JohnPatrick.com

Thanks for stopping by. My name is John Patrick and Attitude LLC is the name of my company. My activities include writing, speaking, investing, and board service. My areas of focus include healthcare, Internet and mobile voting, and technology. As you will see in the books I have written, I believe most big problems and big solutions involve Attitude. My latest book is Robot Attitude: How Robots and Artificial Intelligence Will Make Our Lives Better (2019). Robot Attitude and all the prior books are part of a Series called “It’s All About Attitude“. You can find all the details about each book here.


My blog below has more than 2,000 stories about technology, music, motorcycles, travel, business, Internet voting, robots, AI, healthcare, and more. Every Saturday morning, I publish an e-brief which contains an easy to read post or two about new developments in my areas of interest. Please sign up and give it a try. If you don’t like it, you can make one click and you will not receive it again. You can find me on social media on Facebook, LinkedIn, Twitter, and YouTube. You can also find my background in Wikipedia.

John R. Patrick
Which Is Worse: Power Outage or Digital Outage?

A friend in Westport, Connecticut called me yesterday from his landline. Landlines have declined due to the advancement of mobile network technology and the obsolescence of the old copper wire network. Eventually the metallic networks will be completely out of date, perhaps within the next five years. I don’t know many people who have landlines but, in my friend’s case, without his landline we would not have been able to communicate. You might say, doesn’t he have a cell phone? Yes, he has an iPhone but the cell phone tower closest to him was not functioning because of no electricity. It was not just the half-million+ Connecticut residents without power, it was also their digital infrastructure.

Most cell towers have some form of backup power. When they lose power, they resort to batteries. If the batteries run down, the towers draw power from generators, which rely on fuel. Assuming the generators can be refueled, the towers should be able to operate for days. But do they? In doing some research around the web, I found Verizon had told investors the FCC imposes specific mandates on wireless carriers including backup electric power at most cell sites. Why most and not all? In my brief research, I found cell towers typically have battery backup arrangements to support operations for two to four hours. Power outages from hurricanes usually last longer then 2-4 hours. The current outage in Connecticut started Tuesday. As of Friday afternoon, there are no firm estimates of when power will be restored. 

As we all know, our dependency on a digital infrastructure is continuously growing, even without the pandemic. The pandemic just accelerated a trend already underway. The mobile communications outage highlights two major issues: backup power to maintain the communications infrastructure, and a service attitude to walk in the customer’s shoes.

What I read from various sources is the communications companies do what the regulators specifically mandated, no more, no less. In my friend’s case the provider is AT&T. The company has $12 billion of cash on hand and it just awarded its retiring CEO a $64 million pension. (He was paid $30 million per year for the last three years.) The company has obviously put profitability and executive compensation way ahead of providing a resilient digital infrastructure for its customers.

Another glaring question is about backup technology. Where cell towers have backup, it is based on fossil fuel. Tesla Energy provides solar panels and solar rooves with accompanying Powerwalls. A Powerwall is basically a 3 feet by 4 feet by 5 inches battery. The main thing in the way of me going all out solar at the PA summer home is trees blocking a lot of sunlight. A cell phone tower would not have that problem. One or more Powerwalls could be placed at the base of the tower, and the tower could have power 24 x 7 x 365 even with hurricanes. Rather than hiring lawyers to fight with the FCC over whether two hours or four hours should be satisfactory, AT&T et al should look at the tremendous dependency their customers have on their towers.

The other major issue is Net Attitude, lack thereof. When I wrote the book twenty years ago, I thought all companies would completely get the concept in a year or two. Amazon and Apple and a few others already had it, and inspired me to write the book. Electric utilities have not been known for marketing savvy because they have been so heavily regulated. However, the increasingly more prevalent and damaging storms have caused them to realize the key to managing power restoration is communications and the way to do it is digital. 

More than 450,000 Connecticut customers remain without electricity as of Friday afternoon. Governor Lamont has declared a state of emergency and asked President Trump for a federal declaration. Eversource estimates it will have power restored to most customers by late Tuesday night, a week after Tropical Storm Isaias hit the state. The Eversource website has a comprehensive Storms & Outages section prominent on its homepage. They send regular updates to customers via text messages. Although they are overwhelmed with the scope of the outage, they at least are doing a pretty good job of communicating.

How about AT&T? What stands out on their homepage is:

AT&T: SWITCH. ADD A LINE. UPGRADE. New and existing customers get our best deal

Comcast homepage:

SHOP OUR BEST DEALS ONLINE. Get a $500 Visa® Prepaid Card Plus $10 a month off this deal when you add Xfinity Mobile after checkout.

Verizon homepage:

Devices, accessories and mobile plans. Wireless. Buy Samsung Galaxy S20 5G UW

You can see their priority. No mention of storms or outages. I searched the web for AT&T wireless outages in Westport, CT where my friend lives. Here is what I found:

An AT&T webpage labeled “Find outages in your area”

Here’s what we found for Westport, CT : 06880. Your service status: All clear! No outages to report. We didn’t find any internet, TV, or digital home phone service issues in your ZIP Code.

All clear? Take a look at the map at the top of this story. The big red blotch shows AT&T outages in CT and nearby states. In searching further, I found three very interesting websites all of which had many customer comments about their AT&T outages:

Why do these companies exist? What is their business model? Very simple. They fill the net attitude gap at the communications providers and sell advertising space to pay for it. Down Detector says, “We detect when technology fails. We help you understand what’s going on with your outage by providing real-time insights into problems.” AT&T has more than a half-trillion dollars of assets. It can’t provide these services for its customers? They surely could.

What would cause AT&T to establish a comprehensive backup of its critical infrastructure service? I believe there are three forces which could make it happen. First is regulatory mandates. We already see what happens with that approach. Companies deploy legions of lawyers to negotiate the minimum they can get by with, say 2-4 hours of backup. Second is competition. Europe has dozens of mobile providers. We essentially have three. Huge balance sheets for acquisitions and powerful lobbying have greatly reduced competition. Third is a net attitude awakening. AT&T should not compare itself to T-Mobile or Verizon. Survey after survey shows they all have terrible customer service. They should compare themselves to Amazon and Apple and other companies with a net attitude. Companies with a net attitude don’t have great customer service because of regulators telling them they have to or because of competition. Their leaders are inspired to be as great as possible. They walk the talk. They put the customer first. They make sure the customer is satisfied. Meanwhile, AT&T says, “All Clear!”, and my friend can’t reach the Internet.

News from johnpatrick.com

Incredible Splashdown

This was a big week for SpaceX. SpaceX and NASA brought astronauts Bob Behnken and Doug Hurley back to Earth from the International Space Station safely and exactly according to plan. They splashed down off the western coast of Florida on Sunday afternoon. It was exciting to watch. Like all astronauts, these two have amazing backgrounds. Behnken holds a Ph.D in mechanical engineering and the rank of colonel in the U.S. Air Force. Hurley is also an engineer and a heavily decorated test pilot. Their humility is inspiring. There were a number of firsts including the first splashdown of an American crew spacecraft in 45 years. Later in the week, SpaceX’s big Mars-colonizing spacecraft had a successful test flight. 

The Paper Ballot Chase

The paper ballot stories will get more and more exciting, to put it mildly. Bob Reby and I will be doing a third webinar on the subject in late September. The Zoom event will be hosted by Danbury Library. Stay tuned for details. The paper based system has many faults. Unfortunately, there is not enough time to get a mobile voting system in place by November. Bob and I will discuss the issues next month.

The Birthday Walk

It felt good to turn 75 this week. My wife asked if I felt 75, and I said, no, I feel 85! Just kidding. I used to run marathons. Four of them wore out one of my knees. Twelve years ago, I had one of the knees replaced. With Fitbit and my Apple watch I have counted steps on the new knee, currently 32 million. No running, just walking. Yesterday, I walked 3.1 miles, and in the hills of Pennsylvania, it was quite a workout for me. A friend of mine in Florida reminds me the key to health is to “keep moving”. I’ll do my best. 

Wall Street and the MAGFA Stocks

Despite the congressional hearings and economic woes, the tech heavyweights all roseThe market value of Apple skyrocketed to just shy of $2 trillion. Bitcoin had a 20% rise. I added Bitcoin market cap which is now above $200 billion.

The five giant tech company market caps now represent 25% of the market cap of the U.S. S&P 500. Still mind boggling. Congress is on their trail, but the hearings did not yield much. I would say the companies dodged the bullets really well.

John’s MAGFA Market Cap (08/07/20 4:00pm ET)
 ClosingMarket CapLastChange in%
 PriceTrillionsWeekBillionsChange
Microsoft$212.48$1.608$1.552$56.003.6%
Apple$444.45$1.900$1.842$58.003.1%
Google$1,494.49$1.018$1.015$3.000.3%
Facebook$268.44$0.765$0.724$41.005.7%
Amazon$3,167.46$1.587$1.578$9.000.6%
      
Total $6.878$6.711$167.002.5%
      
S&P 500 7/31/2020 $27.1$25.6 5.5%
      
MAGFA/S&P 500 25.4%24.8% 2.5%
      
Bitcoin$11,519$213.4   
      
Boeing$170.01$96.0$99.1-$3.2-3.2%
Royal Caribbean$52.11$11.2$11.4-$0.2-1.9%
Tesla$1,452.71$270.7$278.4-$7.7-2.8%
Uber$32.91$57.5$56.4$1.01.8%
Zoom$258.73$73.0$69.6$3.44.9%
Note: These six are in billions not trillions
     

Note: My father gave me the following investment advice many years ago, “Don’t give any, and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, startups, crypto, or indexes I write about.

The Dakotas Have the Voting Solution

My father loved cars. So did his father and his father’s father. My great-grandfather, Abner Patrick ran an ad which appeared on March 13, 1912 for a new car made in Philadelphia. The ad was written more than 100 years ago, but it reads like something crafted by Elon Musk.

The Bergdoll “40” with self-starter, long stroke, large valve, motor, 4-speed transmission (direct drive on third speed), 36 inch wheels, Qulck Detachable demountable rims, and cellular radiator, embodies the latest accepted design of motor car construction. It is our aim to furnish in this chassis a beautifully designed and finished car, which has no superior for comfort, flexibility and ease of handling.

In 1914, the dealership began selling the Ford Model T and Model TT Truck. In 1929, they became a Buick dealer. The final change was made in 1961 when the Salem, NJ dealership became Patrick Chevrolet. Dad retired and sold the business in 1976.  

Dad loved to drive. His goal was to drive to all the states (except Hawaii). By the time I reached high school, my two brothers and I had been to 46 of the states. I do not recall when we visited North and South Dakota, but it was probably 70 years ago. The two states are much more interesting to me now than they were then.

North Dakota is dominated by the Great Plains which give way to the rugged Badlands near the border with Montana, where Theodore Roosevelt National Park spans the Little Missouri River. At some point, the state will be known for its visionary election reform.

North Dakota Voters First is a cross-partisan grassroots coalition working to make their elections better serve all North Dakotans. The voting Amendment includes three key provisions:

Make Elections Secure

To ensure the security and integrity of North Dakota elections, the Amendment requires all voting machines to produce a paper record of every vote cast. The state will require random audits of election results. The Amendment specifically gives military-overseas voters more time to cast their ballots. This is important because voter participation from overseas has been abysmal. The millions overseas have learned it is not worth voting because delays getting and/or returning ballots by mail has been unreliable.

Increase Voter Choice

The Constitution gives the States the ball for how to conduct elections. As long as they deliver ballots for Presidential elections on the first Tuesday after the first Monday in November, they can run elections however they want. The only way the November date or processes can be changed is by Congress. I give that zero odds of happening.

I am a registered Independent in Florida. That means I cannot vote in the primary elections. North Dakota’s Amendment establishes open primaries: This simply means all voters can participate in an open primary election, where all the candidates are listed on a single ballot. The four candidates who receive the most votes for each office, regardless of their party, then advance to the general election.

Part 2 of the Amendment has a very progressive provision called Ranked Choice Voting. I explained this in some detail in Election Attitude – How Internet Voting Leads to a Stronger Democracy. RCV assures there will be a Majority winner in general elections. The essence of how this works is voters are asked to pick their first-choice candidate as usual, but then offers the option to pick their second, third, and fourth choices. If no candidate receives more than 50%  of the votes, an instant runoff process is followed. Whoever comes in fourth is out, but the ballots of those who voted for #4 as their first choice are re-distributed to the remaining three candidates based on the ballot choices. If there is still no candidate with 50%, the candidate who came in next to last is out and, once again the ballots of those who voted for that candidate have their second, third, and fourth choices redistributed. This assures one of the remaining two will have more than 50% of the votes. The state of Maine has adopted RCV as have nearly 20 major cities. RCV is gaining momentum because it adds more choice and, in my opinion, can strengthen our democracy.

Fair Legislative Districts

The third part of the North Dakota amendment will ensure voters are picking their politicians—not the other way around. The concept of politicians picking the voters is called gerrymandering. Both parties do it. North Dakota is transferring the responsibility to draw political district lines to a citizen-led North Dakota Ethics Commission. The Commission will redraw the maps in public, holding hearings around the state and taking comment from North Dakotans. The process will create districts which are fair, equal in population, respectful of existing communities, and free from partisan bias. All of the Commissioners would need to agree on the maps to put them into practice, unlike how it works in many places where politicians lead the effort and then the courts end up deciding.

The only thing missing from North Dakota’s excellent amendment is, you guessed it, mobile voting. Unfortunately, there is not enough time to plan, implement, train, and test for mobile voting. Too bad because the surge in Vote by Mail is going to lead to major problems.

I am not concerned about fraud, but I am very concerned about delays and inaccuracies. Millions of votes get thrown out because of problems with the signature on the back of the envelope missing or not matching the registration database. Another problem is the x’s and checkmarks which do not cover enough of the circle or oval to enable the ballot scanner to consider them filled in. Some states require 10-15% of the circle or oval be filled in for the ballot reader to count it. Some states set the threshold lower. Blind voters like technology which reads things to them from the web and various apps. With paper ballots, vision imparied voters (there are millions) have to rely on someone to help them and this destroys the hallmark of American voting – privacy. There are many more benefits to mobile voting as I have written here and in Election Attitude. North Dakota can inform its future voting plans by just looking toward Pierre, the capital of neighbor South Dakota.

Following the momentum of successful mobile voting in both Utah and Arizona, Boston startup Voatz completed its third virtual political convention. Mobile voting in those states has encountered no incidents, and garnered increased voter participation. The South Dakota Republican Party convention brought together delegates from 31 counties. 

The Party Chairman said that the goal was to create a convention experience which energized the party in South Dakota and replicated an in-person convention. South Dakota did it right. They worked with Voatz for weeks ahead of the convention to credential delegates, ensure a smooth rollout, and provide a test vote to get delegates comfortable with the system. More than half of the voters using the mobile voting app submitted their official ballot within the first 20 minutes of the voting window opening.  

Oregon, Washington, Colorado and a few others are experienced with Vote by Mail. In other states, it is a hodgepodge. Some require an “excuse” for why VBM is needed. Restrictive dates are imposed by others. In some states which are now shifting rapidly to VBM because of concerns at the polls, there is a shortage of staff and training to count the votes timely and accurately. I hate to say it, but I predict a disaster for November 3. I hope 2021 sees more mobile voting pilots across the country.

News from johnpatrick.com

Mars Here We Come

This was a big week for America, China, and the UAE. All three countries launched spacecraft on 300 million mile journeys to land on Mars in February, 2021. The NASA launch with the United Launch Alliance (ULA) was dazzling. On board is a compact car sized six-wheeled robotic vehicle which has 23 cameras and 13 computers on board. Plus, a small helicopter. If it flys, it will be the first time a human-made device will fly on another planet. The purpose of the mission includes studying whether there was microscopic life on the planet in the past. Even more exciting at the moment is SpaceX and NASA are planning to bring astronauts Bob Behnken and Doug Hurley back to Earth from the International Space Station. They are scheduled to splash down Sunday afternoon

The Big Four Tech CEOs and Congress

Photo Illustrations by The New York Times

It was not as exciting as the ULA launch of Perseverance to Mars, but I watched all of the 5+ hours the big four tech CEOs testimonies at the antitrust hearing by the House Judiciary Committee. The four CEOs are super smart and they were articulate. None of committee members appeared super smart. Some were articulate but misguided. Some read their questions, and you could tell they did not really understand what they were asking. Quite a few members asked a question and then cutoff the CEO seconds into an answer so they could make another statement. I do not feel the tech giants should be broken up because I don’t think government can possibly understand the tech companies and what they do to break them apart. I do feel the techs need more (light) regulation, especially with regard to privacy, security, and anti-competitive activities. More on all this another time.

The Straight Scoop On Covid-19, Masks, and Vaccines

If you missed the Mark Zuckerberg interview of Dr. Fauci, and are wondering about various claims about Covid-19 online, I highly recommend viewing it. Just click on his picture to the left. They discussed the status, how to reset, importance of masks, a plead for young people to take more social responsibility, therapeutics, and vaccine development. I will just add my own non-political view. Randomized controlled trials (RCT) are very reliable if done properly. An RCT can produce a scientifically valid proof of whether something works or doesn’t work. In the case of hydroxychloroquine, multiple RCTs have confirmed the drug does not work. Like phenomenon, this doesn’t mean the drug can never work for anyone. There may be cases where it has worked, but they would be statistical outliers. 

Wall Street and the MAGFA Stocks

Despite the congressional hearings and economic woes, the tech heavyweights all rose except for a slight pullback  by Google. The market value of Apple skyrocketed to within striking distance of $2 trillion. Bitcoin had a huge rise, similar to gold. I continue to believe Bitcoin is the new gold.

The five giant tech company market caps now represent 26% of the market cap of the U.S. S&P 500. Still mind boggling. Congress is on their trail, but the hearings did not yield much. I would say the companies dodged the bullets really well.

John’s MAGFA Market Cap (07/31/20 4:00pm ET)
 ClosingMarket CapLastChange in%
 PriceTrillionsWeekBillionsChange
Microsoft$205.01$1.552$1.524$28.001.8%
Apple$425.04$1.842$1.606$236.0014.7%
Google$1,482.96$1.015$1.032-$17.00-1.6%
Facebook$263.67$0.724$0.658$65.429.9%
Amazon$3,164.68$1.578$1.501$77.005.1%
      
Total $6.711$6.321$389.426.2%
      
S&P 500 5/31/2020 $25.6$25.6 0.0%
      
MAGFA/S&P 500 26.2%24.7%1.52%6.2%
      
Bitcoin$11,342.85  $0#DIV/0!
      
Boeing$158.00$99.1$99.1$0.00.0%
Royal Caribbean$48.71$11.4$11.4$0.00.0%
Tesla$1,430.76$278.4$278.4$0.00.0%
Uber$30.26$56.4$56.4$0.00.0%
Zoom$253.91$69.6$69.6$0.00.0%
Note: These five are in billions not trillions
     

Note: My father gave me the following investment advice many years ago, “Don’t give any, and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, startups, crypto, or indexes I write about.

The Power of Wind

Last weekend, the weather was nice so we departed our summer home on Lake Wallenpaupack for a random motorcycle ride on the backroads of northeastern Pennsylvania. We rode through Greentown, Hamlin, Jessup, Archbald (not a typo), Jermyn, Carbondale, Waymart, Honesdale, Hawley, Paupack, and back to Greentown, where we live. During the second half of our 75-mile ride, we ended up on Route 6. U.S. Route 6 is a transcontinental United States Numbered Highway, stretching from Bishop, California, in the west to Provincetown, Massachusetts, in the east. The PA Route 6 Alliance says, 

Named by National Geographic as “One of America’s most scenic drives”, US Route 6 in Pennsylvania is the heart of the American Dream. This magical and tranquil highway along Pennsylvania’s northern tier is 400 plus miles of history and heritage, linking small towns, generations of people and wondrous sights often forgotten. 

Not sure it is magical and tranquil or the American Dream, but it is a beautiful ride. As we approached Waymart, about 15 miles west of Honesdale, we suddenly saw giant turbines emerge seemingly out of nowhere. The wind turbines appeared huge, and the closer we got the more amazing the size appeared.

For most turbines, the blades are 120 feet long, so the total height from the ground to the tip of the blade is more than 380 feet, approximately the height of a 32-story building. Depending on wind conditions, the blades turn between 10 and 20 revolutions per minute, making loud swoosh sounds as they turn. I have heard of cows falling over from the noise, and farmers who sold or leased their land to turbine operators getting headaches. There is more to the story of wind energy.

On average, a single wind turbine produces more than 6 million kWh in a year, enough to supply the average electrical needs of 1,500 households. I had never thought of Pennsylvania as a significant source of wind power, but there are more than twenty wind power projects operating in the state. The most productive wind energy regions generally fall in mountain or coastal terrains. The northern portion of the Appalachian chain, including most of Southwestern Pennsylvania, is one of the areas with the highest potential for wind energy in the Eastern United States. The mountain ridges of central and northeastern Pennsylvania, including the Poconos in the eastern part of the state, where we were riding, offer some of the best wind resources in the region.

Currently, wind power is producing less than 2% of the state’s needs, but if all the wind energy potential in Pennsylvania was developed, it could produce approximately 6.5% of the state’s electricity consumption. The latest data I could find shows the state currently has 777 wind turbines. I was curious about which Pennsylvania power company owned the wind turbines. I was surprised to learn the owner is from Florida!

