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about innovators, both in business and real life.
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Hi, and welcome to another episode of the Innovation
Conversation. Today we are joined by Dr. Georgia
Fleet and Carla Southworth. Welcome to the podcast.
Thank you. Thank you for having us. Should I
say ladies? I'm not sure that's a bit pretentious.
Would you like to please go and introduce yourself
to the audience? So, yeah, my name is Georgia.
I am the co -founder and CEO at Zonova. My background
is primarily that I am a scientist. I've had
a bit of a weird and wonderful background of,
you know, different types of experiences. But
yeah, we founded Cinova back in 2023. Yeah, we're
really excited to be speaking with you about
it today. Carla, what were you doing in Cinova?
Sorry, and I'm Carla. I have backgrounds in NHS
healthcare, 12 years working across various different
sectors. met George a couple of years ago and
then the rest is history. Interesting. So what
does Sinova do? So we are a medtech startup and
what we have developed is a novel antimicrobial
technology that we incorporate into medical devices.
So that's a bit of a mouthful but effectively
what we do is we make medical devices that are
used every day in hospitals so things like IV
cannulas, catheters, endotracheal tubes, those
types of medical devices that are associated
with infections. We just reduce the risk of that
by adding our novel antimicrobial technology
into it. Isn't that already antimicrobial? I
would assume you already have some protection
in those things, or just plain plastic? No, these
devices are all just polymers, so they're all
just flexible plastic tubing. And, you know,
these devices are used every day. They're really
common, you know, into the billions used annually
across all these different types of devices around
the world. And, yeah, they have really high infection
rates. You know, the surface of the device itself.
provides a really nice environment for bacterial
biofilms to grow. And basically, the longer they're
in the body, the higher your chances are of that
infection. So, you know, with long -term intubated
patients, for example, you see that infection
risk go up quite significantly. And urinary catheters
as well, especially the indwelling ones. I think
there was a CDC, part of the CDC website that
says, you know, 75 % of catheterized patients
will experience urinary tract infections, so
UTI. That's horrible. 75 % is super high. Yeah.
I think obviously in terms of the reporting and
the data available, you know, those figures do
vary and they vary across regions and different
areas of the world as well. But yeah, it's a
huge problem. And at the moment, the only solution
is just to treat it with antibiotics. But, you
know, obviously as the antimicrobial resistance
crisis worsens, we have fewer and fewer options
available effective. antibiotic. What prompted
you to come up with the idea? Pardon? What made
you come up with the idea? Oh, so this health,
how long and far back do you want me to go with
this one? Anytime. Okay, so this all really came
about during my PhD. So I started my PhD in 2018.
So pre COVID. And I was actually supposed to
be doing my PhD something on like dental care
or oral health care. but quickly found myself
looking into hospital -acquired infections. So
that is those types of infections that you get
as a result of being in hospital. So, you know,
a large portion of those are device -related.
And the one that really struck me actually was
ventilator -associated pneumonia. So those are
the infections associated with being on a ventilator.
So that specifically is the endotracheal tube.
So when you're intubated and you have that tube
kind of here accessing the lungs, That is the
tube that often gets pretty disgusting over the
course of intubation with bacterial biofilms.
What I was reading was that because the nature
of intubation provides this direct access into
the lungs, you get really serious cases of pneumonia
and actually a really significant portion of
patients that are ventilated die from these secondary
infections and not from what they were put on
the ventilator in the first place for. And so
for me that was really shocking and that's kind
of what got me into this specific area of medical
devices and the associated infections. And then
that was confirmed when I'd spoken to a critical
care consultant at a hospital nearby and he was
saying that he thinks actually his leading cause
of death in his unit were as a result of these
secondary infections. Yeah, really huge problem
and it just seemed really crazy to me and completely
unnecessary that you have these really high mortality
rates from just being in hospital and the devices
that you have to use. Obviously not ventilating
isn't an option either. If you're put on a ventilator,
there's no other choice. So yeah, that's when
I set out to make the tubing itself antimicrobial
to try and reduce the risk of these infections
and ultimately, hopefully, better patient outcomes.
