after receiving an electronic prescription. The unavailability of big-data sharing is a key barrier to the efficiency and usage of an internet hospital 8 , so the use of 5G may be a potential solution to increase the use of internet hospitals.

In the future, we expect that the use of 5G in conjunction with AI will help with data-driven hospital management and decision-making, due to the extensive information available instantaneously, combined with a decision support system. Such rapid decision-making would have been very helpful at the start of the COVID-19 pandemic, when public panic led to a surge of patients into hospitals.

Other uses of the 5G smart hospital include hospital security, training for novice practitioners and researchers, patient self-management, and student teaching. There are also challenges, including public acceptance of 5G, the cost of infrastructure building, data security and privacy protections 9 . The initiation of a 5G-powered smart hospital at GD2H provides an exploratory platform for addressing these concerns. as well as for exploring how this technology can enhance patient outcomes and instill a culture of evidence-based decision-making.

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Acknowledgements

We acknowledge Z. Ye, Y. Zhou, M. Leng and J. Zhu for help in supporting necessary data and materials for this manuscript.

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Center for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou, China

Guowei Li, Hongying Qu & Ziyi Li

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada

Information Department, Guangdong Second Provincial General Hospital, Guangzhou, China

  • Wanmin Lian

Internet Hospital, Guangdong Second Provincial General Hospital, Guangzhou, China

Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Guangzhou, China

Junzhang Tian

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Correspondence to Junzhang Tian .

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Li, G., Lian, W., Qu, H. et al. Improving patient care through the development of a 5G-powered smart hospital. Nat Med 27 , 936–937 (2021). https://doi.org/10.1038/s41591-021-01376-9

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DOI : https://doi.org/10.1038/s41591-021-01376-9

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case study of 5g in health

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How 5g is driving the healthcare transformation.

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Estimated reading time: 10 minutes  

Can 5G save lives? The world's medical professionals think so. Healthcare innovators are working hard to explore how the speed, availability and reliability of 5G can transform medicine. These experts are currently developing ideas such as remote patient monitoring, augmented reality assisted robotic surgery, wearable monitors, connected ambulances and medicine transportation in medical deserts.

Analysts are confident these innovations can deliver. Research firm MarketsandMarkets says the value of the 5G healthcare market could reach $3.67 billion by 2026 , growing at a CAGR of 76.3 percent during the forecast period. For patients, the outcome will be better self-care, fewer days in hospital, higher quality of care, decreased wait times and a generally healthier population.

Before we explore the immense potential of 5G to transform healthcare, let's re-cap the 'story' of 5th generation cellular and summarize its capabilities.

The most important quality to consider with 5G is that it is not just faster 4G. Instead, it’s a new type of network. True ‘standalone’ 5G is cloud-native . This is because its foundational technologies (Network Function Virtualization and Software Defined Networking) turn many traditionally physical network components into software.

The virtual nature of 5G is what makes it so fast, capacious and reliable. Here are the key metrics for 5G :

•    Up to 10 gigabits per second (Gbps) data rate – 10 to 100x speed improvement over 4G and 4.5G networks •    1-millisecond latency •    1000x bandwidth per unit area •    Up to 100x number of connected devices per unit area (compared with 4G LTE) •    99.999 percent availability •    Up to 10-year battery life for low power IoT devices

The latter point – about the IoT – is extremely important. Most of the billions of devices that connect to 5G will not be smartphones. They will be 'things'. These will range from simple monitors and meters to sophisticated robots. 

According to Ericsson, there will be more than 22 billion connected IoT devices by 2024 . 

Which brings us back to telemedicine and telehealth, where high reliability and security matter more than anything else. Let's briefly define the two markets:

Telemedicine is the practice of using technology to deliver clinical services at a distance. It enables a physician in one location to deliver care to a patient at a remote site.

Telehealth refers to a broader set of electronic and telecommunications technologies and services used to provide care and services at a distance.

