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This is Your Brain on Microwaves

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By KIM BELLARD

Those of us of a certain age well remember the 1987 ad campaign from the Partnership for a Drug-Free America. It equated frying an egg to what drugs did to our brains. The ad certainly impacted awareness, but it is less clear that it impacted drug use or, for that matter, that it actually was like what drugs did to our brains.

Well, it turns out that there is something that can scramble our brains, but it’s microwaves, and it appears that “malevolent actors” are using them to do just that. We’re now in the age of “directed, pulsed radiofrequency energy.” 

There were reports coming out of Havana in 2016 of State Department employees complaining of mysterious symptoms, including dizziness, fatigue, headaches, memory loss, balance issues, and hearing loss. Over the next couple years there were more reports, in Cuba and in other countries, including China and Russia, with CIA officers also seemed to be common targets. It has been labeled “the Havana syndrome.”

As least 44 people from Cuba and 15 from China were treated at Center for Brain Injury and Repair at the University of Pennsylvania, with more believed to have been treated elsewhere. No one could pin down exactly what was happening. 

Now the National Academies of Science, Engineering and Medicine has issued a report concluding that the directed, pulsed microwave bursts were “the most plausible mechanism” to explain what happened. They evaluated but ruled out other mechanisms, such as background microwaves, chemical agents, infectious diseases, and even “psychological issues.” 

Committee chairman David Relman, a professor of medicine at Stanford University, said:

The committee found these cases quite concerning, in part because of the plausible role of directed, pulsed radiofrequency energy as a mechanism, but also because of the significant suffering and debility that has occurred in some of these individuals.  We as a nation need to address these specific cases as well as the possibility of future cases with a concerted, coordinated, and comprehensive approach.

One thing in particular that concerned the Committee was the presence of persistent symptoms in many victims – “persistent postural-perceptual dizziness (PPPD), a functional (not psychiatric) vestibular disorder that may be triggered by vestibular, neurologic, other medical and psychological conditions and may explain some chronic signs and symptoms in some patients.”  i.e., not only can you be impacted by such an attack, but the impairment can last an indefinite time. 

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Healthcare on the Edge

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By KIM BELLARD

Perhaps you read about, or were directly impacted by, the massive, multi-hour Amazon Web Services (AWS) outage last week.  Ironically, AWS’s effort to add capacity triggered the outage, although apparently was not the root cause.  It’s no surprise that AWS sought to add capacity; it, like most cloud service vendors these days, has seen skyrocketing growth.  Even healthcare has jumped into the cloud in a big way.

But, as the outage reminds us, sometimes having core computing functions done in far-off data centers may not be always a great idea.  Still, we’re not about to go back to local mainframes or networked PCs.  The compromise may be edge computing. 

Definitions vary, and the concept is somewhat amorphous, but goal is to move as much computing to the “edge” of networks, primarily to reduce latency.  PwC predicts: “Now, with the rise of IoT, the centralised cloud is moving down and out, and edge computing is set to take on much of the grunt work.” 

As they describe it:

With edge, instead of pushing data to the cloud to be computed, processing is done by devices ‘at the edge’ of your network. The grunt work is done closer to the user, at an edge gateway server and then select or relevant data is sent to the cloud for storage (or back to your devices).

The oft-cited example is self-driving cars; you really don’t want the AI to wait a single millisecond longer than necessary to make a potentially life-saving decision.  An article in Nextgov pointed out:

Thus, a Tesla isn’t just a next-generation car; it’s an edge compute node. But even with Tesla, a relatively straightforward use case, building and deploying the edge node is just the beginning. In order to unlock the full promise of these technologies, an entire paradigm shift is required.

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What, Us Worry

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By KIM BELLARD

2020 has been an awful year.  Hurricanes, wildfires, murder hornets, unjustified shootings, a divisive Presidential election, and, of course, a pandemic.  Most of us are spending unprecedented amounts of time sheltering in place, millions have lost their jobs, the economy is sputtering, and over a quarter million of us didn’t survive to Thanksgiving.  If you haven’t been depressed at some point, you haven’t been paying enough attention.

Within the last two weeks, though, there has finally been some cause for hope.  Whether you want to credit Operation Warp Speed or just science doing what it does, we are on the cusp of having vaccines to battle COVID-19.  First Pfizer/BioNTech, then Moderna, and most recently, AstraZenica, announced vaccines that appear to be highly effective. 

We’re having our Paul Revere moment, only this time with good news.  The vaccines are coming!  The vaccines are coming!

