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So you got the vaccine. Can you still infect people? Pfizer is trying to find out.

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Sebastián De Toma joined Pfizer’s clinical trial last year, getting his shots in August and September. The Argentinian journalist still doesn’t know if he got the real covid-19 vaccine or the placebo, but on Sunday, January 31, the trial doctors called him with a new offer.

Would De Toma be willing to undergo a series of nasal swabs to regularly test for the virus? He says the doctors offered to send Cabify (a Spanish ride-sharing service) to bring him to the Hospital Militar in Buenos Aires. “They’ll swab me on the go, through the car window, and that’s it,” says De Toma.

The extra coronavirus tests, being offered to some volunteers in Argentina and in the US, are part of a plan by Pfizer to help answer a key covid unknown—how often vaccinated people develop asymptomatic coronavirus infections and whether they can still spread the virus, despite getting the shot.

Whether or not the vaccines stop “onward transmission” of the virus is likely to be a critical variable in determining how the pandemic plays out and how soon life goes back to normal. Right now, researchers say, their best guess is that vaccines will reduce transmission but may not prevent it entirely.

“We don’t know, but it’s an important question because the answer will influence mask wearing; it will influence behavior; it relates to comfort going to restaurants and movies and the overall benefit we can expect with vaccines,” says Lawrence Corey, who leads operations for the Covid-19 Prevention Network, which carried out several US vaccine trials.

The silent spreader mystery

“There are three things a vaccine can do: stop you from acquiring the disease altogether, stop onward transmission, and stop symptoms,” says Jeffrey Shaman, a public health researcher at Columbia University. A perfect vaccine would create what is called “sterilizing” immunity, which means the virus can’t get a foothold in your body at all. Some inoculations, however, do allow low-level infections that people’s immune systems fight off without any symptoms. Their bodies still accumulate a certain quantity of the virus, which they may be able to transmit to others.

The reason we don’t know how well vaccines stop this transmission is that it’s expensive and complicated to measure. When companies like Pfizer, Novavax, Moderna Therapeutics, and others launched big studies of their new covid-19 vaccines last year, they were testing whether the vaccines could prevent people who caught the disease from getting sick or dying. The results on that count were impressive: hardly anyone who is vaccinated ends up in an ICU on a respirator.

What they didn’t measure was the “indirect” effect of vaccines in preventing the further spread of the virus, even though some computer models have predicted that blocking transmission could save more lives. One model, published in August by a team at Emory University, found that a vaccine that’s good at stopping spread, but not very good at stopping disease, would still lead to fewer deaths overall because it would slow the outbreak enough to reduce the total number of people who get infected.

A step toward understanding how often vaccinated people spread the virus is what Pfizer is doing now: trying to figure out whether people like De Toma are getting infected without ever feeling sick.

The evidence so far suggests that vaccines should cut the chance of transmission, but may not eliminate it. For example, vaccinated monkeys spritzed with the virus do get infected but don’t become particularly sick. Overall, they have much less virus in their airways. “There is strong evidence that contagiousness is correlated with symptoms. If you can cut down symptoms, you are probably cutting down transmission,” says Shaman.

But that doesn’t mean there is no spread. Early in the pandemic, researchers discovered that some people who caught the coronavirus and never felt sick were still spreading the disease. The evidence now suggests that the role of such “silent spreaders” is substantial, even though they tend to infect fewer people on average. In a report published January 7,  a team including epidemiologists at the Centers for Disease Control and Prevention estimated that a third of people infected with the coronavirus never develop symptoms and that they cause about a quarter of all spread.

Moderna Therapeutics, maker of another vaccine, did not reply to questions about whether it is studying transmission. However, preliminary data the company submitted to the US Food and Drug Administration in December offered one clue: people who got one dose of the vaccine were 66% less likely to turn up positive on a coronavirus test than those who got the placebo. Moderna suggested that “that some asymptomatic infections start to be prevented after the first dose.”

While looking for the virus in people’s noses can detect silent infections, it doesn’t actually prove whether these people can then infect others. To figure that out, researchers at the Covid-19 Prevention Network last year proposed studying more than 20,000 students on two dozen US campuses, including Louisiana State University. They proposed “almost daily” nose swabs to monitor exactly when the virus appeared, and in what amounts, in the airways of both vaccinated and unvaccinated students. Then, with contact tracing, they hoped to map how often vaccinated students spread the virus.

“You can learn a lot by understanding the acquisition and viral titers in the nose,” says Corey. “Then close contact tracing could estimate how often the people spread the virus, which is known as forward transmission.”