NextEra Energy Resources (NEER) is a wholesale electricity supplier based in Juno Beach, Florida. NEER is a subsidiary of NextEra Energy, a Fortune 200 company. Prior to 2009, NextEra Energy Resources was known as FPL Energy, and before that Florida Power & Light. The company has $5 billion of assets and more than 5,000 employees. They operate wind facilities in 21 states. Major tech companies, such as Google, which run massive data centers for cloud computing, are customers of NEER.

Congressional hearings by Congress will start on Monday, looking to find all the bad things the companies are doing. When it comes to global climate change, they have a good story. Last week I described Amazon’s Pledge to become carbon neutral. This week, Apple announced a very aggressive plan to be carbon neutral within ten years. More on that in the news section of johnpatrick.com.

News from johnpatrick.com

Carbon Neutral Update

Apple Inc. has pledged to become carbon neutral across its business, including its mostly overseas supply chain, within the next 10 years. I believe many more major companies will rearrange its operations to battle climate change.

The iPhone maker said Tuesday its new commitment means, by 2030, every Apple device sold will have been produced with no net release of carbon into the atmosphere. The company plans to reduce its emissions by 75% and develop carbon-removal solutions for the remaining 25% of its footprint. I doubt if the 25% will occur by donations to the Arbor Tree Foundation. I look forward to learning what their innovative carbon-removal solutions will be.

The Straight Scoop On Covid-19, Masks, and Vaccines

Dr. Anthony Fauci will be 80 in December. I’ll be 75 in ten days. Wish my knees and shoulders were as good as his. If you missed the Mark Zuckerberg interview of Dr. Fauci, I highly recommend viewing it. Just click on his picture to the left. They discussed the status, how to reset, importance of masks, a plead for young people to take more social responsibility, therapeutics, and vaccine development.

Independent Testing Lab Approves Voatz for US Elections

Voatz‘s mobile voting platform has received an important stamp of approval. The company announced this week an independent Voting System Test Laboratory has reviewed the Voatz mobile voting solution and found it to be compliant with the requirements for United States voting systems.

The Voatz platform is essentially a mobile app for electronic voting in elections. It uses blockchain ledger technology to ensure  voting records cannot be tampered with. It uses biometric technology such as Apple’s Touch ID and Face ID for authentication.

Voatz, a Boston startup says its solution has been used in 67 elections spanning across cities, counties, universities, nonprofits, and political parties. At the end of June, for example, Voatz was used for voting in the Republican Party of South Dakota’s virtual convention.

SpaceX Blasts Off Brilliantly

It was a great week for SpaceX as it used its Falcon 9 rocket to lift a Korean communications satellite into orbit. The stage 1 Falcon booster safely returned to Earth and landed on the bullseye of a SpaceX barge 350 miles off the coast of Florida. This is the same booster which had taken astronauts aboard a SpaceX Crew Dragon capsule to the International Space Station. For an encore, SpaceX was able to catch the two $6 million fairings, which returned to Earth with parachutes, in nets aboard two SpaceX boats. SpaceX continues to do things many have said were impossible. Next week we can watch the return of the astronauts from the ISS to Earth.

Wall Street and the MAGFA Stocks

The tech heavyweights pulled down the market today. As of Friday’s close, the market value of all the stocks I have been reporting on declined except for Amazon, now at $1.5 trillion. Caribbean. Apple and Tesla down but continue  on a trajectory to the moon. 

The five giant tech company market caps still represent 25% of the market cap of the U.S. S&P 500. Still mind boggling. Congress is on their trail and hearings will start Monday.

News service Axios reported the key points each of the big four tech CEOs are expected to make during their virtual testimonies Monday at an antitrust hearing by the House Judiciary Committee.

  • Facebook CEO Mark Zuckerberg: Congress should pass better laws. Let’s work together and do that! Axios said Zuckerberg will likely argue Congress should write laws to bolster election security and establish consistent online privacy standards.
  • Google CEO Sundar Pichai:We won search by doing it well — why punish us for that? Axios says Google doesn’t dispute its clear dominance in search, nor of certain corners of the online advertising market, but it contends digital advertising is in fact wildly competitive.
  • Amazon CEO Jeff Bezos:We’re big because we’ve always given users what they want — fast delivery, wide selection and good prices. Axios says Bezos is likely to point to Amazon’s ability to get goods to Americans’ homes during the pandemic as a public service.
  • Apple CEO Tim Cook: Our App Store creates opportunity for countless developers — and Google’s Android controls more of the smartphone market, anyway. Axios says Apple has faced criticism for the way it develops and features its own apps which compete with third-party apps. Axios says to expect Cook to cite the size and vitality of the app market and the continued enthusiasm of Apple’s customers.
News from johnpatrick.com

Note: My father gave me the following investment advice many years ago, “Don’t give any, and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, startups, crypto, or indexes I write about.

Don't Sweat It?

“Don’t sweat it!” has long been a method of telling someone not to worry or be upset. Often called perspiration, sweat is a clear, salty liquid produced by glands in your skin. As sweat evaporates, it enables your body to cool itself and prevent it from overheating. But wait, there is much more about sweat.

Researchers at the University of California San Diego have developed flexible sensors which can be attached to the skin as shown above and track your level of vitamin C. The first question is why is it important to track vitamin C? The second question is what does sweat have to do with this and how does the new technology work? I will do my best to explain answers to both questions.

Vitamin C, also known as L-ascorbic acid, is a water-soluble vitamin naturally present in some foods, and available as a dietary supplement. Unlike most animals, humans are unable to synthesize vitamin C on their own, so we have to get it through our diet or supplements.  Vitamin C is helpful for patients recovering from an infection. As an antioxidant, the vitamin may have potential in treating heart disease and cancer.

A timely aspect of vitamin C is the essential role it plays in helping us maintain a healthy immune system. Researchers believe vitamin C may have potential as a therapeutic for Covid-19. High doses of vitamin C have been linked to reduced death rates in sepsis and acute respiratory distress syndrome, both of which can be present in patients with COVID-19.  

For patients who need close monitoring of vitamin C, there are numerous methods. The most reliable is a blood test following 10-12 hours of fasting. In cases where regular monitoring is needed, a better method is needed and mHealth (mobile health) will be coming to the rescue. As in many other aspects of healthcare, the trend is toward remote monitoring with various biosensors. Initially it was counting steps and miles. Now it includes blood pressure, 1-lead ECG, heart rate, and numerous other health-related measurements. mHealth will enhance Telehealth and connected care consultations.

Based on work by the researchers at the University of California San Diego, monitoring of vitamin C levels may join the mHealth portfolio. The new devices, which could be useful in helping wearers to maintain optimal levels of vitamin C, consist of an adhesive patch a user can wear on their skin. When the body stimulates sweating in the underlying skin, the sensors in the patch capture enough sweat to analyze for vitamin C levels. The flexible patch contains an enzyme, ascorbate oxidase, which converts vitamin C to dehydroascorbic acid, (DHA), an oxidized form of ascorbic acid, the vitamin C. The interaction with oxygen in the process generates an electrical current which flexible electrodes within the patch can sense. The result is data which is proportional to the level of vitamin C present in the sweat.

The biosensor is still in the early stage, but the researchers have tested the sensors in human volunteers. They found they could track changes in the level of vitamin C over a span of a couple of hours. The sensors successfully detected changes in vitamin C levels when the volunteers drank orange juice or took a vitamin C supplement.

The potential of this new vitamin C detection technology could be significant over time. It may even be useful in the treatment of Covid-19. Day to day management of dietary and nutritional guidance may emerge as another mHealth app. Don’t sweat it? Yes, sweat it because the rapid development of biosensors many unlock many other secrets beyond vitamin C.

This article is related to health. These articles are my way of sharing what I have learned through basic research. My doctorate is in health administration. I am not a clinical doctor. Please don’t rely on any of my articles for any form of diagnosis or treatment. If you have any health issues,  please contact your doctor.

News from johnpatrick.com

The Vote on Internet Voting

On Tuesday evening the 14th, Bob Reby, CFP®, Founder and CEO of Reby Advisors, and I discussed Internet voting in a Zoom webinar hosted by the Ridgefield CT Library. In part, it related to my book, Election Attitude: How Internet Voting Leads to a Stronger Democracy.  I pledged to donate 100% of the proceeds from the sale of any of my books this week to the Library. At the beginning of the webinar, the Library posed the question, “Do you believe mobile voting can strengthen our Democracy?”. The vote outcome was 78% said Yes. The audience was asked again at the end and the vote was 87% Yes. Great audience!

 

The Straight Scoop On Covid-19, Masks, and Vaccines

On Thursday evening, Mark Zuckerberg, CEO at Facebook, interviewed Dr. Anthony Fauci. They discussed the status, how to reset, importance of masks, a plead for young people to take more social responsibility, therapeutics, and vaccine development. It was a full 55 minutes of real content, which is hard to get on any news channel. I recommend watching it. You can watch the video here.

I thought I would present the MAGFA idea of tracking the market value of five top tech companies maybe a couple of times. But, I have gotten hooked on it myself because the values of these companies continues to amaze. In addition to what I call the MAGFA stocks, I follow a handful of other stocks I think represent some key trends. Today I tried to improve the MAGFA spreadsheet look. If anyone likes or dislikes this section of the news, please let me know.

As of Friday’s close, market value of all the stocks I have been reporting on declined except for Apple and Royal Caribbean. Apple seems headed for the moon. I believe the cruise lines are up because there is hope of a vaccine sooner rather than later. Amazon had the largest decline, but it is still in the stratosphere. Likewise for Zoom and Tesla. Uber is stable but I think investors are waiting to see if people return to ride sharing. In the meantime the food delivery business is booming.

The five giant tech company market caps still represent 25% of the market cap of the U.S. S&P 500. Mind boggling. Congress is on their trail and hearings will start very soon.

Note: My father gave me the following investment advice many years ago, “Don’t give any, and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, startups, crypto, or indexes I write about.

News from johnpatrick.com
How To Make Money From Carbon Neutral

Over the last few weeks, my e-briefs have focused on the greenhouse effect, greenhouse gases which are the biggest contributors, a discussion about carbon dioxide, how to calculate your carbon footprint, and how to offset the footprint to become carbon neutral. I cited non-profits you can donate to which are engaged in activities to reverse the trend of increasing greenhouse gases.

There are also for-profit opportunities related to reducing footprints. One which I discovered at Wefunder and invested in is called NovoMoto. The startup provides a brighter life for off-grid customers in Sub-Saharan Africa communities with reliable, clean, and affordable electricity. NovoMoto customers get brighter and longer lasting lighting for themselves and their children along with the ability to charge their phones at their convenience. All this for less than the cost of today’s solutions. The company installs complete solar power packages with a rent-to-own approach starting at $10 per month.  The packages range from kits with three LED lamps and phone charging to kits with TVs and more.

NovoMoto was founded by two students as a spinout of the University of Wisconsin-Madison. Aaron Olson has a PhD from the Fusion Technology Institute and is a NASA Space Technology Research Fellow. Mehrdad Arjmand has a Ph.D from the Materials Research Science and Engineering Center in the field of semiconductor thin films.

Olson was born in the Democratic Republic of Congo in a clinic with no electricity. All his Mom had in her room was a dimly lit kerosene lamp. He says, “I was fortunate to grow up in the US, but my family – like 15 million others in the DRC – has dealt with a lack of electricity.” Olson and Arjmand believe NovoMoto has the potential to change life for millions with its clean electricity products.

The market opportunity is huge. Across Sub-Saharan Africa, there are an estimated 120 million families without access to reliable electricity. They spend over $25 billion annually ($18/home per month) on unreliable grid alternatives which use kerosene, candles, and disposable battery flashlights.

NovoMoto has focused initially on a dozen communities outside of Kinshasa, the capital of the Democratic Republic of Congo (formerly Zaire). The DRC and Madison, Wisconsin have one thing in common, they both consume 1.3 gigawatts of electrical power. The difference is Madison has a population of 700,000 and Congo has 80 million. The company plans to go after the Kinshasa, which has a population of more than seven million.

Like all startups, the NovoMoto team and its partners have been directly affected by the Coronavirus.  However, the company has had a positive impact. Many customers say their NovoMoto kits are helping them stay connected, allowing them to more easily adapt to work restrictions and social distancing. The new TV kits are helping them stay up to date with their government’s policies, closures, openings, and guidelines. NovoMoto customer service team has continues to provide support to their customers while respecting DRC guidelines.

The financial performance of NovoMoto has been quite impressive. The founders have set a goal of 5,000 installations and $1.5 million revenue by the end of 2020. If you want to learn more about NovoMoto, take a look at their page on Wefunder.

Note: My father gave me the following investment advice many years ago, “Don’t give any, and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, startups, crypto, or indexes I write about.

News from johnpatrick.com

Fireside Chat About Internet Voting

On Tuesday evening the 14th, Bob Reby, CFP®, Founder and CEO of Reby Advisors, and I will be discussing Internet voting. It will, in part, relate to my book, Election Attitude: How Internet Voting Leads to a Stronger Democracy.  Some of the things Bob and I will discuss include:

  • Voting with paper or via the Internet: Which is more secure, accurate, private, and verifiable
  • How the US can safeguard ballots from hackers and foreign adversaries using blockchain technology
  • Cautionary Case Studies: What went wrong and how mistakes could have been avoided
  • Success Stories: Internet voting in foreign countries and pilot programs in US states.

If you are interested, please register here. You will receive a Zoom invitation in the confirmation email.

As of Friday’s close, market capitalization of all the stocks I have been reporting on had incredible gains, except Boeing which pulled back a bit. Zoom zoomed to a market cap of $78 billion. Royal Caribbean had a 10% rise after acquiring the rest of SilverSea, my favorite cruise line. Tesla gained another 10% and rose to above $1,500 to a market cap of $287 billion and worth more than a bunch of the largest car makers in the world combined (the chart to the left is a week or two old). Tesla may see some headwinds after Rivian raised $2.5 billion in an aggressive plan to beat Tesla and Nikola with the first all-electric pickup truck.

The five giant tech company market caps marched on and gained more than $350 billion after gaining $300 billion the prior week. They now represent 26% of the market cap of the U.S. S&P 500. Mind boggling. Congress is on their trail and hearings will start very soon.

Note: My father gave me the following investment advice many years ago, “Don’t give any, and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, startups, crypto, or indexes I write about.

MAGFA Market Cap (07/03/20 9:00 AM EDT)
 Market CapLastChange in
 TrillionsWeekBillions
Microsoft$1.564$1.489$75.00
Apple$1.578$1.533$45.00
Google$1.001$0.928$72.80
Facebook$0.665$0.616$49.40
Amazon$1.442$1.343$99.00
   $0.00
Total$6.250$5.909$341.20
    
S&P 500 5/31/2020$25.240$25.240 
    
MAGFA/S&P 50024.8%23.4%1.35%
    
Bitcoin (thousands)$9,112$9,185-$73
    
 Market CapLastChange in
 BillionsWeekBillions
Boeing$102.0$95.9$6.1
Royal Caribbean$10.4$9.7$0.7
Tesla$224.2$178.0$46.2
Uber$53.2$51.3$1.9
Zoom$73.8$72.4$1.4
News from johnpatrick.com
How To Calculate Your Carbon Footprint And What To Do About It

As discussed previously, life on Earth depends on energy coming from the Sun. The greenhouse effect has protected life on Earth from unlivable cold conditions for as long as life has been here. To keep greenhouse gases in perspective, we need to remember, once again, greenhouse gases are a good thing, but only as long as there are not too much of them. I described water vapor, carbon dioxide, methane, ozone, and nitrous oxide. The last three are the most potent and pose the greatest threat at a molecular level but, fortunately,  there is not much concentration of them in the atmosphere. The culprit growing the fastest and upsetting the balance which nature has maintained is carbon dioxide (CO2).

The atmospheric concentration of carbon dioxide has been rising since the Industrial Revolution. Data collected by NASA’s orbiting satellites and other measurements indicate the level of CO2 has reached a dangerous level not seen in the last 3 million years. Human sources of CO2 emissions are much smaller than natural emissions but the growth of human created emissions has upset the natural balance which had existed for many thousands of years before the Industrial Revolution.

As described last week, the natural sources of CO2 added to the atmosphere include when organisms respire (exhale) or decompose, carbonate rocks (mostly limestone) break down by weather, from forest fires, and eruption of volcanoes. The human sources of carbon dioxide emissions include the burning of oil, coal, and natural gas, cement production, and deforestation (3.5 to 7 billion trees cut down per year). Almost 90% of all human-produced carbon dioxide emissions come from the burning of fossil fuels.

As described last week, Amazon has pledged to be the leader, but they are not alone. Twenty-three percent of the Fortune 500 companies have made a public commitment they will be carbon neutral by 2030, using 100% renewable power, or meeting a science-based internal emission reduction target. With congressional legislation taking form plus stakeholders and employees making demands, the other 77% will likely get on board sooner rather than later. 

If you go along with the scientific consensus, the logical question is what can you do personally to reduce your own carbon emissions?  The starting point is to calculate your personal carbon footprint. Let’s start with a couple of extreme scenarios to get a grasp of what personal carbon emissions are.

Let me introduce you to Mr. and Mrs. Green. The Greens live in a tent in Costa Rica. They love the weather, the food, and the 15% tax rate. Over the course of the year, the temperature there typically varies from 63°F to 81°F and is rarely below 60°F or above 84°F. They don’t need to use energy for heating or cooling. The Greens work from home in San Jose and get goods and supplies within walking or cycling distance. They do not own a car and don’t fly anywhere. Their diet is quite healthy consisting mostly of fish, fruit, nuts, and grains. The Greens are very conscientious about recycling.

Now, let me introduce you to Mr. and Mrs. Carbon. The Carbons live in Port St. Lucie, the eighth largest city in Florida. The population is more than 189,000. The temperature ranges from 55 to 90. During one-third of the year, a modest amount of heating is needed. The Carbons consider air conditioning a necessity. Port St. Lucie is one of the largest cities in America with no public transportation. More than 90% of people drive to work and 80% drive alone. Mrs. Carbon drives her diesel BMW to work in Melbourne, Florida about an hour drive. Mr. Carbon has a diesel F-150 pickup truck. He drives to his job in Palm Beach Gardens, Florida. It takes about 40 minutes. The Carbons love to go out for dinner. They travel a lot, to a summer home in North Carolina, and at least one major trip to California or Europe. A cruise or two has been the norm. Mr. Carbon loves to fish, but he doesn’t eat any. He gives his catches to a neighbor. The Carbons love to BBQ steaks at home. Yelp lists 22 steak houses in Port St. Lucie. The Carbons enjoy more than a few of them. The Carbons recycle when it is convenient.

The contrast between the lifestyle of the Greens and the Carbons is quite significant. So would be their carbon footprints. The carbon footprint represents how much greenhouse gas a person or family or organization emits. The unit of measure is tons of CO2eThe e stands for equivalent. In other words the other gases such as nitrous oxide and methane are converted to an equivalent amount of CO2. The average American household footprint is 48 tons of CO2e. The Greens would be a fraction of the average, and the Carbons would be twice the average or more.

Science Daily reported on some analysis done by a class at MIT,

“The class studied the carbon emissions of Americans in a wide variety of lifestyles–from the homeless to multimillionaires, from Buddhist monks to soccer moms–and compared them to those of other nations. The somewhat disquieting bottom line is that in the United States, even people with the lowest energy usage account for, on average, more than double the global per-capita carbon emission. And those emissions rise steeply from that minimum as people’s income increases.”

This part is controversial because the footprint calculated includes government services. In other words, if one country has 100,000 armored tanks belching diesel exhaust, and another country has no tanks, the comparison is apples to oranges. Also, there is nothing an individual consumer can do about the size and scope of their government, at least in the short term. 

To get a footprint calculation which is actionable, you use a footprint calculator. There are many of them. I recommend using the one from conservation.org which you can find here. It will ask you about the size of your house, what kind of car you have, what you eat, and a number of other factors. I view the calculation as an estimate. I believe the footprint for my wife and I is somewhere between 50 and 75.

I decided more than five years ago, I wanted to be carbon neutral. That means my net carbon footprint is zero. There are two ways you can reduce your footprint. For example, if you are Mr. and Mrs. Carbon, you can switch the Ford F150 for a Tesla CyberTruck and the BMW for a Tesla Model S or some other electric car. There will be many more choices coming. Electric cars are not zero emissions because you have to use electricity which is made by an electric company which may burn coal to produce the power. An offset is to get a Tesla solar roof and charge your car from the sun. 

In addition to using less fossil fuel for transportation, following are a few other things you can do.

  1. Use only Light Emitting Diodes (LEDs) throughout your house. The old traditional bulbs give up 90% of their energy as heat.
  2. Reduce your garbage. Bring your own bags to the grocery store. Reduce your consumption of products with excess packaging and plastic. Consider buying more bulk and reusing containers. For example – eliminate buying water in plastic bottles and use filtered tap water. There are many related ways to reduce garbage. One person can’t save the planet, but efforts of each individual person helps, assuming enough individuals buy in to the idea.
  3. Plant trees. Trees help remove carbon dioxide from the atmosphere by using it during the photosynthesis process that also releases oxygen as a by-product.
  4. Use water efficiently. Water is a precious natural resource and in need of protection. There are many ways to save water. (I am not recommending stopping showers). Like garbage, a little effort by millions of people makes a difference. Do we need to keep water running when we brush our teeth?

The above are just a few thoughts. There is much more to it. Just Google “carbon footprint” and you will find the resources. Even with aggressive actions on our part, we still will not get our footprint to zero. The other tool at our disposal is to invest in projects which provide offset. Many non-profits are focused on reducing carbon emissions. I guess you could say, to get to carbon neutral, you have to buy your way out of it. I confess. I do. 

