Kamal Obbad - Nebula Genomics & Accessible Genetic Testing

Subscribe for the show. Today I'm joined by Curtis Christopherson of my very first micro interview of the future of fitness. Kurt is the owner and founder of Workout and Innovative Fitness. He is a 20-year veteran in the wellness space and he's got the success to prove it. He's also a long-term friend and colleague. Kurt just recently launched a newsletter called Healthy Inficious. Give back to the industry that's given him so much. His goal is to help other entrepreneurs scale their wellness businesses just like yes. What is one actionable insight? You can provide our listers that has been incredibly valuable to you in your business career.

Wow. Powerful question. And I could have so many answers to that one. But I'd say that you know the biggest element of scaling a business is hiring the right people. And without the right people, you can't scale. And you know, one of my token rules is hire people that you admire. Hire who you admire. When you do that, chances are the people that you admire have some level of experience, education, or impact that you might not be able to provide. And so when you hire people that you admire and the value that they bring to your organization, inevitably they're going to help you scale your business no matter how big or small it is. When you hire people that are unlike yourself that contribute value that you can contribute, that you're winning. And so my biggest role is hire who you admire, whether it's the things that you admire about them from their education, experience, impact, or even how they lead their personal life. I think when you spread yourself with great people, you're winning the day.

That's awesome. Kurt, thank you so much for that. And if you guys want to learn more, please check out the Healthy Ambitions newsletter. You can go to Curtis, Christopherson.com to subscribe and learn more about it and all the great content he's putting out there. Thank you, Kurt. Awesome. Thanks. All right, we are live. Kamal Obad, welcome to the Future of Fitness.

Hey Eric, thanks for having me.

It's a pleasure. There is uh a lot of really, really cool, meaty, interesting topics. Uh, you know, stuff that I love to cover on this. I mean, genomics and health sciences and where the future of all this is going. It's just really exciting. It makes me feel um, you know, very uh small brained when I talk about stuff like this with people like you. I feel like you've really devoted uh you know your young life to this, and we'll um we'll definitely get into it. I mean, man, uh Harvard, Cambridge, Forbes 30 under 30, you've you've done quite a lot in in your young life so far, Kamal. So let's let's set the table. If you could just give us a little bit about your background, and then we'll get into uh nebula genomics, um democratizing that field and all the uh really interesting stuff that you're doing.

