Monday, June 15, 2020

Out of the Crisis #9, the founders of Frontline Foods on the moral imperative to support frontline workers at scale

One of the most consistent features of the volunteer response to the pandemic has been how many people have stepped up to fill roles that aren't necessarily related to their professional experience. In every case, they've simply been asked to take on work and said yes. The founders of Frontline Foods are three of these people. Sydney Gressel is a nurse in the pediatric emergency department at UCSF's Benioff Children's Hospital. Ryan Sarver was a partner at venture capital firm Redpoint. Frank Barbieri is the president of It began with a single text exchange between friends, in which Sydney suggested to Frank that a pizza party might be a great way to boost morale on her unit at the end of a really tough shift.

From there, Frontline Foods was born, like so many relief efforts, in a matter of a few days and with the help of dedicated volunteers who donated time, energy, and skills. The organization is now a national effort that supports restaurants and frontline healthcare workers simultaneously by connecting them. (You can see a list of every city where they operate and make directed donations on their site.)Thanks to thousands of donations, the people who are dedicated to feeding their communities have the opportunity to serve their food to the people providing critical healthcare.

Sydney, Ryan, Frank and I talked about how it all came together, the organization's partnership with José Andrés's World Central Kitchen, Buddhism, and what we all need to do to keep the virus in check. We also talked about the future of Frontline Foods, which they believe lies in "expanding the definition of frontline" to include providing healthcare and other services for communities.

You can listen to our conversation on Apple, Google, or wherever you like to download podcasts.


In addition, the transcript of my conversation with Sydney, Ryan and Frank is below.

Highlights from the show:

  • Sydney, Ryan and Frank introduce themselves (2:48)
  • Their quarantine setups and tips, starting with Frank, then Ryan, then Sydney (3:37)
  • Sydney on the moment she knew the pandemic was going to hit hard (5:50)
  • Sydney's path to nursing via Buddhism (9:04)
  • Meditation and community during the pandemic (12:12)
  • Sydney's report from the frontlines of nursing during the pandemic (14:06)
  • Frank on how Sydney helped save his daughter's life when in pediatric intensive care, his growing awareness of coronavirus, and how he got involved in Frontline Foods (18:00)
  • Frank and Ryan's first efforts to help, and their previous work with No Kid Hungry and Charity Water (22:03)
  • On why buying pizza was Sydney's first suggestion for how they could help (23:56) 
  • How shelter-in-place made the mission more urgent (27:02)
  • The first pizza party and its effects on hospital staff (29:13)
  • Ryan on how he got involved and why (31:14)
  • On the differences in people's understanding of what nurses and other healthcare workers do between now and pre-pandemic. (33:36)
  • Sydney on the difficult daily realities of her job (35:08)
  • The importance of showing respect and care for healthcare workers, and how crises reveal things that should always have been obvious (38:20)
  • Unequal access to healthcare (40:26)
  • Frank and Ryan on the choice to make a local gesture into something bigger and starting the fund-raising via a Google form (42:50)
  • The initial days of operating / MVP stage. (47:04)
  • Working on a mission with the core principles of trust and freedom (49:41)
  • On the need for less hierarchical, top-down management and more empowered autonomy (50:25)
  • Sydney on empowered autonomy at UCSF (53:59)
  • On just putting something in motion and getting to work (55:49)
  • Where the name Frontline Foods came from (57:07)
  • How people have come together for volunteer efforts like Frontline Foods and others (58:40)
  • How to volunteer with Frontline Foods(1:09:09)
  • The metrics on Frontline Foods and its impact (1:01:36)
  • Where the money is going and why they're raising more (1:03:30) 
  • The organization's relationship with World Central Kitchen (1:05:37)
  • Frontline Food's long-term impact and prospects (1:08:11)
  • Expanding the definition of frontline and who needs help (1:11:17)
  • Frontline workers' awareness of the programs available to help them (1:13:55)
  • The possibilities of aid organizations for frontline workers joining forces (1:16:28)
  • How people can help Frontline Foods impact more people (1:18:56)
  • Getting out of the crisis with patience and by supporting communities (1:20:33)

Show-related resources:

Transcript: Out of the Crisis #9, Frontline Foods

Eric Ries: This is Out of The Crisis. I am Eric Ries. When is our society going to start treating nurses with the respect they're due? I think a lot of us have been asking that question as we've watched the horrific images of frontline workers, nurses, doctors, healthcare professionals, being asked to deal with the COVID pandemic without the necessary equipment, without in some cases being paid, without being able to keep their family safe. It's been awful to see. If you've been to a hospital anytime in your life, you'll have some sense of the incredible hours that frontline workers put in. When do they have time to eat? Have you ever wondered? Sydney Gressel is a nurse at UCSF, has been for many years and therefore has found herself on the front lines.

If you think it's been hard to balance the needs of work and family and taking care of kids, imagine doing all of that but still going into an office every day that is at the epicenter of an epidemic. As you'll hear, Sydney is very thoughtful about what needs to be done about the role of nurses and other professions like that in our society. But she's also very practical and when some friends of hers reached out and asked in the very early days, what they could do to support, she gave them a really simple answer. She said, "Listen, buy us dinner. We don't have time to eat. Everyone's going 24/7 and working on adrenaline." And that's the origin story of Frontline Foods, an organization that has purchased meals for frontline workers all over the country, hundreds of thousands of them so far.

They threw a pizza party that first night, they've now raised millions of dollars and have thrown hundreds of thousands more, not just in support of frontline workers, but in support of restaurants who, as everyone knows, are struggling in these times with a dramatic decline in revenue, in customers. So Frontline Foods is a genuine win-win. Those of us who are able can donate to buy meals. We feel better, we feel like we're making a difference. We're acting in support of frontline workers who need every kind of support they can get. And we're supporting local business at the same time. Frontline Foods has now partnered with World Central Kitchen. They have franchised the model into more than 50 cities, and they have hundreds of volunteers scaling up this effort nationwide. Here is the team behind Frontline Foods.

Sydney Gressel: My name is Sydney Gressel, and I'm a nurse at UCSF in the Benioff Children's Hospital in the pediatric emergency department. And my friends and I started Frontline Foods in the middle of March.

Ryan Sarver: My name is Ryan Sarver. I am one of the original organizers of Frontline Foods and prior to this had spent six years as a general partner at RedPoint Ventures.

Frank Barbieri: I'm Frank Barbieri. I'm the president of and one of the original organizers of Frontline Foods.

Eric Ries: Thank you all so much for the work that you do. And Sydney, especially to you for the work that you do in your day job for all of us. And then to all of you for the work that you've done with Frontline Foods. Let's start with, are you all doing all right? How's your family? How's your quarantine setup? Any quarantine tips for those who are coping with this as many of us are for the first time?

Frank Barbieri: I feel like we feel really lucky because I think we just recognized what was happening very early on in the crisis and we made a decision with another family to shelter in place together because we have a six year old and they have a five year old and our thinking was that they would at least have a social interaction in play. So we've been, I think, very fortunate to have this sort of communal experience that's helped everybody in the families cope and adjust.

Ryan Sarver: Yeah. I always preface it with, "All things considered," because I think the personal and individual experience can be difficult. We have a five and a half year old who has no siblings and no friends to play with. And so he's cooped up and going a little crazy and making us go crazy. But when you look at the bigger scale of all the other situations, we're doing pretty well, so we feel lucky.

Sydney Gressel: I also have a couple of little kids. I have two daughters, two and a half and four and a half years old. And I feel like we're doing pretty well. We have good perspective on the fact that our family is healthy. My husband and I are both still working so we haven't had income loss in our household, which has been a huge gift. And yeah, we're hanging in there. And I think part of the sanity exercise has been huge for us just to be able to get, whether it's outside or get a workout in the house. That's been really supportive of our mental health and just being really active with our kids, making art. We've got a tent up in the backyard. Our house is kind of a disaster, I swear I clean it all the time, but it's very lived in right now.

Eric Ries: Join the club.

Sydney Gressel: Yeah. We're just trying to make the most of it. Yeah.

Eric Ries: Well thank you. And I also have two young kids, both of which incidentally were delivered at UCSF.

Sydney Gressel: Oh, nice.

