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European markets: Investors follow Ukraine developments | LONDON — European stocks closed higher on Monday as investors continued monitoring developments in the war between Ukraine and Russia.
The pan-European Stoxx 600 provisionally closed up by 0.3%, with auto shares climbing 1.2% to lead the gains as most sectors and major bourses entered positive territory.
Global markets are watching events in Ukraine closely more than a month after Russia began its invasion of the country.
Ukrainian President Volodymyr Zelenskyy has reiterated that his country is prepared to discuss adopting a neutral status as part of a peace deal with Russia. Meanwhile, U.S. Secretary of State Antony Blinken has sought to clarify President Joe Biden's comments that Russian President Vladimir Putin `` can not remain in power. ''
Read our live updates on the Ukraine-Russia war here
Although European stocks were grinding higher on Monday, Morgan Stanley's chief European equity strategist, Graham Secker, told CNBC that the best investors could hope for in the near future is for stock valuations to remain flat.
`` The multiples look OK but they don't look particularly cheap. They're basically in line with their very long-run average, and given the very tricky environment that we're seeing at the moment, coupled with the Fed raising rates, it's hard to see multiples going up, '' Secker said.
Morgan Stanley came into 2022 projecting 10% earnings growth for European companies, but the bank recently cut this to just 3% in light of the shifting outlook.
`` There's a lot of cost pressures in the systems for companies, '' Secker told CNBC's `` Squawk Box Europe '' on Monday.
`` There's going to be more question marks about whether pricing power will be good enough to allow companies to put their prices up, given some of these building pressures on the consumer from high inflation in general. ''
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Looking at individual stocks, shares of Rolls-Royce slumped 10% as speculation about a possible takeover faded. The stock rose as much as 19% late Friday.
U.S. stocks struggled for direction Monday as investors took a pause following two straight weeks of gains. Traders are awaiting a series of key economic reports, while also keeping a close eye on the Federal Reserve's planned interest rate hikes.
Key data releases in the U.S. this week include the Job Openings and Labor Turnover Survey, and ADP will also release its private payrolls data ahead of the closely watched monthly jobs report, on Friday.
Trade was mixed in Asia-Pacific markets on Monday amid fears over a Covid outbreak in China. Shanghai, China's biggest city, entered a two-stage lockdown on Monday.
The Atlantic Council Global Energy Forum is taking place on Monday and CNBC will be hosting panels with key leaders in the industry, including Bulgaria's and Albania's energy ministers, and Claudio Descalzi, the CEO of Eni.
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— CNBC's Ryan Browne contributed to this report. | business |
Reexamining Global Health: Global Commons, Financing Priorities, and the Role of Institutions in the Global South | With rigorous economic research and practical policy solutions, we focus on the issues and institutions that are critical to global development. Explore our core themes and topics to learn more about our work.
In timely and incisive analysis, our experts parse the latest development news and devise practical solutions to new and emerging challenges. Our events convene the top thinkers and doers in global development.
CGD works to reduce global poverty and improve lives through innovative economic research that drives better policy and practice by the world’ s top decision makers.
The COVID-19 pandemic has showcased the large vulnerabilities of the global health architecture and weaknesses in the resilience of national health systems. It has also reinvigorated a debate about the right way to prioritize and use development assistance for health ( DAH). Should it focus strictly on global capacity for infectious disease surveillance, global governance and policy coordination, and R & D for new health tools? Or should it also be used to subsidize the purchase and delivery of medicines, vaccines, and preventative health technologies and continue investing in national health systems? In an ideal world with infinite resources, the answer is both, but with constraints and new demands, DAH prioritization requires a careful rethink. There has also been growing discontent in low-and middle-income countries about the architecture for global health and how it can be more inclusive and effective.
Olusoji Adeyi highlights some of these issues in his new book Global Health in Practice: Investing Amidst Pandemics, Denial of Evidence, and Neo-dependency. This event will start with a short presentation by Olusoji Adeyi, highlighting key themes from his book, followed by a discussion with senior leaders in health economics and financing, which will explore how we invest today in the global health commons and how it connects and does not connect with national health systems; the growing role of regional institutions; and the issues around external finance for recurrent costs of provision of basic, cost-effective health technologies and services. The panel will also delve into needed reforms in the global health architecture.
If you have questions for our panelists, please submit them to events @ cgdev.org, tweet @ CGDev # CGDTalks, or submit your comments via YouTube.
CGD works to reduce global poverty and improve lives through innovative economic research that drives better policy and practice by the world’ s top decision makers. | general |
Much of Shanghai locked down as mass Covid-19 testing begins | China has begun locking down most of its largest city of Shanghai as part of its strict Covid-19 strategy, amid questions over the policy’ s economic toll on the country.
Shanghai’ s Pudong financial district and nearby areas will be locked down until Friday as citywide mass testing gets underway, the local government said. In the second phase of the lockdown, the vast downtown area west of the Huangpu River that divides the city will start its own five-day lockdown on Friday.
Residents will be required to stay home and deliveries will be left at checkpoints to ensure there is no contact with the outside world. Offices and all businesses not considered essential will be closed and public transport suspended. | general |
Covid-19 killed more people in Republican states — Quartz | Covid-19 hit the US at a time of partisan divide so marked that it spilled into the domain of medicine and science. Even early on in the pandemic it was possible match political affiliation to individual behavior with respect to the virus. In favor of masking, social distancing, and vaccination? Democrat. Prefer a quick return to normal, and oppose mask and vaccine mandates? Republican.
This dynamic showed up in policy and in health outcomes, as well. Comparing covid-19 death rates and spread can be tricky, because factors including population density, socioeconomic status, proximity to correctional facilities, and ethnic composition can influence the outcomes. Yet looking at how states fared in relation to one another gives some indication of the impact of policy on public health. In the case of covid-19, two years into the pandemic, red states have registered higher excess mortality than blue ones.
An article published earlier this month in the Journal of the American Medical Association by Steven Woolf, a professor at the Virginia Commonwealth University’ s Center for Society and Health, looks at the excess mortality registered in 2021 in US states and attributable to the pandemic through the lens of covid-19 policy. ( Excess mortality is the number of deaths that exceed what would be expected in a specific place in a given time.) Deaths were concentrated in states like Florida and Georgia, both with a covid-19 mortality rate above 200 per 100,000 citizens in 2021, where mitigation measures such as masks and distancing were scarce, and vaccination rates lower.
According to the article, states like New Jersey and New York, where the first wave in 2020 hit especially hard, had lower levels of excess covid-19 deaths in 2021, about 112 per 100,000, due to stronger protective policies.
This holds even expanding the analysis to include 2020, when not much was known about ways to contain the virus, and the first two months of 2022, though the Centers of Disease Control and Protection’ s data for those months is still incomplete.
The overall average rate of excess deaths attributable to covid-19 in states run by Republican versus Democratic governors shows that red states had a rate of 268 deaths per 100,000, while in blue states the rate was 240 per 100,000. The disparity was more pronounced when it was linked to actual policy: States that didn’ t enforce any kind of mask mandates, or pushed back against federal requirements, such as Oklahoma and Tennessee, experienced an average death rate of about 300 deaths per 100,000. They all had Republican governors.
Covid-19 excess death rates have been even higher in states where less than 60% of the population is fully vaccinated, reaching an average 316 per 100,000 since the beginning of the pandemic. With the exception of Kentucky and Louisiana, all of those states have Republican governors. So do the five states that experienced the highest excess mortality rates.
This is also consistent with the overall excess mortality ratio from all causes ( not just covid-19), which was just as marked between red states, which tend to have less progressive healthcare policies, compared to blue ones. In the latter, excess mortality rate from all causes was 308 per 100,000 people; in the former, it was 354 per 100,000. | tech |
China's COVID-19 spike preceded by surge in cases from Hong Kong | China’ s worst COVID-19 outbreak since Wuhan was preceded by an influx of imported cases from Hong Kong, showing the risk the city’ s virus crisis poses to the mainland.
Just across the border from Hong Kong, tech hub Shenzhen is emerging from a weeklong lockdown called to tackle an outbreak of the omicron variant. Shanghai, meanwhile, is seeing its highest new case levels of the pandemic, with half the city locked down for testing after a handful of infections ballooned into more than 2,000 in a matter of weeks.
An analysis by Bloomberg News found the uptick in cases in both cities — key entry points into the mainland — came around the same time or shortly after a surge in infections was recorded in quarantined travelers coming from Hong Kong, where the number of recorded new cases still hovers above 8,000.
While China isolates everyone coming into the country for at least two weeks in line with its “ COVID zero ” policy, health officials in both Shenzhen and Shanghai have pointed to lax oversight in quarantine facilities for arrivals as a potential cause for the virus’ s spread.
Having gone long stretches without COVID-19 thanks to its zero-tolerance approach, China has typically been quick to point out the foreign sources of virus cases that seed outbreaks in the community, tracing flareups back to a traveler from Pakistan, for example, or people who came in from the U.S.
On this current wave, the National Health Commission has only said that China has come under increasing pressure from COVID-19 incursions as outbreaks in neighboring regions surge.
Data from Shenzhen’ s health authorities, however, show those traveling from Hong Kong accounted for the overwhelming majority of imported cases detected there since the beginning of the year, with over 93% of the 901 confirmed infections from abroad as of March 26 originating from the financial hub.
In Shanghai, more than half of the imported cases reported by the city’ s health commission this month to March 26 originated from Hong Kong. In this period, locally acquired infections skyrocketed from two to 2,676.
The two cities have been top destinations for those fleeing Hong Kong’ s outbreak, with the number of people leaving the territory hitting records from late February, as the outbreak there quickly spiraled out of control. Mainlanders living in Hong Kong, in particular, have sought refuge at home, where the national caseload is still below the city’ s.
Quarantine hotels are effective at catching COVID-19 cases, but as the virus has evolved to become more infectious, leaks have become more common.
Places that utilized them as a key part of their pandemic response, including Australia and New Zealand, as well as Hong Kong, have all seen outbreaks spawned by escaped cases. It’ s one of the reasons most countries that sought to eliminate the virus early on in the pandemic have now — unlike China — pivoted to living alongside it, like the U.S. and much of Europe.
Contact tracing data released by Shenzhen’ s health authorities show that the earliest domestic cases in February stemmed from staff working at quarantine hotels, while Shanghai’ s government has also acknowledged the role of “ lapses in management ” of imported cases in quarantine driving local outbreaks.
China may be mute on whether Hong Kong was the source of its current outbreak, but its actions indicate officials recognize the risk.
After airlines added more flights in February to cater to the demand from fleeing mainlanders, authorities capped the number of passengers per plane to 50% from Feb. 25 on the Hong Kong-to-Shanghai route.
Flights to Shanghai — which is emerging as a key epicenter of the mainland’ s current wave — have been steadily pared. Until recently, more flights from Hong Kong went to Shanghai than anywhere else, but now Shanghai has fallen below Taipei, Singapore and Manila as the top destination, according to data from Cirium.
Similarly, at Hong Kong’ s land crossing with Shenzhen, cross-border truckers plying the flow of fresh food were also found to be infected, forcing drivers and close contacts to go into compulsory quarantine.
The city has instead sought to maintain the supply of food through deliveries by train and ship from China.
Despite these actions and the lack of finger-pointing by mainland officials, the perception arrivals from Hong Kong have fueled the mainland’ s outbreak has taken hold on Chinese social media.
There was outcry mid-March over pictures of Hong Kongers crowding beaches despite record numbers of cases. A post on Weibo — China’ s equivalent of Twitter — featuring photos of the beach-goers, was liked over 126,000 times and received more than 5,000 comments in a day before being removed by the platform.
Users criticized Hong Kong residents as selfish and called for the withdrawal of support such as mainland medical staff, and for Hong Kong visitors to be banned from entering Shenzhen.
While Hong Kong has in the past pushed hard for reopening the border with the mainland, and Chief Executive Carrie Lam last week expressing optimism about the resumption of talks to do so, the threat still posed by the city’ s still-high caseload may give Chinese officials pause for thought. | tech |
Deaths of generals expose Russia's troubles in Ukraine | Hi, what are you looking for?
The killing in action of several Russian generals in Ukraine has revealed the extent of the heavy losses encountered by Moscow.
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The killing in action of several Russian generals and senior military figures in Ukraine has revealed the extent of the heavy losses and logistical problems encountered by Moscow’ s invading army.
According to Kyiv, seven Russian generals have been killed since the invasion was launched on February 24, in what Western officials say would be an unusually high casualty rate among military top brass.
It is not possible to independently verify this figure and official Russian sources have so far confirmed only the death of one general and another senior naval commander.
According to the Ukraine defence ministry on Friday, the seventh Russian general to lose his life was Lieutenant General Yakov Rezantsev who was killed in fighting in Chornobaivka outside the southern city of Kherson.
“ I would treat these numbers with a grain of salt, ” said Colin Clarke, director of research at the New York-based research thank tank Soufan Centre.
“ But whether it’ s five or 15 generals, the fact that they are losing any generals at all demonstrates that Russian command-and-control is extremely weak and its lines of communication have been severed by Ukrainian military success, ” he added.
In a post on Telegram, Ukrainian President Volodymyr Zelensky’ s adviser Mykhailo Podoliak described an “ extraordinary ” death rate among Russian generals and senior military figures.
“ This is a sign of total unpreparedness of the army, ” he said. “ All this, no doubt, demoralises the Russian army — they realise that their top leadership is completely incompetent ”.
The weaknesses shown by the Russian army in Ukraine, in particular in intelligence, logistics and tactical errors, have forced military chiefs to go to the front lines, said a senior French military official, who asked not to be named.
“ Orders may not have been well understood or received, units could be disobedient or there is a major problem with morale. All this could make the generals go to the front. ”
– ‘ Not a word’ –
Of the generals, only the death in action on February 28 of Major General Andrei Sukhovetsky, deputy commander of Russia’ s 41st Combined Arms Army, has been confirmed by official Russian sources.
Andrei Paliy, the Kyiv-born deputy commander of the Black Sea fleet, was killed in fighting around Mariupol, the governor of annexed Crimea, Mikhail Razvozhayev, announced on his Telegram channel.
But these admissions have been exceptions in a climate where Russia has only been disclosing the most limited information about its losses.
Russia has only on two occasions in the month-long conflict given an official toll for Russian soldiers killed, the latest on March 25 giving a figure of 1,351 deaths.
In a possible sign of the troubles, Defence Minister Sergei Shoigu disappeared from view for some two weeks this month, re-emerging only on Saturday, although the Kremlin insisted nothing was untoward.
While Western sources do not confirm Ukraine’ s figure of 17,000 Russians killed, they say the actual Russian toll is likely several times higher than the official one.
Leonid Volkov, a close ally of jailed Russian opposition leader Alexei Navalny, said the funeral of major general Vitaly Gerasimov — the second general Ukraine said it had killed — had taken place in Yekaterinburg on March 16.
“ There is not a word about this in any Russian media… This general will be buried in a grave without a name, ” he wrote.
A Western security source, who asked not to be named, confirmed Ukraine’ s claim that Rezantsev was the seventh Russian general to have been killed.
The official said another Russian colonel commanding a brigade had even been killed by his own troops, who ran him over “ as a consequence of the scale of losses that had been taken by his brigade ”.
– ‘ Easily intercepted’ –
There remains uncertainty about some of the Russian generals Ukraine says have been killed.
According to the Ukrainian authorities, major general Magomed Tushaev was killed in fighting outside Kyiv on February 26.
Aged 36, he was a general in the National Guard ( Rosgvardia), an internal military force that answers directly to Putin. He is the highest-ranking Chechen said to have been killed.
However, Chechnya’ s leader Ramzan Kadyrov has insisted that Tushaev is alive, saying he took part in a meeting on March 23 and posting a video of a man purported to be him speaking on March 13.
Russian TV on Monday broadcast images allegedly showing Kadyrov in the Ukrainian city of Mariupol meeting a man it said is Lieutenant General Andrei Mordvichev, one of the generals Ukraine says have been killed.
Ukrainian officials have made clear that the Russian generals are a target and their task appears to have been eased by the Russian army using communication tools that are easily intercepted by their adversary.
The Russian units “ do not pay attention to computer security procedures and are easily intercepted, ” Alexander Grinberg, analyst at the Jerusalem Institute for Security and Strategy ( JISS), told AFP.
He said in the battlefield the commanders were identifiable with the naked eye in vehicles recognisable by “ antennas and other vehicles that protect it ” which can then be attacked.
With 2,400 staff representing 100 different nationalities, AFP covers the world as a leading global news agency. AFP provides fast, comprehensive and verified coverage of the issues affecting our daily lives.
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COPYRIGHT © 1998 - 2022 DIGITAL JOURNAL INC. Digital Journal is not responsible for the content of external sites. Read more about our external linking. | general |
Russia will 'always ' be a part of OPEC+, UAE energy minister says | The United Arab Emirates ' energy and infrastructure minister has insisted that Russia will always be a part of OPEC+ even as governments across the globe shun the oil exporter over its war in Ukraine.
Speaking to CNBC on Monday, Suhail Al Mazrouei, a former president of the oil alliance, said no other country could match Russia's energy output and argued politics should not distract from the group's efforts to manage energy markets.
`` Always, Russia is going to be part of that group and we need to respect them, '' he told Hadley Gamble at the Atlantic Council's sixth annual Global Energy Forum in Dubai.
`` OPEC+, when they speak to us, they need to speak to us including Russia, '' he said, referring to the group's negotiations with energy importers.
The U.S., Europe and Japan have called on oil-producing nations to do more to tackle record-high prices amid the war in Ukraine and ongoing supply shortages.
But, Al Mazrouei said Russian oil would play a vital role in achieving that. The comments come as Western allies express concern that Russian energy imports are indirectly topping up President Vladimir Putin's war chest with oil and gas revenue.
`` Who can replace Russia today? I can not think of a country that can in a year, two, three, four or even 10 years replace 10 million barrels. It's not realistic, '' he said.
OPEC+, led by Saudi Arabia and Russia, has the capacity to increase oil output and bring down crude prices, which have jumped to over $ 100 a barrel.
`` We are in agreement with their target or their objective of trying to calm the market and balance the market, '' Al Mazrouei said. `` But you don't do it this way. You don't do it by putting sanctions on a hydrocarbon that you can not replace — unless you want the prices to go high. ''
`` They are doing something but expecting the opposite reaction, and it's not going to happen. ''
OPEC and non-OPEC ministers are slated to meet on Thursday via videoconference to determine the next phase of production policy.
It comes amid renewed pressure for the influential alliance to boost oil supplies after G-7 energy ministers said OPEC `` has a key role to play '' in easing market tensions.
`` We call on oil and gas producing countries to act in a responsible manner and to examine their ability to increase deliveries to international markets particularly where production is not meeting full capacity noting that OPEC has a key role to play, '' G-7 energy ministers said in a joint statement on March 10.
`` This will help to ease tensions and note with appreciation announcements already made to this end. ''
The G-7 group of major economies is comprised of the U.K., U.S., Canada, Japan, Germany, France and Italy.
OPEC+ is in the process of unwinding record supply cuts of roughly 10 million barrels per day. The historic production cut was put in place in April 2020 to help the energy market recover after the coronavirus pandemic cratered demand for crude.
Most recently, the group's been raising output by 400,000 barrels per day each month. The energy alliance has stayed the course despite sustained pressure from top consumers to pump more to cool prices and aid the economic recovery.
OPEC alone accounts for around 40% of the world's oil supply. | business |
New Balance bulks up manufacturing presence in U.S. amid supply chain backlogs | While many retailers are struggling to preserve relationships with overseas vendors and manufacturers, against pandemic uncertainty and shaky foreign relations, one is doubling down on its presence in North America.
New Balance, a privately held business known for its cushioned sneakers and retro-inspired workout gear, has opened a manufacturing facility in Methuen, Massachusetts, the company announced Monday. The move strengthens its reliance on North America for production, as businesses try to navigate an obstructed global supply chain, said President and Chief Executive Joe Preston.
The move comes as prominent business leaders are considering whether globalization as we know it is coming to an end. Larry Fink, chairman and CEO of the world's biggest asset manager, BlackRock, said last week that Russia's invasion of Ukraine has upended the world order that had been in place since the end of the Cold War. Over time, that could result in U.S. businesses lessening their reliance on foreign economies to grow.
New Balance said the 80,000-square-foot space recently underwent about $ 20 million in renovations.
Currently, almost 100 people are employed at the facility, where they make New Balance's most popular Made 990v5 running sneaker. New Balance said it aims to more than double the size of its workforce there as well as its production capabilities by year's end. It will help to produce an additional 750,000 pairs of sneakers annually.
`` It's part of our overall mantra of controlling our destiny, which has really come into play in the last couple of years with with Covid, '' said Preston, in a phone interview. `` The supply constraints have certainly impacted our business, but we were still able to grow [ revenue ] over 30% in 2021. ''
The Boston-based shoe company is building on its current production capabilities in the U.S. Including the Methuen space, New Balance owns five manufacturing facilities across Maine and Massachusetts that employee about 1,000 workers. These spaces help to put together its line of `` New Balance Made '' sneakers, which are at least 70% domestically manufactured and make up a limited portion of U.S. sales, according to the retailer. New Balance said its worldwide sales totaled $ 4.4 billion last year.
According to Preston, the goal is to keep growing in North America — a move that is core to the brand's `` Made in America '' ethos.
`` It differentiates us from our competition, if we make product and don't outsource all of our production, '' the CEO said. `` That helps in the quality and the craftsmanship. ''
The footwear industry has been particularly whacked by pandemic-fueled supply chain obstacles, including temporary factory shutdowns across both China and Vietnam. Retailers including Nike and Adidas are incredibly reliant on cheap labor and materials overseas.
Pre-Covid, about 70% of shoes sold in the U.S. came from China, according to the Footwear Distributors & Retailers of America. In recent years, however, a trade war between the U.S. and China has pushed retailers to increasingly diversify their manufacturing presence into other countries with hopes of avoiding steep tariffs.
But then the coronavirus pandemic struck, and factory shutdowns hampered operators in places outside of China, including Vietnam. Russia's attack on Ukraine has heightened uncertainty, as has the resulting tension between the U.S. and China.
Matt Priest, president and CEO of FDRA, said the unpredictability is forcing brands to make decisions day to day, such as where to source from for the next batch of orders.
`` There's this big geopolitical shift that's happening underneath our feet, '' he said in a phone interview. `` When you see what can happen in a place like Russia, where brands across the whole Western corporate world collectively pull out in a matter of weeks... it just blows your mind about the kind of the shifts that are happening. ''
Nike said last week that its facilities in Vietnam are all up and running, but that the window of time to get goods to North America from overseas remains elongated. It still takes about six weeks longer to get goods compared with pre-pandemic levels, the company said, and two weeks longer than the same period a year earlier. As a result, Nike said it was moving up buying timelines to prepare for the fall season, to try to keep shelves stocked.
It might seem as if the easy answer would be to bulk up production in the U.S. But, according to Priest, it's a costly option and workers can be hard to come by.
`` If you can't find someone to work at the cafe on Main Street in your hometown, you're definitely not going to be able to find workers for a shoe factory, '' he said. `` We don't have the raw materials. We don't have the supply chain here. ''
New Balance says it sees low turnover rates among its U.S. workers in factories. And, to be sure, the retailer still relies on factories overseas for the remainder of its production. So it faces some of the same challenges as Nike and Adidas, but it can at least offset some hurdles with a North American presence, according to Preston.
`` The fact that you can get product quicker to market, the fact that you can respond quicker to consumer trends if you're closer to the consumer... that's what domestic manufacturing affords you, '' he said.
And, he added, New Balance needs the extra capacity as it sees heightened momentum for its running shoes and reaches a new generation of younger customers.
New Balance is the fifth-largest sneaker brand in the U.S., in terms of dollar sales, with 3.4% of market share, according to data from The NPD Group. While that might seem like a small percentage, it only trails four rivals: Nike, Adidas, Jordan and Skechers, NPD said.
`` The brand momentum that we have right now is rooted in our performance business and our lifestyle business, '' Preston said. `` And it's the intersection of both of those things that can really drive some energy. '' | business |
Lockdown in China won't affect GM, VW Shanghai factories | General Motors and Volkswagen Group China on Monday said that their Shanghai operations have not been affected by the city's lockdown to try to stem the spread of COVID-19.
Both companies operate factories in the city as part of joint ventures with state-owned Chinese automaker SAIC Motor Corp.
A GM spokesperson told Reuters that its manufacturing facilities were operating normally.
The snap lockdown announced on Sunday splits China's most populous city roughly along the Huangpu River for nine days to allow for `` staggered '' coronavirus testing.
GM's Shanghai factories sit to the east of the river in areas that have been locked down from Monday to Friday for authorities to carry out mass testing.
The company did not immediately comment on what measures it had put in place to keep production lines running, but Shanghai has said that factories that put in `` closed-loop '' systems can continue production.
Tesla, which also has a factory on the east side of the river, has suspended production for four days after it was unable to put in such a system, sources told Reuters on Monday.
Volkswagen Group China said its operations in Anting, Shanghai, were unaffected by the lockdown, adding that it is monitoring the situation day by day.
Anting is in the west of Shanghai, where the lockdown is scheduled to start on April 1.
Volkswagen operations in the northeastern city of Changchun, however, remain suspended. Its production there has been halted since March 14 because of a COVID-19 lockdown.
| general |
Watch live: Biden discusses proposed tax on ultra-rich and defense spending in 2023 budget | [ The stream is slated to start at 2:45 p.m. ET. Please refresh the page if you do not see a player above at that time. ]
President Joe Biden is scheduled to unveil his 2023 federal budget on Monday afternoon at the White House.
The budget request to Congress features tax hikes on the ultra-wealthy and corporations while providing billions of dollars in new spending for the Defense Department and the Justice Department.
Overall, the 2023 fiscal year budget shifts focus away from the Covid-19 pandemic, which has subsided after the massive omicron wave late last year. Notably, there are no emergency pandemic or supplemental funds being requested.
In place of Covid, the budget focuses on the need to tackle crime and public safety, and the global peril created by Russia's invasion of Ukraine. | business |
First use of mRNA COVID vaccine to treat persistent SARS-CoV-2 infection | A new case report published in the Journal of Clinical Immunology has presented the first description of a mRNA COVID-19 vaccine being used to therapeutically treat a patient experiencing a persistent SARS-CoV-2 infection. The immunocompromised patient, who repeatedly tested positive for SARS-CoV-2 for well over six months, was seen to finally clear the virus from his system following two doses of an mRNA vaccine.
Viral infections are usually characterized as either acute or chronic. Chronic viral infections, such as herpes or the Epstein-Barr virus, are often undetectable for long periods of time. The virus can sit dormant for years, occasionally reactivating and leading to physiological symptoms and new waves of infectiousness.
In some rare cases, those with weakened immune systems can experience a form of chronic viral infection known as a persistent infection. In these instances a virus can remain acutely active for months with the patient consistently experiencing negative symptoms and shedding infectious viral particles.
A new study from researchers in the UK reports on the case of a 37-year-old man named Ian Lester who experienced a persistent SARS-CoV-2 infection, consistently delivering positive PCR tests for 218 days. Lester has a rare genetic disease called Wiskott-Aldrich syndrome, and initially he displayed very mild COVID-19 symptoms.
“ Although most people are able to stop isolating after 10 days of contracting the virus, I was an exception to the rule, ” said Lester. `` Each test came back positive, time and time again. Months passed, which felt like a lifetime when you’ re not able to go anywhere or see friends or family. ”
Over time, Lester’ s symptoms worsened as he returned positive PCR tests every fortnight. Blood tests five months into the infection showed no SARS-CoV-2 antibodies, indicating his immune system had not at all responded to the invading coronavirus. Stephen Jolles, clinical lead at Cardiff University, figured it was time to try a more experimental treatment.
“ Given the persistent positive PCR tests and impact on his health and mental health, we decided on a unique therapeutic approach, ” said Jolles. “ We wondered whether therapeutic vaccination could help in finally clearing the virus by inducing a strong immune response within the body. ”
The team gave Lester two doses of Pfizer’ s mRNA COVID-19 vaccine, separated by about four weeks. Within 14 days of the first dose PCR testing indicated a distinct decrease in the volume of viral material gathered during each nasopharyngeal swab. About six weeks after the second dose Lester tested negative to SARS-CoV-2 for the first time 218 days.
“ It was a pretty astonishing moment, ” said Mark Ponsford, another clinician working on the case. “ To our knowledge, this is the first time mRNA vaccination has been used to clear persistent COVID-19 infection. Importantly, the vaccine was well tolerated by the patient and successfully induced a strong antibody and T-cell response. This was remarkable given Ian’ s response to conventional vaccinations in the past has been extremely limited. ”
The case study is a compelling example of how mRNA vaccines could be used for therapeutic purposes alongside more traditional prophylactic approaches. Therapeutic vaccines can help prompt the immune system to target a pre-existing disease and much research is currently focused on therapeutic vaccines to target a variety of cancers.
The new study was published in the Journal of Clinical Immunology.
Source: Cardiff University | science |
As key goods grow more expensive, 'demand destruction ' threatens global recession | Prices for some of the world’ s most pivotal products — foods, fuels, plastics and metals — are rising beyond what many buyers can afford. That’ s forcing consumers to cut back and, if the trend grows, may tip economies already buffeted by pandemic and war back into recession.
The phenomenon is happening in ways large and small. Soaring natural gas prices in China are forcing ceramic factories that burn the fuel to halve their operations. A Missouri trucking company debates suspending operations because it can’ t fully recoup rising diesel costs from customers. European steel mills using electric arc furnaces scale back production as power costs soar, making the metal even more expensive.
Global food prices set a record last month, according to the United Nations, as Russia’ s invasion of Ukraine disrupted shipments from the countries that, together, supply a quarter of the world’ s grain and much of its cooking oil. More expensive food may be frustrating to the middle class, but it’ s devastating to communities trying to claw their way out of poverty. For some, “ demand destruction ” is just another way to say “ hunger. ”
In the developed world, the squeeze between higher energy and food costs could force households to cut discretionary spending — evenings out, vacations, the latest iPhone or PlayStation.
China’ s decision to put its top steel-making hub under COVID-19 lockdown could limit supply and push up prices for big-ticket items like home appliances and cars. Electric vehicles from Tesla Inc., Volkswagen AG and General Motors Co. might be the future of transportation, but the lithium in their batteries is almost 500% more expensive than a year ago.
“ Altogether, it signals what could turn into a recession, ” said Kenneth Medlock III, senior director of the Center for Energy Studies at Rice University’ s Baker Institute for Public Policy.
The International Monetary Fund is poised to cut its global growth forecast because of the war, and it sees recession risks in an increasing number of countries, Managing Director Kristalina Georgieva said. The world economy is still set to expand this year, though by less than the 4.4% previously anticipated, Georgieva said in an interview with Foreign Policy magazine.
Federal Reserve Chair Jerome Powell has said Russia’ s invasion of Ukraine is aggravating inflation pressures by boosting prices on food, energy and other commodities “ at a time of already too high inflation. ” Curbing high inflation is a top priority, and the central bank is prepared to raise interest rates by half a percentage-point at its next meeting if needed, he said.
A Volkswagen assembly line in Dresden, Germany. Electric vehicles from Tesla Inc., Volkswagen AG and General Motors Co. might be the future of transportation, but the lithium in their batteries is almost 500% more expensive than a year ago. | REUTERS
The danger is more acute in Europe, where energy bills are soaring due to a reliance on Russian supplies. Natural gas prices on the continent are six times higher than a year ago, and electricity costs almost five times more.
Those prices may fuse with the conflict raging on the European Union’ s doorstep to make businesses and households averse to all kinds of spending. The U.K. downgraded its economic forecast from 6% to 3.8% as consumers face the worst squeeze on living standards in at least six decades.
“ There’ s little doubt that inflation’ s going to stay higher for longer as a result of the war in Ukraine, ” said James Smith, a London-based economist for developed markets at ING. “ A renewed spike in gas prices would see demand destruction become more widespread. ”
The dynamic is playing out in products as ubiquitous as oil and as specialized as lithium, a key ingredient in advanced batteries for consumer electronics and plug-in cars. Battery makers in China, paying five times more for the metal than a year ago, have to pass some of that cost on to car companies, potentially slowing EV sales.
“ The pressure is on the automakers, ” said Maria Ma, an analyst at Shanghai Metals Market. “ What worries the market now is that the EV sales in the next couple months may stay flat or may not perform very well after the price adjustments. ”
Fertilizer-makers, who use natural gas as a raw material, started scaling back operations last year. Italy, Germany and the U.K. are exploring whether to burn more coal next winter to ease the need for gas in power generation. That would free up more of the fuel for industries, such as in glassmaking and production at large steel mills where it can’ t easily be replaced.
But that still may not be enough, and there are contingency plans to limit some demand. Brick-makers in the U.K. have been asked by the government to prepare for production slowdowns if the war chokes energy supplies, the industry’ s lobby group said.
Higher fuel costs are already having a dramatic effect in Asia. Foshan, a city in southern Guangdong province, started rationing gas deliveries to industrial users, and half of the province’ s ceramics production lines stopped running.
American consumers and businesses are more insulated from surging fuel prices since the country doesn’ t rely heavily on Russian oil or natural gas, but they’ re not immune.
Crude oil prices in the U.S. soared in January and February as the threat of war grew, and retail gas prices followed, setting a nominal record of $ 4.31 for a gallon of regular. In Los Angeles, the average now tops $ 6.
Still, demand isn’ t budging. It’ s about 4% higher than this time last year, the U.S. Energy Information Administration said. That may reflect how Americans cooped up by years of restrictions are hell-bent on traveling.
“ That has skewed everything, ” said Andrew Gross, a spokesman for Florida-based AAA ( formerly the American Automobile Association). “ Had there not been a pandemic, these high prices might crush demand. ”
Nonetheless, if oil prices stay high for a sustained level, demand destruction looms. JPMorgan Chase & Co. trimmed its second-quarter global demand forecast by 1.1 million barrels a day and reduced the outlook for both of the remaining quarters by about 500,000 barrels. Europe accounts for most of the cuts.
“ Whether it’ s motorists in filling up their cars, or heating or cooling their houses, this is a level that consumers have started to push back a little bit, and we’ ve seen demand destruction in the past, ” said Ryan Lance, chief executive officer of ConocoPhillips, on Bloomberg TV. “ People start conserving and changing their behavior. ”
The ArcelorMittal steelworks in Dunkirk, France. European steel mills using electric arc furnaces are scaling back production as power costs soar, making the metal even more expensive. | AFP-JIJI
Gary Hamilton, owner of an independent trucking company in Frankford, Missouri, is weighing whether to suspend operations until costs drop. Diesel there averages $ 4.67 a gallon, according to the AAA, and if prices climb above $ 5.25, that’ s enough for him.
Part of the problem is he doesn’ t set his own prices; the agribusinesses he hauls for do. If he asks for higher rates as fuel prices rise, they’ ll just “ call the next guy, ” he said.
“ Fuel is killing us, ” Hamilton said. “ It’ d be cheaper for us to park our trucks and potentially lay off employees than to just keep going. ”
Much like gasoline, demand for groceries in the developed world tends not to change much with price. Shoppers may change what they buy — ditching pricier items for cheaper substitutes — but they still have to buy.
Yet restaurants find rising prices an obstacle as they try to rekindle business after COVID-19. Gus Kassimis, owner of New York City-based Gemini Diner, said customers are ordering fewer steaks and less seafood, so he’ s decreased his purchases from suppliers by about 10%. Gemini boosted menu prices once and is poised to do it again.
“ People are more cautious on what they spend, ” Kassimis said. “ I don’ t know how much more consumers are willing to take. ” | tech |
Texas Upstream Natural Gas, Oil Workforce Growth Continued in February | Sign in to get the best natural gas news and data. Follow the topics you want and receive the daily emails.
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Texas’ upstream oil and gas employment rose to 181,900, representing increases of 5,100 jobs month/month and 20,700 positions year/year, the Texas Independent Producers and Royalty Owners Association ( TIPRO) reported last week.
“ Rising global energy demand and strains on oil and natural gas supply exacerbated by geopolitical conflicts necessitate…increased domestic production, ” said President Ed Longanecker.
February’ s month/month upstream job growth is more than four times that of the 1,200 jobs Texas added from December to January. The Texas Oil and Gas Association ( TXOGA) called the monthly gain “ the highest spike in over a decade and the second highest jump in at least 32 years, ” trailing only the 5,600-job gain in June 2011.
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“ News of this historic job growth in Texas’ upstream sector is encouraging for all Americans, because Texas continues to lead the way in meeting our energy needs, fortifying our national security, and assuring continued environmental progress, ” said TXOGA’ s Todd Staples, president.
TIPRO, which reviews upstream jobs data from the U.S. Bureau of Labor Statistics Current Employment Statistics report, said Texas’ oil and gas services workforce expanded by 18,800 jobs year/year. The state’ s oil and gas extraction headcount grew by 1,900 during the period, the trade group added.
TIPRO observed 9,985 active unique job postings across Texas’ natural gas and oil industry in February, a 20% increase from January.
Based on its classification of Texas’ oil and gas industry across 14 specific sectors, TIPRO said support activities ranked highest in February with 2,712 unique job postings. Crude petroleum extraction, with 1,239 listings, and petroleum refineries, with 905, claimed the second and third spots, respectively.
With 3,319 postings, Houston ranked highest among Texas cities for unique oil and gas job listings in February. Next in line were the Permian Basin hubs Midland ( 1,048) and neighboring Odessa ( 541).
For February, TIPRO noted that Baker Hughes Co., with 524 listings, was the top company based on oil and gas job postings in Texas. National Oilwell Varco, Inc. ( 450) and Halliburton Co. ( 422) were second and third, respectively.
With 413 listings, heavy tractor-trailer truck drivers took first place among Texas’ posted occupations in February, TIPRO said. The second most common occupational group was maintenance and repair workers ( 284), followed by software developers and software quality assurance analysts and testers ( 262).
“ Though the U.S. energy sector is not immune to supply chain challenges and workforce shortages presented by both Covid-19 and the unfolding conflict in Eastern Europe, Texas oil and natural gas operators stand ready to supply growing energy demand here and around the world, ” said Longanecker.
Successfully meeting present and future demand calls for encouraging “ long-term investment in domestic production, ” he added.
In addition to “ taking immediate action ” on all U.S. liquefied natural gas export facility and gas pipeline applications, promoting domestic output would require “ ending the moratorium on new leases on federal lands and putting a stop to the political rhetoric against our industry, including the inaccurate and irresponsible notion that the oil and natural gas sector is taking advantage of the global energy crisis to increase profits, ” said Longanecker.
Texas’ upstream workforce has added 24,900 jobs overall since hitting a low point in September 2020 and has expanded 15 of the past 17 months, said TXOGA.
“ A year ago, many people were questioning the future of oil and natural gas and, today, people are questioning if they have a future without it, ” said Staples. “ Our nation has an opportunity to reshape American energy policy that recognizes oil and natural gas as an asset rather than a liability. ”
Overall, Texas added 77,800 nonagricultural jobs in February and saw its unemployment rate drop one percentage point month/month to 4.7%, according to the Texas Workforce Commission ( TWC). The latest TWC data show 13,184,100 jobs in the state – a year/year gain of 832,200 positions from February 2021.
“ February marks the fourth consecutive month of record-setting employment levels in Texas, ” said TWC’ s Bryan Daniel, chairman. “ This continued growth highlights the strength of our Texas economy and signals significant opportunities for Texans in the Lone Star State. ”
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Ghana is the latest African country to ease covid-19 restrictions — Quartz Africa | Ghana has ended its mandatory requirement to wear face masks in public, becoming the newest African country to ease covid-19 containment measures as infections fall, and pressure grows to reopen economies.
In a televised address on March 27, president Nana Akufo-Addo announced that for the fully vaccinated, outdoor functions can resume, and travelers no longer have to take covid-19 tests to enter the country, among other changes.
“ It has been a difficult two years for all of us, and we are seeing light at the end of a very long tunnel, ” Akufo-Addo said.
Cases have gone down around the continent since January 2022, when there was a spike driven by the omicron variant.
But the World Health Organization is urging caution. According to a survey earlier this month, the WHO says 22 African countries have stopped doing contact tracing and 21 no longer required quarantine for people exposed to the virus.
“ The pandemic isn’ t over yet and the preventive measures should be eased cautiously with health authorities weighing the risks against the anticipated benefits, said Matshidiso Moeti, the WHO’ s regional director for Africa, at a press briefing on March 24. “ Lifting the public health measures does not mean lifting the foot off the pedal of pandemic vigilance. ”
Despite lower infections, Africa lags behind the rest of the world in vaccination against covid-19, with only 15.6% of the population fully vaccinated, compared with the global average of 57%.
The continent has officially recorded 11.3 million covid-19 cases.
Sign up to the Quartz Africa Weekly Brief here for news and analysis on African business, tech, and innovation in your inbox. | tech |
Shanghai's two-part citywide lockdown sends oil prices down — Quartz | China’ s financial hub Shanghai has abandoned its strategy of spot neighborhood lockdowns and embarked on a citywide lockdown instead. Authorities found 3,450 asymptomatic infections yesterday, which makes the city China’ s largest covid hot spot at the moment.
The two-part lockdown for the city of 25 million, which comes after a shutdown of tech hub Shenzhen, shows that Beijing doesn’ t yet have a roadmap away from covid zero, despite murmurs from Chinese government health advisers that the country must find a path to “ coexisting ” with covid. The country’ s latest outbreak involves a relatively low number of cases compared to many countries following a far more relaxed approach.
The eastern side of the city will be under lockdown from today ( March 28) until April 1, while the areas to the west of the Huangpu River that runs through the city will shut down between April 1 to 5. Taken together, this is China’ s largest citywide lockdown yet.
After an outbreak starting earlier this month, Shanghai authorities appeared to be trying to avoid a lockdown, as officials increasingly recognize the economic toll of the drastic measure. But Wu Fan, an expert on the city’ s covid prevention work team, has said that because the virus situation in the city shows a pattern of regional concentration and city-wide distribution, it needs to have “ firmer, decisive ” measures to reduce mobility and extinguish community spread.
During their respective lockdowns, citizens are prohibited from leaving their homes, companies must require employees to work from home, and public transportation and car-hailing services are suspended, according to the official notice ( link in Chinese). The steps sparked concerns over China’ s fuel demand this year, which sent crude oil future prices down $ 5 a barrel on Monday to $ 115.5. Still, unlike the turmoil that battered Chinese stocks on March 14, amid concern over Beijing’ s ties to Moscow and the start of a one-week lockdown in Shenzhen lockdown, markets have so far reacted relatively calmly to the new lockdown.
Meanwhile workers being dispatched for mass testing could impact everything from delivery to operations at the country’ s largest port. To avoid disruptions, some office-goers are remaining on site, including bankers, many of whom were required by their companies to go back to their offices yesterday before the lockdown took effect, according to Chinese finance media. And some factories and plants are adopting a “ closed-loop ” system similar to that in place for the Beijing Winter Olympics, with the approval of authorities.
Tesla, whose Chinese gigafactory, which produces around 2,000 cars a day, is in an area that is under the first stage of lockdown in Shanghai, and has said it will halt its production for four days. It also suspended operations for two days earlier this month to allow so authorities could test all its employees. According to the Wall Street Journal, it had been planning for a covid bubble at its plant, but didn’ t have time to set it up before the Shanghai lockdown was announced.
An employee of Chinese tech giant ByteDance told Quartz that she has started working from home since early March amid the city’ s growing covid cases. “ It is total chaos here, sometimes I don’ t even know whether my compound is under lockdown or not, ” she said.
Many memes surfaced showing Shanghai citizens’ confusion about the changing rules, including one joking that the Huangpu River, used as the divide between the two parts of the city for carrying out the lockdowns, has become a Milky Way or Berlin Wall that would separate people on each side. | tech |
Procurement shared services’ role in supporting healthcare | The coronavirus pandemic took a struggling National Health Service ( NHS) and imposed even further pressures on the organisation that was already stretched to its limits. One important lesson that COVID-19 taught us is that supply chain resilience is critical to maintaining services. The procurement shared service team played a key role to ensure the Trust maintained supply and supported other hospitals across the region, from setting up a 3D Print Farm and air freighting PPE from China to providing over one million items as mutual aid to over 40 healthcare organisations.
The organisation’ s procurement team, comprised of around 200 employees, is responsible for sourcing, systems, and supply chain operations across four NHS Trusts with responsibility for over £500mn direct spend.
With just over 20 years at the organisation, David Lawson, Chief Procurement Officer at the Trust divulged the developments in the organisation’ s procurement strategy throughout the pandemic and his team’ s contribution to procurement programmes and initiatives.
Over the past few years, Guy’ s and St Thomas’ has worked to transform procurement and supply chain from deployment, the largest implementation of automated inventory management systems in Europe to leading major complex commercial initiatives. Procurement and supply chain is critical to the day-to-day running of healthcare services. In 2021 for example, the team led the re-procurement of Pathology Services across South East London, covering a patient population of two million, processing over 35 million tests per year, and with an annual spend of £135mn. The new 15-year contract worth £2bn involved a major service transformation with the consolidation of 70% of test activity from four hospital sites into a new pathology hub together with the adoption of new digital systems.
Lawson commented that “ it would be difficult to imagine a more complex procurement. ”
He explains: “ You had an incumbent joint venture supplier that the two Trusts — Guy’ s and St Thomas’ and King’ s College Hospita l— part-owned under a joint venture structure, you had a major service transformation in terms of service consolidation, and you had a mission-critical service which touched almost every patient that interfaced with the local health system from GP Surgery to Acute Hospitals. ”
Understanding the criticality of the process and the involvement of procurement, Lawson set about leading his team to streamline proceedings, which, through competitive dialogue between bidders, led to a change in supplier and a novel “ buy-out buy-in approach into the Joint Venture to avoid the need to TUPE transfer over 1,500 staff and ensure a smooth service transition.
Lawson highlights the three main challenges of the process, which were stakeholder engagement to achieve agreement on the new operating model, ensuring robust bids despite gaps in key data sets, and despite the complexity and scale of the procurement, keeping the evaluation simple and manageable.
The procurement team also recently led the £10bn Increasing Capacity Framework Agreement on behalf of NHS England to support reducing the current backlog of elective activity by making available independent sector capacity to the NHS. The new framework agreement replaced a capacity model in which block contracts were agreed upon with the main independent sector providers irrespective of whether the capacity was used or not. The framework was set up in under 12 weeks with over 100 providers listed.
“ While the rest of the NHS was tied up with treating COVID patients, the challenge for the NHS was to try and get to a point of business as usual, in order to avoid or mitigate a growing backlog of elective cases. To secure funding from the treasury, there was a need to move away from direct awards and the previous capacity model to demonstrate value for money, ” Lawson says.
“ So, I was asked to support NHS England setup. A new national framework where independent sector providers bid against all procedures that are available on the national tariff, ” Lawson says. “ My role was to set up the procurement strategy and work out a timetable to deliver the framework within quite a short period of time — within about 12 weeks — and make that ready for the new calendar year in January when the existing block contracts were due to expire. ”
When it comes to procurement in the NHS, the siloed nature of its operations has presented weaknesses over the years due to the lack of scale and investment. Five years ago, the SmartTogether shared service was established to scale up both procurement and supply chain capacity and capability. “ It was very much formed on the back of the hospitals, around us asking for help and support to transform the procurement service, ” Lawson says. “ In response to the request for help, we expanded the team and created SmartTogether. ”
SmartTogether was able to apply common performance standards for order management, inventory management, and CIP delivery. In the first year of Lewisham and Great Ormond Street joining the shared service, CIP delivery increased five-fold. Lawson explains how this helps improve procurement: “ We have a scorecard with key metrics and we compare each of the member trusts against national benchmarks, as well as benchmarks within the shared service to drive that performance. ” He also spoke about some of the resulting effects of SmartTogether: “ We're seeing process improvement, expansion of inventory management systems, and cost improvement delivery as well. So we 've been able to influence more spend. ”
Without its partner organisations, the SmartTogether service would not have been as well-received as the team has experienced. The organisation works closely with selected strategic partnerships to encourage efficiency and more sustainable operations across its network of healthcare services.
SmartTogether partners with Apogee, an HP company specialising in print services, to funnel its printing resources and technology solutions through the company, which supports all the member Trusts of the shared service. Partnering with Apogee resulted in an organisation-wide revamp of its printers, creating an ecosystem of manageable and more sustainable machines, and also allowed SmartTogether to leverage Apogee’ s managed print services at scale.
Lawson explains how the Trust has negotiated better solutions across all operations. “ It means that we 've been able to negotiate better technology and better processes as well, ” he says.
“ So, from a sustainability perspective, benefits around energy efficiency, and from a cost perspective, double-digit percentage savings in terms of having a larger single contract, a multi-year contract and developing a partnership with Apogee going forward. ”
Following this, Lawson delves into another strategic partnership as he talks about some of the challenges that the Trust faces in terms of risk management, particularly in its supply chain, which is a critical phase in ensuring fast and reliable patient care.
CEVA Logistics works with Guy’ s and St Thomas’ to manage its offsite Supply Chain Hub; a necessary response to the coronavirus pandemic that supported deliveries to the hospital and supported the wider London Region. To help gauge the scale of the task, Lawson says: “ We previously had over 40,000 trucks arriving into the two Trust campus sites, which equated to a truck delivery hitting one of our loading bay every three minutes. ”
While the offsite Supply Chain Hub, based in Dartford, was primarily a response to COVID-19, the organisation has now set up an in-house wholesaler within the facility; a process that was implemented based on new insights from the pandemic. “ For just over 1,000 high-risk product lines, we hold about a month’ s worth of inventory to enable a same-day delivery service to over 50 Main Theatres, ” says Lawson.
The logistics firm is also working to support the Trusts sustainability strategy with the adoption of bio-fuel and electric vehicles for bulk consolidated deliveries, together with a pilot of a river cargo service for rapid parcel deliveries from the Supply Chain Hub at Dartford into Guy’ s Hospital via Butler’ s Wharf.
The Supply Chain Hub is also been used to support current work to provide urgent medical supplies into Ukraine. Working in partnership with the Ukrainian Medical Association the hub has acted as a staging point to ship deliveries into Lviv and Kyiv hospitals.
One of the themes that could be picked out from the SmartTogether service is the commitment to core values and how this plays a critical role in sourcing goods and, ultimately, finding suppliers with similar core values.
For such large-scale operations, the Trust has begun to select products more carefully. A prime example of this can be seen through its partnership with Banner, an expert provider of workplace supplies, as the organisation focuses a lot of its attention on its environmental, social, and governance ( ESG) impacts.
Lawson further explains the importance of social value when it comes to engaging with suppliers: “ When we carried out the tender process, we weighted social value at 20%. So we weighted it quite high and set up some specific requirements from a sustainability perspective. ”
He continues: “ We pulled together the different sustainability managers from each trust to set out the standards from an environmental perspective in terms of product, but also in terms of delivery model. ”
Ultimately, this process is governed by its partner organisation’ s ability to provide transparency, which is something the Trust is also aiming for with Boston Scientific, a leading global provider of medical devices.
“ We buy a wide range of their devices across a number of clinical settings, ” says Lawson.
“ Boston is an example of a medical device company that we're trying to establish a strategic partnership with and that's looking at different elements or different initiatives.
This really sums up the core activities of Guy’ s and St Thomas’ that we can expect to see over the next few years. As a provider of local healthcare services with specialist capabilities required by the nation, the Trust will continue to develop the way it operates to improve patient care.
The coronavirus pandemic has highlighted some of the key areas in which the organisation must innovate to meet the demands of an ever-growing population, strengthening its strategic partnerships and streamlining procurement and supply chain activities to ensure that patients receive what they need when they need it.
“ Post-COVID, we’ re now trying to learn from the experience of COVID-19 and understand the benefits in the sense of being able to make changes for the good and to use that as the catalyst for more change. ”
Supply Chain Digital is the digital community for the global supply chain & logistics industry that connects the world's largest supply chain & logistics brands. Supply Chain Digital focuses on procurement and supply chain news, key interviews, supply chain videos, along with an ever-expanding range of focused procurement and supply chain white papers and webinars. | general |
Research Shows NFL Stadium Openings in 2020 Had No Impact on Local COVID-19 Infections | The findings may inform decisions on holding large outdoor gatherings amid future public health crises.
As with most everything in the world, football looked very different in 2020. As the Covid-19 pandemic unfolded, many National Football League ( NFL) games were played in empty stadiums, while other stadiums opened to fans at significantly reduced capacity, with strict safety protocols in place.
At the time it was unclear what impact such large sporting events would have on Covid-19 case counts, particularly at a time when vaccination against the virus was not widely available.
Now, MIT engineers have taken a look back at the NFL’ s 2020 regular season and found that for this specific period during the pandemic, opening stadiums to fans while requiring face coverings, social distancing, and other measures had no impact on the number of Covid-19 infections in those stadiums’ local counties.
As they write in a new paper published in the Proceedings of the National Academy of Sciences, “ the benefits of providing a tightly controlled outdoor spectating environment — including masking and distancing requirements — counterbalanced the risks associated with opening. ”
An MIT study finds NFL stadium openings had no impact on local Covid-19 infections during the 2020 season. Credit: Jose-Luis Olivares, MIT
The study concentrates on the NFL’ s 2020 regular season ( September 2020 to early January 2021), at a time when earlier strains of the virus dominated, before the rise of more transmissible Delta and Omicron variants. Nevertheless, the results may inform decisions on whether and how to hold large outdoor gatherings in the face of future public health crises.
“ These results show that the measures adopted by the NFL were effective in safely opening stadiums, ” says study author Anette “ Peko ” Hosoi, the Neil and Jane Pappalardo Professor of Mechanical Engineering at MIT. “ If case counts start to rise again, we know what to do: mask people, put them outside, and distance them from each other. ”
The study’ s co-authors are members of MIT’ s Institue for Data, Systems, and Society ( IDSS), and include Bernardo García Bulle, Dennis Shen, and Devavrat Shah, the Andrew and Erna Viterbi Professor in the Department of Electrical Engineering and Computer Science ( EECS).
Last year a group led by the University of Southern Mississippi compared Covid-19 case counts in the counties of NFL stadiums that allowed fans in, versus those that did not. Their analysis showed that stadiums that opened to large numbers of fans led to “ tangible increases ” in the local county’ s number of Covid-19 cases.
But there are a number of factors in addition to a stadium’ s opening that can affect case counts, including local policies, mandates, and attitudes. As the MIT team writes, “ it is not at all obvious that one can attribute the differences in case spikes to the stadiums given the enormous number of confounding factors. ”
To truly isolate the effects of a stadium’ s opening, one could imagine tracking Covid cases in a county with an open stadium through the 2020 season, then turning back the clock, closing the stadium, then tracking that same county’ s Covid cases through the same season, all things being equal.
“ That’ s the perfect experiment, with the exception that you would need a time machine, ” Hosoi says.
As it turns out, the next best thing is synthetic control — a statistical method that is used to determine the effect of an “ intervention ” ( such as the opening of a stadium) compared with the exact same scenario without that intervention.
In synthetic control, researchers use a weighted combination of groups to construct a “ synthetic ” version of an actual scenario. In this case, the actual scenario is a county such as Dallas that hosts an open stadium. A synthetic version would be a county that looks similar to Dallas, only without a stadium. In the context of this study, a county that “ looks ” like Dallas has a similar preseason pattern of Covid-19 cases.
To construct a synthetic Dallas, the researchers looked for surrounding counties without stadiums, that had similar Covid-19 trajectories leading up to the 2020 football season. They combined these counties in a way that best fit Dallas’ actual case trajectory. They then used data from the combined counties to calculate the number of Covid cases for this synthetic Dallas through the season, and compared these counts to the real Dallas.
The team carried out this analysis for every “ stadium county. ” They determined a county to be a stadium county if more than 10 percent of a stadium’ s fans came from that county, which the researchers estimated based on attendance data provided by the NFL.
Of the stadiums included in the study, 13 were closed through the regular season, while 16 opened with reduced capacity and multiple pandemic requirements in place, such as required masking, distanced seating, mobile ticketing, and enhanced cleaning protocols.
The researchers found the trajectory of infections in all stadium counties mirrored that of synthetic counties, showing that the number of infections would have been the same if the stadiums had remained closed. In other words, they found no evidence that NFL stadium openings led to any increase in local Covid case counts.
To check that their method wasn’ t missing any case spikes, they tested it on a known superspreader: the Sturgis Motorcycle Rally, which was held in August of 2020. The analysis successfully picked up an increase in cases in Meade, the host county, compared to a synthetic counterpart, in the two weeks following the rally.
Surprisingly, the researchers found that several stadium counties’ case counts dipped slightly compared to their synthetic counterparts. In these counties — including Hamilton, Ohio, home of the Cincinnati Bengals — it appeared that opening the stadium to fans was tied to a dip in Covid-19 infections. Hosoi has a guess as to why:
“ These are football communities with dedicated fans. Rather than stay home alone, those fans may have gone to a sports bar or hosted indoor football gatherings if the stadium had not opened, ” Hosoi proposes. “ Opening the stadium under those circumstances would have been beneficial to the community because it makes people go outside. ”
The team’ s analysis also revealed another connection: Counties with similar Covid trajectories also shared similar politics. To illustrate this point, the team mapped the county-wide temporal trajectories of Covid case counts in Ohio in 2020 and found them to be a strong predictor of the state’ s 2020 electoral map.
“ That is not a coincidence, ” Hosoi notes. “ It tells us that local political leanings determined the temporal trajectory of the pandemic. ”
The team plans to apply their analysis to see how other factors may have influenced the pandemic.
“ Covid is a different beast [ today ], ” she says. “ Omicron is more transmissive, and more of the population is vaccinated. It’ s possible we’ d find something different if we ran this analysis on the upcoming season, and I think we probably should try. ”
Reference: “ Public health implications of opening National Football League stadiums during the COVID-19 pandemic ” by Bernardo García Bulle, Dennis Shen, Devavrat Shah and Anette E. Hosoi, 22 March 2022, Proceedings of the National Academy of Sciences. DOI: 10.1073/pnas.2114226119 | tech |
Salivary Immune Signature of COVID Infection – Different Than Other Flu-Like Illnesses | Frank A. Boksa, University of Iowa College of Dentistry, Iowa City, IA, presented “ Salivary Immune Signature of SARS-nCoV2 Infection ” at the hybrid 51st Annual Meeting & Exhibition of the AADOCR, held in conjunction with the 46th Annual Meeting of the Canadian Association for Dental Research ( CADR), online and onsite in Atlanta, GA, on March 26, 2022.
With more than 219 million confirmed cases of SARS-nCoV2 infection and 4.55 million deaths, the COVID-19 pandemic has led to a dramatic loss of human life worldwide. Besides saliva being a reservoir for the virus, emerging evidence correlates the salivary virus levels to severity of infection, hospitalization, and death. Saliva is a complex secretory fluid with several bacterial and host breakdown products that perform numerous housekeeping functions. The inflammatory complications of COVID-19 are well-established at this time, however, the levels of these inflammatory mediators in saliva are not quantified. The researchers quantified the salivary inflammatory mediators in COVID-19 using a cross-sectional study design.
The researchers collected saliva from 87 patients that were frequency matched for gender, age, BMI, and smoking status were divided into three groups: Symptomatic COVID-19 positive ( symptomatic), Symptomatic COVID-19 negative ( presenting with a flu-like illness, FLI), Asymptomatic ( Negative) based on their titers from RT-PCR in nasopharyngeal swabs and saliva. Levels of proinflammatory cytokines and other immune mediators were quantified using a TH-17 cytokine assay kit and read using the Bio-Plex 200 fluorescent microplate reader. Steel-Dwass test protecting the overall error rate was used to determine statistical significance.
The researchers concluded that identification of inflammatory markers in COVID-19 patients that is different than the other flu-like illnesses indicate a unique immune signature associated with the disease. Salivary levels of several of these immune mediators mirror the systemic levels, indicating a potential role of saliva in COVID pathogenesis.
This research was presented as an in-person Interactive Talk on March 26, 2022. View the abstract on the 2022 Annual Meeting Hybrid Platform.
The American Association for Dental, Oral, and Craniofacial Research ( AADOCR) is a nonprofit organization with over 3,000 members in the United States with a mission to drive dental, oral, and craniofacial research to advance health and well-being. AADOCR is the largest division of the International Association for Dental Research which has over 10,000 members. | tech |
Macau International Airport’ s Passenger Terminal Building South Extension | Airport terminal expansion
Macau special administrative region, China
Macau International Airport Company ( CAM)
Nam Fong Construction & Real Estate Company
March 2020
The Macau International Airport ( MIA) is situated on the eastern side of Taipa Island, in the Chinese special administrative region ( SAR) of Macau. Its passenger terminal building ( PTB) is being expanded to meet the growing passenger demand.
The north extension of the PTB was completed in 2018. Design works for the south extension of PTB began in 2019, and a ceremony was held to mark the beginning of construction works in March 2020. The construction started with the site formation and piling works onsite. The topping-out ceremony was held in February 2021.
The south extension is expected to be completed in 2022.
The airport handled 9.61 million passengers in 2019, which fell to 1.17 million in 2020 amid the Covid-19 pandemic. Passenger traffic further declined by 2.2% year-on-year to 1.14 million in 2021, whereas cargo volume rose by 45.72%, to 48,595t.
Spanning three storeys, the south extension building will comprise an immigration hall, departure lounge, offices, and commercial spaces, as well as facilities such as a prayer room, conference rooms, and an entertainment room. It will increase the terminal area by more than 18,000m² ( 193,750ft²).
It is designed to comply with local codes and regulations, as well as the guidelines of the International Air Transport Association ( IATA).
Three new passenger boarding bridges were added to accommodate either three aircraft ( two Code E and a Code C), or four aircraft ( a Code E and three Code C), thereby increasing the total number of operational boarding bridges to eight.
The terminal’ s overall passenger handling capacity is estimated to increase to ten million a year, up from 7.8 million passengers.
The PTB south extension will be integrated seamlessly with the existing passenger terminal.
The installation of the three additional passenger loading bridges was completed in June 2021.
Construction of the main structure of the south extension building was completed in February 2021. Construction works also included the external structure, facade, and interior partition.
Other works include the installation of pipes and ducts, and mechanical, electrical, and plumbing ( MEP) equipment.
The Nam Fong Construction & Real Estate Company was appointed as the construction contractor for the terminal building expansion project.
Renovation of the baggage handling system, with a handling capacity of ten million passengers a year, is expected to be completed in 2022.
Airport Information Management Solution ( AIMS), an IT company owned by CAM, signed a smart airport blueprint planning consultancy service agreement with Huawei Technologies ( Huawei) in December 2021.
AIMS and Huawei collaborated for cooperation in digital transformation and smart airport blueprint planning. AIMS is responsible for providing technical support and maintenance services for the airport operation and management systems.
The airport executed 60 information and technology optimisation projects in 2021. The projects included the terminal’ s public wireless network capacity expansion, commissioning of an outdoor wireless network system, and other initiatives to enhance the airport website experience and airport security.
CAM will continue to focus on smart airport development initiatives in 2022. It will work on preparing for the adoption of 5G network technology.
The measures include upgrades to the airport public wireless network, and the development of the airport operation management platform ( AOMP), which will be launched in 2022.
The flight information display systems ( FIDS) will be replaced while the airport staff channel will be optimised with facial recognition technology.
The printing function of radio-frequency identification ( RFID) baggage tags will be launched to optimise the integration of baggage security information and the passenger reconciliation system ( PRS).
MIA achieved a 40% reduction in carbon emissions per aircraft movement in 2018, compared to 2012.
Several plants were installed in different areas of the terminal building to improve air quality. | general |
Trouble at Glovo: how 'good vibes ' turned into a 'nightmare ' | One year ago Glovo cofounder Oscar Pierre told Sifted he didn’ t want to sell his company. Instead, he had his sights set on publicly listing at the right moment.
Glovo was then one of Spain’ s startup superstars: the delivery company hit a billion-dollar valuation in 2019, had raised more than €890m in equity fundraising by the end of 2021 and had plans to become a market leader in the much-hyped speedy delivery market.
And while rumours swirled of the possibility of a gradual buyout by the then-minority shareholder Delivery Hero, Pierre told Sifted there was nothing to it.
“ I speak to Niklas [ Östberg, CEO at Delivery Hero ] almost every other day. They believe a lot in our company, ” he said. “ They know our dream is to stay independent, to keep running this, to take this public and he respects that a lot. And in that sense the plan is that they stay as a minority shareholder. ”
But on December 31 at 11pm, news broke that Delivery Hero had agreed a deal to acquire a majority stake in the Spanish scaleup.
From what Sifted has learnt, it appears that the company was struggling to make good on its heavy investment into quick commerce, as better-funded competitors have emerged in key markets. Some employees seem to have borne the brunt, telling Sifted they’ ve become victims of a ruthless hire and fire culture.
When news of the acquisition broke, Pierre said in a statement: “ I believe our potential is untapped [ or “ wasted ”, depending on your translation of “ desaprovechado ” ], and I am happy to have found a partner that matches our ambition and culture and who will continue to support this adventure. ”
It’ s easy to read a phrase like “ untapped potential ” as a euphemism for “ things not going to plan ”, given what we knew about the company’ s ambitions. So what went wrong in 2021?
Late last year, Sifted began receiving messages from current and former staff at the company, many of whom said that Glovo’ s ruthless and unempathetic management style had had serious impacts on their mental health.
“ It was mentally so stressful. It gave me nightmares and I’ m still having them, ” one of them told us.
These early conversations were with staff from Glovo’ s Italian office, the company’ s second biggest market ( which has been running since 2016 and currently employs more than 300 people), and initially seemed like they could be a symptom of an isolated, regional issue for the company.
“ It was mentally so stressful. It gave me nightmares and I’ m still having them ”
But after speaking to 10 current and former staff, some of whom reported to the senior leadership team in the Barcelona HQ, a picture emerged of a company making frantic and poor decisions, at a cost to Glovo’ s performance and the wellbeing of some of its employees.
In January last year, Glovo announced a €100m partnership with a Swiss real-estate investor to enable it to double down on its new quick-commerce ( “ q-commerce ”) business. The plan was to build 100 dark stores by the end of 2021, in a bid to become the market leader for rapid delivery in its 22 markets.
“ I think grocery is a clear bet that we will crack, ” Pierre told Sifted. “ It’ s a clear trend for the future: all ecommerce products will be closer to the user, and this means [ inner ] city, urban warehouses. ”
But as speedy delivery competitors Getir and Gorillas have spread across Europe — and raised billions in VC funding — Glovo has struggled to keep up, despite being one of the first movers in the market, according to one former employee, Hannah. She held a senior position at the company for more than two years, reporting directly to the C-suite.
“ Grocery delivery has not really picked up because Getir and Gorillas got in there. Getir is probably doing just as many, if not more orders already than Glovo [ in Barcelona ]. The same is happening in other markets — you see the difference, ” she told Sifted in October.
Glovo hasn’ t been able to keep pace with competitors in European markets. At the end of February 2022, the company told us it had 103 “ micro-fulfilment centres ” across nine European countries and 43 cities. Getir, meanwhile, told us it has 300 spread over seven European countries while Gorillas ( which only launched in June 2020) told us it has 200 in Europe across nine countries and 60 cities.
