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To Have Joy in the Workplace, There Must Be Justice for All | This issue’ s special report explores new ways that leaders can identify which key performance indicators will advance their teams toward their ever-shifting objectives.
This issue’ s special report explores new ways that leaders can identify which key performance indicators will advance their teams toward their ever-shifting objectives.
Joy and justice are two intertwined priorities we should all advance, but leaders sow distrust and unease when they don’ t speak up and take a stand on urgent issues.
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We all want to create spaces full of joy, fulfillment, and happiness. But how do we do that in a world that feels divided, uncertain, and at times far from joyful?
For several years, our firm has been researching the best practices for building joy at work. We have learned about the importance of harmony, acknowledgment, impact, and purpose. But the COVID-19 pandemic and the persistent social injustice it exposed spurred us to think about joy at work around a new fulcrum: justice. Social movements like Black Lives Matter have put justice — and injustice — at the front of people’ s minds. You can’ t have joy without justice. That’ s true at work, at home, and in the community.
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Whether you’ re leading an organization, a team, or your neighbors, joy and justice are two intertwined priorities we should all advance. When leaders don’ t speak up and take a stand on urgent issues, they sow distrust and unease — and they certainly don’ t lay the groundwork for joy.
In our original 2018 Joy @ Work study, we found a stark gap between the levels of joy people expected to feel and the joy they actually experienced: Fifty-three percent of survey respondents who said they expected to feel joy at work reported that they did not actually experience it. Because most people spend a majority of their waking hours working, this joy gap has a pernicious effect on our overall joy, happiness, outlook, and well-being.
In 2021, we conducted our survey again. In just three years, the joy gap had widened substantially — from 53% to 61%. The pandemic has highlighted what’ s important, at work and in life: taking care of one another, finding joy even in hardship, and looking for moments of meaning. The new mantra for leaders: Create spaces where people feel safe, seen, supported, and inspired.
The joy gap is concerning, but it offers us all unique opportunities for positive intervention. What can leaders do to improve outcomes while creating a baseline of justice, and to build the foundations for joy?
Before leaders can start talking about positive change, they must address the toxic, joy-killing norms we should all leave behind. In our research, people cited excessive workloads and unrealistic expectations as their most pressing challenges and barriers at work.
Alex Liu is managing partner and chairman of the board of directors at Kearney, a global strategy and management consulting firm. Beth Bovis is a partner and Kim Fulton is a principal in Kearney’ s Leadership, Change, and Organization practice.
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Walmart Raises Pay For Truck Drivers to As Much As $ 110,000 in the First Year | C3’ s unique products allow customers to maximize the usage of their trailers, dock doors, dedicated yard staff and physical yard space. C3’ s customers include an impressive roster of Fortune 500 clients in manufacturing, …
As reported by Reuters, Walmart ( WMT.N) said it is boosting starting pay for its 12,000 long-haul truck drivers who deliver merchandise to its stores and Sam's Clubs locations amid a U.S. shortage of drivers that threatens to prolong supply chain snarls and merchandise shortages.
Qualified drivers - who tend to be in their late 40s and 50s, according to government and industry officials - remain in short supply. Federal limits on daily working hours, Biden’ s COVID-19 vaccine policy, and other hurdles have prompted many truck drivers to quit.
Walmart Inc is also following rival Amazon.com Inc ( AMZN.O) in incentivizing employees in other roles to retrain for in-demand transportation jobs required to ease supply chain bottlenecks and support their online operations.
Walmart's drivers were already among the best compensated in the nation. Now the world's biggest retailer is upping the ante by resetting truck drivers ' starting salaries to $ 95,000 to $ 110,000 a year, from $ 87,500 previously.
That far exceeds 2020's median pay of $ 47,130 for American big-rig drivers, whose `` real '' earnings have lagged inflation and effectively remain at about 70% of what they were in the 1970s, according to the U.S. Bureau of Labor Statistics. About 1.9 million big-rig drivers use the nation's roads, according to the bureau.
Walmart's move could strengthen its competitive advantage at a time when safe, experienced 18-wheeler drivers are in short supply and as Amazon builds its own network of trucking contractors.
Walmart's Fernando Cortes, Senior Vice President, Transportation, and Karisa Sprague, Senior Vice President, Supply Chain People described how drivers working at Walmart will enjoy better benefits as a result of the new Private Fleet Development program.
Throughout Walmart’ s history, we’ ve been committed to turning ambition into opportunity. In the last several years, we’ ve cast a wide net, inviting associates from across the business to learn more, see more, and do more.
Now, we’ re taking that same approach to the very foundation of our supply chain: the Walmart Private Fleet. Ask drivers in our Private Fleet, and you’ ll probably hear something similar: Walmart is one of the best places to drive and Walmart's benefits are among the best in the industry.
Our approximately 12,000 drivers are deeply dedicated to safety and professionalism, and today, we’ re proud to announce pay raises to ensure Walmart remains one of the best companies in the world to drive for.
These latest investments mean Walmart drivers can now make up to $ 110,000 in their first year with the company. And that’ s just a start – drivers who have been with Walmart longer can earn even more, based on factors like tenure and location.
The Average Salary * For A Long Haul Driver is $ 56,491 a year. Walmart’ s starting wage can nearly double that.
The investments in pay and training build on multiple recent driver bonuses and improved schedules that enable drivers to spend more time at home. There’ s never been a better time to join our fleet. Once drivers are on board, this is a job many leave only for retirement.
`` I can’ t imagine driving anywhere else. Walmart drivers take a lot of pride in delivering for millions of people every day. You know you’ re making a big impact in peoples’ lives and helping them live better, and that’ s a special feeling '' - Allyson Hay, Walmart Private Fleet Driver
Our transportation team will continue to grow with our business, and we’ ll continue to invest in them along the way. It’ s an exciting time to be part of one of the world’ s largest Private Fleets and we plan to keep hiring the best drivers in the industry to join our team.
To apply to drive for Walmart, visit drive4walmart.com.
Leveling Up: Navigating the New Trucking Landscape The goal of this White Paper is to, not only provide a deeper understanding of the causes of the situation but also outline ideas you can apply to your own logistics operation. Download Now!
Dealing with Disruption In this paper, we look at a number of the fundamental, even seismic shifts, companies are facing, and while we don’ t claim to have all the solutions, we do have a few practical tips that we hope will help your organization adapt to disruption. Download Now!
5 Ways to Maximizing Your Fleet Management ROI This informative and educational guide showcases five key considerations to ensure you get the most out of your fleet management technology - both for your needs today but in anticipation of your needs in the months and years ahead. Download Now! | general |
Federal budget 2022: More defence funding in wake of Canada's F-35 about-face | The Canadian government recently announced its decision to enter negotiations with American aerospace giant Lockheed Martin to buy 88 F-35 fighter jets.
The $ 19-billion contract is separate from $ 8 billion in additional funding for defence that Finance Minister Chrystia Freeland unveiled as part of the 2022 federal budget.
This is the second time Ottawa has chosen the stealthy aircraft. In 2010, the governing Conservatives said the F-35 was the only choice for the Royal Canadian Air Force. The opposition disagreed, and the warplane became an issue in successive federal elections.
This history is what makes the recent announcement so embarrassing for the Liberal government.
Campaigning to unseat the Conservatives in 2015, the Liberals criticized the sole-sourcing of the F-35 as both unfair and misguided. They were wrong.
In 1997, the United States government asked a few of its allies to participate in co-developing and co-producing a fighter jet that would become the F-35, and Canada agreed.
The deal was unusual, but its logic made sense, especially to the Canadian government. Why not work with its biggest economic and security partner while also giving Canadian aerospace firms opportunities to win contracts in what is sometimes referred to as the “ the arms deal of the century? ”
The current lifetime cost estimate of $ 1.6 trillion makes it the most expensive weapon system ever built and puts it on equal footing with the entire outstanding U.S. federal student loan debt and President Joe Biden’ s Build Back Better plan.
In 2017, the Trudeau government launched what it called an “ open and transparent ” competition for fighter jets. Designed to rigorously assess bids on elements of capability, cost and economic benefits, this process eventually came down to just two warplanes — the F-35 and Sweden’ s Saab Gripen.
This all but guaranteed the F-35’ s win. The last non-American fighter to enter the Royal Canadian Air Force was the Vampire in 1948, manufactured by the British company de Havilland.
As a general rule, Canada’ s military wants platforms that offer seamless or advanced interoperability with U.S. forces — not merely compatibility or basic interoperability that would have been the case with the Swedish jet.
The fact that the F-35 is yet to lose a competition is due both to the size of the program and U.S. influence.
The more air forces that buy it — Canada’ s decision brings that number to 18 — the lower its operational and other costs. That’ s because network effects, as economists call them, generate not only profits for contractors but also international power and influence.
Citing security concerns about the aircraft’ s design details, the U.S. government is requesting every F-35 customer remove all 5G equipment made by China’ s Huawei from their networks in the coming years. Those failing to comply will likely be removed from the program.
Something similar happened to Turkey in 2019 after its government decided to buy a Russian missile defence system. U.S. officials said that posed risks to the F-35s, including the possibility that Russia could covertly use the system to obtain classified details on the jet.
The strings attached to F-35 purchases have prompted some to call the fighter jet program “ America’ s One Belt, One Road ” — a tongue-in-cheek reference to China’ s major foreign policy initiative and the Chinese tendency to strong-arm smaller states into participating. In Canadian politics, however, those strings are largely immaterial because dependence on the U.S. and its military power has long been a huge net benefit.
But what about today, with the ongoing Russian invasion of Ukraine, a rising China and a radicalized U.S. Republican Party?
These developments are troubling and disorienting, but the fundamentals of Canada’ s defence are not necessarily shifting dramatically. Whatever happens in Ukraine and in future American elections, the U.S. will almost certainly prioritize the North American homeland, keeping a close eye on both Russia and China.
Accordingly, Ottawa will be expected to add capacity to Canada’ s NORAD and NATO commitments, and that means investing in the new aircraft. The new defence budget measures announced by Freeland are in fact designed to strengthen these commitments.
But Trudeau’ s topsy-turvy relationship with the F-35 will continue to be mocked. Had the Conservative plan survived the end of the Harper government, RCAF pilots would now be much closer to flying the new jet.
Instead, until at least 2025 — when the first new F-35s are expected to arrive — they will have to rely on an aging CF-18 fighter force, plus the equally aging, used F/A-18s the Liberals acquired in 2019 from Australia as a stop-gap measure.
Some taxpayer money might have been saved, too, had the government bought the F-35s 12 years ago.
Given the assorted risks and threats Canada could face — including from authoritarian powers, cyber warfare, another pandemic, natural disasters and the accelerating effects of climate change — military procurement is only a small piece of the overall puzzle.
The principal challenge for the federal government is assessing problems in their totality and improving Canada’ s own ability to tackle these issues on its own, without being overly affected or reliant on the U.S.
Read more: Coronavirus shows why Canada must reduce its dependence on the U.S.
This requires aligning goals and commitments with necessarily limited resources. A far-reaching, comprehensive review of the defence, security, diplomatic and development issues facing Canada would be a step in the right direction.
One way for the Liberals to atone for their contributions to Canada’ s fighter jet replacement farce would be to put forth a strategic vision for the country — and do so sooner rather than later. | business |
Better Financing for Pandemic Preparedness, Prevention, and Response | There is a clear economic case for accelerating investment and progress toward improved global health security: the cost of preparedness and prevention is only a fraction of the cost of response and recovery, but the financing landscape is fragmented and poorly governed.
CGD experts have been exploring ways to improve financing for preparedness, prevention, and response since long before the COVID-19 pandemic, including work on financing for the response to Ebola and antimicrobial resistance.
Since 2020, CGD’ s experts have been focusing on informing the COVID-19 response and recovery efforts of the IMF and the World Bank.
In 2021, CGD supported the G20 High-Level Independent Panel ( HLIP) on Financing the Global Commons for Pandemic Preparedness and Response in collaboration with Bruegel. The Panel recommended the establishment of a global financing facility `` to ensure adequate and sustained financing for pandemic prevention, preparedness, and response. '' Heeding these calls, the United States government has announced its commitment to develop a Financial Intermediary Fund at the World Bank.
CGD’ s experts continue to provide evidence-based analysis and commentary to support decisionmakers in securing adequate financing for pandemic preparedness across the spectrum, from disease surveillance to expanded manufacturing capacity for emergency health products.
Your contribution makes it possible for the Center’ s researchers to devise practical, evidence-based solutions for today’ s most pressing development challenges. | general |
Musk promises 'dedicated robotaxi ' with futuristic look from Tesla | - Electric carmaker Tesla will make a `` dedicated '' self-driving taxi that will '' look futuristic, '' Chief Executive Elon Musk said on Thursday, without giving a timeframe.
The 50-year-old billionaire, wearing a black cowboy hat and sunglasses, made the comments at the opening of Tesla's $ 1.1 billion factory in Texas, which is home to its new headquarters.
`` Massive scale. Full self-driving. There's going to be a dedicated robotaxi, '' Musk told a large crowd at the factory.
Musk has several times missed his targets of full autonomy. In 2019, he said robotaxis with no human drivers would be available in some U.S. markets in 2020.
In January he said he would be `` shocked '' if Tesla did not achieve full self-driving that is safer than that of humans this year.
Tesla will expand its `` Full Self-Driving '' beta software to all North American FSD subscribers this year, he said on Thursday.
Tesla now sells the advanced driver assistance systems for $ 12,000, with a promise of more features. It says the software does not make its vehicles autonomous, and requires driver supervision.
The beta version, launched in late 2020, aims to enable cars to navigate city streets better. By January, it had been installed in nearly 60,000 vehicles in the United States.
Musk said Tesla had started deliveries of Texas-made Model Y electric sport utility vehicles, with a goal of producing half a million a year at the Texas factory, which he said would be the biggest car factory in the United States.
He gave no details of such Model Ys, but they are likely to be lower-priced versions to better take on cheaper competitors.
Tesla will start production next year of its Cybertruck as well as a humanoid robot, Optimus, Musk said.
The firm's new giga factories in Texas and Berlin, which will make vehicles and its own battery cells, face challenges of ramping up production with new processes https: //www.reuters.com/business/autos-transportation/musks-plan-tesla-built-batteries-has-an-acceleration-challenge-2022-03-11, analysts have said.
Musk said Tesla was simplifying car making by making a car using three major parts.
Despite record deliveries in the first quarter, a recent COVID-19 spike in China has forced Tesla to suspend production at its Shanghai factory for several days.
Thursday's event comes after Musk surprised the market this week by revealing he had bought a stake of 9% in Twitter and will join the board of the social media network. ( Reporting by Hyunjoo Jin; Additional reporting by Akash Sriram in Bengaluru; Editing by Richard Pullin and Clarence Fernandez) | business |
Dry bulk quarterly: High commodity prices, volatile bunkers arrest freight demand | In this episode of the Oil Markets Podcast, S & P Global Commodity Insights editors Paul Hickin, Emma...
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The seasonality that typically dictates dry bulk freight price movements in the second quarter is likely to take a back seat this year to the challenges being posed to the spot market by volatile bunker prices, high commodity prices and disruptive geopolitical events.
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Dry bulk freight spreads between different ship sizes flipped considerably in Q1 as larger Capesize tonnage registered far lower time charter equivalent rates or earnings compared with smaller Kamsarmax and Supramax bulkers -- and this trend could reverse in the current quarter, market watchers said.
The Cape T4 index, a trade flow-based weighted average of four key Capesize routes, averaged at just $ 11,435/d in Q1, well below the $ 25,227/d and $ 22,622/d averaged by the APSI 5 and KMAX 9 indexes, which are a weighted average of five key Asia-Pacific Supramax routes and nine key Panamax routes respectively.
Going forward, issues like the continuing Russia-Ukraine conflict, COVID-19 related protocols at ports and a firm container market are expected to impact spot freight rates.
A Singapore-based ship-operating source said traders were hesitant to `` take a call '' on the market in Q2 due to high commodity prices, which he said may stabilize only if there is an end to the Ukraine war.
Another ship-operating executive said stock-and-sale activity among coal traders was adversely affected by high commodity prices and freight rates, which in turn could lead to a decline in shipping movements. While trading margins remain thin, the challenges in securing financing in a high-commodity price environment are multifold.
In fact, the world's two largest coal importers, China and India, have become more price-sensitive to changes in coal prices, with both purchasing smaller parcels that were moved mainly on Supramax ships rather than larger Panamax vessels in Q1, shipping market sources said.
The two energy-hungry countries have also reacted to higher seaborne coal prices by increasing domestic coal production to further to reduce reliance on imports, which could subsequently limit shipping activity for transporting coal.
The Capesize market, which was under pressure in Q1, could have a better run in the current quarterd with Brazilian and Western Australian iron ore majors expected to increase production and exports after the completion of maintenance, and as seasonal weather-related disruptions ease in Q2.
While support for the Capesize segment is expected in terms of burgeoning ton-mile demand due to more coal being delivered into Europe on these ships, some market sources expect this trend to result in more vessels opening around Europe and thereby pressuring trans-Atlantic and front-haul freight rates.
West Africa is quickly becoming a major Capesize loading location, with demand for shipping out bauxite and iron ore surging from this region. China imported a record 21 million mt of bauxite over January and February -- 55% of it from Guinea, with majority of cargoes moving on Capesizes.
Out of the Asia-Pacific, the Supramax sector was the beneficiary of robust bauxite movement from Indonesia in Q1 on the back of market chatter that Jakarta could limit exports later in the year.
The uncertainty caused by the Russia-Ukraine conflict has also resulted in many shipowners preferring to trade their Panamax, Supramax and Ultramax vessels in the Pacific region.
With hefty premiums being sought on spot ships for moving cargoes from the Pacific to the Atlantic, charterers are rushing in to fix ships on period charter in order to lock in tonnage for longer durations, sources said.
Some participants argue that the high rates for period fixtures in the Supramax and Ultramax segments in the mid- to high $ 30,000s/d range reflect the underlying strength in the market going forward.
Shipowners are also counting on operational inefficiencies such as a lack of marine pilots, port congestion, supply chain bottlenecks and delays caused by crew changes, which were dominant factors last year, to again help drive up freight rates in Q2.
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A clumsy lockdown of Shanghai is testing the “ zero-covid ” strategy | THE EFFORT to stamp out covid-19 in Shanghai has taken on the characteristics of a military campaign. The army has published photos of planes offloading personnel and supplies. Tens of thousands of medical workers have marched into the city. At least as many covid patients will be spirited out—bused to field hospitals in neighbouring areas, sometimes hundreds of kilometres away. The rest of the city’ s 25m residents will remain locked down as the fight against the virus drags on.
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For two years China’ s business and finance hub remained relatively unscathed by covid. Shanghai was evidence of the government’ s skilful handling of the pandemic. The country’ s “ zero-covid ” approach, involving mass testing and strict lockdowns to crush outbreaks, led to fewer deaths and stronger economic growth than in other big countries. Xi Jinping, the president, has hailed the strategy as a great success—and proof that China’ s socialist system is superior to Western democracy.
But the situation in Shanghai is testing all that. Not since the start of the pandemic, when the government sealed off Wuhan, a city of 11m people, have the country’ s covid measures come under such scrutiny. The campaign in Shanghai has been nothing short of a mess, say residents. They have faced varying restrictions since early March and are now confined to their homes. Food shortages are a problem. People complain of going without medicine. In China’ s largest city the government’ s strict covid controls are stoking anger.
For weeks the authorities in Shanghai experimented with a looser approach. They used targeted lockdowns on housing compounds to contain the virus. But the highly transmissible Omicron variant continued to spread. The government tried to quash any talk of harsher measures in the offing, even detaining people for spreading rumours. “ We’ re not going to use the lockdown strategy for now, ” said Zhang Wenhong, who runs Shanghai’ s covid response, on March 25th. Three days later a two-phase lockdown was announced. First the east side of the city was closed for four days, then the west side. Even that proved ineffective. So, as the staggered lockdown came to an end, the government closed the entire city indefinitely.
Unsurprisingly, the authorities were unready to support people during the hastily conceived lockdowns. And residents themselves were given little time to prepare. Some rushed to supermarkets, leaving aisles empty. Getting basic provisions has become a struggle. Messaging boards linked to Weibo, a popular Twitter-like platform, have been inundated with pleas for help. One woman said her father, who is suffering from cancer, was blocked from leaving his home and is “ considering suicide ”. A man sought epilepsy medication for his young son; he “ did not dare consider the consequences ” of failing to obtain it. Videos show people fighting over boxes of food. This correspondent has struggled to obtain potable water.
Abandoned warehouses, expo centres and shipping containers have been converted into makeshift isolation centres for those who test positive. Videos show patients protesting against a lack of food, water and treatment. Health workers have been filmed striking people or pulling them by their hair from their homes. But the authorities’ most controversial policy has been separating covid-positive children from their parents. Videos of dozens of children, some just months old, lying five to a bed, caused an uproar. The government has since said that infected parents could accompany their covid-positive offspring, and that healthy parents of infected children with special requirements could apply to go with them.
People have also been angered by the leaked recording of a phone call purportedly between a Shanghai resident and an official from the local office of the Chinese Centre for Disease Control and Prevention. On the call, which The Economist has not verified, the official says Shanghai’ s policies have been driven by political considerations, not public-health concerns. She says that co-ordination between hospitals has been poor and that medical supplies are running low. People with mild or no symptoms should quarantine at home, she suggests, contradicting official policy. She also says tests have been rigged to show negative results in order to free up capacity in the overwhelmed health system while appearing to adhere to the government’ s zero-covid mandate.
News of the call was quickly followed by a visit to Shanghai by Sun Chunlan, a deputy prime minister in charge of fighting covid, who reiterated the state’ s “ unswerving adherence to the dynamic zero-covid approach ”. Until recently that strategy has seemed broadly popular, as it has allowed most of China’ s 1.4bn people to lead relatively normal lives. But the fast spread of Omicron means the number of people caught up in the state’ s covid controls is growing, including all of Shanghai’ s residents. The grumbling is getting louder on social media, despite the state’ s best efforts to censor it. Complaints from Shanghai resonate loudly among China’ s leaders: the city is of immense political importance, being home to many of the country’ s rich and powerful.
There is no easy remedy for its sufferings. Mr Xi is expected to gain a third term as party chief later this year, in violation of recent norms. He does not want that moment of triumph to be overshadowed by pandemic-related chaos. A relaxation of controls might cause an even bigger surge of infections that could imperil far more of the country’ s rickety health infrastructure. But maintaining them would be risky, too. Analysts believe the measures are dealing a big blow to China’ s economy, which may not grow at all this quarter compared with the last.
What effect this will have on China’ s politics is a subject of much speculation. One name to watch is that of Li Qiang, Shanghai’ s party secretary and a close ally of the president. Experts expect Mr Li to be picked for the seven-member Politburo Standing Committee, the country’ s most powerful political body, later this year. Some think he will become the next prime minister. But the mess in Shanghai may dim Mr Li’ s prospects. In Hong Kong, central-government frustration with the city’ s handling of a recent covid wave could be one reason why Carrie Lam has announced she will not stand again as the territory’ s chief executive.
For now, cases in Shanghai continue to rise. Food is growing scarcer. Residents have been filmed on their balconies, chanting to be set free. But most old people have not been vaccinated and relatively few Chinese have natural immunity. A large outbreak in the country could result in millions of deaths. The effort in Shanghai may look like a military campaign, but it is to avoid a broader war. ■
All our stories relating to the pandemic can be found on our coronavirus hub. You can also find trackers showing the global roll-out of vaccines, excess deaths by country and the virus’ s spread across Europe.
Shared security concerns bring China and Russia close. But so do similar views of history
Shared security concerns bring China and Russia close. But so do similar views of history
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Copyright © The Economist Newspaper Limited 2022. All rights reserved. | business |
Rieter Annual General Meeting 2022: All Motions Approved | WINTERTHUR, Switzerland — April 7, 2022 — The Corona Virus also had an impact on the 131st Annual General Meeting of Rieter Holding Ltd., Winterthur, on Thursday, April 7, 2022.
Based on Article 27 of Regulation 3 on measures to combat the Corona Virus ( COVID-19), the Board of Directors of Rieter Holding Ltd. decided that shareholders can exercise their voting rights exclusively by authorizing the independent proxy. Shareholders therefore could not attend the Annual General Meeting in person. The Annual General Meeting was held on the premises of Rieter Holding Ltd. at the company’ s headquarters in Winterthur.
At the Annual General Meeting of Rieter Holding Ltd. on April 7, 2022, the independent proxy represented a total of 1 986 shareholders who hold 64.4% of the share capital.
The shareholders approved the proposal of the Board of Directors to distribute a dividend of CHF 4.00 per share. In addition, they approved the proposed maximum total amounts of the remuneration of the members of the Board of Directors and of the Group Executive Committee for fiscal year 2023.
The Chairman of the Board, Bernhard Jucker, and the members of the Board of Directors Hans-Peter Schwald, Peter Spuhler, Roger Baillod and Carl Illi were confirmed for an additional one-year term of office. Sarah Kreienbühl and Daniel Grieder were newly elected to the Board of Directors for a one-year term of office.
Furthermore, Hans-Peter Schwald and Bernhard Jucker, the members of the Remuneration Committee who were standing for election, were also each re-elected for a one-year term of office. Sarah Kreienbühl was newly elected to the Remuneration Committee and is taking over the chair.
Shareholders also adopted all other motions proposed by the Board of Directors, namely the approval of the annual report, the financial statements and the consolidated financial statements for 2021, and formal approval of the actions of the members of the Board of Directors and those of the Group Executive Committee in the year under review. In addition, the authorized capital was extended for a further two years. | general |
Turkey confirms 10,314 daily COVID-19 cases | Turkey reported 10,314 new COVID-19 cases, according to its health ministry, Trend reports.
The death toll from the virus in Turkey rose by 41, while 14,332 more people recovered in the last 24 hours.
A total of 220,536 tests were conducted over the past day, it said. | general |
Call for a more flexible UK immigration regime | For all the latest industry news, markets and jobs in aquaculture
The UK’ s immigration system is making labour shortages worse in the food and drink sector, according to Scotland’ s salmon farmers.
Tavish Scott, chief executive of the producers’ organisation Salmon Scotland, has urged the UK Government to add fish processing to its shortage occupation list to make it easier for firms to recruit from the European Union.
In a letter to the UK Environment, Food and Rural Affairs Secretary, George Eustice, Mr Scott joined the chief executives of four other Scottish food and drink organisations in calling for the recommendations of a new report by Westminster’ s Environment, Food and Rural Affairs Committee to be urgently implemented.
These include a recommendation for the UK Government to work with industry leaders to address labour shortages, and to develop a long-term labour strategy.
The letter, signed by Salmon Scotland, Quality Meat Scotland, Seafood Scotland, Scotland Food & Drink, and National Farmers Union Scotland, warned that the Scottish food and drink industry is suffering from “ acute labour shortages ”.
The organisations wrote: “ This labour force issue is affecting the ability of our producers and manufacturers to serve customers both at home and abroad, restricting growth and curbing exports.
“ The committee makes a number of recommendations, including a call for government to work with industry to address labour shortages and develop a new, long-term strategy to ease the situation for years to come.
“ We support the committee’ s recommendations and call on you and your department to deliver the step change requested by the MPs.
“ Our members have the ability to thrive and help the country recover from both the long-term effects of Covid and the additional costs of Brexit caused by non-tariff barriers.
“ But, to do this, we need proper access to labour and this can only come with the help and support from the government. ”
Scott said that fish processing, in the farm-raised salmon sector in particular, is suffering from a “ labour squeeze. ” | general |
EFI Reggiani Celebrates 75 Years Of Innovative Solutions For The Textile World | BERGAMO, Italy — April 7, 2022 — Last June, EFI™ Reggiani celebrates 75 years of heritage, innovation and glamour in the textile world. As part of its anniversary celebration, the textile technology innovator is revealing the imminent launch of three new, state-of-the-art digital textile printers.
With three quarters of a century of innovation, research and technological excellence, EFI Reggiani has become the trusted partner for integrated, scalable solutions for the entire textile process – from yarn treatment to fabric printing and finishing. EFI Reggiani has always had its customers in the forefront, enabling their business’ success and growth.
“ Textile has been in our DNA since the beginning, ” said EFI Reggiani Senior Vice President and General Manager Adele Genoni. “ We are always moving to the next level, thinking ahead and developing high-tech, quality and reliable products as well as new textile industry solutions and processes. We are proud of achieving this 75 years of innovation milestone.
“ We are also pleased to be a part of the success of so many global textile manufacturers and apparel brands over the past seven decades and into the future, ” she added. “ We have very close relationships with our customers, and the collaboration we have together allow us to develop groundbreaking new technologies. The three new printers we are launching this year speak to the legacy and expertise for solutions that have made our technologies a benchmark of productivity and quality ever since the creation of the first Reggiani textile printer in 1946. ”
Always striving to be at the cutting edge of technology, EFI Reggiani delivers world-class products offering boosted uptime and reliability, high performance throughput, unparalleled printing uniformity, and accuracy – all while helping customers increase the sustainability of their textile manufacturing activities.
From the creation of its first traditional printer to its latest technological innovations, EFI Reggiani’ s tradition and dedication to its products have contributed to the global transformation of the textile market. EFI Reggiani solutions are used in high-quality, highly productive operations in all of the world’ s major textile manufacturing centres. New EFI Reggiani innovations also help facilitate the spread and localisation of industrial textile manufacturing closer to end users in new geographic markets.
Reggiani Tessile – which was one of the largest fabric manufacturing companies in Italy – created the company to meet its needs in machinery development. Then known as Reggiani Macchine, the company grew tremendously over five decades thanks to continuous product innovation and close customer relationships.
Reggiani Macchine started a new chapter in the early 2000s with the introduction of digital printing technology to their product range. Then, in 2015, Reggiani Macchine joined the Electronics For Imaging family. Since then, the company, based in Bergamo, Italy, has accelerated its mission in driving the transformation of analogue to digital imaging in the textile segment. EFI Reggiani’ s product portfolio has continued to expand, ranging from rotary and flatbed printing machines to scanning/multi-pass digital printers to the world’ s fastest digital textile printer – the award-winning EFI Reggiani BOLT single-pass inkjet printer launched in 2018. The company has also substantially advanced its ink offerings, becoming a recognised leader as one of the only manufacturers of a full range of inks used in industrial textile manufacturing.
Today, EFI Reggiani’ s leadership in innovation is the result of extensive research targeted at improving productivity and quality, optimising the textile manufacturing process, and reducing energy use, water consumption and overall environmental impact.
While the COVID pandemic made 2020 a difficult year for all involved in textile printing, EFI Reggiani took the opportunity to further strengthen its research and development activities – all to ensure that its customers have the right solutions as the market recovers.
Genoni believes productivity is key to any solution that will help customers recover and thrive post-pandemic, and one of the company’ s new launches will specifically target a noticeable gap in the market.
“ We want to help support our customers in their digital transformation, ” she said. “ One of our three new printers is going to target the industrial high-speed segment of the multi-pass textile printing sector. The new printer will not only be the fastest multi-pass printer that EFI Reggiani has ever developed, but we are also expecting it to be the fastest of its kind in the market. ”
In the growing industrial, entry-level segment of the market, EFI Reggiani is strengthening its multi-pass offering by introducing two new scanning machines, which will help facilitate customers’ needs to manufacture closer to the end consumer. The pair of scanning printers EFI Reggiani is bringing to market in 2021 will enable new customers to take their first steps in industrial textile digital printing. The new printers will not only be easy to use, but, as with all of the company’ s solutions, they will also give customers access to the best technology platforms and innovation for digital industrial printing with EFI Reggiani’ s renowned quality and reliability.
For more information about advanced EFI technologies for textile production, visit www.efi.com/reggiani. | general |
NRF: U.S. Ports Seeing Brief Slowdown From Last Year But Imports Remain High | WASHINGTON — April 7, 2022 — The nation’ s major retail container ports have begun to catch up with the backlog of cargo seen over the past several months, but could experience another surge this summer, according to the monthly Global Port Tracker report released today by the National Retail Federation and Hackett Associates.
“ As we entered 2022, the biggest question was when the supply chain would return to normal, ” NRF Vice President for Supply Chain and Customs Policy Jonathan Gold said. “ Unfortunately, we still don’ t have a definitive answer. Congestion at West Coast ports has eased, but congestion at some East Coast ports is growing. Ports aren’ t as overwhelmed as they were a year ago, but they are still significantly busy moving near-record volumes of cargo. ”
U.S. ports covered by Global Port Tracker handled 2.11 million Twenty-Foot Equivalent Units – one 20-foot container or its equivalent – in February, the latest month for which final numbers are available. That was down 2.3 percent from January but up 13 percent year-over-year.
Hackett Associates Founder Ben Hackett said volumes remained high in February despite factories in parts of Asia closing for the Lunar New Year holiday because U.S. ports were able to handle cargo from ships already waiting for a berth.
“ With West Coast ports still congested, there were still plenty of containers to be unloaded, ” Hackett said. Similarly, the current near-shutdown of Shanghai because of COVID-19 precautions means fewer ships are leaving China and “ the wait on that side of the Pacific will help reduce the pressure of vessel arrivals at Los Angeles-area terminals. ” An influx of vessel arrivals following the resumption of normal operations in China could result in renewed congestion at U.S. ports, however.
Ports have not yet reported March numbers, but Global Port Tracker projected the month at 2.27 million TEU, unchanged from the same month last year. April is forecast at 2.13 million TEU, down 1.1 percent from last year, and May at 2.21 million TEU, down 5.3 percent year-over-year. Increases are expected to resume in June, which is forecast at 2.26 million TEU, up 5.2 percent year-over-year. July is forecast at 2.32 million TEU, up 5.6 percent, and August at 2.35 million TEU, a 3.3 percent year-over-year increase that would set a new record for the number of containers imported in a single month since NRF began tracking imports in 2002. The current record is 2.33 million TEU in May 2021.
The first six months of 2022 are expected to total 13.1 million TEU, up 2.5 percent year-over-year. Imports for all of 2021 totaled 25.8 million TEU, a 17.4 percent increase over 2020’ s previous annual record of 22 million TEU.
How to build a stronger and more sustainable supply chain will be addressed as retailers, industry experts and technology innovators meet at the NRF Supply Chain 360 conference in Cleveland in June.
Global Port Tracker, which is produced for NRF by Hackett Associates, provides historical data and forecasts for the U.S. ports of Los Angeles/Long Beach, Oakland, Seattle and Tacoma on the West Coast; New York/New Jersey, Port of Virginia, Charleston, Savannah, Port Everglades, Miami and Jacksonville on the East Coast, and Houston on the Gulf Coast. The report is free to NRF retail members, and subscription information is available at NRF.com/PortTracker | general |
Banking as a Platform: A Practical Business Model That Can Benefit Everyone. | Banking as a Platform is becoming a hot topic but what exactly does it mean? BaaP refers to a model where a bank integrates services from fintechs and offers these to its own customers. In practice it is the inverse of Banking as a Service ( BaaS). Banking as a Platform empowers a bank to adopt a fintech approach and accelerate delivery of products and services that increase customer engagement and build loyalty. This blog explores its benefits and why the time is right to act. Technology is a transformative component of bank success, and COVID has expedited the need for change throughout the banking industry – advanced tech is shaping a wholly new and improved Customer Experience ( CX), and redefining how banks make their money. Innovative business models that employ advanced technologies are evolving rapidly, reflective of a banking landscape that is steadily becoming more open and collaborative. As a result, Banking as a Platform ( BaaP) is emerging as a compelling option, one that has moved quickly from theory into practice. What is Banking as a Platform ( BaaP)? Incumbent banks with legacy technology stacks recognize the need to digitalize to remain competitive. Banks know they need to adopt a fintech approach, and BaaP can accelerate that progress. But there is often confusion about what BaaP means and how it works. Essentially, BaaP refers to banks that integrate services from fintechs to augment their own offerings. In this model, the bank “ owns ” the customer relationship and keeps the customer in its own ecosystem; the fintech owns the platform behind the scenes and orchestrates the potentially expansive range of possible commercial arrangements for the ecosystem. Benefits Abound A primary appeal of BaaP is that it enables banks to jumpstart innovation. Many incumbent banks welcome this approach – perhaps because they know that technology is not one of their fundamental strengths, or a realization that their in-house tech expertise has become outdated and outmoded. BaaP can offer significant benefits to banks, fintechs and customers alike. For example: Banks are freed from the worry and risk of managing technology and the need for speculative tech investments Fintechs have a ready market for their product and – with the right approach – are assured of repeat business Customers benefit from a constant stream of service innovations based on modern and intuitive technology BaaP – Why Now? Moving to a Banking as a Platform model represents a major shift in mindset for incumbent banks, many of which have designed, built and/or managed their own technology for decades. However, the time is right for banks to consider BaaP as a path forward. Reasons for the shift to BaaP include: Open banking. Around the world, open banking legislation dictates that banks become more open and collaborative. In several major markets participation in open banking is mandatory, so banks must shed their closed “ vault ” mindset. Over time, open banking will require banks to move toward a more open, horizonal architecture that facilitates collaboration. Banking has become an ecosystem business, and BaaP offers an ideal foundation for collaboration using application program interfaces ( APIs). Technology. Although APIs have been around for decades, they have recently become mainstream as a prime driver of innovation and growth. Companies like Uber owe their very existence to APIs and modern developers everywhere use APIs to build better software, faster. The benefits of APIs are apparent in almost every industry, and are a building block of open banking and BaaP. At a simple level, they allow disparate systems to be integrated on a single platform and be choreographed in real time. Customers. Technology has dramatically raised customers’ expectations. In an age of “ mass personalization ” customers expect financial services that meet their exact needs. With BaaP, banks can focus on their product and service innovations, while leveraging a technology partner’ s expertise, functionality, infrastructure and scale. The bank can deliver more new products to more customers and geographies, all with speed and agility; this ultimately increases customer engagement and builds loyalty. Multiple stakeholders. While the need to keep customers happy is obvious, banking in an ecosystem creates a new array of stakeholders, each of whom plays a vital role in delivering seamless customer journeys. Banks must balance the needs of multiple stakeholders and curate an ecosystem which is constantly changing. A platform approach helps ensure that all participants operate in harmony. Banks need to embrace innovation and transform to a future that will be defined by change. BaaP has come of age and heralds a new era in banking, one that is defined by both collaboration and competition. In my next blog, we’ ll explore Banking as a Service ( BaaS) to better understand how the BaaP and BaaS models differ as well as what unites them.
1180 | tech |
Managing risk capability in financial organizations | The ability to understand and control risk allows organizations to be more confident in their business decisions. The culture of risk analysis is characterized by the alignment of risk management with the strategy of the organization and the promotion of an integrated approach to risk management. The culture of risk analysis is a delicate balance between innovative methods and risk management methods. Regardless of what risk management systems, policies, procedures, or technologies companies have or lack, during an unexpected challenge, an organization that has established a culture of sound risk management is more likely to respond well to a sudden threat. Proper and effective implementation requires regular and timely coordination to achieve the desired result of risk optimization for maximum benefit to the organization. In a culture of marginal risk, each individual acts as a risk manager and will continuously evaluate, monitor and optimize risk to make informed decisions and create sustainable competitive advantage for the organization. In order to create an effective risk management culture and make it work successfully for the benefit of the organization, management must constantly improve it to adapt it to changing business goals and requirements while reacting to market and regulatory demands. Lessons learned from COVID-19 Traditional risk management ignores the reality of the uncertainty organizations face in the digital age and is often influenced by past experience and judgment, encourages groupthink, predicts thinking outside the box, and does not provide enough insight to address risk exposures and destructive events. As a result, risk management becomes a psychological process rather than a technical process of collecting, evaluating and presenting data at expected intervals of different outcomes or even improvements. 45% of professionals say that Microsoft Office is still the primary method for managing important GRC initiatives and documents, despite its shortcomings in terms of scalability and transparency, and only 36% say they use integrated GRC software. Nearly two-thirds ( 63%) of integrated GRC software users report greater visibility into their organization's risks, compared to 47% of multipoint users and 32% of those using Microsoft Office. Everyone involved in governance, risk, compliance ( GRC), ICS, data protection, security, BCM and audit will confirm that the pandemic has highlighted even more the critical nature of GRC professionals in their organizations, especially as the ongoing constant stream of new business continuity challenges continues. In fact, the pandemic not only digitized many management processes increasing the burden on risk managers, but also radically changed the role of GRC specialists. GRC professionals are almost four times more likely to say they are more risk-aware than they were before the COVID-19 pandemic, but their level of understanding of the risks their companies face varies by technology of choice. Technology as a gamechanger Technology undoubtedly proves to be a gamechanger and is able to ensure with the right tools that business processes and information technology continue to meet the organization's governance, risk and compliance requirements. Consequently, the GRC technology market is growing through core technologies and emerging technology areas that provide domain-specific insights such as RegTech, Cyber Risk Quantification, and Privacy Management. More importantly, technology makes it possible to create a centralized system for collecting risk information and organizing data items while further strengthening the culture of risk management. Today, when leaders consider information technology and governance, risk management, and compliance ( GRC), they tend to focus on compliance with IT-specific requirements, such as information privacy and security. A compliance and risk management software ( GRC software) is a tool that companies can use to manage IT-related operations that require oversight and ensure they meet compliance and risk standards. On the other hand, Integrated Risk Management ( IRM) is a set of practices and processes supported by a risk culture and advanced technologies that improve decision making and performance by providing a comprehensive view of how an organization manages its unique risks. For organizations that use the right application of IT resources to improve the knowledge, efficiency and integration of GRC professionals and businesses within the organization, GRC efforts do not become a burden, but can translate into enormous benefits. About 85% of organizations surveyed said they would benefit from integrating and streamlining the use of technology for GRC operations, according to Deloitte. Banks struggle to assess company-wide risk exposure In the decade since the global financial crisis, banks and their regulators have become increasingly aware of the need to manage risk. However, they find it difficult to put in place the cultural, managerial, and governance structures that can systematically manage these risks. To manage a range of emerging risks in areas such as technology, data and financial crime, banks need specialized knowledge and tools. Therefore, financial institutions must understand the full range of strategies available to them to manage these financial and operational risks. Compared to financial risk, operational risk is more complex and more difficult to control and manage. Until recently, operational risk has been more difficult to measure and manage with generally accepted data and limits than financial risk. Many banks seem to struggle to understand, measure and manage the interrelated factors that affect operational risk, including human behaviour, organizational processes and IT systems. Failure to assess company-wide risk exposure can be costly. Active and cost-effective risk management requires managers to systematically think about the many categories of risk they face so that appropriate processes can be established for each. For example, external risks generally can not be reduced or eliminated by the approaches used to manage avoidable and strategic risks. These threats or risks can arise from a variety of sources, including financial uncertainty, legal liability, strategic mismanagement, accidents and natural disasters. Risk management standards are designed to help organizations identify specific threats, evaluate unique vulnerabilities to determine their risks, determine how those risks can be mitigated, and then implement risk mitigation efforts based on the organization's strategy. The ISO 31000 principles, for example, provide frameworks for improving the risk management process that can be used by companies, regardless of the size of the organization or the target industry. This approach can help a financial institution stay abreast of current and emerging industry risks and use risk assessments to identify actionable opportunities for improvement. The latter will take time, financial and management commitment, but the transformation of operational risk management presents an appealing opportunity for institutions to minimize operational risk while boosting business value, security, and resiliency. Improvements in bank risk management, on the other hand, will result in a more stable financial system, making firms more resilient to shocks. Banks that incorporate and proactively manage organizational risk with technology at the heart of their efforts can see substantial financial benefits while also preventing crises that could have long-term ramifications. Experts surely agree that financial services managers have the same powerful tools to model and manage operational risk that they use to model and manage financial risk. By combining financial instruments and operational risk modelling tools in a framework-driven process, financial services managers can actually implement their own tools. What they do not have or may not even know about, are the tools and techniques that can help them model operational risk with equal accuracy, including causal modelling approaches based on system dynamics. Rather than adopting a proactive and long-term operational risk management ( ORM) approach that is deeply integrated into their overall business risk management ( ERM) framework, many banks end up managing operational risk through short-term responses. Regulatory and market trends drive the need for integrated risk management platforms Pressure remains high on banks and other financial service providers to demonstrate effective and sustainable risk management as regulators demand higher levels of accountability and enforce stricter enforcement measures. The current economic environment requires all financial services firms to accurately measure the level of regulatory compliance and economic capital required to support their business strategy and risk appetite. Therefore, banks can find it difficult to comply with the ever-changing rules, but they must comply so as not to expose themselves to the risk of non-compliance and the potentially serious consequences that come with it. Today, banking sector companies must comply with a number of rules and standards, including the Basel III risk-weighted capital requirements, the Bank Secrecy Act, the Dodd-Frank Act, current expected credit loss ( CECL), provision for loans and leases ( ALL) and many others. To comply, banks must develop automated and continuous risk assessment workflows that provide synergy between compliance policies, business areas and associated processes, resources ( people, technology) and regulatory requirements. In particular, in order to manage third party risk, which is an important part of what banks should be doing from a regulatory standpoint, institutions need to obtain sources of evidence that they are properly managing a partner or supplier. Typical examples of operational risk in banks include service outages and security breaches. Vulnerabilities include rising compliance and risk management costs, rapidly changing regulatory environments, operational approaches, and operational inefficiencies. Unsurprisingly, risk management and compliance technologies are focused not only on solving the current problems facing the financial sector, but also on the systematic handling of vulnerabilities. Compliance activities still take time and are manual in most banks and tend to lag behind the pace of change in the financial sector. As a result, they can benefit from business understanding of new tools and technologies. A systematic, company-wide approach to governance, risk, and compliance results is a process that continuously improves management's understanding of what is happening in the company while increasing confidence in managing risk and effectively executing key business strategies. What is next in GRC for financial organizations GRC has come a long way in integrating various risk management, compliance and governance modules to provide a holistic view of risk across the various silos in the retail banking system. When it comes to managing the triumvirate of governance, risk and compliance ( GRC), many financial institutions will agree that they face difficulties. Historically, only the largest banks and financial institutions have been able to afford integrated governance, risk and compliance platforms. Many banks approach risk management and compliance from a departmental rather than an enterprise perspective. Over the last 15 years, the role of technological innovation in governance, risk management, and compliance ( GRC), as well as its impact on the global financial services industry, has shifted substantially. While the GRC industry has changed dramatically – each generation now lasts a few years less than the one before it - huge financial institutions with significant pockets and greater regulation ( SIFI) are the first to stay up with the latest big financial institution advances. Fintech businesses have dominated the market by offering low-cost financial goods and services. Most financial services and products are powered by technology, which has generated a fundamental need for security and reliability, exposing financial services organizations and clients to inherent dangers. Following the financial crisis of 2008, a greater emphasis was placed on financial indicators such as capital sufficiency, scenario planning, and loss management, as well as a significant increase in financial regulation. The focus has turned to financial risk after the implementation of Basel IV and the height of compliance innovation. The pandemic spurred a third wave of GRCs, according to Gunjan Singh, executive chairman of MetricStream. The first wave was triggered by the 2008 financial crisis, and the second by technical developments around 2015 have not found the same level of applicability as projected, and these patterns will take time to materialize. Overall, financial crime and financial risk compliance will improve as changing digital trends accelerate industry-wide transformation, making the global financial services industry safer than ever from the financial crisis or COVID-19 and other dramatic events. The advent of model risk management is also a key step towards greater control over the development of models and their use: some financial institutions prefer to create bespoke solutions in-house to meet specific requirements and retain control of technology and scalability considerations. As banks and financial service providers move from basic services such as insurance, accounting, credit, investment and treasury management to non-banking ecosystems such as mobile services, business process outsourcing, healthcare services and inventory management, the need for integrated GRC systems have become omnipresent and a key element in company-wide strategies. Essential components of a sustainable development plan and comprehensive approach to risk and compliance are best achieved by incorporating the overall GRC policy into the business agenda.
1749 | tech |
Medication Abortion Is Getting More Expensive | In the United States, there were 27 “ abortion deserts, ” according to research conducted in 2017. That means, there were 27 major cities that are at least 100 miles or more from an abortion clinic. The South and the Midwest had the fewest number of clinics overall, with Texas being home to the most abortion deserts in any one state. With the recent rise of restrictive abortion bans — in Texas, Idaho, Arizona, and most recently, Oklahoma — more and more people are forced to travel over state lines for care.
So, it makes sense that medication abortion ( AKA the “ abortion pill ”) accounted for over half of all abortions in 2020, since they allow pregnant people to receive abortion care with a bit more privacy. While there are rules around how you can access medication abortion, in some places you can get abortion pills via mail, or from a doctor. While regulations around medication abortion was relaxed during the pandemic, 19 states have moved to restrict abortion pills, and the pricing of abortion pills has, according to The 19th, dramatically increased in recent years.
During the COVID-19 pandemic, the FDA temporarily waived rules requiring patients to have an in-person visit before getting a medication abortion, permitting telehealth visits as an alternative. In December, 2021, the FDA went on to permanently allow abortion pills to be sent by mail. While that could have expanded access, the increase in pricing of abortion bills creates yet another barrier to access. A new study published in Health Affairs found that the average out-of-pocket cost for a medical abortion pill increased from $ 495 in 2017 to $ 560 in 2020. While prices went up, facilities that accepted insurance for the medication decreased from 89% to 80%, the study found. “ Lack of financial resources can create an insurmountable barrier to abortion. For many people, the cost of an abortion can exceed the capacity to pay, ” the study says.
