Imagine a world where a wristband alerts industrial workers whenever someone is less than two metres away from them; where a pay-as-you-go app for small medical providers in sub-Saharan Africa identifies patients who are susceptible to serious COVID-19 complications; and where modular off-grid facilities can be rapidly deployed for housing, health and educational purposes anywhere in the world.

You don’t have to imagine such a world, thanks to the Creative Destruction Lab (CDL).

“Novel crises require novel responses, and novel responses require innovation — often predicated on insights from science.” That according to CDL founder Ajay Agrawal, who is the Geoffrey Taber chair in Entrepreneurship and Innovation at the Rotman School of Management and whose team has been on the front lines of developing solutions to help the world recover from COVID-19.

CDL’s stated mission — pre-pandemic — was “to accelerate the commercialization of science for the betterment of humankind.” And it was well on its way when COVID-19 shut down most of the world last March. “In the early days of the pandemic, it occurred to us that honouring our mission would mean redeploying our resources to focus on this global crisis by applying the CDL model and community to rapidly translate science into solutions,” he says.

What CDL does well — arguably better than anyone else — is accelerate the commercialization of new ideas. And with the first global pandemic in a century on the horizon, the world sorely needed them. “With COVID-19, we had a novel crisis on our hands that nobody had faced before,” says Agrawal. “Experts in Public Health had seen pandemics before, but not with such a broad economic impact. Suddenly, we were faced with a problem that nobody knew how to solve.”

CDL had been designed to take ideas — many of which emerge from university labs around the world — and commercialize them. A team of scientists in Toronto or San Francisco would come up with an innovation with commercial potential, but they had no idea how to turn it into a product. Enter CDL. Through its network of mentors — some of the world’s most successful tech entrepreneurs, inventors, scientists and investors — it provides the support required to bring the product to market.

 When something like this happens, it’s like you are called upon to step up.

“We realized at the outset that we were going to need science-based solutions to beat this pandemic,” says Mara Lederman, site lead at CDL Toronto and a professor of strategic management at the Rotman School. “But we knew that traditionally, there was a very long and challenging path from innovation to commercialized solution.” The CDL team looked at each other one day in early March and said, ‘Hey, this is what we’re good at!’ “It seemed obvious that we should bring our machinery to bear on this problem with a dedicated program,” says Lederman. “In a sense, we’ve been developing the muscle to do this for a long time. When something like this happens, it’s like you are called upon to step up.”

Eureka: it’s an information problem

In the early weeks of the pandemic, virtually everyone was talking about four things: shortages of personal protective equipment (PPE) and how to produce more of it; ventilator shortages; finding treatments for COVID-19; and producing a vaccine. The CDL team chose not to focus on any of these things — for two reasons.

“First, other people were already focusing on them — and doing a great job,” says Lederman. “We also knew that vaccines and treatments would likely take significantly longer, and that those solutions would not likely come from start-ups.”

The second reason was that the team approached the problem differently. “Our approach was motivated by my Rotman colleague (and CDL chief economist) Joshua Gans. Early on, he said to us, ‘wait a minute, what we have here isn’t just a health crisis or an economic crisis — it’s an information crisis’.” COVID-19 is caused by a virus, he explained, but the pandemic is caused by a lack of good information. “At its core, a pandemic is essentially an information problem: How can we figure out who has it?”

This insight not only formed the basis for Gans’s book (The Pandemic Information Gap: The Brutal Economics of COVID-19), it would be embraced as the over-arching principle by the CDL Recovery program going forward. “As Joshua argues in his book, when we don’t know who is infected, we have to act as if everyone is infected. The vast majority of people weren’t getting sick — and they still aren’t,” says Lederman. “When we close the economy and send everyone home, it’s not because we think most people are sick. Even early on, we knew that less than one per cent of people were sick. The problem was, we didn’t know who the sick people were.”

In short, we had a health problem that didn’t have any solutions yet, and that health problem created an information problem. If we could actively manage the information problem — by figuring out who was infected and with whom they have had con tact — we could suppress the virus and get the economy back up and running sooner rather than later.

