CDC removes updated guidelines around COVID-19 aerosol transmission, but this expert explains why it should reverse the reversal

Last week at TechCrunch Disrupt 2020, I got the chance to speak to Dr. Eric Feigl-Ding, an epidemiologist and health economists who is a Senior Fellow of the Federation of American Scientists. Dr. Feigl-Ding has been a frequent and vocal critic of some of the most profound missteps of regulators, public health organizations and the current White House administration, and we discussed specifically the topic of aerosol transmission and its notable absence from existing guidance in the U.S.

At the time, neither of us knew that the Centers for Disease Control (CDC) would publish updated guidance on its website over this past weekend that provided descriptions of aerosol transmission, and a concession that it’s likely a primary vector for passing on the virus that leads to COVID-19 – or that the CDC would subsequently revert said guidance, removing this updated information about aerosol transmission that’s more in line with the current state of widely accepted COVID research. The CDC cited essentially an issue where someone at the organization pushed a draft version of guidelines to production – but the facts it had shared in the update lined up very closely with what Dr. Feigl-Ding had been calling for.

“The fact that we haven’t highlighted aerosol transmission as much, up until recently, is woefully, woefully frustrating,” he said during our interview last Wednesday. “Other countries who’ve been much more technologically savvy about the engineering aspects of aerosols have been ahead of the curve – like Japan, they assume that this virus is aerosol and airborne. And aerosol means that the droplets are these micro droplets that can float in the air, they don’t get pulled down by gravity […] now we know that the aerosols may actually be the main drivers. And that means that if someone coughs, sings, even breathes, it can in the air, the micro droplets can stay in the air from anywhere from, for stagnant air for up to16 hours, but normally with ventilation, between 20 minutes to four hours. And that air, if you enter it into a room after someone was there, you can still get infected, and that is what makes indoor dining and bars and restaurants so frustrating.”

Dr. Feigl-Ding points to a number of recent contact tracing studies as providing strong evidence that these indoor activities, and the opportunity they provide for aerosol transmission, are leading to a large number of infections. Such studies were featured in a report the CDC prepared on reopening advice, which was buried by the Trump administration according to an AP report from May.

“The latest report shows that indoor dining bars restaurants are the leading leading factors for transmission, once you do contact tracing,” he said, noting that this leads naturally to the big issues around schools reopening, including that many have “very poor ventilation,” while simultaneously they’re not able to open their windows or doors due to gun safety protocols in place. Even before this recent CDC guideline take-back, Dr. Feigl-Ding was clearly frustrated with the way the organization appears to be succumbing to politicization of what is clearly an issue of a large and growing body of scientific evidence and fact.

“The CDC has long been the most respected agency in the world for public health, but now it’s been politically muzzled,” he said. “Previously, for example, the guidelines around church attendance – the CDC advised against church gatherings, but then it was overruled. And it was clearly overruled, because we actually saw it changed in live time. […] In terms of schools, gatherings, it’s clear [that] keeping kids in a pod is not enough, given what we know about ventilation.”

Despite slowdowns, pandemic accelerates shifts in hardware manufacturing

The COVID-19 pandemic didn’t hit every factory in China at once.

The initial impact to China’s electronics industry arrived around the time the nation was celebrating its new year. Two weeks after announcing 59 known cases of a new form of coronavirus, the national government put Wuhan — a city of 11 million — under strict lockdown.

As with most of the rest of the word, the manufacturing sector was caught somewhat flat-footed. according to Anker founder and CEO Steven Yang .

“Nobody had a great reaction,” said Yang, whose electronics company is based in Shenzhen. “I think this all caught us by surprise. In our China office, everybody was prepared to go on vacation for the Chinese New Year. I think the first reaction was that vacation was prolonged the first week and then another several days.

People were just off work. There wasn’t a determined date for when they could come back to work. That period was the most concerning because we didn’t have an outlook. They had to find certainties. People had to work from home and contact supplies and so forth. That first three to four weeks was the most chaotic.”

Numbers from early 2020 certainly reflect the accompanying slowdown in the manufacturing sector. In February, the Purchasing Manager’s Index (PMI) — a metric used to gauge the health of manufacturing and service sectors — hit a record low.

