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‘Taking Action Earlier’ Could Have Delayed U.S. Outbreak, Says CDC’s No. 2 Official

TOPLINE

The U.S. government and its top health agency missed several opportunities to slow the spread of the coronavirus, the No. 2 official at the Centers for Disease Control and Prevention told the Associated Press Friday—a more critical evaluation than what has come from the White House.

KEY FACTS

Limited testing and delayed travel alerts for areas like Europe led to a sharp rise in coronavirus cases across the country starting in late February, Dr. Anne Schuchat, the principal deputy director of the CDC, said Friday.

In a report published by the CDC, she analyzed the U.S. response to the outbreak, concluding that action was not taken quickly enough and several opportunities were missed to curb the spread of the pandemic.

“We clearly didn’t recognize the full importations that were happening,” Schuchat told the AP, adding, “I think the timing of our travel alerts should have been earlier.”

While the Trump administration imposed travel restrictions on anyone who had traveled to China starting in early February, it didn’t block travel from Europe until March 11.

Nearly 2 million travelers arrived in the U.S. from Italy and other European countries that were having outbreaks during February, Schuchat notes in her article.

Delaying travel bans allowed for the virus to spread throughout the U.S. and “contributed to the initiation and acceleration of domestic COVID-19 cases in March,” her report found.

Crucial quote

“I think in retrospect, taking action earlier could have delayed further amplification [of the U.S. outbreak], or delayed the speed of it,” Schuchat said in an interview. “The extensive travel from Europe, once Europe was having outbreaks, really accelerated our importations and the rapid spread.”

Tangent

“This report seems to challenge the idea that the China travel ban in late January was instrumental in changing the trajectory of this pandemic in the United States,” Jason Schwartz, an assistant professor of health policy at the Yale School of Public Health, told the AP. He noted that while the article is carefully worded, it marks a departure from that White House narrative.

Big number: Over 1.1. Million

That’s how many Americans have contracted coronavirus so far, with over 65,000 deaths. The United States is the hardest-hit nation from the pandemic, with about a third of the world’s reported cases and more than a quarter of the deaths.

Further reading

Public Health Response to the Initiation and Spread of Pandemic COVID-19 in the United States, February 24–April 21, 2020 (CDC)

Most World Leaders See Approval Ratings Surge Amid Coronavirus. Not Trump. (Forbes)

Report: CDC Director Warns A Second Coronavirus Wave Would Be ‘Even More Difficult’ (Forbes)

Reopening States Before June Would Save Millions Of Jobs But Result In Hundreds Of Thousands More Coronavirus Deaths: Report (Forbes)

Full coverage and live updates on the Coronavirus

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European Founders “seizing The Day” Amidst Crisis

A surprising number of both founders and VCs are taking the (possibly apocryphal) advice of Winston Churchill to “never let a good crisis go to waste.” In their recent weekly VC and entrepreneur sentiment surveys, Chausson Finance has produced some timely insights into how investors and founders are behaving and a weekly sentiment gauge.

A full two thirds of European founders are seeing the crisis as an opportunity, with a whopping peak of 85% of founders surveyed in the UK saying the adoption of digital tools is a driver for their business. A surprising 44% are also still growth focused, with the rest pulling back into cash preservation mode. A healthy 42% of the companies say they may take advantage of state support when it comes to subsequent funding but a majority still think they can rely upon VC backers to fill the coffers

While founders are optimistic about opportunity and financing potential they still face headwinds as investors slow their pace of investments. The survey shows while investors are generally optimistic their capacity for deals is slowed by the inability to travel and meet founders in person.

A striking percentage of European VCs, 70%, think the recovery will follow a ‘U’ shaped curve but still has yet to bottom out. This means only half of funds really are operating at their usual capacity, as many still do have fires to fight among existing portfolio companies and are otherwise slowing their new investment pace assuming a market bottom is still yet to come. Further, given that at least one-third of investors say they are not comfortable making investments remotely, the other two-thirds are likely to limit their investments mainly to founders they’ve previously known or previously worked with in earlier investments.

Founders, especially those without existing venture financing or previous relationships, will see some of their optimism dampened when it comes time for them to seek that financing. First time founders especially will struggle to build these relationships when they can only do Zoom meetings for the indefinite future. The consensus amongst surveyed investors was that it would be 14-19 months until business was “back to usual” so founders should heavily consider that timing in their own fundraising plans. Even when isolation restrictions are lifted many VCs will still choose to limit their time in the office and prefer virtual meetings, so it could be a substantial wait before these founder relationships can be fully developed enough to drive investment decisions.

