'We don’t believe in ‘impossible'

Tech giants race to be no.1 in healthcare of tomorrow

Google was the first tech giant to bring its innovations to healthcare, but it’s been followed by Apple, Facebook and hundreds of startups competing to digitise biology as they grab market share. Artificial intelligence, virtual reality and data mining are now on the horizon of tomorrow’s medicine

Thomas Schulz
January 14, 2019

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Verily first announced in 2014 the development of contact lenses that can sense glucose levels. The project was put on hold last year GOOGLE / AFP

Behind several security gates, in a windowless workshop, engineers are screwing into the surgeon of the future: a machine equipped with artificial intelligence (AI), embedded in virtual reality and advertised as a “complete solution for all operating theatres”. Right next door, researchers are working on minicomputers that can be implanted in humans to manipulate electrical signals in the nerve tracts in order to treat diseases: the first step towards a new “bioelectrical medicine”.

A few doors further on, new therapies against cancer and depression are being developed. Almost a thousand scientists are developing new biosensors, medical robots, drugs. They come from the most diverse fields: biology, medicine, chemistry, material sciences, computer science, mechanical engineering.

And they all do research for Google.

When the internet giant announced five years ago that it wanted to conquer medicine for the first time, many people were still laughing on the executive floors of pharmaceutical companies. The beginnings were modest: two dozen Google employees relocated to a meaningless bungalow on the outskirts of the company headquarters in Silicon Valley.

But now, a five-storey rectangle of steel and green glass is already spreading out on San Francisco Bay, an independent research campus 40 kilometres north of Google headquarters the size of a well-equipped university hospital with countless laboratories. Grass grows up the walls in the lobby.

The department has become an independent company, Verily, under the umbrella of Google parent company Alphabet. Prominent physicians and even the former head of the US Food and Drug Administration have gone to work for Verily, attracted by high-flying plans: “Our mission is to harness the world’s health data so that we can live healthier lives,” says Jessica Mega, Verily’s chief physician. She is one of the leading cardiologists in the U.S., and was previously a professor at Harvard Medical School.
She smiles almost continuously as she talks about Verily’s plans to build a new medical platform, “the infrastructure for the digital healthcare world. Google provided more than a billion dollars – for starters.”

Dr. Algorithm

Google is no longer the only tech player attempting to digitise health. The whole of Silicon Valley is pouncing on medicine, from Apple to Facebook as well as hundreds of startups. Venture capital firms are investing billions in biotechnology and health.

In recent decades, the digital revolution has conquered and transformed one industry after another, fundamentally changing the way we live. The Silicon Valley strategists are now convinced that no area is better suited to be revolutionised by the ever more powerful digital instruments than our own biology. Nowhere is there a greater chance of changing the path of mankind – and to open up new fields of business.

Data is the key to this future medicine: read from devices, genomes, sensors and countless tests on all kinds of biomarkers, from bacterial colonisation of the intestine to protein composition. And they are analysed and processed by intelligent software that learns and recognises patterns even in huge amounts of information. Where the doctor can no longer see through it, Dr. Algorithm provides the answers.

Many of the Silicon Valley technologists see the greatest opportunities for new digital instruments not in treatment, but in diagnosis. Verily is therefore currently working primarily on “mapping human health”, as Mega puts it. In cooperation with universities, the company is collecting all conceivable biodata of 10,000 people over a period of four years: genetic, molecular, psychological.

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Googleplex is the corporate headquarters of Google and its parent company Alphabet in Mountain View, California

Among other things, the participants were equipped with new sensors and measuring devices that deliver data around the clock. At the end of the day, the exact definition of a healthy person should be in place to calibrate the new digital measuring devices with these values. Digital early warning systems could then be built for many clinical pictures that warn the doctor: attention, something is happening here.

Most forms of cancer, for example, are already treatable today, many even curable, as long as they are detected in time. The mortality rate increases rapidly only when the tumours remain undetected for too long and the patient enters the clinic in the third or fourth stage of the disease. What if cancer could be detected at its earliest stage with a simple blood test?

