Seeing Through the Molecular Curtain

Dr. Drew Endy is a science fellow and senior fellow (by courtesy) at the Hoover Institution and heads the Bio-Strategies and Leadership Initiative . He is also the Martin Family University Faculty Fellow in Undergraduate Education (Bioengineering) at Stanford University.

Erik Malmstrom is a veteran fellow at the Hoover Institution and a participant in the Bio-Strategies and Leadership Initiative. He is the CEO of SafeTraces, a dual-use technology company focused on predicting, detecting, and preventing biological threats, and previously served as a White House Fellow.

Erik, you've had a unique path from military service and the White House to leading SafeTraces. Tell us briefly about your public service.

I view everything that I've done in my professional career in the context of service. I graduated from college in 2003, and when I was going into my junior year, 9/11 happened. My experience in the military was colored by the global war on terrorism. I served for four years as an infantry officer, doing very little with bio. After four years of active service, I left the military, and everything since then has been focused on security in a variety of different forms. Biosecurity is one of the biggest challenges of our times.

What brought you to Hoover? How did you get connected with Hoover's Bio-Strategies and Leadership Team?

I learned about the Veteran Fellowship Program about a year and a half ago and was fortunate to be selected when I applied. My application included a capstone project proposal focused on modernizing US early warning systems for biological threats. Prior to my veteran fellowship, I had been a follower and fan of the Bio-Strategies and Leadership Team-the high quality of its people and thought leadership, particularly on biosecurity, was extremely impressive. Now, I'm in this unique position of being able to advance my project within a really amazing existing initiative.

Erik, what brought you into biosecurity, and what are you focused on today? What is SafeTraces? How did it get started?

I come from the security side of the house, not from the bio side of the house. But bio was always in the background of my military service and my post-military experience in startups, commercial agriculture, and government service. At SafeTraces, bio is the core of what we do. SafeTraces is a dual-use technology company and spinout of Lawrence Livermore National Laboratories focused on predicting, detecting, and preventing biological threats through an autonomous environmental biosecurity technology platform.

Erik, at Hoover's recent Bio Leadership Summit (BLISS), you had a live biosensor running throughout the event. What does your machine do?

Right now, when you go into a building, you do not know if there are pathogens floating around. We take 25,000 breaths a day and breathe 2,000 gallons of air per day. Not knowing what we're breathing is problematic and unacceptable. Our biosensor is intended to break this black box and provide a rapid, autonomous, accurate way of detecting pathogens in the air. In layman's terms, it's like a smoke detector for pathogens.

We deployed the biosensor at the Bio Leadership Summit, monitoring the air for influenza A and B, and RSV. We also had a positive control to provide confidence in our data.

When you bring large groups of people together, ironically even at health and wellness conferences, the air quality is often bad and sickness spreads. Deploying the biosensor at the Bio Leadership Summit was a great way to spotlight biotech innovation and leverage this biotech to have a practical, real, and positive impact on human health.

Drew, tell us about BLISS. Why was it important to you to feature Erik's machine?

The Bio Leadership Summit was an opportunity for us to convene 350 biotechnology leaders. It's the first time we've held such an event at Hoover. It is an unbelievable event. We didn't want to have a bio event that became a super-spreader event. And we wanted to model what is becoming possible with biotechnology and biosecurity. With Erik and SafeTraces's biosensor, we had, for the first time in my professional career, the option of seeing the airborne pathogens in the room. Having events that are black boxes and often turn into super-spreader events is not how we get to biosecurity victory.

Drew, there were concerns about running the sensor and potentially announcing the results. Tell us about these concerns. What made you decide to move forward anyway?

During the Cold War, the Iron Curtain descended on Europe, and you couldn't see what was on the other side until cameras and satellites allowed us to achieve geospatial intelligence. The threats in biosecurity are microscopic; they're on the other side of a molecular curtain. Until we develop and deploy biological intelligence, or BIOINT, we won't know what's there. For the first time in human history, we're capable of using technology to see on the other side of the molecular curtain, so we're compelled to try. The concern is: What do you do with the information?

Drew, you asked the audience if they wanted to have their air sampled and be told the results, and the summit participants overwhelmingly said yes. What did that response signal to you about public attitudes toward biosensing and transparency?

Just before lunch, we asked participants two questions. One, do you want us to run the machine? Yes or no? And that gave the participants agency and allowed us, as the organizers, to share the responsibility. Two, do you want the data? And it was very heartening. The entire room put their hands up, and some people put up two hands. They wanted the data and were excited to not get sick.