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Coronavirus Pushes Aviation Industry in New Directions

This article is part of our continuing Fast Forward series, which examines technological, economic, social and cultural shifts that happen as businesses evolve.

The coronavirus outbreak has upended commercial aviation, with consequences that are not fully realized. The airline trade group, International Air Transport Association, anticipates that the world’s air carriers will see this year’s revenues drop by more than half, and a number of industry watchers predict that it will be years before air travel returns to 2019 levels.

The crisis has created both hurdles and opportunities for entrepreneurs offering new products or services.

“Timing is often out of our control, but our ability to be nimble and keep pivoting, that is essential,” said Marie Forleo, the owner of an online business training program and the author of the book “Everything Is Figureoutable.”

Sometimes even that is not enough, as Heather Howley, the owner of Independent Helicopters, is learning. Her charter air service was thriving for nearly a dozen years, providing aerial inspection and mapping services in New Windsor, N.Y., a rapidly developing area about 60 miles north of New York City. But when drones started making inroads into that business several years ago, Ms. Howley looked elsewhere to keep her company aloft.

“We fill in in situations where a drone can’t go,” said Ms. Howley, the business’s chief pilot. “We do football games, baseball games.” At the same time, she increased her focus on flight training and offered the ground portion of it online. But with large events canceled and flight schools deemed nonessential, the coronavirus pandemic threatens Ms. Howley’s business in spite of her flexibility.

At the end of March, Ms. Howley was worried about how she would survive if the economy shut down for more than a month and projected that even after business resumes, it would be slow.

“We may see another drop in students even after we get back to work,” she said. “We’re still supporting the utility company, but they’re not paying us at the moment since none of their staff is in the office to cut the checks. It’s a vicious cycle.”

The opposite has happened to Arthur Kreitenberg, a physician and inventor, and his son Elliot. In 2013, the duo bet that airlines would be eager to buy a product that disinfects planes. After the Ebola virus outbreak in 2014, Virgin America (now part of Alaska Airlines) gave the Kreitenbergs access to its airliners so they could create the GermFalcon, a device that kills germs in airplane cabins using ultraviolet light.

“Airlines play a direct role in the way disease is spread around the world,” the younger Mr. Kreitenberg said, a claim supported by a 2015 U.S. National Security Strategy that cited the growth in intercontinental air travel as a factor in the global spread of dangerous pathogens.

But the Kreitenbergs misjudged the market; no airlines were interested. Instead, they turned their attention to disinfecting hospitals.

“People dismissed us as Chicken Little, but in the last couple of months there’s been a change of heart” in the aviation industry, the younger Mr. Kreitenberg said.

An entrepreneur can turn a crisis to an advantage by “focusing first what you can give and not what you can get,” Ms. Forleo said. In early March, Mr. Kreitenberg offered the free use of GermFalcon and a similar device for airports to help the air travel industry with the pandemic. Mr. Kreitenberg said he was in touch with nearly every U.S. airline. Seattle’s secondary airport at Paine Field is now a customer and an investor. Alaska Airlines evaluated the device but opted to use a different kind of disinfection technique, a spokeswoman said in late April.

Aviation, with its emphasis on safety, can be a challenging environment for new ideas.

“Regulations have taken risk-taking away, and not even swashbuckling risk, but even a way of looking at the future as something you can construct,” said Saras Sarasvathy, a professor at the University of Virginia Darden School of Business. As a result, many beneficial innovations may never be realized, Professor Sarasvathy said.

Luke Miles, co-founder and creative director of the London-based industrial design firm New Territory, came up with a novel idea for how to make airplane seats more comfortable. But he recognized that having to get government approval for an entirely new seat design would be an expensive and time-consuming problem, so he found a workaround. Last fall, he unveiled Interspace, a set of panels embedded in the upholstery of seat backs that already meet government regulations. During flight, a traveler can unfold the panels, lean into them and sleep.

“Sometimes, it is not about grand moves and everything has to change,” Mr. Miles said. “Here’s where we could enter carefully in a considered way and have more success.”

