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

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

Some call this another Kardashian publicity gimmick.

This maneuver is brilliance upon closer inspection. Why?

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

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

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

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

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

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

2) She has a special aptitude for identifying trends.

Kim Kardashian can sense trends.

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

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

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

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

Early founders would kill for Kim Kardashian's network.

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

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

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

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

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

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

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

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

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

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

I'm curious about the company's growth.

It's free now.

Most content writers—including me—write about side hustles because they do well.

I wrote several articles on a profitable programming side hustle.

Later, I learnt about AI content-generating platforms like Jasper.ai and Copy.ai, which I thought were terrible because they required subscriptions and had bad content. Even I dislike automatic online posting.

Since ChatGPT is becoming more popular, I tried it. It's free now.

Note: I wasn’t compensated to write this piece by this tool. In other words, I don’t receive any payment from their founders. There is no affiliate link, and right now it is free to use. Also, ChatGPT can do a lot more than what I ever did.

Begin.

OpenAI account registration requires visiting the website (if you don’t have one). Just write anything into the chatbot and get a response.

First, I wrote about the top 10 2023 side businesses.

This came in seconds.

2023 is shaping up to be a year of growth and opportunity for entrepreneurs and side hustlers. With the rise of remote work and the growing gig economy, there are many income streams to consider launching in the coming year. Here are the top 10 income streams to launch in 2023:

1. Virtual Assistant — The demand for virtual assistants is on the rise as more businesses move online. As a virtual assistant, you can offer administrative, technical, or creative services to clients remotely.

2. Online Tutoring — If you have expertise in a particular subject, consider becoming an online tutor. There are many platforms that connect tutors with students looking for help with their studies.

3. Freelance Writing — If you have a knack for writing, consider becoming a freelance writer. You can offer your services to businesses, bloggers, and individuals looking for content for their websites or social media platforms.

4. Graphic Design — If you have a talent for design, consider starting a graphic design side hustle. You can create logos, banners, and other visual content for businesses and individuals.

5. Social Media Management — Many businesses are looking for help with managing their social media accounts. As a social media manager, you can help businesses create and execute social media strategies to reach their target audience.

6. Dropshipping — Dropshipping is a business model where you sell products without actually holding any inventory. You can partner with suppliers and ship the products directly to the customer on behalf of the business.

7. Pet Sitting — If you love animals, consider starting a pet-sitting side hustle. You can offer your services to pet owners who need someone to take care of their pets while they are away.

8. Home Cleaning — With busy schedules, many people are looking for help with cleaning their homes. As a home cleaning service provider, you can offer your services to help keep homes tidy and organized.

9. Event Planning — If you have a talent for organization and planning, consider starting an event planning side hustle. You can offer your services to help plan and execute events for businesses and individuals.

10. Online Teaching — With the rise of online education, there is a growing demand for online teachers. If you have expertise in a particular subject, consider becoming an online teacher and offer your services to students looking for personalized instruction.

In conclusion, 2023 is shaping up to be a great year for launching new income streams. Whether you are looking to start a virtual assistant business, become an online tutor, or offer home cleaning services, there are many opportunities to turn your skills and expertise into a profitable side hustle.

Better than most online side hustle posts, right?

Write about the top 10 programming side hustles to start in 2023.

I got this.

If you are a programmer looking to start a side hustle, 2023 is the perfect time to launch your own business. With the growing demand for software and app development, there are many opportunities for programmers to turn their skills into a profitable side hustle. Here are the top 10 programming side hustles to start in 2023:

1. App Development — With the rise of smartphones and tablets, there is a growing demand for app development. You can offer your services to businesses and individuals looking to create custom apps for their needs.

2. Website Development — Many businesses and individuals are looking for help with creating and maintaining their websites. As a website developer, you can offer your services to help design, build, and manage websites for your clients.

3. Software Development — If you have expertise in a particular programming language, consider starting a software development side hustle. You can offer your services to businesses and individuals looking to create custom software solutions for their needs.

4. Game Development — The gaming industry is thriving, and there is a growing demand for game development. If you have experience in game development, you can offer your services to businesses and individuals looking to create custom games.

5. Data Analysis — With the rise of big data, there is a growing demand for data analysts. As a data analyst, you can offer your services to businesses and individuals looking to make sense of their data and gain insights from it.

6. Machine Learning — Machine learning is a rapidly growing field, and there is a growing demand for machine learning experts. If you have experience in machine learning, you can offer your services to businesses and individuals looking to develop custom machine learning solutions.

7. Cloud Computing — With the rise of cloud computing, there is a growing demand for cloud experts. If you have experience in cloud computing, you can offer your services to businesses and individuals looking to migrate their applications and data to the cloud.

