'Needle in a haystack': Reborn tech offices may need distance and mass testing

Tech companies starting to plan for how they will reintroduce employees to shuttered offices, warehouses and factories may want to take a look at what's going on at health tech startup Color, which over the past month has transformed its Silicon Valley headquarters from a highly automated genomic lab to a COVID-19 testing hub. The new lab is processing 500 tests a day for the city of San Francisco's 38,000 essential workers, and should be up to 1,000 a day in the coming week.

Next up: Color wants to bring a testing program to its own workforce — and to those of existing customers like Salesforce, SAP and Levi's.

As companies evaluate how to safely go back to work in anticipation of the day when government lockdowns lift, they are navigating an array of challenges. Executives are talking about restricting the number of employees onsite, perhaps by staggering shifts. They are looking to support workers through benefits like child care. Real estate firms that pioneered "6-foot offices" in China are coaching U.S. companies on spreading out workspaces. Ford is experimenting with wearable technology — like bracelets to buzz workers when they get too close.

And at the center of this planning is the most potentially difficult element: testing and tracking the virus. Companies are considering a variety of testing and contact-tracing systems, but as early movers like Color have discovered, rolling out mass testing is a balancing act that requires answering thorny questions about effectiveness, privacy, price and access, while keeping up with fast-moving science and managing unprecedented health risks.

"This is literally the first time in human history where we're going to try to reintroduce 350 million people back into the workforce amidst an infectious disease that we are trying to suppress," Color CEO Othman Laraki told Protocol. "It is fundamentally going to be a technological solution. That is the only way for it to work."

It may also be a slow, ever-evolving set of solutions. As many in tech hunker down for several more weeks, and perhaps months, of working from home, public health experts warn that the national conversation around "reopening" the country could be misleading.

"I don't think reopening hits the nail on the head," said David Eisenman, a professor of community health sciences at UCLA's Fielding School of Public Health. "Reopening has the implication of a return to normal."

Save the date?

In the early days of the crisis, the CEOs of Coinbase and Box publicly shared their plans for how to close offices, what to tell employees, and how to transition to remote work. But so far, the conversation about when and how to go back to work has been less open. Color's Larakai expects that to change in short order.

"There's going to be a small set of companies that take a strong leadership role and position in this," he said, similar to how Silicon Valley led other sectors in a voluntary shift to remote work.

Slack is among the few companies that has publicly floated an open date — June 1 — in a blog post by Senior Vice President of People Robby Kwok, based on guidance from the World Health Organization, the Centers for Disease Control and Prevention and local governments. In California, Gov. Gavin Newsom has not given a timeline for lifting a shelter-in-place order. He said the state is monitoring six indicators, including testing and tracing capacity, progress on treatments, and the ability to shut back down if needed.

More than a dozen leading companies, including Apple, Google and Facebook, declined to comment or did not respond to Protocol's questions about reopening.

At HP, Chief Human Resources Officer Tracy Keogh said the company is considering local regulations and the localized dynamic of the outbreak when making decisions about all of its global locations. Though some offices in China were recently reopened — and employees greeted with welcome-back kits of masks, gloves and hand sanitizer — there is no concrete timeline for other locations.

"There isn't a one-size-fits-all answer to returning to the office," Keogh said. "It won't be like flipping a switch."

In the heart of Silicon Valley, venture capital firm Playground Global's Palo Alto incubator is usually a lively space with its advanced manufacturing labs and two-story metal slide. General partner Laurie Yoler said the 35-person company is triaging concerns from its 50 portfolio companies one by one. But it isn't focused on setting an exact date to reopen facilities while government guidance is in flux.

"It would be silly to say, 'Hey, everybody should plan for June," Yoler said. "Who am I to tell them what to do?"

Test cases

Whenever companies go back to work, some form of employer-sponsored testing and tracing appears likely to become the norm.

At Color's first walk-up and drive-through testing site for San Francisco city workers, clinical professionals must administer or observe swab tests. But guidance from federal regulators is expected to evolve, said Color Chief Commercial Officer Caroline Savello. There's also the option of bringing testing to tech campuses. Since large companies like Apple already have health clinics on site, Savello expects to see several different models for employer testing.

"A lot of the risk of exposure of this disease and of transmission is going to happen in the workforce," Savello said. "I think what you're going to need to see is just generally testing moving outside of the traditional health care system."

In that rush, firms and their employees may turn to retail health care providers like Walgreens and CVS, along with providers of so-called "non-medical use" tests. In that case, an employee who tests positive for COVID-19 using a workplace test wouldn't be added to official government tallies, unless they were retested with a sanctioned test at a traditional health care provider. Companies must apply with the FDA for approval to sell these tests privately, but the review process includes little scrutiny.

