South African Gambling Industry Sees Major Impact Due to

UPDATE – 26 January 2021
COVID has been in Canada for one year now.
The strange case of the CEO in disguise to get vaccine for himself.
COVID-19 tax tips.
COVID-19 and the world of work – the International Labor Organization.
A breakdown of cases among healthcare workers.

If you’re having trouble regulating life while working from home, the fake commute might be for you, have a look: https://www.cnn.com/2021/01/18/success/fake-commute-meaning-benefits-pandemic-wellness/index.html
“For the many who have been doing your part, you may be asking, what more can I do? Be the voice of support and encouragement for those who may be wavering in their resolve.” – Dr. Bonnie Henry.
Feel free to share this post, or copy and paste, in whole or any part of it.

LOCAL:
· 82 cases among New West residents in the previous week.
· No new school exposures in New Westminster since that of the Queensborough Middle School on January 11th.
· Current outbreaks: Royal City Manor, declared Jan 21; Royal Columbian Hospital, declared Jan 20.
· The Rio Theatre in Vancouver has converted into a sports bar.
· The theatre is dealing with a full closure of movie theatres. But as restaurants and bars can remain open with safety protocols, the theatre is seeking other ways to do business. The move does show that the Rio cannot do business as a theatre right now, but can meet the safety requirements to operate as a sports bar.
· There are differences though. The theatre has to actually meet the requirements for a bar, such as taking orders from people’s seats rather than allowing a line-up at the concession.
· The move has stirred controversy, with some decrying the Rio as finding a loophole while the basic lay-out is still that of a theatre, with narrow entryways and tiny washrooms. Others welcome the move as innovative, a way for a theatre to survive during the closure.
Sources: CBC, Global News, Fraser Health

PROVINCIAL:
· The strange case of the CEO in disguise.
· Vancouver couple Rod and Ekaterina Baker were fined $575 after sneaking into the Yukon to try to get the vaccine for themselves.
· The couple posed as local motel workers.
· The clinic at Beaver Creek normally has one nurse and a receptionist, but a team of six was flown in to do vaccinations. Beaver Creek was chosen because “of its remoteness, elderly and population, and limited access to health care,” said Chief Angela Demit of the White River First Nation in Beaver Creek.
· The story of the wealthy executive trying to get vaccine intended for remote elderly First Nations people has not gone over well.
· Rod Baker is the Chief Executive Officer of Great Canadian Gaming, since 2011, where he earns $900,000 per year as salary, but last year also made $45.9 million from company stock options.. The company announced his resignation yesterday. The gambling company cited it’s “core values.” Ekaterina Baker is an actor, but not apparently a good enough one to fool Yukon officials. The couple chartered a flight to the Yukon.
· “We had not been imagining that someone would go to this length to mislead or deceive.” John Streicker, Yukon’s Minister of Community Services.
· The manager of the 1202 Motor Inn, where the couple claimed to work, was also rather upset. “That’s a risk (serving travellers) that we take – not a risk that somebody enforces upon us because they are too ignorant.” Staff at the Beaver Creek clinic found the couple suspicious, and phoned the motel to check on their story. While at the clinic and pretending to live and work in town, the couple rather oddly asked if anyone could drive them to the airport afterwards.
· Story from the Globe and Mail: https://www.theglobeandmail.com/canada/article-great-canadian-gaming-ceo-resigns-after-being-charged-in-yukon-ove?utm_medium=email&utm_source=Coronavirus%20Update&utm_content=2021-1-25_19&utm_term=Coronavirus%20Update:%20Great%20Canadian%20Gaming%20CEO%20resigns%20after%20alleged%20botched%20disguise%20as%20Yukon%20motel%20worker%20in%20attempt%20to%20get%20COVID-19%20vaccine&utm_campaign=newsletter&cu_id=czq7hF%2BueFDcmmCKozRUQ1bduJl6paGe
· Ekaterina Baker is known for acting in productions such as Chick Fight, Fatman, The Asset, and The Comeback Trail, and as producer of Big Gold Brick.
· IMDB page: https://www.imdb.com/name/nm9698063/
· BC has adopted a four phase vaccination plan.
· Phase 1, December to February: Residents, staff, essential visitors with long-term care and assisted living; people waiting for long-term care; people in remote Indigenous communities and hospital workers caring for patients with COVID-19.
· Phase 2, February to March: Seniors over 80; Indigenous seniors over 65, Indigenous elders; more health-care workers; vulnerable populations and nursing-home staff.
· Phase 3, April to June: Members of the general public aged 60 to 79.
· Phase 4, July to September: Members of the general public aged 18 to 59.
· Premier John Horgan says the plan is based on those who get most sick, and those most likely to die, so priority goes to the elderly and vulnerable, and those who work around them.
· The Premier said multiple groups argued that they were front-line workers and so should get priority. But with vaccine supply limited, it didn’t seem to make sense to vaccinate people on the basis of their job, like being a front-line worker, ahead people ahead of seniors or those more likely to be hospitalized or to die. Health care workers are not only the most likely to be exposed, but they also work with and have direct contact with patients and the vulnerable.
· Here is a good article with the numbers and the rationale behind the priorities: https://www.newwestrecord.ca/local-news/opinion-elderly-should-get-covid-19-vaccine-before-bc-teachers-3291898
· The dates might vary, depending on supply.
· Covid cases in BC have plateaued to an average of 500 per day.
· Dr. Bonnie Henry said that the number is still dangerously high. “For the last few weeks, we have plateaued at 500 new cases. This is too many. We are at a precipice. The virus continues to circulate in our communities. We are at the threshold of where we were in late October and November when cases started to rise.”
· “Over the next two week, I believe we can bend our curve. Not just plateau, but bend it back down…. More than you’ve done before, stay home, stop social interactions.”
· B.C. will receive no new doses of vaccine over the next two weeks. It is not sure how much will be received in February.
· Over the past three days – Saturday, Sunday, Monday:
· 1,344 new cases. 618 of those in Fraser Health. 527 reported on Saturday, 472 on Sunday, 346 on Monday. 64,828 cases to date.
· 26 new deaths. 1,154 total.
· 4,392 active cases.
· 57,831 recovered.
· 11 outbreaks in long-term care declared over.
· 6 cases of the UK variant in BC, 3 cases of the South Africa variant. No community transmission of the UK variant, but the South Africa variant cases are not connected to travel and are being investigated. Dr. Henry: “I’m very concerned. I’m concerned that if those variants start to spread, it’s just going to make our job that much more difficult.”
· 119,850 doses of vaccine administered to date.
· New numbers for Tuesday:
· 14 new deaths. 1,168 total.
· 407 new cases. 65,234 total. (Comparison: a high of 911 cases happened for Nov 27).
· 313 hospitalized, 71 in intensive care. (A high of 381 were hospitalized on January 6th).
· 4,260 active cases.
· 6,450 in self-isolation.
· 58,352 recovered.
· 122,359 doses of vaccine administered to date. 4,105 are second doses.
· No new outbreaks, one outbreak declared over.
· Dr. Bonnie Henry: “For the many who have been doing your part, you may be asking, what more can I do? Be the voice of support and encouragement for those who may be wavering in their resolve.”
· New restriction may be necessary if the number begins to climb again.
· 4,850 cases among health care workers, from January 2020 to 15 January 2021. About 8% of cases.
· From January to December 17th 2020, care aides had the highest number of cases among healthcare workers at 1,193 or 24.6%. Nurses were second at 833 or 17.2%. Below are the ten highest number of cases by healthcare worker category.
· 1,193 – care aids.
· 833 – nurse.
· 304 – licensed practical nurse.
· 280 – administration.
· 177 – housekeeping.
· 156 – dental professional.
· 151 – physician.
· 149 – kitchen staff, dietary aid, food services.
· 91 – occupational therapist, physiotherapist, respiratory therapist.
· 75 – student.
· The document is here: http://www.bccdc.ca/Health-Info-Site/Documents/COVID_sitrep/COVID19_healthcare_workers_2021_01_15.pdf
· BC has has opened 3 clinics for people with longer term Covid symptoms.
· Located at St. Paul’s Hospital, Vancouver General, and the Outpatient Care and Surgery Centre in Surrey.
· Some people still have symptoms months after the start of the disease. Of patients who were hospitalized in BC, after three months half still had breathing issues. About 20% have permanent lung scarring.
· The St. Paul’s clinic already has 160 patients.
· Nanaimo Regional Hospital has had an outbreak.
· Two staff and a patient tested positive.
· Limited to the 4th Floor on the east wing.
· A homeless shelter in Surrey has had an outbreak.
· 2 staff and 24 clients test positive.
· The Surrey Emergency Response Centre was set up to make more shelter available to homeless people during the pandemic.
Sources: CBC, New Westminster Record, Globe and Mail, BC Centre for Disease Control.

NATIONAL:
· Worked from home during Covid-19? Be sure to check out these tax tips: https://www.cbc.ca/news/canada/ottawa/accountants-break-down-tips-for-working-from-home-expenses-1.5872477
· Covid has been in Canada for one year now, starting back on the 25th of January, 2020, with one case in Toronto.
· Long-terms care homes are particularly hard hit, and it continues to be so that care homes are getting outbreaks.
· From the CBC, “What we’re seeing in the long-term care facilities just demonstrates, unfortunately, years and years of neglect.” https://www.cbc.ca/news/canada/toronto/covid-19-ontario-canada-first-case-one-year-1.5884630
· In those early days, the public was generally told in Canada that the risk was low, and that people should not wear masks, and emphasized into March that there was no community spread.
· In late February, community transmission was evidenced in the U.S., and people returning to Canada from the U.S. began to show Covid. The halt to non-essential travel, on the land border, came on March 20.
· Canada is considering more travel restrictions, says the Canadian government.
· 143 flights have arrived in Canada in past two weeks with confirmed Covid cases. Deputy Prime Minister Freeland has assured, “We are considering the issue very, very seriously.”
· In this story, you can see where Canadians are flying during the pandemic. There sure seems to be a lot of urgent need to travel to places that happen to be warm vacation spots: https://www.cbc.ca/news/politics/freeland-travel-restrictions-1.5887163
· There is an 8 p.m. curfew in Montreal, and that is hard on the city’s homeless people.
· Homeless people have seen a dramatic reduction in help since the pandemic began. Shelters have to have social distancing, if they are safe to open at all.
· The province has refused to exempt homeless people from the curfew. People who break the curfew are subject to fines that start at $1,000 and can go up to $6,000. Premier Legault says making an exception for homeless people could cause people to pretend to be homeless.
· Some shelters have been forced to close altogether, because they can’t meet the requirements.
· Story: https://www.cbc.ca/news/canada/montreal/montreal-homeless-covid-curfew-1.5880946
· 90 “adverse events following immunization,” 0.015% of the 601,901 doses administered as of January 9th 2021.
· 63 were non-serious, 0.010%. This includes things like a skin rash.
· 27 were serious, 0.004%. In Canada, this includes a wide range of symptoms from headache to nausea to anaphylaxis.
· Learn about the Canada Adverse Events Following Immunization Surveillance System (CAEFISS) here: https://www.canada.ca/en/public-health/services/immunization/canadian-adverse-events-following-immunization-surveillance-system-caefiss.html
· Here is where the numbers are updated every Friday (but not consistently): https://health-infobase.canada.ca/covid-19/vaccine-safety/#seriousNonSerious
· Manitoba is now requiring a 14 day quarantine for non-essential travel from other parts of Canada.
· The move is being made to attempt to prevent new variants of Covid-19 from entering the province.
· Applies to air and land travel.
· Includes Manitobans who are returning to the province from elsewhere.
Sources: CBC, Toronto Star, Public Health Canada

