Dear clients and friends: Given your interest in health and medicine, we would like to share with you our collection of the most interesting perspectives on our industry's trends and developments. We are happy to share them with you — and hope you share your thoughts with us.

1. Bill Gates Is Optimistic…But Not Really

WIRED speaks to Bill Gates about the global response to COVID-19. His arguments would be hard to fit in a tweet. He wants to hold power to account for its failures, but not yet. He sees success in the pace of innovation, but at a terrible cost:

You have to admit there’s been trillions of dollars of economic damage done and a lot of debts, but the innovation pipeline on scaling up diagnostics, on new therapeutics, on vaccines is actually quite impressive. And that makes me feel like, for the rich world, we should largely be able to end this thing by the end of 2021, and for the world at large by the end of 2022…[But] we will have lost many years in malaria and polio and HIV and the indebtedness of countries of all sizes and instability. It’ll take you years beyond that before you’d even get back to where you were at the start of 2020. It’s not World War I or World War II, but it is in that order of magnitude as a negative shock to the system.

2. Why Aren't We Using More AI?

The Atlantic offers a stunning prediction: AI will soon take over radiology. 

That was 2011. Nearly a decade later, K@W asks why AI remains the stuff of journalism, not medicine:  

Fear of replacement is not the biggest barrier to radiologists adopting AI; it is the fear that AI will slow them down. Radiologists are already working at near maximum efficiency. Though more radiologists are beginning to acknowledge that the best patient care will be provided by radiologists who use AI, many are concerned about the legal consequences of using AI.

K@W ends with a note of optimism: “algorithms will, one day, do wonders for patient care without stealing anyone’s job.”

3. R&D: Running Dry

Economist Tyler Cowen talks with Stanford Business School professor Nicholas Bloom. Their wide-ranging discussion covers everything from remote work to India’s legal system. Perhaps most relevant to this moment is their discussion about the falling efficiency of research and researchers:

If you think of the US, the number of research universities has exploded, as have the number of firms with research labs. Thomas Edison, for example, was the first lab about 100 years ago, but post–World War II, most large American companies have been pushing huge amounts of cash into R&D. But despite all of that increase in inputs, productivity growth has been slowing over the last 50 years. That’s the sense in which it’s harder and harder to find new ideas. We’re putting more inputs into labs, but actually productivity growth is falling.

4. “This Post Is About What It’s Like”

A patient chronicles his experiences getting radiation therapy for throat cancer. The blog – half novel, half fact sheet – captures one patient’s unadulterated voice: 

At the CT session, the radiation team made a mask of my face, head, and neck. They took a big sheet of some kind of plastic mesh and warmed it until it softened. Next, I had to lie on my back on a table with my head on a moulded plastic cushion that positioned my head to look at the ceiling. This is the position that they want my head to be in during the radiation. Then they placed the softened plastic sheet over my head and pressed it down so that it conformed to my head and neck. It’s a mesh, so I could breathe through it. In a couple of minutes, the plastic cooled and became rigid. They lifted it off — it wasn’t sticky — and there was my mask.

5. How to Test COVID Vaccines?

The “challenge” vaccine trials would deliberately expose a set of volunteers to the coronavirus. Rutgers bioethicist Nir Eyal and Harvard epidemiologist Marc Lipsitch favor the approach:

The main risks in a challenge study are greater per volunteer but can be brought down dramatically by recruiting only young, healthy volunteers. Either trial type risks accidents from the test vaccine’s toxicities or its enhancement of disease severity. In a traditional design, such accidents could happen to many more participants and take place in the field, not in the relative safety of a controlled medical environment. 

Not so simple, warns Marcia Angell, the former Editor-in-Chief of the New England Journal of Medicine:

First, we still know very little about this novel virus, including what hidden or long-term effects it might have on even young, healthy volunteers. And second, will a vaccine be equally effective in the elderly and chronically ill, those who are most vulnerable to Covid-19?... But more generally, I worry about the erosion of our hard-won ethical consensus (starting with the Nuremberg Code) that people should not be used as means to an end if they might be harmed.