The further along a person is into pregnancy, the more expensive abortion care typically becomes. The same study showed that a second-trimester abortion cost an average of $ 895 in 2020. They also note that according to the Federal Reserve, about one in four Americans are not able to pay for a $ 400 emergency out of pocket, which means they likely wouldn't be able to afford an abortion.
The week that Texas passed its 6-week abortion ban, orders to an abortion advocacy organization called Aid Access for mail-in abortion pills increased by 1,200%. Shortly after, the state passed another law criminalizing sending the medication by mail. The bill also implements harsh restrictions, like requiring an in-person follow-up exam and forbidding physicians from prescribing it after seven weeks of pregnancy.
Texas isn’ t alone in its pursuit of making abortion pills inaccessible. Currently, 19 states ban the abortion pill being sent via mail or prescribed through telemedicine. This summer, if we do see Roe v. Wade overturned — the landmark bill that set the precedent for pregnant folks having abortion access — it could mean even more severe restrictions and the complete ban of abortions in some states.
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Bank of England increases spending on data scientists | The data, retrieved via the Freedom of Information Act ( FOI) and analysed by the Parliament Street think tank, revealed the number of data scientists and data analysts employed by the Bank of England, alongside the total payroll for these roles each year between 2017 and 2021. In total over the period, the bank spent a grand total of £2,994,785 on data scientist and data analyst roles. The most significant increase came between 2019 and 2020, amidst the Covid-19 pandemic, when the BoE’ s total payroll for data scientist rose from £224,579 to £914,472, an increase of 307 per cent. Whilst during that year data analyst spending also grew sharply from £195,031 to £474,303. Prior to the pandemic, the Bank of England employed “ fewer than 10 ” data scientists and “ fewer than 10 ” data analysts, before a hiring drive saw the number of staff increase to 21 and 14 respectively. The Bank of England highlighted that the role of their data staff revolved around informing strategic policy, explaining key variance and trends, and solving complex data challenges. There was a sharp decline in the number of staff specifically employed in data scientist and data analyst roles in 2021, which the Bank of England attribute to “ a change in job titles. ” Analytics expert Neil Parker, General Manager EMEA for Laiye, comments: “ With a critical role to play at the centre of the UK’ s financial system and a workforce of over 4,000 people, the BoE is right to invest heavily in analytics and automation technologies to speed up operations and equip staff with the insights they need to operate effectively. As we emerge from the shadow of the Covid-19 pandemic, organisations in the financial services sector have a huge opportunity to transform their business models, overhauling manual processes and removing repetitive tasks that drain resources and energy from the workforce. With the right automation systems in place, organisations like the BoE can empower staff to concentrate on front line tasks, improve customer service and build a better more efficient organisation. ” Sridhar Iyengar, MD for Zoho Europe, comments: “ Data fuels the economy. It elevates organisations by enabling bespoke insight into aspects such as consumer activity and reducing risk. In fact, data insights have played an invaluable role in digitising businesses throughout the course of the pandemic, and it will only continue to grow in importance as businesses and organisations look to weather the long term effects of a turbulent economy. “ It is great to see the Bank of England recognising the value that data can hold in aiding processes and informing decision-making, particularly when it pertains to fiscal and monetary policy impacting an entire nation. “ However, not all organisations have the budget to hire data scientists, or indeed the business need to do so. Businesses can adopt purpose-made business intelligence tools that leverage natural language programming, AI and machine learning, so that data insights are at the fingertips of any member of an organisation, not just those deemed to be data experts. The technology sector has already made huge strides in developing sophisticated business intelligence software that can be used by anyone. The tech and business industries must now work to ensure these tools are within easy reach of any business or department that requires it. ” | tech |
An Accelerator Hub to Foster Investment in Africa | The COVID-19 pandemic unveiled huge investment needs in Africa. Yet risk aversion continues to significantly impair private investment, leading to a dearth of bankable projects. CGD experts have identified the problem of limited financial resources that are being dedicated to developing strong feasibility studies, analysing market prospects and developing viable business plans. Building on the model and experience of the European Union ( EU) in project preparation within its own borders, Mikaela Gavas and Samuel Pleeck put forward a proposal for an Accelerator Hub—a single access point for targeted support to identify, prepare and develop investment projects—pooling and convening the relatively small-scale technical assistance programmes of the European development finance institutions to help African businesses develop bankable projects.
The proposal was received with enthusiasm by a variety of African partners and trade associations, as well as corporations and development finance institutions including the association of 15 European Development Finance Institutions ( EDFI). The Dutch Development Finance Institution, FMO have structured a proposal for a technical assistance facility based on the Accelerator Hub.
CGD is continuing to engage in further discussions on the practicalities of design and implementation of the Accelerator Hub with European development financial institutions and the European Commission.
Your contribution makes it possible for the Center’ s researchers to devise practical, evidence-based solutions for today’ s most pressing development challenges. | general |
Avoiding COVID Complacency by José Manuel Barroso | While wealthy countries ease COVID-19 restrictions and welcome a return to normal life, many low-income countries are still struggling to get vaccines into people’ s arms. The longer they remain short of the 70% immunization target, the more chances the virus will have to acquire dangerous new mutations.
GENEVA – History has shown that some of the most dangerous periods of pandemics come when life returns to normal too soon. A century ago, a premature “ all clear ” helped the second wave of Spanish influenza claim far more lives than the first, after a more virulent strain emerged. Today, many G7 and G20 countries are relaxing COVID-19 restrictions and shifting their focus away from pandemic response to pandemic prevention and preparedness ( or to other issues entirely). But until every country achieves its national vaccination target, we can not know whether we are out of the woods.
With 2.8 billion people unvaccinated, the coronavirus still has ample opportunity to circulate and mutate, potentially giving rise to new, more dangerous variants and fresh resurgences. Even in the face of other pressing crises such as the war in Ukraine, COVID-19 must remain a high global priority. The only way to eliminate the uncertainty and put the pandemic behind us is for global leaders to finish the job they started, by helping the dozens of lower-income countries that are still struggling to achieve adequate vaccine coverage.
These countries need help scaling up their vaccine delivery systems and turning doses into actual vaccinations. Now that high-income countries have achieved high coverage rates, the hoarding and bottlenecks that previously hindered global supply have eased. In fact, global vaccine supply is outstripping global demand for the first time. That’ s good news for the global vaccination effort, and particularly for low-income countries where less than 15% of people have received their first shot. But it also underscores the challenge of getting doses into the arms of people living in difficult-to-reach, resource-poor environments.
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Writing for PS since 2009 8 Commentaries
José Manuel Barroso, a former president of the European Commission ( 2004-14) and prime minister of Portugal ( 2002-04), is Chair of Gavi, the Vaccine Alliance.
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Faced with populist demagogues, the judiciary often must choose between bending the knee or defiantly asserting the supremacy of fundamental legal norms. Ketanji Brown Jackson took the latter route in her recent Supreme Court confirmation hearing; but she will now join an institution that has come to be regarded as political through and through.
While the terrible human and physical cost of Russia’ s invasion of Ukraine is understandably the focus of political attention, the fight against global warming risks becoming another casualty of the war. What can policymakers do to prevent 2022 from being a lost year for climate action?
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Equitable Capitalism or Bust by Bertrand Badré & Yann Coatanlem | Two decades of economic crises have exposed the flaws of a system that has grown increasingly incompatible with sustainable development and equality of opportunity. To reform capitalism requires rethinking social welfare and how public policy can tackle inequality in all its forms.
PARIS – Global crises have grown in frequency and intensity over the past 20 years, with worrying implications for future economic development. The World Bank warns that the effort to reduce poverty has suffered its “ worst setback ” in a quarter-century, owing to the COVID-19 pandemic. Inequalities are deepening within and between countries, and across many key sectors, from education to health.
Given the scale of these problems, public policy can not focus narrowly on income and wealth. The situation demands a holistic approach with longtime horizons. Otherwise, subsequent governments will always be tempted to pursue short-term improvements with immediate political payoffs ( such as an increase in households’ purchasing power), rather than investing in future welfare. We will need to quantify the necessary trade-offs so that politicians can explain to voters why they should support having a bit less now for the sake of gaining more later.
We also need to be mindful of how we measure inequalities. Is it fair to demand that developing countries reduce their greenhouse-gas emissions at the same rate as advanced economies, even though the latter have contributed far more historically?
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Writing for PS since 2014 21 Commentaries
Bertrand Badré, a former managing director of the World Bank, is CEO and Founder of Blue like an Orange Sustainable Capital and the author of Can Finance Save the World? ( Berrett-Koehler, 2018).
Writing for PS since 2022 1 Commentary
Yann Coatanlem, an economist and fintech executive, is President of Club Praxis and the author of Le Capitalisme contre les inégalités ( Presses Universitaires de France, 2022).
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Socialists are experts at denying reality, when it comes to capitalism. Charlie Munger: „ the Basis needs of humans have been filled in the last 100 years, today the principal problem of the poor people is they’ re too fat, where in the past they were mostly starving. The interesting thing is that with all this enormous increase in living standards in the last 100 years ( just think of access to knowledge in the last 10yrs, even for the poorest nations through smartphones), people are less happy today, and that has a very simple explanation - The world is not driven by greed, it’ s driven by envy. The fact that everyone today is at least 500% better off than 100 years ago ( GDP per capita up 5x), doesn’ t matter when others appear to have more. There are now whole networks that want to pour gasoline on the flames of envy. As it gets better and better the people get less and less satisfied “. Europe’ s standard of living is falling quickly behind America and China. Three decades of Chinese capitalism has lifted living standards much faster than three decades of socialism in Europe.
`` Economist Philippe Aghion’ s research shows that innovation satisfies this condition: although it increases the weight of the top 1% ( in income and wealth), it also tends to increase social mobility, and it does not necessarily increase inequalities across the rest of the population. `` This shares nothing at all with John Rawls ' difference principle. Please stop the window dressing.
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Faced with populist demagogues, the judiciary often must choose between bending the knee or defiantly asserting the supremacy of fundamental legal norms. Ketanji Brown Jackson took the latter route in her recent Supreme Court confirmation hearing; but she will now join an institution that has come to be regarded as political through and through.
While the terrible human and physical cost of Russia’ s invasion of Ukraine is understandably the focus of political attention, the fight against global warming risks becoming another casualty of the war. What can policymakers do to prevent 2022 from being a lost year for climate action?
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Как избежать беспечности по отношению к COVID by José Manuel Barroso | ЖЕНЕВА – История показывает, что некоторые из самых опасных периодов пандемий наступают, когда жизнь возвращается в нормальное русло слишком рано. Столетие назад преждевременное “ все понятно ” помогло второй волне испанского гриппа унести гораздо больше жизней, чем первой, после того как появился более вирулентный штамм. Сегодня многие страны G7 и G20 ослабляют ограничения, введенные в связи с COVID-19, и переключают свое внимание с реагирования на пандемию на предотвращение пандемии и обеспечение готовности к ней ( или вообще на другие вопросы). Но до тех пор, пока каждая страна не достигнет своей национальной цели по вакцинации, мы не можем быть уверенны, что опасность миновала.
Поскольку в мире не вакцинированы 2,8 миллиарда человек, у коронавируса все еще есть огромные возможности для циркуляции и мутации, что потенциально может привести к появлению новых, более опасных вариантов и вспышек. Даже перед лицом других неотложных кризисов, таких как война в Украине, COVID-19 должен оставаться одним из глобальных приоритетов. Единственным способом устранить эту неопределенность и оставить пандемию позади является завершение начатой мировыми лидерами работы, по оказанию помощи десяткам стран с низким уровнем дохода, которые все еще пытаются добиться надлежащего охвата вакцинацией.
Этим странам необходима помощь в расширении их систем поставок вакцин и использование доз для актуальной вакцинации. Теперь, когда страны с высоким уровнем дохода достигли высоких показателей охвата, накопление запасов и узкие места, которые ранее препятствовали глобальному предложению, уменьшились. По сути, глобальные поставки вакцины впервые превышают мировой спрос. Это хорошая новость для глобальных усилий по вакцинации, особенно для стран с низким уровнем дохода, где менее 15% людей получили первую прививку. Но это также подчеркивает проблему доставки доз непосредственно людям, живущим в труднодоступной среде с ограниченными ресурсами.
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José Manuel Barroso, a former president of the European Commission ( 2004-14) and prime minister of Portugal ( 2002-04), is Chair of Gavi, the Vaccine Alliance.
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Faced with populist demagogues, the judiciary often must choose between bending the knee or defiantly asserting the supremacy of fundamental legal norms. Ketanji Brown Jackson took the latter route in her recent Supreme Court confirmation hearing; but she will now join an institution that has come to be regarded as political through and through.
While the terrible human and physical cost of Russia’ s invasion of Ukraine is understandably the focus of political attention, the fight against global warming risks becoming another casualty of the war. What can policymakers do to prevent 2022 from being a lost year for climate action?
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Roundup: Bayer to launch 27 telemedicine centres in India and more briefs | German multinational pharmaceutical company Bayer is setting up 27 telemedicine centres in 12 districts across eight states in India over the next two years through Bayer Foundation India.
The company has identified the states of Bihar, Chhattisgarh, Jharkhand, Karnataka, Gujarat, Uttar Pradesh, Maharashtra, and Madhya Pradesh to launch telemedicine facilities that will provide healthcare via telehealth.
Bayer partnered with multispecialty clinic RxDx Healthcare and Piramal Swasthya, the public health arm of the Piramal Foundation, which are both experienced in running telemedicine in primary health centres located in some targeted districts.
A press statement noted that each telemedicine centre will be manned by a trained nursing and midwifery staff, along with a coordinator and a GP. It will offer about 20 medical specialties via telehealth.
Additionally, Bayer will conduct medical camps to raise awareness on pressing health topics, such as breast cancer, diabetes, and dermatology, as well as training and awareness sessions on health, hygiene, and nutrition.
It is expected that the telemedicine centres will reach between 35,000 to 50,000 beneficiaries within the targeted states.
Vietnam's Health Ministry has announced that it will start issuing vaccine passports on 15 April.
The country's vaccine pass will bear a person's name, birth date, and vaccination record, including shots, date of vaccination, and the diseases they are vaccinated against. De-identified data will be stored in a QR code, which will expire after 12 months.
Vietnamese citizens can download their vaccine pass through the PC Covid mobile app or other digital health apps. They can also obtain their passports by accessing the Health Ministry's website.
The vaccine passports have been tried out in late March at some hospitals in major cities.
Malaysian eye specialist centre VISTA has added another computer-aided robotic device to its range of tools for conducting cataract surgeries.
The company started using the Sophi Wireless Phaco System by Swiss medical device maker This AG.
The device is a battery-based phacoemulsification system used to remove cataracts. It features voice information assistance and text-to-speech, as well as a video display of microscope images transmitted through Wi-Fi.
According to Dr Aloysius Joseph Low, VISTA's chief ophthalmic surgeon, they stand to benefit from Sophi's safety features that minimise the risk of contamination and raise surgical stability, `` resulting in a safe and fast surgery ''.
Sophi will be coupled with the clinic's existing Ziemer Z8 Femtosecond Laser-Assisted Cataract Surgery system, which uses computer-aided lasers to make initial cuts to enter the eye. Their combination will `` increase the efficiency and safety of our surgery, '' said VISTA growth chief Grace Heng.
`` Having robotic computer-aided technology that automates processes takes away the constant demands of a surgeon's attention on non-essential details, freeing up the surgeon to focus on important processes that impact surgical outcomes and which require human experience, '' VISTA said about their adoption of robotic devices in cataract surgeries.
`` VISTA's objective is to raise the bar in the evolution of cataract surgery and migrate away from manual procedures towards computer-assisted technologies, artificial intelligence, and the latest generation of trifocal lenses that aim to help increase patient's safety, comfort and results, '' Dr Low added.
Taikang Healthcare Investment Holdings, the aged care service unit of insurance firm Taikang Insurance Group, has partnered with Infobird, a provider of AI-powered customer engagement solutions, to transform its digital contact centre management and intelligent services.
Taikang Healthcare has been providing elderly care, rehabilitation care, and medical and health services in China for over a decade. Its physical elderly care agencies now cover 24 provinces in the country.
As its business continues to grow, the company intends to upgrade its contact centre. According to a press statement, its collaboration with Infobird will be done in two phases.
In the first phase, Infobird will deliver cloud telemarketing and cloud customer service solutions to enhance its customer service and lead management, as well as optimise outbound calling.
In the second stage, Infobird's omnichannel call centre will serve Taikang Healthcare's home care service centre, handling reservations and scheduling. It will also deploy its AI chatbots to assist with issuing reminders on medications and return visits. | tech |
No le bajemos la guardia a la COVID by José Manuel Barroso | GINEBRA – La historia muestra que algunos de los momentos más peligrosos de las pandemias ocurren cuando la vida vuelve a la normalidad demasiado pronto. Hace un siglo, la creencia prematura en que el peligro había pasado contribuyó a que la segunda ola de gripe española se cobrara muchas más vidas que la primera, al aparecer una cepa más virulenta. Hoy, muchos países del G7 y del G20 han comenzado a relajar las restricciones contra la COVID‑19, y a prestar menos atención a las medidas de respuesta a la pandemia y más a la prevención y a la preparación para pandemias futuras ( o incluso a cuestiones totalmente diferentes). Pero mientras quede un solo país que no haya alcanzado la meta nacional de vacunación, no tendremos garantías de estar a salvo.
Con 2800 millones de personas sin vacunar, el coronavirus todavía tiene amplio margen para circular y mutar, con riesgo de que aparezcan nuevas variantes más peligrosas y haya rebrotes. Incluso frente a otras crisis apremiantes como la guerra en Ucrania, la COVID‑19 tiene que seguir siendo una alta prioridad mundial. El único modo de eliminar la incertidumbre y superar la pandemia es que la dirigencia internacional termine la tarea comenzada, ayudando a los numerosos países de bajos ingresos que todavía no consiguen una cobertura vacunatoria adecuada.
Estos países necesitan ayuda para expandir sus sistemas de distribución de vacunas y convertir las dosis en inmunizaciones reales. Ahora que los países ricos lograron altas tasas de cobertura, los problemas de acaparamiento y cuellos de botella que obstaculizaban el suministro global se redujeron. De hecho, la oferta de vacunas en todo el mundo ha superado por primera vez la demanda. Es buena noticia para la campaña mundial de vacunación, y en particular para los países de bajos ingresos en los que menos del 15% de la gente recibió la primera dosis. Pero también resalta el desafío de la provisión de vacunas a las personas que viven en entornos remotos y desprovistos de recursos.
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Cryptocurrencies and blockchain-based technologies are here to stay. But what will their next chapter look like?
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Writing for PS since 2009 8 Commentaries
José Manuel Barroso, a former president of the European Commission ( 2004-14) and prime minister of Portugal ( 2002-04), is Chair of Gavi, the Vaccine Alliance.
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Faced with populist demagogues, the judiciary often must choose between bending the knee or defiantly asserting the supremacy of fundamental legal norms. Ketanji Brown Jackson took the latter route in her recent Supreme Court confirmation hearing; but she will now join an institution that has come to be regarded as political through and through.
While the terrible human and physical cost of Russia’ s invasion of Ukraine is understandably the focus of political attention, the fight against global warming risks becoming another casualty of the war. What can policymakers do to prevent 2022 from being a lost year for climate action?
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Country registers 25 new COVID-19 cases, 61 recoveries | Azerbaijan registered 25 new COVID-19 cases in the past 24 hours, Operational Headquarters under the Cabinet of Ministers reported on April 7.
Some 61 patients have recovered and 2 patients have died in the reported period.
So far, 792,166 COVID-19 cases have been registered in the country. Some 782,204 patients have recovered, and 9,703 people have died. Currently, 259 people are under treatment in special hospitals.
Over the past day, 4,755 tests were conducted in Azerbaijan to reveal coronavirus cases.
In general, 6,731,315 tests have been conducted in Azerbaijan so far.
So far, some 13,523,432 COVID-19 vaccines have been provided to Azerbaijani citizens. In the past 24 hours, some 9,497 citizens have been vaccinated against COVID-19. | general |
Ruble Nears Two-Month High, Sparks Doubt Over ‘ Synthetic’ Rally | The information you requested is not available at this time, please check back again soon.
Pedestrians walk by Saint Basil's Cathedral on Red Square in Moscow, Russia, on Sunday, May 2, 2021. Facing a rising wave of Covid-19 infections and a vaccination rate that isn’ t keeping up, the Kremlin is trying to contain the epidemic without alarming Russians. Photographer: Andrey Rudakov/Bloomberg, Bloomberg
( Bloomberg) -- The ruble rallied for a third day to approach the highest in more than two months, evoking skepticism from currency strategists who say the market is broken because of capital controls, forced dollar sales and ultra-thin volumes.
Russia’ s currency jumped as much as 7.3% on Thursday, sealing its rebound from a collapse that followed the nation’ s invasion of Ukraine and sanctions that isolated it from the global financial system. A key driver of the latest gains is the continued demand for Russia’ s oil and gas in Europe and elsewhere, handing the country almost $ 1 billion a day in revenue.
Strategists say the ruble’ s rally isn’ t credible: The exchange rate is no longer free-floating and the currency would be at a very different level if barriers were removed. With Russia tottering on the brink of a debt default and the economy shrinking, the ruble no longer reflects the country’ s fundamentals, they say.
“ It’ s a completely artificial level and so very little credence should be given to it, ” said Cristian Maggio, the head of portfolio strategy at Toronto Dominion Bank in London. “ Almost no one can trade the ruble and those who really do, they trade at very different levels than what the screens report. From a market and macroeconomic point of view, it makes no sense. ”
The exaggerated moves in the ruble coincide with a plunge in trading volumes. The 20-day average of daily volumes in the currency has fallen to the lowest since 2012 as foreign investors cut exposure to Russian assets.
Ruble volatility is surging. Realized 30-day swings have jumped to 79%, a record high that beats the 74% reached in the aftermath of the 2014 ruble crisis. While one-month implied volatility has come off its peak, it still remains high at 55%, compared with less than 12% before the invasion.
Given the thin participation, the ruble’ s moves are dictated by the government’ s tough capital controls. Those include a ban on foreigners selling Russian assets as well as mandated hard-currency sales by exporters.
“ It’ s important to stress that it’ s not a properly functioning market, ” said Piotr Matys, a senior currency analyst at InTouch Capital Markets Ltd. in London. “ The ruble is not a free-trading currency after Russia imposed various restrictions that essentially prevent capital outflows. ”
Adding to the complexity, Putin has demanded that foreign buyers pay in rubles for Russia’ s natural gas. While European officials rejected the plan when it was first announced, a French official said March 31 that the new mechanism won’ t change payments as mandated in supply deals, which will continue as before.
All the moving parts mean price discovery is close to impossible.
“ My focus has been limited on ruble lately purely because it is a synthetic market, ” said Simon Harvey, the head of currency analysis at Monex Europe. “ Once the depth comes back, pricing will look wildly different to where it is currently trading at, unless there is severe intervention or continued capital restrictions. ”
Here are nine things you need to know about Budget 2022.
The federal government is taking sharper aim at real estate investors and property flippers in a bid to help halt the country’ s long-standing – and worsening – housing affordability problem.
The Liberal government is scaling back its strategy to single out Canada's most profitable banks and insurers with targeted tax measures, resulting in about $ 4 billion less in revenue than originally planned. | general |
Shopify to allow staff to pick between cash and stock components - The Globe and Mail | The changes will fully come into effect by the second half of this year, starting in July, according to the report.
Shopify did not immediately respond to a Reuters request for comment.
The changes were disclosed at a company town hall on Thursday afternoon, the report said, and were aimed at making salaries more competitive at a time when the e-commerce infrastructure firm's stock has taken a beating.
As of Thursday's close, Shopify's New York-listed shares had fallen 65% from their peak in November last year, as the company struggles to maintain a sales surge seen during the early days of the coronavirus pandemic.
( Reporting by Yuvraj Malik in Bengaluru; Editing by Shinjini Ganguli) | business |
Sound Global Ltd. Announces Delay in Publication of Interim Results for the Six Months Ended 30 June 2020 | Sound Global Ltd. announced that pursuant to Rule 13.49 ( 1) and Rule 13.46 ( 2) ( a) of the Listing Rules, the Company is required to publish the announcements in respect of its annual financial results for the year ended 31 December 2020 and the year ended 31 December 2021 not later than three months after the end of the relevant financial period, i.e. on or before 31 March 2021 and 31 March 2022, respectively, and to despatch the annual report for the year ended 31 December 2020 to the shareholders of the Company not later than four months after the end of the relevant financial period, i.e. on or 30 April 2021. Pursuant to Rule 13.48 ( 1) and Rule 13.49 ( 6) of the Listing Rules, the Company is required to publish the announcements in respect of its interim financial results for the six months ended 30 June 2020 and the six months ended 30 June 2021 not later than two months after the end of the relevant financial period, i.e. on or before 31 August 2020 and 31 August 2021, respectively and to despatch its interim reports for the six months ended 30 June 2020 and for the six months ended 30 June 2021 to the Shareholders not later than three months after the end of the relevant financial period, i.e. on or before 30 September 2020 and 30 September 2021, respectively. Due to the travel restrictions as a result of the COVID-19 pandemic, the Company is still in the process of preparing the 2020 Interim Results, the 2020 Annual Results, the 2021 Interim Results and the 2021 Annual Results for the Company and its subsidiaries. Based on the current progress of works, it is estimated that the 2020 Interim Results, the 2020 Interim Report, the 2020 Annual Results, the 2020 Annual Report, the 2021 Interim Results, the 2021 Interim Report and the 2021 Annual Results will be available for publication by 30 June 2022. The Company will make further announcement ( s) to update the Shareholders of any changes to the proposed dates of publication and despatch or any update information as and when appropriate. | business |
Nanotechnology research: Faster, cheaper COVID tests -- ScienceDaily | In March 2022, the group filed a patent application and published its first paper on rapid detection of COVID-19, using a localized surface plasmon resonance ( LSPR) virus sensor, developed based on human angiotensin-converting enzyme 2 protein ( ACE2) functionalized silver nanotriangle arrays.
The sensor has high sensitivity and specificity to the spike protein RBD of SARS-CoV-2 as well as human coronavirus NL63.
`` Right now, we already have rapid antigen test kits available on the market, though the big issue continues to be the high rate of false positives, around 60%, '' said Yanjun Yang, doctoral student in the UGA College of Engineering and lead author on the new paper.
`` Our technology, also in a rapid kit but using a spectrometer to do the detection, is much more accurate. ''
The swab-based rapid test developed by the Zhao group uses a UV spectrometer for spike protein detection. The test will cover all COVID-19 variants, as well as any future variants.
`` The method we developed shall have a much better sensing performance than the rapid test kits, very close to the PCR tests currently in use, '' said Zhao, Distinguished Research Professor in the Franklin College of Arts and Sciences department of physics and astronomy. `` The setup and the operation of the sensor is very simple, and the test time essentially will be less than 10 minutes. ''
Zhao's lab is developing a detector based on this work within $ 10 and the sensor will link to a smartphone app.
`` The LSPR sensor has several advantages in rapid diagnostics of SARS-CoV-2 ( CoV2). Highly sensitive, specific, and able to detect CoV2 at picomolar concentrations in saliva, it's rapidity at less than 20 minutes is as good or better than current diagnostic platforms including RT-qPCR, also known as the 'gold standard ', '' said Tripp, professor and GRA Chair in Vaccine and Therapeutic Development in the College of Veterinary Medicine department of infectious diseases and co-author on the study. `` In addition, this method of detection is highly reproducible. This platform is a significant leap forward in diagnostics. ''
`` Working with biologists and developing this technology was a great experience, '' Yang said. `` I 've only done research in the lab, so I never knew how to make something become a product, so it's a really good opportunity to understand how we can tie our work to the practical issues and make it commercialized. ''
The study is published in Sensors and Actuators B: Chemical | science |
Computerized, rolling DNA motors move molecular robotics to next level: The motors can sense chemical information in their environment, process that information, and then respond accordingly, mimicking some basic properties of living cells. -- ScienceDaily | `` One of our big innovations, beyond getting the DNA motors to perform logic computations, is finding a way to convert that information into a simple output signal -- motion or no motion, '' says Selma Piranej, an Emory University PhD candidate in chemistry, and first author of the paper. `` This signal can be read by anyone holding a cell phone equipped with an inexpensive magnifying attachment. ''
`` Selma's breakthrough removes major roadblocks that stood in the way of making DNA computers useful and practical for a range of biomedical applications, '' says Khalid Salaita, senior author of the paper and an Emory professor of chemistry at Emory University. Salaita is also on the faculty of the Wallace H. Coulter Department of Biomedical Engineering, a joint program of Georgia Tech and Emory.
The motors can sense chemical information in their environment, process that information, and then respond accordingly, mimicking some basic properties of living cells.
`` Previous DNA computers did not have directed motion built in, '' Salaita says. `` But to get more sophisticated operations, you need to combine both computation and directed motion. Our DNA computers are essentially autonomous robots with sensing capabilities that determine whether they move or not. ''
The motors can be programmed to respond to a specific pathogen or DNA sequence, making them a potential technology for medical testing and diagnostics.
Another key advance is that each motor can operate independently, under different programs, while deployed as a group. That opens the door for a single massive array of the micron-sized motors to carry out a variety of tasks and perform motor-to-motor communication.
`` The ability for the DNA motors to communicate with one another is a step towards producing the kind of complex, collective action generated by swarms of ants or bacteria, '' Salaita says. `` It could even lead to emergent properties. ''
DNA nanotechnology takes advantage of the natural affinity for the DNA bases A, G, C and T to pair up with one another. By moving around the sequence of letters on synthetic strands of DNA, scientists can get the strands to bind together in ways that create different shapes and even build functioning machines.
The Salaita lab, a leader in biophysics and nanotechnology, developed the first rolling DNA-based motor in 2015. The device was 1,000 times faster than any other synthetic motor, fast-tracking the burgeoning field of molecular robotics. Its high speed allows a simple smart phone microscope to capture its motion through video.
The motor's `` chassis '' is a micron-sized glass sphere. Hundreds of DNA strands, or `` legs '' are allowed to bind to the sphere. These DNA legs are placed on a glass slide coated with the reactant RNA, the motor's fuel. The DNA legs are drawn to the RNA, but as soon as they set foot on it they erase it through the activity of an enzyme that is bound to the DNA and destroys only RNA. As the legs bind and then release from the substrate, they keep guiding the sphere along.
When Piranej joined the Salaita lab in 2018, she began working on a project to take the rolling motors to the next level by building in computer programming logic.
`` It's a major goal in the biomedical field to take advantage of DNA for computation, '' Piranej says. `` I love the idea of using something that's innate in all of us to engineer new forms of technology. ''
DNA is like a biological computer chip, storing vast amounts of information. The basic units of operation for DNA computation are short strands of synthetic DNA. Researchers can change the `` program '' of DNA by tweaking the sequences of AGTC on the strands.
`` Unlike a hard, silicon chip, DNA-based computers and motors can function in water and other liquid environments, '' Salaita says. `` And one of the big challenges in fabricating silicon computer chips is trying to pack more data into an ever-smaller footprint. DNA offers the potential to run many processing operations in parallel in a very small space. The density of operations you could run might even go to infinity. ''
Synthetic DNA is also biocompatible and cheap to make. `` You can replicate DNA using enzymes, copying and pasting it as many times as you want, '' Salaita says. `` It's virtually free. ''
Limitations remain, however, in the nascent field of DNA computation. A key hurdle is making the output of the computations easily readable. Current techniques heavily rely on tagging DNA with fluorescent molecules and then measuring the intensity of emitted light at different wavelengths. This process requires expensive, cumbersome equipment. It also limits the signals that can be read to those present in the electromagnetic spectrum.
Although trained as a chemist, Piranej began learning the basics of computer science and diving into bioengineering literature to try to overcome this hurdle. She came up with the idea of using a well-known reaction in bioengineering to perform the computation and pairing it with the motion of the rolling motors.
The reaction, known as toehold-mediated strand displacement, occurs on duplex DNA -- two complementary strands. The strands are tightly hugging one another except for one loose, floppy end of a strand, known as the toe hold. The rolling motor can be programmed by coating it with duplex DNA that is complementary to a DNA target -- a sequence of interest.
When the molecular motor encounters the DNA target as it rolls along its RNA track, the DNA target binds to the toe hold of the duplex DNA, strips it apart, and anchors the motor into place. The computer read out becomes simply `` motion '' or `` no motion. ''
`` When I first saw this concept work during an experiment, I made this really loud, excited sound, '' Piranej recalls. `` One of my colleagues came over and asked, 'Are you okay? ' Nothing compares to seeing your idea come to life like that. That's a great moment. ''
These two basic logic gates of `` motion '' or `` no motion '' can be strung together to build more complicated operations, mimicking how regular computer programs build on the logic gates of `` zero '' or `` one. ''
Piranej took the project even further by finding a way to pack many different computer operations together and still easily read the output. She simply varied the size and materials of the microscopic spheres that form the chassis for the DNA-based rolling motors. For instance, the spheres can range from three to five microns in diameter and be made of either silica or polystyrene. Each alteration provides slightly different optical properties that can be distinguished through a cell phone microscope.
The Salaita lab is working to establish a collaboration with scientists at the Atlanta Center for Microsystems Engineered Point-of-Care Technologies, an NIH-funded center established by Emory and Georgia Tech. They are exploring the potential for the use of the DNA-computing technology for home diagnostics of COVID-19 and other disease biomarkers.
`` Developing devices for biomedical applications is especially rewarding because it's a chance to make a big impact in people's lives, '' Piranej says. `` The challenges of this project have made it more fun for me, '' she adds. | science |
New evidence suggests California's environmental policies preferentially protect whites: Systemic racism could explain why minorities are exposed to more pollution throughout the state -- ScienceDaily | The study published in the journal Nature Sustainability suggests California's environmental regulations as a whole preferentially protect white, non-Hispanic people within the state from exposure to air pollution.
The study focused on 2020 when the state issued shelter-in-place orders in response to COVID-19. The researchers compared patterns of air pollution both before and during the shutdown, using data from public and privately-owned air monitor networks, along with satellite measurements of the pollutant gas nitrogen dioxide. After considering various factors, even how much communities were sheltering-in-place, the researchers found that during the period when the `` in-person '' economy was shut down, neighborhoods with high Asian and Hispanic populations experienced disproportionately large declines in air pollution. That means the inverse is true when it's business as usual.
They also found that Black communities didn't see a similar disproportionate benefit in air quality during the shutdown. Black California residents were exposed to higher levels of pollution compared to whites during the shutdowns when only essential businesses were operating. The same was true after COVID-19 restrictions lifted. This suggests power plants, electricity generators and other emission sources that were not curtailed during the shelter-in-place orders are regularly exposing these populations to dirtier air.
The paper also finds low-income communities are consistently exposed to more pollution when the economy is fully functioning and that these neighborhoods also saw disproportionately cleaner air during the shutdown. However, when the researchers accounted for income in their analysis, it didn't explain the findings of higher air pollution exposures for Asian, Hispanic communities throughout the state.
`` Income only explains about 15 percent of the disproportionate decrease in air pollution experienced by Asian and Hispanic communities during the shutdown, '' said Jennifer Burney, the Marshall Saunders Chancellor's Endowed Chair in Global Climate Policy and Research at the School of Global Policy and Strategy. `` This may be surprising to many because people tend to conflate income and race, both because systemic discrimination is a hard thing to face and because we have accepted that we live in a world where individuals can 'buy ' cleaner air through higher housing prices in less polluted areas. ''
Burney added, `` the COVID shutdown gave us a window into what pollution patterns look like when most of the economy is turned off and it showed that though there is some small overlap, income does not explain the racial and ethnic bias in how our economy creates and distributes pollution. ''
Burney and the research team take this as evidence of an environmental policy failure. In California, all emissions are subject to regulation -- transportation, energy, construction and other industries have to meet strict environmental standards.
`` One would think that in a state with strong environmental policies, where we track what is being emitted where, that our regulatory system might do a good job of protecting everyone equally, '' Burney said. `` But this is really strong evidence of systemic bias. Pollution sources from everything that was shut down, transportation, businesses, restaurants, etc. all add up during business-as-usual conditions. Thus, the total system is tipped, exposing racial and ethnic minorities to more pollution. ''
The health impacts of poor air quality are far-reaching. Unhealthy air is linked to higher rates of infant mortality and adult mortality as well as respiratory and cardiovascular illnesses.
Policy recommendations to address systemic environmental racism
While the study is limited to the state of California, the researchers believe that the disparity in air quality between ethnicities most likely applies to other states. The paper includes various policy recommendations. For example, the largest pollution source affected by the pandemic's slowdown was transportation, so policies that affect transportation emissions could have important impacts for California's underrepresented communities.
Additionally, given that air pollution disparities experienced by racial and ethnic minorities are not explained by income, it means environmental strategies based on income alone could not be expected to achieve strong racial and ethnic equity. This suggests that different metrics should be incorporated when evaluating environmental regulations to meet average environmental standards and promote equity.
`` There is no clear, quantitative equity criterion applied in regulatory analysis to safeguard against environmental racism, '' said co-author Katharine Ricke, an assistant professor at the School of Global Policy and Strategy and Scripps Institution of Oceanography. `` For example, if an industry wants to build a factory, they have to complete an environmental assessment report, but that report isn't required to include a set of metrics to demonstrate how different demographic groups nearby would be affected. If industries had to run atmospheric models to show that the proposed facility is not going to disproportionately affect minority neighborhoods nearby, that could instigate a significant shift in making environmental regulation more equitable. ''
The authors also suggest including communities in the planning process when there are proposed changes to their surrounding environment that could impact air quality.
`` This is not new, but procedural justice is also critical, '' said co-author Pascal Polonik, a Ph.D. candidate at Scripps Oceanography. `` Communities need to be engaged in meaningful ways to ensure that everyone has access to what should be a democratic process. ''
Polonik added that `` by improving access to information, such as data from the crowd-sourced sensors that were utilized in the study, could help communities be part of informed decision-making. Unfortunately, these sensors tend to be located in the places least likely to be impacted by unjust pollution exposure. ''
Other paper authors include Richard Bluhm, assistant professor at Leibniz University Hannover and fellow in the Department of Political Science at UC San Diego; Kyle S. Hemes, postdoctoral research fellow at Stanford Woods Institute for the Environment; Luke C. Sanford, assistant professor at Yale University's School of the Environment; Susanne A. Benz, postdoctoral fellow at Dalhousie University; and Morgan C. Levy, assistant professor at the School of Global Policy and Strategy and Scripps Institution of Oceanography. | science |
Early Th2 inflammation in the upper respiratory mucosa as a predictor of severe COVID-19 and modulation by early treatment with inhaled corticosteroids: a mechanistic analysis - The Lancet Respiratory Medicine | BackgroundCommunity-based clinical trials of the inhaled corticosteroid budesonide in early COVID-19 have shown improved patient outcomes. We aimed to understand the inflammatory mechanism of budesonide in the treatment of early COVID-19.MethodsThe STOIC trial was a randomised, open label, parallel group, phase 2 clinical intervention trial where patients were randomly assigned ( 1:1) to receive usual care ( as needed antipyretics were only available treatment) or inhaled budesonide at a dose of 800 μg twice a day plus usual care. For this experimental analysis, we investigated the nasal mucosal inflammatory response in patients recruited to the STOIC trial and in a cohort of SARS-CoV-2-negative healthy controls, recruited from a long-term observational data collection study at the University of Oxford. In patients with SARS-CoV-2 who entered the STOIC study, nasal epithelial lining fluid was sampled at day of randomisation ( day 0) and at day 14 following randomisation, blood samples were also collected at day 28 after randomisation. Nasal epithelial lining fluid and blood samples were collected from the SARS-CoV-2 negative control cohort. Inflammatory mediators in the nasal epithelial lining fluid and blood were assessed for a range of viral response proteins, and innate and adaptive response markers using Meso Scale Discovery enzyme linked immunoassay panels. These samples were used to investigate the evolution of inflammation in the early COVID-19 disease course and assess the effect of budesonide on inflammation.Findings146 participants were recruited in the STOIC trial ( n=73 in the usual care group; n=73 in the budesonide group). 140 nasal mucosal samples were available at day 0 ( randomisation) and 122 samples at day 14. At day 28, whole blood was collected from 123 participants ( 62 in the budesonide group and 61 in the usual care group). 20 blood or nasal samples were collected from healthy controls. In early COVID-19 disease, there was an enhanced inflammatory airway response with the induction of an anti-viral and T-helper 1 and 2 ( Th1/2) inflammatory response compared with healthy individuals. Individuals with COVID-19 who clinically deteriorated ( ie, who met the primary outcome) showed an early blunted respiratory interferon response and pronounced and persistent Th2 inflammation, mediated by CC chemokine ligand ( CCL) -24, compared with those with COVID-19 who did not clinically deteriorate. Over time, the natural course of COVID-19 showed persistently high respiratory interferon concentrations and elevated concentrations of the eosinophil chemokine, CCL-11, despite clinical symptom improvement. There was persistent systemic inflammation after 28 days following COVID-19, including elevated concentrations of interleukin ( IL) -6, tumour necrosis factor-α, and CCL-11. Budesonide treatment modulated inflammation in the nose and blood and was shown to decrease IL-33 and increase CCL17. The STOIC trial was registered with ClinicalTrials.gov, NCT04416399.InterpretationAn initial blunted interferon response and heightened T-helper 2 inflammatory response in the respiratory tract following SARS-CoV-2 infection could be a biomarker for predicting the development of severe COVID-19 disease. The clinical benefit of inhaled budesonide in early COVID-19 is likely to be as a consequence of its inflammatory modulatory effect, suggesting efficacy by reducing epithelial damage and an improved T-cell response.FundingOxford National Institute of Health Research Biomedical Research Centre and AstraZeneca.
Community-based clinical trials of the inhaled corticosteroid budesonide in early COVID-19 have shown improved patient outcomes. We aimed to understand the inflammatory mechanism of budesonide in the treatment of early COVID-19.
The STOIC trial was a randomised, open label, parallel group, phase 2 clinical intervention trial where patients were randomly assigned ( 1:1) to receive usual care ( as needed antipyretics were only available treatment) or inhaled budesonide at a dose of 800 μg twice a day plus usual care. For this experimental analysis, we investigated the nasal mucosal inflammatory response in patients recruited to the STOIC trial and in a cohort of SARS-CoV-2-negative healthy controls, recruited from a long-term observational data collection study at the University of Oxford. In patients with SARS-CoV-2 who entered the STOIC study, nasal epithelial lining fluid was sampled at day of randomisation ( day 0) and at day 14 following randomisation, blood samples were also collected at day 28 after randomisation. Nasal epithelial lining fluid and blood samples were collected from the SARS-CoV-2 negative control cohort. Inflammatory mediators in the nasal epithelial lining fluid and blood were assessed for a range of viral response proteins, and innate and adaptive response markers using Meso Scale Discovery enzyme linked immunoassay panels. These samples were used to investigate the evolution of inflammation in the early COVID-19 disease course and assess the effect of budesonide on inflammation.
146 participants were recruited in the STOIC trial ( n=73 in the usual care group; n=73 in the budesonide group). 140 nasal mucosal samples were available at day 0 ( randomisation) and 122 samples at day 14. At day 28, whole blood was collected from 123 participants ( 62 in the budesonide group and 61 in the usual care group). 20 blood or nasal samples were collected from healthy controls. In early COVID-19 disease, there was an enhanced inflammatory airway response with the induction of an anti-viral and T-helper 1 and 2 ( Th1/2) inflammatory response compared with healthy individuals. Individuals with COVID-19 who clinically deteriorated ( ie, who met the primary outcome) showed an early blunted respiratory interferon response and pronounced and persistent Th2 inflammation, mediated by CC chemokine ligand ( CCL) -24, compared with those with COVID-19 who did not clinically deteriorate. Over time, the natural course of COVID-19 showed persistently high respiratory interferon concentrations and elevated concentrations of the eosinophil chemokine, CCL-11, despite clinical symptom improvement. There was persistent systemic inflammation after 28 days following COVID-19, including elevated concentrations of interleukin ( IL) -6, tumour necrosis factor-α, and CCL-11. Budesonide treatment modulated inflammation in the nose and blood and was shown to decrease IL-33 and increase CCL17. The STOIC trial was registered with ClinicalTrials.gov, NCT04416399.
An initial blunted interferon response and heightened T-helper 2 inflammatory response in the respiratory tract following SARS-CoV-2 infection could be a biomarker for predicting the development of severe COVID-19 disease. The clinical benefit of inhaled budesonide in early COVID-19 is likely to be as a consequence of its inflammatory modulatory effect, suggesting efficacy by reducing epithelial damage and an improved T-cell response.
Oxford National Institute of Health Research Biomedical Research Centre and AstraZeneca.
Understanding of the inflammation that occurs following SARS-CoV-2 infection has increased.1Leist SR Schäfer A Martinez DR Cell and animal models of SARS-CoV-2 pathogenesis and immunity.Dis Model Mech. 2020; 13dmm046581Google Scholar Mainly, the immune response in patients with severe infection who require hospitalisation has been investigated.2Peluso MJ Deitchman AN Torres L et al.Long-term SARS-CoV-2-specific immune and inflammatory responses in individuals recovering from COVID-19 with and without post-acute symptoms.Cell Rep. 2021; 36109518Google Scholar The early COVID-19 studies focused on inflammation caused by the systemic immune response3Farr RJ Rootes CL Rowntree LC et al.Altered microRNA expression in COVID-19 patients enables identification of SARS-CoV-2 infection.PLoS Pathog. 2021; 17e1009759Google Scholar whereas the inflammatory response in the airway of patients remains largely unknown, in part because of the risk of contagion through aerosolisation of the virus. The airway inflammatory response to common respiratory viruses in healthy individuals4Rouse BT Sehrawat S Immunity and immunopathology to viruses: what decides the outcome?.Nat Rev Immunol. 2010; 10: 514-526Google Scholar and in patients with chronic airways disease has been extensively studied.5Message SD Johnston SL The immunology of virus infection in asthma.Eur Respir J. 2001; 18: 1013-1025Google Scholar, 6Guo-Parke H Linden D Weldon S Kidney JC Taggart CC Mechanisms of virus-induced airway immunity dysfunction in the pathogenesis of COPD disease, progression, and exacerbation.Front Immuno. 2020; 111205Google Scholar Inhaled corticosteroids are often prescribed in patients with asthma and chronic obstructive pulmonary disease ( COPD) to reduce the risk of exacerbations, which are usually mediated by respiratory viruses.7Tan WC Viruses in asthma exacerbations.Curr Opin Pulm Med. 2005; 11: 21-26Google Scholar, 8Papi A Bellettato CM Braccioni F et al.Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations.Am J Respir Crit Care Med. 2006; 173: 1114-1121Google Scholar, 9Bafadhel M McKenna S Terry S et al.Acute exacerbations of chronic obstructive pulmonary disease: identification of biologic clusters and their biomarkers.Am J Respir Crit Care Med. 2011; 184: 662-671Google Scholar During the ongoing COVID-19 pandemic, it has been reported that patients with asthma and COPD are less likely to be hospitalised with severe COVID-19 than people with comorbidities ( eg, cardiovascular, diabetes, hypertension, and obesity).10Guan WJ Liang WH Zhao Y et al.Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis.Eur Respir J. 2020; 552000547Google Scholar, 11Rogliani P Lauro D Di Daniele N Chetta A Calzetta L Reduced risk of COVID-19 hospitalization in asthmatic and COPD patients: a benefit of inhaled corticosteroids?.Expert Rev Respir Med. 2021; 15: 561-568Google Scholar The reasons for this observation are unclear but, in patients with asthma, the use of inhaled corticosteroids 2 weeks before hospitalisation for severe COVID-19 was associated with better clinical outcomes.12Bloom CI Drake TM Docherty AB et al.Risk of adverse outcomes in patients with underlying respiratory conditions admitted to hospital with COVID-19: a national, multicentre prospective cohort study using the ISARIC WHO Clinical Characterisation Protocol UK.Lancet Respir Med. 2021; 9: 699-711Google Scholar Our recent STOIC study13Ramakrishnan S Nicolau Jr, DV Langford B et al.Inhaled budesonide in the treatment of early COVID-19 ( STOIC): a phase 2, open-label, randomised controlled trial.Lancet Respir Med. 2021; 9: 763-772Google Scholar investigated inhaled budesonide, a corticosteroid, as a treatment for early SARS-CoV-2 infection with positive findings in improvement of self-reported symptom recovery, with fewer patients experiencing adverse outcomes and less symptom persistence. This finding was replicated in a large phase 3 efficacy trial ( PRINCIPLE),14Yu LM Bafadhel M Dorward J et al.Inhaled budesonide for COVID-19 in people at high risk of complications in the community in the UK ( PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial.Lancet. 2021; 398: 843-855Google Scholar but has yet to be adopted globally. The mechanism for how inhaled corticosteroids can improve early COVID-19 is currently unknown.
