This is one of a series of interviews by Bloomberg Opinion columnists on how to solve the world’s most pressing policy challenges. It has been edited for length and clarity.

Lisa Jarvis: The last two years of enduring nasal swabs for Covid have all of us thinking a lot more about the way in which we test for infectious diseases. You helped found Mammoth Biosciences in 2018, fresh from getting your Ph.D. under Nobel laureate Jennifer Doudna, one of the pioneers of the gene-editing technology Crispr. At the time, most Crispr companies were focused on finding treatments and cures for human diseases. You were pitching the idea that Crispr could transform how diseases are identified in the first place. How can Crispr make a difference in detecting disease?

Janice Chen, founder and chief technology officer, Mammoth Biosciences: When we first came across this unexpected finding that you could use CRISPR to detect DNA, it opened up a new world for molecular detection. Basically, you could say, I want this Crispr to be programmed to detect, say, HPV, and then you could provide a result in less than 30 minutes.

We worked with [researchers] at the University of California at San Francisco. We brought over very simple equipment to their lab and received a set of blinded samples. After running the tests, we then started to identify which types of HPV were in these patient samples. We were able to differentiate HPV 16 versus HPV 18, which are two cancer-causing HPV strains. To be able to do that with very limited equipment showed us there was a path to creating a new kind of diagnostic test with very little infrastructure, which could go into low-resource, point-of-care or near-patient settings, rather than having to send it out to a lab.

LJ: Why has it been so hard to change the way we test for some of our most common ailments? Is it that it’s too hard to find new technologies? Or are we just stuck on older ones?

JC: I think it's a combination of both technology and regulation — and also human behavior.

On the technology side, there are a lot of incumbent technologies, like PCR-based testing, that have limitations in terms of going into point-of-care or at-home settings. At the other end of the spectrum, antigen-based tests are very low cost and accessible, but they struggle to get the lab-quality results that patients need to be able to trust the results. You still have a gap in terms of the technology that can bridge those two ends of the spectrum. And that’s where Crispr diagnostics has a real potential.

The FDA has opened the floodgates for technologies like at-home tests to be made available through emergency use authorization (EUA); before the pandemic, that was a door that was not going to open in the near future. That’s really allowed companies like us to rethink how patients interact with their own healthcare information.

LJ: So it sounds like the promise of Crispr is in combining the accuracy of PCR with the speed of antigen tests. Can the technology do that for multiple diseases at once? Right now, my at-home test only tells me that my sore throat and fever isn’t Covid — I still don’t know if I have the flu or maybe some garden variety rhinovirus.

JC: That’s exactly right. Part of it is being able to very rapidly reconfigure an assay to look at new targets. In a multiplex setup where you’re looking at multiple pathogens from a single sample, you could get more information from a single source. Or you can also adapt the technology in a way to capture, for example, rapidly mutating viruses. Things like the flu and Covid — these sequences and strains change over time. You can use Crispr to capture the entire universe of upcoming strains.

The ability to [use Crispr] to target multiple viruses or bacteria pathogens is going to lead the revolution in what we call syndromic testing, where you test based on your symptoms and get an answer [about your illness.] With PCR and antigen tests, you say, “I think I have Covid, let me test for Covid: yes or no?” That’s where the story ends. But Crispr is going to allow us to go into this world of syndromic testing, where one test can tell you what illness you have. That’s something these older technologies haven’t been able to achieve.

LJ: When the pandemic hit, Mammoth was still a pretty young company. Could you describe what Mammoth looked like at the time? How did you think about quickly pivoting into addressing Covid?

JC: Before the pandemic, we were about 20 to 30 people. We had just moved into a new space down in South San Francisco. We had been basically paving the foundation for this Crispr diagnostics technology since starting the company in 2018.