Sure, yeah. Um so for my background, so I was actually originally born in Canada, uh, moved uh to the US, was mostly raised in San Diego, I consider um San Diego home. Um I grew up kind of always having the idea of being a doctor or being in healthcare in some capacity. That was um kind of my overarching goal from a pretty young age. So I went to college with that idea in mind, did all like the typical pre-med things with really the mission of having like a traditional career um in healthcare, um, working uh in in some sort of patient-facing role. Um as college uh progressed, I got a little more interested in technology, in startups, um, started studying computer science. Um and then once I graduated, uh I found myself my first job out of college joining uh Google. So doing nothing related to healthcare, doing nothing related to uh biotech or medicine. And um, I spent a couple of years there, um learned a lot, but the entire time kind of felt that uh I still wanted to do something that bridged the gap between both medicine, health, wellness, and and technology. That was really uh uh kind of an area that I that I honed in on that I thought lent itself well to my skills, my my interests. Um I eventually left Google. I went to go study uh as a Gates Cambridge uh scholar studying computer science at Cambridge. Um kind of around that time, I started exploring what was interesting to me in the biotech, health, fitness world, like more broadly. Um, and and something that had piqued my attention, so this is around 2017, 2018, um, was really all the traction and adoption in the personal genomics space. Um so I started looking at that very closely. Um, that space has kind of been uh led by by companies like 23andMe, like Ancestry DNA. And around 2017, 2018, we were in a situation where personal genomics or consumer genomics was was kind of like a household name. People knew what it was. It wasn't some just like scientific experiment. Tens of millions of people in the US have done it. Um, there were applications of it that were seeing wide adoption. What really interested me at the time was that when I was in school and I was learning about personal genomics, what we learned about was how it was going to affect precision medicine, how it's gonna affect your health. But what we saw in 2017-2018 was now that the technology has finally become mainstream, um, all of the applications that were really taking off weren't based around health and wellness. They were mostly based around like ancestry or what we call uh like infotainment applications. So if you know somebody who's done like 23andMe or Ancestry DNA, um they've probably done it most of the time. And then a lot of our research and public research shows this. Mostly they've done it to learn about where they came from. Um and it's been a very popular product for that purpose. That's kind of like why 23andMe sells an ancestry-only test. So the only information they'll provide you is the ancestry. So the thesis I formed around that time was okay, great. The technology's advanced a lot. Personal genomics is a thing that people know about. The consumer has been educated, it's reached mainstream appeal. You can buy it at Walgreens, you can buy it at CVS, but we still haven't realized the full promises of technology. We need something that pushes it to the edge and actually helps uh people manage their health, um, understand what interventions might be better for them, understand what lifestyle changes might be better for them. All these applications that we were kind of promised for 20 years as people talked about DNA sequencing, personal genomics, they talked about the technology, but um ended up never fully happening. So around that time, I reached out to um a professor who I briefly met in college. He's a professor at Harvard Medical School, Dr. George Church. Um and he's like the he's the guy in personal genomics. He's he's kind of like um has been one of the biggest driving factors in pushing the technology forward for for really decades. Um and the goal, uh one of the overarching themes of his career and one of his biggest goals was how can we get everybody in the world to do genetic testing and benefit from it? He has this great vision that genetic testing is is is this really critical public health intervention, kind of like wearing a seatbelt where everybody really needs to do it for it to reach its maximal impact and for it to reach like its its overarching societal benefit. Um I reached out to George, reconnected with him, flew to Boston, kind of pitched him on what I was thinking about the space and this this the like inklings of an idea we had around building a next generation personal genomics company. So kind of like the next iteration of a 23andme, for instance, that that focused on different applications, used more modern technologies, had a bigger emphasis on privacy, less focus on monetizing data, and was really more aligned with the actual customer. So that was the initial kind of themes we we riffed on. Um he told me he was working on something similar with a grad student in his lab. Um and then I just dropped out of Cambridge and we we teamed up and started a company. Um and we could talk about that as well, but I guess that's was five years ago, almost to the date now. Um ran the company for a few years. It became the largest provider of direct-to-consumer whole genome sequencing, um, which I'm sure we'll get into what what whole genome sequencing is as well and kind of why that's that's different. Um we sold that company a couple of years ago. Um so I'm still regularly uh involved with it. The whole founding team, the whole original team is still regularly involved with it. We've just partnered with uh a company called Prophase Labs to um invest more in the business. We built out a probably the largest lab sequencing lab in North America. We built it out in in um Long Island, um, New York. Um but since then, for me, I I returned to the Bay Area Um after living in New York for a little bit. Um I actually decided to re-continue like my childhood dream of uh going into medicine. Um I'm now doing my MD PhD um at Stanford while continuing to contribute um to Nebula and other companies in the space.

That's quite a story. And uh, you know, there's I'm sure we'll circle back on a bunch of that stuff. But one of the one of the things that popped up was you were telling me that, um, why do you think that, you know, historically or early in those days, I guess circa 17, 18, you know, 23andMe came out. Why do you think it was just ancestry? Like, why weren't people digging into the deeper opportunities? Like, what's taken so long to get to that point?

