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.

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

No, it’s not smartphones, overeating, or sugar.

Everyday practices affect brain health. Good brain practices increase memory and cognition.

Bad behaviors increase stress, which destroys brain cells.

Bad behaviors can reverse evolution and diminish the brain. So, avoid these practices for brain health.

1. The silent assassin

Introverts appreciated quarantine.

Before the pandemic, they needed excuses to remain home; thereafter, they had enough.

I am an introvert, and I didn’t hate quarantine. There are billions of people like me who avoid people.

Social relationships are important for brain health. Social anxiety harms your brain.

Antisocial behavior changes brains. It lowers IQ and increases drug abuse risk.

What you can do is as follows:

• Make a daily commitment to engage in conversation with a stranger. Who knows, you might turn out to be your lone mate.

• Get outside for at least 30 minutes each day.

• Shop for food locally rather than online.

• Make a call to a friend you haven't spoken to in a while.

2. Try not to rush things.

People love hustle culture. This economy requires a side gig to save money.

Long hours reduce brain health. A side gig is great until you burn out.

Work ages your wallet and intellect. Overworked brains age faster and lose cognitive function.

Working longer hours can help you make extra money, but it can harm your brain.

Side hustle but don't overwork.

What you can do is as follows:

• Decide what hour you are not permitted to work after.

• Three hours prior to night, turn off your laptop.

• Put down your phone and work.

• Assign due dates to each task.

3. Location is everything!

The environment may cause brain fog. High pollution can cause brain damage.

Air pollution raises Alzheimer's risk. Air pollution causes cognitive and behavioral abnormalities.

Polluted air can trigger early development of incurable brain illnesses, not simply lung harm.

Your city's air quality is uncontrollable. You may take steps to improve air quality.

In Delhi, schools and colleges are closed to protect pupils from polluted air. So I've adapted.

What you can do is as follows:

• To keep your mind healthy and young, make an investment in a high-quality air purifier.

• Enclose your windows during the day.

• Use a N95 mask every day.

4. Don't skip this meal.

Fasting intermittently is trendy. Delaying breakfast to finish fasting is frequent.

Some skip breakfast and have a hefty lunch instead.

Skipping breakfast might affect memory and focus. Skipping breakfast causes low cognition, delayed responsiveness, and irritation.

Breakfast affects mood and productivity.

Intermittent fasting doesn't prevent healthy breakfasts.

What you can do is as follows:

• Try to fast for 14 hours, then break it with a nutritious breakfast.

• So that you can have breakfast in the morning, eat dinner early.

• Make sure your breakfast is heavy in fiber and protein.

5. The quickest way to damage the health of your brain

Brain health requires water. 1% dehydration can reduce cognitive ability by 5%.

Cerebral fog and mental clarity might result from 2% brain dehydration. Dehydration shrinks brain cells.

Dehydration causes midday slumps and unproductivity. Water improves work performance.

Dehydration can harm your brain, so drink water throughout the day.

What you can do is as follows:

• Always keep a water bottle at your desk.

• Enjoy some tasty herbal teas.

• With a big glass of water, begin your day.

• Bring your own water bottle when you travel.

Conclusion

Bad habits can harm brain health. Low cognition reduces focus and productivity.

Unproductive work leads to procrastination, failure, and low self-esteem.

Avoid these harmful habits to optimize brain health and function.

Quick, easy and tasty (and dollops of parenting around food).

My wife and mom are both great mothers. They're super-efficient planners. They soak and ferment food. My 104-year-old grandfather loved fermented foods.

When I'm hungry and need something fast, I waffle to the pantry. Like most people, I like to improvise. I wish I knew these 11 hacks sooner.

1. The world's best pasta sauce only has 3 ingredients.

You watch recipe videos with prepped ingredients. In reality, prepping and washing take time. The food's taste isn't guaranteed. The raw truth at a sublime level is not talked about often.

Sometimes a radical recipe comes along that's so easy and tasty, you're dumbfounded. The Classic Italian Cook Book has a pasta recipe.