These bottlenecks resulted in product shortages — a fact that was rendered relatively moot in some sectors as demand for nonessentials dropped, many small businesses shuttered and COVID-19-related layoffs began. The U.S. lost 20.5 million jobs in April alone, hitting a record high 14.7% unemployment. (When you suddenly find yourself indefinitely unemployed, a smartphone upgrade seems much less pressing.) Such events only served to compound existing mobile trends and has delayed the adoption of 5G and other technologies.

It seems likely, too, that COVID-19 will accelerate other trends within manufacturing — notably, the shift toward diversifying manufacturing sites. China continues to be the dominant global force in electronics manufacturing, but the price of labor and political uncertainty has led many companies to begin looking beyond the world’s largest workforce.

The Peloton effect

During the most recent quarter, only a few earnings reports stood out from the rest. Zoom’s set of results were one of them, with the video-communications company showing enormous acceleration as the world replaced in-person contact with remote chat.

Another was Peloton’s earnings from the fourth quarter of its fiscal 2020, which it reported September 10th. The company’s revenue and profitability spiked as folks stuck at home turned to the connected fitness company’s wares.


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Shares of Peloton have rallied around 4x since March, roughly the start of when the COVID-19 pandemic began to impact life in the United States, driving demand for the company’s at-home workout equipment. In late June, the leisure company Lululemon bought Mirror, another connected fitness company aimed at the home market for around $500 million.

With Peloton’s 2019 IPO and its growth along with Mirror’s exit in 2020, connected fitness is demonstrably hot, and private-market investors are taking notice. A recent Tweet from fitness tech watcher Joe Vennare detailing a host of recent funding rounds raised by “digital fitness” companies made the point last week, piquing our curiosity at the same time.

Is there really some sort of Peloton effect driving private investment into lots of connected fitness startups? How hot is the more nascent side of connected fitness?

This morning let’s take a look through some recent funding rounds in the space to get a feel for what’s going on. (If you’re a VC who cares about the sector, feel free to email in your own notes, subject line “connected fitness” please.) We’ll then execute the same search for Q3 2019 and see how the data compares.

Hot Wheels

To start with the current market I pulled a Crunchbase query for all Q3 funding rounds for companies tagged as “fitness” and then filtered out the cruft to get a look at the most pertinent funding events.

Here’s what I came up for for Q3 2020, to date:

Illumina buying cancer-screening spinout Grail in blockbuster $8B biotech deal

Biotech has become one of the hottest areas of venture investment in recent years, as progress in machine learning, genetics, medical devices and biology fuse together into new products for the gargantuan health industry.

Case in point: Grail, which began in 2016 as a spinoff from genetic sequencing giant Illumina and co-founded by longtime Google executive Jeff Huber (who was involved in the creation of the company’s experimental laboratory Google[x]), is now being spun back in to the tune of an $8 billion acquisition announced this morning.

Illumina originally invested $100 million in the spinout, and Grail would go on to raise about $2 billion in funding from prominent biotech firm ARCH, one of China’s top VCs Hillhouse Capital, among many others according to Crunchbase. Illumina currently owns 14.5% of the company’s outstanding shares, making the effective purchase price for Grail closer to around $7 billion.

Grail’s technology was designed to use modern genetic sequencing tools coupled with data science to detect cancer earlier than other competing products on the market.

As we discussed on TechCrunch back in 2017 when the company raised $900 million, “while liquid biopsies to detect cancer aren’t anything new and GRAIL will have to compete with several other contenders both large and small, the technology to take a blood sample and detect the early, free-floating cancer DNA floating in your bloodstream is revolutionary in the industry and only made possible through new DNA sequencing machinery.”

Cancer screening is a $100 billion market and growing rapidly, particularly internationally as countries like China and India develop economically and more patients require active screening. Detecting cancer early is pivotal for reducing mortality risk, and so Grail’s promise was to offer the “holy grail” (couldn’t help myself) for saving these lives. According to the U.S. government, roughly 600,000 people will die this year from cancer, and it is a leading cause of death.

As part of the deal, Grail will receive $3.5 billion in cash, with another $4.5 billion earmarked for Illumina stock. The company set a deadline of December 20th for consummating the acquisition, at which point Illumina will begin offering Grail $35 million per month in cash payments until the deal closes. The two companies have signed a $315 million merger termination agreement as part of the deal.

The acquisition is subject to customary regulatory review.

Update Sept 21, 2020: Added Illumina’s current ownership of Grail numbers.

Does early-stage health tech need more ‘patient’ capital?