So yeah, that was what my entire PhD was focused
on. And, you know, effectively I did it. You
know, we made, I say we, the royal we, I made
an antimicrobial endotracheal tube, the ventilator
tube. But as with a lot of things that come out
of academia, it was really expensive and difficult
to make. It just was, it was never going to be
commercially viable to make this. endotracheal
tubes, all these types of medical devices are
like one use, single use throwaway devices that
they have to be cheap. And yeah, putting this
technology in was just not going to be that and
therefore you just wouldn't be able to commercialize
it and scale it. So when I left my PhD, that
was when I really focused on, okay, we're definitely
onto something here in terms of like there's
a need, but how do we make that affordable? So
yeah, that was basically how Zonova was born.
I was just thinking about the stats and it's
actually really crazy. 75 % of people intubated
are going to get some type of infection. That's
actually super high. I don't want to go to the
hospital now anymore. Not that it's something
that happens on a regular basis getting intubated,
but still it's incredibly high. Yeah, so I don't
know the figures for intubation off the top of
my head and I think the figures for intubation
are quite complicated and especially when COVID
came along, we had significantly more people
being intubated, and so the figures are debated
for that one. But yeah, the 75 % figure was for
the urinary catheters. And then for IV catheters,
for example, you know, again, you've got a device
that sits, you know, in the body, access to your
bloodstream, and the infections that you get
that are typically associated with IVs, you know,
you can get like phlebitis and phlegm information,
but also, you know, sepsis. another really big
serious infection. And what the literature that
I've read has shown is that off the top of my
head from memory, I think it was about 25 % associated
with infection in terms of your likelihood of
getting an infection, sorry, but when you are
immune compromised, so for example, if you are
in critical care, and you have that IV in, then
your likelihood goes up to more towards the 50
% end. And obviously, you know, these are all
like, you know, in literature, maybe I can put
some sources or something below to add on to
this. But yeah, so it's, yeah, it's, it's really
problematic. And I think at the moment, you know,
the doctors and vets, because this runs across
both human and animal health care, the only kind
of tool that they have is, you know, good, good
clinical practice. And, you know, in terms of
preventing infections, like washing your hands,
x, y, z. But other than that, it's pretty much
just antibiotics. And so, yeah, with antibiotics
becoming less and less effective, we're going
to end up in a really, really serious situation
quite soon if the forecasts are correct. Yeah,
that's quite scary, actually. It brings me back
to before they just found germs, right? That
was a big issue because I had no idea what was
causing so much mortality. And then they all
of a sudden realized, oh, there's a thing called
germs. That's probably what's killing this many
people. And to think that we still die from stuff
like that, because there's not nothing like the
stuff you guys are doing for the market. Actually,
it's a bit crazy. So what you know, you came
up with this with a system you found in academia,
and then he decided to launch a startup. How
was that journey? Like, all the journey to starting,
starting the company, long and hard. So I, I've
got notes going back on my phone from like 2021
on terms of starting a company. So I think it
was always back of mind, especially whilst I
was doing my PhD. We didn't officially incorporate
until the 8th of March 2023, which was also International
Women's Day. So that was nice. And yeah, so the
journey to getting there, it was basically a
year and a half of me bootstrapping and trying
to get what work I could done in my spare bedroom.
So we did do a few experiments in the spare bedroom
with what we could order off Amazon and, you
know, what chemical companies would deliver to
a residential. location. And then yeah, then
we used that to get an initial US provisional
patent filed and then go from there and do our
fundraise. So we, it was a year and a half of
bootstrapping and me working, you know, multiple
part -time jobs on top of that. And then we closed
our first pre -seed round last June. So that's
June, 2024. And what was the market telling you
so far? Pardon? What's the market telling you
so far? So the feedback that we've had from,
you know, doctors and veterinarians is that,
you know, this, if it works, is their main concern,
you know, if it works, would be, you know, completely
revolutionary in terms of how we prevent infections
and, you know, in general, just like infection
control within hospitals. Yes, I think the pressures,
particularly in the healthcare system at the
moment are massive and with recent announcements
of further cuts and reorganisations, which takes
up so much capacity and kind of the focus away
from delivering clinical service to patients.
Any opportunity to try and reduce risk of infection,
reduce hospital stays, reduce admissions in the
first place is very much welcome at the moment.
