ZERO GRACE/ZERO MALICE

Amazon's purchase of One Medical could speed up American healthcare

The U.S. healthcare industry is a 7-ton seal bleeding at sea. Predators are circling. Unearned margin: price increases relative to inflation without quality improvements. Amazon is the 11-foot megalodon with 7-inch teeth. Amazon is no longer circling... but attacking.

In 2020 dollars, per capita U.S. healthcare spending increased from $2,968 in 1980 to $12,531. The result is a massive industry with 13% of the nation's workers and a fifth of GDP.

Doctor No

In 40 years, healthcare has made progress. From 73.7 in 1980 to 78.8 in 2019, life expectancy rose (before Covid knocked it back down a bit). Pharmacological therapies have revolutionized, and genetic research is paying off. The financial return, improvement split by cost increases, is terrible. No country has expense rises like the U.S., and no one spends as much per capita as we do. Developed countries have longer life expectancies, healthier populations, and less economic hardship.

Two-thirds of U.S. personal bankruptcies are due to medical expenses and/or missed work. Mom or Dad getting cancer could bankrupt many middle-class American families. 40% of American adults delayed or skipped needed care due to cost. Every healthcare improvement seems to have a downside. Same pharmacological revolution that helped millions caused opioid epidemic. Our results are poor in many areas: The U.S. has a high infant mortality rate.

Healthcare is the second-worst retail industry in the country. Gas stations are #1. Imagine walking into a Best Buy to buy a TV and a Blue Shirt associate requests you fill out the same 14 pages of paperwork you filled out yesterday. Then you wait in a crowded room until they call you, 20 minutes after the scheduled appointment you were asked to arrive early for, to see the one person in the store who can talk to you about TVs, who has 10 minutes for you. The average emergency room wait time in New York is 6 hours and 10 minutes.

If it's bad for the customer, it's worse for the business. Physicians spend 27% of their time helping patients; 49% on EHRs. Documentation, order entry, billing, and inbox management. Spend a decade getting an M.D., then become a bureaucrat.

No industry better illustrates scale diseconomies. If we got the same return on healthcare spending as other countries, we'd all live to 100. We could spend less, live longer and healthier, and pay off the national debt in 15 years. U.S. healthcare is the worst ever.

What now? Competition is at the heart of capitalism, the worst system of its kind.

Priority Time

Amazon is buying One Medical for $3.9 billion. I think this deal will liberate society. Two years in, I think One Medical is great. When I got Covid, I pressed the One Medical symbol on my phone; a nurse practitioner prescribed Paxlovid and told me which pharmacies had it in stock.

Amazon enables the company's vision. One Medical's stock is down to $10 from $40 at the start of 2021. Last year, it lost $250 million and needs cash (Amazon has $60 billion). ONEM must grow. The service has 736,000 members. Half of U.S. households have Amazon Prime. Finally, delivery. One Medical is a digital health/physical office hybrid, but you must pick up medication at the pharmacy. Upgrade your Paxlovid delivery time after a remote consultation. Amazon's core competency means it'll happen. Healthcare speed and convenience will feel alien.

It's been a long, winding road to disruption. Amazon, JPMorgan, and Berkshire Hathaway formed Haven four years ago to provide better healthcare for their 1.5 million employees. It rocked healthcare stocks the morning of the press release, but folded in 2021.

Amazon Care is an employee-focused service. Home-delivered virtual health services and nurses. It's doing well, expanding nationwide, and providing healthcare for other companies. Hilton is Amazon Care's biggest customer. The acquisition of One Medical will bring 66 million Prime households capital, domain expertise, and billing infrastructure. Imagine:

"Alexa, I'm hot and my back hurts."

"Connecting you to a Prime doctor now."

Want to vs. Have to

I predicted Amazon entering healthcare years ago. Why? For the same reason Apple is getting into auto. Amazon's P/E is 56, double Walmart's. The corporation must add $250 billion in revenue over the next five years to retain its share price. White-label clothes or smart home products won't generate as much revenue. It must enter a huge market without scale, operational competence, and data skills.

Current Situation

Healthcare reform benefits both consumers and investors. In 2015, healthcare services had S&P 500-average multiples. The market is losing faith in public healthcare businesses' growth. Healthcare services have lower EV/EBITDA multiples than the S&P 500.

Amazon isn't the only prey-hunter. Walmart and Alibaba are starting pharmacies. Uber is developing medical transportation. Private markets invested $29 billion in telehealth last year, up 95% from 2020.

The pandemic accelerated telehealth, the immediate unlock. After the first positive Covid case in the U.S., services that had to be delivered in person shifted to Zoom... We lived. We grew. Video house calls continued after in-person visits were allowed. McKinsey estimates telehealth visits are 38 times pre-pandemic levels. Doctors adopted the technology, regulators loosened restrictions, and patients saved time. We're far from remote surgery, but many patient visits are unnecessary. A study of 40 million patients during lockdown found that for chronic disease patients, online visits didn't affect outcomes. This method of care will only improve.

Amazon's disruption will be significant and will inspire a flood of capital, startups, and consumer brands. Mark Cuban launched a pharmacy that eliminates middlemen in January. Outcome? A 90-day supply of acid-reflux medication costs $17. Medicare could have saved $3.6 billion by buying generic drugs from Cuban's pharmacy. Other apex predators will look at different limbs of the carcass for food. Nike could enter healthcare via orthopedics, acupuncture, and chiropractic. LVMH, L'Oréal, and Estée Lauder may launch global plastic surgery brands. Hilton and Four Seasons may open hospitals. Lennar and Pulte could build "Active Living" communities that Nana would leave feet first, avoiding the expense and tragedy of dying among strangers.

Risks

Privacy matters: HIV status is different from credit card and billing address. Most customers (60%) feel fine sharing personal health data via virtual technologies, though. Unavoidable. 85% of doctors believe data-sharing and interoperability will become the norm. Amazon is the most trusted tech company for handling personal data. Not Meta: Amazon.

What about antitrust, then?

Amazon should be required to spin off AWS and/or Amazon Fulfillment and banned from promoting its own products. It should be allowed to acquire hospitals. One Medical's $3.9 billion acquisition is a drop in the bucket compared to UnitedHealth's $498 billion market valuation.