INTERNATIONAL:
· The world is experiencing Covid-somnia – an epidemic of insomnia.
· Insomnia is now at one-quarter of the population in the UK, and at 40% in Italy and Greece.
· There is concern that this is affecting people’s health in other ways.
· Work productivity is also affected.
· A University of Ottawa study of health care workers in 55 countries and 190,000 people showed that depression, anxiety, and PTSD have all risen at least 15% since the start of the pandemic. Insomnia has risen by over 23%.
· People are advised to seek help, which many are not as people avoid medical services, or those services are unavailable. Seeking help is important, because sleep issues over time can become and ongoing sleep disorder. “Tele-health” now makes treatment more available despite the pandemic.
· Working and using screens in bed is a big part of it. The recommendation is to use your bed only as a place of sleep.
· Full article: https://www.bbc.com/worklife/article/20210121-the-coronasomnia-phenomenon-keeping-us-from-getting-sleep
· Vaccine delays are happening around the world.
· Canada is receiving zero doses this week.
· Health workers who were scheduled for vaccination were mostly notified by email of their cancellations.
· In Canada, 50% of doses will be delayed for up to four weeks, up to 400,000 doses delayed.
· Restoration of supply will happen in the European union before it happens in Canada. Pfizer explained this as differing contract deals but did not reveal details. Europe has also threatened to sue Pfizer for breach of contracts, and threatened to abandon Pfizer altogether as a supplier, perhaps in doing so catching the company’s attention.
· Pfizer and AstraZeneca say they will catch up to their commitments in the Spring. Pfizer says their delay is due to changing production systems, so a short-term shut down for a greater number of people vaccinated more rapidly overall. Pfizers says that they are upgrading to be able to produce 2 billion doses per year, from the current 1.3 billion. AstraZeneca has not given details.
· UPDATED: The Pfizer production facility in question is in Belgium. The European Union has threatened to ban exports of the vaccine if commitments to Europe are not met. The company is attempting to distribute the problem in the world somewhat equitably. If Europe followed through on the threat, that could mean delays for other countries would be longer, including Canada, which is served by the Belgium facility.
· The UK, having had Brexit and pulled out of the European Union, has realized that they, too, would be one of those outside countries. The UK, somewhat ironically, is now arguing against nationalism as government policy, referring to what they called “the dead end of vaccine nationalism.”
· The World Health Organization’s Covax program, to distribute vaccine around the world fairly to low-income countries, has not been affected, some good news in the mix. The Covax problem is still on schedule, as its vaccine supply is produced in India and South Korea. The program has also received a substantial boost, following US President Joe Biden’s decision to contribute $4 billion to the program.
· The CDC in the US says that allergic reactions to the vaccine are extremely rare.
· Out of 4 million given the Moderna vaccine, 10 had severe allergic reactions.
· Moderna – 2.5 per million doses have severe allergic reactions.
· Pfizer – 11.1 per million.
· Normal flu vaccine – 1.3 per million.
· Allergic reactions begin quickly, at a median of 7 and a half minutes, so people are able to be supported through it. The majority were known to have severe allergies in advance. In the US, all vaccination sites must have people trained in responding to anaphylaxis, or severe allergic reaction.
· Story: https://www.cnn.com/2021/01/22/health/moderna-severe-allergic-reactions-rare/index.html
· A doctor in Texas has been arrested for stealing vaccine.
· The doctor stole 9 doses to give to his friends and family, authorities allege.
· A man lived in the Chicago O’Hare airport for three months because he was afraid to fly. Story: https://www.bbc.com/news/world-us-canada-55702003
· Los Angeles has lifted its air quality limitations for cremations. An emergency order was issued so that crematoriums can catch up with the number of bodies. One person every eight minutes was dying from Covid every 8 minutes. The rate of death in LA county is double the norm from past years. 13,800 deaths in the city, 7,400 currently hospitalized, and 23% of those in intensive care.
· Over 200 incidents with plane passengers over the wearing of masks have been reported in the U.S.
· The behaviour has included refusal to wear masks once onboard, shouting abusively at flight attendants, and even physical assault.
· On Thursday, President Biden issued an executive order requiring the wearing of masks across transportation, a move welcomed by flight unions.
· The FAA, Federal Air Administration, has introduced fines up to $35,000 and potential jailing for abusing aircraft personnel, a move made in December after two flight attendants were assaulted.
· One person has been fined $15,000 after hitting the flight attendant, and grabbing her phone away from her while she was notifying the captain of the problem. Another passenger was fined $7,500, who when asked to wear a mask approached other passengers without a mask and sexually harassed a flight attendant.
· Some airlines are banning passengers from their flights who refuse to follow the rules. United Airlines has banned 615 people from flying on the airline since June, Delta Airlines has banned 700.
· There is a lot of news about variants of the virus.
· New variants have appeared in Britain, South Africa, and Brazil, all countries that have had high rates of Covid.
· So, what about vaccines? Scientists have actually expected that vaccines would still work against the variants. Moderna says that antibodies triggered by their vaccine works on new variants in lab test results. More study will be needed of people who actually have been vaccinated and who had the variant. The study so far was a small sample of eight people. Early results with the Pfizer vaccine also show that it works against variants.
· Moderna is also studying to see if there is a benefit of giving a third booster shot.
· Reports vary almost daily about if the variants are more deadly or not. The truth is that data is too limited and it is too early to really tell.
· Covid job losses have been four times worse than in the financial crisis in 2009.
· That’s according to a report by the International Labor Organization.
· The report estimates that 8.8% of the world’s work hours were eliminated. The ILO looks not only at those who have become unemployed, but those who have had reduced hours of work as well. That loss is equivalent to 255 million full-time jobs, or $3.7 trillion dollars of income.
· Press release: https://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_766949/lang--en/index.htm
· Study: COVID-19 and the world of work. Seventh edition. https://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/documents/briefingnote/wcms_767028.pdf
· What’s the latest with the Tokyo Olympics?
· The government of Japan wants to go ahead with the Olympics that were delayed last summer.
· The Olympics are planned to start on July 23, and the Paralympics on August 24.
· The International Olympic Committee is currently planning on proceeding, but has not made a final decision. Efforts are underway to have Olympics that are Covid safe. That might mean no audiences, athletes restricted to their accommodation areas, and each sport would have to have protocols around training and competition areas.
· “We need the vaccine to come to Africa.” A note about Grandmothers in Zimbabwe. I encourage you to read this one: https://www.bbc.com/news/world-africa-55726054
Sources: BBC, Toronto Star, International Labor Organization, CNN, Los Angeles Times.

STATS (as of end of Monday)
CANADA
· 144 new deaths. 19,238 total.
· 5,628 new cases. 753,011 total.
· 1,222 fewer active. 62,446 total.
· 849 in critical care.
· 6,706 new recovered. 671,327 total.
USA
· 1,887 new deaths. 431,392 total.
· 152,244 new cases. 25,861,597 total.
· 9,812,845 active.
· 26,259 in critical care.
· 207,426 new recovered. 15,617,360 total.
WORLD
· 2,149,496 deaths.
· 100,286,772 cases.
· 72,315,474 recovered.
Sources: www.covid-19us.live/, https://www.covid-19canada.com/

Pandemic updates provided on a voluntary basis as a community service, on Tuesdays and Fridays unless circumstances do not allow (currently dealing with an injury that limits my typing).
To provide accurate and timely information, locally, provincially, nationally and internationally, all in one place.
Feel free to share.
With love and hope,
Jaimie McEvoy, City Councillor, New Westminster, B.C.

r/CoronavirusDownunder random daily discussion thread - 08 February, 2021

DraftKings (NASDAQ: DKNG) - Deep Dive Research - Part 1

TL:DR

This is Part 1 of my two part deep dive on DraftKings (Ticker: DKNG, I will refer to the company as “DK”)
This first part introduces you to (1) me, (2) the company, (3) my thesis on the company, and (4) digs into how they make money.
The second part (already released, you can read it here - but get through part 1 first :) ) will go in depth to explore the question “Can we 10x from here?”
DK is an exciting, disruptive company working to change how we experience watching sports and make it better.
I am not a financial advisor and this is not investment advice. These are just my opinions to help facilitate learning and discussion.

Hello, welcome to my first deep dive write up.
My name’s Mark and I’m an accountant with a passion for investing. About two years ago, I used to work as an auditor at a public accounting firm and have been behind the scenes at many different publicly traded and privately held companies in the U.S. My goal is to bring my unique perspective from that past experience, my current experience working in a new role at a large corporation, and my understanding of accounting to help break down some of the most exciting growth stocks on the market today.
I’m a long-term investor. I am focused on finding great companies and holding them for a long time. I’m willing to endure volatility, crazy price drops, and everything that comes with this approach as long as the facts that led me to originally invest and believe in that company have not changed. If you want to learn more about this approach. I recommend reading the book “100 Baggers” by Chris Mayer.
Introduction
I think it’s fitting that my first stock pick has to do with sports. Sports has been a part of my life since I could walk at the age of 2. First with baseball and soccer, and then later in my childhood with golf. I’ve always played American football and basketball for fun as well and have always been an avid fan of all the major sports in the US.
I started playing fantasy sports (mostly just fantasy football) about 6 years ago and have always enjoyed it. Traditionally, with fantasy football you draft a team at the beginning of the year and those are your players for the rest of the season. If you have a bad draft, oh well. You can try to improve your team with trades and free agent additions but it is tough. Leagues usually consist of 10-14 teams (each managed by an individual) and there’s obviously only one winner at the end of the season (about 4 months after the draft). This can lead to the managers of the lower performing teams losing interest as the season wanes on. I believe DraftKings’ (DK) founders saw this issue and saw an opportunity. Enter, daily fantasy sports. Now, with the DK platform you can draft a new team every week. Or if you want, every day. This allows fans of fantasy sports to engage at whichever point of the season they want and at varying financial stakes.
The Thesis Statement
For every stock pick I make, I want to provide a quick thesis statement that can serve as a reminder for why I’m buying and holding that stock for the long term. I’ll always aim to make it just a few sentences long so it can easily be remembered and internalized. This helps during times when the price may sporadically drop and you need to remember why you’re holding this position.
The thesis statement I have come up with for DK is as follows:
“DraftKings: The leader in allowing fans to engage financially with their favorite sports, teams, and players. Having money at stake makes the game a lot more interesting to watch. The era of daily fantasy sports games, online sports betting, and online betting (outside of sports), is just getting started and DK is as well positioned (or better positioned) than anyone to capitalize off of this trend.”
Notice how I said “allowing fans to engage financially” as the first sentence and not necessarily “allowing fans to gamble”. There’s a reason for that. According to US Federal Law, Daily Fantasy Sports (DFS) contests have specifically been exempted from the prohibitions of the Unlawful Internet Gambling Enforcement Act (UIGEA). DK has always been, and I believe will continue to be DFS contests 1st, sports betting 2nd, and other forms of gambling/entertainment 3rd. It is noteworthy that states at an individual level can still deem DFS contests illegal if they so wish, but as of this writing (11/26/20), 43 of the 50 US States allow DFS contests and DK, accordingly, is offering DFS contests in all 43 of those US States.
I’ll try to clarify the difference between DFS contests and sports betting real quick:
DFS Contest – Pay a pre-set entry fee to enter a contest. All entry fees go towards “The Pot”. “Draft” 9 players to be on your “Team” for 1 week. Enter your “Roster” into a contest with other players (could range from 1 other person to 1,000s of people, the DK user can choose). Whichever “Roster” amasses the most points for that week out of all contestants wins. The winner will get the highest payout, and depending on the nature of the contest, other top finishers will receive smaller payouts as well.
Sports Gambling – Team A is considered a 10 point favorite to defeat Team B. This means that Team A is expected, by the professional gambling line setters, to outscore Team B by 10 points. This is known as a point spread. You can bet on the underdog or the favorite. If you bet on the favorite, they have to win by more than 10 points for you to win the bet. If you bet on the underdog, you will win the bet as long as the underdog keeps the game within less than a 10 point defeat.
These are just a couple simple examples to help you see the difference. Sports Gambling (the 2nd priority of DK) is a very lucrative market just as the DFS contests are. However, in the US, Federal Laws and regulations are a lot stricter on Sports Gambling than they are on DFS. As of this writing (11/27/20), 22 states (including the District of Columbia) out of 51 possible allow sports gambling.
DK is still in the infancy stages of getting their sports gambling business going. In the 22 states where they could potentially operate, they currently have a sports gambling offering in 11 of those states. The sports gambling business model for DK can be broken into two main offerings – mobile sports betting, and retail sports betting. Mobile sports betting means you can place a sports bet online from the comfort of your own home, while retail sports betting means you must go to a casino and place a bet with the sportsbook in person. I personally believe mobile sports betting is the real potential cash cow for DK out of the two types of sports betting offerings due to the convenience and ease of access. DK is currently working on and encouraging customers to lobby their state lawmakers to legalize sports gambling in more states.
How DK makes money
At the very least, before you invest in a company, you better understand how they make money. In Chris Mayers’ excellent book, 100 Baggers, that I mentioned above, he continually references top line revenue growth as one of the main common indicators of a possible 100 Bagger. This isn’t to tell you that any stock I pick will be a 100 Bagger just because it has great top line revenue growth, but if I am looking at a growth stock to hold for the long term, revenue growth is one of the first things I look at.
For DK, their means of making money is quite simple. I already went into detail above about DFS Contests and Sports Gambling. In DK’s latest 10-Q filing with the SEC (filed 11/13/20), revenue is broken out into two main streams: Online Gaming and Gaming Software.
Online Gaming (82% of Total Revenue for 9 months ended 9/30/20):
Online gaming is the true core business of DK and includes the aforementioned DFS Contests, Sports Gambling and additional gambling (non-sports) opportunities. DK refers to their additional gambling (non-sports) as “iGaming” or “online casino”.
For the 9 months ended 9/30/20, Online Gaming revenue totaled $239M, up 30% YoY from $184M in the same prior year period. Keep in mind, that this is an increase that happened during a COVID-19 global pandemic that delayed and shortened many professional sports seasons.
Online gaming revenue is earned in a few ways that are slightly different, but very similar overall. In order to enter a DFS contest, a customer must pay an entry fee. DFS revenue is generated from these entry fees collected, net of prize payouts and customer incentives awarded to users. In order to place a sports bet (sports gambling), a customer places a wager with a DK Sportsbook. The DK Sportsbook sets odds for each wager that builds in a theoretical margin allowing DK to profit. Sports gambling revenue is generated from wagers collected from customers, net of payouts and incentives awarded to winning customers. The last form of online gaming revenue is earned in similar fashion to a land-based casino, offering online versions of casino games such as blackjack, roulette, and slot machines.
Gaming Software (18% of Total Revenue for 9 months ended 9/30/20):
While the Online Gaming revenue stream mentioned above is a Business to Consumer (B2C) model, the Gaming Software revenue stream is a Business to Business (B2B) model. The Gaming Software side of the business was born out of the acquisition of SBTech, a company from the Isle of Man (near the UK) founded in 2007 that has 12+ years of experience providing online sports betting platforms to clients all over the world. The acquisition occurred as part of the SPAC driven IPO in April of 2020 that combined “the old DK company” with SBTech so that they now are “the new DK company” listed as DKNG on the NASDAQ. SBTech is a far more important part of the story than just being 18% of today’s revenue. The reason for this is because DK will eventually (planned mid-late 2021) be migrating all of their DFS and gambling offerings onto SBTech’s online platforms. Currently, for DFS, DK uses their own proprietary platform but that will move to SBTech with the migration. Currently, for online gambling, DK uses Kambi, the same online gambling platform that services Penn Gaming (PENN), a DK rival. But that’s enough about the software migration for now, back to the Gaming Software revenue.
The Gaming Software revenue stream for DK is essentially a continuation of SBTechs’ B2B business model. DK contracts with business customers to provide sports and casino betting software solutions. DK typically enters two different type of arrangements with B2B customers when selling the gaming software:

Direct Customer Contract Revenue: In this type of transaction, the software is sold directly to a business (casino for example) that wants to use the software for their own gambling operations. This revenue is generally calculated as a percentage of the wagering revenue generated by the business customer using DK’s software and is recognized in the periods in which those wagering and related activities conclude.
Reseller Arrangement Revenue: In this type of transaction, DK provides distributors with the right to resell DK’s software-as-a-service offering to their clients, using their own infrastructure. In reseller arrangements, revenue is generally calculated via a fixed monthly fee and an additional monthly fee which varies based on the number of gaming operators to whom each reseller sub-licenses DK’s software.

As mentioned above, SBTech was an international company based in the Isle of Man before being acquired by DK. Thus, the majority of their business in their first 12 years of operating independently has always been international and outside of the United States. This has helped DK, which has historically been US focused, expand it’s international reach.
A perfect example of expanding this international reach occurred recently during October (technically Q4) in which DK’s B2B technology (powered by SBTech) helped enable the launch of “PalaceBet”, a new mobile and online sportsbook offering from Peermont, a South Africa based resort and casino company. The deal was headed by DK’s new Chief International Officer, Shay Berka, who previously spent 10 years working for SBTech as CFO and General Manager. Mr. Berka took on the role of DK’s Chief International Officer upon the merger in April earlier this year. I think this deal shows that DK has integrated SBTech and it’s business very well into the larger business as a whole. They are not wasting any time using their newly acquired resources to expand their reach and bring in new sources of revenue.
This is the end of my first article about DK. My goal is to drop Part 2 later this week. The focus of Part 2 will be an in depth answer of the question – “Can we 10x from here?”
Disclosure: I am/we are long DKNG. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it. I have no business relationship with any company whose stock is mentioned in this article.

DraftKings (NASDAQ: DKNG) - Deep Dive Research - Part 1

TL:DR

This is Part 1 of my two part deep dive on DraftKings (Ticker: DKNG, I will refer to the company as “DK”)
This first part introduces you to (1) me, (2) the company, (3) my thesis on the company, and (4) digs into how they make money.
The second part (to be released later this week) will go in depth to explore the question “Can we 10x from here?”
DK is an exciting, disruptive company working to change how we experience watching sports and make it better.
I am not a financial advisor and this is not investment advice. These are just my opinions to help facilitate learning and discussion.

Direct Customer Contract Revenue: In this type of transaction, the software is sold directly to a business (casino for example) that wants to use the software for their own gambling operations. This revenue is generally calculated as a percentage of the wagering revenue generated by the business customer using DK’s software and is recognized in the periods in which those wagering and related activities conclude.
Reseller Arrangement Revenue: In this type of transaction, DK provides distributors with the right to resell DK’s software-as-a-service offering to their clients, using their own infrastructure. In reseller arrangements, revenue is generally calculated via a fixed monthly fee and an additional monthly fee which varies based on the number of gaming operators to whom each reseller sub-licenses DK’s software.

Introducing: The Royal Family of Monaco

Prince Rainier III (1923-2005)
Rainier’s mother, Princess Charlotte, was actually illegitimate. Her father Louis II, getting older and with no legitimate children, legitimized her and made her his heir. She never took the throne, and in fact renounced her rights to her son, Rainier, the day before his 21st birthday.
Rainier became the Sovereign Prince of Monaco upon the death of his grandfather in 1949.
During WW2, Rainier served in the Free French Army. During the 40s and 50s he was in a long term relationship with the French film actress Gisele Pascal. Rainier’s sister, Princess Antoinette, wanted her own son to ascend to the throne, and spread rumors that Pascal was infertile. The rumors along with her treatment by the press and public ended their relationship.
After the war Monaco, a country who made its money primarily as a gambling origin, was in crisis as wealthy Europeans found their funds diminished after the war. To restore Monaco’s treasury Rainier decided to promote Monaco as a tax haven, and he personally took control of SBM (the company who owns the Monte Carlo Casino, Opera, and Hostel de Paris) in 1964. Prince Albert still retains a large share of the company and profits from it today.
Marriage:
Everyone knows this one. Rainier married American film star Grace Kelly in 1956.
Their marriage is rumored to have been turbulent. It is said that Grace struggled with adjusting to royal life, regretted ending her film career, and that Rainier had extramarital affairs. Her children have stated that though she was a loving mother, they spent more time with nannies than with their parents.
Grace's dress is iconic, but here you go if you want to revisit some photos from that day.
Rainier smoked up to 60 cigarettes per day, and in the last years of his life his health steadily declined. On March 8th, 2005 he entered the hospital for a lung infection and by the end of the month he was on a ventilator suffering from renal and heart failure. On March 31st he officially announced his son Albert, as regent, and on April 6th he died.
The Constitution
Monaco’s constitution stated that Monaco is a constitutional monarchy ruled by the hereditary princes of the Grimaldi. If the reigning prince were to die without leaving a male heir, Monaco, according to the treaty, would be incorporated into France. In 2002, realizing he had a 43 year old bachelor son, Rainier amended the constitution to allow the crown to pass to his daughters should Albert not marry.
Grace, Princess of Monaco (1929-1982)
Grace was born in Philadelphia to an affluent and influential family. Her father was an Olympian and a Democratic nominee for Mayor of Philadelphia and was appointed by President Roosevelt as National Director of Physical Fitness. Her mother taught physical education at the University of Pennsylvania and coached women’s athletics at Penn.
Her Uncle, George Kelly, was a Pulitzer prize winning dramatist, screenwriter, and director and used his influence to gain Grace admission to the American Academy of Dramatic Arts in New York. Grace became one of the biggest movie stars of her generation.
In 1955 she was sent to the Cannes Film Festival and invited to appear in photos with Prince Rainier. After a year-long courtship, they were married in 1956.
Grace was not allowed to continue her acting career after her marriage. She instead devoted herself to her role as Princess, become heavily involved with the Red Cross of Monaco and the Rainbow Children Coalition.
On September 13, 1982, Kelly was driving back to Monaco after spending time at her country home. During the drive she had a stroke, lost control of her vehicle, and drove off the mountainside. She died a day later.
An article on their relationship
Prince Albert II (b. 1958)
Prince Albert is one of the wealthiest royals in the world with a net worth at more than $1B. He attended Amherst College in Massachusetts, studying political science, economics, music, and English literature, and completed his education with a Bachelor of Arts degree in Political Science. He toured Europe in 1979 as part of the Amherst College Glee Club.
Albert competed in the bobsleigh for five consecutive Winter Olympics on behalf of Monaco, and was their flag bearer at the 1988, 1994, and 1998 Olympics. He is also a judo black belt.
He became Prince of Monaco when his father died in 2005.
Marriage:
Prior to his marriage his status as a bachelor was a hot topic of discussion. He was known to date well-known fashion models and actresses, however at age 53 had never married. It was rumored that Albert was gay, something he expressed great frustration with in the press. In 2006 he attended the opening ceremony of the Torino Olympics with South African swimmer Charlene Wittstock. They were engaged in 2010, and married in 2011.
There are rumors that Charlene tried to flee the country the day before their wedding. It is reported that the future bride, after discovering Albert may have fathered yet another child during their relationship, attempted to flee as many as three times before their wedding, however was always intercepted at the airport. It is also said she attempted to seek refuge at the South African embassy, and that officials in Monaco ended up hiding her passport so she could not leave the country.
Moreover, during their wedding, Charlene openly cried at parts, and Prince Albert was caught on camera begging her to kiss him. Honestly, she looked pretty miserable the whole time. The palace has denied all of these claims.
During their honeymoon, they stayed in separate hotels
Here's everything you ever needed to know about their wedding
Watch it
Prince Albert is passionate about the environment and an avid sportsman. Prince Albert speaks French, English, German, and Italian. He speaks English with basically no accent thanks to his American mother.
Illegitimate Children
In 2005, the day before Prince Rainier died, Albert publicly acknowledged he had fathered a son out of wedlock. In 2006, he confirmed he had also fathered a daughter. These children were barred from the line of inheritance because of a 2002 constitutional amendment requiring an heir’s parents to be married.
Alexandre (b. 2003)
Alexandre’s mother (Nicole Coste) was a flight attendant for Air France and met Prince Albert when he was a passenger on a flight. He asked for her number, the beginning of a years-long affair. The relationship ended at the insistence of Prince Rainier. Albert visited Alexandre and Nicole often, however when he refused to acknowledge Alexandre publicly, Nicole sold an interview and pictures to the media. Albert was in mourning for his father and made no public comment, but later did acknowledge paternity. Alexandre and Nicole live in France at an estate given to them by Albert.
Jazmin (b. 1992)
Jazmin’s mother, Tamara, met Albert while working as a waitress. Albert knew of Jazmin and visited her, however did not acknowledge her publicly until she was in high school to protect her identity. In 2006 the French magazine Voici published photographs of Jazmin and her mother on a visit to Monaco, outing her as Albert’s daughter. She has attended events with Albert and Charlene, and is listed as a sponsor for her father’s royal foundation.
An interview with Jazmin
Princess Charlene (b. 1978)
Born in Zimbabwe, Charlene’s family relocated to South Africa in 1989. She represented South Africa at the 2000 Sydney Olympics, finished fifth in the 4x100 meter relay.
Albert and Charlene met at the Mare Nostrum swimming competition in Monaco in 2000, however were not seen together until 2006.
Charlene converted to Roman Catholicism for her wedding, and has learned French and Monegasque after her move to Monaco. She is an ambassador for the Special Olympics, patron of the South African Red Cross, and is passionate about sport.
In recent news, she completed “the crossing” water bike challenge, a 180 kilometer water bike race for charity.
An interview with Charlene and Albert on the 1st birthday of their twins
Albert and Charlene have 2 children:
Hereditary Prince Jacques *twin* (b. 2014)
Princess Gabriella *twin* (b. 2014)
Gabriella was born 2 minutes before her brother, however because of the constitution her brother will inherit the throne. They are super sweet together and you see them at events often.
Princess Caroline of Hanover (b. 1957)
Caroline is the eldest child of Rainier and Grace Kelly, however because of the constitution her brother, Albert, sits on the throne of Monaco. She served as de facto first lady of Monaco until the marriage of Albert and Charlene.
Until the birth of her niece and nephew she was heir presumptive to the throne, although she had only held that title since 2005 after the change of the constitution to include female heirs.
Caroline received her French baccalaureat in 1974, and received a degree in Philosophy from Sorbonne University. She is fluent in French, English, Spanish, German, and Italian. Her hobbies include horseback riding, swimming, and skiing.
Marriages:

Marriage 1: Philippe Junot

Married Phillippe, a Parisian banker, in 1978. The couple divorced in 1980 with no children.

