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Sam Hickmann

Sam Hickmann

3 years ago

What is headline inflation?

More on Economics & Investing

Jan-Patrick Barnert

Jan-Patrick Barnert

3 years ago

Wall Street's Bear Market May Stick Around

If history is any guide, this bear market might be long and severe.

This is the S&P 500 Index's fourth such incident in 20 years. The last bear market of 2020 was a "shock trade" caused by the Covid-19 pandemic, although earlier ones in 2000 and 2008 took longer to bottom out and recover.

Peter Garnry, head of equities strategy at Saxo Bank A/S, compares the current selloff to the dotcom bust of 2000 and the 1973-1974 bear market marked by soaring oil prices connected to an OPEC oil embargo. He blamed high tech valuations and the commodity crises.

"This drop might stretch over a year and reach 35%," Garnry wrote.

Here are six bear market charts.

Time/depth

The S&P 500 Index plummeted 51% between 2000 and 2002 and 58% during the global financial crisis; it took more than 1,000 trading days to recover. The former took 638 days to reach a bottom, while the latter took 352 days, suggesting the present selloff is young.

Valuations

Before the tech bubble burst in 2000, valuations were high. The S&P 500's forward P/E was 25 times then. Before the market fell this year, ahead values were near 24. Before the global financial crisis, stocks were relatively inexpensive, but valuations dropped more than 40%, compared to less than 30% now.

Earnings

Every stock crash, especially earlier bear markets, returned stocks to fundamentals. The S&P 500 decouples from earnings trends but eventually recouples.

Support

Central banks won't support equity investors just now. The end of massive monetary easing will terminate a two-year bull run that was among the strongest ever, and equities may struggle without cheap money. After years of "don't fight the Fed," investors must embrace a new strategy.

Bear Haunting Bear

If the past is any indication, rising government bond yields are bad news. After the financial crisis, skyrocketing rates and a falling euro pushed European stock markets back into bear territory in 2011.

Inflation/rates

The current monetary policy climate differs from past bear markets. This is the first time in a while that markets face significant inflation and rising rates.


This post is a summary. Read full article here

Ray Dalio

Ray Dalio

3 years ago

The latest “bubble indicator” readings.

As you know, I like to turn my intuition into decision rules (principles) that can be back-tested and automated to create a portfolio of alpha bets. I use one for bubbles. Having seen many bubbles in my 50+ years of investing, I described what makes a bubble and how to identify them in markets—not just stocks.

A bubble market has a high degree of the following:

  1. High prices compared to traditional values (e.g., by taking the present value of their cash flows for the duration of the asset and comparing it with their interest rates).
  2. Conditons incompatible with long-term growth (e.g., extrapolating past revenue and earnings growth rates late in the cycle).
  3. Many new and inexperienced buyers were drawn in by the perceived hot market.
  4. Broad bullish sentiment.
  5. Debt financing a large portion of purchases.
  6. Lots of forward and speculative purchases to profit from price rises (e.g., inventories that are more than needed, contracted forward purchases, etc.).

I use these criteria to assess all markets for bubbles. I have periodically shown you these for stocks and the stock market.

What Was Shown in January Versus Now

I will first describe the picture in words, then show it in charts, and compare it to the last update in January.

As of January, the bubble indicator showed that a) the US equity market was in a moderate bubble, but not an extreme one (ie., 70 percent of way toward the highest bubble, which occurred in the late 1990s and late 1920s), and b) the emerging tech companies (ie. As well, the unprecedented flood of liquidity post-COVID financed other bubbly behavior (e.g. SPACs, IPO boom, big pickup in options activity), making things bubbly. I showed which stocks were in bubbles and created an index of those stocks, which I call “bubble stocks.”

Those bubble stocks have popped. They fell by a third last year, while the S&P 500 remained flat. In light of these and other market developments, it is not necessarily true that now is a good time to buy emerging tech stocks.

The fact that they aren't at a bubble extreme doesn't mean they are safe or that it's a good time to get long. Our metrics still show that US stocks are overvalued. Once popped, bubbles tend to overcorrect to the downside rather than settle at “normal” prices.

The following charts paint the picture. The first shows the US equity market bubble gauge/indicator going back to 1900, currently at the 40% percentile. The charts also zoom in on the gauge in recent years, as well as the late 1920s and late 1990s bubbles (during both of these cases the gauge reached 100 percent ).

The chart below depicts the average bubble gauge for the most bubbly companies in 2020. Those readings are down significantly.

The charts below compare the performance of a basket of emerging tech bubble stocks to the S&P 500. Prices have fallen noticeably, giving up most of their post-COVID gains.

The following charts show the price action of the bubble slice today and in the 1920s and 1990s. These charts show the same market dynamics and two key indicators. These are just two examples of how a lot of debt financing stock ownership coupled with a tightening typically leads to a bubble popping.