Crista Galli Ventures, a new early-stage health tech fund in Europe, officially launched last week. The firm offers “patient capital” — with only a single LP (the Danish family office IPQ Capital) — and promises to provide portfolio companies with deep healthcare expertise and the extra runway needed to get over regulatory and efficacy hurdles and to the next stage.

The firm has an initial $65 million to deploy and is led by consultant radiologist Dr. Fiona Pathiraja. With offices in London and Copenhagen, it operates as an “evergreen” fund, meaning it doesn’t follow traditional five-year VC fundraising cycles.

In fact, Crista Galli Ventures’ pitch is that traditional venture isn’t well-suited to early-stage health tech where it can take significantly longer to find product-market fit with healthcare practitioners and systems and then become licensed by local regulators.

To dig deeper into this and CGV’s investment remit more generally, I interviewed Pathiraja about what she looks for in health tech founders and startups. We also discussed Crista Galli LABS, which operates alongside the main fund and backs founders from underrepresented backgrounds at the pre-seed stage.

TechCrunch: You describe Crista Galli Ventures (CGV) as an early-stage health tech fund that offers patient capital and backs companies in Europe. In particular, you cite deep tech, digital health and personalised healthcare. Can you elaborate a bit more on the fund’s remit and what you look for in founders and startups at such an early stage?

Dr. Fiona Pathiraja: We like founders with bold ideas and international ambitions. We look for mission-driven founders who believe their companies can make a real and positive impact on the lives of people and patients the world over.

We will look for founders who deeply understand the problem they are trying to tackle from all angles — especially the patient’s perspective, but also that of the clinician and relevant regulators — and we want to see that they are building their solutions to solve this. This means they will make an effort to understand the complex and nuanced healthcare landscape and all the stakeholders in it.

In terms of founder characteristics, in my opinion, the best founders will be mission driven, able to tell a compelling story, and motivate others to join them. Grit and resilience are important and several of our portfolio companies were founded around 6-8 years ago and they are doggedly continuing to build.

Daphne Koller: ‘Digital biology is an incredible place to be right now’

Working at the intersection of biology and computing may be the most exciting new spot for technologists at the moment.

That’s the word from Daphne Koller, the founder and chief executive officer of Insitro — the biotech company that’s raised over $243 million in the two short years since it launched.

Speaking at our virtual TechCrunch Disrupt conference, Koller, a serial entrepreneur who previously co-founded Coursera and briefly served as the chief computing officer for the Alphabet subsidiary focused on human health, Calico, views digital biology as the next big technological revolution.

“Digital biology is an incredible place to be right now,” Koller said in an interview.

It’s certainly been an incredible opportunity for Koller whose work now spans the development of treatments for potential neurological diseases and a nearer term research and development effort on hepatitis with Gilead Pharmaceuticals.

Koller’s Insitro takes its name and inspiration from the combination of two different practices in biological research — the in vitro experiments that are done on living samples in labs and the in silico experiments that are done on the computer.

By synthesizing these two disciplines Koller’s company flips the process of drug discovery on its head, the company is designed sift through massive amounts of data to search for patterns in the expression of certain conditions. Once those patterns are determined, the company can examine the pathways or mechanisms associated with that expression to determine targets for potential therapies.

Then Insitro will pursue the development of novel molecules that can be used to intervene and either reverse or stop the progression of an illness by stopping the biological mechanisms associated with it.

“We now have massive amounts of data that is truly relevant to human disease,” Koller said. “Machine learning has given us a bunch of tools to really make sense of data.”

The company can identify new patient segments, new interventions new drugs that may modulate the expression of those conditions. “We view ourselves as being on the first phase of a very long journey using machine learning,” said Koller.

Take the company’s work on hepatitis in conjunction with Gilead. There, Koller and her team were able to take a small, high-quality dataset from Gilead’s trials and identify how a disease progressed by looking at the patient data from different points in time. Looking at the progression allowed the company to identify drivers that facilitated the progression of fibrosis that causes tissue damage. Now the company is using those targets as a starting point to find modifiers that could slow down the progression of the disease. 

It comes down to using computers to understand the biology, new biotechnology to model that biology in a Petri dish, and from the different models determine the interventions that will make a difference, Koller said.

“What we’re trying to do is so different and so out of alignment with how these [pharmaceutical] companies do their work,” Koller said. “It’s trying to shift the trajectory of these companies of hundreds or thousands of people and shift the culture to a tech culture that is going to be really a challenge.”