Marriage 2: Stefano Casiraghi

Married Stefano in 1983, the sportsman heir to an Italian industrial fortune. The two had to marry in a civil ceremony rather than a religious ceremony because Caroline, a Catholic, was divorced. Caroline was 3 months pregnant at the time of their wedding.
They have three children:

Andrea Casiraghi (1984)

Married to Tatiana Santo Domingo and has 3 children

Charlotte Casiraghi (1986)

Married to French producer Dimitri Rassam and has two children

Pierre Casiraghi (b. 1987)

Married to Beatrice Borromeo and has 2 children

Note: The Casiraghi’s are all very beautiful and very fashionable but I don’t want to go much into them here because they are so far down the line of succession. They’re fun to follow for their fashion if you have the time to check them out.

Marriage 3: Prince Ernst August of Hanover

Married Ernst August, a Prince, in 1999. They have one daughter, Princess Alexandra.
Caroline is thus a Princess twice-over, through her family and through her husband. She and Ernst August have been separated since 2009 however are still legally married, thus she retains the title of Princess Caroline of Hanover.
Read about all of her weddings here
See her speaking in English around 12:00 here
Princess Stephanie (b. 1965)
Stephanie was in the vehicle with her mother when Grace died. She suffered a fracture of the neck.
She has studied classical dance and piano, and competed in gymnastics and horse riding. She interned at Christian Dior and debuted as a model in 1984. She has a swimwear and perfume line, and owns cafes and stores in both Monaco and Barcelona. She also has sold more than 2 million copies of her song, Ouragan, and sold 1.5M copies of her album Besoin. She recorded “In the Closet” with Michael Jackson, however is listed as “mystery girl” in the credits.
Marriages/Relationships:

Marriage 1: Daniel Ducruet

Stephanie married her former body guard, Daniel Ducruet, in 1995. When Rainier learned of their relationship Daniel was not only still his employee, but had a pregnant girlfriend too. Stephanie gave birth to their two children “out of wedlock” because Rainier refused to grant permission for them to marry, however eventually relented. The two divorced a year later after Ducruet was photographed naked with a stripper.
Read more
They have two children:

Louis (b. 1992)

Married Marie Chevallier in 2019

Pauline (b. 1994)

Relationship 2: Jean Raymond Gottlieb

Stephanie and Jean never married, however have a child together. He was Rainier’s Head of Security. She did not identify him on the birth certificate and it was not confirmed that he was Camille’s father until she confirmed it herself on her Instagram.
More about Jean

Marriage 3: Franco Knie

Stephanie met elephant trainer (yeah, you read that right) when she presented him with the award for “best animal tamer” at the Monaco Circus Festival in 1997. Franco, a decade older than Stephanie, was married with two children at the time. Franco left his family for Stephanie, moving her and her three children into his circus caravan in Zurich. Marrying in 2001, their relationship lasted 18 months until their divorce.
An interview with Stephanie in English in 1990
Why is he a Prince and not a King?
From vogue:
It goes back deep into the history of Monaco. Monaco has always been a tiny nation, and, for protection, allied itself with (or, at some points, was flat-out annexed by) big powerful countries, with big powerful rulers—aka kingdoms, or, a nation ruled by a king or queen. So Monaco’s rulers styled themselves as prince and princess. That, by definition, made the nation a principality, or one ruled by prince or princess.
Regardless, Albert actually plays a bigger role in the day to day operations of the country than most of his European peers. Legislative power is divided between the Prince who initiates the laws, and the National Council who votes on them. Executive power is retained by the Prince, and he has full judiciary powers.
Jewels
See their tiara collection
I think the Ocean Tiara, gifted to Charlene for her wedding, is particularly interesting. You either love it or you hate it.
The Grimaldi Curse
What do you think?