So, yeah, as George said, if it works is always
kind of the first feedback we get. But I think
once we can... or not even convinced, but once
we can evidence that for them, I think the appetite
is going to be huge and very much appreciated.
And I think one of our concerns was whether people
were really buying into how much AMR and the
antimicrobial resistance crisis was kind of real
and prevalent. I know a lot of people in frontline
healthcare were just firefighting and having
that kind of foresight further ahead to understand
what's coming. they don't always have the capacity
to see but I think we've really seen that people
are becoming increasingly worried about the lack
of availability of antibiotics and their efficacy
and at the moment they can treat things and they
can keep their patients alive and I think the
threat that really really minor infections could
now be the thing that means that they can't see
that patient three to a kind of a good outcome
is becoming very worrying so yeah it's been pretty
well received so far. And I think as well, building
on what Carla is saying is that I think AMR and
our ability to treat infections and prevent infections
in the first place has such a huge knock on effect
to other diseases. So for example, anywhere,
anything where you're immune compromised, such
as, you know, cancer treatments, as one example,
you are going to be at a significantly higher
risk of infection. and therefore having complications
as a result of those infections and so it's not
just a case of you know antimicrobial resistance
affecting you know one area of health care it
really will affect everything from you know cancer
treatments to you know surgeries even you know
things like giving birth like things that we
really take for granted now and have the potential
to become really dangerous in the next um in
the next literally 10 20 30 years. Yeah, the
current projections, there was like a massive
study or, you know, big projected figure that
was put out that was that by 2050, antimicrobial
resistance related mortality will be larger than
cancer related mortality. So it's going to overtake
and kind of be up there in terms of leading cause
of death globally. And it also affects different
parts of the world differently as well. So it's
going to really ramp up healthcare inequality.
So it's a really huge problem. And then the last
thing I wanted to say is because we made a big
point about if it works, is that we have great
lab data. But obviously getting this into the
market specifically for human healthcare, it's
a longer road. What we do have coming up actually
though are two really exciting pilots with veterinary
hospitals in the UK. So we've got one of those
currently being set up for urinary catheters
and another one for IV catheters. So we should
have some real world data, you know, we think
by next year to give us an indication and initial
insights into how they're working in the real
world outside of the lab. So how does it work?
Do you manufacture yourself or do you, you pented
the technology and then you give it to manufacturers
to actually do it the way you think it should
be done. So how does it work? I think. just going
to say, can you move closer to the mic? And then
I think you said something about manufacturing.
Yes. So who does the manufacturing? So at the
moment, we would be manufacturing small batches.
And then, you know, licensing with external partners
for sterilization and packaging. And, you know,
that would be the case for the for the pilots.
But ultimately, we in an ideal world don't actually
want to manufacture these on a larger scale.
We don't want to be the manufacturer. I think
the thing with our technology is that it's a
technology that can be incorporated into existing
medical devices. We are not reinventing the wheel
when it comes to catheters, for example. So in
an ideal world, what we would love to do is work
and partner with existing device manufacturers
and just put our technology effectively. into
their catheters to offer people an antimicrobial
version of their favorite brands. And a huge
reason for that is actually this is all about
impact for us. We want to have the biggest impact
possible. And so we think that, you know, rather
than trying to fight against the giants of the
world in terms of medical devices, we would much
prefer to work with them and just provide an
antimicrobial version of what they're already
offering, which we think will then increase the
end user uptake as well. I think in terms of
what the end users are seeing, it will be much
easier. For example, if they see from their existing
brand that there's just an antimicrobial version
of what we're already using. And we think that
that will then lead to more impact if more people
have easy access to them. And how complex is
this actually? Do you need to go through a lot
of regulation? Like do you need to get FDA approval,
for example? Or how does it actually work? Yeah,
so the regulatory pathway, and I'm not a regulatory
expert, so you're just going to put that out
there right now, but it will depend by the sector
and the region. So the veterinary sector will
be completely different to the human sector.
And then for the human sector, my understanding
is that it goes by region. So for example, it
would have to pass MHRA regulations for the UK,
FDA for the US, and so on for each different
region that the device would be sold in. Yeah.
And this isn't by you or then by the company
that actually manufactures the devices? Pardon?