I donate to Arbor Day Foundation. They are laser focused on planting trees. Visit the site to learn more. At about 10 years age, trees are estimated to soak up about 48 pounds of CO2 per year. The National Tree Benefit Calculator can show you more specifics. For example, if you have a 6-inch Fir tree on a property in Pennsylvania where I am for the summer, that tree will reduce atmospheric carbon by 77 pounds per year. Yes, it would take a lot of trees to offset Mr. and Mrs. Carbon, but if they were committed to be carbon neutral, the Arbor Day Foundation can calculate the size of a donation it would take to plant the required number of trees. I donate $750 to the Foundation to get me to neutral.

The topic I have been writing about is complex and to some people it is controversial. What I have tried to do is drill down on the basics and keep it simple. If you want to dip your toe in the water, I recommend a book like Reduce Your Carbon Footprint: A Beginners Guide To Reducing Your Greenhouse Gas Emissions by Ann Colson.

News from johnpatrick.com

SpaceX is on an incredible roll. On Tuesday it launched the military’s newest, most accurate GPS satellite after a two-month delay due to the pandemic. A Falcon 9 rocket blasted off from Florida’s Cape Canaveral Air Force Station, carrying the GPS satellite to orbit. The brand new first-stage booster with nine rocket engines landed perfectly on an ocean platform several minutes later. It will be recycled for future use. A feat many thought was impossible.

If you want to make a difference in Black education, you can donate to benefit the Thurgood Marshall College Fund, Inc. The fund is the only national organization representing America’s 47 publicly-supported Historically Black Colleges and Universities (HBCUs), and the nearly 300,000 students that attend them each year, The Fund’s mission is to ensure student success by promoting educational excellence and preparing the next generation of workforce talent through leadership development.

Thurgood Marshall was an American lawyer who served as Associate Justice of the Supreme Court of the United States from October 1967 until October 1991. Marshall was the Court’s first African-American justice.

The tax deductible gofundme page is here.

As of Thursday’s close, market capitalization of all the stocks I have been reporting on had nice gains. Zoom reached a market cap of $74 billion. Apple continues to set records. If you didn’t watch last Monday’s keynote about Apple’s plans for the rest of the year, I highly recommend it. Watch it here.

The five giant tech company market caps marched on and gained more than $300 billion and now represent 25% of the market cap of the U.S. S&P 500. Mind boggling. Congress is on their trail and hearings will start very soon.

Note: My father gave me the following investment advice many years ago, “Don’t give any and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, crypto, or indexes I comment on.

MAGFA Market Cap (07/03/20 9:00 AM EDT)
 Market CapLastChange in
 TrillionsWeekBillions
Microsoft$1.564$1.489$75.00
Apple$1.578$1.533$45.00
Google$1.001$0.928$72.80
Facebook$0.665$0.616$49.40
Amazon$1.442$1.343$99.00
   $0.00
Total$6.250$5.909$341.20
    
S&P 500 5/31/2020$25.240$25.240 
    
MAGFA/S&P 50024.8%23.4%1.35%
    
Bitcoin (thousands)$9,112$9,185-$73
    
 Market CapLastChange in
 BillionsWeekBillions
Boeing$102.0$95.9$6.1
Royal Caribbean$10.4$9.7$0.7
Tesla$224.2$178.0$46.2
Uber$53.2$51.3$1.9
Zoom$73.8$72.4$1.4
News from johnpatrick.com
What Is Your Carbon Footprint?

As discussed last week, life on Earth depends on energy coming from the Sun. The greenhouse effect has protected life on Earth from unlivable cold conditions for as long as life has been here. To keep greenhouse gases in perspective, we need to remember greenhouse gases are a good thing, but only as long as there are not too much of them. The purpose of this article is to simply describe which greenhouse gases are most likely to get out of balance with nature. Up until recently, nature has kept things in balance. 

The main greenhouse gases described last week are water vapor, carbon dioxide, methane, ozone, and nitrous oxide. The last three are the most potent and pose the greatest threat at a molecular level but, fortunately,  there is not much concentration of them in the atmosphere. The culprit growing the fastest and upsetting the balance which nature has maintained is carbon dioxide (CO2). See the graph below which shows the growth.

The atmospheric concentration of carbon dioxide has been rising since the Industrial Revolution. Data collected by NASA’s orbiting satellites and other measurements indicate the level of CO2 has reached a dangerous level not seen in the last 3 million years. Some of the data is debatable but very large numbers of scientists have reached a consensus  about the impact and the role of humans. Human sources of CO2 emissions are much smaller than natural emissions but their growth has upset the natural balance which had existed for many thousands of years before the Industrial Revolution.

The natural sources of CO2 added to the atmosphere include when organisms respire (exhale) or decompose, carbonate rocks (mostly limestone) break down by weather, from forest fires, and eruption of volcanoes. The human sources of carbon dioxide emissions include the burning of oil, coal, and natural gas, cement production, and deforestation (3.5 to 7 billion trees cut down per year). Almost 90% of all human-produced carbon dioxide emissions come from the burning of fossil fuels.

Multiple studies published in peer-reviewed scientific journals show at least 97 percent of actively publishing climate scientists agree the climate-warming trends over the past century are extremely likely due to human activities. The 3% have a voice and they get heard, but mostly not believed. Most of the leading scientific organizations worldwide have issued public statements endorsing the consensus position. (I wasn’t so sure some years ago, until I read some books on the subject).

Many global issues, perhaps most, don’t have consensus. On the subject of emissions and global warming, the consensus is very solid. If you go along with the consensus, the logical question is what can you or your organization do to reduce carbon emissions.

One individual, Jeff Bezos, the wealthiest man on Earth, has made a number of statements on what to do. In September 2019, he announced a massive new commitment to fight climate change called The Climate Pledge. He said Amazon will work to drastically reduce its carbon emissions with the ultimate goal of becoming carbon-neutral by 2040. In other words, for every ton of CO2 the company’s trucks and warehouses and other activities emit, the company will do things to equally reduce emissions by the company or assisting others to do so. He is one of a growing list of business leaders who believe rising greenhouse gases will have catastrophic effects on climate change. His $10 billion pledge is 10 years earlier than the most ambitious version of the Paris agreement.

The pledge doesn’t mean Amazon will have zero carbon emissions. Part of the pledge will be met by offsetting emissions, by planting trees or using other carbon capture technologies. Amazon is transitioning to electric delivery vans and tapping renewable energy to power its operations.

In addition to a $2 billion fund for “decarbonizing” technologies, Amazon announced on Thursday of this week it had acquired the naming rights to KeyArena, which will play home to a new Seattle based NHL hockey team and the Seattle Storm professional basketball team. Most stadiums are named after the company who bough a sponsorship (e.g. Verizon), but Jeff Bezos wanted to highlight the importance of fighting climate change. 

The plan is to convert the arena into an all-electric building powered by renewable energies, including solar. Ice for NHL games will rely on reclaimed rainwater. All events will use durable and compostable containers enabling the arena to divert 95 percent of trash away from landfills.

But what about us individuals? What can we do to reduce our personal carbon emissions, known as our carbon footprint? And how can we determine the size of our footprint? Next week, I will explain the answers.

News from johnpatrick.com

Maccene Grimmett, at 106, was one of the first to test mobile voting when her county in Utah extended the mobile voting option to voters with disabilities in November 2019. Maccene recently turned 107 years old! Watch the video below where Maccene explains the importance of voting.

Unfortunately, there is not enough time to properly plan, test, and implement new mobile voting solutions for the November 3 election. Too bad. The need becomes more clear each day. If disabled people voted at the same rate as those without disabilities, an estimated 2.3 million more people would cast their ballots. Georgia was a disaster, disenfranchising a lot of votes. Paper ballot problems popping up in other states. Is Internet mobile voting perfect? Compared to what? That should be the response. I have stayed up late to watch the numbers come in every election day for the last 50+ years. Not this time. They will be counting paper ballots for days, and possibly arguing for weeks about the accuracy. Whoever loses will claim fraud.

The Ridgefield library will host a fireside chat on the subject of voting.  The Zoom webinar is titled, “Could Internet Voting Strengthen Our Democracy in Turbulent Times?” Bob Reby and I will discuss the following:

  • Voting with paper or via the Internet: Which is more secure, accurate, private, and verifiable
  • How the US can safeguard ballots from hackers and foreign adversaries using blockchain technology
  • Cautionary Case Studies: What went wrong and how mistakes could have been avoided?
  • Success Stories: Internet voting in foreign countries and pilot programs in US states.

The webinar will be on July 14 at 6 PM EDT. Please register here.

If you want to make a difference in Black education, you can donate to benefit the Thurgood Marshall College Fund, Inc. The fund is the only national organization representing America’s 47 publicly-supported Historically Black Colleges and Universities (HBCUs), and the nearly 300,000 students that attend them each year, The Fund’s mission is to ensure student success by promoting educational excellence and preparing the next generation of workforce talent through leadership development.

Thurgood Marshall was an American lawyer who served as Associate Justice of the Supreme Court of the United States from October 1967 until October 1991. Marshall was the Court’s first African-American justice.

The tax deductible gofundme page is here.

As of Friday’s close, market capitalization of all the stocks I have been reporting on except for Microsoft, Apple, Amazon, and Zoom. Zoom reached a market cap of $72 billion. Apple continues to set records. If you didn’t watch Monday’s keynote about Apple’s plans for the rest of the year, I highly recommend it. Watch it here.

The five giant tech company market caps were mostly flat but still 23% of the market cap of the U.S. S&P 500. 

Note: My father gave me the following investment advice many years ago, “Don’t give any and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, crypto, or indexes I comment on.

MAGFA Market Cap (06/26/20 4:00 PM EDT)
 Market CapLastChange in
 TrillionsWeekBillions
Microsoft$1.489$1.480$0.01
Apple$1.533$1.516$0.02
Google$0.928$0.977-$0.05
Facebook$0.616$0.680-$0.06
Amazon$1.343$1.334$0.01
    
Total$5.909$5.987-$0.1
    
S&P 500 5/31/2020$25.240  
    
MAGFA/S&P 50023.4%23.7%-0.31%
    
Bitcoin (thousands)$9,185$9,323-$138
    
 Market CapLastChange in
 BillionsWeekBillions
Boeing$95.9$105.6-$9.7
Royal Caribbean$9.7$11.6-$1.9
Tesla$178.0$185.6-$7.6
Uber$51.3$56.0-$4.7
Zoom$72.4$68.7$3.8
What Are the Top Greenhouse Gases?

As discussed last week, life on Earth depends on energy coming from the Sun. The greenhouse effect enables us to live here. About half the light reaching Earth’s atmosphere passes through the air and clouds on the way to the surface. The light is then absorbed and radiated upward in the form of infrared heat. About 90 percent of this heat is then absorbed by the greenhouse gases and radiated back toward the surface.

To keep greenhouse gases in perspective, we need to remember greenhouse gases are a good thing. Without them, Earth would be too cold, and we would not be able to live here. The flip side is there can be too much of a good thing. Many scientists are worried human activities are adding too much greenhouse gases to the atmosphere. More on that question later. The purpose of this article is to simply describe what exactly the greenhouse gases are.

The main greenhouse gases are:

  • Water vapor
  • Carbon dioxide
  • Methane
  • Ozone
  • Nitrous oxide

Water vapor

Water vapor (H2O)is water in the form of gas. Think of it like steam from a pot of boiling water or water evaporating from the surface of a pond. The vapor forms clouds and then it rains on Earth. This often causes a cooling effect, but the water vapor blocks heat from escaping so it acts like a greenhouse and makes Earth warmer. The warmer Earth makes even more water evaporate, and the cycle continues.

Carbon dioxide

Carbon Dioxide (CO2) consists of carbon and oxygen. It is all around us, and comes from natural sources including volcanoes, and from combustion of organic matter such as coal, oil, and natural gas. It also comes from the respiration processes of living aerobic organisms. The average human exhales about 2.3 pounds of carbon dioxide per day. A person exercising vigorously can produce up to eight times as much CO2. The main human-made source of CO2 is from burning fossil fuels for electrical power generation and transportation. For example, the average gasoline-powered car emits about 30 pounds of CO2 per day.

Methane

Methane (CH4) is gas found in small quantities in Earth’s atmosphere. It is the simplest hydrocarbon, consisting of one carbon atom and four hydrogen atoms. Simple, but a powerful greenhouse gas. Methane is flammable, and is a principal component of natural gas. Methane is released from wetlands, growing rice, raising cattle, burning natural gas, and mining coal. Although a small component of the greenhouse gases, it traps a lot of heat. Scientists consider it the second most important contributor to warming of the Earth.

Ozone

Ozone (O3), also called trioxygen, is composed of three oxygen atoms. It can be found in the upper and lower parts of the atmosphere. The stratosphere is the second major layer of Earth’s atmosphere, just above the troposphere, which is the lowest part of the atmosphere. Ozone in the stratosphere is good for us because it absorbs the Sun’s ultraviolet radiation thereby protecting us from it. Ozone in the lower parts of the atmosphere acts as a greenhouse gas.

Nitrous oxide

Nitrous oxide (N2O) is a colorless and odorless chemical compound also known as “laughing gas.” When inhaled, the gas slows down the body’s reaction time, and produces a calm and euphoric feeling. I remember receiving it from my dentist some years ago as a sedative. It was first used by a dentist in the mid 1800s, and is still used by dentists today. The use of nitrous oxide is considered safe with few side effects. Nitrous oxide is produced by bacteria in soil and the ocean. Nitrous oxide is released by some types of factories, power plants, and plant fertilizer. It is considered a powerful greenhouse gas, but the greater concern is it damages the protective ozone layer.

There is much more to know about each of the five greenhouse gases described. Some of the gases occur naturally and some are by-products of things done by humans. In another article, I will give some specific examples and describe how you can calculate what your own contribution to greenhouse gases may be. Stay tuned.

 

News from johnpatrick.com

I am learning a lot from Zoom webinars. Thursday night I attended one hosted by the Ridgefield, CT library. The subject was the impact of AI in health sciences, presented by an IBM PhD researcher. The library will host another fireside chat on July 14, “How to Strengthen Our Democracy in Troubling Times”. Unfortunately, there is not time to implement new mobile voting solutions for the November 3 election. Too bad. The need becomes more clear each day. If disabled people voted at the same rate as those without disabilities, an estimated 2.3 million more people would cast their ballots. Georgia was a disaster, disenfranchising a lot of votes. Paper ballot problems popping up in other states. Is Internet mobile voting perfect? Compared to what? That should be the response. I have stayed up late to watch the numbers come in every election day for the last 50+ years. Not this time. They will be counting paper ballots for days. 

We took a poll at the beginning of the Zoom session and 67% of the attendees said they believed Internet voting could strengthen our democracy. A poll at the end of the Zoom session showed 93%. Bob Reby and I will be doing a second Zoom fireside chat on the subject of voting hosted by the Ridgefield Library on July 14. Details and how to register will follow. You can watch a video excerpt from our prior fireside chat here.

As of Friday’s close, Tesla market capitalization continued to climb and was at $186 billion. It finished at just above $1,000 per share. Zoom reached a market cap of $69 billion, and Uber was unchanged at $56 billion. The five giant tech company market caps marched past their already meteoric level by another $200 billion. All five companies are global, but to put their massive valuation into perspective, it now represents 24% of the market cap of the U.S. S&P 500. Shareholders are happy but government regulators and politicians are ramping up the discussion about new regulations and anti-trust hearings. I believe pressure on big tech will continue to mount. There is a push to remove liability protections which made a lot of sense in the mid 1990s when the Internet was a baby, but perhaps not now. I have included a few other stocks I follow in the list this time. Boeing is so important to not just the airlines but also space and defense. The cruise industry projected 32 million passengers were set to travel on cruise ships in 2020, up from 30 million in 2019. Almost nobody is cruising right now. Will they come back? I think so, but nobody knows.

Note: My father gave me the following investment advice many years ago, “Don’t give any and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, crypto, or indexes I comment on. 

MAGFA Market Cap (06/19/20 4:30 PM EDT)
 Market CapLastChange in
 TrillionsWeekBillions
Microsoft$1.480$1.424$56.0
Apple$1.516$1.468$48.0
Google$0.977$0.964$12.7
Facebook$0.680$0.651$29.1
Amazon$1.334$1.269$65.0
    
Total$5.987$5.776$210.8
    
S&P 500 5/31/2020$25.240  
    
MAGFA/S&P 50023.7%22.9%0.8%
    
Bitcoin (thousands)$9,323  
    
 Market CapLastChange in
 BillionsWeekBillions
Boeing$105.6$106.9-$1.3
Royal Caribbean$11.6$12.8-$1.2
Tesla$185.6$173.5$12.1
Uber$56.0$55.9$0.1
Zoom$68.7$61.9$6.8
The Simple Science of a Greenhouse

Every day, there are stories in the media about climate change. Opinions on the subject vary widely. Based on a UN report, Axios wrote “Nothing is happening remotely fast enough to save humanity from facing the self-inflicted disaster of runaway climate change”. Some see it quite differently. The challenge is the subject consists of incredibly complex and interconnected elements. My goal is to write about this starting with the basics and develop an understandable picture which can shed some light on various policy decisions which could affect the situation.

An executive I reported to many years ago at IBM was a believer in making things simple. He was a brilliant scientist. We were working on a presentation for the board of directors. I will never forget him saying the only way to get this across to the board is to assume they are fifth graders. He had a set of rules for how to prepare a board presentation. One of his rules was to never put more than five bullets on a slide. Keep it simple. Lets start with the greenhouse.

A greenhouse is a building with glass walls and a glass roof. (Some greenhouses use polycarbonate instead of glass). The purpose of a greenhouses is to provide a perfect environment for non-stop gardening. In the early part of the year, it is a good time to get a head start with frost-tolerant plants such as broccoli, cabbage, lettuce, and spinach. When spring arrives, it is time for more tender plants such as cucumbers, melons, and squash. When internal and external greenhouse temperature reaches a peak, it is great for heat-loving plants such as eggplant, peppers, and tomatoes. After a warm summer and the beginning of cool weather, gardeners like to begin a second crop of cool-season vegetables like kale, snow peas, and turnips.

A greenhouse maintains a great environment, staying warm inside, even during the winter. The principles which make this possible are really simple. During the daytime, sunlight shines into the greenhouse and warms the air inside and the plants. At night, it gets colder outside, but the temperature in the greenhouse stays pretty warm. The simple reason is the glass walls and roof of the greenhouse trap the heat of the sun and prevent it from escaping.

Fortunately, we have a virtual greenhouse which envelops our planet Earth and keeps the temperature tolerable. Instead of glass walls and ceiling, our planet’s greenhouse consists of a layer of gasses called the atmosphere. Because the atmospheric gasses act like the walls and ceiling of a greenhouse, they are called greenhouse gases and what they do is called the greenhouse effect. The primary greenhouse gases in Earth’s atmosphere are water vapor (H2O), carbon dioxide (CO2), methane (CH4), nitrous oxide (N2O), and ozone (O3). 

The greenhouse effect means the gases in the atmosphere trap the sun’s heat just like the glass roof of a greenhouse. During the day, the Sun shines through the atmosphere and warms the Earth’s surface. At night, Earth’s surface cools, releasing some of the heat back into the air, but some of the heat is trapped by the greenhouse gases. The greenhouse effect is a good thing. It keeps our Earth a warm and cozy 59 degrees Fahrenheit (on average). Without the greenhouse effect, Earth’s temperature would be 32 degrees below freezing. We would not be able to live here.

On the other hand, if there is too much gas in the atmosphere, more heat would be trapped, and the greenhouse effect would make the average temperature on Earth go up. NASA has placed satellites in orbit which measure the amount of gases in the atmosphere. I don’t believe there is much debate the amount of gases has increased quite a bit over the years. The scientific consensus is the increase in greenhouse gases is trapping more heat in the atmosphere and raising the temperature on Earth.

There is debate about what has caused the amount of greenhouse gases to increase. Next week, I will drill down on the subject. The deeper one gets into the subject, the more complex it becomes. I will do my best to keep it simple.

News from johnpatrick.com

Another fireside chat coming up July 14, “How to Strengthen Our Democracy in Troubling Times”. Unfortunately, there is not time to implement new mobile voting solutions in time for the November 3 election. Too bad. The need becomes more clear each day. Georgia was a disaster, disenfranchising a lot of votes. Paper ballot problems popping up in other states. Is Internet mobile voting perfect? Compared to what? That should be the response. I have stayed up late to watch the numbers come in every election day for the last 50+ years. Not this time. They will be counting paper ballots for days. You can watch a video excerpt of the fireside chat here.

We took a poll at the beginning of the Zoom session and 67% of the attendees said they believed Internet voting could strengthen our democracy. A poll at the end of the Zoom session showed 93%. Bob Reby and I will be doing a second Zoom fireside chat on the subject of voting hosted by the Ridgefield Library on July 14. Details and how to register will follow.

As of Friday’s close, Tesla market capitalization continued to climb and was at $174 billion. It traded above $1,000 per share during the week. Zoom reached a market cap of $62 billion, and Uber was down to $56 billion after the GrubHub merger fizzled. The five giant tech company market caps marched past their already meteoric level. All five companies are global, but to put their massive valuation into perspective, it now represents 23% of the market cap of the U.S. S&P 500. Shareholders are happy but government regulators and politicians are ramping up the discussion about new regulations and anti-trust hearings. I believe pressure on big tech will continue to mount. I have included a few other stocks I follow in the list this time. Boeing is so important to not just the airlines but also space and defense. The cruise industry projected 32 million passengers were set to travel on cruise ships in 2020, up from 30 million in 2019. Almost nobody is cruising right now. Will they come back? I think so, but nobody knows.

