00:00:00.000-->00:00:06.874 >>Uh our next uh our next speaker is Chief Medical Officer for the Intel Corporation. You 00:00:06.874-->00:00:13.847 might of heard of them. Umm and I was I was surprised that Intel had a Chief Medical Officer and 00:00:13.847-->00:00:19.753 I am personally really excited to hear what uh Dr. John is going to share with us. So 00:00:19.753-->00:00:24.758 please join me in welconing- welcoming to the st- uh to the DEFCON stage Dr. John Sotos. 00:00:31.865-->00:00:36.336 [applause] [indistinguishable shouting off mic] Thanks I will [voice off mic] Thank you very 00:00:36.336-->00:00:40.941 much. Did somebody say break? >>[from crowd] BREAK! >>I'm a cardiologist I'm not gonna 00:00:40.941-->00:00:45.946 destroy brain cells. [crowd laughs] It's against my professional ethics. [applause] 00:00:48.849-->00:00:52.586 So uh it's an honor to be here today um I hope you get something out of the talk at 00:00:52.586-->00:00:56.556 least something to think about but first I of course I have to start with disclaimers. What I'm 00:00:56.556-->00:01:02.095 gonna talk is not necessarily the official position of Intel or the Department of Defense. 00:01:02.095-->00:01:06.466 I've got a Department of Defense affiliation too which I'll go over. So anyway with that let's 00:01:06.466-->00:01:11.471 get going. I'm gonna use my um pointer over on this side I hope everybody uhhhhh ok. Well. Here 00:01:14.775-->00:01:19.780 we go. So first uhh let's go back to 1978 when I was a college student uhh in about 00:01:22.015-->00:01:27.421 this part of the country. [clears throat] And umm I got sick really sick I was sick as 00:01:27.421-->00:01:32.826 crap. I was laying in bed shivering [clears throat] excuse me, my teeth were actually 00:01:32.826-->00:01:39.433 chattering and every muscle in my body hurt. Wasn't just me it was everybody it seemed like. 00:01:39.433-->00:01:46.073 Well almost the professors didn't get sick. Just the students. And it wasn't just my 00:01:46.073-->00:01:51.044 college. At the Air Force Academy 77 percent of the recruits got sick, the cadets, 00:01:51.044-->00:01:56.049 sorry. It wasn't till 30 years later I found out what had happened. In 1918 that's when 00:01:59.386-->00:02:05.659 the story starts, a virus got from a bird into humans and that killed about 1 percent of the 00:02:05.659-->00:02:12.633 entire world's population in 1918. And that virus and its descendants stayed circulating 00:02:12.633-->00:02:17.971 in the population for another 40 years or so. And you know how there's an influenza every 00:02:17.971-->00:02:23.210 winter and there's a different shot you get every winter the virus changes little by little 00:02:23.210-->00:02:30.183 so over the next 40 years that virus hung around. And then in 1957 it went away it was 00:02:30.183-->00:02:36.723 replaced by another influenza virus, an H2 virus, and then in 1968 another virus replaced 00:02:36.723-->00:02:41.728 that. So far all is normal. In 1977 though, H1 came back. And in fact it just wasn't a random 00:02:47.300-->00:02:52.305 H1 it was almost exactly identical to the H1 from 1948. And that's why the professors 00:02:57.377-->00:03:03.750 didn't get sick. The professors had all gotten sick in 1948 cause they were older. It was 00:03:03.750-->00:03:08.755 only the students who had never seen this virus that got sick in 1977. So how did that happen? 00:03:11.925-->00:03:18.832 Because these viruses change you can't get a 30 year span in time when a vi- when an influenza 00:03:18.832-->00:03:25.505 virus doesn't change. And so the common consensus is the reemergence on this virus in 00:03:25.505-->00:03:31.278 1977 is unexplained and probably represents reinduct- reintroduction to humans from a 00:03:31.278-->00:03:36.283 laboratory source. What does that mean? It means something got out of a lab. It got out of 00:03:38.418-->00:03:45.225 a lab and it came halfway across the world and it got me. This is where this virus first appeared 00:03:45.225-->00:03:49.563 in the wild, somewhere in northeast Asia. We don't know if it was the Soviet Union or 00:03:49.563-->00:03:56.002 China. But it went worldwide. And it didn't affect the old and the infirm it affected the 00:03:56.002-->00:04:00.941 healthiest people; the college students. So you're affected by this too because ever since 00:04:03.877-->00:04:10.450 then, the descendants of this H1 virus have stuck around and this H3 virus has stuck around too. 00:04:10.450-->00:04:14.688 So every year when you get your flu shot and I hope you do, you're getting immunized against 00:04:14.688-->00:04:19.693 something like this and something like this. So that's the one of the motivations for 00:04:22.395-->00:04:28.802 this talk. Stuff that happens in labs can have worldwide reach. And we know that micro engineer- 00:04:28.802-->00:04:32.839 that engineering of microorganisms is happening every day today in laboratories. 00:04:32.839-->00:04:38.612 The question is: What is the potential when malicious engineering of organisms starts? 00:04:38.612-->00:04:43.917 And how do we defend against it? And I would- claim that only massive preemptive development 00:04:43.917-->00:04:48.188 of counterhacking bio technologies can save the world. Cause I think the threat is that 00:04:48.188-->00:04:54.628 grave. So who am I? As I mentioned, I'm a cardiologist who doesn't drink much. I work 00:04:54.628-->00:05:00.267 for Intel uh I've been in the Air National Guard for 30 years uh mostly as a rescue flight 00:05:00.267-->00:05:05.805 surgeon. I've been programming since 1970 uh I don't get to do much of it at Intel 00:05:05.805-->00:05:11.378 unfortunately that was my first computer that I ever programmed there. Am- am I a hacker? Do I 00:05:11.378-->00:05:16.883 deserve to be here? Well, I wouldn't presume on the computer side but I have an interest in 00:05:16.883-->00:05:21.955 what you might call diagnostic hacking. Hacking the diagnostic process. And I wrote a book on 00:05:21.955-->00:05:28.428 that and I was a professor for a long time but uhhh you probably know me if at all from my work 00:05:28.428-->00:05:35.035 on House for 6 years where I was a consultant. And also on uh Torchwood Miracle Day, and umm 00:05:35.035-->00:05:39.539 I'll be consulting for a new show this fall on ABC called the Good Doctor. So tune in Monday 00:05:39.539-->00:05:44.544 nights. [crowd laughs] So today I wanna talk about uh epidemics and bioweapons. Talk about 00:05:46.580-->00:05:52.519 digital biology. Uhh show how exploits where they'll come from and then uh conclude with a few 00:05:52.519-->00:05:59.125 uh reflections. So uh bioweapons are actually amazingly effective and they date from ancient 00:05:59.125-->00:06:03.763 times. The Hippocratic Oath that all us physicians take that started because there was a 00:06:03.763-->00:06:10.637 doctor who told his his military commander how to poison a village and uh over run it. So 00:06:10.637-->00:06:17.544 uh in the middle ages the black plague killed about 25 percent of Europe's population. Smallpox 00:06:17.544-->00:06:23.350 killed about 95 percent of the Aztecs, that's why nobody in this room knows any Aztecs. 