Antitrust enforcement shouldn't assume some people/firms are good/bad. It should recognize that competition is good and focus on making markets more competitive in each deal. The FTC should force asset divestitures in e-commerce, digital marketing, and social media. These companies can also promote competition in a social ill.

U.S. healthcare makes us fat, depressed, and broke. Competition has produced massive value and prosperity across most of our economy.

Dear Amazon … bring it.

Kim Kardashian created Skky Partners. Consumer products, internet & e-commerce, consumer media, hospitality, and luxury are company targets.

Some call this another Kardashian publicity gimmick.

This maneuver is brilliance upon closer inspection. Why?

1) Kim has amassed a sizable social media fan base:

Over 320 million Instagram and 70 million Twitter users follow Kim Kardashian.

Kim Kardashian's Instagram account ranks 8th. Three Kardashians in top 10 is ridiculous.

This gives her access to consumer data. She knows what people are discussing. Investment firms need this data.

Quality, not quantity, of her followers matters. Studies suggest that her following are more engaged than Selena Gomez and Beyonce's.

Kim's followers are worth roughly $500 million to her brand, according to a research. They trust her and buy what she recommends.

2) She has a special aptitude for identifying trends.

Kim Kardashian can sense trends.

She's always ahead of fashion and beauty trends. She's always trying new things, too. She doesn't mind making mistakes when trying anything new. Her desire to experiment makes her a good business prospector.

Kim has also created a lifestyle brand that followers love. Kim is an entrepreneur, mom, and role model, not just a reality TV star or model. She's established a brand around her appearance, so people want to buy her things.

Her fragrance collection has sold over $100 million since its 2009 introduction, and her Sears apparel line did over $200 million in its first year.

SKIMS is her latest $3.2bn brand. She can establish multibillion-dollar firms with her enormous distribution platform.

Early founders would kill for Kim Kardashian's network.

Making great products is hard, but distribution is more difficult. — David Sacks, All-in-Podcast

3) She can delegate the financial choices to Jay Sammons, one of the greatest in the industry.

Jay Sammons is well-suited to develop Kim Kardashian's new private equity fund.

Sammons has 16 years of consumer investing experience at Carlyle. This will help Kardashian invest in consumer-facing enterprises.

Sammons has invested in Supreme and Beats Electronics, both of which have grown significantly. Sammons' track record and competence make him the obvious choice.

Kim Kardashian and Jay Sammons have joined forces to create a new business endeavor. The agreement will increase Kardashian's commercial empire. Sammons can leverage one of the world's most famous celebrities.

“Together we hope to leverage our complementary expertise to build the next generation consumer and media private equity firm” — Kim Kardashian

Kim Kardashian is a successful businesswoman. She developed an empire by leveraging social media to connect with fans. By developing a global lifestyle brand, she has sold things and experiences that have made her one of the world's richest celebrities.

She's a shrewd entrepreneur who knows how to maximize on herself and her image.

Imagine how much interest Kim K will bring to private equity and venture capital.

I'm curious about the company's growth.

or, how I spread monkeypox and got it myself.

This story contains nsfw (not safe for wife) stuff and shouldn't be read if you're under 18 or think I'm a newborn angel. After the opening, it's broken into three sections: a chronological explanation of my disease course, my ideas, and what I plan to do next.

Your journey awaits.

As early as mid-may, I was waltzing around the lab talking about monkeypox, a rare tropical disease with an inaccurate name. Monkeys are not its primary animal reservoir. It caused an outbreak among men who have sex with men across Europe, with unprecedented levels of person-to-person transmission. European health authorities speculated that the virus spread at raves and parties and was easily transferred through intimate, mainly sexual, contact. I had already read the nejm article about the first confirmed monkeypox patient in the u.s. and shared the photos on social media so people knew what to look for. The cdc information page only included 4 photographs of monkeypox lesions that looked like they were captured on a motorola razr.

I warned my ex-boyfriend about monkeypox. Monkeypox? responded.

Mom, I'm afraid about monkeypox. What's monkeypox?

My therapist is scared about monkeypox. What's monkeypox?

Was I alone? A few science gays on Twitter didn't make me feel overreacting.

This information got my gay head turning. The incubation period for the sickness is weeks. Many of my social media contacts are traveling to Europe this summer. What is pride? Travel, parties, and sex. Many people may become infected before attending these activities. Monkeypox will affect the lgbtq+ community.

Being right always stinks. My young scientist brain was right, though. Someone who saw this coming is one of the early victims. I'll talk about my feelings publicly, and trust me, I have many concerning what's occurring.

Part 1 is the specifics.

Wednesday nights are never smart but always entertaining. I didn't wake up until noon on june 23 and saw gay twitter blazing. Without warning, the nyc department of health announced a pop-up monkeypox immunization station in chelsea. Some days would be 11am-7pm. Walk-ins were welcome, however appointments were preferred. I tried to arrange an appointment after rubbing my eyes, but they were all taken. I got out of bed, washed my face, brushed my teeth, and put on short shorts because I wanted to get a walk-in dose and show off my legs. I got a 20-oz. cold brew on the way to the train and texted a chelsea-based acquaintance for help.

Clinic closed at 2pm. No more doses. Hundreds queued up. The government initially gave them only 1,000 dosages. For a city with 500,000 LGBT people, c'mon. What more could I do? I was upset by how things were handled. The evidence speaks for itself.

I decided to seek an appointment when additional doses were available and continued my weekend. I was celebrating nyc pride with pals. Fun! sex! * ‍

On tuesday after that, I felt a little burn. This wasn't surprising because I'd been sexually active throughout the weekend, so I got a sti panel the next day. I expected to get results in a few days, take antibiotics, and move on.

Emerging germs had other intentions. Wednesday night, I felt sore, and thursday morning, I had a blazing temperature and had sweat through my bedding. I had fever, chills, and body-wide aches and pains for three days. I reached 102 degrees. I believed I had covid over pride weekend, but I tested negative for three days straight.

STDs don't induce fevers or other systemic symptoms. If lymphogranuloma venereum advances, it can cause flu-like symptoms and swollen lymph nodes. I was suspicious and desperate for answers, so I researched monkeypox on the cdc website (for healthcare professionals). Much of what I saw on screen about monkeypox prodrome matched my symptoms. Multiple-day fever, headache, muscle aches, chills, tiredness, enlarged lymph nodes. Pox were lacking.

