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.
While reading the news, a story about an asteroid caught my eye. The next I knew, I was doing some research and learning a lot I did not know about asteroids. I am sharing what I learned in this post. I hope you enjoy it.
Asteroids are irregularly shaped rock fragments left over from the formation of the solar system about 4.6 billion years ago when a big cloud of gas and dust collapsed. After the collapse, most of the material fell to the center of the cloud and formed the sun. Much like planets although smaller, asteroids orbit the sun in a belt between Mars and Jupiter. Scientists think there are probably millions of asteroids, ranging in size from hundreds of miles across to as small as pebbles.
Although the Moon, Mars, and the International Space Station make the most headlines, NASA has done some amazing things with numerous spacecraft to learn what asteroids look like, what they are made of, and what orbital paths they take. One thing NASA has learned is no two asteroids are alike. Asteroids are not round like planets. They are jagged and have very odd shapes, some are square or rectangular.
The current known asteroid count is 1,081,163. Scientists study them, categorize them based on their composition, and even give them names, in addition to a number. The International Astronomical Union’s Committee on Small Body Nomenclature controls the naming. Most of the names are based on mythology but there are some exceptions. One giant space rock orbiting the sun was named for Mr. Spock and another is named after rock musician Frank Zappa. Some names are somber tributes such as seven asteroids named after the crew of the Space Shuttle Columbia who died in 2003. The Harvard Smithsonian Center for Astrophysics keeps a fairly current list of the names. A few well known ones include Ceres, Eros, Geographos, Hathor, Hermes, Icarus, Pallas, and Vesta. Asteroids which have been imaged in great detail by NASA spacecraft include Mathilde, Gaspra, and Ida.
One reason asteroids are of interest is they are believed to contain metals such as nickel and iron. We may find out they also have rare minerals which are scarce and in high demand on Earth. This reminds me of a great novel by Michael Suzrez. The bestselling author of Daemon wrote Delta-V, a near-future technological thriller in which a charismatic billionaire recruits a team of adventurers to launch the first deep space mining operation. The plot was for the mission to alter the trajectory of human civilization. A great read.
There is a lot to be learned from asteroids. Since asteroids formed at the same time as other objects in our solar system, the space rocks can give scientists lots of information about the history of planets and the sun. Until now, scientists have had to learn about asteroids by studying meteorites, the small bits of asteroids which have flown through our atmosphere and landed on Earth’s surface. The next step is to actually land on an asteroid and get a sample not contaminated by having fallen through Earth’s atmosphere.
Bennu was selected for OSIRIS-REx because of its ideal proximity to Earth, its size, and its composition. The asteroid contains organic molecules, volatiles, and amino acids which may have been the precursors to life on Earth. The NASA spacecraft took off from Earth in September 2016 and arrived at Bennu in December 2018. On October 20, 2020, the spacecraft made a precision but brief landing on the surface of Bennu. It extended a foot-like appendage which punched the surface and then released a blast of nitrogen to stir up the surface. It then captured the debris in a capsule, closed the lid of the capsule, and headed back into orbit. On Monday, May 10, 2021, the spacecraft turned on its thrusters for seven minutes to begin its journey toward Earth.
Because of various orbital complexities I don’t understand, the spacecraft will have to make two laps around the Sun and then, if all goes as planned, the spacecraft will travel more than a billion miles and return to Earth after more than two years of travel. When the spacecraft gets within about 6,000 miles from Earth, it will eject the capsule carrying two ounces of invaluable samples. When close to Earth, the capsule will release parachutes which will allow for a smooth landing. NASA expects the capsule will land in the desert in Utah on September 24, 2023. The precious samples will then head to a NASA laboratory in Texas where scientists are eagerly awaiting to begin research which could unlock secrets of the early solar system. If you are interested to see a short and interesting video explaining the OSIRIS-REx mission click here.
SpaceX Launches
SpaceX announced plans to put a StarShip into orbit and then land near Hawaii. It would be a 90 minute flight. They continue with a rapid pace to develop a way to get to the Moon and beyond.
Meanwhile China prepares to land its Zhurong rover on Mars targeting the six-wheeled Zhurong robot to land at Utopia Planitia, a vast terrain in the planet’s northern hemisphere. The Chinese rover will use a combination of a protective capsule, a parachute, and a rocket platform to make the descent. If they pull it off, it will be a remarkable achievement. The task is incredibly difficult and so far only Americans have mastered Mars landings.
Wall Street
The MAGFA stocks were strong today but down from recent levels. Coinbase took a 13% hit despite tremendous revenue and profits. Investors are concerned their fees will decline. Tesla was down 16%. A Tesla involved in a fatal crash on a Southern California freeway last week was operating on Autopilot at the time, authorities said.
Bitcoin having continued volatility as expected. Etherum continues to surge. Ethereum is in the DeFi, distributed finance segment. Many new financial and insurance firms are set up to be disrupted by DeFi. This is good in my opinion. Old fashioned ways need to be uprooted. Ethereum is playing a role. Doge coin was up 30+% and is also volatile based on Elon Musk comments. He may get himself in trouble as a manipulator. Crypto is on a wild ride. There are now 9,818 crypto coins out there. Most are a joke but people are buying them. Bitcoin was 75% of total crypto market cap and now it is 40% as ETH has soared.
During a trip to China a dozen or so years ago, we visited the Three Gorges Dam, and it was a sight to behold. The straight-crested concrete gravity structure is almost one and a half miles long with a maximum height of 607 feet. The structure incorporates 37 million cubic yards of concrete and 463,000 metric tons of steel. The hydroelectric gravity dam spans the Yangtze River by the town of Sandouping, in Yiling District, Yichang, Hubei province in central China. The Three Gorges Dam electricity generation capacity is the largest in the world. When it comes to infrastructure, the Chinese think big and act big. They don’t let impact studies get in their way.
One of the highlights of our trip was a cruise on the Yangtze River. The river is 3,900 miles long, and the river basin is 698,300 square miles. The basin accounts for 40% of China’s freshwater resources, more than 70% of the country’s rice production, 50% of its grain, 70% of fishery production, and 40% of China’s GDP. Approximately 400 million people live along the Yangtze River and its 700 tributaries.
As the river cruise progressed, I noticed huge wooden chutes extending from hundreds of feet up the shores of the gorge sloping steeply down to near the water. At the top of the gorge were coal preparation plants associated with the coal-burning electric plants. The chutes were used to pour the coal slurry, a mixture of solids and liquids, into the river. Not only did the power plants pollute the environment, but the slurry wreaked havoc with the Chinese sturgeon, a critically endangered species native to China. We stopped in a museum along the river and saw a giant preserved sturgeon.
Fast forward to May 5, 2021 when NPR reported, “A Huge, Ancient Lake Sturgeon Has Been Lurking In The Detroit River”. Three scientists with the U.S. Fish and Wildlife Conservation Office in Alpena, Michigan were doing their annual survey of the lake sturgeon population. After quite a struggle they were able to get a sturgeon in their net and haul it to the deck of their boat. They were amazed at the size of the fish.
The sturgeon turned out to weigh 240 pounds and measured nearly 7 feet long with a girth of nearly 4 feet. The scientists believe the fish is a female and is at least 100 years old. You can see the comparison in the picture of Jennifer Johnson, a member of the survey crew, laying next to the massive sturgeon. The scientists tagged the sturgeon with a microchip and released her back to the river.
Scientists estimate there were more than half a million sturgeon swimming in the Detroit River in the 19th century. At the present time, they believe there are fewer than 7,000 due to overfishing and destruction of habitat. The good news is the scientists believe the Detroit River water has improved vastly during the last few decades. Yangtze River conditions are also said to be improving.
Monitoring the trends of fish movement is important for the long term preservation of species. Researchers at the University of Minnesota, Cedar Creek Bioelectronics Laboratory, were early pioneers of using electronic methods to track wildlife. They went on to form a company, Advanced Telemetry Systems, which specializes in creating sensors, receivers, and tracking equipment for biotelemetry. They make sensors which can be injected, implanted, or attached to fish such as the giant sturgeon in Detroit. The big one got away, but she will be tracked for years to come.
Many emissions from Earth can cause warming, from cars to cows and a multitude of other things. Some of the top contributors to the warming are electricity power plants (40%), transportation (33%), farming, deforestation, fertilizers, and oil and gas drilling. An important single digit contributor is aluminum. It seems like such a clean and benign metal until you learn how it is made.
In 1886, Charles Martin Hall discovered how to make aluminum, a very strong but light metal used today in countless applications. He formed a company and called it Alcoa. The technique he used was electrolysis, passing an electric current through a mixture of aluminum and oxygen called alumina.
The process starts with the mining of bauxite. Bauxite is not a mineral. It is simply a sedimentary rock with a relatively high aluminum content. The Huntly mine in Australia, owned by Alcoa World Alumina, is the world’s largest producer.
The electric current passes through the alumina mixture in a large vat which has electrical anodes made of carbon bricks. The resulting chemical reaction causes the aluminum to be separated from the oxygen. Unfortunately, the byproduct is a huge emission of carbon dioxide into the environment. The whole process is very dirty and uses a huge amount of electricity. For every ton of aluminum produced, 11 tons of CO2 are belched upward.
The good news is employees, investors, and customers are demanding action to change the process so it produces “green aluminum”. The demands are especially strong from Europe’s Audi, BMW, and beer producer AB inBev. The industry has been trying to change the process for many years but was about ready to give up without progress. Things are changing now. Strongly aiding and abetting the effort has been Apple, which makes millions of aluminum-cased devices, and is committed to carbon neutrality across its facilities and its entire supply chain.
Following a big push from Apple, Rio Tinto, and Alcoa, had a breakthrough and formed a new company called Elysis. The founders were able to replace the carbon bricks with an inert material. They are keeping secret what the material is, but they hope to license the new technique later.
There is a lot of enthusiasm about what Elysis is doing. I have no doubt some of the car companies will start promoting “green aluminum vehicles”. Retailers are already advertising green aluminum patio furniture and green aluminum foil. And, of course, aluminum cans are the largest single use of aluminum globally. We use about 180 billion of them every year. Companies are putting their money where there mouth is. Bloomberg reported in February buyers are paying a $14 per ton extra premium for the low-carbon aluminum.
Epilog: The United States Government is making a huge push on climate change. What I have written about in this article is proof positive industrial leaders around the world are pushing too. I am not saying no government help is needed but the power and speed of decision making by Apple, Amazon, Google, Microsoft, and many others shows they are not going to wait for Congress to agree on something.
Note: For any British readers, I hope you can tolerate me calling it a.LU.mi.num. I know you call it a.lu.MI.ni.um.
SpaceX Launches
SpaceX had another amazing Falcon 9 launch. The StarShip SN15, which will be taking people to the Moon and Mars, was to have a test on Friday but it got scrubbed. Weather. China blasted off which a huge rocket to put the first component of its own Chiina Space Station. It will be all China, a step in its plan to surpass all other countries.
Wall Street
My MAGFA stocks was mixed bag. Most important is tech revenue and earnings are spectacular and likely to continue to be so. A number of price pull backs. Not worried. Coinbase seems to be following crypto.
Bitcoin having continued volatility as expected. Etherum has had a huge run-up also but had small gain today. Ethereum is in the DeFi, distributed finance segment. Many new financial and insurers are set up to be disrupted by DeFi. This is good in my opinion. Old fashioned ways need to be uprooted. Ethereum is playing a role.
If we could just stop polluting and warming our planet, and stop the dozens of wars underway, there would be no need to go to Mars. There are some signs of progress but avoiding nuclear war and major flooding is not a sure thing. In addition to establishing human settlements on Mars, there is a lot which will be learned in the process which can have benefits on Earth. Learning is underway and NASA’s Perseverance rover on Mars is leading the way with multiple firsts.
One of the firsts we are learning from is the extraction of oxygen from the red planet. The atmosphere on Mars is very thin but contains 96% carbon dioxide (CO2). The CO2 molecules consist of one carbon atom and two oxygen atoms. NASA has developed a toaster-size experimental instrument aboard Perseverance called the Mars Oxygen In-Situ Resource Utilization Experiment (MOXIE) which can accomplish the task. MOXIE was tested on April 20. The test was successful. The MOXIE separated oxygen atoms from carbon dioxide molecules. The byproduct was carbon monoxide (CO), CO2 with just one oxygen atom, which was emitted into the Martian atmosphere as a waste product.
Another possibility is to recover water from regolith, a blanket of unconsolidated, loose, heterogeneous superficial deposits covering solid rock. It includes dust, broken rocks, and other related materials. Scientists believe they can extract potable water from the regolith. Developing a supply of oxygen and water from Mars is essential for space exploration because the supply would be too heavy to transport. What the scientists are developing is a strategy of “living off the land”.
NASA said the MOXIE technology demonstration could “pave the way for science fiction to become science fact”. The proof of concept for extracting and storing oxygen on Mars is a really big deal for two reasons. First, the oxygen can help power rockets to lift astronauts from the planet’s surface and head back to Earth or on to other planets. Second, a MOXIE could potentially provide breathable air for astronauts. MOXIE is just one of many innovations onboard the six-wheeled rover.
The Perseverance project cost $2.7 billion, but one of the most exciting projects onboard was the $85 million Ingenuity helicopter. After the Perseverance landed, the helicopter was released from the belly of the rover onto the surface. On April 22, NASA’s Ingenuity lifted off from “Wright Brothers Field” on the surface of Mars for its second flight. The strategy is for each of the planned five flights to be more aggressive in terms of altitude, duration, and maneuvering. This second flight lasted 51.9 seconds.
The first flight went to an altitude of 10 feet, this time to 16 feet. After hovering, the helicopter tilted five degrees enabling the craft to move sideways for seven feet. After angling its camera in different directions, Ingenuity headed back to the center of the airfield and landed. NASA said, “It sounds simple, but there are many unknowns regarding how to fly a helicopter on Mars.” It is much easier on Earth.
Gravity on Mars is about one third that on Earth. One of the challenges is the atmosphere is just 1% of the density on Earth. That means there aren’t as many particles of air to allow the rotating blades to gain lift. The blades are super light and spin at 2,500 revolutions per minute. The four-pound Ingenuity is gathering huge amounts of data which will prove invaluable for planning future missions. The data is also corroborating the modeling, simulations, and tests performed by the incredible engineering team on Earth.
Ideally, the rotorcraft would be flown with a joystick back at NASA but being 170 million miles away and the complexity of getting the data timely makes the joystick approach impossible. Instead, the engineers create software instructions which are transmitted to an orbiting satellite which in turn sends the instructions down to the Perseverance rover and then to the Ingenuity. The instructions allow the helicopter to fly autonomously, in other words on its own. Ingenuity is a robotic helicopter.
Using a helicopter for surveillance on Mars could become very important in future missions. The rover is amazing as it shoots laser beams at rocks, drills into them, and travels around the surface of the planet. However, other areas of interest are cliffs, craters, and mountains. A helicopter might be able to find water seeping from the side of a cliff or deep in a crater. NASA is already sketching out plans for a larger helicopter which can carry additional instrumentation.
Perseverance and Ingenuity demonstrate awesome engineering and science, and are setting an exciting stage for future human exploration and colonization on Mars. In the meantime, we are going to see some amazing video as Perseverance captures the flights of Ingenuity. The plan is to push the Ingenuity to its limit, meaning until it can no longer fly.
Space Launches
SpaceX had another amazing Falcon 9 launch. On Friday morning, four astronauts from three countries safely lifted off from Cape Canaveral at 5:49 a.m. aboard a SpaceX Crew Dragon. On Saturday morning, they will be docked to the International Space Station. There will then be 11 astronauts on the ISS. A lot of important scientific experiments going on up there. Astronauts are amazing people. The current crew of four civilians all have masters degrees in engineering. One has a PhD. They are all enthusiastic and serve as great role models for young people.
Wall Street
My MAGFA stocks were mostly flat after a very volatile week. Not sure why Uber took a hit. They are struggling to find enough drivers but I would think that is a good sign. Coinbase took a very big hit related to crypto. See crypto section to follow.
Bitcoin and Etherum both fell after experiencing a lot of volatility. The total market cap of all 9,000+ cryptocurrencies fell 16%. A 10% drop in Bitcoin is no big deal from my point of view. It has done that many times. Ethereum has had a huge run-up also but sold off some today. The leading call for why the sell off is the Biden capital gains tax. The threat gave those who have amassed huge crypto gains an excuse to sell now and save on taxes.