Eric Ries: So I have so much empathy for the difficulty that you must be having, trying to balance the kind of work that you're doing and the health and safety of your family. And so an extra special thank you on behalf of all of us in the city of San Francisco for what you're doing.

Sydney Gressel: Thanks so much.

Eric Ries: Sydney, maybe, you've literally been on the frontline of this crisis yourself personally in a way that none of us have. Can you talk about, was there a moment for you when you realized what was coming or you had a sense of the disaster that was about to unfold? When did it really hit home for you?

Sydney Gressel: I think pretty early on. My workplace started making really deliberate preparations for, we've been talking about the surge. We've got an accelerated care unit tent, like a COVID tent set up outside of our department. The hospital has poured a tremendous amount of resource into training us and doing all kinds of drills for how we're going to handle all of these kind of worst case scenarios. And just seeing the ramped up efforts and the amount of resources and specialized personnel and infectious disease prevention teams and epidemiologists in our department and bringing in the person who runs all of our disaster preparedness training. And so just really seeing very directly the hospital's heightened response clued me in in an undeniable way. This is really a thing. And so I feel like I was getting a good taste of it long before even the average citizen was really cluing into what was happening here.

I remember trying to talk with my kids’ preschool about it and say, "I really think schools are going to be closing. I really think we should be talking about..." And she wasn't ready to hear it and even when the school closed, I was sort of like, "I think this is going to go on for a while. We're not coming back after spring break." And yeah, so I think I had the position of being able to see some of this stuff firsthand and just get a sense of this is going to be really big and really different than previous disaster events that have happened in my nursing career. I've been a nurse through H1N1 and SARS and Ebola. I've been on different disaster response teams in the past, but the heightened response on this one was really different across the board, the kind of training that we've gone through, the amount of resource the hospitals have poured into this, and then very directly how it's been hitting US cities, then the numbers that we're starting to see. It's pretty horrifying. And I think hospitals have done a really good job trying to brace themselves for this event.

Eric Ries: One of the things that's been very striking to me in doing these interviews is, I've been talking to business leaders and CEOs and investors and all kinds of people. And I always try to ask them who they think the real heroes of this crisis are and almost all of them will say nurses or frontline healthcare workers or doctors, that's what immediately comes to mind. And I have this feeling of guilt that I think if I'd ask people that question last year, I don't think they would have said nurses. But are nurses any less valuable to our society? I just, I wonder if you could talk a little bit about your path to become a nurse, your background, why you made that choice in the old era, when we seem to forget that nurses are heroes?

Sydney Gressel: So my undergraduate degree is in Buddhism and I had a religious studies degree and I started doing hospice care from a Buddhist background and started taking care of people in their end of life. And I did some international travel. I spent many months actually in India, where I was doing work on HIV and sex workers and got to see that, wow, if I had some additional training, if I had a nursing degree, I would be able to help people just that much more.

So got into nursing from the Buddhist background. And the core tenants of the Buddhist tradition is that in life there is suffering and that seemed like this really good working ground to recognize that actually one of the common themes in human life is that we all face struggle at some point in time. We all get sick. Most of us get old. And we all die. And people can look at that tradition and say, "Well, that's kind of a depressing starting place." And for me, it just resonated as, this is just this very real way of relating with what's happening in the world.

So from the Buddhist background, I got really interested in how do I make a life of service in a way that I could get a job and take care of people and have some actual skills? So that's what got me into nursing. And I'm still very interested in end of life care, I'm currently in a palliative care fellowship training. And so there's something really rewarding for me about being with people in their hardest times, in their worst days, in their moments of loss, because I think we're right there on the pulse of what actually unites us as people. So, that's what got me into nursing. And then of course it's become all different things throughout the course of my career and I've always worked in pediatric critical care in some form. So I get to work with kids, which are incredible. I love children. So, that's my kind of history before nursing.

Eric Ries: How'd you get interested in Buddhism?

Sydney Gressel: I'm not actually sure. I went to that school not knowing that it was a Buddhist university when I first enrolled. So it was kind of on accident and even the first meditation retreat that I went on, it was an accident. I thought that I was signing up for a summer school course and then I got information that it was like, oh, it was at this other site. And I was like, "Oh, that's interesting." It's at a different place where you stay overnight. And I thought it was this summer school course and I got there and they're like, "This is actually a 10 day silent meditation retreat." I thought I'd signed up for a psychology course.

Eric Ries: Oh my goodness.

Sydney Gressel: So I got into it kind of by accident and then-

Eric Ries: So it was clearly meant to be. Clearly meant to be.

Sydney Gressel: Yeah, totally. Yeah. The more I did meditation practice and the more I studied, I really felt like there was some useful material there and some tools that I could use to relate to my own challenges or the difficulties in the world and give me a little bit of framework for making sense of it, I guess.

Eric Ries: It's one of the tragedies of the pandemic, not in the first order of course, but like meditation retreats and centers are all closed. You can't go to Spirit Rock or Green College. Have you found ways to be in a community of practice, in spite of those obstacles?

Sydney Gressel: One of my favorite meditation teachers is a man named Chögyam Trungpa Rinpoche. He was a Tibetan guy and he would talk about how we go into retreat so that we can come back out into the world. So this is actually our practice ground. This is the exact reason why we practice. It's easy to actually find some peace of mind when you're alone in the woods and you don't have to get to work and you don't have to be home with your kids or whatever challenges we're facing right now. Right? But this is really the moment where our practice gets put to the test where we're right in the fire, where there's so many uncertain elements, where everything's out of our control. And so I think that we're doing the work right now. This is the retreat. This is the practice space, so...

Eric Ries: Okay. We could do a whole conversation just about the spiritual implications of it.

Ryan Sarver: I think you should.

Eric Ries: Boy, I have so many questions and I just feel like a very common issue that comes up as lay people try to get into meditation or these kinds of spiritual practices is, how can you still be active in the world if you're spending all this time in this inner life, inner retreat? And so, this is the living embodiment of that principle and the kind of lived explanation of what it means to use that inner work to then be of service to others. So let's pick up the story from those early days. You were doing this extra training. This is February, March timeframe, before the city had gone on lockdown, is that right?

Sydney Gressel: Correct. Yeah. Yeah.

Eric Ries: What's it been like on the front lines as the crisis has worsened?

Sydney Gressel: It's very specific to where you're working. So, the numbers in San Francisco are very different than what we're seeing in other parts of the country. New York, of course, being one of the epicenters for the pandemic in our country, but other cities being hit very hard, New Orleans and Detroit, and what's happening in Mississippi right now. I mean, there's places that are seeing-

Eric Ries: Yeah I've heard the rural areas are about to be even more highly hit.

Sydney Gressel: Yeah. So depends on where you are in terms of what you're experiencing in the hospitals. And then also what kind of practice environment you work in. So places that have fewer hospital beds or fewer ventilators or just fewer resources across the board. Clinicians there have a very different experience than clinicians working in other places. So my experience is not the uniform nursing experience. I want to be really clear about that. And then also, I work in pediatrics and just the nature of the virus is it does not as commonly have a severe presentation in children as it does in older people, immunocompromised folks, or just adults in general. So I feel in some ways like actually really all of us have been protected compared to some of my colleagues in other places. So the things I'm seeing are not as maybe horrifying, I guess.

Yeah. So on the front lines, we're seeing a very heightened response. We're seeing every single day that I come to work, we're doing huddles where we have updated policies and protocols about how we're screening people and our changes to visitation policies and who we're testing and even just the issues around having access to tests has been a huge problem throughout the country and different places have come up with a response to that. I know where I work at UCSF, we've designed our own test and we've even revised our own test a few different times to make available was not happening on the federal level.

Eric Ries: To our great shame.

Sydney Gressel: Yeah. So, there have been all different kinds of challenges and then I think the way that it's experienced directly has everything to do with where any person is working and how the infection is hitting that region, as well as what resources are available in that practice environment.

Eric Ries: Mm-hmm (affirmative). Have we flattened the curve here in San Francisco?