Is this done by your company or then by the company
that actually manufactures the devices? Yeah.
So if we end up finding a partner to partner
with prior to regulatory pathways, then great.
And then we'd be more than happy for obviously
the other company to take that forward with all
of their expertise. Failing that, if we were
going to be taking it to market, we would definitely
have to get an external help. in terms of going
through those regulatory pathways. But yeah,
so it definitely wouldn't be just us to try to
get through MHRA and FDA regulatory pathways.
And they are constantly evolving and changing
at the moment as well with governments at the
moment. And how hard was it to explain this whole
idea to investors? responses. I think it depends
on people's kind of previous knowledge of AMR
and understanding what that is if they're not
from a medical background. It can be quite difficult
to kind of explain the gravity of the problem
and how huge it can be and how impactful this
kind of technology can be globally. I think once
you're kind of over that first hurdle of understanding
how big it is, people have been kind of really
involved with the idea and very keen to be part
of understanding it and kind of getting it to
market. A lot of kind of common question we get
is if it's so amazing how has nobody invented
it already? Which just makes me laugh every time
because I think you could say that about any
venture ever. But yeah, it's been difficult but
I think once you get past that initial kind of
understanding, people are so keen to kind of
learn more and be part of it. And I think we're
improving as well. We have a great set of angel
investors and advisors, you know, a growing advisory
board and each of them coming from very different
backgrounds as well. And I think having their
input in kind of what got them initially interested
has been really valuable for us. So, yeah, I'd
like to think I've definitely improved since
uh you know two years ago coming straight off
the back of a PhD um but yeah I think as Carla
said I think I think one of the problems is that
you know as we've kind of discussed is that AMR
is so big it's such a huge problem and it affects
so many different you know it affects humans
animals the environment you know it it's almost
like too big for its own good and so I think
for us it's been really trying to like make our
messaging more like concise and to the point
because I think, yeah, it's a bit of an unwieldy.
And I think because our solution is so simple
as well, so because the problem is so massive,
but then our technology and solution is so simple,
that can be quite difficult for people to get
their head around, I think, as well. Would you
have other applications apart from medical devices?
Like you can put it on surfaces so there's not
any bacteria growing there or stuff like that.
Is that a possibility or even a need? There are
a ton of other applications and that actually
forms part of our pitch deck. But yeah, so I
think medical devices for me, obviously, that's
kind of what got me into all of this. And I think
that's where the most one of the most significant
impacts will be. You know, these, you know, catheters
and endotracheal tubes, orthopedic implants as
well, huge problems with infections there as
well. um you know we think there are potential
in dental applications one that keeps coming
up is also kids toys or like kids like um makes
sense yeah they get quite grimy though don't
they so yeah yeah yeah i was thinking like things
like um you know when you go on the tube and
then you grab the handle because you need to
grab the handle otherwise you're gonna fall i'm
just thinking is there any way that it looks
like scrammy feels that scrammy uh because that's
like for me what's the most disgusting things
on the planet like oh no i need to touch this
but uh so i don't know i always end up washing
my hands um a lot um but yeah okay i can see
the cube is particularly disgusting i have noticed
actually that some of the um i think it was during
covid actually that some of the escalator files
that you hold onto they have like this uv thing
now where it kind of goes through like a uv light
sterilization um but yeah that would be an interesting
one for sure Interesting. So literally, the world
is yours. I mean, the future is bright. You have
multiple applications for this. And I was just
thinking, if I'm running in a hospital and you
come come over and say, actually, you know, I
can reduce your immortality rate by this much
percent. Like, oh, wow, that's that's quite impressive.
And it's just by changing this little tiny thing.
That's that's huge. It's actually going to be
a massive. Yeah. Well, yeah, I think I'm definitely
all about kind of like small relatively easy
to implement changes that could have the potential
for a significant impact. I think, you know,
I think research and startups and innovation
in general needs innovation from all different
aspects. But for me personally, I've never been
about wanting to, you know, create the next antibiotic
or like develop the next antibiotic. For example,
I am much more on the end of this is, you know,
an area that we could have significant impact
on, but it's a relatively small change, therefore
easier to implement. Um, so for me, I think that's
definitely what, what it's all about. And that's
where kind of my focus is directed at rather
than the kind of massive, uh, kind of more big,
much wider, uh, targets. And what was, you know,
what was the worst day for you? You know, growing
the company, um, for both of you, obviously,
uh, Carl and Georgia, um, what was the worst
day? How was that like? How did you manage to
overcome the worst that you ever had in the company?