I told my doctor my concerns pre-medically. I'm occasionally annoying.

On saturday night, my fever broke and I felt better. Still burning, I was optimistic till sunday, when I woke up with five red splotches on my arms and fingertips.

As spots formed, burning became pain. I observed as spots developed on my body throughout the day. I had more than a dozen by the end of the day, and the early spots were pustular. I had monkeypox, as feared.

Fourth of July weekend limited my options. I'm well-connected in my school's infectious disease academic community, so I texted a coworker for advice. He agreed it was likely monkeypox and scheduled me for testing on tuesday.

nyc health could only perform 10 monkeypox tests every day. Before doctors could take swabs and send them in, each test had to be approved by the department. Some commercial labs can now perform monkeypox testing, but the backlog is huge. I still don't have a positive orthopoxvirus test five days after my test. *My 12-day-old case may not be included in the official monkeypox tally. This outbreak is far wider than we first thought, therefore I'm attempting to spread the information and help contain it.

*Update, 7/11: I have orthopoxvirus.

I spent all day in the bathtub because of the agony. Warm lavender epsom salts helped me feel better. I can't stand lavender anymore. I brought my laptop into the bathroom and viewed everything everywhere at once (2022). If my ex and I hadn't recently broken up, I wouldn't have monkeypox. All of these things made me cry, and I sat in the bathtub on the 4th of July sobbing. I thought, Is this it? I felt like Bridesmaids' Kristen Wiig (2011). I'm a flop. From here, things can only improve.

Later that night, I wore a mask and went to my roof to see the fireworks. Even though I don't like fireworks, there was something wonderful about them this year: the colors, how they illuminated the black surfaces around me, and their transient beauty. Joyful moments rarely linger long in our life. We must enjoy them now.

Several roofs away, my neighbors gathered. Happy 4th! I heard a woman yell. Why is this godforsaken country so happy? Instead of being rude, I replied. I didn't tell them I had monkeypox. I thought that would kill the mood.

By the time I went to the hospital the next day to get my lesions swabbed, wearing long sleeves, pants, and a mask, they looked like this:

I had 30 lesions on my arms, hands, stomach, back, legs, buttcheeks, face, scalp, and right eyebrow. I had some in my mouth, gums, and throat. Current medical thought is that lesions on mucous membranes cause discomfort in sensitive places. Internal lesions are a new feature of this outbreak of monkeypox. Despite being unattractive, the other sores weren't unpleasant or bothersome.

I had a bacterial sti with the pox. Who knows if that would've created symptoms (often it doesn't), but different infections can happen at once. My care team remembered that having a sti doesn't exclude out monkeypox. doxycycline rocks!

The coworker who introduced me to testing also offered me his home. We share a restroom, and monkeypox can be spread through surfaces. (Being a dna virus gives it environmental hardiness that rna viruses like sars-cov-2 lack.) I disinfected our bathroom after every usage, but I was apprehensive. My friend's place has a guest room and second bathroom, so no cross-contamination. It was the ideal monkeypox isolation environment, so I accepted his offer and am writing this piece there. I don't know what I would have done without his hospitality and attention.

The next day, I started tecovirimat, or tpoxx, for 14 days. Smallpox has been eradicated worldwide since the 1980s but remains a bioterrorism concern. Tecovirimat has a unique, orthopoxvirus-specific method of action, which reduces side effects to headache and nausea. It hasn't been used in many people, therefore the cdc is encouraging patients who take it for monkeypox to track their disease and symptoms.

Tpoxx's oral absorption requires a fatty meal. The hospital ordered me to take the medication after a 600-calorie, 25-gram-fat meal every 12 hours. The coordinator joked, "Don't diet for the next two weeks." I wanted to get peanut butter delivered, but jif is recalling their supply due to salmonella. Please give pathogens a break. I got almond butter.

Tpoxx study enrollment was documented. After signing consent documents, my lesions were photographed and measured during a complete physical exam. I got bloodwork to assess my health. My medication delivery was precise; every step must be accounted for. I got a two-week supply and started taking it that night. I rewarded myself with McDonald's. I'd been hungry for a week. I was also prescribed ketorolac (aka toradol), a stronger ibuprofen, for my discomfort.

I thought tpoxx was a wonder medicine by day two of treatment. Early lesions looked like this.

however, They vanished. The three largest lesions on my back flattened and practically disappeared into my skin. Some pustular lesions were diminishing. Tpoxx+toradol has helped me sleep, focus, and feel human again. I'm down to twice-daily baths and feeling hungrier than ever in this illness. On day five of tpoxx, some of the lesions look like this:

I have a ways to go. We must believe I'll be contagious until the last of my patches scabs over, falls off, and sprouts new skin. There's no way to tell. After a week and a half of tremendous pain and psychological stress, any news is good news. I'm grateful for my slow but steady development.

Part 2 of the rant.

Being close to yet not in the medical world is interesting. It lets me know a lot about it without being persuaded by my involvement. Doctors identify and treat patients using a tool called differential diagnosis.

A doctor interviews a patient to learn about them and their symptoms. More is better. Doctors may ask, "Have you traveled recently?" sex life? Have pets? preferred streaming service? (No, really. (Hbomax is right.) After the inquisition, the doctor will complete a body exam ranging from looking in your eyes, ears, and throat to a thorough physical.

After collecting data, the doctor makes a mental (or physical) inventory of all the conceivable illnesses that could cause or explain the patient's symptoms. Differential diagnosis list. After establishing the differential, the clinician can eliminate options. The doctor will usually conduct nucleic acid tests on swab samples or bloodwork to learn more. This helps eliminate conditions from the differential or boosts a condition's likelihood. In an ideal circumstance, the doctor can eliminate all but one reason of your symptoms, leaving your formal diagnosis. Once diagnosed, treatment can begin. yay! Love medicine.