Note: My father gave me the following investment advice many years ago, “Don’t give any and don’t take any.” Wise man. I am not recommending buying or selling any of the stocks, crypto, or indexes I comment on. 

MAGFA Market Cap (06/05/20 2:30 PM EDT)
 Market CapLastChange in
 TrillionsWeekBillions
Microsoft$1.424$1.415$9.0
Apple$1.468$1.431$37.0
Google$0.964$0.983-$19.2
Facebook$0.651$0.658-$6.3
Amazon$1.269$1.237$32.0
    
Total$5.776$5.724$52.5
    
S&P 500 5/31/2020$25.240  
    
MAGFA/S&P 50022.9%22.7%0.2%
    
Bitcoin (price)$9,441.000  
    
 Billions  
Boeing$106.9  
Royal Caribbean$12.8  
Tesla$173.5  
Uber$55.9  
Zoom$61.9  


Healthcare workers often use the word “code” as slang for a cardiopulmonary arrest happening to a patient in a hospital or clinic. Announcement of the word energizes a team of providers, sometimes called a code team, to rush to a specific location and begin immediate resuscitative efforts. Code means different things to different people. Broadly speaking, code means a systematic statement of a body of law or a system of principles or rules. Politicians and activists use jobs, healthcare, or a change in leadership. Developing a vaccine for the coronavirus revolves around genetic code. If you ask a high school student what code means, she or he will wonder why you don’t know, and then explain code is the set of instructions which tells a computer what to do.

A set of instructions which tells a computer what to do is often called a “program” or a “script”, or more likely today, an app, short for application. When you click the CNBC app on your smartphone, a set of instructions are executed to display the business news of the day or retrieve a quote for the current price of a stock, bond, option, or fund. A typical smartphone app contains thousands of lines of code.

To offer an example of what code can do, I will describe a script (program) I wrote for one of my hobbies, home automation. Code is written using a computer programming language. There are many of them, the most popular being Python. When I wake up in the morning, I push a button on my nightstand which initiates a Python script  called Good Morning. It runs on a Mac computer in my home office. In the following lines, I will describe what the script does in layperson terms. The actual script follows a very strict syntax, the arrangement of words and phrases formed in a detailed way which the computer understands.

  • Retrieve the season, date, time, and weather from the Internet.
  • Raise the motorized solar shade.
  • Wait 15 seconds and then turn on the night table lamp and ceiling fan light to  low brightness.
  • Gradually increase the brightness.
  • Set thermostats based on the current season.
  • Wait 15 minutes and then unlock all doors.
  • Prepare a good morning announcement from various data.
  • Use Amazon Web Services Polly artificial intelligence to create an announcement using Salli’s amazingly human voice, and play it on the master bedroom Sonos wireless speaker.
  • Friday’s announcement was:”Good morning. Today is Friday, June 5. The time is 7:00 AM and the current weather is overcast. The temperature outside is 67 and the humidity is 85 percent. The forecast is light rain throughout the day. The high temperature will be 77 with winds out of the South at 6 miles per hour and gusts up to 16 miles per hour. There is a 94 percent chance of precipitation. Have a nice day at the Ridge.”
  • Make a music selection at random from a list of favorite stations, playlists, and albums. If it is Sunday, select at random from a list of Baroque music sources. If it is not Sunday, select at random from a list of favorite music sources, mostly from Spotify.
  • Play the selected music on Sonos speakers throughout the house. Set volume levels based on preference for each room.

The actual Python script is 115 lines of code. It took quite a few hours to write and test the code, to get it to do exactly what I wanted it to do. One thing I learned many years ago is software does exactly what you tell it to do, not necessarily what you want it to do. The process to get it right is called “debugging”.

I first learned to code (write code) more than 50 years ago in engineering school. The computer was made by GE and the computer language was called WIZ. Later, when I joined IBM, I learned other computer programming languages including Fortran, RPG, APL, and Basic. I was never a programmer (coder), but IBM required all sales people to be conversant in software so as to give good advice to customers. If you asked a high school student about the languages I just mentioned, they would say they never heard of any of them. Todays most popular code languages are Python, Java, Javascript, C#, PHP, and Ruby on Rails. There are many more. One of my grandchildren learned the basics of an Apple coding language called Swift.

Code is everywhere. A countertop toaster oven has a computer chip in it with a set of instructions to make your toast or baked casserole come out just right. Most all “televisions” today are actually computers which run code to select and play the streaming service you like. The Apple and Google app stores have roughly five million apps.

The range of lines of code in apps and devices is extraordinary. The average iPhone app has up to 50,000 lines of code. Google’s apps in total are believed to use more than two billion lines of code. To put this in perspective, a million lines of code, if printed, would be about 18,000 pages of text, 14 times the length of War and Peace.

Code is running in millions of pacemakers, games, and just about everything electronic. A few other examples:

  • The control software to run a U.S. military drone uses 3.5 million lines of code.
  • A Boeing 787 has 6.5 million lines
  • The Google Chrome browser runs on 6.7 million lines of code.
  • A Chevy Volt uses 10 million lines.

Famed venture capitalist Marc Andreesen said, “software is eating the world”. What he means is software is replacing human labor. Everywhere. In most everything. My Good Morning script is trivial, but consider the SpaceX Crew Dragon which autonomously docked itself with the International Space Station while both were circling the Earth at 17,000 mile per hour. I don’t know how many lines of code it took to do this, but a lot. A Tesla electric car is believed to have 100 million lines of code running under the hood.

The title of this article is “Do We All Have To Learn To Code?” My answer is a qualified yes. When it comes to education, every kid needs to learn at least the basics of coding, regardless of career path they may aspire toward. For those of us who have moved beyond our first careers, an understanding of coding can feed our curiosity about how things work. It is never too early or too late to learn to code. Here is what CodeMonkey has to say,

“CodeMonkey is user-friendly and intuitive. CodeMonkey takes a straight-forward approach, teaching real text-based code in a manner that even 8-year-olds can understand.”

CodeMonkey is one of many online learning platforms. Thousands of courses on coding and other topics are available. Some are expensive, many are free or low cost. I am currently taking Python courses at Treehouse. I have also taken some courses at edX.org, which offers 2,500+ online courses from 140 institutions including Berkeley, Harvard, MIT, and the University of Texas. For those aspiring to a new career, many of the courses offer certifications. As I wrote in Net Attitude back in 2001, many employers would much rather hire people who have certifications in the various skills the employer needs than people with a college degree without any specialty.

Ok, lets get back to coding or learning to code.

News from johnpatrick.com

May 30 was a really big day for astronauts Doug Hurley and Bob Behnken, and SpaceX founder Elon Musk. The launch of Crew Dragon atop a SpaceX Falcon 9 rocket was spectacular, and it made space history as the first private launch vehicle to put humans into orbit. The mission was the first NASA spaceflight to depart from American soil since NASA retired its space shuttle fleet in July 2011. The autonomous docking of the Crew Dragon to the International Space Station, while they were both circling the Earth at 17,000 miles per hour was magical. This is the beginning of a new era in space.

On May 28, Bob Reby and I had a Zoom a fireside chat, “How to Strengthen Our Democracy in Troubling Times”. We discussed Internet voting, paper ballots, and how they may impact the future of our democracy. You can watch a video excerpt of the fireside chat here.

We took a poll at the beginning of the Zoom session and 67% of the attendees said they believed Internet voting could strengthen our democracy. A poll at the end of the Zoom session showed 93%. Bob and I will be doing a second Zoom fireside chat on the same subject with the Ridgefield Library on July 14. Details and how to register will follow.

The How We Feel app continues to be important to help scientists track the virus impacts. It may prove a digital approach can work, or at least help. The app is completely private. No login required. If you don’t have the app yet, get it here for Apple or here for Android. As of Friday, in Danbury, CT, 9 thousand people were feeling well and 326 said they were not well.

The World Community Grid just launched OpenPandemics – COVID-19, a new project to help scientists at Scripps Research look for potential COVID-19 treatments. The project is getting off to a fantastic start, but there are likely more than a billion work units of data which need to be crunched as scientists race against the clock to find and test potential treatments. Scientists predict pandemics may become more frequent. That is why the project was designed to be deployed rapidly to fight future outbreaks. I’ll have more about the World Community Grid in a future article.

As of Friday afternoon, Tesla market capitalization continued to climb and was at $164 billion. Zoom reached a market cap of $58 billion, and Uber was at $65 billion. The five giant tech company market caps marched past their already meteoric level. All five companies are global, but to put their massive valuation into perspective, it now represents 24% of the market cap of the U.S. S&P 500. Shareholders are happy but government regulators and politicians are ramping up the discussion about new regulations and anti-trust hearings. I believe pressure on big tech will continue to mount.

MAGFA Market Cap (06/05/20 2:30 PM EDT)
Microsoft$1.415Trillion
Apple$1.431Trillion
Google$0.983Trillion
Facebook$0.658Trillion
Amazon$1.237Trillion
   
Total$5.724Trillion
   
S&P 500 4/30/20$24.140Trillion
   
MAGFA24% 
Is Vote by Mail The  Best We Can Do?

When I published Election Attitude – How Internet Voting Leads to a Stronger Democracy in 2016, I thought Internet mobile voting could be in place by 2018 in a number of counties around the country and then ready for widespread use by 2020. How wrong I was! The momentum against the idea gained strength as media coverage of Russian meddling caused fear among secretaries of state and election officials. The nail in the coffin, for now, was the incredibly incompetent use of technology by the Democrat party in Iowa. This article is not another plea from John about the virtues of mobile voting. Instead, the focus here is about the huge push for Vote by Mail.

I would like to make two macro points before I get into some specifics. First, the founding fathers made it very clear in the Constitution, Section 1, Article 4 the States have the ball when it comes to managing their election processes. In theory, the Federal government could overrule and take over voting, but I believe turning voting into a National process is politically impossible. The result is the country will have to live with a hodgepodge of voter registration and voting procedures. With a paper based system, this is going to cause problems in November as I will describe shortly.

The second point is the matter of “comparison”. Political and computer science pundits compare Internet voting to a perfect system of perfect computers, perfect networks, no hacking, no malware, etc. The perfect system will never ever exist. I would like to see us compare Internet voting to the paper based system which is expanding. That is the subject of this article.

Problems at the Polling Places

In some cases, availability of convenient polling places is a problem. Election officials in Arizona in 2016 reduced the number of polling sites as part of a purported budgetary necessity. The 70% reduction in polling places from 200 in 2012 to 60 in 2016 resulted in one polling place per 21,000 voters. Hundreds of thousands of voters appearing for the March 22 primaries were confused, inconvenienced, and outraged at the excessive wait times. Many Arizonans left the polls in disgust. Others waited as much as five hours. Arizona was not alone in reducing the number of polling places. Rhode Island opened only 144 of the state’s 419 polling places for the April 2016 primary. Open government advocate John Marion of Common Cause Rhode Island said, “Voters could be confused because their polling place may have changed from what it was the last time they voted.”

In Brooklyn, New York, there was a range of complaints during the April, 2016 primary. Faulty ballot scanners caused continuing interruptions and delays. Inadequate staffing at polling sites and poll workers failing to open up sites on time prevented some people from voting because the voters could not wait. Many voters reported their names were mysteriously missing from the voter rolls, so they were not allowed to vote. The New York City Board of Elections confirmed more than 125,000 Democratic voters in Brooklyn were removed from the rolls. Voters complained there were numerous errors caused by the purging of entire buildings and blocks of voters. The Brooklyn Board of Elections Executive Committee voted to suspend their Chief Clerk without pay pending an internal investigation.

Crazy things happen at polling places. Fights have broken out in the lines. Inexperienced poll workers have given bad advice and turned people away. Although trying to help confused voters, the poll workers could not avoid seeing how some people voted causing angst on both sides. 

One might say the solution to the polling place problems is to move to Vote by Mail. Pushed along by the pandemic, the idea has gone from tempting to mandatory in the minds of many. However, let us consider some realities of paper ballots we don’t hear much about.

Problems with Ballots

During the March 15, 2016 primaries in Florida, the hanging chad problem was resolved, but other problems with ballots persist and new ones arose. According to the Supervisor of Elections Office, the voters in one precinct in Flagler County were given the wrong ballots, resulting in about 30 people who voted for the wrong county commissioner candidates. The county election was not impacted and there was no effect on the Presidential race, but errors in handling paper ballots are significant.

In Orange County, Florida, during the 2016 primary, about a dozen of the 251 precincts ran out of ballots. As early as 9 a.m., the Pinecastle Masonic Lodge and several additional precincts ran out of both Democrat and Republican ballots. At some precincts, the order to print more ballots was incorrect. Instead of printing more Presidential ballots, more city ballots were printed. Voters were told to come back later. More than a dozen citizens protested outside the Orange County Supervisor of Elections Office. The Supervisor had absentee ballots printed and hand-delivered to voters’ homes or at workplaces later in the day. Also, several polling places in Orange County had problems verifying voter registration. The tablet computers used to swipe a voter’s driver license had technical problems. These locations had to request delivery of printed registration books from the archives.

In Polk County, Florida, a precinct poll worker couldn’t find the Democratic primary ballots. When the worker opened the polling place, the volunteer only handed out the Republican ballots and told Democrats they couldn’t get a ballot. Voters called the Supervisor of Elections Office, which told the poll worker where to find the ballots. In another case, ballots were loaded on a truck for delivery. The driver got lost. These are a few examples of ballot problems which happened in many states during the 2016 Presidential primary.

Ballot Complexity

Polling place or mail in, the current voting methods can be subject to error because they depend on a certain level of a person’s knowledge of the voting process. Some ballots are not well designed and can be confusing. Some ballots require a simple choice: vote for A or vote for B. The design of some other ballots is not so straightforward.

In Voting Technology: The Not-So-Simple Act of Casting a Ballot (2009), Paul Herrnson, Richard Niemi, and Michael Hanmer reported on their research into the complexities of voting. The authors described election ballots as having curiosities and inconsistencies in their format.

Ballot instructions, candidate and party listings, party symbols, and, in general, variations that result from a complex and highly decentralized election system provide ample opportunity for all but the most sophisticated voters to misunderstand, mismark, or spoil their ballots and for all voters to feel confused and frustrated. The authors cited the enormous disparity in ballot designs across the states and to individual state designs inconsistent and needlessly complex.

The most famous example of ballot complexity is the butterfly ballot problem in Florida in 2000 when 19,235 people voted for both Bush and Gore. None of those votes counted. It was 4% of Palm Beach County votes. There are many other examples. Most recently, in the North Carolina primary, the selection of a senatorial candidate was placed below the ballot instructions at the bottom of page. Thousands of voters did not notice and did not make a choice. More lost votes.

Early Voting

Many states provide a method for eligible voters to cast a ballot prior to Election Day. These early votes may occur during a defined early voting period or by requesting an absentee ballot. Colorado, Oregon, and Washington have been using Vote by Mail for a long time and have enjoyed increased voter turnout as a result. However, there are problems. On Super Tuesday, four million people in California voted early. I don’t know the exact number but it is safe to say a significant number may have voted for Klobuchar, Steyer, or Mayor Pete. All three dropped out of the race before Super Tuesday. More votes thrown away.

The other problem is, because of Covid-19 fears, many more states are being pushed to Vote by Mail. They will be deluged with envelopes. Budget cuts will likely reduce staff. Votes will not be counted timely. Forget about staying up late on November 3 to see who won. It will take days for the counting. Mistakes will be made. Recounts may be justified and stretch out timelines even further. It is logical to expect when 100 million ballots get dumped into the system there will be human errors.

A survey discovered voting on Election Day has been the most popular form of voting with 60.6% of voters casting a regular ballot in person. Others voted by domestic absentee ballot (17.5%); by early voting before Election Day (10.7%); and by mail voting (7.6%). These numbers will surely change for November.

The problems with overseas voting for six million people remain. Soldiers and ex-pats have been conditioned to ballots not getting to the polling place on time and, if they do, they may not get counted unless there is a tie. So why bother voting? West Virginia conducted pilot mobile voting for overseas military. It was quite successful but was subsequently criticized, unfairly in my opinion, as being insecure. There were no problems with the voting and voter satisfaction and participation were excellent.

Mail Votes Lost or Not Counted

Some people lose their ballot or mail it too late for it to be counted. The pipeline from deciding to vote to having a vote actually counted can be long and frustrating. Charles Stewart III, the Kenan Sahin Distinguished Professor of Political Science at MIT, studied the question of whether voting by mail causes more lost votes, compared to in-person voting. In a published study, “Losing Votes by Mail”, Stewart concluded, “The number of lost votes through the Vote By Mail system in 2008 may have been as large as 7.6 million.” The number represents approximately one in five citizens who attempted to vote by mail. These votes include voters at home and abroad. The 7.6 million lost votes included 3.9 million absentee ballots requested but never received, 2.9 million ballots received but not returned, and .8 million returned but not counted.

The ballots received but not returned can be due to a ballot lost in the mail or the voter deciding to vote at the polls or not vote at all. Votes returned but not counted can be a result of numerous kinds of errors. Typical errors include the ballot envelope not being signed, the name not matching the voter registration list, failure to provide the voter’s address, missing or bad signatures, no witness signature (if required), no ballot application on record, missed deadline, already voted in person, or the voter had died. The President recently said a state had sent every voter a ballot in the mail. That was not true. The state had sent an application for an absentee ballot. The time allotted to sending the application, the voter sending it back, the state sending them a ballot, and then the ballot being returned all on the backs of USPS. It is likely all will not make the due date to be counted.

Voter Fraud

The purported frequency and extent of voter fraud is a highly controversial issue. There can be no question there is a perception of voter fraud. Vivid stories have been passed through generations. One of the most famous is a reported quote from Earl Long (1895-1960), Governor of Louisiana. “When I die, if I die, I want to be buried in Louisiana, so I can stay active in politics.” Losing candidates often contribute to the lore. The facts however, do not demonstrate voter fraud. In 2012, Loyola law professor Justin Levitt estimated, “Over the previous twelve years, the voting fraud rate was 0.000002%.” He found only nine instances of specific allegations of voter fraud out of approximately 400 million voters. Voter fraud was used as the reason for Governor Scott Walker’s determination to make the special voter ID requirements in Wisconsin more stringent and difficult. Even though a 2014 study at Marquette University found 39 percent of voters from a Wisconsin state-wide poll believed voter fraud affected a few thousand votes at each election, no claims of voter fraud were substantiated.

Some politicians have alleged voter fraud is rampant and is jeopardizing the integrity of American elections and democracy. The allegations claim elections are being stolen by unscrupulous registration activists, vote buyers, and illegal immigrants voting. Despite a history of stories about fraud, in my research for Election Attitude, I found no contemporary charges voter fraud is rampant. In The Myth of Voter Fraud, Lorraine C. Minnite describes the results of her research to find evidence of voter fraud. She contended that while voting irregularities created by our complex and fragmented electoral process in the United States are common, intentional voter fraud is quite rare. Minnite examined public records obtained from all fifty state governments and the U.S. Department of Justice. She concluded, “Voter fraud is in reality a politically constructed myth intended to further complicate the voting process and reduce voter turnout.”

Although legally fraud, a problem with Vote by Mail is coercion. Helpful agents may visit a nursing home and offer to “help” people vote. A spouse may handle two votes for the family. There could be a lot of “helpful” persons involved but unseen in the election process. Special ballot mailboxes placed next to USPS mailboxes in certain neighborhoods could be transplanted from a pickup truck to a trash dumpster.

Weather

Regardless of the expansion of Vote by Mail, millions of people will go to the polls despite the weather and possible need for masks. Even with an adequate number of polling places and a sufficient quantity of the correct kind of ballots on hand, other problems can affect voter participation. Long lines in bad weather can dissuade voters, especially the elderly or people with special needs, from voting. Some polling places make voters wait outside since they can only accommodate a small number of voters inside. This will be exacerbated by social distancing. A friend told me her sister in Wisconsin waited outside in 40 degree weather and high winds for an hour and 45 minutes to vote in 2016. Her son in Florida had to wait outside five hours in the sun. Work schedules can make it impossible for some workers to get adequate time to drive in bad weather to and from the voting location. Inadequate, convenient parking can prevent some people from voting particularly in hazardous weather. In some polling places, there is insufficient, designated handicapped parking.

People with Special Needs

Some voters may be ill and homebound on Election Day. Other voters may not try to vote because disabilities may impose physical limitations in using the voting equipment. There are at least 35 million voting-age people with disabilities in the United States, representing 1 out of 7 voting-age people. This number is likely to grow with the aging of the population. People with disabilities have lower voter turnout than people without disabilities. Lisa Schur, Associate Professor at Rutgers University, said, “Twelve surveys covering the 1992-2004 elections, using varying samples and definitions of disability, found eligible citizens with disabilities were between 4 and 21 percent less likely to vote than eligible citizens without disabilities.” The lower voter turnout among people with disabilities appears to be caused in part by their greater likelihood of experiencing voting difficulties, including with Vote by Mail.

Conclusion

The problems with existing voting systems are challenging. The Federal Government provided funding for new voting machines in 2002, but did not provide funding to maintain or replace them when they became out dated. Unfortunately, the machines are at the end of their life cycle, in fact at a crisis, and have not been replaced. One alternative to resolve the problem is to patch the existing system of antiquated machines. Another alternative is to embrace an election attitude.