I first started writing about mobile device health (mHealth) about seven years ago. When the Apple Watch was announced in 2015, I knew mHealth adoption would accelerate. In March 2015, Health Attitude: Unraveling and Solving the Complexities of Healthcare was published and in July that year a peer-reviewd journal published “How mHealth will spur consumer-led healthcare“. In both of these I expressed my optimism about how mHealth would ultimately have a profound impact on our health.
Before proceeding, I would like to clarify the difference between mHealth and telehealth, both terms being used more frequently. Telehealth refers to all instances of healthcare using modern technology such as Zoom, WebEx, Microsoft Teams, and other healthcare-specific systems to communicate, diagnose, and prescribe. mHealth refers to the concept of mobile self-care. The predominant examples are consumer technologies like smartphone and tablet apps which enable consumers to capture their own health data.
According to IQVIA, an American multinational company serving the combined industries of health information technology and clinical research, estimates there are now 318,000 mHealth apps. Many of these are trivial exercise related apps to record steps or miles. However, some mHealth apps are quite sophisticated. The Apple Watch can perform an EKG of your heart rhythm in 60 seconds and measure your oxygenation level in 15 seconds. In addition to the apps, the FDA has approved hundreds of mHealth devices.
An example of an mHealth device is a digital otoscope which attaches to a smartphone and enables a parent to take a picture of the inside of a child’s ear. A physician looking at the result can make a diagnosis. A more advanced mHealth device is smartphone-based microscopy. The technology is fast approaching the standard of laboratory-based microscopes but with a substantially lower upfront cost. Smartphone-based microscopy is even yielding portable handheld options for fluorescent imaging of viruses and DNA molecules. My book and journal article describe many more examples.
One mHealth device and app many have awaited is a way to measure blood pressure without the cuff. A Swiss company, Aktiia, developed a cuffless blood pressure monitor several years ago, and has now announced their wrist-worn device has received a medical device approval in Europe. The device could have a very positive impact on hypertension detection and management. It is now available for pre-order in the UK through the Aktiia website.
The obvious question is how does this device work without a cuff? The full explanation is quite long and technical, but a high level summary is the heart valve opens and closes and waves are created which propagate through the artery. A standard optical sensor, as shown in the picture above, captures data about what the waves do. The Aktiia technology uses pulse wave analysis to derive the exact blood pressure. Seems like magic but five clinical trials proved it to be accurate.
I will be surprised if Apple doesn’t acquire Aktiia or introduce its own technology using the Apple Watch for the task. We are still in the early stages of mHealth but I believe we will see many more amazing technologies emerge and have a very positive impact on the quality and cost of healthcare.
Space Launches
SpaceX had a fourth StarShip test on March 30 which blew up. SN15 has been built and is undergoing various ground tests. Elon Musk says it will fly next week. I have my fingers crossed on this important step toward getting humanity to Mars.
The Quest to Understand Mars
The landing of the Perseverance spacecraft on February 18 chalk4r up a lot of firsts. The smallest in size but tremendously important is the $85 million Ingenuity helicopter. A software glitch was discovered. The NASA team will modify and reinstall Ingenuity’s flight-control software. Sometimes it seems software updates are tough to do down the hall. This one is being done from 180 million miles away. NASA is planning to set the flight date sometime next week.
Wall Street
My MAGFA stocks added another 1% to their market cap. The S&P 500 was flat. MAGFA steady at 25% of the S&P. I added Coinbase (COIN) to the watch list of stocks I think are interesting and unique. Coinbase and Roblox, newly listed via the direct listing approach, are over $100 billion combined. These two stocks have been volatile since their listings. I expect that will continue. Some think they are going to grow substantially and others don’t believe it. My granddaughters are the experts on Roblox but I see Coinbase as a proxy for the conversion of the world’s economies to digital. There are many who don’t believe that and think the bubble will break for them.
Bitcoin and Etherum continue to rise. The total market cap of all 9,000+ cryptocurrencies is up to $2.2 trillion, and 21% of the market cap of gold. Bitcoin is 52% of the total and Ethereum is 13%. Many big banks and assorted pundits have pooh-poohed crypto, but now they are beginning to participate. Crypto may be the next tulip mania as in 1637, or it may be the world is becoming digital. I believe the latter. One analyst now covering COIN is predicting a price of $500.
I once asked a friend, who had retired from his decades-long career, what his hobbies were. He said he had no hobbies. I asked him how he spent his time. He said traveling to visit with grandchildren is the activity he always looks forward to. Travel is a hobby loved by people of all ages. Grandparenting doesn’t appear in lists of hobbies, but it is a serious endeavor and, in the broadest sense, spending time with grandchildren easily qualifies as a bona fide hobby. Jill Savage, founder of Hearts at Home and author of 14 books, put it this way.
Grandparenting allows us a second chance to influence the life of a child. It’s an encore of sorts, where we become part of the supporting cast. A little bit of intentionality partnered with a realistic perspective can forge a special relationship between you and your grandchildren for years to come.[i]
Many people have one enjoyable hobby consuming much of their time. For example, more than a few friends of mine consider golf to be their primary if not their only hobby. Most of them say the game frustrates them to no end but, nevertheless, they love it and spend an amazing amount of time at it. People engage in other similarly engaging hobbies such as gardening, reading, sewing, writing, and many more.
Hobbies, dozens of them, have been an important part of my life for as long as I can remember. Some, such as various collector hobbies, disappeared due to lost interest. Still others, like aviation, electronics, home automation, and motorcycles have endured for decades and continue to hold my interest. I don’t rule out some new hobbies will emerge as technology continues to expand into new areas of our lives. Some may find my plethora of hobbies an attention disorder of some kind but, to me, they have enriched my personal and professional life for more than 70 years and continue to do so.
In addition to the pleasure and potential relaxation from a hobby, there can be an educational component which benefits a profession or another hobby. For example, as part of the motorcycling hobby, the Motorcycle Safety Foundation, a national not-for-profit organization sponsored by the U.S. manufacturers and distributors of motorcycles, offers a highly recommended course which covers the basics of operating a motorcycle and safety-oriented mental strategies. Learning to be defensive and always maintain situational awareness can make you a better and safer automobile driver, boat sailor, or airplane pilot.
Many of my hobbies have been centered on technology. It started with toys and blocks, which were much more than toys and blocks to me. They had practical purposes. The earliest I can recall building things was with Lincoln Logs, after which came Erector Sets. Both founding companies went into bankruptcy, but after multiple ownership changes, the products are still available. There were no Lego construction sets when I was a child. If there had been, I would surely have been an enthusiastic LEGO builder, which I am now. Chemistry sets, junior scientist kits, and ham radio piqued my interest. In my adult years, the trend continued with GPS, digital cameras, personal digital assistants, personal computers, home automation, 3-D printing, virtual reality goggles, airplanes, motorcycles, electric cars, and Pokémon. In the case of ham radio, it became dormant for me at 16 but then roared back to life at 75. When a new technology comes on the scene, it is likely to arouse my curiosity, and I want to be one of the first to get my hands on it. Some refer to people like me as “heat seekers”.
A seventh book, Hobby Attitude: How Hobbies Can Make Our Personal and Professional Lives Better is underway. In some ways, Hobby Attitude will be a general reference book about a range of hobbies. I hope the book poses some potential benefits for the personal and professional lives of the readers. I have taken a very personal approach to writing about hobbies. Hobby Attitude will be somewhat of an autobiography. I decided to take the personal approach based on my experience writing the six books in the It’s All About Attitude series. In each book I made reference to personal experiences whether it was about personal healthcare encounters or how I created my smart home. Feedback from readers has been consistent; they like personal examples and can relate to them. Although Hobby Attitude will not be a pure autobiography, it will include a high proportion of personal examples. It is the best way I can fully describe the passion which hobbies can present. I hope you will go on the journey with me and read about hobbies and how they have enriched my life. I hope you will enjoy reading Hobby Attitude and it will whet your appetite to learn more about hobbies and explore those of interest. Now I have to get busy and finish writing the book.
[i] Jill Savage, “A Grand Influence: How to Bond with Your Grandkids,” Focus On The Family (2019), https://www.focusonthefamily.com/parenting/a-grand-influence-how-to-bond-with-your-grandkids/
Space Launches
SpaceX had another StarShip test on March 30. Serial number 11, or SN11, had a beautiful launch but then crashed in a huge ball of fire upon attempting a landing. That makes four in a row. The problem turned out to be some fuel plumbing. SN15 has already been built (12-14 skipped). I predict SN15 will be successful. Getting people to Mars is going to happen, but it will take some time.
The Quest to Understand Mars
The landing of the Perseverance spacecraft on February 18 will chalk up a lot of firsts. The one I am excited about is the $85 million Ingenuity helicopter. NASA is targeting no earlier than Sunday, April 11, for the first attempt at powered, controlled flight on another planet. It will be spectacular to witness this.
Wall Street
The market continues to set new records. My MAGFA stocks added a trillion dollars to their market cap since the last time I posted the index. The S&P 500 rose even more than the MAGFA stocks. They now represent 25% of the S&P. The government is coming after them but I don’t see them getting slowed down. I replaced Royal Caribbean with Roblox, a newly listed public stock which used the direct listing approach. I have been an investor in Roblox since 2009 as a limited partner in First Round Capital, but it was not until my five and eight year old granddaughters recently demonstrated Roblox to open my eyes to the potential.
Bitcoin and Etherum continue to rise. The total market cap of all 9,000+ cryptocurrencies is just shy of $2 trillion, approaching 20% of the market cap of gold. Bitcoin is 55% of the total and Ethereum is 12%. Many big banks and assorted pundits have pooh-poohed crypto, but now they are beginning to participate.
I started working at IBM Corporation on June 1, 1967. Two years later, in 1969, I received a letter from President Nixon. It said, “Greeting: You are hereby ordered for induction into the Armed Forces of the United States”. I entered the U.S. Army on May 29, 1969 weighing 225 pounds. Two years, six months, and 22 days later, I was honorably discharged and weighed 150 pounds. Some day I may write a book about my military experience, but for now my focus is vaccinations.
The ingestion of recruits and draftees into the Army was quite a process. I remember lining up to get a haircut. No questions were asked, we all cut the same buzz cut. Next was another line (of many) to get vaccinated. They used an air gun. The shot in the arm took a couple of seconds. Each soldier was given a Yellow Card on which the vaccination was recorded.
The International Certificate of Vaccination or Prophylaxis (ICVP), also known as the Yellow Card, or Carte Jaune in French, was the official vaccination record created by the World Health Organization (WHO). As a travel document, it served as a kind of ‘medical passport’ recognized internationally and required for entry to certain countries where there are increased health risks for travelers (or soldiers).
The yellow card is an official medical record, recognized worldwide, of the diseases you’ve been immunized against. It could include a record of vaccination against rabies, shingles, flu, typhoid, pneumonia, diphtheria/tetanus/pertussis, and yellow fever. Various schemes for health passports or vaccination certificates have been proposed for people who have been vaccinated against COVID-19.
In theory, we all have an electronic health record (EHR) which is a complete record of all our medications, immunizations, conditions, etc. In reality, the EHR is a train wreck. Some people on Medicare may have as many as 15 EHRs from the various providers they may access. EHRs are hard to use. In theory the EHR is a database for the patient. In reality, the EHR does not allow a patient to easily access it, make queries of past blood test results, sort records, export them to other providers, etc. The big user of EHR data is law firms who are representing plaintiffs or defendants in medical liability suits. Unfortunately, the EHR is not a practical solution for proof of vaccination for Covid-19.
For now, we have the Covid-19 Vaccination Record Card, a piece of paper courtesy of the CDC. I don’t think this will be adequate for the days ahead. Australian airline Qantas has already announced it will start requiring coronavirus shots for all passengers on its international flights. Our little easy to counterfeit piece of paper will likely not be satisfactory for the various airlines, cruise lines, sports stadiums, schools, etc. who want to protect themselves from lawsuits for allowing infected people to enter.
A number of technology and travel companies are working on a solution. The best I have seen is from The Commons Project Foundation. CommonPass is a digital health app that enables travelers to present standardized, verifiable proof they tested negative for COVID-19. The Commons Project, The World Economic Forum and a broad coalition of public and private partners are collaborating to launch CommonPass, a trusted, globally-interoperable platform for people to document their COVID-19 status including health declarations, PCR tests, and vaccinations. The goal is to satisfy country entry requirements while protecting their health data privacy.
The premise behind CommonPass is for global travel and trade to return to pre-pandemic levels, travelers will need a secure and verifiable way to document their health status as they travel and cross borders. Countries will need to be able to trust that a traveller’s record of a COVID PCR test or vaccination administered in another country is valid. Countries will also need the flexibility to update their health screening entry requirements as the pandemic evolves and science progresses. Airlines, airports and other travel industry stakeholders will need the same.
CommonPass lets individuals access their lab results and vaccination records, and consent to have the information used to validate their COVID status without revealing any other underlying personal health information. Lab results and vaccination records can be accessed through existing health data systems, national or local registries or personal digital health records on your Apple or Android device where you can store your health records securely and privately entirely under your control.
The CommonPass platform assesses whether your lab test results or vaccination records come from a trusted source and will satisfy the health screening requirements of the country or facility you want to enter. CommonPass delivers a simple yes/no answer as to whether you meet the current entry criteria, but the underlying health information stays in the individual’s control.
CommonPass is designed to be accessed directly through other apps and services. For example, Lufthansa has announced an integration of CommonPass into their airline app usable on all flights from Frankfurt to the USA. I expect similar integrations will occur at all major airlines which fly internationally because it can give both travelers and governments confidence in each traveler’s verified COVID-19 status.
Currently, COVID-19 test results are presented on a piece of paper from unknown labs or vaccination sites, often written in languages foreign to those inspecting them. There is no standard format or certification system for lab results. Similarly, vaccination records are generally shared on paper cards that can be easily forged. As countries contemplate relaxing border restrictions and quarantine requirements, they need a more trustworthy model for validating the health status of incoming travelers.
CommonPass is currently in trials. I am on the list to get the app as soon as it is available, which I expect to be very soon. Some are skeptical but having read the details of how CommonPass works, I am completely confident it will be easy to use, secure, and with strong privacy protection. I see it as an enduring app. Unfortunately, Covid-19 is not the last significant virus we will see.
Last week, I attended a virtual wedding, a virtual cocktail party, and several virtual board meetings. Becker’s Hospital Review reported, “Led by COVID-19 surge, virtual [health] visits will surpass 1B in 2020”. Some schools have said they are all virtual. Everything is virtual. Or is it? I believe none of these things were virtual. They were all real, and we should not call them virtual. To prove my point, let me first describe an example of an encounter which was in fact virtual.
Sometime in the late 1990s when I was Vice President for Internet Technology at IBM, I was invited to visit the Argonne National Laboratory in Lemont, Illinois, outside of Chicago. Argonne is a national science and engineering research lab operated for the United States Department of Energy. It is one of the 17 DOE laboratories which comprise a preeminent federal research system, providing the nation with strategic scientific and technological capabilities.
Part of the tour I received included a review of some advanced work Argonne was doing with virtual reality. Before entering the VR lab, I was asked to wear VR goggles and a pair of VR gloves. The gloves used haptic technology, also known as kinesthetic communication or 3D touch. The VR gloves can create an experience of touch by applying forces, vibrations, or motions to the wearer’s hands. It is similar to the haptic feedback you get from your steering wheel if you cross a highway lane.
After entering the VR lab, I saw a Golden Labrador sitting on his or her haunches with a big tongue hanging out. The executive director conducting the tour asked me to pet the dog. I reached out with my glove and petted the dog on the head. He or she liked it and wagged its tail. Then the executive director asked me to take off my goggles. When I did, I saw an empty room. There was nothing there. The Golden Lab was virtual. The dog was not real.
Contrast this experience with using your iPad for a telehealth consultation with your physician, frequently called a virtual visit. You and your doctor are talking, asking and answering questions. The consult is very real. You and the doctor are real. You might say the consult was remote, connected, or even in the cloud, but not virtual.
Work at home, meetings and conferences from home, and remote medical consultations are here to stay. Perhaps not to the same degree as in the height of the pandemic, but here to stay. Many meetings and consultations just don’t require in person meetings.