Research in contextEvidence before this studyAlmost all patients with COVID-19 have an early prodromic illness and some develop severe COVID-19 illness requiring hospital care. There is a widespread view that the symptoms in early COVID-19 reflect a viral replication phase, whereas the severe hospitalised phase of the illness reflects an inflammatory phase of COVID-19. We searched PubMed with search terms “ early COVID-19 ”, “ SARS-CoV-2 ”, “ respiratory inflammation ”, “ inhaled steroids ”, “ mechanism ”, and “ clinical trials ”, from database inception to July 19, 2021, for studies published in English. Two community based randomised clinical trials ( STOIC and PRINCIPLE) have shown that treating patients within 7 or 14 days of symptom onset with inhaled budesonide reduced the time to symptom resolution and reduced the risk of increase health-care resource utilisation. The early respiratory inflammatory manifestation following SARS-CoV-2 virus infection and mechanism of efficacy of inhaled budesonide is unknown.Added value of this studyTo our knowledge, the STOIC study is the only study to have sampled the nasal mucosa in early COVID-19, both at the early stages of the illness and following 2 weeks of study follow-up. Sampling was done routinely and prospectively on all trial participants, avoiding any sampling bias. Contrary to the prevailing view that inflammation occurs in the later, more severe stage of disease, there is a marked inflammation in the airway in early COVID-19. This effect was observed across viral response proteins, and T-helper 1 ( Th1) lymphocyte and T-helper 2 ( Th2) lymphocyte pathways. In patients with COVID-19 not treated with budesonide, there was persistently raised interferon and eosinophil chemokines. Interestingly, in patients with COVID-19 who met the primary endpoint ( ie, clinical deterioration measured by urgent care visits), there was a muted early inflammatory response, except for raised eosinophil chemokines, followed by a severe second peak of inflammation. Budesonide treatment attenuated the eosinophil chemokine-driven inflammation, reduced the peak of the interferon and Th1 and Th2 lymphocyte-related inflammatory pathways, in addition to modulating inflammation in the respiratory tract and in the circulation. To our knowledge, this is the first study on the nasal mucosa and inflammatory markers in early disease and the first to investigate the mechanism of treatments used to treat COVID-19, which has determined potential biomarkers that can predict worsening COVID-19.Implication of the all the available evidenceMany drugs were repurposed during the COVID-19 pandemic. Although some of these medications have been shown to be effective, there is little known about the mechanistic mode of action. This study provides further scientific validity to the STOIC trial, with prospectively and longitudinally collected airway samples showing that inhaled budesonide effectively altered the airway mucosal and the systemic inflammatory pattern. Inhaled corticosteroids are therefore efficacious in treating early COVID-19.
Almost all patients with COVID-19 have an early prodromic illness and some develop severe COVID-19 illness requiring hospital care. There is a widespread view that the symptoms in early COVID-19 reflect a viral replication phase, whereas the severe hospitalised phase of the illness reflects an inflammatory phase of COVID-19. We searched PubMed with search terms “ early COVID-19 ”, “ SARS-CoV-2 ”, “ respiratory inflammation ”, “ inhaled steroids ”, “ mechanism ”, and “ clinical trials ”, from database inception to July 19, 2021, for studies published in English. Two community based randomised clinical trials ( STOIC and PRINCIPLE) have shown that treating patients within 7 or 14 days of symptom onset with inhaled budesonide reduced the time to symptom resolution and reduced the risk of increase health-care resource utilisation. The early respiratory inflammatory manifestation following SARS-CoV-2 virus infection and mechanism of efficacy of inhaled budesonide is unknown.
To our knowledge, the STOIC study is the only study to have sampled the nasal mucosa in early COVID-19, both at the early stages of the illness and following 2 weeks of study follow-up. Sampling was done routinely and prospectively on all trial participants, avoiding any sampling bias. Contrary to the prevailing view that inflammation occurs in the later, more severe stage of disease, there is a marked inflammation in the airway in early COVID-19. This effect was observed across viral response proteins, and T-helper 1 ( Th1) lymphocyte and T-helper 2 ( Th2) lymphocyte pathways. In patients with COVID-19 not treated with budesonide, there was persistently raised interferon and eosinophil chemokines. Interestingly, in patients with COVID-19 who met the primary endpoint ( ie, clinical deterioration measured by urgent care visits), there was a muted early inflammatory response, except for raised eosinophil chemokines, followed by a severe second peak of inflammation. Budesonide treatment attenuated the eosinophil chemokine-driven inflammation, reduced the peak of the interferon and Th1 and Th2 lymphocyte-related inflammatory pathways, in addition to modulating inflammation in the respiratory tract and in the circulation. To our knowledge, this is the first study on the nasal mucosa and inflammatory markers in early disease and the first to investigate the mechanism of treatments used to treat COVID-19, which has determined potential biomarkers that can predict worsening COVID-19.
Many drugs were repurposed during the COVID-19 pandemic. Although some of these medications have been shown to be effective, there is little known about the mechanistic mode of action. This study provides further scientific validity to the STOIC trial, with prospectively and longitudinally collected airway samples showing that inhaled budesonide effectively altered the airway mucosal and the systemic inflammatory pattern. Inhaled corticosteroids are therefore efficacious in treating early COVID-19.
Here, we report the nasal mucosal inflammatory response in patients with early COVID-19 disease and examine the evolution of inflammation in the natural course of COVID-19 in patients from the STOIC study. We also identify how inflammation in the airway can predict illness severity and investigate the effect of inhaled budesonide on the respiratory mucosa in early COVID-19 disease. Finally, we show, by use of network analysis, how inhaled budesonide can resolve the exaggerated inflammatory response observed in early SARS-CoV-2 infection and aim to restore health.
In this experimental analysis, we report on measures of inflammation using nasal mucosal lining fluid samples and serum samples collected during the STOIC trial. STOIC was a randomised, open-label, parallel group, phase 2 clinical intervention trial, which has been previously published.13Ramakrishnan S Nicolau Jr, DV Langford B et al.Inhaled budesonide in the treatment of early COVID-19 ( STOIC): a phase 2, open-label, randomised controlled trial.Lancet Respir Med. 2021; 9: 763-772Google Scholar In brief, participants aged 18 years or older with early COVID-19 symptoms ( defined as new onset of cough, fever, anosmia, or a combination of these symptoms for less than 7 days) were randomly assigned ( 1:1) to receive usual care ( as needed antipyretics) or inhaled budesonide at a dose of 800 μg twice a day plus usual care. Participants were seen by nurses at home at randomisation ( day 0) and day 14, when self-performed nasosorption was collected. At day 28, whole blood was collected. Full details of the study design can be found in the appendix ( p 4). Participants provided written informed consent. The STOIC study was approved by the Fulham London Research Ethics Committee ( 20/HRA/2531) and the National Health Research Authority.
Healthy controls were adults aged 18 years or older without any known history of lung disease or COVID-19 symptoms ( including negative COVID-19 antigen tests done on the day of nasal epithelial lining fluid and blood sampling), recruited from a long-term observational data collection study at the University of Oxford ( ethics reference 18/SC/0361). Healthy controls were used as a comparator to evaluate inflammation in the healthy upper respiratory tract.
For this experimental analysis, nasal mucosal lining fluid was collected at days 0 and day 14 after randomisation with a nasosorption FX.I device ( Hunt Developments UK, London, UK), consisting of a synthetic absorptive matrix strip against the inferior turbinate, for 1 min. Whole blood was collected at day 28 after randomisation and was allowed to clot for 60 min at room temperature. RNA was extracted using the QIAamp Viral RNA Mini Kit ( Qiagen, MD, USA) following manufacturer's instructions, and testing for SARS-CoV-2 infection was done by quantitative real-time RT-PCR. Full details of sample collection and processing is in the appendix ( p 1).
Immunoassays of mediators were selected to represent putative mechanistic inflammatory pathways associated with respiratory virus infections, and thus COVID-19,15Lucas C Wong P Klein J et al.Longitudinal analyses reveal immunological misfiring in severe COVID-19.Nature. 2020; 584: 463-469Google Scholar, 16Morton B Barnes KG Anscombe C et al.Distinct clinical and immunological profiles of patients with evidence of SARS-CoV-2 infection in sub-Saharan Africa.Nat Commun. 2021; 123554Google Scholar, 17Thwaites RS Sanchez Sevilla Uruchurtu A Siggins MK et al.Inflammatory profiles across the spectrum of disease reveal a distinct role for GM-CSF in severe COVID-19.Sci Immunol. 2021; 6eabg9873Google Scholar and were quantified using MSD ( Meso Scale Diagnostics, Rockville, MD, USA). All values at or below the lower limit of detection ( LLOD) or above the upper limit of detection ( ULOD) were replaced by the LLOD or ULOD value as suggested by the assay parameters and are shown in the appendix ( p 16). The mediator transforming growth factor beta-1 ( TGFB1) was not done in the control samples because of assay unavailability.
We investigated the nasal mucosal inflammatory response in patients with early COVID-19 disease from samples collected in the STOIC study at an early timepoint of disease onset ( ie, within 7 days of symptoms) and compared it with the nasal mucosal inflammatory response in healthy controls. We also assessed the natural course of inflammatory response by evaluating resolution of inflammation in participants of the STOIC study comparing inflammation at an early timepoint and 14 days after study randomisation. Our analysis provides insight of mucosal inflammation following SARS-CoV-2 infection, which is predictive of worsening of COVID-19 illness. Finally, we studied the effect of treatment with inhaled budesonide on nasal mucosal inflammation compared with usual care and determined how budesonide resolves the exaggerated inflammatory response.
To illustrate the temporal trends in inflammatory mediator concentrations in the usual care and budesonide study groups, we plotted smoothed splines of longitudinal mediator concentration data, using raw pg/mL data and the date from which symptoms started. This spline best-fit curve analysis assesses kinetic inflammatory changes over the disease course of early COVID-19 disease ( represented in this study by the usual care study group) and with inhaled corticosteroids intervention ( budesonide study group). Spline analysis considers the timing of the first symptom and gives an indication of peak of inflammation and resolution. The spline analysis was performed on all inflammatory mediators. Heatmaps were drawn to visualise data as a magnitude of change of all inflammatory mediators between healthy controls, early COVID-19 disease ( day 0), and longitudinal ( day 14) follow-up in usual care and budesonide treatment study groups. Inflammatory mediator data were standardised between mediators by calculating Z scores ( using mean and SD from raw mediator values [ pg/mL ]).18Del Valle DM Kim-Schulze S Huang HH et al.An inflammatory cytokine signature predicts COVID-19 severity and survival.Nat Med. 2020; 26: 1636-1643Google Scholar
Volcano plots were drawn to illustrate in a scatterplot the magnitude of change ( fold change, x-axis), against the statistical significance of that change ( log10 of p value, y-axis). These were drawn for all mediators against the following conditions: comparison of inflammation in health and early COVID-19 ( healthy controls against early COVID-19); the evolution of inflammation in the usual care study group ( day 0 and day 14); the evolution of inflammation in the budesonide study group ( day 0 and day 14); and comparison of day 0 inflammation in patients that deteriorated with COVID-19 ( reaching primary endpoint) compared with those who did not deteriorate. Mann-Whitney or Wilcoxon signed-rank test was performed for unpaired or paired analysis for the magnitude of change. Serum samples were analysed with the Kruskall-Wallis test with post-hoc Dunn's multiple comparison test performed on all mediators.
To further elucidate the patterns of interactions between all inflammatory mediators in COVID-19 in the usual care and budesonide study groups, network analysis and visualisation software were developed in-house using MATLAB version 2021. We studied correlation matrices of mediator responses across the study groups, removing the noise eigenvalues and thus building up error-free mediator–mediator interaction networks. We then analysed these matrices to find modules of mediators that are interconnected with each other and relatively unconnected to other modules.
p values of less than 0·05 were considered statistically significant. All statistical analyses used GraphPad Prism version 9.0.0 and MATLAB version 2021. Full details of the network statistical analysis are presented in the appendix ( p 2).
The STOIC trial was registered with ClinicalTrials.gov, NCT04416399.
The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
The STOIC study recruited 146 participants aged 18–79 years ( mean 45 years [ SD 13 ]) with a median duration of COVID-19 symptoms of 3 days ( IQR 2–5). 140 nasal mucosal samples were available at day 0 ( randomisation, visit 1) and 122 samples after 14 days ( visit 3). At day 28 ( visit 4), whole blood was collected from 123 participants ( 62 in the budesonide group, 61 in the usual care group). The healthy control cohort consisted of 20 samples from 20 healthy individuals. The demographics of the healthy volunteers and COVID-19 STOIC participants are presented in the appendix ( p 15). Time to self-reported clinical recovery for all participants in the STOIC study was a mean of 9 days ( SD 6).
We examined the inflammatory profile of nasal mucosal fluid in healthy controls and early COVID-19 ( figure 1A). We found that 16 mediators were increased in all patients infected with COVID-19 in both treatment groups compared with controls. These mediators were T-helper-type 1 ( Th1) cytokines ( interleukin [ IL ] -2, IL-12, tumour necrosis factor [ TNF ] -α, and IL-6,), T-helper-type 2 ( Th2) cytokines ( IL-4), interferon response proteins ( interferon [ IFN ] -α2a, IFN-β, IFN-γ, CXC chemokine ( CXC) L10, CXCL9, and CXCL11), and other chemokines ( CC chemokine ligand ( CCL) 3, CCL4, CCL5, CCL11, and CCL13; figure 1B). An altered T-cell response with statistically significantly reductions in concentrations of thymic stromal lymphopoietin ( TSLP) and CCL17 was also found in these patients; CCL2 concentrations were also decreased, related to impaired monocyte recruitment ( figure 1B). Patients with COVID-19 also had lower concentration of vascular endothelial growth factor ( VEGF; figure 1B). Some mediators were unaltered ( IL-1β, IL-33, CCL24, CCL26, IL-5, granulocyte-macrophage colony-stimulating factor [ GM-CSF ], and IL-10; figure 1B), highlighting less activation during early COVID-19. CXCL8 was unchanged between health and early COVID-19.Figure 1Immunological features of the nasal mucosa in patients with early COVID-19 over time in the STOIC studyShow full captionA) Heatmap and B) volcano plot of 26 nasal mediators from 20 healthy individuals and 140 patients with community-based early COVID-19. C) Heatmap and D) volcano plot of 30 nasal mediators from patients with community based early COVID-19 at day 0 after enrolment in the trial and day 14 in the usual care group ( n=60). E) Heatmap and F) volcano plot of 30 nasal mediators from patients with community based COVID-19 at days 0 and 14 in the budesonide group ( n=62). Horizontal dotted line on volcano plots depicts the cutoff for statistical significance; the vertical dotted line represents the cutoff point determining whether mediator concentrations were higher significantly ( right, red) or lower ( left, blue) for day 14 samples compared with either healthy controls ( unpaired) or paired day 14 samples. Black dots represent changes in mediator concentration. Data were analysed using Mann-Whitney t-test or Wilcoxon matched pairs signed rank test. IL=interleukin. TNF=tumour necrosis factor. IFN=interferon. TSLP=thymic stromal lymphopoietin. CXCL=CXC chemokine ligand. CCL=CC chemokine ligand. GM-CSF=granulocyte-macrophage colony-stimulating factor. VEGF=vascular endothelial growth factor. PDGF=platelet-derived growth factor. TGF=transforming growth factor.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
A) Heatmap and B) volcano plot of 26 nasal mediators from 20 healthy individuals and 140 patients with community-based early COVID-19. C) Heatmap and D) volcano plot of 30 nasal mediators from patients with community based early COVID-19 at day 0 after enrolment in the trial and day 14 in the usual care group ( n=60). E) Heatmap and F) volcano plot of 30 nasal mediators from patients with community based COVID-19 at days 0 and 14 in the budesonide group ( n=62). Horizontal dotted line on volcano plots depicts the cutoff for statistical significance; the vertical dotted line represents the cutoff point determining whether mediator concentrations were higher significantly ( right, red) or lower ( left, blue) for day 14 samples compared with either healthy controls ( unpaired) or paired day 14 samples. Black dots represent changes in mediator concentration. Data were analysed using Mann-Whitney t-test or Wilcoxon matched pairs signed rank test. IL=interleukin. TNF=tumour necrosis factor. IFN=interferon. TSLP=thymic stromal lymphopoietin. CXCL=CXC chemokine ligand. CCL=CC chemokine ligand. GM-CSF=granulocyte-macrophage colony-stimulating factor. VEGF=vascular endothelial growth factor. PDGF=platelet-derived growth factor. TGF=transforming growth factor.
We examined nasal mucosal inflammation during the course of disease ( ie, in the usual care group), examining paired samples from the usual care group population at day 0 and day 14 ( n=60; figure 1C). Over the course of 14 days, concentrations of CXCL9, CXCL10, CXCL11, IL-12, IL-10, IL-2, IFN-α2a, CCL2, CCL3, CCL4, IL-6, IL-4, CCL13, and TNF-α statistically significantly decreased. Of the 16 mediators elevated in early COVID-19 compared with healthy controls, 11 decreased over time ( CCL3, CCL4, TNF-α, IL-6, CCL13, IL-4, IFN-α2a, CXCL10, CXCL11, IL-2, and IL-12). CCL11, IFN-β, and IFN-γ did not significantly change between day 0 and day 14 and remained elevated after 14 days in patients with COVID-19 in the usual care group compared with healthy volunteers. VEGF, TSLP, and CCL17 concentrations were unchanged over time in patients with COVID-19, remaining lower than those measured in healthy volunteers, but CCL2 and IL-10 concentrations significantly reduced further compared with day 14 ( figure 1C and figure 1D). IL-1β, CXCL8, IL-33, CCL24, CCL26, IL-5, and GM-CSF did not show any changes between the two study visits over time.
To investigate the potential mechanisms of how budesonide reduces time to clinical recovery in patients with COVID-19, we examined the concentrations of 30 mediators in paired day 0 and day 14 samples in the inhaled budesonide group of the STOIC trial ( n=62, figure 1E). Of the mediators examined, those that were different to the natural course of early COVID-19 disease ( as described for the usual care group), IL-33 and IFN-γ were significantly reduced, CCL17 concentrations were significantly increased, and CCL13 was no longer significantly reduced between the two visits ( figure 1F). The delta change between paired visits in the usual care study group and the budesonide study group showed that budesonide treatment significantly reduced IL-33 and IFN-γ with increased concentrations of CCL17, whereas CCL13 was no longer significantly reduced ( additional data in appendix p 5). As all day 0 samples were obtained before randomisation to the study groups, we also compared both the usual care group and budesonide group day 14 samples with all day 0 samples to assess the return to health. We found that, following treatment with inhaled budesonide, CCL5 was significantly reduced, but not GM-CSF; concentrations of IL-2 and IL-4 were sustained ( ie, did not decrease), despite decreasing in the usual care group ( appendix pp 6–8). As the median time to clinical recovery was 1 day shorter in the budesonide study treatment group than in with the usual care study treatment group, these changes in the concentrations of these mediators might explain differences in the recovery and the part played in the disease course of COVID-19.
SARS-CoV-2 viral load and nasal mucosal mediator measurements were available in 122 paired samples at randomisation ( day 0). We found that IFN-α2a, CXCL10, CXCL11, IL-12, CCL2, and IL-6 correlated with viral load ( appendix p 17).
To assess whether the inflammation associated with SARS-CoV-2 infection declined over time to concentrations similar to healthy individuals, we compared our healthy cohort to the day 14 samples of the usual care and budesonide study groups ( figure 2A). In both usual care and budesonide groups, compared with healthy controls, IL-2, CCL11, IL-4, TNF-α, IFN-β, IFN-γ, and CXCL11 remained significantly elevated over time, whereas CCL3, CCL4, IL-6, CCL13, IFN-α2a, CXCL11, and IL-12 reduced to comparable healthy concentrations ( figure 2B). CCL2 and TSLP remained significantly lower in both study groups than in healthy volunteers. The concentration of CCL17 was increased in the budesonide study group over time and did not return to healthy concentrations. IL-10 significantly decreased over time in the usual care study group but not in the budesonide study group ( figure 2B), indicating a sustained anti-inflammatory response in patients treated with inhaled budesonide.Figure 2Temporal changes in mediator concentrations in the usual care and budesonide groupsShow full captionA) Heatmap of 26 nasal mediators from 20 healthy individuals compared with samples at day 14 after recruitment ( day 14) in the usual care group ( n=60) and the budesonide group ( n=62). B) List of significantly altered mediators compared with healthy controls at day 14 in both usual care and budesonide groups. C–E) Longitudinal analysis of mediator profiles in the usual care and budesonide groups displayed as representative best fit curves by smoothed spline analysis. Additional data are presented in appendix ( p 9). IL=interleukin. TNF=tumour necrosis factor. IFN=interferon. TSLP=thymic stromal lymphopoietin. CXCL=CXC chemokine ligand. CCL=CC chemokine ligand. GM-CSF=granulocyte-macrophage colony-stimulating factor. VEGF=vascular endothelial growth factor. PDGF=platelet-derived growth factor. TGF=transforming growth factor.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
A) Heatmap of 26 nasal mediators from 20 healthy individuals compared with samples at day 14 after recruitment ( day 14) in the usual care group ( n=60) and the budesonide group ( n=62). B) List of significantly altered mediators compared with healthy controls at day 14 in both usual care and budesonide groups. C–E) Longitudinal analysis of mediator profiles in the usual care and budesonide groups displayed as representative best fit curves by smoothed spline analysis. Additional data are presented in appendix ( p 9). IL=interleukin. TNF=tumour necrosis factor. IFN=interferon. TSLP=thymic stromal lymphopoietin. CXCL=CXC chemokine ligand. CCL=CC chemokine ligand. GM-CSF=granulocyte-macrophage colony-stimulating factor. VEGF=vascular endothelial growth factor. PDGF=platelet-derived growth factor. TGF=transforming growth factor.
In general, temporal trends in mediator concentrations in each group showed that peak inflammation occurred early in the disease course ( figures 2C–E, appendix p 9). Additionally, IL-4, IL-12, IL-2, CXCL10, platelet derived growth factor subunit A ( PDGFA), and IFN-α2a kinetic changes were similar between the natural course of early COVID-19 and inhaled budesonide. However, inhaled budesonide supressed kinetic inflammation and in particular a secondary increase in inflammation beyond day 15 ( as seen with TNF-α, GM-CSF, and CCL5). IFN-γ increased following inhaled budesonide at day 15.
11 participants met the primary outcome for deterioration in the STOIC clinical trial ( defined as needing urgent care assessment, emergency care consultation, hospitalisation, or a combination of these outcomes), with 70% needing oxygen treatment. In comparison with healthy individuals, participants with early COVID-19 who met the primary outcome ( ten in the usual care group and one in the budesonide group) had an increase of CCL3, CCL5, TNF-α, IFN-α2a, IFN-β, CXCL10, CXCL11, CCL11, and CCL24, but a reduction of CCL2, TSLP, CCL17, IL-10, GM-CSF, CXCL9, and IL-33 ( figure 3A). However, there was an initial differential mediator response in participants who deteriorated compared with those who did not deteriorate following SARS-COV-2 infection. Firstly, there was no increase in CCL4, IL-12, IFN-γ, IL-4, CCL13, IL-2, and IL-6 in patients who deteriorated ( figure 3H), showing an impaired inflammatory response. Secondly, there was a reduction in IL-10, IL-33, and GM-CSF in the primary outcome group. Finally, CCL24 concentrations were increased in participants who met the primary outcome, confirming that a high eosinophilic phenotype is associated with severe disease. Specifically, in participants who had clinical deterioration, the time course spline analysis showed that there was an aberrant immune response during the early part of SARS-CoV-2 infection ( appendix pp 10–11), with significant downregulation of GM-CSF, IL-10, IL-12, IL-2, IFN-α2a, and IL-33 ( figure 3B–G), suggesting a blunted early response to infection occurs in patients who then deteriorate. In one participant, who needed critical care support ( usual care study group), longitudinal nasal sampling was available giving insight into course of the disease in a more severe patient. The interferon response proteins, CCL5, CXCL9, and CXCL10, remained elevated and CXCL11 decreased. Concentrations of the inflammatory markers IL-1β, IL-33, and IL-6 also increased over time ( figure 3I, appendix p 12), illustrating persistent inflammation and epithelial damage.Figure 3Alterations in nasal mucosal inflammation in patients with early COVID-19 who clinically deteriorateShow full captionA) Volcano plot of 26 nasal mediators from 20 healthy individuals and 11 patients who met the primary outcome of the study. Red dots represent significantly increased mediator concentrations, blue dots sifnificantly decreases, and black dots no changes. B–G) Significantly altered mediators at day 0 from patients with early COVID-19 ( n=129) and those who met the primary outcome ( n=11). B) GM-CSF. C) IL-10. D) IL-12. E) IL-2. F) IFN-α2a. G) IL-33. H) Comparison table of significantly altered mediators from nasal samples comparing healthy volunteers ( n=20) and patients with early COVID-19 ( n=129) without deterioration and with COVID-19 with deterioration ( n=11). I) Change in concentrations of 30 mediators from day 0 to day 14 of 1 patient who required critical care respiratory support ( see appendix p 12 for heatmap). Data were analysed using Mann-Whitney t-test. IL=interleukin. TNF=tumour necrosis factor. IFN=interferon. TSLP=thymic stromal lymphopoietin. CXCL=CXC chemokine ligand. CCL=CC chemokine ligand. GM-CSF=granulocyte-macrophage colony-stimulating factor. VEGF=vascular endothelial growth factor. PDGF=platelet-derived growth factor. TGF=transforming growth factor.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
A) Volcano plot of 26 nasal mediators from 20 healthy individuals and 11 patients who met the primary outcome of the study. Red dots represent significantly increased mediator concentrations, blue dots sifnificantly decreases, and black dots no changes. B–G) Significantly altered mediators at day 0 from patients with early COVID-19 ( n=129) and those who met the primary outcome ( n=11). B) GM-CSF. C) IL-10. D) IL-12. E) IL-2. F) IFN-α2a. G) IL-33. H) Comparison table of significantly altered mediators from nasal samples comparing healthy volunteers ( n=20) and patients with early COVID-19 ( n=129) without deterioration and with COVID-19 with deterioration ( n=11). I) Change in concentrations of 30 mediators from day 0 to day 14 of 1 patient who required critical care respiratory support ( see appendix p 12 for heatmap). Data were analysed using Mann-Whitney t-test. IL=interleukin. TNF=tumour necrosis factor. IFN=interferon. TSLP=thymic stromal lymphopoietin. CXCL=CXC chemokine ligand. CCL=CC chemokine ligand. GM-CSF=granulocyte-macrophage colony-stimulating factor. VEGF=vascular endothelial growth factor. PDGF=platelet-derived growth factor. TGF=transforming growth factor.
Serum inflammatory mediators up to 35 days after initial infection remained elevated compared with healthy controls ( figure 4A–F, appendix p 13). These mediators included higher concentrations of TNF-α, CXCL8, and the family of eosinophil chemotactic proteins ( CCL11, CCL24, CCL26). This systemic inflammation was supressed to a greater degree by inhaled budesonide for CCL11, TNF-α, and IL-33.Figure 4Persistence of systemic inflammation following 28–35 days of COVID-19 in the communityShow full captionViolin plots comparing some mediator concentrations in the serum of healthy individuals ( n=20), those in the usual care group ( n=61), and those in the budesonide group ( n=62) of the study at 28–35 days following COVID-19 ( see appendix p 13 for further results). ( A) CCL11. ( B) CCL13. ( C) VEGF. ( D) TSLP. ( E) TNF-α. ( F) IL-6. Data were analysed by Kruskal-Wallis with post-hoc Dunn's test. IL=interleukin. TNF=tumour necrosis factor. TSLP=thymic stromal lymphopoietin. CCL=CC chemokine ligand. VEGF=vascular endothelial growth factor.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Violin plots comparing some mediator concentrations in the serum of healthy individuals ( n=20), those in the usual care group ( n=61), and those in the budesonide group ( n=62) of the study at 28–35 days following COVID-19 ( see appendix p 13 for further results). ( A) CCL11. ( B) CCL13. ( C) VEGF. ( D) TSLP. ( E) TNF-α. ( F) IL-6. Data were analysed by Kruskal-Wallis with post-hoc Dunn's test. IL=interleukin. TNF=tumour necrosis factor. TSLP=thymic stromal lymphopoietin. CCL=CC chemokine ligand. VEGF=vascular endothelial growth factor.
Network analysis of inflammatory mediators in the nasal mucosa and serum showed an anti-inflammatory response ( IL-10 upregulation) and T2 inflammatory ( CCL11 and CCL24 upregulation) response with co-existent inflammation ( upregulation of IL-6 and CXCL8) in early COVID-19 ( figure 5A-1). 2 weeks after initial infection, the natural course of COVID-19 shows persistent nasal mucosal inflammation with an exaggerated T2 inflammatory response ( CCL11 and IL-5) and a sustained pro-inflammatory response ( figure 5A-2). In the usual care study group, network analysis showed a 72% overlap between the inflammatory response during the first 7 days of COVID-19 symptom onset and at day 14 after randomisation, indicating persistent inflammation of similar immune pathways. Following inhaled budesonide treatment, the nasal mucosal response is different with an increased anti-inflammatory response ( IL-10) and alarmins ( IL-33 and TSLP), but a reduced T2 inflammatory response highlighting normalisation of the anti-viral immune response and the T2 hyper-inflammatory response. The overlap between the inflammatory response at an early timepoint in COVID-19 and at the later timepoint was only 27% in the budesonide study group ( figure 5A-3). Network analysis of serum mediators performed between 28 and 35 days after initial infection in the usual care study group shows persistent IFN-α2a, CCL11, and CCL2 ( figure 5B-1). There was only a 30% overlap with the serum of participants that had been treated with inhaled budesonide ( figure 5B-2) again indicating immunomodulation.Figure 5Network analysis of mediator correlation dataShow full caption ( A) Modularity maximisation and community detection for eigenvalue-based noise-cleaned nasal mucosal mediator data. ( A1) Networks at initial SARS-CoV-2 infection. ( A2) Networks after 14 days of initial SARS-CoV-2 infection. ( A3) Networks after treatment with inhaled budesonide. Node size indicates eigenvalue centrality and arcs indicate non-zero noise-cleaned correlation. There are four modules of roughly equal size in each network. A1 and A2 are similar with 72% overlap indicating persistent relationship of inflammation over time. A1 and A3 have 27% overlap ( which would be expected by a chance reassignment of nodes to the four modules) indicating that treatment with inhaled budesonide changes the inflammatory networks entirely. ( B) Modularity maximisation and community detection for eigenvalue-based noise-cleaned serum data in participants from 28 to 35 days following SARS-CoV-2 infection. ( B1) Network analysis of serum from participants in the usual care group. ( B2) Network analysis of serum from participants in the budesonide group. The two networks are entirely different in terms of membership with 30% overlap ( equivalent to a random node reassignment to modules). The network analysis shown here suggests that budesonide treatment dramatically rearranged the mediator pathways in serum. CCL=CC chemokine ligand. CRP=C-reactive protein. CXCL=CXC chemokine ligand. GM-CSF=granulocyte-macrophage colony-stimulating factor. IFN=interferon. IL=interleukin. PDGF=platelet-derived growth factor. TGF=transforming growth factor. TNF=tumour necrosis factor. TSLP=thymic stromal lymphopoietin. VEGF=vascular endothelial growth factor. vWF=von Willebrand factor.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
( A) Modularity maximisation and community detection for eigenvalue-based noise-cleaned nasal mucosal mediator data. ( A1) Networks at initial SARS-CoV-2 infection. ( A2) Networks after 14 days of initial SARS-CoV-2 infection. ( A3) Networks after treatment with inhaled budesonide. Node size indicates eigenvalue centrality and arcs indicate non-zero noise-cleaned correlation. There are four modules of roughly equal size in each network. A1 and A2 are similar with 72% overlap indicating persistent relationship of inflammation over time. A1 and A3 have 27% overlap ( which would be expected by a chance reassignment of nodes to the four modules) indicating that treatment with inhaled budesonide changes the inflammatory networks entirely. ( B) Modularity maximisation and community detection for eigenvalue-based noise-cleaned serum data in participants from 28 to 35 days following SARS-CoV-2 infection. ( B1) Network analysis of serum from participants in the usual care group. ( B2) Network analysis of serum from participants in the budesonide group. The two networks are entirely different in terms of membership with 30% overlap ( equivalent to a random node reassignment to modules). The network analysis shown here suggests that budesonide treatment dramatically rearranged the mediator pathways in serum. CCL=CC chemokine ligand. CRP=C-reactive protein. CXCL=CXC chemokine ligand. GM-CSF=granulocyte-macrophage colony-stimulating factor. IFN=interferon. IL=interleukin. PDGF=platelet-derived growth factor. TGF=transforming growth factor. TNF=tumour necrosis factor. TSLP=thymic stromal lymphopoietin. VEGF=vascular endothelial growth factor. vWF=von Willebrand factor.
In this study, we examined the inflammatory effect of SARS-CoV-2 on the upper airway at a very early timepoint during the course of COVID-19 disease13Ramakrishnan S Nicolau Jr, DV Langford B et al.Inhaled budesonide in the treatment of early COVID-19 ( STOIC): a phase 2, open-label, randomised controlled trial.Lancet Respir Med. 2021; 9: 763-772Google Scholar and followed patients over the evolutionary course of SARS-CoV-2 infection. Our findings show that there is an early activated and enhanced immune response in early COVID-19 in the upper airway. We have also shown that we might be able to predict which patients will clinically deteriorate, by noting that they have a blunted interferon and an exagerated CCL24 airway inflammatory response. This finding has value in the early identification, monitoring, and therapeutics of this population by using biomarkers from the nose to detect the patients who might get worse. We have also found that there is persistent systemic inflammation in COVID-19, which can be measured up to 35 days after the initial infection and past the median time of clinical recovery. Finally, network analysis has shown that patterns of inflammation and inflammatory pathways in the airway and circulation are modified significantly following treatment with inhaled budesonide. These findings suggest that inhaled budesonide modulates the inflammatory pathways in the upper respiratory tract and circulation following COVID-19 infection ( appendix p 14).
Due to the nature of the STOIC study13Ramakrishnan S Nicolau Jr, DV Langford B et al.Inhaled budesonide in the treatment of early COVID-19 ( STOIC): a phase 2, open-label, randomised controlled trial.Lancet Respir Med. 2021; 9: 763-772Google Scholar design, we were able to examine the kinetics of inflammation between patients with early COVID-19 and in patients who received inhaled budesonide as a treatment intervention. We found that, in early COVID-19, there is upregulation of inflammation, which does not return to levels observed in healthy patients over time. Furthermore, mediators such as VEGF were found to be lower in the respiratory tract in early disease as previously found in severe COVID-19.19Morton B Barnes KG Anscombe C et al.Distinct clinical and immunological profiles of patients with evidence of SARS-CoV-2 infection in sub-Saharan Africa.Nat Commun. 2021; 123554Google Scholar Examination of the mediator temporal relationship showed that there was often a biphasic peak of inflammatory mediators, which is staggered and persists over time. Importantly, however, we found that in patients given inhaled budesonide, the inflammatory peak was attenuated for TNF-α, GM-CSF, and CCL5, and promoted for IFN-γ. IFN-γ is an important promoter of anti-viral immunity20Lee AJ Ashkar AA The dual nature of type I and type II interferons.Front Immunol. 2018; 92061Google Scholar playing a role in the inhibition of viral replication in cells,21Murira A Lamarre A Type-I interferon responses: from friend to foe in the battle against chronic viral infection.Front Immunol. 2016; 7: 609Google Scholar suggesting that this is another mechanism for the efficacy of inhaled corticosteroids. Following inhaled budesonide treatment, the nasal mucosal response is different from that of the usual care group with an anti-inflammatory response ( IL-10), an increase in alarmins ( IL-33 and TSLP), and a reduction in the Th2 inflammatory response, which suggests the promotion of a normal anti-viral response and suppression of the exaggerated Th2 inflammatory response.
Our study suggests, unlike previous assumptions,22Mason RJ Thoughts on the alveolar phase of COVID-19.Am J Physiol Lung Cell Mol Physiol. 2020; 319: L115-L120Google Scholar that there is a vigorous and early immune response in the upper airway in patients who develop COVID-19. This response, in comparison with healthy controls, is an early combined type I and type II interferon response, pro-inflammatory response, and anti-inflammatory response. Interestingly, early in COVID-19, there is also a Th2 immune response, mediated mainly by CCL11 and IL-4. This early COVID-19 innate cytokine immune response leads to recruitment of eosinophils, natural killer cells, and macrophages, and is an immune response similar to that observed with other respiratory viruses.23Vareille M Kieninger E Edwards MR Regamey N The airway epithelium: soldier in the fight against respiratory viruses.Clin Microbiol Rev. 2011; 24: 210-229Google Scholar
We have found that, in patients in whom there was a clinical deterioration following SARS-CoV-2 infection, the initial inflammatory response in the airway is blunted with reduced concentrations of IL-2, IL-33, IL-12, and IFN-α2a, in comparison with patients with COVID-19 without deterioration. A blunted interferon response, as a feature of severe COVID-19, has previously been observed in the systemic circulation24Hadjadj J Yatim N Barnabei L et al.Impaired type I interferon activity and inflammatory responses in severe COVID-19 patients.Science. 2020; 369: 718-724Google Scholar and from in-vitro cell line transcription expression.25Blanco-Melo D Nilsson-Payant BE Liu WC et al.Imbalanced host response to SARS-CoV-2 drives development of COVID-19.Cell. 2020; 181 ( 45.e9): 1036Google Scholar As our study focused in early COVID-19, these findings suggest that an early impaired interferon response to COVID-19 could indicate a poor prognosis, potentially offering a strategy for early treatment for this at risk patient population. The identification of patients early and at high risk of deterioration could markedly improve clinical care for patients. Our findings might also suggest why treatment trials enhancing or attenuating specific inflammatory mediators might have larger treatment effects if given early, with an even greater likelihood of success if targeted to patients with a biological high risk. Interestingly, CCL24 was the only mediator that increased in patients who deteriorated following SARS-CoV-2 infection. The CCL subfamily of eosinophil chemotactic proteins ( CCL11, CCL24, and CCL26), along with IL-5, GM-CSF, and CCL5 are responsible for lung recruitment and activation of eosinophils.26Gleich GJ Mechanisms of eosinophil-associated inflammation.J Allergy Clin Immunol. 2000; 105: 651-663Google Scholar Recruitment of eosinophils to the lung is the most probable explanation for the reduced circulatory number of eosinophils observed as part of the clinical picture of severe COVID-19.27Zhou F Yu T Du R et al.Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.Lancet. 2020; 395: 1054-1062Google Scholar Furthermore, inhaled corticosteroids are recognised to be therapeutically effective in patients with an eosinophilic phenotype of airways disease.28Bafadhel M Pavord ID Russell REK Eosinophils in COPD: just another biomarker?.Lancet Respir Med. 2017; 5: 747-759Google Scholar The elevation of CCL24 in patients that subsequently deteriorated from our study validates that the high eosinophilic phenotype is associated with severe disease, which is in line with previously published findings.15Lucas C Wong P Klein J et al.Longitudinal analyses reveal immunological misfiring in severe COVID-19.Nature. 2020; 584: 463-469Google Scholar
Our study is also the first to show that there is ongoing inflammation in the circulation, over 4 weeks after SARS-CoV-2 infection, with elevated concentrations of IL-2, IL-6, CXCL8, CCL13, TNF-α, CCL11, CCL24, and CCL26. Persistent symptoms following SARS-CoV-2 infection have been identified as an emerging problem ( long COVID) 29Iyengar KP Jain VK Vaishya R Ish P Long COVID-19: an emerging pandemic in itself.Adv Respir Med. 2021; 89: 234-236Google Scholar and our study indicates that this issue might be underlined by persistent inflammation. To note, the airway and peripheral blood immune profile in severe COVID-19 is different from early infection.30Saris A Reijnders TDY Nossent EJ et al.Distinct cellular immune profiles in the airways and blood of critically ill patients with COVID-19.Thorax. 2021; 761010Google Scholar It is, therefore, plausible that the identification of inflammatory mediators in the systemic circulation is delayed compared with assessing samples proximal to the site of infection. The STOIC study showed that persistence of symptoms was significantly lower in patients given inhaled budesonide, suggesting that early inhaled corticosteroid treatment can improve symptoms of COVID-19 and might help to prevent the effects of long COVID. We found that TNF-α and CCL11 were significantly lower in the systemic circulation in patients who had been treated with inhaled budesonide compared with usual care, suggesting that these mediators could be key for future clinical targets, particularly against long COVID. Interestingly, patients with long COVID commonly report symptoms of breathlessness,31Sudre CH Murray B Varsavsky T et al.Attributes and predictors of long COVID.Nat Med. 2021; 27: 626-631Google Scholar and asthma has been found to be the only pre-existing comorbidity with an independent association of long COVID.31Sudre CH Murray B Varsavsky T et al.Attributes and predictors of long COVID.Nat Med. 2021; 27: 626-631Google Scholar Whether there is a pre-existing host or exaggeration of the Th2 phenotype that leads to long COVID warrants further investigation.
Our study provides a unique mechanistic insight into the host respiratory immune and inflammatory response to early COVID-19 and following a therapeutic intervention that has been shown to have clinical benefit in treating these patients.13Ramakrishnan S Nicolau Jr, DV Langford B et al.Inhaled budesonide in the treatment of early COVID-19 ( STOIC): a phase 2, open-label, randomised controlled trial.Lancet Respir Med. 2021; 9: 763-772Google Scholar, 14Yu LM Bafadhel M Dorward J et al.Inhaled budesonide for COVID-19 in people at high risk of complications in the community in the UK ( PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial.Lancet. 2021; 398: 843-855Google Scholar Notably, studies thus far have examined only a small number of airway samples from severe and hospitalised patients, often late in the disease course32Liao M Liu Y Yuan J et al.Single-cell landscape of bronchoalveolar immune cells in patients with COVID-19.Nat Med. 2020; 26: 842-844Google Scholar, 33Chua RL Lukassen S Trump S et al.COVID-19 severity correlates with airway epithelium–immune cell interactions identified by single-cell analysis.Nat Biotechnol. 2020; 38: 970-979Google Scholar or measured the immune response in the circulation.34Han H Ma Q Li C et al.Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors.Emerg Microbes Infect. 2020; 9: 1123-1130Google Scholar Moreover, these studies have focussed on transcriptional analysis, namely gene expression, which might not fully capture the protein environment. In contrast, our study is the first to examine protein concentration in the upper respiratory tract of patients with early COVID-19, thus providing a mechanistic insight into the host respiratory immune and inflammatory response to early COVID-19. The number of participants studied was based on the STOIC sample size, calculated for assessment of a clinical treatment endpoint. Although we did not conduct a formal sample size for an immunological endpoint, we can confirm that this analysis was suitably powered and that for any one single mediator the sample size we have is on average twice the number needed for an α of 0·05 and a β of 0·20 ( 80% power).
Our study has some limitations. Firstly, we did not obtain daily samples, nor did we obtain samples from the lower respiratory tract. However, to our knowledge, this is the first study to evaluate the respiratory tract in early COVID-19 and it is well recognised that the greatest abundance of angiotensin-converting enzyme 2 receptors is in the nasal mucosa35Hoffmann M Kleine-Weber H Schroeder S et al.SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor.Cell. 2020; 181 ( 80.e8): 271Google Scholar and thus our findings are relevant to the primary site of infection. Second, our analysis used raw mediator concentration data, and not log-transformed mediator data, which can overestimate the SD. However, this analysis was performed to avoid overinterpretation. Furthermore, we could not determine any changes in CXCL8 between health and early COVID-19 as would be expected, but this finding is likely to reflect assay sensitivity because CXCL8 was repeatedly over the limit of detection, occurring in over one third of healthy control samples and one half of COVID-19 samples. Third, the STOIC study was conducted in a community setting in Oxfordshire ( UK) and we recognise that our population were mainly white, despite our attempts to recruit ethnic minorities via advertisements and social media in local minority communities, such as places of worship. We believe, however, these inflammatory findings are likely to be independent of ethnicity,36Lacroix J Zheng C Goytom S Landis B Szalay-Quinodoz I Malis D Histological comparison of nasal polyposis in black African, Chinese and Caucasian patients.Rhinology. 2002; 40: 118-121Google Scholar but acknowledge further study is warranted. Fourth, our study has focused on inflammation in early COVID-19 and, therefore, does not allow the evaluation of severe symptoms and inflammation. Fifth, only 11 patients met the primary outcome for the STOIC trial, thus replication of CCL24 as an early biomarker for deterioration is warranted. Finally, we note that our healthy control sample size was small, in comparison to the STOIC sample size, but our evaluation here was primarily as a comparator. Recruitment of a bigger sample size of controls was limited due to assay availability and due to the third national lockdown in the UK. 21 ( 15%) of STOIC participants had a history of past or current ( but untreated) asthma, whereas none of the healthy controls by definition had a respiratory comorbidity. Although, the absence of respiratory comorbidities in the healthy controls might be noted as a limitation, our findings do show that the Th2 response to SARS-CoV-2 is similar across both individuals with or without respiratory disease.
To conclude, the initial observation of a significant under-representation of patients with obstructive lung disease ( asthma and COPD) with severe COVID-19 and the knowledge that treatment with inhaled corticosteroids is routinely used to prevent viral exacerbations was the founding hypothesis for the STOIC trial. We have observed that the clinical benefit of inhaled budesonide as treatment in early COVID-19 is a consequence of its inflammatory modulatory effect. Moreover, our study supports a potential airway biomarker to detect clinical deterioration of COVID-19 and possible therapeutic targets for long COVID.
JRB, MM, and SR were responsible for all sample collection, processing, and analysis. JRB, DVN, PJB, JLS, SPC, REKR, LED, and MB were responsible for data interpretation critical revision of the work. JRB and SPC verified the data. All authors had access to the raw data. All authors contributed to this manuscript and approved the final submission. The corresponding author had full access to all of the data and the final responsibility to submit for publication.
All data can be shared upon written request to the corresponding author. Matlab code will also be made available upon request.
SR reports grants and non-financial support from Oxford Respiratory National Institute for Health Research ( NIHR) Biomedical Research Centre ( BRC), during the conduct of the study; and non-financial support from AstraZeneca and personal fees from Australian Government Research Training Program, outside of the submitted work. LED reports grants from AstraZeneca and Boehringer-Ingelheim, outside of the submitted work. PJB reports grants and personal fees from AstraZeneca and Boehringer Ingelheim, and personal fees from Teva and Covis, during the conduct of the study. REKR reports grants from AstraZeneca, and personal fees from Boehringer Ingelheim, Chiesi UK, and GlaxoSmithKline, during the conduct of the study. MB reports grants from AstraZeneca; personal fees from AstraZeneca, Chiesi, and GlaxoSmithKline; and is a scientific advisor for Albus Health and ProAxsis, outside of the submitted work. JRB, SPC, MM, DVN, and JSL declare no competing interests.
The study was funded by the Oxford NIHR BRC and AstraZeneca ( Gothenburg, Sweden). The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR, or the Department of Health.
Download.pdf ( 1.66 MB) Help with pdf files Supplementary appendix
Inhaled corticosteroids: not just for asthma, but for COVID-19? A multipronged approach has been developed for the treatment of COVID-19 disease: antivirals and antibody therapy are effective during early infection when the SARS-CoV-2 load is high, whereas systemic steroids and cytokine blockade are best for the late inflammatory phase1–3 ( figure). In human challenge studies of respiratory syncytial virus infection, the pre-existing so-called immunological tone of the respiratory mucosa is crucial to the receptiveness of the mucosa to viral infection.4 However, so far, in SARS-CoV-2 infection, there has been little focus on altering the condition of the respiratory mucosa. Full-Text PDF | tech |
Takeaways from Bain’ s 2022 Asia-Pacific Private Equity Report |
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Bain's Kiki Yang, Hugh MacArthur, and Lars Verheyen discuss major themes from Bain's 2022 Asia-Pacific Private Equity Report.
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Despite the ongoing Covid-19 pandemic, countries in the Asia-Pacific region set new investment highs in 2021, successfully growing their economies and increasing investment value. In this webinar, Kiki Yang, Hugh MacArthur, and Lars Verheyen, partners in our Private Equity practice, launch Bain & Company’ s 2022 Asia-Pacific Private Equity Report. They provide key insights from the report, and discuss the state of the Asia-Pacific private equity market and the trends that are already changing the industry's landscape.
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© 1996-2022 Bain & Company, Inc. | business |
People wrongly believe their friends will protect them from COVID-19: False sense of safety may cause feelings of invulnerability, study finds -- ScienceDaily | During the two years of the COVID-19 pandemic, many people have become accustomed to spending time with their closest social circle, which may have unintended consequences, said study authors Hyunjung Crystal Lee, PhD, assistant professor of marketing, and Eline De Vries, PhD, associate professor of marketing, at the Universidad Carlos III de Madrid in Spain.
`` Friends and family can provide a sense of comfort, but it's irrational and dangerous to believe they will protect you from being infected by COVID-19, '' Lee said. `` This tendency that we call the 'friend-shield effect ' could intensify a false sense of safety and contribute to future infections. ''
De Vries and Lee conducted five online experiments with U.S. residents in a study that was published online in the Journal of Experimental Psychology: Applied.
The experiments found that individuals engaged in fewer health protection behaviors when the COVID-19 infection risk was associated with close friendships, including situations when people thought of a friend while reading COVID-19-related news, believed a friend was the source of a prior COVID-19 infection or noted a friend's presence while dining at an indoor restaurant. Under such circumstances, study participants decided to purchase fewer health protection items, such as masks and hand sanitizers, and perceived less likelihood of infection, even when the infection risk could stem from strangers in crowds.
The friend-shield effect was more prominent among people who identified themselves as conservatives than those who said they were liberals, arguably because conservatives tend to have clearer boundaries between people whom they hold as close friends and those they regard as distant others.