Obviously, 5G fulfils the fundamental speed and capacity requirements of the Internet of Medical Things. But there are still important design considerations for makers of connected medical devices to factor in. These include: 

•    Reliable connectivity Devices that record and send critical data must be trusted to stay connected for extended periods.

•     Compliant with medical devices regulation Devices must comply with the rising number of privacy and cybersecurity regulations being introduced across the world.       •    Long-lasting Devices must be future-proofed to allow secure remote software or security updates that provide optimal performance over extended periods.       •     Easy to use It must be easy for patients and doctors to connect and run IoT medical devices with minimal intervention or set up.

In 2022, many transformative Internet of Medical Things projects have already been launched. The COVID-19 pandemic might have helped to accelerate this process . It focused attention on the question of how doctors might continue to treat patients when one-on-one, low-touch sessions are not feasible. 

As a consequence, physicians and the public are now more accepting of bodily sensors and remote consultations. However, this just the start. The more dramatic breakthroughs might come with the emergence of the ‘tactile Internet’. Here, a physician might be able to perform a procedure on a patient in a different location. The surgeon’s movements at one site would be recreated instantaneously by computerised equipment at the other site. This is just one of a range of dramatic – potentially life-saving – applications of 5G in healthcare. 

Let's explore some of them.  Download our infographic .

case study of 5g in health

5G Technology in Healthcare and Wearable Devices: A Review

Affiliations.

  • 1 Department of AI & DS, Karpaga Vinayaga College of Engineering and Technology, Chengalpattu 603308, Tamil Nadu, India.
  • 2 Department of Biomedical Engineering, Karpaga Vinayaga College of Engineering and Technology, Chengalpattu 603308, Tamil Nadu, India.
  • 3 Department of Electrical Engineering, College of Engineering, Jouf University, Sakaka 72388, Saudi Arabia.
  • 4 Faculty of Engineering and Technology, Parul Institute of Engineering and Technology, Parul University, Waghodia Road, Vadodara 391760, Gujarat, India.
  • 5 Department of Electronics and Communication Engineering, IMPS College of Engineering and Technology, Malda 732103, West Bengal, India.
  • 6 Department of Electrical Engineering, Faculty of Engineering, Al-Azhar University, Nasr City, Cairo 11884, Egypt.
  • PMID: 36904721
  • PMCID: PMC10007389
  • DOI: 10.3390/s23052519

Wearable devices with 5G technology are currently more ingrained in our daily lives, and they will now be a part of our bodies too. The requirement for personal health monitoring and preventive disease is increasing due to the predictable dramatic increase in the number of aging people. Technologies with 5G in wearables and healthcare can intensely reduce the cost of diagnosing and preventing diseases and saving patient lives. This paper reviewed the benefits of 5G technologies, which are implemented in healthcare and wearable devices such as patient health monitoring using 5G, continuous monitoring of chronic diseases using 5G, management of preventing infectious diseases using 5G, robotic surgery using 5G, and 5G with future of wearables. It has the potential to have a direct effect on clinical decision making. This technology could improve patient rehabilitation outside of hospitals and monitor human physical activity continuously. This paper draws the conclusion that the widespread adoption of 5G technology by healthcare systems enables sick people to access specialists who would be unavailable and receive correct care more conveniently.

Keywords: 5G; IoMT; IoT; chronic disease; health monitoring; healthcare; robotic surgery; telemedicine; wearable devices.

Publication types

  • Delivery of Health Care*
  • Monitoring, Physiologic
  • Wearable Electronic Devices*

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case study of 5g in health

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Liverpool 5G Testbed

This health and social care testbed saw a group of organisations working together to reduce the digital divide

Liverpool 5G

The Liverpool 5G Testbed was the first health and social care testbed in the 5G Programme. The project managed to successfully build a low cost, publicly-owned 5G network to provide affordable connectivity in a disadvantaged area of Liverpool. It also demonstrated high-quality healthcare applications and devices that could deliver both substantial cost savings to health providers as well as improved health and quality of life to its users.

