Tremendous

An angel investor's take on life and business

  • Could a Head Lice Medication Help COVID Patients?

    There is increasing evidence that ivermectin, a drug usually used for head lice and other parasitic infections, may help COVID patients. A new randomized controlled trial from India found patients with mild to moderate COVID admitted to the hospital were more likely to survive.

    Another study from Florida also showed lower mortality among patients given ivermectin, but others have shown no effect. There are also concerns about being able to safely get to the necessary blood levels of ivermectin in humans.

    The investigation of this drug as a treatment is ongoing, and we cannot definitively say yet whether it works or not. But given its low cost and wide availability, it could be very helpful in the fight against COVID if it is found to be effective. Many trials are ongoing.

    “Pills” by Grumpy-Puddin is licensed under CC BY 2.0

  • How We Could’ve Known Theranos Was a Fraud

    Investors lost over $9 billion on Theranos, the diagnostics testing company run by Elizabeth Holmes that was exposed as a fraud. Worse yet, patients received inaccurate test results, imperilling their health. But what if asking one simple question could’ve prevented all this?

    In the book Editing Humanity, Keith Davies notes that Theranos’ technology had no foundation in peer-reviewed, published research. The always-astute John Ioannidis pointed this out as early as 2015. Theranos published a single paper in 2018, after the company was already exposed as fradulent and was near bankruptcy. Theranos made incredible claims for its technology, but without peer review by respected journal, there was no one to check if those claims were actually true. (Theranos had filed patent applications, but that doesn’t necessarily provide the same level of detail and review.)

    This stands in contrast to many other biotech companies, such as several in the CRISPR area (Editas Medicine, Intellia Therapeutics, etc.) whose approach grows out of research published in major journals. Also, such companies have major scientists as co-founders, not a 19 year old unknown.

    I am considering getting involved in early-stage biotech investment, so asking “What papers can you point me to that underlie your technology?” is a question I plan to ask in the future. That may be able to weed out some weaker companies and potential frauds.

    For more background on Theranos, I strongly recommend the outstanding book Bad Blood by John Carreyrou. I listened to it as an Audible audiobook. It was read by Will Damron, whose voice is outstanding.

    I also hear excellent things about the ABC News podcast series The Dropout, which details Holmes’ path from Stanford student to billionaire to accused criminal awaiting trial today. I haven’t listened to it yet, but I look forward to getting a chance soon!

    “File:Elizabeth Holmes 2014 cropped.jpg” by Photo by Max Morse for TechCrunch TechCrunch is licensed under CC BY 2.0

  • Why I Just Did a 3 Day Fast

    I just completed a 3 day fast this morning. I celebrated by munching on chocolates and having some of my mother-in-law’s outstanding banana bread. It’s a great feeling to have made it!

    No, you do not die if you don’t eat for three days. In fact, fasting for 3-5 days can regenerate the immune system. Older cells are eliminated through a process called autophagy, and new ones generated. Fasting also has significant life extension benefits. I also feel a sense of accomplishment and I get a chance to hone my willpower, which is critical in all areas of life.

    But aren’t you hungry? Yes, of course you are, sometimes. But that’s okay! You’ll get comfortable with it. I’ve done quarterly 3 day fasts for about 2 years and countless 24 hour fasts. Here are my top tips for coming through your fast comfortably:

    1) Supplement electrolytes. You’re as good as your electrolyte supplementation. If your electrolytes are at a good level, you’re comfortable. If they get low, your life sucks until you replenish. The first day, I was beginning to feel a bit run down, but then I supplemented and I felt fine. Often the fatigue is related much more to electrolytes than to actual hunger.

    I use a supplement similar to this, but generic (bought at a local store). I recommend 1 liter per day, consumed gradually. The mixed fruit or fruit punch flavors tend to be the best. Some sources recommend starting supplementation after several days, but I find I need it starting right away.

    2) Keep busy! The more you do, the less you’ll think about being unable to eat.

    3) Enjoy the freedom! You can do more without all the time involved with meal prep, eating, and clean up. I find myself focused and productive during these periods.

    What are your experiences with fasting? Maybe you’re considering it and haven’t tried it yet? Leave a comment and let me know.

  • New Administration Will Release All Available COVID Vaccine Doses Immediately

    CNN just reported that the Biden administration plans to release all doses of the COVID vaccine right away, instead of holding back half of them to ensure 2nd doses are available. This could make the vaccine more widely available sooner.

