STACEY VANEK SMITH, HOST:
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VANEK SMITH: Anne Wyllie is a microbiologist at Yale. Her career has focused on testing for bacteria using saliva samples.
DARIAN WOODS, HOST:
Has saliva been kind of like a - I don't know - an underdog of sample types?
ANNE WYLLIE: Definitely. And I still can't quite figure out why.
WOODS: That's a shame for people who don't like things shoved up their nose.
WYLLIE: Which I think most of us...
WOODS: (Laughter) I think a decent number of us.
VANEK SMITH: But hanging over Anne's research in the lab has always been this need to spend a lot of time finding funding.
WYLLIE: People don't go into academia going, hey; I want to be a really successful grant writer. You go in there wanting to do your research.
WOODS: This constant stress and time finding money is frustrating for researchers, and it can be deadly. This is THE INDICATOR FROM PLANET MONEY. I'm Darian Woods.
VANEK SMITH: And I'm Stacey Vanek Smith. Today on the show, faster, cheaper saliva tests for COVID-19. They could be one of the keys to reopening schools and workplaces as the delta variant spreads.
WOODS: These particular saliva tests were pioneered by Anne. She struggled to find funding until she connected with one economist - oh, and also the NBA.
VANEK SMITH: When the coronavirus spread around the world in early 2020, Anne joined a team at Yale that was trying to learn more about the virus. She and the team were testing patients, taking samples and learning everything they could about the disease. And among all of that work, Anne was experimenting with early forms of saliva tests. And the work was hectic.
WYLLIE: We were working around the clock. You know, we'll get in the lab 6, 7 a.m. We were there till 1 to 3 a.m. because we just had samples to get through. We had data to process. We had results to write up. And on top of all of that, we had grant funding applications to write up.
WOODS: Grant applications. Anne and her team had been just using their existing grants that might have been intended for something completely different, and they were repurposing them for coronavirus research. And that funding was running out right as Anne was starting to make breakthroughs in saliva testing.
VANEK SMITH: And the stakes were huge. I mean, if you could make a cheap, accurate saliva test, schools, hospitals, businesses could test everyone regularly and nip a COVID outbreak in the bud.
WOODS: It's mind-boggling, really, in the middle of a pandemic, but you're still fighting for scraps.
WYLLIE: It was tough. I was having grant funding writing in my dreams.
WOODS: You know, the thing I hate about work-related dreams is that you're not even getting paid for those hours.
WYLLIE: Exactly. You did all that work. It doesn't count, or actually you didn't make that much progress. I kind of feel that a grant written in a dream has almost as much as the likely outcome as one of the grants that you write in real life.
VANEK SMITH: But then in early April, one of Anne's colleagues posts a funding opportunity. It promises to make a decision on all applications within 48 hours. And it has this really simple short application form. It is called Fast Grants.
WYLLIE: I think we were all very intrigued by this word fast in there.
WOODS: Yeah. Yeah, it's like, grant - fine. I mean, there's a lot of promises of grants out there. But fast - that is what we want.
WYLLIE: Exactly.
VANEK SMITH: This fast grant scheme was set up by an economist who kind of became, like, Anne's financial fairy godfather. His name is Tyler Cowen. And Tyler knows all about how much time researchers spend on grant writing. He surveyed some of them recently, and over half of them said this.
TYLER COWEN: They spend more than a quarter of their time just doing applications. That's astonishing.
WOODS: And that's why he set up Fast Grants. He got a bunch of philanthropists together, raised some $50 million, all with the idea of cutting through long processing times and getting money quickly into the hands of COVID researchers.
VANEK SMITH: Fast Grants was set up so that experts in a field would quickly review the applications. And if they looked promising, it would go straight to the top for approval.
COWEN: We set up what was very much a non-bureaucratized structure. There were a very small number of individuals involved doing the real work - the team of referees, myself as the final evaluator - and they did it.
WOODS: So Anne's team applied, and they get half a million dollars just a few days after they sent in the application. And that meant that Anne could get back into the lab.
WYLLIE: Yeah, it really has. It's really - yeah, really made a difference.
VANEK SMITH: In the lab, Anne ran saliva tests through a long, complicated process with specialized equipment. But now that she could focus on her research, she had this idea this one night. What if she ran her saliva samples directly into the same machine that the nasal swabs were going into? This would skip a few steps, could cut down on time and would dramatically cut down on costs.
WOODS: But to try all that, she needed more funding and more data to really validate the technique and see if it worked in the real world. And while she says that the National Institutes for Health, the NIH, weren't being particularly helpful, her team did receive an intriguing inquiry a month later from the NBA.
WYLLIE: You know, there was a little bit of, hang on. The NBA is reaching out to us? But there's also, we're in the middle of a pandemic where crazy things are happening every day.
VANEK SMITH: The NBA, like the basketball guys. They had heard about Anne's direct saliva testing technique called SalivaDirect, and they wanted to use it for the NBA season. The idea was get all the basketball players to live in one place with minimal contact with the outside world, and then get tested for COVID all the time.
WYLLIE: They deidentified data, I must say, that came through to us. You know, we didn't actually know if we had LeBron saliva or anyone else.
WOODS: (Laughter) Put this in a gold vial over here.
WYLLIE: Exactly, exactly.
WOODS: The deal was worth another half-million dollars.
WYLLIE: It's as bizarre to us when we couldn't get funding from the NIH, but we could get funding from the NBA. And the NBA almost had a bigger role to play in this than, you know, the government.
VANEK SMITH: So why did traditional funders miss Anne's work on saliva testing? Tyler Cowen acknowledges that there were some successes out there, like Operation Warp Speed - free to spend money on vaccine development. But that was a pop-up institution, unburdened by the old ways of doing things.
WOODS: Tyler says that one reason most institutions fail in a crisis is that over time, they get trapped in this business-as-usual mindset.
COWEN: Inertia sets in. Routine - the notion that there's a series of procedures that have to be followed no matter what, even if the skies are falling.
WOODS: I mean, part of me is still a little bit skeptical of this, especially outside of the crisis situation. How do you ensure value for money while also being fast?
COWEN: I think the way to ensure value for money is to make sure you have some big winners.
VANEK SMITH: Tyler says Operation Warp Speed was a good example of that - helping develop successful vaccines and also a willingness to accept that some ideas would fail.
WOODS: Is the Fast Grants model primarily useful in a crisis?
COWEN: Well, I think it's most useful in a crisis, but I would stress the point - we're in more crises than we realize. If you're sick with some disease, that for you is a crisis, right? So malaria for the world is a crisis. Dengue for the world is a crisis. And even something like, you know, fixing K-12 education - it doesn't feel like a crisis. It's a slow-simmering problem. But if we could do it now rather than 13 years from now, we'll have a much better world, a much better America.
WOODS: Anne's technique of direct saliva testing has been a clear winner. It's been used for millions of tests around the world, and it's deployed in schools and universities for frequent testing. Just a few small grants sent out fast has likely saved a lot of lives.
VANEK SMITH: We want to hear from you your thoughts about this episode and the show. Go to npr.org/indicatorsurvey. It's short, it's anonymous, and it would help us out a lot.
WOODS: This episode of THE INDICATOR was produced by Julia Ritchey with help from Gilly Moon. It was fact-checked by Michael He. Kate Concannon edits the show, and THE INDICATOR is a production of NPR.
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