Glovo has also raised less money than both Getir ( which has raised more than €1.7bn to date and is valued at $ 11.8bn) and Gorillas ( which has raised $ 1.3bn to date, valued at $ 3bn). The capital raised by Glovo has also been spread across its various products, rather than just focused on scaling q-commerce.
According to Hannah, this market position has forced the company into a scattergun strategy of constantly trying new things in a bid to stand out: “ They’ re competing with global businesses that are multibillion-dollar-worth or public, and when you look at their capability to fundraise or grow the business, they’ ve mainly been a tier-two player, right? Which basically means that for them to increase the valuation they need to try a lot of things like dark kitchens and B2B logistics, to name a few. ”
Some of the new business lines that Glovo has added to its core restaurant delivery service include dark kitchens, quick grocery delivery, quick pharmacy delivery, B2B logistics and courier services.
The temptation to try and convert an existing network of drivers or couriers to new business models like q-commerce isn’ t uncommon: other European food delivery startups that have tried similar strategies include Foodpanda, Takeaway and Wolt.
But this isn’ t always smart, according to Christian Meermann, founding partner at Cherry Ventures. The Berlin-based fund is a backer of q-commerce startup Flink ( which doesn’ t compete with Glovo in any markets), and Meermann says that moving from restaurant takeaway to q-commerce is a bigger jump than you might expect.
“ I think many tried to do this [ use a driver/courier network for a new business model ]. I think the problem is that, when you’ re building a company, focus is very important. I think you can’ t do five things in parallel and be the best, ” he says. “ If you’ ve been in the restaurant takeout business so far, the grocery business is very different. Suddenly you need to manage your own assortment, you need to find a good supplier for all your products, you suddenly have to deal with waste, which wasn’ t a problem before. Your rider operations are different. There’ s actually not many synergies. ”
Glovo told Sifted that its grocery business is predicted to grow 100% this year, but did not comment on the claim that it is struggling in key markets where competition is fierce.
Hannah says that a lack of focus was a big reason that she left the company.
“ One of the reasons I left was that there’ s no clarity on what essentially they are really trying to achieve. What Glovo does is say, ‘ I want to start a certain initiative. I want to re-pivot my business model to another type of business model by adding new business lines. And I also want to — while I’ m doing all of this — I also want to try this other thing. They decide to set up a team to do that. And in the case that the project goes south and does not have the same results as expected, then they have to let people go. And that’ s where this ‘ hire and fire’ comes from, ” she says. “ I know this, because I’ ve been very close to it from a senior perspective. ”
Glovo says it’ s in an industry where companies “ need to consistently adapt ”. It adsd: “ Glovo is an agile company and gives room to new ideas to navigate a fast-paced industry. Whether an idea is a success or not, we take responsibility for it and ensure that we learn from it. We encourage taking risks. ”
On the face of it, this might seem like bread and butter startup operating. But with more than 3,700 employees now working in 26 countries, Glovo isn’ t a startup any more and moving fast and breaking things has bigger implications.
One former employee who learnt this the hard way was Laura, who worked on one of these new products at Glovo Italy before things started to go wrong.
“ The objective was to build up this big team in just a few months. We kept on going ahead at the speed of light, kept on hiring people, without really focusing on the structure of the company, without really focusing on the talent that we were looking for, ” she remembers. “ After a few months, the project wasn’ t going well, and I don’ t mean just Glovo Italy, but in Spain and all the other countries, these innovation projects were shipwrecking. ”
Then one day, Laura got a message she wasn’ t expecting.
“ Out of the blue one day one of the managers spoke to me and said, ‘ It’ s going to be your last day here. We don’ t feel like you have strong leadership and problem solving skills,’ ” she says. “ It was so unexpected, they had been totally pretending that everything was super OK, super going good, and then the day after they just told me, ‘ today you’ re going to be leaving your laptop here.’ ”
Laura says that she hadn’ t received any negative feedback in the months leading up to her sacking, and believes that she wasn’ t fired due to bad leadership, but due to Glovo’ s own misguided strategy on innovation projects.
“ They discovered in two to three months that the project I’ m working on is not a thing. None of these projects bring the company anywhere because they are bloody expensive. And they acknowledge this, and they have started kicking out people for this reason. It’ s not a lack of leadership, ” she says.
Laura says that she’ s now getting good feedback from her team and her managers in her new job, but the way that Glovo dealt with her dismissal had a big impact on her.
“ They make you really feel that you’ re lacking something, ” she says. “ It really gets you down from an emotional point of view… It’ s so wrong, so unfair and so mean as well. ”
She isn’ t the only one who feels as though they were dismissed by Glovo Italy unfairly. Patrick, who worked at Glovo Italy in 2021 and had worked at large international organisations previously, says that he had never seen such a ruthless firing culture.
“ In Glovo I witnessed a lot of firings and illegitimate treatment of workers which were totally arbitrary. It was something that I’ ve never experienced in any company that I’ ve worked with, ” he says.
In Patrick’ s case, he says he received a letter of dismissal after raising legitimate concerns about a core area of the business. When he asked the reasons, he was told he was being too negative.
“ Glovo has this obsession with cultish company values. There are five of them [ this number has now grown to six ] and one of these is ‘ good vibes’, so you always have to be happy, as though working is some kind of a joke, ” he says. “ I was told: ‘ You know what, we don’ t want negativity, we don’ t want bad vibes. We don’ t want your serious attitude.’ So I was told I didn’ t have enough good vibes to stay in the company. The ‘ cultural alignment’ is often the best way to fire a person, as it is totally arbitrary and not tied to performance. It’ s mainly based on emotions or personal relations. ”
Patrick told us about another employee who was fired for asking about the possibility of a promotion — a supposed breach of the “ Stay humble ” value.
Katy, also a former employee at Glovo Italy, spoke to Sifted shortly after being told she was being fired for being too negative and not being “ aligned with company values ”. In her case the value was “ Gas ”, which Glovo describes as: “ We’ re quick to deliver value. We’ re passionate and we’ re ambitious. ”
“ According to KPIs and targets there was no reason to push me out from the company, ” she says. “ I’ m really, really sad, disappointed and confused. ”
The dismissed employees we spoke to had been working at Glovo for periods ranging between two years and six months — the majority were not fired within their probation period.
This isn’ t the first time that Glovo Italy has come under criticism for its employment practices. Last summer, Italian investigative documentary outlet “ Report – Rai 3 ” anonymously interviewed a former Glovo Italy employee who said that the company took advantage of Covid furlough policies. The source said that Glovo put 30 employees on government subsidised leave ( some for more than six months), even though Glovo Italy’ s revenues grew during the lockdown.
In response to these quotes from former employees, Glovo told us: “ We understand the disruption losing a job can bring someone. This is why we only resort to immediate dismissals in cases of fraud or misconduct such as committing illegal acts or behaviour that puts Glovo’ s people or the company in grave danger. A reason is always given, and this action is never taken lightly. ”
Patrick, Laura and three other former employees all told Sifted that this ruthless attitude towards staff was a huge shock to them, given Glovo’ s public-facing image of being an inclusive and supportive workplace.
“ It’ s all about, ‘ The best job, the social impact, the diversity.’ It’ s really weird to see that all this storytelling is completely different from the reality, ” says Patrick.
“ From the outside it’ s good vibes: the fucking values that they pretend to have. But when you see it from the inside it’ s really, really a nightmare, ” says Laura. “ Junior staff are victimised and bullied, while senior friends of top management face little to no accountability. ”
“ It looked like an amazing startup in which everyone was super friendly. They make you think it’ s a good place in which you can work and you can be mentored and in which you can grow, ” says Jim, a young professional who says he was fired by Glovo and treated with a “ lack of humanity ” which had a big impact on his mental wellbeing.
“ I know quite a few people in Italy that have been through this, and the vast majority of them are young professionals… It’ s super, super, super common. ”
Glovo said that in 2021, only 97 out of 2,000 new joiners left the company within the first year of joining.
Lisa was another of Glovo Italy’ s young employees who says she was fired without explanation. She said the experience had a major impact on her self esteem.
“ I cried for a month, ” she says. “ When I got a new job, my new team knew that I had gone through a kind of trauma. The only thing that I could do was to get away from Glovo because all my self esteem was gone, dead. ”
Glovo tells Sifted that 85% of its employees say they would recommend Glovo as a workplace. The company adds: “ On public platforms like Glassdoor, Glovo is one of the best-rated companies in the industry and ranks higher than most of our competitors. While these survey results reflect a positive work environment we know we have more work to do, and this is something we’ re committed to constantly improving. ”
It’ s worth noting that Sifted did not hear similar employee complaints from Glovo’ s Spanish office. Marie, a former senior employee at Glovo who reported directly to the C-suite in Barcelona, says that problems at the company’ s Italy office are due to an inability to adequately replace outgoing senior leadership.
Two big losses, she says, were former managing director Matteo Pichi ( who left in December 2018) and former PR chief Simone Ros ( who left in September 2021): “ With Italy they lost two very experienced people with a lot of credibility, who knew the jobs very, very well. I’ m not sure what was left was sufficient to keep it running as smoothly as it has had. ”
David, a current employee at Glovo Italy, agrees that the company is struggling to maintain high operational standards outside of Spain.
“ There is very bad communication between Italy and HQ. The structure in Italy is very bad. HR is almost zero, almost nothing, ” he says. “ Glovo in other countries is not as organised as in HQ… In Italy it’ s like they’ re trying to build a villa, but they’ re talking about the swimming pool before building the walls. ”
Christian Meermann from Cherry Ventures agrees that rapidly growing young companies often struggle when they don’ t bring in more experienced leadership.
“ When you’ re running an organisation with thousands of people, then you need C-level executives that have done that before, that know how to establish processes, ” he says. “ Because being pragmatic and quick and hands on in the beginning, that’ s a very strong skill for seed stage and Series A stage companies. Once you’ re big, and you have thousands of people, you need processes, you need reporting lines. I think that’ s what these companies usually struggle with. ”
In response, Glovo said: “ We are still a young company navigating a new and changing industry. We have grown our workforce significantly and have been bringing more experienced leaders onboard. Growing from a startup to a multinational company at speed and in a short period of time is challenging, which is why we continue to hire top talent across the company. ”
Now, with Delivery Hero set to become a majority shareholder in Glovo when the deal closes, subject to regulatory approval, staff might hope that change is coming.
But when Sifted asked the company what it hoped to learn from Delivery Hero, Glovo said: “ Delivery Hero is not going to become a sole owner of Glovo. After Delivery Hero acquires the majority stake, Glovo will continue operations under their current brand, culture and leadership, using their existing technology. ”
Staff who were hoping for big change as a result of the acquisition seem to be in for a disappointment. | tech |
Tesla wants to split its stock so it can pay a stock dividend; shares gain | In this article
Tesla wants to split its stock so it can pay a stock dividend to shareholders, according to a filing Monday.
The Securities and Exchange Commission filing said the electric car maker will ask at its annual shareholders meeting `` for an increase in the number of authorized shares of common stock... in order to enable a stock split of the Company's common stock in the form of a stock dividend. ''
A stock dividend is a dividend paid to shareholders in the form of additional company shares instead of cash. These dividends do not affect the value of a company, but they dilute its share price.
In other words, if there is a 6-for-1 split, investors will get a stock dividend of five shares for every one share of Tesla they own. This would be a one-time event.
Tesla's shares were up more than 6% at about $ 1,075.
The company last split its stock in August 2020. The shares have more than doubled since that 5-for-1 split took effect on Aug. 31, 2020.
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The news comes as Tesla's stock has struggled this year, slipping 4.4% for 2022 through Friday's close. That said, it jumped 49.8% in 2021 and surged 743.4% in 2020. The shares have also risen in each of the last five years.
The move also follows a Bloomberg News report that said Tesla will halt production at its Shanghai factory due to a Covid-19 lockdown in the city. | business |
Oscar best film winner Coda makes a case for hybrid release model — Quartz | If consumers ever decide to ditch their iPhones, Apple will do just fine in the movie business. That’ s one of the open roads ahead in the wake of the tech giant’ s Best Picture Academy Award on Sunday for Coda, the first such trophy for any streaming company.
And while breaking Oscars ground for streaming companies is a milestone, what’ s more notable in the wake of the pandemic is the fact that this is the first hybrid release film to win Best Picture at the Oscars.
In 2020, as Hollywood’ s box office revenue sank in due to covid-19 lockdowns and movie theater closures, Warner Bros. experimented with a simultaneous Christmas Day release of Wonder Woman 1984 in theaters and HBO Max simultaneously.
The bold move, which other studios adopted to varying degrees in 2021, was designed to accommodate moviegoers concerned about public spaces during the pandemic, as well as serve as an experiment for the future of film distribution.
Coda was simultaneously released in theaters and on Apple TV+ on Aug. 13, 2021. The film’ s theatrical debut was initially limited to around 40 theaters in major markets, with additional theaters added in the following weeks, and another run of free showings in February of 2022.
Hybrid releases have been a touchy subject for film studios as well as for actors with an equity stake in their films. The practice has raised concerns that being able to stream a film that is also in theaters may negatively impact box office revenue.
🎧 For more intel on the global box office, listen to the Quartz Obsession podcast episode on sequels. Or subscribe via: Apple Podcasts | Spotify | Google | Stitcher.
The issue came to a head when Black Widow star Scarlett Johansson filed a lawsuit against Sony over the film’ s hybrid release. That legal skirmish was ultimately settled, but nevertheless highlighted simmering industry tensions over the practice.
Whether hybrid releases on average help or hinder a film overall financial performance is still an open question for movie studios. But at least one major film, Dune, managed to pull in $ 400 million from theaters despite its hybrid release on HBO Max—and its 155-minute running time.
For its 2022 production slate, Apple Original Films will debut films starring Will Smith ( Emancipation), Ryan Reynolds ( Spirited), Ewan McGregor and Ethan Hawke ( Raymond & Ray), and Leonardo DiCaprio directed by Martin Scorsese ( Killers of the Flower Moon), as well as others.
The company hasn’ t announced which films will be distributed as hybrid releases or as initially exclusive to either theaters or streaming. But now that Apple has a new Oscar pedigree, whichever route it decides to take will be welcomed in Hollywood, as will other hybrid releases, even as the memories of the pandemic fade. | tech |
Bond market is flashing a warning sign that a recession may be coming | The bond market is flashing a warning sign for the U.S. economy.
That harbinger is called an `` inverted yield curve. '' These inversions in the bond market have been reliable predictors of past recessions. Part of the yield curve inverted on Monday.
An economic downturn isn't assured, though. Some economists think the warning is a false alarm.
Here's what to know.
When the bond market is healthy, yields are higher for bonds with a longer time to maturity.
For example, a 10-year Treasury bond would carry a higher yield ( or, interest rate) than a one-year Treasury.
In other words, short-term yields are lower than long-term yields. Investors expect a bigger reward for lending their money for a longer time, giving the `` yield curve '' an upward sloping shape.
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When the curve inverts, short-term bonds pay a higher yield than long-term ones. It's a distortion in the market.
`` Generally, it should be the opposite, '' said Stephanie Roth, a senior markets economist for global wealth management at J.P. Morgan.
An inversion in the yield curve doesn't trigger a recession. Instead, it suggests bond investors are worried about the economy's long-term prospects, Roth said.
Investors pay most attention to the spread between the two-year U.S. Treasury and the 10-year U.S. Treasury. That curve isn't yet flashing a warning sign.
However, the five-year and 30-year U.S. Treasury yields inverted on Monday, the first time since 2006, before the Great Recession.
`` It doesn't mean a recession is coming, '' Roth said of the inversions. `` It just reflects concerns about the future economy. ''
The two- and 10-year Treasury yield curves inverted before the last seven recessions since 1970, according to Roth.
However, data suggest a recession is unlikely to be imminent if one materializes. It took 17 months after the bond-market inversion for a downturn to start, on average. ( Roth's analysis treats the double-dip recession in the 1980s as one downturn.)
There was one false alarm, in 1998, she said. There was also an inversion right before the Covid-19 pandemic, but Roth said it can arguably also be considered a false alarm, since bond investors couldn't have predicted that health crisis.
`` It doesn't work all of the time, but it has a high success rate for portending a future recession, '' said Brian Luke, head of fixed income for the Americas at S & P Dow Jones Indices.
The Federal Reserve, the U.S. central bank, has a large bearing on bond yields.
Fed policy ( namely, its benchmark interest rate) generally has a bigger direct impact on short-term bond yields relative to those of longer-term bonds, Luke said.
Long-term bonds don't necessarily move in tandem with the Fed benchmark ( called the federal funds rate). Instead, investors ' expectations of future Fed policy have more bearing on long-term bonds, Luke said.
The U.S. central bank raised its benchmark rate in March to cool down the economy and rein in inflation, which is at a 40-year high. It's expected to do so many more times this year.
That has helped push up yields on short-term bonds. Yields on long-term bonds have risen, too, but not by as big a margin.
The yield on the 10-year Treasury was about 0.13% higher than that of 2-year bonds as of Monday. The spread was much larger ( 0.8%) at the beginning of 2022.
Investors seem concerned about a so-called `` hard landing, '' according to market experts. This would happen if the Fed raises interest rates too aggressively to tame inflation and accidentally triggers a recession.
During downturns, the Fed cuts its benchmark interest rate to spur economic growth. ( Cutting rates reduces borrowing costs for individuals and companies, while raising them has the opposite effect.)
So, an inverted yield curve suggests investors see a recession in the future and are therefore pricing in the expectation of a Fed rate cut in the longer term.
`` It's the bond market trying to understand the future path of interest rates, '' said Preston Caldwell, head of U.S. economics at Morningstar.
Treasury bonds are considered a safe asset since the U.S. is unlikely to default on its debt. Investor flight to safety ( and hence higher demand) for long-term bonds also serves to suppress their yield, Luke said.
A recession isn't a foregone conclusion.
It's possible the Federal Reserve will calibrate its interest-rate policy appropriately and achieve its goal of a `` soft landing, '' whereby it reduces inflation and doesn't cause an economic contraction. The war in Ukraine has complicated the picture, fueling a surge in prices for commodities like oil and food.
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`` There's nothing magical about a yield-curve inversion, '' said Caldwell, adding that it doesn't mean the economy is going to shrink. `` It's not a light switch that's flipped. ''
Many economists have adjusted their economic forecasts, though. J.P. Morgan puts the odds of recession at roughly 30% to 35%, which is elevated from the historical average of about 15%, Roth said. | business |
Canadian Oil, Gas Activity Undermined by Politics, Says Calgary Contractor | Sign in to get the best natural gas news and data. Follow the topics you want and receive the daily emails.
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The recovery in oil and gas activity last year, which allowed oilfield services contractors to their losses, still led to many working below capacity and vulnerable to setbacks, according to a Calgary firm.
Western Energy Services Corp., which recently issued its 2021 and fourth quarter results, has 120 drilling and well service rigs combined in Canada and the United States.
“ Heightened uncertainty persists, ” management said. “ The precise duration and extent of the adverse impacts of the current macroeconomic environment and the Covid-19 pandemic…remain highly uncertain. ”
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Pipeline politics undermine the Canadian industry, executives noted. They cited the U.S. rejection of the Keystone XL oil pipeline, the Michigan government’ s campaign to shut down Enbridge Line 5, and the Trans Mountain Pipeline expansion ( TMX) delays and cost inflation.
The “ largest challenges ” facing the industry in the short term, executives said, “ are a lack of qualified field personnel and ongoing liquidity concerns. ” Challenges are in part because of “ prevailing preferences ” of oil and gas customers “ to return cash to shareholders through share buybacks, increased dividends or repayment of debt, rather than grow production. ”
The firm predicted oil and gas field activity would gradually accelerate in 2022. However, the pace would be short of a full recovery preceding the 2020 pandemic collapse.
Rig employment tracked by the Canadian Association of Energy Contractors improved in 2021, but only to an annual average 18% from 12% in 2020. In the United States, 2021 rig use averaged 13%, up from 7% in 2020.
Western Energy reported that 10 of its 57 drilling rigs are currently working. Of 63 well service rigs, 26 had jobs.
The contractor, which reports in Canadian dollars ( US $ 1/C $ 1.25), posted fourth quarter losses of $ 6 million ( minus 7 cents/share), from $ 7.4 million ( minus 8 cents) a year earlier. Full-year 2021 losses totaled $ 35.8 million ( minus 39 cents/share), compared with 2020 losses of $ 41.3 million ( minus 45 cents).
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Aon chief executive Greg Case: resilience protects, but it also promotes growth | Edited by Bill Coen and D. R. Maurice
This article was paid for by a contributing third party.More Information.
During this time of great uncertainty – marked by protracted pandemic-related risks, rising geopolitical tensions, expanding cyber threats and talent market upheavals – senior leaders are sharpening their focus on resilience. What makes some companies so much more resilient than others? How can resilience be built into organisations? How should we think about potential trade-offs between resilience and more immediately obvious benefits such as speed, efficiency and cost?
McKinsey & Company recently hosted a virtual leaders’ summit on building resilience in uncertain times. Among the guest speakers was Greg Case, chief executive of global professional services firm Aon. Greg is also a member of the company’ s board of directors and serves on multiple boards externally. He was interviewed by McKinsey senior partner Alex Singla, global leader of McKinsey Analytics and QuantumBlack.
Since you became chief executive in 2005, Aon has grown tremendously amid unprecedented levels of volatility. To what do you attribute Aon’ s resilience?
Greg Case: Resilience is typically defined as a defensive capability that’ s needed to ‘ protect the house’. At Aon, we consider resilience a company-building capability, which is a fundamentally different orientation. We define resilience as the ability to take actions at scale that simultaneously defend and build the house, and we’ ve seen many opportunities to do both during volatile times.
The most compelling and durable source of resilience is organisational. About 15 years ago, we recognised that our clients’ needs were outpacing our ability to innovate, so we took targeted actions to improve. This included making structural changes to operate as a truly global firm, which we call Aon United. Our organisational ability to deliver the best of Aon to our clients globally through this strategy has proven critical to our success. It’ s helpful in times of crisis but, as we’ ve learned from our clients, it also enables us to see opportunity where others may see only volatility and risk.
Greg Case: It’ s natural to ask:’ What’ s the ROI on resilience?’ But, again, that philosophy assumes a discrete investment in resilience, whereas we take a broader view. If resilience drives opportunity in times of volatility, then it’ s not ancillary to the core business. Fundamentally, resilience is the business. Having the ability to quickly take action at scale while others are struggling to mobilise opens doors. We certainly saw this during the Covid-19 pandemic when some – but not all – companies acted quickly to defend the house and, in doing so, also build the house by capturing opportunities that arose in the moment.
Leaders who are unable to link the two may be less resilient than they think in times of unexpected volatility. Those who clearly establish how resilience fits into their core business – and use that understanding to inform better decision-making – can most effectively protect and build their businesses.
Greg Case: Risk placement as a percentage of global GDP increased for 20 straight years from the 1970s to the 1990s. But, from the 1990s onwards, it has decreased almost every year, despite the proliferation of risks – from ageing populations and a higher concentration of people living in high-risk coastal areas, to more interconnected companies, and much more. On a proportional basis, risk management and investments are lagging increased volatility. Our mission is to break that 30-year cycle.
Greg Case: Early on, we brought together more than 100 leading companies and organisations across 10 global cities from a broad range of sectors to examine the issues arising from the pandemic and learn from each other’ s experiences. As the various regional coalitions met to discuss the crisis, the topic of work quickly became by far the highest priority for participants. And, as the meetings progressed, one core understanding emerged: returning to the way things were was not an option. As a result, we are engaging with clients in countless ways, both big and small, to help them build more resilient workforces in ways that were not possible before the pandemic.
You’ ve previously observed that the pandemic has caused a great awakening among chief executives about the next generation of long-tail risks. What did you mean by this?
Greg Case: Within months of the first case of Covid-19, companies of all sizes and in every global region were confronting unprecedented volatility. This prompted many leaders to deeply consider, perhaps for the first time, the true implications of other long-tail risks. Climate risk, for example, has been on our radar for a long time, but the pandemic’ s profound impact on supply chains laid bare what can happen when a massive disruption takes place.
Intangible assets, including intellectual property, are another category of long-tail risk that companies may be underestimating. Roughly 90% of the aggregate value of the world’ s companies today is in intangible assets, yet there is little they can do to accurately value and then protect them. Cyber risk, which intensified during the pandemic, is another long-tail risk that likely warrants even more attention than many companies are currently giving it. Whereas these and other long-tail risks were primarily on the minds of risk leaders, Covid-19 has catalysed chief executives, chief financial officers and boards to question how to manage them more actively – a trend that was revealed in our report, A new approach to volatility: the importance of making better decisions.
Greg Case: Of the $ 5 trillion in economic losses from adverse events so far this century, only about 20% of that loss is insured. That’ s the biggest gap ever and it’ s growing. Every three or four years we’ re seeing a once in a 100-year event, so we may need a new definition. Adverse weather events caused by global warming, for example, are becoming more frequent. Combine that with the possibility of future pandemics or a cyber attack, and the likelihood of a disruption – no matter what the cause – is increasing. This is challenging for the largest, most sophisticated companies, and even more so for middle-sized and smaller companies that have fewer options to prepare or protect themselves, but it starts with prioritising resilience backed by risk management strategies that proactively tackle volatility.
Greg Case: Mounting a resilient response when the next earthquake, flood or wildfire occurs takes a combination of public and private support. For example, the Pacific Alliance countries of Mexico, Chile, Peru and Colombia are experiencing more frequent and severe earthquakes than ever before, and have struggled to respond due to a lack of financial support. In 2018 they asked the World Bank for help transferring earthquake risk to the capital markets. The World Bank responded by issuing a catastrophe ( cat) bond that provided $ 1.36 billion in earthquake cover. The cat bond attracted more than 45 investors globally, including insurance-linked securities funds, pension funds and reinsurers. Those responsible for overseeing the disbursements – to rebuild schools, roads, hospitals, and so on – have future climate resilience as a key criterion.
Certainly, insurers have a role to play, but they can’ t do it alone. The industry’ s balance sheet on aggregate is worth about $ 4 trillion compared with $ 150 trillion for pension funds, sovereign funds and high-net worth individuals. If we can mobilise that funding engine, then we can really start to activate the business transition to net zero and protect countries.
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Serum neutralisation of the SARS-CoV-2 omicron sublineage BA.2 | The rapidly emerging SARS-CoV-2 omicron variant is associated with high transmissibility, compromised serum neutralising activity, and reduced vaccine effectiveness.1Lu L Mok BW Chen LL et al.Neutralization of SARS-CoV-2 Omicron variant by sera from BNT162b2 or Coronavac vaccine recipients.Clin Infect Dis. 2021; ( published online Dec 16.) https: //doi.org/10.1093/cid/ciab1041Google Scholar, 2Chen LL Chua GT Lu L et al.Omicron variant susceptibility to neutralizing antibodies induced in children by natural SARS-CoV-2 infection or COVID-19 vaccine.Emerg Microbes Infect. 2022; 11: 543-547Google Scholar, 3WHOCOVID-19 weekly epidemiological update.https: //www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19 -- -8-february-2022Date: Feb 8, 2022Date accessed: February 12, 2022Google Scholar BA.1 is the dominant omicron sublineage, making up more than 97% of omicron variant sequences worldwide in November and December, 2021, whereas BA.2 and BA.3 were rare.3WHOCOVID-19 weekly epidemiological update.https: //www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19 -- -8-february-2022Date: Feb 8, 2022Date accessed: February 12, 2022Google Scholar Hence, early studies of the omicron variant were mainly based on the BA.1 sublineage. Since early January, 2022, there has been a sudden upsurge of BA.2 in Europe and Asia, accounting for 15·6% of omicron variant sequences detected at the end of January, 2022.3WHOCOVID-19 weekly epidemiological update.https: //www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19 -- -8-february-2022Date: Feb 8, 2022Date accessed: February 12, 2022Google Scholar In view of the increasing epidemiological importance, there is an urgent need to assess the serum neutralising activity against BA.2, which correlates with vaccine effectiveness.
We measured the serum neutralising antibody ( NAb) activity against BA.1 and BA.2 with a live virus NAb assay,1Lu L Mok BW Chen LL et al.Neutralization of SARS-CoV-2 Omicron variant by sera from BNT162b2 or Coronavac vaccine recipients.Clin Infect Dis. 2021; ( published online Dec 16.) https: //doi.org/10.1093/cid/ciab1041Google Scholar, 2Chen LL Chua GT Lu L et al.Omicron variant susceptibility to neutralizing antibodies induced in children by natural SARS-CoV-2 infection or COVID-19 vaccine.Emerg Microbes Infect. 2022; 11: 543-547Google Scholar and report the results here. We tested serum specimens collected from individuals who had received three doses of COVID-19 vaccine ( three-dose vaccinated; n=21; appendix p 4),4Khong K-W Liu D Leung K-Y et al.Antibody response of combination of BNT162b2 and CoronaVac platforms of COVID-19 vaccines against omicron variant.Vaccines ( Basel). 2022; 10: 160Google Scholar patients who had COVID-19 in 2020 who received one dose of the Pfizer-BioNTech BNT162b2 vaccine after recovery ( pre-variant of concern [ VOC ] convalescent, one-dose vaccinated; n=15),5Lu L Chen LL Zhang RR et al.Boosting of serum neutralizing activity against the omicron variant among recovered COVID-19 patients by BNT162b2 and Coronavac vaccines.SSRN. 2022; ( published online Feb 8.) ( preprint).https: //papers.ssrn.com/sol3/papers.cfm? abstract id=4029746Google Scholar patients who had COVID-19 in 2020 but had not been vaccinated ( pre-VOC convalescent, non-vaccinated; n=9),5Lu L Chen LL Zhang RR et al.Boosting of serum neutralizing activity against the omicron variant among recovered COVID-19 patients by BNT162b2 and Coronavac vaccines.SSRN. 2022; ( published online Feb 8.) ( preprint).https: //papers.ssrn.com/sol3/papers.cfm? abstract id=4029746Google Scholar and patients recently infected by the omicron sublineage BA.2 ( omicron BA.2 convalescent; n=10; appendix p 4). Overall ( n=55), the geometric mean NAb titre ( GMT) against BA.2 was 1·68 ( CI 1·63–1·73) times higher than against BA.1 ( 73·2 against BA.2 vs 43·7 against BA.1; p < 0·0001; appendix p 2). Subgroup analysis showed that the GMT against BA.2 was 2·0 times higher ( 95% CI 1·99–2·01) than the GMT against BA.1 in the pre-VOC convalescent, one-dose vaccinated group ( 422·2 against BA.2 vs 211·1 against BA.1; p=0·0005), 2·3 times higher ( 95% CI 2·12-2·56) in the pre-VOC convalescent, non-vaccinated group ( 29·4 against BA.2 vs 12·6 against BA.1; p=0·0078), and 2·0 times higher ( 95% CI 1·63–2·50) in the omicron BA.2 convalescent group ( 32·5 against BA.2 vs 16·3 against BA.1; p=0·031). However, the difference between BA.2 and BA.1 in the three-dose vaccinated group was not statistically significant ( p=0·14).
To better understand the difference between BA.2 and BA.1, we calculated the ratio of BA.2 NAb titre to BA.1 NAb titre in each individual. All individuals in the pre-VOC convalescent, one-dose vaccinated group; the pre-VOC convalescent, non-vaccinated group; and the omicron BA.2 convalescent group had equal or higher NAb titres for BA.2 than BA.1. However, four ( 19%) of 21 individuals in the three-dose vaccinated group had a lower NAb titre for BA.2 than BA.1. The BA.2-to-BA.1 NAb titre ratio in the three-dose vaccinated group was numerically lower than in other groups, but was only significantly lower than in the pre-VOC convalescent, non-vaccinated group ( p=0·041; appendix p 3).
Our data indicate that the immune escape from BA.2 is not as severe as from BA.1, suggesting that other viral or host factors are driving the rapid spread of BA.2. Since NAb titres correlate with vaccine effectiveness, our data suggest that currently available vaccines might be more effective against BA.2 than BA.1. This study was approved by the institutional review board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster ( UW 13–265 and UW 21–214) and the Hospital Authority Kowloon West Cluster ( KW/EX-20–038 [ 144–26 ]). Written informed consent was obtained from all study participants.
We declare no competing interests. L-LC and AW-HC contributed equally. This work was supported by Health and Medical Research Fund, the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region ( ref no. COVID190124 and COVID1903010 [ Project 1 ]), the Emergency Collaborative Project ( EKPG22-01) of Guangzhou Laboratory, and donations from Richard Yu and Carol Yu, Shaw Foundation Hong Kong, Michael Seak-Kan Tong, May Tam Mak Mei Yin, Lee Wan Keung Charity Foundation, Hong Kong Sanatorium and Hospital, Respiratory Viral Research Foundation, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund, Chan Yin Chuen Memorial Charitable Foundation, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, the Jessie and George Ho Charitable Foundation, Kai Chong Tong, Tse Kam Ming Laurence, Foo Oi Foundation, Betty Hing-Chu Lee, and Ping Cham So. The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to all data in the study and had final responsibility for the decision to submit for publication. L-LC and KK-WT directly accessed and verified the underlying data. Data are available from the corresponding author upon reasonable request.
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Safety monitoring of COVID-19 vaccines in Japan - The Lancet Regional Health – Western Pacific | The assessment of the efficacy and safety of coronavirus disease 2019 ( COVID-19) vaccines in actual practice is extremely important, and monitoring efforts are being implemented worldwide. In Japan, a joint council in the Ministry of Health, Labour and Welfare is held every two to three weeks to summarise information on the adverse events following COVID-19 vaccination, with careful assessment of individual case safety reports and comparison with background incidence rates. In 2021, the joint council mainly reviewed anaphylaxis, death, myocarditis/pericarditis, and thrombosis with thrombocytopenia syndrome. These activities resulted in several safety-related regulatory actions, including the revision of vaccine package inserts with warnings about myocarditis/pericarditis. International sharing of vaccine safety information, as well as details of the evaluation systems, is important for international discussion and decision-making on better safety monitoring of COVID-19 vaccines.
The assessment of the efficacy and safety of coronavirus disease 2019 ( COVID-19) vaccines in actual practice is extremely important, and monitoring efforts are being implemented worldwide. In Japan, a joint council in the Ministry of Health, Labour and Welfare is held every two to three weeks to summarise information on the adverse events following COVID-19 vaccination, with careful assessment of individual case safety reports and comparison with background incidence rates. In 2021, the joint council mainly reviewed anaphylaxis, death, myocarditis/pericarditis, and thrombosis with thrombocytopenia syndrome. These activities resulted in several safety-related regulatory actions, including the revision of vaccine package inserts with warnings about myocarditis/pericarditis. International sharing of vaccine safety information, as well as details of the evaluation systems, is important for international discussion and decision-making on better safety monitoring of COVID-19 vaccines.
Coronavirus disease 2019 ( COVID-19) has affected people's lives worldwide, with total casualties being over 5 million by November, 2021.1WHO Coronavirus disease ( COVID-19) dashboard; 2020. https: //covid19.who.int/. Accessed 10 January 2022.Google Scholar In Japan, the first case of the SARS-CoV-2 infection ( COVID-19) was reported on January 15, 2020. By the end of November 2021, there had been five waves of the pandemic, with around 173 million infected patients and approximately 18,000 deaths.1WHO Coronavirus disease ( COVID-19) dashboard; 2020. https: //covid19.who.int/. Accessed 10 January 2022.Google Scholar The BNT162b2 ( Pfizer-BioNTech) was approved in Japan on February 14, 2021, followed by mRNA-1273 ( Moderna/Takeda) and ChAdOx1-S ( AstraZeneca) on May 21, 2021. Vaccinations using BNT162b2, mRNA1273, and ChAdOx1-S began on February 17, May 24, and August 1, 2021, respectively. The vaccination coverage has risen dramatically since then. In November 2021, the proportion of people receiving two doses of vaccinations exceeded 75%, indicating that Japan has one of the highest vaccination coverage globally.2Ritchie H, Mathieu E, Rodés-Guirao L, et al. Coronavirus Pandemic ( COVID-19); 2020. published online March 5. https: //ourworldindata.org/covid-vaccinations? country=JPN. Accessed 10 January 2022.Google Scholar
Accordingly, safety monitoring of COVID-19 vaccines is increasingly important. In Japan, vaccine safety monitoring has been conducted mainly by the Ministry of Health, Labour and Welfare ( MHLW) and the Pharmaceuticals and Medical Devices Agency ( PMDA). Since the start of COVID-19 vaccination in Japan, several safety-related regulatory actions have been taken, such as revision of package inserts with warnings of myocarditis/pericarditis.3Ministry of Health, Labour and Welfare. Revision of Precautions. Coronavirus modified uridine RNA vaccine ( SARS-CoV-2) ( Comirnaty intramuscular injection); 2021. https: //www.pmda.go.jp/files/000243865.pdf. Accessed 10 January 2022.Google Scholar,4Ministry of Health, Labour and Welfare. Revision of Precautions. Coronavirus modified uridine RNA vaccine ( SARS-CoV-2) ( COVID-19 Vaccine Moderna Intramuscular Injection); 2021. https: //www.pmda.go.jp/files/000243866.pdf. Accessed 10 January 2022.Google Scholar
Japan's national strategy for safety monitoring of COVID-19 vaccines is considered to work well, but records of the proceedings and results of the analyses have been published almost exclusively in Japanese.5Ministry of Health, Labour and Welfare. Health Sciences Council ( the Immunization and Vaccination committee - the committee on Adverse Reactions) [ in Japanese ]. https: //www.mhlw.go.jp/stf/shingi/shingi-kousei 284075.html. Accessed 4 March 2022.Google Scholar Sharing Japan's experiences would be informative to countries that still have low vaccine coverage, and also stimulate international discussions on improved vaccine safety monitoring of COVID-19 vaccines. This report aims to show the Japanese systems of COVID-19 vaccines safety monitoring, analytical results through November 2021, and safety-related regulatory actions by focusing on four outcomes of national and international interest: anaphylaxis, death, myocarditis/pericarditis, and thrombosis with thrombocytopenia syndrome ( TTS). Because implementation of the third vaccination ‘ booster’ shot has begun in Japan since December 2021, the statistics in the current report represent the first and second COVID-19 vaccinations.
In Japan, safety monitoring of vaccines has been conducted mainly by the MHLW and PMDA under the Immunisation Act6Immunization Act ( Act No. 68 of 1948) ( Amendment Act No. 75 of 2020). [ in Japanese ] https: //elaws.e-gov.go.jp/document? lawid=323AC0000000068 & msclkid=54af0d94a93211ec8ff6f73a9b87d507. Accessed 22 March 2022.Google Scholar and the Act on Securing Quality, Efficacy and Safety of Products Including Pharmaceuticals and Medical Devices.7Act on securing quality, efficacy and safety of products including pharmaceuticals and medical devices ( Act No. 145 of 1960) ( Amendment Act No. 63 of 2019). [ in Japanese ] https: //elaws.e-gov.go.jp/document? lawid=335AC0000000145 20210801 501AC0000000063 & keyword=% E8% 96% AC% E6% A9% 9F% E6% B3% 95. Accessed 22 March 2022.Google Scholar External review panels have been formed from the Health Sciences Council and the Pharmaceutical Affairs and Food Sanitation Council. This joint council has played a central role in determining safety-related vaccine policy ( Figure 1). This joint council comprises 15 members, including two chairs. The members and chairs are selected by the Minister of the MHLW.Figure 1Governmental structure for vaccine safety monitoring in Japan.Show full captionAEFIs = adverse events following immunisation, JADER= Japanese Adverse Drug Event Report database, ICH = International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
AEFIs = adverse events following immunisation, JADER= Japanese Adverse Drug Event Report database, ICH = International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use.
COVID-19 vaccinations have been implemented under the Immunisation Act. In response to the increasing numbers of individual case safety reports ( ICSRs) of adverse events following COVID-19 vaccination, the systems of receiving and evaluation reports at PMDA were enhanced, and the frequency of joint council meetings was increased.
Individual case safety reports ( numerator data): Japanese spontaneous reporting system is designed to accept reports of adverse events following immunisation and detect safety signals of licensed vaccines. There are two types of ICSR in Japan ( Figure 1). First, based on the Immunisation Act, healthcare professionals are required to report adverse events following immunisation using a standardised reporting format.8Report of Suspected Adverse Reactions after Immunization ( Attachment Form 1) [ in Japanese ]. https: //www.pmda.go.jp/safety/reports/hcp/prev-vacc-act/0002.html. Accessed 10 January 2022.Google Scholar The Japanese standardised form includes the basic items similar to the World Health Organisation ( WHO)'s reporting form for Adverse Events Following Immunisation.9World Health Organization. Reporting form for adverse event following immnization ( AEFI). https: //www.who.int/vaccine safety/initiative/tools/AEFI reporting form EN Jan2016.pdf. Accessed 4 March 2022Google Scholar In addition, the questionnaire consistent with Brighton Classification for some specific adverse events is provided separately. Reporting has been mandatory since 2013.6Immunization Act ( Act No. 68 of 1948) ( Amendment Act No. 75 of 2020). [ in Japanese ] https: //elaws.e-gov.go.jp/document? lawid=323AC0000000068 & msclkid=54af0d94a93211ec8ff6f73a9b87d507. Accessed 22 March 2022.Google Scholar Second, the Act on Securing Quality, Efficacy and Safety of Products Including Pharmaceuticals and Medical Devices requires vaccine marketing authorisation holders ( MAHs) to report suspected adverse reactions that come to their attention,7Act on securing quality, efficacy and safety of products including pharmaceuticals and medical devices ( Act No. 145 of 1960) ( Amendment Act No. 63 of 2019). [ in Japanese ] https: //elaws.e-gov.go.jp/document? lawid=335AC0000000145 20210801 501AC0000000063 & keyword=% E8% 96% AC% E6% A9% 9F% E6% B3% 95. Accessed 22 March 2022.Google Scholar using the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use ( ICH) E2B format.10ICH E2B ( R3) Electronic transmission of individual case safety reports ( ICSRs) - data elements and message specification - implementation guide; 2013. https: //www.ema.europa.eu/en/documents/scientific-guideline/international-conference-harmonisation-technical-requirements-registration-pharmaceuticals-human-use en-4.pdf. Accessed 10 January 2022.Google Scholar Reporting has been mandatory for MAHs since 1980.7Act on securing quality, efficacy and safety of products including pharmaceuticals and medical devices ( Act No. 145 of 1960) ( Amendment Act No. 63 of 2019). [ in Japanese ] https: //elaws.e-gov.go.jp/document? lawid=335AC0000000145 20210801 501AC0000000063 & keyword=% E8% 96% AC% E6% A9% 9F% E6% B3% 95. Accessed 22 March 2022.Google Scholar All reports from healthcare professionals and MAHs are received, managed, maintained, and assessed by the PMDA based on the Pharmaceuticals and Medical Devices Agency Act.11Pharmaceuticals and Medical Devices Agency Act ( Act No. 192 of 2002) ( Amendment Act No. 63 in 2019) [ in Japanese ]. https: //elaws.e-gov.go.jp/document? lawid=414AC0000000192. Accessed 10 January 2022.Google Scholar
Reports to the PMDA from healthcare professionals cover adverse events, including minor and severe ones. The PMDA shares the information with each MAH, which conducts further investigation, follows up each case, and reports severe cases back to the PMDA. Therefore, the total number of reports from MAHs is smaller than that from healthcare professionals.
PMDA conducts additional investigations and causality assessments, and reports evaluation results to the MHLW in cooperation with the National Institute of Infectious Diseases. Detailed information of ICSRs for COVID-19 vaccines from MAHs, including unstructured data ( e.g., details of clinical encounters), is fully open to the public.5Ministry of Health, Labour and Welfare. Health Sciences Council ( the Immunization and Vaccination committee - the committee on Adverse Reactions) [ in Japanese ]. https: //www.mhlw.go.jp/stf/shingi/shingi-kousei 284075.html. Accessed 4 March 2022.Google Scholar Structured data from these reports are available on the PMDA website via the Japanese Adverse Drug Event Report database.12Pharmaceuticals and Medical Devices Agency. Terms and Conditions for Japanese adverse drug event report database ( JADER) [ in Japanese ]; 2015. https: //www.pmda.go.jp/safety/info-services/drugs/adr-info/suspected-adr/0003.html. Accessed 10 January 2022.Google Scholar
Vaccination data ( denominator data): As the denominator for estimating the incidence rate of adverse outcomes, the number of COVID-19 vaccinations can be estimated from the Vaccination Record System ( VRS) and Vaccination System ( V-SYS) data, by brand name, age, sex, dose number, and date. The VRS, established by the Digital Agency,13Japanese Government Chief Information Officers’ Portal. Vaccination Record System ( VRS) [ in Japanese ]; 2021. published online Jan 25. https: //cio.go.jp/vrs. Accessed 10 January 2022.Google Scholar is a system that records the vaccinations for COVID-19 and is managed by municipalities in a cloud-based system provided by the government. Information regarding when, where, and which vaccines were administered is input into the VRS. The V-SYS was established by the MHLW for the government, prefectures, municipalities, and medical institutions to share information and adjust the supply and demand of vaccines. Because of periodic time lags in updating VRS data, the V-SYS data are complementarily used for more accurate and timely estimation of the number of COVID-19 vaccinations.
Other data sources ( background incidence rates): For comparison with the incidence rate of adverse outcomes among COVID-19 vaccine recipients, mortality rates before the pandemic ( i.e., in 2019) were obtained from the National Vital Statistics death data.14Ministry of Health, Labour and Welfare. Overview of vital statistics ( fixed number) in the first year of Reiwa ( 2019) [ in Japanese ]; 2020. published online Sept 17. https: //www.mhlw.go.jp/toukei/saikin/hw/jinkou/kakutei19/index.html. Accessed 10 January 2022.Google Scholar The background incidence rates of several adverse events, including myocarditis/pericarditis, were calculated using data from the National Database of Health Insurance Claims ( NDB).15Yasunaga H. Real world data in Japan: chapter I NDB.Ann of Clin Epidemiol. 2019; 1: 28-30Google Scholar The NDB contains information on insurance claims from almost all Japanese residents, derived from the universal health insurance system in Japan.
The joint council's strategy for COVID-19 vaccine safety monitoring consists of several steps. The first step is ‘ signal detection’, which is mainly based on the ICSR information. A signal in pharmacovigilance is defined by the WHO; a signal does not indicate a direct causal relationship between a side effect and a medicine but is essentially only a hypothesis that justifies the need for further assessment.16Uppsala Monitoring Centre. What is a signal? https: //who-umc.org/signal-work/what-is-a-signal/. Accessed 4 March 2022.Google Scholar Generally, if the accumulated number of ICSRs for a specific adverse event is increasing, especially suggesting causal relationship by qualitative assessment from clinical aspects, the adverse event is considered as a safety signal for the vaccine. As a reinforcement system for COVID-19 vaccines, the PMDA conducts a review and evaluation involving two or more clinical experts in an assessment of all the ICSRs on COVID-19 vaccines, which is then confirmed by the joint council. ICSRs with anaphylaxis, myocarditis/pericarditis, TTS, and other adverse events are formally graded using Brighton classification.17Brighton Collaboration Case Definitions; 2021. https: //brightoncollaboration.us/category/pubs-tools/case-definitions/. Accessed 10 January 2022.Google Scholar
If safety signals of adverse outcomes are detected in the first step, the second step is ‘ signal strengthening’ by a population-level comparison for that outcome. This process compares the incidence rate of the adverse outcome, estimated as the number of reported cases divided by the number of people receiving the COVID-19 vaccine, with its background incidence rates in 2019.
Among the potential serious adverse outcomes associated with COVID-19 vaccines, the joint council agreed that the priority of investigation should be given to anaphylaxis and death, based on reports from other countries, as well as previous experience in 2009 with influenza A/H1N1 vaccinations. Myocarditis/pericarditis and TTS were additionally given priority for detailed investigation, based on the results of the first step as well as international reports.
The vaccination coverage in Japan has risen dramatically since the introduction of vaccines in February 2021 ( Figure 2). As of November 14, 2021, among a national population of approximately 125 million, an estimated 99.3 million ( 79.4%) have received at least one dose and 95.6 million ( 76.4%) have received two. Of these shots, 83.6% were of BNT162b2, 16.3% of mRNA-1273, and < 0.1% of ChAdOx1-S. The age-sex distribution according to the vaccine type is shown in Appendix P 1. People receiving BNT162b2 were older and more likely to be women compared to those receiving mRNA-1273, whereas the majority of people receiving ChAdOx1-S were middle-aged men.Figure 2Trend in the cumulative number of people receiving second dose in 2021.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Concurrently, there has been an increasing number of ICSRs from healthcare professionals and MAHs ( Figure 3). As of November 14, 2021, there were 25,522 ( 0.02%) reports from healthcare professionals and 16,040 ( 0.01%) from the MAH ( Pfizer-BioNTech) among 163,059,502 shots of BNT162b2. There were 3,919 ( 0.01%) reports from healthcare professionals and 2,133 ( 0.1%) from the MAH ( Moderna/Takeda) among 31,768,352 mRNA-1273 shots. The number of reports from healthcare professionals was 12 ( 0.01%), and the MAH ( AstraZeneca) reported 8 ( 0.01%) among 101,502 shots of ChAdOx1-S. The age distribution of events by vaccine type is presented in Appendix P 2.Figure 3Trend in the cumulative number of individual case safety reports in 2021.Show full captionMAH=marketing authorisation holder.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
MAH=marketing authorisation holder.
Statistics: As of November 14, 2021, among 163,059,502 shots of BNT162b2, the MAH ( Pfizer/BioNTech) reported 3,012 ICSRs of suspected anaphylaxis, of which 581 were confirmed as Brighton classifications 1–3 by the expert review panels ( 4 cases per 1 million shots). Among 31,768,352 shots of mRNA-1273, the MAH ( Moderna/Takeda) reported 504 cases of suspected anaphylaxis, of which 50 were confirmed as Brighton classifications 1–3 by the expert panels ( 1.6 cases per 1 million shots). No cases associated with ChAdOx1-S met Brighton classification levels 1–3. Occurrence tended to be higher in BNT162b2 than in mRNA-1273 in all age and sex groups ( Table 1). However, the frequency of reports involving BNT162b2 was highest during the first three months, possibly reflecting the fact that healthcare workers ( including many younger females) were among the initial recipients. After May 2021, the frequencies of confirmed anaphylaxis were comparable between BNT162b2 and mRNA-1273 ( Appendix P 3).Table 1The number of individual case safety reports for anaphylaxis from marketing authorization holders confirmed as Brighton classifications 1–3 as of November 14, 2021.BNT162b2mRNA-1273nPer 1 million vaccinationsnPer 1 million vaccinationsTotal5814501.6Male10-14y10.50015-19y61.70020-24y93.562.925-29y62.121.130-34y113.40035-39y82.131.540-44y61.30045-49y71.210.450-54y20.30055-59y50.90060-64y000065-69y60.90070-74y40.50075-79y000080y-20.300unknown1-0-Female10-14y21.118.615-19y7222.520-24y3210.463.425-29y44137530-34y421197.235-39y7415.821.640-44y7112.732.345-49y8111.821.350-54y497.132.355-59y345.61160-64y182.90065-69y192.712.970-74y80.90075-79y50.70080y-181.300unknown2-0-Unknown-11 Open table in a new tab
Interpretation: The frequency of anaphylaxis associated with COVID-19 vaccines in Japan is as expected, and comparable to or even lower than that in other developed countries.18Klein N. Rapid cycle analysis to monitor the safety of COVID-19 vaccines in near real-time within the vaccine safety datalink: myocarditis and anaphylaxis; 2021. https: //www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-08-30/04-COVID-Klein-508.pdf. Accessed 10 January 2022.Google Scholar,19Medicines and Healthcare products Regulatory Agency. Coronavirus ( COVID-19) vaccines adverse reactions; 2021. https: //www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions. Accessed 11 January 2022).Google Scholar For example, the frequency of reported anaphylaxis in the United States as of the end of July 2021 was 37 out of 7.4 million shots of BNT162b2 ( 5.0 cases per 1 million shots) and 26 out of 5.31 million shots of mRNA-1273 ( 4.9 cases per 1 million shots).18Klein N. Rapid cycle analysis to monitor the safety of COVID-19 vaccines in near real-time within the vaccine safety datalink: myocarditis and anaphylaxis; 2021. https: //www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-08-30/04-COVID-Klein-508.pdf. Accessed 10 January 2022.Google Scholar As of November 17, 2021, the frequency of reported anaphylaxis in the United Kingdom was 555 out of 45 million shots of BNT162b2 ( 12.3 cases per 1 million shots) and 43 out of 2.8 million shots of mRNA-1273 ( 15.4 cases per 1 million shots).19Medicines and Healthcare products Regulatory Agency. Coronavirus ( COVID-19) vaccines adverse reactions; 2021. https: //www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions. Accessed 11 January 2022).Google Scholar
Regulatory action: At the approval of the COVID-19 vaccines, anaphylaxis had already been included in the package insert sections on ‘ ADVERSE REACTIONS’ and ‘ CONTRAINDICATIONS’ for people with a history of anaphylaxis. Similar to other countries, to date, no additional safety measures have been implemented in Japan.
Statistics: The real-time cumulative number of deaths after COVID-19 vaccination was calculated using de-duplicated reports from both healthcare professionals and MAH reports due to the time lag between the two reports. Among the 1,368 deaths ( 1,315 with BNT162b2, 53 with mRNA-1273, and 0 with ChAdOx1-S), the most common cause of death was ischaemic heart disease ( n=138), followed by heart failure ( n=118), and haemorrhagic stroke ( n=109). However, none of the cases were confirmed by experts as suggesting a causal relationship between vaccination and death.
The proportions of reported death among people with the COVID-19 vaccine were 8.1 and 1.7 cases per 1 million shots ( 1,315 cases/163,059,502 shots and 53 cases/31,768,352 shots), or 15.8 and 3.3 cases per 1 million people with at least one shot ( 1,315 cases/83,094,685 people and 53 cases/16,173,124 people) for BNT162b2 and mRNA-1273, respectively. When partitioned by cause of death, the incidence rates of death with ischaemic heart disease ( Appendix P 4) or intracranial haemorrhage ( Appendix P 5) within 21 days of vaccination were strikingly lower than the background incidence rates in 2019. The distribution of the time interval between vaccination and death is shown in Appendix P 6, suggesting that reporting was more frequent when death was soon after vaccination.
Interpretation: It is generally difficult to infer a causal relationship between vaccination and death, especially among older people, because of various potential causes of death. Indeed, the experts confirmed none of the cases as suggesting a causal relationship between vaccination and death. Moreover, the population-level comparisons did not detect an excess risk of death associated with COVID-19 vaccination.
The proportion of reported deaths in Japan is lower than seen in other countries ( 22.2 cases in the United States,20Centers for Disease Control and Prevention. Selected adverse events reported after COVID-19 vaccination; 2021. https: //www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html. Accessed 10 January 2022.Google Scholar and 13.6 cases in BNT162b2 and 6.8 cases in mRNA-1273 per 1 million shots in the United Kingdom).19Medicines and Healthcare products Regulatory Agency. Coronavirus ( COVID-19) vaccines adverse reactions; 2021. https: //www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions. Accessed 11 January 2022).Google Scholar However, direct comparison between these rates may be affected by different reporting methods between the countries.
As the next step, a large cohort study to compare the mortality of vaccinated and unvaccinated people in Japan may be warranted, as has been conducted elsewhere.21Pottegård A. Lund L.C. Karlstad Ø. et al.Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: population based cohort study.BMJ. 2021; 373: n1114Google Scholar,22Lopez Bernal J. Andrews N. Gower C. et al.Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on Covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study.BMJ. 2021; 373: n1088Google Scholar These observational studies found significantly lower mortality rates in the vaccinated groups compared to those in the unvaccinated groups,21Pottegård A. Lund L.C. Karlstad Ø. et al.Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: population based cohort study.BMJ. 2021; 373: n1114Google Scholar,22Lopez Bernal J. Andrews N. Gower C. et al.Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on Covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study.BMJ. 2021; 373: n1088Google Scholar although the results may be affected by confounding if vaccinated persons tend to be healthier than the unvaccinated.
Regulatory action: To date, there has been no safety-related regulatory action in Japan for COVID-19 vaccine-associated deaths. Nonetheless, careful monitoring is ongoing.
Statistics: Since the first case report of myocarditis in March 2021, the number of reported cases of myocarditis or pericarditis has steadily increased in patients receiving BNT162b2 and mRNA-1273. By November 14, 2021, there were 476 reports from the MAHs ( 281 from Pfizer-BioNTech and 195 from Moderna/Takeda), suggesting the incidence rates of 1.7 and 6.1 cases per 1 million shots ( 3.4 and 12.1 cases per 1 million people with at least one shot) for BNT162b2 and mRNA-1273, respectively. Of these cases, 20 cases ( 16 cases for BNT162b2 and 4 cases for mRNA-1273) were followed by death, although the causal relationship between the vaccination and death remained inconclusive by experts. Many of which were reported within 30 days, particularly within 5 days of vaccination ( Appendix P 7). As of November 14, 2021, there had not been any reports of myocarditis or pericarditis associated with ChAdOx1-S. Table 2 shows the incidence rate of myocarditis/pericarditis according to age, sex, and vaccine type. Moreover, an observed-to-expected ( OE) analysis was conducted using the 2019 NDB background incidence rates for myocarditis/pericarditis ( Figure 4). In men in their teens and twenties, the lower 95% confidence interval limit of the OE ratio was above 1.0 for both BNT162b2 and mRNA-1273; this trend was more pronounced for mRNA-1273: the OE ratio was 6.8 and 3.7, and 41.1 and 17.4 in their teens and twenties, for BNT162b2 and mRNA-1273, respectively, while their confidence intervals overlapped. Stratified by the number of doses, the risk was larger following the second dose than the first dose ( Appendix P 8).Table 2The number of individual case safety reports for myocarditis/pericarditis as of November 14, 2021.BNT162b2mRNA-1273nPer 1 million vaccinationsPer 1 million personsnPer 1 million vaccinationsPer 1 million personsTotal2811.73.41956.112.1Male10-14y157.714.3325.346.915-19y308.616.43845.387.620-24y207.914.96028.856.325-29y186.311.93719.938.930-34y154.68.8105.510.735-39y71.83.531.5340-44y81.73.373.56.945-49y71.22.373.1650-54y61210.5155-59y61.12.221.32.660-64y50.91.811.12.265-69y101.5312.14.370-74y101.22.500075-79y71.32.600080y-111.42.8000unknown1 -- 2 -- Female10-14y42.24.100015-19y92.6533.77.220-24y20.61.221.12.225-29y30.91.721.42.830-34y30.81.543.26.335-39y71.52.921.6340-44y71.22.421.5345-49y50.71.442.65.250-54y121.73.432.34.455-59y50.81.600060-64y91.42.800065-69y60.81.712.95.770-74y80.91.700075-79y30.40.900080y-171.22.5000unknown5 -- 0 -- Open table in a new tab Figure 4Result of observed-to-expected ratio analysis of myocarditis and pericarditis by age and sex.Show full captionThe risk period was set as seven days ( i.e., observed cases in each subgroup were counted only during the risk window of seven days from the date of each vaccination). The background incidence rate in each subgroup was calculated using the National Database of Health Insurance Claims data ( NDB), including the International Classification of Diseases 10th revision codes suggesting myocarditis/pericarditis and the population census data. The expected cases were calculated by multiplying the background incidence rate by the follow-up period ( calculated by multiplying the total number of COVID-19 vaccinations by seven days).View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
The risk period was set as seven days ( i.e., observed cases in each subgroup were counted only during the risk window of seven days from the date of each vaccination). The background incidence rate in each subgroup was calculated using the National Database of Health Insurance Claims data ( NDB), including the International Classification of Diseases 10th revision codes suggesting myocarditis/pericarditis and the population census data. The expected cases were calculated by multiplying the background incidence rate by the follow-up period ( calculated by multiplying the total number of COVID-19 vaccinations by seven days).
Interpretation: Increasing amounts of data suggest that the incidence of reported myocarditis/pericarditis after mRNA vaccination is significantly higher than the background incidence rates for men in their teens and twenties. This finding is in line with many reports from other countries suggesting that mRNA vaccines may increase the risk of myocarditis/pericarditis in younger men.23Klein N.P. Lewis N. Goddard K. et al.Surveillance for adverse events after COVID-19 mRNA vaccination.JAMA. 2021; 326: 1390-1399Google Scholar, 24Witberg G. Barda N. Hoss S. et al.Myocarditis after COVID-19 vaccination in a large health care organization.N Engl J Med. 2021; 385: 2132-2139Google Scholar, 25Mevorach D. Anis E. Cedar N. et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 26Simone A. Herald J. Chen A. et al.Acute myocarditis following COVID-19 mRNA vaccination in adults aged 18 years or older.JAMA Intern Med. 2021; 181: 1668-1670Google Scholar, 27Barda N. Dagan N. Ben-Shlomo Y. et al.Safety of the BNT162b2 mRNA COVID-19 vaccine in a nationwide setting.N Engl J Med. 2021; 385: 1078-1090Google Scholar For example, in Israel, the overall incidence rate of myocarditis after vaccination of BNT162b2 was 21.3 cases per 1 million people with at least one shot, whereas the highest incidence rate was observed in men aged 16–29 years ( 106.9 cases per 1 million).24Witberg G. Barda N. Hoss S. et al.Myocarditis after COVID-19 vaccination in a large health care organization.N Engl J Med. 2021; 385: 2132-2139Google Scholar In addition, the current analysis may be the first to suggest a higher risk of myocarditis/pericarditis from mRNA-1273 than from BNT162b2 in men in their teens and twenties.
Regulatory actions: As of July 7, 2021, based on the increasing number of ICSRs from Japan and several scientific reports from other countries such as the United States,28Centers for Disease Control and Prevention. Vaccines and Immunizations. Myocarditis and pericarditis considerations; 2021. https: //www.cdc.gov/vaccines/covid-19/clinical-considerations/myocarditis.html. Accessed 10 January 2022.Google Scholar the package inserts of both BNT162b2 and mRNA-1273 vaccines were updated in the ‘ IMPORTANT PRECAUTIONS’ and ‘ OTHER PRECAUTIONS’ sections.29Ministry of Health, Labour and Welfare. Revision of Precautions, coronavirus modified uridine RNA vaccine; 2021. https: //www.pmda.go.jp/files/000241562.pdf. Accessed 10 January 2022.Google Scholar The relevant MHLW web pages instructed vaccine recipients or their caregivers to seek medical attention immediately if they experience or notice any symptoms suggestive of myocarditis or pericarditis.
On October 15, 2021, the joint council concluded that the risk of myocarditis/pericarditis from mRNA vaccines, particularly mRNA-1273, is specifically increased in men in their teens and twenties. The council decided to suggest that those who had received the first dose of mRNA-1273 could choose BNT162b2 for their second dose. However, the council also emphasised that people should not be discouraged from receiving COVID-19 vaccines, considering the balance between the relatively small risk of myocarditis, and the benefit of preventing COVID-19, which is known to induce myocarditis much more frequently than the vaccination itself. These messages were immediately sent to the public via the mass media.
On December 3, 2021, the package inserts of both the BNT162b2 and mRNA-1273 vaccines were further updated to list myocarditis/pericarditis as one of the clinically significant adverse reactions in the ‘ ADVERSE REACTION’ section.3Ministry of Health, Labour and Welfare. Revision of Precautions. Coronavirus modified uridine RNA vaccine ( SARS-CoV-2) ( Comirnaty intramuscular injection); 2021. https: //www.pmda.go.jp/files/000243865.pdf. Accessed 10 January 2022.Google Scholar,4Ministry of Health, Labour and Welfare. Revision of Precautions. Coronavirus modified uridine RNA vaccine ( SARS-CoV-2) ( COVID-19 Vaccine Moderna Intramuscular Injection); 2021. https: //www.pmda.go.jp/files/000243866.pdf. Accessed 10 January 2022.Google Scholar
The ChAdOx1-S vaccine was approved in Japan on May 21, 2021, but its use in the community was delayed due to concerns expressed internationally about the potential risk of TTS and other thrombotic events.30European Medicines Agency. Signal assessment report on embolic and thrombotic events ( SMQ) with COVID-19 Vaccine ( ChAdOx1-S [ recombinant ]) – COVID-19 Vaccine AstraZeneca ( Other viral vaccines); 2021. https: //www.ema.europa.eu/en/documents/prac-recommendation/signal-assessment-report-embolic-thrombotic-events-smq-covid-19-vaccine-chadox1-s-recombinant-covid en.pdf. Accessed 10 January 2022.Google Scholar Actual use of ChAdOx1-S in Japan began in August 2021, while encouraging reporting of TTS through the ICSRs. However, as of November 14, 2021, there had been only one reported case of TTS following 101,502 shots to 56,832 people. This case occurred in a 48-year-old man without a history of relevant comorbidities, and was classified as Brighton classification 1. The risk of TTS had already been included in the first version of the ChAdOx1 package insert, and no additional regulatory action has been taken. Careful monitoring is ongoing.
Spontaneous reporting of adverse events by healthcare professionals and MAHs, and other national data sources is well established in Japan. This has enabled the government to conduct immediate evaluation, information sharing, and data analysis, leading to effective safety monitoring of COVID-19 vaccines. The conference minutes and statistics of every meeting were immediately open to the public on the MHLW of Japan website,5Ministry of Health, Labour and Welfare. Health Sciences Council ( the Immunization and Vaccination committee - the committee on Adverse Reactions) [ in Japanese ]. https: //www.mhlw.go.jp/stf/shingi/shingi-kousei 284075.html. Accessed 4 March 2022.Google Scholar which can be accessed by the general people and mass media. This timely approach is expected to increase vaccine confidence among Japanese people.
Although safety monitoring systems may differ across countries, broadly sharing monitoring information on COVID-19 vaccination, and how the data are used in decision making, will stimulate international discussion for the enhanced safety monitoring of COVID-19 vaccines. Moreover, the details of the adverse outcomes associated with COVID-19 vaccinations in Japan would be informative to other countries with low vaccine coverage, especially countries in Asia, as there may be ethnic differences in the effectiveness and safety of the COVID-19 vaccinations.