To give away a Duchess

Stepping from the carriage of the Transmanche link was akin to stepping through a door between worlds. One was one warm, and quiet, and cosy. The other was the roar of traffic, the bustle of crowds and the encroaching winter. I had been sitting down for three-hours on the train and my leg was stiff and sore around the old wound. Fortunately the crowd disembarking the train was gathered in a slow moving throng as they bottlenecked to file through the distant platform exit barriers. Manoeuvring was impossible, and I wasn’t in a particular rush regardless – better to just amble along and pay attention.
The Transmanche link was still only a year old and exuded an air of modernity and sophistication that had once been enjoyed by passenger air travel. The clientele then was still the affluent class, businessmen making trips on the London-Federal Amiens-Paris route – as-well as those on official business like me. I could discern between the French and the British by the cut of their suits, a rear-vent on the English jacket and side-vents on the French ones. That and the attitudes of-course – the French didn’t feel obliged to apologise if they bumped into you.
As the crowd dispersed into Waterloo Station’s main concourse, I was finally able to disengage myself and lean against a sign post. I pawed at my right thigh, willing circulation back and wincing at the occasional shooting pain from scarred nerves. I had already decided on the platform back in France that I was going to walk the short distance over to Head Office. I enjoyed London’s familiar ambiance and seeing the progress on all the new towers which crept steadily higher on each of my rare visits.
The only question really was whether I was going to take a “pré-prêt” sandwich and a coffee-to-go from an assuredly British chain-shop, or an actual sandwich and an espresso somewhere nicer and assuredly French. It wasn’t a difficult choice. I’d traipsed everywhere between Baghdad and Lahore for these people and, not but an hour ago, a tunnel under damn sea just to get here. They could begrudge me an extra kilometre to enjoy a London evening, especially since I’d been recalled for something seemingly so trite. As if they didn’t have people with Red Grouse clearance in London.
Exiting the station and gingerly taking the steps down to the street I began by passing effortlessly between the traffic backed up from the Waterloo Bullring roundabout. Next the Sutton Walk underpass to the South Bank on the Thames. A whip of cold breeze struck immediately as I stepped out from behind the shield of the buildings and onto the embankment. Across the river camped the great stone imperial buildings with only Vickers-Matra House and top of the Lodge Telecom Tower disturbing century old view – from this vantage anyway.
I ended up taking an espresso, a croissant and the evening edition of the News du Monde from a small vendor set-up close to Westminster Bridge whilst further down the famous old criminal Buster Edwards was selling flowers from his little stall. Over the way Big Ben showed eighteen-and-twenty and the restaurant boats moored along the Thames were filling up for the evening. Men and women drinking Pastis and smoking Gitanes cigarettes in a pale imitation of the Bâton-Mouche of Paris; a result of the (unsurprisingly one-way) cultural exchange in the decades since Union. Their collars however were pulled up and hats down against the bracing cold of all British winter.
Sipping the blissfully warm coffee, I noticed more cranes than last time; their height a physical gauge between my visits. Characteristically, the British approach to modernity had been neither dynamic nor conservative, but enough of both sufficient to irritate all factions as they tried to gear old London for a traffic and population problem it had never been built to serve. The French of-course had done it their way, send the post-war architects and utilitarians to Federal Amiens where their experiments in concrete brut and glass couldn’t mutilate the Parisian skyline.
Ruminating on London was certainly more pleasant than the news which I was casually thumbing through before reaching the foreign affairs section. A photograph of an explosion and black clouds over Nairobi, the Dominion of East Africa’s capital, where ANU-PF rebels had detonated a car bomb on Delamare Avenue – killing twenty-six people. Just another incident in the “Kenyan Emergency”, one of many occurring through-out the Colonies. Thank God our offices were located in Mombasa. We were never the target directly of-course because nobody knew we existed – but sometimes there was bad luck.
I put the paper down, folded it, and pushed it across the length of the terrace table. The news, especially these days, always dampened my spirits and the sudden feeling of my benighted duty robbed my appetite. Suddenly Big Ben was chiming and I looked across the river at the clock face on the Dominion Parliament Building. It was eighteen-and-thirty now. I finished the coffee but left the croissant half-eaten, along with the newspaper and a couple of dollars before heading towards Westminster Bridge.
In great British tradition, Head Office was located in a building which had been rented in the distant past, altered ad-hoc over time, and remained in-use through mere inertia. It was tucked away deep in central London on Carlton Terrace, sandwiched between Pall Mall and Buckingham Palace, with a nice view overlooking Waterloo Gardens for those who secured an east facing office. When it was first occupied it was equidistant from The Royal Society of which most of our Founders were affiliated and the eponymous Carlton Club – the ancient stronghold of the old Conservative Party. Even the obliteration of the Carlton Club itself by a Luftwaffe bomb hadn’t seen the headquarters moved, at-least once an investigation confirmed that we hadn’t been the intended target.
Nominally it was the London headquarters of the Lodge Group Limited, which was certainly what the chic sign on the building’s corner read. I swiped my card at the front door and entered a long, austere lobby at the end of which a lone receptionist was perched behind an impenetrable slab of brown marble. It was a retirement posting, typically for former field operatives of which the stocky, grey-haired receptionist qualified. I didn’t need to see the document confirming that the lobby had been designed for emergency defence rather than the opulence which would befit the office of the world’s largest electronics and defence conglomerate.
The receptionist was already looking at the door as I pushed it open and, likely recognising my face from the list of expected visitors, didn’t enquire any further. I strode across the polished tiles and right around him towards the bank of elevators in the rear corridor.
“You’re expected on basement level 2 sir,” the receptionist called back as the elevator arrived and opened with a ding. Not the main office first for the brief? Curious. I must then be here for the second-round of the interrogations.
It was austerity all the way down as I stepped from the elevator at basement level 2 into a room so generic it may have been anywhere in the Federation. Drop ceiling, manila walls, and speckled linoleum.
“Mr Maxwell,” a voice called from the corner. “You’ve finally arrived.”
My eyes widened slightly. That was Jameson, his rattling baritone as familiar in the flesh as it had been so often down the telephone.
“Mr Jameson sir,” I said, turning on the spot to face him and keeping the surprise from my voice.
Lewis Jameson was rising from an old wooden bench in the corner of the room – both looking equally haggard under the unflattering brilliance of the florescent lighting. I didn’t know how old he was exactly, but he was too young for the Great War and had been recruited in the third-wave. He may even have met some of the Founders. More to the point he was the head of my sub-function, Esoteric Intelligence Western Europe, and judging by the empty polystyrene cup and a familiar copy of theNews du Monde, I’d kept him waiting here.
“I wasn’t aware that you were the point of contact sir,” I said flatly and honestly. I could have dialled up the innocent tone to make the flattering illusion that, had I known, I would have course been here right on time. But there was no point trying to bullshit the boss with tones and inclinations.
“Ah,” he said with a sagely nod. “And I’m guessing that’s why you didn’t came straight here? What time did you arrive at Waterloo?”
“Environ eighteen-and-five sir.”
“Five-past six?” He feigned incredulity. “By the head of Oliver Cromwell did you crawl here?”
“No sir. I just needed a longer march after the train to get my leg working,” I rubbed my thigh. “And I may have paused for an espresso along the way.”
Jameson grunted his annoyance and blinked slowly to hide his rolling eyes; old boys like him regarded coffee as European rubbish if it had a vaguely foreign sounding name.
“This is a serious matter Maxwell. That’s why we brought you here from Amiens.” He dismissively waved his hand and began walking, somewhat irritatingly with smoother motion than I could manage at decades his junior.
“I’ll be generous and begrudge you your small luxuries. It seems fair in the face of events to come.”
I ambled after him, trepidation mounting with each step through the warren of bland, featureless corridors. Multiple things were off already and it no longer seemed like it had been a mere bureaucratic oversight to assign me here.
“So what can you tell me then?” I asked. “This is the second-round.”
“Of-course,” Jameson growled. “We brought him here from the Shanghai Concession. The nature of his Red Grouse condition has proved disconcerting both to me personally and to the High Echelon.”
High Echelon? On a Red Grouse case? I almost exclaimed it out-loud. Special Studies Project Red Grouse was minor; it was often used to ingratiate new recruits into the world of the Esoteric and Metaphysical Operations. I realised, then, that’s why I was here. I was one of the few veterans on the Project and had only transferred in because the leg injury invalided me from Counter-Ops.
Not only was the High Echelon involved, they’d decided that this case must be processed further at Head Office and not in Shanghai. I honestly hadn’t felt this nervous since the Peshawar tulpamancy case.
“This goes to the High Echelon sir?” I managed in a more composed tone.
“Yes,” Jameson barked. “As I said it’s been deemed very serious. I hope you enjoyed your coffee.”
Under normal circumstances I’d have written that off as just a petty remark, a reminder of authority, but given the seeming gravity of the case perhaps not. A lack of punctuality was but one of the many reasons for a sunset posting like the man upstairs as the token receptionist. I still hoped for something more.
“You said Shanghai sir?” I said, a bit awkwardly after the remark. “Merde. That’s a hell of a long trip for him.”
“Yeah he looks like real shit,” Jameson said with a humourless chuckle.
Which would be the least of his worries of-course since his world tour was only half over. What-ever this man had to say would almost certainly necessitate a one-way trip to Saint Mary’s via Capetown – and only then for a long stint in a sensory deprivation tank. Maybe they’d just drop him straight off on the Other Side.
“Damn,” Jameson said suddenly looking back; I’d slowed down slightly whilst musing. “Your leg that bad you struggle to match pace with an old man?”
He paused for a brief moment to allow me to catch up.
“It was the ’76 Uprising in Persia if I’m not mistaken?”
“Iran sir, and yes right. I just happened to be at the Federation Embassy when the Tudeh attacked.”
“Tudeh? Are they religious or other?”
“They’re an Iranian communist party. I was just leaving the Federation embassy to go back to the Tehran office when the bombs started going off.”
“Bad luck,” Jameson said – I thought it sounded sincere. “I don’t know much about that Theatre. Wasn’t my area. When I was in Counter-Ops I was mostly based in East Africa,” he said, the name buried under derisive emphasis.
“Did you see the article in the Monde sir?”
“I knew about it yesterday Maxwell,” he growled. “I’ve still got connexions to the Mombasa office.”
Around a final corner was the third person I’d seen since entering. Another stocky middle-aged man in a dark suit working the Home Office until he cashed his pension. Unlike the receptionist though he could wear his gun openly – the service issue, French-made MR73 – it was polished to a mirror sheen.
“Sirs,” he said, bracing slightly as Jameson and I gradually approached. “You’re ready to begin?”
“Yes thank you Carter,” Jameson said. He took the revolver from Carter, stowing it in a shoulder-holster just under his blazer, as-well as a small aluminium briefcase. He caught my quizzical look at the gun.
“Carter isn’t coming in,” he said. “This is Top Secret and I’m on watch – as unlikely as it is that they’ll be any trouble. The subject’s name is Jianyu Zhong.”
“Right,” I said, it was go time.
I approached the door and willed a final, silent, breath for what-ever was about to transpire. Carter leaned over and unlocked it before returning to his post.
I stepped into a simple room, with a single table and a pair of chairs beneath long strips of recessed fluorescent lighting which bathed everything in white light.
Jianyu Zhong was seated at the chair facing the door and had been clothed in a pair of grey coveralls. He was looking right at me as I stepped in but the marks on his forehead and the back of his hands, still placed on the table before him, meant that he had probably been trying to sleep. He looked middle-aged, maybe ten years older than me, with the wrinkles developing around his dark eyes.
He must speak English, at-least sufficiently that it hadn’t been worth the exposure to find a translator. His hair had been cut neat with a right-hand parting but his fringe hung in a cowlick in front of his face. It probably required some product to hold it in-place, which even in the coastal cities of China wasn’t cheap. He was likely some kind of businessman working with Federation companies.
I took me seat before him. I was in professional mode now and the brief nagging doubt regarding whether I should offer the seat to Jameson, and conduct the interrogation standing, was quashed. That kind of indecision looked bad and it shouldn’t be made clear to Zhong that his interrogator was not the superior of the two men he was facing. Zhong for his part regarded me through half-closed eyes, a mixture of tiredness and utter contempt.
Jameson had followed after me and placed the aluminium briefcase on the table just after I sat down. He removed a tape-recorder, Lodge Electronics brand, from the case, slid a fresh tape into the machine and prepped his finger over the record button. I gave him a brief nod and he pressed it. A red light switched on.
“This is Robert Maxwell, ten zero-one twenty-seven forty-five, SSP Red Grouse. My time is…” I checked my watch. “Nineteen-and-five, first of November, nineteen-eighty-one.”
There was brief flash of surprise on Zhong’s face at that. He’d almost certainly had no ability to see what time or even day it was for a while.
“Good evening Mr Zhong,” I began in a well-practiced tone of authoritative politeness.
He said something in Mandarin that I couldn’t understand, except for Laowai which I figured was not being employed in a generic sense.
“I am here to ask you some questions.”
“Ah of-course. More questions,” he said, managing sardonic amusement through his weariness. “I don’t know why you have brought me here or what I have done. I run a respectable enterprise. Not a criminal. Not a terrorist. Or perhaps you come to ask me more nonsense questions.”
In truth that was exactly what I was here to ask – as far as Zhong knew it was inconsequential nonsense. The terrorist line was interesting though.
“Why did they suspect you were a terrorist Mr Zhong?”
“They didn’t say terrorist,” Zhong spat. “They asked about the Royal Wedding, what I knew of it and why I spoke of it. As if merely to talk about something so public means I am plotting something against your Federation.”
“The Royal Wedding,” I said in the same calm and passive tone. You must never bias the subject, only ask for more information. “Tell me about the Royal Wedding.”
“As if you don’t know. What is this technique? To drive me crazy?”
“Answer the question Mr Zhong. Tell me about the Royal Wedding.”
“Of your English Prince Charles obviously.”
Nothing too outlandish there I suppose.
“Who is the bride?”
“I don’t remember her name. He had an affair. Looks to me like he made a bad choice. I only hear this in passing. Your Royal news is not the most important thing in China.”
“How old do you think Prince Charles is – unless you happen to know the exact date?”
“I think he was born between the Japanese surrender and defeated of Mao. Late 1940.”
That ruled out another question. It was typically customary to ask the subject who was in charge of China during interrogations. It went back to the first known case concerning a German businessman whom erroneously believed that Mao Zedong had successfully established a communist regime in China in the late nineteen-fourties. I hadn’t been intending to ask since Zhong’s nationality meant he’d have far too much familiarity with the subject matter – which appeared to be a factor in how Red Grouse seemed to affect its subjects.
I asked more questions concerning the apparent subject, Prince Charles, but Zhong seemingly had no more specific insight.
“Who will be attending this wedding Mr Zhong?” I asked, I was honestly losing a bit of steam with the whole affair. Being the second interrogator was surprising more difficult than the first since you didn’t get a good brief.
“How should I know? His brothers. His aunt. His children. All will come.”
It was that exact moment that I felt the hairs on the back of my arms begin to rise slightly, and something like cold dread fall into my stomach.
“Who is Prince Charles aunt?”
“The Queen’s sister obviously,” Zhong said. He’d been getting louder, more alert and angry as the interrogation had proceeded and he’d roused himself from his torpor.
The penny dropped.
“And what is the name of the Her Majesty’s sister?”
I heard a brief sound behind me, Jameson shuffling his stance where-ever he had positioned himself.
“I don’t know every detail of the family,” Zhong said, slowly and mockingly, his patience evidently gone now. “You have stolen me here, where-ever we are, to ask me these pointless questions.”
I gazed back at him blankly, despite my growing sense of uneasiness it was important to remain in control and never acknowledge these kinds of outbursts.
“I do not understand this,” Zhong continued, for all the world truly baffled at what was happening to him.
Jameson suddenly appeared, pressing the button to end the recording. It was over. Silently then I stood and picked up the recorder, placing it in the briefcase which Jameson was holding before me. Evidentially Jameson had heard what-ever it was that he needed.
“You are in-charge here,” Zhong said, immediately rounding on Jameson and overflowing with revenant anger. “You must release me at once!”
We didn’t speak a word between us as we left the still curing Zhong in his seat and filed out of the room. His rising bellowing silenced as the attentive Carter closed and locked the door behind us. Jameson turned and handed the revolver back to Carter.
“I’ll be sending some people down shortly,” Jameson began. “You are to remain at post until then. When they arrive they will relieve you.”
As Carter murmured an affirmation I fell in behind Jameson again and we navigated our way silently away from the cell.
“There is a debrief suite on the next floor,” Jameson said. “We’ll discuss there.”
We took the elevator up a floor and made the short journey to the debriefing suite in silence. There was little doubt now as to the what, only the how, and it was very little wonder that Jameson and the High Echelon had directly intervened with this case. The Royal Family legalised our operations through the executive powers of the sovereign. They had served as the first patrons of the Founders when the proto-organisation was formed seventy years ago.
The suite itself was differentiated only by its large robust door, the sign above reading “suite zero-eleven-f”. Jameson took the handle and the heavy door glided open on its polished hinges. With a brief nod, he motioned me inside and pulled it closed after us. The suite contained only eight garden-variety office chairs around a plain conference table and lone cabinet in the corner of the room. I took a seat roughly centre whilst Jameson deposited the aluminium briefcase on the table as he strode past and towards the cabinet.
As Jameson struggled with the cabinet doors I was left alone to gather my thoughts before the final confrontation. I had been selected, almost certainly, because of my veteran status respective to the rest of the Red Grouse project and the obvious revelations surrounding Her Majesty’s sister only complicated matters further. It wasn’t confirmed yet but…
Jameson returned with a label maker, a large rotating wheel on a pistol-grip handle. It was the first time I’d properly looked into Jameson’s face since we’d entered Zhong’s interrogation suite. He somehow looked even older and more worn and I noticed how old he was to still be working a full time position as took the tape and recorder from out of the briefcase, along with a few documents – his hands trembled. Jameson began fumbling with the label machine, twisting the dial to select the characters; a strip of black tape with embossed white lettering emerging from the end with every heavy click.
“TOP SECRET – ESOTERIC”
By any external standards everything that we did should be marked top secret. Even internally, information was compartmentalised so much (for reasons which were growing even clearer by the moment) that security markings were applied unevenly – an aspect of the High Echelon routinely adjusted them. The true kingmakers were the caveats, esoteric, the what, and esoteric principle, the how and why. Never in over a decade of service though had I ever seen something esoteric be marked as top secret – more surprising still a Red Grouse case. Even the events in Peshawar weren’t so secret that they couldn’t be used as a case-study or training exercise for other Counter-Ops units.
Jameson had produced a second tape and affixed to the box.
“SPECIAL STUDIES PROJECT PAPILLION”
I’d never heard of it but Jameson had known before I’d even arrived what Zhong was going to impart. It was standard with Red Grouse cases for a second team to go in mostly blind, to see if they could gleam some further insight from another mostly organic interrogation session. He’d waited for the confirmation regarding the Her Majesty’s sister before pulling the plug.
“I’m going to need you to bind this,” Jameson said, breaking the silence and my own reverie. He grabbed the piece of paper and handed it across to me, along with a bleeder.
It read:
“SPECIAL STUDIES PROJECT PAPILLION - INDOCTRINATION”.
“I, Robert Edwin Maxwell, an ego, understand and affirm to be bound by the conditions and prescriptions ensuite.”
What followed was little more than fairly boilerplate terms for a binding oath, a Horkos, which would prevent me from wittingly telling anyone outside of Papillion any information bound to it. Beneath the terms was the binding space. A two-by-two centimetre box above my own name – printed because Jameson knew exactly what was going to be divulged. Besides my space was another, already prefilled, and the name “Lewis Archibald Jameson, SSP Papillion, Director.”
I placed the bleeder against my thumb and pressed the button and a minute needle darted out to prick my thumb. I waited a second as a small drop of blood formed around the tiny piercing before pressing it into the space on the document. I didn’t feel anything of-course, the esoteric did not work in such a manner. If I had goose bumps at that moment then their causes were perfectly natural. I handed the document back to Jameson, who slipped it neatly into a plastic wallet and returned it to the briefcase.
“Right,” he said finally, and matter-of-factly. “Now we can start.”
“I’ve never seen a Red Grouse case get a Top Secret marking before Sir,” I began.
“Of course not,” Jameson scoffed. He took a packet of cigarettes from his pocket and pulled an ashtray over from across the table. I decided to do the same. We both smoked for a pregnant moment.
“Most cases,” James began, “are little more than gossip – a mere inkling of something greater.” Had the situation not been so dire, I would have chuckled that the old fashioned Jameson was smoking French made filterless cigarettes.
“There’s probably thousands or millions of Red Grouse cases out there. Undoubtedly most concerned with total rubbish. The knowledge gained is random and the people who receive it are barely aware of the subject matter. The most it’s likely cost the majority of cases is that they lose a question in a trivia quiz. But then the rare case like Mr Zhong comes around, where not only can we identify that it’s a Red Grouse case – obviously in this case,” he snarled bitterly. “But it actually concerns a subject of interest for the organisation.”
He took a long, pensive drag on his cigarette. I was certain he was stoking himself up for what-ever he had planned for this discussion – mapping in his head the order in which he was going to dangle the pearls of wisdom.
“What do you know about the Faiteur?”
The Faituer was one of the “Empyreans” an entity of pure consciousness in the Third World.
“Only what’s told in the Confidential level brief on the Empyreans. We’ve used them for ESOINT in Iran to provide the Shah with intelligence on subversive and terrorist organisations. The Faituer itself though is not one I’m familiar with past the name.”
“What about Potential Difference?” Jameson said, apparently not feeling any need to enlighten me regarding the previous topic. Presumably then he was satisfied with my response. “As an esoteric concept,” Jameson continued, “not physical energy. Well,” he gave forceful sigh. “Six of one I suppose.”
“I’m not familiar with term sir,” I said truthfully. “Guess I didn’t have need to know.”
“Well now you do,” he said, tapping the aluminium case for emphasis. “You’ll get a proper brief on Papillion. Like all briefs it’ll be dry and clinical. But whilst we’re in this room. Well,” a tiny shrug. “I’ll give you skinny. Potential Difference is the change in First World material and Second World consciousness that occurs when a series of events, a possible outcome if-you-will, is obliterated. What do you think of that?”
“Well,” I began, conscious of just how dry my throat had become. “Surely that must happen all the time? Every-time someone makes a choice?”
“You’d think so right? Well that’s because I only told you first part. If the Fire Brigade arrives at a house and saves a family of five, those five people being alive rather than dead doesn’t create any potential difference. No, an ego must be aware of the future that is being deliberately destroyed – at-least the broad strokes.”
“Like... oh,” the words left me as realisation began to dawn.
“I think you’re on the cusp. Welcome to the club pal,” Jameson said, without a trace of humour or sympathy.
“Then that would require then esoteric intelligence taken from the Third World.”
“Taken is not the right word Maxwell.”
“Then… given,” I swallowed hard. “But if everything we actioned from esoteric intelligence resulted in this Potential Difference then the need-to-know net would be wider. Especially if it has some measurable effect.”
“Therefore…”
“Therefore,” I said, my mind racing. “That’s not how it works either. The hypothetical future is being obliterated entirely for the sake of its obliteration. Only the Empyreans would have fore-knowledge of what was being obliterated at first and only they could provide the knowledge…” I paused to think for a moment between the few likely options. “So it’s like a deal?”
“Did you never wonder? All that ESOINT on insurgent leaders, camps, and plans you gave to MI6 and the Shah’s SAVAK. You think the Empyreans did that out of a love for the Persian monarchy, or the Imperial Federation’s oil supply or, hell, even our organisation and continuity of operations in the region?”
“This is the Faiteur then since you mentioned it so prominently…” I said. My mind was mind spinning. I had no idea that we might have been talking to a single entity all that time.
“I thought they, or it I guess, was our ally. I didn’t ask why – either of Head Office or them. It’s not in my bracket... and we didn’t make any deals out-there.”
“It’s not our ally Maxwell,” Jameson said gravely. “It’s our partner. The deals were already made before you were born… I think. Were you sucking air back in latish nineteen-fourty?”
“Not for another six years no.”
“Well then there you have it. You’re guiltless. Relax.”
I certainly didn’t feel relaxed. The unflappable Jameson, who I’d always assumed wise behind his callous nature looked beaten. The creases across his face looked deeper and his skin sallow as he peered at me through half sunken lids.
“So that’s when you made a deal? With the Faiteur.”
“Not me no. I was present in a capacity we’d now call Counter-Ops,” he gave another of the forceful, I see now, resigned sighs. “Funnily enough since you mentioned it before, it all happened not too far from Nairobi... it would have been the site of a future coronation.”
I let out a dry breath, my chest feeling icy cold, as I opened my mouth and prepared to lead this conversation down its final road.
“The Queen’s sister died in the war,” I said.
“That is correct.”
“And the U-Boat in the Atlantic...”
“Is not…”
Jameson took another long drag on his cigarette, he was staring at spot on the wall behind I knew was blank.
“Yeah… yeah… In a different world it would be have been the exact place that she would have become our Queen… twelve years hence anyway.”
Nineteen fourty, twelve years hence…
“King George didn’t die in 1952,” I said in something scarcely more than a whisper.
“No, but he would of… his heart couldn’t last that long in this world. If I were a gambling man I’d wager that it was probably due to the time when the Special Committee to the Privy Council convinced him to bargain his daughter’s future with a fucking alien.”
“Jesus Christ in heaven…”
The silence between us stretched out as a tower ash fell from my cigarette onto the table.
“She would have been a good Queen I think. She would have lived past the millennium as one of the most recognisable people in the World. A piece of consciousness snatched from the majority of the population of the Earth over four or more generations. That is Potential Difference,” he said each word like it weighed a metric ton. “She, for her part, approached the whole thing with a level of solemn resignation and courage the likes of which I’ve never seen before or again in anyone so young.”
“What happened?” I croaked.
Jameson looked away from the empty wall and right back at me.
“She was hanged,” Jameson said, he spoke calmly now but his face was twisted into a snarl. “Treetops Hotel, Kenya Colony, September the Twelfth, Nineteen-Fourty. Those were the terms we were given.”
I choked slightly. Nobody ever promised that working for the organisation would ever be a clean job. I hadn't always done things I was proud of in looking back. But that had all been real, messy politics between the organisation and its enemies. Human beings ultimately whose motivations could be understood even if disagreed with. To sell a young women to the Empyreans...
“What exactly did we get?”
“Proper access to the Third World and the Empyreans." Jameson said, his voice was truly flat now as the final embers of his cigarette smouldered away. "The knowledge to win the War. The knowledge that the Americans would be brought in if we did nothing. To make a deal with the Third World before the Nazi’s actually stumbled on something useful in their pseudo-esoteric research. The ability to impose the Érgégore on Britain and France which permitted the creation of the Imperial Federation and therefore total global access for us and our operation." A final resigned sigh. "
I’m just happy that old Oliver Lodge died a month before and didn’t have to face what happened.”
He stubbed the end of his cigarette out into the ashtray. “God save Queen Margot.”