Well, I still think we're not 100% at that point yet. There's been a lot of progress, but it's really the technology was the limiting factor. So so you you you you might like remember the the Human Genome Project, for instance. Um that was a a I think multi-billion dollar effort to sequence human DNA. So to read you know, effectively an entire genome, so 100% of your DNA, and that was super expensive. And in the past 25 years since that project, um this type of DNA analysis, so looking at 100% of your DNA, has been prohibitively expensive for consumers. So most of these mainstream genetic tests you've heard of, like 23andMe Ancestry DNA, they aren't doing what's called DNA sequencing. They aren't doing whole genome sequencing. They're not looking at 100% of your DNA. They're typically looking at less than 1% of your DNA just because the costs are so prohibitive to do whole genome sequencing. Um so they use a very different technology. I won't get into too much detail, I guess, on how the technology works, but that that technology for the greater part of the past two decades has been the only thing that's been at a price point that is accessible for the average consumer. So that was one huge limiting factor. And and what contributed to that is you know, 15, 20 years ago, many people like predominating belief was that your genetics influence your health in a monogenic way. So what that means is you have a gene, right? A gene might might be related to some trait. Let's say, I don't know, let's say it's like muscle density or whatever it might be. It's not necessarily that simple, but that's kind of like an illustrative example. Um, you might have a mutation in that gene, and that gene will affect that trait. So people thought for a long time that, you know, if you can detect a mutation, we can predict what's gonna happen to you. And it was kind of like we need to look at one gene, we need to look for one specific mutation, and that'll tell us what the trait is. But it's turned out that most of the ways that genetics affects your health is actually polygenic. And what that means is you have many, many genes that all have small effects on many, many traits. So to truly understand how your genetics is influencing a specific trait. So, for instance, if you want to understand the genetics of your sleep, there isn't one gene you can look at. You might need to look at potentially thousands of genes and slight variations and look at the heritability of those genes and the effect on your sleep and kind of analyze what the small incremental changes, all of your slight differences from the average person might have and how that might affect whatever traits you're interested in. So it turns out genetics is not monogenic, it's mostly polygenic. It's very hard to understand what changes, what differences you know between me and you are causing what differences in our health or wellness or various traits. Like why, why, why may you sleep, maybe you sleep better than me? Why is that? Maybe my vision is better than yours. Why is that? A lot of the genetics of this aren't fully worked out. Why might person A be more likely to develop a mental health uh illness? These, these, the the heritability, like the genetic components of a lot of these types of traits aren't fully understood. But we do know the genetic components are polygenic. They're typically not monogenic. It's not so simple that you can look at one gene. And a lot of these original genetic tests, um, the like mainstream consumer ones, are giving you monogenic traits for the most part. So they can only report on things because they're looking at a very small fraction of your genome, right? They're only reporting on things that we do know are monogenic, which are actually very few things. And those few things are very, very rare for the population to have. So if you've done 23andMe and if you've done ancestry DNA, which to keep in mind, I think those are both like amazing, amazing products and kind of trailblazed the way in personal genomics. But if you look at those reports, the average person, like the health category, it's gonna say not applicable for almost everything, right? Because you're most likely not to have this super rare variant that might give you Huntington's disease. You're most likely not gonna have this super rare variant that might uh predispose you to Alzheimer's. Like almost certainly you don't have these traits. So people have generally described themselves being underwhelmed by like the health and wellness aspects of these types of tests. And if you do find that you have something, it's not actionable, right? There's really nothing you can do. We can't edit your genome quite yet. Um it's kind of like you learn something scary. What are you gonna do about it? Most of the time, you can't. Um that's how most of these monogenic traits are. They're very scary, and there's really nothing we can do about them. Um, that's different than polygenic traits. Those are types of things that are not we can tell you about things that aren't scary. We can tell you things about you know what kind of training you might be, your genetics might best suit you for, um, what kind of vitamin deficiencies you might be at highest risks for, what kind of metabolic disorders you might be at highest risk for. These are all things you can make real lifestyle uh changes or interventions to actually impact, and these are polygenic. Um the issue has been that doing whole genome sequencing in a way that's accurate enough and broad enough to actually calculate, you know, these we call them these polygenic scores for different traits. So our reports have a bunch of traits on them, sleep, um things related to exercise metabolic disorders that I mentioned. Um, we give you a polygenic score. And to have enough accuracy to like calculate those relatively well was really expensive. So when we started the company, to do this type of genetic testing, it cost about $1,000. So compare that to $100 for a 23andMe test. So our our c our costs would have been around $1,000. So for the consumer, it'd be even more. Um, so what we had to do was we we our our belief was that the cost was gonna go down. We thought there was business model innovation that uh could be had to bring uh the cost down. And we also noticed that historically the cost had been going down very quickly. So if you looked at like the cost of it's called genotyping, the thing that I mentioned at like 23andMe and Ancestry DNA, so SNP chip, DNA microarray is the name of the technology, that cost had been flat for a very long time. So that's specific technology. While the cost of DNA sequencing, which you can use for whole genome sequencing, has been going down exponentially over the same time. So we thought those lines were gonna cross, where DNA sequencing, you know, we thought this was 2018, we thought in the next few years DNA sequencing would be, whole genome sequencing would potentially be cheaper than these other technologies, because the innovation has been happening so rapidly in the pay in the space. So we thought if we could position ourselves to launch to be alive, to exist, uh, to have a company ready to operate when this the kind of the cost curves crossed, we would be well positioned to be um to provide those services to consumers really globally, which is essentially what we did. So we had a bunch of tricks, we did a bunch of business model innovation, we made a bunch of risky bets, invested a ton in equipment and and machinery and automation and and um partnerships with with vendors and um a lot, a lot of people were involved, but we were able to drive the cost down. When we launched our test, we did it for $300. So it was by far the cheapest anyone's ever offered whole genome sequencing. It's it's yeah, it's still not, I think, accessible. It wasn't accessible to the average consumer, um, but it's way, way cheaper. And we're now moving our pricing even lower. So you'll be regularly seeing sequencing around $100 from us. So for the same price as 23andMe, you're getting 10,000 times more data. Um, and that's that's kind of like was our big mission was make it so if you ever are going to get a personal genomic test, which we think tens of millions of people a year are going to get a personal genomic test, we should make it a no-brainer to get whole genome sequencing versus DNA microarray, because the data is so much more impactful, it's so much more interesting. Um, and more importantly, is even though we don't understand, like I mentioned, we're still learning more about genetics and how your genetics affects your health, your wellness, all these different traits. Um, when we do our whole genome sequencing, we sequence 100% of your DNA versus this less than 1% that most of the tests are doing. We don't know what 99% of your DNA does, but every day we're learning more, right? And by us I mean, you know, scientists, academics, researchers, more and more is getting published, is getting validated in clinical trials. And we update the report because you you've sequenced 100% of your DNA. You need to do that once in your entire life. And the results are just gonna get, the reports are gonna get more and more accurate and more and more comprehensive over time as our understanding of how genomics affects health uh becomes clear.

