I’m wearing Oura, the smart ring NBA players are using to warn of possible COVID-19

I go to bed too late every night and wake up feeling groggy. I peel away my CPAP mask. I wear two silver rings, one on each hand: one is my wedding ring and one is the Oura ring. It doesn’t beep, or blink, or vibrate. I just wear it — sleeping, showering, all the time. Occasionally, I check the Oura app on my phone. It says: Here’s your readiness score. Or, this is how you slept. I can see my temperature fluctuations through the app. I can see my heart rate.

The Oura ring has been around for two years, but I never got around to wearing one (although I once wore another health ring by a company called Motiv). I was late to the party. Someone on Facebook recommended I try it. And recently, the ring’s gotten attention for its possible solutions to detecting COVID-19 symptoms days before you’re aware of them. According to researchers working with the ring, it could assist in offering a future-forward glimpse of your health forecast, or indicate when you should go get a coronavirus test. 

Then, news came of NBA players beginning to bubble off and practice, while wearing the Oura ring as a way to help preindicate possible risk factors.

I’m not playing basketball, but I’ve been at home for four months, feeling like I live on a ship. I don’t go anywhere and I don’t commute anymore. But at some point, somehow, I might have to. How will I navigate the risk? And could a ring possibly help?

What Oura detects and what it doesn’t

The Oura was originally marketed as a wellness ring focused mainly on sleep. Now it looks like a pointer to future ideas in wearables. Unlike many other watches and bands, the ring can read temperature. That doesn’t mean it can take my exact reading, but it tracks a relative temperature state each night while sleeping and shows trends in your daily temperature. 

The NBA’s version of the Oura ring connects to an app that coaches and managers can access, showing a risk score calculated from some sets of data: temperature, resting heart rate, respiration and heart rate variability (or HRV). The consumer version of the ring’s software shows those readouts plus others in a larger daily report called “Readiness,” which gives me a score. Today’s is 82, which is Good. I can see grades, in a sense, for each category: HRV balance, “optimal.” Body temperature, “optimal.” Recovery index, “optimal.” Sleep balance, “good.”

Of course, I’m highly sedentary lately and average about 3,000 steps a day compared to the 12,000 or so a day I used to take when I commuted to New York City. I know things aren’t optimal. But how can I get better? Oura’s readouts aren’t really fitness-focused like Fitbit, although there is a daily activity goal you’re encouraged to hit. It’s mostly about wellness, sleep and a dash of meditation in a feature called “take a moment.” The mini meditations are breakout features from a separate subscription Aura app, but included as bonus mindfulness tools in the Oura app, where I can see how my HRV, temperature and heart rate fared during the session.

Again, to some extent, I wonder what the data means to me. My Readiness Score each day doesn’t always coincide with how I feel. This is a similar thing I see in other apps that give scores, like Fitbit’s sleep score. It’s a fuzzy relationship.

Temperature: A fascinating, if nonspecific, tool

Despite what you might have heard, the Oura ring won’t take a specific temperature and isn’t cleared as a health device that can be used as a thermometer. Instead, the ring’s sensors show relative gains and losses in daily body temperature. I can know if my temperature has gone up 0.5 degrees, but not what my temperature is. The ring doesn’t use continuous temperature measurements: instead, it takes readings overnight while sleeping. CNET’s Lexy Savvides, who’s also been wearing an Oura ring, notes that the relationship between menstrual cycles and app metrics isn’t clearly noted, either, or clearly taken into account.

In a daily graph on my phone, I can see the trends: up a little, down a little, nothing telling. If I were to get a fever, I’d see the levels spike up, I suppose. It’s weirdly comforting to see my temperature status, considering I don’t take my own temperature very often. If I saw changes that were significant, I’d take my temperature and confirm. I think of it as a preflag. It’s not a bad thing right now, especially since I’m becoming paranoid about whether or not I’d know if I was getting sick.

But the nonspecific nature of Oura’s sensing, much like the nonspecific way that Fitbit scans for blood oxygenation, should let you know that this isn’t a substitute for a thermometer, it’s an additional screener.

Sleep tracking: Like Fitbit, but on a ring

I wore a fitness ring years ago, called Motiv, that also tracked my sleep and could check my heart rate. I’ve worn Fitbits, Garmins and Samsung watches that have done the same. Oura’s sleep tracking gives a sleep score much like Fitbit now does and estimates REM, light and deep sleep times, plus bedtimes, resting heart rate, respiration and relative temperature. The breakdown of categories ends up feeling pretty detailed, but also lets me know if my problem was not enough logged sleep, or maybe my sleep being too light.

