Amazing diversity to COVID-19 solutions for society's needs: Khosla Ventures

The COVID-19 pandemic is likely to be one of the biggest disruptions we will face in some time.

In this difficult environment, we have found a commonality that makes us incredibly proud to be associated with our portfolio startups: the desire to help the nation and the world combat the pandemic. As mission-driven entities, we’re seeing our companies trade-off other priorities for this urgent societal need in a time when resources are scarce and it is not always easy to do “the right thing”. To be sure, some view it as a business opportunity. Many in our portfolio are working on deep tech, and are particularly well suited to help with critical needs like testing and treatment options. There are also efforts in managing the well being of those on the front lines, expanding access to medical care, and even fighting loneliness during periods of forced isolation among other needs. This breadth of effort is both admirable and astonishing and the short time periods surprising.

Some examples of current efforts (in alphabetical order) include:

Alivecor: FDA cleared QT duration measurement service for COVID medications that have a QT prolongation side effect (eg: Hydroxychloroquine, Azithromycin for example). Partnership with Mayo Clinic to diagnose long QT and build advanced algorithmic measurement of QT.

Augmenta: Searching for neutralizing therapeutic antibodies in patients who have recovered. They are scaling into a therapeutic which they hope to dose into patients by fall.

Caption Health: Deploying Caption AI to enable more frontline healthcare providers to quickly and accurately perform ultrasound echo exams, reducing personnel exposure and stretching limited resources, in the absence of skilled ultrasound technicians.

Clear Labs: Developing an automated, very low cost, and fast next-generation sequencing platform for deep-screening of COVID-19, which can simultaneously screen for the infection and generate deep genomic information that enables differentiating various RNA viruses, identifying infection clusters and transmission events, monitoring the evolution of the virus, and identifying cases of co-infections. FDA filing is expected in April.

Color: Launching a high-capacity COVID-19 testing lab and will open-source its design and protocols.

Curai: AI-based Virtual Primary Care and prescription of COVID testing to scale front end access to healthcare. Helps offload physicians who must decide whether a COVID test is warranted or some other urgent condition exists. This is part of their broad free primary care offering.

E25Bio: Makes direct antigen rapid tests for at-home use at a very affordable cost. All you need is your phone for the test, very much like a pregnancy test. They expect 100,000 tests per day in the next 30 days, subject to FDA approval.

Fundbox: Building a coalition of companies to #paytoday, encouraging large enterprises + government to pay SMBs outstanding receivables to alleviate financial burden.

Genalyte: A 15min serology test - IgG and IgM to multiple CoV proteins in April. No FDA clearance is needed on the already FDA approved Maverick instrument with this lab-developed test.

Ginger: Offering U.S.-based health systems free on-demand behavioral health coaching for their frontline healthcare workers.

Inflammatix: A host-response (mRNA) blood test run on COVID-19 positive patients to determine if hospitalization is needed and to decrease unnecessary admissions. The timeline is a few months if the system shows efficacy as expected in further trials. No such test exists to manage hospital capacity to our knowledge.

Luminostics: Developing, towards FDA EUA, a 15-minute high-sensitivity point-of-care test with smartphone readout for the parallel detection of SARS-CoV-2 virus from respiratory samples (to diagnose active COVID-19 infection) and anti-SARS-CoV-2 IgG/IgM antibodies from finger-stick blood (to quantitatively test for COVID-19 immunity).

Ontera: Building a molecular diagnostics point of care platform to conduct both nucleic acid and serology testing for both bacterial and viral pathogens using nanopore technology. The low-cost platform is expected by the fall.

Opentrons: An eight robot configuration for a fully automated qPCR testing pipeline. An eight robot $100k configuration can do 2400 tests/day fully automated. Opentrons has deployed 60+ robots to fight COVID-19 in the last 3 weeks, many of which have already started testing live patients under emergency use authorization.

Prellis: Using their organ growth technology, Prellis constructs human lymph nodes outside of the body and can vaccinate them to rapidly isolate human antibodies against emerging pathogens for the direct treatment of patients. Because it is a fully human antibody are there are minimal reported side effects therein a clinical trial with this antibody would happen extremely fast.

Replika: Teamed up with clinical psychologists from UC Berkeley to come up with more activities that can help deal with loneliness, financial uncertainty, homeschooling (for teens), sickness, caring for your family, having to work at crowded places (ie. grocery stores) and co-quarantining.

Totemic: Developing a wireless home fall detection and motion monitoring service, has launched a COVID-19 telephone concierge line, Ask Koko, which empowers older adults with the local services and tools they need to remain safely at home.

Viome: Applied to FDA for the only at-home collection COVID-19 test based on stool. Research shows the COVID virus shows up in stool even though it shows negative in a throat swab.

Many others are also helping in numerous other ways. Oscar is offering a risk assessment tool for non-members. Forward is offering care for non-members for COVID-19. Zocdoc is helping non-COVID-19 patients to connect to telemedicine. Carrot is offering its Pivot tobacco cessation app at no cost to all smokers to help people who smoke get started on a path to reducing or quitting to reduce risks of COVID-19. Creator has built an open-source design for a food Transfer Chamber to protect retail and delivery workers from virus spread. The chamber uses a positive pressure system combined with a self-sanitizing conveyor. Homebase is compiling and sharing data on how closures of businesses are impacting local communities and hourly workers. Gen1e is in the early stages of development of a drug for ARDS (acute respiratory distress syndrome), the primary cause of death from COVID-19. Model No, a related company, is working directly with Stanford and UCSF to develop an Aerosol Box. Based off a design from Taiwanese doctor Hsien Yung Lai, it’s a clear plastic box that can be placed over a patient when intubated. This is a high-risk procedure for the doctor, for they are very likely to be exposed directly with droplets to their face, and the preferred full-ventilated suits for protection are in very short supply.

As always in startup land, not all of these will work, but some will and could have a significant impact. The nature of startups allows them to try avenues that would take too long in established companies, as they are more able to quickly pivot and shift resources in new directions, which will be especially critical in the pandemic landscape. We’re proud of our companies’ efforts in combating this pandemic, and celebrate all startups helping in this effort, be they in our portfolio or not. These are the companies in our portfolio but many more startups outside our portfolio are also trying to contribute in significant ways.

We strongly believe the startup community can bring a unique view and skillset to ameliorating this pandemic, and in this time of national crisis, it is important to bring to bear the best each sector of society has to offer.

*This is by no means a comprehensive list, merely a quick snapshot of companies, and we apologize for any omissions of projects in our portfolio that are also contributing to the effort. In this list we prioritized companies that can have an impact within 2020.