Mr. Miles, whose company has done design work for Airbus, Aeromexico and Virgin Atlantic, said his experience and connections with airlines contributed to the final product. This collaboration with potential customers is critical.

In his book “Upstream: The Quest to Solve Problems Before They Happen,” the author Dan Heath calls this “surrounding a problem.”

“When you have a complex problem, there is usually no one person or entity who has all the answers,” he said in an interview. “You have a situation where people only see a facet of the problem, and it’s only by assembling the different facets you can come to appreciate the whole and solve for the whole.”

But the Kreitenbergs had no experience in aviation and few contacts, only Elliot Kreitenberg’s evangelism for his father’s invention.

“All we could do was say, ‘We’re using this technology that works in hospitals, and we built it so it fits on an airplane,’” he said.

Stan Malicki, a Polish businessman, faced a similar problem generating buzz for his invention, a system that moves airplanes on an electric track, instead of using engine thrust. The company, Aircraft Towing Systems, claimed U.S. carriers could save millions of gallons of fuel each year while reducing their carbon emissions. But on its own, the company couldn’t get traction until the State of Oklahoma got involved.

“Thrust is a terrible way to move airplanes. It’s great in the air, but terrible on the ground,” said Vince Howie, who saw the idea’s value and could do something about it as director of aerospace and defense with the Oklahoma Department of Commerce.

Mr. Howie persuaded Mr. Malicki to move from Europe to Oklahoma, joining the state’s substantial aviation network, which includes two of the world’s largest aircraft maintenance stations, Tinker Air Force Base and American Airlines. A.T.S. contracted with Oklahoma State University to help develop the prototype, and Mr. Howie became the chief executive at the end of last year.

“It is a collaboration of 10 people with different ideas, and of course everybody we talk to, I always want to hear the negatives,” Mr. Howie said. “I want to hear the negatives so we can put a mitigation or design changes as needed.”

Because good ideas do not thrive on their own, Professor Sarasvathy said, entrepreneurs should remain open to the ideas of their potential customers and investors.

Ideas are the products the Florida-based aviation consultant Tricia Fantinato was selling to airports and aerospace companies until the coronavirus brought an abrupt halt to funding for many projects.

“This is going to be the new normal, so we have to be prepared,” she said she planned to tell them, adding that she was there to advise them during the crisis.

“Aviation is an industry that is crippled right now,” Ms. Forleo said. “But any industry, no matter how complex, is made of humans. In helping folks — that’s where all creative possibilities lie.”

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NY Needed Ventilators for Coronavirus. They Developed One in a Month.

The nudge came in an email in early March from an Italian friend alarmed by how fast the deadly coronavirus was spreading in his country.

A shortage of ventilators, he told Scott Cohen and Marcel Botha, was a critical problem in Italy, and he warned that it soon would be in the United States, too. He urged the pair to apply their skills to the ventilator challenge.

Both Mr. Cohen, co-founder of a technology center for researchers and start-ups, and Mr. Botha, chief executive of a product design and development company, were skeptical. A standard ventilator, with thousands of parts requiring a complex global supply chain, was hardly a device that could be manufactured quickly and affordably.

“I was dismissive at first,” said Mr. Botha, whose company is called 10XBeta. “It looked impossible.”

But they soon found a design for a basic ventilator that could serve as their core technology. Since then, they have orchestrated from New York a far-flung collaboration of scientists, engineers, entrepreneurs, physicians and regulatory experts and accomplished in a month what would normally take a year or more.

Image
Credit…Gabby Jones for The New York Times

The result are machines known as “bridge” ventilators, or automatic resuscitators, priced at $3,300. They are mainly meant to help less critically ill patients breathe. If patients become sicker, with lung function more compromised by the disease, they still need to be placed on standard ventilators, which typically cost more than $30,000.

On Friday, the Food and Drug Administration approved the new device, the Spiro Wave, to be used on patients in hospitals, under an expedited process called emergency use authorization.

The project was initially targeted at New York City as a stopgap solution for what only a month ago appeared to be a looming, life-threatening shortage of ventilators in the city.

But the urgency has receded for now. While the city’s coronavirus death toll continues to mount, hospital admissions are trending down, and intensive-care units seem to have enough ventilators.

But health experts say a machine like the Spiro Wave should be a valuable tool in the arsenal of treatment. It can, they say, expand access to breathing assistance in other parts of the country as the pandemic spreads, and especially to rural communities without major medical centers. And capable, low-cost machines could greatly expand access to treatment in developing countries in Asia, Africa and Latin America.