My symptoms two weeks ago did not suggest monkeypox. Fever, pains, weariness, and swollen lymph nodes are caused by several things. My scandalous symptoms weren't linked to common ones. My instance shows the importance of diversity and representation in healthcare. My doctor isn't gay, but he provides culturally sensitive care. I'd heard about monkeypox as a gay man in New York. I was hyper-aware of it and had heard of friends of friends who had contracted it the week before, even though the official case count in the US was 40. My physicians weren't concerned, but I was. How would it appear on his mental differential if it wasn't on his radar? Mental differential rhymes! I'll trademark it to prevent theft. differential!

I was in a rare position to recognize my condition and advocate for myself. I study infections. I'd spent months researching monkeypox. I work at a university where I rub shoulders with some of the country's greatest doctors. I'm a gay dude who follows nyc queer social networks online. All of these variables positioned me to think, "Maybe this is monkeypox," and to explain why.

This outbreak is another example of privilege at work. The brokenness of our healthcare system is once again exposed by the inequities produced by the vaccination rollout and the existence of people like myself who can pull strings owing to their line of work. I can't cure this situation on my own, but I can be a strong voice demanding the government do a better job addressing the outbreak and giving resources and advice to everyone I can.

lgbtqia+ community members' support has always impressed me in new york. The queer community has watched out for me and supported me in ways I never dreamed were possible.

Queer individuals are there for each other when societal structures fail. People went to the internet on the first day of the vaccine rollout to share appointment information and the vaccine clinic's message. Twitter timelines were more effective than marketing campaigns. Contrary to widespread anti-vaccine sentiment, the LGBT community was eager to protect themselves. Smallpox vaccination? sure. gimme. whether I'm safe. I credit the community's sex positivity. Many people are used to talking about STDs, so there's a reduced barrier to saying, "I think I have something, you should be on the watch too," and taking steps to protect our health.

Once I got monkeypox, I posted on Twitter and Instagram. Besides fueling my main character syndrome, I felt like I wasn't alone. My dc-based friend had monkeypox within hours. He told me about his experience and gave me ideas for managing the discomfort. I can't imagine life without him.

My buddy and colleague organized my medical care and let me remain in his home. His and his husband's friendliness and attention made a world of difference in my recovery. All of my friends and family who helped me, whether by venmo, doordash, or moral support, made me feel cared about. I don't deserve the amazing people in my life.

Finally, I think of everyone who commented on my social media posts regarding my trip. Friends from all sectors of my life and all sexualities have written me well wishes and complimented me for my vulnerability, but I feel the most gravitas from fellow lgbtq+ persons. They're learning to spot. They're learning where to go ill. They're learning self-advocacy. I'm another link in our network of caretaking. I've been cared for, therefore I want to do the same. Community and knowledge are powerful.

You're probably wondering where the diatribe is. You may believe he's gushing about his loved ones, and you'd be right. I say that just because the queer community can take care of itself doesn't mean we should.

Even when caused by the same pathogen, comparing health crises is risky. Aids is unlike covid-19 or monkeypox, yet all were caused by poorly understood viruses. The lgbtq+ community has a history of self-medicating. Queer people (and their supporters) have led the charge to protect themselves throughout history when the government refused. Surreal to experience this in real time.

First, vaccination access is a government failure. The strategic national stockpile contains tens of thousands of doses of jynneos, the newest fda-approved smallpox vaccine, and millions of doses of acam2000, an older vaccine for immunocompetent populations. Despite being a monkeypox hotspot and international crossroads, new york has only received 7,000 doses of the jynneos vaccine. Vaccine appointments are booked within minutes. It's showing Hunger Games, which bothers me.

Second, I think the government failed to recognize the severity of the european monkeypox outbreak. We saw abroad reports in may, but the first vaccines weren't available until june. Why was I a 26-year-old pharmacology grad student, able to see a monkeypox problem in europe but not the u.s. public health agency? Or was there too much bureaucracy and politicking, delaying action?

Lack of testing infrastructure for a known virus with vaccinations and therapies is appalling. More testing would have helped understand the problem's breadth. Many homosexual guys, including myself, didn't behave like monkeypox was a significant threat because there were only a dozen instances across the country. Our underestimating of the issue, spurred by a story of few infections, was huge.

Public health officials' response to infectious diseases frustrates me. A wait-and-see approach to infectious diseases is unsatisfactory. Before a sick person is recognized, they've exposed and maybe contaminated numerous others. Vaccinating susceptible populations before a disease becomes entrenched prevents disease. CDC might operate this way. When it was easier, they didn't control or prevent monkeypox. We'll learn when. Sometimes I fear never. Emerging viral infections are a menace in the era of climate change and globalization, and I fear our government will repeat the same mistakes. I don't work at the cdc, thus I have no idea what they do. As a scientist, a homosexual guy, and a citizen of this country, I feel confident declaring that the cdc has not done enough about monkeypox. Will they do enough about monkeypox? The strategic national stockpile can respond to a bioterrorism disaster in 12 hours. I'm skeptical following this outbreak.

It's simple to criticize the cdc, but they're not to blame. Underfunding public health services, especially the cdc, is another way our government fails to safeguard its citizens. I may gripe about the vaccination rollout all I want, but local health departments are doing their best with limited resources. They may not have enough workers to keep up with demand and run a contact-tracing program. Since my orthopoxvirus test is still negative, the doh hasn't asked about my close contacts. By then, my illness will be two weeks old, too long to do anything productive. Not their fault. They're functioning in a broken system that's underfunded for the work it does.

*Update, 7/11: I have orthopoxvirus.

Monkeypox is slow, so i've had time to contemplate. Now that I'm better, I'm angry. furious and sad I want to help. I wish to spare others my pain. This was preventable and solvable, I hope. HOW?

Third, the duty.

Family, especially selected family, helps each other. So many people have helped me throughout this difficult time. How can I give back? I have ideas.

1. Education. I've already started doing this by writing incredibly detailed posts on Instagram about my physical sickness and my thoughts on the entire scandal. via tweets. by producing this essay. I'll keep doing it even if people start to resent me! It's crucial! On my Instagram profile (@kyleplanckton), you may discover a story highlight with links to all of my bizarre yet educational posts.

2. Resources. I've forwarded the contact information for my institution's infectious diseases clinic to several folks who will hopefully be able to get tpoxx under the expanded use policy. Through my social networks, I've learned of similar institutions. I've also shared crowdsourced resources about symptom relief and vaccine appointment availability on social media. DM me or see my Instagram highlight for more.

