JohnPatrick.com

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


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

John R. Patrick
News from johnpatrick.com

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

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

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

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

News from johnpatrick.com

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

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

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

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

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

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

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

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

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

Preclinical studies

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

Phase 0

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

Phase I

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

Phase II

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

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

Phase III

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

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

Phase IV

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

Overall cost

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

Final Comments

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

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

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

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

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

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

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

News from johnpatrick.com

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

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

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

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

News from johnpatrick.com

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Download on the App StoreDownload on the Play Store

 

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

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

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

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

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

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

News from johnpatrick.com

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

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

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

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

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

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

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

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

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

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

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

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


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


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


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

Date

Event

Time

Location

June 11, 2020

Meet the Author

7:00 PM

Ridgefield Library
472 Main Street, Ridgefield, CT 06877

May 15, 2020 (to be rescheduled)

Meet the Author

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

Arpil 15, 2020

Origins of the Internet   with Doug Maine and John Patrick

7:30 PM with Zoom

Virtual Playhouse
by Bedford Playhouse 
Bedford, NY

March 19, 2020 (to be rescheduled)

Community Forum

11:30 AM

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

February 14, 2020

Health Attitude with John Patrick

8:30 AM

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

February 6, 2020

Tech Talk 9 with John Patrick

1:00 PM

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

November 14, 2019

Meet the Author

1:00 PM

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

October 9, 2019

Housatonic Habitat for Humanity Robotics Night

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

Meet the Author

5:30 PM

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

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

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

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

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

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

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

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

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

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

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

Virtual Playhouse

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

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

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

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

Coronavirus Dashboard
Global
States 
Connecticut
Florida 
New York
Pennsylvania


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


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

Date

Event

Time

Location

June 11, 2020

Meet the Author

7:00 PM

Ridgefield Library
472 Main Street, Ridgefield, CT 06877

May 15, 2020 (to be rescheduled)

Meet the Author

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

Arpil 15, 2020

Origins of the Internet   with Doug Maine and John Patrick

7:30 PM with Zoom

Virtual Playhouse
by Bedford Playhouse 
Bedford, NY

March 19, 2020 (to be rescheduled)

Community Forum

11:30 AM

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

February 14, 2020

Health Attitude with John Patrick

8:30 AM

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

February 6, 2020

Tech Talk 9 with John Patrick

1:00 PM

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

November 14, 2019

Meet the Author

1:00 PM

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

October 9, 2019

Housatonic Habitat for Humanity Robotics Night

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

Meet the Author

5:30 PM

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

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

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

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

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

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

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

 
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