For healthcare, more and more mHealth devices and smartphone apps are changing how healthcare is delivered. An Apple watch can take an EKG and check your oxygenation level. The Apple Health app stores a lot of information about your activities, medications, and much more. Smartphone connected devices can enable a parent to place a small snout connected to the phone’s camera in a child’s ear to take a picture using an Otoscope app. The physician can look at the picture and determine if the child has an ear infection. The FDA has approved hundreds of mHealth devices and apps. Digital stethoscopes are available. A fake smartphone x-ray app is out there. At some point the real thing will be. As devices proliferate and apps get smarter and easier to use, healthcare will be transformed.
Remote learning is not a new idea. I wrote about it in Net Attitude in 2001 and it was not even new then. I got my doctorate by studying online for four years. Hopefully, our kids will get back to in-school learning asap, but they can do supplemental learning during summers. Older people can continue learning all their lives with remote learning.
In the case of business interactions after the pandemic, travel will be reduced, real estate square footage will be reduced, and many employees will work from home permanently. In person meetings will come back but not to the level of before, just not necessary in many cases.
Call all these things whatever you want, but don’t call them virtual. They are very real!
The United Kingdom’s Boris Johnson announced a plan to increase the size of the cap on the UK’s nuclear weapons stockpile. The outcry has been significant with regard to international law and the Treaty on the Non-Proliferation of Nuclear Weapons. Iran called the move hypocrisy. I am more interested in the numbers.
The UK government conducted an integrated defense review and concluded the nuclear arsenal should be lifted by 40% to 260 warheads. The UK had previously committed to cutting its stockpile to 180 warheads by the mid-2020s, but the government says the review requires a change in recognition of the “evolving security environment” including the developing range of nuclear, biological, chemical, and doctrinal threats”. The argument is to show a deterrent. More on that shortly.
In 1986, there were more than 70,000 nuclear weapons. Since then, there has been a significant reduction but there still remain nearly 15,000. The numbers vary depending on the source but roughly speaking the United States has about 7,000 and so does Russia. Eight other countries including the United Kingdom, France, China, India, Pakistan, North Korea, and Israel collectively have about 1,000 weapons.
Two nuclear weapons have been used in the course of warfare, both by the United States near the end of World War II. On August 6, 1945, the day after I was born, a bomb code named Little Boy was detonated over the Japanese city of Hiroshima. Three days later, on August 9, a second bomb code named Fat Man was detonated over the city of Nagasaki. Combined, these two bombings resulted in the nearly instantaneous death of approximately 200,000 people. The yield of the blasts was 15 kilotons and 22 kilotons. That was two nuclear weapons. Today, the world has about 15,000.
A typical nuclear weapon today weights about 250 pound and has a yield of up to 150 kilotons, ten times the bombs which destroyed two cities and 200,000 people. The Russians have a weapon known as the Tsar Bomba. It is the most powerful nuclear weapon ever created and tested. The bomb is 26 feet long and 7 feet in diameter. It weighs 60,000 pounds. The yield is equivalent to 50 million tons of TNT 3,000 times greater than the 1945 bombs. When the Russian bomb was tested, the mushroom cloud could be seen from 100 miles away. The crown of the cloud was 40 miles high. The United States and Russia each have the power to render Earth an uninhabitable nuclear wasteland.
Unfortunately, the technological barriers to going nuclear are low. Barry McCaffrey, a retired U.S. Army four-star general, said,
The science is available on the internet. With less than 20 lbs. of donated, stolen or manufactured highly enriched uranium, or a plutonium device, even primitive Libya under Gen. Muammar Gaddafi’s rule was close to going nuclear. There are easily some 30 nations that in less than five years, with the help of a rogue power, could cross the nuclear threshold.
Although the total arsenal has declined, it likely remains an irreversible existential threat to U.S. national security. General McCaffrey said,
We are stuck permanently with deterrence as the central pillar to prevent their future use. There is no going back. However, we can dramatically lower the chances of a future Armageddon through smart arms-control negotiations and international diplomacy.
I hope our political and policy leaders clearly understand the horrific magnitude of the devastation which would result from a nuclear exchange. General McCaffrey said that an all-out exchange with the Russians would be over in about 30 minutes, along with most life in the two nations. Some experts believe North Korea is developing a one-megaton weapon which, if they could detonate it over Seattle or Honolulu could kill 50% of the populations within a five mile range. Kim Jong Un may now have 30 to 60 nuclear devices and a prototype of an intercontinental ballistic missile. He is also believed to have the initial design for a sub-launched nuclear missile. An even bigger fear is North Korea making their nuclear technology available to terrorists.
Despite the gloom and doom possibilities, there is hope. The nuclear threat initiative (nti.org) is a non-profit bipartisan organization focused on protecting lives, the environment, and our quality of life now and for future generations. It is working to prevent catastrophic attacks with weapons of mass destruction and disruption, nuclear, biological, radiological, chemical and cyber. I hope the free world will put our brightest arms-control minds to work on multiple approaches to the constraint and reduction of the nuclear global threat.
General McCaffrey outlines some important steps,
Step one should be a U.S. unilateral presidential announcement of “No First Use” in the first year of the next [now current] administration. Step two should be the U.S. unilateral removal of our 150 largely useless B61 gravity nuclear weapons in Europe. Step three would be congressional binding legislation to eliminate the president’s “sole use” authority to employ nuclear weapons.
The hawks will argue the three steps will reduce the U.S. nuclear deterrent capability. General McCaffrey has a lot of experience with issues surrounding nuclear weapons, and he believes that would not be the case. He further believes our sea-based nuclear capability for a massive second strike would create a very clear deterrence. Finally, the General believes we need to freeze in place the further global expansion or modernization of nuclear weapons with verifiable international monitoring. I hope the new administration gives a very high priority to make this happen.
During my research for Health Attitude: Unraveling and Solving the Complexities of Healthcare, I discovered Coupon Chile, a website which lists valid coupon codes, voucher codes, and online discount deals. The company had done some research about fax machines and found there are 46.3 million of them around the world, 17.4 million in the United States. They estimated the total number of faxes sent each year is 16.9 billion, representing 853 miles high of paper, which equates to 2 million trees cut down every year.
The fax machine and the Internet have something in common. They both provide integration for incompatible data. Anybody with a fax machine can send anybody a fax and know the recipient will be able to read it or have it translated. The Internet’s World Wide Web allows anyone with a browser to be able to connect to any server and retrieve information, regardless of what kind of server contains the information. In effect the Web provides integration and removes any incompatibilities. If the Internet had arrived sooner, there would have been no need for fax machines, which have since seen a steady decline in usage throughout the business community, except in healthcare.
Jeff Tangney was the founder of Epocrates, a smartphone app which replaced the 3,250 page Physician Desk Reference, and is used by one million Epocrates subscribers. Jeff is now CEO of Doximity, a social media company networking service used by more than 50% of U.S. physicians. Tangney said, “Fax machines are the lingua franca of healthcare.” Faxing is ingrained in the workflow of physicians. When you call most healthcare providers, you will typically not hear, “Our website is… or our email address is”. You will most certainly hear, “Our fax # is….”. Tangney added, “It’s still an industry that runs by and large by the fax machine.” It is not that doctors like paper or faxes, but I believe many feel they are chained to the eco-system of which they are a part.
Healthcare is making slow progress toward paperless in some areas. For example, e-prescribing is improving patient safety and streamlining the process of getting a prescription from the doctor to medication in your hands. However, it doesn’t always work that way. Millions of prescriptions are handled by specialty pharmacies operated by all the major pharmacy companies. They handle medications needing refrigeration or some form of special preparation or handling. When a physician completes an online e-script to a specialty pharmacy, the e-script is converted to a fax. When the specialty pharmacy receives the fax, someone manually keys it into his or her system. It usually takes an extra day for an e-script to be filled in this manner, and the extra steps add cost to the fulfillment. When it comes to scheduling an appointment for a Covid-19 vaccination, many seniors are overwhelmed with the poor responsiveness or difficulty to use the available websites. While the healthcare industry is making some strides in adopting the Internet, it has a long way to go. Without the fax machine, healthcare would come to a screeching halt.
In some cases, even fax machines are deemed too progressive. I recently had a routine shingles vaccination. The provider sent me a Health Insurance Claim Form to send to my healthcare insurance payer. I asked to get the form by email. Cannot do. How about fax? No. Paper only. I called UnitedHealthcare, the largest health insurance provider in America, to ask where to send the form. Can I email it to you? No. Surely I can fax it to you? No. Paper only. “And don’t forget to include a receipt”. Called the provider again. Receipts can only be sent by USPS mail. From the day of vaccination to the day my reimbursement gets into my bank will likely be six months.
There are numerous reasons why our healthcare is so expensive compared to other countries, and one of them is not because the care is better. One of the reasons is the healthcare industry has been slow to adopt progressive information and communications technology to reduce waste through improved administration. One study projected the adoption of administrative standards for healthcare billing and payment would save $300 billion. (unnecessary tests and procedures is at least three times that). The other failure is the U.S. government has not demanded standards for healthcare information like we have with the Internet, banking, and railroad tracks.
In his book, Faxed: The Rise and Fall of the Fax Machine, Jonathan Coopersmith, an associate history professor, whose speciality is the history of technology, likens the fax machine to the rise and fall of the Roman Empire. He said that the fax machine reached the mighty heights of the business machine world and then crashed spectacularly. There are two places you can find fax machines. One is in technology history museums. The other is in every healthcare provider’s office or in pharmacies.
In the early 1960s, I remember regular visits to Mccoubrie’s Pharmacy in Salem, NJ. We called it the drug store, and it had a soda fountain. We would stop by after school for a cherry coke. The back of the store was the pharmacy. Jack Mccoubrie was a distinguished looking man and a friend of my father. I can picture him on the elevated floor behind the counter filling prescriptions.
A lot has changed since then. In 2019, 80 percent of all prescriptions were e-prescriptions. Doctors accelerated e-prescribing when Medicare starting paying a small bonus if they did so. The e-prescribing process automates the creation of the medication order, but it doesn’t include the patient. You call the pharmacy and ask about the prescription, after you go through a monotonous phone tree of choices. “We don’t have the prescription yet”. You call the doctor’s office and go through another phone tree. “The doctor didn’t get to do it yet. She will do it this afternoon.” Eventually, you get the word the script is ready for pickup. You wait in a long line at the pharmacy. When it is your turn, “What is your address?” If you are lucky enough to have a vacation home, the answer is not always the one they expect. All this is going to change big time.
PillPack was founded in Manchester, NH in 2013 by TJ Parker and Elliot Cohen. The founders had a vision to automate the drug store by packing medications in dosage packets using robots to handle the packaging process. Each little packet shows the date and time for when the medications in the packet are to be taken. The medications and dose are listed, and it can include over the counter medications. There may be one, two, or more packets per day. In June 2018, Amazon.com acquired PillPack for a reported $753 million. In November 2019, the company was rebranded as “PillPack by Amazon Pharmacy.”
The secret sauce in the PillPack acquisition is not the packets, although the packets are a good idea and still available from Amazon. I believe the real value is PillPack is licensed for drug distribution in all states. Although Amazon Pharmacy still offers PillPack as an option, I like the Pharmacy option even better. To get started, you register on the site and provide your medications and your insurance information. It is a very simple process, unlike most things related to healthcare. If you have an existing medication coming up for a refill, you just go to the Amazon Pharmacy and select the medication and choose the option to have Amazon contact the existing pharmacy, say CVS, Walgreens, or Rite Aid. Amazon takes it from there. You get an email saying your refill is ready. You click and it gets added to your cart. The cart shows the medication and the pricing. If it is a new prescription, your doctor can e-prescribe, fax, or call, just like with the traditional pharmacies.
As a pricing example, consider Levothyroxine. There are different manufacturers that make levothyroxine. It may be branded Synthroid, Levoxyl, or Tirosint. Levothyroxine is the most prescribed medication, with more than 100 million prescriptions per year. The price in my cart using AARP UnitedHealthcare insurance was a copay of $14.88. The other option shown in the cart was “Price without Insurance” $3.80, “Includes 79% savings with Prime”. I wondered how that can be. Likely Amazon Pharmacy went to Abbott Laboratories and asked for a price on 10 billion levothyroxine pills.
Once you place the order, you get a confirming email, just like when you order anything else from Amazon. In two days, the Amazon Prime van shows up in the neighborhood as it does every day, with a free shipping package with your medications, just like anything else you buy from Amazon. Amazon Pharmacy only offers a 30-day supply “for now”. Not sure why, but it doesn’t matter. If your doctor prescribes 90 days, Amazon Pharmacy sends you 30 days with two renewals. When it is time for a refill, you get an email. You click, it goes in your cart, you pick your price, with or without insurance, and the refill is delivered. No calling, no standing in line at the pharmacy. It is no surprise the pharmacy stocks all declined the day Amazon announced the purchase of PillPack.
This is just the beginning. Our healthcare system is broken badly, and in my opinion, things are getting worse. Amazon, JP Morgan, and Berkshire Hathaway created a healthcare company to shake up the industry, but it did not work out. I suspect they concluded it is better to take on the industry one segment at a time. Pharmacy is first and it will save billions. Congress is incapable of acting because of the huge lobbying lock on them. I think Amazon Pharmacy is the tip of the iceberg.
If you are a pessimist and revel in the gloom and doom the future may hold, robots and artificial intelligence (AI) can add a lot of fodder. Robots are mostly in manufacturing plants today, but their presence is growing in many other places, including hospitals, restaurants, retail stores, and homes. Millions of jobs will be replaced by robots. AI will become pervasive in finance, insurance, and legal companies, healthcare, and educational institutions replacing lawyers, accountants, financial analysts, radiologists, teachers, and professors. As robots and AI get smarter, some believe there may not be much left for humans to do. Ultimately, the robots and AI could merge, and form a new population of super strong and super intelligent beings. The new beings may look back at history and see how humans have wiped out numerous species over time. Then, they may conclude humans are no longer needed. The End.
Some experts believe the scenario I just described is a very real threat. They believe humanity is at great risk. The late Stephen Hawking, an English theoretical physicist, cosmologist, author, and Director of Research at the Centre for Theoretical Cosmology at the University of Cambridge, said efforts to create thinking machines pose a threat to our very existence. He told the BBC, “The development of full artificial intelligence could spell the end of the human race.” Elon Musk, Founder of Tesla and SpaceX, said, “If you’re not concerned about AI safety, you should be. Vastly more risk than North Korea. In the end the machines will win.”
There are other threats. The possibility of a nuclear war is hard to imagine, but it could happen. At a lecture I attended some years ago, a scientist from IBM Research said the biggest risk is a terrorist or anarchist getting hold of smallpox or other biological agents and finding a way to initiate infections among a population. We all well know the devastation the coronavirus has caused. For all these reasons, Elon Musk, Jeff Bezos, and other smart people feel we need to colonize Mars as a Plan B in case humanity on Earth gets wiped out. A thoughtful friend of mine sees a different set of risks. He said,
While all of those are real threats that we have no choice but to endure and very well may never experience, Stephen Hawking was more focused on what he considered to be inevitable, we are using up our planet. When we were kids, there were about 2.5 billion people on this planet. Today there are about 7.8 billion – far too many to be supported for very long. We won’t need a bomb or a plague. Overpopulation and the resultant over use of resources seems to be inevitable. Also, however real one thinks the threat of climate change is, it certainly would not exist if we had only 2.5 billion neighbors.
In 1970, when I was serving in the United States Army, I read a book called The Limits to Growth, published by The Club of Rome. The heart of the book was about exponential economic and population growth with a finite supply of resources for the world civilization. A computer simulation model at MIT proved the point. The model considered the growth of the population, growth of pollution, and the decline in rare minerals needed for industry and the limit of food sources. The model included many other variables and predicted The End of humanity by the year 2000, 30 years from the publishing of the study. The model considered the effect of breakthroughs in the handling of pollution, discovery of new sources of food and materials. Even with the most optimistic scenario, the year 2000 would still be The End. Needless to say, The End did not occur. Unexpected breakthroughs of all kinds occurred, and growth continued.
Now the question is whether we are once again at or approaching a point of unsustainability as my friend suggests. New policies and new technologies are needed. The basic message of Limits to Growth warned exponential growth of our world civilization cannot continue very long and a very careful management of the planet is needed. The concerns of 1970 remain as valid as ever.