3. Community action. During my illness, my friends' willingness to aid me has meant the most. It was nice to know I had folks on my side. One of my pals (thanks, kenny) snagged me a mcgriddle this morning when seamless canceled my order. This scenario has me thinking about methods to help people with monkeypox isolation. A two-week isolation period is financially damaging for many hourly workers. Certain governments required paid sick leave for covid-19 to allow employees to recover and prevent spread. No comparable program exists for monkeypox, and none seems to be planned shortly.

I want to aid monkeypox patients in severe financial conditions. I'm willing to pick up and bring groceries or fund meals/expenses for sick neighbors. I've seen several GoFundMe accounts, but I wish there was a centralized mechanism to link those in need with those who can help. Please contact me if you have expertise with mutual aid organizations. I hope we can start this shortly.

4. lobbying. Personal narratives are powerful. My narrative is only one, but I think it's compelling. Over the next day or so, i'll write to local, state, and federal officials about monkeypox. I wanted a vaccine but couldn't acquire one, and I feel tpoxx helped my disease. As a pharmacologist-in-training, I believe collecting data on a novel medicine is important, and there are ethical problems when making a drug with limited patient data broadly available. Many folks I know can't receive tpoxx due of red tape and a lack of contacts. People shouldn't have to go to an ivy league hospital to obtain the greatest care. Based on my experience and other people's tales, I believe tpoxx can drastically lessen monkeypox patients' pain and potentially curb transmission chains if administered early enough. This outbreak is manageable. It's not too late if we use all the instruments we have (diagnostic, vaccine, treatment).

*UPDATE 7/15: I submitted the following letter to Chuck Schumer and Kirsten Gillibrand. I've addressed identical letters to local, state, and federal officials, including the CDC and HHS.

I hope to join RESPND-MI, an LGBTQ+ community-led assessment of monkeypox symptoms and networks in NYC. Visit their website to learn more and give to this community-based charity.

How I got monkeypox is a mystery. I received it through a pride physical interaction, but i'm not sure which one. This outbreak will expand unless leaders act quickly. Until then, I'll keep educating and connecting people to care in my neighborhood.

Despite my misgivings, I see some optimism. Health department social media efforts are underway. During the outbreak, the CDC provided nonjudgmental suggestions for safer social and sexual activity. There's additional information regarding the disease course online, including how to request tpoxx for sufferers. These materials can help people advocate for themselves if they're sick. Importantly, homosexual guys are listening when they discuss about monkeypox online and irl. Learners They're serious.

The government has a terrible track record with lgtbq+ health issues, and they're not off to a good start this time. I hope this time will be better. If I can aid even one individual, I'll do so.

Thanks for reading, supporting me, and spreading awareness about the 2022 monkeypox outbreak. My dms are accessible if you want info, resources, queries, or to chat.

y'all well

kyle

Recently, I saw an interesting social media post. In an entrepreneurship forum. A blogger asked for help because he/she couldn't find customers. I now suspect that the writer’s occupation is being disrupted by A.I.

Introduction

Artificial Intelligence (A.I.) has been a hot topic since the 1950s. With recent advances in machine learning, A.I. will touch almost every aspect of our lives. This article will discuss A.I. technology and its social and economic implications.

What's AI?

A computer program or machine with A.I. can think and learn. In general, it's a way to make a computer smart. Able to understand and execute complex tasks. Machine learning, NLP, and robotics are common types of A.I.

AI's global impact

AI will change the world, but probably faster than you think. A.I. already affects our daily lives. It improves our decision-making, efficiency, and productivity.

A.I. is transforming our lives and the global economy. It will create new business and job opportunities but eliminate others. Affected workers may face financial hardship.

AI examples:

OpenAI's GPT-3 text-generation

Developers can train, deploy, and manage models on GPT-3. It handles data preparation, model training, deployment, and inference for machine learning workloads. GPT-3 is easy to use for both experienced and new data scientists.

My team conducted an experiment. We needed to generate some blog posts for a website. We hired a blogger on Upwork. OpenAI created a blog post. The A.I.-generated blog post was of higher quality and lower cost.

MidjourneyAI's Art Contests

AI already affects artists. Artists use A.I. to create realistic 3D images and videos for digital art. A.I. is also used to generate new art ideas and methods.

MidjourneyAI and GigapixelAI won a contest last month. It's AI. created a beautiful piece of art that captured the contest's spirit. AI triumphs. It could open future doors.

After the art contest win, I registered to try out these new image generating A.I.s. In the MidjourneyAI chat forum, I noticed an artist's plea. The artist begged others to stop flooding RedBubble with AI-generated art.

Shutterstock and Getty Images have halted user uploads. AI-generated images flooded online marketplaces.

Imagining Videos with Meta

Meta released Make-a-Video this week. It's an A.I. app that creates videos from text. What you type creates a video.

This technology will impact TV, movies, and video games greatly. Imagine a movie or game that's personalized to your tastes. It's closer than you think.

Uses and Abuses of Deepfakes

Deepfake videos are computer-generated images of people. AI creates realistic images and videos of people.

Deepfakes are entertaining but have social implications. Porn introduced deepfakes in 2017. People put famous faces on porn actors and actresses without permission.

Soon, deepfakes were used to show dead actors/actresses or make them look younger. Carrie Fischer was included in films after her death using deepfake technology.

Deepfakes can be used to create fake news or manipulate public opinion, according to an AI.

Voices for Darth Vader and Iceman

James Earl Jones, who voiced Darth Vader, sold his voice rights this week. Aged actor won't be in those movies. Respeecher will use AI to mimic Jones's voice. This technology could change the entertainment industry. One actor can now voice many characters.

AI can generate realistic voice audio from text. Top Gun 2 actor Val Kilmer can't speak for medical reasons. Sonantic created Kilmer's voice from the movie script. This entertaining technology has social implications. It blurs authentic recordings and fake media.

Medical A.I. fights viruses

A team of Chinese scientists used machine learning to predict effective antiviral drugs last year. They started with a large dataset of virus-drug interactions. Researchers combined that with medication and virus information. Finally, they used machine learning to predict effective anti-virus medicines. This technology could solve medical problems.