Key findings

Liverpool 5G Testbed Project

  • The project successfully deployed a publicly-owned, operational network in the Kensington ward of Liverpool. This network provided improved connectivity to target houses and other facilities (e.g. care homes).
  • The project created the largest 5G mmWave mesh network in the UK and second largest in the world, using the city council’s fibre CCTV ring and lamposts for the backhaul. Using wireless 5G backhaul is a huge advantage as it avoids digging up roads in urban areas.
  • The use cases that were tested showed the potential for growth and investment in the local, digital economy.
  • There are 8.8 million people who are unpaid carers in the U.K. This testbed offers an example of how technology like this could be used to help the reduction of loneliness in people feeling socially isolated.
  • The project received further Government funding (£4.3 million) in the 5G Create competition. The Liverpool 5G Create project will stimulate the development of low-cost 5G technology as well as improving future pandemic resilience and reducing inequalities.
  • Reduced loneliness: Of the 49 participants there was over 25% reduction in those who felt often or sometimes lonely.
  • Increased quality of life: Worth over £8,000 per person.
  • Reduced feelings of loneliness: 75% increase in those saying they hardly felt left out.
  • Decreased GP use: Average number of GP visits dropped by over 15%.
  • Reduced Time burden for carers: Average 5 hour reduction per carer.
  • Fewer Visits to GPs: Over 10% reduction in total GP visits.
  • Fewer visits to hospital: Over 40% decrease in hospital attendance.
  • Increased quality of life reported life satisfaction, worth over £4,000 per person.
  • Fewer medical errors: Over 50% reduction in people given the wrong medication or taking the wrong dosage.
  • Medication adherence levels: 95% (this is 40% higher than the national average of 55%).
  • Fewer visits to hospital: 60% reduction in those attending hospital.
  • Fewer GP visits: Reduction of over 30% in the number of people who visited their GP and an over 15% drop in the average number of visits per user.
  • Reduced time burden for care workers: Saved over 300 hours per person per year, that requires support taking medication.
  • Overall cost savings : Administering this service led to cost savings of over £2,000 per user per year. Reduction in GP visits could lead to potential cost saving over £2,000 per 100 users per year.
  • Increased quality of life reported life satisfaction, worth over £5,000 per person.
  • Telehealth in a box (Virtual Reality pain relief) - This use case explored how 5G could be used in assistive technology to support early discharge of patients from hospital and into their own homes. VR headsets were used as a distraction in palliative care for pain management. This, however, was inconclusive.

Blog: How the Liverpool 5G Project helped bridge the health gap during Covid19

  • Liverpool 5G Health and Social Care Testbed: Benefits Outcomes and Impact (November 2019) - This report outlines the data and benefits from the different use cases in the project and how they benefited the users during the trial.
  • Liverpool 5G Health and Social Care Testbed: Developing the Network (January 2020) - This report outlines the planning, installation and deployment of the network and how it was managed throughout the project.
  • Liverpool 5G Health and Social Care Testbed Overview (January 2020) - An overview of the project, including rationale, how the project was executed and key learnings from the data of the use cases.
  • "Push to Talk" Prototype Rebuild and LoRaWAN Connection - An in-depth analysis of the ‘Push to Talk’ device, which was used to connect users to reduce loneliness.
  • Using 5G Technology to Improve Digital Health and Social Care Applications - Final presentation providing an overview of the project and its findings.
  • Other publications can be found on the Liverpool 5G Testbed website .

Project Partners

  • Sensor City (Lead) - Liverpool
  • Royal Liverpool and Broadgreen University Hospital NHS Trust
  • eHealth Cluster
  • CGA Simulation
  • Amazon Web Services
  • Liverpool John Moores University (LJMU)
  • Liverpool City Council
  • Blu Wireless
  • DefProc Engineering
  • The Medication Support Company
  • Number of local social care providers

More information on the project can be found here .

