Pandemic XPrize Competition: Dr. Daniel Kraft on Quest to Leverage Tech and AI For Solutions to Address COVID-19

Dr. Daniel Kraft – Exponential Medicine

[ Music ]

Female : Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter , a show where we speak to the top thought leaders
in health innovation , health policy , care delivery and the great minds
who are shaping the health care of the future. This week Mark and
Margaret speak with Dr. Daniel K raft Chair of the XPRIZE Pandemic
Alliance Task Force, a coalition of 70 organizations, universities, NGOs,
startups and corporations that are seeking to catalyze the dramatic
amount of research go ing on around COVID - 19. They're holding
competitions for improvements on everything from rapid testing
technology to building a better ma sk.

Lori Robertson also checks in , Managing Editor of FactCheck.org look s
at misstatements spoken about health policy i n the public domain ,
separating the fake from the facts . W e end with a bright idea that’s
improving health and wellbeing in everyday lives. If you have
comments please e - mail us at [email protected] or find us on
Fa cebook , Twitter , or wherever you listen to p odcast . You can also
hear us by asking Alexa to play the program Conversations on Health
Care . Now stay tuned for an interview with Dr. Daniel K raft here on
Conversations on Health Care .

Mark Masselli : We're spea king today with Dr. Daniel Kraft Chair of the XPRIZE
Pandemic Alliance Task Force seeking radical solutions to COVID - 19
and future pandemics. Dr. Kraft is an oncologist inventor, entrepreneur and founder of the Exponential Medicine Conference which seeks t o explore the potential of technologies to improve biomedicine and health care. He's also a Chair of Medicine at
Singularity University.

Margaret Flinter: Dr. Kraft is an inaugural member of the Aspen Institute's Health Innovation Fellowship Program, he ha s launched several entities including Digital . H ealth in telemedicine and MarrowMiner, an FDA
approved device for marrow harvesting. He's published numerous
papers , books , won many awards and distinctions, including 40
smartest people in h ealth care. Dr. Kr aft, welcome back to
Conversations on Health Care , i t's been a while.

Dr. Daniel Kraft: Thanks for having me back.

Mark Masselli : Yeah. I think it's been seven years , and you caught our attention back
then as we were looking at the XPRIZE competition. The challenge
around the Tricorder competition being Trekkies, we enjoyed the sort
of framing up of the opportunity followed. I think there were a family
that might have won that , i t was kind of exciting . Y ou're back at it
again, and certainly around the pande mic. I've been thinking how
exciting it is for getting the seriousness of the pandemic of all of this
research that's going on and sort of been thinking about what other

Dr. Daniel Kraft – Exponential Medicine

types of discoveries might we see out of this real focus on trying to
stand up new pla tforms, th e sort of all the collaboration goes on . Now
you have a new role as Chair of the XPRIZE Pandemic Alliance Task
Force competition. Maybe tell us a little bit about that , what you're
hoping to find and how big is this collaboration?

Dr. Daniel Kraf t: Thanks. T he idea around the XPRIZE Pandemic Alliance is that one of
the silver linings of this horrible pandemic is the amount of
innovation , collaboration and ideas and solutions that are emerging.
The challenge also there could be a thousand flowers b looming , and
thousand flowers aren't helpful, you need one or two solutions that
actually work. P art of the goal of the Alliance which is made up of 70
plus organizations, from NGOs, universities, to big and small startups
and major organizations is to hel p collaborate, find the challenges and
help foster the solutions and catalyze them to impact whether that's
in testing , diagnostics, therapy, education and beyond.

One thing that’s emerged out of the Pandemic Alliance into that key
unmet needs is around te sting , and t hat's one of our largest new
initiatives that have launched . F or folks who are listening or haven't
been familiar with the XPRIZE , t he idea is that often you can help
speed and incentivize something with a prize model. Charles
Lindbergh even cr ossed the Atlantic to win a prize, and the re have
been other XPRIZE s , but the sort of model is quite effective. The
Alliance itself is not all about prizes, but again, bringing smart entities
and organizations together to help move things faster.