    If more people get their first dose, that could get them up to 90% protection, slowing the pandemic. The UK and Canada have already adopted this approach, and I’m happy to see the new administration’s openness to giving it a try.

    Our current pace of vaccination, while increasing, would take 3 years to reach herd immunity. We simply don’t have that long.

  • What’s Really Going On in the World Today

    We’ve seen some scary headlines lately. But I threw caution to the wind and went out exploring anyway so you guys wouldn’t have to. What I found: beautiful sun, empty sidewalks, no rioters, indeed nothing out of the ordinary besides a few inflatable Santas. I encourage everyone to remember that even when there are problems, 99.99% of what’s out there is great and we should enjoy it!

  • How We Can Rewrite Our Genetic Blueprint

    We may soon be able to edit our own genes using a new technology called CRISPR. It uses a bacteria to change data in the genetic code and could one day cure rare genetic diseases. There is also potential in editing genes to prevent cancer and heart disease.

    In the new excellent book Editing Humanity by Kevin Davies, we learn how the technology was developed and how it has been applied and misapplied. CRISPR has cured a patient of sickle cell disease already, but was also used inappropriately to sloppily modify the genes of several babies in China. It’s tool with enormous potential, but that includes potential for abuse.

    I am intrigued to see if this tool could one day be used to reverse the DNA errors that come with aging.

    As an investor, it struck me that Beam Therapeutics, a company founded by David Liu and Feng Zhang, two of the best scientists in the field, went public at a valuation of only $180 million. If CRISPR doesn’t revolutionize health, perhaps it’s worth zero. But what if it succeeds? It could be the most valuable company in history. Indeed, since this book came out in mid-2020, I see the share price has increased nearly fivefold.

    I also think we would benefit greatly from increasing our investment as a society in basic research. I was surprised to learn that the Howard Hughes Medical Institute supports the lab of one of the co-inventors of CRISPR, Jennifer Doudna, at a rate of $1 million per year. While HHMI’s work is outstanding and to be commended, I imagine Doudna could use a lot more than that. What would she do with $10 or $100 million a year? Our government and we as individuals (through crowdfunding) could get it to her and other leading scientists. The benefits we could reap can only be imagined.

    Davies’ book is entertaining, readable, and informative throughout. I’d highly recommend it to anyone with an interest in CRISPR, gene editing, or health in general!

  • How I Quit Smoking

    Six years ago, I did something people say is almost impossible. I quit smoking, and I haven’t touched tobacco since.

    Here’s a secret: it’s very, very possible.

    I smoked about a pack a day of cigarettes for over 7 years, and as I was about to get married, I thought about how I had to prioritize my health now that someone else would be depending on me. What’s more, I knew all the disastrous health impacts, and wanted to quit eventually anyhow. But I had always pushed that date conveniently into the future.

    Until January 20, 2015. That was the quit date I set for myself. In the two weeks prior to quitting, I reduced my consumption from about a pack a day (20 cigarettes) to 10. I maintained that for a week, and found it fairly easy. This was based on the concept of drug tapering, which I learned about working in medical organizations as a software consultant. I had tried Chantix in the past, a prescription drug designed to help you quit smoking, but I found the taper more effective.

    A week later (January 13), I reduced that to five cigarettes a day. That’s when things got interesting. I experienced a degree of nicotine withdrawal and cravings, but I could still have a few cigarettes per day, which helped salve the wound.

    When January 20 came along, I was actually looking forward to quitting. I had already gone through a lot of the withdrawal. And I was looking forward to the benefits of not having to go outside in the cold to smoke and not incinerating money, among others.

    I remember tossing away that final cigarette, a Camel Turkish Gold, on a cold day and heading back upstairs. I was done. And although I expected to feel dread, I actually felt glad, if a little whistful.

    Within 3 days, I felt my brain and body functioning better. It felt like oxygen was actually hitting my system for the first time in years! I felt exhilaration and energy, which is something not many people mention when quitting smoking. If you can make it through those first 3 days, there’s likely a big payoff waiting.

    Nearly 6 years later, I’m able to do things I could never have done before. When I sprint up stairs or hike up a mountain or do a hardcore strength training session, I think to myself that my lungs could’ve never withstood this before. I’m also not a slave to a habit that has me going outside every few minutes in any weather, desperately counting the hours until I can get off an airplane, and scurrying to convenience stores for the next fix.