One 28-ounce can of whole, peeled tomatoes, one medium peeled onion, and 5 tablespoons of butter. And salt to taste.

Combine everything in a single pot and simmer for 45 minutes, uncovered. Stir occasionally. Toss the onion halves after 45 minutes and pour the sauce over pasta. Finish!

This simple recipe fights our deepest fears.

Salt to taste! Customized to perfection, no frills.

2. Reheating rice with ice. Magical.

Most of the world eats rice. I was raised in south India. My grandfather farmed rice in the Cauvery river delta.

The problem with rice With growing kids, you can't cook just enough. Leftovers are a norm. Microwaves help most people. Ice cubes are the frosting.

Before reheating rice in the microwave, add an ice cube. The ice will steam the rice, making it fluffy and delicious again.

3. Pineapple leaf 

if it comes off easy, it is ripe enough to cut. No rethinking.

My daughter loves pineapples like her dad. One daddy task is cutting them. Sharing immediate results is therapeutic.

Timing the cut has been the most annoying part over the years. The pineapple leaf tip reveals the fruitiness inside. Always loved it.

4. Magic knife words (rolling and curling)

Cutting hand: Roll the blade's back, not its tip, to cut.

Other hand: If you can’t see your finger tips, you can’t cut them. So curl your fingers.

I dislike that schools don't teach financial literacy or cutting skills.

My wife and I used scissors differently for 25 years. We both used the thumb. My index finger, her middle. We googled the difference when I noticed it and laughed. She's right.

This video teaches knifing skills:

5. Best advice about heat

If it's done in the pan, it's overdone on the plate.

This simple advice stands out when we worry about ingredients and proportions.

6. The truth about pasta water

Pasta water should be sea-salty.

Properly seasoning food separates good from great. Salt depends is a good line.

Want delicious pasta? Well, then kind of a lot, to be perfectly honest.

7. Clean as you go

Clean blender as you go by blending water and dish soap.

I find clean as you go easier than clean afterwords. This easy tip is gold.

8. Clean as you go (bis)

Microwave a bowl of water, vinegar, and a toothpick for 5 minutes.

2 cups water, 2 tablespoons vinegar, and a toothpick to prevent overflow.

5-minute microwave. Let the steam work for another 2 minutes. Sponge-off dirt and food. Simple.

9 and 10. Tools,tools, tools

Immersion blender and pressure cooker save time and money.

Narrative: I experienced fatherly pride. My middle-schooler loves science. We discussed boiling. I spoke. Water doesn't need 100°C to boil. She looked confused. 100 degrees assume something. The world around the water is a normal room. Changing water pressure affects its boiling point. This saves energy. Pressure cooker magic.

I captivated her. She's into science and sustainable living.

Whistling is a subliminal form of self-expression when done right. Pressure cookers remind me of simple pleasures.

Your handiness depends on your home tools. Immersion blenders are great for pre- and post-cooking. It eliminates chopping and washing. Second to the dishwasher, in my opinion.

11. One pepper is plenty

A story I share with my daughters.

Once, everyone thought about spice (not spicy). More valuable than silk. One of the three mighty oceans was named after a source country. Columbus sailed the wrong way and found America. The explorer called the natives after reaching his spice destination.

It was pre-internet days. His Google wasn't working.

My younger daughter listens in awe. Strong roots. Image cast. She can contextualize one of the ocean names.

I struggle with spices in daily life. Combinations are mind-boggling. I have more spices than Columbus. Flavor explosion has repercussions. You must closely follow the recipe without guarantees. Best aha. Double down on one spice and move on. If you like it, it's great.

I naturally gravitate towards cumin soups, fennel dishes, mint rice, oregano pasta, basil thai curry and cardamom pudding.

Variety enhances life. Each of my dishes is unique.

To each their own comfort food and nostalgic memories.

Happy living!

Effective date: August 31, 2022

This Privacy Statement describes how INTΞGRITY ("we," or "us") collects, uses, and discloses your personal information. This Privacy Statement applies when you use our websites, mobile applications, and other online products and services that link to this Privacy Statement (collectively, our "Services"), communicate with our customer care team, interact with us on social media, or otherwise interact with us.