Despite the threats and trends, I am optimistic about the future. The landing of Perseverance on Mars shows the incredible capabilities of humans who are smart, innovative, and motivated. If someone had described the landing feat 30 years ago, no one would have believed it possible. A lot of money is flowing into technology startup companies who are working on new ways to reduce pollution and new ways to grow food. Shortages of rare minerals needed in electronic chips and devices are very real, but within 30 years or less, we may be mining minerals from other planets and asteroids. I am betting on the future of technology and believe it will sustain us, not eliminate us.
Last July 30th, a United Launch Alliance Atlas V rocket blasted off from Space Launch Complex 41 at Cape Canaveral Air Force Station in Florida. On February 18, 2021, 203 days later, and having travelled 293 million miles, the spacecraft reached Mars. The the car-size Perseverance, the centerpiece of NASA’s Mars 2020 mission, entered the Mars atmosphere at 12,000 miles per hour.
Ideally, engineers at the Jet Propulsion Laboratory in Pasadena, California would guide Percy, as some are calling it, to land at the right place. Unfortunately, this was not possible. Mars is currently 128 million miles away, and a radio signal takes 11 minutes and 22 seconds to get from Earth to Mars. Instead, Percy used onboard computers with artificial intelligence as its autonomous guidance system to avoid hazardous terrain in the target area. Perseverance was going to navigate on her own. The spacecraft encountered a temperature of 2,370 degrees Fahrenheit as it blazed toward the surface of Mars, which caused a temporary blackout, as expected.
After ejecting its heat shield, the spacecraft deployed a 70-foot-diameter parachute while still going nearly twice the speed of sound. After ditching the parachute, the craft lit up its rocket thrusters to slow down further, and then a system known as a sky crane lowered the rover the final distance to the surface. The video above of the entry, descent, and landing (EDL) phase of the Mars mission is gripping and shows how NASA was able to pull off such an amazing feat. There were thousands of things which could have gone wrong. In a second equally thrilling video, scientists and engineers describe “7 Minutes to Mars: NASA’s Perseverance Rover Attempts Most Dangerous Landing Yet“.
The goal was to land inside the 28-mile-wide Jezero Crater, which scientists say is the ideal place to look for signs of life on the planet. It is believed to have previously been a lake as big as Lake Tahoe. The landing put the rover in exactly the optimum place. The rover, about the size of a small car, weighs about 1 ton and is 10 feet long by 9 feet wide by 7 feet tall. It has a 7 foot long robotic arm which has a robotic hand. The hand has a camera, a chemical analyzer, and a rock drill. Perseverance is nuclear powered with a plutonium generator provided by the U.S. Department of Energy. The power supply will generate electricity and charge the rover’s pair of lithium-ion batteries.
The six-wheeled robot will be looking for signs of past Martian life. It will drill and remove samples of soil and rock. The plan is for a future mission to go to Mars and bring the samples back to Earth where they can be studied in laboratories.
Perseverance is the first multibillion-dollar NASA mission to Mars in nine years. It almost immediately produced two low-resolution images of the landing site. In the days ahead we will be seeing high resolution color images from some of the craft’s 23 cameras. One of the many leading edge technologies aboard Perseverance is a four pound helicopter called Ingenuity. The helicopter will drop from the underbelly of the rover, the rover will pull ahead, and the helicopter will fly. The helicopter has been under development for years. It is an aeronautical engineering feat to be able to fly an aircraft autonomously above the surface of another world. The world will be amazed with the incredible scientific and engineering firsts, but the question remains why should be spending billions to explore Mars? I believe there are a number of good reasons.
Scientists theorize Mars was once a relatively warm and habitable world. The curiosity is intense about what the planet was like billions of years ago. It could help us better understand the evolution of Earth. There are also reasons to colonize Mars. Humans could provide more in-depth research than unmanned robots. There is also an economic interest in resources the red planet may have. Pundits believe the settlement of other planets could decrease the odds of human extinction.
I have listened to debates about this. Some say we should spend the money here and fix the problems which could end life on Earth, things such as climate warming and pandemics. Others argue even if we solve those problems, there is still the risk of a nuclear war which wipes out the world’s population. Colonizing other planets is a plan B.
The first step is to colonize the Moon as a gateway to Mars and beyond. An opportunity exists to figure out how to separate oxygen from CO2 and then liquify it to create rocket fuel to return to Earth or on to other planets. NASA has a plan for the Moon called Artemis. I’ll write about this another time.
In November 2008, Satoshi Nakamoto, the presumed pseudonymous creator, posted a paper on the Internet called, “Bitcoin: A Peer-to-Peer Electronic Cash System”. The paper described a system where a digital currency, called Bitcoin, could be used to buy and sell goods and services, transfer Bitcoin to others, or just buy and hold Bitcoin as an investment. Currencies such as the U.S. dollar, the Canadian dollar, or the German Deutschmark are called fiat currencies. Fiat money is currency for which a government has declared it to be legal tender for buying and selling. The government also puts its full faith and credit behind the currency. Some people buy foreign currency and hold on to it as an investment, just like stocks, bonds, or commodities. It now appears investors are eyeing Bitcoin similarly.
For Bitcoin, there is no government standing behind it. It is backed by the strength of cryptography and the mathematical algorithm described in Satoshi Nakamoto’s eight-page paper. The use of cryptography led to digital currencies being called cryptocurrencies. The Satoshi paper was published openly so all could read it. If you are interested, you can see the paper at johnpatrick.com/satoshi.pdf. I read the paper in 2013, multiple times. I cannot say I completely understand it, but I understand it well enough to be a believer.
To buy, sell, or transfer Bitcoin requires having a digital wallet. I acquired mine in 2013 from Coinbase, a San Francisco startup with more than $500 million of venture capital behind it. Late last year, Coinbase announced it would be going public in 2021. I connected my Coinbase digital wallet to my bank account and purchased 2 BTC for $1,125. Disclosure: I am an investor in Coinbase.
Now that I had some cryptocurrency, I was curious about how a Bitcoin transaction would actually work. I found a list of merchants which accepted Bitcoin for payment. The only name on the list I recognized was Overstock.com. The unusually cold weather in Florida in early 2014 gave me reason to look for a long-sleeved shirt. Overstock offered a nice steel blue canvas thermal shirt for $22.99, and I got a 10% discount for opening the Overstock account.
At checkout, I was presented with a number of payment options including the normal credit cards plus PayPal and several other newer payment methods including BillMeLater, RewardsPay, V.me, and Bitcoin. Overstock clearly did not want to lose a sale for a buyer’s lack of ability to pay. The only thing they don’t take is fiat currency. I selected Bitcoin and clicked the Submit Order Now button. I opened the Coinbase app on my iPhone and then scanned the QR code Overstock presented on my Mac. A dialog presented the details: $23.64 purchase price after discount and shipping, which would result in a debit to my digital wallet at Coinbase of .02862804 BTC. One Bitcoin at the time was worth $825.76, and .02862804 X $825.76 is $23.64. I was not sure of the exact timing used to lock in the BTC price and convert the payment to U.S. dollars for Overstock, but I am sure it works for them or they wouldn’t accept BTC.
Now that I could see exactly how it worked, I was convinced Bitcoin was the future of money. I began to purchase Bitcoin every Monday morning for the next three years with no intention to spend any of it.
There are inhibitors to the transition to a digital economy. Not many merchants accept Bitcoin because of the volatility and fees involved. There are also some technical performance issues. Numerous FinTech startups are focused on this. I believe the issues will be resolved.
A little less than seven years after my Overstock experience, Elon Musk announced Tesla would invest $1.5 billion of its idle cash in Bitcoin. More importantly, he announced Tesla would accept Bitcoin as payment for Tesla products and services. I did not think it would take this long to catch on, but it is clear to me others will follow Tesla. The WSJ today reported CFOs are skeptical. Same as 1995 when most CEOs were skeptical of the Internet.
There are millions of digital wallets out there, and I believe there will be many more merchants willing to accept Bitcoin. In 2019, I wrote wallets and merchants would grow dramatically. 2021 is the beginning of the growth. Gemini, an alternative to Coinbase, has announced a new credit card which will give you back 3% on all purchases. The 3% credit will be in Bitcoin. Bitcoin is one of thousands of cryptocurrencies. Most of them will disappear over time, in my opinion. As of this week, Bitcoin represents 62% of the market cap of all the cryptocurrencies. The current value of all Bitcoin is almost $900 billion. This is about 10% of the market cap of gold. The 10% will continue to grow, in my opinion. I hold several other cryptocurrencies in a digital wallet at Gemini including Ethereum (ETH), which is similar to Bitcoin and also appreciating rapidly.
In the summer of 2019, Facebook announced its new Libra cryptocurrency. Some pundits said Libra would be the end of Bitcoin. I said it was the beginning, a booster. The Facebook initiative could potentially lead to many new digital currency options for consumers. However, the political winds currently blowing make it unlikely to me.
The billions in fees charged to merchants become part of their cost of business and are passed on to the consumer. For highly competitive consumer products, the credit card fee can be more than the gross profit on the merchandise. The inefficiency of credit cards for online commerce provides a strong motivation for the adoption of BTC.
I think of Bitcoin as the Internet in 1995. Is it any wonder that Jamie Dimon, CEO at JPMorgan Chase said the question isn’t whether the bank accepts Bitcoin, but rather “The question is do we even participate [with] people who facilitate Bitcoin?” Sound familiar? Music companies 15 years ago decided not to participate with downloadable music. Publishers at the time decided not to participate in digital books. The Internet creates disintermediation industry by industry. Look at what Internet streaming is doing to Cable TV. Do you think people will continue to pay $150 per month for 500 channels of content, only a handful of which they watch? Healthcare is not excluded from disintermediation either. I now get my medications from Amazon Pharmacy. It is way more convenient than traditional pharmacies.
Notes
- Bitcoin operates over the Internet with a secure distributed database called a blockchain. I did not discuss blockchain in this article. There are 54 articles on johnpatrick.com I have written since 2013. Some are just mentions in the weekly news blurbs, but there are a number which explain blockchain and how it works. You can find them here. Another source of information is Election Attitude – How Internet Voting Leads to a Stronger Democracy. In this book I described how a Bitcoin Blockchain could be used for mobile voting and other civic applications.
- I did not comment on the rise of the price of Bitcoin from less than $100 to nearly $50,000. Pundits have various forecasts. The Crypto Research Report has predicted Bitcoin will be worth $397,000 in 2030. A major Tesla investor has predicted Bitcoin could be worth more than $1 trillion in under 10 years. Other pundits forecast Bitcoin will be worth zero. Poof. I have no doubt a financial revolution is underway. What is my forecast for the price of Bitcoin? I don’t have one. When asked by friends whether they should invest in Bitcoin, I say only if you are prepared to lose it all.
- Related areas of investment include DeFi and FinTech (decentralized finance and financial technology). I expect these two areas to lead the way to more modern banking, payment, and insurance technology.
One of the many things I like about Florida is Publix Super Markets. No income tax or inheritance tax is very nice, but having a great place to buy groceries is also nice. In addition to great food selections and a clean store, you get the feeling all the employees really care about what they are doing and about their customers. How was that attitude achieved? Answer: the employees own the company.
Publix has 1,266 stores, with 818 of them in Florida. Other store locations are in Alabama, Georgia, North Carolina, South Carolina, Tennessee, and Virginia. The company has nine distribution centers and eleven manufacturing facilities where they make bakery, deli, and dairy items, and fresh foods. The food is great, but the employees are even greater.
Publix was founded in 1930 in Winter Haven, FL by George Washington Jenkins Jr. He was born in Warm Springs, GA in 1907 and died in 1996. The company is the largest employee-owned company in the United States and is one of the 10 largest-volume supermarket chains in the country. Retail sales in 2019 reached $38.1 billion. Publix employs over 225,000 people. They get quarterly dividends just like a public company.
ESOP companies are not new. Benjamin Franklin pursued a form of employee ownership as early as 1733, when he sent the first of many journeyman employees to various cities to set up new print shops. Currently there are more than 4,000 employee owned companies, but Publix is the largest.
Moderna Dose #2
Thursday was the day for Moderna dose #2. It was painless. The dozens of volunteers and Flagler County Department of Health employees were impressive, friendly, and efficient. Like many others, I had side effects the next day, roughly after 18 hours. I had a mild fever, chills, nausea, and general discomfort. By dinner time, the fever went away and now I feel fine. Well worth a little malaise go get vaccinated.
Space Launches
SpaceX had another StarShip test this week. Serial number 9, or SN9, had a beautiful launch but then crashed in a huge ball of fire upon attempting a landing. I view it as a successful mission to gain a ton of data to make the next launch more successful. Getting people to Mars is going to happen. It will take some time.
The Quest to Understand Mars
The big thing coming up this month will be the landing of the Perseverance spacecraft on February 18. China and UAE will also have landings on Mars this month.
Wall Street
The market continues to make new records. GameStop (GME) was up 20%. I can’t see how. The company lost more than a billion dollars over the last two years. Bitcoin and Etherum continue to rise. I’ll have more to say about cryptocurrencies later.
Apple’s earnings report this week included a lot of staggering numbers. As of noon Friday the company was valued by the market at 2.2 trillion dollars, the largest in the world. Skeptics have questioned whether the company can continue to grow rapidly, if at all. As written here many times, the skeptics have underestimated the potential of Apple’s services business which includes iCloud storage, Apple Music, and the App Store. Services revenue was just shy of $16 billion for the quarter, approaching the goal of a $50 billion a year business. Sales for every product category showed double-digit growth. Total revenue for the quarter was $111.44 billion up 21% year over year. Growing more than 20% on such a huge base is staggering.
Skeptics have said people would not pay $1,000 for an iPhone. Turns out people are more than willing to do so and, in fact, paid more than $1,000, helped by financing plans from Apple and carriers. With the Apple Upgrade plan, I pay $58.25 per month and get a new iPhone every year. I order the new iPhone when it open for orders. When it arrives, I place it on my desk next to my old iPhone. The new iPhone copies all my apps, data, and settings from the old phone to the new iPhone. I then put the old iPhone in a box Apple FedEx’ed to me and return it to Apple. Done.
Placing the monthly charge on my Apple Card, I get $1.75 (3%) in Apple Cash which accumulates and can be spent from the iPhone Wallet. I don’t think of it as paying $1,000+ for the iPhone 12 Pro Max. I think of it as paying $56.50 per month for a personal supercomputer. I am not alone in my passion for the iPhone. After the past quarter, there are now more than one billion iPhones out there.
During the quarter, Apple shipped 90.1 million iPhones. Imagine more than one million iPhones every day, 41,713 shipped per hour, 695 per minute, and 11.6 per second. The staggering numbers are hard to imagine. Apple’s revenue was $501,000 per minute. The seemingly flawless supply chain and logistics for delivery are even harder to imagine.
Behind everything Apple does is an incredible customer support process. Whoever is in second place for support is not even close. I agree no business can grow straight up forever, but I see no signs of things slowing down at Apple. As for the stock price, who knows? A wise friend once told me, “Never confuse a great company with a great stock.”
Disclosure: I am an investor in Apple. I am not making any recommendation about whether the stock will go or down from where it is. I am simply reporting on what I see as a great company doing amazing things.
Space Launches
Space launches and landings were a record in 2020d, and many more will happen in 2021. SpaceX continues to break records and do amazing things. On Sunday, January 24 at 10:00am, Falcon 9 launched Transporter-1, SpaceX’s first dedicated SmallSat Rideshare Program mission, from Space Launch Complex 40 (SLC-40) at Cape Canaveral Space Force Station in Florida.
Falcon 9’s first stage booster had previously been launched into space five times. Following stage separation, the booster landed on a SpaceX droneship, stationed off the coast of Florida. The two fairing halves were also retrieved in huge nets mounted on SpaceX ships in the Atlantic. SpaceX now routinely does things long considered impossible by space scientists. SpaceX returns rockets to soft landings on Earth instead of ditching the boosters into the ocean as NASA has done for decades.
On board this launch were 133 commercial and government spacecraft (including CubeSats, microsats, and orbital transfer vehicles) and 10 Starlink satellites – the most spacecraft ever deployed on a single mission. You can watch a replay of the mission here.
The Quest to Understand Mars
The biggest thing will be the landing of the Perseverance spacecraft on February 18. China and UAE will also have landings on Mars this month. We can also look forward to test flights of the SpaceX Starship in Texas. If you want to follow this activity, you can sync with a Google calendar here.