An election attitude offers a practical approach to voting. A key component of the new attitude is Internet voting. It uses mobile devices and the Internet to enable citizens to vote from the comfort and privacy of their home or at a local library. Though the risks of Internet voting are real and cannot be ignored, there are numerous benefits to adopting Internet voting. With Internet voting it can replicate successful web services such as Amazon which is used by millions of people daily. If voting online could reach the level of adoption of e-commerce, it would be possible for voter participation to increase significantly. With a changed focus, increased funding, changes in election registration and security, and increased access for people with special needs, I believe the voter participation rate would be greatly improved. I urge all of us to compare our fears of the Internet with the challenges of the paper based system we have today.

News from johnpatrick.com

The weather rained on their parade this past week, but today will be a really big one for astronauts Doug Hurley and Bob Behnken. They arrived in Florida last week to prepare for their launch into space in Crew Dragon atop a SpaceX Falcon 9 rocket. The launch will make space history as the first private launch vehicle to put humans into orbit. The mission will be the first NASA spaceflight to depart from American soil since NASA retired its space shuttle fleet in July 2011. I can’t wait to watch the proceedings this afternoon.

 

On Thursday, I was privileged to participate in a fireside chat with Bob Reby, “How to Strengthen Our Democracy in Troubling Times”. A few dozen people attended the Zoom webinar. Bob and I discussed the following :

  • Voting with Paper or Internet: Which is more secure, accurate, private and verifiable?
  • How the U.S. can use blockchain technology to safeguard ballots from hackers and foreign adversaries
  • Cautionary Case Studies: What went wrong and how mistakes could have been avoided
  • Success Stories: Internet voting in foreign countries and pilot programs in U.S. states

The How We Feel app continues to be important to help scientists track the virus impacts. It may prove a digital approach can work, or at least help. The app is completely private. No login required. If you don’t have the app yet, get it here for Apple or here for Android.

As of Friday’s close, Tesla market capitalization continued to climb and finished at $155 billion. Zoom reached a market cap of $50 billion. The five giant tech company market caps maintained their meteoric level. All five companies are global, but to put their massive valuation into perspective, it now represents 23% of the market cap of the U.S. S&P 500. Shareholders are happy but government regulators and politicians are gearing up for new regulations and anti-trust hearings. I believe pressure on big tech will continue to mount.

MAGFA Market Cap (05/29/20 4:30 PM)
Microsoft$1.390Trillion
Apple$1.378Trillion
Google$0.963Trillion
Facebook$0.641Trillion
Amazon$1.218Trillion
   
Total$5.590Trillion
   
S&P 500 4/30/20$24.140Trillion
   
MAGFA23% 

 

The Path to Global Immunization

Humans have been very fortunate to have been protected by vaccines for more than two centuries. The path to get from the identification of an infectious disease to have an effective vaccine is complex, to put it mildly. The issues include research and development, testing, procurement of dependable funding, scaleable manufacturing, equitable distribution, assured safety, management of public fears of inoculation, and global political considerations. Covering all these issues is beyond the scope of this article, but I hope to shed some light on some important aspects of vaccinations and present a view of what we might see in the future. First, a glimpse into the history.

Edward Jenner was a country doctor in Gloucestershire, England. He was a generalist, not a specialist. Jenner had a strong interest in natural history and he was very good at observing basic behaviors. Health Affairs, in “The History Of Vaccines And Immunization: Familiar Patterns, New Challenges”, delved into Jenner’s experience in considerable detail. It reported that sometime during the 1770s, Jenner heard a Bristol milkmaid boast, “I shall never have smallpox for I have had cowpox. I shall never have an ugly pockmarked face.” Years later, Jenner developed a cowpox inoculation hypothesis for smallpox.

Health Affairs described the remarkable scenario about how Jenner performed the world’s first vaccination in 1796. “Taking pus from a cowpox lesion on a milkmaid’s hand, Jenner inoculated an eight-year-old boy, James Phipps. Six weeks later Jenner variolated [inoculated] two sites on Phipps’s arm with smallpox, yet the boy was unaffected by this as well as subsequent exposures.”

Jenner conducted a dozen similar experiments and documented sixteen additional case histories. With no government or publishing subsidies, Jenner published his studies in “Inquiry into the Causes and Effects of the Variolae Vaccine”. Health Attitude said the work, “swiftly became a classic text in the annals of medicine: His assertion “that the cow-pox protects the human constitution from the infection of smallpox” laid the foundation for modern vaccinology”.

As Dr. Anthony Fauci and others predicted, the mortality has gotten worse since we reached the top of the curves. If we all do a good job in hygiene, screening, distancing, and masks, the country will be able to re-open without uncontrollable spikes in cases. The government is pulling out all stops for therapeutic solutions, as Dr. Kuhn of the FDA has described. Testing is ramping up rapidly. The remaining tool needed is a vaccine for Covid-19 and, hopefully, other variations which may follow.

Significant progress is being made by Moderna Therapeutics, CureVac, Inovio Pharmaceuticals, and others. All are going as fast as possible to advance the clinical trials. Nevertheless, the approach they are taking uses biological DNA and RNA as the core ingredients. As advanced as the current development process is, vaccines as we know them have a number of shortcomings. The most visible is they take a long time to develop and manufacture. Potentially more significant is they can become obsolete if and when the virus evolves, which it will. There are already multiple strains, and there will be more. Finally, the immune response the vaccines produce may not be strong enough to be effective.

A totally new approach is under development using synbio. The Bill and Melinda Gates Foundation has put $60 million into coronavirus research including for the synbio effort. Synbio stands for synthetic biology. Synbio is mostly about the design and construction of new biological parts, devices, and systems, and the re-design of existing, natural biological systems. More specific to the issue of the day, synbio may replace the DNA and RNA ingredients mother nature has provided for the development of vaccines with synthetic ingredients. Huge advances in cloud computing, AI, genetic sequencing, and collaborative tools are making timelines possible which were unthinkable in the recent past.

A vaccine made from synthetic ingredients can potentially offer some significant advantages. The big one is scalability. Synbio vaccines could be produced efficiently for millions or even billions of doses. Another advantage is synthetic ingredients do not need to be refrigerated. This would be a huge benefit for places like sub-Saharan Africa.

Synbio vaccines are developed using computer models, not flasks and test tubes. With billions of calculations, a nanoparticle can be designed which has the exact properties desired. The really big breakthrough with synbio is the attachment of viral molecules to the nanoparticle. Neil King at the University of Washington and his synbio colleagues knew there would be another coronavirus epidemic, like the SARS and MERS outbreaks before the current Covid-19 outbreak. King said, “…there will be another one after this,” perhaps from yet another member of this virus family. We need a universal coronavirus vaccine.” One vaccine for all corona viruses. That will be the breakthrough.

Sharon Begley wrote a beautiful article in STAT which explains the synbio efforts underway in much more detail. See To develop a coronavirus vaccine, synthetic biologists try to outdo nature. STAT has great articles about life sciences and the fast-moving business of making medicines.

Dr. Craig Venter, an American biochemist, geneticist, and entrepreneur known for being one of the first to sequence the human genome, is an advocate for a new and innovative digital approach for the development of vaccines. Venter said the current process used for developing the H1N1, otherwise known as swine flu, vaccine took many months and the supply was barely adequate to cover healthcare workers. He said if the H1N1 virus had been as deadly and widespread as some had forecasted, we would have had a very bad situation.

Venter envisions vaccines being developed using synthetic DNA instead of “billions of eggs”. He has written how DNA data about a virus to be protected against can be developed into a digital recipe and emailed to laboratories which could then begin production of the vaccine at facilities all over the world within 12 hours. Venter said a couple of years ago FDA approval was imminent. The Covid-19 crisis has caused an increase in the sense of urgency.

One final thought about the future of vaccinations has to do with syringes, essential for delivering vaccine. I will be the first to admit, I don’t like needles. My wife and daughter, both nurses, think I am a wuss. I am not afraid, I just don’t like the experience. Unfortunately, many people are afraid for themselves or their children and transfer the fear into inaction. The fear jeopardizes their own health and also the public health.

Syringes could become a thing of the past. Scientists at the Hilleman Labs in India have developed micro-patches which can be used for routine immunizations. The patches are cheap to produce and easy to store without chilling. The patches don’t need special training to be applied, and potentially will be able to be used by consumers at home. Delivered by drones, the patches could become a potential lifeline for rural and poor families around the world. Vaccination by patches could become a reality before the end of the decade. 

Saturday was sunny and warm in Connecticut. I went out for a walk and saw a lot of people. Almost none were wearing masks. What were they thinking? At a homeowners association meeting in FL before I came North, a woman said she did not need to wear a mask because she is not infected. There are multiple ways such a comment could be interpreted but, to me, the salient point is, how does she know she is not infected? Incubation and the emergence of symptoms is typically five days after getting the virus. During those five days, a person can infect others. Masks are not to protect you, they are to protect others. If we all wear them, we are all more safe. Such a simple principle.

News from johnpatrick.com

A really big week is coming up for Doug Hurley and Bob Behnken. They arrived in Florida this week to prepare for their launch into space in Crew Dragon atop a SpaceX Falcon 9 rocket. The launch will make space history as the first private launch vehicle to put humans into orbit. The mission will be the first NASA spaceflight to depart from American soil since NASA retired its space shuttle fleet in July 2011. I can’t wait to watch the proceedings. NASA officials announced on Friday there were no showstoppers found during a crucial flight readiness review (FRR) for SpaceX’s Demo-2 mission.

Reminder: The fireside chat with Bob Reby, “How to Strengthen Our Democracy in Troubling Times”, will be happening in one week. You can register here.

The Zoom conference will be on May 28, 2020 6:00 PM Eastern. Join from a PC, Mac, iPad, iPhone or Android device.

 

 

Bob and I will discuss the following :

  • Voting with Paper or Internet: Which is more secure, accurate, private and verifiable?
  • How the U.S. can use blockchain technology to safeguard ballots from hackers and foreign adversaries
  • Cautionary Case Studies: What went wrong and how mistakes could have been avoided
  • Success Stories: Internet voting in foreign countries and pilot programs in U.S. states

    We look forward to seeing you there!

The How We Feel app continues to gain momentum. States are hiring people to be contact tracers. However, if we all donate our non-personally-identifiable data to help scientists track the virus, it may prove a digital approach can work, or at least help. The app is completely private. No login required. If you don’t have the app yet, get it here for Apple or here for Android.

As of mid-afternoon Friday, Tesla market capitalization is up to $152 billion. The five giant tech company market caps continued to climb. All five companies are global, but to put their massive valuation into perspective, it now represents 23% of the market cap of the U.S. S&P 500. Shareholders are happy but government regulators and politicians are gearing up for new regulations and anti-trust hearings. I believe pressure on big tech will continue to mount.

MAGFA Market Cap (05/21/20 3:30 PM)
Microsoft$1.387Trillion
Apple$1.377Trillion
Google$0.963Trillion
Facebook$0.668Trillion
Amazon$1.214Trillion
   
Total$5.608Trillion
   
S&P 500 4/30/20$24.140Trillion
   
MAGFA23% 
Do What The Doctor Tells You

In the old days of medicine, a common mantra was “Do as the doctor told you”. In Health Attitude: Unraveling and Solving the Complexities of Healthcare, I suggested patients should take more responsibility for their health and question their doctors and collaborate with them. I am quite fortunate to know a lot of doctors, some who are part of my care team, and others who are just friends. I learn from all of them. Two doctors who I pay very close attention to and listen to all the words they say are Dr. Robin Cook and Dr. Atul Gawande.

Robin Cook, 80, is an American physician and novelist who writes about medicine and topics affecting public health. More specifically, he writes medical thrillers, and has published nearly 40 of them. Probably the most famous is Coma (1977), which has been adapted for both film and television. A few other of his well known novels include Sphinx (1979), Brain (1980), Mindbend (1985), Outbreak (1987), Mutation (1989), Vital Signs (1991), Toxin (1998), Nano (2013), and Cell (2014). His books have sold nearly 400 million copies worldwide. I read mostly non-fiction, but whenever I need a break from learning, I read another Robin Cook medical thriller. Although Cook’s writings are novels, they probe deeply into important healthcare issues. They are really great books. Hard to put one down.

The other doctor to listen to is Atul Gawande, 54, a Brooklyn born surgeon, writer, and public health researcher. He practices general and endocrine surgery at Brigham and Women’s Hospital in Boston. He is a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and also a Professor of Surgery at Harvard Medical School. In public health, he is executive director of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit that works on reducing deaths in surgery globally. He is also the Chairman of healthcare venture Haven, which is owned by Amazon, Berkshire Hathaway, and JP Morgan Chase.

As a Rhodes Scholar with degrees from Stanford University, Balliol College at the University of Oxford in England, and Harvard Medical School, Dr. Gawande is a superb author and speaker. All four of his books are excellent reads. His third book, The Checklist Manifesto: How to Get Things Right (2009) was a best seller. No one likes to talk about the error rate in surgery, but suffice it to say the numbers are not pretty. Thousands of people are harmed in some way.

The ChecklistManifesto is an easy read because the recommendations are practical and understandable. His extensive examples from medicine and aviation make the point about how easy it is for people to forget things which can jeopardize the lives of others. Being a pilot, I already appreciated the importance of checklists, but had not thought of them in medicine. When learning to fly, the checklist is fundamental. You learn to use it all the time, whether you have ten hours of flight experience or 10,000. The book is replete with examples of how things went wrong in a medical setting when a simple step was skipped due to the frenetic pace of the operating room and possible distractions and interruptions. Dr. Gawande’s focus and enthusiasm for patient safety has had a positive impact around the world.

Being Mortal: Medicine and What Matters in the End (2014) was another bestseller and was the basis of a documentary for a PBS television series . It discusses end of life choices about assisted living and the effect of medical procedures on terminally ill people. It challenges many traditionally held notions about the role of medicine. This is an outstanding and highly relevant book. I first met Dr. Gawande in New York in 2010 at a breakfast hosted by IBM. It was followed by an articulate and emotional speech called “How To Live When You Have To Die” based on Being Mortal.

On the coronavirus/Covid-19 front, the information explosion continues. Axios described it as an infodemic of misinformation and disinformation. As biologists, epidemiologists, immunologists, virologists, and researchers around the world intensely study all aspects of what we are facing and why, what emerges to me is recognition of how much is not known. In a number of areas, there are disagreements. Some say the differences are political, but I attribute them to the different backgrounds and areas of experience. Fortunately, there are a number of excellent articles which explain the risks and how to minimize them. One of best is by none other than Dr. Atul Gawande.

In “Amid the Coronavirus Crisis, a Regimen for Reëntry“, Gawande breaks down the risks and actions into four areas which he calls a combination therapy, like a drug cocktail. The elements are all familiar: hygiene measures, screening, distancing, and masks. Gawande says, “Each has flaws. Skip one, and the treatment won’t work. But, when taken together, and taken seriously, they shut down the virus.” Following are a few highlights about the four elements.

Hygiene 

Studies have confirmed a dedication to hand washing can cut infections nearly in half. The key, Gawande says, is “washing or sanitizing your hands every time you go into and out of a group environment, and every couple of hours while you’re in it, plus disinfecting high-touch surfaces at least daily.” The more you wash your hands the more effective it becomes.

Distancing

Hygiene is essential but not sufficient because most of the infections occur by transmission from others. This is where distancing comes in. Transmission can occur from coughing, sneezing, shouting, singing, and even breathing. Your risk depends on how close you are to an emitter and for how long. Dr. Erin Bromage wrote in “The Risks – Know Them – Avoid Them” about the community choir in Washington State.

“The choir avoided the usual handshakes and hugs hello, people also brought their own music to avoid sharing, and socially distanced themselves during practice. A single choir member with no symptoms infected most of the people in attendance. “The choir sang for 2 1/2 hours, inside an enclosed rehearsal hall which was roughly the size of a volleyball court.” Singing, more so than talking, aerosolizes respiratory droplets exceptionally well. The 2 1/2 hour exposure “ensured people were exposed to enough virus over a long enough period of time for infection to take place.” “Over a period of 4 days, 45 of the 60 choir members developed symptoms, 2 died.”

Distancing may be much more important than we all realize. The beauty of it is how simple it is to implement. What is unique about coronavirus is it can spread before the carrier has any symptoms. The average incubation period is five days. Gawande said, “A single unchecked case can lead, over two months, to more than twenty thousand infections and a hundred deaths.”

One more thing. Six feet is not always enough if people are unmasked. Dr. Bromage said, “A single sneeze releases about 30,000 droplets, with droplets traveling at up to 200 miles per hour. Most droplets are small and travel great distances (easily across a room).”

Screening 

Hygiene and distancing are not sufficient. Screening plays a key role and will be essential as the country begins to open up. At Mass General Brigham in Boston where Dr. Gawande works, employees are given an app needed to enter a building. The app asks about symptoms such as, “a new fever, cough, sore throat, shortness of breath, loss of taste or smell, or even just nasal congestion or a runny nose.” Based on responses, the employee gets a red or green light from their app. Some workplaces will no doubt be using the contactless thermometers to look for fever. The other part of screening is testing. While there is no debate about the bumpy start, the number of tests has now risen above ten million and is ramping up rapidly. Availability and use of testing will go much higher as reopening accelerates.

Masks 

Hygiene, distancing, and screening/testing are essential but not sufficient. That is why we need masks. Whether it is a handkerchief, teeshirt, one layer, two layer, or industrial N95 mask, the use of masks is universally a very good thing. Research by an international consortium of scientists found “if at least sixty per cent of the population wore masks that were just sixty-per-cent effective in blocking viral transmission—which a well-fitting, two-layer cotton mask is—the epidemic could be stopped.”

The benefit of covering of your face when you go outside is a bit subtle. A bandana, non-medical mask, or homemade cloth mask does not protect you from viruses in the air. However, it does prevent you from breathing, coughing, or sneezing on someone else. So, if everybody wears a mask when they are near others then everybody gets protected. It is a very good idea and, like distancing, is easy to implement. While out for a two-mile walk yesterday, I saw a lot of people out walking. I would say half wore masks. What are they thinking? Where needed, I zig zagged my way across the street to keep my distance even though I wore a mask. The Surgeon General did a great job explaining the need for masks. Listen to him on YouTube (fast forward to 1:10 to bypass what the President had to say).

Summary

None of the four elements solves the problem. However, taking each of the four seriously will have a huge impact. Dr. Gawande says there is a fifth element to make it happen: culture. You can say it is not being selfish. It is being a team player. It is believing if you take care of others, they will take care of you. Many ways to say it, but I know you get the point. I am optimistic about the reopening because I believe the governors are doing it thoughtfully. There will be some abusers who don’t think of others. Some hotspots will pop up, but they will get isolated and create an example for others to avoid. One last thing. Today, I checked in with the How We Feel app for the 26th time. I hope you are doing it also. The app can supplement contact tracing. All will benefit from each of us donating our (non personally identifiable) data to the researchers who are dedicated to learn and prepare.

Can Mobile Internet Voting Strengthen Our Democracy in These Troubling Times

Bob Reby, Certified Financial Planner, founded Reby Advisors in 1985. I have known Bob by reputation for many years, and more recently have gotten to know him personally. Bob is a very smart forward looking businessman. He recently forged an alliance with Singularity University in order to bring a visionary component to the Danbury, CT area. Bob has invited me to engage in a lively Virtual Fireside Chat to discuss Internet voting, a subject I have written quite a bit about. Our agenda is to discuss:

  • Voting with Paper or Internet: Which is more secure, accurate, private, and verifiable?
  • How the U.S. can use blockchain technology to safeguard ballots from hackers and foreign adversaries
  • Cautionary Case Studies: What went wrong and how mistakes could have been avoided
  • Success Stories: Internet voting in foreign countries and pilot programs in U.S. states 

Our chat will be followed by Q&A, open to all. If you would like to attend, click here.

News from johnpatrick.com

There was a lot of interest in my post about heart cell implants. Bill McGowan, founder and CEO of MCI was the oldest recipient of a heart transplant when he got his in the late 1980’s.  The surgery was done in Pittsburgh at UPMC.  Mr. McGowan and his wife donated $1 million the following year to build the William McGowan Center for Regenerative Medicine. Interesting article about this is here.

The amount of information about Covid-19 is overwhelming. One thing clear to me is experts do not all agree on various aspects of the virus and the disease it causes. This is because there is much not yet well understood. For example, is the coronavirus airborne or droplets? Or both? A friend forwarded me an article by Dr. Erin Bromage titled, “The Risks – Know Them – Avoid Them“. Dr. Bromage is a Comparative Immunologist and Professor of Biology (specializing in Immunology) at the University of Massachusetts Dartmouth. His article is easy to read and offers practical explanations of the risks specific to different environments such as restaurants, workplaces, churches, birthday parties, and indoor sports. He also explains in practical terms the differences between droplets and aerosols and the effects of various encounters with fellow citizens. A very good read. Another not to miss article is “Amid the Coronavirus Crisis, a Regimen for Reëntry” in the New Yorker by Dr. Atul Gawande. He distills all the issues into four basic steps to take to stay safe.

 

The How We Feel app continues to gain momentum. States are hiring people to be contact tracers. However, if we all donate our non-personally-identifiable data to help scientists track the virus, it may prove a digital approach can work, or at least help. The app is completely private. No login required. If you don’t have the app yet, get it here for Apple or here for Android.

News from johnpatrick.com

As of mid-afternoon Friday, Tesla market capitalization is up $20+ billion to $148 billion. The five giant tech company market caps climbed another couple of hundred billion for the week. Quite a bit higher than at the end of February. All five companies are global, but to put their massive valuation into perspective, it now represents 23% of the market cap of the U.S. S&P 500. Shareholders are happy but government regulators and politicians are gearing up for new regulations. I believe pressure on big tech will continue to mount.