Sydney Gressel: We've done a great job of slowing the rate of infections. Our work is not done and I do think that we will see a second resurgence. We've talked about how that might look. I think our biggest strength in this is that we have continued to do our sheltering in place, that we started that early, and we've stuck with this quarantine. I'm definitely scared about the places that are opening up their cities now. I don't think that--we have not done enough testing, we don't have enough safety measures in place to make that a safe endeavor just yet. So I think that sticking with the quarantine is going to be really, really supportive everywhere. So I think we are starting to see evidence of flattening the curve, but something that I'd liken this to on a call earlier this week is I said, "When you start to take antibiotics when you're sick, you start to feel better within a few days. You don't want to stop taking your antibiotics." And this is a similar situation. We're starting to see some improvement. We're starting to see a slowing of infections and that's fantastic news. And also we have to stay the course, so that we can really not just slow the curve, but actually get ahead of the curve. That's really the goal. And so we need to give it a little more time.

Eric Ries: So Frank, maybe I can bring you into the story because, as hard as this must have been for Sydney, I can understand what it would be like to feel like you're on the front lines, this wave is hitting, but at least you're preparing to take action. Many of us who are not on the front lines have been sitting at home, watching this wave come mostly with a feeling of dread. So what were you doing right as the pandemic unfolded? And how did you get connected to Sydney? How did this all get started?

Frank Barbieri: Well, Sydney and I are old friends and matter of fact, my wife was instrumental in setting Sydney up with her now husband, Michael. So, for me, and this goes with the Sydney story as well, is our daughter has respiratory issues so I was following the news very closely from December on. A matter of fact, Sydney helped save our daughter's life in the PICU at CPMC at the time when my daughter had bilateral pneumonia and was in the pediatric intensive care unit for four days with some real struggles. So, I'm tearing up now.

Eric Ries: I'm so sorry. Listen, I'm sad to say that I've been in that same pediatric ICU. So I have some sense of what it's like.

Frank Barbieri: Well, I'm sorry to hear about yours as well. And Sydney was a rock, she was just there for everything. And she just lays out in very, very dispassionate and analytical tones what is happening with situations, as she calls them and how situations develop and what the outcomes and actions you can take as a situation develops. She's just such a clear headed thinker about these things. So when I started just becoming aware of this respiratory disease that was born in China and starting to spread around the world, I love Ira Glass's description of it as, "the low hum of menace," is what he called it and in February, there was that low hum of menace and I felt it and there was a sense of vertigo, which you just don't know what the world looks like anymore and what's going to happen.

And we had a Fat Tuesday dinner with Sydney, which is an annual event by our mutual friend, Molly. Molly Ditmore. And she was sharing with me some of the preparations and I think that really heightened my awareness of the need to prepare for a new reality in the world. And we started doing so as a family and Sydney and I stayed in close touch. And at one point, that feeling of helplessness pervades a little bit. As a leader in business and as somebody who's kind of has been trained to take action, I didn't know what action I could take. And I don't deal well with helplessness and I texted Sydney once about a week or two later and said, "What can a private citizen do to help you all?" And that's when the apocryphal story that she replied and said, "Well, buy us pizza." And I said, "That's a great idea." And reached immediately out to Ryan Sarver, our partner in this and said, "Let's buy pizza for the nurses and doctors at UCSF who are working long hours and dealing with unprecedented circumstances."

And of course, Ryan jumped right to it. You know, a little context is that I've been working on hunger issues for 10 years in cooperation with the No Kid Hungry Campaign and several local leaders in that. And Ryan's been working on water and hunger issues. He's been with me in the No Kid Hungry Campaign, as well as working closely with Charity Water.

So I think we already had built into us this ... Ryan and I have built into us this sort of innate understanding of the power of food in crisis situations. And how food can help first responders and heroes on front lines and people working long and hard hours adjust better to crises and actually be more effective during crises. So it formed very quickly when we just married the power of food to the help it could do with our clinicians.

And then the last piece, as both of us are connected fairly closely to the local restaurant scene, was putting in a way to help our local restaurants and businesses. We want our communities to be intact when this is all over. And the restaurant community and every community across the nation, and San Francisco specifically, is part of the fabric of the community.

So when we put together this formula to be able to help restaurants by feeding local clinicians in time of crisis, I think we recognized that we could be on to something and that can help a lot of communities. Not only in San Francisco, but nationwide.

Eric Ries: I think it's an amazing model. You know, it's such a win, win, win, but I want to focus in on that initial conversation that you had, because it's very counterintuitive now. I think we've gotten used, first, to the idea that we need to be, all of us need to be in support of our frontline medical personnel. But Sydney, maybe you could help explain to people, why is it that buying pizza, like why that of all the things people could be doing to help.

It's very counterintuitive. Presumably, the hospitals have food. Or I don't know. It's not that I have an objection to it, it's just more like when I first heard the story, I was surprised that that's what came up. So say a little bit more about what you were thinking.

Sydney Gressel: The actual day that Frank had messaged me, I remember it well. It was a really busy day. I think we'd had, even actually apart from COVID, we'd had like three code events in our department that day.

Eric Ries: Explain what that means for those that don't know.

Sydney Gressel: Yeah. Oh, good question. A code is when somebody is having a life threatening acute problem. That's when we page overhead and we get every resource and every person in our department in that room. It may involve doing chest compressions or intubating somebody. We're saving somebody's life. If we didn't respond immediately, they would die in a matter of moments.

So I think it was a shift when we had three code events. We have an entire resuscitation room, we have a code room that we can code multiple people at the same time. And we're set for kind of doing some really high acuity stuff, but we have some shifts that are more quiet and we end up not having an event in the resuscitation room. And then we have some shifts where it's a big day.

So I remember there were multiple resuscitation events that day. And I was working a 16 hour shift, we were really busy. Actually, this was before the shelter in place, and we had kind of a high census. And somebody had come in and brought in like chips and salsa and chips and guacamole from La Taqueria. And it was like 10:00 PM or something like that, and it just shifted the mood. Like we were all just running around, doing the work and somebody brought in a snack and it was like, it just lifted us. It was awesome.

And we had our snack and then we just kept going, we got back to work. But there was just this really palpable, like, that was exactly right. So Frank was texting me that day and I said, it maybe sounds silly, but somebody just brought in chips and salsa and it was such a morale boost. What about a pizza party?

So that kind of morale boost, it just can be a moment when you're busy and you're running around and you're taking care of multiple different kinds of people and patients. And in one room has got a kid who's had a heart transplant and in the next room, you've got a kid who's having an adverse reaction to their chemotherapy. And in the next room, I've got a broken arm ... It's really busy. And somebody is like, hey, here's a treat. It shifts everything for you.

And so that initially started as this suggestion around, let's have a morale boost, let's bring in something that perks people up. But then, within a few days after we started doing this, the shelter in place actually was started in San Francisco. So that actually changed the food landscape in a big way. So suddenly on our break, I couldn't step out to one of the many local restaurants in the Mission Bay neighborhood where I live ... I'm sorry, where I work, and go grab something and get a lunch and come right back to work.

So food actually became a challenge in a way that didn't exist before all this. Going to the grocery store is now a much bigger ordeal than it was previously. You can't just run into a store for five minutes, grab something and go, it's a line out the door. It may take upwards of an hour to get inside the store. And then with the shelter in place, my job is to keep myself and my family home as much as possible.

So even just ... my kids are home from school. So getting to the grocery store, do I put the mask on my kids and we all go out and stand there for the hour before I can run in? Do I bring them in the store? That's all become a lot more complicated than it used to be. And then the final thing is, because I'm somebody who takes care of, whether it's a COVID positive patient or a COVID rule out patient, I take care of those patients every day that I go to work.

So I'm also considered a high risk person because of my exposure. So you don't want me to be the person next to you at the grocery store, right? And that's true for my colleagues, we are all coming in contact with some high risk stuff. So the more that we can count on these meals when we go to work, it actually takes something off our plate in terms of responsibility. It allows me to spend more time with my kids before I go into work. It maybe allows me to get that workout in that is so central to my sanity.

And at the same time, it protects the public because this is one less time that we're going out into public to go source our own food. It allows us to keep a tighter quarantine and basically just go between home and to work, which is better for everyone. So it started off as an idea, as a morale boost. And then as this has unfolded, it's become so much more. And it's really such a core support measure for clinicians like myself.

Eric Ries: Tell us about that first pizza party.