Wall Street
The market pulled back about 2%, pretty much across the board, except for GameStop. GME was up 68% to $325. I took a look at the company’s latest annual report. It shows number of retail stores down every year since 2015. Revenue is also in decline. The company lost more than a billion dollars over the last two years. At the closing price it had a market cap of $22 billion. Why would anyone buy this stock? Go figure. Concern over COVID-19 vaccines weighed on sentiment. I am optimistic states and counties will get their act together and supply will ramp up. I will get dose #2 of Moderna on Thursday, February 7.
We all probably agree the election of November 2020 could have gone more smoothly. I have been thinking about 2024 and beyond and how the process could be improved. I have written extensively about mobile blockchain voting as an improved method of voting. The purpose of this article is to share my vision for the overall process, not just the method of voting. The changes I am suggesting would require action by Congress, and we all know how hard it is to get Congress to agree on anything, so my vision may not happen soon. Nevertheless, I will share the vision and look forward to your feedback.
The first part of the vision has to do with political parties. What we have today is basically a two-party system. It is quite clear all voters do not nicely fit into one or the other. At a minimum we should have five parties. There are different ways to name the parties but for starters I will call them Democrat, Progressive Democrat, Republican, Conservative Republican, and Independent. There are numerous smaller parties such as Constitution, Green, and Libertarian. Every party would need a leader and an organization to raise funds to make their platforms visible.
The second part of the vision is to make it easy to register to vote. I live in Florida where we have the Motor-Voter Law, which means when a person receives a driver license or makes a change to an existing one, he or she are asked if they would like to register to vote. Some states have gone further with Automatic Voter Registration which means when a citizen has an interaction with any government agency, his or her voter information can be electronically, accurately, and securely transmitted to election officials. Federal control of the process is not needed, but the Federal government should mandate standardized data formats so states can easily identify voters who have moved or died. Modernizing voter registration does not require rocket science, it just needs an election attitude.
Part three includes open primaries. In Florida, I am a registered independent, which means I cannot vote in the primary. I would like to see all states do what North Dakota did, which is allow all registered voters to vote in the primary and vote for whoever they want from any party. The top 5 (could be 7 or even more) candidates from the primary would then become the slate for the general election in November 2024.
The final part of the vision is to use Ranked Choice Voting (RCV) for the general election. Maine has already adopted RCV, but I would like to see all States use it. Instead of voting for one of the two major parties, with RCV, voters would rank the five candidates, first choice, second choice, etc. If a candidate receives a majority of the first choice votes cast for an office, that candidate will be elected. This is highly unlikely. If no candidate receives a majority of the first-choice votes cast, a runoff process begins.
The candidate who received the fewest first-choice votes is eliminated. Next, each ballot cast for the losing candidate would have its second, third, fourth, and fifth choices transferred to the vote totals for the remaining four candidates. Next, the remaining candidate who received the fewest first-choice votes is eliminated, and each ballot cast for the losing candidate would have its second, third, fourth, and fifth choices transferred to the vote totals for the remaining three candidates. The elimination process continues until a candidate receives a majority and is deemed the winner. You can see an animated visualization of RCV at https://www.youtube.com/watch?v=8Z2fRPRkWvY.
RCV offers a number of advantages over the traditional voting process. There is no need for expensive runoff elections. In 2014, Alabama had a runoff election for several elected positions. It cost the state $3 million. RCV assures a candidate with a majority will win. With traditional voting, candidates for Mayor and Governor can be elected even when most voters are opposed to them. With RCV, that cannot happen.
A more subtle advantage of ranked choice voting is it can discourage negative campaigning. This is not guaranteed, but in traditional voting elections, candidates sometimes benefit from mudslinging. With RCV, candidates do best by connecting with as many voters as possible, including those voters who support an opponent. Those voter’s second choice might help the leading candidate to get to 50%.
I believe democracy is stronger when more voices are heard. RCV, where more than two candidates compete without fear of splitting the vote, ensures all voices are heard and every vote counts in every election. RCV encourages voting for candidates voters support, not just voting against candidates they oppose. When there are only two candidates, voters may feel they need to vote for the lesser of two evils. By ranking multiple candidates, voters can feel they expressed their preferences without being influenced by mass media or social media about which of two candidates will win. The ranked choices allow people to think about all the candidates, not just one or two. Additionally, a Washington, D.C. think tank, said racial minority populations would prefer ranked choice voting, find it easy to use, and it would increase voter participation significantly.
More than 20 cities and counties are using RCV. There are a couple of obstacles. First, many cities do not have the proper equipment to perform the instant runoff. Existing voting machines are programmed to only count the number of votes for each candidate. Machines could be reprogrammed but that would require funding and lengthy approval processes. The concern about not having the funds to purchase new voting machines presents an excellent opportunity to move to Internet voting where ranked choice voting could be implemented on the existing voting server. A second concern is the potential confusion of voting for multiple candidates.
Voter registration and election voting processes are complex topics. Because the Founding Fathers gave the States near autonomy to administer elections, it is difficult for standardized changes to be made. In Election Attitude – How Internet Voting Leads to a Stronger Democracy, I examined some of the complexities and provided political leaders and election officials background material to help them as they consider alternatives to the aging voting infrastructure.
Computer scientists across the country have accomplished extraordinary developments in cloud computing, analytics for big data, the Internet of Things, artificial intelligence, and an inter-planetary Internet. All of these areas faced skeptics and critics who said, “It couldn’t be done”. I believe working with election officials, voting machine vendors, computer scientists, and software engineers we can solve the challenges and complexities of modernized voting. As a result, Americans could be proud of a stronger democracy with the highest voter participation in the world.
In 1901 Guglielmo Marconi communicated across the Atlantic with a radio device using high power and giant antennas. Once radio communication was proved by private citizen to work, Congress approved the Radio Act of 1912, which required amateurs to be licensed and established regulations for how radio communications would work. In 1914 the American Radio Relay League (ARRL) was founded to represent the interests of amateur radio operators before federal regulatory bodies. Today, the ARRL provides technical advice and assistance to more than 160,000 amateur radio enthusiasts in the United States.
Amateur Radio, called ham radio, has become a globally popular hobby. Ham radio is a service that brings people, electronics and communication together. The word “ham” goes back to 1908 when the first amateur wireless station was launched at the Harvard Radio Club. The amateurs who formed the club were Albert S. Hyman, Bob Almy, and Poogie Murray. At first they called their station “hyman-almy-murray”, but then abbreviated it to ham. From then on, the hobby became ham radio. Today, there are approximately three million hams globally, with 750,000 in the United States. Hams use a variety of equipment and modes of communication to bounce signals off the ground, ionosphere, and the Moon.
Hams are active in nearly every country of the world and from ages less than 10 years to more than 100. Hams have basic knowledge of radio technology and operating principles and must pass an examination to receive an FCC license to operate on radio frequencies known as the “Amateur Bands.” These bands are radio frequencies allocated by the FCC for use by ham radio operators. Not only is ham radio fun, social, and educational, it can provide a lifeline during emergencies when traditional communications are often knocked out. Emergency relief efforts in both Lower Manhattan and at the Pentagon were augmented by volunteer amateur radio operators in the weeks after the attacks.[i]
Hams talk across town, around the world, or even into space, all without the Internet or cell phones. One of the most exciting opportunities for hams is to chat with astronauts aboard the International Space Station (ISS). A ham with a few hundred dollars of equipment or less can connect to ISS, which cost more than $100 billion.[ii] Astronauts and ham radio operators have been talking to each other for years. Science X™, a leading web-based science, research and technology news service, published “Earthlings and astronauts chat away, via ham radio”. The journalist explained why such chats take place,
NASA astronaut Doug Wheelock was just a few weeks into his six-month mission at the space station when feelings of isolation began to set in. Wheelock would be separated from loved ones, save for communication via an internet phone, email or social media. At times, the stress and tension of serving as the station’s commander could be intense. One night, as he looked out a window at the Earth below, he remembered the space station’s ham radio. He figured he’d turn it on—see if anyone was listening.[iii]
Wheelock made a broadcast on an assigned ISS frequency to see if anyone was there. He quickly got a flood of responses from hams who were monitoring the frequency. Astronauts speak with students on a scheduled basis, but some use their time off during evenings or weekends to engage with any hams. NASA set up a ham radio station on the ISS to encourage young people to get interested in science and engineering. The almost-all-volunteer organization called Amateur Radio on the International Space Station (ARISS) arranges contact between students and astronauts so the students can ask rapid fire questions during a brief 10-minute window before the space station, travelling at roughly 18,000 miles per hour, flies out of range. Astronaut Ricky Arnold II said, “You’re talking to someone and looking right down at where they are.”[iv] Astronaut Owen Garriott, during his 10-day shuttle mission in 1983, spoke with about 250 hams all over the world, including King Hussein of Jordan and Senator Barry Goldwater of Arizona. Read the full article including quotes of the exchanges between hams and astronauts is here.[v]
Epilogue: I got my ham radio license in 1959 at age 14. More on that and my plan to talk to an astronaut to come.
[i] “New York City Arecs Members and the Attacks of September 11, 2001,” New York City Amateur Radio Emergency Communications Service (2011), http://www.nyc-arecs.org/911.html
[ii] JR Minkel, “Is the International Space Station Worth $100 Billion?,” space.com (2010), https://www.space.com/9435-international-space-station-worth-100-billion.html
[iii] Samantha Masunaga, “Earthlings and Astronauts Chat Away, Via Ham Radio,” PHYS.ORG (2020), https://phys.org/news/2020-12-earthlings-astronauts-chat-ham-radio.html
[iv] Ibid.
[v] Ibid.
Sync your calendar with the solar system
Space launches and landings were a record in 2020. Many more will happen in 2021. The biggest thing will be the landing of the Perseverance spacecraft in February. China will also have a landing that month. We can also look forward to test flights of the SpaceX Starship in Texas. If you want to follow this activity, you can sync with a Google calendar here.
Wikipedia began as a free alternative to encyclopedias, and now it is celebrating its 20 year anniversary. It has become testament to the open Internet. I use it every day. Wikipedia has 55 million articles, across 300 languages, and more than 280,000 volunteers act as the editor. Edits occur 350 times per minute, and are read more than 8,000 times a second. Statistics reported by Axios.
Wall Street
The market pulled back pretty much across the board. Concern over a slow rollout of COVID-19 vaccines weighed on sentiment. Tesla’s joining the S&P 500 was followed by a meteoric rise and the Biden administration focus on green may help further. Elon Musk remains the wealthiest person on Earth.
Vaccination is an important topic of the moment. This article will be longer than usual, but I wanted to share what I have learned. I believe the entire world will get vaccinated against the deadly SARS-CoV-2 virus which has proved to be deadly and highly contagious causing COVID-19. Equally important is what has been learned about creating a synthetic vaccine based on a sequencing of the virus and using computers to model different scenarios of how the human immune system can be mobilized to prevent the disease. There are trillions of viruses out there and we need to be able to respond quickly without needing an Operation Warpspeed which infused $12 billion into the process.
Bringing millions of doses to the population within just 10 months after the virus was identified and sequenced in a Chinese lab was truly amazing. IEEE Spectrum reported that as of early December, the World Health Organization is tracking 50 other vaccine candidates which have clinical trials underway with human patient volunteers, with 13 of the trials in the final pre-approval stage. Tens of thousands of volunteers are being monitored for side effects and efficacy. As I have written before, I believe the mRNA synthetic vaccine is the future, although at this time, many vaccines will use the traditional approach.
What we are witnessing is spectacular scientific research to develop effective vaccines and at least equally spectacular engineering to develop processes to manufacture huge numbers of doses and distribute them while preserving the effectiveness. The missing ingredient is information technology (IT) to enable governments to analyze population segments based on front line exposure, age, and underlying conditions and then plan for storage and distribution within the states and countries, and to schedule appointments. IT is often an afterthought because our governmental leaders are frequently clueless about IT. As demonstrated in the CARES Act, many states had decades old unemployment compensation IT systems. Some collapsed and required paper-based backup systems. Our leaders love to debate high level policy issues but rarely ask about IT.
For decades, CEOs ignored IT and viewed it as a boring set of activities which belonged somewhere down the chain under the CFO. Many CFOs don’t like to get into the nitty gritty of IT either, so it all comes down to the CIO. I have witnessed more than a few cases where a CIO was selected from executives who were not going to rise to the top, were “good guys or gals”, but for whom the company didn’t know where to put them, leading to “make him or her the CIO”. There are many great CIOs, but not enough.
Let me dive a bit deeper on the complexities of getting needles into arms. The manufacturing process to create vaccines for the current world population of 7.8 billion people is daunting. With a number of the vaccines needing two doses, the manufacturing demand is huge. The recipe of ingredients is mind numbing. The Moderna COVID-19 Vaccine contains the following: messenger ribonucleic acid (mRNA), lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose. To make this highly complex biotech product, the producers and their suppliers have had to construct new factories to mass-produce the vaccines along with the vials, syringes, and other materials needed.
Getting the right amount of each ingredient at precisely the right right time at the right temperature and viscosity and then blended enough to become a vaccine but not enough to break down the synthetic biological mRNA is incredible. Then comes the vials. Corning developed a strong aluminosilicate glass that can be prestressed during vial manufacture. They did this by replacing sodium atoms in the raw materials with potassium atoms, which enables the glass to resist breakage during freezing and transportation. As the doses of vaccine get closer to the arms of Americans, the sophistication becomes a bit reduced.
I am living in Florida this time of year. The state announced a plan to receive 367,000 doses of the Moderna vaccine before Christmas. The vaccine doses were distributed to 173 hospital locations which did not receive doses in the first allocation of the Pfizer COVID-19 vaccine. The hospital locations for the delivery span 43 of Florida’s 67 counties. The public health and emergency management teams take it from there. The variability among counties is quite different than what goes on in the manufacturing.
After Governor DeSantis changed the CDC recommended priority for the second wave to anyone over 65. The news reported how large numbers of Floridians camped out overnight to get in line for a vaccination. I live in Flagler County, which set up a text alert system to notify subscribers of when and how persons older than 65 could make an appointment.
On Monday, January 4, I received a text providing a link to a website to make an appointment. I immediately visited the link to find it was at Eventbrite, a system widely used to sell concert tickets. It turns out the supply of Moderna vaccine was roughly 1,000 to be dispensed on the following Tuesday, Wednesday, and Thursday mornings. Eventbrite was not well suited to the task of making an appointment with terminology and process oriented toward buying concert tickets. I acted quickly and was lucky to get a 10:30 appointment for Thursday. The roughly 300 15-minute appointment slots were sold out in less than 10 minutes. The Eventbrite app did not indicate how many slots there were and how many were left, and many people were understandably frustrated.
On Thursday morning at 9:45am I left home for Cattleman’s Hall at the Flagler County Fairgrounds in Bunnell, Florida. The process was incredibly well organized and staffed with public health workers and volunteers. Signage was clear and a half-dozen checkpoints were staffed with friendly people. They were organized to handle thousands, but unfortunately there was not enough vaccine supply for so many. At one checkpoint on the Fairgrounds, I was presented with a clipboard to fill out some basic information such as name, address, date of birth, and certain medications and conditions.
At the next checkpoint, a nurse asked a few questions, and then I moved on to tent #1 to which I had been assigned at the prior checkpoint. Remaining in my car, a very pleasant nurse asked a couple of questions, raised my shirt sleeve, and injected a half-milliliter dose of Moderna 012L20A vaccine in my deltoid muscle. I knew from experience to relax my arm to minimize pain. The injection was completed in seconds without getting out of the car, and I barely felt a thing. On to the next checkpoint where another person asked how I felt. Fine. The next few checkpoints were designed to last a total of 15 minutes to ensure no allergic reactions. A Post-it was placed on my windshield to show the last checkpoint person I could be cleared to leave at 10:32.
I was given a vaccination record card showing my second dose should be within a few days of February 3. An instruction sheet was provided to log in to vsafe.cdc.gov to register my vaccination. The site was very simple to use and requested basic name and address, date of vaccination, which vaccine, and mobile phone number. Later that afternoon I received a text message asking me to log in to the v-safe site with an assigned registration code. I was asked how I felt and about any symptoms. These health checks will continue until some time after the second dose.
Some people don’t like the Federal government having more data about them. I am happy to know the CDC is checking up on me and telling me how to report any side effects I may have. Overall, it was a very positive experience, except for the Eventbrite app. I received a text message from Flagler County saying, “We will not be using the Eventbrite system for new appointments. State has advised that we will have access to a new system next week.”