AI ideas AI-generated Itself

OpenAI's GPT-3 predicted future A.I. uses. Here's what it told me:

AI will affect the economy. Businesses can operate more efficiently and reinvest resources with A.I.-enabled automation. AI can automate customer service tasks, reducing costs and improving satisfaction.

A.I. makes better pricing, inventory, and marketing decisions. AI automates tasks and makes decisions. A.I.-powered robots could help the elderly or disabled. Self-driving cars could reduce accidents.

A.I. predictive analytics can predict stock market or consumer behavior trends and patterns. A.I. also personalizes recommendations. sways. A.I. recommends products and movies. AI can generate new ideas based on data analysis.

Conclusion

A.I. will change business as it becomes more common. It will change how we live and work by creating growth and prosperity.

Exciting times,  but also one which should give us all pause. Technology can be good or evil. We must use new technologies ethically, fairly, and honestly.

“The author generated some sentences in this text in part with GPT-3, OpenAI’s large-scale language-generation model. Upon generating draft language, the author reviewed, edited, and revised the language to their own liking and takes ultimate responsibility for the content of this publication. The text of this post was further edited using HemingWayApp. Many of the images used were generated using A.I. as described in the captions.”

Managers spend much time in 1:1s. Most team members meet with supervisors regularly. 1:1s can help create relationships and tackle tough topics. Few appreciate the 1:1 format's potential. Most of the time, that potential is spent on small talk, surface-level updates, and ranting (Ugh, the marketing team isn’t stepping up the way I want them to).

What if you used that time to have deeper conversations and important insights? What if change was easy?

This post introduces a new 1:1 format to help you dive deeper, faster, and develop genuine relationships without losing impact.

A 1:1 is a chat, you would assume. Why use structure to talk to a coworker? Go! I know how to talk to people. I can write. I've always written. Also, This article was edited by Zoe.

Before you discard something, ask yourself if there's a good reason not to try anything new. Is the 1:1 only a talk, or do you want extra benefits? Try the steps below to discover more.

I. Reflection (5 minutes)

Context-free, broad comments waste time and are useless. Instead, give team members 5 minutes to write these 3 prompts.

1. What's effective?

2. What is decent but could be improved?

3. What is broken or missing?

Why these? They encourage people to be honest about all their experiences. Answering these questions helps people realize something isn't working. These prompts let people consider what's working.

Why take notes? Because you get more in less time. Will you feel awkward sitting quietly while your coworker writes? Probably. Persevere. Multi-task. Take a break from your afternoon meeting marathon. Any awkwardness will pay off.

What happens? After a few minutes of light conversation, create a template like the one given here and have team members fill in their replies. You can pre-share the template (with the caveat that this isn’t meant to take much prep time). Do this with your coworker: Answer the prompts. Everyone can benefit from pondering and obtaining guidance.

This step's output.

Part II: Talk (10-20 minutes)

Most individuals can explain what they see but not what's behind an answer. You don't like a meeting. Why not? Marketing partnership is difficult. What makes working with them difficult? I don't recommend slandering coworkers. Consider how your meetings, decisions, and priorities make work harder. The excellent stuff too. You want to know what's humming so you can reproduce the magic.

First, recognize some facts.

• Real power dynamics exist. To encourage individuals to be honest, you must provide a safe environment and extend clear invites. Even then, it may take a few 1:1s for someone to feel secure enough to go there in person. It is part of your responsibility to admit that it is normal.

• Curiosity and self-disclosure are crucial. Most leaders have received training to present themselves as the authorities. However, you will both benefit more from the dialogue if you can be open and honest about your personal experience, ask questions out of real curiosity, and acknowledge the pertinent sacrifices you're making as a leader.

• Honesty without bias is difficult and important. Due to concern for the feelings of others, people frequently hold back. Or if they do point anything out, they do so in a critical manner. The key is to be open and unapologetic about what you observe while not presuming that your viewpoint is correct and that of the other person is incorrect.

Let's go into some prompts (based on genuine conversations):

• “What do you notice across your answers?”

• “What about the way you/we/they do X, Y, or Z is working well?”

• “ Will you say more about item X in ‘What’s not working?’”

• “I’m surprised there isn’t anything about Z. Why is that?”

• “All of us tend to play some role in maintaining certain patterns. How might you/we be playing a role in this pattern persisting?”

• “How might the way we meet, make decisions, or collaborate play a role in what’s currently happening?”

Consider the preceding example. What about the Monday meeting isn't working? Why? or What about the way we work with marketing makes collaboration harder? Remember to share your honest observations!

Third section: observe patterns (10-15 minutes)

Leaders desire to empower their people but don't know how. We also have many preconceptions about what empowerment means to us and how it works. The next phase in this 1:1 format will assist you and your team member comprehend team power and empowerment. This understanding can help you support and shift your team member's behavior, especially where you disagree.

How to? After discussing the stated responses, ask each team member what they can control, influence, and not control. Mark their replies. You can do the same, adding colors where you disagree.

This step's output.

Next, consider the color constellation. Discuss these questions:

• Is one color much more prevalent than the other? Why, if so?

• Are the colors for the "what's working," "what's fine," and "what's not working" categories clearly distinct? Why, if so?

• Do you have any disagreements? If yes, specifically where does your viewpoint differ? What activities do you object to? (Remember, there is no right or wrong in this. Give explicit details and ask questions with curiosity.)

Example: Based on the colors, you can ask, Is the marketing meeting's quality beyond your control? Were our marketing partners consulted? Are there any parts of team decisions we can control? We can't control people, but have we explored another decision-making method? How can we collaborate and generate governance-related information to reduce work, even if the requirement for prep can't be eliminated?

Consider the top one or two topics for this conversation. No 1:1 can cover everything, and that's OK. Focus on the present.

Part IV: Determine the next step (5 minutes)

Last, examine what this conversation means for you and your team member. It's easy to think we know the next moves when we don't.

Like what? You and your teammate answer these questions.

1. What does this signify moving ahead for me? What can I do to change this? Make requests, for instance, and see how people respond before thinking they won't be responsive.

2. What demands do I have on other people or my partners? What should I do first? E.g. Make a suggestion to marketing that we hold a monthly retrospective so we can address problems and exchange input more frequently. Include it on the meeting's agenda for next Monday.

Close the 1:1 by sharing what you noticed about the chat. Observations? Learn anything?