In many developed countries, in addition to spontaneous reporting systems for signal detection, active monitoring using large electronic medical information databases ( including vaccination data) has been conducted for signal strengthening. For example, the United States Vaccine Safety Datalink, a collaboration between health plans and the Centers for Disease Control and Prevention for active safety monitoring, has conducted weekly monitoring of 23 serious outcomes, including death, haemorrhagic and ischaemic stroke, thromboembolism, myocarditis, and anaphylaxis, since December 14, 2020.23Klein N.P. Lewis N. Goddard K. et al.Surveillance for adverse events after COVID-19 mRNA vaccination.JAMA. 2021; 326: 1390-1399Google Scholar,31Weintraub MPH, Fireman B, Gee J, et al. Rapid Cycle Analysis ( RCA) to monitor the safety of COVID-19 vaccines in near real-time within the Vaccine Safety Datalink. 2021. https: //www.cdc.gov/vaccinesafety/pdf/VSD-1342-COVID19-RCA-Protocol FinalV1.1 508.pdf. Accessed 10 January 2022.Google Scholar In comparing the incidence of events one to 21 days postvaccination with 22 to 42 days postvaccination, the study had not found any safety concerns until June 26, 2021, when analyses began detecting indications of myocarditis in people aged 12-39 years.23Klein N.P. Lewis N. Goddard K. et al.Surveillance for adverse events after COVID-19 mRNA vaccination.JAMA. 2021; 326: 1390-1399Google Scholar There are other examples of observational studies using such databases, including descriptive analyses estimating the incidence of an outcome among vaccinated persons,26Simone A. Herald J. Chen A. et al.Acute myocarditis following COVID-19 mRNA vaccination in adults aged 18 years or older.JAMA Intern Med. 2021; 181: 1668-1670Google Scholar the OE analysis,21Pottegård A. Lund L.C. Karlstad Ø. et al.Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: population based cohort study.BMJ. 2021; 373: n1114Google Scholar a matched cohort study,27Barda N. Dagan N. Ben-Shlomo Y. et al.Safety of the BNT162b2 mRNA COVID-19 vaccine in a nationwide setting.N Engl J Med. 2021; 385: 1078-1090Google Scholar and a self-controlled case series.32Hippisley-Cox J. Patone M. Mei X.W. et al.Risk of thrombocytopenia and thromboembolism after COVID-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study.BMJ. 2021; 374: n1931Google Scholar
The analyses found a statistically significant difference between the background incidence rate of myocarditis/pericarditis and that among people receiving the mRNA vaccines. Further, the analyses found the possibility of differences in the incidence rates for people who had received different types of mRNA vaccines. This was particularly true for men in their teens and twenties, and resulted in prompt safety-related regulatory action. Ideally, this finding should be further confirmed by additional studies, such as a matched cohort study. Ongoing efforts to link different nationwide databases ( e.g., NDB and vaccination data) by the government and vaccination information and medical claims data in local municipalities, will help enable such studies.
There were several limitations to the statistical and analytical results presented in the current paper. First, the numbers and incidence rates of adverse events following immunization ( defined as any adverse events following vaccination, with or without a causal relationship) could be underestimated by using the spontaneous reporting data, which may suffer from under-reporting. Therefore, comparison of the statistics in the current paper with those estimated in other data sources is warranted as soon as these data are available for analysis; however, the different data sources have their own limitations ( e.g., small sample size of active surveillance data to identify rare outcomes, such as myocarditis/pericarditis and TTS, and misclassification or overdiagnosis in the administrative claims data). Notably, in the OE analysis for myocarditis/pericarditis, the incidence rate based on the ICSRs ( possibly underestimated) was significantly larger than the background incidence rate calculated from the administrative claims data in NDB ( possibly overestimated) in men in their teens and twenties. Secondly, most of the vaccinations so far have been with mRNA vaccines ( BNT162b2 or mRNA1273) in Japan, and the experiences of viral vector vaccines for COVID-19 ( such as ChAdOx1-S) have been small. Furthermore, the statistics in the current report represent only the first and second COVID-19 vaccinations, whereas implementation of the third vaccination ‘ booster’ shot has begun since December 2021 in Japan. Thus, data on the booster shots and types of vaccines other than mRNA vaccines should be analysed and reported in the near future.
Safety monitoring of emerging vaccines and timely regulatory actions are important for public health. If the safety of a vaccine is found to be questionable after analysis of accumulating data, the most radical safety-related regulatory action may be to pause vaccination in the community. Less radical actions include informing people about the risk through measures such as revised package inserts and medication guides. While the final benefit-risk assessments of vaccination may be up to individuals, governments are expected to provide the general public with the best information available, and may sometimes need to take regulatory action for the public good. National experiences of COVID-19 vaccination should be shared internationally and utilised to further improve the safety monitoring system of vaccines.
In conclusion, Japan is conducting safety monitoring of COVID-19 vaccines at the national level. So far, the process is considered to be working well, and has led to regulatory actions regarding vaccine-associated risks of myocarditis/pericarditis. The Japanese government is continually working to enhance the quality, timely collection, and analysis of available data to monitor this and other health risks.
TY, MI, and CI drafted the manuscript TY, DF, MN, and TT had full access to and verified all the data in the study and were responsible for data acquisition, analysis, and interpretation and drafting of the manuscript. TN substantially contributed to the analysis of the National Database of Health Insurance Claims data for the background incidence rates of myocarditis/pericarditis. HU, NK, and TI contributed significantly to the observed-to-expected analysis. NY, ST, AO, TM, KN, and SH contributed substantially to the interpretation of data and drafting of the manuscript. All authors had final responsibility for the decision to submit the manuscript for publication.
The data for this report are available to the public on the webpage ( Japanese language only) of the Ministry of Health, Labour and Welfare of Japan ( https: //www.mhlw.go.jp/stf/shingi/shingi-kousei 284075.html).
AO receives grants from Eisai Co., Ltd, SHIONOGI & CO., LTD., Takeda Pharmaceutical Co, Eli Lilly Japan K.K., Chugai Pharmaceutical Co., Ltd., and Pfizer Japan Inc. All other authors declare no competing interests.
The authors would like to thank Dr. Tomoaki Imamura, Dr. Tomoya Myojin, Dr. Yuichi Nishioka, and Mr. Shinichiro Kubo of Nara Medical University for their support in the National Database of Health Insurance Claims analysis. The authors would further like to thank the members of the Health Sciences Council and the Pharmaceutical Affairs and Food Sanitation Council for their contribution to the council. The National Database of Health Insurance Claims analysis was partially funded by a grant from the Health Science and Labour Research Grants [ Grant No.: 21IA1006 ] of the Ministry of Health, Labour and Welfare, Japan. The publication of this paper was supported by the National Center for Global Health and Medicine Intramural Research Fund [ Grant No.: 21A2010 ] for investigation of the legal and regulatory framework for post-approval vaccine safety monitoring. The funders had no role in paper design, data collection, data analysis, interpretation, or writing of the paper.
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Richard Carapaz attacked Saturday to win the stage and secure a podium spot at the Volta a Catalunya. Photo: Gonzalo Arroyo Moreno/Getty Images
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Ineos Grenadiers is finding new ways to win early in 2022 following a spate of illnesses and devastating injuries that have sidelined many of the team’ s marquee riders.
With Egan Bernal recovering in Colombia and many of the team’ s top stars from Richie Porte to Geraint Thomas and Thomas Pidcock continuing to fend off illnesses, the UK powerhouse is digging deeper into its back bench and tactical playbook to deliver results.
Though the team was not in the frame for victory at E3 Saxo Bank Classic or Gent-Wevelgem over the weekend, Ineos Grenadiers saw quality podium time in Italy and Spain.
At last week’ s Coppi e Bartali, three of the team’ s younger riders took center stage, with Ethan Hayter and Ben Tullett each taking stage wins and Eddie Dunbar winning the overall.
“ I’ ve been on the team a few years now and everyone knows how much this means to me, ” Dunbar said. “ It’ s like a weight has been lifted off my shoulders. ”
In Spain, Olympic gold medalist Richard Carapaz won for the first time in Europe this season Saturday and finished second overall at Volta a Catalunya on Sunday.
Yet instead of being part of the team’ s bulldozing podium sweep at the Spanish WorldTour tsvr like it was in 2021, Carapaz was forced to uncork a long-distance attack in Saturday’ s hilly stage to rewrite the script.
“ We knew it could be a difficult stage, first of all because the rainy weather and difficult climbs, too, ” Carapaz said after Saturday’ s big raid. “ It was a hard terrain but it’ s my strength. We planned this attack beforehand, [ it ] was all or nothing and we did well. ”
These days, Ineos Grenadiers isn’ t winning on pure brawn, it’ s winning with finesse.
Though Ineos Grenadiers is being overshadowed of late by the sensational Slovenian duo of Tadej Pogačar and Primož Roglič and their respective teams, UAE Emirates and Jumbo-Visma, the UK outfit is still a force to reckon with.
The team leads the PCS rankings of points from the 100 best top-30 results over a 12-month period. Though that’ s an unofficial ranking, it reveals the team’ s ever-steady consistency.
Ineos Grenadiers will see a bump in the next official UCI team ranking after its recent successes, and will likely jump back into the top-3 after slipping from second to fifth in the rankings released at the end of last week.
In terms of straight-up wins, Ineos Grenadiers is now third among the WorldTour, with an impressive haul of 12 wins so far in 2022.
Nine different riders have won so far, with Filippo Ganna, with three wins, and newcomers like Magnus Sheffield also stepping up. Yet only two of those — Carapaz’ s stage win at Catalunya and Ganna’ s TT win at Tirreno-Adriatico — have come in the WorldTour.
For a team that once dominated stage racing and grand tours, so far the team’ s only stage-race win in early days of 2022 is Dunbar’ s trophy Saturday at the five-day Coppi e Bartali.
UAE Emirates is on a tear, with 22 victories so far this season, with the always there presence of Quick-Step Alpha Vinyl with 17. In contrast, Jumbo-Visma “ only ” has eight wins, yet six of those are WorldTour race victories.
Ineos Grenadiers also has a WorldTour-leading number of second places with 14, and 11 more third places.
In fact, coming out of this weekend, only UAE Emirates with 42 top-3 places has more than Ineos Grenadiers’ s 37 among the WorldTour so far in 2022.
So where does Ineos Grenadiers rank going into 2022? With a spate of injuries, most importantly to GC anchor Bernal, the team is clearly having to reshuffle its deck.
Team stalwart Porte isn’ t buying some of the media headlines that the team’ s best days are behind it. In fact, the Australian who is set to retire at the end of 2022 says for his money, the UK squad is still at the top of its game.
“ I still think we’ re the best team in the peloton, ” Porte said. “ It’ s hard not to have the luxury of having a Bradley Wiggins or a Chris Froome, who 99 percent of the time would finish it off. You look at UAE and Jumbo-Visma, and you hope those guys enjoy what they’ re on at the moment. Because those times don’ t last forever. I think this team in the future will be the top team again. ”
Dunbar was glad he could finally deliver a big result after riding in Ineos Grenadiers colors since 2018.
His overall victory is the first Irish rider to win a stage race since the recently retired Nicolas Roche won the Route du Sud in 2014. The overall crown was also Dunbar’ s first professional victory.
“ I knew I could be up there in races, GC-wise and I said, ‘ once I get a good run I can be good enough to contest these races, ' ” Dunbar said. “ Everything fell into place this week and it’ s a relief.
“ I was grateful to all of the guys for believing in me and backing me these last few days to stick in there, ” he said. “ It’ s nice to finally get a win and show how grateful I am to them, and all the staff, too. ”
Dunbar’ s victory last week at Coppi e Bartali comes as a salve not only for the 25-year-old Irishman, but also for the injury- and illness-ravaged lineup at Ineos Grenadiers.
The boys were on fire this week 🔥 Congrats on the first pro wins @ EddieDunbar and Lil @ bentulett01. Back on the roads where it all started for me too 🇮🇹 # bellaitalia # coppiebartali pic.twitter.com/huBe31OKp1
Like many teams, the UK squad is seeing its fair share of COVID cases, sicknesses, crashes, illnesses and other setbacks.
Top stars Pidcock, Thomas, Carapaz, Tao Geoghegan Hart, Porte, and Michal Kwiatkowski have all been ill of late and been forced out of races.
Adam Yates, second at the UAE Tour and fourth at Paris-Nice, has so far avoided the worse of the latest waves of illnesses and is slated to lead at Itzulia Basque Country. The Ardennes, Tour of the Alps and Tour de Romandie also loom, where the team hopes to hit some big results.
Even with Bernal in rehab, team brass is insisting it’ s not changing its GC lineup going into the Giro and Tour. Yates, Martínez and Thomas are pencilled in for the Tour, with Carapaz, Porte and Geoghegan Hart heading to the Giro.
Carapaz is set to lead at the Giro, where he returns as a former winner from 2019.
“ We didn’ t have luck with some of our leaders having to go home, but we are fulfilling the objectives of the team, and we got a good result here, ” Carapaz said in Spain. “ We hope that things keep going in this direction. ”
Ineos Grenadiers is hoping the worst of the health issues are behind the team just in time for its familiar stomping ground in the grand tours.
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Prevalence, progress, and subgroup disparities in pharmacological antidepressant treatment of those who screen positive for depressive symptoms: A repetitive cross-sectional study in 19 European countries - The Lancet Regional Health – Europe | BackgroundThe European Mental Health Action Plan ( EMHAP) 2013–2020 promoted community-based mental health services. One potential success indicator is the provision of antidepressant medication to those needing it.MethodsPublic data from two surveys ( Health Survey for England, UK; Survey of Health, Ageing and Retirement in Europe) covered 19 European countries across EMHAP phases one ( 2011–2015) and two ( 2015–2018). People screening positive for depressive symptoms by self-report were included. The primary outcome was antidepressant use: using country-specific weighted regression models, we estimated temporal trends and subgroup disparities in antidepressant receipt, with secondary analysis by country-level measures including healthcare expenditure.FindingsAcross 37,250 participants, after controlling for age, sex, wealth, and physical disability, antidepressant use ( amongst those screening positive) increased significantly in 14/19 countries, with the smallest increase being in Slovenia ( adjusted OR [ AOR ] for trend=1.68 [ 1.20–2.36 ]) and the highest increase being in Germany ( AOR for trend=10.07 [ 7.54–13.46 ]) and Austria ( AOR for trend=10.07 [ 7.32–13.74 ]). The overall proportion using antidepressants was positively associated with national health expenditure ( coefficient=5.43 [ 1.62–9.25 ]), but not with gross national income per capita or the number of psychiatrists, general practitioners, or psychiatric hospital beds. In 15/19 countries, antidepressants were used less by ≥65-year-olds than 50–64-year-olds, with the smallest differential reported in Luxembourg ( AOR=0.70 [ 0.49, 0.98 ]) and the highest in Germany ( AOR=0.28 [ 0.21, 0.37 ]); this disparity widened in 12/15 countries. Men used antidepressants less than women in 8/19 countries, across phases. In 13/19 countries, people with physical disability were more likely to receive antidepressants, with the smallest gap in Italy ( AOR=1.42 [ 1.12–1.80 ]) and the largest in Israel ( AOR=2.34 [ 1.46–3.74 ]); this disparity narrowed in 5/13 countries. Disparity by wealth was found in 8/19 countries, but its temporal trend varied.InterpretationUsage of antidepressants by those with depressive symptoms has increased, with wide variation between countries and subgroups. Disparities across age, sex, and disability should prompt further research.FundingMedical Research Council ( grants MC PC 17213 and MR/W014386/1), UK National Institute for Health Research ( NIHR) Applied Research Collaboration ( ARC) East of England, NIHR Cambridge Biomedical Research Centre ( BRC-1215-20014).
The European Mental Health Action Plan ( EMHAP) 2013–2020 promoted community-based mental health services. One potential success indicator is the provision of antidepressant medication to those needing it.
Public data from two surveys ( Health Survey for England, UK; Survey of Health, Ageing and Retirement in Europe) covered 19 European countries across EMHAP phases one ( 2011–2015) and two ( 2015–2018). People screening positive for depressive symptoms by self-report were included. The primary outcome was antidepressant use: using country-specific weighted regression models, we estimated temporal trends and subgroup disparities in antidepressant receipt, with secondary analysis by country-level measures including healthcare expenditure.
Across 37,250 participants, after controlling for age, sex, wealth, and physical disability, antidepressant use ( amongst those screening positive) increased significantly in 14/19 countries, with the smallest increase being in Slovenia ( adjusted OR [ AOR ] for trend=1.68 [ 1.20–2.36 ]) and the highest increase being in Germany ( AOR for trend=10.07 [ 7.54–13.46 ]) and Austria ( AOR for trend=10.07 [ 7.32–13.74 ]). The overall proportion using antidepressants was positively associated with national health expenditure ( coefficient=5.43 [ 1.62–9.25 ]), but not with gross national income per capita or the number of psychiatrists, general practitioners, or psychiatric hospital beds. In 15/19 countries, antidepressants were used less by ≥65-year-olds than 50–64-year-olds, with the smallest differential reported in Luxembourg ( AOR=0.70 [ 0.49, 0.98 ]) and the highest in Germany ( AOR=0.28 [ 0.21, 0.37 ]); this disparity widened in 12/15 countries. Men used antidepressants less than women in 8/19 countries, across phases. In 13/19 countries, people with physical disability were more likely to receive antidepressants, with the smallest gap in Italy ( AOR=1.42 [ 1.12–1.80 ]) and the largest in Israel ( AOR=2.34 [ 1.46–3.74 ]); this disparity narrowed in 5/13 countries. Disparity by wealth was found in 8/19 countries, but its temporal trend varied.
Usage of antidepressants by those with depressive symptoms has increased, with wide variation between countries and subgroups. Disparities across age, sex, and disability should prompt further research.
Medical Research Council ( grants MC PC 17213 and MR/W014386/1), UK National Institute for Health Research ( NIHR) Applied Research Collaboration ( ARC) East of England, NIHR Cambridge Biomedical Research Centre ( BRC-1215-20014).
Research in context Evidence before this studyWe conducted a literature search in PubMed and Web of Science for papers published before 10 September 2021, using the terms ‘ ( “ depression ” OR “ depressive ”) AND ( “ antidepressant ” OR “ medicine ” OR “ drug ”)’. The search terms were restricted to title and abstract. There were no language restrictions. Mental disorders are one of the top public health challenges in the World Health Organization ( WHO) European Region, affecting about 25% of the population in a lifetime. Concerted efforts were adopted by European countries to enable community-based mental health services to be accessible to all groups in the population. Some studies have evaluated antidepressant usage among European countries before the European Mental Health Action Plan ( EMHAP, 2013–2020), finding an increasing trend during 2007–2011, with women and the elderly having the highest usage of antidepressants. In addition, between-country variability in antidepressant consumption was found to be correlated with pharmaceutical expenditure, number of general practitioners, healthcare spending, and public attitudes towards mental illness. 2020 marked the end of the EMHAP, but no subsequent study has examined changes in treatment and what is still to be achieved. Added value of this studyThis is the first study to assess usage of antidepressants by those who screen positive for depressive symptoms following the end of the EMHAP. Using repetitive cross-sectional population-based datasets covering 19 countries ( with participants aged 50+ for 18 countries and 13+ for one country), we found significant increases in usage of antidepressants by people screening positive for depressive symptoms. Among those screening positive, the mean percentage receiving antidepressants increased from 24.5% to 38.7% from the first phase ( 2011–2015) to the second ( 2015–2018). There was wide variation between countries, with the lowest prescription rate in Estonia ( 13.5%) and highest prescription rate in Austria ( 81.3%) during the second phase. Salient subgroup disparities were found for sex, age ( ≥65 versus 50–64), and physical disability. Across phases, the age disparity widened, the sex disparity persisted, and the physical disability disparity narrowed. Disparity by wealth status was inconsistent and variable. We also examined antidepressant receipt in relation to five country-level measures of affordability and availability of resources, and found that the percentage receiving antidepressants was positively associated with national health expenditure, but not with measures of affordability/availability of resources. An increase in antidepressant usage was associated with a decrease in psychiatric inpatient beds, but not with changes in four other country-level factors. Implications of all the available evidenceOur findings suggest that characteristics other than clinical need influence access to, or usage of, antidepressants for those who screen positive for depressive symptoms. Non-pharmacological treatments of depression are also available, and this may represent an important factor in determining the observed differences in antidepressant use. Commissioners, practitioners, and policy makers could use our findings as one starting point to investigate and improve appropriate access to mental health treatments in their regions.
We conducted a literature search in PubMed and Web of Science for papers published before 10 September 2021, using the terms ‘ ( “ depression ” OR “ depressive ”) AND ( “ antidepressant ” OR “ medicine ” OR “ drug ”)’. The search terms were restricted to title and abstract. There were no language restrictions. Mental disorders are one of the top public health challenges in the World Health Organization ( WHO) European Region, affecting about 25% of the population in a lifetime. Concerted efforts were adopted by European countries to enable community-based mental health services to be accessible to all groups in the population. Some studies have evaluated antidepressant usage among European countries before the European Mental Health Action Plan ( EMHAP, 2013–2020), finding an increasing trend during 2007–2011, with women and the elderly having the highest usage of antidepressants. In addition, between-country variability in antidepressant consumption was found to be correlated with pharmaceutical expenditure, number of general practitioners, healthcare spending, and public attitudes towards mental illness. 2020 marked the end of the EMHAP, but no subsequent study has examined changes in treatment and what is still to be achieved.
This is the first study to assess usage of antidepressants by those who screen positive for depressive symptoms following the end of the EMHAP. Using repetitive cross-sectional population-based datasets covering 19 countries ( with participants aged 50+ for 18 countries and 13+ for one country), we found significant increases in usage of antidepressants by people screening positive for depressive symptoms. Among those screening positive, the mean percentage receiving antidepressants increased from 24.5% to 38.7% from the first phase ( 2011–2015) to the second ( 2015–2018). There was wide variation between countries, with the lowest prescription rate in Estonia ( 13.5%) and highest prescription rate in Austria ( 81.3%) during the second phase. Salient subgroup disparities were found for sex, age ( ≥65 versus 50–64), and physical disability. Across phases, the age disparity widened, the sex disparity persisted, and the physical disability disparity narrowed. Disparity by wealth status was inconsistent and variable. We also examined antidepressant receipt in relation to five country-level measures of affordability and availability of resources, and found that the percentage receiving antidepressants was positively associated with national health expenditure, but not with measures of affordability/availability of resources. An increase in antidepressant usage was associated with a decrease in psychiatric inpatient beds, but not with changes in four other country-level factors.
Our findings suggest that characteristics other than clinical need influence access to, or usage of, antidepressants for those who screen positive for depressive symptoms. Non-pharmacological treatments of depression are also available, and this may represent an important factor in determining the observed differences in antidepressant use. Commissioners, practitioners, and policy makers could use our findings as one starting point to investigate and improve appropriate access to mental health treatments in their regions.
Mental disorders are one of the top public health challenges in the World Health Organization ( WHO) European Region, affecting about 25% of the population in a lifetime.1World Health OrganizationThe European Mental Health Action Plan 2013–2020. 17. World Health Organization, 2015Google Scholar One of the aims of the WHO's European Mental Health Action Plan ( EMHAP) 2013–2020 was to enable community-based mental health services to be accessible to all groups in the population.1World Health OrganizationThe European Mental Health Action Plan 2013–2020. 17. World Health Organization, 2015Google Scholar Following the end of this plan, timely evaluation is required to measure changes and establish where action is still needed.
Access to pharmacological treatment for mental disorder is a significant part of community-based mental health services.2World Health OrganizationMental Health Action Plan 2013-2020. World Health Organization, 2013Google Scholar For instance, antidepressants are effective in around 60–70% of individuals with moderate to severe depression, and can be prescribed by non-specialist health professionals ( e.g. general practitioners) with training.3World Health OrganizationImproving Access to and Appropriate Use of Medicines for Mental Disorders. World Health Organization, 2017Google Scholar Psychopharmacological medicines are part of the WHO List of Essential Medicines; their availability and accessibility is a core mental health indicator for a health system.3World Health OrganizationImproving Access to and Appropriate Use of Medicines for Mental Disorders. World Health Organization, 2017Google Scholar
Some studies had evaluated antidepressant usage among European countries before the EMHAP, finding an increasing trend during 2007–2011, with women and the elderly having the highest levels of antidepressant use.4Lewer D. O'Reilly C. Mojtabai R. Evans-Lacko S. Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors.Br J Psychiatry. 2015; 207 (: the journal of mental science): 221-226Google Scholar,5Gomez-Lumbreras A. Ferrer P. Ballarin E. et al.Study of antidepressant use in 5 European settings. Could economic, sociodemographic and cultural determinants be related to their use?.J Affect Disord. 2019; 249: 278-285Google Scholar In addition, between-country variability in antidepressant consumption was found to be correlated with pharmaceutical expenditure, number of general practitioners, healthcare spending, and public attitudes towards mental illness.4Lewer D. O'Reilly C. Mojtabai R. Evans-Lacko S. Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors.Br J Psychiatry. 2015; 207 (: the journal of mental science): 221-226Google Scholar,5Gomez-Lumbreras A. Ferrer P. Ballarin E. et al.Study of antidepressant use in 5 European settings. Could economic, sociodemographic and cultural determinants be related to their use?.J Affect Disord. 2019; 249: 278-285Google Scholar However, to our knowledge, no corresponding study has followed the completion of the EMHAP.
Our primary aim was to evaluate temporal trends in pharmacological treatment of individuals who screened positive for depressive symptoms in 19 European countries ( a subset of member states of the WHO Regional Office for Europe) after the EMHAP, by age, sex, wealth status, and physical disability. The second aim was to examine the percentage receiving antidepressants in relation to five country-level measures of affordability and availability of healthcare resources.
We used publicly available data from two surveys: the Health Survey for England ( HSE) in the UK,6Morris S. Earl K. Neave A. Health Survey for England 2016: Well-being and Mental Health. Health and Social Care Information Centre, London2017Google Scholar and the Survey of Health, Ageing and Retirement in Europe ( SHARE) for another 18 countries.7Aichberger M.C. Schouler-Ocak M. Mundt A. et al.Depression in middle-aged and older first generation migrants in Europe: results from the Survey of Health, Ageing and Retirement in Europe ( SHARE).Eur Psychiatry. 2010; 25 (: the journal of the Association of European Psychiatrists): 468-475Google Scholar In brief, the HSE is an annual population-based survey of people aged 13 or over in England, UK, which uses stratified multistage probability sampling to produce nationally representative estimates of the English population. SHARE is a biennial multi-nationally representative individual survey of people aged 50 or over, with centrally standardized methods across its participating countries for the explicit purpose of cross-country comparison. SHARE participants are sampled based on probability selection methods; sample frames ( mostly population registers) are chosen in accordance with the best available frame resources in the country to achieve full probability sampling, though there are small variations in sampling frames.7Aichberger M.C. Schouler-Ocak M. Mundt A. et al.Depression in middle-aged and older first generation migrants in Europe: results from the Survey of Health, Ageing and Retirement in Europe ( SHARE).Eur Psychiatry. 2010; 25 (: the journal of the Association of European Psychiatrists): 468-475Google Scholar,8Alcser K.H. Benson G. Börsch-Supan A. et al.The Survey of Health, Aging, and Retirement in Europe—Methodology. Mannheim Mannheim Research Institute for the Economics of Aging ( MEA, 2005Google Scholar In both surveys, participants were interviewed by trained personnel using computer-assisted interviewing.6Morris S. Earl K. Neave A. Health Survey for England 2016: Well-being and Mental Health. Health and Social Care Information Centre, London2017Google Scholar,7Aichberger M.C. Schouler-Ocak M. Mundt A. et al.Depression in middle-aged and older first generation migrants in Europe: results from the Survey of Health, Ageing and Retirement in Europe ( SHARE).Eur Psychiatry. 2010; 25 (: the journal of the Association of European Psychiatrists): 468-475Google Scholar Items included sociodemographic characteristics ( age, sex, and wealth status), activities of daily living ( ADL), a measure of depressive symptoms, and use of antidepressants. Differences between HSE and SHARE include: ( 1) a single country within a study ( HSE) versus multiple countries ( SHARE); ( 2) age range: HSE includes both adults ( 16+) and children ( 0–15) but only children aged 13+ are interviewed directly,9NatCen Social Research, University College London. Health Survey for England User Guide. London: NHS Digital, 2019.Google Scholar while the age range is 50+ in SHARE10Borsch-Supan A. Brandt M. Hunkler C. et al.Data resource profile: the survey of health, ageing and retirement in Europe ( SHARE).Int J Epidemiol. 2013; 42: 992-1001Google Scholar; ( 3) a sample of people in private residential addresses ( HSE) versus people in private residences ± people living in institutions ( SHARE, varying by country); ( 4) repeated resampling with facilities for further longitudinal linkage ( HSE) versus longitudinal re-interviewing plus sample refreshment ( SHARE); ( 5) interviewer visit then nurse visit ( HSE) versus interviewer only ( SHARE); ( 6) the measure of depressive symptoms used ( see below); ( 7) whether medication usage was recorded by a nurse ( HSE) or self-recalled by participants ( SHARE) ( see below); ( 8) the wealth measure ( see below).11Mindell J. Biddulph J.P. Hirani V. et al.Cohort profile: the health survey for England.Int J Epidemiol. 2012; 41: 1585-1593Google Scholar,12Bergmann M, Kneip T, De Luca G, Scherpenzeel A. Survey participation in the survey of health, ageing and retirement in Europe ( SHARE), Wave 1-7: SHARE ERIC, 2019.Google Scholar Detailed descriptions of HSE and SHARE, including the sampling methods, quality control procedures, and data collection, can be found elsewhere.10Borsch-Supan A. Brandt M. Hunkler C. et al.Data resource profile: the survey of health, ageing and retirement in Europe ( SHARE).Int J Epidemiol. 2013; 42: 992-1001Google Scholar,11Mindell J. Biddulph J.P. Hirani V. et al.Cohort profile: the health survey for England.Int J Epidemiol. 2012; 41: 1585-1593Google Scholar,13NatCen Social Research; University College London. Health survey for England 2018: methods, 2019.Google Scholar,14Survey of Health AaRiE. Release Guide 7.1.1 - SHARE, 2020.Google Scholar
The data collected by SHARE in each wave that was required for our analysis did not cover all countries and ages. We included the available data nearest to the relevant implementation times of the EMHAP. We excluded data collected by SHARE in 2020, in view of the unusual influence that the COVID-19 pandemic is likely to have had on both services and data collection.15Chen S. Jones P.B. Underwood B.R. et al.The early impact of COVID-19 on mental health and community physical health services and their patients ' mortality in Cambridgeshire and Peterborough, UK.J Psychiatr Res. 2020; 131: 244-254Google Scholar,16Chen S. She R. Qin P. et al.The medium-term impact of COVID-19 lockdown on referrals to secondary care mental health services: a controlled interrupted time series study.Front Psychiatry. 2020; 11585915Google Scholar We retrieved data from HSE and earlier versions of SHARE, covering 19 European countries, with a first ( or start) phase of 2011–2015 and a second ( or end) phase of 2015–2018.
Our analysis only included participants scoring above established clinical cut-offs for depressive symptoms. The instrument used by HSE was the 12-item General Health Questionnaire ( GHQ-12), which rates concentration, sleep loss, sense of contribution, decision-making capability, strain, overcoming difficulties, enjoyment/anhedonia, problem-facing, low mood, loss of confidence, worthlessness, and happiness,17Sanchez-Lopez Mdel P. Dresch V. The 12-item general health questionnaire ( GHQ-12): reliability, external validity and factor structure in the Spanish population.Psicothema. 2008; 20: 839-843Google Scholar via 12 questions each scored 0–1, with a cut-off point for ‘ caseness’ of 4/12.6Morris S. Earl K. Neave A. Health Survey for England 2016: Well-being and Mental Health. Health and Social Care Information Centre, London2017Google Scholar The instrument used by SHARE was the EURO-D scale, validated to measure depressive symptoms; this consists of 12 dichotomous items indicating the presence or absence of depressed mood, pessimism, death wish, guilt, irritability, tearfulness, fatigue, sleep disturbance, loss of interest, loss of appetite, reduced ability to concentrate, and loss of capacity to enjoy things over the preceding month, with a screening cut-off point of 4/12.7Aichberger M.C. Schouler-Ocak M. Mundt A. et al.Depression in middle-aged and older first generation migrants in Europe: results from the Survey of Health, Ageing and Retirement in Europe ( SHARE).Eur Psychiatry. 2010; 25 (: the journal of the Association of European Psychiatrists): 468-475Google Scholar We took these thresholds as reflecting screening positive for depressive symptoms, accepting the caveats and limitations that self-report scales entail, with both false positives and false negatives with respect to a diagnosis of depression.18Levis B. Benedetti A. Thombs B.D. Depression Screening Data ( DEPRESSD) CollaborationAccuracy of Patient Health Questionnaire-9 ( PHQ-9) for screening to detect major depression: individual participant data meta-analysis.BMJ Clin Res ed. 2019; 365: l1476Google Scholar
Further details, including a flowchart of population selection and lists of the countries included and the years covered in this study, are provided in the Supplementary Materials.
The data are publicly available. The use of secondary de-identified data made this study exempt from institutional review board review. Participants in the original studies gave informed consent and each study was approved by a relevant ethics body: for HSE, the London Medical Research Ethics Council and/or local Research Ethics Councils prior to each annual data collection cycle6Morris S. Earl K. Neave A. Health Survey for England 2016: Well-being and Mental Health. Health and Social Care Information Centre, London2017Google Scholar,9NatCen Social Research, University College London. Health Survey for England User Guide. London: NHS Digital, 2019.Google Scholar; for SHARE, the Ethics Council of the Max Planck Society plus ethics committees in participating countries.19Wolfrum R. Opinion of the ethics council of the max Planck society on the “ SHARE ” project. [ http: //www.share-project.org/fileadmin/pdf documentation/SHARE ethics approvals.pdf ] Accessed in 14 December 2021.Google Scholar
Utilization of antidepressants ( yes vs no), noted by a nurse in HSE based on the participants ' prescription records and the medications they were taking,6Morris S. Earl K. Neave A. Health Survey for England 2016: Well-being and Mental Health. Health and Social Care Information Centre, London2017Google Scholar or self-recalled by participants in SHARE.8Alcser K.H. Benson G. Börsch-Supan A. et al.The Survey of Health, Aging, and Retirement in Europe—Methodology. Mannheim Mannheim Research Institute for the Economics of Aging ( MEA, 2005Google Scholar In HSE, participants were asked if they were taking any medications prescribed for them by a doctor or nurse; if so, they were asked to show the medications to the assessing nurse, who classified them according to British National Formulary ( BNF) sections20National Institute for Health and Care ExcellenceBritish National Formulary ( BNF). National Institute for Health and Care Excellence, 2022https: //bnf.nice.org.uk/Google Scholar; the definition of “ antidepressant medications ” included tricyclic and related antidepressant drugs, monoamine oxidase inhibitors, selective serotonin re-uptake inhibitors, and other antidepressant drugs ( BNF section 4.3, “ antidepressant drugs ”).21Health and Social Care Information CentreHealth Survey for England 2016: Prescribed Medicines. Health and Social Care Information Centre, 2017http: //healthsurvey.hscic.gov.uk/media/63790/HSE2016-pres-med.pdfGoogle Scholar In SHARE, participants were asked to indicate whether they were taking “ drugs for anxiety or depression ”, “ at least once a week ”.8Alcser K.H. Benson G. Börsch-Supan A. et al.The Survey of Health, Aging, and Retirement in Europe—Methodology. Mannheim Mannheim Research Institute for the Economics of Aging ( MEA, 2005Google Scholar
The wealth measure in HSE was the 2015 UK Index of Multiple Deprivation ( IMD). The IMD, which is calculated for a small geographical area of residence ( a national census Lower Layer Super Output Area, mean population 1500), is the official measure of relative deprivation in England, and incorporates seven domains: income, employment, health and disability, education, barriers to housing and services, living environment and education, and crime.22Ministry of Housing CLGEnglish Indices of Deprivation 2015. Ministry of Housing CLG, 2015https: //www.gov.uk/government/statistics/english-indices-of-deprivation-2015Google Scholar ( A potential weakness of IMD is that individual household income may differ from the mean level of wealth/deprivation associated with this small geographical area; a potential strength is its multi-domain nature. HSE collects direct household income directly but the data are provided in categorical format prohibiting the calculation of quintiles.) The wealth measure in SHARE was self-reported gross total household income. Both were divided into five quintiles for analysis, with quintiles calculated within each country and across all survey participants ( including those not screening positive for depressive symptoms); we took the lowest quintile as the reference category.
Disability was assessed by six basic ADLs ( such as getting out of bed and walking across a room) and nine “ instrumental ” ADLs ( such as shopping for groceries and preparing a hot meal).23Steptoe A. Di Gessa G. Mental health and social interactions of older people with physical disabilities in England during the COVID-19 pandemic: a longitudinal cohort study.Lancet Public Health. 2021; 6: e365-ee73Google Scholar Participants who responded positively to one or more items ( indicating difficulty) were defined as having a physical disability.23Steptoe A. Di Gessa G. Mental health and social interactions of older people with physical disabilities in England during the COVID-19 pandemic: a longitudinal cohort study.Lancet Public Health. 2021; 6: e365-ee73Google Scholar
We extracted data on five measures of affordability and availability of resources for services from Eurostat, the statistical office run by the European Commission and the official provider of statistics at European level.24European Commission. https: //ec.europa.eu/eurostat/web/main. 2021. https: //ec.europa.eu/eurostat/web/main. Accessed 01 Jnue 2021.Google Scholar These were ( 1) gross national income per capita ( GNI, in US $ 1000), ( 2) public expenditure on health as a percentage of GDP, ( 3) psychiatrists per 100,000 inhabitants, ( 4) general practitioners ( GPs) per 100,000 inhabitants, and ( 5) psychiatric care beds in hospitals per 100,000 inhabitants ( being, along with the number of psychiatrists, a potential indirect measure of resources in community psychiatric care).
Data were analysed for each country separately. This makes within-country comparisons ( analyses of changes over time) robust to any between-country or between-survey differences between survey methods ( as summarized above), since survey methods were consistent for any given country over time. Repeated cross-sectional sampling is a standard method for measuring changes,25Rafferty A, Walthery P, King-Hele S. Analysing change over time: repeated cross sectional and longitudinal survey data. 2015.Google Scholar,26Heeringa S.G. West B.T. Berglund P.A. Applied Survey Data Analysis. Chapman and Hall/CRC, 2017Google Scholar including for the assessment of trends relating to depression based on screening tools.27Chobufo M.D. Khan S. Agbor V.N. et al.10-Year trend in the prevalence and predictors of depression among patients with heart failure in the USA from 2007-2016.Int J Cardiol. 2020; 301: 123-126Google Scholar Survey weighting was used to adjust for the complex survey design, including the unequal probability of selection, clustering, and stratification, to make estimates representative of each country. The weight values were provided directly in the HSE and SHARE datasets. Details of how the weights were calculated can be found elsewhere.13NatCen Social Research; University College London. Health survey for England 2018: methods, 2019.Google Scholar,14Survey of Health AaRiE. Release Guide 7.1.1 - SHARE, 2020.Google Scholar
To estimate temporal trends, we fitted country-specific weighted logistic regression models ( one model per country), with antidepressant receipt as the dependent variable and phase ( start phase [ reference ] vs. end phase) as the predictor, whilst controlling for age, sex, wealth status, and disability. To estimate subgroup disparity, we added the interaction term between the relevant subgroup variable and phase.
We explored further the association of the percentage receiving antidepressants with five country-level factors relating to the affordability and availability of health care resources. We used linear regression with the percentage receiving antidepressants as the outcome and these country-level factors as predictors. We also explored associations between the change in antidepressant use and changes in these measures during the period studied. If all countries used different methods, comparison of absolute values across countries would be impossible and comparison of changes would require the assumption that methodological differences did not affect rates of change across countries. However, cross-country comparison is fully supported by the standardized methods used by SHARE, though there are caveats with regard to HSE/SHARE ( UK/other country) cross-comparison ( discussed in detail later). Cross-country comparison using SHARE data is an established technique and several studies have addressed other cross-country questions in the domain of depressive symptoms using this data source.7Aichberger M.C. Schouler-Ocak M. Mundt A. et al.Depression in middle-aged and older first generation migrants in Europe: results from the Survey of Health, Ageing and Retirement in Europe ( SHARE).Eur Psychiatry. 2010; 25 (: the journal of the Association of European Psychiatrists): 468-475Google Scholar,28Castro-Costa E. Dewey M. Stewart R. et al.Ascertaining late-life depressive symptoms in Europe: an evaluation of the survey version of the EURO-D scale in 10 nations. The SHARE project.Int J Methods Psychiatr Res. 2008; 17: 12-29Google Scholar,29Ploubidis G.B. Grundy E. Later-life mental health in Europe: a country-level comparison.J Gerontol Ser B Psychol Sci Soc Sci. 2009; 64: 666-676Google Scholar
The data are complete except for the wealth variable, which had 615 ( 1.7%) records with missing values. For wealth, we imputed data by using multiple imputations with chained equations and generated five imputed data sets to reduce bias and maintain power.30van Buuren S. Groothuis-Oudshoorn K. Mice: multivariate imputation by chained equations in R.J Stat Softw. 2011; 45: 1-67Google Scholar
We used R version 3.6.0. We report two-tailed P values and 95% confidence intervals ( CIs) throughout. P <.05 was considered statistically significant. Results are reported following the STROBE checklist for cohort studies.
The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the article. The views expressed are those of the authors and not necessarily those of the NHS and the NIHR.
37,250 participants from 19 countries, who all screened positive for depressive symptoms, were included in this analysis ( 23,213 participants in the start phase, 2011–2015, and 14,037 participants in the end phase, 2015–2018). Table 1 shows demographics by country and study phase. Among these participants, 68.4% were female and 38.2% had a physical disability. People aged 65 or over accounted for 59.1%, followed by people aged 50–64 ( 36.7%). With respect to the wealth measure, 16.2% ( start phase) or 15.2% ( end phase) were in the most affluent quintile ( across all survey participants including those not screening positive for depressive symptoms), whilst 22.6% were in the least affluent quintile ( Table 1), evidence of a significantly higher prevalence of depressive symptoms amongst the less wealthy ( start phase: χ24 = 653.07, p < 2.2 × 10−16; end phase: χ24 = 509.61, p < 2.2 × 10−16).Table 1Demographic characteristics of included participants, who all screened positive for depressive symptoms, by country and study phase.CountryData periodPhaseNAge, n (%) Sex ( = female) Wealth status quintile, n (%) Physical disability ( = yes) 13–1920–2425–4950–6465+n (%) 1 ( Low) 2345 ( High) n (%) Austria2013–2017start936–––346 ( 37) 590 ( 63) 657 ( 70.2) 246 ( 26.3) 208 ( 22.2) 181 ( 19.3) 152 ( 16.2) 149 ( 15.9) 409 ( 43.7) end337–––89 ( 26.4) 248 ( 73.6) 239 ( 70.9) 95 ( 28.2) 66 ( 19.6) 76 ( 22.6) 53 ( 15.7) 47 ( 13.9) 174 ( 51.6) Belgium2013–2017start1832–––911 ( 49.7) 921 ( 50.3) 1222 ( 66.7) 444 ( 24.2) 380 ( 20.7) 376 ( 20.5) 342 ( 18.7) 290 ( 15.8) 766 ( 41.8) end915–––327 ( 35.7) 588 ( 64.3) 653 ( 71.4) 249 ( 27.2) 230 ( 25.1) 151 ( 16.5) 155 ( 16.9) 130 ( 14.2) 426 ( 46.6) Czech Republic2013–2017start1557–––637 ( 40.9) 920 ( 59.1) 1119 ( 71.9) 273 ( 17.5) 457 ( 29.4) 319 ( 20.5) 248 ( 15.9) 260 ( 16.7) 641 ( 41.2) end487–––107 ( 22) 380 ( 78) 374 ( 76.8) 52 ( 10.7) 189 ( 38.8) 109 ( 22.4) 76 ( 15.6) 61 ( 12.5) 254 ( 52.2) Denmark2013–2017start863–––466 ( 54) 397 ( 46) 577 ( 66.9) 224 ( 26) 181 ( 21) 175 ( 20.3) 167 ( 19.4) 116 ( 13.4) 297 ( 34.4) end358–––133 ( 37.2) 225 ( 62.8) 252 ( 70.4) 98 ( 27.4) 70 ( 19.6) 89 ( 24.9) 48 ( 13.4) 53 ( 14.8) 161 ( 45) Estonia2013–2015start2073–––682 ( 32.9) 1391 ( 67.1) 1430 ( 69) 361 ( 17.4) 655 ( 31.6) 487 ( 23.5) 273 ( 13.2) 297 ( 14.3) 943 ( 45.5) end1907–––654 ( 34.3) 1253 ( 65.7) 1347 ( 70.6) 329 ( 17.3) 601 ( 31.5) 444 ( 23.3) 292 ( 15.3) 241 ( 12.6) 828 ( 43.4) France2013–2017start1659–––673 ( 40.6) 986 ( 59.4) 1146 ( 69.1) 404 ( 24.4) 416 ( 25.1) 306 ( 18.4) 273 ( 16.5) 260 ( 15.7) 604 ( 36.4) end623–––165 ( 26.5) 458 ( 73.5) 457 ( 73.4) 178 ( 28.6) 117 ( 18.8) 124 ( 19.9) 101 ( 16.2) 103 ( 16.5) 261 ( 41.9) Germany2013–2017start1498–––834 ( 55.7) 664 ( 44.3) 984 ( 65.7) 365 ( 24.4) 368 ( 24.6) 240 ( 16) 265 ( 17.7) 260 ( 17.4) 492 ( 32.8) end387–––155 ( 40.1) 232 ( 59.9) 251 ( 64.9) 108 ( 27.9) 87 ( 22.5) 52 ( 13.4) 77 ( 19.9) 63 ( 16.3) 153 ( 39.5) Greece2015–2017start1566–––631 ( 40.3) 933 ( 59.7) 1067 ( 68.1) 337 ( 21.5) 354 ( 22.6) 286 ( 18.3) 278 ( 17.8) 311 ( 19.9) 601 ( 38.4) end528–––83 ( 15.7) 445 ( 84.3) 383 ( 72.5) 103 ( 19.5) 181 ( 34.3) 99 ( 18.8) 79 ( 15) 66 ( 12.5) 286 ( 54.2) Israel2013–2015start646–––180 ( 27.9) 466 ( 72.1) 415 ( 64.2) 182 ( 28.2) 169 ( 26.2) 116 ( 18) 97 ( 15) 82 ( 12.7) 369 ( 57.1) end584–––136 ( 23.3) 448 ( 76.7) 385 ( 65.9) 185 ( 31.7) 131 ( 22.4) 116 ( 19.9) 77 ( 13.2) 75 ( 12.8) 301 ( 51.5) Italy2013–2017start1732–––615 ( 35.5) 1116 ( 64.5) 1193 ( 68.9) 402 ( 23.2) 433 ( 25) 351 ( 20.3) 294 ( 17) 252 ( 14.5) 623 ( 36) end784–––147 ( 18.8) 637 ( 81.2) 531 ( 67.7) 209 ( 26.7) 190 ( 24.2) 147 ( 18.8) 109 ( 13.9) 129 ( 16.5) 330 ( 42.1) Luxembourg2013–2015start489–––274 ( 56) 215 ( 44) 307 ( 62.8) 108 ( 22.1) 127 ( 26) 96 ( 19.6) 80 ( 16.4) 78 ( 16) 172 ( 35.2) end489–––255 ( 52.1) 234 ( 47.9) 329 ( 67.3) 114 ( 23.3) 105 ( 21.5) 89 ( 18.2) 90 ( 18.4) 91 ( 18.6) 142 ( 29) Netherlands2013–2017start832–––418 ( 50.2) 414 ( 49.8) 553 ( 66.5) 209 ( 25.1) 199 ( 23.9) 129 ( 15.5) 154 ( 18.5) 141 ( 16.9) 289 ( 34.7) end893–––386 ( 43.2) 507 ( 56.8) 584 ( 65.4) 208 ( 23.3) 195 ( 21.8) 176 ( 19.7) 168 ( 18.8) 146 ( 16.3) 346 ( 38.7) Poland2015–2017start724–––289 ( 39.9) 435 ( 60.1) 479 ( 66.2) 124 ( 17.1) 235 ( 32.5) 133 ( 18.4) 95 ( 13.1) 137 ( 18.9) 284 ( 39.2) end691–––201 ( 29.1) 490 ( 70.9) 470 ( 68) 116 ( 16.8) 197 ( 28.5) 149 ( 21.6) 117 ( 16.9) 112 ( 16.2) 302 ( 43.7) Portugal2011–2015start863–––413 ( 47.9) 450 ( 52.1) 605 ( 70.1) 209 ( 24.2) 197 ( 22.8) 145 ( 16.8) 158 ( 18.3) 154 ( 17.8) 343 ( 39.7) end758–––286 ( 37.7) 472 ( 62.3) 528 ( 69.7) 160 ( 21.1) 185 ( 24.4) 159 ( 21) 132 ( 17.4) 122 ( 16.1) 337 ( 44.5) Slovenia2013–2015start750–––280 ( 37.3) 470 ( 62.7) 531 ( 70.8) 135 ( 18) 213 ( 28.4) 158 ( 21.1) 140 ( 18.7) 104 ( 13.9) 254 ( 33.9) end1077–––403 ( 37.4) 674 ( 62.6) 736 ( 68.3) 239 ( 22.2) 245 ( 22.7) 248 ( 23) 145 ( 13.5) 200 ( 18.6) 426 ( 39.6) Spain2013–2017start2089–––698 ( 33.4) 1391 ( 66.6) 1436 ( 68.7) 428 ( 20.5) 559 ( 26.8) 414 ( 19.8) 344 ( 16.5) 344 ( 16.5) 936 ( 44.8) end945–––180 ( 19) 765 ( 81) 685 ( 72.5) 168 ( 17.8) 268 ( 28.4) 214 ( 22.6) 141 ( 14.9) 154 ( 16.3) 472 ( 49.9) Sweden2013–2017start982–––374 ( 38.1) 608 ( 61.9) 669 ( 68.1) 266 ( 27.1) 208 ( 21.2) 202 ( 20.6) 137 ( 14) 169 ( 17.2) 284 ( 28.9) end371–––61 ( 16.4) 310 ( 83.6) 264 ( 71.2) 117 ( 31.5) 77 ( 20.8) 66 ( 17.8) 67 ( 18.1) 44 ( 11.9) 126 ( 34) Switzerland2013–2017start609–––269 ( 44.2) 340 ( 55.8) 417 ( 68.5) 134 ( 22) 132 ( 21.7) 131 ( 21.5) 106 ( 17.4) 106 ( 17.4) 175 ( 28.7) end238–––64 ( 26.9) 174 ( 73.1) 161 ( 67.6) 55 ( 23.1) 40 ( 16.8) 40 ( 16.8) 48 ( 20.2) 55 ( 23.1) 87 ( 36.6) UK2014–2018start151389 ( 5.9) 60 ( 4) 586 ( 38.7) 409 ( 27) 369 ( 24.4) 993 ( 65.6) 389 ( 25.7) 296 ( 19.6) 298 ( 19.7) 278 ( 18.4) 252 ( 16.7) 162 ( 10.7) end1665106 ( 6.4) 90 ( 5.4) 600 ( 36) 457 ( 27.4) 412 ( 24.7) 1066 ( 64) 383 ( 23) 386 ( 23.2) 346 ( 20.8) 307 ( 18.4) 243 ( 14.6) 161 ( 9.7) Totalstart2321389 ( 0.4) 60 ( 0.3) 586 ( 2.5) 9399 ( 40.5) 13076 ( 56.3) 15800 ( 68.1) 5240 ( 22.6) 5787 ( 24.9) 4543 ( 19.6) 3881 ( 16.7) 3762 ( 16.2) 8644 ( 37.2) end14037106 ( 0.8) 90 ( 0.6) 600 ( 4.3) 4289 ( 30.6) 8952 ( 63.8) 9695 ( 69.1) 3166 ( 22.6) 3560 ( 25.4) 2894 ( 20.6) 2282 ( 16.3) 2135 ( 15.2) 5573 ( 39.7) Categorical variables are reported as number ( percentage). Wealth quintiles are calculated with respect to all survey participants ( including those not screening positive for depressive symptoms). “ – ” means not applicable. Open table in a new tab
Categorical variables are reported as number ( percentage). Wealth quintiles are calculated with respect to all survey participants ( including those not screening positive for depressive symptoms). “ – ” means not applicable.
Among people who screened positive for depressive symptoms, the percentage receiving antidepressants varied substantially between countries, with the lowest prescription rate being in Estonia ( 13.5%, 95% CI [ 11.9%, 15.3% ]) and the highest prescription rate being in Austria ( 81.3% [ 76.5%, 85.4% ]) during 2015–2018 ( Figure 1). After controlling for age, sex, wealth, and disability, there was a statistically significant increase in the proportion receiving antidepressants in 14 of 19 countries, with the smallest increase being in Slovenia ( AOR for trend 1.68 [ 1.20, 2.36 ]) and the highest increase being in Germany ( AOR for trend 10.07 [ 7.54, 13.46 ]) and Austria ( AOR for trend 10.07 [ 7.32, 13.74 ]) ( Figure 1). The percentage receiving antidepressants decreased in the UK ( AOR for trend 0.78 [ 0.66, 0.92 ]), and did not change significantly in Israel, Luxembourg, the Netherlands, or Estonia ( Figure 1).Figure 1Percentage receiving antidepressants ( among those screening positive for depression) by phase. Odds ratios ( ORs) and their 95% confidence intervals ( CIs) were estimated from weighted logistic regression, with antidepressant receipt as the dependent variable and phase ( end, vs start [ reference ]) as the predictor. Adjusted ORs ( with 95% CIs) were estimated from the model controlling for age, sex, wealth status, and disability. OR > 1 indicates a higher likelihood of receiving antidepressants during the end phase compare to the start phase. * * * p < 0.001; * * p < 0.01; * p < 0.05;. p < 0.1.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Table 2 shows that an increase in public expenditure on health of 1% of GDP was significantly associated with a 5.43 [ 1.62, 9.25 ] per cent increase in antidepressant receipt, while the percentage receiving antidepressants was not associated with the other four country-level factors. Table 2 also shows that change ( across phases) in the percentage receiving antidepressants was negatively and significantly associated with the change in the number of psychiatric beds ( coefficient −2.22 [ −4.34, −0.11 ]) but not with the other four country-level factors.Table 2Associations between antidepressant receipt ( among those screening positive for depression) and national-level health system factors.National-level variablesAssociation with percentage receiving antidepressantsAssociation with change in the percentage receiving antidepressantsCoefficient ( 95% CI) pCoefficient ( 95% CI) pPsychiatrists per 100 000 inhabitants−1.27 ( −2.67, 0.12) 0.0720.97 ( −7.18, 9.12) 0.7997General practitioners per 100 000 inhabitants0.05 ( −0.18, 0.28) 0.6570.20 ( −0.89, 1.30) 0.6933Gross national income per capita ( 1000 US dollars) 0.26 ( −0.11, 0.64) 0.1653.60 ( −0.72, 7.93) 0.0946Public expenditure on health (% of GDP) 5.43 ( 1.62, 9.25) 0.0070.18 ( −25.20, 25.57) 0.9876Psychiatric hospital beds per 100 000 inhabitants−0.04 ( −0.22, 0.13) 0.626−2.22 ( −4.34, −0.11) 0.0411Phase ( end, vs start [ reference ]) 22.64 ( 12.02, 33.26) < 0.001––R20.5480.429 Open table in a new tab
Table 3 shows the age disparity in receiving antidepressants. Compared with people aged 50–64, people aged 65 or over had a lower likelihood of receiving antidepressants in 15 of 19 countries, with the smallest differential reported in Luxembourg ( AOR 0.70 [ 0.49, 0.98 ]) and the highest in Germany ( AOR 0.28 [ 0.21, 0.37 ]). This disparity widened further in 12 of 15 countries from 2011–2015 to 2015–2018 ( AORs for trend < 1, p < 0.05). Unlike other European countries, people aged 65 or over in the UK had a 35% higher likelihood of receiving antidepressants compared to 50–64 year olds ( AOR 1.35 [ 1.05, 1.73 ]). Data on younger people were only available in the UK, in which younger people ( especially those aged 13–19) were less likely to receive antidepressants during 2014–2018. They were 94% less likely to receive antidepressants than the reference group ( AOR 0.06 [ 0.03, 0.12 ]), with no change in this gap from 2014 to 2018 ( AOR for trend 3.74 [ 0.71, 19.69 ]). In contrast, we detected no age disparity in Israel, Netherlands, or Portugal.Table 3Percentage receiving antidepressants ( among those screening positive for depression) by phase and age.CountryAgeStart phaseEnd phaseAdjusted OR ( 95% CI) Adjusted OR for trend ( 95% CI) Austria50–6441.58 ( 35.2, 48.26) 96.02 ( 92.04, 98.05) ReferenceReference65+24.99 ( 21.31, 29.06) 67.92 ( 61.33, 73.86) 0.33 ( 0.24, 0.44) * * * 0.19 ( 0.08, 0.45) * * * Belgium50–6433.4 ( 29.39, 37.68) 86.2 ( 81.89, 89.61) ReferenceReference65+28.57 ( 25.69, 31.63) 51.01 ( 46.9, 55.1) 0.42 ( 0.35, 0.52) * * * 0.21 ( 0.14, 0.33) * * * Czech Republic50–6427.25 ( 19.69, 36.39) 88.89 ( 79.3, 94.35) ReferenceReference65+20.89 ( 17.77, 24.39) 61.7 ( 54.92, 68.05) 0.45 ( 0.31, 0.66) * * * 0.34 ( 0.15, 0.79) * Denmark50–6427.98 ( 23.89, 32.46) 66.36 ( 57.63, 74.1) ReferenceReference65+32.75 ( 28.17, 37.69) 37.57 ( 31.26, 44.34) 0.64 ( 0.49, 0.84) * * 0.24 ( 0.14, 0.41) * * * Estonia50–6415.14 ( 12.38, 18.38) 16.17 ( 13.28, 19.55) ReferenceReference65+10.41 ( 8.86, 12.19) 11.54 ( 9.81, 13.53) 0.55 ( 0.44, 0.69) * * * 1.06 ( 0.70, 1.62) France50–6425.39 ( 21.76, 29.41) 76.33 ( 69.28, 82.18) ReferenceReference65+24.12 ( 21.45, 27.01) 43.65 ( 39.08, 48.34) 0.51 ( 0.41, 0.64) * * * 0.26 ( 0.16, 0.42) * * * Germany50–6420.93 ( 18.08, 24.11) 87.7 ( 81.62, 91.97) ReferenceReference65+13.73 ( 11.11, 16.86) 40.6 ( 33.81, 47.77) 0.28 ( 0.21, 0.37) * * * 0.17 ( 0.09, 0.31) * * * Greece50–6418.85 ( 15.71, 22.45) 52.69 ( 39.88, 65.15) ReferenceReference65+18.82 ( 16.34, 21.58) 33.26 ( 28.9, 37.94) 0.64 ( 0.48, 0.85) * * 0.46 ( 0.25, 0.87) * Israel50–6427.87 ( 16.2, 43.58) 29.93 ( 14.56, 51.72) ReferenceReference65+36.01 ( 30.56, 41.85) 20.66 ( 16.64, 25.36) 0.82 ( 0.45, 1.49) 0.51 ( 0.18, 1.42) Italy50–6417.29 ( 13.59, 21.73) 71.13 ( 61.64, 79.06) ReferenceReference65+17.67 ( 15.27, 20.35) 33.08 ( 29.11, 37.32) 0.51 ( 0.38, 0.68) * * * 0.19 ( 0.11, 0.34) * * * Luxembourg50–6425.84 ( 20.72, 31.72) 26.53 ( 19.84, 34.5) ReferenceReference65+27.67 ( 21.66, 34.61) 19.6 ( 14.67, 25.69) 0.70 ( 0.49, 0.98) * 0.61 ( 0.32, 1.20) Netherlands50–6425.52 ( 17.23, 36.08) 24.09 ( 20.07, 28.63) ReferenceReference65+20.46 ( 16.53, 25.05) 20.91 ( 17.58, 24.68) 0.71 ( 0.41, 1.23) 1.08 ( 0.59, 1.97) Poland50–6415.44 ( 10.67, 21.82) 70.95 ( 63.76, 77.22) ReferenceReference65+18.98 ( 15.23, 23.41) 37.56 ( 32.98, 42.37) 0.59 ( 0.41, 0.83) * * 0.20 ( 0.11, 0.36) * * * Portugal50–6434.4 ( 24.52, 45.84) 45.12 ( 32.58, 58.3) ReferenceReference65+24.51 ( 16.8, 34.29) 43.29 ( 32.9, 54.31) 0.68 ( 0.41, 1.12) 1.57 ( 0.61, 3.97) Slovenia50–6415.35 ( 10.2, 22.45) 22.27 ( 17.65, 27.7) ReferenceReference65+10.92 ( 8.17, 14.44) 18.73 ( 15.67, 22.22) 0.63 ( 0.44, 0.89) * * 1.11 ( 0.58, 2.12) Spain50–6437.67 ( 30.04, 45.97) 87.16 ( 79.46, 92.25) ReferenceReference65+33.97 ( 30.33, 37.8) 48.53 ( 43.95, 53.13) 0.42 ( 0.31, 0.58) * * * 0.17 ( 0.08, 0.34) * * * Sweden50–6430.85 ( 25.64, 36.59) 93.24 ( 86.32, 96.79) ReferenceReference65+26.7 ( 23, 30.76) 47.92 ( 41.99, 53.91) 0.39 ( 0.29, 0.53) * * * 0.08 ( 0.04, 0.20) * * * Switzerland50–6428.25 ( 22.72, 34.52) 78.89 ( 67.69, 86.95) ReferenceReference65+22.52 ( 18.29, 27.4) 46.48 ( 38.95, 54.17) 0.47 ( 0.34, 0.66) * * * 0.32 ( 0.15, 0.67) * * UK13–191.93 ( 0.47, 7.62) 6.65 ( 3.09, 13.71) 0.06 ( 0.03, 0.12) * * * 3.74 ( 0.71, 19.69) 20–2414.81 ( 7.43, 27.34) 17.99 ( 11.1, 27.82) 0.23 ( 0.14, 0.38) * * * 2.05 ( 0.69, 6.05) 25–4932.25 ( 28.42, 36.34) 28.13 ( 24.42, 32.17) 0.53 ( 0.43, 0.64) * * * 1.02 ( 0.68, 1.54) 50–6447.82 ( 42.77, 52.9) 42.71 ( 38, 47.55) ReferenceReference65+50.8 ( 45.53, 56.04) 44.13 ( 39.31, 49.07) 1.35 ( 1.05, 1.73) * 0.94 ( 0.61, 1.46) Adjusted odds ratios ( ORs) and their 95% confidence intervals ( CIs) were estimated from weighted logistic regression, with antidepressant receipt as the dependent variable and age as the predictor, controlling for sex, phase, wealth status, and physical disability. Adjusted ORs for trends ( with 95% CIs) were estimated by adding an age × phase ( start [ reference ] vs end) term into the previous model and estimating from the interaction coefficient. * * * p < 0.001; * * p < 0.01; * p < p < 0.05;. p < 0.1. Open table in a new tab
Adjusted odds ratios ( ORs) and their 95% confidence intervals ( CIs) were estimated from weighted logistic regression, with antidepressant receipt as the dependent variable and age as the predictor, controlling for sex, phase, wealth status, and physical disability. Adjusted ORs for trends ( with 95% CIs) were estimated by adding an age × phase ( start [ reference ] vs end) term into the previous model and estimating from the interaction coefficient. * * * p < 0.001; * * p < 0.01; * p < p < 0.05;. p < 0.1.