Man, there's a lot to unpack there. I guess you know, the first, I want to go through it as a consumer experience because I think that always uh, you know paints the picture really well. So I guess first question is I want to hear like if I'm a consumer, you know, what is the experience like? What are some of the revelations anecdotally that you've seen for people who use Nebula Genomics? But first of all, like why? Why why do most consumers come to you guys to get this testing done? What seems to be the motivation for people to do it?

Yeah, so early on, um we had kind of like two general audiences. One was maybe a lot of people that listen to this podcast, for instance, like like hardcore health and wellness enthusiasts. So people who are they're using, you know, they're trying continuous glucose monitors, they're buying chilled mattresses, they're getting a front of greens, all this stuff. Like they're investing a lot in their health. Um that's been like that was that was that was that was like a big chunk of our audience early on. So it's really the enthusiast who likes to be on the cutting edge. Um the second chunk of our audience was the rare disease community. So this is people who have undiagnosed diseases. They need to, they're on really their own like diagnostic odyssey, trying to figure out what's going on with them or a loved one. They're trying to get as much data as they possibly can and they're taking it to experts, clinical geneticists. So a big part of our mission early on was making all the data fully and freely accessible, which surprisingly a lot of companies don't do. Um, they want to keep you siloed on their platform, they want to monetize that data eventually. Um, a big part of our mission was not monetizing data, not making the data the product, focusing on the consumer. So a lot of rare disease folks came to us since we gave them hundreds of gigabases or gigabytes of data that they could go and take to a clinical geneticist, uh a genetic counselor, um a nonprofit, uh, a research organization to help them with their diagnosis. So that was our early audience. I would say people come to us for varied reasons. Um, because what we've kind of learned is um a lot of people in like the personal genomics space talk about, you know, they ask the question, what is the killer app in personal genomics? Like, what is the thing that leads to a lot of adoption? And the killer app so far has only been ancestry, has been like the infotainment stuff, right? That's that's what's gotten mass market appeal. And the health and wellness stuff, there hasn't been a killer app. And and we think that's because we don't think there is a killer app. We think every single person is different. You know, by definition, this is personalized medicine. So everybody has a different reason for why they'd want to get. This test. So our goal is to help you answer any question you might have where you want to interpret how your genetics might be affecting your health, your wellness, your fitness, etc. So that's people who have those questions are the ones that come to us. And sometimes these are really they have really open-ended questions. So we provide tools on the website, easy to use tools that you don't need to be a scientist, where you can really go into depth on your genome, you can browse your genome, you can link it to uh peer-reviewed literature and actually understand really at the cutting edge what people are saying about certain traits you might have and how that could affect things you're interested in. So what we try to do is not focus on one killer app in health and wellness that that that applies to you know a critical mass of people, but instead build a product that enables people to explore their genomes in a way that's fruitful and useful to them. So that's that's that's really like today. We're sequencing in 110 plus countries, um, really all over the world. Those are the people that are coming to us. So it could be anywhere from you have a life-threatening rare disease, you need this data, and we get emails all the time from people who um have used our data to um identify variants or or or genetic diseases uh that maybe they may have might have with the help of an expert. They always have to go to an expert to do this. Um, we don't do any diagnostics ourselves. Then we have people who are using this to see if they can improve their training or their athleticism. They're really just trying to get an edge.

Gotcha. So uh walk me through the consumer experience, Kamal. Like, you know, if I'm I find you online, right? So take me from there. What happens next?