Yourself, you, and the 1:1

As a leader, you either reinforce or disrupt habits. Try this template if you desire greater ownership, empowerment, or creativity. Consider how you affect surrounding dynamics. How can you expect others to try something new in high-stakes scenarios, like meetings with cross-functional partners or senior stakeholders, if you won't? How can you expect deep thought and relationship if you don't encourage it in 1:1s? What pattern could this new format disrupt or reinforce?

Fight reluctance. First attempts won't be ideal, and that's OK. You'll only learn by trying.

On January 1, "Public Domain Day," thousands of creative works immediately join the public domain. The original creator or copyright holder loses exclusive rights to reproduce, adapt, or publish the work, and anybody can use it. It happens with movies, poems, music, artworks, books (where creative rights endure 70 years beyond the author's death), and sometimes source code.

Public domain creative works open the door to new uses. 400,000 sound recordings from before 1923, including Winnie-the-Pooh, were released this year.  With most of A.A. Milne's 1926 Winnie-the-Pooh characters now available, we're seeing innovative interpretations Milne likely never planned. The ancient hyphenated version of the honey-loving bear is being adapted for a horror movie: "Winnie-the-Pooh: Blood and Honey"... with Pooh and Piglet as the baddies.

Counterintuitively, experimenting and recombination can occasionally increase IP value. Open source movements allow the public to build on (or fork and duplicate) existing technologies. Permissionless innovation helps Android, Linux, and other open source software projects compete. Crypto's success at attracting public development is also due to its support of open source and "remix culture," notably in NFT forums.

Production memes

NFT projects use several IP strategies to establish brands, communities, and content. Some preserve regular IP protections; others offer NFT owners the opportunity to innovate on connected IP; yet others have removed copyright and other IP safeguards.

By using the "Creative Commons Zero" (cc0) license, artists can intentionally select for "no rights reserved." This option permits anyone to benefit from derivative works without legal repercussions. There's still a lot of confusion between copyrights and NFTs, so nothing here should be considered legal, financial, tax, or investment advice. Check out this post for an overview of copyright vulnerabilities with NFTs and how authors can protect owners' rights. This article focuses on cc0.

Nouns, a 2021 project, popularized cc0 for NFTs. Others followed, including: A Common Place, Anonymice, Blitmap, Chain Runners, Cryptoadz, CryptoTeddies, Goblintown, Gradis, Loot, mfers, Mirakai, Shields, and Terrarium Club are cc0 projects.

Popular crypto artist XCOPY licensed their 1-of-1 NFT artwork "Right-click and Save As Guy" under cc0 in January, exactly one month after selling it. cc0 has spawned many derivatives.

"Right-click Save As Guy" by XCOPY (1)/derivative works (2)

XCOPY said Monday he would apply cc0 to "all his existing art." "We haven't seen a cc0 summer yet, but I think it's approaching," said the artist. - predicting a "DeFi summer" in 2020, when decentralized finance gained popularity.

Why do so many NFT authors choose "no rights"?

Promoting expansions of the original project to create a more lively and active community is one rationale. This makes sense in crypto, where many value open sharing and establishing community.

Creativity depends on cultural significance. NFTs may allow verifiable ownership of any digital asset, regardless of license, but cc0 jumpstarts "meme-ability" by actively, not passively, inviting derivative works. As new derivatives are made and shared, attention might flow back to the original, boosting its reputation. This may inspire new interpretations, leading in a flywheel effect where each derivative adds to the original's worth - similar to platform network effects, where platforms become more valuable as more users join them.

cc0 licence allows creators "seize production memes."

"SEASON 1 MEME CARD 2"

Physical items are also using cc0 NFT assets, thus it's not just a digital phenomenon. The Nouns Vision initiative turned the square-framed spectacles shown on each new NounsDAO NFT ("one per day, forever") into luxury sunglasses. Blitmap's pixel-art has been used on shoes, apparel, and caps. In traditional IP regimes, a single owner controls creation, licensing, and production.

The physical "blitcap" (3rd level) is a descendant of the trait in the cc0 Chain Runners collection (2nd), which uses the "logo" from cc0 Blitmap (1st)! The Logo is Blitmap token #84 and has been used as a trait in various collections. The "Dom Rose" is another popular token. These homages reference Blitmap's influence as a cc0 leader, as one of the earliest NFT projects to proclaim public domain intents. A new collection, Citizens of Tajigen, emerged last week with a Blitcap characteristic.

These derivatives can be a win-win for everyone, not just the original inventors, especially when using NFT assets to establish unique brands. As people learn about the derivative, they may become interested in the original. If you see someone wearing Nouns glasses on the street (or in a Super Bowl ad), you may desire a pair, but you may also be interested in buying an original NounsDAO NFT or related derivative.

Blitmap Logo Hat (1), Chain Runners #780 ft. Hat (2), and Blitmap Original "Logo #87" (3)

Co-creating open source

NFTs' power comes from smart contract technology's intrinsic composability. Many smart contracts can be integrated or stacked to generate richer applications.

"Money Legos" describes how decentralized finance ("DeFi") smart contracts interconnect to generate new financial use cases. Yearn communicates with MakerDAO's stablecoin $DAI and exchange liquidity provider Curve by calling public smart contract methods. NFTs and their underlying smart contracts can operate as the base-layer framework for recombining and interconnecting culture and creativity.

cc0 gives an NFT's enthusiast community authority to develop new value layers whenever, wherever, and however they wish.

Multiple cc0 projects are playable characters in HyperLoot, a Loot Project knockoff.

Open source and Linux's rise are parallels. When the internet was young, Microsoft dominated the OS market with Windows. Linux (and its developer Linus Torvalds) championed a community-first mentality, freely available the source code without restrictions. This led to developers worldwide producing new software for Linux, from web servers to databases. As people (and organizations) created world-class open source software, Linux's value proposition grew, leading to explosive development and industry innovation. According to Truelist, Linux powers 96.3% of the top 1 million web servers and 85% of smartphones.