Information-based solutions would involve predicting who is infectious and who is immune and developing tools to leverage this information. For example, if the system detects that some one in an office has an elevated temperature, security would be notified to direct that individual to a testing station for further examination.

Most of the solutions we have been using to date are what CDL calls ‘always-on solutions’: ‘Everyone must stay at home’ or ‘Let’s surround our workers with plexiglass’. “These are entirely un-innovative solutions,” says Lederman. “They are the bluntest form of measure — and the most costly, in terms of economic impact.” She notes that shutting down businesses for months at a time was costing the economy trillions of dollars per day. “That’s where we wanted to have an impact. Nobody else was focusing on this, and we knew information-based solutions would enable us to begin to reopen the economy.”

Seizing the moment

By the time the pandemic hit, the CDL had already grown to offer 15 streams for start-ups around the world, ranging from space to health, operating in four countries at nine sites globally. For the first time in its history, it decided to move away from its traditional location-based programming and designed CDL Recovery to run globally.

This new format meant two things: The new program could draw on mentors from all of its sites; and it would operate with a much more compressed timeline than the regular program. “We weren’t sure what to expect when we put the call out to our network of mentors,” says Agrawal. “Summer was on the horizon, and we were asking them to volunteer their time on this. But we felt like we had a world-class community who knew how to get things done, so we gave it a shot.”

The team was blown away by the response: more than 400 mentors stepped forward. Some came from health-related fields, but they also heard from people like Rhiannon Davies, whose background is in supply chain and food; Mark Evans, a finance leader who previously ran capital markets at Goldman Sachs; and Inmar Givoni, the former director of engineering at Uber. All came forward because they had expertise in commercializing innovation and they shared a deep desire to seek solutions to the pandemic.

Another mentor who responded was Laura Rosella, the Canada research chair in Population Health Analytics and director of the epidemiology program at the University of Toronto’s Dalla Lana School of Public Health. Rosella had been in volved with the CDL since the fall of 2019 as a mentor. “My area of expertise is health data analytics and population health, so I had advised several start-ups in the Health stream. The difference with CDL Recovery was, given my expertise, my input was relevant to many of the companies that were accepted into the program.”

With a leadership structure and mentors in place, applications from start-ups quickly rolled in from around the world be fore an initial cohort of 99 ventures was selected to move through the program. Virtual meetings started early in the morning in Toronto — early afternoon at CDL Oxford and CDL Paris, very early morning for CDL Vancouver participants — and sleep deprived start-up leaders from as far away as New Zealand were starting their day at 2 or 3 a.m.

Once a company made it past the intake stage, it went through up to four rounds of sessions which operated much like regular CDL sessions: there were small group meetings with mentors where objectives were discussed and set, and progress tracked. At the end of the first round of sessions, mentors de liberated to ensure that only the strongest concepts progressed to the next round. Because these sessions were held every four weeks as opposed to the regular program’s every eight, the time frame was cut in half. In the end, of the 90 start-ups accepted into CDL Recovery, 28 graduated in August [see full list of alumni].

This, in itself, was a massive accomplishment, generating 28 new world-changing products and services within a six-month period. But the story doesn’t end there. What most of these entrepreneurs didn’t know was that, behind the scenes, another ground-breaking initiative was taking off within CDL.

Getting Canadians back to work

As the CDL Recovery program progressed, its leaders agreed that part of the focus had to be placed on finding solutions to get Canadians back to work. But how?

The truth is, universities are great at problem solving, but they’re not very good at executing; and corporations are often good at executing, but they often don’t have much of a muscle for innovation outside of their specific expertise. “We didn’t know the minute details of what the sub-problems and issues were for companies in terms of getting people back to work, so we asked, who would know?,” says Agrawal.

“The answer was, the CEOs of large corporations like Air Canada, Magna and Rogers, who would have to put thousands of people back to work.” So, he invited them — along with an impressive cadre of talent from diverse fields from business (Loblaw executive chair Galen Weston) to global affairs (Munk School founding director Janice Stein) to the arts (legendary author Margaret Atwood and opera singer Measha Brueggergosman) to consulting (McKinsey Global head Kevin Sneader) to form the CDL Vision Council.