So you come to our website, it's it's you come to our website, you buy a genetic test. So you can pick three different tiers. There is a low pass test, which is really cheap. So the way it works is for whole genome sequencing, you you you read the DNA uh several times. So it's kind of like proofreading an essay. You know, you read it more than once to find any errors. So the more you read it, the h more accurate it is, and the more confidently we can tell you that you all that you have this variant or this like this difference, this change in in your DNA. So we have three different products, which is three different levels of accuracy. One is low pass, which is effectively just reading your DNA one time. So one time end to end. Actually, many people, most people don't get that one. Our most popular one is a 30x. So 30x means reading your DNA 30 times. That's kind of what's considered um uh clinical grade, is 30x, it's called 30x whole genome sequencing. So it's effectively proofreading your genome 30 times over, super, super high accuracy at every individual base in your DNA. That's our best seller. And then we have a 100x product, which is reading through your genome a hundred times. Um, and that one is mostly popular for people who are looking for really rare variants. So if you have something that, if you suspect you have something that's really rare, if you're like in the rare disease community and you want to take this data to a clinical geneticist or um some sort of specialized doctor or something, to to for us to for you to detect rare variants accurately, you might need the 100x. But those are the three products, you pick one. Um we ship you a kit, it's just a cheek swab, a buccal swab. So you swab it, you put it in the tube, you ship it back to the lab uh that goes directly to our lab in New York. Um, and then the processing occurs. And it's a fairly long process today. Um, it takes six to eight weeks. Um, we'll be reducing that pretty soon in the near term, and then you get a report. Um, and the report has a bunch of different aspects to it, depending on how comfortable you are with the data. We have some people who are trained scientists and there are tools for them that they can use, and we have some people who are just complete like consumers, have no specialized training or expertise in this. So a report has a library of traits. Right now it's got like 300 traits in it. Um, examples, like I mentioned, you know, things like sleep, things like vitamin deficiencies, etc. And it gives you a polygenic score. So this is a summary statistic that tells you, you know, looking at all of your genetics, you know, we might be the summary statistic might have a thousand different genes contributing to it. We give you like one high-level summary of are you more likely to have this, are you less likely to have this than the average person in our database? Just very, very high level, and then a vernacular explanation of what the trait is and what this means. Um, again, mostly non-diagnostics, so we're not like diagnosing diseases or anything. Um, we're not doing any of that uh today. Um if you want more detail, you can actually click in and you can see specifically what the variants are, what their relative weighted effect is on this trait, what the genes are. You can go really into as much detail. You can go to a separate tab, again, really kind of like leveling up in terms of complexity now. So the first thing I showed you was the least complex. That's 95% of our customers just spend their time in that part. The next part is what we call the gene analysis tool. So this allows you to look at whatever you want in your DNA, not just the things we curated in that library, but literally anything, and look at annotations. So you can look at specific genes and you can identify all you can see a bunch of annotations on the gene, click on them, and then go directly to the primary literature. So people who found that useful are people who work with like a concierge, physician, they might work with some sort of expert in the space who will use that tool to build their own hypotheses on um whatever they might be looking at. Um those kind of like the two main tools. We have some others, I won't go too much into that, but we do also provide like ancestry services as well, though much less detailed and sophisticated than like 23andMe and Ancestry DNA, since it's not really our focus. Um besides that, is that's the consumer experience. You get your report, you find what's interesting. Um, but what's unique about us is I mentioned we do whole genome sequencing. So we look at 100% of your DNA, and we don't know what 99% of your DNA does today. So incrementally we learn more and we provide those updates to you at a weekly or bi-weekly cadence. So you come back to your report and you get new entries in the library, or your scores might change in the library. Maybe new variants were detected that might affect a trait. So it's constantly being improved and getting more accurate, and more traits are being added, and we continue to add those and support that over time for everybody who is a member.

Wow. Well, so it's kind of like a wiki for your own genes, right? Like it just keeps uh exactly.

Yeah.

It keeps uh updating as the science improves. Wow. What uh okay. So I talk about this often in the podcast, is like we have a lot of really cool, cool stuff coming out nowadays. Like this is very much, I feel like we're living in the future nowadays. And um all this lead sounds really valuable. The question I have is like, now what, right? So people get this information, they start to understand a little bit more about their genomics. What do they do about it? Like, you know, how does it how does it change their lives? What are the next steps after gaining the information that they can actually effectually create change um positively in their lives?