    The reality is, if you are ready to quit, and you make a plan and stick to it, it’s really not that hard. Imagine yourself sitting on the couch all day watching TV, gut sticking out, eating Doritos and cake. If you’re quitting smoking, and you didn’t smoke that day, that day was a 100%, unqualified success! How often can you say that about such an unproductive day? You see, the bar is set very low: just don’t do this one thing.

    On the 20th, I plan to take myself out for a nice dinner. Whatever it costs will be a fraction of what cigarettes would have. And more importantly, I have a longer and healthier life to look forward to.

  • A New Strategy for Getting More People Vaccinated Faster

    If the average benefit from a booster is only 5%,(increasing efficacy from 90 to 95%), then intuitively it seems logical that this dose is better used by giving it to another individual without any vaccination to increase their immunity from 0 to 90%.

    A number of researchers have proposed getting first COVID vaccine doses to as many people as possible right away, instead of holding back vaccine to give as 2nd doses later. A new paper released today estimates that we could immunize everyone much more quickly given this approach.

    Most of the protection comes from the first dose, so getting more first doses out should be able to protect more people than reserving doses so people can get a second one.

    The clinical trials did not delay 2nd doses, so this approach is somewhat speculative. However, the paper shows that even if immune function drops off significantly with just one dose, getting more doses out faster leads to faster herd immunity.

    This is being done in Canada and the UK. Former FDA Commissioner Scott Gottlieb favors it. It may be time to give this innovative approach a try in the United States.

  • My Best Resources for Home Workouts

    When my gym closed last March, I wondered how I’d continue to train and stay healthy. Even with gyms reopened now, lines are often long and many people are still not comfortable going. So how can we stay in shape at home, preferably with little or no equipment? These are the best resources I’ve found:

    • Athlean-X. Terrific YouTube channel created by Jeff Cavaliere, a physical therapist and trainer to professional athletes. It’s one of the marvels of today that you can have the same trainer as NFL players and other elite athletes, all for nothing and without leaving your house.

      His Athlean Xero program in particular has countless exercises that use no equipment whatsoever. But just because they’re bodyweight exercises doesn’t make them easy! I particularly like the sidelying bicep curl and the Bulgarian split squat.
    • Body by Science. The author is a doctor with deep knowledge of how strength training works. I used his principles even while I was still going to the gym, but I find them just as applicable now that I’m doing mostly bodyweight training.

      This program has you move slowly to maximize time under load and lift to failure so that the muscles will be overloaded and grow. Moving slowly can also make a small weight feel like a big one if your equipment is limited. The program also emphasizes the importance of training each muscle group only once a week, since the muscles take significant time to repair and grow. A burn or cut doesn’t heal in a couple of days, and neither do the microscopic tears in the muscle caused by strength training.

    These resources have helped me gain a significant amount of mass and strength in the last 10 months. In fact, I’m progressing at a faster rate than I did with a gym membership. I also find that moving slowly and using primarily bodyweight means I don’t injure myself, which was a problem in the past.

    No more excuses! Let’s get to it!

  • The Painting I Love the Most

    I’ve always found Picasso’s Les Demoiselles d’Avignon particularly beautiful. When you walk into the room where it lives in the Museum of Modern Art, it’s impossible not to be drawn to it. The bright, rose color, the striking jagged shapes, and the eyes of the women staring back at you always hold me rapt.

    I particularly liked to go to MoMA during the wonderful Free Fridays, but last March the pandemic shut MoMA along with everything else. I remember being home at night, looking at the darkness outside, and thinking that inside that gallery was dark now too.

    For perhaps the first time since it was made in 1907, no one was looking at my favorite painting. Perhaps a caretaker came by from time to time to check on it, and cleaning crews to sweep up, but aside from that it was alone. I missed it like a friend. And I wondered if it was lonely.

    In the fall, I finally got the opportunity to see my old friend again. I relished looking at the warm colors and the beautiful figures. I was happy to be together with it again, happy to reclaim something of the life I’d had. And maybe the painting was happy too, to be admired once more.

    My point: what we’ve lost, we will regain. Even more. Let’s be patient and look forward to that day. Everything we’ve loved before, we’ll appreciate more than ever.