This Privacy Policy may be modified from time to time. If we make modifications, we will update the date at the top of this policy and, in certain instances, we may give you extra notice (such as adding a statement to our website or providing you with a notification). We encourage you to routinely review this Privacy Statement to remain informed about our information practices and available options.

INFORMATION COLLECTION

The Data You Provide to Us

We collect information that you directly supply to us. When you register an account, fill out a form, submit or post material through our Services, contact us via third-party platforms, request customer assistance, or otherwise communicate with us, you provide us with information directly. We may collect your name, display name, username, bio, email address, company information, your published content, including your avatar image, photos, posts, responses, and any other information you voluntarily give.

In certain instances, we may collect the information you submit about third parties. We will use your information to fulfill your request and will not send emails to your contacts unrelated to your request unless they separately opt to receive such communications or connect with us in some other way.

We do not collect payment details via the Services.

Automatically Collected Information When You Communicate with Us

In certain cases, we automatically collect the following information:

We gather data regarding your behavior on our Services, such as your reading history and when you share links, follow users, highlight posts, and like posts.

Device and Usage Information: We gather information about the device and network you use to access our Services, such as your hardware model, operating system version, mobile network, IP address, unique device identifiers, browser type, and app version. We also collect information regarding your activities on our Services, including access times, pages viewed, links clicked, and the page you visited immediately prior to accessing our Services.

Information Obtained Through Cookies and Comparable Tracking Technologies: We collect information about you through tracking technologies including cookies and web beacons. Cookies are little data files kept on your computer's hard disk or device's memory that assist us in enhancing our Services and your experience, determining which areas and features of our Services are the most popular, and tracking the number of visitors. Web beacons (also known as "pixel tags" or "clear GIFs") are electronic pictures that we employ on our Services and in our communications to assist with cookie delivery, session tracking, and usage analysis. We also partner with third-party analytics providers who use cookies, web beacons, device identifiers, and other technologies to collect information regarding your use of our Services and other websites and applications, including your IP address, web browser, mobile network information, pages viewed, time spent on pages or in mobile apps, and links clicked. INTΞGRITY and others may use your information to, among other things, analyze and track data, evaluate the popularity of certain content, present content tailored to your interests on our Services, and better comprehend your online activities. See Your Options for additional information on cookies and how to disable them.

Information Obtained from Outside Sources

We acquire information from external sources. We may collect information about you, for instance, through social networks, accounting service providers, and data analytics service providers. In addition, if you create or log into your INTΞGRITY account via a third-party platform (such as Apple, Facebook, Google, or Twitter), we will have access to certain information from that platform, including your name, lists of friends or followers, birthday, and profile picture, in accordance with the authorization procedures determined by that platform.

We may derive information about you or make assumptions based on the data we gather. We may deduce your location based on your IP address or your reading interests based on your reading history, for instance.

USAGE OF INFORMATION

We use the information we collect to deliver, maintain, and enhance our Services, including publishing and distributing user-generated content, and customizing the posts you see. Additionally, we utilize collected information to: create and administer your INTΞGRITY account;

Send transaction-related information, including confirmations, receipts, and user satisfaction surveys;

Send you technical notices, security alerts, and administrative and support messages;

Respond to your comments and queries and offer support;

Communicate with you about new INTΞGRITY content, goods, services, and features, as well as other news and information that we believe may be of interest to you (see Your Choices for details on how to opt out of these communications at any time);

Monitor and evaluate usage, trends, and activities associated with our Services;

Detect, investigate, and prevent security incidents and other harmful, misleading, fraudulent, or illegal conduct, and safeguard INTΞGRITY’s and others' rights and property;

Comply with our legal and financial requirements; and Carry out any other purpose specified to you at the time the information was obtained.