The Vison Council would focus specifically on finding back-to-work solutions. “Initially, the goal was for the Council to identify the discrete problems to be solved by businesses in getting people back to work, so we could throw those problems over the wall for the entrepreneurs to tackle,” says Agrawal. But in its very first session, Margaret Atwood asked the group a key question: Why can’t we create a simple test for COVID-19, similar to a pregnancy test?

“We all agreed that early detection of infectiousness was the key to stopping the spread of COVID-19 and reopening the economy — and that rapid testing could be a huge part of the solution,” says Agrawal. By their fourth meeting in August, the CEOs on the Vision Council said, ‘Let’s stop talking about this and do it’.

The CDL agreed to oversee the initiative, on three conditions: the project had to make good business sense for the companies involved — it couldn’t be viewed as charity — because CDL would ask for a significant time commitment from key talent at each company; member companies would share their learnings and data with other member companies (rapid learning was the main motivation for doing this as a collective rather than individually); and after the member companies incurred the time and expense of solving the key problems (supply chain, regulatory compliance, implementation), they would give away the blueprints to the solution for free — including to their competitors.

With all parties aligned, the CDL Rapid Screening Consortium was born.

CDL generated 28 world-changing products within its first six months.

A powerful partnership

The world is an increasingly complex place and different organizations are designed to solve different types of problems, says Agrawal: “for-profit companies produce goods and services, and their focus is generally to provide as desirable a product as they can and make a profit. It has become fashionable for people to turn their noses up at profits, but they are actually really important, because they drive efficiency and innovation.”

Universities have a different but complementary set of strengths, he notes. “These are magical places where people are incented to create and develop ideas. It doesn’t matter if nobody needs them right away. Rather than being motivated by profit, academics are motivated by curiosity and tackling tough problems that may help the world progress in important ways.”

That’s why this partnership made so much sense. “We were able to pull together people who had developed a muscle for solving novel problems, but didn’t know how to execute; and pair them with people who didn’t have the muscle for that kind of innovation, but knew how to execute at scale. Whether their business focused on air travel, groceries, or auto parts, they had something important in common: They wanted to get their companies back to pre-pandemic levels of activity,” he says.

CDL recovery start-ups

The following 28 ventures have graduated from the CDL Recovery program.

AccuroLab has developed a service that acts as an intermediary between cellphone users and Trusted Health Organization (THO) sources, allowing users to assess the accuracy of incoming text messages related to COVID-19.

Altis Labs helps pharmaceutical companies and hospitals accelerate therapeutic R&D and guide personalized treatment by predicting patient outcomes from radiological imaging. As COVID-19 spread, Altis expanded its technology to predict outcomes of patients with pulmonary infections, allowing hospitals to better manage their resources.

Avro Life Science develops skin patches that administer generic drugs through the skin and eliminate the need for oral medication. Their first product—an allergy patch—helps children avoid the side effects of taking oral medication, including trouble swallowing.

BioXplor is developing an AI and network-based drug-discovery platform for pharma and biotech, which will prioritize drug combinations for complex diseases. In response to the pandemic, it has

positioned the platform for antiviral and anti-inflammatory COVID-19 drug combinations, which it will leverage to build a pipeline of biotech and academic partners and clients.

Careteam’s virtual-care collaboration platform facilitates a continuum of care planning and enables healthcare providers, patients and families to act as a team. The platform offers integrated care plans that can be personalized and shared, enabling healthcare providers to manage COVID-19 patients remotely while continuing the delivery of needed care.

Crowdless is a mobile app that helps people avoid queues and crowds. The app provides real-time and predicted information on how busy venues are, so people can shop at the least-busy hours. This helps the public meet social-distancing standards during COVID-19 while also allowing commercial partners to reduce the amount of time that stores are over capacity.

En Carta is developing a rapid and reliable test for COVID-19. The test is paper-based and seeks to address the dual problem of short supplies for traditional testing methods and the high cost of these tests. The initial technology was validated in 2019 with the Zika virus and has been adapted for COVID-19.

Gradient Ascent’s product, Greeter, is a health and safety solution to improve compliance outcomes, such as wearing personal protective equipment (PPE) and maintaining social distancing. It uses computer vision and AI to monitor compliance and issue an audio-visual alert when an individual is not wearing PPE.