MAGFA Market Cap (05/15/20 4:15 PM)
Microsoft$1.389Trillion
Apple$1.334Trillion
Google$0.938Trillion
Facebook$0.601Trillion
Amazon$1.202Trillion
   
Total$5.463Trillion
   
S&P 500 4/30/20$24.140Trillion
   
MAGFA23% 
heart cells
iPS-derived cardiomyocytes

Fifty-three years ago, the first human heart transplant took place at Groote Schuur Hospital in Cape Town, South Africa. The daring surgery was performed by Dr. Christiaan Barnard. The world’s media covered the progress of the patient, Mr. Louis Washansky, on an hourly basis. Mr. Washansky lived with his new heart for 18 days. Barnard’s second transplant patient led an active life for more than 18 months. His fifth and sixth patients lived for almost 13 and 24 years, respectively.

Today, approximately 3,500 heart transplants are performed every year. Recent figures show 75% of heart transplant patients live at least five years after surgery. Nearly 85% return to work or other activities they previously enjoyed. Many patients enjoy swimming, cycling, running, or other sports.

The last paragraph is the good news. The bad news is more than 115,000 people in the United States are on the waiting list for a lifesaving organ transplant (not just hearts). Sadly, 8,000 people per year die while waiting. Fortunately, there is an emerging alternative called regenerative medicine. I have written ten stories about regenerative medicine here in my blog. Today’s story is about a new breakthrough: lab-grown heart cells have been implanted in a human for the first time.

New Atlas has published more than 50,000 articles covering advances in various fields of technology. In January the site published “Lab-grown heart cells implanted into human patient for the first time“. The article describes a research plan for patients with ischemic cardiomyopathy (IC). IC is most commonly caused by coronary heart disease, the leading cause of death in the United States. IC leads to the heart’s decreased ability to pump blood properly.

Professor Yoshiki Sawa, a cardiac surgeon at Osaka University in Japan, believes regenerative medicine will be a cure for IC. The potential cure starts with induced pluripotent stem cells (IPSCs), a Nobel Prize-winning technology developed at Kyoto University in 2006. The IPSCs are created by harvesting cells from the patient’s own tissue and then inducing the stem cells to transform themselves into heart cells called cardiomyocytes.

The heart has a few billion cardiomyocytes and, in a patient with IC, some of those cells are weakened. Dr. Sawa developed a technique to turn IPSCs into sheets of 100 million heart muscle cells, which can be grafted onto the heart to promote regeneration of damaged muscles. The sheets are biodegradable and, once implanted on the surface of the heart, release growth factors which encourage the new cells to grow and boost cardiac function. The sheets on which the cells were deposited will dissolve.

The technique was first tested on pigs and shown to improve heart function. Based on that result and supporting research, Japan’s health ministry approved a research plan involving human subjects. The first patient received the graft in January and is recovering in the hospital. Over the next three years, the clinical trial will add nine more patients. If the trial proves successful, many lives will be saved.

If you are interested in regenerative medicine, you may want to take a look at “3D Printing of Body Parts“.

While driving back to CT from PA, it became time for lunch. What to do? McDonalds made it really easy. We pulled into one of four parking spaces designated for delivery. We placed a lunch order on the iPhone McDonalds app. My credit card is stored in the app so there was no need for anyone to touch any money or credit cards. Five minutes later, a young man named Aaron came out with his mask and handed us the lunch. Not quite the same as sitting down inside the restaurant, but very efficient and safe. Way to go, McDonalds.

News from johnpatrick.com

There is an overwhelming amount of information out there about Covid-19, more than anyone can read. Bill Gates wrote in his Gates Notes a post he calls “The first modern pandemic“. If you found Bill’s comprehensive post interesting, you may want to listen to the podcast with him on the Ezra Klein show.

You can follow the curves and projections by country or state at healthdata.org. Monitor the number of new cases and deaths by country or state at the Coronavirus Dashboard.

The How We Feel app is gaining momentum. The number of people using it has more than doubled in ten days. Just 4.4% of people are not feeling well. It seems simple, but to researchers the data is powerful and it will help in contact tracing efforts. Donate your data to help scientists track the virus. It is completely private. No login required.

If you don’t have the app yet, get it here for Apple or here for Android.

News from johnpatrick.com

As of mid-afternoon Friday, Tesla market capitalization is up $20 billion to $142 billion. The five giant tech company market caps climbed another couple of hundred billion for the week. Quite a bit higher than at the end of February. All five companies are global, but to put their massive valuation into perspective, it now represents 20% of the market cap of the U.S. S&P 500. Shareholders are happy but government regulators and politicians are gearing up for new regulations. I believe pressure on big tech will continue to mount.

MAGFA Market Cap (05/08/20 3:45 PM)
Microsoft$1.396Trillion
Apple$1.340Trillion
Google$0.946Trillion
Facebook$0.603Trillion
Amazon$1.185Trillion
   
Total$5.470Trillion
   
S&P 500 1/31/20$26.720Trillion
   
MAGFA20% 
Will Clinical Trials Give Us The Best Cure For Covid-19?

In last week’s e-brief, I listed a number of terms from our coronavirus related vocabulary. A very important addition to the list is the term clinical trials. With the high mortality we are experiencing from Covid-19, there is a tremendous interest in finding therapies and vaccines, and finding them fast. A particular drug which cures one disease doesn’t mean it will cure another, and proclaiming about a drug for the most seriously ill, “Try it. What is there to lose?” does not validate whether a treatment is safe and effective.

Only clinical trials can provide a scientific basis for approval of a new cure. I believe the processes for developing, approving, and manufacturing can be made more streamlined and efficient and get drugs and treatments to needy patients more quickly. However, only scientific methods can ensure a new cure is safe and effective. Clinical trials are central to the scientific methods.

The experts have been using the term clinical trials in their testimonies and interviews, but many people may not know exactly what a clinical trial is. It is the purpose of this article to shed some light on the subject.

First, a few words on what a clinical trial is not. Clinical means the observation and treatment of actual patients, not a theory or something in the laboratory. Trial means a test of the performance, qualities, or suitability of something. A clinical trial is not giving a patient a new drug and see if it works and, if not, then try a different new drug.

Clinical trials are research investigations in which people volunteer to test new treatments. Researchers look at how people respond to a new intervention and what side effects might occur. The trials extend over four phases and, as I describe what goes on in each phase, it may help explain why the approvals take so long. As I mentioned earlier, I believe the time can be shortened.

At the latest count on angel.co, there are 255 startup companies focused on improving all aspects of clinical trials. There are 13,866 investors who have bet more than $1 billion on the startups. They are promising cloud based technologies for collaboration and artificial intelligence to accelerate data analysis. I am 100% certain new technologies will have a big impact on the time and cost of getting new drugs and treatments available to patients.  

Following are the steps involved in bringing a new drug to market.

Preclinical studies

Before pharmaceutical companies start clinical trials on a drug, they conduct extensive preclinical studies. These studies take place in test tubes or petri dishes. They also do animal experiments using wide-ranging doses of the study drug to obtain preliminary data on efficacy, toxicity and pharmacokinetics. The latter measures what living cells will do to the drug which in turn helps establish drug dosage. The bottom line is the preclinical studies help companies determine if it is worth moving forward.

Phase 0

Phase 0 trials are relatively new and are known as human micro-dosing studies.  The purpose is to speed up development of promising drugs by establishing very early if the drug behaves in human subjects as was expected from the preclinical studies. Phase 0 trials include the administration of very small doses of the drug to 10 to 15 patients to gather preliminary data. Drug companies use Phase 0 studies to rank drug candidates in order to decide which has the best odds of justifying human studies.

Phase I

Phase I trials are sometimes called “first-in-humans” trials. They are designed to test the safety, side effects, best dose, and formulation for the drug in a small group of 20 – 100 healthy volunteers who are recruited. These trials are often conducted in a clinic where the subject can be observed by full-time staff. The subject who receives the drug is usually observed until the amount of the drug remaining in the body is very low. The focus of Phase I is the safety and tolerability and to find the best dosage. About 70% of Phase I trials are successful and move to phase II.

Phase II

Phase II trials are performed on larger groups, 100 – 300 patients who have the disease the drug is supposed to help or cure. The goal is to assess efficacy and side effects. Design of the trial is key. There are many types of study designs but the workhorse praised by most experts is the randomized controlled trial (RCT).

An RCT is a scientific experiment which aims to reduce bias when testing the effectiveness of something new. RCT is used in many areas but currently the most interesting use is for medical treatments and drugs. The concept of an RCT is to randomly allocate patients into two groups, treat each group differently, and then compare the outcomes to see if there is a statistically significant difference. The experimental group receives the treatment or drug being evaluated. The other group, usually called the control group, receives standard care without the experimental treatment or drug. The success rate for Phase II trials is about 33%.

Phase III

If an experimental drug or treatment makes it to Phase III, it is presumed to be at least somewhat effective. This is why, when a new drug gets to Phase III, the stock of the pharmaceutical company goes up. Phase III trials typically have 300 – 3,000 patients with the specific disease being addressed. Even though the success rate for a Phase III trial is about 50%, the manufacturer begins building up the marketing and manufacturing programs to be ready if the trial is successful and the drug gets approved. 

Once a drug has had a successful Phase III trial, an enormous amount of “paperwork” is unleashed containing a comprehensive description of the methods and results of human and animal studies, manufacturing procedures, formulation details, dosage information, and shelf life. The massive collection of information makes up the “regulatory submission” for review by the regulatory authorities.

Phase IV

A Phase IV trial is basically a form of post marketing surveillance. Phase IV monitors safety but also provides a way for manufacturers to test interaction with other drugs, find new applications of the drug, and test in other populations. If any safety issues are discovered, a drug can be pulled off the market such as happened with Merck’s Vioxx in 2004 after a clinical trial showed the drug carried an increased risk for heart attacks and strokes. Unfortunately, I was a Merck stockholder at the time.

Overall cost

Phase II and III trials can cost tens of millions of dollars. The entire process of developing a drug from preclinical research to marketing can take 10 to 15 years or more and cost hundreds of millions of dollars, some well over $1 billion. This is why there are so many startup companies focused on clinical trials and other related processes. 

Final Comments

If you were not already familiar with the phases of clinical trials, I hope the summary level description I have cobbled together is helpful. I have been a subject in a clinical trial some years ago (and still recall the huge amount of paperwork involved). Then in 2014, I conducted a randomized controlled trial for my doctoral dissertation. I will conclude by sharing a bit of what I learned.

First is the design of the trial. It can be complex, but getting the right design is critical to a successful study. I saw a study about a product where the experimental group consisted of participants who were paid a fee. Such a design would not be a random selection of participants and would introduce bias into the study. Likewise, if the experimental group is 80% female and the control group is 80% male, that is not a random selection. An RCT has to have participants in both groups which are similarly situated; age, gender, sickness, degree of sickness, etc. If one group is in a metro hospital, and the other group is in a nursing home, that would not be a randomized selection.

Another factor is the size of the groups. This is called the N. You may have noticed Dr. Fauci comment on one of the Remdesivir trials saying it was very well “powered”. That means the N was large, in that case about 1,000. I have seen studies with an N equal 25 or even less. A small N proves nothing because the results might have been random or not statistically significant. 

Suppose a new drug trial shows the control group patients were discharged from the hospital after an average of 15 days and the experimental group after 14 days. Even with a big N, the difference achieved is probably not statistically significant. The results could actually have an equal probability of being 15/14 or 14/15. In other words, the study design was ok and proved the drug or treatment was not effective.

In the case of one of the Remdesivir trials, the control group patients were discharge from the hospital in 15 days on average and for the experimental group after 11 days. This is statistically significant, but at what cost. The four day improvement is good, but how about if the drug cost $250,000? In cancer treatment, a $1 million drug sometimes adds a few weeks to a person’s life. Is that justified? In Europe, they don’t think so. In the U.S. the usual opinion is adding a day to Daddy’s life is worth whatever it costs (as long as the government or health insurer is paying for it).

Finally, I would like to say a few words about clinicaltrials.gov. The site currently shows details on 337,990 research studies in all 50 states and in 210 countries. There are 1,133 studies related to Covid-19. For Covid-19 and Remdesivir, there are 19 studies.

Some studies take place only in hospitals. Others at home. Some are with seriously ill patients. Others with patients who are only mildly ill. Some compare one drug to another. You can see many variations of study designs. Some studies are underway, others are actively recruiting subjects. You can search for a drug or a disease or ailment, and learn everything about the study. If they are recruiting, you or your doctor can contact the researchers directly. Unfortunately, there are many conditions which don’t have reliable cures. Clinicaltrials.gov is a great resource to either join a study or follow one to its conclusion. In summary, yes, clinical trials will give us the best cure for Covid-19.

News from johnpatrick.com

There is an overwhelming amount of information out there about Covid-19, more than anyone can read. Bill Gates wrote in his Gates Notes a post he calls “The first modern pandemic“. If you found Bill’s comprehensive post interesting. You may want to listen to the podcast with him on the Ezra Klein show.

You can follow the curves and projections by country or state at healthdata.org. You can monitor the number of new cases and deaths by country or state at the Coronavirus Dashboard.

The How We Feel app is gaining momentum. It seems simple but to researchers the data is powerful and it will help in contact tracing efforts. Donate your data to help scientists track the virus.

If you don’t have the app yet, get it here for Apple or here for Android.

News from johnpatrick.com

As of mid-morning Friday, Tesla market capitalization is up to $134 billion. The five giant tech company market caps are climbing back and now all higher than they were at the end of February. All five companies are global, but to put their massive valuation into perspective, it now represents 20% of the market cap of the U.S. S&P 500. Shareholders are happy but government regulators and politicians are gearing up for new regulations. The pressure on big tech will continue to mount.

MAGFA Market Cap (05/01/20 11:30 AM)
Microsoft$1.341Trillion
Apple$1.287Trillion
Google$0.907Trillion
Facebook$0.580Trillion
Amazon$1.143Trillion
   
Total$5.258Trillion
   
S&P 500 1/31/20$26.720Trillion
   
MAGFA20% 
Do We Really Need 100,000 Contact Tracers?

According to lexicographer and dictionary expert Susie Dent, the average active vocabulary of an adult English speaker is around 20,000 words. We also have a passive vocabulary of around 40,000 words, words we have stored but don’t use. The current environment is adding to our active vocabularies. It seems every day we hear the words antibody testing, bioinformatics, community spread, computational biology, contact tracing, coronavirus, Covid-19, epidemiology, flattening the curve, N95 masks, pandemic, pathogens, personal protection equipment (PPE), serology testing, social distancing, swabs, therapeutics, and ventilators, just as a sample.

Between now and year end, the most important term in our vocabulary may turn out to be contact tracing. In combination with extensive testing, contract tracing is an important tool to counteract a potential second wave and prevent cases from spiraling upward again.

The concept behind contact tracing is simple: identify those who test positive for Covid-19, isolate them and monitor their health, and reach out to people who may have been in contact with the infected person and urge them to quarantine themselves. “In contact with” means the people who may have been within 6 feet of the infected person for more than 10 minutes, more like 5 minutes in a healthcare setting. Communication with those contacts needs to advise them to quarantine themselves and monitor their health. The goal is simple — stop the spread. The implementation is difficult.

One estimate of the scope of contact tracing in the U.S. calls for 100,000 contact tracers at a cost of nearly $4 billion. Even if they can be brought on board and trained, their task is daunting. For example, suppose, sometime in phase 3, a person tests positive and the county department of health assigns a tracer to call her. The tracer asks where the infected person has been in the last 14 days. Who had she been close to? Where had she been? If the answer is visiting a friend or relative, the tracer records the contact information and reaches out to them. That would be the easy examples. Suppose the infected person responded she had been at the shopping mall. What stores? Apple store. Who did you talk to? What time were you there? What did you touch? She called the tracer back and said she had forgotten to mention a couple of things. She had also stopped at Chick-fil-A at the Food Court and had some lunch. Also, took a walk through Macy’s and looked at various things on three floors of the store. Oh, and stopped in Bed Bath & Beyond and looked at some things. Talked to one of the sales people but don’t know their name. Oh, one more thing, on the way out of the mall, she walked through the Concourse where a number of merchants had small booths selling smartphone covers, jewelry, and other items. Don’t recall exactly, but I might have stopped at a few of them. It is easy to imagine the tracing task could overwhelm the departments of health.

Is it possible technology could help with contact tracing? I think so. I will first describe an imaginary solution to show an extreme of what might be possible, but may not be practical. Then I will describe an approach which I believe is practical.

Imagine you had an app which could perform an accurate Covid-19 test by simply touching the fingerprint reader on your smartphone or perhaps with a small attachment of some kind which could test a drop of blood you extract from a finger. The test could be done as often as you would like. If you become tested positive, the app would ask your permission to notify the public health department. They would confirm your positive test and advise you on steps to take and they would monitor your health status.

Now here comes the interesting part. Your app would detect a notification from others who have a smartphone whenever you are within ten feet of them. Your smartphone would receive an encrypted code from the other person’s smartphone via BlueTooth. Bluetooth is a wireless technology built into all smartphones. It is typically used to connect AirPods or other wireless headphones. The code you receive contains no personal information about the other person. Codes are only stored for 14 days. If you become tested positive and your smartphone has notified the public health department, the department would then notify the people who have opted in to participate in the program and let them know they have been in close contact with a person who is infected. They are advised to quarantine themselves for 14 days and to monitor their temperature and be on the lookout for symptoms.

In effect, the smartphone app, in conjunction with a public health database, have become the contact tracers. Would it work? Perhaps. To make it work would require a large number of people, perhaps 60-70%, to opt in. The whole process would have to be designed to insure privacy, and people would have to trust that the privacy protection is real and enduring. The other major assumption in this imaginary scenario is the availability of fast, easy, regular testing, which is not yet the case.

I believe there is another alternative or at least a supplement to full blown manual contact tracing. It is called “How We Feel” (HWF). HWF is a smartphone app which lets you self-report your age, sex, ZIP code, and any health symptoms you may have. It only takes 30 seconds or less to use it. Aggregate data is shared securely with select scientists, doctors and public health professionals who are actively working to stop the spread of Covid-19. The app doesn’t ask you to sign in or share your name, phone number or email address. The first time you download the app and donate your data with a check-in, HWF donates a meal to people in need through Feeding America, a nationwide network of more than 200 food banks which feed more than 46 million people through food pantries, soup kitchens, shelters, and other community-based agencies.

The HWF app was built by an independent, nonprofit organization called The How We Feel Project. The organization was founded by a volunteer team of scientists, doctors and technologists. Their mission is to make the world healthier by connecting citizens with the global health community. The organization was created in March 2020 to help fight the COVID-19 pandemic.

HWF works with scientists, doctors and public health professionals from leading institutions including The Harvard T.H. Chan School of Public Health, the McGovern Institute for Brain Research at MIT, Broad Institute of MIT and Harvard, Howard Hughes Medical Institute, University of Pennsylvania, Stanford University, University of Maryland School of Medicine, and the Weizmann Institute of Science.

I like everything I have learned about HWF, and I use it every day. HWF is collaborating with Dr. Gary King from Harvard University’s Institute for Quantitative Social Science’s Privacy Insights Project. Dr. King specializes in developing technologies to make data available to researchers while protecting participants’ individual identities. Here is where you can get the app:

Download on the App StoreDownload on the Play Store

 

Scientists and doctors will use the data the public provides to identify new outbreaks, understand how the virus is spreading, discover new populations that may be at risk, and evaluate how interventions are working to slow the spread of the disease. This data is crucial right now because there’s a widespread shortage of COVID-19 testing. Self-reported data can be a powerful new tool in the fight against the pandemic. We need to find a way to stop the spread of the virus.

I urge everyone to use the HWF app and use it daily. If you are feeling great, that is important data too. The goal of the app is to get an aggregate sense of how people are feeling across America. I trust this app. You do not need to provide any personal information, no name, phone number, or email address. You won’t be asked to create an account or log in through other accounts.

There are other innovative technologies and aggregate county-by-county surveys which I believe will help automate contact tracing. Mark Zuckerberg wrote an op-ed for the Washington Post this week which summarized the situation quite well. Following are some excerpts from what he had to say.

“I think providing aggregate data to governments and health officials is one of the most important tools tech companies can provide to help respond to COVID”. “We have a new superpower: the ability to gather and share data for good.” “If we use it responsibly, I’m optimistic that data can help the world respond to this health crisis and get us started on the road to recovery.”

Notes: As of April 24, 2020 in Danbury, CT, the How We Feel app showed 1,132 people were feeling well and 79 not well.

I would like to thank my friend Myles Trachtenberg for telling me about #HowWeFeel. The app is not perfect, but it strikes a good balance between surveillance and privacy.

News from johnpatrick.com

There is an overwhelming amount of information out there about Covid-19, more than anyone can read. Bill Gates wrote in his Gates Notes a post he calls “The first modern pandemic“.  It is quite long and parts of it are technical. However, it is the best article I have seen. Gates breaks the needed innovation into five categories: treatments, vaccines, testing, contact tracing, and policies for opening up. He concludes without advances in each of these areas, we cannot return to the business as usual or stop the virus. I highly recommend taking the time to read Bill’s comprehensive post.

You can follow the curves and projections by country or state at healthdata.org. You can monitor the number of new cases and deaths by country or state at the Coronavirus Dashboard.

My post about telehealth last week got picked up by CircleID. They have published several other of my articles. CircleID claims it “is the world’s leading platform for Internet developments with more than 5200 professional participants worldwide.”