Updated case study

First published.

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In the tech world and beyond, new 5G applications are being discovered every day. From driverless cars to smarter cities, farms, and even shopping experiences, the latest standard in wireless networks is poised to transform the way we interact with information, devices and each other. What better time to take a closer look at how humans are putting 5G to use to transform their world.

What is 5G?

5G (fifth-generation mobile technology) is the newest standard for cellular networks. Like its predecessors, 3G, 4G and 4G LTE, 5G technology uses radio waves for data transmission. However, due to significant improvements in latency, throughput and bandwidth, 5G is capable of much faster download and upload speeds than previous networks.

How is 5G different from other wireless networks?

Since its release in 2019, 5G broadband technology has been hailed as a breakthrough technology with big implications for both consumers and businesses. Primarily, this is due to its ability to handle large volumes of data generated by complex devices using its networks.

As mobile technology has expanded over the years, the amount of data users generate every day has increased exponentially. Currently, other transformational technologies like artificial intelligence (AI), the Internet of Things (IoT ) and machine learning (ML) require much faster speeds to function than 3G and 4G networks offer. Enter 5G, with its lightning-fast data transfer capabilities that allow newer technologies to function in the way they were designed to.

Here are some of the biggest differences between 5G and previous wireless networks.

  • Physical footprint: The transmitters used in 5G technology are smaller than in predecessors’ networks, allowing for discrete placement in out-of-the-way places. Furthermore, “cells”—geographical areas that all wireless networks require for connectivity—in 5G networks are smaller and require less power to run than in previous generations.
  • Error rates: 5G’s adaptive Modulation and Coding Scheme (MCS), a schematic that WiFi devices use to transmit data, is more powerful than ones in 3G and 4G networks. This makes 5G’s Block Error Rate (BER)—a metric of error frequency—much lower.
  • Bandwidth: By utilizing a broader spectrum of radio frequencies than previous wireless networks, 5G networks can transmit on a much wider range of bandwidths. This increases the number of devices they can support at any given time.
  • Lower latency: 5G’s low latency , a measurement of the time it takes data to travel from one location to another, is a significant upgrade over previous generations. This means routine activities like downloading a file or working in the cloud is going to be much faster with a 5G connection than a connection on a different network.

How does 5G work?

Like all wireless networks, 5G networks are separated into geographical areas known as cells. Within each cell, wireless devices—such as smartphones, PCs and IoT devices—connect to the internet via radio waves transmitted between an antenna and a base station. The technology that underpins 5G is essentially the same as in 3G and 4G networks, but due to its lower latency, 5G networks are capable of delivering much faster download speeds—in some cases as high as 10 gigabits per second (Gbps).

As more and more devices are built for 5G speeds, demand for 5G connectivity is growing. Today, many popular Internet Service Providers (ISPs), such as Verizon, Google and AT&T, offer 5G networks to homes and businesses. According to Statista, more than 200 million homes and businesses have already purchased it with that number expected to at least double by 2028 (link resides outside ibm.com).

Let’s take a look at three areas of technological improvement that have made 5G so unique.

New telecom specifications

The 5G NR (New Radio) standard for cellular networks defines a new radio access technology (RAT) specification for all 5G mobile networks. The 5G rollout began in 2018 with a global initiative known as the 3rd Generation Partnership Project (3FPP) that defined a new set of standards to steer the design of devices and applications for use on 5G networks.

The initiative was a success, and 5G networks began to grow swiftly in the ensuing years. Today, 45% of networks worldwide are 5G compatible, with that number forecasted to rise to 85% by the end of the decade according to a recent report by Ericsson  (link resides outside ibm.com).