Can the world get vaccinated. I believe so. In developing countries it will be more complex, but there are organizations which care about getting the vaccine out there. In the U.S., we have about six million people vaccinated with a first dose. The first dose gives efficacy roughly equal to flu vaccine. The second dose will take it up to 95%. The holiday made a quick start difficult, but vaccinations have ramped up to 500,000 per day. The new administration is planning to double that. I suspect priorities will begin to shift to getting it out there to anybody rather trying to perfect a needs/risk based approach. We need to get to 75%-90% in order for the herd effect to take control.
In summary, from my perspective, the scientific research, development, and manufacturing have been miraculous. IT has lagged, but I believe it will catch up because the motivation is high. Work is underway at IBM and other organizations to leverage mobile devices. The Commons Project, based in Switzerland, The World Economic Forum and a broad coalition of public and private partners are collaborating to launch CommonPass, a trusted, globally-interoperable platform for people to document their COVID-19 health declarations, PCR tests, and vaccinations. The plan is to satisfy country entry requirements, while protecting health data privacy.The CommonPass app created by the group allows users to upload medical data such as a COVID-19 test result or a proof of vaccination. The app will create a QR code that authorities can scan. No sensitive personal information other than the health declarations is revealed. The app should be available as early as this month.
Epilogue: I use Apple Notes to keep track of immunizations for flu, shingles, pneumonia, Covid, and others. Not that I don’t trust the government or my healthcare provider, but if I have my data stored in iCloud and available on all my devices, I feel much better.
Sync your calendar with the solar system
Space launches and landings were a record in 2020. Many more will happen in 2021. The biggest thing will be the landing of the Perseverance spacecraft in February. China will also have a landing that month. We can also look forward to test flights of the SpaceX Starship in Texas. If you want to follow this activity, you can sync with a Google calendar here.
Wall Street
The big market news was Tesla’s joining the S&P 500 followed by a meteoric rise making Elon Musk the wealthiest person on Earth. This will also be a record year for IPOs with Roblox planning to raise $1 billion with a valuation of $8 billion or more. Coinbase has announced it has filed for an IPO in 2021. This could be a big one also. Coinbase is a digital currency exchange and the most valuable American crypto company. Bitcoin closed at 8 times its 52 week low and Etherum closed at 10 times its low. I believe a successful IPO by Coinbase could signal the legitimacy of cryptocurrency. The IPO stocks are speculative. With interest rates at essentially zero, investors are looking for something they perceive having growth potential. Tech is certainly in that category, but the bubble could break as we saw in 2000. High volatility seems likely to me.
Disclosure: I am a private investor in Roblox and Coinbase.
Dr. Marc Raibert said at a 2018 TechCrunch robotic conference at UC Berkeley he believes the impact of robots will be greater than from the Internet. Marc, a professor at Carnegie Mellon University and MIT may be one of the few who has the credibility to make such a statement. In 1980, Marc founded the CMU Leg Lab, and then in 1992, he founded Boston Dynamics, a simulation and robotics company. Knowing a lot about how legs work, Dr. Raibert developed the first self-balancing, hopping robot. This was a significant step forward in robotics. Raibert’s dream is to advance bipedal and quadrupedal robotics to a supernatural state.
Boston Dynamics started out in 1992 as a spin-off from MIT, where it became known for its dog-like quadrupedal robots. The company was bought by Google and then later was sold to SoftBank. It was just sold again, this time to Hyundai for more than one billion dollars. Boston Dynamics just recently started selling its four legged Spot robot for commercial applications with a price tag of $74,500.
The progress made by Boston Dynamics is amazing, even just since I wrote Robot Attitude: How Robots and Artificial Intelligence Will Make Our Lives Better in 2019. To demonstrate the point, think about how awkwardly C-3PO from Star Wars walked and then watch the robots dancing to “Do You Love Me” here.
Epilogue: To learn more about robots and AI, get a Kindle copy of Robot Attitude here for just $4.99.
We normally think of the word conjunction as a word which connects clauses or sentences or to coordinates words in the same clause. For example, the words and, but, if are conjunctions. When it comes to astronomy, a conjunction is an alignment of two planets or other celestial objects making them appear to be in the same, or nearly the same, place in the sky.
Last week, there was a conjunction of Jupiter and Saturn not seen for hundreds of years. The event made a lot of news. Cloud cover made it impossible for me to see it, but many people did. No doubt some took photos, but nothing like what Jason De Freitas did.
Jason is a fine art photographer who has created a lot of unique and experimental works. He lives on the South Coast of New South Wales, Australia. He has been recognized for his analog astrophotography, aerochrome infrared landscapes, and stereoscopic star trails. I never heard of these, but when I visited his website, I saw some really unique things.
His most unique photography ever may have been last week when he captured the International Space Station passing between Jupiter and Saturn during the conjunction. The ISS is orbiting Earth at 4.76 miles per second, which is 17,136 miles per hour. The 39-second video on YouTube will go down in history.
Jason described the project,
Probably the most unique shot I’ve ever taken. I had the incredible luck of figuring out I could see the path of the International Space Station traveling through the Jupiter-Saturn conjunction. After much planning and scrambling I had to drive an hour (quite a short distance in the scheme of things) to align the shot perfectly and somehow everything on the night worked out. Beyond thrilled with this one. Taken on the 17th of December, 2020 at precisely 21:53:05 for 10 seconds. Location: Jellore Lookout, Mittagong NSW, Australia.
For photography buffs, the equipment he used included Pentax 67 Takumar 600mm f/4 Fujifilm Provia 100f Equatorial Mount: Skywatcher NEQ6 Digital gear: Nikon D750.
Jennifer Doudna was born in Washington, D.C. She grew up in Hilo, Hawaii. After graduating from Pomona College in 1985, she earned a Ph.D. from Harvard Medical School in 1989. Doudna is a renowned American biochemist known for her pioneering work in CRISPR gene editing. She was awarded the 2020 Nobel Prize in Chemistry. In addition to being a professor at UC Berkeley, she is also president and chair of the board of the Innovative Genomics Institute, a faculty scientist at Lawrence Berkeley National Laboratory, a senior investigator at the Gladstone Institutes, and an adjunct professor of cellular and molecular pharmacology at the University of California, San Francisco. It is brilliant and dedicated people like Jennifer Doudna who are creating breakthrough after breakthrough and saving lives.
Doudna is the go-to figure for what is referred to as the “CRISPR revolution”. In 2012, Doudna and Emmanuelle Charpentier were the first to propose that CRISPR could be used for programmable editing of genomes. The technique is now considered one of the most significant discoveries in the history of biology.
I first wrote about CRISPR technology in 2016. It is not exactly a household name. CRISPR stands for Clustered Regularly Interspaced Short Palindromic Repeats. If you read the details about CRISPR, it might make your head hurt. It is really complex. CRISPR was discovered in 2007 and is partly based on what a yogurt company unearthed about a bacteria which could eliminate viruses. The technology has evolved dramatically over the last few years into a gene editing technique which may become a powerful tool for the cure of multiple diseases, including cancer. You will be seeing the term CRISPR more frequently in the months ahead.
The words cancer and cure will be used together more and more. Laboratory experiments have shown it is possible to literally eliminate cancer tumors. Today’s chemotherapy treatments are aimed at killing the cancer cells. Sometimes it works and sometimes it does not. The side effects can be severe. The gene editing approach is designed to modify our DNA and have our body fight the cancer instead of the chemo. I think of CRISPR technology like video editing. A video clip consists of a series of video frames. A video editor enables you to remove frames which might be irrelevant or unappealing. You then save the modified video.
Sickle cell disease (SCD) is a disease for which those afflicted may benefit greatly from CRISPR. SCD affects millions of people throughout the world, especially those whose ancestors came from sub-Saharan Africa; Spanish-speaking regions in the Western Hemisphere (South America, the Caribbean, and Central America); Saudi Arabia; India; and Mediterranean countries such as Turkey, Greece, and Italy.
Healthy red blood cells are round, and they move smoothly through our blood vessels to carry oxygen throughout the body. For those with SCD, the red blood cells become hard and sticky and look like a C-shaped farm implement, hence the name sickle. The sickle cells are short lived, and as a result the patient has a constant shortage of red blood cells. When sickle cells move through small blood vessels, they can get stuck and clog the blood flow causing pain and other serious and life-threatening effects.
A clinical trial with ten patients has shown some amazing results. The treatment is complex. Doctors remove stem cells from the patients’ bone marrow and use CRISPR to edit a gene in the cells. The result is the production of fetal hemoglobin, just like what is produced by fetuses in the womb. The patients are given chemotherapy to destroy most of their bone marrow. This is a grueling step but it is needed to make room for the gene-edited cells. The last step is the infusion of billions of new cells into the patient’s body.
Researchers reported this month the first 10 patients treated with the CRISPR gene-editing responded well, although enduring the intense chemotherapy step. Jennifer Doudna was quoted in NPR Health News, “I’m very excited to see these results. Patients appear to be cured of their disease, which is simply remarkable.”
The early stage of CRISPR was difficult and viewed as highly risky. A gene-editing trial with a volunteer teenager in 1999 ended in his tragic death. This was a setback of years, but much has been learned. The University of Pennsylvania, where the trial took place, became very cautious but is now advancing the technology. Other trials have included participants who have sarcoma, melanoma or myeloma. The end goal of the CRISPR technology is to create living drugs which can be put in our bodies to eradicate tumor cells. Progress is much more imminent than when I wrote the 2016 article. What I have read and heard from experts suggests it is not far away to say cancer has finally been eliminated.
See other stories I wrote about CRISPR here.
Spy Satellite On The Way
SpaceX called off the planned launch of a Falcon 9 rocket carrying a classified spy satellite for the U.S. National Reconnaissance Office due to a sensor flagging high pressure in the second-stage booster. The launch is currently rescheduled for Saturday. Since June 2010, rockets from SpaceX’s Falcon 9 family have been launched 105 times.
Why Are Vaccines So Cold?
Vaccinations are underway, but the distribution and storage are really complex logistically. The Pfizer vaccine has to be kept an ultrafrosty –70° Celsius. The vaccine requires large and expensive ($10,000 each) special storage freezers and complex shipping containers. Pfizer and Moderna both require their vaccines to be super cold. The reason is to protect molecular structure of the synthetic vaccines. Both vaccines are based on messenger RNA (mRNA). The mRNA carries instructions which enable human cells to build copies of the coronavirus spike protein. The protein enables our immune system to attack the coronavirus if it attacks. The super cold status prevents the vaccines from breaking down and becoming useless.
Wall Street
The big market news will be Tesla’s joining the S&P 500, the most widely tracked stock index. It will be the largest company by market value to ever join the S&P. Tesla’s inclusion will cause dozens of index funds which track the S&P to purchase tens of billions of dollars of stock at Friday’s closing price so they will be tracking the index as closely as possible. Nobody knows exactly what the volatility of Tesla shares will mean. Traders say the ripple is unpredictable. As of 4pm Friday, Tesla was at $695 with a market cap of an astounding $659 billion, an incredible run for 2020. This will also be a record year for IPOs with DoorDash, AirBnB and quite a few others. Next year may be equally hot. Roblox is planning to raise $1 billion with a valuation of $8 billion or more. Coinbase has announced it has filed for an IPO in 2021. This could be a big one also. Coinbase is a digital currency exchange and the most valuable American crypto company. The rise in Bitcoin and an IPO by Coinbase could signal the legitimacy of cryptocurrency. The IPO stocks are speculative. With interest rates at essentially zero, investors are looking for something they perceive having growth potential. Tech is certainly in that category, but the bubble could break as we saw in 2000.
Disclosure: I am a private investor in Roblox and Coinbase.
Sixty percent of people questioned in November said they would “definitely or probably” take the coronavirus vaccine. In September, the number was 51%, so the trend is good. However, the Pew Research Center said 39% of people polled would definitely or probably not take the vaccine, and 21% of people polled said they won’t take the vaccine and are “pretty sure” more information won’t change their minds. The poll found differences in willingness to get vaccinated based on political affiliation, race, and ethnicity. Whatever the perception, the forecasted numbers are a problem. The exact threshold to achieve herd immunity is not known, but Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said recently 75% to 85% of the population will need to get the vaccine to stop the spread of the virus.
What is going through the minds of the nearly 40% naysayers? Some people don’t trust government, and government has been much more visible than usual because of the high stakes of the pandemic situation. Some would say the politicization of the pandemic situation is part of the problem. I believe one of the factors in the doubters’ minds is the perception the vaccine development process was “rushed” and involved a lot of “cutting the corners”. Statements saying it “usually” takes up to ten years and naming the vaccines project Warp Speed fuel those feelings. To me, the key question is what is it which is different between the “years” case versus the “months” case?
My hypothesis is the difference is paperwork and related inefficiency. I don’t know anything about the internal workings of the FDA and CDC, but if it is anything like our healthcare system, there is likely a lot of paper and a lot of inefficiency. Reports said the FDA has 150 people working night and day on the analysis of the data. That doesn’t sound right to me. 150 people to analyze the data from a clinical trial?
Healthcare provider offices are well stocked with clipboards and Post Its. The authors of a new report which collected data from more than 20,000 physicians in nearly 30 specialties described the time physicians are spending on paperwork as “mind-boggling.” Nearly a third of physicians said they spend 20 hours or more a week on paperwork and administrative tasks. I wonder how much time of the 150 people at the FDA is spent with paperwork as opposed to cloud-based analytical and collaborative apps. I know there are many issues involving privacy, incompatible systems which collect the data, etc.
I was in a clinical trial once. It was all driven by paper forms. Just like with paper ballots, 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 involves a lot of paper. I believe the time can be shortened, and that is what Warp Speed has done.
Investors think time can be shortened also. When I last looked at angel.co, there were 255 startup companies focused on improving the efficiency of 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. It seems Warp Speed somehow broke through the barriers. Lets hope the trend continues beyond the current work on Covid-19 vaccines.
Mark Toshner is a University Lecturer in Translational Respiratory Medicine at the University of Cambridge and an Honorary Consultant Physician. Somebody referred me to a series of tweets he made last week about the subject I have been discussing in this post. I made some minor edits to make the multiple tweets flow as one story. Following is what Dr. Toshner had to say,
More on vaccines. I’m going to get boring and geeky on this (no apologies) on the 10 year thing. Vaccines “normally take 10 years”. This is being used as a reason to be fearful (ie rushed job). I’m a clinical trials doc. I can tell you most of that time is spent doing …. nothing. It’s spent submitting funding requests, then resubmitting them, then waiting, then submitting them somewhere else, then getting the money but the company changes it’s mind or focus, then renegotiating then submitting ethics, then waiting for regulators …then having problems with recruitment and having to open other sites, then dealing with more regulatory issues, then finally when you eventually get to the end of all of this you might have a therapy … or not. At this point it may not be deemed profitable or any number of other obstacles.
However we have collectively now shown that with money no object, some clever and highly motivated people, an unlimited pool of altruistic volunteers and sensible regulators. That we can do amazing things (necessity being the mother etc). These trials have been nothing short of miraculous, revolutionary but in the context perhaps it is not surprising given our ability to innovate when we REALLY need to and we really needed to. Safety hasn’t been compromised. 100s of thousands of great people volunteered for experimental vaccines. The world watched closely. The press reported every serious adverse event. There have so far been a handful. A triumph of good people/good process. I am confident that when regulators and scientists pour over the safety data (and we will because we are a bit that way inclined) that vaccines will only be used if we are confident that the risk is definitively outweighed by benefit. This should give you confidence too.
Well said, Dr. Toshner. As I wrote in the Spring, there are a lot of positive things which will come from the silver lining of the dark cloud. One of the many things is what we have learned collectively. Data analysis and processes can go faster. As the startup companies promote their advances, at least one of them will introduce breakthrough technology which will enable warp speed to be part of the new normal.
Learning From a RUD
RUD stands for Rapid Unscheduled Disassembly, and that is what happened at the end of the Starship flight test on Wednesday. The 6+ minutes flight ended with a huge explosion. Was it a failure? No. In fact the test was a great success. The engineers got all the data they need to perfect the next flight test. The Starship is 30 feet in diameter and the height of a 12 story building. Getting it off the ground at all seems like a miracle. Most amazing is the testing of a return to land vertically. This remarkable feat was amazing to watch. The Starship turned over horizontally and literally fell toward Earth.When near the ground it righted itself and fired its rocket engines to slow it down for a landing. Unfortunately, there was a fuel pressure problem and not enough thrust to slow down adequately. Elon Musk’s comments later were, “Mars here we come”. The Starship will be able to carry 100 people to the Moon, Mars, and beyond.