I recall attending a bio-threats conference in D.C. in January 2020. There were a lot of government representatives, other industry groups, talking about this novel coronavirus that was just emerging in China. Coming back to San Francisco shortly after, I talked to one of our scientific advisory board members, Charles Chiu, who said, “Hey, we have some of the first [virus] samples in the U.S. Let’s collaborate and figure out if you can develop a test.” And before any lockdowns, before any real outbreak in the U.S., we recognized that our technology could really rapidly pivot. So one afternoon we brought the company together and said, “OK, we’re gonna push on this.” We had some incredible team members who worked day and night to build an assay. Within days, we were actually able to demonstrate it on the real patient samples from UCSF. That became the very first peer-reviewed paper for using Crispr to detect Covid. It catalyzed a number of different partnerships with government and industry groups. We’ve basically quadrupled over the course of the pandemic.

LJ: Mammoth has raised north of $260 million. That puts the company in unicorn territory in terms of its valuation. At the same time, you’re going up against some very entrenched players on the diagnostic side of the business. As we exit the acute phase of the pandemic, how hard it will be for you and others working on Crispr diagnostics to carve out a space in that area?

JC: There’s always going to be a space for new technology. This is broader than just Covid. The pandemic will end. There is going to be a world in which some behaviors might stick around, but some behaviors might just go back to pre-pandemic, where people just aren’t going to be motivated to take a test. I think we’re going to see a decrease in asymptomatic testing. But when you when you start feeling sick, you want to know what you’re infected with. And that’s where new technologies that enable that sort of information, and the convenience of what you want as a consumer — all those elements don’t quite yet exist. And that’s the area that we can really differentiate as a company.

LJ: You're not even four years into this experiment, which you started straight out of graduate school. Two of those four years involved a global pandemic. What have you learned about leadership and about building the company?

JC: I don’t know if this is a learning, but just more of an appreciation of how far teamwork and collaboration can take you. As a Ph.D. student, oftentimes you’re pretty siloed. You might have a couple of collaborators, but you really kind of focus on a single project, becoming a deep expert in that area. There’s a lot of sinking or swimming on your own. But at a company, especially leading a company, you sink or swim as a team.

Having never done this before, I often had a lot of doubt in myself. Imposter syndrome is very much something that I have to manage all the time. But we’re trying to build something new. Even if [people have] developed products over three decades, we’re trying to build a Crispr diagnostic. This is new, so all of us are starting at the same starting point.

LJ: I’m guessing that starting a new company is always a pressure cooker, but do you think that the bizarre experience of doing it in a pandemic brought folks closer together?

JC: I think so. You had a unified mission that was larger than the company, right? I think that was so powerful: trying to understand how we’re going to get beyond some of the scariest phases of the pandemic. It was incredibly motivating for us to be able to be part of the solution. We recognize it was a real opportunity and a real responsibility to play a role.

LJ: I have to ask about your brother: Olympic gold medal ice skater Nathan Chen. Let’s start with where you were when you watched his performance. Was it hard to not be in the room?

JC: It was tough not to be there in person. I was just at home in San Francisco. My mom drove up from Southern California and my dad flew in from Colorado, and then my brother also came up from SoCal. I have a big family — five siblings — and we’re all scattered around the country. It’s hard to even [describe] what it’s like to watch your brother, who you’ve seen from when he was three years old getting on the ice, actually achieve his dreams. And, of course, being with my parents was really special. It’s hard to put into words, just how much he’s overcome to meet this moment. I’m so proud of him.

LJ: He’s reached the most elite status in his sport, and at 30 years old, you founded and are helping to lead a company valued at nearly $1 billion. Clearly you both have incredible drive. Maybe you could tell me where that comes from.

JC: My parents immigrated here to the U.S. from China over 30 years ago. They came here with nothing. They sacrificed everything for us, and really pushed us to always work hard to follow our dreams, and that whatever we do, it doesn’t matter, just try to do your best. Those are the values that we’ve carried on throughout our life. Even if we didn’t have a lot of money growing up, to have parents like that is invaluable in itself.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Lisa Jarvis at ljarvis7@bloomberg.net

To contact the editor responsible for this story:
Romesh Ratnesar at rratnesar@bloomberg.net