Much like what Apple suggested recently on how its sleep tracking will focus on actionable bedtimes, Oura’s phone app focuses on reminding me on bedtime as a way to get better sleep. Besides that, really, there’s not a whole lot I can do try to make my sleep more restful… or if there is, Oura’s not ready to really be clear about what that is.

One thing the Oura (or any smart ring) has a problem with is notifications. It doesn’t ring, buzz or light up. I forget about it and unless it’s pinging me on the phone app, it can’t let me know when to go to sleep or wake up.

Totally invisible (which isn’t always great)

I got a sizing kit before receiving the Oura ring, which pointed me towards which size to get. The ring’s not adjustable afterwards, though. The metal ring, with its plastic underside, feels comfortable. I got used to it and now forget it’s even there. I wear it all day, all night, while showering and every other moment. (Lexy notes here that she doesn’t wear the ring all the time and finds it uncomfortable at times, too, especially when running or using weights.)

The $300-$400 ring is made of titanium on the outside and a plastic-like material on the inside where the sensors are. I wore the shiny silver design; there’s also a shiny black and a matte ($100 more expensive) black “stealth.”

The ring does need to be taken off to charge, though. A proprietary included charger works like a jewelry stand, where the ring drops on top and charges automatically. The ring has a 5-7 day battery life, but there’s no way to know what the battery status is unless you check the phone app or its notifications. I’ve been reminded to charge the ring and then forgotten. Suddenly, five days or more of tracking data is missing. Pairing happens via a phone app, automatically, but the ring has no buttons or controls at all. That invisible design makes it seem less like tech, but also prevents it from being anything more interactive.

Is a ring better than a watch? It depends. Rings are less conspicuous, but also, they’re more in the way of germy things like raw food or whatever other gross stuff you pick up. Doctors may not be wild about a sensor ring, versus a watch. So far, the ring’s held up well over a few months and hasn’t gotten cruddy or dirty.

Possibilities of wellness forecasts… but when?

Oura is working with research groups at the moment to explore how effective the ring is at detecting COVID-19 symptoms, but also how well it could be an advance indicator of oncoming signs of illness in general. Several researchers seem to think that temperature sensing is a key difference-maker. 

UCSD’s Dr. Benjamin Smarr, a researcher working on the current opt-in UCSF study already available to Oura wearers that aims to explore the ring’s ability to detect coronavirus symptoms, says, “The finger really seems to be a much more informative place to take temperature,” indicating that the ability to detect temperature changes several days before someone reports feeling sick is already possible. In a conversation over video chat, he said, “The ring’s temperature sensing is very precise. It’s not for head temperature … but it turns out because your finger is smaller than your head, the heat can dissipate more easily. So you actually see these rhythms more clearly in the finger because it can change faster.”

Another study being conducted by Rockefeller Neuroscience Institute at West Virginia University is exploring how the ring can help create a forecast of illness symptoms. According to RNI’s executive chair, Dr. Ali Rezai, the ring has a high likelihood of being able to show presymptomatic signs of illness, up to 90% based on trials with a thousand or so front-line first responders in various states in the US. Those might be signs of a cold, a fever, or possibly even COVID-19 (the predictive algorithms are meant to detect possible signs of fatigue, fever, coughing, breathing difficulties a few days down the road). But the research here is limited to particular studies, in a standalone test app. There are no signs yet of these tools emerging in the Oura ring’s actual app or consumer features yet.

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I think the goal here is absolutely to see if wearables, with and without temperature sensors, can help predetect and flag risk factors to make future office and public interaction less dangerous for others. But that means, of course, that others would also need to be tracking their data, too. Much like contact tracing, social distancing or masks, it’s only as good as the collective agreed behavior. In a conversation with Dr. Rezai, he called it a “decision making tool,” with plans to eventually make a Waze-like app that will show others’ contributions, alerting them of dangerous areas. But again, that eventual idea requires participation and everyone agreeing to contribute data. “It requires participation, in the same way that Waze requires participation of drivers,” Rezai says of that idea, which isn’t turned on yet in RNI’s study.

This is what makes me realize the likely truth of all of this: I’m not commuting to work anytime soon and I don’t know what’s happening with my kids and school. I can’t control the outside world, just my inside one. No one else is wearing a temperature-sensing ring right now, just me and a bunch of NBA players. And I’m not participating in any studies for predictive sickness indicators. I’d love a better heads-up on how I’m feeling, to get any advantage on knowing if I might need medical attention. But that future isn’t really here yet. Still, the Oura ring is just one step forward, even if it’s more of a general wellness device and sleep tracker right now.

But it could be something more down the road. And it may not be the only wearable device to do this when that happens.