Margaret Flinter: Well, Dr. Kraft, let's talk about testing , something we have a lot of first
hand experience with these days. W e have a terrific research
infrastructure here in the United States, obviously , NIH, FDA, the
National Academ y, CDC, but it just has cont inued to feel over these
many months that we missed the opportunity to confront the crisis
head on. Testing has been generally considered one of the greatest
failures in our response. Let's take a look at the pandemic X PRIZE
COVID testing competition with a goal of making testing frequent and
fast and cheap and easy. What are you looking for from your
participants and what do you think is really promising that you're
already seeing out there in terms of game changing potential for what
looks like w ill be wi th us for a while in terms of this pandemic?

Dr. Daniel Kraft: Yeah, I think one of the critical elements for this pandemic or for
preventing any others, the basics of public health and contact t racing
is to pick up infections early [inaudible 00:05:29] pu blic health. W e've
had a major failure, particularly at the national leadership level in
rolling out a national testing program, many other countries have
been far ahead of us. O ne of the challenges is that today's testing is
not fast, frequent, cheap or e asy. It's not fast. Most of the test take at
least a day or often four or more days in a backlog. They're not

Dr. Daniel Kraft – Exponential Medicine

inexpensive. They're over $100 on average each. They're not easy.

Many of us I've had three tests, if you like the swab is going to the
back of yo ur brain and they're not that easy. You might need training ,
you need to have a facility . To get ahead of the curve, particularly on
detecting cases early before patients even know they have them or
can spread and be infectious , is to do fast, frequent, ch eap and easy
testing . T o open up schools, we might want to test twice a week , t o
open up workplaces safely and to return to life. T he instigation
around this prize is to really move that forward together with the
regulators and others. We have now over 500 teams that have done
the initial registration.

The next stages which will open up w ill be narrowing those down the
top 200 teams , will be getting sort of blinded test kits , will identify
those who didn't have high sensitivity , specificity . The winners of that
phase will go to on - site testing, and then the top five teams will roll
out to actual sites where we can scale and demonstrate that you can
really do this in an impactful manner. T hen there's a lot of funds and
support to bring those teams forward eve n faster. N ot just for this
pandemic , for preventing future ones we need fast, frequent, cheap
and easy testing.

Mark Masselli : Yeah, and I think we've heard that people are looking to have a whole
strip of test that you have at home, you administer yourse lf, the
whole country does it, you can determine whether or not you go into
work . Specificity on those may not be as great , but the larger effect of
having everybody tested is kind of exciting . J ust thinking about these
blocking and tackling issues of test ing , but also we've seen a lot of
articles on social distancing and mask wearing and, unfortunately,
mask wearing some how has become a political issue versus just the
basics of science . B ut in the context of trying to get to efficient,
effective and elegan t on mask wearing , because you need a little
elegance for people on mask wearing because it's a little cumbersome
or seems to be . W hat types of work are you seeing out there in terms
of development , i s that an area that you are also focused in ? I s there
an ything on the horizon that you know -- has that -- as I think back to
the Apple success, it was all about design, right? Everything is about
design. To the extent that a m as k can mirror up that work, what are
you seeing on the horizon?

Dr. Daniel Kraft: I think to zoom back out , any sort of innovation particularly in health
care needs, as you mentioned, smart design thinking, smart
communication, integration of the workflow, whether that's an
individual or a clinician. One of the XP RIZE Pandemic Alliance
me mbers is IDEO, which is a major design firm. They've done a lot of
work with the Alliance and others to think about how do you message
everything from social distancing, to wearing masks , to thinking not

Dr. Daniel Kraft – Exponential Medicine

just about our pandemic, but the infodemic. I mean, we have a huge
percentage of the population , a big percentage that is resistant to
wearing masks and let alone maybe getting vaccinated when a safe
and effective vaccine is here. W hen you think carefully about how to
message and make the design experience whether that's , in this case,
a mask of which there is a XPRIZE challenge to make a much better
sort of N 95 level mask that doesn't have some of the barriers to
wearing in terms of cost design, comfort, and affectivity. That's
another example of leveraging the crowd to come up with new
solutions and helping the best solutions move into the market.

Again , I think there's a big challenge around the whole design element
for public health . I f I was to think forward into where this almost
practice pandemic c an t ake us is to get as ready for the next one, how
might we have the next generation Tricorder s or test that can be on
our smartphones? How do we think about even having a volunteer,
g lobal h ealth , p ublic h ealth c orps like we have volunteer EMTs and
f iremen t hat can be in their local neighborhoods to help do contact
tracing, educate their neighbors and help lower the soci al economic
disparities when they’re present.