00:06:23.350-->00:06:27.887 Influenza as I mentioned killed uh 1 percent of the world's population and it went 00:06:27.887-->00:06:33.360 everywhere there were only 2 places on earth it didn't go. And even today we have an 00:06:33.360-->00:06:38.265 epidemic of small headed babies. I mean who would have thought such a thing is possible it 00:06:38.265-->00:06:43.803 turns out the Zika virus can do that. And uh no less than Bill Gates says "Of all the things 00:06:43.803-->00:06:48.975 that could kill more than 10 million people around the world, the most likely is an epidemic." 00:06:48.975-->00:06:53.980 So uh we haven't even started to see unnatural epidemics, just the natural epidemics. So this I 00:06:56.916-->00:07:01.855 saw an exhibit in uh Oxford England this is from a book published in 1625. And um when 00:07:04.324-->00:07:10.397 the black plague came through and so here you have obviously death and the population of the 00:07:10.397-->00:07:15.802 town we fly, they try to get out of the town you can see soldiers stop them. But even though they 00:07:15.802-->00:07:22.309 try to flee, death follows them and then we die. Here are the coffins. So that's what we're up 00:07:22.309-->00:07:27.314 against. And the effect of bioweapons can be long lasting. Um the Brits tested some anthrax 00:07:30.083-->00:07:35.388 in the world war 2 and the island where they tested it was uninhabitable for 50 years. 00:07:35.388-->00:07:40.760 Malaria has affected the evolution of multiple human genes, I'v got a gene that that 00:07:40.760-->00:07:46.566 I have only because um my ancestors survived malaria and they were good at it. And about 00:07:46.566-->00:07:53.473 8 percent of your genome started out in viruses. So the problem there the reason you haven't 00:07:53.473-->00:07:58.545 heard much about bio weapons when we talk about war fare is they've been held back by a 00:07:58.545-->00:08:03.817 pretty severe limitation which is a potential for blowback. If I use a bio weapon on some 00:08:03.817-->00:08:09.055 adversary across a border, that epidemic is probably gonna spread back and get me to so 00:08:09.055-->00:08:14.494 that doesn't make it a great weapon. There are international treaties that outlaw bioweapons 00:08:14.494-->00:08:19.499 but you know treaties are easily broken. So lets get now into um the exploits and and how they 00:08:21.968-->00:08:25.472 might work and how to think about them. The first thing to realize is what's called the 00:08:25.472-->00:08:31.211 central dogma of biology. You start with DNA and you make RNA out of that and then you make a 00:08:31.211-->00:08:37.384 protein. And the proteins are the real work horses of of life they do various jobs. Now if you 00:08:37.384-->00:08:42.922 wanna make a medicine today, you're usually making a medicine that attacks the protein and for 00:08:42.922-->00:08:48.661 you know just convenience we can call that analog therapy. Uh you know you des- design a chemical 00:08:48.661-->00:08:53.767 that fits into the protein or does something to it and this is pretty difficult and its 00:08:53.767-->00:08:59.139 imprecise, there's lots of cross reactivities across different proteins and that makes it hard 00:08:59.139-->00:09:03.843 to design safe and effective new medications. Its why drug companies spend so much money 00:09:03.843-->00:09:10.216 developing drugs because it's so difficult. So tomorrow though I think we're gonna see digital 00:09:10.216-->00:09:16.656 medicines, and we're starting to see a few. Remember RNA and DNA are digital programs, they're 00:09:16.656-->00:09:21.661 written not in binary but in uh quaternary code, A C T G A. Umm and there amenable to digital 00:09:25.732-->00:09:32.071 manipulation which means you can reprogram them and so this is going to allow an algorithmic or 00:09:32.071-->00:09:37.076 a digital design of medications. And the Cancer Moonshot which uh vice president Biden uh of 00:09:39.479-->00:09:45.418 course pushed is going to really uh drive these new technologies to manipulate DNA. Because 00:09:45.418-->00:09:50.423 cancer really is a disease of DNA. And if we get a good cancer uh mechanism er uh uh mechanism 00:09:53.126-->00:09:59.699 to combat cancer going uh using this root it's going to be exquisitely persp- sp- specific. 00:09:59.699-->00:10:05.205 Because cancer cells are not that different from normal cells. OK and just some of the 00:10:05.205-->00:10:09.509 th- um catch words you might have heard, some of these digital DNA technologies, 00:10:09.509-->00:10:14.647 there's something called RNA Interference which won a Nobel prize in 2006. You've probably 00:10:14.647-->00:10:20.253 heard about Crispr cas9 and uh for sure there will be a nobel prize for that some day. 00:10:20.253-->00:10:25.258 There're things called gene drives. Um spreading these um DNA programs can be done through 00:10:27.327-->00:10:34.167 measles virus let's say it's unbelievably contagious. Um and even nanodiamonds can be used to 00:10:34.167-->00:10:40.573 get uh viruses, er uh DNA into you. So what you could do with this sort of t-uh digital 00:10:40.573-->00:10:45.778 approach to DNA and RNA is you can do things like program in an if/then statement. And this is 00:10:45.778-->00:10:52.018 already happened uh in fact somebody programmed a 5 part predicate in here for the if 00:10:52.018-->00:10:58.358 statement. So far nobody I don't think is working too hard on th- or is is succeeded in the deploy 00:10:58.358-->00:11:04.898 payload part but the if part is is very uh well along the road. And this sort of construct is 00:11:04.898-->00:11:09.903 gonna be the key to biohacking. So um I'm from Intel we talk a lot about Moore's Law, but uh 00:11:12.539-->00:11:18.478 biotechnology is blowing Moore's law out of the water. Uh this graph here shows how much it 00:11:18.478-->00:11:24.317 costs to sequence a human genome, going back to I guess that about 2000 I cant read it. 00:11:24.317-->00:11:29.489 Uh and this uh lines this straight line is Moore's law and this is the cost of genome 00:11:29.489-->00:11:35.128 sequencing and you can see it is dropping way faster than Moore's law. So in 10 years we might be 00:11:35.128-->00:11:41.568 talking about a 10 dollar genome sequence. And uh you know these sort of uh if/then statements 00:11:41.568-->00:11:47.440 are gonna continue to um get better and better and so this whole talk was prompted by the 00:11:47.440-->00:11:52.145 question: "With this kind of exponential increase in biotechnology, with new things 00:11:52.145-->00:11:58.084 like Crispr, where is bio technology going to be in 5 years or 15 years?" And it's 00:11:58.084-->00:12:03.022 kinda scary because defensive technology always lags offensive technology. So um you know the 00:12:05.725-->00:12:11.431 Cancer Moonshot I would propose is dual use. Just like nuclear weapons and nuclear power are 00:12:11.431-->00:12:17.403 two sides of the same coin, the ideal cancer