It’s the main reason Koller launched her own company rather than joining a big pharma play, and it’s a classic example of the innovator’s dilemma and the disruptive power of technology laid out in the theories of Clayton Christensen that give the Disrupt conference its name.

“[It’s] the notion of the innovator’s dilemma and coming in with a mindset that says we’re going to do this a completely different way,” said Koller. “The drug discovery effort is becoming increasingly expensive and increasingly prone to failure and if we do this in a different way will it enable us to generate better outcomes.”

Zwift, maker of a popular indoor training app, just landed a whopping $450 million in funding led by KKR

Zwift, a 350-person, Long Beach, Calif.-based online fitness platform that immerses cyclists and runners in 3D generated worlds, just raised a hefty $450 million in funding led by the investment firm KKR in exchange for a minority stake in its business.

Permira and Specialized Bicycle’s venture capital fund, Zone 5 Ventures, also joined the round alongside earlier backers True, Highland Europe, Novator and Causeway Media.

Zwift has now raised $620 million altogether and is valued at north of $1 billion.

Why such a big round? Right now, the company just makes an app, albeit a popular one.

Since its 2015 founding, 2.5 million people have signed up to enter a world that, as Outside magazine once described it, is “part social-media platform, part personal trainer, part computer game.” That particular combination makes Zwift’s app appealing to both recreational riders and pros looking to train no matter the conditions outside.

The company declined to share its active subscriber numbers with us — Zwift charges $15 per month for its service — but it seemingly has a loyal base of users. For example, 117,000 of them competed in a virtual version of the Tour de France that Zwift hosted in July after it was chosen by the official race organizer of the real tour as its partner on the event.

Which leads us back to this giant round and what it will be used for. Today, in order to use the app, Zwift’s biking adherents need to buy their own smart trainers, which can cost anywhere from $300 to $700 and are made by brands like Elite and Wahoo. Meanwhile, runners use Zwift’s app with their own treadmills.

Now, Zwift is jumping headfirst into the hardware business itself. Though a spokesman for the company said it can’t discuss any particulars — “It takes time to develop hardware properly, and COVID has placed increased pressure on production” — it is hoping to bring its first product to market “as soon as possible.”

He added that the hardware will make Zwift a “more immersive and seamless experience for users.”

Either way, the direction isn’t a surprising one for the company, and we don’t say that merely because Specialized participated in this round as a strategic backer. Cofounder and CEO Eric Min has told us in the past that the company hoped to produce its own trainers some day.

Given the runaway success of the in-home fitness company Peloton, it wouldn’t be surprising to see a treadmill follow, or even a different product entirely. Said the Zwift spokesman, “In the future, it’s possible that we could bring in other disciplines or a more gamified experience.” (It will have expert advice in this area if it does, given that Swift just brought aboard Ilkka Paananen, the co-founder and CEO of Finnish gaming company Supercell, as an investor and board member.)

In the meantime, the company tells us not to expect the kind of classes that have proven so successful for Peloton, tempting as it may be to draw parallels.

While Zwift prides itself on users’ ability to organize group rides and runs and workouts, classes, says its spokesman, are “not in the offing.”

Incredible Health updates its healthcare career platform to help nurse hiring cope with COVID

The healthcare industry, even prior to the current pandemic, has never looked much like other industries when it comes to hiring and career management. That was the impetus behind Incredible Health, a startup founded by medical doctor Iman Abuzeid and Amazon alum Rome Portlock. The platform Incredible Health built is all about connecting nurses with jobs — but it goes above and beyond your typical online job board in order to provide better service both to job seekers and hospitals, and to help nurses throughout the course of their careers.

I spoke to Abuzeid, who serves as Incredible Health’s CEO, about some new features that Incredible Health has just introduced, in part to address the particular needs of nurses and hospitals considering the constraints of COVID-19 and the ongoing challenges it presents. She first explained why Incredible is a unique platform to begin with, among a sea of relatively undifferentiated job search products.

“There are three unique things about the platform,” she said. “The first is that the employers apply to the nurses instead of the other way around — which we can do because of this huge supply-demand imbalance. The second is that we’ve automated the screening and pre-vetting of the nurses, so we’re able to automatically verify things like licenses and certifications, and experiences and so on, because we’ve integrated with so many databases. And the third thing we do is custom matching algorithms.”