On December 31, the Wall Street Journal reported that the proposed study had failed to win funding, because of high costs and questions over its feasibility. Corey says the group has since updated the proposal and that it again being considered by the National Institutes of Health. He believes the study is worth the effort. “We just need to know,” he says. “Because we may need to turn our attention to the kinds of vaccines that do reduce transmission.”

Stemming the flood

Researchers know that stopping transmission is the only way to get rid of the coronavirus for good. One way the pandemic can end is via “herd immunity”—that is, when enough people are vaccinated, or infected, for the outbreak to recede on its own because there aren’t enough people left to infect. That threshold is commonly thought to be about 70% of the population.

But if vaccinated people are “leaky”—if they can still spread the virus sometimes—the threshold will rise. In fact, according to basic outbreak math, if the vaccine stops anything less than two-thirds of transmission events, it’s impossible to reach herd immunity at all. And that’s not even considering that many people will refuse the vaccine, nor mounting evidence that immunity may not last against new variants of the virus.

So if the vaccines don’t almost completely stop transmission, “you will still have continued circulation and there won’t be much herd immunity,” Corey says. “It’s going to be in the population a long time.”  

Jody Lanard, a medical risk communicator who has worked with the World Health Organization, says until questions about vaccine transmission are answered, public health officials will likely send out contradictory messages. On the one hand, she says, exhorting people to “keep wearing a mask” implies that a vaccinated person can still transmit the virus. At the same time, encouraging everyone to get vaccinated, even those who are not in a high-risk group, “leans heavily on the notion that transmission will likely be reduced by vaccination.”

Lanard herself took extreme measures to avoid the virus, barely venturing out; when she did, she wore special masks and goggles in her building’s elevator. She says she recently managed to get a vaccine appointment, and now that she’s had the shot, she thinks she may loosen up and visit with some younger relatives.

But Lanard says she is still going to wear a mask at least until case numbers in New York, where she lives, go back down. “It would be so stupid to catch covid at this point in the pandemic,” she says. “I’m a fairly well-protected grandmom now, thanks to the vaccine. The last thing I want to do is infect some unprotected grandmom.”

Lyron Foster is a Hawaii based African American Musician, Author, Actor, Blogger, Filmmaker, Philanthropist and Multinational Serial Tech Entrepreneur.

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An AI is training counselors to deal with teens in crisis

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Counselors volunteering at the Trevor Project need to be prepared for their first conversation with an LGBTQ teen who may be thinking about suicide. So first, they practice. One of the ways they do it is by talking to fictional personas like “Riley,” a 16-year-old from North Carolina who is feeling a bit down and depressed. With a team member playing Riley’s part, trainees can drill into what’s happening: they can uncover that the teen is anxious about coming out to family, recently told friends and it didn’t go well, and has experienced suicidal thoughts before, if not at the moment.

Now, though, Riley isn’t being played by a Trevor Project employee but is instead being powered by AI.

Just like the original persona, this version of Riley—trained on thousands of past transcripts of role-plays between counselors and the organization’s staff—still needs to be coaxed a bit to open up, laying out a situation that can test what trainees have learned about the best ways to help LGBTQ teens. 

Counselors aren’t supposed to pressure Riley to come out. The goal, instead, is to validate Riley’s feelings and, if needed, help develop a plan for staying safe. 

Crisis hotlines and chat services make them a fundamental promise: reach out, and we’ll connect you with a real human who can help. But the need can outpace the capacity of even the most successful services. The Trevor Project believes that 1.8 million LGBTQ youth in America seriously consider suicide each year. The existing 600 counselors for its chat-based services can’t handle that need. That’s why the group—like an increasing number of mental health organizations—turned to AI-powered tools to help meet demand. It’s a development that makes a lot of sense, while simultaneously raising questions about how well current AI technology can perform in situations where the lives of vulnerable people are at stake. 

Taking risks—and assessing them

The Trevor Project believes it understands this balance—and stresses what Riley doesn’t do. 

“We didn’t set out to and are not setting out to design an AI system that will take the place of a counselor, or that will directly interact with a person who might be in crisis,” says Dan Fichter, the organization’s head of AI and engineering. This human connection is important in all mental health services, but it might be especially important for the people the Trevor Project serves. According to the organization’s own research in 2019, LGBTQ youth with at least one accepting adult in their life were 40% less likely to report a suicide attempt in the previous year. 