Erik, after BLISS, you also deployed the sensor in an emergency room. How is that going? What are the biggest challenges of using this technology in real-world settings?

Emergency departments are an obvious place for a biosensor to be deployed-it is where an unknown health risk is literally walking in the door all the time. Right now, we're establishing a baseline of what we're detecting in the air and referencing it against what is being detected clinically.

There are three categories of challenges. First, the product and underlying science are technically challenging. Our biosensor is focused on transitioning environmental biodetection from a highly manual, slow, and unscalable world to a highly autonomous, rapid, and scalable one. Second, when you put things in a real-world environment, there are practical concerns. Where do you find the power outlet? Where do you put the machine so random people can't mess with it? Third, there's the challenge of what you do with the data that you collect. Having data that is accurate and rapid implies a burden on the people doing the data collection to act. Our responsibility is to help them work through how to respond, including making the response autonomous via the HVAC system, in an effective and manageable way.

Drew, this connects to your idea of "biological intelligence" from your recent Biosecurity Really report. What does BIOINT mean? How would things look different if BIOINT were fully in place?

If you were going for a walk and you saw a mountain lion, you would behave accordingly, right? You might change the direction of your walk, back away, or call for help. Because we can't see dangerous pathogens, we can't change our behaviors. The idea of BIOINT is that we have an awareness of the invisible biological pathogens that are around us, and simply by being able to see them, we can act accordingly.

Once we have this as an option, we get to choose whether to know the risks. For me, I'd like to know, because then I can take actions to reduce my risk of harm. This is such a different world from our current one. Look at the Hantavirus outbreak on the cruise ship or my seventh grader recently coming back from school with COVID. It doesn't have to be like this. We don't have to sit around waiting for bad things in biology to happen to us-natural or intentional. Now is the time to act.

Drew, what policy or governance changes are needed to scale technologies like this responsibly?

It's both a cultural and a policy call for action. This requires policymakers, the public, and parents to solve it. It is all hands. Our number one recommendation is launching and sustaining a modern BIOINT program. Thing one is at the federal level. Thing two is for everyone. Think about the Fourth of July parades in your community and the heroes that are a part of them. For anybody reading this, make sure there are floats in your Fourth of July parade for public health and biosecurity heroes, along with the policemen and the firemen. We need to elevate these biosecurity heroes. By doing so, we can create a culture that expects continuous improvement in terms of managing and mitigating risks from biology.

Erik, what would you like to see done from a policy and governance perspective?

I see a lot of parallels between BIOINT and "INT" INT. The events of 9/11 exposed tremendous problems in intelligence. Systems were fragmented, multilayered, and multilevel. After 9/11, we started bridging divides between different stakeholders, intelligence sharing, and collective response.

The analogy for BIOINT and biosecurity is the COVID pandemic, which I view first and foremost as an intelligence failure that then triggered a domino effect of other system failures. From my perspective, auditing our biological intelligence capabilities starts from a systems-level analysis of our current status quo-versus a defined future goal state-focused on what BIOINT we need to prevent catastrophic natural, accidental, and weaponized biological threats. Then we can determine how to develop the critical downstream capabilities for data fusion, analytics, anomaly detection, and ultimately effective collective response. Building toward that type of system is what I hope for in terms of a policy or governance change and is the focus of my capstone project at Hoover.

Erik, if BLISS was an early test case of BIOINT, what would a more mature version of this look like at future events or even at a national level?

A hundred years ago, building fires regularly killed everyone in the building and became an unacceptable threat to public safety. Over time, we methodically developed life safety codes to protect buildings from fires, supported by a set of enabling technologies and infrastructure, from smoke detectors for early warning to suppression mechanisms like fire extinguishers and sprinklers. Eventually, we reduced the number of fire safety deaths by 95 percent. Biosecurity needs to go through a similar evolution. We have new building standards to control airborne bio-threats in buildings, early-warning biosensors, ways of suppressing pathogens through HVAC systems, and germicidal UV. If we realize this vision, we can live in a world where our kids are not getting sick as much at school and bringing it home, where long-term-care facilities don't put our vulnerable elderly population at risk of dying or getting hospitalized if they get sick, and where our warfighters are protected on the battlefield as well as on our military installations as a matter of force protection and readiness.

Any final thoughts, Drew?

Let's make infectious diseases operationally obsolete. Let's go do it.

Erik, any final thoughts from you?

I agree. Get it done.