Although the basic protocols of the Internet have not changed in 50 years, the Internet has been able to handle the surge in traffic brought on by the novel coronavirus. Vint Cerf, co-father of the Internet and recovering from COVID-19, said, “This basic architecture is 50 years old, and everyone is online,” he said. “And the thing is not collapsing.”

Last week, Doug Maine and I presented “The Origins of the Internet” in a Zoom webinar hosted in the Virtual Playhouse of Bedford, NY. During the Q&A after our presentations, a Zoom attendee asked me if I believe autonomous cars will be possible within five years. I said yes definitely. If you have any doubts watch the YouTube video lecture by Andrej Karpathy. Andrej is the director of artificial intelligence and Autopilot Vision at Tesla. The 33-year-old Stanford PhD blew my mind. I can see why Tesla is so far ahead of others and why Elon Musk pays him a $2 million salary. Watch the video here or at the end of this post.

In early April I had a routine consultation with my electrophysiologist at Nuvance Health via telehealth. Nuvance uses telehealth technology from American Well. In preparation for the consult, I took my blood pressure with a Qardio cuff and my iPhone, weighed myself on the Fitbit scale, and took a 30-second ECG with the Apple Watch. A nurse called 15 minutes before my appointment and took the information for input to the Electronic Health Record. The consult went very smoothly between the iMac and FaceTime camera at my home, and the doctor with a Windows computer with a camera. No drive to the Medical Arts building where the doctor is located. No crowded waiting room with other senior citizens during flu season during a pandemic.

A week later, my wife had a routine consultation with her primary care physician using Apple FaceTime. Other providers use Zoom, WebEx, or Skype. Hospitals and larger groups use more clinically oriented video platforms such as AmWell and Teladoc.

Why did it take a pandemic to be able to use telehealth? One thing I learned in the early years of my study of healthcare was a very simple concept: follow the money. It answers most questions about why and how things in healthcare are done. Providers did not like telehealth prior to now for a number of reasons. The main reason was they were not compensated. I agree with them. Telehealth reimbursements have been in place for years, but only for patients in very remote areas. Part of the executive orders related to Covid-19 eliminated the remote areas provision. Telehealth is now booming, although there are some consumers who may not have access to good Internet connectivity.

Telehealth is going to get better and better. In my first example, I described how the nurse called me for information which she then entered into a system. In time, the patient will be able to enter the data directly themselves. Another big change to make telehealth more comprehensive will be the integration of mHealth devices. (See peer-reviewed paper about mHealth I wrote in 2015). For example, one mHealth device allows a mother to insert an iPhone camera attachment into a child’s ear and enable a telehealth doctor to see whether there is an infection.

A hospital in Israel shows how mHealth can be applied to diagnosis of a Covid-19 patient who is at home but being followed. The hospital sends a small package to the patient. The patient schedules a telehealth consult with the doctor. First he or she logs in with a computer or mobile device. The telehealth app guides the patient to use two devices which were delivered in the package. The first device is a small handheld wireless scanner which can take the patient’s temperature from the forehead. The device also has a camera which can look at the patient’s throat. The other device is a small handheld wireless stethoscope. The app guides the patient to the places on the body where they should place the device. After the doctor has received the inputs, he or she can tell the patient how their progress is with their Covid-19 infection. Watch the 2-minute video above and you will see how all this works.

When we return to “normal”, I expect we will see telehealth continue to expand. There still will remain a number of scans and other diagnostics which cannot be done at home. However, I believe we will see a large percentage of cases which will be handled by mHealth devices and telehealth. The docs will be reimbursed. The patients will be happy they don’t have to drive to a crowded waiting room.

The Covid-19 curves are bending at different rates depending on country, state, and county. You can follow the curves by country or state at healthdata.org. Unfortunately, the deaths curves are continuing to rise. The healthdata site shows the projections. You can monitor the number of new cases by country or state at the Coronavirus Dashboard.


In last week’s e-brief, I wrote about how Zoom works nicely for family gatherings. I got an email from Khris Hall, Selectman from the town of New Fairfield, CT. She pointed out Zoom has allowed towns such as New Fairfield to continue to move forward with required processes, such as producing, publicizing, taking comment, finalizing the annual budget, and reviewing plans for new school buildings. She said, “We would be frozen without this tool.”


On Wednesday evening, Doug Maine and I presented “The Origins of the Internet” in a Zoom event hosted in the Virtual Playhouse of Bedford, NY. Doug and I were both involved in the early days of the Internet, circa 1993-1995. Doug was CFO at MCI and I was VP of Internet Technology at IBM. Twenty-six attendees connected and we had a robust Q&A session for a half-hour after our presentations. Zoom is not the same as being there, but we will all get used to video chats as a way to remain connected to learn and share.


The Founders Hall event for May 15 will be rescheduled to the Fall. Other author events are under discussion.

Date

Event

Time

Location

June 11, 2020

Meet the Author

7:00 PM

Ridgefield Library
472 Main Street, Ridgefield, CT 06877

May 15, 2020 (to be rescheduled)

Meet the Author

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

Arpil 15, 2020

Origins of the Internet   with Doug Maine and John Patrick

7:30 PM with Zoom

Virtual Playhouse
by Bedford Playhouse 
Bedford, NY

March 19, 2020 (to be rescheduled)

Community Forum

11:30 AM

AdventHealth Palm Coast 
60 Memorial Medical Pkwy
Palm Coast, FL 32164

February 14, 2020

Health Attitude with John Patrick

8:30 AM

Senior Provider Information Network
2 Corporate Dr.
Palm Coast, FL

February 6, 2020

Tech Talk 9 with John Patrick

1:00 PM

Hammock Dunes Club
Palm Coast, FL
Private event: Request invite
Mail to [email protected]

November 14, 2019

Meet the Author

1:00 PM

New Fairfield Senior Center
33 CT-37
New Fairfield, CT

October 9, 2019

Housatonic Habitat for Humanity Robotics Night

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

Meet the Author

5:30 PM

The Boiler Room
Hawley Silk Mill
8 Silk Mill Drive
Hawley, PA

Gallery View of a Video Chat. This is not my family.

Social distancing has pushed us apart. At the same time, it has pushed many of us online. Children are learning online. Old and young are streaming video entertainment. Millions are at their job virtually. They are communicating and collaborating with colleagues and customers. Doctors are seeing their patients via Telehealth portals. 

When we get to the other side of the curve, we will have learned a lot about how to get proficient with all these things online. A lot of our newly formed online engagements will continue. It will seem very odd to sit in a doctor’s waiting room reading old magazines and enduring the coughs and sneezes of other patients. Some parents will get interested in lifelong learning after watching the experience their children have had. Some companies will find part of the work employees have been doing online can continue to be done online. They will save office space and business related travel expense.

One of the beneficiaries of the e-stay_at_home phenomenon has been San Jose, CA based Zoom Video Communications, Inc. Even before the Covid-19 outbreak, Zoom had become the de facto video chat service for the roughly 90% of Americans who are under orders to stay at home. Zoom users have gone from 10 million per day to 200 million. The company’s technology has gone from an interesting enterprise communications tool to global critical infrastructure.

The company’s share price (ZM) has risen substantially since its initial public offering last year. On March 23, Zoom shares surged 135%, closing at an all-time high of $159.56. As of the close on Thursday, Zoom was valued at about $35 billion, and the CEO has joined the Forbes list of billionaires. Various security weaknesses have emerged but the CEO claims to have a solid plan in place to regain customer loyalty. More on the security issues coming up.

Early in the week, I setup a group video chat with my wife and I plus our four children, two spouses, and six grandchildren. Our family group spanned Colorado, Connecticut, Massachusetts, and Pennsylvania. Ages varied from 5 to 75. Each person, or in some cases a few persons, appeared in a separate video window. The video quality was excellent and everybody had a good time sharing what they are doing, cooking, eating, watching, reading, learning, etc. 

You may have read about security concerns with Zoom. Zoombombing, where uninvited participants have joined Zoom meetings, has gotten headlines. The primary solution to prevent Zoomboming is simple: use strong passwords. Zoom should make it mandatory to use a password. Another security exposure is the meeting ID. The host/owner/administrator of a Zoom video conference has a meeting ID; e.g. 189-654-652. If an invited participant shares the ID on social media or email, it is possible someone may get access to it and guess the password if it is abc123 or other trivial password, and then join the meeting and act inappropriately. A simple precaution is the Zoom option to have a random meeting ID assigned for each meeting.

Zoom is one of many video conferencing services. I have used a number of them, but I find Zoom to be the easiest and most reliable. The cost is free for video chats of 40 minutes or less. For $150 per year, the PRO option allows for unlimited chats with up to 100 people. The Zoom service works on desktops, laptops, or mobile devices. Whether it is FaceTime, Google Hangout, WebEx, Uber Conferences, or Zoom, video chats are a good way to communicate with friends, family, or professional engagements.

Zoom is also being used for community engagement. The Bedford Playhouse, Home of Clive Davis Arts Center is in downtown Bedford, New York. The Playhouse website has a Virtual Playhouse where Zoom is used to bring content to the community. The Playhouse website says,

If there’s a silver lining on lockdown, it’s that we have an unprecedented amount of time with our families + the opportunity to explore an exciting amount of art, film and culture online.  Virtual Playhouse aims to bring you a selection of interactive experiences, connectivity and conversations to enjoy with our amazing community — just like you normally would at the Playhouse. 

Virtual Playhouse

Bedford is in Westchester County, NY where, as of Friday morning, there were more than 17,000 Covid-19 cases and growing. You can see below the information about one of the Playhouse’s programs for next week. Doug Maine and I have known each other for decades. Doug was a senior exec at MCI and I was at IBM. We both had involvement with the early days of the Internet and that will be the topic we discuss next week. Anyone is free to listen in with or without video.

The Origins of the Internet ~ Presentation + Discussion with Doug Maine and John Patrick – April 15, 7:30pm

Deep inside the offices of IBM and MCI in the 1980s, Doug Maine and John Patrick were two men at the heart of conversations, inventions, partnerships and developments that would transform our lives, business and culture on a global scale. Join us on April 15 via Zoom for a TED-talks style conversation with Doug and John about their fascinating rolls in “inventing the internet”.

The coronavirus numbers are growing as expected, and will be growing much more. There are many websites with coronavirus information. I am sharing below the sites I have found most useful to see how the data are trending. The newest site I have discovered was created by Avi Schiffmann, a high schooler in Washington State. He calls the site Coronavirus Dashboard. It is very colorful and creative. Unfortunately, like the other sites, it is a dire story the data are telling us.

Coronavirus Dashboard
Global
States 
Connecticut
Florida 
New York
Pennsylvania


Data Fact. The Human Genome Project estimated humans have between 20,000 and 25,000 genes. In our mouths are ten times that many and there is a like amount in our guts. Researchers are sequencing the microbiome, and a lot will be learned.


The next author event will be about the Origins of the Internet. I will be doing this with Doug Maine. The Zoom event is scheduled in the Virtual Playhouse on April 15th at 7:30 PM. See table below and the last part of this week’s e-brief above. The Founders Hall event on May 15 will be rescheduled in the Fall.

Date

Event

Time

Location

June 11, 2020

Meet the Author

7:00 PM

Ridgefield Library
472 Main Street, Ridgefield, CT 06877

May 15, 2020 (to be rescheduled)

Meet the Author

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

Arpil 15, 2020

Origins of the Internet   with Doug Maine and John Patrick

7:30 PM with Zoom

Virtual Playhouse
by Bedford Playhouse 
Bedford, NY

March 19, 2020 (to be rescheduled)

Community Forum

11:30 AM

AdventHealth Palm Coast 
60 Memorial Medical Pkwy
Palm Coast, FL 32164

February 14, 2020

Health Attitude with John Patrick

8:30 AM

Senior Provider Information Network
2 Corporate Dr.
Palm Coast, FL

February 6, 2020

Tech Talk 9 with John Patrick

1:00 PM

Hammock Dunes Club
Palm Coast, FL
Private event: Request invite
Mail to [email protected]

November 14, 2019

Meet the Author

1:00 PM

New Fairfield Senior Center
33 CT-37
New Fairfield, CT

October 9, 2019

Housatonic Habitat for Humanity Robotics Night

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

Meet the Author

5:30 PM

The Boiler Room
Hawley Silk Mill
8 Silk Mill Drive
Hawley, PA

On March 13, I posted a story about the silver lining in the coronavirus cloud (See re-post below). Despite the enormous pain and suffering millions of people will endure, I continue to believe there will be many good things, in addition to the things I mentioned in the earlier post, which will emerge on the other side. In today’s post, I will highlight some DIY (Do It Yourself) activities happening which will have long term benefits.

Gui Cavalcanti is Founder & Co-Executive Director of Open Source Medical Supplies in the San Francisco Bay Area. Mr. Cavalcanti has a background in robotics and has been working on  creating robust, low-cost fluidic robots which can operate in environments as extreme as deep water, outer space, and everything in between. Over the past couple of months he stopped building robots due to a Covid-19-based global supply chain failure which stopped the supply of parts needed to build them.

Mr. Cavalcanti realized the world would soon face the same supply chain situation for medical equipment and supplies. He founded a Facebook group to collect open source medical supply designs and document them so local communities could fabricate their own medical supplies. Within less than three weeks, the Facebook group had grown to 64,000 people from all over the world. In addition, 460 dedicated volunteers jumped on board helping write an 80+ page Open Source Medical Supply Guide and a Local Response Guide to help communities self-organize. The DIY group produced more than 280,000 medical supply items and delivered them to healthcare institutions all over the globe.

You can visit the Open Source COVID19 Medical Supplies group on Facebook and see the amazing things the group is doing. One person uploaded a detailed instruction guide on how to make vented masks starting with cutting cardboard pieces from a used cereal box. Rod, a local yet internationally experienced fabric and apparel designer, engineered and spearheaded the first production cutting run for an additional 230 hoods and gowns. Another group is making powered, air-purifying respirators (PAPR) used to safeguard healthcare workers. The DIY group is doing remarkable things.

One of the most pressing shortages facing hospitals is a lack of ventilators. These machines keep patients breathing when they can no longer breath on their own. The media has widely reported ventilators cost around $30,000 or more. A rapidly assembled team of volunteer engineers, physicians, computer scientists, and others, centered at MIT, has developed a safe, inexpensive alternative for emergency use. MIT is going to post the free detailed plans for an emergency ventilator which can be built quickly around the world at a cost of $100.

Part of the silver lining is the revelation of the dependence on a non-U.S. supply chain and the cost of critical healthcare supplies and equipment. Why does a ventilator cost $30,000? Because medical equipment companies can charge that much. These companies are very profitable. They should be profitable, but how profitable? Is there enough competition? Why is the supply chain broken? Because companies outsourced to China to shave pennies off the cost of production. The silver lining is these issues will get significant focus on the other side of the pandemic. The results will be positive and help prepare for the next pandemic and also lower the cost of medical equipment.

The coronavirus numbers are growing as expected, and will be growing much more. There are many websites with coronavirus information. I am sharing below the sites I have found most useful to see how the data are trending. The newest site I have discovered was created by Avi Schiffmann, a high schooler in Washington State. He calls the site Coronavirus Dashboard. It is very colorful and creative. Unfortunately, like the other sites, it is a dire story the data are telling us.

Coronavirus Dashboard
Global
States 
Connecticut
Florida 
New York
Pennsylvania


Data Fact. The Human Genome Project estimated humans have between 20,000 and 25,000 genes. In our mouths are ten times that many and there is a like amount in our guts. Researchers are sequencing the microbiome, and a lot will be learned.


The next author event is scheduled for May 15th at Founders Hall in Ridgefield, CT. I expect it will need to be rescheduled.

Date

Event

Time

Location

June 11, 2020

Meet the Author

7:00 PM

Ridgefield Library
472 Main Street, Ridgefield, CT 06877

May 15, 2020 (to be rescheduled)

Meet the Author

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

Arpil 15, 2020

Origins of the Internet   with Doug Maine and John Patrick

7:30 PM with Zoom

Virtual Playhouse
by Bedford Playhouse 
Bedford, NY

March 19, 2020 (to be rescheduled)

Community Forum

11:30 AM

AdventHealth Palm Coast 
60 Memorial Medical Pkwy
Palm Coast, FL 32164

February 14, 2020

Health Attitude with John Patrick

8:30 AM

Senior Provider Information Network
2 Corporate Dr.
Palm Coast, FL

February 6, 2020

Tech Talk 9 with John Patrick

1:00 PM

Hammock Dunes Club
Palm Coast, FL
Private event: Request invite
Mail to [email protected]

November 14, 2019

Meet the Author

1:00 PM

New Fairfield Senior Center
33 CT-37
New Fairfield, CT

October 9, 2019

Housatonic Habitat for Humanity Robotics Night

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

Meet the Author

5:30 PM

The Boiler Room
Hawley Silk Mill
8 Silk Mill Drive
Hawley, PA

In January, virologists in China isolated a new virus. In March the Coronaviridae Study Group of the International Committee on Taxonomy of Viruses named the virus SARS-CoV-2. Most people call it the coronavirus. The virus causes a disease called Covid-19. The vocabulary can be very confusing. The goal of this article is to shed some light on the various terms.

Let’s start with taxonomy, a scheme of classification of things, especially living things. A Swedish naturalist named Carolus Linnaeus is considered the “Father of Taxonomy”. In the 1700s, Linnaeus developed a method we still use today to name and organize species. The table below shows one version of the Linnaean Classification of Humans.

Kingdom

Animalia

Phylum

Chordata

Subphylum

Vertebrata

Class

Mammalia

Subclass

Theria

Infraclass

Eutheria

Order

Primates

Suborder

Anthropoidea

Superfamily

Hominoidea

Family

Hominidae

Genus

Homo

Species

Sapiens

The level of detail can make your head hurt. We humans are often referred to simply as Homo Sapiens. There is much more detail beyond the table if you want to drill down. When it comes to viruses, the taxonomy makes the human taxonomy look really simple. See the following table from Nature.com to get a glimpse of it. The complete 8,000-word article is here.

To put the complexity in perspective, consider SARS-CoV-2, the cause of the pandemic, is one of 6,828 virus species which have been named. Researchers say they know of hundreds of thousands more species. Some believe there may be trillions waiting to be found. This is the virosphere.

The good news is there are a number of profound research projects underway to deal with the world of viruses. This is incredibly important because viruses are not going away. Some experts are saying a new and different virus will appear next year or even later this year. Hopefully, we will be ready. The wake up call this time was so loud and clear, I believe we will be prepared.

One new approach under development is the use of synbio, as described in last week’s e-brief. A vaccine made from synthetic ingredients can potentially offer some significant advantages. The big one is scalability. Synbio vaccines could be produced efficiently for millions or even billions of doses. Synbio vaccines are developed using computer models, not flasks and test tubes. With billions of calculations, a nanoparticle can be designed which has the exact properties desired. The really big breakthrough with synbio is the attachment of multiple different viral molecules to the nanoparticle and thereby create a universal coronavirus vaccine. One vaccine for all corona viruses. That will be the breakthrough.

Another positive development in the silver lining of the coronavirus cloud is tech companies large and small are jumping in the boat to help. For example, IBM is collaborating with the White House Office of Science and Technology Policy and the Department of Energy to launch the COVID-19 High Performance Computing Consortium. The Consortium will provide supercomputing power to researchers developing predictive models to analyze the coronavirus progression and identify potential treatments. Researchers from around the world can submit proposals, and the Consortium will select the projects which could have the most immediate impact. Other partners in the consortium include NASA, MIT, and the Argonne National Laboratory.

Another significant Covid-19 effort is taking place at Oak Ridge National Laboratory in Oak Ridge, Tennessee. As of November 2019, Oak Ridge had the fastest supercomputer in the world. It is capable of performing one thousand million million (1015) operations per second.

Scientists at Oak Ridge have deployed the massive supercomputer to look for compounds which can bind to the “spike protein” of the virus. It is the spike protein which the virus uses to infect host cells. The right compound could render the spike protein ineffective, and the virus would be stopped from spreading. Using digital models, the supercomputer can simulate how particles in the viral protein would react to different drug compounds. The researchers started with a list of 77 compounds and narrowed it down to the top seven most promising candidates which could become effective treatments for covid-19. The research is at the early stage but I believe we can be hopeful.

The coronavirus numbers are growing as expected, and will be growing much more. There are many websites with coronavirus information. I did some digging around to find the ones which presented the data I wanted to see. I am sharing below the sites I have found most useful to see how the data is trending. Fyi.

Global
States 
Connecticut
Florida 
New York
Pennsylvania

The numbers are going to rise significantly from what already looks high. We should not be surprised or alarmed. More tests are going to happen and more cases will be found. If you are interested in the impact of the numbers, I suggest reading “The Sober Math Everyone Must Understand about the Pandemic” by Jason Warner. The essence of his article is if we take action on social distancing now, we can bend the curve and save a lot of lives and avoid a crisis for our healthcare system. If we do not do a good job of social distancing, like what millennials were doing on Florida beaches, then we face catastrophe. Jason’s article steps through the numbers, and it is not pretty.


I posted an op-ed piece in a technical newsletter called TNW. The title of the op-ed is “Mobile voting is far from perfect, but it’s better than what we have now”. The current situation of voting challenges is proof perfect. You can read the op-ed it here. The Congress could do remote voting very easily and safely. One Senator said the Senate should get with it in the 21st century. The vote on the rescue package was 96-0. The four missing Senators were at home. Senators are so technically unaware they could agree on a way to allow the four Senators to vote remotely. The speaker of the house said, “We can not vote from home”. As I have said so many times, we can put a robot on Mars, but we can’t figure out how to vote remotely.