Everything driving the bubbles in this market segment is classic—the same drivers that drove the 1920s bubble and the 1990s bubble. For instance, in the last couple months, it was how tightening can act to prick the bubble. Review this case study of the 1920s stock bubble (starting on page 49) from my book Principles for Navigating Big Debt Crises to grasp these dynamics.

The following charts show the components of the US stock market bubble gauge. Since this is a proprietary indicator, I will only show you some of the sub-aggregate readings and some indicators.

Each of these six influences is measured using a number of stats. This is how I approach the stock market. These gauges are combined into aggregate indices by security and then for the market as a whole. The table below shows the current readings of these US equity market indicators. It compares current conditions for US equities to historical conditions. These readings suggest that we’re out of a bubble.

1. How High Are Prices Relatively?

This price gauge for US equities is currently around the 50th percentile.

2. Is price reduction unsustainable?

This measure calculates the earnings growth rate required to outperform bonds. This is calculated by adding up the readings of individual securities. This indicator is currently near the 60th percentile for the overall market, higher than some of our other readings. Profit growth discounted in stocks remains high.

Even more so in the US software sector. Analysts' earnings growth expectations for this sector have slowed, but remain high historically. P/Es have reversed COVID gains but remain high historical.

3. How many new buyers (i.e., non-existing buyers) entered the market?

Expansion of new entrants is often indicative of a bubble. According to historical accounts, this was true in the 1990s equity bubble and the 1929 bubble (though our data for this and other gauges doesn't go back that far). A flood of new retail investors into popular stocks, which by other measures appeared to be in a bubble, pushed this gauge above the 90% mark in 2020. The pace of retail activity in the markets has recently slowed to pre-COVID levels.

4. How Broadly Bullish Is Sentiment?

The more people who have invested, the less resources they have to keep investing, and the more likely they are to sell. Market sentiment is now significantly negative.

5. Are Purchases Being Financed by High Leverage?

Leveraged purchases weaken the buying foundation and expose it to forced selling in a downturn. The leverage gauge, which considers option positions as a form of leverage, is now around the 50% mark.

6. To What Extent Have Buyers Made Exceptionally Extended Forward Purchases?

Looking at future purchases can help assess whether expectations have become overly optimistic. This indicator is particularly useful in commodity and real estate markets, where forward purchases are most obvious. In the equity markets, I look at indicators like capital expenditure, or how much businesses (and governments) invest in infrastructure, factories, etc. It reflects whether businesses are projecting future demand growth. Like other gauges, this one is at the 40th percentile.

What one does with it is a tactical choice. While the reversal has been significant, future earnings discounting remains high historically. In either case, bubbles tend to overcorrect (sell off more than the fundamentals suggest) rather than simply deflate. But I wanted to share these updated readings with you in light of recent market activity.

Cody Collins

Cody Collins

2 years ago

The direction of the economy is as follows.

What quarterly bank earnings reveal

Photo by Michael Dziedzic on Unsplash

Big banks know the economy best. Unless we’re talking about a housing crisis in 2007…

Banks are crucial to the U.S. economy. The Fed, communities, and investments exchange money.

An economy depends on money flow. Banks' views on the economy can affect their decision-making.

Most large banks released quarterly earnings and forward guidance last week. Others were pessimistic about the future.

What Makes Banks Confident

Bank of America's profit decreased 30% year-over-year, but they're optimistic about the economy. Comparatively, they're bullish.

Who banks serve affects what they see. Bank of America supports customers.

They think consumers' future is bright. They believe this for many reasons.

The average customer has decent credit, unless the system is flawed. Bank of America's new credit card and mortgage borrowers averaged 771. New-car loan and home equity borrower averages were 791 and 797.

2008's housing crisis affected people with scores below 620.

Bank of America and the economy benefit from a robust consumer. Major problems can be avoided if individuals maintain spending.

Reasons Other Banks Are Less Confident

Spending requires income. Many companies, mostly in the computer industry, have announced they will slow or freeze hiring. Layoffs are frequently an indication of poor times ahead.

BOA is positive, but investment banks are bearish.

Jamie Dimon, CEO of JPMorgan, outlined various difficulties our economy could confront.

But geopolitical tension, high inflation, waning consumer confidence, the uncertainty about how high rates have to go and the never-before-seen quantitative tightening and their effects on global liquidity, combined with the war in Ukraine and its harmful effect on global energy and food prices are very likely to have negative consequences on the global economy sometime down the road.

That's more headwinds than tailwinds.

JPMorgan, which helps with mergers and IPOs, is less enthusiastic due to these concerns. Incoming headwinds signal drying liquidity, they say. Less business will be done.

Final Reflections

I don't think we're done. Yes, stocks are up 10% from a month ago. It's a long way from old highs.

I don't think the stock market is a strong economic indicator.