treatment some day is gonna be: the doctors gonna 00:12:17.403-->00:12:22.408 biopsy your tumor, get a sample, send it down to the lab, the lab will figure out the genetic 00:12:22.408-->00:12:28.881 syndrome, or the signature of your exact cancer tumor, then somebody will build a virus that 00:12:28.881-->00:12:33.886 using that if/then statement only targets the cancer cells in you. They'll put that virus 00:12:36.022-->00:12:42.195 inside you, you'll feel like you have a cold for a few days, and then that virus will go to work 00:12:42.195-->00:12:45.999 and tha- that's because the virus is going to work destroying your cancer, and then 00:12:45.999-->00:12:51.004 you'll wake up cancer free. That's a pretty good deal, we all want that to happen. But 00:12:51.004-->00:12:56.009 notice this exquisite targeting overcomes that big drawback against bio weapons. So the new 00:13:00.146-->00:13:06.919 technology is gonna allow incredibly targeted bio weapons. So think about 3 different axis. 00:13:06.919-->00:13:13.593 Who might you target? A specific tissue? That's what cancer does if that that cancer therapy. And 00:13:13.593-->00:13:19.599 if you wanted to edit an embryo uh as is just starting now, uh that will certainly come along 00:13:19.599-->00:13:25.371 too. But you could also target a family like the royal family, you could target a whole group 00:13:25.371-->00:13:30.877 of people, you could target an entire species so that's the who. Then there's the what you 00:13:30.877-->00:13:35.481 know if you're doing cures that's great but you know you might be making life 00:13:35.481-->00:13:40.286 inconvenient for somebody you might be giving them a disease, or you might be killing them. 00:13:40.286-->00:13:44.490 And then there's the when. And uh there's a very important factor here I'll talk about 00:13:44.490-->00:13:49.495 later too. So if you were gonna cause death in an individual well we'd call that 00:13:49.495-->00:13:55.935 assassination, or murder. If you were gonna cause death in an identifiable group of people, 00:13:55.935-->00:14:00.840 we'd call that genocide. And you might say "Well, why would we ever want to kill off an entire 00:14:00.840-->00:14:06.579 species?" If that species is the malaria parasite, or if it's the mosquito that carries Zika 00:14:06.579-->00:14:11.584 virus, or Yellow fever. You'd want to kill those off too. So certainly this part of the graph 00:14:13.753-->00:14:18.758 is uh in the sights of scientists working today. And so this talk is about what happens 00:14:22.128-->00:14:28.201 in this part of the graph. The technology is inevitable, let's remember that, everybody wants 00:14:28.201-->00:14:32.772 that cure for cancer. And so they're gonna be you know I think thousands of people down 00:14:32.772-->00:14:38.111 in the basement of hospitals doing these viral manipulations. This genetic program and that's 00:14:38.111-->00:14:43.116 a lot of power to put into those people. So what could happen? Umm let's talk about that. So 00:14:45.318-->00:14:51.357 first um let's talk about that "what" axis. The damage people could do. So I'm gonna use 00:14:51.357-->00:14:56.729 genetic diseases as a guidebook for exploits. And here I define disease as any kind of abnormal 00:14:56.729-->00:15:01.434 function in your body. So an exploit is anything that includes a genetic that induces 00:15:01.434-->00:15:06.472 a genetic disease. So here's an example. Here a rare genetic disease called Xeroderma 00:15:06.472-->00:15:12.879 Pigmentosum. Add this uh little girl has it and it's a defect of DNA repair that arises from a 00:15:12.879-->00:15:19.285 variant in the XPA gene, one of the 25 thousand genes that you have in your body. And these 00:15:19.285-->00:15:25.158 people are intolerant of sunlight. Every time sunlight hits your skin, it damages DNA. 00:15:25.158-->00:15:30.163 But your body repairs it. These people don't have that repair capability. So when they go out 00:15:32.932-->00:15:39.172 in the sun they will blister after a few minutes. OK now if you're hackers and you could 00:15:39.172-->00:15:44.544 deploy something like this worldwide, you know, why might you want to do it? Think about 00:15:44.544-->00:15:51.117 that for a few minutes and and I'll come back and and give you a suggestion. So there's lots of 00:15:51.117-->00:15:56.889 potential in our hu- human genomes to cause this kind of problem. This is um my mentor at 00:15:56.889-->00:16:03.596 at Johns Hopkins he was a terrific guy and back in the 1960s he started collecting 00:16:03.596-->00:16:10.069 every inherited trait that the profession of medicine could identify in humans. And uuh this 00:16:10.069-->00:16:16.175 is my copy of his book. Uh in 1990 that's the 1990 version and if you've read Moby Dick you 00:16:16.175-->00:16:22.949 know you can see that it's way bigger than Moby Dick. And that was in 1990. And since then the 00:16:22.949-->00:16:29.088 book got so big they couldn't publish it in hard copy anymore and this only goes up to 2004. 00:16:29.088-->00:16:33.926 And uh you know I think they just gave up counting at that point. So we know a lot about 00:16:33.926-->00:16:38.931 what happens in people's bodies. So within this book this big book of uh genetic umm ummmm 00:16:44.303-->00:16:49.075 susceptibilities in human beings there's a lot of stuff. And in fact there's some stuff worse 00:16:49.075-->00:16:53.679 than dying. And I and I call that hell. And and you don't want to know what that is. What 00:16:53.679-->00:17:00.186 could happen. So the question is really: "What happens in these 2 places?" So let's give some 00:17:00.186-->00:17:06.893 examples. So let's say you were a passionate animal rights person. And you didn't want 00:17:06.893-->00:17:12.465 people eating animals, you might be uh a passionate vegetarian as well. Well there's a disease 00:17:12.465-->00:17:17.837 called Ornitheintranscarbamolise defficiency which is in that big book, and it arises from a 00:17:17.837-->00:17:24.610 variant in the OTC gene. So if you could spread if you could mess up everybody's OTC gene 00:17:24.610-->00:17:29.448 across the world, all the sudden, almost nobody in the world could eat meat. That's 00:17:29.448-->00:17:36.022 something that as a an extreme vegetarian you might uh want to have happen. Let's say you 00:17:36.022-->00:17:41.093 believed in sexual chastity and you really wanted to punish people who were a little 00:17:41.093-->00:17:45.998 profligate, you could make everybody in the world hyper susceptible to Gonorrhea by 00:17:45.998-->00:17:51.003 messing with the C5 or the C6 7 8 or 9 genes. It'd cause lots of other problems, but you could 00:17:53.172-->00:17:59.145 you could make people really susceptible to Gonorrhea. Let's say I didn't want anybody at 00:17:59.145-->00:18:05.585 DEFCON to do a shot. And I wanted to make them intolerant to alcohol. I could screw with 00:18:05.585-->00:18:10.589 their ALDH2 gene or to go back to xeroderma pigmentosum if I wanted all women to be veiled 00:18:13.259-->00:18:18.264 when they went outside I could design something that would mess up the XPA gene only in women. 