I'd say one of the biggest challenges we had
when we went through our first raise was accepting
so many no's before you get to a yes. I think
they say something like it's you have to get
through your first hundred no's before you'll
get to a yes investment. And I think when you've
put your heart and soul into a company and obviously
you think it's the greatest idea in the world
and you get so many no's, it's really hard not
to take that personally. and I think every time
you get a no you get feedback and people give
feedback every time and you're not ever going
to be able to kind of have the perfect model
that fits every person that you pitch it to.
So I think it feels really hard at first and
you take that quite personally at the beginning
and then you kind of go on a journey where you
start to understand that you know not every no
is a personal no and that it's not going to be
right for a video and sometimes it's right place
right time and you grow and learn on that journey
and and kind of adapt and then once you do get
your first yes and somebody sort of starts to
believe in you, it feels like the best feeling
ever. So yeah, that was that was quite a journey
to go on. Yeah, I think as well in the same breath
as that, keeping it real is that that bootstrapping
journey, I maybe made the mistake of trying to
do this right off the back of my PhD with absolutely
no savings. And so just that period where, you
know, it was like a year and a half of very,
very minimal income because I was working, you
know, part -time jobs, but it was, you know,
I was obviously working on turnover at the same
time. There's only so many hours in the day.
So there was a lot of, you know, not being able
to go out with friends, not being able to go
out with my partner. And, you know, it was a
year and a half of, you know, I'm sure my partner
would echo this as well. A really, really hard
year because you've got mentally, you know, all
the millions of no's. And then, just from a life
perspective as well, you know, just not really
being able to do anything but kind of sit in
it. That was really tough. And so maybe that's
advice for everybody else. Don't be so silly
to do it with no savings off the back of your
lowly paid PhD. Would not recommend. So yeah,
I think that personally was really, really hard.
post -precede round, I've obviously been able
to pay myself like a basic salary, which has
changed everything. And that was, you know, we
were really thankful that actually that was something
that our investors brought up as well, because,
you know, ultimately they want us to be in this
and focused and not, you know, fighting for scraps.
So yeah, that I think was a big, big challenge
for me as well in starting this. So what advice
would you give to people just starting out, especially,
especially in your area? The best advice I would
have liked to put back then was, you'll never
know the answer to everything and that's okay.
So surround yourself with the best team of people
and advisors and people who've done it before,
people who've made mistakes, people who are willing
to share their experiences and their journeys
and people that you can trust in that essentially.
So keep your kind of ears open to all the advice
you can take. Some of it will be with a pinch
of salt and some of it will be Some people will
have a motive behind that, so you've kind of
got to be a bit savvy about where it's coming
from, but to try and surround yourself with people
who have experience, because every single day
in a startup, you'll be doing something that
you haven't done before, that you have no experience
in, and having people around you that you can
reach out to, ask for advice from, and learn
from, has been absolutely invaluable for us.
Yeah, completely. You completely agree. You completely
echo that. And I think actually that's probably
when it started to all change, is when we had
a few different advisors or people that are either
in startups or, you know, we had legal advice
as well. And that really began to kind of change
the change the tides for us. And I think as well,
it's it's hard if you are a medical, sciencey
focused company, because what we were finding
was that it would be, you know, we're too early,
too early, we're too early. Obviously, we're
not an app. I can't just sit on my computer and
release a product. Obviously, that's oversimplifying
it. I don't want to be insulting to people developing
software, but there's a lot more front -end costs.
We need to set up a lab and we need to hire people
and we need a lot of legal advice. That all costs
a lot of money upfront. It's hard because you
are going to be too early for a lot of people
that you know, especially when you're looking
at an app that might be generating millions in
revenue, compared to your kind of like idea for
a medical device that is going to take investors
like 10 years to get their money back, it's,
you know, it's quite clear which one's looking
the better options for investors. And so, yeah,
I think for us, it was, you know, communicating
the impact, getting to know us personally as
well. I think we've heard from invest, especially
early stage investors that they're investing
in the people. as much as they are like the company
and the science and the idea. So yeah, I think
those two are probably the biggest things. And
that everything takes longer than you think.