Figure 2 shows the sex disparity in receipt of antidepressants. Men were less likely to receive antidepressants in 8 out of 19 countries, with the smallest gap being in Italy ( AOR 0.74 [ 0.58, 0.95 ]) and the highest in the Czech Republic ( AOR 0.42 [ 0.28, 0.61 ]). We detected no significant change in these disparities from 2011–2015 to 2015–2018 ( AOR for trend, p > 0.05). In Belgium, although there was no overall sex disparity in receiving antidepressants ( AOR 0.91 [ 0.75, 1.12 ]), over time, men became more likely to receive antidepressants ( AOR for trend 1.62 [ 1.07, 2.44 ]).Figure 2Percentage receiving antidepressants ( among those screening positive for depression) by phase and sex. Adjusted odds ratios ( ORs) and their 95% confidence intervals ( CIs) were estimated from weighted logistic regression, with antidepressant receipt as the dependent variable and sex ( female [ reference ] vs male) as the predictor, controlling for age, phase, wealth status, and physical disability. Adjusted ORs for trends ( with 95% CIs) were estimated by adding a sex × phase ( start [ reference ] vs end) term into the previous model and estimating from the interaction coefficient. * * * p < 0.001; * * p < 0.01; * p < 0.05;. p < 0.1.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Table 4 shows the relationship between wealth status and antidepressant receipt ( amongst those screening positive for depressive symptoms). In more than half of the countries, there was no wealth status effect, but there were some such effects in Austria, Belgium, Czech Republic, Denmark, Luxembourg, Slovenia, Spain, and Sweden. In Austria, Belgium, Denmark, Slovenia, Spain, and Sweden, some groups of more affluent people were less likely to receive antidepressants than those of the lowest wealth status. In Belgium, this wealth status disparity narrowed from 2013 to 2017, with richest people becoming more likely to receive antidepressants ( AOR for trend 2.14 [ 1.15, 3.97 ]). In Sweden, this wealth status disparity also narrowed from 2013 to 2017, with middle-to-high-income people ( AOR for trend 2.39 [ 1.01, 5.64 ]) and highest-income people ( AOR for trend 3.03 [ 1.22, 7.54 ]) becoming more likely to receive antidepressants. In the Czech Republic and Luxembourg, some groups of higher-income people were more likely to receive antidepressants than those of the lowest wealth status ( AORs > 1, p < 0.05), with no change in this wealth status disparity over time ( AOR for trend, p > 0.05).Table 4Percentage receiving antidepressants ( among those screening positive for depression) by phase and wealth status.CountryWealth status ( quintile) Start phaseEnd phaseAdjusted OR ( 95% CI) Adjusted OR for trend ( 95% CI) Austria1 ( low) 37.48 ( 30.43, 45.1) 82.8 ( 73.58, 89.27) ReferenceReference225.62 ( 19.08, 33.47) 69.27 ( 55.92, 80.02) 0.58 ( 0.37, 0.89) * 1.02 ( 0.42, 2.46) 327.82 ( 20.87, 36.03) 84.53 ( 74.74, 90.98) 0.83 ( 0.54, 1.25) 1.77 ( 0.73, 4.26) 429.35 ( 21.92, 38.07) 87.77 ( 75.98, 94.21) 0.82 ( 0.52, 1.27) 2.44 ( 0.88, 6.69).5 ( high) 39.24 ( 29.75, 49.62) 78.08 ( 60.85, 89.09) 1.04 ( 0.65, 1.68) 0.96 ( 0.34, 2.75) Belgium1 ( low) 36.25 ( 31.34, 41.46) 65.49 ( 58.99, 71.45) ReferenceReference229.07 ( 24.24, 34.42) 62.58 ( 54.2, 70.28) 0.77 ( 0.59, 1.01).1.15 ( 0.68, 1.95) 330.45 ( 25.23, 36.23) 62.74 ( 53.77, 70.91) 0.79 ( 0.60, 1.06) 1.13 ( 0.64, 1.99) 431.51 ( 25.63, 38.04) 62.8 ( 54.51, 70.4) 0.79 ( 0.59, 1.05) 1.16 ( 0.66, 2.05) 5 ( high) 25.36 ( 19.62, 32.11) 69.46 ( 60.52, 77.14) 0.70 ( 0.51, 0.94) * 2.14 ( 1.15, 3.97) * Czech Republic1 ( low) 16.99 ( 11.18, 24.97) 60.35 ( 41.13, 76.83) ReferenceReference222.98 ( 18.6, 28.04) 70.96 ( 61.92, 78.6) 1.52 ( 0.96, 2.44).0.94 ( 0.35, 2.56) 330.99 ( 18.91, 46.38) 62.51 ( 50.6, 73.08) 1.84 ( 0.98, 3.46).0.54 ( 0.17, 1.75) 428.68 ( 18.76, 41.18) 79.39 ( 57.64, 91.6) 1.86 ( 1.05, 3.25) * 0.84 ( 0.23, 3.00) 5 ( high) 18.74 ( 12.62, 26.89) 74.99 ( 58.88, 86.26) 1.34 ( 0.79, 2.27) 1.40 ( 0.42, 4.71) Denmark1 ( low) 34.94 ( 28.8, 41.63) 56.77 ( 46.38, 66.6) ReferenceReference232.21 ( 25.52, 39.71) 41.84 ( 30.21, 54.45) 0.71 ( 0.49, 1.02).0.61 ( 0.28, 1.32) 328.61 ( 22.24, 35.97) 38.02 ( 27.67, 49.58) 0.57 ( 0.39, 0.82) * * 0.63 ( 0.30, 1.32) 426.66 ( 20.25, 34.22) 60.7 ( 45.48, 74.09) 0.71 ( 0.49, 1.04).1.80 ( 0.77, 4.18) 5 ( high) 22.68 ( 15.65, 31.7) 40.5 ( 27.19, 55.38) 0.45 ( 0.29, 0.70) * * * 0.96 ( 0.39, 2.32) Estonia1 ( low) 14.18 ( 10.42, 19) 16.11 ( 12.16, 21.02) ReferenceReference210.87 ( 8.61, 13.65) 13.35 ( 10.62, 16.65) 0.87 ( 0.64, 1.20) 1.14 ( 0.62, 2.08) 310.07 ( 7.23, 13.85) 13.35 ( 10.12, 17.41) 0.85 ( 0.60, 1.20) 1.19 ( 0.60, 2.34) 414.91 ( 10.66, 20.47) 11.23 ( 7.9, 15.73) 0.88 ( 0.61, 1.27) 0.61 ( 0.30, 1.26) 5 ( high) 15.32 ( 11.54, 20.05) 12.56 ( 8.86, 17.52) 1.03 ( 0.73, 1.46) 0.70 ( 0.35, 1.42) France1 ( low) 24.74 ( 20.36, 29.71) 55.3 ( 47.22, 63.11) ReferenceReference223.05 ( 18.89, 27.8) 64.12 ( 54.38, 72.82) 1.09 ( 0.82, 1.45) 1.54 ( 0.83, 2.86) 325.34 ( 20.4, 31.01) 54.85 ( 45.14, 64.2) 1.03 ( 0.76, 1.40) 0.95 ( 0.51, 1.77) 425.64 ( 20.14, 32.04) 45.75 ( 35.28, 56.62) 0.88 ( 0.63, 1.22) 0.68 ( 0.35, 1.31) 5 ( high) 25.5 ( 20.11, 31.75) 50.73 ( 40.02, 61.37) 0.98 ( 0.70, 1.35) 0.78 ( 0.40, 1.51) Germany1 ( low) 17.92 ( 13.99, 22.66) 53.99 ( 43.3, 64.32) ReferenceReference217.7 ( 13.75, 22.48) 66.2 ( 54.24, 76.4) 1.21 ( 0.83, 1.75) 1.46 ( 0.68, 3.16) 316.16 ( 11.85, 21.64) 64.5 ( 49.19, 77.32) 1.11 ( 0.74, 1.65) 1.77 ( 0.74, 4.18) 417.22 ( 12.96, 22.51) 70.87 ( 58.81, 80.56) 1.26 ( 0.87, 1.84) 1.99 ( 0.92, 4.31).5 ( high) 16.91 ( 12.62, 22.29) 67.91 ( 53.75, 79.4) 1.15 ( 0.78, 1.72) 1.90 ( 0.81, 4.48) Greece1 ( low) 18.25 ( 14.39, 22.88) 33.9 ( 24.62, 44.63) ReferenceReference222.25 ( 17.82, 27.4) 39.29 ( 31.95, 47.15) 1.28 ( 0.92, 1.77) 0.94 ( 0.48, 1.86) 319.46 ( 15.08, 24.74) 33.43 ( 24.57, 43.64) 1.11 ( 0.77, 1.58) 0.90 ( 0.43, 1.93) 415.39 ( 11.39, 20.46) 36.96 ( 25.73, 49.81) 0.94 ( 0.64, 1.38) 1.45 ( 0.64, 3.32) 5 ( high) 18 ( 13.76, 23.2) 36.55 ( 23.58, 51.82) 1.05 ( 0.71, 1.54) 1.20 ( 0.50, 2.92) Israel1 ( low) 32.79 ( 18.72, 50.82) 18.62 ( 12.38, 27.04) ReferenceReference229.65 ( 20.8, 40.35) 40.04 ( 18.14, 66.82) 1.60 ( 0.74, 3.46) 3.25 ( 0.90, 11.70).340.57 ( 30.09, 52) 23.76 ( 14.28, 36.85) 1.60 ( 0.90, 2.80) 1.07 ( 0.35, 3.22) 426.96 ( 17.02, 39.93) 19.28 ( 11.05, 31.47) 0.90 ( 0.47, 1.73) 1.39 ( 0.40, 4.85) 5 ( high) 37.48 ( 25.21, 51.6) 15.15 ( 7.9, 27.11) 1.25 ( 0.66, 2.32) 0.52 ( 0.15, 1.80) Italy1 ( low) 15.6 ( 12.01, 20.02) 40.06 ( 32.19, 48.47) ReferenceReference218.25 ( 13.92, 23.57) 41.07 ( 32.37, 50.37) 1.19 ( 0.86, 1.65) 1.00 ( 0.52, 1.92) 320.56 ( 15.77, 26.35) 34.41 ( 26.3, 43.56) 1.15 ( 0.81, 1.62) 0.59 ( 0.31, 1.16) 415.52 ( 11.35, 20.86) 46.17 ( 33.19, 59.69) 1.06 ( 0.73, 1.55) 1.46 ( 0.67, 3.19) 5 ( high) 18.04 ( 13.22, 24.12) 52.03 ( 41.72, 62.16) 1.34 ( 0.94, 1.90) 1.55 ( 0.76, 3.13) Luxembourg1 ( low) 21.87 ( 14.77, 31.13) 18.14 ( 11.97, 26.53) ReferenceReference224.49 ( 17.32, 33.42) 28.41 ( 18.63, 40.74) 1.48 ( 0.90, 2.44) 1.60 ( 0.61, 4.22) 333.83 ( 24.29, 44.9) 28.27 ( 18.83, 40.12) 1.86 ( 1.14, 3.03) * 0.99 ( 0.37, 2.64) 420.62 ( 12.51, 32.06) 30.74 ( 18.79, 45.98) 1.52 ( 0.84, 2.75) 2.12 ( 0.71, 6.30) 5 ( high) 35.33 ( 24.57, 47.82) 12.34 ( 6.07, 23.45) 1.21 ( 0.70, 2.05) 0.32 ( 0.10, 1.00).Netherlands1 ( low) 24.18 ( 15.83, 35.1) 22.6 ( 17.38, 28.83) ReferenceReference226.98 ( 14.38, 44.84) 20 ( 14.93, 26.26) 1.08 ( 0.46, 2.53) 0.82 ( 0.31, 2.14) 317.2 ( 11.09, 25.72) 25 ( 19.11, 31.99) 0.68 ( 0.32, 1.43) 1.68 ( 0.69, 4.10) 424.03 ( 17.41, 32.17) 22.62 ( 16.87, 29.63) 1.01 ( 0.50, 2.01) 1.02 ( 0.44, 2.39) 5 ( high) 18.53 ( 12.22, 27.08) 21.23 ( 15.29, 28.71) 0.74 ( 0.36, 1.52) 1.35 ( 0.56, 3.25) Poland1 ( low) 20.66 ( 12.29, 32.61) 45.12 ( 34.87, 55.8) ReferenceReference215.41 ( 11.01, 21.15) 46.61 ( 39.18, 54.2) 0.79 ( 0.48, 1.31) 1.48 ( 0.61, 3.56) 317.91 ( 11.28, 27.25) 45.42 ( 36.5, 54.65) 0.93 ( 0.53, 1.65) 1.16 ( 0.44, 3.10) 413.69 ( 8.12, 22.17) 48.51 ( 38.55, 58.58) 0.80 ( 0.46, 1.39) 1.88 ( 0.68, 5.21) 5 ( high) 18.74 ( 12.2, 27.68) 56.59 ( 46.19, 66.45) 1.07 ( 0.61, 1.90) 1.67 ( 0.63, 4.35) Portugal1 ( low) 22.44 ( 14.32, 33.35) 42.22 ( 24.59, 62.1) ReferenceReference226.99 ( 14.72, 44.19) 29.11 ( 18.35, 42.87) 0.78 ( 0.38, 1.60) 0.47 ( 0.12, 1.82) 321.7 ( 11.21, 37.84) 50.69 ( 34.97, 66.28) 1.23 ( 0.61, 2.51) 1.38 ( 0.36, 5.37) 433.61 ( 19.08, 52.09) 46.17 ( 30.25, 62.9) 1.57 ( 0.75, 3.29) 0.77 ( 0.19, 3.06) 5 ( high) 37.93 ( 23.02, 55.53) 56.69 ( 35.66, 75.56) 2.05 ( 0.96, 4.44).0.84 ( 0.20, 3.56) Slovenia1 ( low) 19.7 ( 10.92, 32.94) 24.28 ( 18.17, 31.66) ReferenceReference210.9 ( 7.36, 15.86) 20.58 ( 15.38, 26.99) 0.67 ( 0.42, 1.06).1.51 ( 0.59, 3.82) 39.3 ( 5.31, 15.77) 17.23 ( 11.83, 24.4) 0.57 ( 0.34, 0.94) * 1.58 ( 0.54, 4.57) 49.62 ( 5.65, 15.91) 22.96 ( 16.17, 31.53) 0.68 ( 0.41, 1.13) 2.10 ( 0.74, 5.93) 5 ( high) 15.13 ( 8.59, 25.25) 16.97 ( 12.11, 23.26) 0.68 ( 0.41, 1.14) 0.84 ( 0.29, 2.41) Spain1 ( low) 38.18 ( 30.18, 46.89) 56.05 ( 46.44, 65.23) ReferenceReference229.98 ( 23.78, 37) 51.07 ( 42.22, 59.86) 0.67 ( 0.46, 0.97) * 1.22 ( 0.60, 2.46) 338.06 ( 29.59, 47.32) 67.9 ( 57.54, 76.76) 1.09 ( 0.73, 1.63) 1.67 ( 0.78, 3.53) 438.44 ( 28.23, 49.77) 49.76 ( 38.79, 60.76) 0.86 ( 0.54, 1.36) 0.83 ( 0.35, 1.93) 5 ( high) 34.42 ( 26.44, 43.39) 69.84 ( 57.55, 79.82) 1.06 ( 0.70, 1.60) 1.95 ( 0.88, 4.35) Sweden1 ( low) 34.16 ( 27.89, 41.04) 63.27 ( 52.02, 73.23) ReferenceReference225.65 ( 19.37, 33.13) 57.51 ( 43.88, 70.08) 0.73 ( 0.50, 1.08) 1.45 ( 0.66, 3.19) 328.23 ( 21.84, 35.65) 65.08 ( 49.6, 77.92) 0.82 ( 0.55, 1.21) 1.52 ( 0.66, 3.49) 423.17 ( 16.06, 32.22) 65.39 ( 50.1, 78.04) 0.61 ( 0.40, 0.93) * 2.39 ( 1.01, 5.64) * 5 ( high) 26.6 ( 19.47, 35.19) 73.53 ( 57.73, 84.96) 0.67 ( 0.44, 1.03).3.03 ( 1.22, 7.54) * Switzerland1 ( low) 26.68 ( 19.38, 35.51) 48.81 ( 34.61, 63.21) ReferenceReference223.58 ( 16.77, 32.08) 66.69 ( 49.13, 80.59) 1.15 ( 0.70, 1.88) 2.12 ( 0.74, 6.05) 325.29 ( 18.14, 34.09) 61.73 ( 44.23, 76.63) 1.09 ( 0.66, 1.82) 1.46 ( 0.50, 4.26) 428.64 ( 20.14, 38.98) 53.94 ( 37.2, 69.83) 1.12 ( 0.66, 1.88) 1.07 ( 0.38, 3.03) 5 ( high) 22.09 ( 14.65, 31.89) 66.55 ( 51.38, 78.93) 1.04 ( 0.63, 1.73) 2.29 ( 0.81, 6.42) UK1 ( low) 35.66 ( 30.46, 41.23) 32.41 ( 27.59, 37.63) ReferenceReference244.24 ( 37.48, 51.22) 32.53 ( 27.88, 37.56) 1.20 ( 0.93, 1.52) 0.75 ( 0.46, 1.23) 339.28 ( 32.94, 46.01) 31.34 ( 26.31, 36.85) 0.98 ( 0.76, 1.26) 0.81 ( 0.49, 1.35) 437.64 ( 31.13, 44.63) 37.12 ( 31.62, 42.98) 1.16 ( 0.90, 1.51) 1.02 ( 0.61, 1.72) 5 ( high) 34.51 ( 28.18, 41.45) 30.01 ( 24.45, 36.22) 0.90 ( 0.68, 1.17) 0.84 ( 0.49, 1.45) Adjusted odds ratios ( ORs) and their 95% confidence intervals ( CIs) were estimated from weighted logistic regression, with antidepressant receipt as the dependent variable and wealth status as the predictor, controlling for age, sex, phase, and physical disability. Adjusted ORs for trends ( with 95% CIs) were estimated by adding a wealth status × phase ( start [ reference ] vs end) term into the previous model and estimating from the interaction coefficient. * * * p < 0.001; * * p < 0.01; * p < 0.05;. p < 0.1. Open table in a new tab
Adjusted odds ratios ( ORs) and their 95% confidence intervals ( CIs) were estimated from weighted logistic regression, with antidepressant receipt as the dependent variable and wealth status as the predictor, controlling for age, sex, phase, and physical disability. Adjusted ORs for trends ( with 95% CIs) were estimated by adding a wealth status × phase ( start [ reference ] vs end) term into the previous model and estimating from the interaction coefficient. * * * p < 0.001; * * p < 0.01; * p < 0.05;. p < 0.1.
Figure 3 shows the disparity in receiving antidepressants with respect to physical disability. In 13 of 19 countries, people with physical disability were more likely to receive antidepressants compared to those with no such disability. The smallest gap was in Italy ( AOR 1.42 [ 1.12, 1.80 ]) and the largest gap was in Israel ( AOR 2.34 [ 1.46, 3.74 ]). This disability disparity narrowed in 5 of 13 countries from 2011–2015 to 2015–2018 ( AORs for trend < 1, p < 0.05). In the UK, after adjustment for age, phase, wealth status, and physical disability, in contrast to the unadjusted risk, people having physical disability were less likely to receive antidepressants than those without such disability ( AOR 0.61 [ 0.44, 0.84 ]), with no change in the size of the gap from 2014 to 2018.Figure 3Percentage receiving antidepressants ( among those screening positive for depression) by phase and disability. Adjusted odds ratios ( ORs) and their 95% confidence intervals ( CIs) were estimated from weighted logistic regression, with antidepressant receipt as the dependent variable and physical disability ( versus “ no physical disability ” as the reference) as the predictor, controlling for age, sex, phase, and wealth status. Adjusted ORs for trends ( with 95% CIs) were estimated by adding a physical disability × phase ( start [ reference ] vs end) term into the previous model and estimating from the interaction coefficient. * * * p < 0.001; * * p < 0.01; * p < 0.05;. p < 0.1.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Usage of antidepressants by those who screened positive for depressive symptoms increased greatly from 2011–2015 to 2015–2018, but the magnitude of change varied widely among the European countries studied. The percentage receiving antidepressants was positively associated with the health expenditure in a country, but not with affordability ( reflected by gross national income per capita) or availability of specific measured healthcare resources ( the number of psychiatrists, general practitioners, or psychiatric hospitals beds). Increased usage of antidepressants was associated with a decrease in psychiatric bed provision, but not with changes in the other four country-level factors. Salient subgroup disparities were detected for sex, age, and physical disability. From the first phase ( 2011–2015) to the second ( 2015–2018), the age disparity widened, the sex disparity persisted, and the physical disability disparity narrowed. Disparity by wealth status was relatively weak.
Increases in usage of antidepressants by those with depressive symptoms may reflect improvements in access, via a concerted effort by European countries to integrate mental health in primary care, including de-institutionalization and developing community-based care.31Barbato A, Vallarino M, Rapisarda F, Lora A, Almeida J. Access to mental health care in Europe. 2016. https: //ec.europa.eu/health/sites/default/files/mental health/docs/ev 20161006 co04 en.pdf.Google Scholar,32Gutierrez-Colosia M.R. Salvador-Carulla L. Salinas-Perez J.A. et al.Standard comparison of local mental health care systems in eight European countries.Epidemiol Psychiatr Sci. 2019; 28: 210-223Google Scholar Our findings are consistent with previous European studies on antidepressant use within long-term care facilities, and on hospitalization rates for mental disorders.4Lewer D. O'Reilly C. Mojtabai R. Evans-Lacko S. Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors.Br J Psychiatry. 2015; 207 (: the journal of mental science): 221-226Google Scholar,5Gomez-Lumbreras A. Ferrer P. Ballarin E. et al.Study of antidepressant use in 5 European settings. Could economic, sociodemographic and cultural determinants be related to their use?.J Affect Disord. 2019; 249: 278-285Google Scholar,33Borghini A. Seghieri C. Brodo L. Breschi M. Variations in use and access of mental health services in Europe.Eur J Public Health. 2020; 30 ( ckaa165. 1284) Google Scholar, 34Giovannini S. Onder G. van der Roest H.G. et al.Use of antidepressant medications among older adults in European long-term care facilities: a cross-sectional analysis from the SHELTER study.BMC Geriatr. 2020; 20: 310Google Scholar, 35Lukacisinova A. Fialova D. Peel N.M. et al.The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study.BMC Geriatr. 2021; 21: 277Google Scholar Our finding of the negative association between the change in the proportion with depressive symptoms receiving antidepressants and reductions in psychiatric hospital beds is also consistent with the influence of de-institutionalization. However, the changes observed were not consistently in line with the process of community-based care in the countries studied. For instance, results varied between countries considered to have well established and strong community-oriented delivery systems, such as the UK, Italy, Spain, Austria, and France.32Gutierrez-Colosia M.R. Salvador-Carulla L. Salinas-Perez J.A. et al.Standard comparison of local mental health care systems in eight European countries.Epidemiol Psychiatr Sci. 2019; 28: 210-223Google Scholar Our country-level analyses ( Table 2) provide more detail on this variation, showing that the percentage receiving antidepressants was associated with overall health expenditure in a country, but not with GNI or specific mental health care resource measures ( general practitioners, psychiatrists, psychiatric beds). Furthermore, the progress made by countries was negatively associated with the changes in psychiatric beds, but not other country-level measures. Possible explanations include that financed public campaigns to inform the population about depression and to educate frontline professionals may have reduced stigma and encouraged people to seek help for depression.4Lewer D. O'Reilly C. Mojtabai R. Evans-Lacko S. Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors.Br J Psychiatry. 2015; 207 (: the journal of mental science): 221-226Google Scholar,31Barbato A, Vallarino M, Rapisarda F, Lora A, Almeida J. Access to mental health care in Europe. 2016. https: //ec.europa.eu/health/sites/default/files/mental health/docs/ev 20161006 co04 en.pdf.Google Scholar Compared to additional financial input, reconfiguration of existing services could also have increased access to, or use of, antidepressants. In addition, country-specific actions, such as clinical guidelines, may also affect prescription practice.34Giovannini S. Onder G. van der Roest H.G. et al.Use of antidepressant medications among older adults in European long-term care facilities: a cross-sectional analysis from the SHELTER study.BMC Geriatr. 2020; 20: 310Google Scholar, 35Lukacisinova A. Fialova D. Peel N.M. et al.The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study.BMC Geriatr. 2021; 21: 277Google Scholar, 36Rat C. Penhouet G. Gaultier A. et al.Did the new French pay-for-performance system modify benzodiazepine prescribing practices?.BMC Health Serv Res. 2014; 14: 301Google Scholar For instance, the UK Improving Access to Psychological Therapies ( IAPT) programme emphasizes psychological treatment ( i.e. a non-pharmacological approach),37Chen S. Cardinal R.N. Accessibility and efficiency of mental health services, United Kingdom of Great Britain and Northern Ireland.Bull World Health Organ. 2021; 99: 674-679Google Scholar and could explain why the percentage receiving antidepressants ( among those screening positive for depressive symptoms) decreased in the UK.
The results for 2015–2018 ( Figure 1) also indicate variable usage of antidepressants, ranging from Austria ( approximately 20%) to Estonia ( more than 85%), compared to the mean of 38.7%. Patient preference, local clinical practice, under-accessibility, and potentially over-prescription of antidepressants might all contribute,5Gomez-Lumbreras A. Ferrer P. Ballarin E. et al.Study of antidepressant use in 5 European settings. Could economic, sociodemographic and cultural determinants be related to their use?.J Affect Disord. 2019; 249: 278-285Google Scholar,38MARÍA ÁLVAREZ DEL VAYO, ÁNGELA BERNARDO, TORRECILLAS C. Antidepressant use in Europe continues to break records. 2021. https: //civio.es/medicamentalia/2021/04/30/antidepressant-use-in-europe-continues-to-break-records/. Accessed 28 June 2021.Google Scholar as might differences in national policies or interventions. In addition, there is evidence that promotion by the pharmaceutical industry is positively associated with antidepressant prescription.39Hansen R.A. Chen S.Y. Gaynes B.N. Maciejewski M.L. Relationship of pharmaceutical promotion to antidepressant switching and adherence: a retrospective cohort study.Psychiatr Serv. 2010; 61 ( Washington, DC): 1232-1238Google Scholar Variations in this effect ( which might be affected by a variety of factors such as limitations on promotional activities, promotional budgets, type of relationships with prescribers, and professional training) might explain some part of the cross-national differences in temporal trends; however, we did not have data enabling us to measure any such effect in our study. Systematic study of these variations in practice, including economic evaluations, could enhance practice and clinical outcomes in Europe and beyond.
The high rates of antidepressant use and large increases in some countries studied are comparable to the USA ( 69.4% in 2015, increased from 52.1% in 1996),40Luo Y. Kataoka Y. Ostinelli E.G. Cipriani A. Furukawa T.A. National prescription patterns of antidepressants in the treatment of adults with major depression in the US between 1996 and 2015: a population representative survey based analysis.Front Psychiatry. 2020; 11: 35Google Scholar but there are reasons for caution. People included in the present study had screened positive for depressive symptoms but that does not necessarily reflect a clinical diagnosis of a depressive disorder ( self-report scales are imprecise with respect to formal diagnosis18Levis B. Benedetti A. Thombs B.D. Depression Screening Data ( DEPRESSD) CollaborationAccuracy of Patient Health Questionnaire-9 ( PHQ-9) for screening to detect major depression: individual participant data meta-analysis.BMJ Clin Res ed. 2019; 365: l1476Google Scholar), or its severity if present. Use of antidepressants may have been inappropriate for those screening positive but without the disorder. Those who did have depression might have been treated appropriately with psychological therapy alone, declined antidepressants, or stopped antidepressant treatment following improvement or because of side effects. Therefore, high prevalence, or increases in, antidepressant usage ( and thus prescription) in a given country does not necessarily imply better management. Potential alternative reasons for this trend include over-prescription and a use of antidepressants instead of an appropriate non-pharmacological therapy.
People aged 65 or over were less likely to be prescribed antidepressants than people aged 50–64 in 15 of 19 European countries studied, a finding consistent with previous studies showing a decrease in antidepressant usage with age, or highest usage in middle-aged populations.34Giovannini S. Onder G. van der Roest H.G. et al.Use of antidepressant medications among older adults in European long-term care facilities: a cross-sectional analysis from the SHELTER study.BMC Geriatr. 2020; 20: 310Google Scholar,35Lukacisinova A. Fialova D. Peel N.M. et al.The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study.BMC Geriatr. 2021; 21: 277Google Scholar,41Karkare S.U. Bhattacharjee S. Kamble P. Aparasu R. Prevalence and predictors of antidepressant prescribing in nursing home residents in the United States.Am J Geriatr Pharmacother. 2011; 9: 109-119Google Scholar Older populations are more likely to present with multiple diseases resulting in polypharmacy, and are more likely to suffer cognitive and functional impairment. Physicians may, as a result, be reluctant to prescribe antidepressant medications to avoid potential adverse drug–drug reactions, or may prefer psychological therapies because of the suboptimal effectiveness of antidepressant medications among frail individuals with cognitive and functional impairment42Brown M.N. Lapane K.L. Luisi A.F. The management of depression in older nursing home residents.J Am Geriatr Soc. 2002; 50: 69-76Google Scholar, 43Coupland C. Dhiman P. Morriss R. Arthur A. Barton G. Hippisley-Cox J. Antidepressant use and risk of adverse outcomes in older people: population based cohort study.BMJ Clin Res ed. 2011; 343: d4551Google Scholar, 44Estrela M. Herdeiro M.T. Ferreira P.L. Roque F. The use of antidepressants, anxiolytics, sedatives and hypnotics in Europe: focusing on mental health care in Portugal and prescribing in older patients.Int J Environ Res Public Health. 2020; 17Google Scholar; patient preference in considering of benefits and adverse effects of antidepressant use versus psychological therapies may also contribute.45Winter S.E. Barber J.P. Should treatment for depression be based more on patient preference?.Patient Prefer Adherence. 2013; 7: 1047-1057Google Scholar,46Cartwright C. Gibson K. Read J. Cowan O. Dehar T. Long-term antidepressant use: patient perspectives of benefits and adverse effects.Patient Prefer Adherence. 2016; 10: 1401-1407Google Scholar Alternatively, these findings could also indicate inappropriate under-prescription of antidepressants to the older population, as suggested by findings from Germany ( using data from 2008 to 2010) and the United States ( using data from 2004 to 2005).47Boehlen F.H. Freigofas J. Herzog W. et al.Evidence for underuse and overuse of antidepressants in older adults: results of a large population-based study.Int J Geriatr Psychiatry. 2019; 34: 539-547Google Scholar,48Hanlon J.T. Wang X. Castle N.G. et al.Potential underuse, overuse, and inappropriate use of antidepressants in older veteran nursing home residents.J Am Geriatr Soc. 2011; 59: 1412-1420Google Scholar An updated study is needed, as our findings suggest that the age disparity in access to antidepressants has widened from 2011–2015 to 2015–2018—particularly as the underuse of antidepressants for depressive disorders is associated with increased disability, worsening of clinical outcomes and increased mortality.49Alexopoulos G.S. Depression in the elderly.Lancet. 2005; 365: 1961-1970Google Scholar A further reason for the increase in age disparity might be population/sample aging ( e.g. if the average age of people in the ≥65-year-old group was higher during 2015–2018 than 2011–2015). In contrast to other European countries, people aged 65 or over in the UK were more likely to be prescribed antidepressants than people aged 50–64. Prior work has also suggested over-prescription of antidepressants for older people, identified in England and Wales using data from 1993 to 1997.50Shah R. Uren Z. Baker A. Majeed A. Deaths from antidepressants in England and Wales 1993-1997: analysis of a new national database.Psychol Med. 2001; 31: 1203-1210Google Scholar
Some large-scale studies have found that the peak onset for depression is from the late teens to about 20 years old51Pedersen C.B. Mors O. Bertelsen A. et al.A comprehensive nationwide study of the incidence rate and lifetime risk for treated mental disorders.JAMA Psychiatry. 2014; 71: 573-581Google Scholar ( though estimates have varied52Kessler R.C. Berglund P. Demler O. Jin R. Merikangas K.R. Walters E.E. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication.Arch Gen Psychiatry. 2005; 62: 593-602Google Scholar). We found that UK people aged 13–19 were 94% less likely to receive antidepressants, followed by people aged 20–24 ( 77%), than people aged 50–64. Given evidence from data gathered at a similar time of increasing prevalence of depression among young people in the UK, we should be concerned about under-prescription.53Sadler K, Vizard T, Ford T, Goodman A, Goodman R, McManus S. Mental health of children and young people in England, 2017: trends and characteristics. 2018.Google Scholar,54McManus S. Gunnell D. Cooper C. et al.Prevalence of non-suicidal self-harm and service contact in England, 2000-14: repeated cross-sectional surveys of the general population.Lancet Psychiatry. 2019; 6: 573-581Google Scholar However, UK clinical guidelines advise psychological therapies as the first-line treatment, unless depression is severe, for those under 18 years old.55Luxton R. Kyriakopoulos M. Depression in children and young people: identification and management NICE guidelines.Arch Dis Childh Educ Pract Ed. 2021; Google Scholar There is a great deal of media and policy attention to mental health in young people, a mental health workforce shortage, and consequent referral pressures impeding access to child and adolescent mental health services.56Digital NHS. NHS workforce statistics. 2019. https: //digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics. Accessed 25 June 2021.Google Scholar We lacked data on younger age groups from other European countries, but access to child and adolescent mental health services is also sometimes suboptimal in other European countries.57Gregoric Kumperscak H. Clausen C. Anagnostopoulos D. et al.Child and adolescent psychiatry training and mental health care in Southeast Europe.Eur Child Adolesc Psychiatry. 2020; 29: 29-39Google Scholar More attention to depression in young people is needed, given the particularly high developmental price of impairment during this key life stage, with further evidence of worse outcomes in recent cohorts.58Thompson E.J. Richards M. Ploubidis G.B. Fonagy P. Patalay P. Changes in the adult consequences of adolescent mental ill-health: findings from the 1958 and 1970 British birth cohorts.Psychol Med. 2021;: 1-10Google Scholar
Subgroup disparities were also identified in relation to sex and physical disability. In accordance with previous studies,4Lewer D. O'Reilly C. Mojtabai R. Evans-Lacko S. Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors.Br J Psychiatry. 2015; 207 (: the journal of mental science): 221-226Google Scholar,5Gomez-Lumbreras A. Ferrer P. Ballarin E. et al.Study of antidepressant use in 5 European settings. Could economic, sociodemographic and cultural determinants be related to their use?.J Affect Disord. 2019; 249: 278-285Google Scholar,33Borghini A. Seghieri C. Brodo L. Breschi M. Variations in use and access of mental health services in Europe.Eur J Public Health. 2020; 30 ( ckaa165. 1284) Google Scholar,59Kagstrom A. Alexova A. Tuskova E. et al.The treatment gap for mental disorders and associated factors in the Czech Republic.Eur Psychiatry. 2019; 59 (: the journal of the Association of European Psychiatrists): 37-43Google Scholar,60Cabezas-Rodríguez A. Bacigalupe A. Martín U. Diagnosis and treatment of depression in spain: are there gender inequalities?.Int J Environ Res Public Health. 2020; 17Google Scholar we found that males were significantly less likely to receive antidepressants in 8 of 19 countries. Physicians’ prescribing behaviour may be influenced by sex difference in external expression of emotions, or because men may be less likely to seek help.33Borghini A. Seghieri C. Brodo L. Breschi M. Variations in use and access of mental health services in Europe.Eur J Public Health. 2020; 30 ( ckaa165. 1284) Google Scholar,59Kagstrom A. Alexova A. Tuskova E. et al.The treatment gap for mental disorders and associated factors in the Czech Republic.Eur Psychiatry. 2019; 59 (: the journal of the Association of European Psychiatrists): 37-43Google Scholar,60Cabezas-Rodríguez A. Bacigalupe A. Martín U. Diagnosis and treatment of depression in spain: are there gender inequalities?.Int J Environ Res Public Health. 2020; 17Google Scholar This disparity changed little from 2011–2015 to 2015–2018, even widening in Belgium. Our finding that people with physical disability were significantly more likely to receive antidepressants in 13 of 19 countries is also consistent with previous studies.59Kagstrom A. Alexova A. Tuskova E. et al.The treatment gap for mental disorders and associated factors in the Czech Republic.Eur Psychiatry. 2019; 59 (: the journal of the Association of European Psychiatrists): 37-43Google Scholar,61Twomey C.D. Baldwin D.S. Hopfe M. Cieza A. A systematic review of the predictors of health service utilisation by adults with mental disorders in the UK.BMJ open. 2015; 5e007575Google Scholar Physical disability is associated with a higher prevalence of depression, so it is possible that depression is more likely to be recognized and treated in this context.59Kagstrom A. Alexova A. Tuskova E. et al.The treatment gap for mental disorders and associated factors in the Czech Republic.Eur Psychiatry. 2019; 59 (: the journal of the Association of European Psychiatrists): 37-43Google Scholar,61Twomey C.D. Baldwin D.S. Hopfe M. Cieza A. A systematic review of the predictors of health service utilisation by adults with mental disorders in the UK.BMJ open. 2015; 5e007575Google Scholar This disability disparity narrowed in 5 of 13 countries primarily because of the improvement for people without physical disability, including Belgium, Germany, Switzerland, Poland, and Greece, which yet might suggest a degree of diagnostic overshadowing or lack of access to treatment for people with disability. The disparity in the UK was different from other European countries, in that people with physical disability in the UK ( and screening positive for depressive symptoms) were less likely to receive antidepressants than those having no such disability, a picture that did not change from 2014 to 2018. A further study is needed to explore if this results from the use of psychological therapies or under-treatment, or potentially methodological differences between HSE and SHARE ( discussed below).
Significant disparity by wealth status was found in 8/19 countries studied, with variation in the direction of the relationship between individual wealth and antidepressant. This finding is to some extent in line with previous studies; for instance, a study from Peru concluded that62Villarreal-Zegarra D. Cabrera-Alva M. Carrillo-Larco R.M. Bernabe-Ortiz A. Trends in the prevalence and treatment of depressive symptoms in Peru: a population-based study.BMJ Open. 2020; 10e036777Google Scholar individuals with lower levels of wealth were less likely to be treated for depression,62Villarreal-Zegarra D. Cabrera-Alva M. Carrillo-Larco R.M. Bernabe-Ortiz A. Trends in the prevalence and treatment of depressive symptoms in Peru: a population-based study.BMJ Open. 2020; 10e036777Google Scholar while a study from Denmark63Hakansson K.E.J. Renzi-Lomholt M. Backer V. Ulrik C.S. High use of antidepressant medication in both mild-to-modelate and possible severe asthma - a nationwide cohort study.J Asthma Allergy. 2022; 15: 13-23Google Scholar indicated that having higher income was associated with lower odds of using antidepressants.63Hakansson K.E.J. Renzi-Lomholt M. Backer V. Ulrik C.S. High use of antidepressant medication in both mild-to-modelate and possible severe asthma - a nationwide cohort study.J Asthma Allergy. 2022; 15: 13-23Google Scholar Our findings are likely to reflect the complex factors influencing the desirability of medication or psychological therapy as well as access that individual wealth could buy.
To our knowledge, this is the first study to assess the accessibility of antidepressants for those who screen positive for depressive symptoms following the end of the EMHAP ( 2013–2020). The repetitive cross-sectional representative data enabled the exploration of the progress made towards this goal. Subgroup analysis allowed a more nuanced and practical assessment of progress before the COVID-19 pandemic. The SHARE study used standardized methodology across its participating countries explicitly to support cross-country comparison, and we used this alongside measures of national health system factors to compare countries’ responses.
However, our findings should be treated with caution in that absolute comparisons between the UK and other countries should not be made, and comparisons between countries are subject to some caveats. The two surveys in this study ( HSE, SHARE) have differences including: ( a) the age range covered; ( b) the sampling methods and the sample frames; ( c) the instrument used to collect the information on depression symptoms; ( d) measurement of wealth status; and ( e) the method of cataloguing antidepressants. The antidepressant recording methods may have had different biases: for example, HSE's method, based on formulary drug class, would categorize a tricyclic antidepressant prescribed for neuropathic pain in the antidepressant category, but would omit lamotrigine for bipolar depression, while SHARE's self-rating method, based on perceived purpose, would enable participants to include benzodiazepines in the anxiolytic/antidepressant category but might exclude antidepressant drugs prescribed for an indication other than depression. Within SHARE, sampling methods are designed to be as similar as possible, but are not identical. We used survey weighting to adjust for differences caused by the survey design to make the data representative for each country and each period, and also analysed the data for each country separately. While this method provides robust handling of individual countries ( as a given country was surveyed consistently over time), and consistent methods were used across 18/19 countries, statistical comparisons between countries, particularly between the UK and other countries, should be viewed with care. For other country-specific reasons ( discussed above/below), Figure 1 should not be taken as a measure of countries’ performance against some kind of standard.
Our study also has a number of other limitations. First, informal support, other measures within primary care ( such as exercise and sleep management), and psychological therapies are important complements to antidepressants for treating depression.31Barbato A, Vallarino M, Rapisarda F, Lora A, Almeida J. Access to mental health care in Europe. 2016. https: //ec.europa.eu/health/sites/default/files/mental health/docs/ev 20161006 co04 en.pdf.Google Scholar,64Brown J. Evans-Lacko S. Aschan L. Henderson M.J. Hatch S.L. Hotopf M. Seeking informal and formal help for mental health problems in the community: a secondary analysis from a psychiatric morbidity survey in South London.BMC Psychiatry. 2014; 14: 275Google Scholar, 65Kvam S. Kleppe C.L. Nordhus I.H. Hovland A. Exercise as a treatment for depression: a meta-analysis.J Affect Disord. 2016; 202: 67-86Google Scholar, 66Gee B. Orchard F. Clarke E. Joy A. Clarke T. Reynolds S. The effect of non-pharmacological sleep interventions on depression symptoms: a meta-analysis of randomised controlled trials.Sleep Med Rev. 2019; 43: 118-128Google Scholar, 67Cuijpers P. van Straten A. van Oppen P. Andersson G. Are psychological and pharmacologic interventions equally effective in the treatment of adult depressive disorders? A meta-analysis of comparative studies.J Clin Psychiatry. 2008; 69 ( quiz 839-41): 1675-1685Google Scholar However, no corresponding data from primary care were available. Second, there was a lack of clinical confirmation of diagnosis, as data were drawn from large-scale population surveys using self-administered instruments. Additionally, as a result, we were unable to distinguish unipolar depression ( major depressive disorder) and bipolar depression; the latter is often not treated with conventional antidepressants. Third, the self-administered instruments have only been validated for binary detection of depressive disorders, and do not provide accurate quantification of severity. No data on antidepressant type/dose/duration were available. These limitations prevent us from establishing the relationship between degree of need and antidepressant prescription or measuring any potential over-prescription. Fourth, people with depression may have been successfully treated, and thus have been taking antidepressants but without residual symptoms to be identified by the survey instruments; such people would have been missed by this approach, underestimating the proportion of people with depression being treated with antidepressants. We note also the potential for bias in the other direction by including such people, given ( for example) that monoaminergic antidepressants are also used for other conditions such as migraine or neuropathic pain syndromes. Fifth, the results of country-level analyses should be treated with caution. For instance, in most countries a considerable proportion of antidepressant prescribing is by non-psychiatrists; although we took into account the number of GPs, other types of non-psychiatric specialists, such as general physicians ( internists) also make such prescriptions. Public expenditure on health is a common index to reflect country-level input and healthcare affordability, but in countries without universal health coverage, this measure may not account adequately for the requirement for patients to pay directly for antidepressant prescriptions, sums that are not included in national health expenditure evaluations. Psychiatric bed count and antidepressant receipt may be only loosely associated, because a majority of people with major depressive disorder are not treated in hospital psychiatric settings ( though bed counts and the number of psychiatrists may be proxies for spending on secondary mental health care more broadly). Therefore, the national-level results are only a macroscopic reflection with multiple possible underlying reasons. For instance, spending saved by reducing psychiatric beds might be used to improve mental health care in primary ( or outpatient secondary) care, or promote awareness in the general population. Sixth, since within-country analyses were of a priori interest, such comparisons were made without correction for multiple comparisons across all countries to reduce the chance of type II errors, though this of course increases the potential for type I error.
Usage of antidepressants by those who screen positive for depressive symptoms has increased greatly among European countries, but the wide variance and subgroup disparities raise the possibilities of both under-accessibility and over-prescription. There were disparities in antidepressant usage by age, sex, and physical disability. The difference in usage by age deserves particular attention, as this disparity has in some cases widened. Our findings suggest that characteristics other than clinical need influence access to antidepressants for those who screen positive for depressive symptoms, though there are limitations that may reduce generalizability to those with depressive disorder. Commissioners, practitioners, and policy makers could use these findings as one starting point to investigate and improve appropriate access to mental health treatments in their regions.
SC contributed to the concept and study design. SC conducted the analysis. SC, TJF, PBJ, and RNC interpreted the results. SC drafted the manuscript. TJF, PBJ, and RNC made critical revision of the manuscript for important intellectual content. All authors edited and approved the final manuscript.
The data are publicly available. The Health Survey for England can be accessed in UK Data Service ( https: //beta.ukdataservice.ac.uk/datacatalogue/series/series? id=2000021). The Survey of Health, Ageing and Retirement in Europe can be accessed here ( http: //www.share-project.org/data-access.html).
• SC declares no conflict of interest with this work.
• TF consults to Place2Be, a third sector organisation providing mental health support to schools.
• PBJ is a scientific advisory board member for MSD.
• RNC consults for Campden Instruments Ltd and receives royalties from Cambridge University Press, Cambridge Enterprise, and Routledge.
We thank sincerely the teams of HSE and SHARE, for their efforts in data collection and for making the data publicly available. We thank three anonymous referees for helpful comments.
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Extending a lifeline to people with HIV and opioid use disorder during the war in Ukraine - The Lancet Public Health | Oleksander navigates a bomb-shelled northern Ukrainian city between air raid sirens. He is on his way to the clinic to collect methadone for his opioid use disorder—a trip he has made regularly since 2016. However, this time the situation is quite different. 3 days earlier he sent his wife and children to Lviv for safety and has been living with 20 other men in the basement of his building, which doubles as a bomb shelter. Water has been disrupted and food is increasingly scarce. Yesterday, his doctor texted him a 30-min window to pick up his methadone, when emergency sirens are less common. The doctor dispenses a 10-day supply and Oleksander is relieved. He was not sure how much he would receive with the crisis worsening. Before the COVID-19 pandemic, he went to collect his methadone daily but, since the pandemic began, take-home doses have been permitted, making it easier for him to work and take care of his family. In non-occupied Ukraine, both methadone and buprenorphine are available as medications for opioid use disorder. Although grateful to receive today's supply of methadone, Oleksander asks for an increased supply, just in case the Russian army takes over. Even though Ukraine's Ministry of Health has just released new guidance allowing for a 30-day supply, his doctor is reluctant because he needs to keep enough for his other patients or for new patients that might be fleeing the east. His doctor is also concerned about disruptions in the supply chain and delivery of more medications for opioid use disorder.
Treatment programmes and their staff throughout the country are struggling to navigate the needs of their patients. Some doctors are reducing dosages to prolong supplies while others are dispensing what they have because they are uncertain when new medications will arrive. The consequences of a disrupted supply chain to patients are substantial. Tapering the dose every few days will result in a prolonged period of physically and emotionally uncomfortable side-effects from withdrawal symptoms. However, running out of medication abruptly will result in serious side-effects from withdrawal symptoms. In either case, withdrawal symptoms from opioids will not only accentuate the stresses and anxieties of war, but many patients could then relapse to injectable opioids, elevating their risk for overdose, skin and soft tissue infections, and transmission of blood-borne viruses such as HIV or hepatitis C virus. Approximately half of all people on methadone are also being treated for HIV,1Mazhnaya A Marcus R Bojko MJ et al.Opioid agonist treatment and improved outcomes at each stage of the HIV treatment cascade in people who inject drugs in Ukraine.J Acquir Immune Defic Syndr. 2018; 79: 288-295Google Scholar and the discontinuation of methadone could result in high rates of discontinuation from HIV medications, which could accelerate progression of HIV or, in the case of ongoing HIV risk-taking, transmit HIV to others.
Oleksander began injecting opioids when he was 19 and remembers the chaos in his life until he started treatment with methadone 6 years ago. He will do anything to ensure he never again endures the struggles of his previous life. He feels reliant on his methadone, much like a diabetic is tied to their insulin. He notes that even friends with diabetes are concerned about their next dose of insulin, but he emphasises that insulin is not as highly regulated as methadone, making it more palatable to doctors to dispense more extended take-home supplies.
Oleksander, unlike his wife and two children, has no way to leave. He is of conscription age and can not cross the border. Because he is dependent on opioids, Oleksander feels unsuitable for the army. Individuals who are dependent on opioids and who have other comorbid disabilities can be officially certified as disabled by a specialised doctor and are exempt from conscription. However, this exemption is seldom used and access to this service is uncertain during war. When asked about moving west to a safer region, despite the presence of a national hotline to help guide patients, he has no idea where methadone supplies exist or whether he will be treated at other methadone clinics as he is registered only in his city. The Ministry of Health allows a prescription for methadone that could be used at any private pharmacy, free of charge, but the online medications for opioid use disorder tracking system showed no pharmacies that had medication available. Medications for opioid use disorder in Ukraine are tightly regulated under Order 200 and otherwise mostly available in licensed clinics. With a 90-day supply of his HIV medications, it is the small 10-day supply of methadone that restricts him from finding safer refuge.
Despite the ongoing conflicts in Ukraine since 2014, no disaster plan has ever been in place for patients such as Oleksander. Oleksander's current situation is complicated due to his requirement for treatment for an opioid use disorder, his HIV infection, and living within a war zone. When such disasters occur, the rigid treatment requirements for methadone delivery often become impossible to maintain amid unpredictable chaos. With 3·5 million Ukrainians having left the country and millions more displaced internally due to the current war, there is untold military and humanitarian need, resulting in treatments such as methadone becoming quickly deprioritised. The allowance of 30-day take-home dosing and using prescriptions to pick up medications for opioid use disorder are a first step; however, there is no uniform response throughout the country, leaving the treatment plan to local physicians and administrators. Treatments such as methadone ( and the people who require them) are highly stigmatised and this stigma is seldom reduced in a crisis setting. Moreover, taking medications for opioid use disorder improves adherence to taking HIV medications,1Mazhnaya A Marcus R Bojko MJ et al.Opioid agonist treatment and improved outcomes at each stage of the HIV treatment cascade in people who inject drugs in Ukraine.J Acquir Immune Defic Syndr. 2018; 79: 288-295Google Scholar making it doubly important to continue medications for opioid use disorder beyond the 30-day allowance. The Ukrainian people have been extraordinarily resilient in response to the current war; however, the impact on patients such as Oleksander are potentially profound. Although Oleksander's situation is unimaginable, his friend Iryna ( who is also on methadone and pregnant) is facing an even greater challenge. Oleksander's friends are of the opinion that going “ cold turkey ” ( a term often used by people with opioid use disorder to describe the agonising symptoms of abrupt withdrawal from opioids) from methadone is worse than from heroin if his supply is interrupted, but Iryna knows that withdrawal from opioids could result in spontaneous abortion.
An effective and immediate response is urgently needed. The first step is the creation of an effective real-time strategy for patients to be able to track down supplies of methadone within the country. There is a smartphone application ( app) that provides a list of sites providing medications for opioid use disorder, HIV, and tuberculosis services, but it requires a smartphone and would need to be modified to provide real-time information on which sites have adequate supplies. For those without a smartphone, there is a bot on the Telegram messaging service that links to the same information. One short-term solution would be to use the dedicated Telegram channel or enhance the current app to allow for patients and doctors to receive real-time information to coordinate the logistics of receiving treatment in any place in the country. For patients who flee the country to Moldova, where Ukrainian patients can be readily re-linked to care, such strategies can optimise methadone treatment continuity. For those who flee to other countries where methadone is more limited or who become refugees in remote rural settings, logistical considerations will be needed to accommodate them, which might be challenging since methadone delivery is often tightly controlled.
Crowd sourcing, the process of aggregating crowd wisdom to solve a problem, is another potential community-based strategy to improve access and delivery of medical services.2Wang C Han L Stein G et al.Crowdsourcing in health and medical research: a systematic review.Infect Dis Poverty. 2020; 9: 8Google Scholar Given pressing time constraints, existing crowd sourcing solutions are commendable and need to be expanded. Because a patient is registered at a specific clinic, there is no current system to allow patients to move between them and continue treatment. In the current system, a patient transferring to a new clinic must be referred from one clinic to the other. Such a system does not work during the chaos of a disaster. One potential short-term solution to support patients and treatment programmes is to use the national SyReX database that lists all patients who have ever received medications for opioid use disorder and uses a unique identifier that can be quickly verified. This database, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria ( GFATM) and operated by the Alliance for Public Health3Farnum SO Makarenko I Madden L et al.The real-world impact of dosing of methadone and buprenorphine in retention on opioid agonist therapies in Ukraine.Addiction. 2021; 116: 83-93Google Scholar could be leveraged to assist transfers by allowing clinics or pharmacies to obtain minimal information from the presenting patient, use it to generate the unique identifier, and then speak to someone maintaining this database to confirm previous treatment. Because this database is only updated quarterly, it can not confirm the last date the patient received medication from the clinic, nor the last dosage provided, but could verify eligibility for treatment and expedite dispensing for patients within Ukraine and potentially for refugees who leave Ukraine.
Next, ensuring a sustainable supply chain is crucial. Beyond the described communication methods, there are other potential strategies to be considered. The central supply of methadone is located near Kyiv, which is under siege. This large supply must be moved to a more secure location in western Ukraine. Medications for opioid use disorder are produced in factories in Kharkiv and Odesa where there is a large amount of shelling. Both factories have already been closed. Existing supplies must be safely transferred to a new storage site.
In the absence of local production, securing adequate medications for opioid use disorder from outside Ukraine immediately as humanitarian aid ( or purchased using GFATM sources) is crucial. The import of such medications must address logistical constraints including importation and storage near the western Ukraine border. Once available, supply chain networks for medications for opioid use disorder must be established. The current rigid regulations require transportation in an armoured car with two security personnel, and removing this requirement might be necessary, but must be balanced with concerns of safety during medication transport. For cases in which ground transportation is either unsafe or impossible, drones could be used for the delivery of essential medications such as those for opioid use disorder and medical supplies. A 30-day supply of medication for a clinic with 250 patients prescribed an average dose of 100 mg daily would weigh 21 kg. Given the costs of war, affordable drones could make deliveries to the most dangerous settings. Patients could be advised of the delivery of new medication using closed social media chatrooms or be disseminated using crowd sourcing, given the uncertainties of delivery as fighting intensifies.
As patients become increasingly uncertain about opioid use disorder medication supplies, there are potential ways to transition patients off methadone. The preferred taper off methadone is typically prolonged, usually over weeks to months, using reductions of 5 mg every few days at a maximum. If adequate supplies of buprenorphine can be imported, low-dose buprenorphine can be used to comfortably transfer patients to buprenorphine ( sometimes inaccurately described as micro-dosing),4Ahmed S Bhivandkar S Lonergan BB Suzuki J Microinduction of buprenorphine/naloxone: a review of the literature.Am J Addict. 2021; 30: 305-315Google Scholar after which they can be tapered completely off medications for opioid use disorder. Therefore, planning for the import of buprenorphine is important, should methadone become completely unavailable. Transfer off medications for opioid use disorder should only be considered if there is no way to extend treatment, because this might result in relapse to drug injection and death by opioid overdose or suicide.
The harsh reality learned from the annexation of Crimea serves as a sharp reminder of what could come if Russia overwhelms the Ukrainian army. In 2014, Russia abruptly discontinued methadone within 10 days of occupying Crimea for more than 800 stabilised patients on methadone. Although more than 200 patients were emergently relocated to mainland Ukraine and continued treatment,5Kiriazova T Dvoriak S Ukraine: drug situation and drug policy. Pompidou Group of the Council of Europe, Strasbourg, France2015Google Scholar more than 10% of those who did not receive care in other regions died soon afterwards, mostly by overdose and suicide.6Carroll JJ Sovereign rules and rearrangements: banning methadone in occupied Crimea.Medical Anthropology. 2019; 38: 508-522Google Scholar This could become the fate of more than 17 000 patients currently on medications for opioid use disorder in Ukraine, with half of these also having HIV. As was the case in Russia and Crimea after the banning of medications for opioid use disorder, HIV transmission would be expected to increase in Ukraine. Such increases would undermine the hard-fought successes of the past decade in Ukraine, the country with the highest adult HIV prevalence in Europe ( 1·2%) with an epidemic concentrated among people who inject drugs, most of which are opioids. Data from Ukraine confirm that medications for opioid use disorder successfully improve the HIV treatment cascade,1Mazhnaya A Marcus R Bojko MJ et al.Opioid agonist treatment and improved outcomes at each stage of the HIV treatment cascade in people who inject drugs in Ukraine.J Acquir Immune Defic Syndr. 2018; 79: 288-295Google Scholar including diagnosis, antiretroviral therapy, and viral suppression, all of which improve both individual health and public health by substantially reducing transmission to others.
Since the invasion of Ukraine, most adult men younger than age 60 years can not leave the country unless they have substantial dependent care responsibilities or have an official exemption for a medical reason. For those on methadone who enlist, there is extra need to ensure medication continuity because failure to do so will render them physically incapable of fighting and put them at greater risk of harm while in combat. For those Ukrainian men who are medically disabled, new mechanisms are needed to legally certify their disability, perhaps using telemedicine, along with safe passage out of the country and linkage to medications for opioid use disorder outside of Ukraine. In the worst-case scenario should Ukraine not prevail over Russia, there should be a strategy to expatriate all patients requiring methadone to nearby countries in Europe that provide medications for opioid use disorder and facilitate their continuity. Many women on methadone reported not leaving the country because of uncertainties about methadone continuity if they relocate to different countries. A clear path to continuity of medications for opioid use disorder in Ukraine and for refugees who flee to neighbouring countries must be developed, including enough supplies to continue with their medication while crossing the border and selecting housing that is proximate to medications for opioid use disorder care. Neighbouring countries have not yet ensured a sufficient supply of medications for opioid use disorder, should a large proportion of the 17 651 people on medications for opioid use disorder enter their country.
We are in the middle of an evolving humanitarian crisis that was previously unimaginable. We will be defined by our response to it, especially for the most vulnerable. The challenges encountered during a disaster, as all the most challenging problems converge, will have the greatest impact on those most vulnerable. These issues are predictable and, although some solutions seem unlikely due to economic or logistical constraints, some of them could be implemented immediately and improved through collaborative learning among the many stakeholders, inclusive of patients themselves who often have the most to lose.
FLA and DJB wrote the initial draft of the manuscript with input from LA and LMM. SD, AM, IP, and ZI collected testimonies from patients.
We declare no competing interests.
We acknowledge support from the National Institutes of Health, including the National Institute of Drug Abuse, National Institute of Allergy and Infectious Diseases, and the National Institute of Mental Health. Many personal stories were collected by SD, IP, AM, and ZI to guide the needed response for Ukraine. All personal names in the manuscript have been changed to protect the anonymity of the patient. | tech |
Transport locked down in China's Shanghai as asymptomatic COVID cases surge | China's financial hub of Shanghai launched a planned two-stage lockdown of the city of 26 million people on Monday, closing bridges and tunnels, and restricting highway traffic in a scramble to contain surging local COVID-19 cases, Trend reports citing Reuters.
The snap lockdown, announced by Shanghai's city government on Sunday, will split the city in two roughly along the Huangpu River for nine days to allow for `` staggered '' testing. It is the biggest COVID-related disruption to hit the city so far.
The announcement also marks a turnaround for the local government, which last week expressly denied Shanghai would be locked down as it pursued a more piecemeal `` slicing and gridding '' approach to try to prevent infections from spreading. read more
Wu Fan, a member of Shanghai's expert COVID team, told a briefing on Monday recent mass testing had found `` large scale '' infections throughout the city, triggering a stronger response.
`` Containing the large scale outbreak in our city is very important because once infected people are put under control, we have blocked transmission, '' she said, adding that testing would be carried out until all hidden risks are eliminated.
A record 3,450 asymptomatic COVID cases were reported in Shanghai on Sunday, accounting for nearly 70% of the nationwide total, along with 50 symptomatic cases, the city government said on Monday. | general |
Japan and African ministers stress importance of democracy and the rule of law | Ministers from Japan and African nations highlighted the importance of democracy and the rule of law in their two-day online talks that ended Sunday, amid China's growing assertiveness and Russia's invasion of Ukraine.
`` The participants underscored the need for the consolidation of democracy and good governance under the rule of law as a pressing priority, '' the Foreign Ministry said in the chair's summary released Monday following the meeting, which precedes the eighth Tokyo International Conference on African Development slated for August.
At a time when Beijing has been stepping up its maritime activities in the Indo-Pacific region, the ministers also reaffirmed the importance of `` maintaining a rules-based maritime order in accordance with the principles of international law, '' the summary said.
In an apparent criticism of Chinese financing practices in which countries receiving Chinese investment are sometimes saddled with loans they can not repay, they agreed that `` development finance adhering to international rules and standards, such as debt sustainability, enhanced transparency and mutual accountability '' is vital.
China has been accused of adopting a `` debt trap '' policy in which debt is used as leverage to gain strategic concessions from borrowing nations, such as the long-term lease of port facilities in a resource-rich, strategically important region.
`` Japan will work with international organizations to create an environment where developing countries, especially those in Africa, do not have to rely on such financing, '' Foreign Minister Yoshimasa Hayashi told reporters Sunday.
`` We must not allow such financing practices to prevail and destabilize the developing economies most in need of financial resources, '' he said, without naming China.
Hayashi and representatives from 50 African nations `` urge all major creditors including private ones to follow fair and open lending practices, '' the document said.
Referring to the Russian invasion of Ukraine launched last month, the ministers also stressed the importance of `` respecting sovereignty and territorial integrity, '' although they fell short of blaming Moscow collectively. Japan has strongly condemned Russia's aggression as `` totally unacceptable. ''
`` The participants expressed concern about the situation in Ukraine and its impacts and called for the international community to work together, '' according to the summary.
As for the coronavirus pandemic, they confirmed the need for the international community to cooperate in addressing its economic and social impact on African nations, and to urge `` a robust, sustainable and inclusive development to achieve build back better. ''
To encourage economic growth in a post-COVID era, the ministers pledged to promote investment in digital transformation-related businesses and a low-carbon and resource-efficient `` green economy, '' underpinned by `` a free and open international economic system. ''
`` Since we held the seventh TICAD meeting ( in 2019), one of the biggest changes hitting Africa has been the coronavirus, '' Hayashi said.
`` Focusing on the quality of growth, we will continue to support development in Africa and their realization of the U.N. sustainable development goals, '' Hayashi added.
The COVID-19 pandemic has significantly impacted the African economy and society, raising the need for support from the international community.
The upcoming TICAD meeting to be chaired by Tunisia is scheduled for Aug. 27 to 28, although the details, including whether it will be held in a virtual format, are still being arranged, according to the ministry.
Tunisia will be the second African nation to host TICAD after Kenya in 2016.
Co-sponsored by Japan, the United Nations and a few other international organizations, TICAD was launched in 1993. It was last held in August 2019 in Yokohama. | tech |
Crude oil futures slide amid demand concerns; eyes on Russia-Ukraine talks | Center-South Brazil's crop officially started on April 1, and although more than 70% of the expected...
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Crude oil futures slipped in midafternoon Asian trade March 29 as investors continued to fret over China's COVID-19 lockdowns that could ravage the country's energy demand.
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At 3:33 pm Singapore time ( 0733 GMT), the ICE May Brent futures contract dipped 14 cents/b ( 0.12%) from the previous close at $ 112.34/b while the NYMEX May light sweet crude contract edged down 30 cents/b ( 0.28%) at $ 105.66/b.
`` In light of China's lockdown and depleting demand by largest importer, both Brent and WTI saw a sharp decline of over 7% on Monday, and extending losses from yesterday, '' said Avtar Sandu, senior manager commodities at Phillip Futures.
OANDA's Senior Market Analyst Jeffrey Halley echoed a similar sentiment, adding, `` Oil's volatility continues to make eye-watering viewing, but increasingly, the moves are being driven by falling liquidity in the futures markets, and the exchanges ' itchy trigger fingers on raising margins. ''
Shanghai's Pudong financial district entered its second day of lockdown. Residents are ordered to work from home, and public transit and ride-hailing services have also been suspended.
Meanwhile, investors perked up on news of possible progress on the Russia-Ukraine conflict. Delegates from both countries would be meeting in Turkey for the first face-to-face talks in more than two weeks.
`` Markets are always keen to price in the prospect of a peace deal, if one could call it that, with what might be hints of concessions by both sides, '' Halley said.
`` Comments out from both sides though late in the day, suggest an agreement will be as elusive as ever, '' he added.
Market participants will also be closely watching the scheduled meeting between OPEC and its allies March 31 to decide on May production levels.
Analysts have said that supplies would be `` restored with ease '' despite the ongoing Russia-Ukraine conflict, and unlikely to be boosted sharply to meet increased demand.
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Experimental nasal spray prevents COVID-19 in mouse models | New research led by a team from Cornell University and the University of British Columbia has demonstrated a novel nasal spray can prevent infection from SARS-CoV-2. The experimental treatment was found to be effective in preliminary animal studies with the researchers now looking to optimize the spray and move to human trials in the near future.
A nasal spray that can protect a person from a SARS-CoV-2 infection is certainly a compelling prospect. Imagine taking a few short puffs in the morning before heading out in the world and knowing that you are protected from one of the most infectious airborne viruses known to humanity. It’ s an ambitious goal, and a new study is indicating it could be possible.
An article published in Nature is describing the discovery and development of a new small molecule that can inhibit the entry of SARS-CoV-2 particles into animal cells. The molecule, dubbed N-0385, was discovered as researchers explored a variety of ways to inhibit the mechanisms SARS-CoV-2 uses to enter human cells.
To test the new molecule the researchers turned to a special kind of engineered mouse model. Normal mice, the mainstay of lab research, unfortunately are not useful for most COVID-19 studies because they don’ t carry the same receptors that SARS-CoV-2 attaches to in humans. Scientists have, however, genetically engineered a specific mouse model to express those human receptors and enable effective testing of new COVID-19 treatments.
The new research tested intranasal dosages of N-0385 in this particular mouse model and found it effectively prevented SARS-CoV-2 infection. The nasal spray was protective against the original strain of SARS-CoV-2, as well as several variants including Alpha and Delta. It has yet to be tested against Omicron, but the researchers expect it to remain effective.
As well as working successfully as a prophylactic the nasal spray was found to also serve as an effective treatment, reducing disease when it was administered within 12 hours of the animals being exposed to the virus. Hector Aguilar-Carreno, senior author on the study, said this new molecule is unique in its ability to work as both a preventative tool and an antiviral treatment.
`` There are very few, if any, small molecule antivirals that have been discovered that work prophylactically to prevent infection, '' said Aguilar-Carreno. `` This is the first of its kind. One advantage is that it works early in the infection, even after someone has already acquired the virus. ''
The research is not the first to look at developing a nasal spray that can prevent SARS-CoV-2 infection. A human clinical trial is already underway in Australia testing a widely used anti-coagulant called heparin for this very purpose. That Australian research expects to have some results to report later this year.
The team behind N-0385 optimistically suggest it is possible the treatment could be available by the end of the year. But that timeframe depends on large volumes of money being quickly raised and every stage of human trials going perfectly.
It is more likely this research will move a little more slowly as plenty of work is still needed to establish the safety of this new molecule in humans. Aguilar-Carreno does indicate this molecule is promising as it could hypothetically be used to target a number of viral infections such as influenza and other coronaviruses that rely on this same mechanism of cellular entry.
`` The N-0385 therapy is simpler and less expensive to mass produce than other types of COVID-19 treatments, such as monoclonal antibodies, '' added Aguilar-Carreno.
The new study was published in the journal Nature.
Source: Cornell University | science |
Myles de Courcy is Ready to Skate with Celine Ready to Wear |
Over the past few decades, skateboarding’ s trick progression has seen a generational surge as evidenced by its Olympic debut being dominated by some of its youngest pros. While the level of skateboarding has usurped that of the ‘ 80s and ‘ 90s, culturally it can feel stuck in the social trappings and prejudices of 30-plus years ago.
Myles de Courcy understands that landscape intensely. Growing up in Orange County, California as a Queer Black skateboarder, the lack of acceptance and support led them to abandon their passion for it entirely. But as Myles was pursuing music, a sea change in skateboarding was occurring, best evidenced by the Bay Area collective, Unity Skateboarding, who not only champion Queer skateboarding but also create a network to push the culture and diversity forward.
At the beginning of Covid-19 lockdowns, Myles rekindled their love of skateboarding and through longtime friend Chandler Burton, became inspired by the positive changes in the community. They started working on an independent video together, and eventually landed a spot on There Skateboards.
More than tricks, style is everything in skateboarding. Myles not only stands out on this front, but challenges the tropes and norms. They can pull off baby blue Celine runway boots in one look, and a sheer organza skirt in the next. An oversized cotton military vest from Celine's Cruiser collection is tossed over a glitzy silver sequin turtleneck, and the brand's nylon Trekking backpack is worn with a black maxi dress.
With a deep bag of tricks and a unique lens, Myles ' sense of crust punk speaks to the change, diversity, and creative renaissance skateboarding needed for years. Captured on the streets of New York by Daniel Weiss, that mix is on display on and off-board.
I started skating when I was 10 years old. It was around the time we were living in Georgia, and we had just moved back to California. My aunts took me and my little brother on a shopping spree because we didn’ t have a lot when we moved back, like toys and shit. We went to Walmart and bought some Walmart skateboards. We knew a couple of people who skated—it just seemed cool. Then my cousin got a skateboard and we were all super into it. It’ s been the only thing in my life that’ s pretty much been consistent, you know what I mean?
I didn't start filming right away. I’ d get some stuff for Instagram throughout high school but I didn’ t film videos until we started working on the first Bottom Feeder video in 2020. I had actually stopped skating for about three years. I live in Orange County, California, and the scene out here is a little rough, in terms of, it's a bunch of conservative, white people. It was not a welcoming environment for a Queer Black person. So I just quit and focused on playing music and doing a bunch of other shit. My boyfriend at the time was bummed that I wasn’ t skating anymore because I was so into it when we met. This was right around the beginning of the pandemic. He was like, “ You should hit up your friend Chandler ( Burton) to skate. ” He’ s the person I make the Bottom Feeder videos with now. So I hit him up one day and we hung out and he mentioned he was starting to work on a video and that I should have some clips in it. It's funny because I started filming a video part having been super rusty, just two years ago, and here I am now.