00:18:20.967-->00:18:25.972 Or if I wanted uh to uh blur the some of the distinctions between races I could um distribute 00:18:28.507-->00:18:34.747 genes or uh vectors that would cause skin color to change. If I'm a pharmaceutical company uh 00:18:34.747-->00:18:38.818 and I have a drug that treats some genetic illness, how great would it be if everybody in the 00:18:38.818-->00:18:44.991 world had that genetic illness? That would do wonders for sales. And let's say um you were once 00:18:44.991-->00:18:48.694 turned down for the astronaut program because you were colorblind, I don't know who 00:18:48.694-->00:18:54.300 that might be. But you're looking at him. [crowd laughs] And um [more laughter] let's say 00:18:54.300-->00:18:59.305 you wanted everybody in the world to be colorblind, then they couldn't turn you down. 00:19:01.807-->00:19:06.412 [crowd laughs] So there's more [clears throat.] Let's say I just don't want to um hurt 00:19:06.412-->00:19:13.285 people but I want to target national economies I have a a nat- uh an enemy an adversary 00:19:13.285-->00:19:19.158 and I know that it would bankrupt their economy to take care of epidemic expensive 00:19:19.158-->00:19:24.196 diseases. So there are ways that I could give people cancer, Parkinson's disease, Alzheimer's 00:19:24.196-->00:19:29.668 disease, cystic fibrosis, I could give everybody pain all the time. Or I could make them 00:19:29.668-->00:19:35.508 insensitive to pain, which, trust me, uh causes a lot of problems. I could immuno- 00:19:35.508-->00:19:42.448 compromise people or I could accelerate aging. Umm [clears throat] let's say I just wanted 00:19:42.448-->00:19:47.453 to impair uh do things to impair workers. I could give everybody narcolepsy. Um the face 00:19:49.722-->00:19:55.327 blindness syndrome is probably genetically deter- uhh mediated no one's discovered the gene 00:19:55.327-->00:20:01.734 yet. Or if I wanted to give a whole generation of children learning disabilities so um some 00:20:01.734-->00:20:08.040 country couldn't compete against me, I could do that. [breathes][sucks teeth] Let's 00:20:08.040-->00:20:14.013 say I just objected to se- to a life style. Um you know I could make everybody deaf or blind and 00:20:14.013-->00:20:19.452 look at this there are 540 genes that goes into our that go into our hearing process and 600 00:20:19.452-->00:20:25.391 genes that go into vision. Could make everybody night blind, interfere with taste and smell, 00:20:25.391-->00:20:30.730 and destroy uh a big industry right from that. There are genetically des- er mediated 00:20:30.730-->00:20:36.535 diseases that make you die from excitement, these are cardiology diseases actually. And then 00:20:36.535-->00:20:41.540 there are diseases of physical fragility. OK, we've got a few more. Uh epidemic micropenis, 00:20:43.576-->00:20:49.248 ummm [crowd laughs]. Epidemic erectile disfunction, or you could make everybody uh hyper 00:20:49.248-->00:20:54.286 libidinous. You could I think I couldn't quite find the gene but I'm sure this is genetically 00:20:54.286-->00:20:59.625 determined somehow, uhh you could fix it so a nation just became a nation of sons or a 00:20:59.625-->00:21:05.397 nation of daughters. Um there are reports that uh certain organizations uh were looking to 00:21:05.397-->00:21:10.703 try to change the sexual preference of their adversaries and uh you could sterilize an 00:21:10.703-->00:21:17.676 entire population. Uh let's say I just wanted to mess with some politicians and you know I could 00:21:17.676-->00:21:24.550 make somebody go totally bald or I could give them a really bad fishy odor and that is actually 00:21:24.550-->00:21:30.089 an incredibly tough disease to have. It's caused by this TMAU gene because there's no 00:21:30.089-->00:21:34.527 treatment for it and it's impossible to disguise the odor and those people have a very 00:21:34.527-->00:21:39.832 difficult time socially. Uh I could give somebody intractable diarrhea, cause them massive 00:21:39.832-->00:21:44.904 weight gain, or um you know in some forms of Tourette's syndrome which is mediated by 00:21:44.904-->00:21:50.009 this gene, people uh involuntarily uh emit obscenities, so that would be uh 00:21:50.009-->00:21:55.147 interesting in a politician. I put this in before uh Mr. Scaramucci started [crowd 00:21:55.147-->00:22:00.886 laughs] his work, so. [laughter and applause] We might have to cross it off the list. [crowd 00:22:00.886-->00:22:06.992 laughs] OK that's the what. Umm we talked a little bit about the population um I would recommend 00:22:06.992-->00:22:12.998 keeping your genome secret, ummm so you know we talked about the royal family and you know you 00:22:12.998-->00:22:17.636 could get just uh DNA from one member of the royal family and and you could then target the 00:22:17.636-->00:22:24.043 whole family. Um you know this word "race" is uh very squishy, but if you use it to mean any 00:22:24.043-->00:22:29.882 observable physical characteristic defines a race, then um you know it it becomes 00:22:29.882-->00:22:34.386 possible to think about in a sort of rigorous way. So for instance um there's a gene 00:22:34.386-->00:22:39.391 called EDAR and 87 percent of asians have that. And um you can exclude asian descent in nearly 00:22:42.127-->00:22:48.133 100 percent of europeans and africans by looking at this one gene. So if you wanted to do uh 00:22:48.133-->00:22:53.138 racial elimination um EDAR is a good place to start if this is your target. So obviously this 00:22:55.174-->00:23:01.213 is very dangerous if used by hate groups. And then there are easy ways to identify uh genetic 00:23:01.213-->00:23:06.785 males and genetic females, which of course is genetic. Umm you know identifying ethnic groups 00:23:06.785-->00:23:13.325 is a little tougher. Uh you know Tay Sachs disease tends to run in umm the Ashkenazi jewish 00:23:13.325-->00:23:19.265 group. But even there it its not very good uh quote unquote, if uh you're using it to target 00:23:19.265-->00:23:25.170 them. So that may be sort of a a blessing you know interbreeding uh is is helpful. Umm and we 00:23:25.170-->00:23:31.543 talked about species, uh you know if you're a dog person and you want to wipe out cats you 00:23:31.543-->00:23:38.284 can do that or vica versa. Uh you could wipe out uh food sources. And you know if you um 00:23:38.284-->00:23:44.590 wanted to kill a wine crop uh if you're from Napa and you wanted to kill the French wine industry 00:23:44.590-->00:23:51.163 uh you might be able to do that. So let's talk about time. Um you know I think it's possible to 00:23:51.163-->00:23:55.634 build binary weapons, so you insert one thing but the bad thing doesn't happen until a 00:23:55.634-->00:24:01.240 second agent is exposed. But the really interesting thing about time is yeah I could do 00:24:01.240-->00:24:07.179 something to everybody who is living here and make some of you sick or whatever but if we can 00:24:07.179-->00:24:12.184 get that gene change into