The AI-powered training role-play, called the crisis contact simulator and supported by money and engineering help from Google, is the second project the organization has developed this way: it also uses a machine-learning algorithm to help determine who’s at highest risk of danger. (It trialed several other approaches, including many that didn’t use AI, but the algorithm simply gave the most accurate predictions for who was experiencing the most urgent need.)

AI-powered risk assessment isn’t new to suicide prevention services: the Department of Veterans Affairs also uses machine learning to identify at-risk veterans in its clinical practices, as the New York Times reported late last year. 

Opinions vary on the usefulness, accuracy, and risk of using AI in this way. In specific environments, AI can be more accurate than humans in assessing people’s suicide risk, argues Thomas Joiner, a psychology professor at Florida State University who studies suicidal behavior. In the real world, with more variables, AI seems to perform about as well as humans. What it can do, however, is assess more people at a faster rate. 

Thus, it’s best used to help human counselors, not replace them. The Trevor Project still relies on humans to perform full risk assessments on young people who use its services. And after counselors finish their role-plays with Riley, those transcripts are reviewed by a human. 

How the system works

The crisis contact simulator was developed because doing role-plays takes up a lot of staff time and is limited to normal working hours, even though a majority of counselors plan on volunteering during night and weekend shifts. But even if the aim was to train more counselors faster, and better accommodate volunteer schedules, efficiency wasn’t the only ambition. The developers still wanted the role-play to feel natural, and for the chatbot to nimbly adapt to a volunteers’ mistakes. Natural-language-processing algorithms, which had recently gotten really good at mimicking human conversations, seemed like a good fit for the challenge. After testing two options, the Trevor Project settled on OpenAI’s GPT-2 algorithm.

The chatbot uses GPT-2 for its baseline conversational abilities. That model is trained on 45 million pages from the web, which teaches it the basic structure and grammar of the English language. The Trevor Project then trained it further on all the transcripts of previous Riley role-play conversations, which gave the bot the materials it needed to mimic the persona.

Throughout the development process, the team was surprised by how well the chatbot performed. There is no database storing details of Riley’s bio, yet the chatbot stayed consistent because every transcript reflects the same storyline.

But there are also trade-offs to using AI, especially in sensitive contexts with vulnerable communities. GPT-2, and other natural-language algorithms like it, are known to embed deeply racist, sexist, and homophobic ideas. More than one chatbot has been led disastrously astray this way, the most recent being a South Korean chatbot called Lee Luda that had the persona of a 20-year-old university student. After quickly gaining popularity and interacting with more and more users, it began using slurs to describe the queer and disabled communities.

The Trevor Project is aware of this and designed ways to limit the potential for trouble. While Lee Luda was meant to converse with users about anything, Riley is very narrowly focused. Volunteers won’t deviate too far from the conversations it has been trained on, which minimizes the chances of unpredictable behavior.

This also makes it easier to comprehensively test the chatbot, which the Trevor Project says it is doing. “These use cases that are highly specialized and well-defined, and designed inclusively, don’t pose a very high risk,” says Nenad Tomasev, a researcher at DeepMind.

Human to human

This isn’t the first time the mental health field has tried to tap into AI’s potential to provide inclusive, ethical assistance without hurting the people it’s designed to help. Researchers have developed promising ways of detecting depression from a combination of visual and auditory signals. Therapy “bots,” while not equivalent to a human professional, are being pitched as alternatives for those who can’t access a therapist or are uncomfortable  confiding in a person. 

Each of these developments, and others like it, require thinking about how much agency AI tools should have when it comes to treating vulnerable people. And the consensus seems to be that at this point the technology isn’t really suited to replacing human help. 

Still, Joiner, the psychology professor, says this could change over time. While replacing human counselors with AI copies is currently a bad idea, “that doesn’t mean that it’s a constraint that’s permanent,” he says. People, “have artificial friendships and relationships” with AI services already. As long as people aren’t being tricked into thinking they are having a discussion with a human when they are talking to an AI, he says, it could be a possibility down the line. 

In the meantime, Riley will never face the youths who actually text in to the Trevor Project: it will only ever serve as a training tool for volunteers. “The human-to-human connection between our counselors and the people who reach out to us is essential to everything that we do,” says Kendra Gaunt, the group’s data and AI product lead. “I think that makes us really unique, and something that I don’t think any of us want to replace or change.”