It's just weird out here, dude. I was a young kid into punk rock and I had friends who were full-on Nazis and would take me to Nazi punk shows. Obviously, I wasn’ t into that scene, but the skate scene is just super hesher—pool skater, Antihero, Thrasher Hell Ride type skaters… very traditional skate punk types. I was a little punk kid, but once I started to grow into my own person, it was difficult being around that stuff—being around people that were shitty.
For real. I totally agree with you. The weirdest experiences I 've had with skateboarders have been at skate parks. Not all the time and not in every place, but in a lot of places they become a really toxic environment. I feel like I stopped skating because I would only skate parks—I didn't have friends who skated street. I had to stop going to my local park because it got too crazy with people throwing slurs around and saying a bunch of other crazy things or when girls would be at the park, actively going out of their way to snake them and not let them get a run.
I’ m kind of late to the scene—I missed all the meet-ups and whatnot because I wasn’ t skating then. I didn’ t even know about Unity until I started hanging out and skating with Chandler again, but they had been doing Unity for a couple of years. It blew my mind that there were people who were creating safe spaces for people to skate to have fun and meet other skaters. It’ s a really cool thing but it also sucks that we’ ve been driven to create those spaces out of necessity. But now we have those spaces and the scene is just growing bigger and bigger, and going international at this point. It’ s awesome to see people from all backgrounds coming through and finding a space where they can have fun.
Yeah, it's sick. It’ s awesome and I 'm so blessed to be able to go on that ride and help create that space. That's all I want to do now other than filming parts. My biggest priority is creating an environment where people feel safe to skate, you know?
There’ s a lot you can do and the biggest thing from square one is knowing how to utilize the privileges that you have that other people don’ t. A lot of times, people that aren't part of a minority or one that is discriminated against have better access to resources, whether it's money or connections or… I hate the word, power, but essentially that. People listen to straight white men way more than anyone else. For anyone that wants to be an ally and show up for those spaces and the people who don’ t have the same access and privilege, you can do it because the biggest thing you can give back is by putting your money where your mouth is. I see so many people that call themselves allies but don’ t do anything to advocate past things that will make them look good. The big issue is that people want to look the part but not play the part. Think about how you act in your circles. How you talk about things and what you can call out in those circles—hard conversations. I think a lot of people forget it starts at a conversation first before anything. Have those conversations with people that look like you. Continually try to learn and educate yourself, as much as you want to educate others too.
We come from grindcore—crusty kids from Orange County—so we thought of ourselves as bottom feeders, like in the ocean or whatever. Not clean-cut, coming from a very DIY aesthetic. And you know, it's also a Queer term. We want to represent that side of Queer culture with Bottom Feeder and There. I feel like a lot of Queer culture that’ s represented in the media or in skate videos is really clean-cut and not completely what Queer people are like. Our biggest thing was to show that we get down like everyone else. Just because we're Queer doesn’ t mean we only like Lady Gaga or shiny, pretty things, and obsessed with makeup. That’ s definitely stuff we are into, but we also get down and dirty, just like everyone else.
I think a little bit of both. Matt King helped us make the first video and he was definitely a big inspiration—he edited the whole thing. That's why the two videos we have out are so different, because Matt was a big part of the first one. The second video was mostly me, Chandler, and his boyfriend, Mike. We make what we want to make. We want it to look sick. If we have an idea, we just try as hard as we can to make it happen, you know? We're trying to represent ourselves and our experience, not just through the actual skateboarding.
Shops can be intimidating, especially to minorities, and I think it’ s something that’ s going to take a long time to change the culture. But on the other hand, I’ ve had a lot of experiences recently where it's been chill. Every time I go to the Bay I try to visit Break Free skate shop—Raney Beres owns it. Everyone that works there is sick. There are not a lot of skate shops in Black neighborhoods and there are not a lot of shops that Black people work at. I went there and it was cool to see people that looked like me working there. The same thing for Pharmacy in Long Beach, California. Boo Johnson owns that location and he’ s really sweet, and again, all the people who work there are really cool. There’ s also Neighbors Skate Shop in Leimert Park, Los Angeles which is Black-owned. There's a lot of change happening in skate shop culture, but I definitely think it's gon na take some time. Slowly but surely it’ s getting there.
Skateboarding is amazing. It makes me so stoked to see the level of representation and recognition in Women's skateboarding and the same thing with Queer skating. I feel like it's really growing. We have Glue, we have There, and it’ s sick to have two Queer-owned companies having their boards on the wall at shops. But on the flip side, there’ s still only two. As much as it’ s great to see the level that women are being represented and standing out, it's not enough. There’ s not enough representation of anyone, other than white men.
I see it with so many companies where they have a token Black person or token woman on their team. Then you see their video and that tokenized person only has a few clips. You can tell they're not prioritizing them—getting them on trips, getting them a full part. I’ ve seen plenty of times where companies put people on flow just to have them there and be like, `` Hey! Look at us, we’ re inclusive! '' but they aren’ t putting the same energy into them as they have these people who have had the spotlight forever. There’ s also this attitude that some skaters have that’ s like, `` She's just popular because she's a girl or because they’ re Queer, '' or whatever. We haven’ t had these platforms historically.
That’ s funny. I feel pretty weird about it, to be honest. I was stoked to work with Celine because I’ m a bit of a fashion nerd and love high fashion, runway, couture, and stuff like that. It was really sick to have that opportunity because it's a brand that I really like. When they said they wanted me to actually skate, I thought it was even better. There’ s room for fashion and skate to collide and work, but brands should be mindful in trying to capitalize off of a very small, tight-knit culture. It needs to be done right if these companies are going to profit off skateboarding. It needs to be done with actual skateboarders and not what some casting director thinks a skateboarder is. Real skaters within the culture, representing the culture through the brand.
Exactly. 100%. That's why I said yes to Celine. They really valued my opinion. During fittings, they were talking to me the same way we’ re talking now. It seemed super genuine and that they wanted my perspective. They even mentioned stuff they’ ve seen that they thought was corny and how they wanted this to be real. After that, I started thinking, `` Fuck, there’ s room for things to be done right. ''
The There video drops at the end of the month. We’ re working on another Bottom Feeder video. I’ m working on another solo part too, so just filming for all of that which is kind of crazy. Just keeping myself busy.
I 'm just thankful for this opportunity and for everyone that's been along for the ride, you know? I 'm thankful to be able to skate and do me right now.
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Health Taxes During the Recovery from COVID-19 | CGD and many other experts find that health taxes – levied on tobacco, alcohol, and sugar-sweetened beverages – can play a part in boosting revenue in low- and middle-income countries while also being a highly cost effective “ best buy ” intervention to support better health outcomes. Despite this, action on health taxes has understandably slowed during the pandemic, and IMF programs’ focus on health tax measures has significantly diminished compared to the pre-pandemic period.
Now is the time to catch up. International financial organizations ( IFIs) and country governments have an important opportunity to ensure health taxes move forward more rapidly. Join CGD for a conversation on how the IMF and World Bank can build on their track record in tobacco, alcoholic, and sugary beverage taxes to help low- and middle-income countries bounce back from the COVID-19 pandemic.
This event is the first of a series hosted by CGD and partners that focus on challenges and opportunities for health taxes implementation at the national, regional, and global levels. Tune in for the second event on May 4, where experts will consider opportunities for health taxes in developing Asia where non-communicable diseases have been rising rapidly, exacerbated by unhealthy diets and consumption of tobacco and alcohol.
If you have questions for our panelists, please submit them to events @ cgdev.org, tweet @ CGDev # CGDTalks, or submit your comments via YouTube. | general |
Latest HIMSS report features APAC digital health transformation stories during COVID-19 | HIMSS has recently published a report that looks into the digital transformation journeys of Asia-Pacific health organisations during the ongoing pandemic.
Their notable efforts are covered in the first volume of the quarterly Digital Excellence in Healthcare: APAC Case Studies series.
This inaugural series has two areas of focus. In one area, it places a spotlight on organisations that have leveraged HIMSS ' evidence-based models and frameworks in their transformation journeys.
Case studies include Queensland Health in Australia and Korea University Anam Hospital in South Korea, which were previously reported to have used the HIMSS Digital Health Indicator to comprehensively assess their digital systems.
Karuna Trust's Tavarekere Urban Primary Health Center in India recently underwent the HIMSS Outpatient Electronic Medical Record Adoption Model assessment to check whether its ongoing digitisation efforts are in tune with advancements in modern healthcare. Its case study is also included in the compilation.
The report also covers case studies of organisations that have undertaken digital technology projects to address their pandemic-related challenges.
It highlights efforts by Baby Memorial Hospital in India, which has redesigned its system to manage COVID-19, and the National University Health System in Singapore, which has saved over 5,000 bed days by setting up a COVID-19 virtual ward.
`` Healthcare organisations have seen the value of digital technologies during a highly contagious pandemic and how they can also help to create resilient health ecosystems, '' said Simon Lin, VP and executive director of HIMSS APAC.
Despite new and persisting challenges in digital transformation, `` many healthcare organisations in APAC have pressed on and harnessed digital technologies to improve clinical outcomes, financial viability or operational efficiencies, '' he added. | tech |
ESA looks for new ride to Mars for its Rosalind Franklin rover | With the invasion of Ukraine severing its cooperations with Russia's Roscosmos, the European Space Agency ( ESA) is now considering alternatives to get its ExoMars Rosalind Franklin rover to Mars without Russian support hardware.
The Rosalind Franklin rover can't seem to catch a break. Originally slated to launch in 2018, it has faced several delays due to technical problems and COVID-19 restrictions. The latest launch window was supposed to open on September 22, 2022, but the Russian invasion of Ukraine put paid to that.
The original plan was for the rover and a German-built cruise stage to launch into space atop a Russian Proton rocket. When the mission reached Mars, the rover would then descend to the surface using a Russian-built landing craft. Unfortunately, relations with Moscow have deteriorated to the point where the 2022 launch has not only been scrubbed, but ESA's Review Board is looking for another ride.
This isn't easy because a Mars mission isn't like putting a satellite into Earth orbit. The energy needed to boost a payload to Mars requires a massive rocket, an electric propulsion system, gravitational slingshots or a combination of all three. In addition, the spacecraft itself and all of its components must conform to the capabilities of the launcher.
In the case of ExoMars, the rover and the cruise stage are already set and the rover is going into storage. This means that any rocket chosen has to be similar in capabilities to the Proton. That's the easy part. The hard part is to find an available rocket by the next launch window in 2024 and get it ready in time.
The harder task will be to replace the Roscosmos lander. This is hardly an off-the-shelf piece of equipment and ESA will either have to find the resources to build one itself or find another partner for the job.
This development is just one example of the fallout that the Ukraine crisis is having on the aerospace sector. Aside from ExoMars, there was a fear that an American astronaut could have been stranded on the International Space Station if the Russians refused to give him a ride to Earth. Meanwhile, comments by some Russian officials suggested that the station itself could be in peril if Russia refused to use its cargo rockets to keep it in a stable orbit.
In the United States, the United Launch Alliance is also at risk because its family of rockets relies on Russian-built engines. With the supply cut off, rivals like SpaceX and Northrop Grumman may pick up lost business, which could greatly alter the aerospace field.
“ I hope that our Member States will decide that this is not the end of ExoMars, but rather a rebirth of the mission, perhaps serving as a trigger to develop more European autonomy, '' said David Parker, Director of Human and Robotic Exploration at ESA. `` We count on brilliant teams and expertise across Europe and with international partners to reshape and rebuild the mission. The team is dedicated and focused on setting out the next steps to ensure we bring this incredible rover to Mars to complete the job it was designed for. ''
Source: ESA | science |
A Scary Time for Santa Barbara Tenants as Eviction Protections Vanish - The Santa Barbara Independent | State Senate Considers Extending Rental Assistance Timeframe to Forestall Evictions
A bill in the California Legislature looks likely to pass on Thursday that would extend the rent relief offered since September 2020. It’ s intended to give tenants who have suffered financially due to COVID until June 30 to pay their landlords in the hope of avoiding eviction, but they must apply by March 31.
Currently, the state’ s rental assistance program ends at the end of March, but Assembly Bill 2179 passed the Assembly on Monday and is expected to pass the State Senate on Thursday, said Senator Monique Limón, one of the legislators who wrote the original rental assistance bill when she was an assemblymember. “ This bill is not going to be perfect or solve all situations, ” Limón said, adding that AB 2179 was very narrow. It only applies to people in the application pipeline for rental assistance as of March 31, but because it is taking several months for applications to be processed, the bill allows applicants until the end of June to get the funds to their landlord.
Lucia Trujillo with the Santa Barbara Tenants Union would like to see the bill do more: “ AB 2179 extends the current COVID eviction protections until June 30, but it preempts local jurisdictions from passing their own ordinances on COVID nonpayment of rent. It also does not extend the Emergency Rental Assistance Program, ” she said.
About 200,000 Californians have completed applications but are awaiting payment, according to the state’ s rent relief dashboard. In Santa Barbara, the county contracted with the United Way to process applications, and the nonprofit is actively working through at least 2,000. More than 6,000 have yet to be processed at all, said Melinda Cabrera, vice president of strategic partnerships for the nonprofit. To date, $ 32 million in assistance has been distributed to 7,500 individuals or households.
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“ We acknowledge that this is a very scary time for a lot of people, ” Cabrera said. “ We want to let the community know that we are working diligently to get to every application and help as many people as possible. ” United Way has $ 16 million left to distribute, and Cabrera said they expect to receive further funding from the State of California, though the amount is not yet known.
Though tenants apply for the funds, the checks go directly to landlords and utility companies and can cover debts retroactively to 18 months ago. What has been holding up applications is incomplete information, Cabrera said. Applicants need to show income, such as two to four current paystubs, unemployment benefits, income tax returns, and so on. “ We need something we can use to extrapolate 12 months of annual income, ” she explained. “ We also need something to show that there’ s been a hardship due to COVID-19, ” she said, and often a personal attestation is accepted.
Cabrera said the majority of the people United Way is helping currently are families who have been scraping to get by or borrowing money from friends or relatives to pay their rent up until now. For people who’ ve been evicted, Cabrera said they were permitted to use rental funds toward hotel stays, rental application fees, and moving expenses.
For people who’ ve applied to the rental assistance program and need to forestall an eviction, their application confirmation can be used to show a landlord that they are in the pipeline and will be receiving funds. Cabrera said there was no need to panic and apply a second time; applicants can get confirmation in a call or email to the United Way program.
While it is difficult to ascertain the actual number of evictions in Santa Barbara County, the Sheriff’ s Office, which serves notices of unlawful detainer, counted 352 that were served in 2021. By comparison, 410 were served in 2019 before the pandemic, and 138 in 2020.
Jennifer Smith, who heads the Legal Aid Foundation of Santa Barbara County, said eviction activity has grown since the state eviction moratorium ended on September 30. Legal Aid’ s eviction case load had doubled by November compared to the summer months. “ We’ ve seen everything from folks still dealing with COVID impacts, landlords attempting to skirt the protections of the Tenant Protection Act, and illegal lockouts and rent increases, too. ” Smith warned that although the rent funds may continue, “ Everyone who owes rent April 1 forward is at risk of eviction, even if AB 2179 passes. And already folks who owe rent could be evicted for nonpayment if they do not have any COVID-related defenses or protections. ”
Legal Aid has seen much confusion amid the changes of the past two years, even beyond the special COVID rules. It’ s resulted in “ record levels of housing insecurity and displacement, ” said Smith. “ It’ s going to take a community-wide effort to prevent more overcrowding, uninhabitable conditions, housing insecurity, and homelessness. ”
The United Way website for the rental assistance program — unitedwaysb.org/rent — has all the details to apply, with priority going to very low-income households. People can also call United Way at ( 805) 965-8591 to leave a message to get help, or email assistance @ UnitedWaySB.org. Should you receive an eviction notice, however, all agencies advise seeking legal help immediately.
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“ Bridgerton ” Star Simone Ashley Tattooed Her Own Ankle After Watching a Prison Inmate’ s Tutorial — See Photos | Bridgerton star Simone Ashley found a truly unique way to pass the time when COVID lockdowns called for everyone to stay home. Appearing on Jimmy Kimmel on March 28, the actor shared that she learned how to tattoo with a YouTube video, and let's all file this one under things not to try at home.
After trying the traditional lockdown activities, like baking banana bread and learning to tie-dye, Simone decided to try something truly unique — becoming a DIY tattoo artist. “ I thought it would be a good idea to get my own tattoo pen with a needle and everything. It's called a rotary pen, ” she said, recounting how she bought it online without any ID required. “ I just clicked a button... Apple Pay, ” she said illustrating the `` surprisingly easy '' buying process with her hands. ( Again, do not try this at home.)
As she pointed out, most tattoo shops were closed during the time she ordered the pen, and so, she taught herself to use it via a very appropriate Google search: “ How to do a tattoo at home. ” After a while, she landed on a video from a YouTuber user called PrisonTattoo.com. “ I looked at his videos and I was like 'Wow, there's an inmate making videos... in prison. This is a fab idea. ' '' She went on to show her tattoo, a sphynx cat on her ankle, which she got following the tutorial's instructions. Simone also revealed she has tattooed castmates as well during the interview.
Simone isn't the first celeb to act as her own tattoo artist, but there are definitely many risks that come with attempting this task yourself. As Allure notes, it's possible to experience an allergic reaction to the ink and to cause infection, especially as an at-home environment is likely not properly sterilized. So, if you are interested in a tattoo, definitely trust the experts, and maybe just stick to baking at home for now.
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Russia’ s COVID-19 cases surge by almost 19,600, a new low since January 12 | Russia’ s COVID-19 case tally rose by 19,660 over the past day to 17,803,503, the anti-coronavirus crisis center reported on Tuesday, Trend reports with reference to TASS.
For the first time since January 12, Russia reports less than 20,000 daily COVID-19 cases. In relative terms, the growth rate reached 0.11%.
As many as 4,932 people were hospitalized with COVID-19 in Russia over the past day, up 179.9% from a day earlier. The number of hospitalized patients increased in 78 regions, while in 4 regions the figure decreased. The situation remained unchanged in three regions. A day earlier, 1,762 people were rushed to hospitals.
Moscow’ s COVID-19 cases surged by 708 over the past day versus 703 cases a day earlier, reaching 2,737,501, according to the anti-coronavirus crisis center. St. Petersburg’ s COVID-19 cases increased by 980 over the past day versus 998 a day earlier, reaching 1,498,269. | general |
Solomon Islands PM says China security deal'ready for signing ' | Hi, what are you looking for?
The Solomon Islands’ prime minister said Tuesday that a contentious security agreement with Beijing was “ ready for signing. ”
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Published
The Solomon Islands’ prime minister said Tuesday that a contentious security agreement with Beijing was “ ready for signing ”, denying reports that his country had been pressured to allow a Chinese naval base to be built in the Pacific island nation.
In an impassioned speech to parliament, Prime Minister Manasseh Sogavare offered little detail on the shape of the final deal beyond saying that there was “ no intention whatsoever… to ask China to build a military base in the Solomon Islands ”.
He dismissed reports in the Australian media that his country was being “ pressured by the People’ s Republic of China to build a military base in Solomon Islands ”.
“ Where does that nonsense come from? The security treaty… is pursued at the request of the Solomon Islands’ government, ” he said.
“ We are not pressured. We are not pressured in any way by our new friends. ”
A draft version of the agreement, leaked last week, sent shockwaves through Canberra because it included proposals that would allow Chinese security and naval deployments to the Pacific island nation.
Asked in parliament about the status of the deal, Sogavare said: “ We will finalise and finish now. The document is ready for signing. ”
Australian Prime Minister Scott Morrison this week said reports of the deal were “ a reminder of the constant pressure and threats that present in our region to our own national security ”.
Morrison said he had been in contact with New Zealand Prime Minister Jacinda Ardern, who this week called the draft deal “ gravely concerning ” and said there was “ very little reason in terms of the Pacific security for such a need and such a presence ”.
– ‘ Very insulting’ –
In his speech Tuesday, Sogavare confirmed that existing security arrangements with Australia would “ remain intact ” under the new pact with China, but added that “ to achieve our security needs, it is clear that we need to diversify the country’ s relationship with other countries — and what is wrong with that? ”
China’ s growing influence in the Pacific in recent years has fed into a tense relationship with Australia, as has Canberra’ s strengthened military ties with the United States and other allies.
The prospect of a Chinese naval base in the South Pacific has long been a concern for Australia and the United States because it would allow Beijing to project its power deeper into the region.
Sogavare labelled concern from “ many leaders ” about China’ s presence threatening regional security in the Pacific as “ unfortunate perceptions ”.
He said that it was “ very insulting… to be branded as unfit to manage our sovereign affairs ” by other nations and condemned those who had leaked the draft pact with China as “ lunatics and agents of foreign regimes ”.
– ‘ Partner of choice’ –
The Solomon Islands were rocked by unrest last November when protesters tried to storm the parliament and then went on a deadly three-day rampage, torching much of Chinatown in the capital of Honiara.
More than 200 peacekeepers from Australia, Fiji, Papua New Guinea and New Zealand were deployed to restore calm and Sogavare managed to avoid being deposed.
Sogavare said Tuesday that Australia and New Zealand would remain the “ partner of choice when it comes to the need to call for assistance in critical times ”.
Last year’ s riots were sparked by a range of tensions in the Solomon Islands, including opposition to Sogavare’ s rule, inter-island rivalries and high unemployment, but anti-China sentiment in the nation also played a key role.
Leaders on the most populous island of Malaita fiercely oppose Sogavare’ s decision to shift diplomatic ties from Taiwan to Beijing in 2019, a switch that became a lightning rod for broader frustration about Chinese investment in the Pacific island nation.
With 2,400 staff representing 100 different nationalities, AFP covers the world as a leading global news agency. AFP provides fast, comprehensive and verified coverage of the issues affecting our daily lives.
Under a shattered crescent hanger at Ukraine's Gostomel Airport the world's largest plane lies buckled and broken.
A federal appeals court upheld Biden’ s vaccine mandate for federal workers, while COVID-19 cases rise.
The fake logic is simple to the point of idiocy, but it’ ll work in information-starved Russia.
At least 52 people are killed, including five children, in a rocket attack on a train station in the eastern Ukrainian city of Kramatorsk.
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Dollar eases, euro rises on Ukraine peace talk hopes | Russia said in talks in Istanbul on Tuesday that it would scale down military operations around Ukraine's capital and north, while Kyiv proposed adopting neutral status, in confidence-building steps that were the first signs of progress towards negotiating peace.
The dollar, which had risen as much as 3.4% since Russia invaded Ukraine, declined 0.596% to 98.496, as traders looked to currencies deemed riskier.
`` Risk appetite is back and I think you're seeing potentially a major turning point in the war in Ukraine as Russia signals talks have been constructive and there's hope that there could be a ceasefire, '' said Edward Moya, senior analyst at Oanda.
The euro was up 0.81% at $ 1.1076, having earlier hit its highest level since March 17.
`` The euro today is enjoying a relief rally built on constructive peace talks, lower oil, and expectations that euro zone data this week could strengthen the case for the ECB ( European Central Bank) to raise interest rates, '' said Joe Manimbo, senior market analyst at Western Union Business Solutions.
Any step toward a ceasefire or potential peace deal in Ukraine would support the euro, as Europe is seen suffering a significant economic blow from the conflict, which began with Russia's invasion on Feb. 24 and sent energy prices soaring.
Inflation figures of euro zone members for March will begin to roll in on Wednesday, with the composite release on Friday.
The greenback slid 0.89% against the yen to 122.83 yen. The Japanese currency had fallen to its lowest level since 2015 on Monday.
Title: Yen vs. dollar percent changes,
Japanese Finance Minister Shunichi Suzuki said the government would closely watch currency moves to prevent a `` bad '' weak yen that hurts the economy.
`` While the comments from Japanese officials overnight are unlikely to reverse the yen weakening trend on their own, they should at least help to slow the recent fast pace of yen selling, '' Lee Hardman, currency analyst at MUFG, said in a note to clients.
The Bank of Japan on Tuesday continued to defend a key yield cap by offering to buy unlimited amounts of 10-year government bonds, which will likely keep the yen on its back foot.
China's offshore yuan dipped 0.14% to 6.3763 against the greenback after new pandemic restrictions in Shanghai. It hit its lowest level since October 2021 at 6.4106 in mid-March.
Shanghai, China's most populous city, tightened the first phase of a two-stage COVID-19 lockdown, asking residents to stay indoors.
In cryptocurrencies, bitcoin was up 0.92% at $ 47,585 after hitting its highest level since late December on Monday.
Ether, the world's second-largest cryptocurrency, was up 2.67% at $ 3,423.
( Reporting by John McCrank; additional reporting by Stefano Rebaudo; Editing by Jan Harvey, Andrea Ricci and Paul Simao)
By John McCrank | business |
What One Million COVID Dead Mean for the U.S.'s Future News and Research | Laura Jackson feels the loss of her husband Charlie like she is missing a part of herself. He died of COVID early in the pandemic, on May 17, 2020, just weeks after the couple celebrated his 50th birthday. Charlie was an Army veteran who served in Iraq during Desert Storm, and Laura finds herself returning to images of war and loss—to those who have lost a limb but still feel its phantom tingle, who unthinkingly reach for a glass of water or try to step out of bed before realizing what has been lost forever. Even now she still turns to find Charlie, eager to share a joy or a disappointment, only to remember with a jolt that there is a missing space where he once was.
“ I don’ t know that you ever get over it, ” says Jackson, who lives in Charlotte, N.C. “ Your person who was supposed to be there for life—to have that tragically ripped away has been a huge, huge adjustment to make. ”
The U.S. will record one million confirmed deaths from COVID in the next several weeks. This toll is likely an undercount because there are more than 200,000 other excess deaths that go beyond typical mortality rates, caused in part by lingering effects of the disease and the strain of the pandemic. These immense losses are shaping our country—how we live, work and love, how we play and pray and learn and grow.
“ We will see the rippling effects of the pandemic on our society and the way it impacts individuals for generations, ” says Nyesha Black, director of demographic research at the University of Alabama. “ This is definitely a huge marker in the way we will think about society moving forward—it will be that anchor event. ” COVID has become the third leading cause of death in the U.S., after heart disease and cancer.
These deaths have wide-ranging consequences. The effects on children may be the longest-lasting. In the U.S., an estimated 243,000 children have lost a caregiver to COVID—including 194,000 who lost one or both parents—and the psychological and economic aftershocks can have lifetime negative impacts on their education and career.
Certain communities have been hit especially hard, with older Americans and people of color suffering disproportionately. As of March 25, about three quarters of the dead, or around 730,000, have been people 65 and older. Many of them were otherwise healthy and, statistically, would have lived many more years, says Jennifer Dowd, a demographer at the University of Oxford. Their passing leaves a giant hole, she notes. “ We’ re probably not accounting for all the ways in which we rely on that age group to contribute to society, ” from caring for grandkids to providing stable intergenerational family structures, Dowd says. On average, every death from COVID leaves nine people grieving.
In the U.S., there were 54.1 million people 65 and older in 2019, and since then the coronavirus has killed one out of every 74 of them. These deaths are more concentrated in even older populations: more than a quarter have occurred in those age 85 and older, while another quarter have been in those 75 to 84.
Younger people have not escaped. About 240,000 Americans between the ages of 18 and 64 have died, nearly a quarter of the total toll. Among working-age Americans, “ we are seeing right now the highest death rates we have ever seen in the history of this business, ” said J. Scott Davison, CEO of the insurance company OneAmerica, in late December 2021. “ Death rates are up 40 percent over what they were pre-pandemic. ” For comparison, he said, “ a one-in-200-year catastrophe ” would lead to a 10 percent increase, “ so 40 percent is just unheard of. ”
“ People are dying in the prime of life, ” says Andrew Stokes, an assistant professor of global health at the Boston University School of Public Health. “ They’ re leaving families. They were caregivers. When we think about the children left behind, the single moms and single dads who don’ t have a partner any longer, that’ s going to create inequity that will be experienced for years to come. ” Those lost took others to the doctor or checked in on friends or neighbors to make sure they were eating well and their blood pressure or sugar levels were okay. “ What does it mean when these ties have been broken? ” Black asks. “ Can you put these pieces back together? ”
And certain types of work were hit harder by COVID than others. Those in fields such as food and agriculture, warehouse operations and manufacturing, and transportation and construction saw higher rates of death than in many other occupations. And working in a nursing home has been one of the deadliest jobs in the U.S.
“ A lot of us demographers have just been tallying the losses, and it kind of snuck up on us—the scale of it all, ” Dowd says. “ We never thought it would keep going like this. ” Such devastation has not been seen since World War II, when about 418,000 Americans died, she says. “ We’ re going to be trying to understand those long-term effects on health and mortality for a long time. ”
Even as Laura Jackson navigated her grief, she was immediately faced with the financial repercussions of her husband’ s death. A small insurance policy barely covered his funeral, and then she was on her own. “ It has thrown my life in a tailspin, ” she says. “ Just in a matter of days, watching everything that we had, everything that he was maintaining, just pretty much go up in flames. ”
After Charlie died, Jackson started getting home foreclosure and overdue bill notices. She relied on her three children, all in their 20s, for support until she could start a new job two months later. “ It was a few months of stretching every dollar, trying to figure out how to balance things, ” she says. Seven months passed before Jackson began receiving disability benefits on her husband’ s behalf, and she still does not receive the full amount, she says.
“ In certain communities or certain economic groups, there is not a lot of room for error, ” Black says. “ You don’ t have the safety net in terms of the economic resources if you lost someone, and they were a contribution to the household. So those disruptions can be more long-term, or the effect of them can be more detrimental. ”
Not all of these resources are part of the official economy. “ A lot of communities that are lower-income, for example, they may not go to the private market to purchase childcare, ” Black says. “ So what happens when you don’ t have your grandmother around or your mother around? Who can now watch your child? ” Losing childcare can affects parents’ ability to work, making it more difficult to provide for their families. More than one million women left the workforce during the pandemic, in large part because of childcare disruptions.
A lot of that childcare came from grandparents, who play an integral role in children’ s lives, providing emotional and financial support. More than 80 percent of Americans age 65 or older are grandparents, and about one in five provide childcare regularly, according to a 2015 Pew Research Center survey. In 2019 grandparents provided housing for 4.5 million children, Grandparents of color are more likely to help financially and logistically. According to a survey reported in 2012, more than half of Hispanic or Latino grandparents said they provided childcare for five years or more, and African American grandparents were most likely to be their grandchildren’ s primary caregivers, compared with other groups—making the disproportionate losses from COVID in communities of color even greater.
After a primary caregiver’ s death, kids often have a higher risk of many problems. More than half of kids report having significant mental health issues. Losses also put children at greater risk for physical, emotional and sexual violence, poverty, suicide, teen pregnancy, and infectious and chronic illnesses. Losing a caregiver can worsen feelings of abandonment, affect self-esteem and make it harder to cope with stress. The difficulties extend to kids’ education. Children who lose a parent tend to see their performance at school suffer, and that, in turn, harms future income and family stability. “ In social epidemiology, we think about these effects as the long arm of childhood trauma—effects that exert themselves throughout the life course, ” Stokes says. “ It’ s kind of a direct path from education to economic viability and security or having more precarious employments. ”
For children, the aged and the rest of society, experts expect to see a long-term worsening trajectory of health and survival in coming years. One reason is the effect of “ long COVID, ” a cluster of debilitating symptoms, including fatigue, headache, pain and shortness of breath, that can last for months after an initial infection. The syndrome may also result in increased mortality, with people dying months after contacting the virus. Delays in getting health care, created by the crush of acute and long COVID patients during the pandemic, may lead to higher death rates for people who have developed diabetes, cardiovascular disease and other conditions. The U.S. already had a crisis of chronic disease, especially in working-age people, which is one reason why the coronavirus wreaked havoc, Stokes adds. “ There’ s an interaction with these chronic diseases, and it’ s increasing the mortality risk from those conditions. ”
When Kristin Urquiza’ s father died of COVID at age 65 in June 2020, it changed her world. She took a leave from her job to grapple with her grief and trauma. The 40-year-old woman, who hails from Arizona but lives in San Francisco, was also filled with anger about what she saw as the pandemic’ s mismanagement by then president Donald Trump and Arizona Governor Doug Ducey. These complicated feelings led Urquiza to co-found a survivor’ s group called Marked by COVID, which now counts 100,000 members nationwide. Marked by COVID’ s intention is to ensure these losses are not forgotten by society. Members are pushing for a national COVID memorial day and a 9/11-style commission to investigate the nation’ s response to the pandemic.
“ I wish, in some way, people could really see with pure visibility how many people are wearing the weight of this pandemic, ” Urquiza says. Sometimes she imagines what would happen if people showed visible reminders of the effects of the pandemic—if the faces of everyone mourning a loss or suffering long-term symptoms shone in vivid color, pink or purple or red. “ I think it would help bring home just how not normal these times are and how many people are suffering, ” Urquiza adds.
These losses are particularly hard because many people did not have a chance to say goodbye in person or mourn with others; the risk of infection was too dangerous. “ We didn’ t get to grieve as we would do traditionally, ” says Jackson, who is a member of Marked by COVID. This problem is made worse by survivors’ sense that a large number of Americans do not want to acknowledge the horrifying toll or learn from it moving forward. Instead people and pundits proclaim that they are “ done with COVID. ”
Urquiza does not want the country to wallow in grief. Rather she wants the U.S. to use the emotion to galvanize action. “ This is a major disrupting event, and it gives us the opportunity to think about how we actually want to rebuild, ” she says. “ We're a country that’ s so deeply divided. I believe we can start to see one another as Americans and humans if we can hold space for what we’ ve been through in this moment. ” | science |
14,549 new cases confirmed as recent case spike puts HSE under ‘ huge pressure’ | Dr Colm Henry said there are more than 6,000 health staff absent from work, as the service struggles to deal with a spike in cases ( PA)
A further 14,549 new cases of Covid-19 have been confirmed this afternoon by officials at the Health Protection Surveillance Centre ( HPSC).
5,962 of the cases were confirmed by PCR testing while the remaining 8,587 cases were recorded through postive antigen test results uploaded to the HSE's portal.
As of 8am this morning, 1,605 Covid-19 patients were hospitalised, down 20 since yesterday.
Of these patients, 50 are being treated in intensive care, a decrease of four on yesterday's total.
Meanwhile the HSE's chief clinical officer has said the health service is under `` huge pressure '' following a large number of new cases of Covid-19 reported over the weekend.
Dr Colm Henry said there are more than 6,000 healthcare staff absent from work as the service struggles to deal with the spike.
Almost 40,000 Covid-19 diagnoses were reported over the weekend alone.
It comes as the Minister for Health Stephen Donnelly said the number of infections is amounting to hundreds of thousands a week.
Dr Henry said hospitals are seeing an ongoing rise in cases, with around 1,600 people in hospital with Covid.
He said around half were admitted with the disease, with the other half picking it up while in hospital.
On Monday, the Emergency Department Taskforce urged the Government to consider bringing back a number of public health measures to help contain the virus.
Dr Henry said he agrees with the reintroduction of mask wearing and urged the public to continue wearing face coverings on public transport and in “ congested areas ”.
He said: “ We are dealing with a new variant, the BA.2 variant, which is much more transmissible.
“ Fortunately, due to the vaccination programme and the booster programme, we see less severe illnesses associated with this variant.
But as it has some new mutations, it means that people who were previously infected are liable and likely to get reinfected.
“ The harm associated with Covid is much diminished because of the vaccination programme – it reduces serious illness. While there is a small rise in patients with Covid in intensive care, it’ s not nearly as marked as January 2021. | general |
Azerbaijan, UNESCO to expand ties in sports [ PHOTO ] | Azerbaijan intends to expand its partnership with UNESCO in the field of sports.
During the visit to Paris, the Minister of Youth and Sports Farid Gayibov met with the Assistant Director General for Social and Human Sciences of UNESCO.
The sides discussed prospects for cooperation between Azerbaijan and UNESCO in the field of youth and sports.
The sides exchanged views on strengthening and expanding ties in this direction.
At the invitation of Gabriela Ramos, Farid Gayibov took part in a high-level political conference titled `` The Youth As Researchers ( YAR) global initiative on COVID-19 ''.
The Youth and Sports informed the conference participants about the country's youth policy.
The Youth As Researchers ( YAR) global initiative on COVID-19 connects and engages with young people to conduct research on the impacts of COVID-19 on young people and the responses young people have implemented to tackle these.
The program has been designed to give young people the skills they need to conduct credible research based on sound methods and ethical practices.
YAR supports young people through training, mentoring and giving advice during the research process to empower them to choose the research topics they want to investigate, design the research and then collect and analyze data. The researchers then use their research to deliver key messages.
Azerbaijan and UNESCO have been enjoying successful cooperation since 1992.
In 2003, the parties signed the framework agreement on cooperation in the areas of culture, science, education, and communication, which allowed Azerbaijan to become one of the donors of UNESCO.
Many Azerbaijani cultural sites have been included in UNESCO's World Heritage List.
Icherisheher ( Old City), Maiden Tower, and Shirvanshah's palace were included in the UNESCO World Heritage List in 2000, while since 2007 the Gobustan National Historical-Artistic reserve was also listed among these heritages.
Shaki, an important city at the crossroads of the historic Silk Roads was inscribed on UNESCO's World Heritage List during the 43rd session of the World Heritage Committee held in Baku.
In 2017, UNESCO recognized Azerbaijan's dolma as the Intangible Cultural Heritage of Humanity.
Art of crafting and playing with kamancha, presented jointly by Azerbaijan and Iran, was also inscribed on the UNESCO Representative List of the Intangible Cultural Heritage of Humanity.
Moreover, the Pomegranate Festival, Art of miniature were inscribed in UNESCO Representative List in December 2020.
UNESCO also successfully celebrated the 600th anniversary of the death of the great Azerbaijani poet and thinker Imadaddin Nasimi and the 200th anniversary of the first settlement of Germans in Azerbaijan.
In 2021, Lankaran region was included in the UNESCO list `` Network of Creative Cities ''. | general |
Iran reveals COVID-19 data for March 29 | As many as 2,743 people have been infected with the coronavirus ( COVID-19) in the past 24 hours in Iran, reads the statement of the Ministry of Health and Medical Education of Iran, Trend reports.
In addition, 46 people have died from the coronavirus over the past day.
At the same time, the condition of 1,477 people remains critical.
So far, more than 49.2 million tests have been conducted in Iran for the diagnosis of coronavirus.
In total, about 147 million doses of vaccines have been used in Iran so far. A total of 63.8 million doses have been used on the first stage, 56.8 million doses - on the second stage, and 26.1 million doses – on the third stage.
Iran continues to monitor the coronavirus situation in the country. According to recent reports from Iranian officials, over 7.15 million people have been infected, and 140,109 people have already died.
Meanwhile, over 6.86 million people have reportedly recovered from the disease. The country continues to apply strict measures to contain the further spread of the virus.
Reportedly, the disease was brought to Iran by a businessman from Iran's Qom city, who went on a business trip to China, despite official warnings. The man died later from the disease. The Islamic Republic announced its first infections and deaths from the coronavirus on Feb. 19.
The outbreak in the Chinese city of Wuhan - which is an international transport hub - began at a fish market in late December 2019.
The World Health Organization ( WHO) on March 11 declared COVID-19 a pandemic. Some sources claim the coronavirus outbreak started as early as November 2019. | general |
‘ Is this a good deal, or should I run for the hills?’ My boyfriend of five years wants me to give him a $ 165,000 loan using his house as collateral | Dear Quentin,
I would like your advice on giving a hard-money loan to the man I’ ve been dating for five years. He pressed me on this issue three years ago. I didn’ t do the loan then, and it was a serious issue between us. The term of the loan that he secured with a third party was three years, which is now expiring. He wants and expects me to loan him $ 165,000 now.
He paid $ 1,100 per month to the previous lien holder, but he wants me to take no more than $ 500 a month, and to allow him to keep $ 15,000 of the loan as a “ cushion “ for the future. He says he has enough equity in the house to cover my loan. He also wants a five-year term. I’ m 74 and he’ s 65. Given that, I don’ t want to be tied to a five-year commitment to that money.
Also, he has a pending bankruptcy ( his second bankruptcy), and he works for himself as a website builder. We live in Nevada. He tells me this is a great deal for me, as I am protected because of the equity in the house, and that I’ m earning 5% on my money. I would appreciate your thoughts on this issue. Time is critical, because he needs the deal done the first of May.
Your thoughts, please. Is this a good deal, or should I run for the hills?
What to Do
Dear What to Do,
Oh, boy.
There are three reasons to reject his request on principle:
1. You already said no, and it’ s not respectful to not keep haranguing or pushing you to change your mind. If you were a bank, and he kept coming back asking the same question and putting pressure on the loan officer, he would be escorted out of the building.
2. He is on the brink of his second bankruptcy, the ultimate sign that someone is not financially stable, or knows how to manage his finances. That’ s a clue that you are not helping him or yourself by becoming embroiled in his financial affairs. What are the bankruptcy rules in Nevada? A bankruptcy attorney will be able to tell you what would happen to this loan during and after bankruptcy proceedings.
3. You have a relationship with this man, and asking you to loan him money — with or without his real estate as collateral — mixes finance and romance. The two rarely, if ever, make suitable bedfellows. It creates an unhealthy, codependent dynamic. ( Where would this $ 165,000 be coming from? A bank account, retirement account, or non-qualified brokerage account? Consult a tax adviser.)
And now three reasons why the offer itself is not attractive:
1. You are correct in your concerns about the loan itself. At the age of 74, you are wise not to get mixed up in a financial commitment over a five-year period. This should be a time in your life when you are enjoying life without financial worries — not inviting more into your life.
2. A 5% interest rate is significantly lower than the interest rate on most hard-money loans. But that does not take into account the risk/reward. You don’ t need to earn 5% on this amount of money, and it’ s not worth the worry and stress such an arrangement would bring. What’ s more, under the terms that your partner proposed, the loan principal would actually grow to $ 177,609.46 by the end of the 5-year term. ( Present value of loan: $ 165,000. Interest: 5%. Number of payments: 60. Payment: $ 500/month. Future value of loan: $ 177,609.46.)
3. Changing the terms of the loan repayments from his previous loan agreement also shows a lack of good faith. Asking to keep $ 15,000 as a cash cushion is another red flag. He is using your romance as leverage to structure this deal. It’ s a final nail in the coffin.
Finally, time is critical — for him, not for you. Before any loan, an individual or financial institution should establish their own timeline to do due diligence. Timeshare and second-hand car salespeople have been known to wear down potential investors under pressure. Real friends do not.
Yo
u
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‘ She had a will, but it was null and void’: My friend and her sister are fighting over their mother’ s life-insurance policy and bank account. Who should win out? | business |
FDA approves another Pfizer, Moderna COVID booster for those 50 and older | Americans 50 and older can get a second COVID-19 booster if it’ s been at least four months since their last vaccination, a chance at extra protection for the most vulnerable in case the coronavirus rebounds.
The Food and Drug Administration on Tuesday authorized an extra dose of the Pfizer
PFE,
+0.02%
or Moderna
MRNA,
+1.16%
vaccine for that age group and for certain younger people with severely weakened immune systems.
Hours later, the Centers for Disease Control and Prevention recommended the extra shot as an option but stopped short of urging that those eligible rush out and get it right away. That decision expands the additional booster to millions more Americans.
Everyone eligible for a first booster who hasn’ t gotten one yet needs to, FDA vaccine chief Dr. Peter Marks said. But the second booster is only for these higher-risk groups because there’ s evidence protection can wane and FDA decided the option “ will help save lives and prevent severe outcomes. ”
The move comes at a time of great uncertainty. COVID-19 cases have dropped to low levels after the winter surge of the
super-contagious omicron variant
. Two vaccine doses plus a booster still provide strong protection against severe disease and death, CDC data show.
But
an omicron sibling
is causing a worrisome jump in infections in Europe — and
spreading in the U.S.
— even as vaccination has stalled. About two-thirds of Americans are fully vaccinated, and half of those eligible for a first booster haven’ t gotten one.
Pfizer had asked the FDA to clear a fourth shot for people 65 and older, while Moderna requested another dose for all adults “ to provide flexibility ” for the government to decide who really needs one.
FDA’ s Marks said regulators set the age at 50 because that’ s when chronic conditions such as heart disease and diabetes become more common, increasing the risks from COVID-19.
Until now, the FDA had allowed a fourth vaccine dose only for the immune-compromised as young as 12. Tuesday’ s decision allows them another booster, too — a fifth dose. Marks said those patients are more likely to see their immune protection wane sooner and therefore can benefit more from extra protection. Only the Pfizer vaccine can be used in those as young as 12; Moderna’ s is for adults.
There’ s limited evidence to tell how much benefit another booster could offer right now. FDA made the decision without input from its independent panel of experts that has
wrestled
with how much data is required to expand shots.
“ There might be a reason to top off the tanks a little bit ” for older people and those with other health conditions, said University of Pennsylvania immunologist E. John Wherry, who wasn’ t involved in the government’ s decision.
But while he encourages older friends and relatives to follow the advice, the 50-year-old Wherry — who is healthy, vaccinated and boosted — doesn’ t plan on getting a fourth shot right away. With protection against severe illness still strong, “ I’ m going to wait until it seems like there’ s a need. ”
None of the COVID-19 vaccines are as strong against the omicron mutant as they were against earlier versions of the virus. Also, protection against milder infections naturally wanes over time. But the immune system builds multiple layers of defense and the type that prevents severe illness and death is holding up.
During the U.S. omicron wave, two doses were nearly 80% effective against needing a ventilator or death — and a booster pushed that protection to 94%, the CDC recently reported. Vaccine effectiveness was lowest — 74% — in immune-compromised people, the vast majority of whom hadn’ t gotten a third dose.
U.S. health officials also looked to Israel, which during the omicron surge opened a fourth dose to people 60 and older at least four months after their last shot. The FDA said no new safety concerns emerged in a review of 700,000 fourth doses administered.
Preliminary data posted online last week suggested some benefit: Israeli researchers counted 92 deaths among more than 328,000 people who got the extra shot, compared to 232 deaths among 234,000 people who skipped the fourth dose.
What’ s far from clear is how long any extra benefit from another booster would last, and thus when to get it.
“ The ‘ when’ is a really difficult part. Ideally we would time booster doses right before surges but we don’ t always know when that’ s going to be, ” said Dr. William Moss, a vaccine expert at the Johns Hopkins Bloomberg School of Public Health.
Plus, a longer interval between shots helps the immune system mount a stronger, more cross-reactive defense.
“ If you get a booster too close together, it’ s not doing any harm — you’ re just not going to get much benefit from it, ” said Wherry.
The newest booster expansion may not be the last: Next week, the government will hold a public meeting to debate if everyone eventually needs a fourth dose, possibly in the fall, of the original vaccine or an updated shot.
Even if higher-risk Americans get boosted now, Marks said they may need yet another dose in the fall if regulators decide to tweak the vaccine.
For that effort, studies in people — of omicron-targeted shots alone or in combination with the original vaccine — are underway. The National Institutes of Health recently tested monkeys and found “ no significant advantage ” to using a booster that targets just omicron. | business |
Open RAN: The final frontier | In the very simplest of terms, a communication network is a set of interconnected nodes that exchange data. When a telco builds a mobile network, the most expensive part is the radio access network ( RAN). This is the radio base station, which connects users to the core network. Telcos have traditionally used proprietary appliances in their networks. These boxes are expensive, and are only made by a handful of suppliers. It’ s also worth remembering that telco networks have to be extremely reliable, with very little downtime, perhaps just 30 seconds a year. The networks also have to be able to handle the scale; imagine if most of South Africa’ s 54 million-odd cellphone users are all on the line? A couple of years ago, the industry began to virtualise its network services. This is known as network functions virtualisation ( NFV). Telcos are now able to use virtual machines for some services, such as routers, firewalls, caching, for example, and these can be run on standard, non-proprietary servers. Now, the radio access network is being virtualised, and this is known as Open RAN. It’ s a complicated area, and is awash in an alphabet soup of acronyms, which is one reason why Brainstorm assembled a panel of industry experts to make sense of it all.
Anybody can make a new piece of the end-to-end network better, and it allows smaller players to come in and do something disruptive. That has benefits, but it also adds a massive challenge: who’ s going to stick it all together?
At the outset, it may also be worth dealing with the nomenclature: O-RAN refers to the O-RAN Alliance standards body, which is working on the Open RAN specifications. Then there’ s OpenRAN, which is the way the collaborative industry group the Telecom Infra Project ( TIP) prefers to write it. Finally, there’ s vRAN, which stands for virtualised radio access networks, which allows telcos to run their baseband functions as software. Open RAN also opens the door to 5G, but as Anthony Laing, GM: Networking, at NEC XON, says, a lot of people mention Open RAN and 5G in the same breath, yet they’ re actually different technologies. Telcos and mobile operators will typically pick one, two, or, if they’ re brave, three vendors, and then they’ d be locked into using their equipment, he adds.
“ Open RAN democratises the network. It’ s broken up into many more components, and the interfaces are open. The concept is that anybody can make a new piece of the end-to-end network better, and it allows smaller players to come in and do something disruptive. That has benefits, but it also adds a massive challenge: who’ s going to stick it all together?
“ You need to be able to glue these things together and make them work seamlessly. That’ s the key in Open RAN, and it’ s a fundamental shift in the way this industry has worked for decades. ”
He mentions that Rakuten Mobile in Japan – which has the first 5G production network in the world – had partnered with NEC, among others, in the trial.
Tholo Lerotholi, commercial executive at Zoom Fibre, says his company is looking into Open RAN as an alternative revenue stream. Sitting on the commercial, not technical side, of the business, he says he’ s ‘ the capitalist in the room’. Zoom has now passed 70 000 homes.
“ There’ s tremendous opportunity for us, both in South Africa and the continent, simply because we see Open RAN as an opportunity to democratise the space. Ultimately, that’ s where FTTH has plugged itself in, making a solution affordable and accessible to the masses. Open RAN is a new wing ( for our business) and we’ re looking to see how we could integrate the two. Obviously, fibre being the bedrock of connectivity at the moment puts us in a decent position to explore Open RAN. ”
Aji Ed, CTO, Nokia Mobile Networks for MEA, says that at present, the O-RAN Alliance defines only 4G and 5G as Open RAN. However, there’ s predominantly 2G, 3G and LTE in the Middle East and Africa, he says, and it will be challenging to migrate to Open RAN with legacy equipment.
Nokia Mobile Networks is one of the established infrastructure players supporting O-RAN as a standard, and is part of two code sharing working groups in the O-RAN Alliance. One of these is the RAN intelligent controller, which provides low latency use cases, at the edge. It’ s also working on ‘ splitting the fronthaul’, which he says is a fundamental part of the O-RAN standard, so that vendors can be ‘ mixed and matched’.
Brainstorm: What kind of timeframes are we talking about for adoption? I’ ve been seeing talk of 2025…
Networks have been built over a very long time, and they’ re not going to democratise these monolithic architectures in less than five years.
Ed says there’ s already been some small-scale successes, and also mentions the Rakuten example, in which the company successfully verified data transfer on a 5G mobile network in Tokyo. There’ s also a consortium in Europe that includes Orange and Deutsche Telekom, among others, working on a solution. Vodafone also announced that it has the first Open RAN site up and running in the UK, he adds.
On the Vodafone site, he says: “ If you ask my opinion, it’ s not Open RAN, it’ s a virtualised RAN, so this is why the terminology plays a big role. A virtualised RAN is disaggregated in a single base station. It’ s not an open interface between the radio and the baseband. In 2025, we expect to see maybe around 5% or 10% market share for Open RAN versus the traditional RAN. ”
Gavin McDougall, solution architect at Red Hat, says open source and open standards are very much connected to one another, and telcos have, over the years, started opening up their network, which used to be comprised of proprietary boxes and proprietary standards.
His company has been working on NFV for a number of years, and the ‘ last bastion’ still to be virtualised is the radio access network.
Ultimately, that’ s where FTTH has plugged itself in, making a solution affordable and accessible to the masses.
McDougall says this trend of virtualisation is now evolving into a ‘ telco cloud’, or software defined cloud infrastructure.
With NFV, he says, the standards body ETSI was involved in drafting what the architecture should look like, and that Red Hat has been turning this into open source code. It was now doing the same with Open RAN.
Red Hat is providing the telco cloud layer from the core to the edge of the network, where the radio units are deployed.
“ Some of the key drivers we’ re seeing is a reduction of vendor lock-in. Telcos have been locked in to three or maybe four major NEPs ( network equipment providers) over the years and this has levelled the playing field, ” McDougall says. “ You mentioned democratisation, and they ‘ re looking at this in a sense of cost reduction and having some flexibility. Now, with the concept of edge computing, you’ re able to run applications closer to the end-user, whether it’ s IoT, AI or video surveillance. We’ re also seeing trends like zero-touch provisioning and closed loop automation to self-organising networks. With Covid hitting us, the traffic patterns changed quite a bit, so everyone moved back to the suburbs. Having a software defined network gives you more flexibility to move and reroute traffic as you need to. ”
He now digs into some of the contributions his company has made.
“ Traditionally, you had all of the software components combined with the radio, and this has now all been decoupled, but we started seeing issues around latency and so we’ ve had to improve the operating system to incorporate things such as a real-time kernel. We’ ve had to implement hardware acceleration, so using components such as GPUs and FPGAs ( Field Programmable Gate Arrays) and because time is quite important, we’ ve now incorporated what we call precision time protocol. We provide the glue between the hardware and the application, we don’ t get involved in the hardware space or application space, but where we’ re adding value is the ecosystem that we build around it. ”
In 2025, we expect to see maybe around 5% or 10% market share for Open RAN versus the traditional RAN.
He echoes Laing and Adji Ed in saying that Rakutan is the Open RAN ‘ shining light’. “ The radios were from Nokia, and I think NEC provided some of the hardware and the management and orchestration with Netcracker. They chose Red Hat as the telco cloud, so we’ ve all participated in that rollout. ”
McDougallsays Red Hat certified its software, or cloud layer, to run on all the different hardware platforms and then it worked with, for example, Nokia, Ericsson or ZTE, to certify their network functions.
“ Once the telcos build their cloud and infrastructure, they could have a radio from Nokia and some of the other radio components, like the DU ( distributed unit) and CU ( centralised unit) from another provider. They could then decide that they’ re going to use a third provider for their 5G core. No longer is it going to be one NEP from end-to-end. So there’ s choice and flexibility. ”
Keoikantse Marungwana, senior research and consulting manager, Telco and IoT lead, Sub-Saharan Africa, IDC, says smaller players are now able to start targeting markets that aren’ t viable for the large operators.
“ A small player can now spin up a RAN network, and they no longer need expensive equipment; 5G can now be opened up for under-serviced markets. It accelerates the opportunity of mobile private networks or enterprise private networks because they no longer need to be a telco to run a mobile network. ”
He does wonder, though, if the technology is going to see the rollout of 5G in underserviced markets.
“ When TCOs and barriers to entry are reduced, are we only going to see profits increase, or are we going to see it opening up deployments for rural and underserviced markets? ”
Marungwana believes the Open Ran deployment to rural areas would also take longer than it would in mature markets.
“ Networks have been built over a very long time, and they’ re not going to democratise these monolithic architectures in less than five years. ”
McDougall says over the years, the telcos have become comfortable with the big NEPs managing everything for them.
“ A telco pays for a service, and there’ s SLAs, and there would be a fixed contract, for example, of five years and they wouldn’ t have to have the skills or knowledge to manage that. Now, you’ re bringing hardware and operating system suppliers, and multi-vendors. Who manages that? There are only so many people who can, and again, it goes back to the network equipment providers. These new players that are coming up with Open RAN technology don’ t have the scale of the network equipment providers to manage a network that spans across Africa. The complexity is holding them back, and not knowing how to manage it, and not having the skills. That’ s why there’ s a little bit of reluctance. They’ ve been doing it the old way, and it’ s worked for them and there’ s accountability. Who’ s accountable if it breaks? There’ s going to be a finger pointing exercise. There always needs to be a single throat to choke. ”
* This feature was first published in the March edition of ITWeb's Brainstorm magazine. | general |
Digital Fashion — Can It Make Industry More Sustainable? | Fashion has become one of the latest industries put under the scope of digitalization. As more people opt for buying virtual clothing, the opportunity to minimize carbon emissions, textile waste, and water usage within the sector presents itself.
March 29, 2022. With the metaverse, the COVID-19 pandemic, and the increasing concerns related to climate change, fashion designers have turned to digital platforms for releasing their pieces. Louis Vuitton, for example, has designed a set of skins for the MOBA video game League of Legends. As virtual clothing becomes more accessible to the average user, fashion could become a more sustainable industry by allowing people to explore their style without needing to buy physical items.
Despite brands incorporating “ green policies ” to reduce their harm to the environment in recent years, the fast-paced nature of the fashion industry causes it to be one of the biggest pollution-spreading sectors in 2021. However, rapid digitalization occurred within clothing companies as they failed to meet manufacturing goals as a result of the pandemic, which paved the way for virtual clothing.
Brands turned to mapping out initial drafts virtually, only physically crafting the clothes once a design has been settled on. In turn, as reported by ProSoft VR, the manufacturing process of one simple dress reduced environmental costs by around four times.
“ As items go out of fashion and new trends pop up, a cycle of environmental harm is created. Old items end up in landfills, while the creation of new ones emit massive amounts of CO2 and deplete water resources. Games alleviate this burden, as unworn pieces may simply be deleted and replaced by other items with substantively less impact, ” notes Victoria Trofimova, CEO of Nordcurrent, the biggest game development company in Lithuania.
While not completely impact-free, digital clothing items save around 3300 liters and produce 97% fewer carbon emissions per item, compared to their physical counterparts. By satisfying the need for engaging with new trends, consumers will likely be more mindful when buying physical pieces, reducing harm in the long-term.
“ Real-life clothing items increasingly find their way onto digital platforms. With famous designer houses joining the trend, virtual wardrobes are becoming more similar to ones in real-life, ” notes Trofimova. “ By emulating clothing, users may explore trends, styles, and brands without needing to purchase physical pieces, and therefore reducing the environmental impact of the fashion industry, ” she continues.
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The trend is significantly supported by video games, as character customization becomes an integral part of an immersive experience. Games such as Pocket Styler allow the player to fully customize their avatar’ s look with different clothing and accessories that can be found in real-life stores.
“ People may express themselves using Pocket Styler by transferring their particular tastes and preferences to the virtual version of themselves. Players may take their time developing a personal sense of style, which is difficult to achieve in real life as trends change and are phased out of stores rapidly, ” explains Trofimova.
With digital fashion only becoming increasingly popular, a new, sustainable route for the industry is coming into view. By playing with style on virtual platforms like video games, people may still express themselves and be creative using clothing – with minimized detriment to the environment.
Nordcurrent is the biggest Lithuanian video game developer and publisher, known for such games as Cooking Fever, Murder in the Alps, Airplane Chefs, Sniper Arena. Focusing on freemium and casual games, the company created over 50 games since 2002, attracting more than half-billion players worldwide. | tech |
InMobi Debuts High Impact Video and Immersive Shopper Experiences | InMobi, a leading provider of content, monetization and marketing technologies that help businesses fuel growth, announced the launch of InMobi Commerce, an innovative suite of product discovery and monetization solutions, for retailers and ecommerce companies that are designed to help maximize media-derived revenues around the world. InMobi Commerce is a pioneer in launching shoppable videos to retailers, helping them create high-impact video shopping experiences, moving immersive product discovery from social platforms back to their owned channels.
Fueled by the Covid-19 pandemic, consumers have dramatically shifted product discovery and purchases online; in fact, eMarketer predicts that ecommerce sales in the U.S. will exceed $ 1 trillion for the first time in 2022 and grow exponentially in the coming years, topping $ 1.6 trillion by 2025. However, it appears that retailers continue to lose consumer browsing time and product discovery on their owned channels to social platforms, leaving retailers to own only the transaction. Sophisticated retailers are reframing their commerce operations, turning their websites into major media platforms to better leverage their first-party shopper audience data and capture larger advertising budgets. Additionally, eMarketer predicts retail media advertising spend will exceed $ 52 billion in 2023.
“ Video-led discovery and monetization solutions are likely to help retailers bring experiences that consumers want and brands need. We’ re leveraging our 15-year history of building high-performance advertising and monetization solutions to help retailers reach and monetize audiences, ” says Abhay Singhal, Co-Founder of InMobi Group and CEO of InMobi Advertising Platform. “ Blending programmatic media with dynamic sight, sound and motion helps retailers reach the true value of their media, data and consumer access. InMobi Commerce provides retailers and brands the tools they need to enrich storytelling and drive effective shopper engagement in a brand-safe environment. ”
“ The most progressive brands are moving away from the traditional separation between brand and performance and closer to a seamless integration of both, ” says Ivonne Kinser, Vice President of Marketing and Innovation at Avocados From Mexico. “ I’ m thrilled to see the InMobi’ s commerce technology leading the way towards a new form of video-led, sales-driven branded storytelling that is so critical for brands like ours that are embracing new ‘ brandformance’ approaches. ”
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InMobi Commerce features an end-to-end, video-led discovery and monetization retail media platform. InMobi Commerce is leading the industry by launching three creative ad experiences that would make it easy for brands to share their unique stories, build trust and bring their products and services to life:
“ To compete with the other rich media environments that consumers expect online, retail media must go beyond static keywords and sponsored brands ads and offer people what they’ ve come to expect from their online experiences: dynamic and emotive video, and ways to engage and interact and even create content, ” says Elizabeth Marsten, Senior Director of Marketplace Strategic Services at Tinuiti. “ InMobi has designed a turnkey solution, which is a slick, easy to use solution, to tell stories beyond price and sentiment that cements connections, helping brands answer the question of ‘ why’ consumers should choose them. ”
Supporting all retail verticals–including consumer packaged goods, consumer electronics as well as apparel and beauty–InMobi Commerce is intended to help retailers successfully capitalize on the growing retail media market opportunity. Leveraging InMobi’ s deep ad tech expertise, InMobi Commerce provides a supply-side platform for retailers to offer premium ad space and connect brands with high-intent shoppers as they research, browse and shop online. The solution’ s video experiences provide advertisers with premium content that helps drive increased engagement and return on investment.
Powered by machine learning and providing deep, strategic insights, InMobi Commerce is designed to help retailers maximize budgets, demand and revenue from all the brands they want to reach without sacrificing the online customer experience. To learn more, visit inmobi.com/retail-media. | tech |
Workers comp fraud report echoes litigation trend | BI’ s Article search uses Boolean search capabilities. If you are not familiar with these principles, here are some quick tips.
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Workers compensation fraud complaints ticked up in New York in 2021 as more employees returned to work, though nearly half were deemed “ unsubstantiated, ” according to a report by state officials.
The rise in fraud allegations, though, correlates with an increase in accused workers seeking legal advice, a well-known workers comp fraud defense lawyer said.
Last week, New York State Inspector General Lucy Lang released the state’ s 2021 Workers Compensation Fraud Annual Report, detailing claims and fraud investigations last year.
In 2021, WCFIG received 1,118 fraud complaints, up from 1,019 in 2020, and dismissed 492 matters as unsubstantiated or 44%, compared with 336 in the prior year.
Aries Dela Cruz, director of strategic initiatives at the Offices of the New York State Inspector General in Albany, New York said there are “ myriad reasons ” complaints were unsubstantiated, but the overriding reason is insufficient evidence to bring a criminal prosecutor or refer to a prosecutor.
“ There may either be insufficient evidence of employees or there is actually workers comp on the employer’ s part, ” Mr. Dela Cruz said. “ For an employee, there’ s either insufficient evidence of outside activity or that the employee has not actually received indemnity benefits during periods of outside activity. ”
Todd Spodek of New York-based Spodek Law Group P.C. – criminal defense attorney to the so-called Soho Grifter fraudster Anna ‘ Delvey’ Sorokin – who represents workers accused of fraud, said his firm has seen an increase in clients seeking representation for fraud in the pandemic.
“ The pandemic definitely drove up fraudulent claims, and since it became easier to file the claims under COVID, more people filed and more people were potentially committing crimes or doing things that were unethical, ” Mr. Spodek said.
Additionally, while courts in New York reopened in 2021, a significant backlog caused by closures during the pandemic limited or delayed of criminal proceedings and the presentation of new cases to grand juries by district attorneys throughout the state, the fraud report states.
Mr. Spodek said the uptick is likely a result of the economic effects of the pandemic on workers – job loss, delays in getting unemployment, housing issues – paired with COVID-19 delays and disruptions.
“ There certainly are more cases being put under scrutiny, ” Mr. Spodek said. “ Just like there was an uptick in Paycheck Protection Program fraud cases, there’ s an uptick in people who tried to take advantage of workers comp benefits. ”
What becomes of unsubstantiated complaints depends on case evidence, Mr. Dela Cruz said. “ Some are closed outright, and some are referred to other agencies for possible further investigation, ” he said.
“ A lot of people filed fraudulent claims and were unable to provide the documentation to support it, ” Mr. Spodek said. “ And, a lot of times people just forget about them. There’ s also a significant amount people who file these things and then wind up moving or leaving. ”
Among the 1,118 complaints, WCFIG opened 28 as full investigations, continued 334 matters as ongoing preliminary investigations, and closed 51 for the failure to allege actionable wrongdoing or where WCFIG lacked jurisdiction to investigate, among other reasons.
Of the 492 unsubstantiated matters, WCFIG referred 213 complaints for further action to the appropriate agency or insurer, including the New York State Insurance Fund, other investigative offices within the New York State Workers’ Compensation Board, or other interested parties.
1. Flight attendants sue to stop CDC mask mandate
2. Positive drug tests in US workforce highest in two decades
4. Pressure to work while driving keeps workers dialed in
5. Workers comp fraud report echoes litigation trend
6. OSHA affirms court order to vacate citations for amputation injury | general |
Minister: National GDP up by 5.6 pct in 2021 [ PHOTO ] | Azerbaijan's Labour and Social Security Minister Sahil Babayev has said that the country's GDP increased by 5.6 percent last year, as a result of the measures taken by the government to combat the COVID-19 pandemic since the early days.
He made the remarks during the Azerbaijan-UAE Small and Medium Enterprise Forum held in Dubai as part of the 11th Annual Investment Conference on `` investing in sustainable innovation for a bright future ''.
The minister noted that over the past three years the country has implemented three packages of social reforms with an annual financial cost of AZN 6.5 billion ( $ 3.8 bn) and covering half of the country's population. He added that as a result of social reforms, social payments increased by 65 percent, the minimum pension by 2.2 times, the average pension by 60 percent, the minimum wage by 2.3 times and the annual wage fund more than doubled.
Moreover, Babayev briefed on DOST centers created to provide transparent and efficient social services from a single platform. In this regard, he stressed that innovative achievements have contributed to improving the quality and modernization of social services.
Noting that 110 of the ministry's 170 services are provided digitally, Babayev also emphasized the importance of the electronic employment system created in recent years. He stated that the country has an employment-oriented economic development policy, supports micro-, small- and medium-sized enterprises, and has a Tripartite Commission on Social and Economic Issues consisting of government, employer and worker representatives.