8. Blockchain Development — Blockchain technology is gaining popularity, and there is a growing demand for blockchain developers. If you have experience in blockchain development, you can offer your services to businesses and individuals looking to develop custom blockchain solutions.

9. Artificial Intelligence — Artificial intelligence is a rapidly growing field, and there is a growing demand for AI experts. If you have experience in artificial intelligence, you can offer your services to businesses and individuals looking to develop custom AI solutions.

10. Virtual Reality — Virtual reality is an exciting and emerging technology, and there is a growing demand for VR developers. If you have experience in VR development, you can offer your services to businesses and individuals looking to create custom VR experiences.

In conclusion, 2023 is a great time to start a programming side hustle. Whether you are interested in app development, website development, or machine learning, there are many opportunities for programmers to turn their skills into a profitable business.

These two blogs show that AI can simplify blog authoring.

I asked some tough programming questions, and most were suitable.

The content may occasionally not be what we want, but it will almost always be very helpful to you.

Enjoy.

Python Heatmap Technical Indicator

Heatmaps provide an instant overview. They can be used with correlations or to predict reactions or confirm the trend in trading. This article covers RSI heatmap creation.

The Market System

Market regime:

• Bullish trend: The market tends to make higher highs, which indicates that the overall trend is upward.

• Sideways: The market tends to fluctuate while staying within predetermined zones.

• Bearish trend: The market has the propensity to make lower lows, indicating that the overall trend is downward.

Most tools detect the trend, but we cannot predict the next state. The best way to solve this problem is to assume the current state will continue and trade any reactions, preferably in the trend.

If the EURUSD is above its moving average and making higher highs, a trend-following strategy would be to wait for dips before buying and assuming the bullish trend will continue.

Indicator of Relative Strength

J. Welles Wilder Jr. introduced the RSI, a popular and versatile technical indicator. Used as a contrarian indicator to exploit extreme reactions. Calculating the default RSI usually involves these steps:

• Determine the difference between the closing prices from the prior ones.

• Distinguish between the positive and negative net changes.

• Create a smoothed moving average for both the absolute values of the positive net changes and the negative net changes.

• Take the difference between the smoothed positive and negative changes. The Relative Strength RS will be the name we use to describe this calculation.

• To obtain the RSI, use the normalization formula shown below for each time step.

The 13-period RSI and black GBPUSD hourly values are shown above. RSI bounces near 25 and pauses around 75. Python requires a four-column OHLC array for RSI coding.

import numpy as np
def add_column(data, times):
    
    for i in range(1, times + 1):
    
        new = np.zeros((len(data), 1), dtype = float)
        
        data = np.append(data, new, axis = 1)
    return data
def delete_column(data, index, times):
    
    for i in range(1, times + 1):
    
        data = np.delete(data, index, axis = 1)
    return data
def delete_row(data, number):
    
    data = data[number:, ]
    
    return data
def ma(data, lookback, close, position): 
    
    data = add_column(data, 1)
    
    for i in range(len(data)):
           
            try:
                
                data[i, position] = (data[i - lookback + 1:i + 1, close].mean())
            
            except IndexError:
                
                pass
            
    data = delete_row(data, lookback)
    
    return data
def smoothed_ma(data, alpha, lookback, close, position):
    
    lookback = (2 * lookback) - 1
    
    alpha = alpha / (lookback + 1.0)
    
    beta  = 1 - alpha
    
    data = ma(data, lookback, close, position)
    data[lookback + 1, position] = (data[lookback + 1, close] * alpha) + (data[lookback, position] * beta)
    for i in range(lookback + 2, len(data)):
        
            try:
                
                data[i, position] = (data[i, close] * alpha) + (data[i - 1, position] * beta)
        
            except IndexError:
                
                pass
            
    return data
def rsi(data, lookback, close, position):
    
    data = add_column(data, 5)
    
    for i in range(len(data)):
        
        data[i, position] = data[i, close] - data[i - 1, close]
     
    for i in range(len(data)):
        
        if data[i, position] > 0:
            
            data[i, position + 1] = data[i, position]
            
        elif data[i, position] < 0:
            
            data[i, position + 2] = abs(data[i, position])
            
    data = smoothed_ma(data, 2, lookback, position + 1, position + 3)
    data = smoothed_ma(data, 2, lookback, position + 2, position + 4)
    data[:, position + 5] = data[:, position + 3] / data[:, position + 4]
    
    data[:, position + 6] = (100 - (100 / (1 + data[:, position + 5])))
    data = delete_column(data, position, 6)
    data = delete_row(data, lookback)
    return data

Make sure to focus on the concepts and not the code. You can find the codes of most of my strategies in my books. The most important thing is to comprehend the techniques and strategies.

