By most measures, Los Angeles, where hospitals are running out of space and morgues are at capacity, is not a model city for how to control a deadly pandemic.
But there’s one thing L.A. irrefutably got right. It partnered with CORE, Sean Penn’s emergency aid organization, and Curative Inc., a San Dimas-based diagnostics startup, to offer free testing to the public at 10 city-run sites, including the drive-thru in Chavez Ravine.
“The scale is just crazy at this point,” said Fred Turner, Curative’s 25-year-old co-founder and chief executive.
And as of last week, Curative isn’t solely a testing company.
It’s now sending “strike teams” to nursing homes to help vaccinate residents and staff. Under a partnership with the city and county announced Dec. 29, Curative had agreed to deliver and administer 69,000 Moderna Inc. vaccines to 339 nursing homes before Jan. 1.
Stunningly, given the scale of its efforts, Curative didn’t even exist one year ago.
Before developing and deploying a Covid-19 test at almost unbelievable speed and rolling it out at an almost unbelievable rate, Turner and business partners Isaac Turner (no relation) and Vlad Slepnev were working together in the Bay Area at Shield Bio, a clinical laboratory specializing in infectious disease testing.
Shield, which Fred Turner co-founded and headed, folded in January.
After that, the trio decided to develop a speedier way to detect sepsis, a dangerous blood infection that can quickly cause organ failure and death.
By February, they were sketching out plans for their initial clinical trial.
But when one of their potential collaborators, a scientist at the Medical College of Wisconsin, called to say he wouldn’t be able to work on their project for at least four months because of the novel coronavirus, they began wondering whether an opportunity existed in testing related to the rapidly spreading disease.
“For him to call and say, ‘I can’t talk until June,’ was very uncharacteristic,” Fred Turner said. “It sounded like a really long time to pause discussing a clinical trial. In hindsight, they were ahead of the curve.”
It was a momentous tip-off.
Curative’s founders had only loosely been paying attention to the coronavirus as it swept through China. Turner says he initially assumed that if the virus also became endemic in the United States, the big labs would be able to handle the volume of testing that would be needed to control its spread.
Their research revealed that few labs, if any, were scaling up in the manner that would allow them to test millions of people each week.
At the very least, they figured they could develop a rapid Covid-19 test while waiting to get back to their clinical trial for sepsis.
They never went back to their work on sepsis.
Search for a lab
Search for a lab
Turner said calls to multiple labs in the Bay Area about running the test Curative was developing were met with a “resounding” no when they learned the tests were for Covid-19.
“At the time, before we knew what the testing protocols would be, (the virus) was much scarier for people,” he said. “No one wanted us in their lab.”
Then, a friend introduced him to KorvaLabs Inc. in San Dimas, a company that specializes in testing athletes for performance-enhancing drugs. With uncertainty mounting over playing schedules for professional sports, Korva was willing to take the risk.
“I met them on a Wednesday, joined a joint venture by Friday, and moved in that same weekend in March,” Turner said.
By that time, Curative had started looking for money from investors. The new company ultimately raised $8 million from venture capital firms DCVC and Refactor Capital, plus Chris Anderson, the curator of TED. Curative used part of that financing round to acquire Korva in May and hire more staff.
By the time Curative found the lab, Slepnev, a molecular biologist, had started developing a prototype for a Covid-19 test that would use a sample collected via oral swab — no Q-tip up the nose required — and could be administered by the potentially infected person rather than a health care worker.
The test, which uses a technique known as polymerase chain reaction, or PCR, requires users to simply cough three times before rubbing a long cotton-tipped stick around their gumline and tongue.
The vast majority of diagnostics companies were producing tests that gathered samples using nasal swabs, which is the method recommended by the Centers for Disease Control and Prevention for self-collection.
Researchers have found similar sensitivity between oral and nasal swabs, and say they show promise as an alternative, but under CDC guidance, oral swabs are only “appropriate” when administered by a health care professional.
Still, everyone agrees that self-collected oral swabs make the logistics of mass testing possible, largely because it necessitates far fewer medical staff and personal protective equipment.
Ability to scale
Ability to scale
First, it uses a virus transport medium that inactivates any viruses on the swab and does not need to be refrigerated, which improves the drive from the testing site to the lab (a job that at first fell to L.A. firefighters). Second, the company’s research and development team worked closely with its supply chain division to prevent bottlenecks.
“We designed our assay around being scaled. We said, ‘Everything that goes into this has to be able to scale into that million-tests-a-week level,’” he said.
Then came a stroke of luck: On March 11, Laura Deming, a venture capitalist with a passion for biotechnology and 28,200 Twitter followers, posted on the platform that she knew of a company that was ready to roll out thousands of rapid Covid-19 tests. Did anyone want them?
After spotting Deming’s call-out, L.A. Mayor Eric Garcetti’s deputy mayor of public safety encouraged Curative to submit a proposal for L.A.’s nascent drive-thru Covid-19 testing program, which initially served only essential workers, residents with symptoms, and those in nursing homes and other institutional settings.
The city initially awarded contracts to multiple providers, including Curative, which launched its tests at Hansen Dam, the West Los Angeles VA Medical Center and Crenshaw Christian Center.
By early April, Curative had developed its own appointment booking software.
“The first version was built by our software team in a single evening. ... They didn’t sleep much and stayed very caffeinated,” Fred Turner said.
On April 16, it secured Emergency Use Authorization from the Food and Drug Administration.
The FDA allows companies to deploy tests for specimen testing for 15 business days while preparing an EUA application. With the authorization, Curative could expand its client base.
The next day, the company signed a $13 million research and development agreement with the Air Force to produce more than 40,000 test kits for military medical personnel and open a new lab in Washington, D.C.
In a statement, Will Roper, the Air Force’s acquisitions “czar,” said the department was eager to work with “innovative tech startups who need fast decisions and cash.”
By early May, Curative had acquired Korva, taken over its lab and scooped up additional warehouses nearby, creating a quasi minicampus. It also became the sole testing and diagnostics provider for the city of L.A.’s mobile and drive-thru testing sites.
“Mayor Garcetti is incredibly grateful for their partnership,” Comisar said.
According to the mayor’s office, the city is paying Curative up to $115 for every test that is not reimbursed by insurance companies. Curative would not share financial information, but it has so far collected $64.7 million from the city, controller records show.
The value of the city contract, however, far exceeds that.
Without the L.A. contract, “I don’t think we would have moved as fast,” Turner said. “For us, working with the city was really important. We had that anchor customer buying a lot of tests, and it allowed us to open our own labs and hire more people.”
Curative’s San Dimas lab has been inundated since Thanksgiving when the number of coronaviruses in L.A. County started exploding at unprecedented levels.
The lab runs 24/7 to deliver results within 24 to 48 hours, and Turner has processed samples himself.
He has also focused on trying to keep his staff “happy even though they’re working hard and pulling some really long weeks.”
The company is hiring “frantically,” he said, for all types of positions, but he’s still finding time to chart its next move: a mass vaccination effort.
According to Turner, Curative administered more than 10,000 doses of the flu vaccine in partnership with CORE and USC and used that success to demonstrate that Curative was capable of doing more than testing.
His goal is to turn the city’s drive-thru testing locations into drive-thru vaccination sites. That will present new logistical issues, but if Curative can do for vaccines what it did for testing, it will rise to the challenge — and do it swiftly.
“The goal is to end the pandemic as quickly as possible,” Turner said.
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