Among the players in this space is DxTerity, a 30-person Southern California biotech firm that specializes in autoimmune disease testing. DxTerity's focus in the past month has been on developing a COVID-19 test that employees can administer themselves. The test — now being offered for free to a handful of companies as beta testers — is done using an employee's saliva and, if the employer requests it, can also include a nasal swab.

Employees turn in their samples to a coordinator at their company, who in turn passes them to DxTerity for processing. Each sample is given a bar code to protect users' privacy; only the coordinator knows which employee is associated with a given test, essentially leaving any privacy concerns up to the employer to address. DxTerity promises results within 48 hours.

"We ultimately view us as, 'How do you get this facility back up and running at some level,'" said CEO Bob Terbrueggen, who said DxTerity plans to file for its "emergency use authorization" with the FDA this week, after it finishes validating preliminary testing results.

Unlike traditional testing through a health care provider, which in the U.S. typically requires that a person show symptoms, nonmedical testing can be done whenever a company wants.

"A business can use us just like a thermometer," Terbrueggen said, adding that one beta tester is planning to test its employees twice a week to start. Pricing for a single test will start around $100, he said, with discounts for high-volume customers.

'Needle in the haystack'

While labs and research institutions are working on aspects of testing to make it more available, what makes DxTerity and Color's approach different is that they are essentially offering one-stop shopping. DxTerity provides its own kit as well as transportation of the kits and testing.

If a result comes back positive and is confirmed with a second test, DxTerity will then help customers collect another sample and send it to a certified lab. This should eliminate false positives, Terbrueggen said. The bigger issue — and the one perhaps most likely to keep executives up at night — is false negatives.

This gets to the root of what has made containing the spread of COVID-19 so difficult: Symptoms tend to arrive days after a person is infected. If an employee is exposed to the virus on Monday and tested at work on Friday, there may not be enough of it to be detected in a small saliva sample. At least not right away.

"It's a needle in the haystack problem," Terbrueggen said. "You have to do regular screening for people — there's no way around it."

Even if some major employers start testing employees, Eisenman of UCLA said testing of the general population "has to be ubiquitous" and include random samples within communities to catch new potential outbreaks before they spiral. For big employers, that process could be helped by adding additional layers of contact tracing and data analysis.

"If you're a company that has a lot of workers in the field, you can imagine — you could have a Google map that shows where there are flare-ups," he said.

Some experts see well-conceived workplace testing programs as critical to slowing the spread of the disease in society. Scott Gottlieb, a former FDA commissioner and American Enterprise Institute resident fellow, and Lauren Silvis, also a former FDA official, wrote in a Wall Street Journal op-ed, "Bringing these activities into the workplace would make them more widespread and routine."

They said businesses should try to coordinate tracing with local health agencies, and consider not only workplace systems but options for employees who work at home or on the road. Another important step, they said, was communicating clearly to workers that they will not lose income if they get sick and stay home. Otherwise, cooperation may suffer.

And what about workplace tests for antibodies? If people have already had the virus, can they operate as they normally would?

"We need to be careful about that," Eisenman said. "There's a lot of us questioning those tests."

Buses and bathrooms

Testing and tracing are just two of numerous challenges for tech firms that want to reopen offices. Another trouble spot is that Silicon Valley's biggest tech campuses more closely resemble small cities than the average cubicle farm.

In addition to raising big questions about the future of office space — both how much of it companies choose to invest in and how it's designed — coronavirus shutdowns have triggered more pragmatic concerns, such as how to reintroduce thousands of hourly cafeteria workers and security guards that tech companies employ, plus the industry's famous private bus system.

"We might have to be thinking about our transportation system differently," Eisenman said. "Do we have smaller numbers of people on buses allowed? Do we require fever checks in order to get onto a bus?"

When employees do return to the office, they're likely to find new rules and fewer co-workers. "We anticipate that approximately 60% of the workforce will shift to some balance of 'in office' and remote work," said Roy Abernathy, executive vice president of global workplace strategy at Newmark Knight Frank.

The commercial real estate service firm is working with clients to "decide who comes back first and how they return," and has offered them a detailed roadmap, with considerations that include how often parts of offices should be cleaned and what should become of common areas.

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Both Newmark Knight Frank and Cushman & Wakefield are telling their clients that offices should have workspaces and routing of foot traffic that allow for social distancing, as well as top-grade ventilation, touchless doors and more. Tech offices in Silicon Valley that tend to have free food, said Despina Katsikakis, head of occupier business performance at Cushman & Wakefield, will have to think about how to distribute it.

For offices that have switched to single-occupancy restrooms, "In the short term," Katsikakis said, "we might find we need attendants to ensure distancing and that washrooms are cleaned after every use."

Correction: This story was updated on April 17, 2020, to reflect the correct name of commercial real estate service firm Newmark Knight Frank.