SHARING OF INFORMATION

We share personal information where required by law or as otherwise specified in this policy:

Personal information is shared with other Service users. If you use our Services to publish content, make comments, or send private messages, for instance, certain information about you, such as your name, photo, bio, and other account information you may supply, as well as information about your activity on our Services, will be available to others (e.g., your followers and who you follow, recent posts, likes, highlights, and responses).

We share personal information with vendors, service providers, and consultants who require access to such information to perform services on our behalf, such as companies that assist us with web hosting, storage, and other infrastructure, analytics, fraud prevention, and security, customer service, communications, and marketing.

We may release personally identifiable information if we think that doing so is in line with or required by any relevant law or legal process, including authorized demands from public authorities to meet national security or law enforcement obligations. If we intend to disclose your personal information in response to a court order, we will provide you with prior notice so that you may contest the disclosure (for example, by seeking court intervention), unless we are prohibited by law or believe that doing so could endanger others or lead to illegal conduct. We shall object to inappropriate legal requests for information regarding users of our Services.

If we believe your actions are inconsistent with our user agreements or policies, if we suspect you have violated the law, or if we believe it is necessary to defend the rights, property, and safety of INTΞGRITY, our users, the public, or others, we may disclose your personal information.

We share personal information with our attorneys and other professional advisers when necessary for obtaining counsel or otherwise protecting and managing our business interests.

We may disclose personal information in conjunction with or during talks for any merger, sale of corporate assets, financing, or purchase of all or part of our business by another firm.

Personal information is transferred between and among INTΞGRITY, its current and future parents, affiliates, subsidiaries, and other companies under common ownership and management.

We will only share your personal information with your permission or at your instruction.

We also disclose aggregated or anonymized data that cannot be used to identify you.

IMPLEMENTATIONS FROM THIRD PARTIES

Some of the content shown on our Services is not hosted by INTΞGRITY. Users are able to publish content hosted by a third party but embedded in our pages ("Embed"). When you interact with an Embed, it can send information to the hosting third party just as if you had visited the hosting third party's website directly. When you load an INTΞGRITY post page with a YouTube video Embed and view the video, for instance, YouTube collects information about your behavior, such as your IP address and how much of the video you watch. INTΞGRITY has no control over the information that third parties acquire via Embeds or what they do with it. This Privacy Statement does not apply to data gathered via Embeds. Before interacting with the Embed, it is recommended that you review the privacy policy of the third party hosting the Embed, which governs any information the Embed gathers.

INFORMATION TRANSFER TO THE UNITED STATES AND OTHER NATIONS

INTΞGRITY’s headquarters are located in the United States, and we have operations and service suppliers in other nations. Therefore, we and our service providers may transmit, store, or access your personal information in jurisdictions that may not provide a similar degree of data protection to your home jurisdiction. For instance, we transfer personal data to Amazon Web Services, one of our service providers that processes personal information on our behalf in numerous data centers throughout the world, including those indicated above. We shall take measures to guarantee that your personal information is adequately protected in the jurisdictions where it is processed.

YOUR SETTINGS

Account Specifics

You can access, modify, delete, and export your account information at any time by login into the Services and visiting the Settings page. Please be aware that if you delete your account, we may preserve certain information on you as needed by law or for our legitimate business purposes.

Cookies

The majority of web browsers accept cookies by default. You can often configure your browser to delete or refuse cookies if you wish. Please be aware that removing or rejecting cookies may impact the accessibility and performance of our services.

Communications

You may opt out of getting certain messages from us, such as digests, newsletters, and activity notifications, by following the instructions contained within those communications or by visiting the Settings page of your account. Even if you opt out, we may still send you emails regarding your account or our ongoing business relationships.

Mobile Push Notifications

We may send push notifications to your mobile device with your permission. You can cancel these messages at any time by modifying your mobile device's notification settings.

YOUR CALIFORNIA PRIVACY RIGHTS

The California Consumer Privacy Act, or "CCPA" (Cal. Civ. Code 1798.100 et seq. ), grants California residents some rights regarding their personal data. If you are a California resident, you are subject to this clause.

