Draft thoughts; edits + comments welcome.

By the end of the year, we will need infrastructure (supply chains, phlebotomy) for testing and vaccinating everyone in the country. We should start that as early as possible, and should avoid bottlenecks managed by a small number of companies.

Microcosm: Cambridge

Testing everyone in Cambridge

Serosurvey

We need a rolling process for testing a cross-section of residents

PCR testing

We need a framework w/ capacity to test most residents, at O($1)/test

Sampling at scale

1. Serology samples: need phlebotomists. fingerprick vs other draw
   See: Boston Heart’s test ($5k/d), POC options

2. PCR samples: saliva vs nasophar options
   Note: nasophar requires deep sterilization (see Korean options)
   Some new approaches (swabseq) have 10x improvements in precision

3. Sample rooms: throughput, exposure of workers, cleaning protocol, storage
   See: phonebooth options (Korea)
   See: BU’s Level-4 cleanroom work (James Davey)

People to talk to

• Michael Mina, Harvard +

• Ethan Garner, related pointers

New testing solutions

Identify regions of testing that are most promising; come up w/ diversified portfolio of potential products in the most likely space, support them.

Identify axes of differentiation (cost v scale v time to deploy)
JW - Market eval/analysis; modified growth/share matrix. Assess each of:

1. Tech / process

2. Market / substitutes

3. Logistics / supply chain

4. Finance / streamline

5. Politics / social integration

RNA testing

• RNA testing assessment

• Spreadsheet of currently approved tests

Implementers (>1k/d)

Broad: starting at Color Genomics, then moving into the Broad building?(RH+)

Berkeley: Doudna lab

UW: Virology lab

Serology testing

Eurofins - Boston Heart Diagnostics

Implementers (>1k/d)

How can we test everyone?

Facilitators

Tech: Quick funds

Market: BC+?

Logistics: Each of int’l shippers into customs, Freight forwarders

• //

Finance: Bridge banks

• Insure shipments [that can be held up / seized] w/o tying up funds of ordering clinics/hospitals. Look to wealth mgmt, community banks (letters of credit, reducing friction)

Politics: In MA - former Warren campaign.