Sydney Gressel: You know, I actually wasn't there. I had that day off. I started getting these text messages like, is your husband's name, Ryan? What? No, why? Well, somebody just delivered dozens of Little Star pizzas, and this is amazing. And they said that it was from Ryan and Sydney was the backup contact. It was, my colleagues were trying to figure out what the hell was happening, because nobody had ever sent good pizza to our hospital.

Eric Ries: Never?

Sydney Gressel: I mean, people have sent ... I shouldn't slam any other businesses right now, but nobody's ever sent Little Star Pizza to a hospital. You know, a stranger. They couldn't believe that it was like a stranger had, just because we were nurses. They were like what? They just sent it. And then not just for the nurses, but they sent enough for our whole staff. They sent enough ... The social workers and the security guards and our clerks and our tax and our environmental services people, the janitors, had pizza. Like that has never happened.

And it was such a moving event in my department. People really ... I got texts for the next three days about it. Like they couldn't believe that that had happened and that it was just because somebody cared and wanted to say thank you to people they've never met before. And that like literally put a smile on everybody's face. People talked about it for days.

And then as this really kind of moved forward and the meals kept coming in, people can't believe it. I mean, it's such a show of generosity and it shows such support from the community. I mean, it's a very, very moving thing that has happened here, and it's changed the landscape of our profession. So it's awesome.

Eric Ries: Ryan, tell us about how you picked Little Star. And also just the rest of the story of how you decided to take this action. And as Sidney was saying, not just to do it for a few nurses or not just to do it for somebody that you had a personal connection to, but to really take a step beyond that.

Ryan Sarver: Yeah. I think Frank laid out the beginning of this, but the three of us have all been kind of mutual friends for a while. I've known Frank since, I think, literally the first week I arrived here in San Francisco. We know Sydney's husband, well, I've gotten to know Sydney over the past few years. And I got a text from Frank just saying, hey, I was talking to Sydney and you know, we were asking what we could do to be helpful, and she said pizza.

And at the same time, I grew up working in restaurants. We helped open some restaurants in San Francisco. And so a set of our friends are people that work as servers and chefs and cooks and kind of throughout the restaurant industry. And as San Francisco was starting to kind of begin the lockdown, they weren't full shelter in place yet, but foot traffic at restaurants had crawled to a halt. And when Frank brought that up, I was like, oh, I hadn't even thought of this, but this would be great business for the restaurants that are decimated right now. I looked up where UCSF was and searched around for one of the restaurants we would know. Saw Little Star, reached out and just called the owner there. And she was there and picked up, unfortunately I don't remember her name. But talked to her for a little while and said, hey, we'd love to send pizza for, I think Sydney was 30 people in the unit at the time.

Eric Ries: I think so.

Ryan Sarver: And so we ordered, I think, 15 pizzas initially. I said, do you think you can do that, to this owner. She's like, can I do it? I have no other business. In fact, I can do it in 20 minutes. So she was ecstatic and delivered it over to the hospital. And we didn't really know any of the protocols or drop off and so it was a little crazy trying to get the food in, but we eventually got it in.

And I talked to the restaurant owner afterwards and she was just like, over the moon. You know, it was a thousand dollars that she wasn't going to see that day, and they did the business in a few minutes. So she was ecstatic. And then we were getting the notes from Sydney on the other end of like, how ecstatic the team was. And I think it just, it triggered for Frank, Sydney and I of like, there are very few moments in life when you get to do something that feels like a genuine win-win.

Like we feel good about giving, the restaurant just got money in their pocket to help feed their staff or employ their staff. And then the clinicians, like you said, it may have been surprising, but they were over the moon about receiving it. So it just felt really good to be able to pull that off. And it felt like an easy, easy setup.

Eric Ries: I want to drill into this a little bit, because I'm sure there's some people listening that are like, come on. Are we really making such a big deal over 30 pizzas? And we are, and it's for a good reason. And I want to maybe go back to you, Sydney. So to me, the thing that's so interesting about this story, is the just supreme disconnect between the world that we used to live in and the world we live in now.

That on the one hand, here's this incredible moment of solidarity and feeling appreciated from the community by this simple act of generosity. And all I can think of is, how is it possible that our clinicians and our nurses and everybody who does this job day in and day out, hasn't felt that level of support before? So is this ... I want you to just address people who might be a little skeptical, like, is this really a big deal? And does it signal some kind of sea change in how we're going to be with each other in our communities going forward?

Sydney Gressel: That's a great question and I think there's a lot of layers that I could address in answering it. So part one is, I do think that the way that the world or that our society thinks about healthcare workers is probably going to change moving forward. But let's keep in mind that traditionally, nursing has always been women's work, right? And people are also shifting the way that we're even thinking now that we're home, and we're doing all of our own housework and taking care of our own kids full time. And everyone's like, well, this is hard.

Well, yeah. This is unpaid women's labor, historically, right? And so I think that this whole experience, this whole pandemic experience is waking us all up to the kind of actual physical labor, emotional labor, time intensive, nurturing, and caring kind of work that has historically been undervalued or possibly taken for granted, right? So I think, and hope and welcome, a shift in the way that we think about all of these kinds of work.

I think it's also, no one's to blame here that people can't really try on what it is to do 12 hour shifts or even 16 hour shifts. A lot of doctors do 24 hour call shifts of really just taking care of people. I've been in jobs where I'm eating my lunch standing in the doorway, watching the arterial line on multiple patients who are intubated from the break room doorway, because I've worked in places that don't have a proper break relief setup.

I realize some of what I just said probably doesn't even make sense to nonclinical people, but the work that we do is demanding. To have to tell somebody, we took an X-ray and we found multiple masses throughout your child's lungs today. Like the kind of news that we have to share with people, the way that we sit with people when they're having a really hard time. Even if we know they're going to get better, today is still the scariest day of their life. Their child has to go in for surgery.

And I keep saying child because I work in pediatrics, but of course this happens in the adult world all the time. You know, we have to share difficult news with people. We have to be with people when it's really, really tough. And right now clinicians are with patients, with COVID patients who are on their final days and they can't even have their family at the bedside. So nurses who are organizing the iPad Zoom call for this person so their family can be in the room in a virtual way to say what they need to say to their loved ones.

Like that is a reality that most people have never had to try on before and imagine what that's like. And it's hard work. It really is hard work. And when you run from that, that's happening in one room and then the next room over, you have the demanding parent who's like, well, I'm friends with Marc Benioff and you're not moving fast enough. I'm going to tell ... I'm like, the person next door to you is dying right now. And I know that you think that this headache for the last hour is the worst thing in the world, but ... And I still have to have the service with a smile, right?

And so the kind of work that we do is hard. We love it. We're trained to do it. We love what we do. We wouldn't change it for the world, but it is so sweet to have people actually kind of think, wow, that's something. That must be hard. Oh, I couldn't do that. Oh, wow. You're taking on risks. You're spending these hours away from your children. You're encountering something that we're all terrified of.

Eric Ries: You're running into the fire.

Sydney Gressel: Yeah. Yeah. And we're excited to do it. We're happy to do it. We love what we do, but it is a shift where people are imagining what it might be like. And then they're recognizing the kinds of challenge and sacrifice or courage or specialized training and work that we have had to do to be able to do this. And so I think there's just a ... Society is waking up to the experience of others in a new way.

And my hope is, moving forward, that we'll have continued respect and love and appreciation. And not just for doctors and nurses, but also the folks who were making minimum wage incomes, cleaning those high risk infectious rooms afterwards. And bringing in the food. And moving people's bodies down to the morgue. Like those are some really hard jobs. And I think that this experience is waking people up to some of what other folks are experiencing in our society.

Eric Ries: Well, let me just tell you, I come from a family of doctors. I'm one of the few non doctors in the family, actually. So in my family, raising your voice or speaking inappropriately to a nurse is like, that's like right up there with ... I don't even know what the right metaphor is, but it's absolutely unacceptable. So nobody ever, ever ... If you're listening to this, don't ever be that person. God forbid.

And I appreciate you saying that, connecting this to the wider struggles of people whose work has been historically unappreciated in our society. I think it's one of many, many changes that this crisis is going to cause. And almost everything that you have to do in a crisis ... This has been a recurring theme in all the work that I've been connected to, is that the things that a crisis reveals that you need to do, are almost always things you should have done before.