My weekly market sentiment report uses complex and simple models to understand the current positioning and predict the future direction of several major markets. Check out the report here:

Using the Heatmap to Find the Trend

RSI trend detection is easy but useless. Bullish and bearish regimes are in effect when the RSI is above or below 50, respectively. Tracing a vertical colored line creates the conditions below. How:

• When the RSI is higher than 50, a green vertical line is drawn.

• When the RSI is lower than 50, a red vertical line is drawn.

Zooming out yields a basic heatmap, as shown below.

Plot code:

def indicator_plot(data, second_panel, window = 250):
    fig, ax = plt.subplots(2, figsize = (10, 5))
    sample = data[-window:, ]
    for i in range(len(sample)):
        ax[0].vlines(x = i, ymin = sample[i, 2], ymax = sample[i, 1], color = 'black', linewidth = 1)  
        if sample[i, 3] > sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 0], ymax = sample[i, 3], color = 'black', linewidth = 1.5)  
        if sample[i, 3] < sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 3], ymax = sample[i, 0], color = 'black', linewidth = 1.5)  
        if sample[i, 3] == sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 3], ymax = sample[i, 0], color = 'black', linewidth = 1.5)  
    ax[0].grid() 
    for i in range(len(sample)):
        if sample[i, second_panel] > 50:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'green', linewidth = 1.5)  
        if sample[i, second_panel] < 50:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'red', linewidth = 1.5)  
    ax[1].grid()
indicator_plot(my_data, 4, window = 500)

Call RSI on your OHLC array's fifth column. 4. Adjusting lookback parameters reduces lag and false signals. Other indicators and conditions are possible.

Another suggestion is to develop an RSI Heatmap for Extreme Conditions.

Contrarian indicator RSI. The following rules apply:

• Whenever the RSI is approaching the upper values, the color approaches red.

• The color tends toward green whenever the RSI is getting close to the lower values.

Zooming out yields a basic heatmap, as shown below.

Plot code:

import matplotlib.pyplot as plt
def indicator_plot(data, second_panel, window = 250):
    fig, ax = plt.subplots(2, figsize = (10, 5))
    sample = data[-window:, ]
    for i in range(len(sample)):
        ax[0].vlines(x = i, ymin = sample[i, 2], ymax = sample[i, 1], color = 'black', linewidth = 1)  
        if sample[i, 3] > sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 0], ymax = sample[i, 3], color = 'black', linewidth = 1.5)  
        if sample[i, 3] < sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 3], ymax = sample[i, 0], color = 'black', linewidth = 1.5)  
        if sample[i, 3] == sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 3], ymax = sample[i, 0], color = 'black', linewidth = 1.5)  
    ax[0].grid() 
    for i in range(len(sample)):
        if sample[i, second_panel] > 90:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'red', linewidth = 1.5)  
        if sample[i, second_panel] > 80 and sample[i, second_panel] < 90:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'darkred', linewidth = 1.5)  
        if sample[i, second_panel] > 70 and sample[i, second_panel] < 80:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'maroon', linewidth = 1.5)  
        if sample[i, second_panel] > 60 and sample[i, second_panel] < 70:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'firebrick', linewidth = 1.5) 
        if sample[i, second_panel] > 50 and sample[i, second_panel] < 60:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'grey', linewidth = 1.5) 
        if sample[i, second_panel] > 40 and sample[i, second_panel] < 50:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'grey', linewidth = 1.5) 
        if sample[i, second_panel] > 30 and sample[i, second_panel] < 40:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'lightgreen', linewidth = 1.5)
        if sample[i, second_panel] > 20 and sample[i, second_panel] < 30:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'limegreen', linewidth = 1.5) 
        if sample[i, second_panel] > 10 and sample[i, second_panel] < 20:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'seagreen', linewidth = 1.5)  
        if sample[i, second_panel] > 0 and sample[i, second_panel] < 10:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'green', linewidth = 1.5)
    ax[1].grid()
indicator_plot(my_data, 4, window = 500)

Dark green and red areas indicate imminent bullish and bearish reactions, respectively. RSI around 50 is grey.

Summary

To conclude, my goal is to contribute to objective technical analysis, which promotes more transparent methods and strategies that must be back-tested before implementation.

Technical analysis will lose its reputation as subjective and unscientific.

When you find a trading strategy or technique, follow these steps:

• Put emotions aside and adopt a critical mindset.

• Test it in the past under conditions and simulations taken from real life.

• Try optimizing it and performing a forward test if you find any potential.