Yeah, so uh it's a it's a good question. That's probably like the most common question we get. It it really depends on the person. So so our our reports do not tell you anything that would like dramatically alter the trajectory of your life, right? Um we're not telling you that you might have some rare genetic disease that is gonna develop later in life and and and drastically affect your quality of life or or or cause your life to shorten or whatever. That those aren't the type of things we report on. We report on things that you know could have you can make lifestyle interventions to change. I think so something we can actually do a better job on, and we're we're working on things right now to improve kind of like the next steps aspects of the coaching and and counseling that you can get to actually take these reports and turn those into actionable change. Um, but the types of things people have been doing is um changing their nutrition, changing their sleep patterns. Sometimes people will have they'll look at results and maybe they'll want to engage in a conversation with their doctors or a clinical geneticist or an expert and move forward from there. Sometimes they'll want to speak with loved ones and have them get their genetics tested as well if they find something that that could be hereditary. I think something that's important to keep in mind though is kind of like where we're at with genetics today, is we were realizing more and more that there's kind of there's two every trait you have, most not every trait, most traits you have, particularly related to your health. Um there's a genetic component and there's like the environmental component, right? Like the nature versus nurture. We're only telling you the nature part of it. So for some of these traits, the nature part could be a very small part of it, right? Um so a good example could be like um like a heart disease, right? You might have a pretty high risk for a genetic risk for cardio, some sort of cardiovascular disease. But the reality is, you know, if you if you don't smoke, if you reduce drinking, if you exercise, those nurture aspects can play a much bigger role than your genetics and actually improving your health. So what we we cater to are really the optimizations that you can do on the nature side of uh on the nature side of things, and then ways that that can impact like the nurture side of things and how how you can change that. So that that's kind of the main way people are using our reports today. We're making a push in the near future into more clinical types of tests that will be more prescriptive, that will be more diagnostic. We're incorporating genetic counseling into what you're doing. So you can talk to like a licensed genetic counselor to actually interpret the report. We're expanding and introducing more types of tests that aren't genetic. So, for instance, if you are, if if you have variants linked to a presupposition for maybe like high cholesterol or something, well, we can actually measure your cholesterol from your house. And we can do that on a regular cadence and track if you're doing actionable things to prevent your genetics from leading to you to getting um or contributing to you getting uh high cholesterol. So these are the types of things we're incorporating um in the test. But I think that's the big challenge really of uh genetic testing today is finding things that are actionable, that are meaningful, um, that you know aren't just fun to know, but can actually meaningfully impact your life. And that's like a continuous work in progress for kind of us and really the entire industry, in my opinion.

Yeah, I agree. I mean, it's it's it's uh everything. I mean, even just something as simple as wearable data, like we're still trying to figure out how we can make that useful to consumer and really impactful, right? Um one of the things I want to cover with you uh is you know, with all these uh really cool forefront science, like how do we democratize it so that it can get through more of the population, right? I think when people think it's about services like this, really it's just me, it's just one person speaking. I think about, okay, this does for like the rich, right? I was actually having a conversation with Brandon Cullen from Anabolic about this, like like you know, all these really like amazing long longevity, um, anti-aging, like all that's fascinating, but is it just gonna be in the hands of the few who can afford it, or are we gonna be like and so how do we democratize it? And part two of that question is like, is artificial intelligence playing a role in that? And how do you see that integrating into this?

Yeah, it's a good question. So I so for genetic testing itself, our focus has been like our core focus has been driving the cost down. Awesome. Like we all that that's been the number one thing for us above everything else. That's been that's the number one barrier to adoption for whole genome sequencing. Um we have to make the tests better, we have to make the reports better, we have to make the interpretation better, but it doesn't matter if the costs aren't uh lower. Nobody's gonna be able to access it. Um we do think there might be a future where genetic testing is almost like a public health intervention. Um I brought up this seatbelt analogy. Um, you know, seatbelts are you have to wear a seatbelt. They they you know the cost of the seatbelt saves society money on average, right? If everybody's wearing a seatbelt, everybody's safer, there's less injuries, um, there's less deaths, etc. Um genetic testing is very similar. There are, and there's good research and literature on this now, where if everybody got sequenced at a young age, there's enough people with totally preventable genetic illnesses or or conditions, there's enough actionable things we can do on that data that we will actually save more money for the healthcare system and uh overall than the cost of the genetic testing. Um so I do think there's a future where we do see that everybody gets genetic testing and it's either subsidized or it's um done as like a public health um intervention. There are there are governments like single-payer systems um outside the US that have been exploring this much more thoroughly than in the US and testing this. Um that that might be what the future of genetic testing looks like to make it accessible. I do think right now the biggest barrier, we're we're the cost has been like really drastically changed over the past few years, just since we started the company. We've really driven costs down um substantially, and it's just gonna continue to drive down. So costs will be a solved problem. Whether it gets uh subsidized or not subsidized, whether it gets reimbursed by insurance or not reimbursed by insurance, um, that's gonna be solved. The harder part is the interpretation, the counseling, the coaching, kind of like the people part of it. Um right now, if you try to go to these precision medicine clinics and get help interpreting your genetic data, they're charging thousands of dollars for this type of expertise. And there's a huge shortage of genetic counselors. Um, and that might be a place where AI plays a role in the future is really making sense of this data and interpreting this data and acting almost as like a doc in a box. Um, I think we're far out from that happening, and I think probably a lot of like doctors and genetic counselors will get mad at the even the notion that AI would do this um one day. But I think that's if AI were to fit in somewhere, I see it fitting in the coaching and interpretation aspect of genetic testing. Really, the genetic testing is a commodity, it's it's fully commoditized service. We do our own genetic testing, we have our own lab, but we also do genetic testing for tons of other companies that have their own genetic testing product because it really is, like I mentioned, it is the actual sequencing itself is just a commodity product. We can do it cheaper than anybody else. Everybody just does it with us. The special sauce is the interpretation, is the reports you you generate from the sequencing. So that's where resources are being invested. That's probably where AI can play the biggest role. Um, that's where I'm kind of most optimistic with it fitting in, and then lowering the barrier to interpreting this data. Um, because it's too expensive uh right now, and there's really no clear path forward to how those costs are gonna go down. Um that is something that's like mostly relegated to wealthier people who have a full-time concierge physician or who can pay for deleting precision medicine or or like longevity spas and clinics that exist who are big, and those spas and clinics are big customers of ours. They buy our genetic tests and and and use them for their patients.