That means Incredible Health provides hospitals with only matches that meet their exact needs for a specific position requirement, rather than forcing them to wade through large numbers of potential applicants who might not have the skills they need. In a field like nursing, which has a lot of specific professional designations and certifications, specificity actually helps both sides quite a bit.

“The end result of all of that is hires that happen at least three or four times faster,” Abuzeid told me. “Our average right now is 13 days, and the efficiency is about 30 times more efficient than a standard job board. Really, some of the biggest impacts we have are financial — we save on average, each hospital we work with, about $2 million per year. We do that by reducing their travel nurse budget, because they don’t have to use as many contract workers when they’re permanently staffed. And we also reduce their overtime costs, and their HR costs.”

Abuzeid also told me that nurses hired through Incredible Health tend to stick around longer. The startup only has about a year of historical data to check against so far, but she said that so far, they’re seeing about 25% higher retention versus the industry average. She added that they suspect this is due largely to the fact that nurses are able to consider multiple offers and hospital options on the platform, since there are often multiple employers vying to hire the same employee, especially in the case of specialization like ICU nurses.

As for what’s new to Incredible Health, the company has introduced automated interview scheduling. Abuzeid says that has led to 70% of interviews being scheduled via automation within 36 hours on the platform currently. The platform has also introduced remote interviewing for safely distanced pre-hiring interactions, and in-app chat between potential employers and nurses right in the iOS, Android and web apps that Incredible Health offers. Profiles for nurses on the platform also now list specialties and skills, from a pre-set catalog of 45 specialties and 250 skills that are specific to the nursing field, like ICU or OR expertise. Abuzeid said that most of these were fast-tracked due to significant changes they were seeing in the hiring process as a result of the COVID pandemic.

“We saw several impacts,” she told me. “First is like the number of offers that started to go out — we see one go out every few hours now. And the number of interview requests is up to one being sent every few minutes. So it’s really accelerated, and that’s been a combination of two things. One is just that we made the software better and more efficient — but the other thing is the urgency also increased on the hospital end, given the pandemic.”

Aside from improving the process of hiring versus traditional methods, and supporting more remote hiring and onboarding workflows, Incredible Health also addresses some of the diversity gaps in the current healthcare industry hiring process. Abuzeid explained that that’s due in part to built-in features of the platform like salary estimate calculators, and adds that some tweaks have been created intentionally to level the playing field.

“Thirty percent of nurses in the U.S. identify as minorities, so we take diversity pretty seriously because that’s a huge chunk of our user base,” she said. “By giving nurses salary data, it democratizes that and makes you more informed. We also provide talent advocates who are also nurses on our team that support every single nurse, helping them almost as career coach to support them throughout the hiring process.”

Incredible Health also takes steps to ensure the product isn’t itself reinforcing any existing biases that may be present, consciously or otherwise, on the part of hiring parties.

“We random sort the list of nurses as they’re displayed in front of employers and the application, or we use avatars instead of profile pictures. We’re also constantly monitoring the data that’s in the platform. So for example, we noticed that recruiters were biasing against nurses that lived farther away. And so we just removed the current location of the nurse, we just stopped displaying that, and that bias went away. So it’s really important that the software and our algorithms actually counter human bias.”

So far, Incredible Health has raised $17 million in funding, including a Series A last year led by Jeff Jordan at Andreessen Horowitz. The company is already in use at more than 200 hospitals across the U.S., as well as at a number of the largest healthcare networks in the country, like HCA and Baylor, and at academic medical centres, including Cedar Sinai and Stanford. The startup is growing quickly by addressing a long-standing need with software designed specifically to the challenge, and looks poised for even more future growth as the demand for qualified, well-supported healthcare professionals grows.

Replace legacy healthcare staffing with a vertical marketplace for workers

Over the last several months, we’ve seen dramatic swings in the demand for healthcare across the country. While hospitals in some cities were overwhelmed by an influx of COVID-19 patients, others sat empty — and in many cases experienced financial distress — as patients postponed elective surgeries and care for non-life-threatening matters. Cities went from relative safe zones to dangerous hotspots and back again within a matter of a few months.

This “COVID-19 whipsaw” has brought into focus a problem that has long been simmering in healthcare: The movement of labor is highly inefficient. We need a new paradigm in healthcare labor markets.