• Transaction costs and any slippage simulation should always be included in your tests.

• Risk management and position sizing should always be considered in your tests.

After checking the above, monitor the strategy because market dynamics may change and make it unprofitable.

The best free tools are probably unknown to you.

Modern startups are easy to build.

Start with free tools.

Let’s go.

Web development — Webflow

Code-free HTML, CSS, and JS.

Webflow isn't like Squarespace, Wix, or Shopify.

It's a super-fast no-code tool for professionals to construct complex, highly-responsive websites and landing pages.

Webflow can help you add animations like those on Apple's website to your own site.

I made the jump from WordPress a few years ago and it changed my life.

No damn plugins. No damn errors. No damn updates.

The best, you can get started on Webflow for free.

Data tracking — Airtable

Spreadsheet wings.

Airtable combines spreadsheet flexibility with database power without code.

• Airtable is modern.

• Airtable has modularity.

• Scaling Airtable is simple.

Airtable, one of the most adaptable solutions on this list, is perfect for client data management.

Clients choose customized service packages. Airtable consolidates data so you can automate procedures like invoice management and focus on your strengths.

Airtable connects with so many tools that rarely creates headaches. Airtable scales when you do.

Airtable's flexibility makes it a potential backend database.

Design — Figma

Better, faster, easier user interface design.

Figma rocks!

• It’s fast.

• It's free.

• It's adaptable

First, design in Figma.

Iterate.

Export development assets.

Figma lets you add more team members as your company grows to work on each iteration simultaneously.

Figma is web-based, so you don't need a powerful PC or Mac to start.

Task management — Trello

Unclock jobs.

Tacky and terrifying task management products abound. Trello isn’t.

Those that follow Marie Kondo will appreciate Trello.

• Everything is clean.

• Nothing is complicated.

• Everything has a place.

Compared to other task management solutions, Trello is limited. And that’s good. Too many buttons lead to too many decisions lead to too many hours wasted.

Trello is a must for teamwork.

Domain email — Zoho

Free domain email hosting.

Professional email is essential for startups. People relied on monthly payments for too long. Nope.

Zoho offers 5 free professional emails.

It doesn't have Google's UI, but it works.

VPN — Proton VPN

Fast Swiss VPN protects your data and privacy.

Proton VPN is secure.

• Proton doesn't record any data.

• Proton is based in Switzerland.

Swiss privacy regulation is among the most strict in the world, therefore user data are protected. Switzerland isn't a 14 eye country.

Journalists and activists trust Proton to secure their identities while accessing and sharing information authoritarian governments don't want them to access.

Web host — Netlify

Free fast web hosting.

Netlify is a scalable platform that combines your favorite tools and APIs to develop high-performance sites, stores, and apps through GitHub.

Serverless functions and environment variables preserve API keys.

Netlify's free tier is unmissable.

• 100GB of free monthly bandwidth.

• Free 125k serverless operations per website each month.

Database — MongoDB

Create a fast, scalable database.

MongoDB is for small and large databases. It's a fast and inexpensive database.

• Free for the first million reads.

• Then, for each million reads, you must pay $0.10.

MongoDB's free plan has:

• Encryption from end to end

• Continual authentication

• field-level client-side encryption

If you have a large database, you can easily connect MongoDB to Webflow to bypass CMS limits.

Automation — Zapier

Time-saving tip: automate repetitive chores.

Zapier simplifies life.

Zapier syncs and connects your favorite apps to do impossibly awesome things.

If your online store is connected to Zapier, a customer's purchase can trigger a number of automated actions, such as:

1. The customer is being added to an email chain.

2. Put the information in your Airtable.

3. Send a pre-programmed postcard to the customer.

4. Alexa, set the color of your smart lights to purple.

Zapier scales when you do.

Email & SMS marketing — Omnisend

Email and SMS marketing campaigns.

This is an excellent Mailchimp option for magical emails. Omnisend's processes simplify email automation.

I love the interface's cleanliness.

Omnisend's free tier includes web push notifications.

Send up to:

• 500 emails per month

• 60 maximum SMSs

• 500 Web Push Maximum

Forms and surveys — Tally

Create flexible forms that people enjoy.

Typeform is clean but restricting. Sometimes you need to add many questions. Tally's needed sometimes.

Tally is flexible and cheaper than Typeform.

99% of Tally's features are free and unrestricted, including:

• Unlimited forms

• Countless submissions

• Collect payments

• File upload

Tally lets you examine what individuals contributed to forms before submitting them to see where they get stuck.

Airtable and Zapier connectors automate things further. If you pay, you can apply custom CSS to fit your brand.

See.

Free tools are the greatest.

Let's use them to launch a startup.