It strikes me, though, that our enthusiasm about these vaccines says a lot about why the U.S. has had such a hard time with the pandemic; indeed, it tells us a lot about why our healthcare system is in the state it is. We’re suckers for the quick fix, the medical intervention that will bring us health.

Unless you were alive when Woodrow Wilson was President, COVID-19 has been the worst public health crisis of our lifetime.  It took some time for us to fully realize how bad it was going to be, and, even then, most of us underestimated exactly how bad that would be.  We may still be underestimating how bad these next few months will be.

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Healthcare’s Bridge Fire

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By KIM BELLARD

We had a bridge fire here in Cincinnati last week.  Two semis collided in the overnight hours.  The collision ignited a blaze that burned at up to 1500 degrees Fahrenheit and took hours to quell.  Fortunately, no one was killed or injured, but the bridge remains closed while investigators determine how much damage was done.  It is expected to remain closed for at least another month.

Unfortunately, the bridge in question is the Brent Spence Bridge, which is the focal point for I-71 and I-75 between Ohio and Kentucky.   It normally carries over 160,000 vehicles daily, and is one of the busiest trucking routes in the U.S. Over $1 billion of freight crosses each day.  There are other bridges nearby, but each requires significant detouring, and none were designed for that traffic load.

What makes this all so galling is that it has been recognized for over 25 years that the bridge has been, to quote the Federal Highway Administration, “functionally obsolete” – yet no action was taken to replace it.  This most recent disaster was a disaster hiding in plain sight.    

Just like, as the coronavirus pandemic has illustrated, we have in health care.

The Brent Spence Bridge was opened in 1963, intended to carry a maximum of 80,000 vehicles daily.  That had been surpassed by the 1990’s, causing calls to replace it with a newer, bigger bridge.  At one time, Rep. John Boehner, from the Cincinnati area, was Speaker of the House and Kentucky’s Mitch McConnell was Senate Majority leader, yet were not able to obtain funding for the replacement, despite strong support from then President Obama and, in turn, President Trump.   

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In Praise of Unsung Heroes

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By KIM BELLARD

Even in this extraordinary year, this has been an extraordinary week.  Last Tuesday we had what many believe to have been the most important Presidential election in recent times, maybe ever.  The week also found the coronavirus pandemic reaching new heights.  That was the week that was.

What struck me, though, is how both our election systems and our healthcare system rely on “ordinary” people to keep them going.  They’ve never been more extraordinary than this year.

The pandemic first impacted voting earlier in the year, during primary season.  Going to the polls suddenly seemed like potentially a life-threatening choice, and working at them practically suicidal.  Dates of primaries were moved, many polling stations were closed, new voting procedures were put into place, and absentee ballots found a new popularity.  And yet people turned out in droves to vote, often standing in line for hours.

President Trump upped the ante by constantly railing against absentee ballots and warning about voter fraud.  Despite this, or perhaps because of it, record numbers of people voted early, in person or by mail.  Several states had surpassed 2016 numbers of voters before Election Day.   Tens of millions more showed up on Election Day.  And, amazingly, Election Day passed with relatively few incidents.

Then the counting started. 

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THCB Gang Episode 31 11/5

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Episode 30 of “The THCB Gang” was live-streamed on Thursday, November 5th. Watch it below!

Matthew Holt (@boltyboy) was joined by regulars, CEO of Day Health Strategies Rosemarie Day (@Rosemarie_Day1), medical historian & health economist Mike Magee MD (@drmikemagee), fierce patient activist Casey Quinlan (@MightyCasey), writer Kim Bellard (@kimbbellard), and patient & entrepreneur Robin Farmanfarmaian (@Robinff3). The conversation revolved around the underlying value structures in America, what a Republican Senate looks like for the ACA, and how will the (at the time likely but not certain) Democratic Administration change the narrative around health policy.

If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

It’s (Cyber)Criminal

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By KIM BELLARD

One of the redeeming aspects of crises is that, amidst all the confusion, suffering, and loss, there are usually moments of grace, of humans showing their best nature.  With COVID-19, we’ve seen health care workers working long hours in dangerous conditions.  We’ve seen other essential workers — including not just first responders but also grocery workers, meatpackers, trash collectors, and countless others — putting their own safety at risk so that our lives can go on.  There are heroes all around.

Unfortunately, crises also tend to bring out the worst of our natures.  With the pandemic, those trillions of dollars in play have brought out not just those seeking to profit, but also those looking to profit by breaking the law.   We’ve seen people stealing or counterfeiting stimulus payments, defrauding COVID unemployment payments, getting fraudulent PPP loans, and stealing PPE. 