the cells that make sperm and ova, then it's in human beings umm in 00:24:16.689-->00:24:21.694 perpetuity until somehow they all get fixed. Umm so this is just the RNA and the DNA part 00:24:25.397-->00:24:31.870 you know there's a whole nother field called epigenetics and epigenetics is way the 00:24:31.870-->00:24:37.142 environment umm signals in the environment are transmitted to your genome. So for example if 00:24:37.142-->00:24:42.681 you moved to Denver where the air is thin where there's not much oxygen, somehow that signal 00:24:42.681-->00:24:48.587 has to get from the oxygen in the air into your genome so that you can make more red blood 00:24:48.587-->00:24:55.361 cells. So there're gonna be I think a whole host of epigenetics uh exploits that uh 00:24:55.361-->00:25:00.366 I really haven't started to think about too much. Umm and then uh targeting based on the 00:25:00.366-->00:25:05.371 microbiome uh would also be uh possible. So uh to summarize, you know a lot of this is 00:25:08.073-->00:25:13.078 possible now, some of the these engineering um angles but it's very difficult. And so not many 00:25:15.214-->00:25:21.387 people can do it. But um with the progress that we all hope the cancer moonshot will make, 00:25:21.387-->00:25:26.859 its gonna get easier and easier to do these kind of things. And then when it's to the point that 00:25:26.859-->00:25:31.864 thousands of people can do this sort of stuff, we have a real problem. So um my first uh 00:25:35.968-->00:25:41.807 statement to you is: don't do this stuff. Umm there's there's just no point in doing that. 00:25:41.807-->00:25:45.878 Yeah we know it can be done, you're not showing anybody you're smart if you do this. Uh 00:25:45.878-->00:25:50.883 but if you have a chance to talk about this problem with policy makers uh do that. Um you know 00:25:53.051-->00:25:57.156 if this group gets scared because not much scares this group, but if this group gets 00:25:57.156-->00:26:01.894 scared, I think that'll get their attention. Or get involved more directly. Go into 00:26:01.894-->00:26:07.266 bioscience yourself and uh try and put your digital way of thinking to work in trying to 00:26:07.266-->00:26:12.738 build the defensive technology for this. I don't have all the answers that's for sure, so we 00:26:12.738-->00:26:19.445 need a lot of help. What I would tell the policy makers to do is to, and and this is very 00:26:19.445-->00:26:22.681 difficult for them its essentially saying "You have to start working on defensive 00:26:22.681-->00:26:28.854 technology for an offensive technology that isn't here yet." But the goals are really quite 00:26:28.854-->00:26:33.492 laudatory in a sense that the first step is to figure out how to cure every infectious disease 00:26:33.492-->00:26:38.997 known to science. And you'd want to do that using some sort of digital technology. And that 00:26:38.997-->00:26:44.369 alone would create the largest amount of wealth that I think uh the world will have ever seen 00:26:44.369-->00:26:49.541 when you think about how much infectious disease costs mankind and and how much people would 00:26:49.541-->00:26:54.546 pay uh not to get infected. Um but that's only the first step um because there're gonna be 00:26:57.716-->00:27:02.187 unnatural infectious diseases that people will build and so we're gonna have to develop an 00:27:02.187-->00:27:07.192 infrastructure that will be able to detect new agents and then characterize the infection, 00:27:09.862-->00:27:15.300 devise a countermeasure, produce the countermeasure, produce the countermeasure in millions or 00:27:15.300-->00:27:21.173 billions of doses and then distribute it across the world, and oh yeah, probably within a 00:27:21.173-->00:27:27.880 month or a couple weeks, of the time the disease is detected because that's how long it takes 00:27:27.880-->00:27:34.686 you know a disease that we get here could go everywhere in a couple weeks. And you know, not 00:27:34.686-->00:27:39.691 too long ago uhh in- infections were of a magnitude that we can hardly believe today. In 1947 00:27:41.727-->00:27:48.233 New York vaccinated 6 million people in 4 weeks against smallpox. So I don't think this 00:27:48.233-->00:27:53.205 is necessarily impossible, I think it's harder than a moonshot, it's like a Mars shot 00:27:53.205-->00:27:59.611 though. If you're interested in this and you want to get more motivated or maybe I should say 00:27:59.611-->00:28:04.917 if you're not interested and you think "Uh is this guy up here talking crazy?" um this is a 00:28:04.917-->00:28:09.922 novel that was published in the 1990s and um it is a terrific novel just on its own merits but 00:28:13.158-->00:28:17.829 eh in the introduction the author says uh "All the science is in this novel is true except 00:28:17.829-->00:28:22.801 for 3 things, and I'm not gonna tell you what they are." So that's what the author said, so 00:28:22.801-->00:28:28.507 uh read it and and have a good time and think about it. And then finally thanks for sticking 00:28:28.507-->00:28:33.645 around today toward the end of the conference and hearing um remember that uh as we leave the 00:28:33.645-->00:28:39.985 conference we're gonna go back all over the world so it's a pretty good thing that we're not 00:28:39.985-->00:28:44.990 carrying any bad bugs with us. Thank you very much. [crowd applause] Uhh, John, do I have 00:28:53.298-->00:28:58.804 time for questions? Where's John? >>Yeah you do. >>OK. Do they go to the mics? Whats they 00:28:58.804-->00:29:03.742 uh..: >>Yeah >>Routine here? >>If you've got a question, come to me. >>Thanks. So I think one 00:29:27.833-->00:29:32.504 of your colleagues just tweeted that you said "Don't share your genome." And I'm wondering how 00:29:32.504-->00:29:39.444 you see reconciling that with doing the research that's needed to better understand genomic 00:29:39.444-->00:29:46.018 medicine and also to treat people genomically, presumably for me to get that precise 00:29:46.018-->00:29:52.190 treatment I'm gonna have to share my genomic information. >>Yeah, if you've got a genetic 00:29:52.190-->00:29:57.863 disorder umm you have approximate threat to your existence and to your life and 00:29:57.863-->00:30:03.168 so there the balance would tip towards sharing the genome so thank you for asking that. 00:30:03.168-->00:30:08.807 That's worth a clarification. Everything in life is a risk benefit balance and so I would 00:30:08.807-->00:30:13.812 say umm don't share your genome without reason. Without good reason. >>Hey um so attribution 00:30:18.650-->00:30:22.954 is a famously challenging problem in computer security, determining the wh- the origins 00:30:22.954-->00:30:27.492 of malicious software. I was wondering if there is any current work that you know of 00:30:27.492-->00:30:32.698 going on around um watermarking these modifications to genomes or other techniques that could 00:30:32.698-->00:30:37.703 be used to trace their source and their progress. >>I I couldn't understand that 00:30:37.703-->00:30:38.937 question. I mean >>Oh 