So did it require this crisis for us to have the empathy for this and to see it? Maybe it did, but that's our failure for our lack of perception and empathy before. It's not that the crisis changed the situation, it made it possible for us to see with new eyes.

Sydney Gressel: Yeah. Yeah. And on that similar line, we're starting to see the ways that health disparities are playing out and how minority communities, and specifically African-American communities, are having worse outcomes with coronavirus. And that is just basically shining the flashlight on what has been there for way too many years. That we have unequal access to care, that people have chronic disease in disproportionate numbers in minority communities. And the kinds of health outcomes that we're seeing now reflect this larger landscape of inequality and racism that we're long overdue for rectifying.

So my hope is that some of the good work and outcomes of this experience are that we start to make the changes that our society needs that are long overdue. PPE, which is personal protective equipment, masks and gowns and things like that, nurses have had struggles over the years of accessing enough of those kinds of supplies anyway. And this situation, of course, has heightened that issue and exacerbated that issue. But this is not the first time that nurses have been concerned about their safety on the job.

And so it's just now taken this pandemic to make us listen in a different kind of way. And hopefully moving forward, we will do a better job in all of these areas.

Eric Ries: Well, only if we will it. What's the saying, if you will it, it is no dream? And I think that is a critical thing for all of us to be focused on. And of course, in this series of interviews, we've talked a lot about PPE and the obligation that we all have to be there in support of people who don't have it. And again, I really thank you for making this connection that this is not causing problems as much as it is shining a spotlight on pre-existing problems that should have been addressed.

Let me follow the thread of the story. So I'm with you so far that you had this insight, starting with the chips and guacamole, I love that. You threw this pizza party. Now I happen to be an entrepreneurial type person. I love startups and starting things. So pretty much if I have a good idea, if I don't trip down the stairs one day, I'm like, ooh, maybe I should have a startup for that ... I'm wired that way. But I think most people, frankly, are not. Probably good for their mental health.

But I still think it was kind of an interesting choice for you to have had this experience, the three of you. I think a lot of people might've said, well, job well done. We fed the people. They're happy. We got the message. It felt good. Everyone's happy, let's go on with our lives. But you all made a different choice to make this into something much bigger. Talk for a moment about how that aspect of this came into your mind and how that unfolded.

Frank Barbieri: Yeah. I think in that text thread with Sydney, as we were talking about it, I just said, I bet if we created a public Google sheet and let people sign up for meals, it would go bonkers. And I think she said, that will be some next level shit. And I don't know if that was almost like a ... I don't know that we thought about it, honestly. I think it was just a reflexive, sort of, this was a really good thing. Shouldn't it be bigger? Or shouldn't it last longer? And how would we do that? And that's where I think Ryan and I have just instincts around it. And we joke all the time that if Sydney weren't a nurse practitioner she would be a startup CEO because she's so clear headed and optimistic. So it just seemed like a natural thing to us to make it bigger. And that weekend Ryan toiled away at creating a Google form, and within one week I think we had raised $250,000.

Ryan Sarver: Yeah. And I would add, Eric, I think that, and again, we each come to this from slightly different angles or similar angles, but I was thinking through on the restaurant side just how long impacted and how impactful is this going to be for each of them. And it felt like, "Oh, this is a really interesting way to help deliver them new business and help make these clinicians feel loved and supported and give them the nourishment they need." We know we have friends that would probably jump in and do the exact same thing that we had if we get it all set up. So we reached out to a few chefs I know, and they all stepped up to offer to try and do the cooking. And they obviously could really use the business for them and their teams who they at the same time were having to lay off.

So I think, like Frank said, it was, it was just a natural reaction to see, there's a lot of need out there. And through not a lot of edits, this wasn't taking custom coding. This is literally a Google sheet and some Google forms and Twitter. We were able to spread it out there and get, I think it was about 200 and some thousand dollars committed in a few days.

Frank Barbieri: The non-instinctive thing for us was, and the things that we still talk ourselves out of and unlearning, is that this is not a startup where we're trying to accrue enterprise value to the idea. I think we joke that if everyone does their job in a nonprofit, the nonprofit should go out of business. The goal is for actually the nonprofit to not exist any more. And that's just a completely different way of thinking from an enterprise startup. And as we looked at that and had discussions and examined what that meant, it really meant distributing the sense of ownership, just pushing it out and opening it up and trying to enable anyone else to do this as well. And really to give away value at every aspect of what the organization does, versus trying to accrue or build value, which is what I think we're reflexively used to doing. So there's this definitely a change for us. And to see how the folks have responded across the country to that ethos and to the mission tied to that ethos, has been just remarkable.

Eric Ries: Where did the initial $250,000 come from?

Ryan Sarver: So I think March 17th we had gotten the Google sheet and Google form set up. And really it was a simple form to say, "If you are interested in pledging money," because we weren't taking funds. The way it worked is we would work with a few partner restaurants, we would schedule Cockscomb in San Francisco, some people will know, or Nightbird. Each one of them would plan to make 50 meals, and one would go to UCSF Mission Bay and one would go to Zuckerberg General. And we created a little form that people could raise their hand and say, "I'm willing to pay for one of those meals." And we at the time made it $1,000 because that was around the cost of serving one of those units.

The restaurant would make it, they would go deliver the meal, and then we would connect the restaurant to the donor and they would pay Venmo directly to the restaurant so we didn't have to touch funds. So it kept it super simple, obviously a high bar at $1,000, but that meant that we didn't have to touch funds and the restaurant didn't have to go chase people down to try and collect $20, $30 apiece. It was focused on simplicity and being able to do it pretty quickly.

Eric Ries: What a great MVP.

Ryan Sarver: Yeah.

Eric Ries: Well, actually, talk about that, because people would have been so tempted to make it complicated and therefore take longer to launch it.

Ryan Sarver: Yeah, I think Frank and I and Sydney talk about this a lot. I think this is so unique in this environment because the crisis is so clear and present and it's not waiting. And so the typical startup, in many ways you take a little more time to think things through and build some systems that you thought were more durable. And really this was a focus on, what is the minimum viable thing we can do to serve these groups, connect the donors, restaurants, and hospitals, and be able to get them to efficiently match? And you could have over-thought it and built a website on day one, but Google spreadsheets and Google forms worked totally well enough to go do it. And Venmo, obviously wouldn't have been able to do it without Venmo, worked enough.

And that was how on that promise we raised, I think it was $250,000 in 48 hours out of sending one tweet. And most of that was all single $1,000 donations. And some were our friends, but a ton of people we didn't know either. So it was an idea that I think was spreading and people were willing, even though we weren't a nonprofit and literally only had a Google form setup so it didn't even feel that official, people were raising their hand to say they would pay $1,000 at a time.

Eric Ries: That's really powerful. The next time I send a tweet about what I had for lunch I'm going to think about how much less effective that is in changing the world than what you tweeted.

Frank Barbieri: I think one other thing that we've noticed is that because it's an all volunteer, some of our early core principles were just trust and freedom. And I think what's been remarkable is that outside of a normal hierarchical enterprise organization that has goals, deliverables, measurements, metrics, bonuses, payment, that traditional structure, if you just eliminate all that and just say, "Okay, it's just trust and freedom and mission." And the people just stand up and do remarkable work because they're freed of all the overhead of the other stuff.

I laugh all the time, our brand work was done by a remarkable woman, Sarah Watson, who was VP of marketing at Away. And she had some time and she did our brand work in six days that another VP of marketing and I were commenting on as we were looking at it, this is a work product that we've all seen before and has cost $100,000 and taken six months. And the level and quality of work she was able to achieve just by releasing, giving her the freedom and permission to do exactly what she wants, just continues to blow me away. We see that at every level across the organization today,

Eric Ries: It's almost like some of those other top-down command and control management structures maybe aren't needed.

Frank Barbieri: Completely.

Ryan Sarver: Yeah. Eric, we talk a lot about Stanley McChrystal's book, Team of Teams.

Eric Ries: Great book, we'll put a link in the show notes.

Ryan Sarver: Yeah, I read that years ago and when I joined Twitter many, many years ago back in 2009, I remember Ev recommended High Output Management, which was a lot about manufacturing and why the systems are set up to have matrix organizations and hierarchical organizations. And it was a really fascinating read at the time. And then you read one years later called Team of Teams, and it was about how as the US went into Afghanistan to go fight, they started in a very command and control, information efficient organization. And they got over there and they were fighting a battle that was hyperdynamic and changing all the time. And they realized they had to change everything they did about how they structured and organized the Army.