Independent virtual networks (network slicing)

On 5G networks, network operators can offer multiple independent virtual networks (in addition to public ones) on the same infrastructure. Unlike previous wireless networks, this new capability allows users to do more things remotely with greater security than ever before. For example, on a 5G network, enterprises can create use cases or business models and assign them their own independent virtual network, dramatically improving the user experience for their employees by adding greater customizability and security.

Private networks

In addition to network slicing, creating a 5G private network can also enhance personalization and security features over those available on previous generations of wireless networks. Global businesses seeking more control and mobility for their employees increasingly turn to private 5G network architectures rather than public networks they’ve used in the past.

5G use cases

Now that we better understand how 5G technology works, let’s take a closer look at some of the exciting applications it’s enabling.

Autonomous vehicles

From taxi cabs to drones and beyond, 5G technology underpins most of the next-generation capabilities in autonomous vehicles. Until the 5G cellular standard came along, fully autonomous vehicles were a bit of a pipe dream due to the data transmission limitations of 3G and 4G technology. Now, 5G’s lightning-fast connection speeds have made transport systems for cars, trains and more much faster than previous generations, transforming the way systems and devices connect, communicate and collaborate.

Smart factories

5G, along with AI and ML, is poised to help factories become not only smarter but more automated, efficient and resilient. Today, many mundane but necessary tasks associated with equipment repair and optimization are being turned over to machines thanks to 5G connectivity paired with AI and ML capabilities. This is one area where 5G is expected to be highly disruptive, impacting everything from fuel economy to the design of equipment lifecycles and how goods arrive at our homes.

For example, on a busy factory floor, drones and cameras connected to smart devices utilizing the IoT can help locate and transport something more efficiently than in the past and prevent theft. Not only is this better for the environment and consumers, but it also frees up employees to dedicate their time and energy to tasks that are more suited to their skill sets.

Smart cities

The idea of a hyper-connected urban environment that uses 5G network speeds to spur innovation in areas like law enforcement, waste disposal and disaster mitigation is fast becoming a reality. Some cities already use 5G-enabled sensors to track traffic patterns in real time and adjust signals, helping guide the flow of traffic, minimize congestion and improve air quality.

In another example, 5G power grids monitor supply and demand across heavily populated areas and deploy AI and ML applications to “learn” what times energy is in high or low demand. This process has been shown to significantly impact energy conservation and waste, potentially reducing carbon emissions and helping cities reach sustainability goals.

Smart healthcare

Hospitals, doctors and the healthcare industry as a whole already benefit from the speed and reliability of 5G networks every day. One example is the area of remote surgery that uses robotics and a high-definition live stream connected to the internet via a 5G network. Another is the field of mobile health, where 5G gives medical workers in the field quick access to patient data and medical history, enabling them to make smarter decisions, faster, and potentially save lives.

Lastly, as we saw during the pandemic, contact tracing and the mapping of outbreaks are critical to keeping populations safe. 5G’s ability to deliver of volumes of data swiftly and securely allows experts to make more informed decisions that have ramifications for everyone.

Better employee experiences

5G paired with new technological capabilities won’t just result in the automation of employee tasks, it will dramatically improve them and the overall employee experience . Take virtual reality (VR) and augmented reality (AR), for example. VR (digital environments that shut out the real world) and AR (digital content that augments the real world) are already used by stockroom employees, transportation drivers and many others. These employees rely on wearables connected to a 5G network capable of high-speed data transfer rates that improve several key capabilities, including the following:

  • Live views: 5G connectivity provides live, real-time views of equipment, events and even people. One way in which this feature is being used in professional sports is to allow broadcasters to remotely call a sporting event from outside the stadium where the event is taking place.
  • Digital overlays: IoT applications in a warehouse or industrial setting allow workers equipped with smart glasses (or even just a smartphone) to obtain real-time insights from an application, including repair instructions or the name and location of a spare part.
  • Drone inspections: Right now, one of the leading causes of employee injury is inspection of equipment or project sites in remote and potentially dangerous areas. Drones, connected via 5G networks, can safely monitor equipment and project sites and even take readings from hard-to-reach gauges.