00:30:38.937-->00:30:43.909 >>>Talk a little slower. >>Sorry, heh [crowd laughs], um so so attribution is this famous 00:30:43.909-->00:30:47.713 problem in computer security like um when a... >>Oh >>..malware spreads around the 00:30:47.713-->00:30:49.047 world... >>Yeah >>...where did it come from? 00:30:49.047-->00:30:53.185 >>>Yeah >>...was it Russia? Was it China? You know? >>Yeah >>Um and so what I was wondering is 00:30:53.185-->00:30:58.824 is there any current work happening in genomics that you know of umm around developing 00:30:58.824-->00:31:05.030 ways to uh watermark or otherwise umm annotate these modifications so that you can 00:31:05.030-->00:31:09.735 determine where they came from and how? >>Uh that's an interesting question . So uh no 00:31:09.735-->00:31:15.540 I haven't heard of that you know um the whole science of epidemiology uh focuses on where 00:31:15.540-->00:31:21.813 did things where did infections come from? How did they spread? And that's been very difficult 00:31:21.813-->00:31:28.587 over the hundreds of years that epidemiology has been a science. And even when we look in genomes 00:31:28.587-->00:31:33.592 we can get some help so uh but but not the kind not the kind of help that you want. So I can if 00:31:37.028-->00:31:42.033 I gave you influenza um the match between our two viruses would be like 100 percent minus 00:31:45.771-->00:31:50.776 epsilon. Some really small number. But if he got influenza from somebody in Portugal it 00:31:53.745-->00:31:58.750 would still be Influenza A an H1 or whatever but his difference between your 2 influences would 00:32:01.586-->00:32:06.591 be bigger. So you can do some sort you can do tracing that way uh but you can't go and say "Oh 00:32:09.694-->00:32:14.699 it's started in you know the Amazon jungle." or anything like that. >>[off mic] If you could 00:32:16.802-->00:32:20.605 [unclear] you could like actually code that genome. Like you could code [unclear] >>So 00:32:20.605-->00:32:26.978 the question is about in coding uh signing modifications uh that you put into the genome sure. 00:32:26.978-->00:32:31.983 There's lots of room in the cell you can add a few more uh DNA base pairs um that you know 00:32:34.319-->00:32:39.324 somehow you would claim or something like that and and put a signature in there. >>Thanks. 00:32:41.660-->00:32:46.665 >>So, I'm thinking a little bit about data archiving. In long term data archiving large 00:32:50.268-->00:32:55.273 amounts of data um one of our primary concerns is bit rot. And and so we so we check that 00:32:58.443-->00:33:04.082 frequently and then readjust it from available sources. I'm wondering if it- it would be 00:33:04.082-->00:33:09.087 reasonable to think about the DNA umm in an archiving maybe personal archiving sort of like 00:33:12.023-->00:33:18.630 backing it up where then with frequent checking you could find something that had gone awry and 00:33:18.630-->00:33:23.635 then essentially restore it by doing it. >>Yeah. [chuckles] Do you have an identical twin? >>No 00:33:26.004-->00:33:32.510 >>Too bad. [audience laughs] Umm so [more laughter] Uhh yeah identical twins are are great 00:33:32.510-->00:33:39.384 great for that kind of backup well. You know uh for cancer umm eeh you know there there's 00:33:39.384-->00:33:45.557 another way which is um se- er cord blood. You know when babies are born they have the umbilical 00:33:45.557-->00:33:50.562 cord and nowadays you can snip that umbilical cord and put it in a freezer and uh that thing 00:33:53.732-->00:33:58.737 is that cord the blood in that cord is loaded with stem cells. And ummm you know if you get a 00:34:01.006-->00:34:07.279 leukemia later you can go back to the cord blood and you have a sample of blood there that is 00:34:07.279-->00:34:12.884 essentially the backup you're talking about there's no leukemic cells in it. Umm you 00:34:12.884-->00:34:17.856 know that was sort of the rage a few years ago I don't even know the technology may have passed 00:34:17.856-->00:34:22.861 that by, I can't say, but you know just from a um from a sort of IT perspective if you put 00:34:25.163-->00:34:30.168 your entire genome in some digital format and put it on a hard drive or something umm the 00:34:32.470-->00:34:38.276 question is how do you restore from that backup? So you know they're several trillion cells 00:34:38.276-->00:34:43.949 in you and that's the worst case scenario is you'd need to get that backup into every one of 00:34:43.949-->00:34:48.853 those cells but if it was the sort of thing where you got leukemia and they were saying: 00:34:48.853-->00:34:53.858 Hey we can't find any non leukemic cells in your blood to do a transplant, a bone marrow 00:34:53.858-->00:34:59.931 transplant on you maybe someday in the future you could go back to that digital backup ,build 00:34:59.931-->00:35:04.869 some cells with your correct DNA and then infuse those into you. >>Regarding your uhh device to 00:35:10.842-->00:35:15.847 work on contra measures umm working on contra measures means to go through the same 00:35:19.551-->00:35:24.556 technology because if we need to fix the- um actually is easier to break then to fix so the 00:35:27.826-->00:35:32.831 whole genetic therapy it- it- it's a bit old and but it's really declined because its 00:35:35.834-->00:35:41.706 really very difficult to fix stuff...to break is... >>Yeah yeah that's why defensive 00:35:41.706-->00:35:47.746 technology tends to lag behind offensive technology. But I would say there there's still 00:35:47.746-->00:35:54.719 ways you could do it. So let's say Crispr turns out to be the former Director of National 00:35:54.719-->00:36:01.192 Intelligence for the United States called Crispr a weapon of mass destruction. So if just 00:36:01.192-->00:36:06.131 working on anti-Crispr technology for instance might be a way to go. So that you know 00:36:06.131-->00:36:12.370 whatever program is embedded in some sort of Crispr implementation if you ca- had a 00:36:12.370-->00:36:17.375 way to kill the Crispr part umm that would be potentially in some situations useful. Umm and 00:36:20.678-->00:36:26.618 the same thi- you know but I think Crispr might be kind of easy. Other things like RNA 00:36:26.618-->00:36:31.322 interference that might be really hard to develop countermeasures for that. But 00:36:31.322-->00:36:38.229 that that's what I was thinking when I made that statement. >>Hey. So I've noticed a recent 00:36:38.229-->00:36:41.433 rise in popularity of these ser... >>Talk slower, 'cause >>Oh my apologies >>Yeah, 00:36:41.433-->00:36:45.804 'cause... >>So I've noticed a recent rise in popularity of these services where say they'll 00:36:45.804-->00:36:50.508 send you a vile, uh you spit in it, you send it back, they give you information on your genome. 