Circumcision: The Uniquely American Medical Enigma | Edward Wallerstein

The continuing practice of routine neonatal nonreligious circumcision represents an enigma, particularly in the United States. About 80 percent of the world's population do not practice circumcision, nor have they ever done so. Among the non-circumcising nations are Holland, Belgium, France, Germany, Switzerland, Austria, Scandinavia, the U.S.S.R., China, and Japan. People employing circumcision do so either for "health" reasons or as a religious ritual practiced by Muslims, Jews, most black Africans, non-white Australians, and others.
The origin of the ritual practice is unknown. There is evidence of its performance in Israel in Neolithic times (with flint knives) at least 6000 years ago.³⁸ Jews accept the Old Testament origin as a covenant between God and Abraham,¹⁸ although it is generally agreed that the practice of circumcision in Egypt predated the Abrahamic Covenant by centuries.⁵⁵ Ritual Circumcision is not germane to this discussion except insofar as the surgical ritual impinges upon accepted medical practice.⁶⁵
So called "health" circumcision originated in the nineteenth century, when most diseases were of unknown etiology. Within the miasma of myth and ignorance, a theory emerged that masturbation caused many and varied ills. It seemed logical to some physicians to perform genital surgery on both sexes to stop masturbation; the major technique applied to males was circumcision. This was especially true in the English-speaking countries because it accorded with the mid-Victorian attitude toward sex as sinful and debilitating.⁶⁴
The most prolific enumerator of the health benefits of circumcision was Dr. P. C. Remondino.⁵⁰ In 1891 this physician claimed that the surgery prevented or cured about a hundred ailments, including alcoholism, epilepsy, asthma, enuresis, hernia, gout, rectal prolapse, rheumatism, kidney disease, and so forth. Such ludicrous claims are still disseminated and possibly believed. The book was reprinted in 1974, without change, and the Circulating Branch Catalogue of the New York Public Library (1983) listed the Remondino book, showing a publication date of 1974. One physician, writing in Medical Aspects of Human Sexuality (1974), called the book "pertinent and carefully thought out."⁶³
Remondino was not the only one expounding such views. In 1911, Dr. Joseph Preuss, in a monumental tome, Biblical-Talmudic Medicine, claimed that Jewish ritual circumcision endowed health benefits; his sole source was Remondino⁴⁶ Some espoused more extreme views; in 1910 an article in J.A.M.A. described a new circumcision clamp. The authoinventor claimed that with this device, the operation was so simple that men and women could now circumcise themselves.³⁰
In the 75-year period (1875 to 1950) there was virtually no opposition to routine circumcision in the United States. Instead there were many articles in medical journal and textbooks extolling the practice; the issue was ignored in the popular press. Yet in the more than a century of acceptance of routine circumcision in the English-speaking countries, from 1870 to the present, no other country adopted newborn circumcision.
The first serious questioning of the practice did not occur until late 1949 (in England with the publication of Gairdner's "The Fate of the Foreskin."¹⁷ which began to affect the practice of circumcision by the British. In 1963, an editorial in J.A.M.A. called the attitude of the medical profession paradoxical and confused, and admitted that the facts about circumcision were still unknown.¹⁴ This was followed by several critiques of circumcision such as those by Morgan (1965 and 1967)³⁸ and Preston (1970).⁴⁵ In 1968 Øster confirmed Gairdner's findings,⁴² as did Reichelderfer and Fraga,⁴⁹ who presented a comprehensive study of circumcision. Yet some physicians continued to support circumcision for surprising reasons. For example, Dr. Robert P. Boland, writing in The New England Journal of Medicine in 1969, compared circumcision with tonsillectomy, calling both procedures "ritualistic," and "widely performed on a non-scientific basis." He opposed routine tonsillectomy but concluded vis-a-vis circumcision: "Little serious objection can actually be raised against circumcision since its adverse effects seem miniscule."⁵
Table 1. Estimated Newborn Nonreligious Circumcision Rates in English-Speaking Countries.

Great Britain	New Zeland	Australia	Canada	America
1	10	30	30	80

In the 1970's, a change seemed in the offing. In 1971 and 1975, the American Academy of Pediatrics Task Force on Circumcision declared: "...there are no valid medical indications for circumcision in the neonatal period."² In 1978, the position of the American Academy of Pediatrics was endorsed by The American College of Obstetricians and Gynecologists.⁶⁴ In 1983 both groups jointly reaffirmed their positions.¹ The "firm" firm declarations should have caused a marked drop in the United States circumcision rate. They did not.
To explore the circumcision rate in the United States, it is essential to compare the American experience with the other English-speaking countries. Anticircumcision articles appeared in the medical press in all of these countries. Gairdner¹⁷ and Øster⁴² were published in journals in England; Morgan (1967) was published in Australia.³⁹ In 1971, the Australia Paediatric Association recommended: "Male infants should not as a routine be circumcised."¹³ In 1975, the Canadian Paediatric Society stated, ". . .there is no medical indication for circumcision in the neonatal period."⁵⁷
Although there is no precise data on circumcision from any country,approximated rates for the English-speaking countries reveal that in Great Britain, the practice has virtually been abandoned; New Zealand follows closely behind. (In a 1982 visit, a number of physicians were apologetic for the "inordinately high" rate of 10 percent. Several physicians stated categorically that they refused to perform routine circumcisions.) The rates in Canada and Australia appear to be declining at about 10 percentage points per decade. The United States stands alone as the only country in the world in which the majority of newborn males are circumcised, purportedly for health reasons.
Before addressing the phenomenon of circumcision in the United States let us examine the Canadian and Australian data. In Canada (Table 2), there are considerable rate differences among the provinces but the overall rate is clearly declining, and in Quebec the practice has been virtually been discontinued. In Australia (Table 3), unlike Canada, the rates by states are relatively uniform, but clearly declining. In 1978, the Australia government recommended that payments for circumcision be reduced or eliminated.⁷¹ (In a visit to Australia in 1982, I was told that a national campaign was planned to reduce unnecessary surgery; circumcision was high on the list.)
Table 2. Hospital Inpatient Male Newborn Circumcision in Canada by Province (data from British Columbia and Newfoundland not reported)* 1970 to 1978 by Rank Order of Percentage change

	1970	1979	Change (% rounded)
Total	64,015	44,853	-30
Quebec	12,995	3,077	-76
Nova Scotia	2,477	1,004	-60
New Brunswick	1,543	673	-43
Alberta	10,857	9,608	-12
Manitoba	5,006	4,424	-11
Ontario	24,476	26,283	+4
Saskatchewan	3,276	3,655	+12

Table 3 Estimated Neonatal Circumcision Rate in Australia by State, 1973-74 to 1979-80(%)* Adapted from Wirth, J.L.: Current circumcision practices in Australia. Med. J. Aust., 1:179, 1982.

