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Houston health tech startup launches game-changing, at-home coronavirus testing

Houston-based Imaware has launched at-home testing that can identify if the patient has — or even had — the coronavirus. Photo via imaware.health

Politicians, scientists, public health officials, and others continue to stress the need for widespread testing to tame the spread of the novel coronavirus.

Houston-based startup Imaware, an at-home health testing platform, recently rolled out an at-home coronavirus test for high-risk people, such as someone with both a fever and recent exposure to someone infected with the virus. Now, it's gearing up to offer an at-home test designed to spot the presence of coronavirus antibodies in your blood.

Experts view antibody testing as a key to corralling the virus and rebooting the virus-crushed U.S. economy. However, some skeptics fear the benefits of antibody testing are being oversold.

As explained by Health.com, a nasal swab test can detect a coronavirus infection. But a blood test can pinpoint whether a person has been exposed to the novel coronavirus, which causes the COVID-19 respiratory illness, and might now be immune to it.

Jani Tuomi, co-founder of Imaware, says his company is working with the U.S. Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) on approval of Imaware's antibody test. The in-home blood test might be available as early as May.

"We're still trying to make sure that everything checks out and validation is completed," Tuomi says, "but it looks like it's headed in the right direction."

In early April, the FDA approved the first test in the U.S. to detect coronavirus antibodies.

Tuomi says the process for Imaware's coronavirus antibody test will be similar to the one for the coronavirus detection test. Both tests, for instance, will be administered by licensed clinicians.

Here's how the basic test works.

To request a coronavirus test, someone completes a 10-question assessment at imaware.health. Austin-based startup Wheel, Imaware's telemedicine partner, created the online assessment.

Someone is given the go-ahead for testing if, as determined by a licensed health care professional, he or she falls into certain risk categories. For instance, somebody who's been exposed to a person with coronavirus and is over 60 years old would be approved for a test.

If health insurance covers the test or a patient pays for it entirely out of pocket, the test costs $135. (The home-based antibody test will cost about $120 to $125.) Public health agencies, including the Houston Health Department, can authorize a test for someone who can't afford it.

A trained health care professional goes to a patient's home to collect a test sample (by taking a nasal swab for the coronavirus test or drawing blood for the antibody test). A CDC-authorized lab then tests the sample. If needed, a board-certified health care professional can provide post-diagnosis care.

Results of a coronavirus test typically are available within three days. Tuomi says he hopes the results window for the test can be narrowed to between one and two days by the end of April.

"As a patient-advocate company, we are uniquely poised to be part of the testing shortage solution in Texas," Tuomi says in a March 23 release announcing the Imaware coronavirus swab test. "Our online platform, telemedicine partner, and in-home sample collection empower patients to take control of their health and access COVID-19 testing from the comfort of home."

Founded in 2018, Imaware employs 14 people. Others involved in the testing process, such as in-home testing clinicians and telemedicine experts, work for third-party partners. As the company adds to its testing lineup, Tuomi envisions the workforce rising to around 30 to 40 people by the end of 2020.

Earlier this year, Imaware (whose legal name is Microdrop LLC) had concentrated on home-based remote screening and monitoring for conditions like celiac disease and heart disease. But once it became clear that the coronavirus pandemic would be striking the U.S., the company shifted to coronavirus testing and, now, to antibody testing.

Before Imaware jumped into coronavirus testing, Tuomi performed a swab test on himself and realized that it wasn't feasible for anyone to do self-testing. On top of that, evidence surfaced that self-collection of test samples was producing a lot of false-negative results, he says. Subsequently, the federal government blocked self-testing for the coronavirus.

Today, health care professionals handle Imaware's at-home coronavirus testing and will handle the at-home antibody testing. The testing initially launched in Houston then expanded to the rest of Texas.

Tens of thousands of people have done coronavirus self-assessments through Imaware's online tool, Tuomi says. Far fewer people — in the hundreds — have actually fallen into high-risk categories based on the self-assessments and then have qualified for testing.

Tuomi says that as testing capabilities grow, Imaware will be able to accommodate people who fit into medium-risk coronavirus categories. Also, the company plans to offer its coronavirus test in states that neighbor Texas. Imaware hopes to provide its antibody test throughout the U.S.

In tandem with the public testing, Imaware teamed up with Austin-based energy tech startup RigUp to enable daily coronavirus screening at oil and gas jobsites. Imaware and RigUp are piloting the screening with several RigUp customers; they hope it eventually can be supplied nationwide.

"A cornerstone of the Imaware solution is the patient-centric approach offering superior telemedicine care from diagnosis to recovery," Tuomi says.

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Building Houston

 
 

Cheers Health has expanded its product line as it evolves as a wellness-focused brand. Photo courtesy of Cheers

Houston-based startup Cheers first got a wave of brand devotees after it was passed over by investors on Shark Tank in 2018. In the years since, Cheers secured an impressive investment, launched new products, and became a staple hangover cure for customers. When the COVID-19 pandemic disrupted businesses, the company rose to the occasion and experienced its first profitable year as drinking and wellness habits changed across America.