Furthermore, mentioning that more than 48,000 families have started their own farms and businesses with the support of the self-employment program in the past five years, he noted that the participation of the World Bank and UNDP in the program has increased its success.
Babayev also briefed on the reconstruction and restoration work carried out in the country's liberated lands.
Additionally, Babayev expressed confidence that the development of business relations between the two countries will make an important contribution to further strengthening cooperation and human capital development.
Speaking at the same event, Azerbaijan's Agency for Small and Medium Business Development board chairman Orkhan Mammadov briefed on economic and trade relations between the two countries, cooperation with energy and relevant agencies of the UAE in the field of SMBs and the support provided to local and foreign businessmen.
Dubai Chamber of Commerce and Industry head of international offices Omar Khan stated that Azerbaijan and the UAE have great potential for cooperation in the field of SMBs, noting that the Chamber is ready to support joint initiatives in this direction.
The event held in Azerbaijan's pavilion at Dubai Expo 2020 aimed to discuss opportunities for SMBs, provide a joint platform for them to network and exchange ideas.
The forum continued with panel discussions on the prospects for joint business initiatives. | general |
HSBC’ s targets for bond emission cuts will be ‘ science-aligned’ | HSBC has gone a step further than many investment banks by revealing the amount of greenhouse gas emissions it supports through its capital markets business — at least, the deals it bookruns for oil, gas and electricity companies.
In 2019 — the year HSBC has used for its calculations, to avoid distortions from the Covid pandemic — the bank reckons the Scopes 1, 2 and 3 emissions it financed in the upstream and integrated oil and gas sector were 29.4m tonnes of CO2 equivalent through capital markets and 35.8m through loans on its balance sheet.
In the power and utilities sector, it facilitated 4.4Mt of Scopes 1 and 2 emissions in capital markets and 10.1Mt on balance sheet.
Scope 3 is the most important for oil and gas companies, because it includes the emissions when fuel is burnt, while Scopes 1 and 2 matter most for power companies, because they do the burning themselves.
Adding all those sums together makes 80Mt, about as much as the annual emissions of Belgium.
Zoe Knight, group head of HSBC’ s sustainable finance centre, spoke to GlobalCapital about how the bank plans to tackle bringing these emissions down, as part of its October 2020 commitment to “ reduce financed emissions from our portfolio of customers to net zero by 2050 or sooner ”.
Banks have so far made more progress in calculating their emissions from their lending than capital markets financing, which HSBC defines as bond and equity issues and syndicated loans.
Much of the work involved is the same — emissions figures have to be calculated or estimated for each issuer. This is not straightforward. Only about a third of HSBC’ s oil, gas and power clients reported their Scopes 1 and 2 emissions and 10% of the oil and gas firms reported Scope 3.
But then a bank has to work out what share of an issuer’ s emissions it should be responsible for, based on how much financing it has done for the client.
HSBC’ s capital markets emissions figures, published in February, follow an engagement campaign by ShareAction, the responsible investing NGO, and 11 institutional investors, which filed a motion in December to be voted on at HSBC’ s annual general meeting in April.
The group have been pushing HSBC to reduce its financing of fossil fuel production, arguing that, six years after the Paris Agreement and more than a year after declaring its net zero ambition, the bank should not still be raising $ 23.5bn of financing a year for the industry.
That figure, HSBC’ s 2018-20 average according to the database maintained by the Rainforest Action Network, includes $ 11.5bn of financing for 100 key companies expanding coal, oil and gas production.
Both sums are larger than the averages for 2016-17, according to RAN.
On March 16, HSBC made a fresh announcement about its fossil financing plans and work towards net zero, which was timed to coincide with the shareholders withdrawing their motion, in recognition of the progress HSBC was making.
The statement included a pledge that it would go beyond publishing its capital markets underwriting emissions, and by the end of this year set targets to reduce them.
So far, few banks have made such commitments, partly because they are waiting for an agreed methodology to be developed. But that should be ready by the end of 2022, since the Platform on Carbon Accounting Financials, a collaborative initiative between banks which has already developed a technique for loans, aims to have its capital markets guidance complete by then.
PCAF’ s approach for on balance sheet finance — increasingly becoming the consensus among banks — involves sharing emissions equally across all a company’ s capital structure, treating debt and equity equally.
Analysing capital markets underwriting relies on a similar approach. In advance of PCAF’ s recommendations being finalised, HSBC is counting the same quantity of emissions for underwritten securities as it would if they are on balance sheet.
However, they must be counted separately to avoid comparing apples with oranges. Capital markets deals are a flow of financing transactions that pass through the bank during a period of time, whereas loans on balance sheet can be totted up at a point in time.
However, PCAF only gives banks a tool with which to describe their emissions — it does not guide them on how fast to bring them down, or how to do this.
For this, HSBC is drawing on all kinds of models and guidance, but particularly from the International Energy Agency’ s Net Zero Emissions by 2050 scenario, published in May 2021, which environmentalists have hailed for declaring that no new fossil fuel infrastructure should be built.
HSBC’ s published targets for on balance sheet fossil financing are to cut the absolute emissions of its oil and gas portfolio 34% from the 2019 level by 2030 — the same reduction used by the IEA in its scenario.
In power and utilities, HSBC is using an intensity metric: to cut emissions per kilowatt hour of energy produced to 140g by 2030, a 75% reduction from 2019’ s baseline of 550g.
The standard used in the EU’ s Taxonomy of Sustainable Economic Activities for sustainable power is a maximum of 100g, while a typical modern combined cycle gas turbine plant emits about 330g/kWh.
Writing to the bank’ s CEO Noel Quinn and chair Mark Tucker after withdrawing their motion, ShareAction and the NGOs called on it to put meat on the bones of its commitments by ceasing any direct financing of new oil and gas projects, phasing out support for unconventional oil and gas, and demanding that clients have transition plans in place by the end of this year.
HSBC should also publish “ core red lines and decarbonisation expectations ” for assessing these plans, and state how it would get tough if clients dragged their feet.
GlobalCapital asked Zoe Knight about how this work is going and what the capital markets targets are likely to look like.
GlobalCapital: ShareAction and the investors that put forward the motion at your AGM say HSBC has made significant advances in your climate policies as a result of the motion, which was why they withdrew it. Is that right?
Zoe Knight, HSBC: With financed emissions, it’ s such a new topic — everyone’ s getting up to speed on it.
I think there’ s a continual engagement with ShareAction and the investor community. The statement [ on March 16 ] was more of a bringing together in one place all the things we have said we were going to do, and provides a bit more clarity on the timelines.
It’ s about providing a continuum of information. That’ s why this was so important to do, to keep up that transparency on our approach and set out a bit more material around what we are going to do.
The investors are particularly pleased that you have agreed to set a target to cut your financed emissions as a result of the capital markets underwriting you do, including bonds and equity deals — so-called facilitated emissions. You’ ve said you’ re going to set this target by the end of this year. Why not set one now?
At the end of last year we said what we were going to do, which is work with the PCAF coalition on a robust method for measuring facilitated emissions. We didn’ t want to confuse colleagues and the external landscape by publishing something now which might have to change in a few months’ time. We felt it made more sense to get balance sheet and financed emissions done because we can own that methodology. We didn’ t want to do two things at once.
That is a fair assessment. We are adopting a science-aligned approach, aligned with the IEA, so yes, our scientific approach will remain in place. What may change is new scientific evidence of what needs to be achieved — so that may mean the targets are different, but it wouldn’ t be because our approach had changed, but more because the surrounding information had changed — we can’ t be in control of that.
[ Taking time to set targets for facilitated emissions ] is more to do with the practicalities of operationalising such a big piece of work — having the right methods and governance. We are making sure it’ s in place. We spent a lot of time last year prioritising financed emissions — making sure we could record and track them.
Simultaneously we were working with PCAF to figure out facilitated emissions. I think it is as straightforward as saying: we are a big organisation, we are working really hard and fast on it. There’ s nothing sinister in the fact we are not doing it this second.
You are cutting financed emissions in your oil and gas portfolio by 34%. On one hand, people could say that isn’ t ambitious enough — scientists say total global emissions need to come down 50% by 2030. HSBC, being a top bank which finances good companies, ought to have a better chance than most of the economy.
But on the other hand, 34% lower emissions is a big change for the oil and gas industry. I would have thought that can only really be done by them switching to producing renewable power. Is that what’ s going to happen?
Clearly the vast majority of what would solve a 50% cut is getting coal out of power, and there are a lot of activities we don’ t have in the oil portfolio mix today. A lot is embedded in power, so consequently the power portfolio cuts are coming through much higher, even in carbon intensity.
On your second question, we are reliant on what the underlying oil and gas companies are doing, and we are asking them about their transition plans. There will be some investments to do with flaring and methane which they will have to do — methane emissions are becoming more transparent by satellite monitoring, so they will be under outside scrutiny. So their operational activities will start to have cuts [ in emissions ].
The other thing we’ ll have to do is think about credible transition plans across all sectors. The starting point will depend on where a company is located and the ability there to shift the energy system. That’ s one of the reasons we adopted a portfolio approach, to take some of these factors into account.
But there is a heavy engagement plan. We are embedding into the industry to understand how companies think they are going to deliver outcomes that are climate-aligned.
Within most oil and gas companies, whether state-owned or receiving shareholder engagement, they have internal teams working on transition plans. The tricky thing is knowing if a plan is on a scientific path to generate an outcome aligned with 1.5°C.
I was at CeraWeek [ a major energy conference ] in Houston last week and talking to a former colleague of mine who works in the oil industry. She said the industry themselves are really working hard on telling the story more effectively of how existing infrastructure needs to be transitioned, and have a narrative of journey and solution, not “ we are here now — we need to be there tomorrow ”.
By having a flag in the ground about financed emissions, it provides the space for us to have the conversation with companies about what is helpful.
For every bank this is a completely new way of thinking, and similar to everything, some are more embracing than others — that’ s just human nature.
Our climate heritage means it’ s not a surprise to anyone — it’ s an evolution. We are doing everything we can to give people the toolkit to have this conversation with clients.
They’ re feeling more empowered to do it, and that means they can turn it round so it’ s more of a relationship-building and solidifying issue, not a negative one.
We’ ve been clear that our starting point is to finance the transition and help companies with that journey. Over time we will learn and engage. There may well be a point when a company doesn’ t want to view the world in the same way as external stakeholders are pointing in terms of scientific alignment [ and hence the relationship has to end ].
It’ s also connected with the granularity of your approach. You’ ve said in your Financed Emissions Methodology that you are assessing companies at group level for now, but as data improves, you may adapt to more granular analysis by the specific entities you’ re financing. If a group is transitioning, but its renewables assets are held in one subsidiary and its oil and gas in another, it could be quite hard to show progress.
We will have to keep reviewing the methodology and its scope over the next eight years. The reality will be that in 2050 there will still be use of fossil fuels for some activities. To be 1.5°C aligned it’ s tiny and you have to have natural or human carbon sinks to counteract it.
But that residual use, whether it’ s in shipping or heavy industry or cement or aviation, will come from somewhere. What the financial sector needs to get better at analysing is how the rest of the world gets emissions down and where that residual bit really sits.
Europe is at a crossroads in energy policy now, because of the Russia-Ukraine war, which is making policymakers think about how to ensure energy security. There are some who think Europe should go heavily for renewables, and others who think it should go for more gas, with new infrastructure. What would be your message to policymakers deciding about this?
They need to enable and empower a shift to hydrogen by creating both the demand and supply sides of the equation. They can do that by policy signalling. One of the things that came out of CeraWeek was that the oil and gas industry have a consensus that hydrogen is part of the solution. What is difficult for finance to establish is how the existing oil and gas infrastructure can be reconfigured to have hydrogen as part of the mix.
The other thing is the role for energy efficiency, which the war does bring home. It’ s quite boring for investors, but it is a climate solution. | business |
How the War in Ukraine Is Causing Indirect Deaths News and Research | The Russian attacks on Ukraine are having a devastating impact on civilians. But the health consequences extend far beyond the effects of bombing and shelling.
Although it may not be the most urgent threat Ukrainians face, COVID remains a serious risk. Crowded trains, bomb shelters and refugee processing facilities provide ideal conditions for COVID transmission. In the country, Russian attacks have destroyed health care facilities and cut off humanitarian aid routes, and those hospitals that are still operating are running out of resources such as oxygen and vital medical supplies.
“ The war in Ukraine is having devastating consequences for the health of Ukraine’ s people... that will reverberate for years or decades to come, ” said World Health Organization Director General Tedros Adhanom Ghebreyesus at the United Nations Security Council meeting on Ukraine on March 17.
When Russia invaded Ukraine on February 24, COVID cases in the country had been declining from their early February Omicron peak of more than 37,000 per day. But since the war began, COVID testing has decreased, and the number of new cases Ukraine’ s health authorities are reporting is likely an undercount. Ukraine also has a relatively low vaccination rate: only about 36 percent of Ukrainians are estimated to have received shots, making it likelier that at least some of those who contract the disease will have a severe case.
COVID is still a threat. “ It hasn’ t gone away..., but priorities certainly changed, ” says Paul Spiegel, director of the Center for Humanitarian Health at Johns Hopkins University. For those who were concentrating on COVID before, “ now you’ re worried about your life. You’ re worried about leaving the country, your children, your partner. ”
Spiegel says the conditions many refugees are facing are likely to increase transmission of SARS-CoV-2, the virus that causes COVID. While he worries this could lead to an uptake in cases among refugees, he says that host countries should be careful not to blame them for spreading disease. Many European countries are already seeing another wave in cases caused by Omicron’ s subvariant BA.2, so the influx of refugees may have little effect on total cases. The millions of refugees entering surrounding European countries will need treatment, however, and those countries should be prepared to handle the demands on their health systems.
In recent days Russia has intensified its attacks on civilians and civilian infrastructure, including hospitals. According to the WHO’ s Surveillance System for Attacks on Health Care, there were 73 attacks on Ukrainian health care facilities between February 24 and March 28.
A tragic and widely shared Associated Press photograph that circulated recently depicts a pregnant women on a stretcher amid the bombed-out remnants of a hospital in the eastern Ukrainian city of Mariupol '. Neither the woman nor her fetus survived.
International health agencies have called for Russia to stop these attacks on health care facilities. “ These horrific attacks are killing and causing serious injuries to patients and health workers, destroying vital health infrastructure and forcing thousands to forgo accessing health services despite catastrophic needs, ” read a March 13 joint statement from the WHO, UNICEF and the U.N. Population Fund ( UNFPA). “ To attack the most vulnerable—babies, children, pregnant women, and those already suffering from illness and disease, and health workers risking their own lives to save lives—is an act of unconscionable cruelty. ” The statement also called for an immediate cease-fire to allow access for humanitarian assistance, a demand that has clearly gone unheeded.
Beyond COVID, the war could increase the risk of other infectious diseases, such as tuberculosis ( TB), measles and polio.
Ukraine has a high rate of death and disability caused by TB, including from drug-resistant TB. “ The situation in Ukraine before the war was not great, ” says Lucica Ditiu, executive director of the Stop TB Partnership, a Geneva-based organization hosted by the U.N. Office for Project Services. But Stop TB had been working with Ukraine to address the problem and procure medicines to treat people with the disease. The country was committed to making progress, Ditiu says. Then the war began.
“ What is happening right now is horrific, ” Ditiu says. Hospitals and dispensaries that provide critical TB treatments are being destroyed. “ It took years to build this [ system ]. It will take tens of years to rebuild this, ” she says. TB’ s symptoms are very similar to COVID’ s—they both can cause cough, fever and night sweats—and both diseases spread easily under the crowded conditions many refugees are experiencing.
Apart from calling for an end to the war, Ditiu recommends several other measures to address the crisis. Countries that are receiving refugees need support, including medical care and staff. And humanitarian corridors must be created to allow health care workers and medical supplies to reach Ukrainians in hard-hit parts of the country.
Polio could also see a resurgence because of the war. The disease is vaccine-preventable and had been nearing eradication in most of the world. But a handful of cases were reported in Ukraine starting last fall. The country responded to that outbreak with a vaccination drive, but the war has disrupted those efforts, raising the risk of further outbreaks.
There is a well-established link between war and disease outbreaks extending back centuries. The civil war in Syria and the refugee crisis it spurred led to measles outbreaks. And the violent conflict in the Democratic Republic of the Congo, which included direct attacks on health care workers, exacerbated the recent Ebola outbreaks there.
“ What we know from studying war [ is that ] there are two kinds of trauma, ” says Rohini Haar, an epidemiologist at the University of California, Berkeley, School of Public Health. There is direct or violent trauma, which results in death and casualties from the fighting itself, and there is indirect trauma, which persists for years and may never be fully documented. “ Usually direct trauma is the major source of death in the first few days and weeks, ” Haar says. “ But by months and years, it pales in comparison to the indirect deaths. ”
She and her colleagues conducted a study of measles cases in Syria based on data starting in 2015, but the country’ s civil war itself started in 2011. “ We don’ t even know what happened before because nobody was counting, ” she says. Haar worries indirect deaths and diseases are likely to be underestimated in Ukraine, too. And the health effects of the war in Ukraine will likely last many years. “ This is just the very early days of what will end up being a protracted crisis, ” she says. | science |
Country registers 48 new COVID-19 cases, 31 recoveries | Azerbaijan registered 48 new COVID-19 cases in the past 24 hours, Operational Headquarters under the Cabinet of Ministers reported on March 29.
Some 31 patients have recovered and 3 patients have died in the reported period.
So far, 791,814 COVID-19 cases have been registered in the country. Some 781,819 patients have recovered, 9,687 people have died. Currently, 308 people are under treatment in special hospitals.
Over the past day, 4,481 tests were conducted in Azerbaijan to reveal coronavirus cases.
In general, 6,692,062 tests have been conducted in Azerbaijan so far.
So far, some 13,425,032 COVID-19 vaccines have been provided to Azerbaijani citizens. In the past 24 hours, some 18,957 citizens have been vaccinated against COVID-19. | general |
Repsol finishes 3D seismic sweep in Indonesia - News for the Energy Sector | Repsol finished its 3D seismic shoot in Indonesia’ s South East Jambi block onshore Southern Sumatra in December 2021 and is currently evaluating the data.
Amir Faisal Jindan, Repsol Indonesia stakeholders relations manager, said last Thursday that seismic data will be evaluated to determine potential drilling sites. Repsol initially planned to carry out seismic acquisition in the block in 2020 but was delayed due to the Covid-19 pandemic.
Meanwhile, Repsol and its Malaysian partner Petronas will spend $ 130 million on a drilling campaign at the Andaman III deepwater block offshore Aceh this year, an official with Aceh Upstream Authority BPMA said. “ Based on our evaluation, the Rencong-1X drilling will cost about $ 130 million, ” BPMA Planning Deputy Muhammad Mulyawan said last Thursday. | general |
Argentina's retail stations begin rationing diesel amid price controls | In this week's highlights: Oil markets to focus on monthly reports from OPEC and the International...
The NYMEX Henry Hub prompt-month contract burst through what has been an impassable resistance point...
Pacific Gas and Electric is telling customers to be prepared for potential power outages as strong...
Argentina's service stations have started rationing diesel, as price controls and import restrictions are discouraging refiners from bringing in enough supplies even as demand rises for the crop harvest, a trade group said March 29.
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`` We are facing the first signs of shortages in key fuels such as diesel, '' the Confederation of Hydrocarbon Entities, a group known as Cecha, which represents more than 4,500 service station owners around the country, said in a statement. `` It is urgent that the government convene all the actors in the sector and seek solutions to guarantee its normal operation. ''
Cecha, which said service stations are capping sales at 15 liters of diesel per customer a day, said a major problem is that pump prices are 30% less than what they would be without government controls, when comparing with import prices.
Argentina is on `` the verge of a crisis '' in diesel supplies, Cecha said.
While diesel production rose only 1.5% in January, year on year, according to the state statistics agency Indec, refiners have been ramping up imports to meet demand, in particular for the harvest. The bringing in of corn, soybeans and sunflower seeds, major export crops in Argentina, is getting underway.
This rise in demand through the harvest, which runs until the middle of the year, is raising concerns of shortages, even as refiners on the whole have stepped up imports twofold this year — and at three times the cost in US dollar terms, Teofilo Lacroze, CEO of Raizen Argentina, the second-largest refiner in Argentina, told S & P Global Platts March 22.
Indeed, diesel imports in dollar terms shot up more than 1,900% to $ 498 million in the first two months of this year compared with the year-earlier period, according to Indec.
Argentina's refiners haven't imported crude since 2018, as domestic production has increased enough to allow them to buy all their supplies locally. Instead, they import diesel to meet peaks in demand, and that demand is rising this year in part because of the harvest but also because the economy has been rebounding from a slump in 2020 during the first year of the coronavirus pandemic. The economy is poised to grow 3% this year, according to the International Monetary Fund.
This reliance on imported supplies for meeting peak demand, however, is hitting refiners, as they must import at international prices and sell locally at government-controlled prices that are 30% less, a disincentive for importing.
`` We have been warning that this will happen for three months, '' Cecha's president, Gabriel Bronoroni, told Infobae newspaper. `` The service stations are operating with a quota system. ''
Bronoroni said that without more diesel supplies in the market, `` the fuel to bring in the harvest is not guaranteed. ''
Lacroze at Raizen said last week that a solution would be for oil producers to reduce crude exports so that refiners can buy more and increase their utilization rates, now at 10% to 15% below full capacity. He said that refiners were seeking to sit down with producers to find out how to make this possible.
Oil producers including one of Raizen's shareholders, Shell, make more money on exports because they can sell at international prices some 30% more than the domestic price.
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U.S. consumer confidence rises for first time in 2022, but inflation and Ukraine still big worries | The numbers:
A survey of consumer confidence rose to 107.2 in March and increased for the first time in 2022, but Americans are still uneasy about high inflation and the economic fallout from the war in Ukraine.
Economists polled by The Wall Street Journal had forecast the index to total in 107.5 in March.
The first increase in three months was the result of the February reading being revised down to 105.7 from an original 110.5
.
Confidence deteriorated last fall after the delta and omicron viral outbreaks. Now rising inflation and the war in Ukraine are adding to angst.
Consumers predict inflation will increase 7.9% in the next 12 months, the highest level ever recorded in the survey
, The Conference Board
said Tuesday.
What’ s kept confidence from plunging even further to new pandemic lows is a strong labor market. Workers have leverage over companies for the first time in decades, resulting in more people switching jobs and earning higher pay.
Big picture:
The U.S. economy is still expanding at a steady pace, but the headwinds are growing.
For one thing, the Federal Reserve is raising interest rates for the first time in four years to combat high inflation.
Fresh Covid lockdowns in China and the Russian attack on Ukraine, meanwhile, threaten to further disrupt global supply chains and and worsen shortages in the U.S. that have sparked the surge in inflation.
The strong labor market is the economy’ s protective shield. As long as Americans feel secure in their jobs the U.S. is likely to remain on the path to recovery.
Key details:
A measure of how consumers feel about the economy right now rose by 10 points to 153.0, marking the highest point since last July.
Yet a similar gauge that looks ahead six months dipped to 76.6 from 80.8, suggesting Americans are still uncertain about the path of the economy.
Worries about high inflation and rising interest rates are largely behind the unease. Fewer Americans expect to buy big-ticket items such as new cars in the months ahead.
The results of the consumer confidence poll are comparatively more optimistic, however, than a similar
survey of consumer sentiment that touched an 11-year low
in March.
The confidence surveys puts more emphasis on what Americans think of the labor market, while the sentiment gauge largely measures what people think about their own financial well-being.
Historically the strength of the labor market offers better cues on the path for the economy.
Looking ahead:
“ As the Fed embarks on what appears likely to be an extended rate hike cycle and financial conditions tighten, consumers are increasingly wary of the outlook for the economy in the latter half of the year and into 2023, ” said Jim Baird, chief investment officer at Plante Moran Financial Advisors.
Market reaction:
In early trades, the Dow Jones Industrial Average
DJIA,
+0.40%
and S & P 500
SPX,
-0.27%
rose sharply in Tuesday trades on hopes of a resolution to the Russia-Ukraine conflict. | business |
Bank of China to boost credit risk control as bad loan buffer grows more slowly | Bank of China Ltd. said it will double down on credit risk control in 2022 after its buffer against bad loans grew at the slowest pace in at least four years.
The nation's fourth-largest bank by assets earmarked 390.54 billion yuan as loan loss provisions in 2021, up 5.9% from a year earlier, according to the lender's full-year earnings announcement March 29. The bank's loan loss provisions, an indicator of asset quality in the near future, grew by between 7.3% and 20.4% year over year from 2018 to 2020.
Its 2021-end loan loss provision coverage ratio rose to 187% of delinquent debt that is unlikely to be recovered, the highest in at least five years. A higher ratio indicates improved ability to withstand future losses on bad loans.
As of 2021-end, Bank of China's nonperforming loan ratio fell to 1.33% from 1.46% a year earlier, in part due to a faster sale of bad loans. The bank's impairment losses on assets, which include loans and other financial investments, fell 12.4% to 104.22 billion yuan in 2021 from a year earlier.
`` We will be even more proactive in risk control in 2022, '' Liu Jiandong, chief risk officer of the bank, told a press conference after the lender reported 12.3% year-over-year growth in net profit for 2021.
Pressure on credit risk forecasting and monitoring comes from sectors facing liquidity stress, such as real estate and local governments, Liu said. Uncertain global economic outlook, insufficient demand, and volatile capital and commodities markets are also weighing on the repayment ability of the manufacturing and external trade sectors, Liu said.
China Merchants Bank Co. Ltd. and Industrial Bank Co. Ltd., the nation's sixth- and eighth-largest lenders by assets, also reported lower nonperforming loan ratios and higher coverage ratios for 2021.
There is incentive for banks to be stringent on provisioning, said Michael Zeng, Hong Kong-based banking analyst at Daiwa Capital Markets. `` Regulators would like to see the release of risk through making provision while banks, even though dragging their bottom lines, would see this as a gesture of sharing profit in response to the theme of common prosperity, '' Zeng said.
While major Chinese banks including Bank of China have limited direct loan exposure to beleaguered property developers, the knock-on effect on the wider economy has been weighing on the lenders ' asset quality and profitability. In addition to the property market slowdown, strict border control and lockdown policies amid recurring COVID-19 outbreaks, alongside various policies to address inequality under its national objective of `` common prosperity, '' have raised concerns about borrowers ' ability to make repayments and overall loan demand.
Bank of China expects its yuan loan book to expand by more than 10% in 2022, after growing 10.5% in 2021, Executive Vice President Wang Zhiheng said.
Major growth in loan demand will likely come from sectors including infrastructure, transportation, utilities and low-carbon industries, Wang said.
In 2021, the outstanding loan balance to small businesses, or so-called inclusive finance, rose 53.2% to 881.5 billion yuan in 2021 from a year earlier. Banks in China are heeding the government's call to lend more aggressively to small businesses to help them survive the current economic slowdown.
`` The credit risk of these loans will likely be lagging. The NPL ratio of these loans may be slightly higher than that of ordinary loans, but it's all expected and manageable, '' said Executive Vice President Wang Wei.
The Chinese economy could grow 5.5%, according to the goal unveiled in the ruling party's annual political meetings in early March. Banks, especially state-owned ones, are expected to issue more loans to help the country meet the growth target.
People's Bank of China is expected to support credit supply by cutting interest rates and lowering the reserve requirement ratio for banks, analysts said. The government may also roll out more measures to revive the sluggish property sector, which is a major component of the nation's GDP, by relaxing restrictions on home purchases, among other things, analysts said.
As of March 28, US $ 1 was equivalent to 6.37 Chinese yuan. | business |
Amazon, Starbucks workers push for unions after Covid upended labor market | The Covid pandemic pushed Americans to reconsider how and where they work, resulting in a tight labor market, rising wages and what's been dubbed the Great Resignation. It also spurred workers, many of them younger, at big companies such as Amazon and Starbucks to flex their newfound leverage with union movements.
Warehouse and store employees seeking union membership feel they have no seat at the table. They're looking for better pay and working conditions, and they want a say with management in day-to-day operations.
`` Employees are feeling powerless, and this solidarity gives them some power, '' said Catherine Creighton, director of Cornell University's Industrial and Labor Relations branch in Buffalo, New York.
Emma Kate Harris, a 22-year-old retail sales specialist at the newly unionized REI Co-Op in Manhattan, has been with the company for three years, and she wants to see more understanding from her bosses.
`` Our managers and higher management throughout the rest of the co-op don't necessarily understand what it is to actually be on the floor for 8½ hours a day for 32 or 40 hours a week, '' said Harris. Workers at the recreation and camping goods store organized with the Retail, Wholesale and Department Store Union, or RWDSU.
REI told CNBC in a statement it is `` committed to sitting down in good faith to negotiate a collective bargaining agreement. ''
Then again, this isn't your grandparents ' organized labor push. Young workers like Harris taking part are driven by a desire to improve the workplace, even if they might not stick around to see the changes come to fruition like union laborers of the past did. Some have little to no experience with unions prior to getting involved in campaigns, but they recognize their power in the current labor environment.
`` I think young people are breaking away from the expectation of previous generations that this is the way it is. And I think that my generation is starting to look more at the way it could be and the way it should be, '' Harris said.
While it may seem like unions are surging again, however, the numbers tell a conflicting story about the state of organized labor in America. In 2021, the union membership rate for government and private sector employees fell to 10.3% from 10.8% in 2020, according to the Bureau of Labor Statistics. Private sector union membership fell slightly in 2021 to 6.1% from 6.2% the prior year.
But at the same time, American approval ratings of unions are near an all-time high. Gallup polling from September 2021 shows 68% of Americans approve of labor unions — the highest reading since a 71% approval rating in 1965. They're particularly popular among the younger members of the workforce. Adults ages 18 to 34 approve of unions at a rate of 77%.
Richard Bensinger, union organizer with Starbucks Workers United and a former organizing director of the AFL-CIO, told CNBC earlier this year the movement was a `` generational uprising. '' The Starbucks union campaign, which began in Buffalo and has now notched eight wins in three states, has spread quickly to cafes across the country and is led by many workers in their early 20s, he said.
Isaiah Thomas is a warehouse worker in Amazon's facility in Bessemer, Alabama. The 20-year-old said he joined the company in September 2020 as a way to help pay bills and for his college education at the University of Alabama, Birmingham. But he told CNBC he took a semester off to focus on the campaign, which is also seeking to organize with RWDSU.
`` I believe that, in order to bring about the change that I want to see, I have to be really involved in it, '' he said. `` And when I saw this opportunity come about, and I knew that it would impact my co-workers in my own life very positively, I threw myself in and I 've been going 100% ever since then. ''
The public part of the vote count in Alabama will happen later this week. `` We look forward to having our employees ' voices heard. Our focus remains on working directly with our team to continue making Amazon a great place to work, '' Amazon spokesperson Kelly Nantel told CNBC in a statement.
A second union voting drive is under way in Staten Island for Amazon workers.
Companies, particularly publicly traded firms, must strike a delicate balance when their employees start to organize. Not all shareholders will believe unionizing is good for the bottom line, while others will think employees should be treated more fairly, according to Peter Cappelli, professor of management and director of the Center for Human Resources at the Wharton School.
`` The calculus that a company has to make on this, in this context where you could be more aggressive, and increase the probability of winning the election and damage your brands, how do you think about that, if all you're thinking about is, let's say, keeping your shareholders happy? '' Cappelli said. `` It's not an easy needle to thread. ''
Some companies take it a step further and hire consultants, such as Joe Brock, president of Reliant Labor Consultants.
Brock was a former union president with a Teamsters local in Philadelphia. He said he became disillusioned with what happens behind the scenes with unions, particularly when contracts are being negotiated. He said companies sometimes call him proactively to make presentations to employees to discourage them from joining a union. Other times, they reach out to him after a campaign has started.
Brock resists the term `` union busting '' and described his job as something more nuanced.
`` The threat of the union is a valid one, I think it causes a lot of workplaces to revisit policies and make some changes; I see it all the time, '' Brock said. `` I also see where they don't address it, and they want me to come in and be the union buster, and my firm doesn't do that. We don't go in and lie to employees. We tell them that this could work out well for them. But it could also work out very poorly. ''
— CNBC's Betsy Spring contributed to this article. | business |
Cathay plans world's longest passenger flight, avoids Russian airspace | Hi, what are you looking for?
Cathay Pacific is planning the world’ s longest passenger flight by rerouting its New York to Hong Kong service in a new path that steers clear of Russia.
By
Published
Cathay Pacific is planning the world’ s longest passenger flight by rerouting its New York to Hong Kong service over the Atlantic instead of the Pacific, the airline said Tuesday, in a new path that steers clear of Russia.
The flight path will cover “ just under 9,000 nautical miles ” ( 10,357 miles) — or 16,668 kilometres — in 16 to 17 hours, Cathay said in a statement to AFP.
It will surpass a Singapore Airlines flight travelling from the Southeast Asian city-state to New York, which flies a shorter distance in a longer time — about 15,343 kilometres ( 9,534 miles) in 18 hours.
Cathay declined to be drawn on the reasons for its flight path giving a wide berth to Russia’ s airspace, which it has previously flown through, according to Bloomberg.
Many airlines have cancelled routes to Russian cities or are avoiding its airspace over Moscow’ s bloody invasion of neighbouring Ukraine last month.
Russia also closed its skies last month to several European countries and all UK-linked flights in a tit-for-tat response to a similar ban placed on them.
Cathay is currently seeking an overflight permit for the journey which will fly across the Atlantic, Europe and Central Asia.
“ We are always running contingency routings for potential events or scenarios within the world of aviation, ” Hong Kong’ s flagship carrier said Tuesday in a statement to AFP.
The trans-Atlantic option is more favourable than their usual trans-Pacific route because of “ strong seasonal tailwinds at this time of the year ”, it said.
Pre-pandemic, Cathay operated three round trips between the two cities every day.
Flights to Hong Kong now face frequent cancellations due to the financial hub’ s strict anti-Covid measures, as well as a lack of passengers.
Starting April 1, flights from the US and eight other countries will be allowed to land in Hong Kong again, as the government relaxes some of the world’ s toughest Covid-19 restrictions.
As of Tuesday evening, Cathay lists a New York-to-Hong Kong flight for April 3 — a non-stop journey that will stay in the air for 17 hours and 50 minutes, according to its website.
With 2,400 staff representing 100 different nationalities, AFP covers the world as a leading global news agency. AFP provides fast, comprehensive and verified coverage of the issues affecting our daily lives.
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ESC 2022: Nadir Rustamli to join PrePartyES [ PHOTO/VIDEO ] | Azerbaijan's entry for Eurovision 2022 Nadir Rustamli will take part in PrePartyES on April 15-16.
The pre-party will feature performances from a number of artists participating in the Eurovision Song Contest 2022. Nadir Rustamli will perform on the second day of the pre-party.
`` Fade To Black '' was released on March 21 2022, with the official music video being released on the Eurovision Song Contest's YouTube channel.
The song is written and composed by Thomas Stengaard and Andreas Stone Johansson. Thomas Stengaard songs are well known to Eurovision viewers, Eurovoix reported.
The songwriter was a part of the teams that produced the Eurovision entries `` El Diablo '' and `` Adrenalina '' for Cyprus and San Marino respectively last year.
Swedish songwriter Andreas Stone Johansson is best known for working on 2019 Eurovision entire `` Too Late for Love '' which was performed and co-written by John Lundvik.
Nadir has been into music since a young age. He took piano lessons for seven years, studied in music school and, while at university and joined a music band `` Sunrise '' as the front man. In the music band, he also served as the art director for the music band. Moreover, Nadir Rustamli is the winner of the Voice of Azerbaijan singing competition's winner.
Meanwhile, Eurovision 2022 will take place in Turin, Italy on May 10-14.
Nadir Rustamli will perform in the first part of the second semi-final of the Eurovision Song Contest 2022.
As a result of the draw, Azerbaijan's entry will perform on May 12. The first semi-final will take place on May 10.
The Azerbaijani delegation at Eurovision 2022 will be headed by composer and producer Isa Melikov.
Azerbaijan marked its debut in 2008 with the duo of Elnur and Samir, who managed to become the eighth in the final with their song `` Day after day ''.
The brilliant duet of Aysel and Arash, which represented Azerbaijan next year, took third place at the song contest, while Safura Alizada, who represented the country at the Eurovision 2010 in Oslo, became fifth.
On its fourth attempt with Ell and Nikki's `` Running Scared '' song, the Land of Fire won the event, bringing the contest to Baku's Crystal Hall in 2012. Ell and Nikki were the first mixed-gender duo to win the contest since 1963 and the first winners from Azerbaijan.
It is noteworthy that Azerbaijan reached the Top 5 in five consecutive contests - 3rd in 2009, 5th in 2010, 1st in 2011, 4th in 2012, and 2nd in 2013.
In 2018, Aysel Mammadova performed brilliantly at the Eurovision 2018 semi-final, but she couldn't make it to the final. The singer represented Azerbaijan with the song `` X My Heart ''.
Azerbaijan's Chingiz Mustafayev impressed all Eurovision fans with his stunning performance in 2019. The singer finished in eighth place at the song contest.
In 2020, the song contest was cancelled amid the coronavirus pandemic. However, fans of the music contest had a great chance to enjoy a spectacular show `` Eurovision: Europe Shine A Light '', featuring 41 songs of this year's entries.
During the show, Samira Efendi pleased Eurovision fans with the song `` Cleopatra '' about trusting your gut instinct, standing up for yourself and being a `` Queen '' - even when things get tough and especially if someone betrays or hurts you.
Last year, Samira Efendi performed in the second half of the Eurovision 2021 final with the song `` Mata Hari '' and took place the 20th place. Speaking about the meaning of the song, Efendi noted that it is about female power.
She thrilled Eurovision fans with stunning performance that featured a giant orb in the background.
At the end of the stage show, the orb was lifted into the air where it exploded in a rain of golden sparkles, leaving the image of Nazar, a symbol of fortune in Azerbaijan.
Efendi's costume was adorned with precious and semi-precious stones; it combined Azerbaijan's traditional elements but with a modern twist. The costume was designed by world-famous fashion designer Rufat Ismayil was behind her outfit. | general |
China's factories were hit harder this quarter as Covid drags on | BEIJING — Manufacturing, one of the main drivers of China's growth since the pandemic began, saw slower growth in the first quarter, according to an independent survey by China Beige Book.
It's another sign that China's economy may not benefit as much from overseas demand as Covid control policies diverge. China's use of swift lockdowns in early 2020 helped the country quickly reopen businesses while much of the world struggled to contain the virus and resume normal business activity.
However, more countries have adopted a `` live with Covid '' strategy in the last several months. China has generally maintained a `` zero-Covid '' policy, although policymakers have tried targeted measures to keep ports or large factories running.
`` Until recently, the China-during-Covid story has been heavy reliance on production and exports, even as consumers largely stayed home, '' U.S.-based China Beige Book said in a report Tuesday. `` This quarter highlights the potential limits of that reliance. ''
The firm surveyed more than 4,300 businesses in China, mostly in the month through March 16. The report is an early look at the first quarter, which isn't over yet, and only included proprietary trend analysis.
Retail businesses saw double-digit year-on-year declines in the rate of revenue and profit growth, as well as a slowdown in hiring, the China Beige Book survey found.
`` Manufacturing is clearly in better shape but revenue, profit, and new domestic order growth are all slower than Q1-2021, '' the report said.
Official figures from the National Bureau of Statistics of China released earlier this month showed surprisingly upbeat data for January and February, with faster-than-expected growth in retail sales, industrial production and fixed asset investment.
However, China's exports grew by 16.3% in the first two months of the year from a year ago. That's slower than the 29.9% growth in 2021.
Data for March and the first quarter are due out April 18.
`` The core problem for manufacturers right now is soft domestic demand and the threat of additional Covid outbreaks, which could further derail growth, '' Shehzad H. Qazi, managing director at the China Beige Book, said in an email. `` Logistics companies are reporting a jump in their backlog of work, but there isn't as yet any evidence of major supply chain logjams. ''
Overall, the survey found that major government stimulus for the economy has yet to arrive, while the pace of borrowing fell to the lowest on record in the China Beige Book's 10-year history.
On China's struggling property sector, the survey found the industry was doing better than headlines might indicate, especially in China's largest cities like Beijing and Shanghai.
`` Accelerating profits say the sector is simply doing better than most observers realize, '' the report said, without providing specific figures. `` The housing market did fare worse than construction, with revenues and sales growth slowing despite better prices. ''
The real estate sector and related industries account for about a quarter of China's GDP, according to Moody's. Developers like Evergrande have defaulted in the last several months as falling sales cut into the amount of cash companies have on hand to pay back investors on large levels of debt.
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Economists have said the ultimate impact of Covid-related lockdowns — most recently in Shenzhen and Shanghai — depends on whether they last for two weeks or more than a month.
Last year, many economists also predicted a slowdown in exports last year, which did not materialize.
Even a forecast of slower export growth in March by Nomura's chief China economist Ting Lu is a double-digit figure — a 14.1% year-on-year increase. He expects industrial production will rise by 4.5% in March from a year ago, slower than the 7.5% year-on-year pace reported for the first two months of the year.
For the full year, Lu predicts 4.3% growth in GDP, as of a report Monday. That's below the `` around 5.5% '' target Beijing announced earlier this month. | business |
FDA Authorizes Second Covid Booster for Adults Aged 50 and Up | A healthcare worker preparing to administer a Pfizer-BioNTech Covid-19 vaccine.
Joe Raedle/Getty Images
U.S. regulators authorized a second booster dose of either
Pfizer
’ s
or
Moderna
’ s
Covid-19 vaccine for adults aged 50 and over on Tuesday, executing what appears to be a rapid change in strategy as the BA. 2 variant threatens a new wave of Covid-19 infections in the U.S.
The Food and Drug Administration issued its updated authorization in the morning, followed Tuesday afternoon by a concurring statement from the Centers for Disease Control and Prevention.
The new authorization will allow adults aged 50 and up, and certain highly immunocompromised people aged 12 and up, to receive a second booster dose of either of the messenger RNA-based vaccines at least four months after their first booster.
In a
statement
on Tuesday, the FDA’ s vaccines chief, Dr. Peter Marks, issued a somewhat lukewarm endorsement of the second booster. “ Based on an analysis of emerging data, a second booster dose of either the
Pfizer
-BioNTech or
Moderna
Covid-19 vaccine could help increase protection levels for these higher-risk individuals, ” Marks said.
The CDC’ s director, Dr. Rochelle Walensky, said in her own statement that a fourth dose is “ especially important ” for those aged 65 and above, and those aged 50 above with underlying conditions.
Evidence supporting the efficacy of a fourth dose is limited. In a press release, Pfizer ( ticker: PFE) cited data from an open-label study of 154 Israeli healthcare workers that showed that neutralizing antibody responses were higher after a second dose than a first dose, and no new safety concerns were reported.
Pfizer also noted that it had shared evidence with the FDA showing that vaccine effectiveness after a second dose dropped after three to six months, and additional Israeli data showing that a fourth dose offers protection against severe disease.
The FDA said in its statement that evidence for safety of the fourth dose of the Pfizer vaccine was based on data from Israel’ s Ministry of Health involving 700,000 fourth doses, and safety of the Moderna ( MRNA) fourth dose was based on the experience with the similar Pfizer vaccine, and on a small 120-patient study.
Speaking on a call with reporters on Tuesday, Marks said that the agency had authorized the additional dose to give people at the highest risk for serious outcomes from Covid-19 the “ option for continued protection. ”
Earlier changes to allow expanded access to Covid-19 vaccines have come after votes by vaccines advisory committees of the FDA and the CDC. The FDA advisory committee has not met to discuss Covid-19 vaccines since October. A meeting is scheduled for April 6, at which the FDA had said the committee would discuss future booster doses, but the agency appears to have chosen not to wait for that meeting before authorizing fourth doses.
Marks, on the press call, said that the decision had not been put before the advisory committee because it was “ relatively straightforward. ”
The new authorizations comes as cases of Covid-19 begin to rise again in parts of the U.S. The daily number of Covid-19 deaths in the U.S. is at its lowest point since last summer, and the average number of new cases a day is still falling from the peaks hit in January. Cases are up, however, across the Northeast, where the CDC says that the BA. 2 variant is now dominant. The average number of daily new cases is up 78% in New York over the past two weeks, and 77% in Connecticut.
Public health officials in the U.S. have made optimistic projections about how the country will weather a BA. 2 wave. Hospital admissions in the United Kingdom, however, where BA. 2 is now dominant, have nearly doubled since mid-February.
Marks said that the FDA had acted now to authorize a fourth dose, in part, because of the surges that have hit countries like the U.K. after their original Omicron wave subsided. “ We’ re hoping that by taking this action we will help allow people to take steps to protect themselves, should we have another wave that comes through this country, ” he said.
Until just weeks ago, Covid-19 vaccine makers had discussed a second round of boosters that wouldn’ t come until
this fall
. That changed in mid-March, when both Pfizer and Moderna asked the FDA to authorize a fourth dose of the original versions of their vaccines,
rather than the Omicron-specific boosters still under development.
Marks said Tuesday that the agency could still authorize another round of boosters this fall. “ There may be a need for people to get an additional booster in the fall, ” he said. “ We may need to shift over to a different variant coverage. ”
Marks explained that the fall booster could be targeted against one of the variants, or a combination of a variant-specific vaccine with an original version. People who took a fourth dose now wouldn’ t necessarily be excluded from getting a dose in the fall, if necessary, he said.
“ We have seen good protection from an initial booster, yet the latest science and data suggest that an additional booster dose may offer more protection to older adults who are most vulnerable to the virus, ” said Pfizer’ s CEO, Albert Bourla, in a statement. “ While this EUA will help address a current need for some, we’ re working diligently to develop an updated vaccine that not only protects against current Covid-19 strains, but also provides more durable responses. ”
In a separate statement, Moderna’ s CEO, Stéphane Bancel, said that the authorization of a fourth dose will allow Americans to maintain protection against the virus. “ The virus continues to evolve, and we are currently on the verge of another potential wave driven by the BA. 2 variant, ” Bancel said. “ Data continue to show that mRNA boosters remain the best defense against severe infection and death, and vaccines are a foundational part of our public health protection. Now, healthcare providers have the opportunity to advise higher-risk people about when and how to get boosted and build immunity in advance of future outbreaks. ”
The FDA’ s action will draw increased attention to a political stalemat in Washington, D.C., that has
cut off funding for new doses
of the Covid-19 vaccines. A Kaiser Family Foundation report last week found that the U.S. currently
does not have enough
doses on hand to offer a fourth dose to all Americans aged 65 and up. If the federal government does not buy more vaccine doses, it could push the vaccines onto the private market.
While fourth doses roll out for adults aged 50 and up, young children remain unprotected. The FDA canceled its advisory committee hearing scheduled for early February on Pfizer’ s vaccine for babies and toddlers aged six months to five years, saying it would wait on data on a third dose in that age group. That data is expected in April. In the meantime,
Moderna said last week
that it would ask for authorization for two doses of its vaccine for children aged six months to under six years, though the efficacy against infection in the age group was under 45%.
Write to Josh Nathan-Kazis at
josh.nathan-kazis @ barrons.com | business |
Injecting real-world data into every day clinical trials – RWE and RWD | The past two years have seen unprecedented pressure on healthcare systems, its workers, and clinical research as a whole. COVID-19 has presented the need for rapid clinical trials to support the effort to address not only the original strain of the virus, but also emerging mutations as they have arisen. Outside of the pandemic, healthcare has had to continue working at the same pace, and standard – leading to more digitalised trial settings. Where trials fall short, however, is in a lack of access, representation, and diversity, and data from the real world may be the key to pick up the slack.
RWD, such as that provided by EHRs, or data from mobile devices, is a by-product of everyday patient care, and can be used to produce deep analyses, which might later inform clinical trials. RWD can be used as a verification tool for data presented in clinical trials, with a more heterogenous patient population, and potentially broader geographical spread. Factors such as location can significantly affect trial results through, due to varied culture, lifestyle, access to healthcare, poverty, homelessness, and more.
RWD can be utilised to identify unmet healthcare needs, underserved patient groups, and areas for further study – treatments can then be modified, or designed to target specific patient groups. We spoke to ICON’ s Katheen Mandziuk, who highlighted this application of RWD: “ researchers can buttress trial results with data supporting what is actually occurring in the real world outside of the clinical trial. With advanced Artificial Intelligence ( AI) and machine learning ( ML) technologies, we can view trends and insights in the data that may not be apparent at the smaller site level. These valuable trends may be applied in the ongoing clinical trial to help investigators and study level staff adapt to trends in the patient population being studied. If all patients with a particular condition of a particular gender or age group have a common comorbidity or serious adverse event with a given therapy, the RWD may serve as a signal to watch for in certain populations. ”
Randomised controlled trials ( RCTs) also have an extensive list of inclusion and exclusion criteria, critical for that phase of the development of the drug. Clinical trials may therefore leave out certain patient populations out through screening processes: this impacts patients with morbidities, and comorbidities, such as renal disease, heart failure, and more. As the presence of these morbidities is higher in the older population, they are often left out of the clinical trial process. However, these patients typically make up a higher percentage of patients being treated in the real world.
Clinical trials exclude participants along other lines, and these participants often make up a significant portion of the overall patient population. Male breast cancer patients are typically underrepresented, or excluded, from breast cancer clinical trials. An estimated 2,710 men in the US will be diagnosed with breast cancer this year, and 530 men diagnosed will die from the disease in the US in 2022. Of these, Black men have the highest incidence rates of breast cancer – 2.7 out of every 100,000 men – however, this demographic is typically underrepresented in clinical trial settings.1
RWE is particularly useful to gain approval for treatments aimed at patient populations not represented in clinical trials. In 2019, Pfizer’ s drug Ibrance was approved for men with HR+, HER2- metastatic breast cancer. Pfizer’ s supplemental regulatory submission for male breast cancer primarily included RWE in order to make the case that Ibrance could be used to treat men. Expanding the scope of evidence generation means that healthcare professionals can better serve specific patient groups, communities, and individuals with multiple comorbidities.
We asked Kathleen Mandziuk how RWD can be used to inform trial recruitment. She shared: “ The utilisation of RWD can help direct study design and patient recruitment efforts to ensure that the clinical trial population is representative of the real-world patient population and detect enrolment bias in near-real time. When the patients recruited for a particular study are in alignment with the patient population, the clinical trial will yield better trial results that are aligned with the patient population. ”
We also spoke to Heather Moses, Country Medical Director, Novartis Oncology UK, who highlighted where RWD can fill in the blanks left by RCTs: “ Real world data and the evidence it supplies can validate and extend the information gathered by RCTs. Unlike an RCT, real world evidence gathering doesn’ t start and end at a particular time, so data collected over a long period of time can be analysed and acted upon; representing how real populations behave, as a snapshot and longitudinally. ”
RWD can therefore provide game-changing care for those living with rare diseases. Stephen Pyke, Executive Vice President, Clinical Data and Digital Services, Parexel, shared with Pharmafocus: “ There are settings where RCTs are simply not possible or ethical to undertake. For example, in rare and very serious diseases, there is a desire to ensure all patients have the best chance of a positive outcome. In these trials, the use of an ‘ external control arm’, or RWE as a comparator, allows researchers to bring in external evidence on standard-of-care outcomes to contrast with the trial data on active treatment. RCTs are good at answering the question, ‘ Can it work?’ Instead, when we emulate as closely as possible to the standard of care and management, we can answer a different question, ‘ Does it work in practice?’ ”
A 2021 JAMA Open Network study uncovered the extent of clinical trial underrepresentation in the US: “ In this cross-sectional study of 230 US-based clinical trials with 219,555 participants, Black or African American, American Indian or Alaska Native, Hispanic or Latino, and older adults were underrepresented and women were overrepresented compared with the US population. ” 2 The study found that Black and African American individuals were represented in just 10.6% of clinical trials. Meanwhile, 48.5% of trials reporting race or ethnicity did not include Indigenous American participants, and 60.4% of the trials did not include Hawaiian participants, or Pacific Islander participants.
How can RWD be used to pick up this slack? With COVID-19 exposing and entrenching health inequalities across the globe, RWD can help to uncover and combat these disparities. RWD can identify gaps in the healthcare system, and areas of unmet need, and inform what further research or trial processes ought to take place, among what patient populations.
Heather Moses highlighted the change in data collection brought about by the pandemic: “ The COVID-19 pandemic enabled a paradigm shift in how real world data is collected, used and valued by healthcare providers, policy-makers, patients and society as a whole.
To provide a very specific example, the DATA-CAN research hub used real-time weekly data on cancer care to determine the adverse effect of the pandemic on cancer services in the UK. Data showed that there were dramatic reductions in the demand for, and supply of, cancer services during the pandemic which may contribute to substantial excess mortality among people with cancer. Data has shown that there have been nearly 50,000 fewer cancer diagnoses across the UK during the pandemic and UK policymakers have since announced a 10-year Cancer Plan for England – a direct response to real world data. Cancer care is a key priority for the NHS, so we are trailblazing innovation to deliver a better, longer life to cancer patients in the UK through our innovative new medicines and novel ways of delivering care. ”
COVID-19 had a significant impact on the way trials could be conducted. “ When existing study sites shut down to treat urgent COVID-19 cases at hospitals, clinics and large integrated delivery networks ( IDNs), it was very difficult to resume the usual course of business of clinical research, ” Kathleen Mandziuk shared.
“ Therefore, the clinical research world had to immediately pivot to decentralized clinical trials and using remote patient monitoring technologies and home health visits/telehealth services. Many of these solutions and technologies use RWD to benchmark what happens in the general patient population. For example, through EMR records, we can notate the reference ranges in lab tests, standard of care in prescribing patterns, treatments and clinical practice. When we have these reference ranges in RWD, we can better compare normal population-based outcomes vs outliers that we may see or expect to see in the controlled clinical research study settings. ”
Arnaub Chatterjee, Senior Vice President at Acorn AI at Medidata, a Dassault Systèmes company, told Pharmafocus that “ expediency has been crucial in the global fight against the virus, but shortened timelines have meant that the level of long-term data that we have been able to collect has not been as extensive as with a typical trial and typical timelines. Long-term safety and monitoring in the real world will therefore be critical in better understanding COVID-19, patient response to the virus and ultimately in improving drug performance. ”
RWD is being used to address healthcare inequality all over the globe. In September 2021, BC Platforms ( BCP) entered into a collaboration with the African Institute of Everyone Genome ( AiEG), a South African genomic company, focused on building the largest integrated clinical and genomics data biobank in Africa. As part of the collaboration, BCP’ s platform enables RWD research, involving over 10 million consenting patient genomes, from all 54 countries in the continent, to be collected over a period of 10-15 years. The main goal of this research is to enable drug development and clinical research for patients in Sub-Saharan Africa.
At the time the collaboration was announced, there had been a poverty of investment in African genome research, with only 1% of total funding directed towards genomics research and clinical studies in Africa. In contrast with up to one million genomes globally, only around 5,000 to 10,000 whole African genomes have been studied. What draws this statistic into starker terms of global healthcare inequality is the fact that 25% of the world’ s population is expected to be based on the African continent by 2050.
The importance of understanding the full genetic diversity of patients in Sub-Saharan Africa is critical for drug development: novel target identification, validation, and early insights into adverse events. The genetic diversity represented by patients from the African continent is the greatest in the world.
When the collaboration was announced, Joe Mojapelo, CEO of AiEG, commented: “ Through the RWE that will be produced by future studies in collaboration with BCP, leveraging their integrated cloud-based platform alongside our region-leading database, we are keen to contribute to a new world of research equity. This means promoting access to African genomic data, and one day eradicating unnecessary side effects for the people of South Africa, the African continent, and eventually the global African diaspora. ”
Data collection is limited in real-world settings in comparison to that of clinical trials: trials are designed to collect data and therefore permission has been given to analyse personal data on how age, sex, race and other factors affect symptoms, drug responses, and medication efficacy. However, data protection, and ethical and legal concerns complicate the issue of population-wide studies based on data presented from, say, EHRs.
With each of their limitations and benefits, RCTs and RWD work best, perhaps, in tandem: Arnaub Chatterjee commented: “ Having a bridge between the trial and real-world evidence means an advancement in long-term monitoring and safety surveillance for patients. Real world data may mimic some patterns of controlled trials, but not all. Figuring out what is unique to the controlled trial and what is unique to the real-world data will happen in the context of the overlap in the trial setting and that could help to provide some longitudinal framing to help regulators make better decisions. ”
1. Visit: www.cancer.net/cancer-types/breast-cancer-men/statistics | tech |
UK Fintech Hits $ 1trillion Valuation With 44 Unicorns Finds Dealroom | This rapid rise in the value of UK tech follows sustained investment in the digital tech sector over the past few years. The covid-19 pandemic, in particular, triggered a wave of tech adoption from digital health apps, to education platforms, video conferencing and eCommerce. The products and services that kept us connected at home have become key parts of our daily lives now, helping propel company valuations higher and the UK tech ecosystem into a new league.
Digital minister Chris Philp said: “ Our tech industry has gone from strength to strength, overtaking the rest of Europe and entering the history books as the third country ever to reach this milestone. We’ re working hard to make the UK the best place in the world to found, grow or float tech businesses – whether they’ re early-stage startups or global innovators – ensuring they have the best talent, investment and regulation to thrive. ”
The Digital Minister announced the figures today ahead of the West Midlands Tech Review in Birmingham, which celebrated the region’ s tech successes and opportunities.
The minister added: “ Every corner of the country has contributed to the sector’ s success including the West Midlands whose digital ecosystem is set to keep growing by at least £2.7billion by 2025 and create 52,000 additional jobs. ”
The region’ s tech excellence will be showcased through the £24million Business and Tourism Programme as part of the Birmingham 2022 Commonwealth Games. The programme will help leverage the profile of this major sporting event to drive inward investment and export opportunities between the West Midlands and Commonwealth markets.
In 2018, the UK tech ecosystem was valued at $ 446billion and was steadily growing until 2020 when it doubled in value to $ 942billion as investments into software and digital companies surged at the start of the covid-19 pandemic, both in private and public markets. This has helped to catapult the valuations of many companies from unicorns – companies valued at $ 1billion or more – to the even rarer decacorn status ( companies worth over $ 10billion).
The UK is now home to 13 decacorns of which 10 have gone on to IPO, and are the most highly valued tech companies in the country. This is double that of Germany ( six) and three times’ Sweden ( four).
The 13 UK decacorns:
This group of leading companies is on track to get larger over the next few years with 14 UK companies, with valuations of between $ 5billion and $ 10billion that are expected to join its ranks and achieve decacorn status. Companies likely to make the grade include cyber security company Synk, zero-emissions transport company Arrival and virtual events platform Hopin. There are more companies valued at $ 5-10billion in the UK than in Germany ( five), France ( three) and Sweden combined.
While most of the UK’ s decacorns and unicorns are concentrated in London, there are now 44 unicorns spread out across the regions and 100 regional futurecorns that are laying the groundwork for future success across the country.
In just the first three months of 2022, UK tech companies have raised over £6billion with more than half ( £3.3billion) raised by fintech companies including FNZ, Checkout.com and GoCardless. This is an indicator of the strength of the sector with private tech valuations continuing to hold up well despite falling valuations in public markets. Regional companies are also raising large sums of money including Durham-based Atom Bank, the UK’ s first challenger bank, which raised £75million in late-stage funding and Oxford-based ONI, a next-generation health tech devices startup, which raised £57million in Series B funding in January.
This growth is only set to continue. Research by DCMS published last year found that the UK digital sector is on track to add £190billion in value to the UK economy and create nearly 700,000 jobs over the next three years.
Following the Russian invasion of Ukraine on February 24, UK tech has rallied to support Ukrainian people organising events to platforms and visa support. Tech Nation, the growth platform for tech companies and leaders, is prioritising Global Talent Visa applications from any nationalities, as well as Ukrainian refugees. London-based Blue Lake VC, run by two Ukrainian founders, is holding events to support founders from Ukraine to raise capital by facilitating intros to other UK-based investors, in a bid to help rebuild the country’ s tech sector. As well, remoteukraine.org is a new digital job platform to support displaced Ukrainian tech professionals find work.
Gerard Grech, chief executive, Tech Nation said, “ This is a watershed moment for UK tech. The industry has gone through difficult global challenges and come out stronger than ever. 10 years ago people said there weren’ t enough startups in the UK. Five years ago people said there weren’ t enough scale-ups. Every day, innovative and experimental tech companies are being launched across the UK that will grow into the next generation of unicorns and decacorn and we at Tech Nation are committed to supporting and fuelling these high-potential businesses across the whole country. ”
Daniel Korski, DEC member and CEO of PUBLIC, said, “ With a $ 1trillion ecosystem value and home to 13 decacorns, the UK has built not only an incredible tech industry but also a resilient one that has continued to grow despite global challenges. By providing the right tools and resources, along with supportive networks, we can ensure the industry continues to scale and remain a world leader in tech. ”
Julia Hawkins, general partner at LocalGlobe, said: “ This is a brilliant milestone for the UK tech industry. Despite the overwhelming challenges of the past few years, UK tech has provided the means to keep us connected and moving forward and helped transform industries across the country, particularly in the healthcare sector. It’ s exciting to be a part of this dynamic ecosystem and I look forward to seeing these startups and scaleups grow over the next few years. ”
Rana Yared, partner at Balderton Capital, said: “ Reaching $ 1trillion in value is an important landmark for the UK. There have often been criticisms that you can’ t build world-leading companies outside of the US but we’ re proving that you don’ t need to be based in Silicon Valley to have an impact. Meanwhile the UK’ s fintech success continues, with fintech companies raising over £3billion already in the first three months of the year. ”
Yoram Wijngaarde, founder and CEO at Dealroom, said: “ The UK is only the third country in the world to reach this $ 1 trillion valuation milestone. The explosion in VC investment started by the pandemic amid the overwhelming demand for digital services for healthcare, education and food delivery has helped spur on this growth but the foundations were laid long before 2020. As companies and investors grapple with the global challenges of 2022 from the Russian Ukraine war to the ongoing supply chain crisis and the cost of living rises, it’ ll be interesting to see how tech ecosystems like the UK’ s adapt and adjust. ”
Francis is a junior journalist with a BA in Classical Civilization, he has a specialist interest in North and South America.
The Fintech Times is the world’ s first and only newspaper dedicated to fintech.
Published Bimonthly, the Fintech Times explores the explosive world of financial technology, blending first hand insight, opinion and expertise with observational journalism to provide a balanced and comprehensive perspective of this rapidly evolving industry.
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CDL: Seizing Ecosystem Opportunities with Insurtech Marketplaces | Nigel Phillips isCEO at CDL, a technology services provider and software supplier, powering transactions across insurance and financial services markets through its insurtech ecosystem. Here he sets out why retailers should be getting in on insurtech marketplaces, using data to drive growth in the new era of tailored propositions.
Ecosystems are driving changes in consumer behaviour, attitudes and expectations in all areas of living. Small benefits, from syncing phones with laptops or automatically populating calendars with travel arrangements and restaurant reservations are now taken for granted, with the Covid experience having further accelerated digital adoption around the globe. Even the most privacy-conscious find it difficult to resist the effortless ease offered.
According to McKinsey, 70 per cent of consumers appreciate ecosystems because they simplify the purchase journey, and the value they create works both ways. Strikingly, in 2020, six of the world’ s top seven companies by market capitalisation were ecosystem companies, with Apple topping the table. And it is this potential to power growth that is attracting increasing attention, including in insurance.
Fundamentally, ecosystems offer consumers and retailers a ‘ marketplace’, enabling an integrated and superior experience as they interact with the brand. Typically, they are designed to add value to consumers by making it easier to access services, information or goods in one place, thus eliminating the need and incentive to shop around any further.
In insurance, for example, ecosystems afford the opportunity to take a more strategic approach to offering a portfolio of insurance products from one brand and a way of challenging the prevailing status quo, where consumers typically hold three to six policies, each with a different provider. Specifically, this can be achieved by delivering end-to-end insurance experiences, product personalisation and consumer engagement, thereby modifying consumers’ habits and their view of insurance as a ‘ grudge’ purchase.
Driving growth
The ecosystem approach is to create a marketplace that enables retailers to increase the uptake of different products by helping their customers to find policies that meet their needs, proactively driven by the use of data to deliver the right level of cover.
As well as enabling insurance retailers to get serious about portfolio offerings, ecosystems create the platform to branch out beyond insurance and bridge product categories, with the most innovative cutting across traditional sector boundaries to offer new services in a seamless way. For example, Ikea’ s expansion into online banking services as an extension of their online furniture shopping experience is just one case in point.
This is where ecosystems go way beyond traditional ideas around ‘ cross-selling’, ancillaries and add-ons, instead looking at the whole consumer experience to build a lasting relationship with them and deliver time-saving propositions that they will not readily give up.
Trends such as the rise of open banking and APIs make it easier than ever before to plug-in partners, either referring the consumer to a third party or retaining control of the end-to-end customer experience.
Integrating data is the key to driving the customer experience by harnessing information to identify what a consumer needs without involving effort on their part: picking up devices from the WiFi network for example or using image recognition to look up data on items being insured.
Beyond this, data is key to creating in-app experiences that offer easy, personalised and often refreshingly disruptive propositions, implementing nudges to drive the customer journey. In the insurance context, this means not just for new business but as consumers’ risk profile changes throughout the policy lifecycle: adjusting cover mid-term based on actual rather than predicted mileage, for example, or periodically updating vehicle valuations as a car depreciates over time.
Designing a successful ecosystem
Investing in an insurtech ecosystem built on a powerful data platform and extensive data integrations has the potential to offer transformational opportunities to players in this space. Achieving this requires a number of key ingredients.
Firstly, real commitment, deep strategic thinking and vision are essential starting points. The most successful ecosystems commonly harness a strategic approach to identifying customer pain points to add real value, and are backed by data, digitisation and a high volume customer base.
Ultimately, it is the effective integration of data and the ability to make intelligent use of that information that will create a new relationship with the customer, and enable retailers to implement triggers that add value and/or save them money.
Access to volume is equally significant. Businesses with a significant customer base to tap into are more likely to be able to reap the reward of their investment in building an ecosystem.
Finally, building a network of relationships that enhance the marketplace being created is vital. Choosing the right partners is an integral part of this, as is having a shared vision for the consumer experience being created. The higher the quality of the relationship, processes and delivery, the greater the potential to translate this into rewards, both for the retailer and the end-user.
With all these points fully considered and in place, it becomes possible to design elegant, time-saving propositions that delight consumers and offer real benefits in terms of cost savings or convenience gains.
Polly is a journalist, content creator and general opinion holder from North Wales. She has written for a number of publications, usually hovering around the topics of fintech, tech, lifestyle and body positivity.
The Fintech Times is the world’ s first and only newspaper dedicated to fintech.
Published Bimonthly, the Fintech Times explores the explosive world of financial technology, blending first hand insight, opinion and expertise with observational journalism to provide a balanced and comprehensive perspective of this rapidly evolving industry.
PR & Editorials Advertise With Us Jobs Partnerships
If you are interested in working with us then please click the appropriate link above.
Telephone: +44 ( 0) 20 7193 5883 | business |
Gun attacks kill five near Tel Aviv: Israel medics | Hi, what are you looking for?