Vaccinations to Start Soon
The question is what should be the priorities. Healthcare workers and others on the on the front line of assistance to others seems clear. But then who? Seniors and others with increased vulnerability would be pretty high on the list. Uber, in a letter to the CDC’s Advisory Committee on Immunization Practices, said its drivers provide critical transportation for essential workers and allow others to stay home and order food. Other industry groups, including aviation, food production, agricultural, consumer goods, and trucking are also asking officials to prioritize their workers for early vaccine distribution. Governors and local officials will call the shots. Healthcare workers will likely be universally at the top of the list, but after them we will see variations. There will probably be some people jumping ahead in the line.
Wall Street
Bitcoin had a pullback but is still more than double year to date. Stocks pulled back some too but newly public companies soared: DoorDash and AirBnB pulled back but still showed extraordinary gains from the IPO price. This will be a record year for IPOs, and there are more to come including Roblox. My granddaughters love to play Roblox. They know way more about it than I do and they are 7 and 9. Roblox is planning to raise $1 billion and the valuation may be $8 billion or more.
I have been digitizing documents for many years, decades. If I receive something in the USPS mail, I open it, scan it, and throw it in the recycle bin. I keep the digital documents in Dropbox folders, which I consider a safe and secure place for them. The documents number more than 150,000. I keep them organized in 50+ folders such as aviation, boat, cars, motorcycles, boards, books, education, friends and family, ham radio, health and fitness, etc. Some documents like birth, marriage, and death certificates of ancestors are more than 100 years old. From time to time, I browse through the files for all years of the current month just to see what I find. When I did this in November, I found a letter I had received 52 years ago from Thomas J. Watson, Jr., Chairman of IBM Corporation.
Tom Watson was a great leader and a fine man. I only met him in person once, but I always felt he was there for all the employees. It felt really good to receive a personal letter from him.
When I was in the U.S. Army on military leave from IBM, I remember receiving an unexpected package at Christmas time. I opened the large package as some of my comrades stood and watched. Inside was an Epicurean Gift Box of fruits, nuts, and other goodies. A gift card said Dear John, Merry Christmas, and we all hope you come back to IBM after you complete your military service. It was signed by Vin Learson, then IBM’s chairman and chief executive officer. We were all impressed. IBM felt like family.
I joined IBM in June 1967. The annual report for that year was very positive. Revenue was $5.34 billion, up 26%, and profit was $651 million, up 24%. At the end of 1967, there were 221,866 employees and 359,459 stockholders. As I recall, there were more than 25,000 employees who joined the company that year.
The IBM Electric Selectric typewriter was quite popular, but most of the revenue came from the IBM System 360 line of mainframes which was announced in 1964. A new smaller mainframe, the System 360 Model 25 was announced at the beginning of 1968. The Model 25 was available with “up to” 48K of core (not solid state) memory. That is 48,000 bytes of memory. My iPhone 12 Pro Max has solid state memory of 6 gigabytes. To put that in perspective, the iPhone has 125,000 times more memory.
Data storage for the Model 25 was in a separate device called the IBM 2311, about the size of a medium-sized refrigerator. The 2311 had a removable disk pack 14 inches in diameter. The Model 25 allowed connection of up to four of the 2311s, each with a storage capacity of 7.25 megabytes for a total of 29 megabytes. My iPhone as a storage capacity of 256 gigabytes, almost 9,000 times more storage. The speed and capabilities are not even comparable.
The Model 25 was considered to be a “compact design”, as it was very small compared to much larger IBM System 360 models. You can see from the picture it was not pocket sized, it weighed 1,600 pounds. The purchase price of the Model 25 was $253,000 or it could be rented for $5,330 per month. My iPhone costs $58.25 per month and gets replaced each year. The comparisons are staggering, but in 1968 IBM technology was considered leading edge.
Many people think mainframes are dead. This is hardly the case, with mainframes still hard at work on critical tasks at more than 70% of Fortune 500 enterprises. Mainframes are a small fraction of IBM’s revenue at this point, with the major focus being AI and hybrid cloud services.
1968-1969 were great years. In the middle of 1969 I entered the U.S. Army for two years, six months, and 22 days. More on that another time.
A Lot Going On in Space
China is clearly a threat to the United States leadership in many ways, one of which is in space. This week China launched a rocket to the dark side of the moon. They placed a satellite in orbit to serve as a relay station to send pictures and data back to Earth. The landing portion of the rocket hovered 300 feet above the lunar surface to pick a smooth spot for landing. After the landing, the vehicle drilled holes in the surface of the Moon and extracted 4+ pounds of samples. On Friday, ascent vehicle lifted off the Moon to rendezvous with the Chang’e 5 orbiter while still circling the moon. After a transfer of its precious cargo to a return capsule, the Chang’e 5 spacecraft will wait in lunar orbit for a number of days for a narrow window in which to fire its engines and head for Earth. The complex mission is quite impressive.
Vaccinations to Start Soon
The question is what should be the priorities. Healthcare workers and others on the on the front line of assistance to others seems clear. But then who? Seniors and others with increased vulnerability would be pretty high on the list. Uber, in a letter to the CDC’s Advisory Committee on Immunization Practices, said its drivers provid critical transportation for essential workers and allow others to stay home and order food. Other industry groups, including in the food production, agricultural, consumer goods and trucking industry, are also asking officials to prioritize their workers for early vaccine distribution. Governors and local officials will call the shots. Healthcare workers will likely be universally at the top of the list, but after them we will see variations.
Wall Street
Bitcoin surged and then pulled back again due to concern about new regulations. In my opinion, some “light” regulation will be a good thing for Bitcoin. The price as of 3pm on Friday was $19,039, up substantially for the week. The market cap for BTC was $353 billion. Gold proponents believe gold is a sound store-of-value and a hedge against fiat currencies losing value. They argue gold has important and valuable attributes such as durability, fungibility, divisibility (into coins of any size), portability, and scarcity (Congress or the Fed can’t print more of it). I would argue Bitcoin has all these same properties. We shall see. Current forecasts for the value of Bitcoin range from $318,000 to Zero.
Machine learning, a key tool in the realm of artificial intelligence (AI) can be applied to data on weather conditions resulting in a forecast of the weather. Similarly, machine learning can be applied to medical data and enable an AI to learn how to diagnose a medical condition. AI systems are learning to diagnose disease across a wide range of medical conditions, and gradually they are becoming as accurate as human doctors.
A good example of AI diagnosing is occurring in London because of a collaboration between researchers from Google’s DeepMind subsidiary, University College London, and Moorfields Private, the private patient division of Moorfields Eye Hospital. The researchers used deep learning, a form of machine learning, to create an AI which can identify more than 50 common eye diseases based on thousands of 3D scans. With a single scan of a patient’s eye, the AI can recommend a specific treatment. While the research is still in the early stage, the results to date are very promising. The Verge, an American technology news and media network, quoted Dr. Pearse Keane, a Consultant Ophthalmologist at Moorfields who was involved in the research, saying,
The number of eye scans we’re performing is growing at a pace much faster than human experts are able to interpret them. There is a risk that this may cause delays in the diagnosis and treatment of sight-threatening diseases. If we can diagnose and treat eye conditions early, it gives us the best chance of saving people’s sight. With further research it could lead to greater consistency and quality of care for patients with eye problems in the future.
The software the researchers developed uses algorithms which can identify common patterns in data from 3D scans of patients’ eyes. The scans are made using a technology called optical coherence tomography (OCT). The researchers submitted data from nearly 15,000 OCT scans from 7,500 patients. In addition to the data from the scans, the researchers included the software diagnoses made by Moorfields doctors. Based on what the AI software learned from the data, it was able to develop a diagnosis without a new scan. The Verge reported the AI’s diagnoses were 94% accurate when compared to the diagnoses made by a panel of eight doctors.
Assuming the AI achieves equal or better accuracy of diagnoses and the software is rolled out to medical providers, there may remain to be issues of concern about the technology. If an AI makes a diagnosis with no human involvement, who is responsible if the diagnosis turns out to be wrong? Doctors are not comfortable with “black box” diagnoses where the basis of a diagnosis is not known.
The researchers at DeepMind and its collaborators are aware of these issues, and they have developed software mitigations. For example, rather than the AI just providing one diagnosis, it can provide several, including information about how the diagnosis was reached and what level of confidence it included. Another ameliorating consideration is the AI can be used for triage. Rather than acting on an AI diagnosis, a provider may look at the diagnoses which are highlighted as the most urgent and consider treatment of those patients with top priority.
Another issue is the ownership of the OCT scan data. Google might argue it owns the data since it expended the effort to store and analyze it. It might argue it has the right to sell the data to other hospitals. Moorfields might argue it owns the data because it came from its patients. Issues such as this are not uncommon in medical research. They are usually resolved with contractual agreements giving the technology company rights to the data for a specific amount of time and then provide royalties to the medical provider.
Regardless of the various issues, it is clear AI may be of great benefit to patients. The Verge reported,
Some 285 million people around the world are estimated to live with a form of sight loss, and eye disease is the biggest cause of this condition. OCT scans are a great tool for spotting eye disease (5.35 million were performed in the United States alone in 2014), but interpreting this data takes time, creating a bottleneck in the diagnostic process. If algorithms can help triage patients by directing doctors to those most in need of care, it could be incredibly beneficial.
As I wrote in Robot Attitude: How Robots and Artificial Intelligence Will Make Our Lives Better , AI will find its way into every aspect of our personal and professional lives. The potential is there for some bad things to happen, and government and scientific experts must be on the lookout and propose appropriate regulations. However, I believe the benefits are huge, and we should learn about and embrace AI.
Election Update
The state of Georgia conducted an audit of the presidential election by performing a manual recount of the five million votes cast. As anyone could have predicted, the results were different than what the machines had counted. However, the difference was not significant. The results showed the winner won by less than a half percent, and a recount has been requested. The State law specified an audit was not the same as a recount. Duh. This is one of many outdated election laws in the 50 states. All different. The anti-Internet voting activists continue to bash the idea of mobile blockchain voting, but a group of researchers at the University of Maryland have written a white paper on how modernized voting can be done safely and securely. See the VoteXX Project.
Tesla Breaks New Ground
Tesla engineering and manufacturing team in Berlin have developed a new way to build their electric Model Y. They will be producing the rear and front underbody in single pieces of casting, and these two pieces will include the battery pack as an integral part of the car’s structure. The pack will include 4,680 battery cells. If successful, the new approach will be exported to other Tesla factories.
Wall Street
Bitcoin has pulled back due to concern about new regulations. In my opinion, some “light” regulation will be a good thing for Bitcoin. The price as of 1pm on Friday was $16,727. This is double a year ago and three times the low in March. The market cap for BTC was $311 billion. The MAGFA five (Microsoft, Apple, Google, Facebook, Amazon) finished the week at an amazing 27%. If Salesforce pulls off its move to acquire Slack, it may put some pressure on Microsoft. Tesla, Uber, and Zoom continue to zoom.
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 and efficient distribution, assured safety, management of public fears of inoculation, and global political considerations. Despite the complexity, what used to take years, now takes months. Politicians pushing to go faster may have helped, but it mostly has to do with bioinformatics, genomics, AI, machine learning, cloud computing, and synthetic biology. As I have said before, I believe the transition from years to months will continue to days and maybe even hours.
Currently, there are nearly 100 vaccines under development for COVID-19. About 20% of them are based on DNA or RNA. Two are about to receive approval, Moderna and BioNtech in partnership with Pfizer. The RNA approach has shown to be best for speedy development. Efficacy of the two vaccines has shown to be more than 90%, compared to 60% for flu vaccine. Safety data is coming in now and so far it looks very good.
The long term implication of the RNA development and manufacturing platform is the potential to respond quickly to new viruses which will surely appear. An antigen from a new virus could be sequenced quickly, and the genetic code for a vaccine could be manufactured using a tested and approved platform. If so, it would eliminate the traditional lengthy process for developing a new vaccine. Axios reported, “This pandemic is a testbed for the next generation of vaccine technologies.”
But what is RNA? A Chief Medical Officer told me when he was in medical school 30+ years ago, very little was known about the role of RNA. In the rest of this article, I hope to shed some light on RNA, but will start with DNA to put things in perspective.
DNA is material found in nearly every cell of every living organism. The structure of DNA is the famed double-stranded helix, some say it looks like a twisted ladder. Our DNA contains genetic information which acts like a recipe enabling us to develop, grow, and reproduce. Although our environment, lifestyle, and nutrition have an influence, our DNA is primarily responsible for our development. The recipe informs our cells how to produce the tens of thousands of human proteins which form our cells, tissues and organs.
Gregor Mendel, has been called the “Father of Genetics”. Like Vint Cerf, who has been called the “Father of the Internet”, there were actually a number of “Fathers”. It started in 1866 when Mendel was the first to note human characteristics get passed down from generation to generation. He coined the terms of dominant and recessive. Numerous discoveries about DNA occurred over the next 87 years. In 1953, Watson and Crick published a detailed paper about DNA’s double helix structure which has become symbolic.
As early as 1939 scientists suspected there was something special which provided the recipe. The something was RNA. There are three types of RNA, but the one most relevant in the current vaccine development is messenger RNA, or mRNA. Using a process called transcription, mRNA copies genetic code to ribosomes, which act like a kitchen where the production of proteins take place.
Scientists have dreamed about the endless possibilities of synthetic mRNA. STAT is a journalistic site which delivers “fast, deep, and tough-minded journalism about health, medicine, life sciences and the fast-moving business of making medicines.” In “The story of mRNA: How a once-dismissed idea became a leading technology in the Covid vaccine race“, National Biotech Reporter Damian Garde described the big picture,
Researchers understood its role as a recipe book for the body’s trillions of cells, but their efforts to expand the menu have come in fits and starts. The concept: By making precise tweaks to synthetic mRNA and injecting people with it, any cell in the body could be transformed into an on-demand drug factory.
Moderna and Pfizer are quite different companies but in both cases there were dedicated researchers with a passion and a vision about mRNA. The government pouring huge amounts of money into the research was no guarantee but it certainly helped. The idea was to inject the synthetic mRNA into a patient, and the patient’s cells would create a protein which would fight the virus. The challenge was the patient’s body would would treat the mRNA as a bad actor. The two companies, in different ways, devised a tailoring of the mRNA so it could get past the patient’s rejection. The results were 95% efficacy.
Epilogue: It seems the more I read and learn about genetics, the amount I don’t know grows more rapidly. When I finish some other courses I am taking, I plan to take an MIT biology course online at edX.org.
The M1 Arrived
The Apple M1 arrived last week for two new MacBooks and the Mac Mini. This is a very significant announcement because it is the beginning of a transition away from Intel chips to using Apple’s own design. The move will surely improve Apple’s profitability but it also introduces incredible performance. It also introduces compatability across all of its computing products. You can run iPhone apps on a MacBook with the M1.
SpaceX and NASA Hooked Up
The SpaceX NASA collaboration has pulled off an amazing feat. The Crew Dragon took four astronauts to the International Space Station. The astrounauts will stay there for six months, and will perform a lot of research including for space manufacturing.
Wall Street
Bitcoin was the big mover for the week, now above $18,000. The market cap for BTC is close to $350 billion and represents 66% of the total market cap for 3,790 cryptocurrencies. Recent forecasts for the price of BTX range from $300,000 to Zero.
I am sure we all remember learning about atoms when we were growing up. The atomic nucleus is the small, dense region consisting of protons and neutrons at the center of an atom. The protons are positively charged, and neutrons are electrically neutral. (Scientists have since learned protons and neutrons are in turn made up of particles called quarks). The other part of atoms consists of electrons, the negatively charged particles of the atom. The electrons’ create a negative charge balancing the positive charge of the protons in the atomic nucleus.
Before I continue, I cannot resist digressing about Larry Fine, Curly Howard, and Moe Howard, the Three Stooges. The three were an American vaudeville and comedy team active from 1922 until 1970, best known for their 190 short subject films. Their hallmark was physical farce and slapstick. They remain hilarious on YouTube, and you can watch here. Every time I see the word electron, I think of one of the Stooges’ episodes where Curly said he knew all about atoms. He said they consisted of electrons, protons, and fig newtons!
