Could We Test For Coronavirus In Sewer Systems, Tracking The Spread? MIT Entrepreneurs Have A Solution That Could Work

As the deadly cracks in our public health system have become apparent in the last two weeks, I happened to be at MIT, part of a journalism residency at the Legatum Center for Entrepreneurship and Development. I had a bird’s eye view as entrepreneurs and innovators in MIT’s famous entrepreneurship ecosystem turned on a dime to work on solutions we need yesterday.

I’ve been dismayed, as I am sure many Americans have been, to see the public health system faltering, to hear tests were slow and faulty, to watch as public health officials tracked people down like old-fashioned gumshoe detectives. I listened as newscasters described infected people slipping through the cracks.

Today, tech companies have grown so skilled at sliding us into sales funnels we worry we’re a surveilled society. But we can’t figure who was at the airport in Seattle the day a traveler from China arrived, when lives are on the line?

To partly explain why we’re so vulnerable to coronavirus, follow the money. “In health care, digital innovation is linearly tied to insurance reimbursement,” said Stephanie Rampello, the founder of WellNested, a platform that connects families to personalized in-home postnatal care. I met her mid-week, over the phone.

A graduate of the Sloan School of Management, Rampello spent several years looking at health care innovation during a corporate career and as she launched her company. It’s a simple equation, she told me: Returns-minded investors haven’t wanted to fund innovation in public health, because there aren’t deep pockets to create a market. 

That could change now, of course.

Governments and philanthropies will likely step up. Companies, including Silicon Valley-based Genentech, report they’ve been approved to test. But testing capacity is just the beginning.

Entrepreneurs are accustomed to working in extreme uncertainty. Public health innovation is a particularly quiet and thankless task, not likely to grab headlines. “My goal now is to create antifragile humans and teams,” wrote Bill Aulet, managing director of the Martin Trust Center for MIT Entrepreneurship.

The question now is how to find more of the innovators in the space (like Dave Alburty working in his lab in Missouri), and get them the resources and funding they need.

Here are the problems I found entrepreneurs working on at MIT:

Antiquated Notification Systems

Right now, in public health in the United States, the standard to notify people that they’ve been exposed to an infectious disease is for a public health official, after that detective work, to reach out, according to Dr. Anatole Sebastian Menon-Johansson, a Legatum fellow working on a company, SXT, that seeks to reinvent this system. 

There are obvious problems with the old-fashioned way of doing things: Forget forgetting who you’ve been in contact with. Some people might lie about who they’ve been in touch with. And lots of people, once notified, won’t bother to get tested, even when there are tests available. (Among them are the same people who think the virus and the moon landing were a hoax).

Menon-Johansson, a sexual and reproductive health attending physician at Guy’s and St. Thomas’ Hospital in London, has an anonymous notification tool that also locates nearby testing facilities to steer people who have been exposed. It was developed to apply to sexually transmitted diseases (and has doubled the rate at which partners were seen and tested. More than two weeks ago Menon-Johansson showed public health officials in the UK how it could be adapted for coronavirus, and he’s now in discussions with the New York City Department of Public Health, he said.

A key problem with our infectious disease infrastructure, Menon-Johansson told me, is that it’s focused on information, not action. “Current public health responses focus on describing the epidemic,” he said. “We need to focus on the whole journey and telling people what to do.”

Individual Testing Is Too Slow

If there’s a fundamental issue in an epidemic, it might be that we’re always a step behind the pathogen. But what if you could design a system that monitors the spread without necessitating that people get tests? It could be an important early indicator of where the virus has arrived and how thoroughly it has taken hold in an individual community.

In fact, that system already exists, in a company called Biobot Analytics. Entrepreneurs Mariana Matus and Newsha Ghaeli founded the company. 

Their team successfully detected human viruses – herpes and HPV – in sewage, according to Ghaeli. Everybody poops and pees, and when we do, pathogens pass out of our bodies.

“There is more R&D required to look specifically for coronavirus. Internationally, wastewater-based epidemiology has been used to detect poliovirus outbreaks,” said Ghaeli by email. “In 2013, Israel measured poliovirus through their WBE program before local clinics reported any symptoms. In response to this, they targeted vaccination efforts that effectively contained the outbreak.”

Turned to the task, MIT, like other top universities, is a powerful innovation engine. Its alumni are among the founders of 30,000 currently active companies, employing 4.6 million people, with revenue of $1.9 trillion, a 2015 study found.

Biobot has deployed in seven cities across the United States fighting the opiod epidemic. “We are currently talking to folks in academia and government to see how best we can support COVID-19 responses with our technology,” said Ghaeli.

Where’s The Money?

So where’s the money going to come from? You’d think the urgency of the situation and the obvious need would mean that money would flow from government and philanthropic sources, but that’s not a fait accompli. In the middle of last week, the White House invited tech leaders from big companies, including Google, Apple and Facebook, to talk about responses to the virus. That suggests a fundamental misunderstanding about where innovation comes from (entrepreneurs and small players), especially in the health care space, where the sensibility to handle complex ethics is also needed.

Rather, we ought to be looking for funding solutions that have developed systems to surface innovations from founders and bring them to market. In MIT, there are a handful, including the Legatum Center, the Martin Trust Center and MIT Solve, a marketplace for social innovation. It’s already launched a health security and pandemics challenge in response to coronavirus, to find teams from around the world working on innovations to address pandemics. The deadline to apply is June 18.

Executive Director Alex Amouyel has seen gaps in the funding available for companies that don’t fit the venture capital mindset of a fast-growing technology play. 

Hard technology – like a testing kit – just doesn’t fit.

“There are near-term opportunities in diagnostics and hygiene,” said Amouyel. “We could see things like affordable primary health care systems and more infrastructure.”

Founded in 2015, MIT Solve picks a total of 40 teams from around the world working on problems in big areas (the others are education, health, sustainability and economic prosperity), working with them over nine months to connect them to funding, networks and investors. It received nearly 1,400 applications from over 100 countries last year; among its standout graduates is Code Nation.

This article was corrected to remove the estimated number of teams being sought by MIT Solve for its pandemic challenge. There is no set number.