Edge computing

Edge c omputing, a computing framework that allows computations to be done closer to data sources, is fast becoming the standard for enterprises. According to this Gartner white paper (link resides outside ibm.com), by 2025, 75% of enterprise data will be processed at the edge (compared to only 10% today). This shift saves businesses time and money and enables better control over large volumes of data. It would be impossible without the new speed standards generated by 5G technology. 

Ultra-reliable edge computing and 5G enable the enterprise to achieve faster transmission speeds, increased control and greater security over massive volumes of data. Together, these twin technologies will help reduce latency while increasing speed, reliability and bandwidth, resulting in faster, more comprehensive data analysis and insights for businesses everywhere.

5G solutions with IBM Cloud Satellite

5G presents big opportunities for the enterprise, but first, you need a platform that can handle its speed. IBM Cloud Satellite lets you deploy and run apps consistently across on-premises, edge computing and public cloud environments on a 5G network. And it’s all enabled by secure and auditable communications within the IBM Cloud.

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VIDEO

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COMMENTS

  1. 5G Use in Healthcare: The Future is Present

    A recent study (Table 1) in which 6 hospitals participated from 6 different cities in China, 5G telerobotic spinal surgeries for 12 patients were performed and a total of 62 pedicle screws were successfully implanted using the 5G telerobotic surgery system. 52 The operation time was 142.5 ± 46.7 minutes, and the mean guide wire insertion time ...

  2. Moskowitz: Cellphone radiation is harmful, but few want to believe it

    Last year, we updated our review, published in the International Journal of Environmental Research and Public Health, based on a meta-analysis of 46 case-control studies — twice as many studies as we used for our 2009 review — and obtained similar findings. Our main takeaway from the current review is that approximately 1,000 hours of ...

  3. Is 5G Safe? Here's What Experts Say

    Verdict: Fiction. Claims state 5G weakens the immune system, making it easier to contract COVID-19, or that it directly causes the virus. Simply put, research emphasizes that the belief that 5G ...

  4. The evolving roles and impacts of 5G enabled technologies in healthcare

    The 5G enabled digital technology can aid more effective medical research, diagnose and treatment, as well as improved healthcare services for both medical professionals and patients in anywhere-anytime . Fig. 2 illustrates a simple 5G based health platform that assists both the patients and the medical professionals .Since 5G promises super-speed (about 100Mbs) with high data bandwidth and ...

  5. What 5G means for our health

    Fast 5G networks are supposed to take hold in 2019, as phones, providers and networks all begin to come online. Behind the scenes, studies modelling the absorption patterns of 5G electromagnetic ...

  6. The population health effects from 5G: Controlling the narrative

    The authors claimed that "there is a large body of data from laboratory and epidemiological studies showing that previous and present generations of wireless networking technology have significant adverse health impacts", and that, with respect to 5G specifically, "superimposing 5G radiation on an already imbedded toxic wireless radiation ...

  7. Improving patient care through the development of a 5G-powered ...

    The 5G-powered ambulance as a mini-hospital will shorten the time from disease onset to treatment received, which should improve the survival of patients and achieve better outcomes. The smart ...

  8. Healthcare Revolution in the 5G Age: Health Risk and Opportunity

    The IoT systems residing on 5G networks can create opportunities to transform existing healthcare processes, thereby enabling a healthcare revolution. This healthcare transformation will save time and costs in administering healthcare services and can potentially save more lives. Currently, 4G and prior networks form the underlying fabric for ...

  9. Will Connectivity Be The Next Cure? Health Care Implications Of 5G

    The potential implications of 5G cellular technology within health care remain unexplored. Targeted policies aiming to facilitate safe and equal access to technologies leveraging 5G will be ...