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How to land startup funding from Brookfield Asset Management, which manages $600 billion in assets

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There are big investment firms, and then there are big investment firms. Brookfield Asset Management, the Toronto-based 122-year-old outfit whose current market cap is $63 billion and that oversees $600 billion in assets, clearly falls into the latter camp. Think real estate, infrastructure, renewable power, private equity, and credit. If it falls into a defined asset class, Brookfield probably has it in its portfolio.

That’s also true of venture capital, though venture is new enough to Brookfield that founders who might like its capital are still getting the memo. Indeed, it was a little less than four years ago that Brookfield Technology Partners began investing off the company’s balance sheet and soon after recruited Josh Raffaelli — a Stanford MBA who cut his teeth as a principal with Draper Fisher Jurvetson, then spent another five years with Silver Lake — to lead the practice.

Its existence came as a surprise to him, actually. “I’ve been a tech investor in Silicon Valley,” says Raffaelli. “My entire professional career has been in a 15-minute drive from the house I grew up in. And I had never heard about Brookfield before they started this practice because it’s in businesses. It’s in real estate. It has done things that are not generally tech-enabled.”

Not until fairly recently, that is. Raffaelli and his 11-person team have not only made dozens of bets since then, but they’re currently investing out of a pool of capital that features third party capital in addition to that of Brookfield — which is a first. As for what they are looking for, the idea is help Brookfield reimagine how its many office towers, malls and other real estate might be used or developed or leased or insured. It’s to make Brookfield smarter, better prepared, and more profitable. In return, the startups get industry expertise and a major customer in Brookfield

 

To date, its bets have varied widely, as with Armis, an IoT startup focused on unmanaged device security; Loanpal, a point-of-sale payment platform for solar and other home efficiency products; and Carbon Health, a primary care company that blends real-world and virtual visits. “”We’re getting our themes effectively from the Brookfield ecosystem,” Raffaelli says.

Pulling back the curtain a bit more, Raffaelli says his team writes checks from $25 million to $50 million dollars and that they look for companies with $10 million in revenue that are seeing top-line year-over-year growth of more than 100%. In terms of pacing, they jump into roughly one new deal per quarter.

The fund is also independent and has its own custom committee, but that the committee is made up of the senior managing partners from each line of Brookfield’s businesses. (“These are the people that actually help us translate our investment themes that we’re generating here,” Raffaelli notes.)

To highlight how the operation works, Raffaelli points to Latch, a smart access software business that announced last month that it’s using a blank-check company backed by the real estate giant Tishman Speyer to become publicly traded. Brookfield owns roughly 70,000 multifamily units in North America, “so we have a lot of doors that need a lot of locks,” Raffaelli says. Latch, of course, is not the only smart access lock out there, so Brookfield ran “what was almost like a mini [proposal process], reaching out to all different companies in the market to understand how they compete,” he says.

It was a “six-month exercise,” but ultimately, his group led Latch’s Series B round in 2018 and since then, Brookfield was bought about 7,000 blocks from the business. It’s a meaningful difference, considering that when Brookfield first invested, the company had less than $20 million in bookings and those 7,000 locks have since brought in an additional $10 million to $15 million in revenue, Raffaelli says. “When we buy a lot of things at that stage of a company,” he adds, “we’re meaningfully enhancing their trajectory.”

It’s not a foolproof strategy, doubling down. If Latch’s locks turned out to be lemons (they haven’t), Brookfield would be out a big check along with that capital expenditure. It’s why Brookfield takes its time, says Raffaelli, adding that if he has done his job right, his team is involved with a company well before it is raising a round and shown already that it is a “strategic partner that has another lever.”

Either way, Raffaelli says that while the commercial real estate market has been hard hit by the pandemic, it has, counterintuitively, been a productive time for his group given the stronger incentive it has given the real estate world to adopt tech tools faster. Among the bets about which Raffaelli sounds most excited right now is VTS, for example, a leasing and asset management platform that can show properties remotely, and Deliverr, an e-commerce fulfillment startup that Raffaelli describes as “Amazon Prime for everybody else.”

In fact, Raffaelli convincingly argues that while the use case for a lot of real estate is changing,  the so-called built world remains Brookfield’s strongest competitive advantage given the size of its footprint.  The way he sees it, its options going forward are plentiful. “You’re looking at retail locations becoming ghost kitchens; you’re looking at retail locations turning into distribution and logistics facilities. We can turn physical locations into healthcare sites for [our portfolio company] Carbon Health, and our mall locations into locations for urgent care and primary care clinics for testing and vaccinations.”