Margaret Flinter: Well, my pick up on the idea of crowds and speaking of crowds, we're
in a bit of a quandary right now. We have the global pandemic, but it's
happening in the midst of a vaccination resistance movement, which
has actually been going on for some time , but h a s really accelerated
and intensified I think . We're gearing up for flu season , everybody in
primary care and public health is doing that . E ven in a good year with
all of our messaging and all of our education, we might get 50% of
vaccine compliance, even though it kills tens of thousands of people a
year. O f course, the memory of t he measles reemergence due to
vaccine resistance and anti vaxxers is always fresh in our mind. G iven
so many people just refuse to believe vaccine science, how are you
addressing vaccine resistance in your competition, sort of on the soft
side of science . What kind of convincing science might alter the
course of this pandemic and sway the vaccine resistor so when it's
finally available, we can actually make progress with it?

Dr. Daniel Kraft: It's such a complex issue. I think in general we need to be think ing
proactively instead of reactively like we do in health care we need t o
immunize against s o the anti vax movement, not just for measles, but
for other elements. Part of that is education, understanding what
basic immunology and vaccines are . Then making things somewhat,
uber ized . We live in this exponential age and companies like Uber
didn't invent the smartphone, GPS online maps, online payments,
they connected the dots , and even Uber and other companies are
now sort of enabled -- and it was in New York City originally , press a
button on your app and a nurse would come to give you a flu shots,
how do we make things sort of easy , provide the personalized

Dr. Daniel Kraft – Exponential Medicine

information that matches someone's age, culture, language, or
biases? It’s like, we want to do precisi on precise medicine, the right
pill, the right person, right time, right dose . T hat goes to how you
might educate -- not everyone where I am in the Bay Area of
California drives to Tesla and has an Apple watch , very different
modalities in how you want to communicate to folks in different parts
of the country living around the world. I think it's a bit of a
combination effort , there ’s no one silver bullet.

Mark Masselli : We're speaking today with Dr. Daniel Kraft , Chair of Medicine at
Singularity University and founder of the Exponential Medicine
Conference . He's also Chair of the XPRIZE Pandemic Alliance Task
Force competition, seeking groundbreaking solutions to challenging
unleashed by the COVID - 19 pandemic . I wanted to sort of pull the
thread on the work that you're doing on exponential medicine. I think
that's a term that our audience would find of interest, a sort of a
definition . B ut , you know, you're talking about leveraging the crowd,
and it sounds like exponential medicine is really how it can be a force
multiplier.

R eally, I'd like to -- sort of , you were talking about specific things that
people might have , but artificial intelligence really hasn't been
leveraged to its fullest extent. It seems to be the next horizon for us.
There's sort of the tec hnology side, but it's the large aggregation of
data and how we apply that . I may not need to have -- i t may tell me
that I need a flu shot and somebody may arrive before I have to get
on my smartphone to do something . What are you seeing in that
area ? B ut first start out with exponential medicine s o our listeners can
have a sense of what that means , and then segue over to i ts use , h ow
it leverages AI and other tools .

Dr. Daniel Kraft: Sure, a bit of the theme about exponential medicine is that many
technol ogies from AI to big data to 3 D printing to low cost genomics
to digital are moving -- sometimes exponentially , sometimes quickly.
The theme of exponential means our brains are somewhat wired
linearly 30 linear steps, I'll be across the room, but 30 expone ntial
th
steps doubling to 2, 4, 8 . 16 , 32 , 64 by the 30 step you ’re in a
billion ,26 times around the planet . T hat's acceleration that we see in
our mobile devices. This is my 10 year old iPhone 2 , Moore's law
encapsulated in a supercomputer in my pocket. T his is amazing 10
years ago . Now , it feels antique.