In an experiment with 495 participants, one group was asked to write down memories of a close friend while the other group wrote about a distant acquaintance. All participants then read a news article stating that unhealthy snacks can increase risks of more severe COVID-19 infection symptoms, while the use of hand sanitizers, face masks and disinfecting wipes can reduce the likelihood of infection.
The participants then chose either a junk food item ( candy bars or chips) or a health protection product ( face mask, hand sanitizer or disinfecting wipes) from an online store. Participants who wrote about a close friend were more likely to pick junk food over a health protection product than those who wrote about a distant acquaintance.
Another experiment divided 262 participants with no history of COVID-19 infection into three groups. They were told to imagine they had been infected with COVID-19 either by a friend, an acquaintance or a stranger. Participants were then asked how much they planned to spend on health protection products over the next two months. Those who imagined infection by a friend planned to spend less than half as much on health protection items ( $ 9.28 average) than those who imagined infection by an acquaintance ( $ 18.84 average) or a stranger ( $ 21.36 average).
The next experiment comprised 109 participants who had been previously infected with COVID-19 and knew the source of their infection. Participants infected by friends or family members were less likely to think they would get infected again than those previously infected by acquaintances or strangers.
The last experiment divided 301 participants into three groups whose members were told to imagine they were going to a coffee shop either alone, with a friend or with an acquaintance. Then they were asked about how crowded they expected the coffee shop to be and about their political orientation. Conservatives expected the coffee shop to be less crowded, and thus estimated a lower likelihood of COVID-19 infection if they were going with a friend rather than an acquaintance or on their own. There was no similar association for liberals.
Based on these findings, the authors stated that COVID-19 public health campaigns should caution against individuals ' tendency to engage in less protective behaviors when the infection risk is associated with friends and family, even if only tangentially. Health campaigns also should consider tailoring messages for different audiences, such as conservatives or liberals.
`` We think health safety campaigns should make greater efforts to inform the public regarding the friend-shield effect and aim for a more holistic response to future pandemics by taking both physical infection rates and psychological risk perceptions into account, '' De Vries said. | science |
Leveraged Finance & CLOs Uncovered Podcast: Covid-19 and its effects on the Global Economy and Corporate Sectors | U.S. and Canada Credit Card Quality Index Report: Canadian Credit Card Quality Index: Monthly Performance -- February 2022
Series 2, Episode 5: We’ re back and we’ ve upgraded! After an extended break since March, we’ re back with our regular Lev Finance and CLO podcasts, and with our updated logo. Stay tuned for even greater insights into the world corporates and CLOs. In episode 5, Hina and Sandeep are joined by Paul Watters, head of EMEA Research at S & P to discuss global macro-economic conditions since the start of the Covid pandemic. Listen in as we also discuss the shape of the economic recovery, the divergence in performance between corporate sectors and how recent trading by European CLO managers highlights a similar trend pattern. | business |
Ex-MSF worker testifies at trial of IS 'Beatle ' | Hi, what are you looking for?
Frida Saide, a Swede, revealed details of her captivity on the seventh day of the trial of El Shafee Elsheikh.
By
Published
A former Doctors Without Borders ( MSF) worker held for three months in Syria in 2014 by the Islamic State group testified on Thursday to the particularly brutal treatment meted out to American and British hostages.
Frida Saide, a Swede, revealed details of her captivity on the seventh day of the trial of El Shafee Elsheikh, a 33-year-old former British national who was allegedly one of her IS jailers.
Elsheikh is charged with the murders of American freelance journalists James Foley and Steven Sotloff and aid workers Kayla Mueller and Peter Kassig and suspected of the kidnapping of nearly 20 other Westerners.
Several former European journalists and Syrian hostages have testified over the past few days at the trial of the alleged member of the notorious IS kidnap-and-murder cell known as the “ Beatles. ”
While there has been extensive reporting about the kidnappings of the four Americans and the European journalists, little has been revealed previously about the abduction of Saide and four other MSF workers.
Saide said she arrived in Syria in November 2013 to work as a hospital administrator and lived in a house with nine international colleagues.
She and four other MSF workers — two women and two men — were seized by a group of armed men on January 2, 2014, she told the court.
“ I went to take a shower, ” Saide said. “ I could hear loud voices from outside.
“ I thought it was our guards, ” she said, but soon “ realized we were attacked. ”
She said a masked man broke down the door, threw her some clothes and took her outside, where she was blindfolded, handcuffed and put into a vehicle.
For the first month, Saide said she and her MSF colleagues were moved among various prisons and placed with other Westerners taken hostage by IS.
She said that on January 31, 2014, three British guards arrived — the so-called “ Beatles ” — and “ that completely changed everything. ”
She said some of the male prisoners who had been held and tortured by the “ Beatles ” described them as “ social psychopaths with no moral boundaries. ”
“ We realized soon it was an accurate description, ” she said.
“ They were very aggressive towards us, very hateful, ” she said.
“ They treated Americans the worst and then the British, ” she said. “ But they hated all of us. ”
Foley and Kassig were singled out for particularly harsh treatment.
– ‘ Threat of torture’ –
Saide said the three MSF women were moved to a cell in mid-February with Mueller, the 25-year-old American relief worker.
She said the “ Beatles ” treated Mueller with “ a lot of aggressiveness ” because she was an American.
“ They mentioned that Kayla might have a djinn or a demon inside her, ” she said, and talked about “ horrible ways ” to expel it.
“ We took it as a threat of torture, ” she said.
Saide said that when it came time for her and the two other MSF women to be released they pleaded with the “ Beatles ” for Mueller to be freed with them.
“ They were angry, ” she said, adding that they would “ keep her here until she dies ” unless a ransom was paid by her family.
The “ Beatles ” held at least 27 foreign hostages in Syria between 2012 and 2015.
A number of European journalists and aid workers were released after ransoms were paid but the Americans — Foley, Sotloff and Kassig — were killed and videos of their murders released by IS for propaganda purposes.
According to prosecutors, Mueller was turned over to IS leader Abu Bakr al-Baghdadi, who raped her repeatedly.
IS announced her death in February 2015 and said she was killed in a Jordanian airstrike, a claim that was disputed by US authorities.
Elsheikh and another former Briton, Alexanda Amon Kotey, were captured in January 2018 by a Kurdish militia in Syria and turned over to US forces in Iraq.
They were flown to Virginia in 2020 to face charges of hostage-taking, conspiracy to murder US citizens and supporting a terrorist organization.
Kotey pleaded guilty in September 2021 and is facing life in prison.
“ Beatles ” executioner Mohamed Emwazi was killed by a US drone in Syria in 2015.
Elsheikh has denied the charges and his lawyers claim his arrest is a case of mistaken identity.
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.
COPYRIGHT © 1998 - 2022 DIGITAL JOURNAL INC. Digital Journal is not responsible for the content of external sites. Read more about our external linking. | general |
Times China, Redsun Properties Downgraded: Evergrande Update | The information you requested is not available at this time, please check back again soon.
A sign for the Sunac Land amusement park in Haiyan, China. Photographer: Qilai Shen/Bloomberg, Bloomberg
( Bloomberg) -- Times China Holdings Ltd. and Redsun Properties Group Ltd. both saw their credit ratings downgraded by Moody’ s Investors Service Thursday, a development that underscores the continued liquidity squeeze plaguing China’ s weakest developers.
Elsewhere, Sunac China Holdings Ltd.’ s key onshore unit said it plans to allow holders of a 4 billion yuan ( $ 629 million) bond more time to cancel their requests for early redemptions if they have missed a prior deadline.
A Bloomberg stock gauge of the country’ s developers fell 3.5% Thursday, paring its advance since mid-March to 40%. Chinese offshore junk bonds, dominated by builders, also dropped Thursday but remained on pace to rise for a third week after advancing the most in 2022 a week earlier, a Bloomberg index shows.
Developer Dexin China Repurchased $ 2.74m of 2022 Notes ( 7:52 a.m. HK)
Dexin China Holdings Co. recently bought back an aggregate principal amount of $ 2.74 million of its 2022 notes in the open market, according to a statement to the Hong Kong stock exchange late Thursday.
The company has so far repurchased $ 16 million of the bond, representing about 8% of its total.
China Developer Rally Runs Up Against Impatience for Policy Plan ( 7:51 a.m. HK)
The Chinese government’ s pledge of support for embattled developers ignited a frenzied rush for stocks and bonds.
But three weeks later, the frantic rally is testing the limits of investors’ patience as Beijing has yet to spell out details of how the government would relax curbs to prevent a disorderly collapse in the property market.
The market is pulling back from a spell of exuberance for an industry that’ s been crippled by crackdowns and mountains of debt that crushed large developers including China Evergrande Group and Shimao Group Holdings Ltd. It’ s a sobering reality check as China braces for the fallout from its worst coronavirus outbreak, which has locked down major economic hubs from Shenzhen to Shanghai.
Sunac Extends Redemption Deadline for 4.78% Yuan Bond ( 7:45 a.m. HK)
Sunac Real Estate Group said it plans to allow holders of its 4 billion yuan bond to still cancel their early redemption requests even if they have missed the prior deadline, according to a filing to the Shanghai Stock Exchange.
The company has earlier allowed bondholders to cancel the requests between March 11 and 28. Bondholders who have missed the March 28 deadline can now make the cancellation requests from April 11 to April 22.
Times China Downgraded to B2 by Moody’ s ( 7:37 a.m. HK)
Times China’ s long-term corporate family rating was downgraded by Moody’ s to B2 from B1. Its senior unsecured debt rating was cut to B3 from B2. Moody’ s said the decision reflects its expectation that the developer’ s liquidity will weaken because of its declining operating cash flow.
Meantime, the risk assessor also lowered Redsun Properties’ corporate family rating to B3 from B2 and the company’ s senior unsecured rating to Caa1 from B3.
“ The downgrade reflects Redsun’ s heightened refinancing risks and weakened liquidity driven by its weak operating cash flow and sizable debt maturities over the next 12-18 months, ” Moody’ s analyst Cedric Lai said in a statement.
While the feds touted the spending in its budget as prudent, prominent Bay Street economist David Rosenberg said the extra fiscal stimulus could lead the Bank of Canada to hike its benchmark rate higher than originally thought.
Canada’ s unemployment rate fell to the lowest level since at least the mid-1970s, as the laboUr market posted another strong monthly employment gain.
Average Canadians might not realize how big a stake they have in the country’ s largest banks in their retirement portfolios; either directly in their RRSPs and TFSAs, or indirectly through mutual funds, ETFs, and pension plans.
Businesses are struggling to cope with an apparent sixth wave of COVID, as staffing shortages hamper sectors from health care to hospitality and retail — though the interruption remains more manageable than last winter's Omicron variant surge. | general |
Ep8: Leadership special with Chairman of Goldman Sachs Asset Management | In a special Leadership Edition of Fixed Income in 15, Joe Cass is joined by President of S & P Global Ratings John Berisford and Chairman of Goldman Sachs Asset Management Sheila Patel. Discussion turned to the future of sustainable finance post-crisis, how John, Sheila and their teams are adapting to working from home and what ‘ the future of work’ could look like at both institutions.
For more on S & P Global Ratings Coronavirus research and publications, click here - https: //www.spglobal.com/ratings/en/research-insights/topics/coronavirus-special-report | business |
Pfizer Takeover Makes Dent in a $ 34 Billion Stock-Market Slump | The information you requested is not available at this time, please check back again soon.
A logo on the Pfizer Inc. facility in Puurs, Belgium, on Thursday, Dec. 3, 2020. The quick approval of Pfizer Inc.’ s coronavirus vaccine in the U.K. isn’ t likely to accelerate the availability of the shot in Asia, as countries work to complete local safety tests and negotiate deals. Photographer: Geert Vanden Wijngaert/Bloomberg, Bloomberg
( Bloomberg) -- Pfizer Inc.’ s acquisition of ReViral Ltd. chipped away at the drug maker’ s stock-market slump.
The company’ s shares gained about 3.7% Thursday after the announcement that it was buying the lung-focused biotech firm for as much as $ 525 million, bucking the broader market’ s drop.
But the shares are still down almost 7% this year -- cutting some $ 34 billion from its market value -- amid investor concern about the loss of revenue as drug patents expire and the uncertain fate of its booster shots as the Covid-19 pandemic winds down. That’ s left the company trading at a discount to health-care peers that have been hitting record highs as investors turn to defensive bets amid geopolitical turmoil and an uncertain economic outlook.
Wall Street is itching for Pfizer to act to shore up growth, potentially by utilizing the $ 150 billion of capacity that Bank of Montreal estimates it has for acquisitions. Yet Thursday’ s deal for a closely-held drug developer, ReViral Ltd. is likely too small to do much to change the pharmaceutical behemoth’ s outlook.
“ While we are encouraged with M & A in BioPharma, this is not exactly the deal we had hoped for, ” BMO analyst Evan David Seigerman Seigerman wrote.
Yet big drugmakers have been eschewing large deals in favor of partnerships or buyouts of smaller companies. That helped drive merger activity for the sector during the first quarter to the slowest since the immediate aftermath of the pandemic in 2020.
Chris Schott an analyst with JPMorgan Chase & Co., said Pfizer is “ the most controversial name ” among the large-cap drugmakers, with bulls pointing to the company’ s Covid vaccines and ability to deploy large amounts of capital and bears saying its valuation is still too high given the company’ s core business beyond the coronavirus inoculations.
Excluding Pfizer’ s Covid-19 vaccine and antiviral sales, Schott sees negative compound annual sales and earnings growth through 2025 as the company faces one of the indstry’ s biggest revenue losses due to patent expirations.
Still, with Pfizer’ s stock up investors appear to support the acquisition, which builds on gene-therapy partnerships forged in January. Truist’ s Robyn Karnauskas said the deal could signal “ a potential return to M & A, especially in an environment where companies seem to face hurdles going public. ”
Here are nine things you need to know about Budget 2022.
The federal government is taking sharper aim at real estate investors and property flippers in a bid to help halt the country’ s long-standing – and worsening – housing affordability problem.
The Liberal government is scaling back its strategy to single out Canada's most profitable banks and insurers with targeted tax measures, resulting in about $ 4 billion less in revenue than originally planned. | general |
Daily Update: April 7, 2022 | On February 28, 2022, S & P Global completed its merger with IHS Markit, the next step in delivering data, technology and expertise that accelerates progress.
As great as last year was for our company, in many ways 2022 is shaping up to be even better. In February, we closed a transformative merger with IHS Markit. We believe combining our two companies will create substantial long-term value for all our stakeholders.
The S & P Global Foundation is about much more than philanthropy—we are about making a difference by finding and developing essential connections between the knowledge- and skill-driven work of S & P Global and the needs of society.
As the Russia-Ukraine conflict continues, the metals industry is feeling the effects. Prices for metals have risen sharply amid high demand and supply chain issues, along with imposed sanctions against Russia.
With a full scale invasion of Ukraine now under way, stock markets, global trade, energy markets, and commodities markets are all registering the impact of a new geo-political reality.
In Europe, market constraints, extreme weather events, and geopolitical tensions have caused gas and power prices to skyrocket, creating an energy crisis that has left the region’ s energy and industrial industries concerned.
Start every business day with our analyses of the most pressing developments affecting markets today, alongside a curated selection of our latest and most important insights on the global economy.
Against the backdrop of heightened market uncertainty and volatility, persistent inflationary pressures, and a flat U.S. Treasury yield curve, Federal Reserve officials plan to reduce the central bank’ s balance sheet by $ 95 billion a month alongside aggressively raising interest rates, with at least one hike of 50 basis points ( bps) this year.
In the Federal Market Open Meeting Committee’ s minutes from its March 15-16 meeting, released yesterday, Fed officials “ generally agreed ” that the central bank would reduce its nearly $ 9 trillion balance sheet by a $ 60 billion in Treasuries and $ 35 billion in mortgage-backed securities over three months likely beginning in May. The minutes also noted that “ many ” central bankers believe one or more 50-bps rate hike could be appropriate if inflation pressures intensify.
The U.S. central bank `` will continue tightening monetary policy methodically through a series of interest rate increases and by starting to reduce the balance sheet at a rapid pace as soon as our May meeting, '' Fed Governor and Vice-Chair nominee Lael Brainard said on Tuesday following the release of the minutes, adding that she `` expects the balance sheet to shrink considerably more rapidly '' now than when the Fed established a pace of $ 50 billion in monthly holdings reductions during the 2017-2019 period.
“ Minutes from the march FOMC meeting all but ensured that the Federal Reserve plans an aggressive monetary policy campaign to combat four-decade high price readings. We anticipate seven rate hikes total in 2022, including a 50-bps rate hike at the Fed’ s policy meeting in May, and that the Fed will announce the start of quantitative tightening in May, ” S & P Global Ratings Chief North America Economist Beth Ann Bovino told the Daily Update. “ But based on the hawkish statements from the FOMC minutes, markets may need to brace themselves for even more this year. ”
The U.S.’ s solid jobs growth—with 431,000 jobs added to U.S. nonfarm payrolls and a net 95,000 job gains in January and February, according to the Bureau of Labor Statistics ' March jobs report—is laying the foundation for the Fed to act sooner and stronger due to confidence that the strong economy can absorb tighter policy and continue to grow, according to Dr. Bovino’ s recent research.
“ The minutes of the Fed’ s March meeting were released yesterday, and the markets did not like them, ” Benedek Vörös Director, director of index investment strategy at S & P Dow Jones Indices, said in a market note today. “ The result was a classic ‘ sell everything’ day—bonds, stocks, gold, and oil all dropped while credit spreads widened and VIX moved up to 22. This morning, European equities are mounting an early comeback, U.S. futures are indicating modest gains, but Asian markets finished today’ s trading with losses. ”
The market sell-off “ wasn’ t that bad, ” Mr. Vörös said. “ But it was widespread. ” The S & P 500 benchmark index closed down 1% yesterday, while every region of the S & P Developed BMI and 20 out of 24 S & P Emerging BMI regions declined. But this doesn’ t necessarily indicate more to come, as historical performance over the last two decades doesn’ t indicate a clear link between changes in interest rates and changes in the equity market, according to S & P Dow Jones Indices.
Following the release of the FOMC minutes and Fed Governor Brainard’ s public comments, yields on benchmark 10-year U.S. Treasury notes reached 2.56%, the highest level seen in three years. U.S. bonds suffered their worst quarter in more than 40 years the January-March of this year, and investors are closing watching the yield curve as a potential indicator of a recession in the U.S. economy. At the same time, the spread between two- and 10-year Treasury yields narrowed notably in March—and low spreads are also often seen as an indicator of recessions.
Still, the Fed appears to be moving forward with its aggressive policy plans amid low bond yields due to companies ' healthy corporate balance sheets, and a sizable reduction in corporate demand for debt, according to S & P Global Market Intelligence.
Today is Thursday, April 7, 2022, and here is today’ s essential intelligence.
S & P Global Ratings estimates sovereign borrowing will reach $ 10.4 trillion in 2022, nearly one-third above the average before the COVID-19 pandemic. Despite an economic recovery, it expects borrowing to stay elevated, owing to high debt rollover needs, as well as fiscal policy normalization challenges posed by the pandemic, high inflation, and polarized social and political landscapes. The global macroeconomic repercussions of the ongoing military conflict between Russia and Ukraine will put further upward pressure on government funding needs this year. Tightening monetary conditions will push up government funding costs. This will pose additional difficulties to sovereigns that have been unable to restart growth, reduce reliance on foreign currency financing, and where interest bills are already critically high.
With Recent Surge, YTD U.S. Leveraged Loan Returns Edge Into Positive Territory
The S & P/LSTA Leveraged Loan Index gained 0.14% on April 4, lifting the year-to-date return for the segment to 0.19%. Just three weeks ago, on March 15, U.S. loans were down 2% for the year as geopolitical risk gripped asset classes worldwide and cast a pall of uncertainty over the financial landscape. Since hitting that low point, however, secondary loan prices have rebounded strongly—the index gained 2.25% between March 16 and April 4. The riskiest names continue to underperform this year. Both single-B and double-B sub-indices are now in the black in 2022, while triple-Cs remain in the red, down 0.86% as of April 4. Single-B names have a small edge over their higher-rated counterparts, at 0.33% to 0.13%, based on total return.
Shippers importing goods into the United States from Asia have been allotting more cargos to the U.S. East and Gulf coasts in an effort to avoid congestion and diversify their risk ahead of potential industrial action at USWC ports, sources said. The shift comes as many North American ports continue to grapple with vessel lineups and congested terminals, unable to efficiently move containers due to inland logistical constraints. Vessel queues outside of the Ports of Los Angeles/Long Beach peaked in January at 109 and have since fallen to just 33 vessels on April 4. Vessel wait times remain unpredictable, sliding from 10 to 40 days depending on terminal availability.
In April 2022, the U.K. introduced a tax on plastic packaging. The tax, introduced to help reduce plastic waste pollution, is the first of its kind globally to cover all types of plastic packaging. Under the new rules, any packaging that is predominantly plastic by weight made in or imported into the U.K. for final sale to the consumer will have to include 30% recycled plastic as a minimum. If the recycled content falls short of this inclusion rate, a £200/mt tax on the total weight of the package will be due.
Asia's carbon markets are on a trajectory of rapid growth as demand for carbon offsets rises and regional governments work towards net-zero commitments. While turmoil in global energy markets has temporarily shifted attention to energy security, commodity trading hubs like Singapore are pushing ahead with plans to become a carbon trading powerhouse. Eric Yep and Roman Kramarchuk of S & P Global Commodity Insights discuss with Mikkel Larsen, CEO of Climate Impact X, a Singapore-based carbon exchange, on what lies ahead for Asia's carbon markets.
Twitter Inc.'s newest director and largest shareholder is both a power user and an outspoken critic of the microblogging platform. On April 4, Twitter's management agreed to appoint Elon Musk, CEO of Tesla Inc. and Space Exploration Technologies Corp., to a two-year director term expiring in 2024, according to an SEC filing. Twitter CEO Parag Agrawal and Musk confirmed the move in an exchange on the platform April 5. `` [ Musk is ] both a passionate believer and intense critic of the service which is exactly what we need on @ Twitter, and in the boardroom, to make us stronger in the long-term, '' Agrawal wrote. | business |
Germany Working on Shield For Companies Hurt by War, Sanctions | The information you requested is not available at this time, please check back again soon.
Pipework at the gas receiving station of the halted Nord Stream 2 project, on the site of a former nuclear power plant, in Lubmin, Germany, on Tuesday, April 5, 2022. Germany is preparing to take a leap into the unknown as Europe starts to get serious about weaning itself off Russian fossil fuels., Bloomberg
( Bloomberg) -- The German government is working on a financial-aid package for companies suffering from the fallout of the Ukraine war and the economic sanctions against Russia.
The support measures, which are being assembled by the economy ministry, will include a loan program by the KfW state-owned bank as well as direct financial aid, according to a person involved in the talks. The state would secure 90% of the liability claims of the KfW loan, said the person, who asked not to be identified discussing non-public information. The ministry wasn’ t immediately available to comment.
Major companies deemed systematically relevant will be offered direct financial aid, similar to the economic stabilization fund WSF created during the coronavirus crisis. However, the volume of this fund will be much lower and range in the single-digit billion Euro area. In addition, mid-sized companies will be able to receive as much as 300,000 euros ( $ 327,990) each, distributed from the EU climate fund program.
Canada joins U.S., U.K. in diplomatic boycott of Beijing games
Trudeau weighs auto-content rules as next U.S. trade flashpoint | general |
Uruguay Steps Up Inflation Fight With 125 Basis-Point Rate Hike | The information you requested is not available at this time, please check back again soon.
Shoppers wearing protective masks ride an escalator at a mall in Montevideo, Uruguay, on Friday, Dec. 18, 2020. Nine months after recording its first coronavirus case, Uruguay is seeing an outbreak in what President Luis Lacalle Pou has called the `` first wave, '' threatening to undo the hard-fought gains throughout the pandemic., Bloomberg
( Bloomberg) -- Uruguay’ s central bank surprised economists by raising borrowing costs by more than it had anticipated as it seeks to guide inflation expectations back to target.
Policy makers lifted the key interest rate on Thursday by 125 basis points to 8.5%, following two straight increases of 75 basis points. It was the most aggressive move since the central bank reintroduced its benchmark rate in September 2020. Two economists surveyed by Bloomberg expected a third hike of the same magnitude while one forecast a 100 basis-point boost.
“ A new interest rate increase is anticipated in the next meeting in May and this process is expected to continue in following meetings, ” the central bank said in a statement, without elaborating on the magnitude of the hike.
The central bank led by former Banco Santander executive Diego Labat had anticipated in its January policy statement that it would hike by 75 basis points both in February and April. However, annual inflation accelerated to 9.38% in March, leading some analysts to pencil in a hike of at least 100 basis points this month. The bank targets inflation between 3% and 6%.
Latin American central banks have ratcheted rates higher to slow above-target inflation in the wake of the pandemic. The war in Ukraine has made their job even harder by sending an inflationary surge through the global economy in the form of sharply higher commodities prices. The central bank said there is considerable uncertainty as to the duration of the current price shock.
Consumer prices accelerated a fourth straight month in March, reaching a 15-month high of 9.38% led by gains in food and transportation costs.
The steady rise in consumer prices is pushing up inflation expectations. Analysts who participate in a central bank survey forecast 24-month inflation of 6.95% in March, up from 6.65% in the February survey and 6.55% last December.
Here are nine things you need to know about Budget 2022.
The federal government is taking sharper aim at real estate investors and property flippers in a bid to help halt the country’ s long-standing – and worsening – housing affordability problem.
The Liberal government is scaling back its strategy to single out Canada's most profitable banks and insurers with targeted tax measures, resulting in about $ 4 billion less in revenue than originally planned. | general |
COVID-19 alters levels of fertility-related proteins in men, study suggests -- ScienceDaily | Although SARS-CoV-2 mainly affects the respiratory system, the virus -- and the body's response to it -- also damages other tissues. Recent evidence indicates that COVID-19 infection can reduce male fertility, and the virus has been detected in male reproductive organs. Firuza Parikh and Rajesh Parikh at Jaslok Hospital, Sanjeeva Srivastava at the Indian Institute of Technology and colleagues wondered if COVID-19 infection could have long-term impacts on the male reproductive system. To find out, they decided to compare levels of proteins in the semen of healthy men and those who previously had mild or moderate cases of COVID-19.
The researchers analyzed semen samples from 10 healthy men and 17 men who had recently recovered from COVID-19. None of the men, who ranged in age from 20 to 45, had a prior history of infertility. The team found that the recovered men had significantly reduced sperm count and motility, and fewer normally shaped sperm, than men who hadn't had COVID-19. When the researchers analyzed semen proteins using liquid chromatography-tandem mass spectrometry, they found 27 proteins at higher levels and 21 proteins at lower levels in COVID-19-recovered men compared with the control group. Many of the proteins were involved in reproductive function. Two of the fertility-related proteins, semenogelin 1 and prosaposin, were present at less than half their levels in the semen of the COVID-19-recovered group than in the semen of controls. These findings suggest that SARS-CoV-2 has direct or indirect effects on male reproductive health that linger after recovery, the researchers say. The work might also reveal insights into the pathophysiology of human reproduction in recovered men, they add. However, they note that larger studies should be done to confirm these findings, and a control group of men who recently recovered from other flu-like illnesses should be included to ensure that the findings are specific for COVID-19.
The authors acknowledge funding from Jaslok Hospital. | science |
Azerbaijan receives special equipment within EU, WHO project [ PHOTO ] | Azerbaijan has received the special equipment within the framework of the “ support for COVID-19 vaccination ” project implemented by the World Health Organization ( WHO) with the financial support of the EU.
A total of 100 refrigerators for storing vaccines with a capacity of 145 liters were transferred to the Centers for Hygiene and Epidemiology and 200 refrigerators with a capacity of 98 liters to the Association for the Management of Medical Territorial Units in order to strengthen the cold chain system for both the storage of vaccines against COVID-19 and other drugs.
Azerbaijan has also received 122 portable containers for vaccines, 102 computers, 79 printers, and 79 uninterruptible power supplies.
It is also planned to supply additional equipment and devices to Azerbaijan within the framework of the project in order to ensure the safe storage and transportation of vaccines.
Speakers at the event noted the work done under this project and the main achievements in the fight against the coronavirus COVID-19 pandemic.
Speaking at the equipment transfer ceremony, EU Ambassador to Baku Peter Michalko stated that Azerbaijan has achieved high results in the COVID-19 vaccination process.
The official emphasized that Azerbaijan has achieved also great success in the fight against the pandemic as a whole.
`` The equipment supplied by the European Union to Azerbaijan contributes to these achievements. The EU will continue to support Azerbaijan, '' he said.
Association for the Management of Medical Territorial Units Board Chairman Vugar Gurbanov noted that Azerbaijan has a sufficient number of vaccination points against COVID-19.
He added that the vaccination process in the regions is regulated depending on the population.
`` Our goal is to speed up the vaccination of the population. So far there have been no problems with the conditions of vaccine storage, '' he said.
WHO Representative in Azerbaijan Hande Harmanci said that the reason for the growth of coronavirus infection in some Eastern European countries is related to the Omicron strain.
`` This shows that the pandemic is not over yet and we must continue to take preventive measures. There are subspecies B1 and B2 of the omicron strain. The B2 subspecies are capable of spreading faster. It is necessary to protect those who are at risk - people over the age of 65, and pregnant women. An important factor is the use of masks in closed places, ” she said.
Noting that in Azerbaijan the vaccination rate of the population is higher than 48 percent, she underlined that the goal is to bring it to 70 percent.
“ In recent days there has been a decrease in the cases and mortality of COVID-19 in Azerbaijan, but we should not forget that the pandemic is still ongoing, '' she said.
The equipment transfer ceremony, which was organized on World Health Day and on the eve of the traditional European Immunization Week, was attended by Azerbaijan’ s Health Deputy Minister Nadir Zeynalov, Association for the Management of Medical Territorial Units Board Chairman Vugar Gurbanov, WHO Representative in Azerbaijan Hande Harmanci and EU Ambassador to Baku Peter Michalko.
The WHO Office with the financial support of the EU has launched a three-year project `` Support for COVID-19 vaccination '' in order to fight the COVID-19 pandemic in Azerbaijan and strengthen immunization programs, since June 2021.
This project is an integral part of the ongoing support of the EU and WHO to Azerbaijan. | general |
IVORY COAST: Charles Kié a contender to head NSIA's banking arm | Cairo has taken on the massive task of digitising Egyptian banks and will soon chose a service provider. Two French groups are competing for this €100m contract: Thales and Idemia. [... ]
The private clinic located in the French capital and favoured by African VIPs, is facing a claim for `` negligence '' and `` fraud '' relating to its treatment of the late business tycoon Victor Fotso, from Cameroon, who died in the hospital on 19 March 2020. [... ]
At the suggestion of several military doctors who had previously been at Paris's Val de Grace Hospital, the privately owned American Hospital of Paris, which has traditionally been a favourite with ailing African VIPs, reinvented itself as a specialised Covid-19 treatment centre for the duration of the crisis [. [... ]
With the minister of defence Hamed Bakayoko having been the guest of honour at the China-Africa Peace and Security Forum and President Alassane Ouattara preparing to visit Moscow at the invitation of Vladimir Putin ( WAN 804), the Trump administration [. [... ]
Discreet as they are, the International Finance Corp’ s bankers count among the most influential forces in the African petroleum world. No local company or major project can be mounted in Africa without the IFC, the private investment arm of the [. [... ]
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How Can the US Accelerate Access to Oral Antivirals for COVID-19? | While oral antivirals are not a substitute for vaccination, they help prevent severe illness, save lives, and preserve health systems. Vaccination rates continue to lag in low-income countries: only 14 percent of the population in low-income countries has received one dose of the vaccine, compared to 80 percent in high- and upper-middle-income countries. As uncertainties about future variants and vaccination campaigns persist, treatments must be elevated as a core strategy to combat COVID-19.
In a CGD paper launched today, we analyze the market landscape for two new oral antiviral therapeutics: a nirmatrelvir and ritonavir combination drug ( Paxlovid), which was developed by Pfizer and reduces the relative risk of hospitalization by 89 percent, and molnupiravir, which was developed by Merck and reduces the relative risk of hospitalization by 30 percent. Both companies signed deals with the UN-backed Medicines Patent Pool ( MPP) to allow some generic manufacturers to produce and sell the drugs in around 100 low-and-middle income countries. Companies selected by MPP for voluntary licensing with Pfizer and Merck were announced in March and January 2022 respectively. The sublicensees are geographically diverse, which enables greater supply chain adaptability, but the number of selected companies is also quite large ( 35 for nirmatrelvir/r and 27 for molnupiravir), which might lead to reduced capacity investments amid uncertain demand.
Given the range of bottlenecks, barriers to entry, demand inefficiencies, and gaps in testing infrastructure, there is considerable risk that production and uptake of oral antivirals will still be far too slow and modest in scale. Building from our analysis of the oral antiviral landscape, the paper offers near and medium-term actions the US government can take to ramp up manufacturing and accelerate access to promising COVID-19 treatments in LMICs. Here are a few of the main messages and recommendations.
In the US context, a global oral antiviral access strategy—if adequately resourced—would first and foremost organize and generate demand. More certain demand will enable greater upfront investments in manufacturing capacity. Given that short-term access in LMICs depends on Pfizer and Merck’ s production, the strategy should incorporate incentives for them to further scale-up manufacturing. To date, lawmakers have failed to deliver on a White House request for additional funding to fight COVID-19—including $ 5 billion for near-term international response efforts. If the US is to address gaps in therapeutic manufacturing incentives, the appropriation of new resources will be a crucial step.
Globally, the US government should create a consultative procurement forum with Africa CDC and the ACT-A therapeutics and diagnostics pillars, including the Global Fund, UNICEF Supply Division, UNITAD, FIND, WHO, and PAHO. This platform would help ensure that “ market health ” is given due importance in procurement awards by each of the relevant purchasers and facilitate information exchange and coordination on oral antiviral market dynamics. An existing external advisory group to the ACT-A therapeutics pillar management team could also be the right forum to discuss evolving demand forecasts.
The short-to-medium term supply outlook thus depends crucially on availability from Pfizer. The below timeline notes the key steps that generic manufacturers must complete before filing for market authorization in LMICs.
First, USAID should leverage its implementing partner architecture and partnership with US Pharmacopeia to enhance technical support for generic manufacturers with voluntary licenses. As investments in process intensification and new formulation pathways yield results, technical assistance could help disseminate and spur more rapid use of such developments.
Second, the FDA should expand the conditional approval pathway currently used for HIV medicines to include generic oral antivirals for COVID-19 to be delivered outside of the US. This would increase global regulatory capacity to assess oral antivirals manufactured by companies with voluntary licensing agreements, strengthen the WHO PQ program, and reduce the time for products to reach LMIC markets. Additional support may be required for the FDA to dedicate resources towards this effort.
Specifically, USAID can build on PEPFAR and PMI implementing partner infrastructure to create country deployment programs for test-treat initiatives, helping address testing and drug-drug interaction ( DDI) management challenges. The US domestic test and treat strategy involves identifying ways to manage the complexities of DDIs for some of the oral antivirals. These efforts should be adapted quickly for use in resource limited health systems. PEPFAR and PMI implementers with significant experience supporting HIV, malaria, and TB test and treat in LMICs could then be resourced to initiate testing and treatment programs by providing countries the relevant tools and technical resources.
The US government can also partner with Pfizer and Merck to ensure needs-based allocation of limited supplies of oral antivirals using the country deployment plans. Such a partnership should define a single point of interface for the companies across different agencies working on COVID therapeutics.
Check out the full paper for more details, analytical insights, and priority actions. And stay tuned for more from CGD on therapeutics for COVID-19 and future outbreak countermeasures in the coming year.
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions. | general |
Long COVID: the elephant in the room - The Lancet Diabetes & Endocrinology | On April 1, 2022, the UK government ended free universal COVID-19 testing, as part of the Living with COVID-19 plan. The legal requirement to isolate if positive has also been scrapped in England under this plan, and all other public health restrictions have now been removed.
The Living with COVID-19 strategy portrays the restrictions from the past 2 years as “ necessary ” but as also coming with a “ huge toll on wellbeing and economic output ”, and states that the “ next phase of the COVID-19 response is to enable the country to manage COVID-19 like other respiratory illnesses, while minimising mortality and retaining the ability to respond if a new variant emerges with more dangerous properties than the Omicron variant ”.
At a time when SARS-CoV-2 infections remain at record levels in the UK due to the omicron ( B.1.1.529) sublineage variant BA.2 ( about one in 13 people were estimated to be infected in the week ending March 26, 2022), and hospitalisation and mortality rates are rising again, removal of all public health restrictions is problematic, if not highly unethical. The new policies will also disproportionally affect the clinically vulnerable and those who are in situations of precarious employment, further increasing disparities. Adding to this exceptionally bleak picture, there is now irrefutable evidence pointing to a high incidence and large burden of long COVID, with devastating effects on quality of life and on the economy already visible. As of Jan 31, 2022, according to data from the Office for National Statistics, 1·5 million people in the UK ( 2·4% of the population) reported experiencing long COVID symptoms, with 65% of those reporting a negative impact on their day-to-day activities. In the USA and UK, millions are taking long-term absence from the workforce due to long COVID.
The adverse health effects from long COVID range from fatigue and difficulty concentrating, to neurological and neuropsychiatric symptoms, respiratory and cardiovascular problems, and metabolic disease. Earlier in the pandemic, the discourse largely centred on acute illness, and perhaps rightly so. However, long COVID has now clearly emerged as a public health concern that will not only disrupt health care of people living with non-communicable diseases ( NCDs) but likely also increase the burden of NCDs.
The Lancet Diabetes & Endocrinology has, on many occasions, editorialised on the alarming increasing rates of poor metabolic health worldwide, and, in August, 2020, we published a large population study showing increased risk of death from COVID-19 in people with type 1 and type 2 diabetes. In this issue of the journal, Yan Xie and Ziyad Al-Aly report significantly increased risk of diabetes in the post-acute phase ( > 30 days) of COVID-19 in a cohort of US veterans, including those who had had mild infections and for whom no previous risk factors for diabetes were known. Publication of this study follows the release of data from the US Centre for Disease Control and Prevention showing that people younger than 18 years were more likely to receive a new diabetes diagnosis in the post-acute phase of COVID-19 than those without it or with pre-pandemic respiratory infections. However, a number of other studies did not report similar associations. A cohort from Scotland shared on the preprint server medRxiv, found that incidence of type 1 diabetes in children ( aged 0–14 years) during 2020–21 was 20% higher than the 7-year average, but these findings were attributed to other causes and not a direct effect of SARS-CoV-2.
Large and well controlled epidemiological studies with reasonably long follow-up ( > 1 year) will be key to further clarify the association between COVID-19, new-onset diabetes, and metabolic complications, and assess potential causal relationships. Epidemiological efforts should also be examined in the context of comprehensive clinical data, such as data from CoviDIAB, a global clinical registry launched in June, 2020, to determine the presentation and course of COVID-19–related diabetes. The contributions of basic and translational research to our understanding of COVID-19 and its prevention have been remarkable and should continue to complement and inform clinical research. Selfless and open collaboration within the international scientific community will be fundamental. If the link between COVID-19 and new-onset diabetes holds true, even a small increase in the global prevalence of diabetes could have disastrous consequences.
In a world where the new mantra is to learn to live with COVID-19, long COVID can not be ignored. Any strategy to learn to live with COVID-19 must also aim for a fair, thriving, and healthy post-pandemic world—that is what return to normalcy should look like. | tech |
MALAWI: Albert Mbawala, presidential party treasurer, parliamentarian and businessman, takes on mining reforms | Lobbyists in the UK parliament are campaigning to diversify Britain's supply of critical minerals. To the delight of the country's juniors, who are exploring for rare earths, graphite and manganese in Africa. [... ]
Sam Matekane, a partner in Gem Diamonds ' lucrative Lets'eng diamond mine and who is reputed to be the richest man in the Kingdom of Lesotho, is now entering politics, with an eye on the premiership in this October's elections. [... ]
Germany may be phasing out nuclear power but demand for uranium in the rest of Europe and Asia is set to increase, as industrialised nations scramble for sources of decarbonised electricity. In Africa, countries such as Tanzania and Botswana are trying to take advantage of the trend to get their uranium production off the ground and join Namibia and Niger in the select group of African countries that produce yelllowcake. [... ]
Yellowcake prices are anticipated to take off within the next twelve months or so. In preparation, and to win over the financial markets, the Australian junior is taking a detour via rare earth minerals. [... ]
President Chakwera, whose governing coalition was already in troubled waters, lost two ministers and a permanent secretary to Covid-19 in a matter of days this week. One of them, Sidik Mia, was his party's number two and a major financial backer. [... ]
After buying the Kayelekera uranium mine in May, Lotus Resources set about hiring former executives of the previous site manager Paladin Energy in the hope they are able to get it back up and running. [... ]
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KENYA: With Kenya Airways in trouble, its partnership with South African Airways remains grounded | Mauritania Airlines, faced with a lack of planes, has been getting help from the Bulgarian charter company Fly2sky for several weeks. Fly2sky has provided several Airbus A320s for the national airline's African routes. [... ]
Many Western nations have closed their borders to travellers from southern Africa following the identification of the new coronavirus variant. Pretoria has since applied diplomatic pressure and launched a media counterattack, with the support of influential doctors and the WHO. [... ]
First he suspended parliament and sacked the prime minister. Now the president plans to turn up the heat on his political enemies by co-opting military intelligence agents in a renewed bid to recover embezzled billions. [... ]
The Treasury has at last drawn up a report on the long-awaited re-nationalisation of Kenya Airways, and its conclusions are final. [... ]
As Uhuru Kenyatta and his Somalian opposite number Mohamed Abdullahi Mohamed Farmajo position their armies on either side of their common border, American, British and European diplomats are trying to persuade the Kenyan head of state to engage in talks. [... ]
President Magufuli is refusing to back down on his decision to ban Kenya Airways from Tanzanian airspace despite Kenyatta's attempts to open up talks. [... ]
The global Covid-19 pandemic has forced the Kenyan authorities to delay a call for tenders for the refurbishment of one of the two terminals at the Nairobi airport. [... ]
The institution's latest report on combating fraud and corruption is due to be published in October. Internally, it began taking steps to crack down harder earlier this year. [... ]
Africa Intelligence uses cookies to provide reliable and secure features, measure and analyse website traffic and provide support to the website users.Apart from those essential for the proper operation of the website, you can choose which cookies you accept to have stored on your device.Either “ Accept and close ” to agree to all cookies or go to “ Manage cookies ” to review your options. You can change these settings at any time by going to our Cookie management page.
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A pioneer on the web since 1996, Africa Intelligence is the leading news site on Africa for professionals. | general |
SOUTH AFRICA: Johann Rupert takes advice from an archbishop and a banker on his Covid-19 business support fund | Stargems, until now present only in diamond processing and trade, is in the process of acquiring two South African rough stone production subsidiaries from the Luxembourg company Reinet Investments, which is run by luxury goods tycoon Johann Rupert. [... ]
The billionaire lost his shirt when scandal struck the furniture giant in 2017. Buoyed by a recent compensation payout, the self-made South African is back in business. [... ]
Justice Minister Ronald Lamola hopes to become one of the ANC's top six at the party's elective conference in December. The 38-year-old, who is in charge of several highly sensitive legal cases, has the confidence of President Cyril Ramaphosa. [... ]
The three most high-profile onshore gas exploration companies in southern Africa, Renergen, Kinetiko and Invictus, are all backed by Australian money. [... ]
After having long been a breeding ground for future party officials, ministers and presidents, the ANC Youth League has been a shadow of its former self since the ousting of its charismatic leader Julius Malema in 2011. [... ]
The Department of Mineral Resources and Energy is used to making the headlines in the South African press over its management of the country's electricity supply network. It also plays a crucial role, however, in the functioning of South Africa's tentacular mining sector. [... ]
South Africa's Financial Intelligence Centre, which is currently being audited by the Financial Action Task Force, has been caught up in the score-settling inside the presidential ANC party. It is trying to forge closer links with the banks so as to better keep tabs on politicians and influential business leaders. [... ]
Over the last two decades, MTN has succeeded in establishing itself as leader on the Nigerian mobile phone market despite the West African country's uneasy relations with the big South African companies. Nigeria and South Africa are fierce diplomatic and economic rivals but MTN has used a varity of different survival techniques to hold on to its position. [... ]
At the outcome of the general election on 7 May, the African National Congress ( ANC) MPs will still have the majority in parliament and will reinstall Jacob Zuma, 72, as the country’ s president. However, he will have a hard time [. [... ]
Africa Intelligence uses cookies to provide reliable and secure features, measure and analyse website traffic and provide support to the website users.Apart from those essential for the proper operation of the website, you can choose which cookies you accept to have stored on your device.Either “ Accept and close ” to agree to all cookies or go to “ Manage cookies ” to review your options. You can change these settings at any time by going to our Cookie management page.
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BOTSWANA: Mining Minister Lefoko Moagi looks to leave his mark on the Kimberley Process | Botswana's Jacob Thamage, coordinator of state-owned diamond-processing centre Diamond Hub Botswana and new chair of the Kimberley Process following Botswana's assumption of the organisation's presidency in November, was in New York 21-22 March [... ]
The risk of seeing diamonds produced by Russian group Alrosa, including in Angola, being used to finance Russia's war on Ukraine has brought a reaction from the civil society coalition monitoring implementation of the Kimberley Process. [... ]
The financial institution has raised the alarm about Tanzania's debt sustainability and has downgraded the prospects for some of its flagship projects in the country. [... ]
To attract independent electricity producers, Gaborone is planning to update the regulatory framework of its electricity sector in order to be in line with President Mokgweetsi Masisi's plans to diversify # Botswana's coal-heavy energy mix [... ]
Botswana is lobbying to host the permanent secretariat of the Kimberley Process diamond certification scheme, with Austria and China also in the race. President Masisi used a recent EU-AU summit to fight for his cause. [... ]
In Gaborone, the government of Mokgweetsi Masisi is hoping to capitalise on the sale of the assets of the former public copper-nickel-cobalt flagship BCL to promote job creation, which until now has been touted as the main weakness of its economic programme. [... ]
The De Beers-Botswana state JV, which represents a third of the country's GDP, is looking for a new boss and with the company in the process of renegotiating its diamond sales contract, the choice of CEO is tangled with political considerations. [... ]
Of all the directorates of the Southern African Development Community, the one charged with regional political, defence, and security issues is by far the most strategic. Headed by Angola's Jorge Cardoso, it has to humour the changing moods of the organisation's rotating presidents at a time when a SADC military response is increasingly expected in Mozambique's Cabo Delgado province. [... ]
Following the failure of the humanitarian truce called for on March 18 by the United Nations to prevent the coronavirus ( Covid-19) spreading in Libya, nothing seems likely to stop the fighting in Tripoli between Khalifa Haftar's Libyan National Army ( LNA) [. [... ]
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Global Credit Conditions Q2 2022: Confluence Of Risks Halts Positive Credit Momentum | The effects of the Russia-Ukraine conflict on global economic and credit conditions are becoming more pronounced, with the first few months of 2022 making a turn in positive credit momentum.
The confluence of the Russia-Ukraine military conflict, nagging inflation and the prospects for higher interest rates, and the lingering pandemic mark a turn in the positive credit momentum of the past 14 months. But while downgrades are now outpacing upgrades, ratings remain resilient overall, and pressure is mounting unevenlyThe effects of the Russia-Ukraine conflict on global economic and credit conditions are becoming more pronounced; widening spreads in major markets suggest investors are growing somewhat more risk-averse. Defaults look set to rise from historically low levels and could exceed our baseline forecasts ( for 3% in the U.S. and 2.5% in Europe) by December.Main risks include an escalation of the conflict or expansion of sanctions to gas and oil exports to Europe, or broader geopolitical tensions; central banks’ struggle to control inflation without choking economic growth, leading to higher borrowing costs ( especially for lower-rated credits); persistent supply disruptions and high commodities prices squeezing profit margins; and new COVID variants.Ratings have been resilient outside of countries directly affected by the conflict and the sanctions, and entities highly exposed to the surge in commodities prices. Many corporates started the year with stronger balance sheets, having taken advantage of two years of cheap funding to extend maturities, with the result that speculative-grade corporate debt coming due through 2023 has fallen roughly 40% since Jan. 1, 2021. Banks, including those in Europe, are also proving resilient, having significantly reduced their exposure to Russia following its annexation of Crimea in 2014.
Overall: Borrowers in North America may soon see the run of remarkably favorable financing conditions come to an end as intersecting credit headwinds could result in pronounced downside effects. While the region is comparatively insulated to the effects of the Russia-Ukraine conflict, it is not immune to the fallout.Risks: On top of heightened geopolitical risks and worsening cost pressures and supply bottlenecks, we see a high risk that investors could soon demand significantly higher returns. This could result in the repricing of financial and real assets, higher debt-servicing costs, and tighter financing conditions.Credit: Credit markets have begun an about-face—kicked off by the aggressive tone of Fed policymakers and followed up by Russia’ s invasion of Ukraine. Nominal yields on U.S. corporate debt have risen quickly, returning to pre-pandemic levels in less than three months, which has kept many issuers on the sidelines.
Higher interest Rates: The interest rate outlook of Asia-Pacific is divided. China, because of its economic slowdown and limited inflationary pressures, has been able to lower interest rates. In contrast, most Asia-Pacific central banks have had or are poised to raise policy rates. Meanwhile, investors look set to seek higher spreads to compensate for higher risks. There has already been some investor risk aversion at the lower end of the rating spectrum.