Cheers initially started its company under the name Thrive+ with a hangover-friendly pill that promised to minimize the not-so-fun side effects that come after a night out. The capsules support the liver by replacing lost vitamins, reduce GABAa rebound and lower the alcohol-induced acetaldehyde toxicity levels in the body. The company's legacy product complemented social calendars and nights on the town, providing next day relief.

With COVID-19 lockdowns and social distancing measures, the days of pub crawls and social events were numbered. Cheers founder Brooks Powell saw the massive behavior change in people consuming alcohol, and leaned into his vision of becoming more than just a hangover cure but an "alcohol-related health company," he says.

When the pandemic first hit, Powell and his team noticed an immediate dip in sales — a relatable story for businesses in the grips of COVID-19.

"There is a three day period where we went from having the best month in company history to the worst month in company history, over a 72 hour stretch," he remarks.

He soon called an emergency board meeting and rattled off worst-case "doomsday" scenarios, he says.

"Thankfully, we never had to do any of these strategies because, ultimately, the team was able to rally around the new positioning for the brand which was far more focused on alcohol-related health," he says.

"We found that a lot less people were getting hangovers during 2020, because generally when you binge drink, you tend to binge drink with other people," he explains.

He noticed that health became an important focus for people, some who began to drink less due to the lack of social gatherings. On the contrary, some consumers began to drink more to fill the idle time.

According to a JAMA Network report, there was a 54 percent increase in national sales of alcohol for the week stay-at-home orders began last March, as compared to the year prior.

"All of a sudden, you have all of these people who probably aren't binge drinking but they're just frequently consuming alcohol. Their drinks per week are shooting up, and they're worried about liver health," explains Powell.

Outside of day-after support, Cheers leaned into its long-term health products to help drinkers consume alcohol in a healthier way. Cheers Restore, a dissolvable powder consumers can mix into their water, rehydrates the body by optimizing sodium and glucose molecules.

For continued support, Cheers Protect is a daily supplement designed to increase glutathione — an antioxidant that plays a key role in liver detoxification — and support overall liver health. Cheers Protect, which was launched in 2019, became a focus for the company as they pivoted its brand strategy and marketing to accommodate consumer behavior.

"The Cheers brand is just trying to reflect the mission statement, which is bringing people together through promoting fun, responsible and health-conscious alcohol consumption," says Powell. "It fits with our vision statement, which is a world where everyone can enjoy alcohol throughout a long, healthy and happy lifetime,."

At the close of 2020, Cheers had generated $10.4 million in revenue and over $1.7m in profit — its first profitable year since launch.

During the brand's mission to stay afloat during the pandemic, the Cheers team was also laying the groundwork for its entry into the retail space. When Powell launched the company during his junior year at Princeton University, bringing Cheers to brick-and-mortar stores had always been a goal. He envisioned liquor and grocery stores where Cheers was sold next to alcohol as a complementary item. "It's like getting sunscreen before going to the beach, they kind of go hand in hand," he says.

"When we spoke with retailers, specifically bars and liquor stores, what we learned is that a lot of these places were hesitant to put pills near alcohol," he says. Wanting an attractive and accessible mode of alcohol-support, the Cheers team created the Cheers Restore beverage.

Utilizing the technology Cheers developed with Princeton University researchers, the Cheers Restore beverage incorporates the benefits of the pill in a liquid, sugar-free form. The company states that its in-vivo study found that the drink is up to 19 times more bioavailable than pure dihydromyricetin (DHM), a Japanese raisin tree extract found in Cheers products and other hangover-related cures.

"What we figured out is that if you combine DHM — our main ingredient — with something called capric acid, which is an extract from coconut oil, the bioavailability shoots way up," says Powell. He notes the unique taste profile and the "creaminess" capric acid provides. "Now you have this lightly carbonated, zero-sugar, lemon sherbert, essentially liver support, hangover beverage that tastes great in 12 ounces and can mix with alcohol," he explains.

The Cheers Restore beverage is already hitting the Houston-area, where its found a home on menus at Present Company. The company has also run promotions with Houston hangouts like Memorial Trail Ice House, Drift, and The Powder Keg.

Currently, the beverage is only available in retail capacity and cannot be ordered on the Cheers website. As Powell focuses on expanding Cheers Restore beverage presence in the region, he welcomes the idea of expanding nationally in the future to come. While eager customers await the drink's national availability, they can actively invest in Cheers through the company's recently-launched online public offering.

Though repivoting a company and launching a new product is exciting, the process did not come without its caveats and stressors. While Cheers profited as a business in 2020, the staff and its founder weren't immune to the struggles of COVID-19.

"I think 2020 was the first year that it really became real for me that Cheers is far more than just some sort of alcohol-related health brand and its products," says Powell. "Cheers is really its employees and everything that goes into being a successful, durable company that people essentially bet their careers on and their family's well-being on and so forth," he continues.

"It really does weigh on you in a different way that it's never weighed on you before," says Powell, describing the stress of the pandemic. The experience was "enlightening," he says, and he wants others to know it's not embarrassing to need help.

"There is no lack of great leaders out there that at long periods of their life they needed help in some way," he says. "For me that was 2020 and being in the grinder and feeling the stress of the unknown and all of that, but it could happen to anyone," he continues.

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