What was known about atoms and the contents of the nucleus was limited because it wasn’t possible to actually see atoms. That changed in 1981. That was the year I moved from Philadelphia to IBM Headquarters in Armonk, NY. I remember seeing the announcement on the bulletin board (there was no web) highlighting Gerd Binnig and Heinrich Rohrer, scientists at IBM Zürich had invented the scanning tunneling microscope (STM). The IBM inventors received the Nobel Prize in Physics in 1986 for their groundbreaking invention. The STM made it possible, for the first time, to actually see at the atomic level, distinguishing features as small as one tenth of a billionth of a meter.
New discoveries have accelerated since the availability of the STM and other technologies. One example is Albert Einstein’s discovery of the photoelectric effect, for which he received the Nobel Prize in Physics in 1921. Einstein discovered when light with energy above a certain threshold hits the surface of a metal atom’s surface, an electron bound to the metal gets knocked loose. For example, the picture above shows an electron escaping from a helium atom after getting hit by a photon.
One of the numerous mind boggling aspects of the research at the atomic level is the minuscule amount of time it takes for an electron to be ejected after a photon strike. In some experiments, researchers were able to measure activities happening in femtoseconds ( 10-15 seconds) or attoseconds (10-18 seconds). These measures of time are an eternity compared to zeptoseconds. One zeptosecond is a trillionth of a billionth of a second. The duration of the electron emerging from the helium atom was measured as taking 850 zeptoseconds.
The iPhone Twins
The iPhone 12 Pro Max (on the right) arrived Friday afternoon. It is busy at the moment copying all the data from the iPhone 11 Pro Max (on the left). It takes about an hour. Meanwhile an Apple Upgrade box is on the way from Apple so I can return the 11 to Apple. My monthly cost for the iPhone will be $58.25, down from $60.33. Turns out the 12 purchase price is down slightly from the 11. The plan works very smoothly, and a new iPhone arrives every year.
An Even Bigger Week Coming Up for SpaceX
SpaceX tested the engines successfully on its Starship SN8 this week. The next test is the biggie — the flight test. SpaceX has announced the window of November 9th to the 11th for SN8, and they are planning for the giant Starship to climb nine miles and then return for a vertical landing. Reusable rockets are the key to a future of us being a space faring civilization. The other biggies, hopefully on Sunday, is the launch of the Crew-1 Mission to the International Space Station. In May, there was the Demo-1 with two astrounauts. This time there will be four astronauts. Stay tuned for the excitement at spaceX.com.
Wall Street
The iPhone 12 Pro Max was delivered on Friday, November 13, well ahead of when all presidential election votes will be counted and verified. Georgia manual counting of 5 million ballots is underway. If you read this column next week, it is unlikely they will be finished. One thing I know for sure is the vote count will be different than what the machines counted. I don’t know if either candidate’s count will be higher or lower, but they will surely be different. Humans are not as accurate as machines. Bitcoin is now above $16,000, more than double for the year. Stocks were up mostly across the board. A lot is riding on vaccines.
Ronjini Joshua is an author, speaker, and founder of The Silver Telegram, a tech-focused communications firm. He thinks enough of our outdated voting system is enough. In “After This U.S. Election, the Case for Online Voting Is Stronger Than Ever“, published Friday afternoon in Foreign Policy, he said,
The gridlock over the U.S. election results is frustrating for voters, embarrassing for Americans, and, perhaps most important, damaging to the spread of democracy around the world. The United States needs to revive its democracy through technology. Online voting can provide transparent, fast, and reliable results. It can also increase voter turnout.
It sounds like Joshua read my book, Election Attitude – How Internet Voting Leads to a Stronger Democracy (2016). We have heard enough from the naysayers. They compare Internet voting (or mobile blockchain voting) to an Internet with no hackers, no cyber criminals, no skilled foreign adversaries, no malware, no old insecure Windows 95 or Windows 7 computers; in other words they compare it to a perfect world we will never have. It is time to compare Internet voting, with all its imperfections, to the paper ballot system we have today, which is full of imperfections, as we see very clearly at this point. Joshua said,
By embracing online voting, the United States can give voters confidence in the system; after all, voters would be able to see the counts in hours, not days (or weeks). Such a system would also allow both parties to connect with those who would not normally vote, and would put the United States in a position to again lead the world with an example of a political system that does what it’s supposed to do.
Internet voting can also assist millions of Americans with visual impairment. It can offer simplified and much more accurate ballot designs, eliminating numerous errors. When the dust settles, I believe we will find millions of ballots were not counted because of “voter errors”, which could have been avoided with Internet voting. Internet voting could also enable voter education as part of the voting process. It could enable more progressive ways to vote such as Ranked Choice Voting, which can eliminate ties. The eight million overseas voters could become enfranchised. Results could be tabulated in seconds. The list of the benefits goes on. Trials in West Virginia, Utah, and other places have proven the security, privacy, and verifiability of Internet voting.
The only thing holding us back is our political and technological will. I hope Joshua’s article is the first of many. It is time for the naysayers to refocus on how to help, not spread fear. It is time for research centers, think tanks, pundits, investigative journalists, and technology experts to shift the focus to how our democracy can be strengthened by a technological, as Joshua said, reboot.
Mobile Voting Webinar
My sixth and final webinar about mobile voting for 2020 took place the day after Election Day. The Zoom session with the Ridgefield Men’s Club had 72 participants. The video recording is here. Hopefully, the paper ballot mess on our hands will result in more questions about why we cannot modernize our voting system. We surely can, if we want to. It just takes some political and technological will.
A Big Week Coming Up for SpaceX
SpaceX and its Starship SN8 will perform an historical flight test this upcoming week. SN8 (abbreviation for serial # 8) has already performed both the static fire and cryogenic tests. The next test is the biggie — the flight test. SpaceX has announced the window of November 9th to the 11th for SN8, and they are planning for the giant Starship to climb nine miles and then return for a vertical landing.
Twin Shoulders In Place
The twins are now both in place, with the cobalt-chromium alloy balls standing out nicely. The new sockets are made from polyethylene and do not show up in the x-rays. Physical therapy is underway, and I hope I will be somewhat normal by the end of the year.
Wall Street
Apple began accepting pre-orders for its new iPhone 12 Mini and the iPhone 12 Pro Max. The pre-order opened at 8am, and my Pro Max pre-order was confirmed at 8:02am. The iPhone will be delivered on Friday, November 13, well ahead of when all presidential election votes will be counted and verified. The big move of the week was Bitcoin, up more than $2,000. I continue to be bullish on BTC and will write a feature article about it sometime soon.
I was hoping for 100 responses to the SurveyMonkey, and you delivered 146! This is really great! Thanks so much. Your response represents almost 15% of the current 1000+ subscribers, and is definitely statistically significant. In the the following paragraph, I will summarize the results. This will be followed by graphics to show bar graphs depicting the specific feedback you provided.
Most important was question number four which asked about my feature stories. 97% of you said you found them interesting and informative. Two people thought they were too long, and one thought they were too technical. 80% said they read the entire e-brief, while 20% said they just read the feature article. 76% said they liked the news section and the diversity of it. About 20% said they like the wall street section, and 24% said they are not interested in it. Based on this feedback, I will be scaling back the tech stock index data I have been providing, but will continue to make some comments in the news section about various tech companies. The only disappointing part of the feedback to me was only about a third share the e-brief with someone else. Since 97% said they found the content interesting and informative, it is likely there are many other people who would also enjoy it, if they knew about it. Finally, with regard to how people read the e-brief, it is roughly 50% on laptop or desktop and 50% on phones or tablets or the web.
Following is more detail on the five questions.
Recording of mobile voting webinar
Paper ballot stories continue to be politicized. Facebook reports it has helped register 4.4 million new voters and sign up 100,000 poll worker volunteers. Hard to say what the outcome of mail in ballots will be as millions vote that way for the first time. As I explain in the webinar, there are many ways to make a mistake. A sixth webinar on the subject for Ridgefield Men’s Club on Wednesday, November 4, 2020.
Watch for a Blue Moon Saturday night (10/31). It will be called a Blue Moon because it will be the 2nd of two full moons in a single calendar month. They only occur once every 2 1/2 years. Halloween will be extra spooky this year when the blue moon rises. The harvest moon appeared on the first day of the month.
Wall Street
I watched the senate committee grill Facebook, Google, and Twitter CEOs. It is clear some regulation is needed, and Facebook is actually asking for it. As for breaking them up, I don’t think the senators can outsmart the tech companies. Bitcoin on the rise. More on that later.
Seventy-nine of you responded to the survey. This is great! Thanks so much. I would like to wait until the responses get to 100 before I share the results. That would make the results statistically solid. If you have not taken the survey yet, please click here or on the graphic. Your input is anonymous. I look forward to sharing the results.
All of us are familiar with arthritis, but we may not realize there are more than 100 different types of arthritis and related conditions. Arthritis is the leading cause of disability in America, and more than 50 million adults and 300,000 children have it. The most common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms can come and go, and they can be mild, moderate or severe. That was the case with my knee, but I finally reached the point where the pain and lack of mobility led me to have it replaced. There are a number of stories about my 2008 knee replacement experience in my blog. One that has the details is here.
Ten years later, my shoulders reached the same stage. After evaluating a number of alternative treatments, I decided to get my right shoulder replaced on October 25, 2018, and the left one sometime later. Rotator cuff repairs and other shoulder surgeries are common, but a total replacement of the shoulder joint is much more complex. A top hip and knee surgeon might do 400 replacements per year. A top shoulder replacement surgeon might do 75 per year. There are not as many cases requiring a total shoulder replacement although, with improved technology and experience plus an aging population, the number is growing.
I elected to have my replacement done at Danbury Hospital in Connecticut by Dr. Ross Henshaw. Dr. Henshaw went to medical school at Columbia University College of Physicians & Surgeons, his residency and internship was at New York Presbyterian Hospital, and a Fellowship in Sports Medicine was at New York’s Hospital for Special Surgery. I have known Dr. Henshaw for many years and entered the OR with complete confidence when the propofol wore off I would wake up in the recovery room with a new and perfectly installed shoulder joint.
For my new shoulder, Dr. Henshaw selected the Tonier Aequalis Ascend Flex shoulder joint made by Wright Medical Group N.V., a Netherlands based global medical device company, soon to be acquired by Stryker, if regulators approve it. I suppose many people would not want to know the details but, as I move along toward becoming a bionic person, I want to know what is going into my body. The video here shows an excellent animation of all the cobalt-chromium alloy and polyethylene components which became part of the new shoulder. When you see the precision engineered components, and considering that the tool boxes and all contents must be sterile, you can see why a joint replacement is complicated. If you have the stomach for it, you can watch an actual shoulder replacement surgery performed at Stanford University here.
The surgery is incredibly impressive, but an equal part of the total solution is physical therapy. I have known Valory Ramsdell, PT, for 15 years. She is a graduate of the University of Connecticut School Of Medicine, and has more than 40 years of experience in physical therapy. Valory is a hands-on therapist. This is really important, especially at the beginning of the therapy program. A final part of the total solution is me, the patient. I prepared mentally for months and was dedicated to following the physical therapy program fully. It is no fun and much of it is painful, but I know it is critical to the most effective recovery.
Life in an awkward sling and bolster was no picnic during the weeks after surgery. Performing matutinal duties without my dominant right hand was challenging. The pain can be debilitating, but I did not want to take too much pain medication and be a vegetable in my office chair. Fortunately, interactions with the Mac, iPhone, and iPad can be done via voice. Ultimately, we probably will have no keyboards, but at this stage, I find voice recognition to have some shortcomings. It is getting better, but until AI takes a larger role, we will still have to do a lot of editing of what we dictate.
Fast forward two years, and the time has arrived for the left shoulder to become a twin of the other. Dr. Henshaw will be using the same proven technology. By the time you read this, I will be home recovering
Surveys have the potential to be very useful tools for any organization to gain insight about their customers, products, and services. The number of surveys presented to us is on the rise but, in my opinion, most are misdirected. The typical survey basically asks two questions.
First is “Based on your most recent interaction with our customer service team, how likely are you to recommend our product or service to friends or family?” I remember back 25+ years ago when this question emerged from the bowels of marketing research firms. The question was shown in some studies to show the most accurate correlation to customer satisfaction. The question has lingered now for decades as the gold standard for surveys. I reject the question because I don’t feel it is my duty to make recommendations, pro or con, for any product or service I may have purchased. The question just doesn’t tell the real story about the quality of the product or service.
The other focus of most surveys is to ask about the customer service representative and how they handled your interaction. The questions are focused on the rep, not on the product or service. For example, AT&T, Comcast, Spectrum, Verizon, and other carriers have terrible customer satisfaction. It is not because their reps are bad, it is because their service price, quality, terms and conditions, etc. are terrible, yet they don’t ask about any of that.
Apple and Amazon understand. Although they both survey about their reps’ responsiveness, they also survey about their products and services. Telecommunications providers are not alone as providers of terrible services. Financial services companies also survey about their reps, not the quality of their products and services.
Healthcare is on a level of its own. Medicare requires all patients to receive a survey called hospital consumer assessment of healthcare providers and systems (HCAHPS). It sounds comprehensive, but is not. They ask about the quality of the food, the level of noise in the hospital room, communications from doctors and nurses, and the level of understanding the patient had. As healthcare has become more digitally oriented with mHealth and Telehealth, none of the HCAHPS questions ask about how well video consults have worked (I have had five video consults and none of the five had working video, although millions, including children, use Zoom every day with no problems.) The survey does not ask how easy it is to retrieve data from lab or imaging studies, how easy it is to transfer that information to another provider, or how easy it is to schedule an appointment.
I don’t take most surveys because I don’t want to add evidence leading to a rep getting fired because their company’s product or service is terrible. Now, it is time for me to practice what I preach. I have created a short five-question, less than one minute, survey about johnpatrick.com. I really want to know what you think about it. Are my e-briefs too long or too short, are they informative, etc. All responses aer anonymous, and I will share the results over the coming weeks. Please take a minute to click on the image at the top of this story or here or click the QR code below. Thanks!
Recording of mobile voting available for viewing
Paper ballot stories continue to be politicized by both parties. It is clear the votes will not all be counted by midnight on November 3. It may take weeks, and possibly longer based on legal challenges. I am hoping things will be orderly at the polls and people will understand the process. I have no doubt millions of the mail in ballots will not count due to errors by the voter. I offered my perspective on this and more about our voting process in four Zoom webinars. The most recent webinar is here.
I will be doing a fifth video webinar on the subject on Monday for Founders Hall on Monday, and a sixth for Ridgefield Men’s Club on Wednesday, November 4, 2020.
Keep your eye on SpaceX this coming week. Could be two rocket launches to deploy another 100+ Starlink satellites. Elon Musks dream of worldwide high speed Internet is happening.
Wall Street and the MAGFA Stocks
The big movers this week were Royal Caribbean down 14% and Zoom up 14%. The underlying trends with both ae obvious. Similarly, brick and mortar is losing out to cloud computing. CarMax market cap is $15B although very profitable with 200 stores. Carvana is not making money (yet), has NO STORES, and a market cap of $37B.With regard to big tech, some legislators want to break them, but I cannot see how breaking them up could be done successfully.
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.
| John’s MAGFA Market Cap (10/16/20 4:00pm ET) | |||||
| Closing | Market Cap | Last | Change in | % | |
| Price | Trillions | Week | Billions | Change | |
| Microsoft | $220 | $1.7 | $1.6 | $67 | 4% |
| Apple | $119 | $2.0 | $2.0 | $0 | 0% |
| $1,573 | $1.1 | $1.0 | $70 | 7% | |
| $266 | $0.8 | $0.8 | $47 | 6% | |
| Amazon | $3,273 | $1.6 | $1.6 | -$6 | 0% |
| Total | $7.2 | $7.1 | $178 | 3% | |
S&P 500 9/30/2020 | $27.9 | $27.9 | |||
| MAGFA/S&P 500 | 26.0% | 25.3% | 3% | ||
| Bitcoin | $11,303 | $209.8 | $204.6 | $5 | 3% |
| Boeing | $167 | $94 | $94 | $0 | 0% |
| Royal Caribbean | $59 | $13 | $15 | -$2 | -14% |
| Tesla | $440 | $409 | $404 | $5 | 1% |
| Uber | $34 | $59 | $65 | -$6 | -10% |
| Zoom | $559 | $159 | $140 | $19 | 14% |
Note: These five stocks and Bitcoin are in billions not trillions | |||||