So much longer than you think it will. Triple
your time. Yeah, I don't think most people realize
that it's actually going to take a long, long
time to get funding and to actually get started,
isn't it? It was so funny. I remember us literally
sitting, registering the company, having a glass
of prosecco. celebrating being like, this is
going to be great. And we were like, yes, it
will probably just plays around in like a couple
months. Obviously, and that's a really funny
graph. And it's basically kind of like the founders
start up journey where it's like, you're super
optimistic, and everything seems like it's going
well. And then it all kind of crashes and burns.
And for us, it was like March, we were like,
this is amazing. But you know, it's exciting.
We were doing like accelerators. And then basically
we got like a really big no towards the end of
the year. And we had other potential angels that
were going to potentially invest off the back
of this big no. Basically we got the big no.
Everything else fell apart. And then I spent
three weeks in bed on the sofa feeling like,
what? Like, no, had a bit of a crisis about it.
And then January came around. Carla was like,
get up, what are you doing? And we got started
again. And actually it was, I had to say it was
probably March again, where everything really
started kicking off seriously. We spent time
reformulating the business plan, reformulating
the deck, completely kind of changing everything,
getting back on our feet and then out we go again.
So yeah, it was a journey. And then we got our
first big yes. And how important was it to actually
be able to bounce back ideas from one another?
Definitely. I do not know. how I would, you know,
I don't know how you would do it alone. Even
just from a sanity point of view. Obviously,
it really helps to have co -founders that are
different in background, coming from different
perspectives. You don't just want two people
saying yes to each other. So yeah, really important.
I always like to ask you this question, which
is the last book you read or the most impactful
book you read for both of you. What was it? I'm
not gonna lie, Ricardo, I am not a reader. This
is gonna be really controversial. I am a podcast
listener, and I am a Real Housewives watcher.
Interesting. Which one? Because there's different
ones, right? There's one in Belver Hills, there's
another one in London, or something like that?
Everywhere. Beverly Hills, Atlanta, Orange County.
I could talk about this. The important takeaway
from that is... Do your taxes correctly. Do not
commit taxes. Unexpected. And what about yourself?
I know what I'm talking about. And Carla, you
also watch the same show? I do, but I'm also
not an avid reader. Which is not a great answer,
I know. I read a lot, and then when I did university
and when you're forced to read a lot of what
you've got to do for your studying, I lost the
love for reading. And then I think when you're
kind of at a laptop all day, kind of plugging
away, just getting your business off the ground.
I just want to like zone out when I go home.
So I listen to a podcast, I call it a podcast
and stomp, which I do most of the time. So I'll
go for a long walk and put a podcast on. But
yeah, it's been a while since I read an actual
physical book. I mean, the answer I should have
said is that I've been actually recommended lots
of different books recently. There's one about
spin selling. I've been trying to learn more
about deal negotiations. You can always pick
up The Art of the Deal by Donald Trump. Apparently
that's quite famous or quite popular right now.
There's a book called The Art of the Deal by
Donald Trump. I think it was released in the
90s or something like that. Very good book apparently,
very effective. So now as we get closer to the
end of the podcast, if people want to reach out
and find out more about the wonderful things
you're doing. What's the best way of doing so?
You can find us on LinkedIn. I think we're under
Zonova Tech, or you can find me personally on
LinkedIn, or Carla on LinkedIn. And you can also
get in touch through our website as well, www
.zonovatech .com. And we also have Instagram,
also at Zonova Tech. So yeah, I'd say those three
are our main channels. Carla and Georgia, it's
been an absolute pleasure having you here. Thank
you so much for your time. Thank you for having
us. Thanks very much. The podcast is also sponsored
by Notion .so. Notion is offering six months
for free for new users. Make sure you check out
our website, the startupevents .co .uk to read
them this offer. This podcast is also sponsored
by startupnetworks .co .uk. Startupnetworks,
it's an online forum where you can find all the
resources you need to run your startup, from
grants to investors to tips and tricks on how
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