Higher inflation: Higher energy and commodity prices, exacerbated by the Russia-Ukraine conflict, are increasing regional inflation pressures. The hit would be most keenly felt by the largest net energy importers ( relative to GDP) of India, the Philippines, Korea, Taiwan, and Thailand; but it is a plus for the net energy exporters of Australia, Indonesia, and Malaysia.
Higher expenses: Corporates unable to pass through the higher input costs to consumers will see margin compression. Coupled with tighter financing conditions and risk repricing, the pain will be especially pronounced for highly leveraged industries and borrowers. These include small and midsized enterprises ( SMEs) and households, which have yet to fully recover from the COVID-related economic shock of the past few years.
Confluence of headwinds: A combination of higher geopolitical uncertainty, cost inflation and accelerating monetary tightening by major central banks, together with China's property sector problems, is pressing down on regional and global economic growth. In more extreme scenarios, economic recession or stagflation could eventuate.
Overall: The Russia-Ukraine military conflict is hampering already feeble credit conditions in emerging markets ( EMs). Inflationary pressures were already denting corporations ' margins and households ' purchasing power prior to the conflict. Now the rising energy and food prices have intensified challenges, at least over the short term, because the potential for a severe confidence shock could weaken global demand and cool off prices.
Risks: Downside risks for EMs are significant. Additional inflationary pressures and persistently high energy prices could result from an extended conflict between Russia and Ukraine, especially if sanctions on Russia hit its hydrocarbon exports. EM sovereigns are struggling to deal with the pandemic costs, managing inflation, and meeting protracted social demands, a balance between fiscal consolidation and social strife. At the same time, financing conditions could weaken rapidly following the hasty U.S. monetary tightening or continued escalation of the military conflict.
Credit: Financing conditions have tightened amid rising volatility. Spreads have surged for EM corporates, particularly those in the EEMEA region. Investors are becoming more selective, while some low-rated entities may struggle to refinance their debt or raise capital if current market conditions persist.
Overall: The invasion of Ukraine represents a seismic systemic shock to Europe and the world. The humanitarian crisis as well as border and energy security are critical short-term priorities. The political and economic repercussions will take longer to play out. They carry significant downside risks given the highly uncertain and volatile situation, even though the European economy and financial markets have held up well so far.
Risks: Energy security, further supply chain disruption, and amplification of existing inflation pressures are the dominant risks in light of the ongoing Russian invasion of Ukraine. Frontloading a monetary policy response to high inflation could lead to an excessive tightening in financing conditions. Barring a more severe variant, COVID-19 is now increasingly viewed as endemic in Europe.
Credit: Financing conditions are expected to tighten as European central banks focus on inflation even as the growth outlook slows. The 14-month improving trend in credit quality is likely to reverse, with cost input pressures to increasingly weigh on corporate margins through the year. We expect default rates to move higher toward 2.5% by year end. | business |
Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 - The Lancet Gastroenterology & Hepatology | BackgroundColorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades.MethodsEstimates of incidence, mortality, and disability-adjusted life years ( DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study ( GBD) 2019 by age, sex, and geographical location for the period 1990–2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer.FindingsGlobally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 ( 95% uncertainty interval [ UI ] 810 408–868 574) to 2·17 million ( 2·00–2·34), and deaths increased from 518 126 ( 493 682–537 877) to 1·09 million ( 1·02–1·15). The global age-standardised incidence rate increased from 22·2 ( 95% UI 21·3–23·0) per 100 000 to 26·7 ( 24·6–28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 ( 13·5–14·9) per 100 000 to 13·7 ( 12·6–14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 ( 294·7–320·7) per 100 000 to 295·5 ( 275·2–313·0) per 100 000 from 1990 through 2019. Taiwan ( province of China; 62·0 [ 48·9–80·0 ] per 100 000), Monaco ( 60·7 [ 48·5–73·6 ] per 100 000), and Andorra ( 56·6 [ 42·8–71·9 ] per 100 000) had the highest age-standardised incidence rates, while Greenland ( 31·4 [ 26·0–37·1 ] per 100 000), Brunei ( 30·3 [ 26·6–34·1 ] per 100 000), and Hungary ( 28·6 [ 23·6–34·0 ] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults ( age < 50 years), particularly in high Socio-demographic Index ( SDI) countries. Globally, a diet low in milk ( 15·6%), smoking ( 13·3%), a diet low in calcium ( 12·9%), and alcohol use ( 9·9%) were the main contributors to colorectal cancer DALYs in 2019.InterpretationThe increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions.FundingBill & Melinda Gates Foundation.
Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades.
Estimates of incidence, mortality, and disability-adjusted life years ( DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study ( GBD) 2019 by age, sex, and geographical location for the period 1990–2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer.
Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 ( 95% uncertainty interval [ UI ] 810 408–868 574) to 2·17 million ( 2·00–2·34), and deaths increased from 518 126 ( 493 682–537 877) to 1·09 million ( 1·02–1·15). The global age-standardised incidence rate increased from 22·2 ( 95% UI 21·3–23·0) per 100 000 to 26·7 ( 24·6–28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 ( 13·5–14·9) per 100 000 to 13·7 ( 12·6–14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 ( 294·7–320·7) per 100 000 to 295·5 ( 275·2–313·0) per 100 000 from 1990 through 2019. Taiwan ( province of China; 62·0 [ 48·9–80·0 ] per 100 000), Monaco ( 60·7 [ 48·5–73·6 ] per 100 000), and Andorra ( 56·6 [ 42·8–71·9 ] per 100 000) had the highest age-standardised incidence rates, while Greenland ( 31·4 [ 26·0–37·1 ] per 100 000), Brunei ( 30·3 [ 26·6–34·1 ] per 100 000), and Hungary ( 28·6 [ 23·6–34·0 ] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults ( age < 50 years), particularly in high Socio-demographic Index ( SDI) countries. Globally, a diet low in milk ( 15·6%), smoking ( 13·3%), a diet low in calcium ( 12·9%), and alcohol use ( 9·9%) were the main contributors to colorectal cancer DALYs in 2019.
The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions.
Bill & Melinda Gates Foundation.
In 2019, colorectal cancer was the third leading cause of cancer deaths and the second leading cause of disability-adjusted life years ( DALYs) for cancer worldwide.1GBD 2019 Diseases and Injuries CollaboratorsGlobal burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1204-1222Google Scholar Around 70–75% of colorectal cancer cases occur sporadically and are associated with modifiable risk factors, whereas 25–30% of cases are linked to non-modifiable risk factors such as genetic factors, a personal history of polyps or adenoma, or a family history of colorectal cancer or hereditary risk ( eg, Lynch syndrome or familial adenomatous polyposis).2Lynch HT de la Chapelle A Hereditary colorectal cancer.N Engl J Med. 2003; 348: 919-932Google Scholar, 3Graff RE Möller S Passarelli MN et al.Familial risk and heritability of colorectal cancer in the nordic twin study of cancer.Clin Gastroenterol Hepatol. 2017; 15: 1256-1264Google Scholar, 4Anand P Kunnumakkara AB Sundaram C et al.Cancer is a preventable disease that requires major lifestyle changes.Pharm Res. 2008; 25: 2097-2116Google Scholar, 5Jasperson KW Tuohy TM Neklason DW Burt RW Hereditary and familial colon cancer.Gastroenterology. 2010; 138: 2044-2058Google Scholar Because of the increased prevalence of modifiable risk factors such as smoking, alcohol consumption, unhealthy diets, sedentary behaviour, physical inactivity, obesity, increasing life expectancy, increasing awareness and affordability of colorectal cancer screening, and increasing screening capacity, incident cases of colorectal cancer are growing rapidly in low-income and middle-income countries ( LMICs).6Arnold M Sierra MS Laversanne M Soerjomataram I Jemal A Bray F Global patterns and trends in colorectal cancer incidence and mortality.Gut. 2017; 66: 683-691Google Scholar, 7GBD 2017 Colorectal Cancer CollaboratorsThe global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet Gastroenterol Hepatol. 2019; 4: 913-933Google Scholar
The UN Sustainable Development Goal ( SDG) target 3.4 focuses on reduction of premature mortality from non-communicable diseases ( including cancers) by a third by 2030.8UN Department of Economic and Social AffairsUnited Nations Sustainable Development Goals. Goal 3: ensure healthy lives and promote well-being for all at all ages.https: //www.un.org/sustainabledevelopment/health/Date accessed: March 22, 2022Google Scholar Colorectal cancer can be prevented by ameliorating modifiable risk factors, and deaths can be prevented through early detection of polyps with proven screening interventions; 9Bhat SK East JE Colorectal cancer: prevention and early diagnosis.Medicine. 2015; 43: 295-298Google Scholar, 10Wang X O'Connell K Jeon J et al.Combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies.BMJ Open Gastroenterol. 2019; 6e000339Google Scholar, 11Frampton M Houlston RS Modeling the prevention of colorectal cancer from the combined impact of host and behavioral risk factors.Genet Med. 2017; 19: 314-321Google Scholar therefore, addressing the global colorectal cancer burden must serve as one of the considerations towards progress on SDG 3.4 relating to non-communicable diseases. In this endeavour, recent changes in the colorectal cancer burden should be tracked at the global, regional, and national levels to identify those countries making progress and those countries and regions where more work is needed.
Research in contextEvidence before this studyColorectal cancer is one of the leading causes of cancer deaths worldwide. Previously, the Global Burden of Diseases, Injuries, and Risk Factors Study ( GBD) 2017 provided estimates for colorectal cancer incidence, deaths, and disability-adjusted life years ( DALYs) for the period 1990–2017. Apart from GBD 2017, the International Agency for Research on Cancer ( IARC) provided estimates for colorectal cancer for 2020 under the GLOBOCAN project. The present study was done as a part of GBD 2019, which produced estimates for 302 causes of death, 369 diseases and injuries, and 87 risk factors for 204 countries and territories for 1990–2019.Added value of this studyIn this study, we provide age-sex-location-specific estimates of colorectal cancer incidence, deaths, and DALYs for 204 countries and territories between 1990 and 2019. GBD 2019 produced estimates with technical collaboration from WHO, which has led to the inclusion of nine more WHO member countries. 28 714 site-years of data were used to estimate colorectal cancer incidence, deaths, and DALYs in GBD 2019, 16% more than in GBD 2017. In comparison with GLOBOCAN 2020, which provided colorectal cancer estimates for 2020, we provide estimates for full time series through 1990 to 2019 for all 204 countries and territories included in GBD 2019. Apart from estimates of incident cases, deaths, and age-standardised rates, as was done in GLOBOCAN 2020, we also estimated the burden of deaths and disability quantified with DALYs. The colorectal cancer burden was also examined in the light of country-level socioeconomic development measured by Socio-demographic Index ( SDI). The contribution of the main risk factors to colorectal cancer DALYs was also examined by sex in 21 world regions.Implications of all the available evidenceIncident cases of colorectal cancer doubled or more than doubled in 16 of 21 world regions, and the number of deaths doubled or more than doubled in 15 of 21 world regions in the past three decades. The age-standardised incidence and death rates ( per 100 000 person-years) either remained the same or decreased in high SDI quintiles and increased in low SDI and middle SDI quintiles. Large increases in colorectal cancer incidence rates were observed in middle SDI countries, as well as in people aged 20–49 years in high SDI countries. Further research is required to understand the causes of the colorectal cancer burden in younger adults ( aged < 50 years) and the main risk factors, including obesity, physical inactivity, alcohol consumption, smoking, and an altered gut microbiome, that might have led to the rise in the colorectal cancer burden. The increasing incidence of colorectal cancer in people younger than 50 years in high SDI countries also necessitates reconsideration of screening recommendations to include younger age groups ( ie, those aged 40–49 years). The public health interventions for colorectal cancer awareness, screening, and prevention through containment of modifiable risk factors such as alcohol, smoking, an unhealthy diet ( high in processed meat and fat, and low in fruits and vegetables), and obesity are key to stemming the tide of colorectal cancer worldwide.
Colorectal cancer is one of the leading causes of cancer deaths worldwide. Previously, the Global Burden of Diseases, Injuries, and Risk Factors Study ( GBD) 2017 provided estimates for colorectal cancer incidence, deaths, and disability-adjusted life years ( DALYs) for the period 1990–2017. Apart from GBD 2017, the International Agency for Research on Cancer ( IARC) provided estimates for colorectal cancer for 2020 under the GLOBOCAN project. The present study was done as a part of GBD 2019, which produced estimates for 302 causes of death, 369 diseases and injuries, and 87 risk factors for 204 countries and territories for 1990–2019.
In this study, we provide age-sex-location-specific estimates of colorectal cancer incidence, deaths, and DALYs for 204 countries and territories between 1990 and 2019. GBD 2019 produced estimates with technical collaboration from WHO, which has led to the inclusion of nine more WHO member countries. 28 714 site-years of data were used to estimate colorectal cancer incidence, deaths, and DALYs in GBD 2019, 16% more than in GBD 2017. In comparison with GLOBOCAN 2020, which provided colorectal cancer estimates for 2020, we provide estimates for full time series through 1990 to 2019 for all 204 countries and territories included in GBD 2019. Apart from estimates of incident cases, deaths, and age-standardised rates, as was done in GLOBOCAN 2020, we also estimated the burden of deaths and disability quantified with DALYs. The colorectal cancer burden was also examined in the light of country-level socioeconomic development measured by Socio-demographic Index ( SDI). The contribution of the main risk factors to colorectal cancer DALYs was also examined by sex in 21 world regions.
Incident cases of colorectal cancer doubled or more than doubled in 16 of 21 world regions, and the number of deaths doubled or more than doubled in 15 of 21 world regions in the past three decades. The age-standardised incidence and death rates ( per 100 000 person-years) either remained the same or decreased in high SDI quintiles and increased in low SDI and middle SDI quintiles. Large increases in colorectal cancer incidence rates were observed in middle SDI countries, as well as in people aged 20–49 years in high SDI countries. Further research is required to understand the causes of the colorectal cancer burden in younger adults ( aged < 50 years) and the main risk factors, including obesity, physical inactivity, alcohol consumption, smoking, and an altered gut microbiome, that might have led to the rise in the colorectal cancer burden. The increasing incidence of colorectal cancer in people younger than 50 years in high SDI countries also necessitates reconsideration of screening recommendations to include younger age groups ( ie, those aged 40–49 years). The public health interventions for colorectal cancer awareness, screening, and prevention through containment of modifiable risk factors such as alcohol, smoking, an unhealthy diet ( high in processed meat and fat, and low in fruits and vegetables), and obesity are key to stemming the tide of colorectal cancer worldwide.
This study aimed to investigate the global, regional, and national burden of colorectal cancer in 204 countries and territories from 1990 to 2019. We examined the age-sex-location-specific burden of colorectal cancer using estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study ( GBD) 2019.1GBD 2019 Diseases and Injuries CollaboratorsGlobal burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1204-1222Google Scholar, 12GBD 2019 Demographics CollaboratorsGlobal age-sex-specific fertility, mortality, healthy life expectancy ( HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1160-1203Google Scholar, 13GBD 2019 Risk Factors CollaboratorsGlobal burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1223-1249Google Scholar, 14Murray CJ Abbafati C Abbas KM et al.Five insights from the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1135-1159Google Scholar The colorectal cancer burden was examined in light of the development status of countries measured by the Socio-demographic Index ( SDI). We also aimed to quantify health loss due to colorectal cancer using DALYs, which encompasses the burden of a disease due to both deaths and disabilities caused by it. Last, we also examined the risk-attributable burden of the main risk factors for colorectal cancer. Apart from GBD, the International Agency for Research on Cancer ( IARC) produced cancer estimates for 2020; however, GBD estimates facilitate examination of temporal patterns at global, regional, and national levels. An assessment of recent trends at the global, regional, and national levels, and the associated risk factors for countries at different levels of development, can help track progress, map resource requirements, and help in policy making and implementation towards prevention and tackling the growing burden of colorectal cancer.
This manuscript was produced as part of the GBD Collaborator Network and in accordance with the GBD Protocol.
The GBD 2019 estimates were generated for 286 causes of death, 369 causes of non-fatal burden, and 87 risk factors.1GBD 2019 Diseases and Injuries CollaboratorsGlobal burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1204-1222Google Scholar, 12GBD 2019 Demographics CollaboratorsGlobal age-sex-specific fertility, mortality, healthy life expectancy ( HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1160-1203Google Scholar, 13GBD 2019 Risk Factors CollaboratorsGlobal burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1223-1249Google Scholar, 14Murray CJ Abbafati C Abbas KM et al.Five insights from the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1135-1159Google Scholar In comparison with the 195 countries and territories included in GBD 2017, nine more countries ( Cook Islands, Monaco, San Marino, Nauru, Niue, Palau, Saint Kitts and Nevis, Tokelau, and Tuvalu) were included in GBD 2019, providing full time-series estimates from 1990 to 2019 for 204 countries and territories, which were grouped under seven super-regions and 21 regions. The colorectal cancer estimates mapped to the International Classification of Diseases ( ICD) codes are available in the appendix ( p 14).15Global Burden of Disease 2019 Cancer CollaborationCancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.JAMA Oncol. 2022; 8: 420-444Google Scholar The GBD estimation framework and calculation of all the metrics are detailed in GBD 2019 capstone publications and the supplementary appendices published with these reports.1GBD 2019 Diseases and Injuries CollaboratorsGlobal burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1204-1222Google Scholar, 12GBD 2019 Demographics CollaboratorsGlobal age-sex-specific fertility, mortality, healthy life expectancy ( HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1160-1203Google Scholar, 13GBD 2019 Risk Factors CollaboratorsGlobal burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1223-1249Google Scholar, 14Murray CJ Abbafati C Abbas KM et al.Five insights from the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1135-1159Google Scholar
For GBD 2019, input data from various sources such as vital registration, verbal autopsy, and cancer registries were used to generate the colorectal cancer estimates. 28 714 site-years of data ( 22 849 site-years for vital registration, 516 site-years for verbal autopsy, and 5349 site-years for cancer registries) were used to estimate the colorectal cancer burden in GBD 2019, 3962 site-years ( 16%) more than GBD 2017. The vital registration system records data of vital events in a person's life ( birth, death, and cause of death). Verbal autopsy is a data collection method generally used in populations without a complete vital registration system; in this method, a trained interviewer uses a questionnaire to collect information about signs, symptoms, and demographic characteristics of a recently deceased person from someone familiar with the deceased. Cancer registries are a data collection system that record and manage the data relating to a person with cancer. The information on various input sources of data used in GBD 2019 can be obtained from the GBD 2019 Data Input Sources Tool.
GBD estimation begins with mortality estimation in multiple steps. The mortality data from cancer registries might be sparse, although incidence data can be available; therefore, to maximise data availability, mortality-to-incidence ratios ( MIRs) were generated from the cancer registries that contained both incidence and mortality data. In the first step, incidence and mortality data from cancer registries were processed before they were matched by cancer, age, sex, year, and location to generate crude MIRs. Final MIRs were estimated by use of spatio-temporal Gaussian Process Regression ( ST-GPR) using the Healthcare Access and Quality ( HAQ) index, age, and sex16GBD 2016 Healthcare Access and Quality CollaboratorsMeasuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016.Lancet. 2018; 391: 2236-2271Google Scholar as covariates. The MIR estimates from the ST-GPR model were multiplied with incidence data to generate crude mortality estimates. The final mortality estimates were produced with the Cause of Death Ensemble Model ( CODEm) using crude mortality estimates from the last step and those from vital registration and verbal autopsy as inputs along with other variables taken as covariates.1GBD 2019 Diseases and Injuries CollaboratorsGlobal burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1204-1222Google Scholar, 15Global Burden of Disease 2019 Cancer CollaborationCancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.JAMA Oncol. 2022; 8: 420-444Google Scholar Only those variables were chosen that have been found to have a plausible relation with death due to colorectal cancer. The list of covariates at different levels used in CODEm for colorectal cancer is presented in the appendix ( pp 15–16).1GBD 2019 Diseases and Injuries CollaboratorsGlobal burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1204-1222Google Scholar, 15Global Burden of Disease 2019 Cancer CollaborationCancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.JAMA Oncol. 2022; 8: 420-444Google Scholar The final mortality estimates from CODEm were then divided by the MIRs from ST-GPR to generate age-sex-location-specific estimates for incident cases.
The mortality estimates generated from CODEm were combined with reference life tables to generate estimates for years of life lost ( YLLs).12GBD 2019 Demographics CollaboratorsGlobal age-sex-specific fertility, mortality, healthy life expectancy ( HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1160-1203Google Scholar The 10-year prevalence was divided into four sequelae of a fixed duration based on expected person-time spent in each of the sequela: diagnosis and primary therapy ( 4·0 months), metastatic phase ( 9·7 months), and terminal phase ( 1·0 month), with the remaining duration assigned to the controlled phase.15Global Burden of Disease 2019 Cancer CollaborationCancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.JAMA Oncol. 2022; 8: 420-444Google Scholar Sequela-specific years lived with disability ( YLDs) were calculated by multiplying disability weights with sequelae-specific prevalence. Total YLDs were calculated by summing the sequela-specific YLDs. The sum of YLLs and YLDs produced the DALYs estimates, with one DALY being equivalent to 1 year of healthy life lost.17Murray CJ Quantifying the burden of disease: the technical basis for disability-adjusted life years.Bull World Health Organ. 1994; 72: 429-445Google Scholar
The age-specific rates of incidence, mortality, and DALYs were expressed per 100 000 person-years and calculated with GBD population estimates,12GBD 2019 Demographics CollaboratorsGlobal age-sex-specific fertility, mortality, healthy life expectancy ( HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1160-1203Google Scholar and the age-standardised rates were calculated as weighted averages of age-specific rates per 100 000 people, in which weights are the proportion of people in corresponding age groups as per the GBD world population age standard.12GBD 2019 Demographics CollaboratorsGlobal age-sex-specific fertility, mortality, healthy life expectancy ( HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1160-1203Google Scholar All GBD estimates in this Article are provided with 95% uncertainty intervals ( UIs). For each computational step, 1000 draws are generated; 95% UIs are calculated by taking values at the 2·5th and 97·5th percentile from the 1000 draws, and are provided alongside the mean estimates.12GBD 2019 Demographics CollaboratorsGlobal age-sex-specific fertility, mortality, healthy life expectancy ( HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1160-1203Google Scholar
The colorectal cancer burden was evaluated against country-level development measured with the SDI,12GBD 2019 Demographics CollaboratorsGlobal age-sex-specific fertility, mortality, healthy life expectancy ( HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1160-1203Google Scholar, 15Global Burden of Disease 2019 Cancer CollaborationCancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.JAMA Oncol. 2022; 8: 420-444Google Scholar which is a composite indicator of three indicators: lag-distributed income per capita, average educational attainment for people aged 15 years and older, and the total fertility rate ( in people aged < 25 years). Each of these indicators was first rescaled on a scale of 0 ( lowest) to 1 ( highest) based on country-specific values. The geometric mean of these three indices provided the final value of the country-level SDI. Based on SDI values, the 204 countries and territories were categorised into five groups: low SDI ( < 0·45), low-middle SDI ( ≥0·45 and < 0·61), middle SDI ( ≥0·61 and < 0·69), high-middle SDI ( ≥0·69 and < 0·80), and high SDI ( ≥0·80).
Estimation of GBD risk factors is based on a comparative risk assessment framework and involves six steps. The first is identification of risk-outcome pairs: only those risk-outcomes that have convincing or plausible evidence, as per World Cancer Research Fund criteria,18World Cancer Research Fund/American Institute for Cancer ResearchFood, nutrition, physical activity, and cancer: a global perspective. A summary of the third expert report. Continuous Update Project Expert Report 2018.https: //www.wcrf.org/wp-content/uploads/2021/02/Summary-of-Third-Expert-Report-2018.pdfDate accessed: February 28, 2022Google Scholar are included in GBD risk factor estimation. The second is estimation of relative risk ( RR) as a function of exposure for each risk-outcome pair. The third is distribution of exposure for each risk factor by age, sex, location, and year. The fourth is determining the theoretical minimum risk exposure level ( TMREL). The fifth is estimation of the population attributable fraction ( PAF) and attributable burden. The RR for each risk-outcome pair, exposure levels, and TMREL are used to model the PAF.13GBD 2019 Risk Factors CollaboratorsGlobal burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1223-1249Google Scholar The PAF of a particular risk factor is multiplied by colorectal cancer DALYs to generate the DALYs attributable to that risk factor. The sixth is estimating the PAF and attributable burden for the combination of risk factors.
The details of each of these steps and the underlying methodology are provided elsewhere.13GBD 2019 Risk Factors CollaboratorsGlobal burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1223-1249Google Scholar In this GBD iteration, 87 risk factors were included, of which ten ( alcohol use, diet high in processed meat, diet high in red meat, diet low in calcium, diet low in fibre, diet low in milk, high body-mass index [ BMI ], high fasting plasma glucose, low physical activity, and smoking) have a non-zero contribution to colorectal cancer deaths and DALYs. We assessed the percentage contribution of these ten risk factors to colorectal cancer DALYs in 2019. The total number of input data sources used for the exposure of different risk factors in GBD 2019 are detailed elsewhere,13GBD 2019 Risk Factors CollaboratorsGlobal burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2020; 396: 1223-1249Google Scholar of which we present the number of input data sources for the ten risk factors related to colorectal cancer ( appendix p 17).
The percentage changes between 1990 and 2019 were interpreted as statistically significant if the 95% UI did not include zero. All data analysis and data visualisation in this study were done with statistical software R ( version 4.1.1), Stata ( version 13.1), and Python ( version 3.8.8).
The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
Globally, for both sexes combined, incident cases of colorectal cancer more than doubled, from 842 098 ( 95% UI 810 408–868 574) in 1990 to 2·17 million ( 2·00–2·34) in 2019 ( figure 1A). Between 1990 and 2019, deaths due to colorectal cancer increased from 518 126 ( 493 682–537 877) to 1·09 million ( 1·02–1·15), and DALYs increased from 12·4 million ( 11·9–12·9) to 24·3 million ( 22·6–25·7). By 2019, 95·6% of colorectal cancer DALYs were due to YLLs and 4·4% were due to YLDs ( appendix p 5). The global age-standardised incidence rate of colorectal cancer increased from an estimated 22·2 ( 21·3–23·0) per 100 000 to 26·7 ( 24·6–28·9) per 100 000 from 1990 through 2019 ( figure 1B). By contrast, the global age-standardised mortality rate decreased from 14·3 ( 13·5–14·9) per 100 000 to 13·7 ( 12·6–14·5) per 100 000, and the age-standardised DALY rate decreased from 308·5 ( 294·7–320·7) per 100 000 to 295·5 ( 275·2–313·0) per 100 000 from 1990 through 2019.Figure 1Global temporal patterns of colorectal cancer burden, 1990–2019Show full caption ( A) All-age counts. ( B) Age-standardised rates. Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019. DALYs=disability-adjusted life-years.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
( A) All-age counts. ( B) Age-standardised rates. Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019. DALYs=disability-adjusted life-years.
Males experienced greater increases in colorectal cancer incidence, deaths, and DALYs, than females in terms of absolute counts, and the age-standardised rates increased in males and remained similar throughout or decreased in females ( figure 1). In 2019, males accounted for 57·2% ( 1·2 million [ 95% UI 1·1–1·4 ]) of colorectal cancer incident cases, and 54·9% ( 594 176 [ 550 959–638 031 ]) of deaths due to colorectal cancer. In 2019, the age-standardised incidence rate was 1·5-times higher in males than in females ( 33·1 [ 30·2– 36·1 ] per 100 000 vs 21·2 [ 19·0–23·2 ] per 100 000), with a similar disparity between males and females in terms of the age-standardised mortality rate ( 16·6 [ 15·4–17·8 ] per 100 000 in males vs 11·2 [ 10·0–12·2 ] per 100 000 in females) and the age-standardised DALY rate ( 360·0 [ 333·1–387·8 ] per 100 000 in males vs 237·9 [ 218·7–257·1 ] per 100 000 in females; figure 1). The number of incident cases increased in all SDI quintiles, whereas the age-standardised incidence rate decreased in the high SDI quintile only ( appendix p 6). Similarly, deaths and DALYs increased in all SDI quintiles, but age-standardised mortality rates stagnated or decreased only in high-middle SDI and high SDI quintiles ( appendix pp 7–8). Notably, the rise in all-age counts was steeper in all SDI quintiles than in the high SDI quintile such that the share of low, low-middle, middle, and high-middle SDI quintiles in the total colorectal cancer burden increased from 47·3% to 62·1% in terms of incident cases, from 57·1% to 69·8% in terms of deaths, and from 62·4% to 74·6% in terms of DALYs between 1990 and 2019 ( appendix pp 6–8).
In 2019, east Asia was the worst-affected region, with 637 096 ( 95% UI 548 895–738 549) new cases, 275 604 ( 238 238–317 886) deaths, and 6·7 million ( 5·8–7·7) DALYs due to colorectal cancer ( table). Australasia had the highest age-standardised incidence rate ( 48·3 [ 39·6–59·1 ] per 100 000) and central Europe had the highest age-standardised mortality rate ( 23·6 [ 20·8–26·4 ] per 100 000) across 21 regions in 2019. The age-standardised incidence rate was the lowest in central sub-Saharan Africa ( 7·7 [ 5·9–10·1 ] per 100 000) and south Asia ( 8·3 [ 7·2–9·4 ] per 100 000). South Asia also had the lowest age-standardised mortality rate ( 7·3 [ 6·2–8·3 ] per 100 000). The age-standardised DALY rate was the highest in central Europe ( 512·6 [ 448·7–577·9 ] per 100 000) and lowest in south Asia ( 165·1 [ 141·7–189·9 ] per 100 000) in 2019 ( table).TableRegion-wise colorectal cancer burden in 2019Incidence ( 95% UI) Mortality ( 95% UI) DALYs ( 95% UI) Age-standardised incidence rate ( 95% UI) Age-standardised mortality rate ( 95% UI) Age-standardised DALY rate ( 95% UI) Global2 166 168 ( 1 996 298–2 342 842) 1 085 797 ( 1 002 795–1 149 679) 24 284 087 ( 22 614 920–25 723 221) 26·7 ( 24·6–28·9) 13·7 ( 12·6–14·5) 295·5 ( 275·2–313·0) Andean Latin America11 094 ( 8935–13 467) 5630 ( 4593–6791) 125 578 ( 101 753–151 796) 20·0 ( 16·1–24·2) 10·3 ( 8·4–12·4) 220·8 ( 179·0–266·3) Australasia23 671 ( 19 439–28 848) 8382 ( 7575–8978) 163 248 ( 150 872–173 959) 48·3 ( 39·6–59·1) 16·2 ( 14·8–17·3) 348·6 ( 324·2–370·7) Caribbean13 813 ( 11 813–15 959) 7995 ( 6935–9176) 172 016 ( 147 186–200 175) 26·7 ( 22·9–30·9) 15·5 ( 13·4–17·7) 333·3 ( 285·2–387·9) Central Asia10 949 ( 9999–12 008) 7467 ( 6822–8166) 199 841 ( 182 012–219 941) 15·2 ( 13·9–16·6) 11·2 ( 10·3–12·2) 256·8 ( 234·4–281·1) Central Europe84474 ( 74 551–95 453) 51 567 ( 45 636–57 749) 1 052 146 ( 922 923–1 184 246) 39·9 ( 35·2–45·1) 23·6 ( 20·8–26·4) 512·6 ( 448·7–577·9) Central Latin America37 542 ( 32 211–43 870) 22 470 ( 19 542–25 997) 539 638 ( 465 200–627 069) 15·9 ( 13·7–18·6) 9·7 ( 8·4–11·2) 223·7 ( 193·1–259·5) Central sub-Saharan Africa3957 ( 3015–5113) 3544 ( 2705–4609) 100 988 ( 75 749–131 447) 7·7 ( 5·9–10·1) 7·4 ( 5·7–9·9) 169·3 ( 129·2–220·2) East Asia637 096 ( 548 895–738 549) 275 604 ( 238 238–317 886) 6 712 862 ( 5 774 277–7 735 907) 30·9 ( 26·8–35·7) 14·1 ( 12·2–16·2) 325·2 ( 280·7–373·2) Eastern Europe106 017 ( 96 250–117 074) 63 476 ( 57 180–70 011) 1 419 105 ( 1 287 540–1 571 374) 31·1 ( 28·2–34·4) 18·3 ( 16·5–20·2) 423·7 ( 384·0–469·3) Eastern sub-Saharan Africa14 227 ( 12 130–16 886) 12 717 ( 10 940–15 001) 356 433 ( 301 931–425 606) 8·8 ( 7·6–10·4) 8·5 ( 7·4–9·9) 193·9 ( 166·0–229·6) High-income Asia Pacific196 371 ( 166 417–225 643) 76 929 ( 64 821–83 603) 1 327 823 ( 1 186 117–1 414 814) 44·6 ( 38·4–51·1) 15·3 ( 13·4–16·4) 323·9 ( 298·6–342·1) High-income North America260 911 ( 229 909–295 693) 95 664 ( 88 321–99 688) 1 987 109 ( 1 895 869–2 059 774) 42·7 ( 37·6–48·6) 14·9 ( 13·9–15·5) 339·9 ( 325·9–351·9) North Africa and Middle East60 010 ( 53 354–67 555) 39 147 ( 34 761–44 107) 1 013 634 ( 896 161–1 146 526) 13·9 ( 12·3–15·6) 9·8 ( 8·7–11) 218·7 ( 194·1–246·5) Oceania691 ( 555–855) 551 ( 443–682) 16 315 ( 12 915–20 556) 10·0 ( 8·2–12·1) 8·8 ( 7·2–10·7) 203·6 ( 163·6–252·5) South Asia113 711 ( 98 190–129 352) 94 846 ( 81 524–109 075) 2 419 098 ( 2 078 019–2 782 570) 8·3 ( 7·2–9·4) 7·3 ( 6·2–8·3) 165·1 ( 141·7–189·9) Southeast Asia117 010 ( 96 631–136 244) 82 024 ( 67 617–94 606) 2 142 434 ( 1 780 490–2 482 287) 19·3 ( 16–22·4) 14·4 ( 11·9–16·6) 334·0 ( 276·6–386·4) Southern Latin America26 866 ( 21 480–33 612) 17 930 ( 16 774–18 975) 366 436 ( 347 729–385 441) 32·2 ( 25·7–40·4) 21·2 ( 19·9–22·4) 447·6 ( 424·7–470·5) Southern sub-Saharan Africa7106 ( 6389–7882) 5922 ( 5329–6580) 147 780 ( 132 439–165 539) 13·1 ( 11·8–14·5) 11·5 ( 10·4–12·7) 250·4 ( 225·1–279·3) Tropical Latin America42 891 ( 40 118–44 928) 27 704 ( 25 668–29 090) 660 129 ( 625 562–687 740) 17·8 ( 16·6–18·6) 11·7 ( 10·8–12·3) 268·3 ( 253·7–279·8) Western Europe382 442 ( 332 800–432 448) 172 454 ( 155 345–181 815) 3 008 234 ( 2 815 060–3 152 895) 42·4 ( 37·1–48·3) 17·3 ( 15·8–18·1) 351·2 ( 332·0–366·8) Western sub-Saharan Africa15 321 ( 12 895–17 824) 13 773 ( 11 698–16 069) 353 242 ( 295 571–420 704) 8·7 ( 7·4–10·0) 8·4 ( 7·3–9·7) 176·1 ( 149·0–206·2) Numbers in parenthesis represent 95% uncertainty intervals ( UIs). DALYs=disability-adjusted life years. The age-standardised incidence rate, age-standardised mortality rate, and age-standardised DALY rate are shown per 100 000 person-years. Source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Open table in a new tab
Numbers in parenthesis represent 95% uncertainty intervals ( UIs). DALYs=disability-adjusted life years. The age-standardised incidence rate, age-standardised mortality rate, and age-standardised DALY rate are shown per 100 000 person-years. Source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019.
The preponderance of colorectal cancer in males in 2019, in terms of both age-standardised incidence rates and age-standardised mortality rates, was more apparent in developed regions ( eg, Australasia, central Europe, and the high-income Asia Pacific) and differences between males and females were smaller in south Asia and regions of Africa ( eg, eastern sub-Saharan Africa and western sub-Saharan Africa; figure 2).Figure 2Age-standardised rates of colorectal cancer in 2019, by sex and regionShow full caption ( A) Age-standardised incidence rate ( per 100 000 person-years). ( B) Age-standardised mortality rate ( per 100 000 person-years). Error bars denote 95% uncertainty intervals. Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
( A) Age-standardised incidence rate ( per 100 000 person-years). ( B) Age-standardised mortality rate ( per 100 000 person-years). Error bars denote 95% uncertainty intervals. Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019.
Three patterns emerged from region-wise temporal trends of age-standardised rates in GBD regions ( appendix p 9). First, in regions with already high incidence rates in 1990 ( eg, Australasia and the high-income Asia Pacific), the age-standardised incidence rates either stagnated or decreased and age-standardised mortality rates decreased in the past three decades. Second, concomitant rises in age-standardised incidence and mortality rates were observed in a few regions of Asia, Africa ( eg, western sub-Saharan Africa and south Asia), and Oceania. Third, large increases occurred in age-standardised incidence rates, whereas a smaller increase was observed in age-standardised mortality rates in a few regions ( eg, east Asia and south east Asia).
From 1990 to 2019, incident cases doubled or more than doubled in 16 of 21 regions, deaths doubled or more than doubled in 15 of 21 regions, and DALYs doubled or more than doubled in 13 of 21 regions, led by regions of Latin America and Asia ( figure 3A). The changes in age-standardised rates were modest, with age-standardised incidence rates increasing by 50% or more in six GBD regions ( east Asia, Andean Latin America, southeast Asia, central Latin America, North Africa and the Middle East, and south Asia; figure 3B). Age-standardised incidence rates decreased, although these decreases were not statistically significant, in high-income North America ( −10·0% [ 95% UI −21·1 to 2·5 ]) and Australasia ( −6·2% [ –22·7 to 14·7 ]) between 1990 and 2019. Age-standardised mortality rates increased the most in southeast Asia ( 46·7% [ 21·8 to 70·0 ]) followed by east Asia ( 37·1% [ 15·1 to 62·3 ]), and decreased in Australasia ( −33·5% [ –29·8 to −37·2 ]) and high-income North America ( −25·3% [ –23·5 to −27·3 ]) from 1990 through 2019, with a couple of other high-income regions experiencing a reduction ( −22·1% [ –25·0 to −19·6 ] in western Europe and −14·8% [ –20·6 to −10·9 ] in the high-income Asia Pacific). Due to large increases in incidence and death rates, the age-standardised DALY rate increased the most in regions of Asia and Latin America, led by southeast Asia ( 41·6% [ 18·2 to 62·7 ]) and central Latin America ( 37·8% [ 19·0 to 59·4 ]) and decreased in high-income regions and regions of Europe ( figure 3B).Figure 3Region-wise percentage change in colorectal cancer burden, 1990–2019Show full caption ( A) All-age numbers. B) Age-standardised rate ( per 100 000). Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Error bars denote 95% uncertainty intervals. DALYs=disability-adjusted life-years.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
( A) All-age numbers. B) Age-standardised rate ( per 100 000). Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Error bars denote 95% uncertainty intervals. DALYs=disability-adjusted life-years.
China, the USA, and Japan had the highest all-age incident counts for both sexes combined, with 607 900 ( 95% UI 521 805–708 420) new cases in China, 227 242 ( 197 022–261 375) new cases in the USA, and 160 211 ( 130 730–186 831) new cases in Japan, in 2019 ( appendix pp 18–43). China ( 261 777 [ 224 403–303 318 ]), India ( 79 098 [ 67 137–92 723 ]), and the USA ( 84 026 [ 77 987–87 516 ]) had the highest death counts. Somalia ( 5·0 [ 3·1–9·2 ] per 100 000), Niger ( 5·6 [ 4·2–7·6 ] per 100 000), and Bangladesh ( 5·6 [ 3·9–8·0 ] per 100 000) had the lowest age-standardised incidence rates, whereas Taiwan ( province of China; 62·0 [ 48·9–80·0 ] per 100 000), Monaco ( 60·7 [ 48·5–73·6 ] per 100 000), and Andorra ( 56·6 [ 42·8–71·9 ] per 100 000) had the highest age-standardised incidence rates ( figure 4A; appendix pp 18–43). Greenland ( 31·4 [ 26·0–37·1 ] per 100 000), Brunei ( 30·3 [ 26·6–34·1 ] per 100 000), and Hungary ( 28·6 [ 23·6–34·0 ] per 100 000) had the highest age-standardised mortality rates, whereas Bangladesh ( 4·9 [ 3·4–7·1 ] per 100 000), Somalia ( 5·0 [ 3·2–9·3 ]), and Nepal ( 5·4 [ 3·9–7·4 ] per 100 000) had the lowest age-standardised mortality rates among 204 countries and territories in 2019 ( figure 4B; appendix pp 18–43). Age-standardised DALY rates varied from 107·4 ( 74·6–152·7) per 100 000 in Bangladesh to 680·3 ( 555·7–812·4) per 100 000 in Greenland in 2019 ( figure 4C; appendix pp 18–43).Figure 4Geographical distribution of age-standardised rates of colorectal cancer in 2019Show full caption ( A) Age-standardised incidence rate. ( B) Age-standardised mortality rate. ( C) Age-standardised DALY rate. Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019. DALY=disability-adjusted life-year.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
( A) Age-standardised incidence rate. ( B) Age-standardised mortality rate. ( C) Age-standardised DALY rate. Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019. DALY=disability-adjusted life-year.
Between 1990 and 2019, for both sexes combined, incident cases doubled or more than doubled in 157 of 204 countries and territories and deaths doubled or more than doubled in 129 of 204 countries and territories ( appendix pp 44–66). Austria was the only country that reported a significant reduction in the number of colorectal cancer deaths ( −20·5% [ –26·4 to −14·8 ]) and DALYs ( −29·7% [ –34·4 to −25·0 ]) between 1990 and 2019. The changes in age-standardised rates were modest across countries in comparison with changes in absolute counts. From 1990 through 2019, the largest increase in age-standardised rates occurred in Cape Verde ( age-standardised incidence rate 180·6% [ 121·1 to 237·3 ], age-standardised mortality rate 152·9% [ 97·3 to 204·0 ], and age-standardised DALY rate 114·2% [ 71·8 to 159·4 ]) and the largest reduction occurred in Austria ( age-standardised incidence rate −34·1% [ –46·7 to −19·1 ], age-standardised mortality rate −50·2% [ –53·3 to −46·8 ], and age-standardised DALY rate −53·2% [ –56·2 to −50·0 ]; appendix pp 44–66).
The relationship between country-level age-standardised rates of colorectal cancer and SDI in 2019 is shown in the appendix ( p 10). SDI seemed to exert a positive relationship with age-standardised rates, with the slope becoming steeper in the upper end of the development spectrum for age-standardised incidence rates, whereas a positive relationship between age-standardised DALY rates and SDI seemed to taper off slightly towards high SDI countries.
Figure 5 illustrates the colorectal cancer incidence count and age-specific rates ( per 100 000 person-years) in 2019. The incidence count followed a bell-shaped distribution with a peak in individuals aged 60–74 years for both males and females. Incident cases were higher in males than in females in all age groups up to age 80–84 years, with a greater number of new cases in females aged 85 years and older ( figure 5A). Unlike incident cases, incidence rates continued to increase with age, increasing much faster in those aged 50–54 years and older ( figure 5B). Between 1990 and 2019, all age groups experienced a rise in incident cases, with the highest increases occurring in those aged 85 years and older ( appendix p 11). Furthermore, incidence rates increased in younger age groups ( 20–49 years) and decreased in older age groups ( 50–80 years) only in the high SDI quintile ( appendix p 12). Percentage changes in incidence rates were higher in females compared to males only in low SDI quintiles; in all other SDI quintiles, males had higher percentage changes in incidence rates. Moving up in the development spectrum, the contrast between increases ( or decreases) in younger age groups ( 20–49 years) and older age groups ( 50–74 years) became more pertinent. For instance, in the high SDI quintile, the incidence rates either remained unchanged or decreased in older age groups ( 50–74 years), whereas large increases were observed in younger age groups ( 20–49 years; appendix p 12).Figure 5Age-specific burden of colorectal cancer in 2019Show full caption ( A) Incident cases. ( B) Age-specific incidence rate ( per 100 000). Error bars denote 95% uncertainty intervals. Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
( A) Incident cases. ( B) Age-specific incidence rate ( per 100 000). Error bars denote 95% uncertainty intervals. Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019.
Figure 6 depicts the contribution of ten risk factors to all-age DALYs due to colorectal cancer, for both sexes combined, for 21 GBD regions in 2019. At the global level, a diet low in milk ( 15·6%), smoking ( 13·3%), a diet low in calcium ( 12·9%), and alcohol use ( 9·9%) were the main contributors to colorectal cancer DALYs, with the relative contribution of different risk factors varying as per the region's development status. In sub-Saharan Africa and Asia ( barring the high-income Asia Pacific), a diet low in calcium and milk were the main risk factors, whereas smoking and alcohol use were the main risk factors in high-income regions ( figure 6). At the global level, high BMI contributed only 8·3% of DALYs, with a higher contribution in comparatively high-income regions ( eg, central Europe [ 14·0% ] and high-income North America [ 13·8% ]). The contribution of smoking to DALYs was greater than 15% in regions of Europe ( eg, 18·2% in central Europe, 15·9% in western Europe, and 15·5% in eastern Europe) as well as in southern Latin America, east Asia, and high-income North America.Figure 6Percentage contribution of risk factors to all-age DALYs of colorectal cancer in 2019, for both sexes, globally and by regionsShow full captionData source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019. DALYs=disability-adjusted life-years.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2019. DALYs=disability-adjusted life-years.
The severity of risk factors also varied by sex, with alcohol use contributing 13·9% of global DALYs and smoking contributing 18·9% of global DALYs in males, whereas alcohol use contributed only 4·5% of global DALYs and smoking contributed only 5·7% of global DALYs in females ( appendix p 13). In females, a diet low in milk ( 15·5%), a diet low in calcium ( 12·0%), and high fasting plasma glucose ( 7·5%) were the major contributors to colorectal cancer DALYs. Similar differences were observed between sexes with regard to the contribution of high BMI, which contributed 11·1% of DALYs in males and 4·6% in females. The differences between sexes in the contribution of risk factors to colorectal cancer DALYs were also apparent in all GBD regions. The distribution of inadequate dietary risk factors ( eg, a diet low in milk and calcium) was similar across the two sexes across regions of sub-Saharan Africa and Asia ( appendix p 13).
Between 1990 and 2019, new cases of colorectal cancer doubled or more than doubled in 157 of 204 countries and territories, and deaths due to colorectal cancer doubled or more than doubled in 129 of 204 countries and territories, and large increases were experienced in low SDI and middle SDI countries. Incidence and mortality rates mostly decreased in high SDI countries, whereas several low SDI and middle SDI countries and regions saw increases in age-standardised rates. The incident cases shared by low SDI, low-middle SDI, middle SDI, and high-middle SDI countries increased from 47·3% to 62·1%, the share of death counts rose from 57·1% to 69·8%, and the share of DALYs increased from 62·4% to 74·6% from 1990 through 2019.
We found large increases in age-standardised incidence rates in Asia ( eg, 142·3% in east Asia and 78·5% in southeast Asia) and Latin America ( eg, 100·0% in Andean Latin America, and 77·0% in central Latin America) between 1990 and 2019. Due to fast economic growth and rapid industrialisation, the thriving middle class in developing countries is adopting a westernised lifestyle characterised by an unhealthy diet ( low in fruits and vegetables and high in red meat and processed meat), sedentary behaviour ( eg, spending a long time watching television), and less physical activity, along with substance abuse ( alcohol and smoking).19WHOWHO report on the global tobacco epidemic 2017; monitoring tobacco use and prevention policies.https: //apps.who.int/iris/handle/10665/255874Date: 2017Date accessed: September 29, 2020Google Scholar, 20Stevens GA Singh GM Lu Y et al.National, regional, and global trends in adult overweight and obesity prevalences.Popul Health Metr. 2012; 10: 22Google Scholar These behavioural changes have resulted in an increased incidence of lifestyle-related illnesses, including colorectal cancer.