The next author event is scheduled for May 15th at Founders Hall in Ridgefield, CT. Time will tell if it will need to be rescheduled.

Date

Event

Time

Location

June 11, 2020

Meet the Author

7:00 PM

Ridgefield Library
472 Main Street, Ridgefield, CT 06877

May 15, 2020 (to be rescheduled)

Meet the Author

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

Arpil 15, 2020

Origins of the Internet   with Doug Maine and John Patrick

7:30 PM with Zoom

Virtual Playhouse
by Bedford Playhouse 
Bedford, NY

March 19, 2020 (to be rescheduled)

Community Forum

11:30 AM

AdventHealth Palm Coast 
60 Memorial Medical Pkwy
Palm Coast, FL 32164

February 14, 2020

Health Attitude with John Patrick

8:30 AM

Senior Provider Information Network
2 Corporate Dr.
Palm Coast, FL

February 6, 2020

Tech Talk 9 with John Patrick

1:00 PM

Hammock Dunes Club
Palm Coast, FL
Private event: Request invite
Mail to [email protected]

November 14, 2019

Meet the Author

1:00 PM

New Fairfield Senior Center
33 CT-37
New Fairfield, CT

October 9, 2019

Housatonic Habitat for Humanity Robotics Night

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

Meet the Author

5:30 PM

The Boiler Room
Hawley Silk Mill
8 Silk Mill Drive
Hawley, PA

Microscopic virus close up with 3D rendering

The numbers continue to grow and, as Dr. Fauci says, it is going to get worse before it gets better. If we all do a good job in social distancing, the curve will bend sooner rather than later. The government is pulling out all stops for therapeutic solutions, as Dr. Kuhn described on Thursday. As I wrote last week, there is a silver lining to the dark cloud hovering over all of us. One of the numerous positive things going on is the development of a vaccine for Covid-19.

Significant progress is being made by Moderna Therapeutics, CureVac, and Inovio Pharmaceuticals, who are going as fast as possible to begin human testing. Nevertheless, the approach they are taking uses biological DNA and RNA as the core ingredient. As advanced as the current development process is, vaccines as we know them have a number of shortcomings. The most visible shortcoming is they take years to develop and manufacture. Potentially more significant is they become obsolete if and when the virus evolves, which it will. There are already multiple strains, and there will be more. Finally, the immune response the vaccines produce may not be strong enough to be effective.

A totally new approach is under development using synbio. The Bill and Melinda Gates Foundation has put $60 million into coronavirus research including for the synbio effort. If you read Daniel Suarez science fiction novels (among my favorite authors) you have already heard of synbio. It takes a major role in his book, Change Agent, which takes place in 2045, and is about Interpol’s Genetic Crime Division which grapples with a new type of crime: illicit genetic editing. It is quite a thriller.

Synbio stands for synthetic biology. Synbio is mostly about the design and construction of new biological parts, devices, and systems, and the re-design of existing, natural biological systems. More specific to the issue of the day, synbio may replace the DNA and RNA ingredients mother nature has provided for the development of vaccines with synthetic ingredients.

A vaccine made from synthetic ingredients can potentially offer some significant advantages. The big one is scalability. Synbio vaccines could be produced efficiently for millions or even billions of doses. Another advantage is synthetic ingredients do not need to be refrigerated. This would be a huge benefit for places like sub-Saharan Africa.

Synbio vaccines are developed using computer models, not flasks and test tubes. With billions of calculations, a nanoparticle can be designed which has the exact properties desired. The really big breakthrough with synbio is the attachment of viral molecules to the nanoparticle. Neil King at the University of Washington and his synbio colleagues knew there would be another coronavirus epidemic, like the SARS and MERS outbreaks before the current Covid-19 outbreak. King said, “…there will be another one after this,” perhaps from yet another member of this virus family. We need a universal coronavirus vaccine.” One vaccine for all corona viruses. That will be the breakthrough.

Sharon Begley wrote a beautiful article in STAT which explains the synbio efforts underway in much more detail. See To develop a coronavirus vaccine, synthetic biologists try to outdo nature. STAT has great articles about life sciences and the fast-moving business of making medicines.

The coronavirus numbers are growing, and will be growing much more. There are gazillions of websites with coronavirus information. I did some digging around to find the ones which presented the data I wanted to see. I am sharing below the sites I have found most useful to see how the data is trending. Fyi.

Global
States 
Connecticut
Florida 
New York
Pennsylvania

The numbers are going to rise significantly from what already looks high. We should not be surprised or alarmed. More tests are going to happen and more cases will be found. If you are interested in the impact of the numbers, I suggest reading “The Sober Math Everyone Must Understand about the Pandemic” by Jason Warner. The essence of his article is if we take action on social distancing now, we can bend the curve and save a lot of lives and crisis for our healthcare system. If we do not do a good job of social distancing, like what millennials have been doing on Florida beaches, then we face catastrophe. Jason’s article steps through the numbers, and it is not pretty.


I posted an op-ed piece in a technical newsletter called TNW. The title of the op-ed is “Mobile voting is far from perfect, but it’s better than what we have now”. The current situation of voting challenges is proof perfect. You can read the op-ed it here. The Congress could do remote voting very easily and safely. One Senator said the Senate should get with it in the 21st century. The speaker of the house said, “We can not vote from home”.


The next author event is scheduled for May 15th at Founders Hall in Ridgefield, CT. Time will tell if it will need to be rescheduled.

Date

Event

Time

Location

June 11, 2020

Meet the Author

7:00 PM

Ridgefield Library
472 Main Street, Ridgefield, CT 06877

May 15, 2020 (to be rescheduled)

Meet the Author

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

Arpil 15, 2020

Origins of the Internet   with Doug Maine and John Patrick

7:30 PM with Zoom

Virtual Playhouse
by Bedford Playhouse 
Bedford, NY

March 19, 2020 (to be rescheduled)

Community Forum

11:30 AM

AdventHealth Palm Coast 
60 Memorial Medical Pkwy
Palm Coast, FL 32164

February 14, 2020

Health Attitude with John Patrick

8:30 AM

Senior Provider Information Network
2 Corporate Dr.
Palm Coast, FL

February 6, 2020

Tech Talk 9 with John Patrick

1:00 PM

Hammock Dunes Club
Palm Coast, FL
Private event: Request invite
Mail to [email protected]

November 14, 2019

Meet the Author

1:00 PM

New Fairfield Senior Center
33 CT-37
New Fairfield, CT

October 9, 2019

Housatonic Habitat for Humanity Robotics Night

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

Meet the Author

5:30 PM

The Boiler Room
Hawley Silk Mill
8 Silk Mill Drive
Hawley, PA

Novel Coronavirus. Microscope virus close up. 3d rendering.

One thing all the Coronavirus experts agree on is the virus will continue to spread for some time. One important question related to this is how contagious is the virus? The key measure is transmissibility, how rapidly the disease spreads. Transmissibility is indicated by its reproductive number, abbreviated as Ro and pronounced R-nought or r-zero. Ro represents the average number of people to which a single infected person transmits the virus. On January 23, the World Health Organization estimated Ro for covid-19 to be between 1.4 and 2.5. Other studies have estimated Ro between 2.4 and 4.0. An outbreak with a Ro less than 1 will gradually disappear. A Ro of 4.0 would produce an extremely bad situation. For comparison, the Ro for the common flu is 1.3 and for SARS it was 2.0.

If we do nothing, then Ro will be high and the number of cases and deaths will be very high. As predicted by some, if we do nothing, the spread could go exponential and lead to millions of cases. If we take aggressive actions, however, the Ro will be lower and the growth rates of the disease will be flattened.

The spread of the disease to date should be a wake up call for every person and organization. Supplies are being hoarded which should already have been on hand. Action plans are rolling out, but they should have been ready from Day 1. The government is prepared for hurricanes but not totally prepared for a pandemic. The good news is the Federal, State, and Local governments are learning a lot from the situation and the emergency plans to reduce bureaucracy should have a very positive impact. Public private partnerships in retail and lab testing are set to solve the critical problem of testing. The wake up call may lead to a silver lining in the coronavirus cloud. Following are some components of the silver lining.

  1. The development time for vaccines must continue to get shorter. The good news on this is they can sequence the genome of the virus in hours. Sequencing the first human genome cost about $1 billion and took 13 years to complete. In the case of the coronavirus, the detection of the virus was confirmed in France on Friday, January 24. Later that day, the Institut Pasteur received samples of three suspected cases they detected with the novel coronavirus and began preparation for the sequencing. The process started on Monday and was completed early Tuesday evening. Remarkable. The next step is the process for creating, testing, and manufacturing a vaccine. The process to get from recipe to tested and available vaccine needs a major upgrade and modernization.
  2. A major information technology (IT) upgrade is needed between state and federal public health organizations. Now that millions of test kits are being distributed, the public will be asking what were the results. As it stands, the answer from the government will have to be, “We don’t know”. This is a problem I wrote about in Health Attitude in 2015. State governments have been reluctant to share data with the Federal government. It is partly cultural and partly because there is no efficient way to do the sharing. The bureaucracy involved is immense. The Feds have spent hundreds of millions on incentives to get states to share their data but it is not happening as it could. The benefits of sharing will be huge. Once millions of consumers, labs, and providers add data to an anonymized national database, a multitude of data will become available for the greater good. Researchers can study the anonymized data and gain insights about the health of the population at a community level, nationally, or globally. This will be extremely helpful for establishing travel bans and imposing quarantines on a more pinpointed basis rather than a cancel everything everywhere approach. Hopefully, better data sharing will be in place before the next pandemic.
  3. A big question which needs an answer is what is the best therapeutic for treating covid-19? Various drugs are being tried. This is new. Historically, if you have a certain disease, you are prescribed a certain drug. For example, if you have breast cancer, then take XYZ drug. Oncologists have learned a combination of drugs may work better than the normally prescribed drug. Either approach in a sense implies one size fits all. In fact, every cancer is different and very personal. This is where AI and machine learning (ML) come in. Globally, more than 350,000 chemical compounds (including mixtures of chemicals) have been registered for production and use. Might one of them work to cure covid-19? I would say it is likely. How do they find the chemicals which can work? ML can be applied to all hundreds of thousands of possible cures based on the genomic sequence of the patient and of the novel coronavirus. You might think of it as a digital clinical trial done in hours, not months. I am confident this type of approach will evolve. 
  4. Like you, I have been receiving emails from a lot of organizations ranging from global travel companies to our local dry cleaner. They are all very similar. One I received caught my eye. They said, “Currently, our entire staff is equipped to work remotely and to support our clients and one another via phone and email. We will send updates to you as appropriate, and information regarding our status and availability will be posted on our website”. This is an organization which was prepared. Many were not. Many companies and schools and conferences are saying they are going remote: e-learning, e-meetings, e-conferences. Saying you are e-whatever doesn’t make it happen. Do all the employees and customers have access to reliable high-speed bandwidth? Probably not. Are they all trained on how the e-engagement works? Probably not. Effective e-whatever takes a lot of planning, testing, and training. The good news is bandwidth is generally much better than it was a decade ago. The wakeup call will result in organizations asking key questions. How well do we function as an e-organization? Before we go back to “normal” do we really need everybody to go back to the way it was? Can we streamline our organization and our services by fine tuning our e-capabilities?
  5. The pandemic is exposing the weaknesses of our paper-based government, including how we vote. Social separation is being urged but to vote, thousands had to stand in line for hours. Those that voted remotely did so by licking an envelope and stamp. Online and mobile voting can work with security, privacy, accuracy, and verifiability if we put our mind to it. Digital discourse can strengthen our democracy. The discourse doesn’t have to be in crowded rooms. Hopefully, the wake up call will get policymakers thinking about the many things we do by touching paper touched by others. Real estate closings, bank loans, paying for things with cash, and the list goes on.

The pandemic has provided a wake up call. If we do nothing, hide like a hermit, and hope it goes away, things will get worse. If we take aggressive actions as described at coronavirus.gov, we can flatten the curves and start thinking about covid-21 and how we can prepare now.


Data Facts of the Week

The coronavirus numbers are growing, but see my article, “Is There a Silver Lining in the Coronavirus Cloud?” If you like to follow what is going on in the coronavirus world statistically, take a look at worldometers.info/conronavirus. After the table of country by country statistics, the page shows the specific things which changed from the prior day. For other interesting real-time statistics about population growth, visit the homepage at worldometers.info. Each day the dedicated doctors and scientists learn more and more about the DNA of the virus and how to cure it and ultimately prevent it.


On Friday morning I was a guest on WNZF “Free For All Fridays”. The Flagler County, Florida news station program was hosted by General Manager David Ayers. Local government officials, a hospital executive, and a congressional representative participated. You can find the podcast here.


The next author event was scheduled for March 19th at AdventHealth in Palm Coast, FL. The event was cancelled by AdventHealth. It will be rescheduled.

Date

Event

Time

Location

June 11, 2020

Meet the Author

7:00 PM

Ridgefield Library
472 Main Street, Ridgefield, CT 06877

May 15, 2020 (to be rescheduled)

Meet the Author

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

Arpil 15, 2020

Origins of the Internet   with Doug Maine and John Patrick

7:30 PM with Zoom

Virtual Playhouse
by Bedford Playhouse 
Bedford, NY

March 19, 2020 (to be rescheduled)

Community Forum

11:30 AM

AdventHealth Palm Coast 
60 Memorial Medical Pkwy
Palm Coast, FL 32164

February 14, 2020

Health Attitude with John Patrick

8:30 AM

Senior Provider Information Network
2 Corporate Dr.
Palm Coast, FL

February 6, 2020

Tech Talk 9 with John Patrick

1:00 PM

Hammock Dunes Club
Palm Coast, FL
Private event: Request invite
Mail to [email protected]

November 14, 2019

Meet the Author

1:00 PM

New Fairfield Senior Center
33 CT-37
New Fairfield, CT

October 9, 2019

Housatonic Habitat for Humanity Robotics Night

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

Meet the Author

5:30 PM

The Boiler Room
Hawley Silk Mill
8 Silk Mill Drive
Hawley, PA

Press articles about Internet voting abound. The articles quote technology experts who are worried about the theoretical risks of Internet voting, mobile or otherwise. They correctly say the Internet is not perfect. But, neither is the paper-base system we have. The anti-Internet voting activists continue to compare Internet voting to a perfect world which we will never have. They fail to compare it to the old fashioned paper based system which is now the preferred method to vote. How good is the paper based approach?

This past week’s Democratic primaries in Texas and California showed some of the imperfections of current voting methods. For many voters, the primaries were a nightmare. Some lines were up to six hours long. CNN reported voters walked away because they could not wait any longer. Axios reported, “Long wait times put a special hardship on low-income voters who are less likely to have flexible work hours, around-the-clock transportation and child care.” Another problem is southern states have closed 1,200 polling sites, presumably because of the cost to maintain them. It is no coincidence the closed polling sites had mostly been for Latino and black citizens, many of whom could not get to the alternate polling sites.

The paper based voting systems have numerous problems. The Los Angeles Times reported, “In California, machine jams slowed the rolls, delaying lines up to two hours.” Errors in voter registration forced voters to cast paper provisional ballots which would not be counted until the voter registration was confirmed manually. Voters were also confused about how to use the new voting machines. In some races, the voter had to click “more” to see additional candidates on the voting machine screen. At some voting locations, voting machines just flat out did not work.

We should not trust Internet voting, but we should trust the paper based approach? But wait, there is more. Western states have been pushing early voting my mail for years. It has grown rapidly. The number of early votes cast for Super Tuesday Democratic primaries was 4 million. In California, the early votes were 40%. Many of the votes were wasted because Pete Buttigieg, Amy Klobuchar, and Tom Steyer dropped out after the early voters had cast their ballot. Many voters were quite disappointed they could not change their vote. With Internet voting, they could have. In fact, with Internet voting a citizen can vote as many times as they want up until the polls close. The last vote is the only one which counts.

We put a robot on Mars, 34 million miles away, and it is still roaming the Red Planet. We can also make Internet voting safe, secure, private, accurate, accessible, reliable, and verifiable. All we need to do state by state and county by county is to develop detailed plans, select vendors which have the best technology, and test, test, test. The only other thing we need is the political and technological will to make it easier for the many millions of people who couldn’t get to the polls or wasted votes by casting paper ballots early.


Data Facts of the Week

This past week, the AP reported there currently are 17 times as many new infections outside China as inside China. If you like to follow what is going on in the coronavirus world statistically, take a look at worldometers.info/conronavirus. After the table of country by country statistics, the page shows the specific things which changed from the prior day. For other interesting real-time statistics about population growth, visit the homepage at worldometers.info. Although each day the dedicated doctors and scientists learn more and more about the DNA of the virus and how to cure it and ultimately prevent it, fear and market reaction continues.


On Friday morning March 13 at 9 AM, I will be a guest on WNZF “Free For All Fridays”. As in past visits to this great local Flagler County, Florida news station, I anticipate a range of challenging questions from host and General Manager David Ayers. Tune in to 92.7 FM or visit flaglerbroadcasting.com/wnzf.


The next author event will be on March 19th at AdventHealth in Palm Coast, FL. The event is open to the public. Seating is limited, so RSVP by calling 386-586-4440 or email [email protected]The first 65 to register will get an autographed copy of Robot Attitude: How Robots and Artificial Intelligence Will Make Our Lives Better which I will be discussing.

Date

Event

Time

Location

June 11, 2020

Meet the Author

7:00 PM

Ridgefield Library
472 Main Street, Ridgefield, CT 06877

May 15, 2020 (to be rescheduled)

Meet the Author

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

Arpil 15, 2020

Origins of the Internet   with Doug Maine and John Patrick

7:30 PM with Zoom

Virtual Playhouse
by Bedford Playhouse 
Bedford, NY

March 19, 2020 (to be rescheduled)

Community Forum

11:30 AM

AdventHealth Palm Coast 
60 Memorial Medical Pkwy
Palm Coast, FL 32164

February 14, 2020

Health Attitude with John Patrick

8:30 AM

Senior Provider Information Network
2 Corporate Dr.
Palm Coast, FL

February 6, 2020

Tech Talk 9 with John Patrick

1:00 PM

Hammock Dunes Club
Palm Coast, FL
Private event: Request invite
Mail to [email protected]

November 14, 2019

Meet the Author

1:00 PM

New Fairfield Senior Center
33 CT-37
New Fairfield, CT

October 9, 2019

Housatonic Habitat for Humanity Robotics Night

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

Meet the Author

5:30 PM

The Boiler Room
Hawley Silk Mill
8 Silk Mill Drive
Hawley, PA

Novel Coronavirus. Microscope virus close up. 3d rendering.

What is becoming clear about the coronavirus situation is it will not be contained. The question is what to do about it. The answer requires knowing where the virus will spread and when. The good news is artificial intelligence (AI) can provide answers now, and even more accurately in the future.

Dr. Kamran Khan, a 49-year-old Canadian epidemiologist and infectious disease specialist in Toronto, was working at a hospital during the SARS epidemic of 2003. The SARS virus started in provincial China and spread to Hong Kong and then to Toronto, where it killed 44 people. Khan concluded there must be a better way to track diseases. With that goal in mind, Khan founded a company in 2014 called BlueDot.

BlueDot has developed an algorithm that can sift through hundreds of thousands of news stories and airline traffic information everyday. The goal is to detect and monitor the spread of infectious diseases. BlueDot applies AI technologies to create alarms about impending virus attacks. Its first success was accurately predicting the spread of Zika from Brazil to south Florida in 2016. Early on, it predicted the spread of coronavirus on December 31, 2019.

BlueDot has 40 employees including data scientists, epidemiologists, physicians, veterinarians, and software developers. Using natural language processing and machine learning, the BlueDot team has developed a real-time warning system based on the vast amount of data it analyzes. The data is retrieved every 15 minutes around the clock from scans of official reports, online news sources, professional forums and information retrieved from key word and phrase searches.

The Economic Times reported BlueDot, “Can read text in 65 languages and can track 150 different types of diseases.” Mr. Khan told The Times, “We call it the needles in the haystack”. After the AI software has analyzed the data, it presents the findings to human experts who tag information they believe is related to a threat.

“There’s a massive amount of data and the machine is finding the needles and presenting it to the human experts,” who then review it and train the AI to understand if the information corresponds to an actual threat. The Times reported, “If the threat looks real, the AI software then looks further for nearby airports and commercial air travel itineraries from around the world. Climate data, national health system databases, and even the presence of mosquitoes or animals that transmit diseases to humans are all taken into account.”

Once BlueDot is confident it has valid data, it sends an alert to its clients including airlines, hospitals, and government agencies informing them where the majority of the airline passengers might disembark. The recipients of the alerts can then prepare for a major disease outbreak.

The Times reported, “So on December 31, in the early morning, the BlueDot system picked up an article in Mandarin that mentioned 27 people suffering from pneumonia, all linked to a wet market in Wuhan.” The virus was not yet identified but the data contained some similarities to the SARS outbreak. BlueDot AI technology predicted the virus would likely spread from Wuhan to Bangkok, Hong Kong, Singapore, Taipei, and Tokyo, all of which have since reported cases of the novel coronavirus.

Other startup companies, government laboratories, Harvard Medical School, and numerous other centers of excellence are using AI to study massive amounts of data. They are using tools which were not available ten years ago. AI is being used to examine large numbers of chemical molecules to determine if they might be therapeutic toward coronavirus. Long term, it is likely there will be new diseases appearing. The good news is AI is getting smarter and smarter every day, and will eventually be able to predict outbreaks earlier and develop cures and vaccines much more quickly than is currently possible.

This Canadian start-up used AI to track coronavirus and raised alarm days before the outbreak

 
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