Notes on Engineering Health, December 2021: ICYMI 2021 Edition

Another year ends and instead of writing about the many challenges in front of the world at the moment which we thought did not carry a very positive message for the festive season, we decided to look back on the subjects we covered in the opening section of these Notes during 2021 and see if any updates on them were in order.

In our opening section, we try to address issues we think are important in our work as investors, company creators, and concerned citizens. We opened 2021 by talking about health equity both when it comes to COVID-19 related deaths but also in society at large. Sadly, the lack of health equity continues but coverage of these disparities has become louder and more pronounced. The CDC has updated its language around the issue and data around this issue can still be accessed and studied. The questions of equity of access and treatment stayed front and center in our June Notes as we addressed the differences between men and women in the ways they are treated by the healthcare system and also in the conditions they are more susceptible to contracting.

In February, we wrote about climate and health addressing both the direct consequences of polluted air and the potential effects of a warming earth. Despite pledges from nations at the COP26, this subject will remain an immense challenge for years to come.

In March, we retraced a brief history of the Electronic Health (and Medical) Record, highlighting its challenges and its promises at its inception and today. This led us to deepen our thoughts and make a distinction between privacy and security linked to the EHR in September.

Similar to the way we wrote about the EHR, we took a historical approach when discussing model organisms in July. Going through how a few of these organisms came to prominence as models helped us think about ways to interrogate systems to test hypotheses. New computational approaches and large datasets have enabled new ways to make biological discoveries. The treatment of infertility, for instance, a field that particularly benefited from these new technologies was covered in our note from April. Although translation into new treatments or methods has been slow to emerge in the fertility field, much confidence has been placed in these new computational approaches. Beyond computational methods, we explored in May new ways to better guide biologic systems to take advantage of their already existing capabilities in engineering therapeutic outcomes.

In October, we experimented with a new format by publishing an interview with Michael Retchin, one of the co-founders of Nucleate. This program aims to give student scientists some of the resources to start their own biotech startups. We are happy to report that Nucleate’s first year has debuted with more applicants and better support than ever imagined.

In November, we covered a personal story on surprise billing. A number of you kindly asked if the insurer had decided to reduce the bill. So far, there is no change but hope is the last thing to die.

We could not finish this note without mentioning the pandemic that has upended so much of our lives. In August, we expressed our concerns about the immense evolution experiment we find ourselves unwillingly participating in. We described the evolution of the SARS-CoV-2 virus in a strain even more contagious and able to evade our immunity (whether acquired through vaccination or prior infections) as all but certain. Sadly, the recent rise of the new Omicron variant has proven us right faster than we had feared.

We are looking forward to returning in 2022 to continue our work thinking and writing about many more pressing issues, interesting technologies, and the hopes and desires we have for our health and health care system.

In the meantime, best wishes to all of you for a happy and healthy New Year.

– Jonathan Friedlander, PhD & Geoffrey W. Smith



Notes on Engineering Health 2021
January — Health Equity
February — Climate and Health
March — A Short History of the EMR
April — A Fertile Ground for AI Companies
May — The Ends, Not The Means
June — XX Versus XY
July — Some Notes on Model Organisms
August — Evolution and Public Health
September — Notes on Privacy and Security
October — Nucleate: Empowering BioTech Founders
November — Surprise Billing: A Personal Story