Yeah, it's it's really interesting. And I'd imagine like whatever you refer to, I think, as like you know, a genetic coach, right? Someone who can help and interpret all the data. I imagine the pool of those people isn't that big overall. It's not like you can't just get a weekend certification.

No, it's very complicated. Whole genome sequencing is even more complicated. Um, you really need like a clinical geneticist who is like an MD or a PhD today. Um those are the people best suited to interpret the type of data um that can be generated to most to maximally interpret the type of data that's being generated from whole genome sequencing. And then um they are not like a diamond dozen. They're they're they're they're hard to find, um, they're hard to hire, it's expensive, it's it's very limited. Um so that's that's a area that needs um a lot more focus.

Uh tell me about Nebula Genomics as a company. Like uh, and I I think you guys are private, right?

Um we're we're now part of a public company. Okay.

Well, yeah, well then share what you can. Like you know, give us some numbers, like where's the company at from uh whatever you feel comfortable sharing from you know, revenue, investments, employees, uh all those key features.

Yeah, we've invested. So what I can share publicly. Um now that we sold the company, I have a boss, so I can't decide, I guess, these things uh on my own anymore. Um, but I think what we can share comfortably is so we have we just built a state-of-the-art lab in New York. Um, probably the largest, highest throughput next-gen sequencing lab in North America. Um, tens of millions of dollars invested in that infrastructure, really with the goal of doing as much sequencing as cheaply as possible for as many people. Um, and we don't just do sequencing for consumers today. We do it for lots of, I mentioned we do it for businesses, we do it for research um organizations, we do it for universities like labs at Stanford, labs at Harvard, um, etc. So we're trying to build as much capacity as possible. Um, we're continuing to make a big push in consumer. So we've served um you know 100,000 plus customers in in 110 plus countries. Um that's that's our customer base. So it's a long cry, to be fair, from you know the tens of millions of customers that 23andMe has has served. Um but the difference the big the big difference for us is is we've mostly grown organically. Um we've done very little paid marketing. We just found paid marketing, we kind of came after the era of paid marketing working very well, right? It kind of worked really well in like 2010 to 2015, 2016, and then direct to consumer got got saturated. So we really have focused on growing in consumer. We've grown with kind of like a most of our history has been an expensive premium um health and wellness product for mostly niche audiences, and we're now just recently at the point where the prices are are becoming more and more comparable to some of the more mainstream genetic tests. So this is the point where we're pushing um really hard for more of that mainstream adoption, so catering less to just um the rare disease and then like hardcore health and fitness enthusiasts, but trying to figure out what the message is for the average consumer. Um I think it's a given, like for sure, in our lifetime, everybody will be doing whole genome sequencing. Everybody will have access to their whole genome sequence, their doctors will have access to their whole genome sequence. It's something you do once, you know, in the near future, it'll probably be like $10 to do. It's just a no-brainer that everyone's gonna do it. Um it's hard to predict when it's gonna happen, but that's kind of like the future that we're preparing for. Um is that idea that whole genome sequencing will become a standard part of even traditional healthcare. Um, even for things like uh pharmacogenomics, so understanding which you know which drugs or which treatments you might have, good or bad um interactions with. Um so that's kind of like the direction the company is is moving is being the leader in in whole genome sequencing, being the the cost leader um in whole genome sequencing and having the most advanced, most state-of-the-art, highest throughput lab, um, which is what we've built uh in New York so far.

Awesome. Um I asked the spirit of this question, the spirit of collaboration. Like, what do you need right now? What do what does Kamal and Nabula genomics need like as far as um, you know, uh are you hiring? Um are you guys raising money? Um do you need marketing experts? What's what's critical?

