It was two o’clock in the morning and Dilian Stoyanov was wide awake, his mind whirring, an idea crystallizing around something he had spent the month of January thinking about: his infant son and COVID-19.
His son, named Moss, was born early, and wound up in intensive care at a west-end Toronto hospital where Stoyanov watched the 24-hour news channel on a loop, with stories on China and the soon-to-be global pandemic repeating.
Stoyanov, a techie with a background in big data and health-care solutions, couldn’t shake the idea of COVID-19 testing. How, in a pandemic, it would be smart to decentralize testing to make it more accessible and have fewer crowds. Testers would go to the individual, the company, the factory — the National Hockey League team — in need of a test, rather than the opposite.
The 31-year-old was so convinced of the simple genius of this vision that he sent if off to the “A-team,” meaning his three colleagues at Switch Health, a startup he led as chief executive. Despite being on paternity leave, he fired off a 2 a.m. text on Jan. 30 outlining his idea for rapid mobile COVID-19 testing units.
Switch Health had five employees when Stoyanov sent his note. It now has closer to 80, a fleet of about 40 vans — or, in the company’s parlance, Mobile Rapid Testing Units (MRTUs) — and more than 35 large clients, including the Canadian Broadcasting Corp., a board of directors featuring a former federal health minister, and much bigger plans for post-pandemic health care.
Their nurses have swabbed hockey players in the NHL bubble in Toronto, as well as factory workers, farm workers, actors and even little old ladies at home.
“The past six months have been exhilarating and terrifying,” Stoyanov said, during a rare, in-person meeting of the aforementioned A-team on the patio of a spacious 16th floor condominium in midtown Toronto.
The condo was a showstopper, with outdoor couches, ample room to social distance and, a guest ventured, a steep purchase price that none of the Switch Health team could actually afford, because they haven’t actually paid themselves a nickel since launching the business. The condo, it turned out, was a loaner from another friend, one stuck in Siberia — yes, really — since the beginning of the pandemic.
Mary Langley, Switch Health’s chief strategy officer, sat in one corner of the couch, next to her husband, Marc Thomson, chief operating officer. The couple, 26 and 29, respectively, met on a dating app and eloped to Niagara Falls where Elvis — and his family — were among the guests at their wedding.
“It was a little weird,” Langley said.
Lately, the pair have been marooned in a much less roomy 600-square-foot condo, working elbow to elbow, day after day, a proximity that has produced some trying marital moments, not to mention the odd thrown pen.
Stoyanov and Olga Jilani, the company’s chief financial officer, forged a near-instant friendship in middle school in suburban Toronto, when he arrived as the new kid from South Africa and she was the girl who made fun of his accent.
“We have all come together in this family unit,” said Thomson, an Australian expat, and the most likely member of the group to “freak out,” he admits. “It is very strange, but there is a lot of love and support among us.”
What there hasn’t been any of since the end of January are holidays, weekends off or even breaks.
The team’s forward planning credo is: “COVID is already over.” Of course, it isn’t nearly over, not medically, and Switch Health is extremely proud of what they are doing with mobile testing, in the here and now.
But they are also gazing into the future, and what they perceive to be an untapped panacea of patient-centric, at-home diagnostics.
People will invest $7 to get a burger delivered to their house, so why not invest in some tech that will mean you don’t have to leave your house and go into a physician’s office and put yourself in potential harm’s way?
In other words: testing at home, using kits and advanced software so that, for example, Joe Blow, with the sore throat, won’t necessarily have to go sit in a doctor’s office for an hour to have his heart listened to and blood pressure checked, only to then be informed that his next stop is the pharmacy to fill a prescription for strep throat.
If physicians can do virtual consults, the thinking goes, patients should be able to do tests at home, instead of languishing in lineups.
“People will invest $7 to get a burger delivered to their house, so why not invest in some tech that will mean you don’t have to leave your house and go into a physician’s office and put yourself in potential harm’s way?” Thomson said.
Crack open the door of at-home diagnostics and behind it may lie an entire world of at-home health-care advances: vaccine delivery, urine analysis, flu shots and more.
“I am a big believer in the need for the health-care system to be disrupted by technology,” said Rona Ambrose, the former federal health minister and one-time interim leader of the Conservative Party.
Ambrose has been a recipient of some 2 a.m. emails from the gang. She will wait until morning to reply, but describes the team’s creative energy, smarts, and can-do attitude, as a “breath of fresh air.”
She likes them and their ideas so much that she agreed to sit on their board.
“I have always thought it would take their generation to really push the system,” she said. “Because the way they think about the health-care system is, “Why can’t we do this?”
It is a great question. For decades, Canadians simply did as they always had: Sit in a waiting room, watch an administrator pull a paper file or two as the clock ticks past the scheduled appointment time, eventually see a doctor, then exit the premises while an administrator faxes off another request.
Sure, there has been innovation in health care, and COVID-19 has only accelerated the pace at warp speed, but there are still fax machines, paper files and lineups.
“We are still so behind,” Ambrose said.
But maybe not for long. Not if Dilian Stoyanov, a guy with a baby at home, and ideas that fly from his fingers in the form of early morning texts, and his three friends, have anything to do with it.
“We have a clear destination,” he said.
Maybe after they get there, they will all be able to get some rest.