00:36:50.508-->00:36:54.879 I've seen uhh a lot of uh educational channels on youtube encouraging people to go out and 00:36:54.879-->00:36:58.917 do this. Uh and it seems quite an interesting thing to do if not something uh information 00:36:58.917-->00:37:03.321 that would be good to know. However I worry about the security of these sort of uh, of 00:37:03.321-->00:37:08.093 these sort of organizations. Are they selling my data? Um what government organizations? Uhh 00:37:08.093-->00:37:13.098 wh- what would your advice be for the security of these? Where do you think uh how do you think 00:37:13.098-->00:37:18.336 we could make sure that uhh our data isn't being sent out? Uh should we discourage family 00:37:18.336-->00:37:22.907 members and friends from using these? That sort of thing? >>Yeah I think it comes back to 00:37:22.907-->00:37:28.813 a bit of what the first questioner asked was the risk benefit trade off. So if you 00:37:28.813-->00:37:35.553 have a medical condition where you think your care could be improved if the full genome were 00:37:35.553-->00:37:40.558 known, ok I can see that. But if you're trying to figure out whether you're Lithuanian or 00:37:43.828-->00:37:48.833 Greek or something else, you know, who cares? Ummm [audience laughter] Soo [scattered 00:37:59.511-->00:38:01.713 applause] [laughs] [applause] And you know I had a friend do that and he found out that his 00:38:01.713-->00:38:06.718 father wasn't his father so you know you really can't get great news from it. But you know 00:38:10.688-->00:38:15.527 [audience laughs] ehh eehh it what I worry about as a physician is let's say there are 00:38:15.527-->00:38:19.664 5 thousand diseases that are mediated by genetics. There are probably more but lets say there 00:38:19.664-->00:38:25.270 are 5 thousand. And let's say some day you get a report back that lists your risk for all 00:38:25.270-->00:38:30.241 those diseases. Well you're gonna be at above average risk for 25 hundred diseases, just 00:38:30.241-->00:38:35.747 statistically. And so if you come in to see me and I'm your doctor and you start talking 00:38:35.747-->00:38:41.386 about 25 hundred diseases that you're at risk for, I have no time to talk to you about 00:38:41.386-->00:38:47.392 anything else. You know, I know that getting your blood pressure down by 10 points is gonna ss- 00:38:47.392-->00:38:51.930 extend your life by so many years or helping you to quit cigarette smoking is gonna 00:38:51.930-->00:38:58.369 extend your life by 10 years. So you crowd all of that out for this information that really 00:38:58.369-->00:39:05.310 isn't helpful. So uh that's that's what I would think about. Medicine is very aggressive in 00:39:05.310-->00:39:12.050 the sense that you know if if we have a way to decrease your risk of disease um we'll develop 00:39:12.050-->00:39:15.987 screening technologies around that. But if we don't have any way to decrease we don't have a 00:39:15.987-->00:39:20.291 way to decrease your risk of rheumatoid arthritis your risk of psoriasis or anyth- anything 00:39:20.291-->00:39:26.464 like that so there's no point umm in a preventative way of of coming of getting tested for 00:39:26.464-->00:39:31.469 that and coming to talk to me about it. >>Thank you >>Mmm-hmm >>So the topic has come up a 00:39:33.838-->00:39:39.844 couple times now that... >>Slower, yeah cause my there yeah >>That it's easier to crash 00:39:39.844-->00:39:44.682 a human than fix it. {clears throat] The number one problem with gene therapy that we've 00:39:44.682-->00:39:49.120 observed from our historical data is random insertions into the genome that lead to 00:39:49.120-->00:39:53.958 different errors that are actually much more catastrophic than the error you were trying 00:39:53.958-->00:39:58.963 to fix. So is anyone working on how you would be able to have a defensive strategy to not have 00:40:01.399-->00:40:06.404 that happen? Because in its current state gene therapy is kind of like playing russian 00:40:06.404-->00:40:12.977 roulette. >>So [clears throat] um let's go back to that big thick book that I showed a 00:40:12.977-->00:40:19.651 picture of. Most of the diseases in there are single gene diseases. Uhh like that 00:40:19.651-->00:40:24.656 xeroderma pigmentosum that's one gene. But if you look at what humans tend to suffer from: 00:40:26.991-->00:40:33.064 obesity, alzheimer's disease, anthroscoladic heart disease, you know the common stuff, those 00:40:33.064-->00:40:39.904 are multiple gene diseases. And so umm it's there are almost like two different sets of 00:40:39.904-->00:40:46.144 targets. The single gene diseases we understand how to find em and we understand how 00:40:46.144-->00:40:51.416 repair would occur theoretically. The multiple gene diseases and I think this is 00:40:51.416-->00:40:56.421 what you're saying are much more mysterious .You know if there are 640 genes that go toward 00:41:00.024-->00:41:05.930 making your visual system work correctly, uh thats a bad example. If there are 50 genes 00:41:05.930-->00:41:12.537 that are involved in umm atherosclerosis you know when you start tweaking one its gonna 00:41:12.537-->00:41:18.676 have a bunch of other effects and your not gonna maybe find a big effect from any one gene so 00:41:18.676-->00:41:24.248 now you're talking about diddling with multiple genes and so that's really hard and that's 00:41:24.248-->00:41:29.620 gonna be quite a ways in the future. Is is that what you're asking about? >>Uhhh >>Cause 00:41:29.620-->00:41:34.225 this you you mentioned like stop codons and things like that that's sort of the single gene 00:41:34.225-->00:41:40.131 disease. >>Yeah it doesn't matter how many genes are involved in the disease. If you 00:41:40.131-->00:41:47.071 introduce something into the code that was external so you downloaded information and it 00:41:47.071-->00:41:53.344 went to the wrong file... >>Mmm >>...and it caused an error that was significantly worse than the 00:41:53.344-->00:41:58.349 original error, the best case was a single gene gene therapy approach the genes randomly 00:42:00.451-->00:42:05.390 inserted into the genome and caused leukemia in most of the patients in that population. 00:42:05.390-->00:42:10.027 >>Yeah so that's gonna be part of the safety and efficacy evaluation of any new 00:42:10.027-->00:42:16.834 therapeutic that comes out. So you know the first gene therapy efforts umm didn't work. You 00:42:16.834-->00:42:23.307 know it it caused harm but lessons were learned from that and so it's getting better. So 00:42:23.307-->00:42:28.913 uhh like an earlier questioner said, it's always easier to break something than to fix 00:42:28.913-->00:42:33.684 something. And any attempt to fi- every attempt to fix something you know you have to 00:42:33.684-->00:42:38.356 be prepared for unintended consequences. And so its just gona be a matter of ref- 00:42:38.356-->00:42:44.429 refining techniques. Your point is well taken uhh but medicine is is pretty used accustomed to 00:42:44.429-->00:42:49.434 trying to work out what the adverse effects of any therapy are. >>Mmmm one final comment on 00:42:51.836-->00:42:56.841 that. Do you think it would be a bit more responsible to target something that's not the 00:43:00.111-->00:43:05.116 equivalent to the source code? >>Umm well that might be like the microbiome because if you 00:43:09.187-->00:43:15.793 screw up your microbiome in some terrible way you can always flush it out and load and reboot 00:43:15.793-->00:43:21.799 essentially by eating the feces of some other person and uhh you're good to go. [crowd 00:43:21.799-->00:43:25.870 laughs] >>That would be a much better approach. >>OK I'll put you down for the feces eating. 