Many executives foresee a 2023 recession. According to the traditional definition, we may be in a recession when Q2 GDP statistics are released next week.

Regardless of criteria, I predict the economy will have a terrible year.

Weekly layoffs are announced. Inflation persists. Will prices return to 2020 levels if inflation cools? Perhaps. Still expensive energy. Ukraine's war has global repercussions.

I predict BOA's next quarter earnings won't be as bullish about the consumer's strength.

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Colin Faife

3 years ago

The brand-new USB Rubber Ducky is much riskier than before.

The brand-new USB Rubber Ducky is much riskier than before.

Corin Faife and Alex Castro

With its own programming language, the well-liked hacking tool may now pwn you.

With a vengeance, the USB Rubber Ducky is back.

This year's Def Con hacking conference saw the release of a new version of the well-liked hacking tool, and its author, Darren Kitchen, was on hand to explain it. We put a few of the new features to the test and discovered that the most recent version is riskier than ever.

WHAT IS IT?

The USB Rubber Ducky seems to the untrained eye to be an ordinary USB flash drive. However, when you connect it to a computer, the computer recognizes it as a USB keyboard and will accept keystroke commands from the device exactly like a person would type them in.

Kitchen explained to me, "It takes use of the trust model built in, where computers have been taught to trust a human, in that anything it types is trusted to the same degree as the user is trusted. And a computer is aware that clicks and keystrokes are how people generally connect with it.

The USB Rubber Ducky, a brainchild of Darren Kitchen Corin

Over ten years ago, the first Rubber Ducky was published, quickly becoming a hacker favorite (it was even featured in a Mr. Robot scene). Since then, there have been a number of small upgrades, but the most recent Rubber Ducky takes a giant step ahead with a number of new features that significantly increase its flexibility and capability.

WHERE IS ITS USE?

The options are nearly unlimited with the proper strategy.

The Rubber Ducky has already been used to launch attacks including making a phony Windows pop-up window to collect a user's login information or tricking Chrome into sending all saved passwords to an attacker's web server. However, these attacks lacked the adaptability to operate across platforms and had to be specifically designed for particular operating systems and software versions.

The nuances of DuckyScript 3.0 are described in a new manual. 

The most recent Rubber Ducky seeks to get around these restrictions. The DuckyScript programming language, which is used to construct the commands that the Rubber Ducky will enter into a target machine, receives a significant improvement with it. DuckyScript 3.0 is a feature-rich language that allows users to write functions, store variables, and apply logic flow controls, in contrast to earlier versions that were primarily limited to scripting keystroke sequences (i.e., if this... then that).

This implies that, for instance, the new Ducky can check to see if it is hooked into a Windows or Mac computer and then conditionally run code specific to each one, or it can disable itself if it has been attached to the incorrect target. In order to provide a more human effect, it can also generate pseudorandom numbers and utilize them to add a configurable delay between keystrokes.

The ability to steal data from a target computer by encoding it in binary code and transferring it through the signals intended to instruct a keyboard when the CapsLock or NumLock LEDs should light up is perhaps its most astounding feature. By using this technique, a hacker may plug it in for a brief period of time, excuse themselves by saying, "Sorry, I think that USB drive is faulty," and then take it away with all the credentials stored on it.

HOW SERIOUS IS THE RISK?

In other words, it may be a significant one, but because physical device access is required, the majority of people aren't at risk of being a target.

The 500 or so new Rubber Duckies that Hak5 brought to Def Con, according to Kitchen, were his company's most popular item at the convention, and they were all gone on the first day. It's safe to suppose that hundreds of hackers already possess one, and demand is likely to persist for some time.

Additionally, it has an online development toolkit that can be used to create attack payloads, compile them, and then load them onto the target device. A "payload hub" part of the website makes it simple for hackers to share what they've generated, and the Hak5 Discord is also busy with conversation and helpful advice. This makes it simple for users of the product to connect with a larger community.

It's too expensive for most individuals to distribute in volume, so unless your favorite cafe is renowned for being a hangout among vulnerable targets, it's doubtful that someone will leave a few of them there. To that end, if you intend to plug in a USB device that you discovered outside in a public area, pause to consider your decision.

WOULD IT WORK FOR ME?

Although the device is quite straightforward to use, there are a few things that could cause you trouble if you have no prior expertise writing or debugging code. For a while, during testing on a Mac, I was unable to get the Ducky to press the F4 key to activate the launchpad, but after forcing it to identify itself using an alternative Apple keyboard device ID, the problem was resolved.

From there, I was able to create a script that, when the Ducky was plugged in, would instantly run Chrome, open a new browser tab, and then immediately close it once more without requiring any action from the laptop user. Not bad for only a few hours of testing, and something that could be readily changed to perform duties other than reading technology news.