The age-standardised mortality rate decreased in high-income regions ( eg, −33·5% [ 95% UI −29·8 to −37·2 ] in Australasia and −25·3% [ –23·5 to −27·3 ] in high-income North America) between 1990 and 2019. The reduction in incident cases and deaths, particularly among individuals older than 50 years, in high-SDI regions and countries suggests early detection of colorectal cancer due to screening, cancer registries, and technological improvements, as well as normalisation of early referral to physicians. In most high SDI countries, 50–75 years is also the age group in which colorectal cancer screening is generally recommended for early detection of adenomatous polyps and adenomas.21Schreuders EH Ruco A Rabeneck L et al.Colorectal cancer screening: a global overview of existing programmes.Gut. 2015; 64: 1637-1649Google Scholar In the USA, the impact of colorectal cancer screening in reduction of deaths due to colorectal cancer is notable given the considerable increases in colonoscopy screening in the 2000s.22Zauber AG The impact of screening on colorectal cancer mortality and incidence: has it really made a difference?.Dig Dis Sci. 2015; 60: 681-691Google Scholar
We found more colorectal cancer cases and deaths among males than females, with male age-standardised rates being 1·5–2·0-times higher than females in different GBD regions and the difference between males and females growing over time. In the 1960s, when the first international reports were published on colorectal cancer, the age-standardised incidence rate used to be higher for females than males, but the incidence has since risen faster for males than for females.23DeCosse JJ Ngoi SS Jacobson JS Cennerazzo WJ Gender and colorectal cancer.Eur J Cancer Prev. 1993; 2: 105-115Google Scholar The predominance of males in the global colorectal cancer burden has been attributed to the high prevalence of visceral fat,24Karastergiou K Smith SR Greenberg AS Fried SK Sex differences in human adipose tissues - the biology of pear shape.Biol Sex Differ. 2012; 3: 13Google Scholar higher smoking prevalence,19WHOWHO report on the global tobacco epidemic 2017; monitoring tobacco use and prevention policies.https: //apps.who.int/iris/handle/10665/255874Date: 2017Date accessed: September 29, 2020Google Scholar and greater alcohol consumption among this demographic.25Wilsnack RW Wilsnack SC Kristjanson AF Vogeltanz-Holm ND Gmel G Gender and alcohol consumption: patterns from the multinational GENACIS project.Addiction. 2009; 104: 1487-1500Google Scholar We also found a greater contribution of alcohol and smoking to colorectal cancer DALYs in males than in females. Some studies have also suggested protective effects of endogenous oestrogen against colorectal carcinogenesis in females.26Murphy N Strickler HD Stanczyk FZ et al.A prospective evaluation of endogenous sex hormone levels and colorectal cancer risk in postmenopausal women.J Natl Cancer Inst. 2015; 107: 107Google Scholar Besides endogenous oestrogens, oral contraceptives might also contribute to the lowered colorectal cancer risk in females compared to males.27Luan NN Wu L Gong TT Wang YL Lin B Wu QJ Nonlinear reduction in risk for colorectal cancer by oral contraceptive use: a meta-analysis of epidemiological studies.Cancer Causes Control. 2015; 26: 65-78Google Scholar Besides the difference in incidence, there are also differences in mortality between males and females, with females tending to have better survival outcomes.28Yang Y Wang G He J et al.Gender differences in colorectal cancer survival: a meta-analysis.Int J Cancer. 2017; 141: 1942-1949Google Scholar, 29Hendifar A Yang D Lenz F et al.Gender disparities in metastatic colorectal cancer survival.Clin Cancer Res. 2009; 15: 6391-6397Google Scholar Sex apparently modulates the circadian clocks of males and females differently, with respect to the effects of chemotherapy in colorectal cancer, which might also contribute to the sex-based differences in survival and mortality.30Giacchetti S Dugué PA Innominato PF et al.Sex moderates circadian chemotherapy effects on survival of patients with metastatic colorectal cancer: a meta-analysis.Ann Oncol. 2012; 23: 3110-3116Google Scholar In terms of the age-specific burden of colorectal cancer in males versus females, the findings of GBD 2019 differ from a previous study in which colorectal cancer incidence and mortality were higher in females than in males in individuals aged 65 years and older, implying that colorectal cancer is a major health threat in older females; 31Kim SE Paik HY Yoon H Lee JE Kim N Sung MK Sex- and gender-specific disparities in colorectal cancer risk.World J Gastroenterol. 2015; 21: 5167-5175Google Scholar in the present study, however, such differences were mainly observed in individuals aged 80 years and older.
In line with previous studies,32Siegel RL Torre LA Soerjomataram I et al.Global patterns and trends in colorectal cancer incidence in young adults.Gut. 2019; 68: 2179-2185Google Scholar, 33Vuik FE Nieuwenburg SA Bardou M et al.Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years.Gut. 2019; 68: 1820-1826Google Scholar, 34Lui RN Tsoi KKF Ho JMW et al.Global increasing incidence of young-onset colorectal cancer across 5 continents: a joinpoint regression analysis of 1,922,167 cases.Cancer Epidemiol Biomarkers Prev. 2019; 28: 1275-1282Google Scholar, 35Araghi M Soerjomataram I Bardot A et al.Changes in colorectal cancer incidence in seven high-income countries: a population-based study.Lancet Gastroenterol Hepatol. 2019; 4: 511-518Google Scholar, 36Wolf AMD Fontham ETH Church TR et al.Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society.CA Cancer J Clin. 2018; 68: 250-281Google Scholar we observed large increases in new cases and age-specific rates in individuals aged 20–49 years between 1990 and 2019, especially in high SDI countries. In the USA, a previous study37Bailey CE Hu CY You YN et al.Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010.JAMA Surg. 2015; 150: 17-22Google Scholar also noted substantial increases in colorectal cancer incidence rates in individuals aged 20–49 years from 1975 to 2010 and the incidence rate of colon cancers is expected to increase by an estimated 90%, and the incidence rate of rectal cancers is expected to increase by 140%, by 2030.37Bailey CE Hu CY You YN et al.Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010.JAMA Surg. 2015; 150: 17-22Google Scholar, 38Cavestro GM Mannucci A Zuppardo RA Di Leo M Stoffel E Tonon G Early onset sporadic colorectal cancer: Worrisome trends and oncogenic features.Dig Liver Dis. 2018; 50: 521-532Google Scholar In most high-income countries, screening is recommended from the age of 50 years onwards; however, the recent trends in growing colorectal cancer incidence in younger adults ( < 50 years) have led to calls for a reconsideration of screening recommendations to include individuals aged 40–49 years. In 2019, the American Cancer Society recommended colorectal cancer screening from the age of 45 years onwards,36Wolf AMD Fontham ETH Church TR et al.Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society.CA Cancer J Clin. 2018; 68: 250-281Google Scholar which can be further modified to include younger people, especially targeting those with a high risk of colorectal cancer ( eg, personal history of polyps or adenoma or family history of colorectal cancer or hereditary risk, males, smokers, and those with a high BMI).
The exact reasons for the increasing incidence of colorectal cancer in people younger than 50 years are less clear, but one possible reason could be due to the birth cohort effect, such that those born in the second half of the 20th century are increasingly exposed to potentially modifiable behavioural risk factors such as unhealthy diets, obesity, sedentary behaviour, low physical activity,18World Cancer Research Fund/American Institute for Cancer ResearchFood, nutrition, physical activity, and cancer: a global perspective. A summary of the third expert report. Continuous Update Project Expert Report 2018.https: //www.wcrf.org/wp-content/uploads/2021/02/Summary-of-Third-Expert-Report-2018.pdfDate accessed: February 28, 2022Google Scholar and increased smoking prevalence in early adulthood.32Siegel RL Torre LA Soerjomataram I et al.Global patterns and trends in colorectal cancer incidence in young adults.Gut. 2019; 68: 2179-2185Google Scholar, 33Vuik FE Nieuwenburg SA Bardou M et al.Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years.Gut. 2019; 68: 1820-1826Google Scholar, 39Keum N Giovannucci E Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies.Nat Rev Gastroenterol Hepatol. 2019; 16: 713-732Google Scholar, 40Young JP Win AK Rosty C et al.Rising incidence of early-onset colorectal cancer in Australia over two decades: report and review.J Gastroenterol Hepatol. 2015; 30: 6-13Google Scholar However, most of these risk factors have been implicated on the basis of evidence generated from patients with colorectal cancer aged 50 years or older, so the exact mechanisms or underlying risk factors remain less clear.40Young JP Win AK Rosty C et al.Rising incidence of early-onset colorectal cancer in Australia over two decades: report and review.J Gastroenterol Hepatol. 2015; 30: 6-13Google Scholar, 41Siegel RL Fedewa SA Anderson WF et al.Colorectal cancer incidence patterns in the United States, 1974–2013.J Natl Cancer Inst. 2017; 109djw322Google Scholar, 42Hur J Smith-Warner SA Rimm EB et al.Alcohol intake in early adulthood and risk of colorectal cancer: three large prospective cohort studies of men and women in the United States.Eur J Epidemiol. 2021; 36: 325-333Google Scholar A previous study has attributed prolonged sedentary television viewing time to early onset of colorectal cancer, particularly rectal cancer.43Nguyen LH Liu PH Zheng X et al.Sedentary behaviors, TV viewing time, and risk of young-onset colorectal cancer.JNCI Cancer Spectr. 2018; 2pky073Google Scholar Early-onset colorectal cancer has also been attributed to the rising obesity prevalence in younger adults.44Liu P-H Wu K Ng K et al.Association of obesity with risk of early-onset colorectal cancer among women.JAMA Oncol. 2019; 5: 37-44Google Scholar, 45Patel P De P Trends in colorectal cancer incidence and related lifestyle risk factors in 15–49-year-olds in Canada, 1969–2010.Cancer Epidemiol. 2016; 42: 90-100Google Scholar, 46Nimptsch K Wu K Is timing important? the role of diet and lifestyle during early life on colorectal neoplasia.Curr Colorectal Cancer Rep. 2018; 14: 1-11Google Scholar A prospective cohort study of 94 217 women showed that dietary and lifestyle factors leading to hyperinsulinaemia are associated with an increased risk of colorectal cancer in younger women in the USA.47Yue Y Hur J Cao Y et al.Prospective evaluation of dietary and lifestyle pattern indices with risk of colorectal cancer in a cohort of younger women.Ann Oncol. 2021; 32: 778-786Google Scholar Binge drinking ( episodic heavy alcohol consumption) is also implicated as one of the risk factors, with binge drinking being higher among adults younger than 50 years than in adults aged 50 years and older ( ie, those of screening age).48Crosbie AB Roche LM Johnson LM Pawlish KS Paddock LE Stroup AM Trends in colorectal cancer incidence among younger adults—disparities by age, sex, race, ethnicity, and subsite.Cancer Med. 2018; 7: 4077-4086Google Scholar
The GBD 2019 colorectal cancer estimates ( 2·17 million incident cases and 1·09 million deaths) are higher than GLOBOCAN estimates for 2020 ( 1·9 million incident cases and 935 173 deaths).49Sung H Ferlay J Siegel RL et al.Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J Clin. 2021; 71: 209-249Google Scholar The global age-standardised rates estimated by GBD are also higher ( age-standardised incidence rate 26·7 per 100 000; age-standardised mortality rate 13·7 per 100 000) than those for GLOBOCAN ( age-standardised incidence rate 19·5 per 100 000 and age-standardised mortality rate 9·0 per 100 000). Both GBD and GLOBOCAN report high incidence and mortality rates in high-income regions and countries in Europe, North America, and Asia, and low incidence and mortality rates in LMICs of sub-Saharan Africa and south Asia, yet there are a few differences in the estimates, which stem from the different methodologies and data sources used. One of the main differences is that GLOBOCAN mostly estimates cancer incidence and deaths from cancer registry data, whereas GBD also models estimates from data sources such as vital registration, cancer registries, verbal autopsy, and sample registration systems. Another key difference between GBD and GLOBOCAN estimates stems from the redistribution of deaths from unknown or non-specific cancers to other cancers in GBD estimates.15Global Burden of Disease 2019 Cancer CollaborationCancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.JAMA Oncol. 2022; 8: 420-444Google Scholar The GBD estimation framework has two key advantages over GLOBOCAN. In addition to producing incidence and mortality estimates, GBD produces estimates for YLLs, YLDs, and DALYs, which encompasses the disease burden due to both death and disability caused by the disease. Second, GLOBOCAN provides estimates for a single year ( eg, 2002, 2008, 2012, 2018, and 2020) and there are some time series available for selected countries up to 2012 ( the CI5Plus: Cancer Incidence in Five Continents Time Trends series); however, continuous time series of estimates of the colorectal cancer burden are not available from GLOBOCAN for sufficiently long time periods at the global and regional levels for all countries and territories. A track of temporal patterns can provide useful information; for instance, the rises in colorectal cancer incidence among younger adults ( < 50 years) in the past three decades, particularly in high-income regions, can allow researchers to examine the changing risk factors, set hypotheses, and help clinicians and policy makers to be more vigilant about the changing trends of colorectal cancer.
The major limitation of this study was the non-availability of data from cancer registries in many countries in Africa, the Caribbean, and Asia. Although GBD uses all available data from sources such as vital registration, verbal autopsy, and cancer registries, the accuracy of GBD estimates crucially depends upon cancer incidence and mortality data from cancer registries. Many LMICs in sub-Saharan Africa and Asia either do not have population-based cancer registries or the existing registries have insufficient coverage. Under-reporting also occurs because of poor documentation of cases, a shortage of medical facilities and adequately trained medical personnel, lack of a well established oncology centre, and as a result of misdiagnosis. Moreover, the 95% UIs reported in the study do not take into account several sources of bias, including measurement bias, selection bias due to missing data, and model specification bias. Second, the disease registration system was inadequate 30 years ago, especially in LMICs, and although it has improved in several LMICs in recent years, the estimates for the early years of the analysis ( ie, the 1990s) are expected to be more biased, which is also reflected in the wider 95% UIs of the mean estimates and percentage changes. Third, there is a lag in the official reporting of cancer data for 2019 even in high SDI countries so the estimates for the most recent years are generated on the basis of recent trends and are provided with wider uncertainty intervals. GBD is an iterative estimation framework providing temporal estimates; the official data for 2019 will be updated as they become available and will be reflected in future GBD iterations.
In conclusion, colorectal cancer incident cases and deaths have more than doubled worldwide in the past three decades. Reducing the prevalence of modifiable risk factors and increasing screening uptake are key to reducing deaths from colorectal cancer, in line with achieving target 3.4 of the SDGs.8UN Department of Economic and Social AffairsUnited Nations Sustainable Development Goals. Goal 3: ensure healthy lives and promote well-being for all at all ages.https: //www.un.org/sustainabledevelopment/health/Date accessed: March 22, 2022Google Scholar Low SDI and middle SDI ( including low-middle, middle, and high-middle SDI) countries, which together comprise close to 75% of colorectal cancer DALYs, are expected to experience further increases in colorectal cancer incidence as a result of population ageing and increasing life expectancy, improved screening and detection, and changing lifestyles. Strategies such as dietary and lifestyle modifications, early screening among high-risk individuals, access to high-quality health care, and better treatment modalities ( including improved personalised therapy and access to clinical trials) are imperative to face this global challenge. Population-based cancer registries are important for monitoring colorectal cancer incidence and survival. The increase in colorectal cancer incidence in people younger than 50 years should serve as an early warning signal, necessitating greater awareness of these trends among clinicians, researchers, and policy makers, as well as more research into the risk factors and mechanisms that underpin these trends.
The data generated through GBD are an important resource for people and health-care providers, as they provide information on the effect of current treatment strategies, the effects of previous interventions, and the need for preventive measures. The findings from GBD 2019 can be used by policy makers and provide new perspectives for scientists and physicians throughout the world. These results provide comprehensive and comparable estimates that can inform efforts for equitable colorectal cancer control worldwide, with the larger goal of reducing the global burden of cancer.
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Kumar Meena, Entezar Mehrabi Nasab, Walter Mendoza, Alexios-Fotios A Mentis, Tomislav Mestrovic, Junmei Miao Jonasson, Bartosz Miazgowski, Tomasz Miazgowski, Gelana Fekadu Worku Mijena, Seyyedmohammadsadeq Mirmoeeni, Mohammad Mirza-Aghazadeh-Attari, Hamed Mirzaei, Sanjeev Misra, Karzan Abdulmuhsin Mohammad, Esmaeil Mohammadi, Saeed Mohammadi, Seyyede Momeneh Mohammadi, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Teroj Abdulrahman Mohammed, Nagabhishek Moka, Ali H Mokdad, Zeinab Mokhtari, Mariam Molokhia, Sara Momtazmanesh, Lorenzo Monasta, Ghobad Moradi, Rahmatollah Moradzadeh, Paula Moraga, Joana Morgado-da-Costa, Sumaira Mubarik, Francesk Mulita, Mohsen Naghavi, Mukhammad David Naimzada, Hae Sung Nam, Zuhair S Natto, Biswa Prakash Nayak, Javad Nazari, Ehsan Nazemalhosseini-Mojarad, Ionut Negoi, Cuong Tat Nguyen, Son Hoang Nguyen, Nurulamin M Noor, Maryam Noori, Seyyed Mohammad Ali Noori, Virginia Nuñez-Samudio, Chimezie Igwegbe Nzoputam, Bogdan Oancea, Oluwakemi Ololade Odukoya, Ayodipupo Sikiru Oguntade, Hassan Okati-Aliabad, Andrew T Olagunju, Tinuke O Olagunju, Sokking Ong, Samuel M Ostroff, Alicia Padron-Monedero, Reza Pakzad, Adrian Pana, Anamika Pandey, Fatemeh Pashazadeh Kan, Urvish K Patel, Uttam Paudel, Renato B Pereira, Navaraj Perumalsamy, Richard G Pestell, Zahra Zahid Piracha, Richard Charles G Pollok, Akram Pourshams, Naeimeh Pourtaheri, Akila Prashant, Mohammad Rabiee, Navid Rabiee, Amir Radfar, Sima Rafiei, Mosiur Rahman, Amir Masoud Rahmani, Vahid Rahmanian, Nazanin Rajai, Aashish Rajesh, Vajiheh Ramezani-Doroh, Kiana Ramezanzadeh, Kamal Ranabhat, Sina Rashedi, Amirfarzan Rashidi, Mahsa Rashidi, Mohammad-Mahdi Rashidi, Mandana Rastegar, David Laith Rawaf, Salman Rawaf, Reza Rawassizadeh, Mohammad Sadegh Razeghinia, Andre M N Renzaho, Negar Rezaei, Nima Rezaei, Saeid Rezaei, Mohsen Rezaeian, Sahba Rezazadeh-Khadem, Gholamreza Roshandel, Maha Mohamed Saber-Ayad, Bahar Saberzadeh-Ardestani, Basema Saddik, Hossein Sadeghi, Umar Saeed, Maryam Sahebazzamani, Amirhossein Sahebkar, Amir Salek Farrokhi, Amir Salimi, Hamideh Salimzadeh, Pouria Samadi, Mehrnoosh Samaei, Abdallah M Samy, Juan Sanabria, Milena M Santric-Milicevic, Muhammad Arif Nadeem Saqib, Arash Sarveazad, Brijesh Sathian, Maheswar Satpathy, Ione Jayce Ceola Schneider, Mario Š ekerija, Sadaf G Sepanlou, Allen Seylani, Feng Sha, Sayed Mohammad Shafiee, Zahra Shaghaghi, Saeed Shahabi, Elaheh Shaker, Maedeh Sharifian, Javad Sharifi-Rad, Sara Sheikhbahaei, Jeevan K Shetty, Reza Shirkoohi, Parnian Shobeiri, Sudeep K Siddappa Malleshappa, Diego Augusto Santos Silva, Guilherme Silva Julian, Achintya Dinesh Singh, Jasvinder A Singh, Md Shahjahan Siraj, Gholam Reza Sivandzadeh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Marco Solmi, Mohammad Sadegh Soltani-Zangbar, Suhang Song, Viktória Szerencsés, Miklós Szócska, Rafael Tabarés-Seisdedos, Elnaz Tabibian, Majid Taheri, Yasaman Taheri Abkenar, Amir Taherkhani, Iman M Talaat, Ker-Kan Tan, Abdelghani Tbakhi, Bekele Tesfaye, Amir Tiyuri, Daniel Nigusse Tollosa, Mathilde Touvier, Bach Xuan Tran, Biruk Shalmeno Tusa, Irfan Ullah, Saif Ullah, Marco Vacante, Sahel Valadan Tahbaz, Massimiliano Veroux, Bay Vo, Theo Vos, Cong Wang, Ronny Westerman, Melat Woldemariam, Seyed Hossein Yahyazadeh Jabbari, Lin Yang, Fereshteh Yazdanpanah, Chuanhua Yu, Deniz Yuce, Ismaeel Yunusa, Vesna Zadnik, Mazyar Zahir, Iman Zare, Zhi-Jiang Zhang, and Mohammad Zoladl.
University School of Management and Entrepreneurship ( R Sharma PhD), Delhi Technological University, New Delhi, India; Social Determinants of Health Research Center ( M Abbasi-Kangevari MD, M Azangou-Khyavy MD, S Ghamari MD, J Khanali MD, A Kolahi MD, M Rashidi MD, A Salimi MD), Department of Epidemiology ( A Ahmadi PhD), School of Advanced Technologies in Medicine ( S Ahmadi PhD), Department of Community Nutrition ( S Doaei PhD), Cancer Research Center ( M Gholamalizadeh PhD), Department of Pharmacology ( A Haj-Mirzaian MD, K Ramezanzadeh PharmD), Obesity Research Center ( A Haj-Mirzaian MD), Department of Health & Community Medicine ( A Kolahi MD), Gastroenterology and Liver Diseases Research Center ( E Nazemalhosseini-Mojarad PhD), Medical Genetics Genomic Research Center ( H Sadeghi PhD), Phytochemistry Research Center ( J Sharifi-Rad PhD, Y Taheri Abkenar PharmD), Medical Ethics and Law Research Center ( M Taheri PhD), Shahid Beheshti University of Medical Sciences, Tehran, Iran ( M Khayamzadeh MD); Evidence-Based Practice Center ( R Abd-Rabu MD), Mayo Clinic, Rochester, MN, USA; Laboratory Technology Sciences Department ( H Abidi PhD), Department of Nursing ( M Zoladi PhD), Yasuj University of Medical Sciences, Yasuj, Iran; Clinical Sciences Department ( E Abu-Gharbieh PhD, Prof R Halwani PhD, M M Saber-Ayad MD, Prof I M Talaat PhD), College of Medicine ( Prof R Halwani PhD), Sharjah Institute for Medical Research ( B Saddik PhD), University of Sharjah, Sharjah, United Arab Emirates; Department of Epidemiology and Population Health ( Prof J M Acuna MD), Khalifa University, Abu Dhabi, United Arab Emirates; FIU Robert Stempel College of Public Health & Social Work ( Prof J M Acuna MD), Department of Epidemiology ( R Jebai MPH), Florida International University, Miami, FL, USA; Biodesign Center for Environmental Health Engineering ( S Adhikari MS), Arizona State University, Tempe, AZ, USA; Terasaki Institute for Biomedical Innovation, Los Angeles, CA, USA ( S M Advani PhD); School of Medicine ( S M Advani PhD), Georgetown University, Washington DC, USA; Department of Life Sciences ( M S Afzal PhD), School of Sciences ( M N Saqib PhD), University of Management and Technology, Lahore, Pakistan; Department of Medicine ( M Aghaie Meybodi MD), Rutgers University, Newark, NJ, USA; The Australian Centre for Public and Population Health Research ( ACPPHR) ( B O Ahinkorah MPH), University of Technology Sydney, Sydney, NSW, Australia; Department of Health and Biological Sciences ( S Ahmad PhD), Abasyn University, Peshawar, Pakistan; Department of Epidemiology and Biostatistics ( A Ahmadi PhD, A Mohammadian-Hafshejani PhD), Shahrekord University of Medical Sciences, Shahrekord, Iran; Department of Biosciences ( H Ahmed PhD), COMSATS Institute of Information Technology, Islamabad, Pakistan; Institute of Public Health ( L A Ahmed PhD, A S Bhagavathula PharmD), United Arab Emirates University, Al Ain, United Arab Emirates; Department of Epidemiology ( M B Ahmed MPH), Department of Health, Behavior and Society ( A T Gizaw MPH), Jimma University, Jimma, Ethiopia; Australian Center for Precision Health ( M B Ahmed MPH), University of South Australia, Adelaide, SA, Australia; Geriatric and Long Term Care Department ( H Al Hamad MD, B Sathian PhD), Rumailah Hospital ( H Al Hamad MD), Hamad Medical Corporation, Doha, Qatar; Mayo Evidence-based Practice Center ( F Alahdab MSc), Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA; Health Information Management and Technology Department ( T M Alanzi PhD), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia ( F M Alanezi PhD); Faculty of Nursing ( F A N Alhalaiqa PhD), Philadelphia University, Amman, Jordan; Psychological Sciences Association, Amman, Jordan ( F A N Alhalaiqa PhD); Pars Hospital ( Y Alimohamadi PhD), Health Management and Economics Research Center ( V Alipour PhD, J Arabloo PhD), Department of Health Economics ( V Alipour PhD), Department of Internal Medicine ( A Anoushirvani MD), School of Medicine ( M Dodangeh MD), Minimally Invasive Surgery Research Center ( A Kabir MD), Student Research Committee ( M Noori MD), The Five Senses Health Institute ( S Rezaei MD), Colorectal Research Center ( A Sarveazad PhD), Trauma and Injury Research Center ( M Taheri PhD), Department of Epidemiology ( A Tiyuri MSc), Iran University of Medical Sciences, Tehran, Iran ( F Pashazadeh Kan BSN); Department of Epidemiology and Biostatistics ( Y Alimohamadi PhD), Liver and Pancreatobiliary Diseases Research Center ( S Alvand MD), Digestive Diseases Research Institute ( A Anoushiravani MD, S Hariri MD, Prof R Malekzadeh MD, S Masoudi MSc, Prof A Pourshams MD, H Salimzadeh PhD, S G Sepanlou MD), Non-communicable Diseases Research Center ( A Aryannejad MD, S Azadnajafabad MD, M Azangou-Khyavy MD, Prof F Farzadfar DSc, N Fattahi MD, S Ghamari MD, M Keykhaei MD, J Khanali MD, M Malekpour MD, S Momtazmanesh MD, M Rashidi MD, N Rezaei PhD, S Rezazadeh-Khadem MD), Experimental Medicine Research Center ( A Aryannejad MD), Iranian Research Center for HIV/AIDS ( IRCHA) ( O Dadras DrPH), School of Medicine ( H Farrokhpour MD, N Hafezi-Nejad MD, A Karimi MD, S Momtazmanesh MD), Students Scientific Research Center ( SSRC) ( M Keykhaei MD), Tehran Heart Center ( E Mehrabi Nasab MD), Faculty of Medicine ( E Mohammadi MD), Department of Cardiology ( S Rashedi MD), Endocrinology and Metabolism Research Center ( N Rezaei PhD), Research Center for Immunodeficiencies ( Prof N Rezaei PhD), Faculty of Medicine ( E Shaker MD, P Shobeiri MD), Cancer Research Center ( R Shirkoohi PhD), Cancer Biology Research Center ( R Shirkoohi PhD), Radiology Department ( E Tabibian MD), Pediatric Allergy, Immunology, and Immunodeficiency Department ( F Yazdanpanah MD), Department of Pharmacology ( M Zahir MD), Tehran University of Medical Sciences, Tehran, Iran; Department of Health Policy and Management ( Prof S M Aljunid PhD), Kuwait University, Safat, Kuwait; International Centre for Casemix and Clinical Coding ( Prof S M Aljunid PhD), National University of Malaysia, Bandar Tun Razak, Malaysia; Department of Internal Medicine ( M Alkhayyat MD, A D Singh MD), Department of Cardiovascular Medicine ( M M Gad MD), Cleveland Clinic, Cleveland, OH, USA; College of Medicine ( S Almustanyir MD), Alfaisal University, Riyadh, Saudi Arabia; Ministry of Health, Riyadh, Saudi Arabia ( S Almustanyir MD); Department of Community Medicine ( R M Al-Raddadi PhD), Rabigh Faculty of Medicine ( A A Malik PhD), Department of Dental Public Health ( Z S Natto DrPH), King Abdulaziz University, Jeddah, Saudi Arabia; Research Group in Hospital Management and Health Policies ( Prof N Alvis-Guzman PhD), Universidad de la Costa ( University of the Coast), Barranquilla, Colombia; Research Group in Health Economics ( Prof N Alvis-Guzman PhD), University of Cartagena, Cartagena, Colombia; Department of Health Services Management ( S Amini PhD), Khomein University of Medical Sciences, Khomein, Iran; Pharmacy Department ( Prof R Ancuceanu PhD), Internal Medicine Department ( M Hostiuc PhD), Department of General Surgery ( I Negoi PhD, B Socea PhD), Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Epidemiology and Biostatistics ( Prof A Ansari-Moghaddam PhD), Health Promotion Research Center ( H Okati-Aliabad PhD), Zahedan University of Medical Sciences, Zahedan, Iran; Department of Biostatistics and Epidemiology ( Prof M Asghari Jafarabadi PhD), Student Research Committee ( M Hosseini MD), Anesthesiology and Critical Care Department ( Prof A Mahmoodpoor MD), Department of Radiology ( M Mirza-Aghazadeh-Attari MD), Department of Immunology ( M Soltani-Zangbar MSc), Department of Pediatric Allergy and Immunology ( F Yazdanpanah MD), Tabriz University of Medical Sciences, Tabriz, Iran; Department of Biostatistics and Epidemiology ( Prof M Asghari Jafarabadi PhD), Department of Immunology ( S Athari PhD), Department of Anatomical Sciences ( S Mohammadi PhD), Zanjan University of Medical Sciences, Zanjan, Iran; Gastro-enterology Department ( F Ausloos MD), University of Liège, Liège, Belgium; School of Business ( Prof M Ausloos PhD), University of Leicester, Leicester, UK; Department of Statistics and Econometrics ( Prof M Ausloos PhD, Prof C Herteliu PhD, A Pana MD), Bucharest University of Economic Studies, Bucharest, Romania; Department of Surgery ( A F Awedew MD), Addis Ababa University, Addis Ababa, Ethiopia; Department of Epidemiology and Preventive Medicine ( M A Awoke MPH), University of Melbourne, Melbourne, VIC, Australia; School of Nursing ( T M Ayana MSc), Biomedical Sciences Department ( B B A Bodicha MSc, T Getachew MSc), Department of Medical Laboratory Science ( M Woldemariam MSc), Arba Minch University, Arba Minch, Ethiopia; Department of Medical-Surgical Nursing ( H Azami MSc), Department of Medicine ( Prof F Eghbalian MD), Department of Pharmacology and Toxicology ( R Haddadi PhD), Health Management and Economics ( V Ramezani-Doroh PhD), Research Center for Molecular Medicine ( A Taherkhani PhD), Hamadan University of Medical Sciences, Hamadan, Iran; School of Medicine ( A Azari Jafari MD, S Mirmoeeni MD), Shahroud University of Medical Sciences, Shahroud, Iran; Department of Forensic Science ( A D Badiye MSc, N Kapoor MSc), Government Institute of Forensic Science, Nagpur, India; School of Medicine ( S Bagherieh BSc), Department of Environmental Health Engineering ( A Fatehizadeh PhD), Research Institute for Primordial Prevention of Non-Communicable Disease ( S Hariri MD), Food Security Research Center ( Z Mokhtari PhD), Isfahan University of Medical Sciences, Isfahan, Iran; Department of Parasitology ( S Bahadory PhD), Department of Clinical Biochemistry ( R Ezzeddini PhD), Tarbiat Modares University, Tehran, Iran; Department of Parasitology ( S Bahadory PhD), Alborz University of Medical Sciences, Karaj, Iran; Unit of Biochemistry ( A A Baig PhD), Universiti Sultan Zainal Abidin ( Sultan Zainal Abidin University), Kuala Terengganu, Malaysia; Center for Clinical Research and Prevention ( J L Baker PhD), Bispebjerg University Hospital, Frederiksberg, Denmark; Department of Hypertension ( Prof M Banach PhD), Medical University of Lodz, Lodz, Poland; Polish Mothers ' Memorial Hospital Research Institute, Lodz, Poland ( Prof M Banach PhD); Department of Public & Environmental Health ( A Barrow MPH), University of The Gambia, Brikama, The Gambia; Epidemiology and Disease Control Unit ( A Barrow MPH), Ministry of Health, Kotu, The Gambia; School of Nursing ( A Y Berhie MSc), University of Gondar, Bahir Dar, Ethiopia; Golestan Research Center of Gastroentrology and Hepatology ( S Besharat PhD, G Roshandel PhD), Medical Genetics Department ( H Sadeghi PhD), Golestan University of Medical Sciences, Gorgan, Iran; Department of Forensic Chemistry ( D S Bhagat PhD), Government Institute of Forensic Science, Aurangabad, India; Department of Social and Clinical Pharmacy ( A S Bhagavathula PharmD), Charles University, Hradec Kralova, Czech Republic; Institutes of Applied Health Research and Translational Medicine ( N Bhala PhD), Queen Elizabeth Hospital Birmingham, Birmingham, UK; Institute of Applied Health Research ( N Bhala PhD), NIHR Global Health Research Unit on Global Surgery ( J C Glasbey MSc), University of Birmingham, Birmingham, UK; Department of Statistical and Computational Genomics ( K Bhattacharyya MSc), National Institute of Biomedical Genomics, Kalyani, India; Department of Statistics ( K Bhattacharyya MSc), University of Calcutta, Kolkata, India; Department of Anatomy ( V S Bhojaraja MD), Department of Biochemistry ( J K Shetty MD), Manipal University College Melaka, Melaka, Malaysia; Institute of Soil and Environmental Sciences ( S Bibi PhD, S Ullah PhD), University of Agriculture, Faisalabad, Faisalabad, Pakistan; Social Determinants of Health Research Center ( A Bijani PhD, M A Jahani PhD), Babol University of Medical Sciences, Babol, Iran; Department of General Surgery and Medical-Surgical Specialties ( Prof A Biondi PhD, M Vacante PhD), Clinical and Experimental Medicine ( C Ledda PhD), Department of Medical and Surgical Sciences and Advanced Technologies ( Prof M Veroux PhD), University of Catania, Catania, Italy; Department of Global Public Health and Primary Care ( Prof T Bjørge PhD), University of Bergen, Bergen, Norway; Cancer Registry of Norway, Oslo, Norway ( Prof T Bjørge PhD); Department of Epidemiology ( D Braithwaite PhD), University of Florida, Gainesville, FL, USA; Cancer Population Sciences Program ( D Braithwaite PhD), University of Florida Health Cancer Center, Gainesville, FL, USA; Division of Clinical Epidemiology and Aging Research ( Prof H Brenner MD), German Cancer Research Center, Heidelberg, Germany; Clinical Pharmacy Department ( Prof D Calina PhD), University of Medicine and Pharmacy of Craiova, Craiova, Romania; Program in Physical Therapy ( C Cao MPH), Department of Surgery ( Y Cao DSc), Washington University in St. Louis, St. Louis, MO, USA; Oncological Network, Prevention and Research Institute ( G Gorini MD), Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy ( G Carreras PhD); Research Unit on Applied Molecular Biosciences ( UCIBIO) ( Prof F Carvalho PhD, V M Costa PhD), Department of Medicine ( Prof N Cruz-Martins PhD), Associated Laboratory for Green Chemistry ( LAQV) ( Prof E Fernandes PhD), Laboratory for Process Engineering, Environment, Biotechnology and Energy ( LEPABE) ( J Loureiro PhD), University Hospital Center of Porto ( J Morgado-da-Costa MSc), Department of Chemistry ( R B Pereira PhD), University of Porto, Porto, Portugal; Mary MacKillop Institute for Health Research ( Prof E Cerin PhD), Australian Catholic University, Melbourne, VIC, Australia; School of Public Health ( Prof E Cerin PhD), University of Hong Kong, Hong Kong, China; Hospitalist Department ( R Chakinala MD), Geisinger Health System, Danville, PA, USA; Department of Clinical Oncology ( W C S Cho PhD), Queen Elizabeth Hospital, Hong Kong, China; Center for Biomedicine and Community Health ( D Chu PhD), VNU-International School, Hanoi, Vietnam; Nova Medical School ( J Conde PhD), Nova University of Lisbon, Lisbon, Portugal; Department of Health Sciences ( Prof N Cruz-Martins PhD), Institute of Research and Advanced Training in Health Sciences and Technologies ( CESPU), Famalicão, Portugal; School of Public Health ( O Dadras DrPH), Walailak University, Nakhon Si Thammarat, Thailand; Institute for Health Metrics and Evaluation ( X Dai PhD, Prof L Dandona MD, Prof R Dandona PhD, Prof S I Hay DSc, Prof S S Lim PhD, A H Mokdad PhD, Prof M Naghavi PhD, S M Ostroff PhD, Prof T Vos PhD), Department of Health Metrics Sciences, School of Medicine ( X Dai PhD, Prof R Dandona PhD, Prof S I Hay DSc, Prof S S Lim PhD, A H Mokdad PhD, Prof M Naghavi PhD, Prof T Vos PhD), Henry M Jackson School of International Studies ( S M Ostroff PhD), University of Washington, Seattle, WA, USA; Department of Research ( A Pandey PhD), Public Health Foundation of India, Gurugram, India ( Prof L Dandona MD, Prof R Dandona PhD, G Kumar PhD); Indian Council of Medical Research, New Delhi, India ( Prof L Dandona MD); Department of Human Nutrition ( A Danielewicz PhD), Uniwersytet Warmińsko-Mazurski w Olsztynie ( University of Warmia and Mazury in Olsztyn), Olsztyn, Poland; Department of Medical Laboratory Sciences ( F M Demeke MSc), Bahir Dar University, Bahir Dar, Ethiopia; Institute of Public Health ( G D Demissie MPH), University of Gondar, Gondar, Ethiopia; Division of Cardiology ( R Desai MBBS), Atlanta Veterans Affairs Medical Center, Decatur, GA, USA; Department of Community Medicine ( D Dhamnetiya MD, R P Jha MSc), Dr. Baba Saheb Ambedkar Medical College & Hospital, Delhi, India; Department of Epidemiology ( M Dianatinasab MSc), Maastricht University, Maastricht, Netherlands; Department of Epidemiology ( M Dianatinasab MSc), Nutrition Research Center ( A Kazemi PhD), Non-communicable Disease Research Center ( Prof R Malekzadeh MD, S G Sepanlou MD), Department of Clinical Biochemistry and Autophagy Research Center ( S Shafiee PhD), Health Policy Research Center ( S Shahabi PhD), Department of Internal Medicine ( G R Sivandzadeh MD), Gastroenterohepatology Research Center ( G R Sivandzadeh MD), Shiraz University of Medical Sciences, Shiraz, Iran; Center of Complexity Sciences ( Prof D Diaz PhD), National Autonomous University of Mexico, Mexico City, Mexico; Faculty of Veterinary Medicine and Zootechnics ( Prof D Diaz PhD), Autonomous University of Sinaloa, Culiacán Rosales, Mexico; Department of Parasitology and Mycology ( M Didehdar PhD), Department of Epidemiology ( R Moradzadeh PhD), Department of Pediatrics ( J Nazari MD), Arak University of Medical Sciences, Arak, Iran; School of Health ( S Doaei PhD), Gastrointestinal and Liver Diseases Research Center ( S Hassanipour PhD, F Joukar PhD, Prof F Mansour-Ghanaei MD), Caspian Digestive Disease Research Center ( S Hassanipour PhD, F Joukar PhD, Prof F Mansour-Ghanaei MD), Guilan University of Medical Sciences, Rasht, Iran; Institute for Global Health Innovations ( L P Doan MSc), Faculty of Medicine ( L P Doan MSc), Duy Tan University, Da Nang, Vietnam; Department of Medicine ( D D Ejeta MD), Ambo University, Ambo, Ethiopia; Department of Epidemiology and Medical Statistics ( M Ekholuenetale MSc), Faculty of Public Health ( M Ekholuenetale MSc), Department of Community Medicine ( O S Ilesanmi PhD), University of Ibadan, Ibadan, Nigeria; Department of Biological Sciences ( T C Ekundayo PhD), University of Medical Sciences, Ondo, Ondo, Nigeria; Biomedical Informatics and Medical Statistics Department ( I El Sayed PhD), Pathology Department ( Prof I M Talaat PhD), Alexandria University, Alexandria, Egypt; Faculty of Medicine ( M Elhadi MD), University of Tripoli, Tripoli, Libya; Department of Health informatics ( D B Enyew MSc), Department of Nursing ( G F W Mijena MSc), Haramaya University, Harar, Ethiopia; Medical Laboratory Sciences ( T Eyayu MSc), Debre Tabor University, Debre Tabor, Ethiopia; Head of the Laboratory of Experimental Medicine ( I R Fakhradiyev PhD), Kazakh National Medical University, Almaty, Kazakhstan; Department of Internal Medicine ( U Farooque MD), Dow University of Health Sciences, Karachi, Pakistan; Endocrinology and Metabolsim Research Institute ( H Farrokhpour MD), Department of Epidemiology ( S Rashedi MD, E Shaker MD), Department of Medicine ( A Salimi MD), Department of International Studies ( P Shobeiri MD), Non-Communicable Diseases Research Center ( NCDRC), Tehran, Iran ( E Mohammadi MD); Centre for Primary Health Care Network Management ( H Fattahi PhD), Ministry of Health and Medical Education, Tehran, Iran; Student Research Committee ( N Fattahi MD), Social Determinants of Health Research Center ( G Moradi PhD), Department of Epidemiology and Biostatistics ( G Moradi PhD), Kurdistan University of Medical Sciences, Sanandaj, Iran; Department of Medicinal Chemistry ( M Fereidoonnezhad PhD), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Nursing ( G Fetensa MSc), Wollega University, Nekemte, Ethiopia; Psychiatry Department ( I Filip MD), Kaiser Permanente, Fontana, CA, USA; School of Health Sciences ( I Filip MD), AT Still University, Mesa, AZ, USA; Institute of Gerontological Health Services and Nursing Research ( F Fischer PhD), Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany; Department of Medical Parasitology ( M Foroutan PhD), Faculty of Medicine ( M Foroutan PhD), Abadan University of Medical Sciences, Abadan, Iran; Health Services Management Training Centre ( P A Gaal PhD, T Joo MSc, V Szerencsés MA), Faculty of Health and Public Administration ( M Szócska PhD), Semmelweis University, Budapest, Hungary; Department of Applied Social Sciences ( P A Gaal PhD), Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania; Gillings School of Global Public Health ( M M Gad MD), University of North Carolina Chapel Hill, Chapel Hill, NC, USA; Department of Environmental Health Sciences ( S Gallus DSc), Mario Negri Institute for Pharmacological Research, Milan, Italy; Department of Radiology ( T Garg MBBS), King Edward Memorial Hospital, Mumbai, India; School of Public Health ( A Ghashghaee BSc), Institute for Prevention of Non-communicable Diseases ( R Kalhor PhD), Health Services Management Department ( R Kalhor PhD), Social Determinants of Health Research Center ( S Rafiei PhD), Qazvin University of Medical Sciences, Qazvin, Iran; Research Group for Genomic Epidemiology ( N Ghith PhD), Technical University of Denmark, Copenhagen, Denmark; Non-communicable Diseases Research Center ( J Gholizadeh Navashenaq PhD, N Pourtaheri PhD), Bam University of Medical Sciences, Bam, Iran; Health Systems and Policy Research ( M Golechha PhD), Indian Institute of Public Health, Gandhinagar, India; Department of Genetics ( P Goleij MSc), Sana Institute of Higher Education, Sari, Iran; Department of Surgery ( K B Gonfa MD), Madda Walabu University, Bale Robe, Ethiopia; Harrington Heart and Vascular Institute ( A Guha MD), Department of Nutrition and Preventive Medicine ( Prof J Sanabria MD), Case Western Reserve University, Cleveland, OH, USA; Division of Cardiovascular Medicine ( A Guha MD), Ohio State University, Columbus, OH, USA; Toxicology Department ( S Gupta MSc), Shriram Institute for Industrial Research, Delhi, Delhi, India; School of Medicine ( V Gupta PhD), Deakin University, Geelong, VIC, Australia; Department of Clinical Medicine ( Prof V K Gupta PhD), Macquarie University, Sydney, NSW, Australia; Department of Radiology and Radiological Science ( N Hafezi-Nejad MD, S Sheikhbahaei MD), Johns Hopkins University, Baltimore, MD, USA; Research & Scientific Studies Unit ( S Haque PhD), Jazan University, Jazan, Saudi Arabia; Department of Zoology and Entomology ( A I Hasaballah PhD), Al Azhar University, Cairo, Egypt; School of Business ( Prof C Herteliu PhD), London South Bank University, London, UK; Kasturba Medical College, Mangalore ( R Holla MD, A Kamath MD), Manipal Academy of Higher Education, Manipal, India ( A Kamath MD); Pattern Recognition and Machine Learning Lab ( M Hosseinzadeh PhD), Gachon University, Seongnam, South Korea; College of Science and Engineering ( Prof M Househ PhD), Hamad Bin Khalifa University, Doha, Qatar; Jockey Club School of Public Health and Primary Care ( J Huang MD), The Chinese University of Hong Kong, Hong Kong, China; Department of Public Health and Community Medicine ( Prof A Humayun PhD), Shaikh Khalifa Bin Zayed Al-Nahyan Medical College, Lahore, Pakistan; Department of Public Health ( Prof I Iavicoli PhD), University of Naples Federico II, Naples, Italy; Department of Community Medicine ( O S Ilesanmi PhD), Department of Medicine ( A S Oguntade MSc), University College Hospital, Ibadan, Ibadan, Nigeria; Faculty of Medicine ( I M Ilic PhD, Prof M M Santric-Milicevic PhD), School of Public Health and Health Management ( Prof M M Santric-Milicevic PhD), University of Belgrade, Belgrade, Serbia; Department of Epidemiology ( Prof M D Ilic PhD), Department of Global Health, Economics and Policy ( Prof M Jakovljevic PhD), University of Kragujevac, Kragujevac, Serbia; Surveillance and Health Services Research ( F Islami PhD), American Cancer Society, Atlanta, GA, USA; Department of Health Services Research ( M Iwagami PhD), University of Tsukuba, Tsukuba, Japan; Department of Non-Communicable Disease Epidemiology ( M Iwagami PhD), London School of Hygiene & Tropical Medicine, London, UK; Institute of Comparative Economic Studies ( Prof M Jakovljevic PhD), Hosei University, Tokyo, Japan; Health Informatic Lab ( T Javaheri PhD), Department of Computer Science ( R Rawassizadeh PhD), Boston University, Boston, MA, USA; Department of Physiology ( R Jayawardena PhD), University of Colombo, Colombo, Sri Lanka; School of Exercise and Nutrition Sciences ( R Jayawardena PhD), Queensland University of Technology, Brisbane, QLD, Australia; Department of Community Medicine ( R P Jha MSc), Banaras Hindu University, Varanasi, India; Department of Community Medicine ( N Joseph MD), Manipal Academy of Higher Education, Mangalore, India; Department of Family Medicine and Public Health ( J J Jozwiak PhD), University of Opole, Opole, Poland; School of Health Professions and Human Services ( I M Karaye MD), Hofstra University, Hempstead, NY, USA; Surgery Research Unit ( J H Kauppila MD), University of Oulu, Oulu, Finland; Department of Molecular Medicine and Surgery ( J H Kauppila MD), Karolinska Institute, Stockholm, Sweden; Department of Public Health ( Prof Y S Khader PhD), Jordan University of Science and Technology, Irbid, Jordan; Amity Institute of Forensic Sciences ( H Khajuria PhD, B P Nayak PhD), Amity University, Noida, India; Department of Biophysics and Biochemistry ( Prof R Khalilov PhD), Baku State University, Baku, Azerbaijan; Russian Institute for Advanced Study ( Prof R Khalilov PhD), Moscow State Pedagogical University, Moscow, Russia; The Iranian Academy of Medical Sciences, Tehran, Iran ( M Khayamzadeh MD); Department of Epidemiology ( M Khodadost PhD), School of Public Health ( M Khodadost PhD), Larestan University of Medical Sciences, Larestan, Iran; College of Medicine ( H Kim BN), Ewha Womans University, Seoul, South Korea; Department of Genomics and Digital Health ( M Kim MD), Samsung Advanced Institute for Health Sciences & Technology ( SAIHST), Seoul, South Korea; Public Health Center ( M Kim MD), Ministry of Health and Welfare, Wando, South Korea; School of Health Sciences ( Prof A Kisa PhD), Kristiania University College, Oslo, Norway; Department of Global Community Health and Behavioral Sciences ( Prof A Kisa PhD), Tulane University, New Orleans, LA, USA; Department of Nursing and Health Promotion ( S Kisa PhD), Oslo Metropolitan University, Oslo, Norway; Social Determinants of Health Research Center ( H Koohestani PhD), Saveh University of Medical Sciences, Saveh, Iran; School of Population and Public Health ( J A Kopec PhD), University of British Columbia, Vancouver, BC, Canada; Arthritis Research Canada, Richmond, BC, Canada ( J A Kopec PhD); Microbiology & Molecular Cell Biology Department ( R Koteeswaran MD), Eastern Virginia Medical School, Norfolk, VA, USA; Biomedical Research Networking Center for Mental Health Network ( CIBERSAM) ( A Koyanagi MD), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain; Catalan Institution for Research and Advanced Studies ( ICREA), Barcelona, Spain ( A Koyanagi MD); Department of Community Medicine ( Y Krishnamoorthy MD), Employees ' State Insurance Model Hospital, Chennai, India; Chemical and Biochemical Processing Division ( M Kumar PhD), Central Institute for Research on Cotton Technology, Mumbai, India; Brigham and Women's Hospital ( V Kumar MD), Oral Health Policy and Epidemiology Department ( Z S Natto DrPH), Department of Internal Medicine ( N Rajai MD), Harvard University, Boston, MA, USA; Department of Clinical Sciences and Community Health ( Prof C La Vecchia MD), University of Milan, Milan, Italy; Department of Community and Family Medicine ( F H Lami PhD), University of Baghdad, Baghdad, Iraq; Unit of Genetics and Public Health ( Prof I Landires MD), Unit of Microbiology and Public Health ( V Nuñez-Samudio PhD), Institute of Medical Sciences, Las Tablas, Panama; Department of Public Health ( V Nuñez-Samudio PhD), Ministry of Health, Herrera, Panama ( Prof I Landires MD); Pattern Recognition and Machine Learning Lab ( Prof S Lee PhD), Gachon University, Seongnam, South Korea; The Office of Health Policy & Legislative Affairs ( W Lee PhD), University of Texas, Galveston, TX, USA; Department of Medicine ( Prof Y Lee PhD), School of Medical Sciences ( Prof Y Lee PhD), University of Science Malaysia, Kota Bharu, Malaysia; Faculty of Science ( E Leong PhD), Universiti Brunei Darussalam ( University of Brunei Darussalam), Bandar Seri Begawan, Brunei; Department of Sociology ( B Li PhD), Shenzhen University, Shenzhen, China; Department of Professional and Medical Education ( S W Lobo PhD), Meharry Medical College, Nashville, TN, USA; Department of Biomedical Sciences ( S W Lobo PhD), Mercer University, Macon, GA, USA; School of Health ( J Loureiro PhD), Polytechnic Institute of Porto, Portugal; Department of General Surgery ( Prof R Lunevicius DSc), Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Department of Surgery ( Prof R Lunevicius DSc), University of Liverpool, Liverpool, UK; Department of Biostatistics and Epidemiology, School of Public Health ( F Madadizadeh PhD), Yazd University of Medical Sciences, Yazd, Iran; Department of Primary Care and Public Health ( Prof A Majeed MD, Prof S Rawaf MD), WHO Collaborating Centre for Public Health Education and Training ( D L Rawaf MD), Imperial College London, London, UK; University Institute of Public Health ( A A Malik PhD), The University of Lahore, Lahore, Pakistan; School of Medicine and Surgery ( Prof L G Mantovani DSc), University of Milan Bicocca, Monza, Italy; Value-Based Healthcare Unit ( Prof L G Mantovani DSc), IRCCS MultiMedica, Sesto San Giovanni, Italy; Department of Nutrition and Dietetics ( M Martorell PhD), Centre for Healthy Living ( M Martorell PhD) University of Concepcion, Concepción, Chile; National Centre for Disease Informatics and Research ( P Mathur PhD), Indian Council of Medical Research, Bengaluru, India; Department of Preventive Oncology ( J K Meena MD), All India Institute of Medical Sciences, New Delhi, India; Peru Country Office ( W Mendoza MD), United Nations Population Fund ( UNFPA), Lima, Peru; University Research Institute ( A A Mentis MD), National and Kapodistrian University of Athens, Athens, Greece; Clinical Microbiology and Parasitology Unit ( T Mestrovic PhD), Dr. Zora Profozic Polyclinic, Zagreb, Croatia; University Centre Varazdin ( T Mestrovic PhD), University North, Varazdin, Croatia; School