Grapheal is developing a disposable, low-cost and rapid diagnostic test enabling multi-strain screening in saliva with an antibody-sensitized sensor coupled to a smartphone app.

Gray Oncology Solutions helps oncology centres optimize resource allocation to reach their maximum treatment capacity at a high quality of care. It is developing AI-guided algorithms to create a virtual model of oncology centres, which can predict the distribution of new patient arrivals, the time required to treat them and perform scheduling—all of which can help reduce the impact of the pandemic on over-capacity healthcare systems.

Hutano Diagnostics is developing MediLego LFD, a rapid lateral flow device for COVID-19 based on proprietary aptamers that detect the virus 10 minutes after a saliva test or nasal/throat swab. The test will be used in conjunction with a smartphone, cloud database and Bluetooth to automate result interpretation, data collection and contact tracing.

Ilara Health is a secure digital web/mobile app platform that brings diagnostic support and essential tests to small medical providers across peri-urban sub-Saharan Africa. Its COVID-19  Readiness Package helps identify patients who are most susceptible to serious COVID-19 complications and can play a crucial role in patient triage at the primary-care level.

LumineSense is designing a rapid autonomous ultraviolet (UV) disinfection system for confined, high-traffic public spaces like gyms and elevators. The LumineSense light source will include sensors to guarantee sufficient and effective disinfection.

Mediphage Bioceuticals is developing next-generation genetics medicines that are safer, customizable, and redosable.

MEMOTEXT is building RapidResponse, a digital communication tool that automates outreach, screening, and mental health follow-ups for students and teachers.

Metabolic Insights has developed a point-of-care device that analyzes saliva and other body fluids for peptides (and thus health-related biomarkers) in less than 10 minutes. It is repurposing its salivary insulin device to detect the SARS-CoV-2 spike protein in saliva, which could be used for daily screening by physicians, pharmacies, employers or airports, as well as for at-home diagnosis.

MyBubble is a social-distancing radar that measures and gamifies users’ social distancing and hygiene practices in the workplace.

nanopathdx has developed a testing platform that can detect multiple viral RNA targets directly from a nasal swab within minutes, instead of hours.

Pngme is a data platform that aggregates financial data on individuals and micro, small and medium-sized enterprises (MSMEs) for financial institutions (e.g. banks and mobile money operators). It enables financial institutions in emerging markets to onboard, approve credit applications and offer products digitally without meeting in person. The company is currently working towards an open banking revolution in Africa.

ProbiusDx has developed an analytical platform that brings the unique integration of multiscale biological information to identify small and large molecules, enabling broad-spectrum and efficient longitudinal studies for preclinical therapeutic discovery and validation.

Provision Analytics provides fruit and vegetable processors a food-safety and traceability solution to reduce food loss. Its core software is being applied to trace and monitor COVID-19 symptoms among workers to help essential food facilities stay open and safe. The venture will be ramping up its sales activities to get its platform into more food-processing facilities in Canada and the U.S.

Proxxi has developed a wearable wristband to protect workers from electricity. It repurposed its core product into a COVID-19 workplace distance and contact-tracing wristband that vibrates to notify wearers that another band is within six feet (two metres).

SensorUp provides an open interface that enables interoperability, analytics and device management across different IoT sensor systems. The company’s founder is an editor of the IoT cloud API standard that will be endorsed as a national IoT standard by governments around the world.

Tenera Care is a hardware and software monitoring and analytics platform that has developed a wearable technology (bracelet, pendant or clip-on) to accurately pinpoint a user’s location within a care facility. The system enables contact tracing by detecting who someone has interacted with, at what distance, in what location, and for how long.

TestCard is a smartphone app that can read a variety of diagnostic tests quickly, easily and from a user’s home via their camera phone. A user does a finger-prick blood test and the TestCard app can let the user know if they have tested positive for COVID-19 within minutes.

VivaVax has developed an antiviral coating material called ShieldAV that can eliminate microbes/viruses within 30 minutes of contact and can last on surfaces such as glass, plastics, metals, ceramic, and textiles for five years indoors and three years outdoors.