We have collected the following categories of personal information over the past year: identifiers, commercial information, internet or other electronic network activity information, and conclusions. Please refer to the section titled "Collection of Information" for specifics regarding the data points we gather and the sorts of sources from which we acquire them. We collect personal information for the business and marketing purposes outlined in the section on Use of Information. In the past 12 months, we have shared the following types of personal information to the following groups of recipients for business purposes:

Category of Personal Information: Identifiers
Categories of Recipients: Analytics Providers, Communication Providers, Custom Service Providers, Fraud Prevention and Security Providers, Infrastructure Providers, Marketing Providers, Payment Processors

Category of Personal Information: Commercial Information
Categories of Recipients: Analytics Providers, Infrastructure Providers, Payment Processors

Category of Personal Information: Internet or Other Electronic Network Activity Information
Categories of Recipients: Analytics Providers, Infrastructure Providers

Category of Personal Information: Inferences
Categories of Recipients: Analytics Providers, Infrastructure Providers

INTΞGRITY does not sell personally identifiable information.

You have the right, subject to certain limitations: (1) to request more information about the categories and specific pieces of personal information we collect, use, and disclose about you; (2) to request the deletion of your personal information; (3) to opt out of any future sales of your personal information; and (4) to not be discriminated against for exercising these rights. You may submit these requests by email to hello@int3grity.com. We shall not treat you differently if you exercise your rights under the CCPA.

If we receive your request from an authorized agent, we may request proof that you have granted the agent a valid power of attorney or that the agent otherwise possesses valid written authorization to submit requests on your behalf. This may involve requiring identity verification. Please contact us if you are an authorized agent wishing to make a request.

ADDITIONAL DISCLOSURES FOR INDIVIDUALS IN EUROPE

This section applies to you if you are based in the European Economic Area ("EEA"), the United Kingdom, or Switzerland and have specific rights and safeguards regarding the processing of your personal data under relevant law.

Legal Justification for Processing

We will process your personal information based on the following legal grounds:

To fulfill our obligations under our agreement with you (e.g., providing the products and services you requested).

When we have a legitimate interest in processing your personal information to operate our business or to safeguard our legitimate interests, we will do so (e.g., to provide, maintain, and improve our products and services, conduct data analytics, and communicate with you).

To meet our legal responsibilities (e.g., to maintain a record of your consents and track those who have opted out of non-administrative communications).

If we have your permission to do so (e.g., when you opt in to receive non-administrative communications from us). When consent is the legal basis for our processing of your personal information, you may at any time withdraw your consent.

Data Retention

We retain the personal information associated with your account so long as your account is active. If you close your account, your account information will be deleted within 14 days. We retain other personal data for as long as is required to fulfill the objectives for which it was obtained and for other legitimate business purposes, such as to meet our legal, regulatory, or other compliance responsibilities.

Data Access Requests

You have the right to request access to the personal data we hold on you and to get your data in a portable format, to request that your personal data be rectified or erased, and to object to or request that we restrict particular processing, subject to certain limitations. To assert your legal rights:

If you sign up for an INTΞGRITY account, you can request an export of your personal information at any time via the Settings website, or by visiting Settings and selecting Account from inside our app.

You can edit the information linked with your account on the Settings website, or by navigating to Settings and then Account in our app, and the Customize Your Interests page.

You may withdraw consent at any time by deleting your account via the Settings page, or by visiting Settings and then selecting Account within our app (except to the extent INTΞGRITY is prevented by law from deleting your information).

You may object to the use of your personal information at any time by contacting hello@int3grity.com.

Questions or Complaints

If we are unable to settle your concern over our processing of personal data, you have the right to file a complaint with the Data Protection Authority in your country. The links below provide access to the contact information for your Data Protection Authority.

For people in the EEA, please visit https://edpb.europa.eu/about-edpb/board/members en.

For persons in the United Kingdom, please visit https://ico.org.uk/global/contact-us.

For people in Switzerland: https://www.edoeb.admin.ch/edoeb/en/home/the-fdpic/contact.html

CONTACT US

Please contact us at hello@int3grity.com if you have any queries regarding this Privacy Statement.