We're seeing accelerations in AI, machine learning, virtual reality,
nanotech and others that are coming together in the theme of
exponential medicine , exponentialmedicine .com is how do we break
upon the silos and health care from different forms of clinicians to
investors , to technologies , to patients , to see what's at the interface ?
W hat's coming together, the convergence that enables to reimagine

Dr. Daniel Kraft – Exponential Medicine

health care from where it is today, which is as we all kn ow, sick care .
We have intermittent data that we only get usually in the clinic
setting. W e ’re reactive, we wait for the heart attack, stroke or
pandemic to arrive . Part of the th eme of exponential medicine i s to
reimagine where we can take existing techno logies and let alone what
they'll be in 2 , 5 and 10 years.

You mentioned AI, that's one area that's moving very, very quickly
and now fits in our supercomputers , in our pocket. The trick is, as
clinicians, we don't want data coming at us. We're already
ove rwhelmed. We want to be synthesizing that to actionable
information. I think part of the potential of AI meets sensors , meets
our digital exhaust is as we as clinicians and as empower ed ind ividuals
and patients can enter this age of digital mobile connecte d health to
connect the dots between the data, the insights and things that will
be personalized to prevent disease, to diagnose it early, and then to
manage it in smarter more connected ways , using AI machine learning
to make sense of that data and person alize it to the individual.

Margaret Flinter: Well, Dr. Kraft , I want to go back for a moment to your XPRIZE
competition, because I'm not sure if this has been do ne before in a
competitive way, so w e're really curious about this . One of your
pandemic XPRIZ E competition centers on the need to create new
ways to upskill the health care professionals and paraprofessionals
to o I imagine , to respond rapidly to some of these dramatic new
threats. F rom your perspective, how's the pandemic exerting
pressures on hea lth care workforce training to respond to a growing
set of threats ? T ell us about this particular XPRIZE .

Dr. Daniel Kraft: I think, broadly, the world is accelerating around us. We all need to be
continually learning what we learned in medical school is o ften out of
date, a year after we graduated . F or many folks, they're being left
behind in this age of technology . W e talked about Uber earlier, the
u berization of lots of things have disrupted fields. What's happened to
taxi drivers can next happen to mayb e primary care doctors as some
forms of technology can overtake or integrate. I would argue we need
to start upskilling the nurse practitioner, the community health
worker, the individual CMO , Chief Mom Officer at home, to use some
of these new tools and t echnologies for health, but also more broadly
as we want to res kill our entire society to enter sort of this evolving
age.

T here's a new XPRIZE , called the Reskilling XP RIZE not focused purely
on health care, but how do we take some of our new learning
eng ines, flipped classrooms, ways to think -- you don't need to get a
PhD or even a master -- a traditional university degree to learn how to
code or to build a virtual reality platform or to solve challenges in
public or global health. In general, that new p rize is focus on how do

Dr. Daniel Kraft – Exponential Medicine

you take folks reeducate them into the new skill sets and integrate
them into the market. Given that the world is digitizing becoming
more democratized, and many of our old technologies that were on
our shelf have now been amplified , and that changes the game for
many fields including health care.

Mark Masselli : Well, I mentioned earlier, Dr. Kraft, that you're an oncologist,
inventor, entrepreneur . B ut tell me , you do a lot of these interviews ,
w hat question do you look for people t o ask you because you're a
custodian of a lot of information. What do you think people need to
know about the work that you're doing?

Dr. Daniel Kraft: I think one of the -- there’s a famous quote, “ The future is already
here, just not evenly distributed ” . That's particularly true in health
care , w e have so many health care systems, there's so much
fragmentation and misaligned incentives. I would say, one of the
themes I would say is don't wait for the future to happen. A s
clinicians, ourselves or as patien ts , w e don't need to wait for some of
these tools. If you [inaudible 00:17:57] atrial fibrillation , y ou can get
a n EKG on your watch or smartphone, you can prescribe an app for
managing hypertension or smoking cessation or stress reduction. I
built a n earl y platform called Digital . H ealth, that's the website
Digital . H ealth to try and find some of those tools and solutions you
might start to prescribe as a clinician or find and use as an individual.

P art of it is about thinking about not just with the technol ogy is today
in 2020, which is already pretty amazing. What's going to be here in a
couple years , how to put those together to solve pain points as an
individual as a clinic , as a hospital system, in a public health , right, and
to not have a failure of ima gination as to what's possible. To move to
this area of continuous proactive true health care to not just manage
sickness but to extend healthy lifespan , and just sort of extend our
imagination into the possibilities of what can come . One of the silver
lin ings , again , of this pandemic is that many technologies are being
put together new ways , new collaborations internationally, new
learnings , what was learned in the hospitals of Wuhan came to New
York City have now c ome full circle and running, hopefully ac celerate
moving from data to information to point of care knowledge in a
faster, better way.