of Public Health and Community Medicine ( J Miao Jonasson PhD), University of Gothenburg, Gothenburg, Sweden; Center for Innovation in Medical Education ( B Miazgowski MD), Department of Propedeutics of Internal Diseases & Arterial Hypertension ( Prof T Miazgowski MD), Pomeranian Medical University, Szczecin, Poland ( B Miazgowski MD); Social Determinants of Health Center ( M Mirza-Aghazadeh-Attari MD), Urmia University of Medical Science, Urmia, Iran; Research Center for Biochemistry and Nutrition in Metabolic Diseases ( H Mirzaei PhD), Kashan University of Medical Sciences, Kashan, Iran; Department of Surgical Oncology ( Prof S Misra MCh), All India Institute of Medical Sciences, Jodhpur, India; Department of Biology ( K A Mohammad PhD), Salahaddin University-Erbil, Erbil, Iraq; Infectious Diseases Research Center ( S Mohammadi PhD), Golestan University of Medical Sciences, Gorgan, Iran; Health Systems and Policy Research Unit ( S Mohammed PhD), Ahmadu Bello University, Zaria, Nigeria; Department of Health Care Management ( S Mohammed PhD), Technical University of Berlin, Berlin, Germany; Dental Basic Sciences Department ( T A Mohammed MSc), University of Duhok, Duhok, Iraq; Oncology Department ( N Moka MD), Appalachian Regional Healthcare, Hazard, KY, USA; Department of Internal Medicine ( N Moka MD), University of Kentucky, Lexington, KY, USA; Faculty of Life Sciences and Medicine ( M Molokhia PhD), King's College London, London, UK; Clinical Epidemiology and Public Health Research Unit ( L Monasta DSc), Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy; Computer, Electrical, and Mathematical Sciences and Engineering Division ( P Moraga PhD), King Abdullah University of Science and Technology, Thuwal, Saudi Arabia; Department of Epidemiology and Biostatistics ( S Mubarik MS, Prof C Yu PhD), School of Medicine ( Z Zhang PhD), Wuhan University, Wuhan, China; Department of Surgery ( F Mulita MD), General University Hospital of Patras, Patras, Greece; Medical School ( F Mulita MD), University of Thessaly, Larissa, Greece; Laboratory of Public Health Indicators Analysis and Health Digitalization ( M Naimzada MD), Moscow Institute of Physics and Technology, Dolgoprudny, Russia; Experimental Surgery and Oncology Laboratory ( M Naimzada MD), Kursk State Medical University, Kursk, Russia; Department of Preventive Medicine and Public Health ( Prof H Nam PhD), Chungnam National University School of Medicine, Daejeon, South Korea; Daejeon Regional Cancer Center ( Prof H Nam PhD), Chungnam National University Hospital, Daejeon, South Korea; Department of General Surgery ( I Negoi PhD), Emergency Hospital of Bucharest, Bucharest, Romania; Institute for Global Health Innovations ( C T Nguyen MPH), Duy Tan University, Hanoi, Vietnam; Center of Excellence in Behavioral Medicine ( S H Nguyen BS), Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam; Medical Research Council Clinical Trials Unit ( N M Noor MRCP), Institute of Cardiovascular Science ( A S Oguntade MSc), University College London, London, UK; Department of Gastroenterology ( N M Noor MRCP), Cambridge University Hospitals, Cambridge, UK; Department of Nutrition ( S Noori PhD), Jundishapur University of Medical Sciences, Ahvaz, Iran; Center of Excellence in Reproductive Health Innovation ( CERHI) ( C I Nzoputam MPH), University of Benin, Benin City, Nigeria; Administrative and Economic Sciences Department ( Prof B Oancea PhD), University of Bucharest, Bucharest, Romania; Department of Community Health and Primary Care ( O O Odukoya MSc), University of Lagos, Idi Araba, Nigeria; Department of Family and Preventive Medicine ( O O Odukoya MSc), University of Utah, Salt Lake City, UT, USA; Department of Psychiatry and Behavioural Neurosciences ( A T Olagunju MD), Department of Pathology and Molecular Medicine ( T O Olagunju MD), McMaster University, Hamilton, ON, Canada; Department of Psychiatry ( A T Olagunju MD), University of Lagos, Lagos, Nigeria; Non-communicable Disease Prevention Unit ( S Ong FAMS), Ministry of Health, Bandar Seri Begawan, Brunei; Early Detection & Cancer Prevention Services ( S Ong FAMS), Pantai Jerudong Specialist Centre, Bandar Seri Begawan, Brunei; National School of Public Health ( A Padron-Monedero PhD), Institute of Health Carlos III, Madrid, Spain; Department of Epidemiology ( R Pakzad PhD), Ilam University of Medical Sciences, Ilam, Iran; Department of Health Metrics ( A Pana MD), Center for Health Outcomes & Evaluation, Bucharest, Romania; Department of Neurology and Public Health ( U K Patel MD), Icahn School of Medicine at Mount Sinai, New York, NY, USA; Research Section ( U Paudel PhD), Nepal Health Research Council, Kathmandu, Nepal; Faculty of Humanities and Social Sciences ( U Paudel PhD), Tribhuvan University, Kathmandu, Nepal; Department of Zoology ( Prof N Perumalsamy PhD), Yadava College, Madurai, India; Zoology ( Prof N Perumalsamy PhD), Annai Fathima College, Madurai, Madurai District, India; Pennsylvania Cancer and Regenerative Medicine Center ( R G Pestell MD), Baruch S Blumberg Institute, Doylestown, PA, USA; Department of Medicine ( R G Pestell MD), Xavier University School of Medicine, Woodbury, NY, USA; Department of Public Health ( Z Z Piracha PhD), Health Services Academy, Islamabad, Pakistan; Institute of Infection and Immunity ( R C G Pollok FRCP), St George's University of London, London, UK; Department of Biochemistry ( Prof A Prashant PhD), Jagadguru Sri Shivarathreeswara University, Mysuru, India; Biomedical Engineering Department ( Prof M Rabiee PhD), Amirkabir University of Technology, Tehran, Iran; Department of Physics ( N Rabiee PhD), Sharif University of Technology, Tehran, Iran; College of Medicine ( A Radfar MD), University of Central Florida, Orlando, FL, USA; Department of Population Science and Human Resource Development ( M Rahman DrPH), University of Rajshahi, Rajshahi, Bangladesh; Future Technology Research Center ( A Rahmani PhD), National Yunlin University of Science and Technology, Yunlin, Taiwan ( province of China); Department of Epidemiology ( V Rahmanian PhD), Jahrom University of Medical Sciences, Jahrom, Iran; Department of Surgery ( A Rajesh MD), University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Health Emergency Operation Center ( K Ranabhat MPH), Ministry of Health & Population, Kathmandu, Nepal; Central Department of Public Health ( K Ranabhat MPH), Institute of Medicine, Kathmandu, Nepal; Epidemiology and Biostatistics ( Prof M Rezaeian PhD), Department of Medical Biochemistry ( M Sahebazzamani MSc), Rafsanjan University of Medical Sciences, Rafsanjan, Iran ( A Rashidi MD); Department of Clinical Science ( M Rashidi DVM), Islamic Azad University, Garmsar, Iran; Cellular and Molecular Research Center ( M Rastegar PhD), Department of Epidemiology ( A Tiyuri MSc), Birjand University of Medical Sciences, Birjand, Iran; University College London Hospitals, London, UK ( D L Rawaf MD); Academic Public Health England ( Prof S Rawaf MD), Public Health England, London, UK; Department of Immunology and Laboratory Sciences ( M Razeghinia MSc), Medical Laboratory Sciences ( M Sahebazzamani MSc), Sirjan School of Medical Sciences, Sirjan, Iran; Department of Immunology ( M Razeghinia MSc), Kerman University of Medical Sciences, Kerman, Iran; School of Medicine ( Prof A M N Renzaho PhD), Translational Health Research Institute ( Prof A M N Renzaho PhD), Western Sydney University, Campbelltown, NSW, Australia; Network of Immunity in Infection, Malignancy and Autoimmunity ( NIIMA) ( Prof N Rezaei PhD), Universal Scientific Education and Research Network ( USERN), Tehran, Iran; Eye and Skull Base Research Centers ( S Rezaei MD), Rassoul Akram Hospital, Tehran, Iran; Department of Medical Pharmacology ( M M Saber-Ayad MD), Cairo University, Giza, Egypt; Department of Gastroenterology ( B Saberzadeh-Ardestani MD), Tehran University of Medical Sciences, Terhan, Iran; Research and Development ( Prof U Saeed PhD), Islamabad Diagnostic Center Pakistan, Islamabad, Pakistan; Biological Production Division ( Prof U Saeed PhD), National Institute of Health, Islamabad, Pakistan; Applied Biomedical Research Center ( A Sahebkar PhD), Biotechnology Research Center ( A Sahebkar PhD), Mashhad University of Medical Sciences, Mashhad, Iran; Department of Immunology ( A Salek Farrokhi PhD), Semnan University of Medical Sciences and Health Services, Semnan, Iran; Research Center for Molecular Medicine ( P Samadi PhD), Hamadan University of Medical Sciences, Hamadan, Iran; Emergency Department ( M Samaei MD), Brown University, Providence, RI, USA; Department of Entomology ( A M Samy PhD), Ain Shams University, Cairo, Egypt; Department of Surgery ( Prof J Sanabria MD), Marshall University, Huntington, WV, USA; Research Development Coordination Section ( M N S Saqib PhD), Pakistan Health Research Council, Islamabad, Pakistan; Faculty of Health & Social Sciences ( B Sathian PhD), Bournemouth University, Bournemouth, UK; UGC Centre of Advanced Study in Psychology ( M Satpathy PhD), Utkal University, Bhubaneswar, India; Udyam-Global Association for Sustainable Development, Bhubaneswar, India ( M Satpathy PhD); Department of Health Sciences ( I J C Schneider PhD), Federal University of Santa Catarina, Araranguá, Brazil; Department of Medical Statistics ( M Šekerija PhD), University of Zagreb, Zagreb, Croatia; Department of Epidemiology and Prevention of Chronic Non-communicable Diseases ( M Šekerija PhD), Croatian Institute of Public Health, Zagreb, Croatia; National Heart, Lung, and Blood Institute ( A Seylani BS), National Institute of Health, Rockville, MD, USA; Center for Biomedical Information Technology ( F Sha PhD), Shenzhen Institutes of Advanced Technology, Shenzhen, China; Clinical Research Development Unit of Farshchian Heart Center ( Z Shaghaghi PhD), Hamedan University of Medical Sciences, Hamadan, Iran; Rajaei Cardiovascular Medical and Research Center ( M Sharifian MD), Zabol University of Medical Sciences, Tehran, Iran; Department of Hematology-Oncology ( S K Siddappa Malleshappa MD), Baystate Medical Center, Springfield, MA, USA; Department of Physical Education ( Prof D A S Silva PhD), Federal University of Santa Catarina, Florianópolis, Brazil; Real World Insights ( G Silva Julian MSc), IQVIA, São Paulo, Brazil; School of Medicine ( Prof J A Singh MD), University of Alabama at Birmingham, Birmingham, AL, USA; Medicine Service ( Prof J A Singh MD), US Department of Veterans Affairs ( VA), Birmingham, AL, USA; Maternal and Child Health Division ( M Siraj MSc), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department No.16 ( V Y Skryabin MD), Moscow Research and Practical Centre on Addictions, Moscow, Russia; Therapeutic Department ( A A Skryabina MD), Balashiha Central Hospital, Balashikha, Russia; Surgery ( B Socea PhD), “ Sf. Pantelimon ” Emergency Clinical Hospital Bucharest, Bucharest, Romania; Department of Neurosciences ( M Solmi MD), University of Ottawa, Ottawa, ON, Canada; Taub Institute for Research on Alzheimer's Disease and the Aging Brain ( S Song PhD), Columbia University Medical Center, New York, NY, USA; Department of Medicine ( Prof R Tabarés-Seisdedos PhD), University of Valencia, Valencia, Spain; Carlos III Health Institute ( Prof R Tabarés-Seisdedos PhD), Biomedical Research Networking Center for Mental Health Network ( CiberSAM), Madrid, Spain; Department of Surgery ( K Tan PhD), National University of Singapore, Singapore, Singapore; Department of Cell Therapy and Applied Genomics ( A Tbakhi MD), King Hussein Cancer Center, Amman, Jordan; Department of Nursing ( B Tesfaye MSc), Debre Markos University, Debre Markos, Ethiopia; Department of Public Health and Medicine ( D N Tollosa PhD), University of Newcastle, Newcastle, NSW, Australia; Nutritional Epidemiology Research Team ( EREN) ( M Touvier PhD), National Institute for Health and Medical Research ( INSERM), Paris, France; Health, Medicine and Human Biology ( M Touvier PhD), Sorbonne Paris Nord University, Bobigny, France; Department of Health Economics ( B X Tran PhD), Hanoi Medical University, Hanoi, Vietnam; Department of Epidemiology and Biostatistics ( B S Tusa MPH), Haramaya University, Haramaya, Ethiopia; Department of Allied Health Sciences ( I Ullah PhD), Iqra National University, Peshawar, Pakistan; Pakistan Council for Science and Technology ( I Ullah PhD), Ministry of Science and Technology, Islamabad, Pakistan; Clinical Cancer Research Center ( S Valadan Tahbaz PhD, S Yahyazadeh Jabbari MD), Milad General Hospital, Tehran, Iran; Department of Microbiology ( S Valadan Tahbaz PhD), Faculty of Medicine ( M Zahir MD), Islamic Azad University, Tehran, Iran; Faculty of Information Technology ( B Vo PhD), HUTECH University, Ho Chi Minh City, Vietnam; Department of Medicine ( C Wang MPH), Vanderbilt University, Nashville, TN, USA; Competence Center of Mortality-Follow-Up of the German National Cohort ( R Westerman DSc), Federal Institute for Population Research, Wiesbaden, Germany; Cancer Epidemiology and Prevention Research ( L Yang PhD), Alberta Health Services, Calgary, BC, Canada; Department of Oncology ( L Yang PhD), University of Calgary, Calgary, AB, Canada; Cancer Institute ( D Yuce MD), Hacettepe University, Ankara, Turkey; Department of Clinical Pharmacy and Outcomes Sciences ( I Yunusa PhD), University of South Carolina, Columbia, SC, USA; Epidemiology and Cancer Registry Sector ( Prof V Zadnik PhD), Institute of Oncology Ljubljana, Ljubljana, Slovenia; Independent Consultant, Tehran, Iran ( I Zare BSc).
The estimates of colorectal cancer were produced as part of GBD 2019. All the estimates are available in the public domain. Members of the core Institute for Health Metrics and Evaluation ( IHME) had full access to the underlying data used to generate estimates presented in this Article. All other authors had access to and reviewed estimates as part of the research evaluation process, which includes additional stages of internal IHME and external formal collaborator review. The corresponding author had final responsibility for the decision to submit the manuscript for publication. Contributions for all authors can be found in the appendix ( p 1).
To download the data used in these analyses, please visit the Global Health Data Exchange GBD 2019 results website.
R Ancuceanu reports consulting fees from AbbVie; payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events from AbbVie, Sandoz, and B Braun; all outside the submitted work. M Ausloos reports grants from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084 “ Understanding and modelling time-space patterns of psychology-related inequalities and polarization ” ( October, 2018, to September, 2022), outside the submitted work. J Conde reports grants from the European Research Council Starting Grant ( ERC-StG-2019-848325); patents planned, issued or pending for functionalised nanoparticles and compositions for cancer treatment and methods ( US Application No. 62/334538), and TRPV2 Antagonists WO Application No. PCT/PT2018/050035; all outside the submitted work. I Fillip reports consulting fees from Avicenna Medical and Clinical Research Institute, outside the submitted work. N Ghith reports grants from Novo Nordisk Foundation as salary payment ( NNF16OC0021856), outside the submitted work. A Guha reports grants from the American Heart Association as the Strategically Focused Research Network Grant in Disparities in Cardio-Oncology ( # 847740 and # 863620), outside the submitted work. C Herteliu and A Pana report grants or contracts from Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084 ( October, 2018, to September, 2022) “ Understanding and modelling time-space patterns of psychology-related inequalities and polarization ” and Project number PN-III-P2-2·1-SOL-2020-2-0351 ( June to October, 2020) “ Approaches within public health management in the context of COVID-19 pandemic ”, all outside the submitted work. C Herteliu reports grants from the Ministry of Labour and Social Justice, Romania, project number 30/PSCD/2018, “ Agenda for skills Romania 2020–2025; ” outside the submitted work. J Jozwiak reports payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events from Teva, Amgen, Synexus, Boehringer Ingelheim, Alab Laboratories, and Zentiva as personal fees, all outside the submitted work. J H Kauppila reports grants from the Sigrid Juselius Foundation and Finnish Cancer Foundation as research grants paid to their institutions; all outside the submitted work. J A Loureiro reports support for the present manuscript from Fundação para a Ciência e Técnologia ( FCT) as a salary payment under the Scientific Employment Stimulus ( CEECINST/00049/2018) and from FCT/MCTES ( Ministério da Ciência, Tecnologia e Ensino Superior) ( PIDDAC) as Base Funding ( UIDB/00511/2020 of LEPABE). A-F A Mentis reports grants or contracts from ELIDEK ( Hellenic Foundation for Research and Innovation, MIMS-860) and EPANEK - MilkSafe ( Τ2ΕΔΚ-02222), all outside the submitted manuscript. O O Odukoya reports support for the present manuscript from the Fogarty International Center of the National Institutes of Health under the award number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. A Radfar reports consulting fees from Avicenna Medical and Clinical Research Institute; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid with MEDICHEM as a board member; all outside the submitted work. M Šekerija reports payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events from Roche and Johnson & Johnson, outside the submitted work. D A S Silva reports support for the present manuscript in part from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil ( CAPES) —Finance Code 001 and in part by Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil ( CNPq - 302028/2018-8), as payments made to their institution. J A Singh reports consulting fees from Crealta/Horizon, Medisys, Fidia, Two labs, Adept Field Solutions, Clinical Care Options, ClearView Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, UBM, Trio Health, Medscape, WebMD, and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Simply Speaking; support for attending meetings or travel, or both from OMERACT, an international organisation that develops measures for clinical trials and receives arm's length funding from 12 pharmaceutical companies, when traveling to OMERACT meetings; participation on a data safety monitoring board or advisory board as a member of the FDA Arthritis Advisory Committee; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with OMERACT as a member of the steering committee, with the Veterans Affairs Rheumatology Field Advisory Committee as a member, and with the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis as a director and editor; stock or stock options in TPT Global Tech, Vaxart Pharmaceuticals and Charlotte's Web Holdings, and previously owned stock options in Amarin, Viking, and Moderna Pharmaceuticals; all outside the submitted work. M Solmi reports payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events from Lundbeck; and participation on a data safety monitoring board or advisory board with Angelini; all outside the submitted work. T Vos reports support for the present manuscript from the Bill & Melinda Gates Foundation as payment to their institution. All other authors declare no competing interests.
This research was supported by funding from the Bill & Melinda Gates Foundation. J M Acuna acknowledges support from the Khalifa University College of Medicine and Health Sciences, Research and Data Intelligence Support Center, Khalifa University, Abu Dhabi, United Arab Emirates. S Ahmad thanks the Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan, for their support. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait, for approval and support to participate in this research project. F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. ( FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant ( ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia ( FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. N Ghith acknowledges support by a grant from Novo Nordisk Foundation ( NNF16OC0021856) in the form of salary payments. J C Glasbey is supported by a National Institute of Health Research ( NIHR) Academy Doctoral Research Fellow ( NIHR300175). V K Gupta and V B Gupta acknowledge funding support from the National Health and Medical Research Council ( NHMRC), Australia. S Haque acknowledges support from the Jazan University, Jazan, Saudi Arabia, for providing the access of the Saudi Digital Library for this research study. A Pana, M Ausloos, and C Herteliu are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. M Jakovljevic acknowledges support from the Ministry of Education Science and Technological Development of the Republic of Serbia through the Grant OI175014 and from the Science Fund of The Republic of Serbia through Grant Em-CEAS. I Landires is a member of the Sistema Nacional de Investigación ( SNI), which is supported by Panama's Secretaría Nacional de Ciencia, Tecnología e Innovación ( SENACYT). B Li was supported by the Guangdong Philosophy and Social Science Fund ( GD21YSH06), the Shenzhen Philosophy and Social Science Fund ( grant number SZ2020C015), and the Shenzhen Science and Technology Fund ( grant number 20200805164059001). J A Loureiro was supported by national funds through the Fundação para a Ciência e Tecnologia, under the Scientific Employment Stimulus ( CEECINST/00049/2018). V Nuñez-Samudio is a member of the Sistema Nacional de Investigación ( SNI), which is supported by Panama's Secretaría Nacional de Ciencia, Tecnología e Innovación ( SENACYT). O O Odukoya acknowledges support from the Fogarty International Center of the National Institutes of Health under the award number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the US National Institutes of Health. A M Samy acknowledges the support from the Egyptian Fulbright Mission Program. D A S Silva acknowledges support in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil ( CAPES) —Finance Code 001 and in part by Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil ( CNPq - 302028/2018-8).
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Download.pdf ( 4.9 MB) Help with pdf files Supplementary appendix
Global epidemiology and prevention of colorectal cancerCharacterisation of the global variation in disease burden and temporal trends can provide important clues about disease aetiology and inform prevention strategies. Although previous studies have reported geographical and temporal trends in the incidence of and mortality due to colorectal cancer based on data from the GLOBOCAN database,1–4 data on disability-adjusted life years ( DALYs) due to colorectal cancer and the contributing risk factors remain sparse. Full-Text PDF | tech |
Senate Votes to Strip Russia of Trade Status, House to Follow | The information you requested is not available at this time, please check back again soon.
A worker operates a binding machine as lengths of steel rod are secured ready for shipping at the Oskol electrometallurgical plant, operated by Metalloinvest Holding Co., in Stary Oskol, Russia, on Friday, Nov. 26, 2021. Iron ore prices rebounded from last week’ s pandemic-driven losses on bets the impact of a new coronavirus variant may not be as severe as initially feared., Bloomberg
( Bloomberg) -- The U.S. Senate voted unanimously to strip normal trade relation status from Russia and Belarus, sending the White House-backed legislation to the House for a vote expected later Thursday.
The trade legislation, passed on a rare 100-0 vote, would put Russia and Belarus in the same category as pariah states such as North Korea and Cuba, and adds to the growing list of economic barriers erected by the U.S. and its allies to punish Russian President Vladimir Putin’ s government over the assault on Ukraine. The bill allows the U.S. to impose large tariff increases on goods from Russia and Belarus.
Under the legislation, the tariffs on iron and some steel products could be raised to 20% from 0%. Plywood could face a 50% levy and some reaction engines could have import taxes of 35%, according to a Senate Democratic aide.
“ No nation whose military is committing war crimes deserves free trade status with the United States, ” Senate Majority Leader Chuck Schumer said on the floor Thursday morning.
President Joe Biden last month already banned imports of signature Russian products including oil, gas, vodka, seafood and industrial diamonds.
The trade bill was delayed in the Senate for about a week because of a hold up from Senator Rand Paul, a Kentucky Republican, about the wording of an expansion of the Global Magnitsky Human Rights Accountability Act, which was embedded in the bill. Other squabbles among senators also delayed the bill. Lawmakers ultimately reached a deal after weeks of haggling.
That provision would authorize the Biden administration to impose further sanctions on Russian officials for human rights violations. Paul wanted the legislation, which is named for a Russian lawyer who died in custody after investigating tax fraud, to be more specific about the types of transgressions that would trigger sanctions. He agreed to stop blocking the bill after reaching a compromise with Senate leaders.
The House overwhelmingly passed the trade measure earlier in March, but revisions in the Senate mean the legislation will need to go back to the House for another vote.
All House lawmakers except for eight Republicans voted to sever trade ties with Russia and Belarus, which has hosted some of the Russian troops who invaded Ukraine.
By mid-March, a quarter of the World Trade Organization’ s 164 members -- collectively representing 58% of the global gross domestic product -- were poised to stop treating Russia as a so-called most-favored-nation under WTO rules.
Besides the U.S., the list includes the European Union’ s 27 members, Japan, the U.K., Canada, South Korea and Australia.
Canada joins U.S., U.K. in diplomatic boycott of Beijing games
Trudeau weighs auto-content rules as next U.S. trade flashpoint | general |
Financing for Outbreak Preparedness and Response | Your contribution makes it possible for the Center’ s researchers to devise practical, evidence-based solutions for today’ s most pressing development challenges.
There is a clear economic case for accelerating investment and progress toward improved global health security – the cost of preparedness and prevention is a fraction of the cost of response and recovery. The question is how to get the sizing, organization, and incentives of financing preparedness right at national and global levels, ensuring resources are in place to mount an effective, coordinated response when health emergencies occur.
Sustained and substantial funds are vital for global health security, but the landscape of financing for preparedness, prevention and response is fragmented and poorly governed. Multiple international programs, initiatives, and institutions have evolved in the aftermath of past pandemics, but many were small and inadequately funded; the COVID-19 pandemic has further exposed the ways in which global preparedness and response are under-resourced and under-prioritized. What financing commitments, structures, and mechanisms will emerge from the COVID-19 pandemic to ensure fit-for-purpose financing for global health security going forward?
CGD experts have been examining and working to improve financing for preparedness, prevention, and response since long before the COVID-19 pandemic, including work on financing for the response to Ebola and antimicrobial resistance, and the global health team continues to provide research, commentary, and analysis for actionable solutions and transformative ways forward. | general |
Pave your own path to a healthier life and planet - News for the Energy Sector | April 7th marks the World Health Organisation’ s World Health Day, where this year’ s focus is “ Our planet, Our health ”. It states that “ global attention on urgent actions ( are) needed to keep humans and the planet health and foster a movement to create societies focused on wellbeing ”.
But where do we start? At a time when we are facing unprecedented financial pressures, on top of what has been the most challenging two years due to the Covid pandemic, the impact is proving devastating for many, with health and wellbeing greatly impacted. This has been further enhanced by the devastating war in Ukraine, where so many lives have been lost, millions are directly impacted, and the ramifications are global.
Even before Russia invaded Ukraine on 24th February, UK households and businesses were already experiencing fresh waves of price hikes, including energy prices, fuel stations, council tax, income tax, not to mention the rise in food prices. Businesses are having to adapt to changing local and global influences, and decisions are having to be made as to the best way forward.
And just as we may feel great hope as we experience a return to some kind of normality as we see Covid restrictions lifting, it is being somewhat dimmed by the fresh worries and uncertainty both within the UK and global activities.
For many, the feeling of being overwhelmed, stress and general worries will be common. However, for the sake of protecting our health and wellbeing, it is important to yes, be fully aware, but so is ensuring we do not allow ourselves to obsess on everything that’ s happening.
It can be hard to change focus but try to look at what can you do in your own personal circumstances. What are the choices, decisions you can make? What can you control and influence? What do you want? What do you need? What can you do to safeguard your health, the health of your loved ones? What can you do to make your own personal world a happier, healthier place?
Worrying about what may or may not be, or the environmental, external factors that you have no direct control or influence on will only add to your worries and drain your energy. Use your energy wisely. | general |
Four-day workweeks can burn you out | ‘ Huge validation’: Why Crypto.com is putting its name on the L.A. Lakers’ arena
An empty office is seen., Bloomberg
The disruptions of the COVID pandemic have prompted workers to reconsider how they can be most productive and forced companies to revisit some long-held beliefs. A few organizations are floating a new possibility: a four-day workweek.
In recent months, a diverse collection of employers including Japanese electronics maker Panasonic, fintech startup Bolt and the government of Belgium have recommended giving employees the option to work four days but get paid for five. Spain and Scotland are conducting their own trials of shorter weeks. They join a clutch of firms mainly in the tech sector that gravitated to a four-day format when the pandemic hit, including crowdfunding site Kickstarter, fashion reseller thredUp and venture capital firm Uncharted.
While most companies have always had a handful of workers on alternative schedules, it is unusual for businesses to reconsider the traditional workweek for all employees. A five-day, 40-hour workweek has been the norm for salaried workers since the early 20th century, when labor leaders pushed back against factory bosses who demanded six- or even seven-day schedules and 12- to 14-hour days.
Companies with a four-day week option tend to trumpet their worker-friendly policies. Yet dig into the details, and “ four-day week ” means different things in different places. At some companies, employees might work four 10-hour days ( a practice called “ four tens ”). At others, employees get Fridays off without working longer on the previous four days. And still others might decide to reduce the overall workload by making the days shorter — so a “ four-day week ” is really still a five-day week, but workers call it quits at 4 p.m. instead of at 5 or 6 p.m.
However the days are configured, researchers say, one finding stands out: Working fewer hours is better for workers and their employers.
The most recent significant study of four-day weeks was conducted in Iceland from 2015 to 2019 and involved more than 1 per cent of the population. Organizations enrolled in the study didn’ t squeeze 40 hours into four days; they shortened the workweek to 35 or 36 hours. And different workplaces chose different approaches — some took every other Friday off, while others shortened the workday by an hour.
Regardless of how the hours were distributed, changing the schedule forced the organizations to rethink how work got done. They discovered ways to spend less time working while maintaining ( or even increasing) output, such as holding shorter meetings or setting clearer priorities. Workers said the experiment left them with less confusion about their roles, more autonomy and more support from colleagues and bosses. Managers noticed their employees showing more discipline and focus.
The experiment was hugely popular. “ For me it is like a gift from the heavens, ” one manager told the researchers. Employee well-being rose, and workers reported having more time for hobbies, friends and exercise. Another key benefit was improved weekends: Shorter weekly hours meant more errands and chores got done during the week, leaving Saturday and Sunday free for leisure and family activities. And men reported more involvement at home, which reduced women’ s stress levels. A gift from the heavens, indeed.
Iceland conducted the trial in part because workers were reporting working more than 40 hours a week — 44.4, to be precise. That makes Icelanders similar to the average full-time worker in the U.S., who puts in 8.5 hours a day, according to the Bureau of Labor Statistics. According to Gallup, 45 per cent of Americans work nine hours a day or more for a minimum of 45 hours a week.
We shouldn’ t be surprised that cutting the length of the workday increased the quality of the work produced in addition to improving employee well-being. We lose energy ( and effectiveness) as the day wears on. More than a century’ s worth of studies back that up. And that’ s something companies should remember before they seek a “ four-day week ” by cramming a 40-hour schedule into four days.
Long work days are taxing, even if they are followed by long weekends. Many people in health care work “ four tens, ” and many nurses work “ three twelves. ” While nurses will tell you that the four-day weekends are great, research shows that the long hours are hard. One study found that shifts of 10 hours or more — although often assumed to be necessary for continuity of patient care — are associated with burnout and intent to leave the profession. Mistakes are more likely at the end of a long shift, calling into question whether the practice truly delivers benefits for patients.
Another study in 2021 focused on Japanese consultants found that when people worked overtime they made more errors; shorter days were associated with better results. And a classic study of construction workers in the 1980s conducted by the Business Roundtable found that 60-hour weeks could be maintained for about two months before causing serious delays. Projects would have been completed more quickly, researchers found, had the same crew worked just 40 hours a week.
Yes, there can be benefits to pushing hard in an emergency, like a war. But even there, we run into the limits of the human mind and body. A Stanford study published in 2015 of British munitions workers in World War I found that worker output at 70 hours wasn’ t much different from worker output at 56 hours.
There is also a long-term health cost to long hours. Studies of people who work more than 50 hours a week have found that overworkers have higher rates of heart disease, diabetes, depression and alcohol use. While I haven’ t yet seen a study that disentangles long days from long weeks, you generally don’ t get the latter without the former.
The four-day week is a worthy management experiment. But to truly make it successful, companies have to shrink the workweek, not shift it.
Omicron came for Lululemon. Which retailer is next? | general |
Use of non-steroidal anti-inflammatory drugs and adverse outcomes during the COVID-19 pandemic: A systematic review and meta-analysis | BackgroundThere are concerns that the use of non-steroidal anti-inflammatory drugs ( NSAIDs) may increase the risk of adverse outcomes among patients with coronavirus COVID-19. This study aimed to synthesize the evidence on associations between the use of NSAIDs and adverse outcomes.MethodsA systematic search of WHO COVID-19 Database, Medline, the Cochrane Library, Web of Science, Embase, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Database for all articles published from January 1, 2020, to November 7, 2021, as well as a supplementary search of Google Scholar. We included all comparative studies that enrolled patients who took NSAIDs during the COVID-19 pandemic. Data extraction and quality assessment of methodology of included studies were completed by two reviewers independently. We conducted a meta-analysis on the main adverse outcomes, as well as selected subgroup analyses stratified by the type of NSAID and population ( both positive for severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2) or not).FindingsForty comparative studies evaluating 4,867,795 adult cases were identified. Twenty-eight ( 70%) of the included studies enrolled patients positive to SARS-CoV-2 tests. The use of NSAIDs did not reduce mortality outcomes among people with COVID-19 ( number of studies [ N ] = 29, odds ratio [ OR ] = 0.93, 95% confidence interval [ CI ]: 0.75 to 1.14, I2 = 89%). Results suggested that the use of NSAIDs was not significantly associated with higher risk of SARS-CoV-2 infection in patients with or without COVID-19 ( N = 10, OR = 0.96, 95% CI: 0.86 to 1.07, I2 = 78%; N = 8, aOR = 1.01, 95% CI: 0.94 to 1.09, I2 = 26%), or an increased probability of intensive care unit ( ICU) admission ( N = 12, OR = 1.28, 95% CI: 0.94 to 1.75, I2 = 82%; N = 4, aOR = 0.89, 95% CI: 0.65 to 1.22, I2 = 60%), requiring mechanical ventilation ( N = 11, OR = 1.11, 95% CI: 0.79 to 1.54, I2 = 63%; N = 5, aOR = 0.80, 95% CI: 0.52 to 1.24, I2 = 66%), or administration of supplemental oxygen ( N = 5, OR = 0.80, 95% CI: 0.52 to 1.24, I2 = 63%; N = 2, aOR = 1.00, 95% CI: 0.89 to 1.12, I2 = 0%). The subgroup analysis revealed that, compared with patients not using any NSAIDs, the use of ibuprofen ( N = 5, OR = 1.09, 95% CI: 0.50 to 2.39; N = 4, aOR = 0.95, 95% CI: 0.78 to 1.16) and COX-2 inhibitor ( N = 4, OR = 0.62, 95% CI: 0.35 to 1.11; N = 2, aOR = 0.73, 95% CI: 0.45 to 1.18) were not associated with an increased risk of death.InterpretationData suggests that NSAIDs such as ibuprofen, aspirin and COX-2 inhibitor, can be used safely among patients positive to SARS-CoV-2. However, for some of the analyses the number of studies were limited and the quality of evidence was overall low, therefore more research is needed to corroborate these findings.FundingThere was no funding source for this study.
There are concerns that the use of non-steroidal anti-inflammatory drugs ( NSAIDs) may increase the risk of adverse outcomes among patients with coronavirus COVID-19. This study aimed to synthesize the evidence on associations between the use of NSAIDs and adverse outcomes.
A systematic search of WHO COVID-19 Database, Medline, the Cochrane Library, Web of Science, Embase, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Database for all articles published from January 1, 2020, to November 7, 2021, as well as a supplementary search of Google Scholar. We included all comparative studies that enrolled patients who took NSAIDs during the COVID-19 pandemic. Data extraction and quality assessment of methodology of included studies were completed by two reviewers independently. We conducted a meta-analysis on the main adverse outcomes, as well as selected subgroup analyses stratified by the type of NSAID and population ( both positive for severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2) or not).
Forty comparative studies evaluating 4,867,795 adult cases were identified. Twenty-eight ( 70%) of the included studies enrolled patients positive to SARS-CoV-2 tests. The use of NSAIDs did not reduce mortality outcomes among people with COVID-19 ( number of studies [ N ] = 29, odds ratio [ OR ] = 0.93, 95% confidence interval [ CI ]: 0.75 to 1.14, I2 = 89%). Results suggested that the use of NSAIDs was not significantly associated with higher risk of SARS-CoV-2 infection in patients with or without COVID-19 ( N = 10, OR = 0.96, 95% CI: 0.86 to 1.07, I2 = 78%; N = 8, aOR = 1.01, 95% CI: 0.94 to 1.09, I2 = 26%), or an increased probability of intensive care unit ( ICU) admission ( N = 12, OR = 1.28, 95% CI: 0.94 to 1.75, I2 = 82%; N = 4, aOR = 0.89, 95% CI: 0.65 to 1.22, I2 = 60%), requiring mechanical ventilation ( N = 11, OR = 1.11, 95% CI: 0.79 to 1.54, I2 = 63%; N = 5, aOR = 0.80, 95% CI: 0.52 to 1.24, I2 = 66%), or administration of supplemental oxygen ( N = 5, OR = 0.80, 95% CI: 0.52 to 1.24, I2 = 63%; N = 2, aOR = 1.00, 95% CI: 0.89 to 1.12, I2 = 0%). The subgroup analysis revealed that, compared with patients not using any NSAIDs, the use of ibuprofen ( N = 5, OR = 1.09, 95% CI: 0.50 to 2.39; N = 4, aOR = 0.95, 95% CI: 0.78 to 1.16) and COX-2 inhibitor ( N = 4, OR = 0.62, 95% CI: 0.35 to 1.11; N = 2, aOR = 0.73, 95% CI: 0.45 to 1.18) were not associated with an increased risk of death.
Data suggests that NSAIDs such as ibuprofen, aspirin and COX-2 inhibitor, can be used safely among patients positive to SARS-CoV-2. However, for some of the analyses the number of studies were limited and the quality of evidence was overall low, therefore more research is needed to corroborate these findings.
There was no funding source for this study.
Research in context Evidence before this studyWe searched seven databases and resources from January 1, 2020, through November 7, 2021, with no restriction by language, for any systematic reviews comparing the clinical adverse outcomes between patients receiving NSAIDs. We used database-specific combinations of the following index terms and phrases: COVID-19, SARS-CoV-2, Coronavirus disease-19, 2019-novel coronavirus, 2019-nCoV, Nonsteroidal Anti-Inflammatory, Non-Steroidal Anti-Inflammatory, NSAID *, Antipyretic *, Ibuprofen *, Aspirin, Acetaminophen, and their derivatives. Previous related meta-analyses have only focused on a subset of NSAIDs and included indirect evidence on middle east respiratory syndrome-related coronavirus ( MERS) and severe acute respiratory syndrome ( SARS) and non-peer-reviewed preprints. Other meta-analyses did not perform subgroup analyses, nor did they grade the quality of evidence for their findings. Added value of this studyWe did a comprehensive systematic review and meta-analysis of forty observational studies across 14 countries and five continents. Our findings suggest that NSAIDs such as ibuprofen, aspirin, and COX-2 inhibitor can be used safely during the COVID-19 pandemic. The use of NSAIDs was not significantly associated with higher risk of SARS-CoV-2 infection, or an increased probability of intensive care unit ( ICU) admission, requiring mechanical ventilation, or administration of supplemental oxygen. Implications of all the available evidenceOur findings suggest that NSAIDs can be used safely in patients to relieve pain, inflammation, and fever during the COVID-19 pandemic. For future studies, there is a lack of high-quality multicenter cohort studies with a large sample size indicating NSAIDs ' impact on the quality of life and long-term survival.
We searched seven databases and resources from January 1, 2020, through November 7, 2021, with no restriction by language, for any systematic reviews comparing the clinical adverse outcomes between patients receiving NSAIDs. We used database-specific combinations of the following index terms and phrases: COVID-19, SARS-CoV-2, Coronavirus disease-19, 2019-novel coronavirus, 2019-nCoV, Nonsteroidal Anti-Inflammatory, Non-Steroidal Anti-Inflammatory, NSAID *, Antipyretic *, Ibuprofen *, Aspirin, Acetaminophen, and their derivatives. Previous related meta-analyses have only focused on a subset of NSAIDs and included indirect evidence on middle east respiratory syndrome-related coronavirus ( MERS) and severe acute respiratory syndrome ( SARS) and non-peer-reviewed preprints. Other meta-analyses did not perform subgroup analyses, nor did they grade the quality of evidence for their findings.
We did a comprehensive systematic review and meta-analysis of forty observational studies across 14 countries and five continents. Our findings suggest that NSAIDs such as ibuprofen, aspirin, and COX-2 inhibitor can be used safely during the COVID-19 pandemic. The use of NSAIDs was not significantly associated with higher risk of SARS-CoV-2 infection, or an increased probability of intensive care unit ( ICU) admission, requiring mechanical ventilation, or administration of supplemental oxygen.
Our findings suggest that NSAIDs can be used safely in patients to relieve pain, inflammation, and fever during the COVID-19 pandemic. For future studies, there is a lack of high-quality multicenter cohort studies with a large sample size indicating NSAIDs ' impact on the quality of life and long-term survival.
Since December 2019, a new infectious disease, coronavirus disease 2019 ( COVID-19), caused by the SARS-CoV-2, has swept across the world and brought huge challenges to the public health and medical service systems worldwide.1Phelan A.L. Katz R. Gostin L.O. The novel coronavirus originating in Wuhan, China: challenges for global health governance.JAMA. 2020; 323: 709-710https: //doi.org/10.1001/jama.2020.1097Google Scholar Current evidence suggests that fever is one of the main clinical symptoms of COVID-19, with 88.7% of hospitalized adults and 63.3% of hospitalized children with COVID-19 presenting fever. Therefore, symptomatic treatment with non-steroidal anti-inflammatory drugs ( NSAIDs) such as ibuprofen is often used in COVID-19 patients.2Guan W.J. Ni Z.Y. Hu Y. et al.Clinical characteristics of coronavirus disease 2019 in China.N Engl J Med. 2020; 382 ( Apr 30): 1708-1720Google Scholar, 3Castagnoli R. Votto M. Licari A. et al.Severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2) infection in children and adolescents.JAMA Pediatr. 2020; 174: 882https: //doi.org/10.1001/jamapediatrics.2020.1467Google Scholar, 4Irfan O. Muttalib F. Tang K. et al.Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis.Arch Dis Child. 2021; 106: 440-448Google Scholar However, a study published on March 11, 2020, questioned the safety of ibuprofen in the treatment of COVID-19, suggesting that SARS-CoV-2 could invade human cells by combining with Angiotensin-Converting Enzyme 2 ( ACE2), with the goal of infestation. Ibuprofen can strengthen the binding ability of ACE2 and SARS-CoV-2 and enhance the infection process of the virus. The possibility that ibuprofen use can deteriorate the course of COVID-19 should thus not be excluded, and ibuprofen should be used with caution in patients during the pandemic.5Fang L. Karakiulakis G. Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?.Lancet Respir Med. 2020; 8: e21Google Scholar
Based on the above research results, Olivier Véran, the Minister of Solidarity and Health of France issued a warning via social media on 14 March 2020, stating that `` the use of anti-inflammatory drugs ( ibuprofen, cortisone, etc.) may aggravate the course of COVID-19, and paracetamol is recommended if fever symptoms occur ''.6Day M. Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists.BMJ. 2020; 368: m1086https: //doi.org/10.1136/bmj.m1086Google Scholar On March 17, 2020, the World Health Organization ( WHO) also issued a statement that `` it is recommended that patients with COVID-19 avoid taking ibuprofen ''.7World Health OrganizationThe Use of Non-Steroidal Anti- Inflammatory Drugs ( NSAIDs) in Patients with COVID-19. WHO, Geneva2020Google Scholar However, at the same time, the European Medicines Agency ( EMA) issued a statement that there is no scientific evidence of an association between ibuprofen and COVID-19 deterioration. The EMA further noted that they would closely monitor the situation and review any new information.8Agence nationale de securite du medicament et des produits de sante. Usage des médicaments en ville durant l’ épidémie de Covid-19: point de situation après cinq semaines de confinement—Point d’ information. https: //www.ansm.sante.fr/S-informer/Points-d-information-Points-d-information/Usage-des-medicaments-en-ville-durant-l-epidemie-de-Covid-19-point-de-situation-apres-cinq-semaines-de-confinement-Point-d-information. Accessed 4 May 2020.Google Scholar In France, the issuance of the above warnings led to an 80% drop in the prescription rate of ibuprofen in general.9European Medicines Agency EMA Gives Advice on the Use of Non-Steroidal Anti-Inflammatories for COVID-19. EMA, London2020https: //www.ema.europa.eu/en/news/ema-gives-advice-use-non-steroidal-anti-inflammatories-covid-19Date accessed: March 30, 2022Google Scholar
The evidence on the impact of ibuprofen and other NSAIDs for patients with COVID-19 is still controversial. The first prospective cohort study of ibuprofen and other NSAIDs for treating adults with COVID-19 showed that among 503 adults with confirmed SARS-CoV-2 infection, the use of ibuprofen during the acute phase was not associated with the risk of death ( hazard ratio [ HR ] =0.63, 95% CI: 0.07 to 5.44) or the risk of hospital admission ( OR = 1.27, 95% CI: 0.55 to 2.95), compared with no ibuprofen use. Long-term use of NSAIDs was also not found to be associated with a higher risk of death ( HR=0.49, 95% CI: 0.18 to 1.36).10Abu Esba L.C. Alqahtani R.A. Thomas A. et al.Ibuprofen and NSAID use in COVID-19 infected patients is not associated with worse outcomes: a prospective cohort study.Infect Dis Ther. 2020; 2: 1-16https: //doi.org/10.1007/s40121-020-00363-wGoogle Scholar However, another retrospective cohort study from South Korea showed that among 1824 hospitalized adult patients with COVID-19, there was an increased risk of adverse outcomes in patients who used NSAIDs ( OR=1.54, 95% CI: 1.13 to 2.11) compared with patients who did not use NSAIDs ( n = 87).11Jeong H.E. Lee H. Shin H.J. Choe Y.J. Filion K.B. Shin J.Y. Association between NSAIDs use and adverse clinical outcomes among adults hospitalized with COVID-19 in South Korea: a nationwide study.Clin Infect Dis. 2020;: ciaa1056https: //doi.org/10.1093/cid/ciaa1056Google Scholar Currently, the research results on whether NSAIDs can be safely used in patients with COVID-19 or not are inconsistent. To answer this question, we included all comparative studies which enrolled patients that took NSAIDs during the COVID-19 pandemic, to conducted this comprehensive systematic review and meta-analysis to explore the association between the use of NSAIDs and adverse outcomes among patients during the COVID-19 pandemic.