And then there are the cyberattacks. 

Last week the federal Cybersecurity & Infrastructure Security Agency, the FBI, and HHS issued a joint alert Ransomware Activity Targeting the Healthcare and Public Health Sector, warning that they have “credible information of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers.”  I’ll spare you the technical details of the expected attack strategies or suggested mitigation efforts, but I will note that they warned: “CISA, FBI, and HHS do not recommend paying ransom.”

Hospitals could ask Universal Health Services (UHS) about that.  UHS took some three weeks to resume “normal services” after a ransomware attack that hit their 250 U.S. hospitals in late September.  UHS claims that “While our information technology applications were offline, patient care was delivered safely and effectively at our facilities across the country utilizing established back-up processes, including offline documentation methods.”   E.g., paper records.

Or they could ask the family of the woman in Germany who died as the result of having to be diverted to another city for her medical emergency because the closer facility had suffered a ransomware attack.  One suspects there may have been other deaths, and other adverse outcomes, due to cyberattacks, and that we can expect there to be more.

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THCB “SPOOKY” Gang: Episode 30 10/29

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Episode 30 of “The THCB Gang” was live-streamed on Thursday, October 29th! Watch it below!

Matthew Holt (@boltyboy) was joined by some regulars and this episode was a spooky be a COSTUME PARTY! On this episode were data privacy expert Deven McGraw (@healthprivacy), writer Kim Bellard (@kimbbellard), health economist Jane Sarasohn-Kahn (@healthythinker), CTO of Carium Health Lygeia Ricciardi (@Lygeia), MD & hospital system exec Rajesh Aggarwal (@docaggarwal), policy & tech expert Vince Kuraitis (@VinceKuraitis), and me, THCB’s Editor-in-Chief (@zoykskhan). The conversation had a more spooked tone to it as many of us are worried about the safe transition of power, the safety of voters, the misinformation about herd-immunity, the rising COVID-19 cases, and everything happening in the Senate. What will the results of November 3rd bring for this country?

If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan, producer

Can You Say “Chemputer”?

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By KIM BELLARD

I learned a new word this week: “chemputer.”   It’s not a new word – it’s been around since at least 2012 — but chances are, unless you are a chemist or maybe a synthetic biologist, it’s not a word you knew it either.   Even if you don’t care about chemistry, biology, or, for that matter, etymology, this is something you might want to pay attention to, because it may end up revolutionizing healthcare. 

The term is credited to Professor Lee Cronin of the University of Glascow.  Back in 2012, when he was first discussing the concept, he told The Guardian: “Basically, what Apple did for music, I’d like to do for the discovery and distribution of prescription drugs.”

Fast-forward most of a decade and a pandemic, and Dr. Cronin and others are closing in on that goal — although they’ve updated their analogy to “Spotify for chemistry.”

I won’t pretend to understand either the chemistry nor the programming involved, but, simply put, chemputers automate the production of molecules – including prescription drugs, such as, for example, COVID-fighting Remdesivir.  CNBC recently profiled activity in the field, spurred by some new papers from Dr. Cronin and Dr. Nathan Collings of SRI Biosciences. 

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Not Just Faxes

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By KIM BELLARD

I missed it when it was first announced in Japan, but fortunately the U.S. mainstream media has finally picked up on the story, with articles in both The Washington Post and The Wall Street Journal: Japan’s new Administrative Reform Minister Taro Kono has “declared war” on fax machines, among other paper-based traditions. 

Wait, what?  “Administrative Reform Minister?”  The U.S., or at least the U.S. healthcare system, has to hear about this. 

Mr. Kono is a well known Japanese politician, including stints as Defense Minister and Foreign Minister.  He is thought of as something of a maverick, at least by Japanese political standards.  New Prime Minister Suga installed Mr. Kono in mid-September, making overhaul of bureaucracy a top priority: “Wherever there are problems, I want all of them brought to Mr. Kono for handling on behalf of the nation.” 

Mr. Kono set up a hotline for people to report government red tape, which was quickly overwhelmed with thousands of examples.  It soon reopened.

It didn’t take long for Mr. Kono to start calling for significant changes.  “To be honest, I don’t think there are many administrative procedures that actually need printing out paper and faxing,” he said in a press conference in late September.  “My job is to clear the road of obstructions to allow the Ferraris and Porsches of digital innovation to speed through.”

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