Mark Masselli : One thing that we've been doing at our Weitzman Institute is looking
at the social determinants of health and trying to reach out to the AI
tech wor ld about who's trying to solve this housing, food insecurity of
the like, because right now what people are doing is just measuring --
i t's a very small scale. R eally we ’d love to have one of our folks reach
out to you, because we've brought a lot of innov ators around the
table who are trying to scale this up. This is the biggest challenge . It’s
not so much what happens inside our clinical walls , it’s what happens

Dr. Daniel Kraft – Exponential Medicine

outside. I'm wondering, as you look at the work that you're doing, do
you have people who are focused in o n social determinants of health?

Dr. Daniel Kraft: You've had a big focus at exponential medicine which seems
technology focused about social determinants, how to understand
them, how to leverage technology in new ways to address them.
T here's that famous quote, “Y our genetic code is less important than
your zip code .” Now this pandemic, certainly, as you know in New
York, amplified the disparities and the outcomes from that. I think we
can use technology newest -- having a smartphone in your po cket
with little AI triage system can g ive almost anybody without regular
access to care, early proactive information, or a smart connected app
or the ability to virtualize d care which has exploded in our COVID era .
Now, we can do virtual visits, just like we're talking , a virtual tumor
board. A ll those can lower disparities . W e need to get folks basic
internet access in some parts of the country, but I think there's so
much we can do at that 80% of health care's related to our social
determinants and our b ehaviors doesn't require fancy technology, but
new thinking and new collaborations that starts with housing, clean
water, good food, social connection, so lots of basic blocking and
tackling that technology can also enable .

Margaret Flinter: We've been spe aking today, with the Dr. Daniel Kraft Chair of the
XPRIZE Pandemic Alliance Task Force , f ounder of the Exponential
Medicine Conference , and the Chair of Medicine at Singularity
University. You can learn much more about his groundbreaking and
exciting work by going to danielkraftmd.net , t hat's Kraft with a K. Join
as many followers on Twitter . You can find him @daniel_kraft . Dr.
Kraft thank you so much for taking all of your intellect and curiosity
and applying them to some of these great health challenges of today
and for joining us again on Conversations on Health Care .

Dr. Daniel Kraft: Thank you .

[Music]

Mark Masselli: At Conversations on Health Care, we want our audience to be truly in
the know when it comes to the facts about health care reform and
pol icy. Lori Robertson is an award winning journalist and Managing
Editor of FactCheck.org, a nonpartisan, nonprofit consumer advocate
for voters that aim to reduce the level of deception in US politics. Lori,
what have you got for us this week?

Lori Robertso n: This week we'll fact check a claim about COVID - 19 from Democratic
presidential nominee Joe Biden's acceptance speech at the
Democratic National Convention. In critiquing President Donald
Trump on his handling of the coronavirus pandemic Biden said, “ J us t
judge this president on the facts. 5 million Americans infected by
COVID - 19. More than 170,000 Americans have died by far the worst

Dr. Daniel Kraft – Exponential Medicine

performance of any nation on Earth. ” Biden is right that in both
c oronavirus cases and deaths, the US has the most of any other
th
country, and his figures were correct as of August 20 when he made
the statement. About a week later, according to Johns Hopkins
University, there were nearly 5.8 million confirmed cases in the US
and more than 178,000 deaths from COVID - 19 , the dis ease caused by
the novel coronavirus , but by other metrics the US does not have the
worst record .

When population is factored in seven other countries had more
cumulative COVID - 19 cases. This includes Qatar with more than
40,000 cases per million people , a nd Bahrain, San Marino, Chile,
Panama, Kuwait and Peru, the US places eight with 16,706 cases per
million. These figures come from Oxford University's O ur W orld in
th
D ata for August 20 . On deaths per capita the US also does not share
th
the worst . Our World i n Data s hows the US with the 10 highest
death rate , better than San Marino, Belgium, Peru , Andorra , Spain,
the UK, Italy, Sweden and Chile. In a similar data set from Johns
Hopkins , t he US does better than an additional country , Brazil.