  10. PDF GSMA 5G Case Studies 5G: EnAblinG DiGitAl HEAltHCArE

    GsMa Case sTUdies - 5G SMART HOSPITAL GsMa Case sTUdies - 5G SMART HOSPITAL 3 HarnessinG ar in HealTHCare 5G infrastructure is also used to support very bandwidth-intensive applications, such as AR and VR services. Today, clinicians use two-dimensional multi-slice images, such as those from a CT scan, to make a diagnosis;

  11. How 5G is driving the healthcare transformation

    Analysts are confident these innovations can deliver. Research firm MarketsandMarkets says the value of the 5G healthcare market could reach $3.67 billion by 2026, growing at a CAGR of 76.3 percent during the forecast period. For patients, the outcome will be better self-care, fewer days in hospital, higher quality of care, decreased wait times ...

  12. 5G mobile networks and health—a state-of-the-science review of the

    The review also included epidemiological studies (cohort, case-control, cross-sectional) investigating exposure to radar but excluded studies where the stated radar frequencies were below 6 GHz. ... Simkó M, Mattsson MO. 5G Wireless communication and health effects—a pragmatic review based on available studies regarding 6 to 100 GHz. Int J ...

  13. 5G Technology in Healthcare and Wearable Devices: A Review

    The requirement for personal health monitoring and preventive disease is increasing due to the predictable dramatic increase in the number of aging people. Technologies with 5G in wearables and healthcare can intensely reduce the cost of diagnosing and preventing diseases and saving patient lives. This paper reviewed the benefits of 5G ...

  14. PDF How 5G is Transforming Healthcare

    The 5G is being used to relay real-time information about a patient travelling in an ambulance to medics in the hospital so they can prepare ahead of the patient's arrival at the emergency room. That information could include vital signs, video images and medical records. Since the 5G technology was deployed in late 2021, the survival rate of

  15. Electromagnetic fields, 5G and health: what about the precautionary

    New fifth generation (5G) telecommunications systems, now being rolled out globally, have become the subject of a fierce controversy. Some health protection agencies and their scientific advisory committees have concluded that there is no conclusive scientific evidence of harm. Several recent reviews by independent scientists, however, suggest that there is significant uncertainty on this ...

  16. PDF GSMA 5G Case Studies SECURE AND RESPONSIVE CONNECTIVITY FOR

    GSMA CASE STUDIES MANUFACTURING AND HEALTHCARE GSMA CASE STUDIES MANUFACTURING AND HEALTHCARE 3 CULTIVATING A 5G ECOSYSTEM True has organised three programmes to help build a 5G ecosystem and community in Thailand: » 5G Worldtech X: an immersive tech show in Thailand showcasing over 40 use cases from over 30 local and global partners.

  17. Liverpool 5G Testbed

    2 August 2021 — See all updates. The Liverpool 5G Testbed was the first health and social care testbed in the 5G Programme. The project managed to successfully build a low cost, publicly-owned ...

  18. 5G use cases that are transforming the world

    The advantages and disadvantages of private cloud 6 min read - The popularity of private cloud is growing, primarily driven by the need for greater data security. Across industries like education, retail and government, organizations are choosing private cloud settings to conduct business use cases involving workloads with sensitive information and to comply with data privacy and compliance needs.

  19. Comment on "5G mobile networks and health-a state-of-the-science review

    The Karipidis review was performed against a backdrop of rising public concerns associated with the health and safety of 5th generation (5G) wireless technology . ... In "late lessons from early warnings" a variety of case studies spanning chemicals, physical agents, pathogens, and environmental issues illustrate how timing is critical for ...

  20. PDF How 5G can make cities safer and healthier

    microphones and other sensors in a 5G connected unit mounted on the rooftop of taxis. If the trial is successful, Motov plans to use 5G to underpin its "urban road safety management system" in other cities from 2023. 5G-based monitoring could help reduce social costs of air pollution by US$ 50 per person per year