The “Holy Grail” of early cancer detection

Several Silicon Valley companies are taking this path. Perhaps the most prominent is Grail, named after the Holy Grail, the legendary mystical vessel that promises eternal life. Researchers at the startup hope to have at least the chance of a longer life by having all people routinely tested by so-called “liquid biopsies”, liquid tissue samples, to see whether they carry warning signs for cancer.

The idea is a big bet on the power of digital technology: the researchers hope that the rapid DNA sequencing machines, AI-supported software and new analytical methods will make it possible to identify the genetic material that is secreted by even the smallest, as yet unidentified tumours.

Grail is as much a software company as a biotech company. The technicians collect around a thousand gigabytes of data from the blood samples of each patient and then chase them through a “classifier” that uses AI algorithms to search for patterns. If such early-detection blood tests were to become standard, Grail would quickly become “the largest big data company in the world,” says Jeff Huber, founding director of Grail. It’s no coincidence that he was previously a top manager at Google.

It’s been known for some time: cancer can be diagnosed early in the blood – even if the patient still feels perfectly healthy. But the development of a general indicator for cancer was possible only with new technology for the rapid and cheap analysis of genetic material. Large parts of Grail’s headquarters in Menlo Park, just around the corner from Facebook, are filled with novel DNA sequencing machines.

Facebook founder Mark Zuckerberg is financing the construction of a “human cell atlas” Shawn Thew / EPA-EFE

The Grail researchers want to test their technology in a first large-scale project: the early DNA signatures of breast cancer are to be filtered out from the blood samples of 120,000 women. Statistically, 650 women from this test group will develop breast cancer within one year. Grail will then analyse the collected samples to determine whether the DNA test would have correctly predicted the cancer.

Many cancer experts doubt whether the company’s major plans to make a commercial cancer blood test available by the end of the decade can be realised. In addition, the test would have to be almost perfect: if millions of people were actually tested every year, just a few faulty cancer diagnoses would be enough to lead to a wave of panic that would overburden hospitals.

Nevertheless, Grail has already raised more than a billion dollars in capital and is one of the best-financed private biotech startups in the world. Grail’s donors include Google, Amazon founder Jeff Bezos and Bill Gates.

Many of the well-known technology pioneers are personally involved in medical research. Facebook founder Mark Zuckerberg is financing the construction of a “human cell atlas”: a research centre equipped with $600 million is to map all the cells of the human body and thus enable the development of new drugs. In total, Zuckerberg and his wife, paediatrician Priscilla Chan, intend to invest more than $3 billion in research into new therapies.

“We don’t believe in ‘impossible’” is the motto of the “Chan Zuckerberg Biohub”, prominently announced on a motivational poster in the corridors of the new research centre, directly opposite the University Hospital of San Francisco. Biohub’s goals are as gigantic as Facebook’s visions of conquering the world: “At first glance, it may seem impossible to cure, prevent or manage all diseases while our children are still alive – until the achievements of the past century are taken into consideration.”

The first complete cell atlas will be an important instrument for this purpose. So far, medical students have learned that there are about 300 types of cells, such as brain cells, blood cells or the T-cells of the immune system. But there are probably many more cell types, up to 10,000, says Stephen Quake, co-president of Biohub and a professor of biotechnology at Stanford University, a serious man with a bald head and nimble eyes who speaks quickly and with intense conviction.

According to Quake’s plan, knowing in advance how exactly which cells react to therapies will make the search for new drugs much easier. His goal: “to develop a universal diagnostic test for every type of infectious disease. A prototype diagnosed a rare bacterial infection in a teenager in which the new DNA analysis technique was able to quickly distinguish between human DNA and that of the pathogen.”

“We are betting on inventing the future,” says Quake. If this succeeds, it would certainly be highly lucrative: creating a new type of therapy promises to generate billions in revenues.

Accordingly, the Silicon Valley innovators are not only driven by a spirit of research, but also by the hope of dominating the digital healthcare industry.

© Spiegel Online distributed by The New York Times Syndicate

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