The pandemic has exposed systemic vulnerabilities

Early in the pandemic, many clinicians moved across state lines to answer Governor Andrew Cuomo’s calls for help in New York, only to be told upon arrival that their contracts had been canceled because the hospitals had overestimated their need. The imbalance of nurse and physician labor across states, which existed well before the pandemic, reached a terrifying apex during the height of the pandemic. In some parts of the country, clinicians were being furloughed or laid off, while in others they were stretched to their full capacity working around the clock to save lives. With each month came new hotspots — New York, Detroit, Miami, Phoenix, Los Angeles — and with each new hotspot a near disaster caused by a shortage of healthcare workers.

The marathon of addressing COVID-19 has imposed severe stress, depression and anxiety on our nation as a whole, with our healthcare providers at the epicenter. Clinician burnout was a serious issue even before COVID-19, but it has only gotten worse in recent months, especially for those working in geographic hotspots.

Healthcare workers across the country have found themselves delivering care for a high volume of acutely ill patients, often with severely limited supplies of personal protective equipment (PPE), magnifying their own risk. Many have watched colleagues fall sick and even die, while others have been asked to ration patient care. Multiple studies have highlighted increased instances of depression, anxiety, insomnia and psychological distress amongst frontline workers, and some clinicians have even taken their own lives.

Challenges with the legacy staffing model

Prior to the pandemic, our healthcare system had long dealt with seasonal and geographic differences in healthcare demand. Flu season, for example, causes more demand for healthcare in December than July. Florida experiences more demand for care in February than June because snowbirds migrate from the northeast in the winter and bring their healthcare needs with them.

In the past, temporary or contingent workers — travel nurses, per diem nurses and locum tenens doctors — helped to balance supply of labor with the seasonal and geographic peaks and troughs in demand. Staffing agencies worked with these temporary clinicians to match them with opportunities at hospitals, ambulatory surgical centers, long-term care facilities and other providers. Many people don’t realize that temporary clinicians are an important part of the healthcare workforce. Estimates are that supplemental staffing accounts for more than 30% of total nursing hours in the U.S.

Staffing agencies, however, cannot scale for pandemic scale events because they are using outdated tools and processes. Recruiters at staffing agencies make phone calls and send emails to communicate with the clinicians who are frequently annoyed by inconvenient and unwanted solicitations. More importantly, these tools are not fast enough when we experience sudden unpredicted spikes in different geographic areas like those in the past six months.

Outdated regulations are partly to blame. Licensure for nurses is handled state-by-state, which creates obstacles that prohibit nurses from working in states where they are not licensed. There are approximately 35 states that are part of a licensing compact that offers mutual recognition, but many of the largest states and those hit hardest by the early days of the pandemic — like California, New York and Washington — are not part of the compact. In California, it takes six weeks on average to get a license for an out-of-state nurse, a number that has not budged even as the state’s COVID-19 cases have skyrocketed.

Some states that are not part of the compact have used executive actions or emergency declarations to allow nurses to cross state lines, but many of those are now expiring and were never meant to be a long-term solution. The pandemic has highlighted the need for new regulations as part of the solution described below that allow for a more fluid movement of clinicians across state lines. Are patients and diseases in California really that different from the patients and diseases in Texas such that we need different regulatory standards and license requirements in each state?

The solution: A vertical marketplace for healthcare workers

We need to move beyond the antiquated staffing agency model to facilitate a more rapid response, a better clinician experience and more efficient matching. The good news is that we are starting to see companies addressing this problem with a software-centric model: the vertical labor marketplace. Some examples of these marketplaces include Trusted Health and Nomad Health.

Like StubHub, the company I started 20 years ago, these marketplaces use the power of the internet to connect supply with demand. In the case of these healthcare labor marketplaces, the clinicians make up the supply while the hospitals and other care facilities make up the demand. Rather than scouring the job boards for individual hospitals or fielding calls from recruiters, clinicians can see all available positions that meet their skills and experience, along with compensation and other job details. They can check the marketplace when it is convenient without getting inundated by phone calls or emails.

Clinicians can use the marketplaces to come in and out of the labor pool as they wish. This helps to reduce stress and increase work-life balance before burnout sets in. Some nurses might choose to leverage the marketplace to move to Florida in the winter to serve the snowbirds while others may choose to take the summer off and work during flu season. The marketplace also creates financial opportunities for underutilized clinicians by better allocating their labor to geographies and hospitals that need them. Hospitals and other providers benefit from these simple-to-use cloud-based marketplaces that allow them to quickly ramp up capacity when they need it most.