	1973-74	1979-80	% Decrease
Total	49	39	10
New South Wales	52	42	10
Victoria	39	28	11
Queensland	62	51	11
South Australia	47	41	6
Western Australia	51	38	13
Tasmania	68	43	25

Although nationwide data on circumcision for Canada and Australia are admittedly imperfect, precise data for the United States are virtually non-existent. The H.E.W. Hospital Records Study excludes neonates.⁷⁰ The Cycle III Health Examination Survey, conducted from 1963 to 1965 among youths aged 12 to 17, reflected the practice of circumcision in the early 1950's.⁷⁰ The total circumcision rate was 765 (whites, 80 percent; blacks, 45 percent); regional differences were also noted.
In 1980 Wallerstein provided a crude compendium of circumcision rates reported in the literature.⁶⁴ This was updated in 1981 by King and Roebuck.²⁹ Since these compendia, other reports from individual hospitals have been noted in the literature (Table 4).²⁵ Of the five hospitals reporting, the lowest rate was 80.7 percent; the other rates ranged from 90 to 98 percent. These data are static, that is, reported within a fixed period, making it impossible to discern a trend. Several hospitals reported longitudinal changes. One New York City maternity center stated that "in the past" the rate was 90 percent; in 1980 it was 60 percent.³⁵ Other reports are more precise, indicating changes from 1978 to 1980, and 1975 to 1979 (Table 4, last two hospitals).³ The year-to-year changes were negligible; clearly there was no precipitous decline. This stability of rate was confirmed by the Commission on Professional and Hospital Activities, which publishes annual data based on projections from atypically large hospitals.⁷² They show a 1970 rate of 88 percent and a 1980 rate of 86 percent. The mean rates from 1970 to 1975 and from 1976 to 1980 are identical (86 percent).⁵⁴
Table 4. Circumcision Rates, Selected Hospitals
References: ^{25, 29, 27, 34, 3, 41} respectively

Hospital	Years	Rates(%)
New Britain General Hospital, Connecticut	1976-77	80.7
Southern Illinois Hospital	1979	95
John Hopkins Hospital	1980	97.6
St. Agnes Hospital, Baltimore	1981	96-98
Hershey. Pennsylvania Hospital	1983	90-96
George Washington University Medical Hospital	1979	79
	1979	77
	1980	81
Largest Hospital in Salt Lake County, Utah	1975	92
	1976	93
	1977	92
	1978	92
	1979	93

In 1982 Slatkowski and King approached the question of circumcision rates specifically with respect to the pronouncements of the American Academy of Pediatrics on the practice of circumcision in Illinois.⁵⁴ They obtained data from 18 Chicago-area hospitals; the rates ranged from 27 to 92 percent (mean 78 percent). Five of the hospitals reported rates from 80 to 88 percent; five from 90 to 92 percent; the rates ranged from 74 to 97 percent, with a single exception: one hospital reported a rate of 4.5 percent. Upon further query, that hospital reported a circumcision rate decline beginning after 1974-75.
These United States data reveal no significant national decline in the circumcision rate desperate the pronouncements of the American Academy of Pediatrics or the American College of Obstetricians and Gynecologists. However there are instances of sharp declines in several hospitals. Dr. Joan Hodgman, director of the Newborn Division of the Los Angeles County University of Southern California Medical Center, reported in 1983 that their circumcision rate is zero. Similarly, J.H.T. Chang, pediatric surgeon at the Parkland Memorial Hospital in Dallas, the largest in the city, stated in 1983 that circumcision is not performed even if the parents demand it.²⁴
Why have most United States physicians persisted in the practice? One reason is that the medical and popular literature abounds in serious errors of scientific judgment, equivocation, and obfuscation. Space limitations permit a brief examination of four issues: pain, venereal disease, cancer, and hygiene.
PAIN
Pain of circumcision is not a debatable question; it is a fact.²¹ However, a perusal of writings in the popular press (1982 and 1983) reveals confusion. Proctor and Gamble, one of the nations largest advertisers, promotes Pampers to parents by offering the Expectant Parents Information Kit (1982), which contains the following statement: "You may be surprised to learn that circumcision will not be painful to your baby because, at this early stage of development, the penis does not yet have functioning nerve endings."¹⁵
A contrary view was found in American Baby (May 1983), in which parents were told that "Newborns who undergo circumcision experience a great deal of stress and pain . . ." Parents were advised that it was now possible to employ local anesthetics to alleviate such pain.³⁶
Mother's Manual (1982) argues against local anesthesia because ". . . it swells the area to the extent of making an unsatisfactory circumcision too likely."⁷ Genesis, published by the American Society for Psychoprophylaxis in Obstetrics, carried an article in 1982 in which two writers who attended a Jewish ritual circumcision described the surgery as bloodless, painless and stressless. They suggested that non-Jewish parents explore the possibility of employing ritual circumcisors.¹¹
Parents who read such an array of literature are bound to be bewildered.
VENEREAL DISEASE
Prior to the turn of the century, little was known about venereal disease, either causes or cures. Understandably, the false claim could be made with impunity that circumcision prevented sexually transmitted diseases.⁶⁴ These claims persisted beyond the middle of the twentieth century: Urologist A. Ravich titled his 1973 book Preventing V.D. and Cancer by Circumcision.¹⁸
Within the past decade there has been virtually no statement that circumcision prevents syphilis or gonorrhea; the present day "whipping boy" is genital herpes. Even a cursory exploration of a link between circumcision and herpes reveals that such claims are without foundation; the presence or absence of the foreskin neither aids nor deters the transmission of herpes. A definitive statement regarding this claim was made in 1979 by Y.M. Felman, director of the New York City Bureau of Venereal Disease Control: ". . . I don't believe that circumcision is of any value in preventing genital herpes, as this disease is quite common in circumcised males and their female sex partners."¹⁶
Yet in 1981, Warner and Strashin wrote: "Herpes genitalis appears to be the only sexually transmitted disease associated with circumcision status."⁶⁷ Strashin defended his statement the following year.⁶⁸ If circumcision prevents herpes or deters its transmission, how can we explain the phenomenal rise in the incidence of this disease to epidemic proportions, particularly among the most sexually active males, ages 15 to 25, of whom perhaps 75 percent are circumcised? Nevertheless, the 1975 American Academy of Pediatrics Task Force reported: "Adequate studies to determine the relationship between circumcision and the incidence of venereal disease have not been performed." This statement is obvious outdated.
PENILE CANCER
Few diseases strike greater fear than cancer, and no site is more potentially alarming to males than the penis. It is not surprising, therefore that when newborn circumcision is presented as an absolute prophylaxis against penile carcinoma, it is a potent argument for circumcision. Wolbarst wrote in 1932: ". . . cancer of the penis does not occur in Jews circumcised in infancy. There is no case on record."⁷³ Subsequent research indicate that there are such cases on record.⁴
The understatement of the incidence of penile cancer in Jews should be contrasted with the overstatement in regard to the uncircumcised people of India and China. In 1973, deKernion and colleagues wrote: ". . . the disease accounts for 12 percent of all malignancies among the Hindus of India."¹² In 1977 Kaplan claimed, "In China, penile carcinoma accounts for 18 percent of all carcinomata."²⁸ In a visit to the Peoples Republic of China (1976) and India (1982) the incidence of penile cancer was discussed with health officials. They stated that no nationwide health data was available; more specifically, no National Cancer Registries were maintained (much as they would like to do so). They remarked that no reputable scientist in their country would provide such data. Precise data on penile cancer are available from countries in which a National Cancer Registry is maintained. The United States does not maintain such a Registry, and so its data are imprecise. The data from Japan, Norway, and Sweden are compared with the United States' estimates (Table 5). The largest difference in incidence is between the United States and Sweden, three cases per million males; for death rates, the difference between the United States and Japan is one case per million males, small differences indeed. It is worthy of note that in countries in which a National Cancer Registry is maintained and precise incidence or death rates is known, routine circumcisions continues not to be practiced. There is no acceptance of the claimed epidemiologic relationship between circumcision and penile cancer.
Table 5. Penile Cancer: Comparison of Approximate Incidence and Death Rates per 100,000 Males for Selected Countries*
*Data from Cancer Deaths 1980 Ministry of Health and Welfare, Tokyo, Japan for Japan. For other countries; Wallerstein, E.: Circumcision an American Health Fallacy. New York, Springer Publications. 1980.

Country	Year	Incidence	Death Rate
America	1972	0.8/100,000	0.3
Japan	1980	N/A	0.2
Norway	1967	1.1	N/A
Sweden	1968	1 1	N/A