Although harder t o interpret and heavily influenced by the number of
coronavirus tests performed, the US also does substantially better on
it's observed case fatality rate or the proportion of people identified
with the virus who have died . In the US , 3.1% of those known t o be
infected with the virus have died , a lower rate than 55 other countries
in the Johns Hopkins analysis. That's my fact check for this week. I'm
Lori Robertson, Managing Editor of FactCheck.org.

Margaret Flinter: F act C heck.org is committed to factual ac curacy from the country's
major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you'd
like checked, e - mail us at www.chcradio.com . We'll have
FactCheck.org’s Lori Robertson check it out for you here on
Conversations on Health Care.

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Mark Masselli : Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Students o f
public health are often tasked with devising interventions for addressing some of h ealth's biggest challenges. For Harvard T.H. Chan
School of Public Health students , Dan Wexler and Priya Patel , t heir
idea netted an award and launched a business idea at the same time .
T he students were tasked with addressing food insecurity in
underserved parts of the world, including in neighborhoods in their own backyard families living in high poverty, low resource area in
finding fresh, affordable, healthy food in nei ghborhoods with no
grocery stores or food markets. They thought of the current trend of
healthy meal or meal services like Blue Apron and wondered what if

Dr. Daniel Kraft – Exponential Medicine

we modified that business model to serve the needs of those living in
food deserts .

Wexler and his pa rtner sourced food delivery companies that could
provide pre - packaged meal kits, with all ingredients included even
spices, dressings and recipes . I nstead of home delivery approach , t hey
design ed refrigerated kiosk that could easily be placed in local
neig hborhoods. Wexler says they wanted to make the idea of healthy
eating and meal prep aration as simple as possible,

Dan Wexler: I think the biggest change is that there is no delivery system door to
door per se. That by going and setting up these kiosks in t he
community, you can have a very lean design , you can have -- you
don't need a storefront, you don't need to pay for shipping , y ou don't
need to have inbox refrigeration. You are very much addressing the
needs of access by physically saying, hey here is h ealthy food. It's
convenient, because everything you need is in the box. The directions
are simple, they’re very picture based , t here's a lot of literacy issues.
J ust really thinking about how can we take all those lean design
principles to facilitate acce ss , t hat really, I think , making a solution
that has the potential for impact s .

Mark Masselli : They also conducted research with local ethnic groups to create
recipes that would resonate with their families.

Dan Wexler: Then we just went down to community and did taste testing at the
Farmers M arket and talk to people and said, do you like this? What do
you want to be able to eat for dinner? How do you want to cook ? It’s
basically we have some dishes that are similar textures, similar spices.
One thing that we found is there's a little bit of contention between
parents who want to eat more traditional foods and kids who want to
eat more American foods , and we try to alleviate that and bridge
those gaps are one of our recipes, for instance, is there’s a chicke n pot
pie pasta. It 's kind of American, it's fun sounding , but also we use a lot
of tr aditional seasonings and spices.

Mark Masselli : Customers can simply walk to the kiosk and purchase their meal kits
with the snap cards or cash and the added benefits. Th e Kiosk will be
run by the residents of the neighborhood, giving them an opportunity
to purchase the kiosk and run them like a franchise , o ffering an
economic benefit to the community as well. Their idea earned them
the Rabobank - MIT Food and Agribusiness I nnovation Prize , and
$15,000 in startup money to launch their enterprise . A low cost
portable, healthy meal service placed in portable kiosk and food
desert neighborhoods, offering families a simple solution to address
the problem of poor nutrition , p rovid ing an economic opportunity at
the same time. Now that's a bright idea.

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Dr. Daniel Kraft – Exponential Medicine
Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.
Margaret Flinter: And I'm Margaret Flinter.
Mark Masselli: Peace and Health.
Female : Co nversations on Health Care is recorded at WESU at Wesleyan
University, streaming live at www.chcradio.com , iTunes, or wherever
you listen to p odcast. If you have comments, please e - mail us at
[email protected] , or find us on Facebook or Twitter. We love
hearing from you. This show is brought to you by the Community Health Center.
[ Music ]