And as they moved to this concept of team of teams, which was not about informational efficiency, it was about empowered execution. So how do you create these fully autonomous teams, give them all of the information that they need, so that when they're in the field they can make effective decisions without having to run it back through the top? And it's a very different way of thinking about how to run an organization. But as we got into starting to build this, that was the structure that I think we thought about the most, of how do we empower people to just execute and not have to come back to some central group for sign-off of check-off, but make sure they have everything they need in their units to be able to go get the work done they need to do?

Eric Ries: Those are two pretty great bookends. If you just want to understand the history of management in the past few decades, you can read Andy Grove's High Output Management and skip right ahead to Team of Teams. And we'll put links to both in the show notes for those.

Frank Barbieri: Yeah, I'm going to put a plug-in for one more. Because I had just come off of taking a class with Frances Frei. I don't know if you know Frances, but she's just a remarkable teacher around new leadership principles. And at the core of her philosophy is trust. And she just helped instill in me the sense that the way to success is by empowering everyone around you and pushing out that response, pushing out that ability and permission for everyone to just be their best. And she's got to, put another book in the thing, she has a book coming up called Unleashed, the Unapologetic Leader's Guide to Empowering Everyone Around You. And I was privy to the early release of that book just by taking the class.

Eric Ries: We'll put a link to her TED Talk, which is also amazing.

Sydney Gressel: Well, and I can speak about, in a similar vein, within my department at the hospital we have a number of nurse driven protocols or project initiatives that are started by and run by the staff. So the person who designs and executes and educates on our disaster preparedness stuff is a nurse who is passionate about it. She's the one who runs all of our quarterly skills trainings and things like that for the team. She's the person who's been designing the workflows for our accelerated care unit tent. Similarly, we have a person who's, basically her passion is running the code room and designing our workflows there and running mock drills with us. And so it's like our department has empowered people, if you have an idea and you have something you're excited about and you have something you're passionate about, run with it and we will put you in charge of it and we will give you the resources we need to make it successful.

And I've actually never worked in a place that does it to this degree, the way that UCSF does. And it's really incredible to see that policy usually is coming top down from somebody who has nothing to do with patient care in an office somewhere, most concerned with liability. And to work at a place where it's coming from the ground up and it's constantly a work in progress and we practice and we drill and we train, it's such a different experience and we actually provide much better care for it as a result. And one of the things I've loved about what Frank and Ryan and I have started here is, even when we put our guidelines out, and I think we posted a medium post saying, "Hey, this is what we've started. Here's an open platform, take our ideas and modify as needed."

And even with that, we said, "This is where we started. These are our ideas of where we still need to improve." It was never perfect. But we still took action, we moved forward, we put out what we had, and we've worked on it to make improvements since then. And I think that's a great way to be. I think people get stuck sometimes when they're more focused on perfection, and you actually can't perfect a final product until you've put something into motion and you've gotten feedback from this lively environment that you're putting it into. And whatever we were doing two weeks ago has changed now based on the people we're partnering with and the restaurants' needs and the hospitals' needs. And so it's this really dynamic, constantly evolving thing. So it only could have happened if we just put something into motion and then of course had listened to the responses and the feedback that's come from the outside and we've gone back and forth to make it better across the board.

Frank Barbieri: We have one of our partners, we're partnered with World Central Kitchen, Jose Andres's organization that provides food, they call themselves food first responders. And the quote that I repeat to myself consistently through this ride has been a quote from Jose. He says, "Sometimes you don't need to plan. You just need to get to work."

Eric Ries: Who coined the name Frontline Foods?

Frank Barbieri: It was me with another original organizer, Brendan Mulligan, who was working on turning the Google docs into a webpage, into a website. And it's one of those things, we said, "Well, what are we trying to do?" He said, "Frontline food is available." So frontlinefood. com was available, but the Twitter handle wasn't available. Can't remember who has it. So we just looked at Frontline Foods, and that was available across all social and across all domains. And it was one of those just, "Okay, there it is. Let's move." Nothing really introspective or very magical about it. Just getting something out there.

Ryan Sarver: And one of the magical, unique things about this structure is if we step away from Slack for 30 minutes, a bunch of things have just been executed and decisions made. Because, again, not needing that hierarchical structure, people are just doing. And so I remember, I think I had stepped away, I came back, we had a brand, the domain, all the handles grabbed, and I think both Tabitha Young and Susan had already been working on the actual graphic branding, within a matter of 30, 40 minutes or an hour, we suddenly had a website and a brand almost totally done. It was pretty incredible.

Eric Ries: At this point it's still only been a matter of days since the first pizzas were delivered. Is that right?

Ryan Sarver: Oh, yeah.

Sydney Gressel: We're like a month into this.

Eric Ries: Yeah, it's only been a month now. But the reason I'm asking these detailed questions is, I've seen this pattern now a bunch of times. And everyone's got a funny domain name story and how fast these things can come together. I'm sure there's some people listening. They're like, "Wait a minute. This idea was conceived on a Sunday, the pizzas were delivered on Tuesday. Now we're on whatever it is, Friday, and we're buying a domain name." And you guys keep referencing the Slack and all these people, and there's a head of marketing of this. Where did all these people come from?

Ryan Sarver: I was just looking at ...

Sydney Gressel: I've got to say, I've been like, "Oh, so this is how the tech world is, huh, guys?"

Frank Barbieri: It sure is.

Sydney Gressel: It's so different than anything I've ever done where I'm like, "Wait, all these people who are just high functioning are just coming in with a good attitude, providing excellent, high quality work?" Wait, this is incredible. Maybe I should switch industries. And then also I'm hearing, "No, it's not always like this."

Ryan Sarver: I always talk about, I joined Twitter around the 30th employee and stayed there until 3,000, and that was breakneck scale and speed of growing. And this blows it away. I've never seen anything like it. I was looking back at the dates, March 17th we posted that first tweet. And a little bit of the history, as people started reaching out saying, "Hey, we really like this idea. Can we do it in more cities?" And Frank and I having come from tech said, "Oh, why don't we just open source this and we'll make it available for everyone?" And so I think it was just literally a week later, we held a Zoom call and we posted on the medium our Google sheet and Google forms. And then I think 30 or 40 people joined that first Zoom call coming from other cities, saying they would want to launch it there.

We just talked through what we had been seeing on the ground. And I think a day or two later we created the Slack and put it out there as an easy way for people to join in. And the growth in numbers of volunteers jumping in to raise their hands and go is just astounding. And I just looked and we're at 650 people in Slack now from across the US and across so many different functions. Clinician side, hospital coordinators, restaurant industry, marketing, press, legal, design. It's just been incredible to see so many people jump in. And I do think part of it is unique because we're all sheltered in place and people have maybe a little more time to give and also want to be able to lean in to do something. But it also speaks to people's ability when they have a mission they're excited about, their ability to just jump in and start getting to action was really incredible.

Eric Ries: If somebody wants to join as a volunteer right now, how do they do so?

Ryan Sarver: You can go to, and there's a link on there to log your interest in being a volunteer. And then we have a volunteer onboarding team that goes through all of that and tries to match skill set and interest with needs inside of the organization.

Eric Ries: We'll put a link to the volunteer intake form in particular, in the hopes that some will be inspired by the story.

Ryan Sarver: Awesome.

Frank Barbieri: That'd be great.

Eric Ries: Give us some more vanity metrics, if you would. So we've got about 650 people working on it. That's amazing. What else would you say a month in are the key numbers that give us a sense of the scale of the impact that you've had?

Frank Barbieri: We're serving now 234 facilities, we've served over 200,000 meals and across 48 states, 48 chapters or localities.

Eric Ries: Bravo.

Sydney Gressel: And I think the number I just saw was $4.1 million raised.

Eric Ries: Wow. Still all from small donors, individuals?

Ryan Sarver: It's a mix. A lot of that, especially as we've gone, so once we partnered with World Central Kitchen we were able to work with them as a fiscal sponsor. And so we get to piggyback off of their 501-C3 status and they manage the actual financial operations. So it allowed us to start taking smaller donations for sure.