The system needs more contingent workers

In the staffing agency paradigm, when an independent hospital experiences a spike in demand it must work with a staffing agency to bring in temporary clinicians quickly. A multihospital health system has the advantage of being able to move clinicians from lower demand hospitals to a sister-hospital that is experiencing an unexpected peak. A widely adopted national marketplace would theoretically have an even greater advantage because its broader visibility across more hospitals would allow it to move resources from hospitals with excess capacity to those with the highest demand, even if the two hospitals are unaffiliated.

There have been heroic doctors and nurses who have volunteered to move to areas with the highest demand. However, hospitals and health systems are not incentivized to lend out their doctors and nurses to nonaffiliated hospitals. Therefore, the solution requires more clinicians to be in the contingent workforce (like travel and per diem nurses). If the mix between contingent nurses and permanent nurses were 70/30 instead of 30/70, peaks and troughs would be more easily handled since a larger percentage of the resources would be shared across a larger network of hospitals. The marketplaces would have an even greater impact on our society because they would be able to allocate even more resources to the hospitals with the most acute needs.

There are two possible sources of additional contingent workers. First, permanent healthcare workers may decide to terminate their affiliation with a single hospital or health system in favor of contingent work because they are attracted to the flexibility. Second, workers in other industries may choose to enter the healthcare industry because it provides more options for contingent work. Regardless of the path, an expansion of the supply of contingent healthcare workers is a necessary part of the solution.

A side benefit: Stronger financial health for our hospitals

During the pandemic, patients across the country chose to postpone many elective surgeries and non-life-threatening procedures because they were scared of contracting the virus at the hospital. As a result, hospitals lost revenue from profitable elective procedures. Because hospitals have huge fixed costs (salaries are a big component), the government has provided tens of billions of stimulus money for hospitals in financial distress.

In addition to all the other benefits described above, a more widely adopted vertical labor marketplace for healthcare workers would provide relief to hospitals by shifting a larger portion of clinician labor from a fixed cost to a variable cost. Hospitals would have a smaller number of permanent employees and a larger number of temporary contingent workers. When demand drops, hospitals would use fewer contingent clinicians. When demand rises, they could tap into the marketplace to bring on more capacity.

A marketplace approach to America’s healthcare and its clinicians is long overdue. While the pandemic magnified our current system’s vulnerabilities, they have been there all along. By leveraging the technology and marketplace paradigm that has made so many other industries efficient, we can improve not only our healthcare system and clinician quality of life, but also our hospitals’ bottom line. Let’s galvanize the collective distress COVID-19 has created and use it to pioneer a more efficient model for all.

* Craft is an investor in Trusted.

Researchers ready world-first vision restoration device for human clinical trials

Over a decade’s worth of work by scientists working at Melbourne, Australia’s Monash University has produced a first-of-its-kind device that can restore vision to the blind, using a combination of smartphone-style electronics and brain-implanted micro electrodes. The system has already been shown to work in preclinical studies and non-human trials on sheep, and researchers are now preparing for a first human clinical trial to take place in Melbourne.

This new technology would be able to bypass the damaged optic nerves that are often responsible for what’s definite as technical clinical blindness. It works by translating information gathered by a camera and interpreted by a vision processor unity and custom software, wirelessly to a set of tiles implanted directly within the brain. These tiles convert the image data to electrical impulses which are then transmitted to neurons in the brain via microelectrodes that are thinner than human hair.

There are still a number of steps required before this becomes something that can actually be produced and used commercially – not least of which is the extensive human clinical trial process. The team behind the technology is also looking to secure additional funding to support the eventual ramp of manufacturing and distribution of its devices as a commercial venture. But its early studies, which saw 10 of these arrays implanted on sheep, saw that one the course of a cumulative total of more than 2,700 hours of stimulation, there weren’t any adverse health affects observed.

Animals studies are a very different thing from human studies, but the research team believes their technology has promise well beyond vision. They anticipate the same approach could provide benefits and treatment options for patients with other conditions that have a neurological root cause, including paralysis.

If that sounds familiar, it might be because Elon Musk recently revealed ambitions to use his company Neuralink’s similar brain implant technology to achieve these kinds of results as well. Musk’s project is hardly the first to imagine how devices paired with modern software and technology could overcome biological limitations, and this effort form Monash has a much longer history of working towards turning this kind of science into something that could impact the lives of everyday people.