00:43:28.539-->00:43:32.777 [audience laughs] >>Huh that was the most scientific way I've ever seen somebody put down a 00:43:32.777-->00:43:37.782 question. That was amazing. [audience laughter] >>Uh close- eh closely related to the uh 00:43:42.286-->00:43:47.291 last question, eh would there be a way or is there any research going towards ehh basically 00:43:50.661-->00:43:55.666 locking the editing of the genetic sequence. >>Yeah >>Turn evolution into something purely 00:43:59.971-->00:44:05.510 directed that would be the int- the there would be no more natural vectors of evolution if 00:44:05.510-->00:44:10.515 we did that but it would secure the uh the the the whole code. >>Uhh I that that's a very 00:44:13.351-->00:44:19.490 interesting idea. I I don't think there's any work going on that. Uhhh I wouldn't know how 00:44:19.490-->00:44:24.495 to implement that. Umm you know there there's 6 uh billion uh between the 2 parents 00:44:26.998-->00:44:32.003 contributions that're fff- billions of base pairs and so you know we have uh the 2 rungs 00:44:35.306-->00:44:42.113 of the double helix which uh provide some measure of error correction in there and it is 00:44:42.113-->00:44:47.118 possible to build a triple helixes using not DNA but there's now uh new kinds of NAs, 00:44:50.254-->00:44:55.993 XNA, and you can build triple helixes so you could actually umm increase the error 00:44:55.993-->00:45:00.565 correcting capabilities but then I think you've got something that's not a human at that 00:45:00.565-->00:45:05.570 point. Because ummm it's just so different from us. >>[inaudible] ...we gotta get through...ok 00:45:08.139-->00:45:13.144 >>Hi there how are you doing? Uh so I have 2 questions, 1 is pretty quick. Umm you talked 00:45:16.414-->00:45:22.553 about changing some physical traits about people to target certain groups. But how complex 00:45:22.553-->00:45:28.025 do you think we could uh develop that technology? Such as if someone has a birth defect where 00:45:28.025-->00:45:34.131 there fingers may not grow properly do you think we would be able to correct that and then 00:45:34.131-->00:45:40.404 through there uhh I guess preteen years when their bodies are developing more they would 00:45:40.404-->00:45:45.409 be able to grow proper fingers, I guess? >>So uh there are a lot of people working on that. Umm 00:45:47.979-->00:45:53.551 you know there are some malformations that occur not because of problems in the 00:45:53.551-->00:45:59.624 genetic code but because of environmental influences. So if you have an encounter with a 00:45:59.624-->00:46:04.562 chainsaw you know you could end up with a uh an abnormality in your anatomical structure. So um 00:46:08.499-->00:46:14.605 you know I had a friend who um found out that the tips of your fingers, the skin on the tips 00:46:14.605-->00:46:20.311 actually regenerates and so he took this as part of his research to figure out if he 00:46:20.311-->00:46:26.784 could expand that regenerative capac- uh capacity beyond your fingertips to the to other parts 00:46:26.784-->00:46:32.390 of your body. Uh he didn't win a Nobel prize so I'll I guess it didn't quite work as well as as 00:46:32.390-->00:46:37.128 we might hoped. But there there's a tremendous amount of work in that going on. >>Thank 00:46:37.128-->00:46:42.733 you >>We got time for one more... >>Okay >>...question. Sorry. >>Hey >>Ex- excellent 00:46:42.733-->00:46:47.138 talk, I just wanted to start by thanking you for scaring the ever loving s**t out of all of 00:46:47.138-->00:46:52.143 us.[applause] Umm because frankly that needs to happen if we're going to avoid this 00:46:55.780-->00:47:00.451 terrible future that you've described. Crispr is the new kid on the block but I think of 00:47:00.451-->00:47:04.655 Crisper as like a root kit that's just really good at doing advanced things but it's the 00:47:04.655-->00:47:10.094 spreading mechanism that frankly mother nature has been giving us for millennia that's the real 00:47:10.094-->00:47:15.099 problem to address. So my question is umm are Intel or the DoD or other organizations that 00:47:17.635-->00:47:22.306 have the resources to tackle this developing the equivalent of biological intrusion 00:47:22.306-->00:47:27.311 detection systems that can sample airborne or or human spreading epidemics through 00:47:29.547-->00:47:35.252 urban population centers to very quickly identify that spreading vehicle? >>So that's a great 00:47:35.252-->00:47:40.825 question. Umm there there's sort of 2 mechanisms one is the science of epidemiology which 00:47:40.825-->00:47:45.830 I've already talked about and of course that is limited uh you know it started in the ss- 1700s 00:47:47.932-->00:47:54.672 or 1800s and we still use the basic same mechanisms. Um on the technology side the Centers for 00:47:54.672-->00:47:59.677 Disease Control has something called a biowatch program which is these today these big carts 00:48:01.879-->00:48:07.485 umm so the San Francisco uh San Francisco area hosted the super bowl last year and on the 00:48:07.485-->00:48:12.823 sidewalks in San Francisco these carts appeared and they have you know sort of a smoke stack and 00:48:12.823-->00:48:18.129 they basically sniff the air and they bring the air into the business part of the cart and 00:48:18.129-->00:48:24.168 with today's technology it's just deposited there and a human comes by, picks up the samples, 00:48:24.168-->00:48:30.441 takes 'em back to a lab and does some PCR some genetic analysis on it. So the CDC tried to 00:48:30.441-->00:48:35.446 develop a ss-second generation of this cart and the program was not successful. And so right now 00:48:38.115-->00:48:43.120 it's in hold as to what to do. Umm you know my idea is that umm when you go into an emergency 00:48:47.591-->00:48:53.264 room and they draw some blood from you and send it for the lab, the blood in that tube uh 00:48:53.264-->00:48:59.370 90 percent of it is thrown away cause it's more than they need. So why not take that blood and 00:48:59.370-->00:49:04.308 throw it into a big vat and once a day just sequence the crap out of all that blood that comes in 00:49:06.310-->00:49:11.315 and send that immense amount of data down to the CDC in Atlanta and that would give them really 00:49:13.684-->00:49:19.857 I think a national picture in real time of what's coming into the emergency room at a genetic 00:49:19.857-->00:49:25.262 level. So I I think that would be kind of a first step on um a new generation of bio 00:49:25.262-->00:49:30.267 surveillance. >>Uh one one for you this is quick. Is it lupus? >>Ha ha ha ha. It's never lupus. 00:49:42.713-->00:49:46.350 [applause] >>Yes! [audience laughs] [applause]