With cc0 licensing empowering NFT community builders, one might hope for long-term innovation. Combining cc0 with NFTs "turns an antagonistic game into a co-operative one," says NounsDAO cofounder punk4156. It's important on several levels. First, decentralized systems from open source to crypto are about trust and coordination, therefore facilitating cooperation is crucial. Second, the dynamics of this cooperation work well in the context of NFTs because giving people ownership over their digital assets allows them to internalize the results of co-creation through the value that accrues to their assets and contributions, which incentivizes them to participate in co-creation in the first place.

Licensed to create

If cc0 projects are open source "applications" or "platforms," then NFT artwork, metadata, and smart contracts provide the "user interface" and the underlying blockchain (e.g., Ethereum) is the "operating system." For these apps to attain Linux-like potential, more infrastructure services must be established and made available so people may take advantage of cc0's remixing capabilities.

These services are developing. Zora protocol and OpenSea's open source Seaport protocol enable open, permissionless NFT marketplaces. A pixel-art-rendering engine was just published on-chain to the Ethereum blockchain and integrated into OKPC and ICE64. Each application improves blockchain's "out-of-the-box" capabilities, leading to new apps created from the improved building blocks.

Web3 developer growth is at an all-time high, yet it's still a small fraction of active software developers globally. As additional developers enter the field, prospective NFT projects may find more creative and infrastructure Legos for cc0 and beyond.

Electric Capital Developer Report (2021), p. 122

Growth requires composability. Users can easily integrate digital assets developed on public standards and compatible infrastructure into other platforms. The Loot Project is one of the first to illustrate decentralized co-creation, worldbuilding, and more in NFTs. This example was low-fi or "incomplete" aesthetically, providing room for imagination and community co-creation.

Loot began with a series of Loot bag NFTs, each listing eight "adventure things" in white writing on a black backdrop (such as Loot Bag #5726's "Katana, Divine Robe, Great Helm, Wool Sash, Divine Slippers, Chain Gloves, Amulet, Gold Ring"). Dom Hofmann's free Loot bags served as a foundation for the community.

Several projects have begun metaphorical (lore) and practical (game development) world-building in a short time, with artists contributing many variations to the collective "Lootverse." They've produced games (Realms & The Crypt), characters (Genesis Project, Hyperloot, Loot Explorers), storytelling initiatives (Banners, OpenQuill), and even infrastructure (The Rift).

Why cc0 and composability? Because consumers own and control Loot bags, they may use them wherever they choose by connecting their crypto wallets. This allows users to participate in multiple derivative projects, such as  Genesis Adventurers, whose characters appear in many others — creating a decentralized franchise not owned by any one corporation.

Genesis Project's Genesis Adventurer (1) with HyperLoot (2) and Loot Explorer (3) versions

When to go cc0

There are several IP development strategies NFT projects can use. When it comes to cc0, it’s important to be realistic. The public domain won't make a project a runaway success just by implementing the license. cc0 works well for NFT initiatives that can develop a rich, enlarged ecosystem.

Many of the most successful cc0 projects have introduced flexible intellectual property. The Nouns brand is as obvious for a beer ad as for real glasses; Loot bags are simple primitives that make sense in all adventure settings; and the Goblintown visual style looks good on dwarfs, zombies, and cranky owls as it does on Val Kilmer.

The ideal cc0 NFT project gives builders the opportunity to add value:

• vertically, by stacking new content and features directly on top of the original cc0 assets (for instance, as with games built on the Loot ecosystem, among others), and

• horizontally, by introducing distinct but related intellectual property that helps propagate the original cc0 project’s brand (as with various Goblintown derivatives, among others).

These actions can assist cc0 NFT business models. Because cc0 NFT projects receive royalties from secondary sales, third-party extensions and derivatives can boost demand for the original assets.

Using cc0 license lowers friction that could hinder brand-reinforcing extensions or lead to them bypassing the original. Robbie Broome recently argued (in the context of his cc0 project A Common Place) that giving away his IP to cc0 avoids bad rehashes down the line. If UrbanOutfitters wanted to put my design on a tee, they could use the actual work instead of hiring a designer. CC0 can turn competition into cooperation.

Community agreement about core assets' value and contribution can help cc0 projects. Cohesion and engagement are key. Using the above examples: Developers can design adventure games around whatever themes and item concepts they desire, but many choose Loot bags because of the Lootverse's community togetherness. Flipmap shared half of its money with the original Blitmap artists in acknowledgment of that project's core role in the community. This can build a healthy culture within a cc0 project ecosystem. Commentator NiftyPins said it was smart to acknowledge the people that constructed their universe. Many OG Blitmap artists have popped into the Flipmap discord to share information.

cc0 isn't a one-size-fits-all answer; NFTs formed around well-established brands may prefer more restrictive licenses to preserve their intellectual property and reinforce exclusivity. cc0 has some superficial similarities to permitting NFT owners to market the IP connected with their NFTs (à la Bored Ape Yacht Club), but there is a significant difference: cc0 holders can't exclude others from utilizing the same IP. This can make it tougher for holders to develop commercial brands on cc0 assets or offer specific rights to partners. Holders can still introduce enlarged intellectual property (such as backstories or derivatives) that they control.

Blockchain technologies and the crypto ethos are decentralized and open-source. This makes it logical for crypto initiatives to build around cc0 content models, which build on the work of the Creative Commons foundation and numerous open source pioneers.

NFT creators that choose cc0 must select how involved they want to be in building the ecosystem. Some cc0 project leaders, like Chain Runners' developers, have kept building on top of the initial cc0 assets, creating an environment derivative projects can plug into. Dom Hofmann stood back from Loot, letting the community lead. (Dom is also working on additional cc0 NFT projects for the company he formed to build Blitmap.) Other authors have chosen out totally, like sartoshi, who announced his exit from the cc0 project he founded, mfers, and from the NFT area by publishing a final edition suitably named "end of sartoshi" and then deactivating his Twitter account. A multi-signature wallet of seven mfers controls the project's smart contract. 

cc0 licensing allows a robust community to co-create in ways that benefit all members, regardless of original creators' continuous commitment. We foresee more organized infrastructure and design patterns as NFT matures. Like open source software, value capture frameworks may see innovation. (We could imagine a variant of the "Sleepycat license," which requires commercial software to pay licensing fees when embedding open source components.) As creators progress the space, we expect them to build unique rights and licensing strategies. cc0 allows NFT producers to bootstrap ideas that may take off.