The New York group has fielded inquiries from across the United States and from companies and governments worldwide. It plans to license its design for free.

The project is one of several pushes in America and abroad to streamline ventilator design and lower costs. This month, Medtronic got F.D.A. approval to offer in the United States a ventilator that it sells in 35 other countries for an average price of less than $10,000. The company is also making the machine’s blueprint freely available to other manufacturers.

The hurry-up engineering feat relied on human networks; two in particular stand out. The original design came from a classroom project at the Massachusetts Institute of Technology a decade ago. Since the coronavirus outbreak, M.I.T. professors and students have worked to upgrade the design in collaboration with outside groups. And several key contributors to the project are M.I.T. alumni.

The other network is the government and business community of New York, where Mr. Cohen and Mr. Botha are based. The city government took on the role of a risk-taking venture investor, first with a $100,000 research grant and then a nearly $10 million agreement to buy 3,000 of the basic ventilators.

“It’s essentially a start-up that has made unbelievable progress in a short time,” said James Patchett, chief executive of New York City’s Economic Development Corporation, which backed the project.

The New York ventilator effort got underway after widespread warnings of shortages. In mid-March, Mayor Bill de Blasio held a conference call with top staff members. Mr. de Blasio recalled that the looming ventilator shortage was “scary as hell.” New York had no ventilator producers, but he told his staff to do and spend what it took to solve the problem.

The city’s economic development chief, Mr. Patchett, who was on the call, knew Mr. Cohen and his technology center, New Lab, which is in the Brooklyn Navy Yard. Mr. Cohen told him about the ventilator-design project that he was putting together. It sounded promising, and the city made its initial grant.

Later, on March 25, after further development of the M.I.T. design, critical care physicians from city’s public hospitals and two private hospitals saw the most recent version of the machine. That evening Mr. Patchett called Dr. Mitchell Katz, who leads the Health and Hospitals Corporation, which operates the city’s public hospitals.

“We should definitely do this,” Dr. Katz recalled telling Mr. Patchett.

The project had launched about 10 days earlier, after Mr. Cohen, on the recommendation of a scientist friend in San Francisco, got in touch with Alex Slocum, a renowned mechanical engineer at M.I.T. whose class created the design in 2010.

Image

Credit…Gabby Jones for The New York Times
Image

Credit…Gabby Jones for The New York Times

A group of faculty and students — Mr. Slocum led hardware design, and Daniela Rus, a professor and robotics expert, led software development — worked to upgrade the design to help coronavirus patients. The device would have to be able to push air into badly impaired lungs at several times the force used to resuscitate a normal lung.

“This was going to take a serious machine,” Mr. Slocum recalled.

The New York group began closely collaborating with the M.I.T. team. Dr. Albert Kwon, an M.I.T. graduate and a medical adviser on the project who is an anesthesiologist at the Westchester Medical Center, and Mr. Botha, also an M.I.T. alumnus, and others from New York made several trips to Boston for joint work and testing.

The M.I.T. academics’ goal has been mainly to develop designs and share information on a website. But the mission for the New York group was to make the low-cost ventilators quickly. The hub of that effort is a former perfume factory in Long Island City, Queens, that is now home to a high-tech manufacturer, Boyce Technologies.

The temperature of everyone who enters the brick building is taken, a precaution against infection. The 100,000-square-foot facility combines engineering and production with robots, a clean room, and circuitry and software design departments.

Manufacturing, engineering and medical experts have worked side by side for three weeks. Dozens of versions of the machine have been carted off to the dumpster, as upgrades and improvements were made. In recent days, M.I.T. engineers traveled to Queens to help with last-minute software tweaks.

“There’s a lot you can’t see in a model,” said Charles Boyce, the founder and chief executive of Boyce Technologies. “And if you can’t manufacture something at scale, it doesn’t matter. It’s not going to have an impact.”

Producing thousands of machines means lining up sometimes scarce supplies. One of those parts was an air-pressure sensor to ensure that a patient’s lungs were not overinflated, which could cause damage. Mr. Cohen knew that Honeywell was a leading producer of the sensor, and he tapped his network of personal contacts to secure it in volume.