Five people were killed in gun attacks Tuesday near the Israeli coastal city of Tel Aviv, emergency responders said.
By
Published
Five people were killed in gun attacks Tuesday near the Israeli coastal city of Tel Aviv, emergency responders said, in the third fatal gun or knife spree in the Jewish state in a week.
“ We unfortunately have to note that five people have died, ” said Eli Bin, the head of the Magen David Adom emergency responders, revising up a death toll of two from shootings in two locations of the ultra-Orthodox town of Bnei Brak.
Israeli police later confirmed that security forces had killed an assailant, but did not reveal his identity.
Residents of Bnei Brak and the neighbouring town of Ramat Gan reported that a man had driven around and opened fire at passers-by.
There was no immediate claim of responsibility for the shootings.
Prime Minister Naftali Bennett said he would convene an emergency meeting with top security officials to review the situation.
This marks the third deadly attack in Israel in the span of one week.
A shooting on Sunday killed two Israeli police officers — identified as Shirel Aboukrat, a French-Israeli citizen, and Yezen Falah — in the northern city of Hadera.
That attack was later claimed by the Islamic State group — the jihadists’ first claim of an attack on Israeli territory since 2017.
Israeli police had said that the two perpetrators of the Sunday attack were killed at the scene.
Hamas, the Islamic Palestinian movement that rules the Gaza Strip, praised Sunday’ s attack as a “ natural and legitimate response ” to Israeli “ crimes against our people ”.
It was also welcomed by the Gaza-based Islamic Jihad militant group and Lebanon’ s Iran-backed Hezbollah movement.
The Sunday attack coincided with a landmark meeting bringing together Israel’ s foreign minister with those of four Arab countries with ties to the Jewish state, as well as the US Secretary of State Antony Blinken.
Last week, a convicted IS sympathiser killed four Israelis in a stabbing and car-ramming spree in the southern city of Beersheba.
The attacks on Tuesday come as Israeli Defence Minister Benny Gantz visits Jordan, where he met King Abdullah II in a bid to ensure calm ahead in the Palestinian territories during the Muslim holy month of Ramadan.
Tensions flared last year during the fasting month, which starts in April, between Israeli forces and Palestinians visiting Al-Aqsa mosque in annexed east Jerusalem, feeding into 11 days of armed conflict between Israel and Hamas in Gaza.
With 2,400 staff representing 100 different nationalities, AFP covers the world as a leading global news agency. AFP provides fast, comprehensive and verified coverage of the issues affecting our daily lives.
Under a shattered crescent hanger at Ukraine's Gostomel Airport the world's largest plane lies buckled and broken.
A federal appeals court upheld Biden’ s vaccine mandate for federal workers, while COVID-19 cases rise.
The fake logic is simple to the point of idiocy, but it’ ll work in information-starved Russia.
At least 52 people are killed, including five children, in a rocket attack on a train station in the eastern Ukrainian city of Kramatorsk.
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Buta Airways to open flights between Baku and Batumi | From June, Buta Airways will start operating flights en route Baku-Batumi and back within the summer schedule.
So, from June 1, the airline will operate flights en route Baku-Batumi-Baku twice a week: on Fridays and Sundays.
The flight to Batumi became the airline's second renewed international destination to Georgia after Tbilisi.
Tickets for these flights are available on the official website of Buta Airways ( “ Budget ”, “ Standard ” and “ Super ” fares), as well as at the official agencies of the Airline ( only at the “ Super ” fare).
The cost of tickets starts from 29 euros.
During the COVID-19 pandemic, these flights will be served via Terminal 1 of the Heydar Aliyev International Airport both for departures and arrivals.
Only passengers who are allowed to fly under the current epidemiological restrictions will be accepted on these flights.
Azerbaijani citizens planning to travel to Georgia should have the right to enter the territory of Georgia. The entry requirements for Georgia during the COVID-19 pandemic are available on the Airline's website at https: //www.butaairways.az/en/covid/georgia.
The list of clinics in Azerbaijan where you can take COVID-19 test is published on the Airline's website at https: //www.butaairways.az/en/covid/clinics.
When departing from Georgia to Azerbaijan, passengers should be tested for COVID-19. Passengers travelling on this route should ensure that their COVID-19 test results are valid for 72 hours prior to flight departure. | general |
Brokers calls for mandatory insurance for all buildings | BI’ s Article search uses Boolean search capabilities. If you are not familiar with these principles, here are some quick tips.
To search specifically for more than one word, put the search term in quotation marks. For example, “ workers compensation ”. This will limit your search to that combination of words.
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Insurance brokers in Nigeria have urged the government to make insurance compulsory for all buildings in the country, Middle East Insurance Review reported. Rotimi Edu, president at the Nigerian Council of Registered Insurance Brokers, said that this is necessary because of incessant building collapses in the country. Currently, the law on compulsory insurance for buildings made such cover mandatory only for buildings that have at least two stories.
1. Regulator revokes licenses of financially troubled insurers
2. Axa won’ t appeal landmark COVID-19 BI ruling
3. Brokers calls for mandatory insurance for all buildings
4. Hardening market to go on longer than anticipated: Howden
5. Insurers settle $ 20.5 million claims related to plane crash
6. Insurance market hardening slows down, but concerns remain | general |
Shanghai’ s two-phase lockdown tests ‘ zero-Covid’ limits | A two-phase lockdown of Shanghai’ s 26 million people is testing the limits of China’ s hard-line “ zero-Covid ” strategy, which is shaking markets far beyond the country’ s borders.
China’ s largest city entered the second day of the lockdown’ s first phase, which includes the Pudong financial district and adjacent areas on the east side of the Huangpu River.
The measures confining Pudong residents to their homes, closing non-essential businesses and requiring mass testing are to be lifted on Friday.
At that time, the vast Puxi area on the opposite side of the river will go under lockdown.
With public transport suspended and bridges and tunnels connecting the two sides of the city closed, usually bustling city streets – including the riverside Bund in Puxi with its historic buildings – were unusually quiet.
Shops along the nearby Nanjing Road pedestrian shopping street were mostly closed, with few people out and about.
Restaurants were offering only takeaway service, and a long line formed outside a McDonald’ s of people awaiting their orders.
The shutdown adds to anxiety in financial markets over Russia’ s war on Ukraine, the US federal reserve’ s effort to cool surging inflation by raising interest rates, and other economic challenges.
Market reactions including Monday’ s 7% drop in oil prices in London do not reflect the “ true reality of the situation ”, but investors already were uneasy about China and the global economy, said Michael Every of Rabobank.
“ We have a whole mountain of problems to worry about, and this is just one foothill among many, ” he said.
“ If that’ s all it is, a Covid lockdown, it’ s not difficult to look in recent history books and see how it plays out. But this interfaces with a lot of other issues. ”
The new Omicron BA.2 sub-variant of coronavirus is widely blamed for bringing a new surge in cases to Shanghai, which had suffered relatively little effect from the pandemic that was first detected in the central Chinese city of Wuhan in late 2019.
Elsewhere in China, new cases have continued to decline in Hong Kong following a recent wave that has led to more than 7,000 deaths.
The semi-autonomous city recorded 7,680 new cases, with no immediate word on whether authorities plan to proceed with mass testing of all of its 7.4 million people.
The north-eastern province of Jilin accounted for 1,055 of the 1,228 new confirmed cases and 812 of the 5,658 asymptomatic cases reported on the mainland on Tuesday.
In Shanghai, panic buying struck markets and some residents have reported shortages of meat and vegetables, including on online platforms.
Authorities are working to ensure food supplies and have converted gymnasiums and exhibition centres to house patients, most of whom show no symptoms. | general |
Tougher phone driver laws are now in place – but are they working?; Cyclists `` pretending to be in the Tour de France '' stump driver; Sagan to miss Flanders; Gazprom-RusVelo suspends activities; Self-hating cyclists; Bizarre poetry + more on the live blog | Like this site? Help us to make it better.
Time to come back home @ NATNAELTESFATS1🔥🚀🇪🇷 @ GrmayeBiniam 🚀🚀🇪🇷 pic.twitter.com/oBb0YSqxVH
— Eritrea cycling fan🇪🇷 ( @ Eri Cycling fan) March 29, 2022
After his ground-breaking and hugely popular win at Gent-Wevelgem on Sunday ( I’ m still smiling just thinking about it), man of the moment Biniam Girmay is on his way back to Eritrea, alongside compatriot and Drone Hopper pro Natnael Tesfatsion, where he will train for the next month before returning to race in May.
While fans have been clamouring for the 21-year-old sensation to race Sunday’ s Tour of Flanders after his breakout performances on the cobbles this spring, Girmay has stuck to his original plan to return home after three months in Europe.
“ I want to go back home, ” he told the media yesterday. “ My family is the most important thing in my life. More important than the bike, yes. It was my plan now to go home to wife and daughter. I want to stick to that plan.
“ For three months, my wife has been taking care of the baby and everything. I 'm in good shape, but I 'm still following my plan. We will [ do the Tour of Flanders ] in the future. This is the beginning, so we have a lot of time.
“ Of course, when you start the season, you have a schedule and I gave that already to my wife. She accepted it and so did I. But now, to stay one week longer is not easy. I will spend all my time in Eritrea with my family, so that's why it's more important to go home. ”
History maker @ GrmayeBiniam returns to Eritrea 🇪🇷 to prepare the @ giroditalia!
We 'll see him back racing on May 1 for @ DerRadklassiker 👋 pic.twitter.com/55l2mNLFJc
— Intermarché-Wanty-Gobert ( @ IntermarcheWG) March 29, 2022
The Intermarché rider’ s next race will be at Eschborn-Frankfurt on 1 May, where he will hope to rebuild his form in time for his grand tour debut at the Giro d’ Italia, which starts five days later in Budapest.
When asked whether he will target stage wins or the points jersey in Italy, Girmay – who says he “ will remain the same man as yesterday ” in the wake of his newfound fame – replied: “ Everything is coming to me quickly now. We will see. I don't know the Giro yet. But you never know. ”
Considering he didn’ t know that much about racing in Flanders before last week, you never know indeed…
Pog saying ' I always go full gas ' must be a huge relief for the rest of the peloton. Can you imagine if he came out and said 'tbh, I 'm not even bothering half the time. ' 😅 https: //t.co/A66bSrIxj4
— Katy M ( @ writebikerepeat) March 29, 2022
Not sure if that’ s a crumb of comfort or a harbinger of doom for Tadej Pogačar’ s rivals as he steps into the cobbled unknown at Dwars door Vlaanderen tomorrow…
On Friday we reported that Max Walscheid was hit by a motorist while out training near his home in Germany. The Cofidis rider was struck almost head-on by a driver who was turning across his lane, resulting in him being airlifted to hospital where he was placed in intensive care.
Walscheid, who had been in sparkling home during the first few months of the season, winning the Grand Prix de Denain-Porte de Hainaut and coming fourth in Brugge-De Panne last Wednesday, yesterday evening shared a shocking photo of his bike taken in the aftermath of the collision.
A post shared by Max Walscheid ( @ maxwalscheid)
Blimey.
But before this turns into another tedious time trial bike safety debate, Walscheid confirmed in the post that at the time of the collision he was “ doing an easy ride - perfect conditions, quiet, open road – hands on the brakes, eyes to the front, on the right side of my lane and luckily only endurance pace. ”
The statement reads: “ A car was coming down the opposite direction, driving in its lane. No reason to worry. But suddenly, without notice and just before reaching me, it turned left and hit me frontal, without braking. It apparently wanted to leave the road into an exit on my right, behind me.
“ Unfortunately my lane and me were in between, it didn’ t see me at all and just wiped me off the road. The windshield catapulted me into the ditch and only there I slowly realised what just happened.
“ I was airlifted to hospital and brought to intensive care. Miraculously I walked away from this without life threatening or major injuries, I was incredible lucky.
“ Still it was by far the hardest impact of my life and I will need time to recover from that.
“ Thanks for the overwhelming amount of messages in the past days! Please take care for yourself and each other in traffic. I don’ t know why this happened, but what the car driver did, such mistakes, can very quickly have very sad consequences. ”
Referring to the broken bike, Walscheid said: “ Surreal to see this, reliving the horrible moments and yet being able to walk into the police station myself to pick it up.
“ I was very unlucky, to be at the wrong moment at the wrong place, but I had quite a few guardian angels on my shoulders. ”
A post shared by Vittoria ( @ vittoriatires)
Vittoria, the Italian tyre manufacturer and former neutral service supplier at the Tour of Britain, is giving away three Pinarello Dogmas as part of a fundraising campaign to support children with cancer in Ukraine.
Proceeds from the raffle will go to the Italian non-profit organisation Soleterre, which has been working to provide continuous cancer treatment for Ukrainian children whose chemotherapy sessions or surgeries have been disrupted following Russia’ s invasion.
Donations towards the bikes will help supply medicines, medical supplies, oxygen, food, transport and chemotherapy drugs.
The Pinarellos are being donated by Vittoria’ s neutral service team and are equipped with Shimano Ultegra, Qurano 46 carbon wheels and Vittoria Corsa cotton tubulars. They are available in sizes 51, 54 and 55.
For more information on how to donate, click here.
The composition on this photograph is second to none.https: //t.co/G7wqwaPU16 pic.twitter.com/deJW8oYFpg
— MPLS Bike Wrath ( @ mplsbikewrath) March 28, 2022
Great news!!!
`` El Tractor '' @ Tim Declercq will be back with the Wolfpack this week, at @ DwarsdrVlaander!
Photo: @ GettySport pic.twitter.com/rLJk8rCBah
— Quick-Step Alpha Vinyl Team ( @ qst alphavinyl) March 29, 2022
Fans of steady tempos and farming analogies, rejoice – ‘ El Tractor’ Tim Declercq is set to make his return to the peloton at Dwars door Vlaanderen tomorrow.
The Quick Step-Alpha Vinyl rider, known for his constant, break-killing presence at the front of the bunch in the classics, has been absent since February after being diagnosed with pericarditis, a swelling and irritation of the tissue surrounding the heart.
Pericarditis is usually the result of a bacterial or viral infection – the kind of which has been making its way around the peloton all season – and tends to alleviate once the infection is gone, though Declercq was advised to take a few weeks off the bike as a precaution.
The big Belgian’ s presence is a much-needed boost for a Quick Step team which has so far failed to set the cobbled classics alight this spring. Reigning Ronde champion Kasper Asgreen was a distant tenth behind the dominant Jumbo-Visma duo of Wout van Aert and Christophe Laporte at E3, while at Gent-Wevelgem the ‘ wolfpack’ even failed to place a rider in the top 30 for the first time since 2009.
With that kind of form, it might take more than a fresh tractor engine to save Quick Step’ s classics season and knock Jumbo off their current perch.
In any case, the chances of breakaway success have taken quite the blow…
Guess who's back? 🔥 https: //t.co/oiJWymB39J pic.twitter.com/6CpN8R34Sf
— Cycling What Ifs ( @ cyclingwhatifs) March 29, 2022
How can the 1hr daylight savings change hurt so bad? It’ s only 1hr 😅
Extra coffee please
— Dan Martin ( @ DanMartin86) March 29, 2022
Let’ s just say that working the news desk on Sunday – and forgetting about the clocks changing the night before – wasn’ t my brightest idea…
I came across a column in the Irish Times over the weekend titled: ‘ As a cyclist, I have the right to despise cyclists’.
Naturally, my ears pricked up.
In the column Donald Clarke, the paper’ s film correspondent, took aim at the literal fair-weather cyclists, “ the half-assed sorts who take to belching internal combustion at the first spit of precipitation ”, asking the reader: “ Don’ t you hate these part-timers? Don’ t you hate their inability to commit? ”
However, Clarke answers his own question by turning the gun on himself: “ No, you don’ t. You hate me. You hate my pompous exclusionary attitude. You are quite right to do so. I hate me. ”
He continues:
Remember Woody Allen in Annie Hall. “ Don’ t you see? The rest of the country looks upon New York like we’ re left-wing, communist, Jewish, homosexual pornographers, ” his character says. “ I think of us that way sometimes and I live here. ”
It is, if anything, easier to be a self-hating cyclist than a self-hating New Yorker.
He goes on to say how he vehemently defends his fellow cyclists from “ the familiar Clarksonian rants ” that veer “ through the unreasonable and into the hysterical ”.
But Clarke also admits his displeasure at the cyclists who have the “ need to publicly confirm all the worst stereotypes ” by riding on the footpath or through red lights, or the lycra-clad “ serious cyclist mob ” who engage in Range Rover whataboutery whenever any biking misdemeanour is noted.
As with all such overheated enthusiasts, the pastime is elevated into a signifier of virtue and spiritual purity.
However, he concludes by stating that cycling is very much akin to tribalism and patriotism. And because of that, just as only the Irish can make fun of the Irish, only cyclists can make roll their eyes at, ridicule, or even hate other cyclists – not “ those non-pedalling blowhards ”.
Any self-hating cyclists out there agree with Mr Clarke?
This footage, shot from the GoPro mounted to Alec Briggs’ bike as he won the eighth edition of the Rad Race Last Wo/Man Standing fixed gear event in Berlin on Saturday, is something else – part crit race, part go-karting, and part German nightclub, all rolled into one:
Here’ s the last lap of Rad Race Last Man Standing with my @ GoPro Max 360°. A fantastic race with my good friend Augusto.
I look forward to the day @ BritishCycling let’ s me use GoPros in their sanctioned races. pic.twitter.com/mTj5yysdrs
— AlecBriggs/ Pedaler ( @ Alec Pedaler) March 27, 2022
That divebomb on the final corner…
Oh, and here’ s some bonus drone footage too:
If you thought the onboard footage was cool, check the drone!!!
Insane pilot skills to follow us that close, amazing. @ RadRace really is living in the future pic.twitter.com/krjxYmJDRM
— AlecBriggs/ Pedaler ( @ Alec Pedaler) March 29, 2022
I’ m not even sure where to begin with this one…
Regret to report that poetry has broken out on Facebook, but page member Phil is there to give an accurate critique. pic.twitter.com/hLFpTffe3E
— Angry People in Local Newspapers ( @ angrypiln) March 28, 2022
When he’ s not having a pop at Remco Evenepoel ( see below), complaining about the peloton’ s toilet habits, or rescuing British tourists, Peter Sagan has endured a pretty rough start to life at Team TotalEnergies.
After a promising fifth place at Milano-Torino, the three-time world champion looked a shadow of his former swashbuckling self at Milan-San Remo, E3, and Gent-Wevelgem, where he failed to finish.
The 32-year-old Slovakian superstar has therefore opted to sit out Sunday’ s Tour of Flanders, a race he won in 2016, to undergo blood tests and a check-up in a bid to explain his poor form.
Sagan will instead race the four-day Circuit Cycliste Sarthe-Pays de la Loire as he aims to find his legs before Amstel Gold and Paris-Roubaix later in April.
TotalEnergies are hoping that the series of tests Sagan will undergo at his home in Monaco will give them greater insight into his early-season lethargy, which has been variously linked in the press to a lack of pre-season training, an unspecified illness, or the aftermath of a second bout of Covid which he suffered in January.
However, as Sagan’ s star begins to wane just as a new generation of attacking, charismatic riders dominate the headlines, former Garmin pro Phil Gaimon may already have all the answers the 32-year-old needs:
Usually I find this answer on my birth certificate https: //t.co/sC8NFgexil
— Phil Gaimon ( @ philgaimon) March 28, 2022
Sagan: `` I made myself. Remco was made. `` 🍿 ( via HLN)
— Benji Naesen ( @ BenjiNaesen) March 29, 2022
`` Am I getting assaulted by a washed cyclist again? '' pic.twitter.com/O3alSEtl0Y
— Benji Naesen ( @ BenjiNaesen) March 29, 2022
As far as multiple-choice questions go, I’ m not sure you’ ll see this one on an upcoming episode of The Chase…
Driving on a narrow twisting road I came across a cycling club pretending to be in the Tour de France do I 1 Beep at them risking a confrontation 2 Drive at 20 miles an hour until it's safe to pass 3 Risk my life by overtaking hoping no one is coming. Someone will get killed soon
— Effie Deans ( @ Effiedeans) March 27, 2022
Surrey’ s Road Policing Unit took the opportunity to provide their own answer:
If you’ re needing to ask that question, the honest answer is:
4. return your driving licence to the DVLA.
— Roads Policing Unit ( RPU) - Surrey Police - UK ( @ SurreyRoadCops) March 28, 2022
While cycling journalist Felix Lowe offered up his take:
Cycling on a narrow twisting road I came across a load of motorists pretending to race the Le Mans rally. Do I 1 Ring my bell risking a confrontation 2 Cycle at a safe speed and hope they see sense 3 Risk my life by trying to make a right turn Someone will get killed soon
— Felix Lowe ( @ saddleblaze) March 28, 2022
Last Friday saw the long-awaited introduction of tougher laws on drivers using their mobile phone behind the wheel.
It is now illegal for motorists to use a phone under virtually any circumstance while driving, including taking photos or videos, scrolling through their Spotify playlist, playing games, or even checking the time.
The new law closes a loophole often exploited by phone-using drivers. Before Friday, it was only illegal if a motorist was using their phone behind the wheel for “ interactive communication ” ( in other words, texting or calling), with the rise of smartphones – and the myriad of non-communication-based distractions that they feature – quickly rendering that piece of 2003 legislation outdated.
The archaic nature of the new law was recently highlighted by the Crown Prosecution Service’ s decision to drop their case against Everton manager Frank Lampard, after he was filmed by Mike van Erp ( better known as CyclingMikey) apparently using a mobile phone and holding a coffee cup behind the week – presumably because the ex-Chelsea footballer’ s phone use wasn’ t for communication purposes.
> Prosecution of football star Frank Lampard filmed by CyclingMikey using mobile phone while driving dropped, CPS confirms
Under the new law, phone use will still be permitted in emergency situations, or as a contactless payment device ( 2022, eh?) if the car is stationary. Hands-free mobile use is still permitted, as well as using the device for satellite navigation purposes, provided it is kept in a cradle.
Anyone caught using their handheld device while driving could face a fine of up to £1,000 as well as six points on their licence or a full driving ban.
The government’ s THINK! team has also launched an £800,000 awareness campaign, explaining the new law to motorists and the potential penalties for ignoring it.
So, how are motorists coping with the new laws?
Jim seemed cautiously optimistic that the message was getting through:
Could it be that driver behaviour IS actually changing? Rode past a long queue of traffic this evening, and nobody was using a handheld phone at the wheel.. usually a target-rich environment! Is the message getting through?
— Jim's Wheels ( @ JimsWheels) March 28, 2022
But he was swiftly brought back down to earth by the expert himself, CyclingMikey:
I guess one swallow doth not a summer make!
— Jim's Wheels ( @ JimsWheels) March 28, 2022
And a few others:
Four on my way to work this morning, five last night on the way home.... I think you had an 'outlier '
— Sven Rufus ( @ SvenRufus) March 29, 2022
Yes, and, no. Sometimes I think it is then shortly after that I encounter lots of drivers using their phones. I 've been very surprised over the last few days by the number of drivers who have spotted me but continued to use their phones.
— jaj991 ( @ jaj991) March 28, 2022
No. Had 2 on the M3 yesterday, another glancing in his lap as he drove toward me and passed a motorist tapping away at the lights while cycling past
— Hantsman ( @ hantsarchitect) March 28, 2022
Speaking of using your phone behind the wheel, active travel campaigner Adam Bronkhorst was sent these snaps of a gang of bike riding youths up to no good, which may or may not have been taken from the driver’ s side of the car…
Is this allowed? Is this OK? pic.twitter.com/qHVP5s0Ifn
— Adam Bronkhorst ( @ AdamBronkhorst) March 29, 2022
pic.twitter.com/SJH5tLeaU0
— Adam Bronkhorst ( @ AdamBronkhorst) March 29, 2022
The cycling team formerly known as Gazprom-RusVelo has bowed to the inevitable, officially suspending all activities and releasing riders and staff from their contracts – as the squad’ s manager blames the UCI for “ playing at politics ” and not doing enough to save the squad.
Yesterday we reported on the blog that the Russian-registered squad had rebranded, changing its name to simply ‘ Professional Cycling Team’ with a plain white and black kit, in a bid to secure a new title sponsor.
We will continue searching for a new title sponsor. Together with a new team partner we will be able to immediately come back to racing under a new name and together decide which country our international team will be representing. pic.twitter.com/K9jrimhD6P
— Professional Cycling Team ( @ RusveloTeam) March 28, 2022
However, as the UCI has banned all Russian and Belarusian teams from racing, the team’ s Russian license meant that – despite the departure of Gazprom and new neutral look – they still couldn’ t compete, even though the squad had funding in place for the whole of March and invitations to 15 days of WorldTour racing.
With no new sponsor on the horizon, which would have allowed the squad to race under a different nationality, manager Renat Khamidulin appears set to formalise the termination of rider and staff contracts, as well as winding down the team’ s management company.
“ We’ ve suspended all activity as we said we’ d do. We’ re still looking for a sponsor but there’ s nothing concrete in place and so I can’ t ask the 52 riders and staff to wait any longer, ” Khamidulin told Cyclingnews.
“ It’ s tragic because we’ ve got a perfectly functioning team structure, with team cars, team buses, bikes and equipment and riders who are able to win. Mathias Vacek won a stage at the UAE Tour and on Sunday Alessandro Fedeli finished second at the GP Industria in Italy [ racing for the Italian national team ]. ”
Riders and staff are now free to seek employment on other teams – but this will prove difficult with most squad budgets already allocated for the year, meaning promising UAE Tour stage winner Vacek and former grand tour contender Ilnur Zakarin will struggle to find new homes.
In a very rare scenario to this race, the breakaway made it in @ uae tour and the 19-year old Mathias Vacek won stage 6. @ RusveloTeam have read the day very well, sending 3 guys on the attack and took a WorldTour victory. 👍 # UAETour 🎥 @ dubaisportstvpic.twitter.com/2gypf0Kqmg
— Mihai Simion ( @ faustocoppi60) February 25, 2022
Despite the Gazprom riders’ predicament and the wave of injury and illness that has swept over the peloton during the early part of the season, the UCI has refused to increase the 31-rider limit for squad sizes.
And Khamidulin has pointed the finger at UCI President David Lappartient, who he says has not done enough to help save the squad or secure new contracts for its staff.
“ The world of cycling is watching to see what the UCI does to help but we’ re seeing they want to play at politics rather than defend and help the riders and staff, ” Khamidulin said.
“ The UCI wanted to punish a Russian team but they’ re penalising riders from Italy, Norway, Spain and even Costa Rica. Even if three or four of the riders find new teams, all the others, 18 or so, are going to be left on the street. That’ s not right.
“ I’ ve also got a mechanic from the Ukraine and Russian staff who have wives from the Ukraine, who have lost their jobs there. They’ re desperate.
We are certain that politics should be kept away from sport and sport should be a platform for unity of nations.
Cycling and our team, in particular, could be a messenger of peace. We stand for peace in the world and do not support any wars. pic.twitter.com/7PYVd3rLVC
— Professional Cycling Team ( @ RusveloTeam) March 28, 2022
“ That’ s why I ask: where’ s the UCI? Why won’ t they help to keep the team alive under a different nationality?
“ I’ ve never had a clear response to my appeals. Yet I’ ve seen that the French president Emmanuel Macron has spoken about trying to find a diplomatic solution for the war between Russia and the Ukraine. Macron speaks but Lappartient hasn’ t spoken. Why not? ”
Ryan joined road.cc as a news writer in December 2021. He has written about cycling and some ball-centric sports for various websites, newspapers, magazines and radio. Before returning to writing about cycling full-time, he completed a PhD in History and published a book and numerous academic articles on religion and politics in Victorian Britain and Ireland ( though he remained committed to boring his university colleagues and students with endless cycling trivia). He can be found riding his bike very slowly through the Dromara Hills of Co. Down.
Deore XT seems to be the sweet spot if you're after low weight and durability. XTR is racing gear ( or at least the pedals are) and does seem to be...
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Here's part of the write-up from MsG's link above:
By the looks of it, some of the unsuccessful projects stole, err, made a lot of money from would be investors. The Chinese one doesn't surprise me... | general |
2021 COVID bounce: Malware has returned with a vengeance | At a particularly perilous moment for privacy and security, Malwarebytes’ research uncovered a COVID bounce, a massive 2021 resurgence of cyberthreats across multiple categories following pandemic-induced declines in 2020.
There was a 77% increase in malware detections over 2020. Business-focused cyberthreats jumped 143%, while consumer-specific threats rose by 65% to more than 152 million in 2021. This increase represents more than a return to business as usual, with detection numbers far exceeding pre-pandemic figures.
“ 2021 was a challenging year for both cybersecurity and user privacy, which points to alarming trends, ” said Marcin Kleczynski, CEO of Malwarebytes. “ With workforces still dispersed, cybercriminals capitalized on both new and latent vulnerabilities, burrowing deeply into critical infrastructure and infecting supply chains, driving increased threat volume, and homing in on targets with maximum potential for disruption. In this climate, ensuring every person and organization is thoroughly fortified against attacks through a simplified patching process and layered security is more critical than ever. ”
In the wake of 2020’ s lockdowns and stay-at-home orders, stalkerware surged, with spyware detections increasing 1,600% in the first six months of that year. 2020 was the worst year for stalkerware to that point, but 2021 would prove to be even worse. Android monitoring apps were detected 54,677 times and spyware apps 1,106 times, notable figures for this targeted form of abuse, especially due to Android’ s history of adware issues.
There’ s also a growing stalking concerns with Apple devices. In 2021, Pegasus spyware infected iPhones used by journalists and government officials, enabling surveillance of their locations and data.
Average users also began struggling with the pros and cons of Apple-developed location trackers – AirTags – that enabled potential victims to be silently monitored by perpetrators. Despite several software updates enabling AirTags to reveal themselves after periods of quiet use, millions of people still face the prospect of being monitored without consent.
I have read and agree to the terms & conditions | tech |
OPEC member warns soaring energy prices could lead to poverty, stagnation | Failure to address energy affordability risks casting significant portions of the world into poverty and stagnating the global economy, according to the United Arab Emirates Energy Minister Suhail Al Mazrouei.
Soaring energy prices have caused inflation to spike around the world and triggered cost of living crises across both developed and emerging economies.
Speaking to CNBC on Tuesday at the World Government Summit in Dubai, UAE, Al Mazrouei voiced concern that the global focus on geopolitics and energy security was leading governments to overlook the long-term implications of declining affordability.
He said leaders of the OPEC+ organization of oil-exporting countries were trying to maintain order and bring resources to the market at a manageable pace but suggested this was becoming increasingly difficult.
`` For that to happen, we need resources – financial resources – we need to invest and we need to decouple politics from energy availability and energy affordability, '' Al Mazrouei said.
`` I 'm worried that because we are mixing the two, we could end up in a situation where energy affordability becomes an issue and that would definitely lead ultimately to poverty, and ultimately could lead to a stagnation of the world economy. We are trying, but we can not be blamed for everything – we are doing our best. ''
Oil and gas prices have surged since Russia's invasion of Ukraine, but Al Mazrouei noted that the focus previously had been on sustainability and the energy transition, which combined with a demand slump due to the Covid-19 pandemic, caused prices to slump to historic lows in 2020.
OPEC+ at the time responded with record production cuts, but Al Mazrouei said the next issue to address beyond securing supply would be securing affordability.
`` I am sure the next is going to be energy affordability and resources, in that sense, because food security is becoming an issue and industrial commodities or minerals are becoming an issue as well, '' he said.
`` So the risk I see, or the danger, is poverty which could lead to people having to go and join those terrorist groups. '' | business |
INMO: Overcrowding in Cork hospitals is 'out of control ' | Ambulances lined up outside the emergency department at the Cork University Hospital. Picture: Dan Linehan
Overcrowding in Cork hospitals is out of control according to the Irish Nurses and Midwives Organisation. The warning was made as the number of Covid patients in hospitals nationally remains extremely high.
The nurses union counted 73 patients waiting on trolleys or chairs for a hospital bed in Cork University Hospital and the Mercy University Hospital. They were among 563 patients nationwide.
“ The amount of patients for whom there are no beds in both acute hospitals in Cork City today is out of control, ” INMO industrial relations officer, Liam Conway said.
“ We have seen huge levels of overcrowding in Cork so far this month with 974 patients on trolleys since March 1 in both hospitals. This is completely unsustainable. ”
On Monday there were 108 Covid patients in CUH, the third-highest in the country and 20 in the smaller MUH, separate HSE data shows.
Overall on Tuesday there were 1,601 Covid patients in hospitals although numbers in ICU dipped slightly to 50.
Professor Gerry Killeen, who can hear ambulances arriving at MUH from his University College Cork office, described the sounds as “ sobering ”.
An expert in pathogens, he said vaccines alone will not stop the current outbreak of this latest Omicron variant.
“ BA.2 is different in that it is slightly more vaccine-evasive. It might be a little more virulent too but what we are definitely sure of, it is even more transmissible, probably a good 30% more transmissible, ” he said.
“ It is questionable as to whether it is stoppable, it is certainly possible to slow it down. ''
He recommended wearing masks on public transport and in some public spaces.
“ The minimum thing we can do for vulnerable folks is protect essential spaces with ventilation, filtration and of course, masks. None of those things are actually restrictions, those are prevention measures, ” he said. | general |
Global supply lines brace for ‘ menacing’ economic storm to widen | Global supply strains that started to ease in early 2022 are worsening again as headwinds strengthen from the war in Ukraine and China’ s COVID-19 lockdowns, threatening slower growth and faster inflation across the global economy.
After the pandemic hit Asia-U.S. trade routes the hardest over the past two years, the latest turmoil is being acutely felt in Germany, which is heavily reliant on Russian energy and suppliers across Eastern Europe. Business expectations in the region’ s biggest economy during March posted the steepest one-month drop on record, factories across the continent face diesel and parts shortages and delays moving cargo through key North Sea gateways such as Bremerhaven are lengthening.
“ We thought Russia was just a resources story that was going to push energy prices up — that it would make supply chains more expensive but it wouldn’ t disrupt them, ” said Vincent Stamer, a trade economist with Germany’ s Kiel Institute for the World Economy. “ It appears a little more threatening than we initially anticipated. ”
On top of the wartime setbacks, omicron outbreaks are widening China’ s use of strict lockdowns in major trade hubs, the latest in Shanghai. A.P. Moller-Maersk A/S, the world’ s No. 2 container carrier, said Monday that some depots serving local ports have closed indefinitely, and trucking to and from terminals will be “ severely impacted. ”
Chinese exports were already tailing off from an October peak — a trend that might continue for the next few months if Beijing maintains the hard line on fighting the virus, Stamer said. That’ ll add shipping delays, sourcing problems and costs for businesses from the U.S. to Europe.
According to supply constraint indexes developed by Bloomberg Economics, pressures in the U.S. and Europe intensified in February after several months of improvement. Anecdotal evidence through March suggests the strains won’ t abate.
Stamer cited the example of electric wire assemblies made in Ukraine for German automakers. “ These cable trees are actually custom-made for individual cars ” and aren’ t easily or cheaply sourced from other countries, he said. Another rare input that’ s suddenly even more scarce is neon gas used in semiconductor production. Ukraine produces 50% of the world’ s purified neon, Stamer said. Russia’ s output of raw materials extends even deeper into the global economy.
More than 2,100 U.S. firms and 1,200 in Europe have at least one direct supplier in Russia, and the total reaches 300,000 when indirect suppliers are included, according to Arlington, Virginia-based Interos, a supply-chain risk management company.
“ Multiple industries are reliant on the same raw materials and a large percentage of them are coming out of Russia, ” Interos CEO Jennifer Bisceglie said. “ You’ re seeing a massive cascading effect on an already limping system of the global supply chain. ”
The economic and political stakes are far more consequential than the developed world’ s biggest worry in 2021 — the concern that slammed global logistics would spoil Christmas for retailers and consumers.
Fears are now rising about food shortages. The cost of living is rising in rich and poor regions alike. Soaring energy prices are spawning street protests from Albania to the U.K.
Costly, longer-term shifts are accelerating, too: Goldman Sachs economists say the new geopolitical risks are forcing companies to reinforce their operations against global disruptions through reshoring, diversification and overstocking inventories.
“ At the moment, the storm clouds on the horizon look quite menacing, ” Citigroup Global Chief Economist Nathan Sheets said in a research note on Friday, explaining why “ a major adverse supply shock ” from the Russia-Ukraine conflict led the bank to cut its outlook for world GDP growth this year and increase its inflation projections. “ Bottom line, an already complicated picture has become even more complex. ”
Trade is already feeling the sting of sanctions on Moscow and blocked transport routes. According to FourKites Inc., a supply-chain visibility platform, Russian imports across all modes of freight transportation dropped 62% over the first month of the conflict, while shipments into Ukraine plunged 97%.
Though Russia accounts for 5% of the world’ s seaborne trade and Ukraine just 1%, a heightened risk of a global economic slowdown has emerged.
Economists at Barclays on Monday said the world is entering a new era of higher volatility for growth and inflation. Allianz Research on Friday warned of a greater risk of a “ double whammy ” in world trade — lower volumes and higher prices — in 2022. Clarksons Research, a shipping analytics firm in London, last week trimmed its projections for global trade this year and next, saying its port congestion indexes are rising again and the latest shocks are “ amplifying an already disrupted maritime transport system. ”
According to data compiled by Bloomberg, the German ports of Hamburg and Bremerhaven saw new highs in ship congestion this month, while Rotterdam, the continent’ s busiest gateway for container traffic, saw its vessel backup at the start of the month reach an 11-month high.
The snarls make any return to normal unlikely this year unless demand unexpectedly craters. Ocean shipping, the workhorse for some 80% of global trade, was stretched so thin that the spot rate to send a 40-foot container of goods to the U.S. from Asia averaged more than $ 10,000 in the second half of last year — about seven times higher than the pre-pandemic level. Those rates have come down in recent weeks, but experts say the reprieve probably reflects a seasonal lull before transport demand and costs pick up again.
“ It’ s going to get worse as we move through the second half of this year and into peak season, ” Mark Manduca, the chief investment officer of GXO Logistics, told Bloomberg Television on Friday. “ You don’ t initially feel the pinch in the first few weeks of a supply-chain shortage — people have inventories. ”
Even greater than the risks Russia’ s war in Ukraine pose to global supply fluidity are the COVID-19 cases and targeted lockdowns in China, according to economists Ana Boata and Françoise Huang at Euler Hermes, a unit of Allianz Group. They see a risk that container freight prices approach or even exceed their previous peaks, before returning to current levels by year end.
“ Overall, even if not returning to the peaks of 2021, the cost and congestion levels of global supply-chains are likely to remain high for most of 2022, ” Boata and Huang wrote in an email. “ The normalization may start more visibly only from 2023. ”
Trying to anticipate how two years of supply constraints affect consumer prices has already challenged central bankers, with Federal Reserve Chair Jerome Powell saying at a news conference earlier this month that Russia’ s isolation from the world economy is “ going to mean more tangled supply chains, so that could actually push out the relief we were expecting. ”
Some of that relief was reflected in the New York Fed’ s Global Supply Chain Pressure Index, a gauge launched in January that most recently showed some easing from peak strains late last year. While it’ s too soon for the New York Fed to quantify any wartime effects, there are signs that the index’ s recent improvement will be limited.
“ There’ s been a decrease in the pressure, but the level of the pressure is still very high. It’ s an improvement but it doesn’ t mean the problems are resolved, ” New York Fed economist Gianluca Benigno said about the direction of the index in its latest update in early March. “ Anecdotal evidence suggests there might be further pressure ahead. ” | tech |
Carl Icahn is expanding his animal-welfare campaign to Kroger | In this article
Carl Icahn is expanding his animal-welfare campaign to the nation's largest supermarket chain, Kroger, after the famed activist investor initially targeted McDonald's.
Icahn has submitted a plan to nominate two candidates to Kroger's board, the Cincinnati-based company said in a release Tuesday.
Kroger said it first heard from Icahn on Friday. The grocer said that during the discussion, the billionaire investor `` voiced his concerns regarding animal welfare and the use of gestation crates in pork production. ''
In a letter to Kroger CEO Rodney McMullen, Icahn also took aim at what he called the `` egregious wage gaps '' between McMullen and other employees at the company.
`` The wage gap between the CEO and median worker at Kroger is unconscionable, '' Icahn wrote in the letter, which was obtained by CNBC. `` Our candidates will take our concerns about deplorable animal suffering and these wage gaps ( and other governance problems) at Kroger seriously and add proper oversight. ''
Kroger's announcement Tuesday comes a little more than a month after Icahn launched a proxy fight with McDonald's focused on the treatment of pigs. In an interview last Tuesday, Icahn addressed his involvement with the fast-food giant.
`` I 'm not doing that to make money, '' Icahn told CNBC's Scott Wapner on `` Closing Bell: Overtime. ''
Instead, Icahn described his efforts as a response to his feelings on animal rights. `` Emotionally, when you read about what they do to these animals, the unnecessary torture and cruelty, it really bothers me. Whenever I can do something about it, I try, '' Icahn said.
Kroger said it will review Icahn's proposed board nominees, Alexis C. Fox and Margarita Palau-Hernandez, as part of its standard governance policies. The company also addressed Icahn's issues with animal treatment.
`` While Kroger is not directly involved in raising or the processing of any animals, we are committed to helping protect the welfare of animals in our supply chain, '' the press release said. `` Kroger has an established Responsible Sourcing Framework to clearly define our policies, requirements and practices, including our Animal Welfare Policy, which articulates our expectation that all suppliers will have transitioned away from gestation crates by 2025. ''
McDonald's also has defended its animal rights policies in the face of Icahn's campaign. The company said last month that by year-end, it expects between 85% and 90% of its U.S. pork volumes will be sourced from sows who do not live in gestation crates during their pregnancy. McDonald's said it expects that percentage to increase to 100% by the end of 2024.
Icahn's stake in Kroger is small, as is his position in McDonald's. Icahn told Kroger he owns 100 shares of the company, according to a person familiar with the matter. The grocer has about 746.8 million fully diluted shares outstanding, according to FactSet.
Kroger shares closed down 1% Tuesday at $ 56.39. The stock has gained about 25% year to date, bringing its market value to $ 41.46 billion.
In his letter to McMullen, Icahn said his goal was not to profit from this proxy campaign, but to make a difference in the `` glaring injustices '' at Kroger. Icahn criticized the company's board for what he called a lack of oversight on supply chain policies and compensation. McMullen is chair of the board, in addition to serving as CEO since 2014.
Icahn, specifically blasted McMullen's compensation increase in 2020, while noting the company removed a $ 2 per-hour raise for store and warehouse workers it offered for a few months during the early days of the Covid pandemic.
`` What has happened at Kroger with the issues of animal welfare and employee wages is an affront to the basic fibers of our society — that of decency and dignity, '' Icahn wrote. `` Your Board of Directors has created an unnecessary situation, placing your company at risk, by rubber stamping unethical policies as well as breaking promises they made to frontline workers during the pandemic. ''
Kroger defended its employee compensation record. A spokesperson told CNBC the grocer has `` been investing more than ever before in wages, '' both prior to the Covid pandemic and during it.
`` Kroger invested an incremental $ 1.2 billion in associate wages and training over the last four years, '' the spokesperson said. `` This has increased our national average hourly rate of pay from $ 13.66 to nearly $ 17, reflecting an increase of more than $ 3 per hour, or a 25% increase. When benefits like health care and pensions are factored in, our average hourly rate is now over $ 22. ''
— CNBC's Scott Wapner contributed to this report. | business |
Remplacer le pétrole et le gaz russes par des renouvelables by Helen Clark, Dan Smith and Margot Wallström | AUCKLAND / STOCKHOLM – L’ invasion de l’ Ukraine par la Russie a ébranlé nombre des postulats les mieux établis quant aux fondements de la paix en Europe. Elle a rappelé à l’ attention des dirigeants, entre autres choses, la question centrale de la dépendance énergétique.
Les États-Unis ont récemment annoncé l’ interdiction à effet immédiat des importations de gaz et de pétrole russes tandis que le Royaume-Uni et l’ Union européenne s’ engageaient à les réduire plus progressivement. Les arguments sont clairs: punir la Russie, réduire son influence, et rétablir la paix en Ukraine. Mais des décisions inopportunes – et notamment de continuer à donner la préférence aux énergies fossiles – pourraient nous contraindre à un avenir beaucoup moins paisible.
Certains pays occidentaux ont laissé se développer ces dernières années une dépendance accrue au pétrole et au gaz russe; y renoncer ne sera donc pas facile. Mais la décision la plus importante et la plus difficile à laquelle sont confrontés les gouvernements occidentaux est celle de réduire leur dépendance à toutes les énergies fossiles, d’ où qu’ elles viennent. Se contenter de remplacer une source d’ énergie polluante par une autre, ce serait remettre à plus tard, voire éluder, la maîtrise nécessaire des périls liés aux changements climatiques.
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Writing for PS since 2011 16 Commentaries
Helen Clark is a former prime minister of New Zealand and former administrator of the United Nations Development Programme.
Writing for PS since 2020 2 Commentaries
Dan Smith is Director of the Stockholm International Peace Research Institute ( SIPRI).
Writing for PS since 2020 2 Commentaries
Margot Wallström is a former Swedish minister for foreign affairs and former European commissioner for environment.
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The point is not'should we build renewables '. They cost less, can be built iteratively, guarantee a return on investment etc. The problem is that permitting and infrastructure take many years, and integrating a lot of excess electricity into an energy system that is only 20% electric is difficult.The genuine answer, as Ursula von der Leyen has stated ( regarding how to replace Russian energy imports) is renewables and hydrogen. In fact, German PM Olaf Schulz has now made €200 billion available for 'climate protection, hydrogen and charging points '. Hydrogen is a direct replacement for much of the fossil fuels we use today, such as diesel for trucks, cars, buses, trains and ships; natural gas for heating and coal for heavy industries such as coal, cement, ceramics etc. Fully 80% of the energy system is made up of fossil fuels such as oil, gas and coal. So realistically, moving to hydrogen should be the primary focus. It can be stored and transported within the existing natural gas network with few modifications ( see a recent Siemens report among many others). Electricity can not be stored any other way for practical use.Many lobby groups argue against hydrogen within the unfounded belief that hydrogen is too expensive, carries an emissions penalty or simply for ideological reasons ( 'electric cars are better ' etc). We can not electrify everything. We must listen to Ursula von der Leyen, Olaf Schulz and others when they try to explain how we must decarbonise. And how we decarbonise is via hydrogen.
This is a very important issue with respect to climate change and national security. The one quibble with the article is that there is one paragraph that deals with the feasibility and workability of renewable energy at this time. Any serious political consideration has to involve how it gets done. It is almost as if the authors assume that the case for renewables is less evident than the feasibility of a renewable energy transition.
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Before Russian President Vladimir Putin’ s attack on Ukraine, Europe’ s recovery from the damage wrought by the COVID-19 pandemic was solidifying. But now European policymakers have exactly zero control over whether their economies ' rebound continues.
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| general |
Highly sensitive nanoimprinted sensor platform for faster, more accurate COVID-19 tests | Mar 29, 2022
Highly sensitive nanoimprinted sensor platform for faster, more accurate COVID-19 tests ( Nanowerk News) A COVID-19 sensor developed at Johns Hopkins University could revolutionize virus testing by adding accuracy and speed to a process that frustrated many during the pandemic.
In a new study published in Nano Letters ( Label-Free Spectroscopic SARS-CoV-2 Detection on Versatile Nanoimprinted Substrates), the researchers describe the new sensor, which requires no sample preparation and minimal operator expertise, offering a strong advantage over existing testing methods, especially for population-wide testing.
The sensor. ( Image: Kam Sang Kwok and Aishwarya Pantula/Johns Hopkins University)
“ The technique is as simple as putting a drop of saliva on our device and getting a negative or a positive result, ” said Ishan Barman, an associate professor of mechanical engineering, who along with David Gracias, a professor of chemical and biomolecular engineering, are senior authors of the study. “ The key novelty is that this is a label-free technique, which means no additional chemical modifications like molecular labeling or antibody functionalization are required. This means the sensor could eventually be used in wearable devices. ”
Barman says the new technology, which is not yet available on the market, addresses the limitations of the two most widely used types of COVID-19 tests: PCR and rapid tests.
PCR tests are highly accurate, but require complicated sample preparation, with results taking hours or even days to process in a laboratory. On the other hand, rapid tests, which look for the existence of antigens, are less successful at detecting early infections and asymptomatic cases, and can lead to erroneous results.
The sensor is nearly as sensitive as a PCR test and as convenient as a rapid antigen test. During initial testing, the sensor demonstrated 92% accuracy at detecting SARS-COV-2 in saliva samples – comparable to that of PCR tests. The sensor was also highly successful at rapidly determining the presence of other viruses, including H1N1 and Zika.
The sensor is based on large area nanoimprint lithography, surface enhanced Raman spectroscopy ( SERS) and machine learning. It can be used for mass testing in disposable chip formats or on rigid or flexible surfaces.
Key to the method is the large-area, flexible field enhancing metal insulator antenna ( FEMIA) array developed by the Gracias lab. The saliva sample is placed on the material and analyzed using surface-enhanced Raman spectroscopy, which employs laser light to examine how molecules of the examined specimen vibrate. Because the nanostructured FEMIA strengthens the virus’ s Raman signal significantly, the system can rapidly detect the presence of a virus, even if only small traces exist in the sample.
Another major innovation of the system is the use of advanced machine learning algorithms to detect very subtle signatures in the spectroscopic data that allow researchers to pinpoint the presence and concentration of the virus.
“ Label-free optical detection, combined with machine learning, allows us to have a single platform that can test for a wide range of viruses with enhanced sensitivity and selectivity, with a very fast turnaround, ” said lead author Debadrita Paria, who worked on the research as a post-doctoral fellow of Mechanical Engineering.
The sensor material can be placed on any type of surface, from doorknobs and building entrances to masks and textiles.
“ Using state of the art nanoimprint fabrication and transfer printing we have realized highly precise, tunable, and scalable nanomanufacturing of both rigid and flexible COVID sensor substrates, which is important for future implementation not just on chip-based biosensors but also wearables, ” said Gracias.
He says the sensor could potentially be integrated with a hand-held testing device for fast screenings at crowded places like airports or stadiums.
“ Our platform goes beyond the current COVID-19 pandemic, ” said Barman. “ We can use this for broad testing against different viruses, for instance, to differentiate between SARS-CoV-2 and H1N1, and even variants. This is a major issue that can’ t be readily addressed by current rapid tests. ”
The team continues working to further develop and test the technology with patient samples. Johns Hopkins Technology Ventures has applied for patents on the intellectual property associated it and the team is pursuing license and commercialization opportunities.
Source: Johns Hopkins University
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How Remote Work Has Changed How Workers Perceive Their Workplaces | Leaders and professionals know that our human compulsion to acquire and defend territory is little different from that of mockingbirds and finches defending their hedges. Robert Ardrey eloquently wrote about this in his foundational 1961 book, The Territorial Imperative. We 've fought for larger offices for years and years. And then Covid happened, and we were all thrust out of our defended hedges to work from home.
In my workplace's most recent research project, completed last month, we set out to explore what this new world of work will look like regarding four important vectors, namely culture, workspace design, technology, and the pandemic itself.
One of the more interesting cross-vector insights was this rise of the `` New Territorial Imperative '' -- the shift of values in how hybrid workers feel about their `` primary work territory. ''
Today, roughly a quarter of U.S workers work from home five days a week, with another third or so defined as hybrid workers who work from one to three days a week in a traditional office. The remaining 40 percent or so work four to five days a week in a traditional office. In the U.K, this number is skewed slightly toward work-from-home, as almost a third work from home full time and just over a third work from a traditional office four or five days a week, with the remaining third working in a hybrid model.
After Covid hit and knowledge workers moved to a work-from-home work style, fewer than a quarter reported that they 'd want to return to an office five days a week, with between 50 and 60 percent in both countries suggesting that two days or less in the office would be ideal.
This Covid-driven change has shifted our values, as well. Half of the workers in both the U.S. and U.K. agreed that their home office is now more important to them than their traditional office. Further, half of the workers in both countries believe their `` office '' is now their laptop, their headset, and wherever they can get a strong internet connection.
This is yet more evidence that workers want greater control over their lives and outcomes -- and a central part of this psychology is the physical space they control, namely their home offices.
In the rush to embrace the new work-from-home normal, it's easy to forget that the other third to half of the workers have returned to traditional offices. But as the world has shifted toward work-from-home, sensibilities in the traditional office have changed as well.
`` Free address '' is a hot topic in boardrooms today, as utilized square feet have decreased because more workers are working from home. But is taking away assigned seating a good thing?
Ardrey's original hypothesis that territory signals prestige tells us to tread cautiously. Only a third of U.S workers say they 'd be comfortable not having an assigned seat, with a full half rejecting the idea. The U.K., in strong contrast to both the U.S. and other European countries studied, is split on the question, with roughly 40 percent expressing some degree of comfort with the idea, versus an equal percentage expressing dissatisfaction.
There are consequences to ignoring this discontent. Forty percent of workers in both the U.S. and U.K. said eliminating assigned seating would harm loyalty, versus almost a third expressing no opinion. Interestingly, almost three-quarters of workers in both countries said they would still try to sit and work in the same spot every day if their assigned seat was taken from them, reminding us that the territorial imperative at work is still alive and well.
So what do we do now? I 'd say that there are three implications.
First, leaders need to actively design the new workplace to meet the new needs of the hybrid worker. If half of all meeting attendees will be remote, how do we improve the experience for those not in the room who can't hear what's being said or see what's being written on the whiteboard? What do we do with huddle rooms if we're no longer willing to huddle? And are we even sure that all-virtual meetings aren't better than meeting face-to-face?
Second, leaders need to re-imagine workspace design so that territory is defined at a team level, not the individual one. Can we successfully create a workplace where `` overlapping hunting grounds '' exist between different members of the same workgroup/tribe?
And third, how can leaders proactively tap into a suddenly location-independent digital nomad talent pool? This calls for a cultural shift and a managerial skill set that few have.
The human need for territory and the status it confers is as old as the human race itself. We need to give thought to this New Territorial Imperative and think about how best to coax the best performance out of our people and ourselves.
Correction: An earlier version of this article misstated the study's name. | business |
World moves from shortages to possible glut of COVID-19 vaccines | After racing to build capacity and meet once seemingly insatiable orders for COVID-19 shots, the global vaccine industry is facing waning demand as many late-to-market producers fight over a slowing market.
The trend is poised to rein in the blockbuster sales that global pharmaceutical giants from Pfizer Inc. to AstraZeneca PLC saw at the peak of the pandemic. It also stands to create new problems for local manufacturers from India to Indonesia that built mammoth capacity to make shots but are now grappling with excess supply.
Even as boosters are likely to keep demand alive for COVID-19 inoculations worldwide, the desperate shortages that existed for much of last year have waned. Instead, in a dramatic reversal, the possibility of a global glut is now looking more likely.
Across the world more than 11 billion doses have been administered, with uptake increasingly coming from poorer countries with low rates of coverage. But after grappling with severe shortages last year, COVAX, the World Health Organization-backed sharing initiative supplying low-to-middle-income countries, said in January that stocks are exceeding demand. Distribution, absorption capacity and hesitancy are now the main challenges to getting shots into arms in places such as Africa.
Shares in companies that have made their names during the pandemic have likewise plunged as movement and travel restrictions ease across many parts of the world. Projections that COVID-19 vaccine revenue for Pfizer, Moderna Inc., AstraZeneca and Johnson & Johnson may top $ 61 billion this year, slightly above 2021 sales, might be “ over-optimistic, ” according to a Bloomberg Intelligence report this month, citing lack of enthusiasm for fourth doses in Israel as an early indicator of diminishing global demand.
“ Supply is exceeding demand in much of the world, even with many countries rolling out booster shots, ” said Scott Rosenstein, a New York-based special health care adviser to Eurasia Group, who expects production to taper off this year and next unless there is a real variant “ curve ball. ”
“ Once the perception set in that omicron is less likely to lead to severe illness, and the vaccines don’ t do a great job at preventing infection while still providing strong protection against severe illness, demand for COVID vaccines has tailed off considerably, ” Rosenstein said.
The number of shots needed in the coming years is expected to decline from the early days of the pandemic. Meanwhile, a growing number of manufacturers are breaking into the market.
More than 9 billion doses could be produced in 2022, but vaccine demand may decline to a rate of about 2.2 billion to 4.4 billion doses per year in 2023 and beyond, with a clearer picture emerging over time, according to analytics firm Airfinity Ltd.
Sales of AstraZeneca’ s Vaxzevria inoculation are set to fall in 2022 after hitting about $ 4 billion last year, the company has said.
Pfizer had vaccine sales of $ 36.8 billion last year, and in February said it expected sales of $ 32 billion in 2022. That’ s based on contracts signed as of late January, and analysts expect the orders to go up during the year. Both Moderna and Pfizer have asked U.S. regulators to clear fourth-shot boosters.
Moderna’ s chief executive said on a conference call that the U.S. government has yet to put in orders for 2022, suggesting room for growth if the country buys a large amount of boosters. AstraZeneca declined to comment. Pfizer didn’ t directly address questions about vaccine demand, saying in a statement that there’ s enough capacity to vaccinate the world in 2022, yet barriers to access remain. Moderna didn’ t provide additional comment.
Yet more supply could be coming online soon. The problem is particularly acute in India, home to the world’ s largest vaccine industry, which is grappling with domestic and global oversupply. Some experts in India have questioned the need for boosters, doubting their effectiveness at preventing infections beyond a few weeks.
Biological E. Ltd., a large manufacturer based in the southern city of Hyderabad, invested about 15 billion rupees ( $ 195 million) to double capacity during the pandemic to about 4 million vaccine doses a day. Corbevax, its protein sub-unit COVID-19 shot, was first granted local emergency approval for adults in December and then 12- to 18-year-olds last month. Yet, with most adults fully inoculated and the government showing no urgency to expand its booster drive, it’ s uncertain how many more Corbevax doses will be purchased beyond the 300 million that New Delhi has guaranteed to take off the firm’ s hands.
Young people wait to receive a dose of a COVID-19 vaccine in Allahabad, India, on March 16. | AFP-JIJI
The real challenge is going to be utilizing the increased capacity, Managing Director Mahima Datla said in an interview in Hyderabad. “ Fixed costs have to go somewhere, right? You’ re not going to be able to send people home, shut off half your plant. ”
Biological E. isn’ t the only Indian manufacturer facing that truth. Zydus Lifesciences Ltd.’ s DNA COVID-19 vaccine was approved late last year, but India’ s government has only ordered 10 million doses, Managing Director Sharvil Patel said on an earnings call last month, conceding there was “ uncertainty ” on further opportunities.
The Serum Institute of India Ltd., the country’ s main supplier that produced 2 billion COVID-19 shots last year, halted manufacturing in December after a lack of orders, Chief Executive Officer Adar Poonawalla told a panel in January. Serum, a mammoth supplier of a variety of vaccines to the developing worlds, didn’ t respond to questions and requests for comment on the company’ s production levels of COVID-19 inoculations.
“ One of the big questions moving forward will be what to do with all of this vaccine manufacturing capacity as demand dwindles, ” said Rosenstein. “ There probably isn’ t sufficient demand for other vaccines for this to be a viable option for all of these manufacturing plants. ”
Privately held Biological E., which was founded by Datla’ s grandparents in 1953 and supplies the likes of Unicef with childhood inoculations, may repurpose lines built for coronavirus shots, Datla said.
Datla said her company hopes to supply COVAX, which will need to replenish stocks that are expiring. However, Biological E. will first need to obtain WHO approval to make those shipments and efficacy data for the vaccine has yet to be published. Datla didn’ t give a timeline for the study’ s release.
Other Indian vaccine suppliers are also looking at innovative immunization opportunities beyond COVID-19.
Vaccine doses arrive at Kotoka International Airport in Accra, Ghana, in May 2021. | REUTERS
“ We believe that not just COVID-19 vaccines, but flu shots, pneumococcal vaccines, vaccines for other neglected diseases will all start becoming very important opportunities, ” Kiran Mazumdar Shaw, the chairperson of Biocon Ltd., which inked an annual 100-million-dose access deal with Serum last year, told Bloomberg Television earlier this month.
Meanwhile, in other parts of the world, some developers are throwing in the towel. Indonesia’ s Kalbe Farma halted work on a COVID-19 shot with South Korea’ s Genexine Inc. this month, citing abundant stocks. It now aims to use the DNA technology for other types of vaccines.
Despite the current pressures, companies will likely keep seeing demand for boosters while they pursue improved inoculations that are superior to the initial products. It appears COVID-19 is evolving to what will likely be an endemic disease, meaning it’ s likely here to stay, said Gary Dubin, president of the vaccines unit at Japan’ s Takeda Pharmaceutical Co.
Still, questions remain about whether regular boosters will be needed and how often, and potential variants “ could rapidly change the picture, ” he said. | tech |
Former residents of disputed, Russian-held islands share hopes of visiting hometowns | Sapporo – With Russia's invasion of Ukraine negatively affecting negotiations between Tokyo and Moscow over a territorial row between the two countries, former residents of the disputed islands off the east coast of Hokkaido have voiced earnest hopes of retaining their right to set foot in their hometowns.
In response to Japanese sanctions against Russia over the war in Ukraine, Russia unilaterally announced a halt to peace treaty talks with Japan and a suspension of a program that allowed visa-free visits by Japanese people to the four Russian-held islands, known in Japan as the Northern Territories.
`` I was prepared for diplomatic retaliation, but I 'm angry at the one-sided announcement, '' said Yuzo Matsumoto, an 80-year-old who lived in Etorofu, one of the four islands claimed by Japan.
The graves of Matsumoto's grandfather and grandmother are on Etorofu, but Matsumoto has not been able to visit them since 2020 as the visa-free visit program was suspended due to the coronavirus pandemic.
`` Visiting ( our ancestors ') graves shows how much we think about our hometowns and is the cornerstone of the movement to have the islands returned, '' Matsumoto said. `` We definitely don't want to lose '' the right to visit the graves, he added.
The disputed islands, which also include Kunashiri, Shikotan and the Habomai islets, were seized from Japan by the former Soviet Union at the end of World War II. Tokyo and Moscow have failed to conclude a peace treaty to formally end their wartime hostilities due to the territorial row.
Hiroshi Tokuno, an 88-year-old who is from Shikotan and has continued telling stories about the Northern Territories for half a century, has participated in exchanges with Russian residents of the islands over 30 times.
Tokuno said he has many Russian friends in Shikotan but has been unable to see them in person due to the pandemic.
Noting that Russia's latest decision came on top of the impacts of the COVID-19 crisis, Tokuno said he misses the exchange program. `` My true desire is to be able to go back to my hometown every year, '' he added.
According to the League of Residents of Chishima and Habomai Islands, the average age of former residents of the islands exceeds 86.
`` My age adds to the sense of urgency. If the exchanges are interrupted by the pandemic, I can keep my hopes high — but I can't do that if the program is suspended due to political reasons, '' Tokuno said.
Matsumoto, also voicing disappointment at the suspension of former residents ' visa-free visits, said, `` I 'm not saying that I want to live there. I just want to go there. '' | tech |
Omicron'stealth ' variant BA.2 now dominant globally | A subvariant of the highly transmissible omicron version of COVID-19 known as BA.2 is now dominant worldwide, prompting surges in many countries in Europe and Asia and raising concern over the potential for a new wave in the United States.
BA.2 now represents nearly 86% of all sequenced cases, according to the World Health Organization. It is even more transmissible than its highly contagious omicron siblings, BA.1 and BA.1.1, however the evidence so far suggests that it is no more likely to cause severe disease.
As with the other variants in the omicron family, vaccines are less effective against BA.2 than against previous variants like alpha or the original strain of coronavirus, and protection declines over time. However, according to U.K. Health Security Agency data, protection is restored by a booster jab, particularly for preventing hospitalisation and death.
The rise of BA.2 has been blamed for recent surges in China as well as record infections in European countries like Germany and the U.K. Yet some European countries are now seeing a slower uptick in new cases, or even a decline.
BA.2 has been called the “ stealth variant ” because it is slightly harder to track. A missing gene in BA.1 allowed it to be tracked by default through a common PCR test. BA.2 and another sibling, BA.3, which is also increasing in prevalence but is currently at low levels, can only be found by genomic sequencing, which some countries do more of than others.
A key concern about BA.2 was whether it could re-infect people who had already had BA.1, particularly as a number of countries seemed to be experiencing “ double peaks ” in infection rates surprisingly close together. But data from both the U.K. and Denmark have shown that while omicron can reinfect people who had other variants, such as delta, only a handful of BA.2 reinfections in people who had BA.1 have been found so far among tens of thousands of cases.
Scientists say a possible explanation for the recent rise in BA.2 could be that the global uptick happened at the same time that many countries lifted public health interventions.
“ In some ways, it could just be that BA.2 was the variant that was circulating when all these people stopped wearing masks, ” said Dr. Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
As such, other U.S. experts such as Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California, said it was “ a little too early ” to call whether the U.S. too would see a significant BA.2 wave.
But whatever the reason for BA.2’ s rise, scientists said it was a reminder that the virus continues to cause harm, particularly among unvaccinated, undervaccinated and vulnerable populations.
“ It is still a huge public health problem and it is going to continue to be, ” said Mark Woolhouse, an epidemiologist at the University of Edinburgh. | tech |
'Disenchanted ' Starring Amy Adams - Cast, Date, Spoilers and More | We may earn commission from links on this page, but we only recommend products we love. Promise.
ICYMI, there are officially (!!) photos of Amy Adams and Patrick Dempsey on the set of Disney's new movie, Disenchanted. The co-stars were seen on location in Buckinghamshire village, and * * potential spoiler alert * * it appears that Amy's character Giselle miiiiight just be a mom in the Enchanted sequel. Either that, or she's babysitting for Idina Menzel Nancy Tremaine since the protagonist is seen pushing a pink pram through the fictional village.
In the newly-released photos, Amy is seen wearing a dreamy, beige dress with gold detailing under a hooded cloak, while Patrick is sporting similarly-regal attire in the form of a navy robe with belted fastenings and lace-up boots.
Just as exciting as seeing the co-stars decked out in some serious getup, however, is the location itself. In another set of images, Amy is seen crossing a wooden bridge that's beautifully covered in flowers and vines.
Disenchanted, a sequel to the hit film Enchanted, will stream exclusively on @ DisneyPlus. Amy Adams returns for more fantastical fun as Giselle! 👑
While COVID-19 restrictions are slowly easing, that doesn’ t mean watching movies from the comfort of our homes will go out the window! Therefore, it makes a lot of sense for this movie to premiere on Disney’ s streaming site. No word yet on whether it will be specifically on Premier Access though…
That’ s right! The six-time Academy Award nominee and the Grey’ s Anatomy alum are set to make their grand returns as Giselle and Robert in the sequel! Patrick even went on Good Morning America in January 2021 to make the big announcement, saying he’ d just gotten the script.
Oh, and we obvs can’ t forget James Marsden and Idina Menzel, because they’ re returning to the movie as well! I’ m truly wondering what’ s in store for our Prince Edward and Nancy Tremaine.