It will never be a completely seamless transition. Brookfield has to be “thoughtful” given the pandemic and its devastating impacts, too. But Raffaelli comes across as excited in conversation nonetheless. The idea of turning physical real estate into a “mechanism for change within technology businesses,” adds Raffaelli, is a “very powerful place to be.”

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Singapore-based Raena gets $9M Series A for its pivot to skincare and beauty-focused social commerce

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A photo of social commerce startup Raena’s team. From left to right: chief operating officer Guo Xing Lim, chief executive officer Sreejita Deb and chief commercial officer Widelia Liu

Raena’s team, from left to right: chief operating officer Guo Xing Lim, chief executive officer Sreejita Deb and chief commercial officer Widelia Liu

Raena was founded in 2019 to create personal care brands with top social media influencers. After several launches, however, the Singapore-based startup quickly noticed an interesting trend: customers were ordering batches of products from Raena every week and reselling them on social media and e-commerce platforms like Shopee and Tokopedia. Last year, the company decided to focus on those sellers, and pivoted to social commerce.

Today Raena announced it has raised a Series A of $9 million, co-led by Alpha Wave Incubation and Alpha JWC Ventures, with participation from AC Ventures and returning investors Beenext, Beenos and Strive. Its last funding announcement was a $1.82 million seed round announced in July 2019.

After interviewing people who were setting up online stores with products from Raena, the company’s team realized that sellers’ earnings potential was capped because they were paying retail prices for their inventory.

They also saw that the even though new C2C retail models, like social commerce, are gaining popularity, the beauty industry’s supply chain hasn’t kept up. Sellers usually need to order minimum quantities, which makes it harder for people to start their own businesses, Raena co-founder Sreejita Deb told TechCrunch,

“Basically, you have to block your capital upfront. It’s difficult for individual sellers or micro-enterpreneurs to work with the old supply chain and categories like beauty,” she said.

Raena decided to pivot to serve those entrepreneurs. The company provides a catalog that includes mostly Japanese and Korean skincare and beauty brands. For those brands, Raena represents a way to enter new markets like Indonesia, which the startup estimates has $20 billion market opportunity.

Raena resellers, who are mostly women between 18 to 34-years-old in Indonesia and Malaysia, pick what items they want to feature on their social media accounts. Most use TikTok or Instagram for promotion, and set up online stores on Shopee or Tokopedia. But they don’t have to carry inventory. When somebody buys a product from a Raena reseller, the reseller orders it from Raena, which ships it directly to the customer.

This drop-shipping model means resellers make higher margins. Since they don’t have to carry inventory, it also dramatically lowers the barrier to launching a small business. Even though Raena’s pivot to social commerce coincided with the COVID-19 pandemic, Deb said it grew its revenue 50 times between January and December 2020. The platform now has more than 1,500 resellers, and claims a 60% seller retention rate after six months on the platform.

She attributes Raena’s growth to several factors, including the increase in online shopping during lockdowns and people looking for ways to earn additional income during the pandemic. While forced to stay at home, many people also began spending more time online, especially on the social media platforms that Raena resellers use.

Raena also benefited from its focus on skincare. Even though many retail categories, including color cosmetics, took a hit, skincare products proved resilient.

“We saw skincare had higher margins, and there are certain markets that are experts at formulating and producing skincare products, and demand for those products in other parts of the world,” she said, adding, “we’ve continued being a skincare company and because that is a category we had insight into, it was our first entry point into this social selling model as well. 90% of our sales are skincare. Our top-selling products are serums, toners, essences, which makes a lot of sense because people are in their homes and have more time to dedicate to their skincare routines.”

Social commerce, which allows people to earn a side income (or even a full-time income), by promoting products through social media, has taken off in several Asian markets. In China, for example, Pinduoduo has become a formidable rival to Alibaba through its group-selling model and focus on fresh produce. In India, Meesho resellers promote products through social media platforms like WhatsApp, Facebook and Instagram.

Social commerce is also gaining traction in Southeast Asia, with gross merchandise value growing threefold during the first half of 2020, according to iKala.

Deb said one of the ways Raena is different from other social commerce companies is that most of its resellers are selling to customers they don’t know, instead of focusing on family and friends. Many already had TikTok or Instagram profiles focused on beauty and skincare, and had developed reputations for being knowledgeable about products.

As Raena develops, it plans to hire a tech team to build tools that will simplify the process of managing orders and also strike deals directly with manufacturers to increase profit margins for resellers. The funding will be used to increase its team from 15 to over 100 over the next three months, and it plans to enter more Southeast Asian markets.

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