Late one night, Mr. Cohen called Kathryn Wylde, chief executive of the Partnership for New York City, a business group of the city’s top executives. Kevin Burke, a former chief executive of New York-based Con Edison, is a Honeywell board member. Introductions were made, and after a series of calls to Honeywell executives in America and Asia, a supply of the sensors was secured.

The New York ventilator project was intended to address a seemingly urgent need before large-scale initiatives — such as a Ford-General Electric partnership — began to produce ventilators.

While New York’s crisis has eased, Dr. Katz cautioned that pandemic viruses are unpredictable and mutate. A later variant, or second wave, in the fall could be less lethal or more, as was the case with the second wave of the 1918 flu pandemic.

“This is still a useful option to have, even if there is not the urgency there was,” he said.

The low-cost ventilator, Mayor de Blasio said, is an “invaluable tool” and part of the stockpile of medical equipment and supplies the city needs as “insurance against a Phase 2” of the pandemic.

“We have to get through this first,” he said. “But for the future, we have to have an ongoing self-sufficiency effort in New York. What we’ve gone through should be a never-again moment.”

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Utilities are the new cool

“Hold on, Boomer. Electric utilities? How much stale control room coffee have you had?”Hear me out. Mitigating global climate change? Electric utilities are the pivot. Adapting to a changing climate? Again, the pivot. Cleaning the air? Ditto. Electric cars, trucks, everything? Unlocking the economic, societal and environmental opportunities in …

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How Chronic-Disease Patients Are Innovating Together Online

HBR Staff/Eggy Sayoga/Getty Images

The internet gives us virtually unlimited access to each other. That deceptively simple insight is an untapped opportunity in health care. When companies are searching for their next idea, they should look to the online communities of patients who are working to solve their health care challenges on their own.
Young people lead the way: 51% of U.S. adults ages 18 to 22 years old say they have looked online for people with health concerns similar to their own. Eight in ten were successful, mostly finding each other through search, YouTube, and other social platforms. And when asked to think about the most recent time they found health peers online, 91% of young adults said it was helpful. The benefits of such connection seem intuitively obvious and have been confirmed in academic studies. Yet, as I’ve seen in my work both in the private sector and as a former chief technology officer in the U.S. Department of Health and Human Services, peer-to-peer health networks are largely being ignored by businesses and even most clinicians. These are satisfied customers for a product that nobody is selling – yet.
Consider Type 1 (insulin dependent) diabetes. People with Type 1 diabetes …

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How Entrepreneurs Succeed Outside Silicon Valley

Alex Lazarow, venture capitalist at Cathay Innovation, says that start-ups in cities around the United States and the world are creating their own rules for success. While Silicon Valley companies have sparked key innovations and generated huge wealth over the past few decades, not everyone should use them as a model going forward. In fact, we can learn a lot from frontier entrepreneurs, who are thinking more creatively about raising capital, sourcing talent, and pursuing social impact. Lazarow is the author of the book Out-Innovate: How Global Entrepreneurs–from Delhi to Detroit–Are Rewriting the Rules of Silicon Valley.
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TRANSCRIPT
ALISON BEARD: Hi everyone, it’s Alison. I hope that you’re all staying healthy and sane during this Covid-19 pandemic. The world has changed so much. At HBR, we’re social distancing – I’m recording this from my bedroom. But the episode that you’re about to hear was taped before the crisis hit, so we did not discuss it or its implications on startup ecosystems around the world. What I do know is that we need the innovation and social impact that our guest talks about more than ever. Thank you and most importantly, stay …

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5 seriously cool climate innovators in fashion

I tend towards startup scrutiny. My impulse to question — or ignore — most pitches for purported silver bullets has slowly developed over the years, due in part to growing up within shouting distance of Silicon Valley, the epicenter of startup sensationalism.Don’t get me wrong: Innovators are an irreplaceable element …

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How Hospitals Are Using AI to Battle Covid-19

Executive Summary
The spread of Covid-19 is stretching operational systems in health care and beyond. The reason is both simple: Our economy and health care systems are geared to handle linear, incremental demand, while the virus grows at an exponential rate. Our national health system cannot keep up with this …

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This is agtech’s fertile future

Amid the white noise of COVID-19 pandemic coverage last week, news about the $80 million funding round for alternative protein company Nature’s Fynd offered a bright beacon of positivity. While the financing revelation was delayed a week because of the crisis, the sizeable round extends the steady growth of funding …

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