Yeah, so marketing experts are always great. Um I well yeah, we'd love to have uh marketing experts to work with. I think the most useful thing for us is you know, you're the like we we would love to be able to talk to people who are leaders in the health, fitness, wellness space. Um, we'd love to really understand how can our product improve what you're doing, right? So whether you're giving um supplements to people, whether you're providing physical therapy or fitness coaching or whatever it might be, there's a role that genetics can play. And that's something we'd love to explore or collaborate with folks. Um, we're always interested in in partnerships, we're always interested in pushing um uh Uh really pushing the needle on what's possible with personal genomics and building more and more examples of applications that have high efficacy, um, are actionable and are really meaningful to consumers. Um that would be a big thing. It'd be great to have people reach out who are who are interested in exploring what they can do with personal genomics, how they can enhance um products, offerings, or or or work that they're doing today.

Awesome. Awesome, man. Um more question for you. Uh if we play our cards right, right, we use this testing, um, we stay fundamentals, right? We sleep well, we eat well, we keep moving. How long do you think we can live?

Oh man. Um I don't know. I I if I answer that question, it would just be pure conjecture, I think. Um there is uh there's this guy I follow. Uh I mean I'm sure your audience is like very familiar with him, Brian Johnson, who's I think that no, I think he's he's doing, I guess, as much as a person can do. And they're saying he he is saying I think 200 years old, I think is what he said. Um he's doing he's doing everything, like he's doing he's spending you know millions of dollars on his health and wellness. I don't know where that number comes from. I don't know if it's grounded in in reality or not. Um uh but that that's yeah, that's that's that that could be uh exciting. I think there's also like more things happening. Like we're just doing genetic testing, we're just reading your DNA, but just wait until we can start writing your DNA, right? When we can start actually changing your DNA. And that that's that's happening today. Like that, there are people being cured of genetic diseases. It sounds, you know, if just a few years ago I said we're gonna be gene editing people and curing sickle cell in patients, um, sometimes curing cancer in patients. It's there are literally people walking the earth today who have been cured with gene editing. Um there's a long way to go before it's like cost-effective and works for more indications and is more applicable and is more useful, etc. But like it's it's happening, it's it's reality. And um, you combine, you know, we've made 25 years of progress in reading DNA, and we're at the point where now we can it's really commoditized and we can do it well and we can do it fast and we can do it accurately. What's 25 more years of working on writing DNA to where that becomes commodified and you can do it well, you can do it accurately and safely. Um, that's where things are gonna start getting like crazy in in my opinion, is when you can you can read and you can write and you kind of have that loop. You know, you can start changing things and seeing what happens. I don't know uh how that's gonna look. Um uh have some like weird-looking people, I guess. People decide to make, but uh that could be interesting. Yeah, it could. It could be very interesting. Uh well that's like my sci-fi. That's like my sci-fi future. Yeah.

Yeah, yeah, I love it. Um well, I I really appreciate all this, Kmall. It's it's fascinating stuff. Uh, if people want to get a hold of you, if there's a place where would you like people to go online after they they listen to this?

Um I guess I'm not I'm not big on social media, but I do have a Twitter. People could like follow me on Twitter, message me there. If they want to get in touch. Um I don't know if there's like show notes or something, I can put the handle in. Um you're always welcome to reach out to partners at nebula.org um as well. Um if you're interested in collaborating or or exploring um working with us, you're always welcome to reach out to me directly. And I'm I'm not too hard to find online. Great.

Well, I I appreciate you taking the time here, Kamal. It's been uh it's been a fascinating journey. I mean, this is a really exciting field, and I think a lot of people don't quite uh it's not on a lot of people's radar yet, right? Um, you know, I I've worked with uh a couple different companies and Insight Tracker was you know um a partner in this podcast for a while too. So I know they're you know at the forefront of consumer um testing, really. All they do they do all kinds of stuff. But um yeah, it's really fascinating. It's it's very interesting, and I look forward to perhaps getting you back on a year or two and see where this whole thing went.

Yeah, sounds great. Thanks so much for having me.

Yeah, ladies and gentlemen, come on, oh bad. Uh hey, wait, don't leave yet. This was your host, Eric Malzone, and I hope you enjoyed this episode of Future of Minutes. If you did, I'm gonna ask you to do three simple things. It takes under five minutes and it goes such a long way. We really appreciate it. Number one, please subscribe to our show wherever you listen to it, iTunes, Spotify, Catbox, whatever it may be. Number two, please leave us a favorable review. Number three, share. Put it on social media, talk about it to your friends, send it in a text message, whatever it may be. Please share this episode because I put a lot of work into it and want to make sure that as many people are getting value out of it as possible. Lastly, if you'd like to learn more, get in touch with me, simply go to the feature of fitness.co. You can subscribe to our newsletter there, or you can simply get in touch with me as I'd love to hear from our listeners. So thank you so much. This is Derek Mountain, and this is the feature of fitness. Have a great day.