WarnerPatch (formerly M2JN) has developed a non-invasive chip sensor that can be embedded in a non-invasive IoT medical device, allowing continuous measurement of tissue health to provide information on respiratory distress episodes.

Worldchanging Ventures is developing modular, rapidly deployable facilities for housing, health and educational purposes. The team has pivoted its current offering away from rapidly deployable field hospitals and towards modular sustainable housing.

As the epidemiologist in the group, Laura Rosella’s role was to make sure that whatever was being proposed lined up with Canada’s public health response. “We didn’t want to create any additional risk,” she notes. “We wanted to complement all of the other great work that was going on.”

“In the end, the government can’t be expected to do every thing for us. They are working hard to support testing and vaccinations; and they have hospitals, long-term care, and schools to worry about.” The workplace setting is a completely different context, she says. “The government just couldn’t take on the operational aspects of different types of workplaces. These companies were willing to do the heavy lifting in terms of thinking through all the minute details.”

As indicated, the Consortium’s solution is all about deploying rapid tests, not producing them (although some CDL Recovery start-ups do produce COVID-19 testing products). Health Canada approved the tests used in the program, similar to the approach with vaccines, and distributes them to the provinces. “We made the decision early on to go right to Health Canada and say, ‘if there are screens available that you want to test in pilot settings, this could be the mechanism to do that’,” says Agrawal.

The rapid-screening protocols developed by the Consortium will support Canada’s management of COVID-19 in two key ways. First, by developing operational knowledge and an implementation strategy for testing. Each consortium member has provided a dedicated workforce pool to implement pilot pro grams. Second, by reducing the load on healthcare systems, al lowing them to focus their screening efforts on infected people.

The 12 Consortium members are: Air Canada, Canadian Pension Plan Investment Board, Genpact, Loblaw, Magna, MDA, Maple Leaf Sports Entertainment (MLSE), Nutrien, Rogers Communications, Scotiabank, Shoppers Drug Mart and Suncor Energy.

The rapid-testing rollout began at Rogers, Air Canada, Suncor and MLSE in January 2021, under the leadership of retired military general Chuck Lamarre and a former commander of Britain’s joint forces command, Sir Chris Deverell.

The Vision Council recognized early on that small businesses would be equally interested in rolling out regular rapid testing for their employees. “The goal was always to make sure that this initiative has broad impact,” says Rosella. “We’re figuring out how this can work in workplace settings, period.”

“Of course, businesses are not the only places where rapid screening is useful, but this is the area we decided to focus our efforts on. The idea of translating the learnings to small businesses that may not have the capacity in-house to set up such a system was raised early on, and we all agreed that this should be part of the program,” says Rosella.

The Consortium approached this as an operational problem, she says. “Different screening technologies will come and go, but creating a system that ensures regular screening — that was our goal.”

As word spread about the Consortium’s activities, the team received several offers from other countries to join in. Were they tempted? “Not at all,” says Rosella. “Working in multiple countries would have spread this initiative too thin and limited our ability to have an impact in Canada. We were determined to make a difference in our own country first and foremost,” she says.
 

In closing

In addition to demonstrating the value of partnerships between universities, business and government, CDL Recovery and the Rapid Screening Consortium have made another thing clear. For many of the participants, a key takeaway has been how important it is to include multiple perspectives on an issue.

“As a scientist and public health expert, I bring a lot to the table,” says Rosella, “but economists, operations experts, entrepreneurs and artists have a distinct way of thinking about things that made me think differently and check my assumptions on several occasions.” Of course, in the context of a public health emergency, progress is tricky because no one wants to make the wrong choice. But at the same time, no one knows what the right choice is, because everyone is learning as they go. That’s where courage of conviction comes in.

A Moonshot can be defined as ‘an audacious ambition that is firmly focused on the future, the art of possibility, and what could be rather than what is. Based on that definition, CDL definitely has at least one moonshot on its hands. And with former Astronaut Chris Hadfield on board as a CDL fellow, it is well on its way to shaping our recovery.

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This article first appeared in the Spring 2021 issue of Rotman Management magazine. Published in January, May and September, each issue features thought-provoking insights and problem-solving tools from leading global researchers and management practitioners. Subscribe here.