Nikhil Vemu

Nikhil Vemu

2 years ago

7 Mac Apps That Are Exorbitantly Priced But Totally Worth It

Photo by Jack Carter on Unsplash

Wish you more bang for your buck

By ‘Cost a Bomb’ I didn’t mean to exaggerate. It’s an idiom that means ‘To be very expensive’. In fact, no app on the planet costs a bomb lol.

So, to the point.

Chronicle

(Freemium. For Pro, $24.99 | Available on Setapp)

Credit: LittleFin LLC

You probably have trouble keeping track of dozens of bills and subscriptions each month.

Try Chronicle.

Easy-to-use app

  • Add payment due dates and receive reminders,

  • Save payment documentation,

  • Analyze your spending by season, year, and month.

  • Observe expenditure trends and create new budgets.

Best of all, Chronicle features an integrated browser for fast payment and logging.

iOS and macOS sync.

SoundSource

($39 for lifetime)

Background Music, a free macOS program, was featured in #6 of this post last month.

It controls per-app volume, stereo balance, and audio over its max level.

Credit: Rogue Amoeba Software Inc.

Background Music is fully supported. Additionally,

  • Connect various speakers to various apps (Wow! ),

  • change the audio sample rate for each app,

  • To facilitate access, add a floating SoundSource window.

  • Use its blocks in Shortcuts app,

  • On the menu bar, include meters for output/input devices and running programs.

PixelSnap

($39 for lifetime | Available on Setapp)

Credit: MTW

This software is heaven for UI designers.

It aids you.

  • quickly calculate screen distances (in pixels) ,

Credit: MTW
  • Drag an area around an object to determine its borders,

Credit: MTW
  • Measure the distances between the additional guides,

Credit: MTW
  • screenshots should be pixel-perfect.

What’s more.

You can

  • Adapt your tolerance for items with poor contrast and shadows.

  • Use your Touch Bar to perform important tasks, if you have one.

Mate Translation

($3.99 a month / $29.99 a year | Available on Setapp)

Credit: Gikken

Mate Translate resembles a roided-up version of BarTranslate, which I wrote about in #1 of this piece last month.

If you translate often, utilize Mate Translate on macOS and Safari.

I'm really vocal about it.

It stays on the menu bar, and is accessible with a click or ⌥+shift+T hotkey.

It lets you

  • Translate in 103 different languages,

  • To translate text, double-click or right-click on it.

  • Totally translate websites. Additionally, Netflix subtitles,

  • Listen to their pronunciation to see how close it is to human.

iPhone and Mac sync Mate-ing history.

Swish

($16 for lifetime | Available on Setapp)

Swish is awesome!

Swipe, squeeze, tap, and hold movements organize chaotic desktop windows. Swish operates with mouse and trackpad.

Some gestures:

• Pinch Once: Close an app
• Pinch Twice: Quit an app
• Swipe down once: Minimise an app
• Pinch Out: Enter fullscreen mode
• Tap, Hold, & Swipe: Arrange apps in grids
and many more...

Credit: Christian Renninger

After getting acquainted to the movements, your multitasking will improve.

Unite

($24.99 for lifetime | Available on Setapp)

It turns webapps into macOS apps. The end.

Unite's functionality is a million times better.

Credit: BZG Apps LLC & Binyamin Goldman
  • Provide extensive customization (incl. its icon, light and dark modes)

  • make menu bar applications,

  • Get badges for web notifications and automatically refresh websites,

  • Replace any dock icon in the window with it (Wow!) by selecting that portion of the window.

This will help know weather or stock prices easily. (Credit: BZG Apps LLC & Binyamin Goldman)
  • Use PiP (Picture-in-Picture) on video sites that support it.

  • Delete advertising,

  • Throughout macOS, use floating windows

and many more…

I feel $24.99 one-off for this tool is a great deal, considering all these features. What do you think?

https://www.bzgapps.com/unite

CleanShot X

(Basic: $29 one-off. Pro: $8/month | Available on Setapp)

Credit: MTW

CleanShot X can achieve things the macOS screenshot tool cannot. Complete screenshot toolkit.

CleanShot X, like Pixel Snap 2 (#3), is fantastic.

Allows

  • Scroll to capture a long page,

  • screen recording,

    With webcam on,
    • With mic and system audio,
    • Highlighting mouse clicks and hotkeys.

  • Maintain floating screenshots for reference

  • While capturing, conceal desktop icons and notifications.

  • Recognize text in screenshots (OCR),

  • You may upload and share screenshots using the built-in cloud.

These are just 6 in 50+ features, and you’re already saying Wow!

Kyle Planck

Kyle Planck

3 years ago

The chronicles of monkeypox.

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.

my current vibe after two long weeks of monkeypox symptoms.

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.

a story i posted on instagram detailing my symptoms.

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.

look at that molecule!!! hot.

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