Amy couldn’ t be more excited to get the gang back together. In a recent interview on Late Night With Seth Meyers, she disclosed her thoughts about starting production, and she’ s thrilled to be returning to a role she played just 15 years ago.
“ It is so nice to get to do something that, really, the whole intention of doing this is to create joy and hope, ” she told the talk-show host. “ And it’ s something that means a lot to me. I was really reticent to come back to the role because I loved her so much, but it really felt like the right time. ”
As if we could expect our fave characters from the first film to just be by themselves in the sequel. In addition to Amy, Patrick, James and Idina, we’ re getting a bunch of new faces to add to the worlds of NYC and Andalasia. Here are some of the actors we can expect to see onscreen:
Not many details are out on exactly what Maya’ s new character will be like, but if her reaction to Patrick’ s tweet about who’ s joining the cast says anything, we’ re about to get a unique—and truly comedic! —performance from the SNL alum.
What’ s a good fairy tale without a great villain? I’ ll see you in Andalasia my pretties....
Oscar’ s character, Edgar, has been kept ~under wraps~, so TBD on what’ s to come.
The kingdom loves new visitors! Let’ s bring @ YNB ( Yvette Nicole Brown), Jayma Mays, @ kolton stewart and @ OscarNunezLA too. Plus, we are SO excited to introduce @ gabbaldacchino as Morgan! Can’ t wait for you to see # Disenchanted, coming to @ DisneyPlus in 2022! -Amy & Adam pic.twitter.com/27ohIsm1PT
How cute is this video of Amy and director Adam Shankman telling Gabriella the news?? FWIW, her reaction is all of us.
According to Entertainment Weekly, the film will follow Giselle, Robert, and a now-teenage Morgan as they relocate to Monroeville. There, they find themselves dealing with a number of new challenges, including trying to keep up a new home and figure out exactly what the phrase “ happily ever after ” truly means. But with evil forces ( aka Maya’ s character, probably) trying to ruin things, it might take a little while before they get an answer to that existential question…
Composer Stephen Schwartz confirmed this ~musical~ piece of news in May 2021, saying he and Alan Menken already have seven (!!) songs ready to go. The best part? Unlike in the first film, Idina will have her moment to shine in the form of a solo song!!
“ There are seven songs plus reprises, which is more songs than the original, ” Stephen wrote in his official newsletter. “ We wrote a song for Idina’ s character in the first movie, and then they didn’ t have her do it. But in Disenchanted, she has one big number and part of another one. ”
Yes, you read this right. You can start swooning right about now! Patrick is expected to exercise his vocals for the first time on camera, but as he told Variety in late April 2021, don’ t expect him to have the voice of an angel…yet.
“ I’ ve never ever sung publicly—for a reason. So bear with me, ” he told the outlet. “ I hope the fans embrace it. But they’ ve set me up for success and the lyrics are really fun. ”
Ireland, prepare yourself, because the cast of Disenchanted started production in the country. The cast has been seen all over, and Disney+ posted the first photo of Amy and director extraordinaire Adam from set.
Good morning! Amy Adams and @ adammshankman here taking over @ DisneyStudios for a bit. Wanted to get a few friends together to tell the story of what ‘ ever after’ looks like… pic.twitter.com/IE4vuV4Hkv
We know, we know—it’ s not the photo you were all hoping for. But some things need to be kept under wraps, right? Soon enough, we’ ll get an idea of what’ s happening on-set, but for now, let’ s just be happy with this little piece of photography. | general |
Kate wears black Alessandra Rich dress for Prince Philip's memorial service | We earn a commission for products purchased through some links in this article.
Like many, the Queen and the rest of the royal family were unable to properly say goodbye to the Duke of Edinburgh when he died last year, thanks to the restrictions enforced at the time by the ongoing Covid-19 pandemic.
A year on, the royals were finally able to celebrate his life and legacy, with a Service of Thanksgiving, which took place at Westminster Abbey today.
The Queen, who was `` actively involved in the plans '', was joined by other members of the British royal family, other European royals and representatives of his charities, to pay their respects.
The Duke and Duchess of Cambridge were also present, joined by two of their three children, Prince George and Princess Charlotte. Their youngest, Prince Louis, stayed at home. William and Kate returned from their eight-day tour of the Caribbean this weekend.
For the occasion, Kate wore a black polka-dot dress by Alessandra Rich, with a wide-brim Lock & Co hat, classic black suede courts, and a pair of pearl droplet earrings that used to belong to Princess Diana. William co-ordinated with the children in complementing shades of navy.
Kate's elegant dress featured a high neckline, long sleeves and a drop-waist pleated skirt. Rich is one of the duchess ' favourite designers; she has worn the London-based brand several times previously - most recently just this weekend for the final appearance of her Caribbean tour, and also notably during a visit to the V & A Museum in 2021, and during a trip to Ireland in 2020.
While Kate's actual version is sold out, it's still available to buy online in navy.
Buckingham Palace confirmed that the Queen, who entered Westminster Abbey discreetly via a side door, helped organise today's memorial service for her late husband, “ with many elements reflecting Her Majesty’ s wishes ”.
The statement read: `` The Service will give thanks for The Duke of Edinburgh’ s dedication to family, Nation and Commonwealth and recognise the importance of his legacy in creating opportunities for young people, promoting environmental stewardship and conservation, and supporting the Armed Forces. ''
`` The Service will in particular pay tribute to The Duke of Edinburgh’ s contribution to public life and steadfast support for the over 700 charitable organisations with which His Royal Highness was associated throughout his life. The Duke of Edinburgh’ s Award, founded by His Royal Highness in 1956, will feature prominently in the Service. ''
Prince Philip passed away peacefully last year at Windsor Castle on 9 April at the age of 99. | general |
Ukraine war: Ordinary Belarusians are also being victimized by Russia | When Russia launched its invasion of Ukraine, one potential inroad was from the north, where Russian and Belarusian troops had been conducting an exercise called Allied Resolve.
Missiles fired from bases in Belarus caused extensive damage to the Ukrainian city of Chernihiv. Yet to date, no Belarusian troops have crossed the border into Ukraine and some Belarusian exiles are fighting alongside Ukrainians.
What is Belarus’ role in this conflict? Is it likely to be drawn in further? The West has sanctioned Belarus alongside Russia for the attack on Ukraine. Is this justified?
Belarus has been under the rule of its president, Alexander Lukashenko, since 1994.
In 1999, Lukashenko and his Russian counterpart, Boris Yeltsin, ratified the Russia-Belarus Union. In theory, the union was one of equals.
For much of his rule, Lukashenko has undermined democracy by amending the Belarusian constitution, elevating the Russian language, controlling the media and manipulating elections. In 1999-2000, several of his key opponents were kidnapped and killed. Every presidential election after 2001 ended in brutal attacks on protesters.
For many years, Lukashenko benefited from cheap oil imports from Russia. The oil was refined and exported to Europe. The Russians eventually started to push for higher prices. They also purchased the main pipeline through Belarus in 2011.
In 2020, however, the situation changed. The COVID-19 pandemic devastated Belarus, but Lukashenko chose to ignore it. He dismissed it as a “ psychosis ” and advised residents to go the countryside and drink vodka or visit saunas.
In response, a grassroots network of self-help organizations developed, particularly in the larger cities.
In August 2020, Lukashenko ran for president for a sixth term, and for the first time he faced opponents from his own elite. Following past practices, security forces arrested two candidates, Viktar Babaryka and Siarhei Tsikhanouski, while the third — Valery Tsapkala — fled the country.
But their campaigns unified behind Tsikhanouski’ s wife, Sviatlana Tsikhanouskaya.
Her campaign ignited Belarus and attracted thousands of followers. When the head of the election commission announced in August 2020 that Lukashenko had won with more than 80 per cent of the vote, thousands of protesters poured into the streets to express their anger and frustration.
Months of protests followed, embracing all sectors of society: women, the elderly, students and workers.
The regime responded with a brutal crackdown. Thousands fled the country; tens of thousands were arrested, tortured and placed in prisons and penal colonies.
The protests were sustained by social media, especially on the Telegram channel Nexta. In April 2021, the authorities diverted a commercial Ryan Air flight from Athens to Vilnius to arrest one of the channel’ s main operators, Raman Pratesevich.
Faced with sanctions from Europe, Lukashenko also created his own migrant crisis, encouraging refugees from Iraq, Syria and other countries to enter Belarus on short-term visas. When the visas expired, they were taken to the Polish border and abandoned. The Poles on the other side erected barbed wire fences to prevent their crossing.
Lukashenko almost fell from power in 2020. He survived, aided by his brutal but loyal security forces. But his real saviour was Vladimir Putin.
Though their relationship was often fractious, they have in common their authoritarianism and ruthlessness. The Russia-Belarus union, finally, came to fruition.
But it came with harsh conditions attached. Belarus is losing its independence in decision-making, media and foreign policy. Lukashenko, a fierce operator, is reduced to a supplicant, travelling to Moscow to plea for loans or aid in dealing with protesters.
In February 2022, Lukashenko held a referendum on a new constitution for Belarus. Modelled closely on Russia’ s, it reduces the power of parliament and creates a new body called the People’ s Assembly.
Every four years, Russia and Belarus have held military exercises under the mantle of Operation Zapad ( Operation West). But in February 2022, they held an impromptu exercise at Russia’ s request. The designated areas for the exercises were expanded to locations close to the Ukraine border.
On Feb. 20, 2022 — ostensibly the final day of the exercises — the Russian troops remained in place. Four days later, they entered Ukraine, occupying the remains of the Chornobyl nuclear plant 10 kilometres to the south.
All of this highlights the conundrum of contemporary Belarus: its ruling regime is alienated from its people and bitterly despised, but it survives through the use of force and Russian support. The country is now being deployed as the base for a Russian invasion of a sovereign country.
Belarusians do not want this war, but their country is under occupation too. They should be regarded as the initial victims before the war escalated into the horror it has become in Ukraine. | business |
Ukraine War, China Lockdowns Hit Global Supply Chains | Global supply strains that started to ease in early 2022 are worsening again as headwinds strengthen from the war in Ukraine and China’ s Covid lockdowns, threatening slower growth and faster inflation across the global economy.
After the pandemic hit Asia-U.S. trade routes the hardest over the past two years, the latest turmoil is being acutely felt in Germany, which is heavily reliant on Russian energy and suppliers across Eastern Europe. Business expectations in the region’ s biggest economy during March posted the steepest one-month drop on record, factories across the continent face diesel and parts shortages, and delays moving cargo through key North Sea gateways such as Bremerhaven are lengthening.
“ We thought Russia was just a resources story that was going to push energy prices up — that it would make supply chains more expensive but it wouldn’ t disrupt them, ” said Vincent Stamer, a trade economist with Germany’ s Kiel Institute for the World Economy. “ It appears a little more threatening than we initially anticipated. ”
On top of the wartime setbacks, omicron outbreaks are widening China’ s use of strict lockdowns in major trade hubs, the latest in Shanghai. A.P. Moller-Maersk A/S, the world’ s No. 2 container carrier, said Monday that some depots serving local ports have closed indefinitely, and trucking to and from terminals will be “ severely impacted. ”
Chinese exports were already tailing off from an October peak — a trend that might continue for the next few months if Beijing maintains the hard line on fighting the virus, Stamer said. That’ ll add shipping delays, sourcing problems and costs for businesses from the U.S. to Europe.
According to supply constraint indexes developed by Bloomberg Economics, pressures in the U.S. and Europe intensified in February after several months of improvement. Anecdotal evidence through March suggests the strains won’ t abate.
Stamer cited the example of electric wire assemblies made in Ukraine for German automakers. “ These cable trees are actually custom-made for individual cars ” and aren’ t easily or cheaply sourced from other countries, he said. Another rare input that’ s suddenly even more scarce is neon gas used in semiconductor production. Ukraine produces 50% of the world’ s purified neon, Stamer said. Russia’ s output of raw materials extends even deeper into the global economy.
More than 2,100 U.S. firms and 1,200 in Europe have at least one direct supplier in Russia, and the total reaches 300,000 when indirect suppliers are included, according to Arlington, Virginia-based Interos, a supply chain risk management company.
“ Multiple industries are reliant on the same raw materials and a large percentage of them are coming out of Russia, ” Interos CEO Jennifer Bisceglie said. “ You’ re seeing a massive cascading effect on an already limping system of the global supply chain. ”
The economic and political stakes are far more consequential than the developed world’ s biggest worry in 2021 — the concern that slammed global logistics would spoil Christmas for retailers and consumers.
Fears are now rising about food shortages. The cost of living is rising in rich and poor regions alike. Soaring energy prices are spawning street protests from Albania to the U.K.
Costly, longer-term shifts are accelerating, too: Goldman Sachs economists say the new geopolitical risks are forcing companies to reinforce their operations against global disruptions through reshoring, diversification and overstocking inventories.
“ At the moment, the storm clouds on the horizon look quite menacing, ” Citigroup Global Chief Economist Nathan Sheets said in a research note on Friday, explaining why “ a major adverse supply shock ” from the Russia-Ukraine conflict led the bank to cut its outlook for world GDP growth this year and increase its inflation projections. “ Bottom line, an already complicated picture has become even more complex. ”
Trade is already feeling the sting of sanctions on Moscow and blocked transport routes. According to FourKites Inc., a supply chain visibility platform, Russian imports across all modes of freight transportation dropped 62% over the first month of the conflict, while shipments into Ukraine plunged 97%.
Though Russia accounts for 5% of the world’ s seaborne trade and Ukraine just 1%, a heightened risk of a global economic slowdown has emerged.
Economists at Barclays on Monday said the world is entering a new era of higher volatility for growth and inflation. Allianz Research on Friday warned of a greater risk of a “ double whammy ” in world trade — lower volumes and higher prices — in 2022. Clarksons Research, a shipping analytics firm in London, last week trimmed its projections for global trade this year and next, saying its port congestion indexes are rising again and the latest shocks are “ amplifying an already disrupted maritime transport system. ”
According to data compiled by Bloomberg, the German ports of Hamburg and Bremerhaven saw new highs in ship congestion this month, while Rotterdam, the continent’ s busiest gateway for container traffic, saw its vessel backup at the start of the month reach an 11-month high.
The snarls make any return to normal unlikely this year unless demand unexpectedly craters. Ocean shipping, the workhorse for some 80% of global trade, was stretched so thin that the spot rate to send a 40-foot container of goods to the U.S. from Asia averaged more than $ 10,000 in the second half of last year — about seven times higher than the pre-pandemic level. Those rates have come down in recent weeks, but experts say the reprieve probably reflects a seasonal lull before transport demand and costs pick up again.
“ It’ s going to get worse as we move through the second half of this year and into peak season, ” Mark Manduca, the chief investment officer of GXO Logistics, told Bloomberg Television on Friday. “ You don’ t initially feel the pinch in the first few weeks of a supply chain shortage — people have inventories. ”
Even greater than the risks Russia’ s war in Ukraine pose to global supply fluidity are the COVID-19 cases and targeted lockdowns in China, according to economists Ana Boata and Françoise Huang at Euler Hermes, a unit of Allianz Group. They see a risk that container freight prices approach or even exceed their previous peaks, before returning to current levels by year end.
“ Overall, even if not returning to the peaks of 2021, the cost and congestion levels of global supply chains are likely to remain high for most of 2022, ” Boata and Huang wrote in an email. “ The normalization may start more visibly only from 2023. ”
Trying to anticipate how two years of supply constraints affect consumer prices has already challenged central bankers, with Federal Reserve Chair Jerome Powell saying at a press conference earlier this month that Russia’ s isolation from the world economy is “ going to mean more tangled supply chains, so that could actually push out the relief we were expecting. ”
Some of that relief was reflected in the New York Fed’ s Global Supply Chain Pressure Index, a gauge launched in January that most recently showed some easing from peak strains late last year. While it’ s too soon for the New York Fed to quantify any wartime effects, there are signs that the index’ s recent improvement will be limited.
“ There’ s been a decrease in the pressure, but the level of the pressure is still very high. It’ s an improvement but it doesn’ t mean the problems are resolved, ” New York Fed economist Gianluca Benigno said about the direction of the index in its latest update in early March. “ Anecdotal evidence suggests there might be further pressure ahead. ”
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French far-right leader Le Pen closing gap on Macron: polls | Hi, what are you looking for?
Veteran French far-right leader Marine Le Pen is closing the gap on President Macron ahead of a possible election duel between the two.
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Veteran French far-right leader Marine Le Pen is closing the gap on President Emmanuel Macron ahead of a possible election duel between the two of them next month, two new polls show.
Macron has long been favourite for the two-round election on April 10 and 24, with his handling of the diplomatic crisis caused by the war in Ukraine seen as boosting his chances.
But his estimated margin of victory over Le Pen is narrowing sharply as the election approaches, two polls published this week suggested.
If they faced each other in the second round, a poll by the Ifop-Fiducial group published on Monday indicated Macron would win by just 53 percent versus 47 percent for Le Pen, who had gained three points in a week.
A poll on Tuesday by Ipsos Sopra-Steria, meanwhile, showed Macron winning by 56 percent to 44 percent, again with Le Pen up by around three points in a week.
Aides to Macron sought to play down the change, with one advisor saying Tuesday that it was a simple correction after a sharp rise in support following Russia’ s invasion of Ukraine on February 24.
“ We knew he wasn’ t going to stay so high, ” the advisor told AFP on condition of anonymity.
But the shift in momentum is being seized on by Le Pen and her anti-immigration National Rally party, with between a quarter and a third of voters believed to be undecided about how to cast their ballots.
“ I have never been so close to victory, ” Le Pen told Le Parisien newspaper in an interview published Saturday.
She has placed less emphasis on her traditional themes of Islam and immigration in favour of a grassroots campaign focused on the economic problems faced by low-income families and the working classes.
– Inflation fears –
Macron has largely shunned the election campaign so far, but during his first public walkabout to meet voters on Monday in the eastern town of Dijon, he heard plenty of complaints about inflation and rocketing fuel prices.
“ Everything is going up… put yourself in the position of a French family. It can’ t carry on, people will go nuts, ” one 46-year-old salesman told him.
Macron has also been forced to defend his government’ s use of costly outside consulting firms such as the US-based McKinsey following a highly critical report from the Senate this month.
The investigation found that the value of such contracts had more than doubled between 2018 and 2021, reaching more than a billion euros ( $ 1.1 billion) last year, a record.
Macron has denied that his governments used consultants more than their predecessors, while adding that additional help was required during the height of the Covid-19 pandemic when ministries and civil servants were stretched thin.
“ It’ s a complicated issue that will sway those who were already convinced that Macron is a ‘ president of the rich,’ but it’ s not a widespread issue, ” political analyst Philippe Moreau Chevrolet told AFP, referring to the label given to Macron, a former investment banker, by his critics.
“ It counts much less than questions around household income and spiralling inflation and even fears about food supplies, ” added Moreau Chevrolet, also the founder of MCBG Conseil, a PR agency specialised in political communication.
Experts emphasise that pre-election polls are a snapshot of voting intentions at the time they are conducted, and that the outcome of the election next month remains uncertain.
With 2,400 staff representing 100 different nationalities, AFP covers the world as a leading global news agency. AFP provides fast, comprehensive and verified coverage of the issues affecting our daily lives.
In the small town of Borodyanka, diggers sort through the rubble of houses destroyed by Russian bombardments, looking for the missing.
The Security Council failed to prevent the brutal invasion of Ukraine, President Zelensky said in a separate address to Japanese lawmakers.
Long considered the “ most peaceful country in the world ”, Iceland’ s tranquillity has been shattered by a spate of shootings and stabbings.
The demonstration was largely peaceful, though one woman was arrested for displaying the letter `` Z '', a symbol of support for the Russian army.
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The Women Who Inspire Pro Cyclists | Gear-obsessed editors choose every product we review. We may earn commission if you buy from a link. How we test gear.
We’ re closing out Women’ s History Month with a tribute to those who motivate us in the sport we love.
Women’ s History Month is all about highlighting the contributions of women throughout history and supporting women through future endeavors. It’ s also about women lifting up other women.
So to help us celebrate, we asked current and former pro cyclists to share stories about the women who inspire them most—the people who motivated them to pursue their passions and continue riding forward.
Here, notes of gratitude to those women who have impacted our lives and by proxy, cycling—the sport we love.
Dear Liza,
Thank you so much for being my guiding light for the last few years of my cycling career. I have always admired and been inspired by your endless gratitude, positivity, and commitment to the craft. Knowing I could reach out to you for guidance and support during my career kept me in a consistent head space and acknowledging what a privilege it is to train, compete, and be in this sport we love.
During our time riding together in Encinitas in spring of 2019 was such a pleasure and the stories you told about your numerous years racing as a pro have stuck with me. Looking forward to seeing each other on the sidelines, rather than the race course 😉.
Dear Jess,
Thank you for your support through multiple phases of our bike careers! As a teammate back in our Hagens Berman Supermint [ pro women’ s cycling team ] days on the road, you were always so reliable and steadfast. One of my favorite career moments was when you won the Redlands crit and got to shine how you deserved.
When I was hit by that driver, you were really encouraging and shared your best practices after you broke your leg and came back from that. During COVID times, you were still invested in my outcome dealing with that. And as I finally entered my first gravel season, you’ ve always encouraged and believed in me, even when I didn’ t believe in myself. Where we each live in this two-wheeled space has changed over the years, but I’ m grateful for the steadfast friendship and looking forward to what 2022 will bring!
Dear Blasi a.k.a. Basil,
Eileen, you’ ve had such a profound impact on my life. You’ ve spread your love and energy into my bike life, my professional life, and my personal life, which is why I consider you family. You set an example of how to be a confident, successful, and empowered woman as a mother, as a cyclist, and as a friend.
Whenever I’ ve hit the lowest valleys in my life, you’ ve been there to make sure I have what I need to make it back to the tippy top of the mountain. You’ ve shown me how to stay positive and keep pushing my career while I balanced professional racing. Most importantly you’ re always game for my crazy ride ideas and elaborate cream-cheese cookie sandwiches. Thank you for being a legendary human.
Dear Flo-Jo,
Thanks so much for being the representation I needed as a child. I remember sitting in front of the television or looking through a magazine and seeing your beautiful flashy outfits, impeccable makeup, and long flowy hair. I wanted to be just like you. You inspired me to get off the sofa and out of my head and just do it.
Back in high school I ran track because you, and women that looked like me, ran track. I felt inspired, and even as the only Black woman on my track team, I always felt like I belonged because you gave me that. Today, as an honor to you, I stand tall as a cyclist in a sport that is dominated by men and lacks the representation of folks of color. I show up in my best outfit and magnificently fiery red lipstick. My beautiful black skin, flashy black and gold outfit, and bright red lipstick stand out in the crowd at the start line. I want those young Black and brown girls to see me. I show up as myself so they can too, an inspiration of you. Thanks Flo-Jo.
Dear Coach Chely,
I have no words to describe how grateful I am to have you as my coach. Since the day I joined the team, I felt part of a family. You’ ve helped me regain my self-confidence and guided me to become the person I am today. I love how fun and understanding your training is.
Chely, you motivate me to become a better person on and off the bike every day. And although I sometimes slip when it comes to decisions, I know you will always stand by me. I have gone through many changes this past year, and even though I was new to the team, you took me under your wing and guided me. I had no idea coaches could be fantastic. Thank you for everything!
Daphne, it’ s safe to say that you got me into this mess. After asking if I’ d like to join a cycling team with you, having no idea what I was getting myself into, I found myself on a run-away train filled with racing, riding, friendships, and nonstop fun. At first, I hated training and riding hard but you pushed me, just as you pushed yourself to demand better out of every ride. You set the bar high and inspired me when you flew right over it. Thirteen years later, we’ ve gone on many adventures together on all different bikes and terrain. Thank you for keeping it interesting and most importantly, fun.
Dear Grandma,
I appreciate the way you always find a way to support me even if you don’ t fully know what I’ m doing. By watching you, I’ ve learned never to let anyone convince me I couldn’ t do something I wanted to do and to absolutely never settle for less. You’ ve taught me patience, compassion, and how to be both a leader and a team player. You are always yourself and from that, I’ ve learned that being yourself is the best and only way to be. I know I can count on your words and your spirit to lift me up on my darkest days even if we’ re not physically in the same place. Anyone who ever gets to be in your presence is the luckiest person alive. I am who I am, because of you. Thank you. | general |
Prior COVID-19 infection linked to robust, accelerated immune response after first vaccine dose, researchers report -- ScienceDaily | Now, in recent research published in the journal JCI Insight, scientists at the Lewis Katz School of Medicine at Temple University show that responses to the Pfizer-BioNTech BNT162b2 mRNA vaccine differ significantly in individuals based on whether or not they were previously infected with SARS-CoV-2. Notably, those who had COVID before vaccination experienced rapid antibody production after the first vaccine dose, with little or no increase after the second dose. The opposite pattern was observed in infection-naive individuals.
`` Our study shows that the presence of immune memory induced by prior infection alters the way in which individuals respond to SARS-CoV-2 mRNA vaccination, '' explained Steven G. Kelsen, MD, Professor in the Department of Thoracic Medicine and Surgery at the Lewis Katz School of Medicine, and first author on the new report. `` The lack of response after the second vaccine dose in previously infected individuals is especially relevant, because it could mean that some people may require only one dose or could potentially skip the booster shot. ''
Dr. Kelsen and Temple colleagues carried out the study in health care workers, some having previously tested positive for SARS-CoV-2 infection and others never having been infected. In both groups, the researchers measured levels of neutralizing antibodies in blood samples taken at three different time points, including before vaccination and after each vaccine dose. They also performed qualitative assessment for local reactions and systemic symptoms, such as fever, headache, and fatigue, associated with vaccination.
While levels of neutralizing antibodies reached their maximum in some people with prior COVID illness after the first vaccine dose, individuals with no history of infection exhibited massive responses after the second dose. But those high levels also plummeted quickly, and for the COVID group, despite the lack of response to a second dose, individuals overall had longer-lasting immunity. Prior infection, however, was also linked to more frequent and longer-lasting adverse reactions to the vaccine.
`` Previous studies had similarly reported long-lasting immunity and strong immune reactions in COVID patients, '' Dr. Kelsen said. `` We now provide new information on how prior infection interacts with vaccination in terms of measurable immune response and how individuals react to mRNA vaccines based on infection history. ''
In future work, Dr. Kelsen and collaborators plan to modify their neutralizing antibody assay to detect Omicron and other SARS-CoV-2 variants. `` We also are interested in understanding how long protection from a booster dose of the vaccine lasts, '' he said.
Other researchers at the Lewis Katz School of Medicine who contributed to the study include Alan S. Braverman, Department of Thoracic Medicine and Surgery and Department of Anatomy; Mark O. Aksoy, Jacob A. Hayman, Puja S. Patel, and Charu Rajput, Department of Thoracic Medicine and Surgery; Huaqing Zhao and Susan G. Fisher, Department of Biomedical Education and Data Science; Michael R. Ruggieri Sr., Department of Anatomy; and Nina T. Gentile, Department of Emergency Medicine.
The study was supported by Temple University institutional funds. | science |
As pandemic and war send prices soaring, people are changing how they eat | In India, roadside restaurateurs are halving their palm oil use and moving into steamed snacks. Bakers in Ivory Coast want to cut the size of their standard baguette. Sandwiches from U.S. fast-food stalls are headed for fewer slices of bacon, pizzas for a more parsimonious sprinkle of pepperoni.
With the world economy already shackled by shortages linked to COVID-19 and now reeling from Russia’ s invasion of Ukraine, prices of basics such as bread, meat and cooking oils have jumped across the world, sending shock waves through commodity markets and damaging the global food system.
For the most vulnerable societies — think Yemen, which imports 90% of its food in the midst of a grinding conflict and depreciating currency — this poses a genuine risk of hunger. Elsewhere, it triggers worries about what economists call demand destruction, a phenomenon where goods get too pricey to purchase.
“ The cupboards are bare, ” said Julian Conway McGill, head of South East Asia at consultancy LMC International, “ and consumers will have to reduce their intake. ”
In households as well as in the food-services industry, vegetable oils have become indispensable — used for deep-frying instant noodles, making cakes moist and giving pastries their flaky texture. Exporters were already grappling with labor shortages and bad weather. The attack on Ukraine further roiled global crop trading and sent prices of the two most common oils, palm and soybean, to records.
Governments are starting to step in, curbing exports, controlling prices and coming down hard on hoarders. But as higher costs seep through to grocery bills and with festivals in Asia fast approaching, consumers are being forced to scale back.
A worker inspects cattle carcasses at the municipal slaughterhouse in Sao Felix do Xingu, Para state, Brazil. | BLOOMBERG
Raju Sahoo, a 48-year-old roadside restaurant operator in the eastern Indian state of Odisha, has halved his daily palm oil purchases to 15 kilograms by selling fewer fried snacks and switching to more steamed foods.
“ I am currently making 300 to 400 fried dumplings a day compared with about 1,000 pieces earlier, ” Sahoo said. “ I have started making idlis and upma to give more options to my customers, ” he added, referring to steamed rice cakes and semolina, which are popular breakfast dishes.
Cooking oil shortages have been worsening since last year. In Malaysia — the world’ s No. 2 palm oil producer — output fell drastically due to a chronic labor shortage. Then drought decimated the canola crop in Canada and slashed the soybean harvests in Brazil and Argentina.
Buyers were counting on filling in with sunflower oil from Ukraine and Russia, which together make up about 75% of the world’ s exports. The invasion ended that possibility.
The market reacted swiftly. Prices of the four major cooking oils — palm, soybean, rapeseed and sunflower — soared, and the rally is set to cascade down to shoppers in the form of higher costs for everything from candy to chocolate. Sub-Saharan Africa and South Asia face the likelihood of heightened poverty, LMC’ s McGill added, and demand destruction may arise suddenly as companies use less oil or shrink their product size all at the same time.
For instance, the Organization of Bakery Employers in Ivory Coast is seeking to cut the weight of a baguette, the price of which is fixed by law, because of the rising cost of wheat due to the Ukraine war. The suggested new weight is 150 grams instead of 200, the current approved weight, the body said in a statement Friday.
With changes like that, social unrest may be looming — especially in India, according to Brice Dunlop, principal industry analyst for food and drink at Fitch Solutions. “ India has a long history of unrest related to shortages in key food products, and vegetable oils are a key ingredient in many of the different Indian cuisines, ” he said.
The war is also exacerbating a record surge in fertilizer prices, which will only make food more expensive.
Brazilian farmer Zilto Donadello plans to cut fertilizer applications 30% to 50% for the next soybean crop, likely resulting in lower yields on his 400-hectare farm in northern Mato Grosso in the agriculture heartland of the world’ s biggest soybean producer. Donadello hasn’ t bought crop nutrients for the planting in September because he was waiting for a price drop after last year’ s high — then faced the new sticker shock from the invasion. Soybean prices have risen but not enough to make up for higher costs.
Stocks of fertilizer at a farm in Brazil. Brazilian farmers are having trouble getting fertilizer for the next soybean crop. | BLOOMBERG
Still, Donadello’ s plan is in line with a recommendation from Aprosoja, Brazil’ s largest farming group. “ We have fertilizer savings in the soil that should be used amid troubled moments like this one, ” said Antonio Galvan, Aprosoja’ s head. “ We have been telling farmers to not buy anything at abusive prices. ”
It’ s not just crops. In Chicago and surrounding suburbs, Joe Fontana owns five locations of the spicy-chicken restaurant Fry the Coop. Prices for chicken have been elevated since the pandemic closed meatpacking plants two years ago. Now, drought in Brazil plus war in Ukraine have boosted feed prices, pushing up chicken costs even more.
Fontana was already avoiding vegetable oils made from seeds such as canola, echoing a diet trend from the Bitcoin community. Instead, he fries his chicken and potatoes using only beef tallow. But the cost of that fat has also surged amid issues at slaughterhouses and soaring demand for fats and oils to produce renewable diesel.
“ Since January 2021, it seems like we’ ve almost doubled our costs across the board, ” Fontana said. A 50-pound cube of beef tallow cost about $ 29 for years, but now it’ s $ 56, he said.
He’ s raised prices for his chicken sandwiches a few times already and more increases are planned, putting them above $ 10. Customers tell him they are delicious but expensive. “ You can only charge customers a certain price when it’ s fast casual, ” he said. “ My fear is that it’ s going to get to a point where it’ s the $ 15 sandwich. ”
He’ s renegotiating all of his supplier deals and creating a centralized kitchen to prepare foods such as coleslaw for all of his restaurants. Still, right now, he’ s barely breaking even, with labor and natural gas costs also rising sharply.
Other favorite dishes won’ t be spared either. Pizza-makers might start to cut the pepperoni that gets placed on a pizza by half, Rabobank protein analyst Christine McCracken said. And that’ s not all.
“ Keep watching bacon, ” she said. “ You’ ll start to see food service take one strip off the sandwich. ” | tech |
Feeling socially anxious about returning to the office? You're not alone | While there is a general consensus hybrid work is here to stay, going back to the office even some of the time might feel strange and overwhelming. Returning to the commute and re-establishing routines and relationships in the workplace is likely to be partly energising and partly exhausting.
Since research has shown employees can work effectively at home, workers are likely to be coming to the office for different reasons, including collaboration, learning and connecting with others.
And while many are looking forward to some time with their colleagues that isn’ t on Zoom, there are downsides to manage. With employers giving up floorspace as more and more companies adopt a hybrid work model, the new office might be smaller, and noisier. For many employees, returning to the office will mean a return to the noise and distraction that is among the leading complaints employees have about their offices.
In addition to not having to commute, for many employees, fewer interruptions and less noise from coworkers were some of the key benefits of working from home. So returning to the office might feel like quite a shock.
My own research has measured the effects of typical open-plan office noise, finding significant increases in physiological stress and negative mood, even after a short exposure time.
Research has shown it can be difficult to concentrate in large open-plan office spaces. Using headphones and working in quieter break away spaces can help.
Taking breaks and getting outside is essential: spending time in nature has evidence-backed benefits for our physical and mental health.
In a landscape of virtually no conferences or live work events for the past two years, and long periods of working from home, many employees might feel uncertain about building relationships face-to-face. And with many employees having started their careers or moved jobs during the pandemic, a lot of us have never met some of our co-workers. It’ s natural we might be feeling a bit rusty.
Getting out for a coffee, doing a walking meeting in nature or having a team lunch can be good ways to ease back into face-to-face interactions.
If you’ re feeling stressed or anxious about returning to the office, you’ re not alone.
Anxiety is the most common mental health disorder in Australia, and can have a significant effect on both work and our lives. And social anxiety – anxiety associated with social or performance situations – affects up to 13% of Australians.
As experts point towards an end to the pandemic, concerns have been raised about a looming mental health pandemic. Data from the World Health Organisation suggests the COVID pandemic has triggered a 25% increase in the prevalence of anxiety and depression worldwide, with young people and women most affected.
Studies by the American Psychological Association prior to the pandemic showed that for 64% of American adults, work was a significant source of stress, and the most common personal stressor. As we return to the office, this issue is more important than ever. In a June 2021 study by McKinsey of 245 employees who had returned to the office, one-third reported negative mental health impacts.
Mindfulness – focusing our attention and awareness in the present – can be a useful tool for managing stress and anxiety in the workplace. Research has shown mindfulness practices are beneficial for our well-being – including emotional exhaustion, psychological detachment, and stress.
Mindfulness has organisation benefits as well, including for intrinsic motivation, work engagement, creativity, and conflict management.
To introduce mindfulness into your work day doesn’ t mean you have to sit down for a 20 minute meditation ( although that will help). Taking small breaks away from your desk and phone and focusing on your breath or a view of nature is a great start. While taking a few minutes to do this regularly in the day might not seem like much, the benefits add up.
It’ s also essential organisations have clear support structures in place to provide assistance to employees, such as knowing who to talk to if they are facing difficulties and access to counselling services in employee assistance programs.
Employers can take practical steps to make the return to the office easier. Starting slowly, with just one day in the office to begin with, can help employees adjust. Retaining flexibility around work hours on the days in the office will be important for employees who have benefited from the increased ability to balance their work and lives while working from home.
There is no one-size-fits-all approach and employers should be cautious about setting blanket policies. Creating a culture where employees feel comfortable to have conversations and to ask for help is essential. While there has been progress around the perceived stigma in discussing mental health at work, it’ s important to recognise there is a long way to go.
It’ s important to remember there are options outside of just home or office. Third locations such as co-working spaces give employees the ability to connect with others when they choose, as well as to create new networks and enjoy social connection. | business |
Biden's 2023 budget makes no mention of student loan forgiveness | Nowhere in President Joe Biden's more than 100-page budget for 2023 is any mention of student loan forgiveness or the payment pause for borrowers, continuing the uncertainty millions of Americans have been in about the future of their debt.
The White House only requested more funding — $ 2.7 billion — to improve customer service for borrowers.
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Yet it's unclear when people with student loans will have to interact with their servicers again. Most borrowers haven't made a payment on their debt in more than two years, thanks to a pause on the bills that has been repeatedly extended.
Despite the omission of any information on the payment pause in Biden's budget, the administration has suggested it was considering delaying the resumption of payments beyond May, when they're currently slated to resume.
White House chief of staff Ron Klain said earlier this month that Biden wanted to make the decision around debt cancellation before turning the payments back on.
`` The president is going to look at what we should do on student debt before the pause expires, or he 'll extend the pause, '' Klain said on the podcast `` Pod Save America. ''
The White House would likely only include a request for forgiveness if it planned to ask Congress to implement it, said higher education expert Mark Kantrowitz.
Its omission could suggest the administration was still contemplating canceling the debt without legislation, either through new regulations or executive action.
Meanwhile, he said, `` they do not need to budget for an extension. ''
Some Democrats and advocates have warned that it would be a disaster to restart payments before the midterm elections in November.
Research shows borrowers may face significant hurdles come May. One estimate found nearly a third of loan holders could be at a high risk of missing their payments without another extension.
Even before the Covid pandemic, the country's outstanding student loan debt balance exceeded $ 1.7 trillion and posed a larger burden for households than credit card or auto debt. Average debt at graduation is around $ 30,000, and roughly a quarter of borrowers, or 10 million people, were estimated to be in delinquency or default.
A recent poll found that nearly 66% of likely voters are in support of Biden canceling some or all of student debt, with more than 70% of Latino and Black voters in favor.
Critics of a student debt jubilee say that it would be unfair to those who didn't borrow for their education or who 've paid off their loans and that it wouldn't significantly stimulate the economy because college graduates tend to be higher earners more likely to redirect their monthly bill to savings than additional spending.
As of now, the lack of guidance at this point is frustrating for borrowers and servicers alike, said Scott Buchanan, executive director of the Student Loan Servicing Alliance, a trade group for federal student loan servicers.
`` Constantly shifting the repayment date arbitrarily means servicers have been forced to ramp up and ramp down, creating confusion and wasting lots of resources, '' Buchanan said. | business |
Lung damage may persist long after COVID-19 pneumonia -- ScienceDaily | The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus type 2 ( SARS-CoV-2), has considerably increased the demand for acute and post-acute healthcare worldwide.
COVID-19's short-term effects on the lungs, such as pneumonia, are well documented. Much less is known about the illness ' long-term effects on the lungs.
As part of an Austria-based observational study on the development of lung disease in patients with SARS-CoV-2 infection, researchers looked at patterns and rates of improvement of chest CT abnormalities in patients one year after COVID-19 pneumonia. CT has been an important imaging tool in the workup of patients suspected of having COVID-19.
The researchers assessed lung abnormalities on chest CT in 91 participants, mean age 59 years, at several points over one year after the onset of COVID-19 symptoms.
At one year, CT abnormalities were present in 49, or 54%, of the 91 participants. Of these 49 participants, two ( 4%) had received outpatient treatment only, while 25 ( 51%) were treated on a general hospital ward and 22 ( 45%) had received intensive care unit ( ICU) treatment.
`` The observed chest CT abnormalities from our study are indicative of damaged lung tissue, '' said study co-author Anna Luger, M.D., from the Department of Radiology at Innsbruck Medical University in Innsbruck, Austria. `` However, it is currently unclear if they represent persistent scarring, and whether they regress over time or lead to pulmonary fibrosis. ''
While CT abnormalities decreased in initial follow-ups, 63% of participants with abnormalities did not show any further improvement after six months. Age over 60 years, critical COVID-19 severity and male gender were associated with persistent CT abnormalities at one year.
Evidence from the SARS-CoV-1 outbreak of 2002 to 2004 shows that lung abnormalities may remain detectable even after decades, but do not show any progression, according to study co-author Leonhard Gruber, M.D., from the Department of Radiology at Innsbruck Medical University. Recent studies, though, have shown a risk of progression of lung abnormalities such as the ones depicted on CT.
`` In a recently published clinical study of our CovILD interdisciplinary working group, we were able to show that the severity of acute COVID-19, protracted systemic inflammation and the presence of residual chest CT abnormalities are strongly related to persistently impaired lung function and clinical symptoms, '' said study co-author Christoph Schwabl, M.D., from Innsbruck Medical University.
The study underscores radiology's role in helping identify patients at risk for post-COVID-19 consequences and assisting in COVID-19 follow-up management.
`` In the end, long-term follow-up, both clinical and radiological, is necessary to gather more information about the course and clinical role of persisting SARS-CoV-2 related chest CT abnormalities, '' said study senior author Gerlig Widmann, M.D., chief thoracic radiologist at Innsbruck Medical University.
The researchers intend to continue gathering data on patients with persistent CT abnormalities. | science |
Women belong in tech – celebrating innovation in our industry - The Official Microsoft Blog | On International Women’ s Day, we celebrate the potential of women and girls everywhere, and their ideas and innovations that are shaping our future. March is also Women’ s History Month in the United States. Introduced in the late 1980s, this month is a celebration of the numerous, but often overlooked, accomplishments by women across history, culture and society. This is a time to reflect — and keep working to close equity gaps.
We know that companies with more diversity generate more innovation [ 1 ] and better financial results. [ 2 ] Yet less than 2% of enterprise software startups in the U.S. feature a women founder. [ 3 ] The COVID-19 pandemic has — and will continue to — disproportionately affect women across the globe, with the time it will take to close the global gender gap increasing by a generation from 99.5 years to 135.6 years. [ 4 ]
The data is staggering and calls for action.
At Microsoft, our goal is to create and maintain a healthy ecosystem where all employees, partners and customers can thrive. We work with purpose and passion to enable inclusive economic opportunity through the Microsoft commercial marketplace and in our Microsoft partner and startup ecosystem.
To help support the growth of diverse businesses within our partner ecosystem, we’ re enabling partners to self-attest relevant diversity business classifications in Partner Center. By building this information into our system, it’ s easy for customers to discover women-led businesses and their solution offerings in the commercial marketplace and through our co-sell channels.
As a partner to the United Nations, Microsoft has pledged to support its Sustainable Development Goals ( SDGs), [ 5 ] a set of 17 initiatives adopted by member states in 2015 focused on creating a more inclusive, sustainable and equitable world by 2030.
Through the Microsoft # BuildFor2030 Initiative, we support SDG 5: achieving gender equality and empowering all women and girls. We partner with community organizations, like Women in Cloud ( WIC), an organization focused on acting with global leaders, corporations and policymakers to help women entrepreneurs create $ 1 billion in economic access and opportunity by 2030.
Through the WIC accelerator, Microsoft supports women entrepreneurs in building and publishing their solutions to the commercial marketplace. We are proud to celebrate these women-led businesses and their innovative solutions that are driving positive business and community impact, such as:
eKidz.eu: Their educational solution helps parents and educators teach German, English and Spanish to children. Realizing the importance of helping people stay connected to their roots while raising trilingual children, co-creator and CEO Nataliya Tetruyeva set out to create more accessible, personalized language learning. The mobile app leverages artificial intelligence ( AI), audio support and visual animation to nurture language development skills like listening, learning, speaking and written expression.
Advocat Technologies: Their solution, Advocat AI, is a conversation-driven, AI-enabled platform that helps make it faster and easier to create and manage legal contracts for in-house legal teams and business users alike. Advocat Founder and CEO Pradnya Desh is a legal advisor and former U.S. diplomat seeking to enable effective business practices that support companies, communities and individuals.
Discover more # BuildFor2030 featured women-led solutions.
Startups play a pivotal role in a thriving ecosystem, and often are the impetus that push everyone else forward. Despite being vital to innovation and growth, by some estimates, more than 90% of startups will go out of business in their first year, [ 6 ] meaning women-founded businesses are fighting an uphill battle.
Earlier this year, we launched a global mentoring program to pair women employees at Microsoft with women founders of startups in the Microsoft for Startups Founder Hub. This new program includes reoccurring safe space talks, monthly role model conferences, and access to VC and investor master classes — and all members of the Hub have access to $ 150,000 of Microsoft Azure. The Microsoft for Startups Founders Hub is open to anyone with an idea, and we’ re seeing an influx of diverse founders including women-led organizations come through.
For example, SciMar ONE, a Microsoft for Startups and Women in Cloud accelerator partner, is using AI technology to speed innovation in drug development through their project management solution, The Scientific Data Engine. A women-owned business, SciMar ONE shifts the time-consuming tasks of clinical data analytics from humans to technology, driving cost savings in R & D.
And Time to Raise helps women founders in Nordic countries with their fundraising journeys from master classes, pitching sessions hosted by Microsoft Reactor, Female Founder networking events supported by Microsoft for Startups to matchmaking connections with participating investors and more.
Speaking of Microsoft Reactor, it partners regularly with ChickTech, an American nonprofit organization empowering people of marginalized genders through tech programs and events. Microsoft Reactor also partners with Women in Data to host collaborative content and events, all with the aim of connecting developers and startups who share the same goals.
Learn more about the Microsoft for Startups Founders Hub and sign up to get the support you need to run your business.
The path to a career in tech is different for everyone. However, exposure to STEM ( science, technology, engineering and math) learning paths and encouragement to follow one’ s interests is critical, especially for those who identify as girls.
We recognize that tomorrow’ s tech talent are today’ s students, and that’ s why we work with Girls Who Code, TechTogether, and IGNITE ( Inspiring Girls Now in Technology Evolution). These organizations are actively and tirelessly inspiring girls to follow their dreams and helping them gain skills across a gamut of technology paths. And the Microsoft DigiGirlz program is our in-house program that offers middle- and high schoolers opportunities to learn about careers in technology, connect with Microsoft employees and participate in hands-on computer and technology workshops.
Historically, girls haven’ t had the same level of encouragement to pursue careers in STEM as boys — and that must change. Fostering tomorrow’ s talent is a critical component to growing women’ s presence in technology.
Both International Women’ s Day and Women’ s History Month remind us to take stock and raise up girls and women. I invite you to join me in supporting women tech entrepreneurs and helping to grow their businesses. What this means looks different to everyone. Here are two ways you can learn how to help women in tech:
Join Women in Cloud and participate in their community engagement opportunities to gain experience, build your network and find ways to support economic access for women.
And register for the May 6 # WICxMicrosoft Lunch and Learn session where I’ ll be the keynote speaker for a session about empowering access and driving inclusive economic opportunity.
Though we’ re talking specifically about women’ s impact in tech, the equity gaps that exist are not solely the responsibility of women to solve. Everyone has a stake in this effort, and it takes all of us to continue to make progress. Through our collective action, we can grow and support diverse representation in our partner and startup ecosystem together.
[ 1 ] Diversity during COVID-19 still matters | McKinsey [ 2 ] How diversity, equity, and inclusion ( DE & I) matter | McKinsey [ 3 ] Female Founders in Short Supply at Enterprise Tech Startups – WSJ [ 4 ] Global Gender Gap Report 2021 | World Economic Forum ( weforum.org) [ 5 ] https: //www.un.org/sustainabledevelopment/ [ 6 ] How Many Startups Fail and Why? ( Investopedia.com) | tech |
How banks can inspire consumers to make sustainable decisions | Banks have a crucial role to play in promoting sustainable lifestyles among their customers. Information such as transactional data can now be leveraged to distribute sustainability advice and product recommendations to end-users. This approach doesn’ t just make sense for the planet and institutions’ net zero journeys – it will prove beneficial from a business perspective, also. This mission to green the economy is an urgent one. The planet continues to suffer natural disasters exacerbated by climate change – from catastrophic fires and devastating storms, to drastic ice and forest cover loss. The impact of global warming is only expected to become more severe. Public discussion around carbon emission reduction often focuses on the role of the individual, but can one person really make a difference to the rate of climate change? The good news is that if financial systems can be re-organised to value natural capital and engender positive change in consumer behaviour, mitigation and resilience practices will become more effective. That’ s why larger institutions – with vast, impactful customer bases – need to share vital information on consumption-based emissions. This data can be used to guide individuals’ actions, in a productive way, within the retail space. At scale, the information will help large firms move the needle toward a more sustainable footprint. Both elements need to work in parallel. Speaking to Finextra, Monika Liikamaa, co-CEO and co-founder at Enfuce, highlights: “ Banks are in a key position because they sit on the data, and enable the payments, which in the end become emissions. To fight climate change is not just about spending less money. It can actually be spending more money but spending on initiatives that reduce emissions. ” Yet, financial institutions may encounter challenges in introducing such initiatives. Murray Simpson, IBM’ s global market integration lead and director points out the wider lack of data and technology, stating: “ a recent IBM Institute for Business Value study revealed that some of the greatest barriers to closing that intention-action gap are technology barriers and lack of data. ” So, how should banks source this critical data? In what areas can we expect to see significant change? And what kinds of products support sustainability goals? Data and targeted insights Banks can collect large amounts of data from customers, such as transaction data, consumer behaviour, consumption patterns and preferences – as well country-specific data models and users’ own inputs. This information has the potential to inform sustainability advice and recommendations. One of the key forms of data is transactional – showing banks not only how much money someone is spending, but also the purchase location, and who they are buying from. An estimate can then be drawn from this payments data of the amount of emissions an individual is responsible for. This estimate can come from how much money they spend on certain foods, travel, or energy, for example. Firms can then make suggestions to consumers from their spending data on how they can improve their carbon footprint. For instance, if a bank sees that a customer often buys meat, financial firms can begin to build a picture of just how much carbon that customer is indirectly responsible for emitting. In this example, the bank may suggest eating meat fewer times a week, or propose alternatives, in order to limit their footprint. This is something Liikamaa contends banks have in their power to do now: “ Banks have us as customers, and they know what we buy and pay for because they enable the payments for us. They even have data on corporate transactions, such as logistics companies – who are in a major way involved in the carbon emissions from consuming goods. All that money flow data holds a lot of important detail. When you start taking the basic data, like who pays who and how much, you can add valuable and actionable insight. ” Liikamaa continues: “ It's about understanding that if I went from eating meat every day of the week, to having a vegan diet three days a week, I would feel better and most likely save money. It's about what I do in everyday life. Get the insights to me for a more sustainable life, because I think my biggest challenge, if I just looked at myself, is changing habits. It's really hard. But I don't want my four kids to consume like I have been taught to consume. ” The domains of change Enfuce has identified five domains where individuals can make big changes: what they eat, how they live, how they travel, what they buy and what kind of services they use. Liikamaa notes that one of the big factors in painting the picture of individual carbon consumption is also which country you live in because this can change what you are buying and what options you have to make changes – making country-specific data all the more critical. These are just some examples of how consumer data can be used to help inform more sustainable choices – but banks can use data in other ways. For instance, a bank might see that a customer is spending a higher-than-average amount of money on heating for their house size or area, and suggest improving their home’ s energy efficiency. Increasing energy efficiency in the home is a key way for individuals to decrease their carbon footprint as it lowers the amount of heating and electricity consumed, and thus emissions. Metro Bank tells explained to Finextra that one of its three strategic focuses in its net zero strategy was: “ building retail customer awareness of the greenhouse gas emissions generated from their home. ” Product recommendations Banks can also use data to recommend products such as green mortgages, which allow buyers – who are on the market for an energy-efficient new build, or who plan to retrofit their new homes – to receive lower rates. Moreover, banks can highlight options such as green pensions, if they see a customer using a pension scheme that invests in ‘ brown’ industries, such as deforestation or coal mining. David Hayman, campaign director, Make Money Matter, pointed out at COP26 that a green pension can be 21x more effective for an individual to cut their carbon footprint than stopping flying, going vegetarian and switching energy provider, combined. Some banks are using data from their own employees to improve their footprint. As part of a review of its carbon footprint, Metro Bank used data collected on its employees to improve its own carbon footprint, commenting that, “ with the unprecedented impact of Covid-19 causing a shift in ways of working, there has been an 80% reduction in corporate travel in 2021 compared to 2019. This enabled us to design a future way of working that permanently reduces the need for people to travel into office locations. We will use data on commuting and, in the future, colleagues’ home energy usage to inform our future approach to the balance between remote working and business travel, as we seek to minimise our carbon footprint, while balancing the need for collaboration. ” What’ s good for the environment is good for business Banks have a lot to win by paying attention to consumer data. Not only is the strategy good for the environment, but it is also good for customer satisfaction. Liikamaa asserts that using data to create advice like this can form part of a personal finance tool kit “ If we look back at banks 10 or 15 years ago, there was a boom of personal finance management tools. These tools mostly reported on historical events where a consumer can see where they spent money. Now we should be taking that data and converting it to real-time insights about how I could consume more sustainably, or how I could save or invest in more sustainable projects and companies. ” Once again, this strategy has a strong business case, because it enables banks to better manage their own climate and transition risks. Simpson comments on this point: “ Environmental risks are among the greatest challenges that business leaders are focused on today. The World Economic Forum 2021 Global Risk Report found that the three ‘ most likely’ risks identified for businesses over the next 10 years were all environmental – extreme weather, climate action failure and human-led environmental damage. ” This means banks must protect their assets in the long-term, because, as Rabobank explains, “ polluting choices actually become more expensive. ” For example, if a bank’ s collateral is houses that are not energy efficient – or houses that are likely to flood due to being on floodplains – this is ultimately a bad investment for the bank. Indeed, ecological and economic concerns are directly connected; if clean water resources are not protected, there is no water for business. Not only will this approach protect a bank’ s actual investments, but it will also help a bank’ s public perception. As Liikamaa notes, “ it will soon become unacceptable to not be sustainable. We are not there yet, but we can see the trend going that way. So, it will be a good investment to be sustainable, not only for the bank. The bank that can actually offer the services and be copied, they should be happy because they are really leading the way and that’ s the shareholder’ s value indefinitely growing. ” Empower customers with information Customers can only start to make more sustainable choices if these choices are presented to them before a purchase is made. Access to this data is a big part of the battle. Unless banks can start to present options to consumers, both business and the environment will suffer. There is no stopping the use of data in the current web landscape, so why shouldn’ t banks use it to put themselves, their customers, and the world in a better position? There is a long road ahead to improve every individual’ s carbon output, but the tools are there for banks to help us along the way. | tech |
lululemon athletica inc. Announces Fourth Quarter and Full Year Fiscal 2021 Results; Board of Directors Authorizes $ 1.0 Billion Stock Repurchase Program | lululemon athletica inc. Announces Fourth Quarter and Full Year Fiscal 2021 Results; Board of Directors Authorizes $ 1.0 Billion Stock Repurchase Program
Fourth quarter revenue increased 23% to $ 2.1 billion Comparable sales increased 22% Diluted EPS of $ 3.36, Adjusted EPS of $ 3.37
lululemon athletica inc. ( NASDAQ: LULU) today announced financial results for the fourth quarter and fiscal year ended January 30, 2022.
Calvin McDonald, Chief Executive Officer, stated: `` 2021 was another successful year for lululemon, which speaks to the enduring strength of our brand and our ability to deliver sustained growth across the business. We are proud that we passed the $ 6 billion in annual revenue milestone for the first time, and successfully achieved our Power of Three growth target ahead of schedule. This was especially impressive given the challenging macro backdrop. We are entering the new year from a position of strength, which we’ ll build upon to continue delivering for our guests and shareholders in the years to come. ''
We refer to the fiscal year ended January 30, 2022 as `` 2021 '', the fiscal year ended January 31, 2021 as `` 2020 '', and the fiscal year ended February 2, 2020 as 2019. The adjusted non-GAAP financial measures below exclude certain costs incurred in connection with the acquisition of MIRROR, and the related tax effects.
Meghan Frank, Chief Financial Officer, stated: `` Our results were driven by consistently strong performance across our products, channels, and regions. In addition, for both the fourth quarter and full year, we delivered revenue growth above our Power of Three goals, despite the continued impact of COVID-19 and global supply chain issues. We are pleased to see our momentum continue at the start of 2022 and are optimistic about our performance for the year ahead. ''
During 2021 the Company repurchased 2.2 million shares of its own common stock at an average price of $ 369.16 per share for a total cost of $ 812.6 million.
As at January 30, 2022 the Company had $ 187.5 million of authorization remaining on its stock repurchase program. During the first quarter of fiscal 2022, the Company completed the remaining stock repurchases under this program.
On March 23, 2022, the board of directors approved a new stock repurchase program for up to $ 1.0 billion of the Company's common shares.
The Company ended 2021 with $ 1.3 billion in cash and cash equivalents compared to $ 1.2 billion at the end of 2020. It had $ 397.0 million of capacity under its committed revolving credit facility at the end of 2021.
Inventories at the end of 2021 increased by 49% to $ 966.5 million compared to $ 647.2 million at the end of 2020. On a number of units basis, inventory increased 33%.
For the first quarter of fiscal 2022, we expect net revenue to be in the range of $ 1.525 billion to $ 1.550 billion, representing growth of 24% to 26%. Diluted earnings per share are expected to be in the range of $ 1.38 to $ 1.43 for the quarter.
For fiscal 2022, we expect net revenue to be in the range of $ 7.490 billion to $ 7.615 billion, representing growth of 20% to 22%. Diluted earnings per share are expected to be in the range of $ 9.15 to $ 9.35 for the year.
The guidance does not reflect potential future repurchases of the Company's shares.
The guidance and outlook forward-looking statements made in this press release are based on management's expectations as of the date of this press release and does not incorporate future unknown impacts, including from the spread of COVID-19. While most of the Company's retail locations are currently open; further resurgences in COVID-19, including from variants, could cause additional restrictions, including temporarily closing all or some of our retail locations again, result in lower consumer demand, and cause further disruption in our supply chain. The Company undertakes no duty to update or to continue to provide information with respect to any forward-looking statements or risk factors, whether as a result of new information or future events or circumstances or otherwise. Actual results and the timing of events could differ materially from those anticipated in these forward-looking statements as a result of risks and uncertainties, including those stated below.
A conference call to discuss 2021 results is scheduled for today, March 29, 2022, at 4:30 p.m. Eastern time. Those interested in participating in the call are invited to dial 1-800-319-4610 or 1-604-638-5340, if calling internationally, approximately 10 minutes prior to the start of the call. A live webcast of the conference call will be available online at: http: //investor.lululemon.com/events.cfm. A replay will be made available online approximately two hours following the live call for a period of 30 days.
About lululemon athletica inc.
lululemon athletica inc. ( NASDAQ: LULU) is a healthy lifestyle inspired athletic apparel company for yoga, running, training, and most other sweaty pursuits, creating transformational products and experiences which enable people to live a life they love. Setting the bar in technical fabrics and functional designs, lululemon works with yogis and athletes in local communities for continuous research and product feedback. For more information, visit www.lululemon.com.
The Company believes that investors would typically find comparable store sales and total comparable sales useful in assessing the performance of its business. As the temporary store closures from COVID-19 have resulted in a significant number of stores being removed from its comparable store base during the first two quarters of 2020, the Company believes total comparable sales and comparable store sales on a full year basis are not currently representative of the underlying trends of its business. The Company does not believe these metrics are currently useful to investors in understanding performance, therefore it has not included these metrics for the full fiscal year in this press release.
Constant dollar changes and adjusted financial results are non-GAAP financial measures. A constant dollar basis assumes the average foreign currency exchange rates for the period remained constant with the average foreign currency exchange rates for the same period of the prior year. The Company provides constant dollar changes in its results to help investors understand the underlying growth rate of net revenue excluding the impact of changes in foreign currency exchange rates.
Adjusted income from operations, operating margin, income tax expense, effective tax rates, net income, and diluted earnings per share exclude items related to the MIRROR acquisition. We exclude transaction, integration costs, the gain on lululemon's previous investment in MIRROR, certain acquisition-related compensation costs, and the related income tax effects of these items. The acquisition-related compensation costs include accelerated expenses related to the transition of the former MIRROR Chief Executive Officer to an advisory role. We believe these adjusted financial measures are useful to investors as they provide supplemental information that enable evaluation of the underlying trend in our operating performance, and enable a more consistent comparison to our historical financial information. Further, due to the finite and discrete nature of these costs, we do not consider them to be normal operating expenses that are necessary to operate the MIRROR business and we do not expect them to recur beyond the expiry of the related vesting periods. Management uses these adjusted financial measures and constant currency metrics internally when reviewing and assessing financial performance.
The presentation of this financial information is not intended to be considered in isolation or as a substitute for, or with greater prominence to, the financial information prepared and presented in accordance with GAAP. For more information on these non-GAAP financial measures, please see the section captioned `` Reconciliation of Non-GAAP Financial Measures '' included in the accompanying financial tables, which includes more detail on the GAAP financial measure that is most directly comparable to each non-GAAP financial measure, and the related reconciliations between these financial measures.
This press release includes estimates, projections, statements relating to the Company's business plans, objectives, and expected operating results that are `` forward-looking statements '' within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. In many cases, you can identify forward-looking statements by terms such as `` may, '' `` will, '' `` should, '' `` expects, '' `` plans, '' `` anticipates, '' `` outlook, '' `` believes, '' `` intends, '' `` estimates, '' `` predicts, '' `` potential '' or the negative of these terms or other comparable terminology. These forward-looking statements also include the Company's guidance and outlook statements. These statements are based on management's current expectations but they involve a number of risks and uncertainties. Actual results and the timing of events could differ materially from those anticipated in the forward-looking statements as a result of risks and uncertainties, which include, without limitation: the Company's ability to maintain the value and reputation of its brand; the current COVID-19 coronavirus pandemic and related government, private sector, and individual consumer responsive actions; its highly competitive market and increasing competition; increasing costs and decreasing selling prices; its ability to anticipate consumer preferences and successfully develop and introduce new, innovative and updated products; the acceptability of its products to guests; its ability to accurately forecast guest demand for its products; changes in consumer shopping preferences and shifts in distribution channels; its ability to expand in light of its limited operating experience and limited brand recognition in new international markets and new product categories; its ability to realize the potential benefits and synergies sought with the acquisition of MIRROR; its ability to manage its growth and the increased complexity of its business effectively; its ability to successfully open new store locations in a timely manner; seasonality; disruptions of its supply chain; its reliance on and limited control over third-party suppliers to provide fabrics for and to produce its products; suppliers or manufacturers not complying with its Vendor Code of Ethics or applicable laws; its ability to deliver its products to the market and to meet guest expectations if it has problems with its distribution system; increasing labor costs and other factors associated with the production of its products in South Asia and South East Asia; its ability to safeguard against security breaches with respect to its technology systems; its compliance with privacy and data protection laws; any material disruption of its information systems; its ability to have technology-based systems function effectively and grow its e-commerce business globally; climate change, and related legislative and regulatory responses; increased scrutiny regarding its environmental, social, and governance, or sustainability responsibilities; an economic recession, depression, or downturn or economic uncertainty in its key markets; global economic and political conditions and global events such as health pandemics; its ability to source and sell its merchandise profitably or at all if new trade restrictions are imposed or existing trade restrictions become more burdensome; changes in tax laws or unanticipated tax liabilities; its ability to comply with trade and other regulations; fluctuations in foreign currency exchange rates; imitation by its competitors; its ability to protect its intellectual property rights; conflicting trademarks and patents and the prevention of sale of certain products; its exposure to various types of litigation; and other risks and uncertainties set out in filings made from time to time with the United States Securities and Exchange Commission and available at www.sec.gov, including, without limitation, its most recent reports on Form 10-K and Form 10-Q. You are urged to consider these factors carefully in evaluating the forward-looking statements contained herein and are cautioned not to place undue reliance on such forward-looking statements, which are qualified in their entirety by these cautionary statements. The forward-looking statements made herein speak only as of the date of this press release and the Company undertakes no obligation to publicly update such forward-looking statements to reflect subsequent events or circumstances, except as may be required by law.
Constant dollar changes in net revenue, total comparable sales, comparable store sales, and direct to consumer net revenue.
The below changes show the change for the fourth quarter of 2021 compared to fourth quarter of 2020.
Total comparable sales includes comparable store sales and direct to consumer net revenue.
Comparable store sales reflects net revenue from company-operated stores that have been open for at least 12 full fiscal months, or open for at least 12 full fiscal months after being significantly expanded. Comparable store sales exclude sales from stores which have been temporarily relocated for renovations or have been temporarily closed.
The below changes show the change for 2021 compared to 2020.
The following tables reconcile adjusted financial measures with the most directly comparable measures calculated in accordance with GAAP. The adjustments relate to the acquisition of MIRROR, including accelerated expenses related to the transition of the former MIRROR Chief Executive Officer to an advisory role, and its related tax effects. Please refer to Note 6. Acquisition included in Item 8 of Part II of our Report on Form 10-K to be filed with the SEC on or about March 29, 2022 for further information on these adjustments.
Company-operated store count and square footage summary excludes retail locations operated by third parties under license and supply arrangements.
Gross square feet added/lost during the quarter includes net square foot additions for company-operated stores which have been renovated or relocated in the quarter.
Investor Contact: lululemon athletica inc. Howard Tubin 1-604-732-6124 or ICR, Inc. Joseph Teklits/Caitlin Churchill 1-203-682-8200
Media Contact: lululemon athletica inc. Erin Hankinson 1-604-732-6124 or Brunswick Group Eleanor French 1-415-671-7676
View source version on businesswire.com: https: //www.businesswire.com/news/home/20220329005922/en/
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In Asia Pacific, Telehealth Adoption Is Expected to Soar through 2024 |
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The region is entering a new era for technology-enabled healthcare delivery.
By Lucy d'Arville, Alex Boulton, and Vikram Kapur
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Covid-19 was the catalyst for the latest great experiment in healthcare: telehealth. While the trend in telemedicine was taking off before the pandemic, adoption soared over the past two years, exceeding both consumer and caregiver predictions.
A Bain survey of 1,750 consumers across the Asia-Pacific region found that telehealth usage essentially doubled since 2019—except in Australia, where adoption increased ninefold. Safety risks related to Covid-19 initially encouraged the growth, but consumers are now turning to telehealth more broadly due to its efficiency, time savings, and accessibility. Asia-Pacific consumers expect to increasingly use telehealth through 2024.
Physicians are enthusiastic about telehealth, too. Their adoption nearly doubled since 2019, and they expect it to continue to grow through 2024. In fact, 56% of physicians said more than 25% of their primary consultations could be delivered virtually in the coming years.
While fact-to-face and physical interactions will resume in some cases, digital delivery models are now a permanent fixture in the healthcare landscape. Providers will need to empower consumers and physicians with the right technology and digital tools in order to continue delivering high-quality outcomes.
The pandemic led to rapid reinvention of healthcare delivery in the Asia-Pacific region.
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