It could be argued that in Japan, Norway, Sweden, high standards of hygiene are maintained. The variable in penile cancer prophylaxis may be hygiene, not retention of foreskin. This is essentially the position taken by the 1975 American Academy of Pediatrics Task Force, which denied a relationship between circumcision and prostatic cancer and stated that "non-circumcision is not of primary etiological significance" in cervical cancer.² In regard to penile cancer, they wrote: "There is evidence that carcinoma of the penis can be prevented by neonatal circumcision. There also is evidence that optimal hygiene confers as much or nearly as much protection" (emphasis added)² In 1981, 6 years later, Grossman and Posner took a more forthright position. Writing in Obstetrics and Gynecology, they stated: "No one today seriously promotes circumcision as a prophylactic against cancer in any form. No significant correlation between cancer and circumcision has ever been proved."²²
The claim that circumcision is related to penile cancer is based upon the "fact" that smegma is a carcinogen. Smegma in infancy consists solely of desquamated epithelial cells, and in adulthood additionally of the secretions of the Tyson's glands. Many attempts have been made to prove a simple cause and effect between smegma and cancer; all failed but one. In 1947 Plaut and Kohn-Speyer "demonstrated" that smegma was a carcinogen. Of the animals examined, 27 percent of those treated with smegma developed cancer whereas 15 percent of the animals treated with cerumen developed cancer.⁴⁴ Is it now possible to claim that cerumen is also a carcinogen with only one half of the carcinogeneity of smegma? This study is deficient in conceptualization, methodology, execution, gathering of data, and analysis.⁴⁴ Understandably, the study has largely been ignored; however, as recently as 1981 it was accepted in one medical journal article without question.²³
Penile cancer scare techniques are still with us. In 1980, Kochen and McCurdy stated that ". . . uncircumcised men are uniquely at risk . . ." They "demonstrated" that the predicted lifetime risk among uncircumcised men was one in 600.31 They did not address why 599 out of 600 at risk" males will not contract penile cancer in their lifetime. More importantly, Kochen and McCurdy based their calculations on the 1968 Stern and Lachenbruch study of one cancer detection center in Los Angeles.⁵⁹ Their 1968 data are obviously skewed in age, ethnicity, religion, social class, and so forth, and are admittedly non-random. Such inadequate local data should not be extrapolated to a national statistic.
The threat of penile cancer hangs over the discussion of circumcision like some mystical demon. It deserves to be exorcised, not circumcised.
PENILE HYGIENE
In several studies, mothers were asked why they agreed to their son's circumcision. The answer given most frequently was "hygiene."⁵³ (In a 1981 United Nations study of female genital surgery in Africa, one reason given for such surgery was "hygiene."¹⁹ ) Why is male genital hygiene viewed with such alarm in the United States that prophylactic surgical intervention is necessary?
For over a century, and to this day, mothers have been warned that proper penile hygiene involves full retraction of the foreskin to clean the glans of smegma, and this procedure should start almost at day one. Such a task is virtually impossible, because in almost all infants the foreskin is attached firmly to the glans. Separation occurs normally within a few months or several years. Separation may be forced but this literally involves tearing the tissues apart, which is usually painful and may result in bleeding. No sane mother enjoys causing distress to her child. No wonder there is fear and reluctance about retraction of the foreskin. This has created a foreskin phobia. Forced retraction of the foreskin may lead to complications, and may well be the reason for so many postinfancy circumcisions (only in the United States).
The problem with this hygienic technique is that it is totally in error. Care of the foreskin is not exceedingly difficult; it is exceedingly simple: leave it alone. The foreskin in infancy should not be retracted. In 1977 Kaplan wrote, " . . . freeing 'adhesions is tantamount to cruel and unusual punishment and is unfounded physiologically or medically."²⁸ Development of the foreskin and the inadvisability of forced retraction was noted by Gairdner (1949),¹⁷ Øster (1968),⁴² Reichelderfer and Fraga (1968),⁴⁹ and others.
Many, if not most, American physicians are ignorant of proper care of the foreskin. This was demonstrated by Osborn and colleagues in 1981, who queried Utah pediatricians and found that 67 percent estimated that the foreskin should retract easily by one year.⁴⁰ This is contrary to all findings of studies of the foreskin. Only 3 percent said the newborn foreskin should never be retracted. In interviewing a small sample of mothers of uncircumcised boys, Osborn and colleagues also found that retraction of the foreskin caused such anxiety that 40 percent of these mothers stated that they would have their next male infant circumcised.
The problem is not limited to Utah. In a study of physicians in the Chicago area, Patel and colleagues reported in 1982 that "only 49 percent of the physicians [in the total sample] were aware of the AAP's [American Academy of Pediatrics position."⁴³ Among the pediatricians and obstetricians in the sample, 62 percent were aware of this position. The major reason given for recommending circumcision was "hygiene" (90 percent). In a 1982 study by Stein and colleagues conducted in San Diego, they noted, "Only 36 percent of the responding physicians were aware that the newborn's foreskin is characteristically not found retractable."⁵⁸ When asked "if a nonretractable foreskin is an indication for circumcision," 47 percent of all respondents answered incorrectly. Such incorrect responses were mare likely to be given by those in family practice (50 percent), obstetrics (55 percent), and general practice (67 percent) than by those in pediatrics (13 percent). At the Spring 1983 meeting of the American Academy of Pediatrics in Philadelphia, an exhibit on circumcision was conducted. The most frequently asked question related to proper care of the foreskin.
If physicians are ill-informed about care of the foreskin, how can parents be well informed? There are thousands of books, pamphlets, and articles available to parents relating to child care. Almost none devotes attention to proper care of the foreskin. Discharging a circumcised child without informing the parents of proper wound care constituted negligence. Discharging an uncircumcised child without informing the parents of proper care of the foreskin is equally negligent. Osborn and colleagues reported that the only written information they could find on the subject was this statement in a 1978 book: " . . .retract the foreskin gently and return the foreskin to its normal position to prevent constriction and swelling."⁸ To begin to correct this lack of information, in 1982 Wallerstein wrote a pamphlet entitled "When Your Baby Boy is Not Circumcised."⁶⁶ Boyce also addressed the subject in an article entitled "Care of the Foreskin (1983).⁶ The American Academy of Pediatrics has issued a pamphlet entitled "Care of the Uncircumised Penis" (1984).
The issue of hygiene is obfuscated by the American Academy of Pediatrics Task Force Report in two ways. As noted earlier, the Report stated that to prevent penile cancer, "optimum hygiene was necessary. The reader, lay public or physician may ask: What constitutes "optimum hygiene? Can parents guarantee such optimum care? If not, isn't it better to play it safe and circumcise? The Report also cautions that retention of the foreskin requires "lifelong" hygiene. This statement is not incorrect; it is incomplete. All body parts require lifelong hygiene, body bathing, hair shampooing, oral hygiene, labial hygiene, and so forth. The discontinuance of any aspect of hygiene may well have deleterious effects. Why single out the foreskin?
The crux of the circumcision/hygiene rationale had its origin in the fear of the "effects" of masturbation; this may persist in attenuated form. Today, however, it is basically a lack of knowledge: the foreskin and glans in infancy are essentially fused, and should not be retracted forcibly, and smegma is not a carcinogen.
Another claimed hygienic benefit is that thousands of United States servicemen, particularly in the South Pacific required circumcision. Would it not be better to circumcise in infancy and thereby avoid the more troublesome operation in adulthood? However, Japanese soldiers were fighting in the identical environment, and the Japanese did not practice newborn circumcision. When Japanese health officials were visited by Wallerstein (1982), they stated that to the best of their knowledge, Japanese military surgeons did not find it necessary to circumcise after World War II. More to the point, in the event of thermonuclear war, the role of the foreskin will pale to insignificance.
Thus, much of the current circumcision misinformation, both lay and professional, is false and misleading. In 1971 and 1975, the American Academy of Pediatrics appeared to take definitive positions; actually they did not. The American Academy of Pediatrics Committee on the Fetus and Newborn noted in 1971 that "there are no valid medical indications for circumcision in the neonatal period."² in 1975, the American Academy of Pediatrics Ad Hoc Task Force on Circumcision reported that there was no basis for changing this statement and concluded, "There is no absolute medical indication for routine circumcision of the newborn."²
However, as previously noted, the use of the words "optimum" and "lifelong" with regard to to penile hygiene and the stated uncertainty of a possible link between circumcision and venereal disease represented equivocation. An additional equivocation is found in the 1975 Report: "A diagnosis of phimosis cannot be made with assurance in the newborn period because the cleavage plane between the glans and the deep preputial layer of the penis is not developed at birth. There is a real need for research which will improve diagnostic accuracy in this area."²
In 1983, this statement was challenged by Thompson, who chaired the ad hoc Committee. He wrote: "One major reason used to justify neonatal circumcision - correction or prevention of phimosis has been shown to be untenable by serial studies from birth to adulthood."^{62 Furthermore,} overwhelming epidemiologic evidence from countries that never adopted circumcision or abandoned the practice obviates the need for further study.
Thompson also provided the setting for the equivocation and the absence of a more definitive position: "The ad hoc commmittee was sharply divided in its opinions, and the resulting statement was a compromise that stated that there was no absolute medical indication for routine circumcision of the newborn.' The words absolute and routine were meant to convey a different impression from the conclusion of the AAP Committee on the Fetus and Newborn, but this has no always been the interpretation of readers."⁶²
If the American Academy of Pediatrics Committee was sharply divided and the report subject to misinterpretation, how can physicians and parents take an unequivocal position on circumcision? They cannot. And if the position of the American Academy of Pediatrics is equivocal, the position of the American College of Obstetricians and Gynecologists is even more so. When the American Academy of Pediatrics committees reported, the statements were published.⁵⁶ The endorsements of the American College of Obstetricians and Gynecologists were not published in their journal.⁶⁴ Moreover, in 1978 Grimes raised an unanswered question: " . . . the American Board of Obstetrics and Gynecology, Inc., warns that 'physicians who assume responsibility for the health of male patients for operative or other care will not be regarded as specialists in obstetrics-gynecology . . .'"²⁰ It is well known that obstetricians perform a large percentage of circumcisions.
The acceptance of circumcision was noted by Herrera is 1983, who reported on a nationwide survey of 400 pediatricians and obstetricians; 50 percent believed circumcision indicated in the newborn, 33 percent opposed, and 17 percent were undecided.²⁶ As to advice to parents, there was acquiescence; 15 percent encouraged it, 19 percent discouraged it, and 66 percent remained neutral. "This is one reason why nearly every male neonate is circumcised," Herrera wrote.²⁶
Ambivalence on the part of physicians about circumcision was illustrated in one study by a Canadian hospital in 1983 where there were two patients with a serious complication of circumcision, denuding of the penile shaft that required plastic surgery. A formal proposal to suspend neonatal circumcisions was made but rejected because of anticipated adverse community reaction. However, the circumcision rate in that hospital dropped from about 40 to 20 percent as a result of the mishaps.⁶¹
Judging from the record, American medical professionals are not truly opposed to circumcision; they perform about 1.25 million annually. Some continue to insist that there are health benefits. Some physicians place the responsibility on the parents. In 1983 Maisels and colleagues wrote, "If circumcision practices are ever to be changed, such changes will likely result from organized advocacy of lay groups . . . rather than from the efforts of the medical profession."³⁴ However when physicians demonstrated that routine tonsillectomy and adenoidectomy were unwise, the rate dropped. No amount of parental pressure would cause an ethical physician to perform such an operation if it were unnecessary.
Some charge venality, possibly true for some physicians, but not for all, and impossible to document. Some of the highest circumcision rates are to be found in military hospitals, where the doctors are salaried. Contrast this with the abandonment of routine tonsillectomy; some physicians had reduced revenues, but no one clamored for the reinstatement of the procedure to refill the coffers. Venality may not be dismissed entirely; in private practice, circumcision results in a fee, and there is loss of time convincing parents not to have their sons circumcised.
Then there is the Jewish question. Some non-Jewish physicians may be hesitant to question routine "health" circumcision in the mistaken belief that this stance may offend Jews. However, according to Jewish theologians, the Jewish ritual has nothing to do with health.⁶⁴ Obversely, occasional private comments suggest that Jews are responsible for nonreligious circumcision. This is a canard.
The "enigma" lies in the United States medical profession's apparent inability to come to grips with the simple fact that there are no demonstrable health benefits of circumcision, and there are risks. (Space limitations preclude delineation.) It should also be noted that the foreskin is useful erogenous, and protective tissue. Smegma, both clitoral and penile, is beneficial, not detrimental. Meatitis is not uncommon in circumcised males; rare in the uncircumcised. Moreover, the penis is the only organ subjected to routine prophylactic surgery.
One explanation for holding to outmoded views was provided by a medical professor who told his students, "It takes less than five minutes to print an article in a medical journal and 50 years to erase it." In 1979 Colletti approximated this estimate. He noted that efforts to reverse current circumcision practice "will need at least a generation of widespread education, coaxing, and encouragement to succeed."¹⁰ Warner and Strashin are even more pessimistic, based upon an erroneous premise: "As for the likelihood of a successful hygiene education program we can only point to our own profession's impotence in combating smoking and obesity."⁶⁸ This approach overlooks the fact that hundreds of millions of dollars are expended annually to promote smoking and food intake. No such effort on behalf of circumcision exists.
As scientific evidence mounted to dispute each of Remondino's exaggerated claims, physicians clutched at straws to retain at least one "health" benefit. Now that all such claims have been refuted, circumcision today has become cultural surgery, not very different from ear- and nose-piercing and tattooing. The extreme to which such cultural surgery is carried may be found in the 1983 warning given by the British Social Service Secretary to Harley Street surgeons who charged up to $1500 for a clitoridectomy performed on young girls from Africa, where such surgery is traditional.⁶⁹ More serious examples were found in France in 1982.⁵²
The medical profession was successful in eliminating routine tonsillectomy and adenoidectomy. This is precisely what is needed for routine circumcision. It is necessary to overcome ignorance and the emotional superstructure surrounding the penis, not very different from ancient (and present phallic worship. It is necessary to accept scientific facts; it is necessary to discard myths about circumcision: the foreskin causes premature ejaculation, it keeps the penis from growing, some disaster will befall the uncircumcised child, the uncovered glans is more esthetically pleasing (that is the foreskin is ugly). The special myth that the boy's penis must be identical to his father's ignores the historic truth that no objection was raised, and no problem arose when circumcising millions of boys whose fathers were uncircumcised.
To resolve the problem, the positions of the American Academy of Pediatrics and American College of Obstetricians and Gynecologists should become definitive statements that circumcision is unnecessary surgery, not to be undertaken except in rare medical circumstances. Endorsements of this position should be obtained from all relevant medical groups. This information should be disseminated to the entire medical profession, to all hospitals, nurses and nursing associations, childbirth educators, and most certainly to parents via the popular press. Meetings professional and lay persons should be called on local, state and national levels to discuss circumcision. With such an approach, routine newborn nonreligious circumcision will soon pass from the scene to join blood-letting and cupping in medical history.
As Prucha observed in 1980, "The history of these few millimeters of skin is utterly fascinating."⁴⁷

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