Frank Barbieri: Another Sydney relationship is this gentleman, Anders Porter, who is the VP of marketing at Bare Life Foods in Chicago. And he saw early on what Sydney was doing through her Instagram and Facebook and established our first corporate sponsorship. And that was $100,000 that came in to bootstrap Chicago and Detroit and Atlanta. So they've just been a remarkable partner, and that broke the dam on corporate sponsorships. We were lucky enough to attract Caroline Barlerin, who is, I think ...

Eric Ries: Shout out to our mutual friend, Caroline. Yeah.

Frank Barbieri: Yeah. Who is just a force of nature and good in the world. And she's just really helped us react to the corporate interest in serving this mission too.

Ryan Sarver: Well, I think the thing I'd say on the vanity metrics piece of it, $4.1 million raised, I think it's interesting to think about every one of those dollars, again, a 100% model, goes back into the cities, and we turn those dollars incredibly fast. So sometimes might feel like a big number, but we're putting that money directly back into the economy right away. And so we need to keep filling the top of that bucket, both with small donors who are interested and excited about the mission, but also with corporate donors who can write big checks and help us keep pushing forward.

Sydney Gressel: That's actually a great point, Ryan, because we were on an all hands call the other day, all hands is a new word for me, guys. I'm trying to weave that into my vernacular.

Eric Ries: Nice work, nicely done.

Sydney Gressel: Yeah, you like that? So we were on this call the other day and there was talk about actually being short financially in some chapters, in some areas. And I naively thought, "Well, we've raised so much money that I thought we had money." And to Ryan's point, we are raising and spending it, raising it and spending it daily. And so we've done a great job, but this is automatically and very quickly going directly right into restaurants to keep them going. And so we do still have the fundraising needs and want, of course, to bring in more so that we can serve more people and we can serve more restaurants as well.

Ryan Sarver: I think it's hard for people to wrap their heads around the size and scale of the crisis, especially on the economic side.

Sydney Gressel: Yeah.

Ryan Sarver: The first $350 billion economic aid package was gone in days. That's incredible.

Frank Barbieri: Yeah.

Ryan Sarver: And so you have $3.4 or $4.8 million, sounds like a lot raised, but it's just a drop in the bucket to the work that we need to go do and that the crisis requires.

Sydney Gressel: And especially from what I've learned from our restaurant friends, a lot of bigger corporate restaurants and chains got a lot of those big relief packages to the tune of $10 and $20 million, and there's literally nothing left for most small businesses and most smaller restaurants. And so the industry just has such a huge need right now.

Eric Ries: Talk a little bit about World Central Kitchen and how you got connected with them and what they do and how they've been helpful.

Ryan Sarver: Yeah. I think World Central Kitchen has been around for about 10 years, a famous chef named Jose Andres was a Spanish immigrant, came to the US, and started opening restaurants in Washington DC and became reasonably well known in the media circuit for kicking off the tapas movement at the time. I think he and his wife pretty early on created World Central Kitchen with this idea that Frank set up, being food first responders, and acknowledging the value that a meal can bring to people during a crisis of nourishment and appreciation in a way that a lot of the people weren't thinking about. So they came onto a lot of people's radars around the hurricane in Puerto Rico. They dropped in there. And usually, their model is to bring in some of their own team and chefs. They hire local chefs, but they may take over a stadium kitchen. So it's a huge facilities and just are cranking out food for local people that are in need. So they're going geographically to where the hotspots are.

So the wildfires hit in Northern California, they showed up here to feed firefighters and displaced families. Hurricanes hit in the south, they show up there. So they'd been on a bunch of our radar at the time we were looking for a fiscal sponsor, and I can't remember I tweeted something out and José retweeted it with a comment. I can't remember exactly what it was, but the CEO of World Central Kitchen, a guy named Nate Mook, had DMed at the time and said, "Hey, we'd love to learn more. Let's chat." Obviously, knowing who they are we were pretty excited to chat with them. I think Frank, you and I think jumped on a call with them almost the next day, talking it through.

It's such a perfect marriage of us needing a partner like that, both just for the fiscal sponsor to help us get the 501(c)(3) status. But these are the same people that are also working with the World Health Organization to figure out food safety protocols. They have restaurant operations and chef operations across the country, an acknowledgement of a brand of that size to help support our small group.

But we were also bringing to the table a grassroots movement and framework that I don't think they really had in place before, but this type of crisis where it is across the US, obviously across the world, but they're more focused in the US, their old model probably wasn't going to work in the same way. So it just felt like a really good marriage. And I think literally a few days later, we were fully engaged with them and we were announcing a partnership.

Eric Ries: I want to talk a little bit about the long term here, because you said that this is not designed to be a long term program. This is an immediate acute problem. But what do you see will be the long term impact of this? Do you see Frontline Foods existing in some form, hopefully as the crisis abates and we start to get into the recovery? What does the future look like?

Ryan Sarver: The honest, short answer is I don't think we know yet. It's something that we, as a group talk about all the time. One, we're getting new data in daily and weekly about the crisis and the outlook, and the path forward. And then we're also thinking through what about the organization is attributed directly to the crisis. And what pieces of it are more like a platform or a service that whether it's COVID or local wildfires, or whatever it might be, are other pieces of this that are repurposable outside of just COVID?

When I think about the COVID piece of it, I think this is getting more commonly held, but it sure feels like at least on the economic side, we are in for a very long path back to normalcy. If we do our job of flattening the curve, that also means we lengthen the curve. So it's going to be long until people feel safe to come back to restaurants. And even if you come back to a restaurant that had a capacity of a 100 people before, you're going to be down to maybe 10, 15 people at a time in that restaurant for a long time. Then maybe it slowly scales back up.

But I think we're just going to see a very, very long trek back to "normalcy". Sydney could probably speak a little better to what we see, the acute piece of COVID issues. But I think that's going to ebb and flow as well. So we think about being in a very early inning of a long battle. I don't know exactly what role Frontline Foods will play at each one of those, but I think we're focused a lot on the economic impact of the restaurants, and that's going to go on for a very long time. And then supporting the frontline, wherever that may be as the frontline may shift over time, too.

Eric Ries: Mm-hmm (affirmative).

Sydney Gressel: Yeah. I would just second everything that Ryan is saying. I think the economic impact is going to be huge and it's going to be long term. And then I think we're going to see a few waves of COVID happen. I can't know and I don't know to what degree, and I think it will also be regional. Some places are going to have some really hard times ahead, and some places may have an easier go at it.

One of the things that we're doing within Frontline Foods is we are raising funds locally, and we're also raising funds nationally. With our local funds, we're supporting local restaurants in any particular city. But then with our national funds, we actually have set up this process where we're identifying places that we're seeing as underserved areas, places that have a high rate of COVID cases and less resources in place. Possibly less fundraising capacity, less infrastructure, where those communities really need additional support.

So I think part of what may happen as we are shifting from this more acute space that we're just getting started here to a longer term view as maybe working more on that national level in the places that really need a lot of ongoing support for medical reasons, as well as economic reasons. And then I think also, working on expanding our definition of what we consider frontline.

We've started working in the hospitals, but that's not the end of the definition of frontline. Actually, one of our groups is delivering meals to morgues right now because they've been hit in an unprecedented way with such busy business and busyness right now.

Eric Ries: Yeah, we've seen the same thing on the PPE side.

Sydney Gressel: Yes.

Eric Ries: That people have this very narrow vision of who needs to be protected, but it's totally inadequate to the scale of a problem.

Sydney Gressel: Yeah. And in fact, a lot of the time it's actually the communities that are outside of the hospital, the workers outside of the hospital that need all the more support because in my hospital capacity, I do have access to PPE and I have a number of protocols in place to make sure that I am protected when I'm caring for patients. And then folks working in shelters, for example, a lot of risk there, especially as we see increases in the number of homeless folks in every city across the country. And we know that the COVID rates are higher in the homeless population because of vulnerability, lack of basic resources, lack of access to hand washing and clean clothes. No place to sleep makes it really difficult for you to be a protected person.

So those folks are at increased risk. And then the places that they're going for support, whether it's community centers, shelters, et cetera, close quarters, not a lot of protection for the staff or the other community members. So we're going to see ways that this has a long lasting impact, and challenge for ... I'm picturing this like how it's going to spread out beyond just happening in hospitals to really having far reaching consequences in communities. So I think we will evolve our model as necessary. And really, we're constantly asking who needs this and how can we help? So I think we will shift gears as more information comes into the picture, and as we really identify where the needs are.

Eric Ries: Broadening our focus beyond food for a moment, the frontline workers have a lot of other needs that are currently being met. I'm curious  if you've seen a lot of awareness of other programs. For example, Airbnb's Frontline Stays program, or obviously there's a lot of work going on with PPE. If you think about it almost like Maslow's hierarchy, we have to take care of the basic needs of the people who are on the frontlines. What have you seen in terms of awareness of those other programs?

Sydney Gressel: I've seen the things that you just mentioned. I've seen mental health resources coming together for frontline workers. I know within my facility, I'm actually leading a health and wellness initiative within my department. So trying to facilitate supportive discussions and activities. Again, I'm speaking about my facility, has a set aside of bank of hours that we can use for payment if our family members become sick and/or. We are without childcare now because of the shelter-in-place, and so we can use those hours if we're unable to work.

Most hospitals have not done that and are not doing that for their staff. So there are a lot of financial needs for frontline workers because a lot of the time, they are the breadwinner for their family. If there is a partner at home, the partner's lost their source of income. There are childcare needs, so some programs are still offering some onsite childcare or limited daycare, things like that for essential workers. So those are the couple of things that are coming to mind.

But physical safety, so being able to provide staff with a place to sleep if they're not safe to come home to their space. I know our hospital is also providing us with scrubs so that I can come to the hospital in my civilian clothes, change into an outfit. Then I take that off and send it right to the hospital's laundry, and I come home in my own clean clothes. So those kinds of things are super supportive of frontline workers.

But again, all this stuff, it just depends on where you are and what's available in your region, or how well resourced your hospital is if they're thinking about these things or if they have the budget to offer this kind of supportive stuff just as an adjunct to just the job itself.

Eric Ries: Well, and so many hospitals are having to furlough doctors and nurses, and lay people off because of the financial stress that they're under.

Sydney Gressel: That's right.

Eric Ries: They're not going to be in a position to do these things.

Sydney Gressel: Mm-hmm (affirmative).

Eric Ries: I want to run an idea by you. I was just talking to a company. I happen to be having a lot of these conversations right now. So as I was talking to a company that provides childcare and education startup, and they obviously can't operate right now, but they are trying to reopen to do nonprofit childcare for frontline workers.

I was talking to a company that's working on accommodations and physical safety for frontline workers. I'm talking to PPE folks all the time. I've been talking to Frontline Foods, and I had this thought. One of the lessons that I've taken from this crisis is we all need to work together to an unprecedented degree. Does it make sense for us to start to think about this broader movement of the frontline community, and turn it to take care of their needs and protect them and to raise funds and join forces across all of these different dimensions of support? So that they really feel protected and supported by their communities, not just now, but into the future.

Sydney Gressel: I mean, yes. Yeah, I think this is a really good question to ask. We've talked, as an idea that hasn't gotten enough traction, about universal childcare. That would be tremendously supportive, not just of frontline workers, but of people everywhere. Just enabling people to work, enabling people to have more balance in their homes, providing early childhood education. These kinds of things that are happening in other countries, and have for a really long time. This comes back to that conversation about how a situation like this shines the light on the places where we are maybe lacking, or where we could do a better job.

So I think yes, more resources and more support. And I would say not just for frontline workers, but really, for all people everywhere. And particularly, for low income folks. I think it's a huge challenge when you're in the spot of recognizing I'm working for minimum wage. And then if I'm going to pay for childcare, my after tax's income, it doesn't even make sense for me to work because I can't afford my childcare. That's a very life-limiting experience, and opportunity-limiting experience when people are torn between even being able to afford to work because their basic childcare needs are not met and/or they can't access education for their kids. So I like what you're thinking about, and I think that there's a lot more that could be said or done in all of that.

Eric Ries: For those that are listening right now, what can they do to help Frontline Foods grow your impact, and help more people?

Ryan Sarver: That's the key question. I think there's two, maybe three major things. Most importantly, we need to continue to drive new funds in so that we can help those local economies. As Sydney said earlier, that can happen on a local level. So you can go to and you'll see all the regions that we are working in, and you can choose to donate directly at your region that matters to you.

I'm from the Detroit area, they're getting hit really hard and so I've donated directly to Southeast Michigan. Or you can choose to donate at a national level, and that gets redirected to the areas we think have a really high need, but not a ton of resources. So those are the two ways to donate. And we both can take individual donors, and then we also have a corporate donor program. So larger checks can really help fuel the thing.

We need volunteers. So if you're interested in volunteering, you can both volunteer at the local level as well as also helping coordinate restaurants or hospitals, do marketing, do fundraising locally, and a little bit at the national level too. So if you want to work at Frontline Foods, the organization that helps power a bunch of this, we're always looking for great, new motivated volunteers. And then just spreading the word.

I think everyone here, we're helping and trying to share the stories, both of what we're doing, but the stories of the people on the frontlines who need the support. And especially of the restaurants who are so deeply affected by this. I think they've got a long road ahead. So helping continue to raise awareness for what they're going through and their experiences, it means a lot.

Eric Ries: So Sydney, where do you think we go from here? How do we get out of the crisis?

Sydney Gressel: I think it's extremely important that we continue to be patient and stick with the shelter-in-place and the quarantine measures. I know that with the millions of people who've applied for unemployment in recent weeks, this is a huge sacrifice and it's a huge challenge. And I think people are really scared and really scratching their heads about what this is even going to look like and how we can move forward. And I know people are so eager to get back to work.

My fear is that if we do it too quickly and without enough testing in place, and without enough safety measures in place, that we are going to have a bounce back and a resurgence in a second wave that is far worse than the first. So as much as we can, we need to be practicing the shelter-in-place. We need to stay in our homes, obviously lots of hand-washing. And when you must go out for essential activities to please wear a mask. Don't wear gloves in public because that's just gross. That means that you're touching all different kinds of things and then touching your face, and touching the credit card machine and everything. And then those gloves don't do anything to protect other people. So it's much better to just be frequently washing your hands.

But I really want to encourage people to be patient and to stick with it. I know it's so, so hard and we're all a little stirred crazy and missing our friends, and then have these huge economic challenges. But the more that we stick with this and then gradually and slowly move forward with a lot of guidance and some safety measures in place, that's going to be our way to transition over time.

Ryan Sarver: Continue supporting the local businesses too. So a lot of restaurants are offering takeout.

Sydney Gressel: Yes.

Ryan Sarver: You can go to They offer a lot of restaurants in each area that do take out. And then there's a few different lists. I'll share one out on Twitter as well that lists all the local farmers and suppliers. As you can imagine, the places they used to deliver to the restaurants for the most part are not serving, and so they're getting hit hard as well. So trying to order from your local farmers and purveyors, as much as you can. A lot of them will do direct door drop-offs. It's really helpful to them as well.

Eric Ries: I just want to thank you, all three of you really for the work that you've done in this area, for taking care of those who are in need and finding these win, win, win partnerships. We're going to need so much more of this in the days and weeks to come. And I hope everybody listening will take inspiration from your example. So thanks for taking time out. I know this is a very busy time to have this conversation

Ryan Sarver: And Eric, thank you for the support as well in this. And honestly, I think the concept of lean principles is so core and fundamental to what we do, so thank you for your work and allowing us to stand on your shoulders and take it from there.

Sydney Gressel: Thank you so much for your interest in the work that we're doing and recognizing that this is this win, win situation. I love the way that technology is putting itself to use, or people are putting technology to use for very good work here. The partnerships between the medical community and this whole group of organizers, it's just been really motivating and inspirational to see the ways that people are coming together in creative and resilient and effective ways to make a difference.

Eric Ries: This has been Out of the Crisis. I am Eric Ries. Out of the Crisis is produced by Ben Erlich, edited by Jacob Tender. Music composed and performed by Cody Martin. Hosting is by Breaker. For more information on COVID-19 and ways you can help, visit If you have feedback or you're working on a project related to the pandemic, please reach out to me on Twitter. I'm at E-R-I-C-R-I-E-S. Let's solve this together.

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