Our systematic review and meta-analysis were performed in accordance with the Cochrane Handbook.12Higgins JPT Thomas J Chandler J Cumpston M Li T Page MJ et al.Cochrane Handbook for Systematic Reviews of Interventions.2nd ed. John Wiley & Sons, Chichester ( UK) 2019Google Scholar We report the results in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses ( PRISMA) statement.13Page M.J. McKenzie J.E. Bossuyt P.M. et al.The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.BMJ. 2021; 372: n71https: //doi.org/10.1136/bmj.n71Google Scholar
We performed a systematic literature search of the WHO COVID-19 Database, Medline ( via PubMed), The Cochrane Library, Web of Science ( WOS), China Biology Medicine disc ( CBM), China National Knowledge Infrastructure ( CNKI), and Wanfang Database for studies published from January 1, 2020, through November 7, 2021. We used database-specific combinations of the following index terms and phrases: COVID-19, SARS-CoV-2, Coronavirus disease-19, 2019-novel coronavirus, 2019-nCoV, Nonsteroidal Anti-Inflammatory, Non-Steroidal Anti-Inflammatory, NSAID *, Antipyretic *, Ibuprofen *, Aspirin, Acetaminophen, and their derivatives. Supplementary searches were conducted on Google Scholar ( https: //scholar.google.nl/). Finally, we reviewed the references from the included articles manually to identify any missed potentially relevant records. The inclusion of studies was not restricted by the publication status or language. An information retrieval specialist helped to develop the search strategy. Details of the search strategies are available in eTable 1 in Supplementary.
We included all comparative studies in comparing the clinical adverse outcomes during the COVID-19 pandemic ( in the time period starting from the end of 2019) between patients receiving and not receiving any NSAIDs. All included studies must be conducted during the COVID-19 pandemic, but the patients could positive or negative to SARS-CoV-2 test. We made no restrictions on age, gender, ethnicity, region, other individual factors, or the COVID-19 status.
We excluded multiple publications on the same population. Studies reporting insufficient details were also excluded unless we were able to retrieve the original data.
Study selection was conducted independently by two investigators. For this purpose, four investigators were divided into two groups ( Siya Zhao and Shuai Peng; Zhili Wang and Lidan Gan), and the records were split randomly between these groups. The retrieval consisted of three phases. In phase one, we screened titles and abstracts of search results to exclude literature that obviously did not meet the inclusion and exclusion criteria. In phase two, full-text articles were obtained for articles identified by one or both investigators as potentially relevant. The full texts of eligible articles were reviewed independently by the same two investigators. In phase three, any disagreements in the decision to include or exclude the study were adjudicated through discussion or consultation with a third investigator ( Qi Zhou).
Two investigators ( Siya Zhao and Lidan Gan) independently extracted data from the included studies using a standardized Microsoft Excel collection form. Disagreements were resolved through discussion or consultation with a third investigator ( Qi Zhou) if necessary. The following information was extracted: ( 1) Basic information: the first author, year of publication, country of origin, sample size, types of study design and complications; ( 2) Characteristics of the exposure: types of NSAIDs taken; ( 3) Information on outcomes: mortality, probability of SARS-CoV-2 infection, probability of ICU admission rate, probability of machine ventilation, probability of administration of respiratory support, a composite risk of adverse outcomes ( defined as having at least one of the following: requirement for supplemental oxygen, mechanical ventilation, sepsis, ICU admission or death). Mortality was the primary outcome of our study. If sufficient data on characteristics or outcomes were not available, we contacted the authors of studies by email to request them or calculated from other reported data according to methods recommended by the Cochrane Handbook, if available.
Two investigators ( Qi Zhou and Siya Zhao) independently assessed the risk of bias in each study included in the systematic review. We used the Newcastle-Ottawa Scale to assess the methodological quality.14Ottawa Hospital Research Institute. The Newcastle-Ottawa Scale ( NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available online: http: //www.ohri.ca/programs/clinical epidemiology/oxford.asp.Google Scholar The tool consists of eight items: representativeness of the exposed cohort, selection of the non-exposed cohort, ascertainment of exposure, the demonstration that outcome of interest was not present at the start of study, comparability of cohorts on the basis of the design or analysis, assessment of outcome, sufficient follow-up for outcomes to occur, and adequacy of follow up of cohorts. Each item was rated as either none, one point or two points. We resolved disagreements by discussion or by consultation with another investigator ( Yaolong Chen).
We assessed the certainty of the evidence with the Grading of Recommendations Assessment, Development and Evaluation ( GRADE) approach15Guyatt G.H. Oxman A.D. Vist G.E. et al.GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336 ( Apr): 924-926Google Scholar,16Norris S.L. Meerpohl J.J. Akl E.A. et al.The skills and experience of GRADE methodologists can be assessed with a simple tool.J Clin Epidemiol. 2016; 79: 150-158Google Scholar for all outcomes. We rated the certainty of the evidence for each outcome based on considerations of five factors that may lead to rating down the quality of evidence ( risk of bias, inconsistency, imprecision, indirectness, and publication bias), and three factors that may lead to rating up the quality of evidence ( dose-response gradient, large magnitude of effect and plausible confounders or biases). The quality of evidence is initially assigned as high for randomized controlled trials ( RCTs) without serious defects in methodology, and low for observational studies, after which the quality is gradually up- or downgraded based on the eight factors mentioned before. The quality of the evidence is finally rated as 'high ', 'moderate ', 'low ' or 'very low '. We performed the assessment using the GRADEpro software and generated a summary of findings ( SoF) table.17GRADEpro G.D.T. GRADEpro Guideline Development Tool [ Software ]. McMaster University, 2015Google Scholar,18Guyatt G. Oxman A.D. Akl E.A. et al.GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables.J Clin Epidemiol. 2011; 64: 383-394Google Scholar
I² statistic was used to quantify the amount of heterogeneity, with I² of greater than 50% representing substantial heterogeneity.19Higgins J.P. Thompson S.G. Deeks J.J. et al.Measuring inconsistency in meta-analyses.BMJ. 2003; 327: 557-560Google Scholar We did our data analyses with RevMan 5.4 software and STATA15.0 ( StataCorp, College Station, Texas). We used a random effects model and calculated odds ratios ( OR) with 95% confidence intervals ( CI) for dichotomous outcomes, and mean differences ( MD) with 95% CI for continuous outcomes.20Borenstein M. Hedges L.V. Higgins J.P. et al.A basic introduction to fixed-effect and random-effects models for meta-analysis.Res Synth Methods. 2010; 1: 97-111Google Scholar We present the pooled results over all studies and performed subgroups analyses by the type of NSAID ( ibuprofen vs. aspirin vs. COX-2 inhibitor vs. other drugs) and population ( C+: all patients tested positive for SARS-CoV-2 vs. C±/C-: part or no patients tested positive for SARS-CoV-2). We also performed a meta-analysis of adjusted OR, risk ratio ( RR) and HR. If both unadjusted and adjusted ORs were reported from the same study, we extracted both and pooled the unadjusted estimates in the main analysis and the adjusted estimates in the secondary analysis. RR and HR from other studies were regarded as OR. If not available, ORs could be obtained through calculating events and total numbers of patients in two groups. If more than one adjusted ORs were reported, we used the one adjusted for the maximum number of covariables. We also performed a sensitivity analysis to assess the robustness of our findings by excluding one research every analysis. Publication bias was assessed by a funnel plot.21Sterne J.A. Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis.J Clin Epidemiol. 2001; 54: 1046-1055https: //doi.org/10.1016/s0895-4356 ( 01) 00377-8Google Scholar
There was no funding source for this study.
A total of 2312 references were identified in our search. After screening on titles, abstracts and full texts, forty comparative studies involving 4867,795 individuals were included in this review, in which eight are from the United States of America ( USA), six are from South Korea, and four are from the United Kingdom ( UK) ( Figure 1).10Abu Esba L.C. Alqahtani R.A. Thomas A. et al.Ibuprofen and NSAID use in COVID-19 infected patients is not associated with worse outcomes: a prospective cohort study.Infect Dis Ther. 2020; 2: 1-16https: //doi.org/10.1007/s40121-020-00363-wGoogle Scholar,11Jeong H.E. Lee H. Shin H.J. Choe Y.J. Filion K.B. Shin J.Y. Association between NSAIDs use and adverse clinical outcomes among adults hospitalized with COVID-19 in South Korea: a nationwide study.Clin Infect Dis. 2020;: ciaa1056https: //doi.org/10.1093/cid/ciaa1056Google Scholar,22Lund L.C. Kristensen K.B. Reilev M. et al.Adverse outcomes and mortality in users of non-steroidal anti-inflammatory drugs who tested positive for SARS-CoV-2: a Danish nationwide cohort study.PLoS Med. 2020; 17e1003308https: //doi.org/10.1371/journal.pmed.1003308Google Scholar, 23Kragholm K. Gerds T.A. Fosbøl E. et al.Association between prescribed ibuprofen and severe COVID-19 infection: a nationwide register-based cohort study.Clin Transl Sci. 2020; 13: 1103-1107https: //doi.org/10.1111/cts.12904Google Scholar, 24Hong W. Chen Y. You K. et al.Celebrex adjuvant therapy on coronavirus disease 2019: an experimental study.Front Pharmacol. 2020; 11561674https: //doi.org/10.3389/fphar.2020.561674Google Scholar, 25Rinott E. Kozer E. Shapira Y. et al.Ibuprofen use and clinical outcomes in COVID-19 patients.Clin Microbiol Infect. 2020; 26: 1259.e5-1259.e7https: //doi.org/10.1016/j.cmi.2020.06.003Google Scholar, 26Bruce E. Barlow-Pay F. Short R. et al.Prior routine use of non-steroidal anti-inflammatory drugs ( NSAIDs) and important outcomes in hospitalised patients with COVID-19.J Clin Med. 2020; 9: 2586https: //doi.org/10.3390/jcm9082586Google Scholar, 27Ong S.W.X. Tan W.Y.T. Chan Y.H. et al.Safety and potential efficacy of cyclooxygenase-2 inhibitors in coronavirus disease 2019.Clin Transl Immunol. 2020; 9: e1159https: //doi.org/10.1002/cti2.1159Google Scholar, 28Drake T.M. Fairfield C.J. Pius R. et al.ISARIC4C investigators. Non-steroidal anti-inflammatory drug use and outcomes of COVID-19 in the ISARIC clinical characterisation protocol UK cohort: a matched, prospective cohort study.Lancet Rheumatol. 2021; 3: e498-e506https: //doi.org/10.1016/S2665-9913 ( 21) 00104-1Google Scholar, 29Martínez-Botía P. Bernardo Á. Acebes-Huerta A. et al.Clinical management of hypertension, inflammation and thrombosis in hospitalized COVID-19 patients: impact on survival and concerns.J Clin Med. 2021; 10: 1073https: //doi.org/10.3390/jcm10051073Google Scholar, 30Gupta S. Hayek S.S. Wang W. et al.STOP-COVID Investigators. factors associated with death in critically ill patients with coronavirus disease 2019 in the US.JAMA Intern Med. 2020; 180: 1436-1447https: //doi.org/10.1001/jamainternmed.2020.3596Google Scholar, 31Sahai A. Bhandari R. Godwin M. et al.Effect of aspirin on short-term outcomes in hospitalized patients with COVID-19.Vasc Med. 2021; ( × 211012754) 1358863https: //doi.org/10.1177/1358863X211012754Google Scholar, 32Alamdari N.M. Afaghi S. Rahimi F.S. et al.Mortality risk factors among hospitalized COVID-19 patients in a major referral center in Iran.Tohoku J Exp Med. 2020; 252: 73-84https: //doi.org/10.1620/tjem.252.73Google Scholar, 33Hwang J.M. Kim J.H. Park J.S. et al.Neurological diseases as mortality predictive factors for patients with COVID-19: a retrospective cohort study.Neurol Sci. 2020; 41: 2317-2324https: //doi.org/10.1007/s10072-020-04541-zGoogle Scholar, 34Imam Z. Odish F. Gill I. et al.Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID-19 patients in Michigan, United States.J Intern Med. 2020; 288: 469-476https: //doi.org/10.1111/joim.13119Google Scholar, 35Chandan J.S. Zemedikun D.T. Thayakaran R. et al.Nonsteroidal antiinflammatory drugs and susceptibility to COVID-19.Arthritis Rheumatol. 2021; 73 ( May): 731-739https: //doi.org/10.1002/art.41593Google Scholar, 36Park J. Lee S.H. You S.C. et al.Non-steroidal anti-inflammatory agent use may not be associated with mortality of coronavirus disease 19.Sci Rep. 2021; 11: 5087https: //doi.org/10.1038/s41598-021-84539-5Google Scholar, 37Wong A.Y. MacKenna B. Morton C.E. et al.Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts.Ann Rheum Dis. 2021; 80: 943-951https: //doi.org/10.1136/annrheumdis-2020-219517Google Scholar, 38Gianfrancesco M. Hyrich K.L. Al-Adely S. et al.Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 global rheumatology alliance physician-reported registry.Ann Rheum Dis. 2020; 79: 859-866https: //doi.org/10.1136/annrheumdis-2020-217871Google Scholar, 39Costantino F. Bahier L. Tarancón L.C. et al.COVID-19 in French patients with chronic inflammatory rheumatic diseases: clinical features, risk factors and treatment adherence.Jt Bone Spine. 2021; 88105095https: //doi.org/10.1016/j.jbspin.2020.105095Google Scholar, 40Huh K. Ji W. Kang M. et al.Association of prescribed medications with the risk of COVID-19 infection and severity among adults in South Korea.Int J Infect Dis. 2021; 104: 7-14https: //doi.org/10.1016/j.ijid.2020.12.041Google Scholar, 41Blanch-Rubió J. Soldevila-Domenech N. Tío L. et al.Influence of anti-osteoporosis treatments on the incidence of COVID-19 in patients with non-inflammatory rheumatic conditions.Aging. 2020; 12 ( Albany NY): 19923-19937https: //doi.org/10.18632/aging.104117Google Scholar, 42Vila-Corcoles A. Satue-Gracia E. Ochoa-Gondar O. et al.Use of distinct anti-hypertensive drugs and risk for COVID-19 among hypertensive people: a population-based cohort study in Southern Catalonia, Spain.J Clin Hypertens. 2020; 22 ( Greenwich): 1379-1388https: //doi.org/10.1111/jch.13948Google Scholar, 43Mancia G. Rea F. Ludergnani M. et al.Renin-angiotensin-aldosterone system blockers and the risk of COVID-19.N Engl J Med. 2020; 382: 2431-2440https: //doi.org/10.1056/NEJMoa2006923Google Scholar, 44Jehi L. Ji X. Milinovich A. et al.Development and validation of a model for individualized prediction of hospitalization risk in 4,536 patients with COVID-19.PLoS ONE. 2020; 15 ( Aug 11) e0237419https: //doi.org/10.1371/journal.pone.0237419Google Scholar, 45Reilev M. Kristensen K.B. Pottegård A. et al.Characteristics and predictors of hospitalization and death in the first 11 122 cases with a positive RT-PCR test for SARS-CoV-2 in Denmark: a nationwide cohort.Int J Epidemiol. 2020; 49: 1468-1481https: //doi.org/10.1093/ije/dyaa140Google Scholar, 46Argenziano M.G. Bruce S.L. Slater C.L. et al.Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series.BMJ. 2020; 369: m1996https: //doi.org/10.1136/bmj.m1996Google Scholar, 47Abdelwahab H.W. Shaltout S.W. Sayed Ahmed H.A. et al.Acetylsalicylic acid compared with enoxaparin for the prevention of thrombosis and mechanical ventilation in COVID-19 patients: a retrospective cohort study.Clin Drug Investig. 2021; 41: 723-732https: //doi.org/10.1007/s40261-021-01061-2Google Scholar, 48Haji Aghajani M. Moradi O. Amini H. et al.Decreased in-hospital mortality associated with aspirin administration in hospitalized patients due to severe COVID-19.J Med Virol. 2021; 93: 5390-5395https: //doi.org/10.1002/jmv.27053Google Scholar, 49Chow J.H. Khanna A.K. Kethireddy S. et al.Aspirin use is associated with decreased mechanical ventilation, intensive care unit admission, and in-hospital mortality in hospitalized patients with coronavirus disease 2019.Anesth Analg. 2021; 132: 930-941https: //doi.org/10.1213/ANE.0000000000005292Google Scholar, 50Karruli A. Boccia F. Gagliardi M. et al.Multidrug-resistant infections and outcome of critically ill patients with coronavirus disease 2019: a single center experience.Microb Drug Resist. 2021; 27: 1167-1175https: //doi.org/10.1089/mdr.2020.0489Google Scholar, 51Kim I. Yoon S. Kim M. et al.Aspirin is related to worse clinical outcomes of COVID-19.Medicina. 2021; 57 ( Kaunas) Published 2021 Sep 4: 931https: //doi.org/10.3390/medicina57090931Google Scholar, 52Liu Q. Huang N. Li A. et al.Effect of low-dose aspirin on mortality and viral duration of the hospitalized adults with COVID-19.Medicine. 2021; 100 ( Baltimore): e24544https: //doi.org/10.1097/MD.0000000000024544Google Scholar, 53Lodigiani C. Iapichino G. Carenzo L. et al.Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy.Thromb Res. 2020; 191: 9-14https: //doi.org/10.1016/j.thromres.2020.04.024Google Scholar, 54Meizlish M.L. Goshua G. Liu Y. et al.Intermediate-dose anticoagulation, aspirin, and in-hospital mortality in COVID-19: a propensity score-matched analysis.Am J Hematol. 2021; 96: 471-479https: //doi.org/10.1002/ajh.26102Google Scholar, 55Merzon E. Green I. Vinker S. et al.The use of aspirin for primary prevention of cardiovascular disease is associated with a lower likelihood of COVID-19 infection.FEBS J. 2021; 288: 5179-5189https: //doi.org/10.1111/febs.15784Google Scholar, 56Osborne T.F. Veigulis Z.P. Arreola D.M. Mahajan S.M. Röösli E. Curtin C.M. Association of mortality and aspirin prescription for COVID-19 patients at the veterans health administration.PLoS ONE. 2021; 16 ( Published 2021 Feb 11) e0246825https: //doi.org/10.1371/journal.pone.0246825Google Scholar, 57Son M. Noh M.G. Lee J.H. Seo J. Park H. Yang S. Effect of aspirin on coronavirus disease 2019: a nationwide case-control study in South Korea.Medicine. 2021; 100 ( Baltimore): e26670https: //doi.org/10.1097/MD.0000000000026670Google Scholar, 58Vahedian-Azimi A. Rahimibashar F. Najafi A. et al.Associastion of in-hospital use of statins, aspirin, and renin-angiotensin-aldosterone inhibitors with mortality and ICU admission due to COVID-19.Adv Exp Med Biol. 2021; 1327: 205-214https: //doi.org/10.1007/978-3-030-71697-4 17Google Scholar, 59Yuan S. Chen P. Li H. Chen C. Wang F. Wang D.W. Mortality and pre-hospitalization use of low-dose aspirin in COVID-19 patients with coronary artery disease.J Cell Mol Med. 2021; 25: 1263-1273https: //doi.org/10.1111/jcmm.16198Google Scholar Twenty-eight ( 70%) of the included studies enrolled patients positive to SARS-CoV-2 tests. All forty studies included only adult cases. Thirty-seven studies were retrospective and the remaining three prospective. Characteristics of the included studies are described in Table 1. Thirty-four ( 85%) of the included studies did not specify whether the assessment of the outcome was blinded. Moreover, we found a risk of bias in the ascertainment of the exposure in seven studies. Overall, the methodological quality of the included studies was good ( eTable 2 in Supplementary).Figure 1Literature search and screening process from: Moher D, Liberati A, Tetzlaff J, Altman D G. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement BMJ 2009; 339: b2535 doi:10.1136/bmj.b2535.View Large Image Figure ViewerDownload Hi-res image Download ( PPT) Table 1Characteristics of the included studies.Study IDCountryStudy designPopulationType of drugsDosage ( daily) Sample sizeAge ( year) * Male (%) Diabetes mellitus (%) Hypertension (%) COPD-Chronic pulmonary disease (%) Cardiovascular disease (%) OutcomesECECECECECECECAbdelwahab et al., 2021 aEgyptRSC+Aspirin81–162 mg313656.0 ± 16.144.0 ± 16.551.633.338.711.148.413.9NRNR25.80④Abdelwahab et al., 2021 bEgyptRSC+Aspirin81–162 mg3512361.0 ± 14.358.0 ± 14.748.646.348.643.162.945.5NRNR22.93.3④Abu Esba et al., 2020Saudi ArabiaPSC+UnspecifiedNR14635747.5 ( 33.0–63.0) 36.0 ( 27.0–49.0) 52.159.441.114.834.914.6NRNR12.32.5①⑤⑦Aghajani et al., 2021IranRSC+AspirinNR33665565.8 ± 14.358.5 ± 17.456.054.047.621.862.530.0NRNR40.88.7① ④Alamdari et al., 2020IranRSC+UnspecifiedNR3742261.8 ± 11.969.7NRNRNRNRNRNRNRNR①Argenziano et al., 2020USARSC+UnspecifiedNR25075063.0 ( 50.0–75.0) 59.637.260.16.6NRNR③⑦Blanch-Rubió et al., 2020SpainRSC±UnspecifiedNR318178466.4 ( 13.3) 19.5NRNRNRNRNRNRNRNR②Bruce et al., 2020UKRSC+UnspecifiedNR541168NRNR46.356.920.427.331.551.1NRNRNRNR①Chandan et al., 2021UKRS & OsteoarthritisUnspecifiedNR8595859568.4 ± 10.468.1 ± 10.534.834.217.015.9NRNR8.17.113.79.7①②Chow et al., 2021USARSC+Aspirin81 mg9831461.0 ( 55.0–72.0) 52.0 ( 37.0–65.0) 62.258.355.129.078.652.5NRNR34.75.7①③④Costantino et al., 2020FranceRSRheumatic diseasesUnspecifiedNR31833751.0 ± 13.438.2NRNRNRNRNRNRNRNR②Drake et al., 2021UKPS & C+UnspecifiedNR421167,96870.1 ± 18.770.2 ± 18.446.446.421.121.5NRNR18.716.535.130.3①③④⑤Gianfrancesco et al., 2020AustraliaRSRAUnspecifiedNR111420NRNRNRNRNRNRNRNRNRNRNRNR⑦Gupta et al., 2020USAPSC+UnspecifiedNR191202460.5 ( 14.5) 64.8NRNRNRNRNRNRNRNR①Hong et al., 2020ChinaPSC+COX-2 inhibitor200–400 mg36749.3 ± 14.849.5 ± 18.347.257.18.314.28.314.2NRNR5.614.2①Huh et al., 2021South KoreaRSC±UnspecifiedNR708036,966NRNR59.5NRNRNRNRNRNRNRNR②Hwang et al., 2020South KoreaRSC+UnspecifiedNR59867.6 ± 15.350.5NRNRNRNRNRNRNRNR①Imam et al., 2020USARSC+UnspecifiedNR46683961.0 ± 16.353.8NRNRNRNRNRNRNRNR①Jehi et al., 2020USARSC+UnspecifiedNR8923644NRNRNRNRNRNRNRNRNRNRNRNR⑦Jeong et al., 2020South KoreaRS & C+UnspecifiedNR354147054.1 ± 17.647.8 ± 19.141.541.017.011.028.019.020.015.0NRNR①③④⑥Karruli et al., 2021ItalyRSC+AspirinLow dose527NRNRNRNRNRNRNRNRNRNRNRNR①Kim et al., 2021 aSouth KoreaRS & C±AspirinNR136136NRNR63.261.867.672.179.482.49.68.148.549.3①②③④⑤⑥Kim et al., 2021 bSouth KoreaRS & C±AspirinNR526526NRNR58.056.850.849.875.576.29.77.236.335.0①②③④⑤⑥Kragholm et al., 2020DenmarkRSC+IbuprofenNR264373858.0 ( 46–68.0) 57.0 ( 45.0–73.0) 44.747.413.311.124.221.86.45.32.72.5⑥Liu et al., 2021ChinaRS & C+Aspirin81 mg2820469.5 ( 61.0–77.0) 54.0 ( 42.0–65.0) 64.353.417.911.371.419.63.62.5NRNR①Lodigiani et al., 2021ItalyRSC+AspirinNR93286NRNRNRNRNRNRNRNRNRNRNRNR①③Lund et al., 2020DenmarkRS & C+UnspecifiedNR22489654.0 ( 43.0–64.0) 54.0 ( 41.0–66.0) 40.241.9NRNRNRNR4.03.910.310.2①③④⑦Mancia et al., 2020ItalyRSC±UnspecifiedNR561531,41668.0 ± 13.063.0NRNRNRNRNRNRNRNR②Martínez-Botía et al., 2021SpainRS & C+UnspecifiedNR366166966.4 ± 15.867.3 ± 16.261.259.813.112.9NRNRNRNRNRNR①③Meizlish et al., 2021USARS & C+Aspirin81 mg9641821NRNRNRNRNRNRNRNRNRNRNRNR①Merzon et al., 2021IsraelRSC±AspirinLow dose16218856NRNRNRNRNRNRNRNRNRNRNRNR①②⑦Ong et al., 2020SingaporeRSC+COX-2 inhibitor60–90 mg2214656.0 ( 53.8–61.0) 62.0 ( 55.8–68.3) 50.056.218.231.531.850.702.74.59.6①③④⑤⑥Osborne et al., 2021USARS & C+AspirinNR6300630067.4 ± 10.867.3 ± 11.295.296.662.541.389.472.643.837.9NRNR①Park et al., 2021South KoreaRS & C+UnspecifiedNR397397NRNR41.836.816.615.928.727.72.50.8NRNR①④Reilev et al., 2020DenmarkRSC±UnspecifiedNR47,503374,316NRNRNRNRNRNRNRNRNRNRNRNR①②③⑦Rinott et al., 2020IsraelRSC+IbuprofenNR8731640.0 ( 24.5–64.0) 46.0 ( 25.0–61.0) 52.955.111.48.8NRNRNRNR13.712.6①③④⑤Sahai et al., 2021 aUSARS & C+UnspecifiedNR44444458.1 ± 17.058.2 ± 18.151.148.635.735.962.766.110.912.1NRNR①Sahai et al., 2021 bUSARS & C+Aspirin81 mg24824868.5 ± 13.669.5 ± 14.156.559.550.45084.98518.713.6NRNR①Son et al., 2021South KoreaRSC±AspirinNR84410,631NRNRNRNRNRNRNRNRNRNRNRNR②Vahedian-Azimi et al., 2021IranRSC+AspirinNR237350NRNRNRNRNRNRNRNRNRNRNRNR①③Vila-Corcoles et al., 2020SpainRSC±UnspecifiedNR165033,286NRNR48.128.1NRNRNRNRNRNR②Wong et al., 2021 aUKRSGeneral populationUnspecifiedNR536,4231,927,28453.0 ( 42.0–64.0) 49.0 ( 36.0–60.0) 40.843.311.09.023.918.42.92.2NRNR①Wong et al., 2021 bUKRSRheumatoid arthritisUnspecifiedNR175,4951,533,28663.0 ( 55.0–71.0) 68.0 ( 58.0–76.0) 37.037.914.715.437.740.84.85.6NRNR①Yuan et al., 2021ChinaRSC+Aspirin75–150 mg5213169.7 ± 1.171.8 ± 0.959.651.925.020.661.553.41.95.3NRNR① Mortality; ② Risk of SARS-CoV-2 infection; ③ ICU admission; ④ Mechanical ventilation; ⑤ Supplemental oxygen; ⑥ Composite adverse outcome; ⑦ Hospital admission; C+: Patients positive to SARS-CoV-2 tests; C±: Partial or none patients positive to SARS-CoV-2 tests; E: Exposure group; C: Control group; NR: Not report; RS: Retrospective study; PS: Prospective study; *: Data are reported as mean ± SD or median ( interquartile range); &: Propensity score–matched cohort study. 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① Mortality; ② Risk of SARS-CoV-2 infection; ③ ICU admission; ④ Mechanical ventilation; ⑤ Supplemental oxygen; ⑥ Composite adverse outcome; ⑦ Hospital admission; C+: Patients positive to SARS-CoV-2 tests; C±: Partial or none patients positive to SARS-CoV-2 tests; E: Exposure group; C: Control group; NR: Not report; RS: Retrospective study; PS: Prospective study; *: Data are reported as mean ± SD or median ( interquartile range); &: Propensity score–matched cohort study.
Twenty-nine studies with 4241,022 cases assessed the association between NSAID exposure and mortality in patients who were positive or negative to SARS-CoV-2 tests during the COVID-19 pandemic. The use of NSAIDs did not increase the odds of death ( OR = 0.93, 95% CI: 0.75 to 1.14, I2 = 89%) ( Figure 2). In the analysis of adjusted estimates, NSAID use was associated with better-adjusted mortality ( aOR = 0.74, 95% CI: 0.61 to 0.90, I2 = 82%) ( Figure 3).Figure 2The association between NSAID exposure and mortality among patients who were positive or negative to SARS-CoV-2 tests during the COVID-19 pandemic. `` Events '' is the number of deaths; `` Total '' is population size; `` Weight '' is study weight in the analysis. `` IV '' is inverse variance statistical method of meta-analysis; `` Random '' is random effects model; `` 95% CI '' is the 95% confidence intervals for the mortality; Each horizontal line in the graphical display represents a study, its width represents 95% CI of the interval estimation of the odds ratio effect of mortality, and the blue midpoint of the line symbolizes the point estimate of the unadjusted odds ratio effect of mortality; `` I2″ represents the quantity of heterogeneity ( 0–100%); `` Test for overall effect: Z = 0.70 ( P = 0.49) '' confirms no statistical difference illustrated by the diamond crossing the line of effect ( For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.).View Large Image Figure ViewerDownload Hi-res image Download ( PPT) Figure 3Adjusted odds ratio of the association between NSAID and mortality among patients who were positive or negative to SARS-CoV-2 tests during the COVID-19 pandemic. “ Log [ Odds Ratio ] ” is the natural logarithms ( In) of odds ratio for each included study; “ SE ” is the standard error of Log [ Odds Ratio ]; “ Weight ” is study weight in the analysis. “ IV ” is inverse variance statistical method of meta-analysis; “ Random ” is random effects model; “ 95% CI ” is the 95% confidence intervals for the adjusted mortality; Each horizontal line in the graphical display represents a study, its width represents 95% CI of the interval estimation of the odds ratio effect of adjusted mortality, and the red midpoint of the line symbolizes the point estimate of the adjusted odds ratio effect of mortality; “ I2 ” represents the quantity of heterogeneity ( 0–100%); “ Test for overall effect: Z = 2.99 ( P = 0.003) ” confirms the statistical difference illustrated by the diamond on the left side of the line of effect ( For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article).View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
The results of subgroup analysis of unadjusted mortality showed that significant associations were not found in the subgroup analyses stratified by the type of NSAID ( ibuprofen: OR = 1.09, 95% CI: 0.50 to 2.39; aspirin: OR = 0.93, 95% CI: 0.58 to 1.48; COX-2 inhibitor: OR = 0.62, 95% CI: 0.35 to 1.11) and the population ( C+: OR = 0.94, 95% CI: 0.74 to 1.20; C±/C-: OR = 0.91, 95% CI: 0.55 to 1.50). However, subgroup analysis showed that administration of aspirin ( aOR = 0.55, 95% CI: 0.40 to 0.78), ibuprofen ( aOR = 0.95, 95% CI: 0.78 to 1.16) and COX-2 inhibitor ( aOR = 0.73, 95% CI: 0.45 to 1.18) were not statistically different in terms of mortality in patients with COVID-19. The results of the subgroup analysis of the population showed a statistical difference, which means that taking NSAIDs may reduce the mortality among patients positive to SARS-CoV-2 tests ( N = 24, OR = 0.94, 95% CI: 0.74 to 1.20, I2=88%; N = 15, aOR=0.72, 95% CI: 0.56 to 0.82, I2=84%). However, the point estimate aORs from different populations ( C+, aOR = 0.72, 95% CI: 0.56 to 0.92; C±/C-, aOR=0.87, 95% CI: 0.77 to 0.98) ( eFigure 1 in Supplementary) all lied within the 95% CI for the total aOR of the association between NSAID and mortality ( aOR = 0.74, 95% CI: 0.61 to 0.90) ( Figure 3). Therefore, the adjusted mortality did not differ significantly across patients with or without COVID-19.
Ten studies with 581,055 cases assessed the association between NSAID exposure and the risk of SARS-CoV-2 infection in patients who were negative to SARS-CoV-2 tests during the COVID-19 pandemic. The use of NSAIDs did not increase the odds of SARS-CoV-2 infection ( OR = 0.96, 95% CI: 0.86 to 1.07, I2=78%) ( Figure 4). Similar results were found in the adjusted analysis ( aOR = 1.01, 95% CI: 0.94 to 1.09, I2=26%) ( eFigure 2 in Supplementary).Figure 4The association between NSAID exposure and risk of SARS-CoV-2 infection among patients who were negative to SARS-CoV-2 tests during the COVID-19 pandemic. “ Events ” is the number of SARS-CoV-2 infection; “ Total ” is population size; “ Weight ” is study weight in the analysis. “ IV ” is inverse variance statistical method of meta-analysis; “ Random ” is random effects model; “ 95% CI ” is the 95% confidence intervals for the risk of SARS-CoV-2 infection; Each horizontal line in the graphical display represents a study, its width represents 95% CI of the interval estimation of the odds ratio effect of risk of SARS-CoV-2 infection, and the blue midpoint of the line symbolizes the point estimate of the unadjusted odds ratio effect of risk of SARS-CoV-2 infection; “ I2 ” represents the quantity of heterogeneity ( 0–100%); “ Test for overall effect: Z = 0.79 ( P = 0.43) ” confirms no statistical difference illustrated by the diamond crossing the line of effect ( For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article).View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Twelve studies ( n = 27,689) evaluated the association between NSAID exposure and ICU admission in patients who were positive or negative to SARS-CoV-2 tests during COVID-19 pandemic. The use of NSAIDs in patients was not associated with the probability of ICU admission ( OR = 1.28, 95% CI: 0.94 to 1.75, I2 = 82%) ( Figure 5). Similar results were found in the adjusted analysis ( aOR = 0.89, 95% CI: 0.65 to 1.22, I2 = 60%) ( eFigure 2 in Supplementary).Figure 5The association between NSAID exposure and ICU admission among patients who were positive or negative to SARS-CoV-2 tests during the COVID-19 pandemic. “ Events ” is the number of ICU admission; “ Total ” is population size; “ Weight ” is study weight in the analysis. “ IV ” is inverse variance statistical method of meta-analysis; “ Random ” is random effects model; “ 95% CI ” is the 95% confidence intervals for the ICU admission; Each horizontal line in the graphical display represents a study, its width represents 95% CI of the interval estimation of the odds ratio effect of risk of ICU admission, and the blue midpoint of the line symbolizes the point estimate of the unadjusted odds ratio effect of risk of ICU admission; “ I2 ” represents the quantity of heterogeneity ( 0–100%); “ Test for overall effect: Z = 1.56 ( P = 0.12) ” confirms no statistical difference illustrated by the diamond crossing the line of effect. ( For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article).View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Eleven studies ( n = 14,717) evaluated the association between NSAID exposure and mechanical ventilation rate in patients who were positive or negative to SARS-CoV-2 tests. The use of NSAIDs did not increase the probability of requiring mechanical ventilation ( OR = 1.11, 95% CI: 0.79 to 1.54, I2 = 63%), compared to those not taking NSAIDs ( Figure 6). In the adjusted analysis, there was also no increase in the odds of mechanical ventilation with the use of NSAID ( aOR = 0.80, 95% CI: 0.52 to 1.24, I2 = 66%), compared with no NSAID use ( eFigure 2 in Supplementary).Figure 6The association between NSAID exposure and mechanical ventilation among patients who were positive or negative to SARS-CoV-2 tests during the COVID-19 pandemic. “ Events ” is the number of patients mechanical ventilation; “ Total ” is population size; “ Weight ” is study weight in the analysis. “ IV ” is inverse variance statistical method of meta-analysis; “ Random ” is random effects model; “ 95% CI ” is the 95% confidence intervals for the mechanical ventilation; Each horizontal line in the graphical display represents a study, its width represents 95% CI of the interval estimation of the odds ratio effect of mechanical ventilation, and the blue midpoint of the line symbolizes the point estimate of the unadjusted odds ratio effect of mechanical ventilation; “ I2 ” represents the quantity of heterogeneity ( 0–100%); “ Test for overall effect: Z = 0.59 ( P = 0.55) ” confirms no statistical difference illustrated by the diamond crossing the line of effect. ( For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article).View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
No association between NSAIDs exposure and administration of supplemental oxygen ( OR = 0.80, 95% CI: 0.52 to 1.24, I2 = 57%), composite adverse outcome ( OR = 1.32, 95% CI: 0.75 to 2.33, I2 = 75%), hospital admission ( OR = 1.58, 95% CI: 1.06 to 2.36, I2 = 93%) among patients who were positive or negative to SARS-CoV-2 tests during the COVID-19 pandemic ( see eFigure 3 in Supplementary). And the adjusted ORs between NSAIDs exposure and administration of supplemental oxygen ( aOR = 1.00, 95% CI: 0.89 to 1.12, I2 = 0%), composite adverse outcome ( aOR = 1.07, 95% CI: 0.66 to 1.73, I2 = 72%), hospital admission ( aOR = 1.07, 95% CI: 0.74 to 1.55, I2 = 62%) also did not show association ( see eFigure 2 in Supplementary).
We performed a sensitivity analysis on the mortality meta analysis by excluding one study at a time because of the high heterogeneity ( I2 = 89%). A major cause of the high heterogeneity was the difference between the very precise estimates in the two sub-studies by Wong et al.37Wong A.Y. MacKenna B. Morton C.E. et al.Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts.Ann Rheum Dis. 2021; 80: 943-951https: //doi.org/10.1136/annrheumdis-2020-219517Google Scholar and Osborne et al.56Osborne T.F. Veigulis Z.P. Arreola D.M. Mahajan S.M. Röösli E. Curtin C.M. Association of mortality and aspirin prescription for COVID-19 patients at the veterans health administration.PLoS ONE. 2021; 16 ( Published 2021 Feb 11) e0246825https: //doi.org/10.1371/journal.pone.0246825Google Scholar ( eFigure 4 in Supplementary). The sample size of Wong et al.37Wong A.Y. MacKenna B. Morton C.E. et al.Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts.Ann Rheum Dis. 2021; 80: 943-951https: //doi.org/10.1136/annrheumdis-2020-219517Google Scholar and Osborne et al.56Osborne T.F. Veigulis Z.P. Arreola D.M. Mahajan S.M. Röösli E. Curtin C.M. Association of mortality and aspirin prescription for COVID-19 patients at the veterans health administration.PLoS ONE. 2021; 16 ( Published 2021 Feb 11) e0246825https: //doi.org/10.1371/journal.pone.0246825Google Scholar were observed to be high as compared with other included studies, which might affect the results. Where the population included in the study of Wong et al.37Wong A.Y. MacKenna B. Morton C.E. et al.Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts.Ann Rheum Dis. 2021; 80: 943-951https: //doi.org/10.1136/annrheumdis-2020-219517Google Scholar was non-COVID-19 patients and the drug administrated in the study of Osborne et al.56Osborne T.F. Veigulis Z.P. Arreola D.M. Mahajan S.M. Röösli E. Curtin C.M. Association of mortality and aspirin prescription for COVID-19 patients at the veterans health administration.PLoS ONE. 2021; 16 ( Published 2021 Feb 11) e0246825https: //doi.org/10.1371/journal.pone.0246825Google Scholar was aspirin. Since the results of the sensitivity analysis found that type of NSAID were sources of heterogeneity between studies, so the sources of heterogeneity found in the sensitivity analysis were consistent with sources of heterogeneity found in subgroup analysis.
Based on the pooled results, we downgraded the quality of evidence for some outcomes by one level due to imprecision ( wide confidence interval) or inconsistency. Consequently, the quality of the evidence was classified as “ Very low ” and “ Low ” for unadjusted and adjusted mortality, respectively. The GRADE quality summary of findings for all outcomes is shown in eTable 3 in Supplementary. The funnel plot for the studies of mortality as an outcome is provided. It shows a lack of small studies showing lower or no risk with NSAIDs. There was no significant evidence of publication bias ( eFigure 5 in Supplementary).
This systematic review and meta-analysis included forty studies with a total of 4881,423 adult patients. We found that the use of NSAIDs did not aggravate mortality, ICU admission rate, mechanical ventilation rate, or any other adverse outcome, although the quality of evidence was low or very low. According to our results, there is no need for patients and clinicians to be concerned about the routine use of NSAIDs to relieve pain, inflammation and fever due to COVID-19.
Fever induced by viral infection is usually self-limiting and does not require specific antiviral therapy. Symptomatic and supportive treatments are the main part of the management of patients with COVID-19 at present. The risk of hemodynamic instability caused by fever is high, and NSAIDs ( in particular ibuprofen and acetaminophen) are one of the most commonly used antipyretic and analgesic drugs to reduce the body temperature of fever patients and treat acute pain worldwide. Therefore, the current recommendations of some guidelines indicate that the use of antipyretic drugs such as ibuprofen, acetaminophen or any other NSAIDs should not be contraindicated in patients with COVID-19.60Alhazzani W. Møller M.H. Arabi Y.M. et al.Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 ( COVID-19).Crit Care Med. 2020; https: //doi.org/10.1097/CCM. 0000000000004363Google Scholar,61COVID-19 Treatment Guidelines PanelCoronavirus Disease 2019 ( COVID-19) Treatment Guidelines. National Institutes of Health, 2021Google Scholar The WHO made a rapid systematic review based on 73 studies about SARS, MERS and COVID-19 and found no effect of NSAIDs on the risk of ischemic and hemorrhagic stroke and myocardial infarction in adults with acute respiratory infections. Moderate to high-quality evidence suggests that there is no significant association between ibuprofen or acetaminophen use and all-cause mortality, hospitalization, acute renal failure or acute gastrointestinal bleeding on febrile children. Most included studies found either no adverse events or only mild or moderate adverse events, and there was no evidence indicating that NSAIDs have an impact on the quality of life or long-term survival.62World Health Organization The Use of Non-Steroidal Anti-Inflammatory Drugs ( NSAIDs) in Patients With COVID-19. World Health Organization, Geneva2020https: //www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti- inflammatory-drugs- ( nsaids) -in-patients-with-covid-19Date accessed: March 30, 2022Google Scholar
In our study, both unadjusted and adjusted mortality were analyzed. When the results of the two analyze agreed, we drew conclusions based on the direction of agreement, and when the results of the two analyses did not agree, they were discussed and drew reasonable conclusions primarily based on the adjusted results and quality of the evidence. After the subgroup analysis, we found that ibuprofen, COX-2 inhibitor, and other NSAIDs all could not reduce the risk of death, and the results of analysis of unadjusted and adjusted mortality were consistent. While the adjusted analysis found that aspirin could reduce mortality in patients with COVID-19, however this was not confirmed by the unadjusted analysis. The results of our review were in line with these previous findings.63Yousefifard M. Zali A. Zarghi A. et al.Non-steroidal anti-inflammatory drugs in management of COVID-19; a systematic review on current evidence.Int J Clin Pract. 2020; 74: e13557https: //doi.org/10.1111/ijcp.13557Google Scholar, 64Moore N. Bosco-Levy P. Thurin N. et al.NSAIDs and COVID-19: a systematic review and meta-analysis.Drug Saf. 2021;: 1-10https: //doi.org/10.1007/s40264-021-01089-5Google Scholar, 65Kow C.S. Hasan S.S. The risk of mortality in patients with COVID-19 with pre-diagnosis use of NSAIDs: a meta-analysis.Inflammopharmacology. 2021; 29: 641-644https: //doi.org/10.1007/s10787-021-00810-1Google Scholar, 66Wijaya I. Andhika R. Huang I. et al.The effects of aspirin on the outcome of COVID-19: a systematic review and meta-analysis.Clin Epidemiol Glob Health. 2021; 12100883https: //doi.org/10.1016/j.cegh.2021.100883Google Scholar, 67Martha J.W. Pranata R. Lim M.A. et al.Active prescription of low-dose aspirin during or prior to hospitalization and mortality in COVID-19: a systematic review and meta-analysis of adjusted effect estimates.Int J Infect Dis. 2021; 108: 6-12https: //doi.org/10.1016/j.ijid.2021.05.016Google Scholar, 68Kow C.S. Hasan S.S. Use of antiplatelet drugs and the risk of mortality in patients with COVID-19: a meta-analysis.J Thromb Thrombolysis. 2021; 52: 124-129https: //doi.org/10.1007/s11239-021-02436-0Google Scholar
This is a comprehensive systematic review and meta-analysis of the correlation between the use of NSAIDs and unfavorable outcomes of COVID-19, and it thus can be expected to reflect the best available evidence on this topic. The study is reported according to the Cochrane guidelines and the PRISMA statement. We performed a meta-analysis of included studies and were thus able to draw quantitative conclusions. Our study has however also some limitations. The forty studies included were all observational studies, some of them had small sample sizes, and all studies presented with a risk of bias in the implementation of blinding methods of outcome evaluators. To get the pooled adjusted OR, HR and RR in the original research were deirectly merged with OR in the meta-analysis, so there are limitations in the results of the adjusted OR. The results of high quality multicenter cohort study with large sample size are therefore still lacking. The clinical heterogeneity among the studies was large and we could thus not draw conclusions or give specific recommendations for different sub-populations ( based on e.g. age or severity of disease), or the timing of medication, dosage, or any other aspect, to conduct quantitative analysis. Due to the particularity and urgency of the public health situation, our study was not registered on the international registration platform PROSPERO. The participants of all included studies were all exclusively adults, so the results can not necessarily be generalized for children.
The use of NSAIDs ( especially, ibuprofen, COX-2 inhibitor and low-dose aspirin) was not found to be associated with higher mortality, ICU admission rate, machine ventilation rate or administration of respiratory support. Despite the concerns that NSAID could enhance the ability of SARS-CoV-2 to invade human cells, there is no evidence to support that NSAID would worsen the prognosis of COVID-19.
Qi Zhou and Siya Zhao had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Yaolong Chen, Enmei Liu and Xiaohui Wang.
Acquisition, analysis, or interpretation of data: Qi Zhou, Siya Zhao, Lidan Gan, Zhili Wang, Shuai Peng, Yaolong Chen.
Drafting of the manuscript: Qi Zhou, Siya Zhao, Lidan Gan, Zhili Wang, Shuai Peng.
Critical revision of the manuscript for important intellectual content: Qiyuan Li; Zijun Wang, Xiao Liu; Hui Liu; Qianling Shi; Zhengxiu Luo; Janne Estill; Yaoliong Chen; Xiaohui Wang and Enmei Liu.
Statistical analysis: Qi Zhou and Siya Zhao.
Supervision: Enmei Liu; Yaolong Chen and Xiaohui Wang.
The decision for the manuscript submission and publication: Yaolong Chen.
The data analyzed during the current systematic review and meta-analysis is available from the corresponding author on reasonable request.
There was no funding source for this study.
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Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study | BackgroundThe SARS-CoV-2 variant of concern, omicron, appears to be less severe than delta. We aim to quantify the differences in symptom prevalence, risk of hospital admission, and symptom duration among the vaccinated population.MethodsIn this prospective longitudinal observational study, we collected data from participants who were self-reporting test results and symptoms in the ZOE COVID app ( previously known as the COVID Symptoms Study App). Eligible participants were aged 16–99 years, based in the UK, with a body-mass index between 15 and 55 kg/m2, had received at least two doses of any SARS-CoV-2 vaccine, were symptomatic, and logged a positive symptomatic PCR or lateral flow result for SARS-CoV-2 during the study period. The primary outcome was the likelihood of developing a given symptom ( of the 32 monitored in the app) or hospital admission within 7 days before or after the positive test in participants infected during omicron prevalence compared with those infected during delta prevalence.FindingsBetween June 1, 2021, and Jan 17, 2022, we identified 63 002 participants who tested positive for SARS-CoV-2 and reported symptoms in the ZOE app. These patients were matched 1:1 for age, sex, and vaccination dose, across two periods ( June 1 to Nov 27, 2021, delta prevalent at > 70%; n=4990, and Dec 20, 2021, to Jan 17, 2022, omicron prevalent at > 70%; n=4990). Loss of smell was less common in participants infected during omicron prevalence than during delta prevalence ( 16·7% vs 52·7%, odds ratio [ OR ] 0·17; 95% CI 0·16–0·19, p < 0·001). Sore throat was more common during omicron prevalence than during delta prevalence ( 70·5% vs 60·8%, 1·55; 1·43–1·69, p < 0·001). There was a lower rate of hospital admission during omicron prevalence than during delta prevalence ( 1·9% vs 2·6%, OR 0·75; 95% CI 0·57–0·98, p=0·03).InterpretationThe prevalence of symptoms that characterise an omicron infection differs from those of the delta SARS-CoV-2 variant, apparently with less involvement of the lower respiratory tract and reduced probability of hospital admission. Our data indicate a shorter period of illness and potentially of infectiousness which should impact work–health policies and public health advice.FundingWellcome Trust, ZOE, National Institute for Health Research, Chronic Disease Research Foundation, National Institutes of Health, and Medical Research Council
The SARS-CoV-2 variant of concern, omicron, appears to be less severe than delta. We aim to quantify the differences in symptom prevalence, risk of hospital admission, and symptom duration among the vaccinated population.
In this prospective longitudinal observational study, we collected data from participants who were self-reporting test results and symptoms in the ZOE COVID app ( previously known as the COVID Symptoms Study App). Eligible participants were aged 16–99 years, based in the UK, with a body-mass index between 15 and 55 kg/m2, had received at least two doses of any SARS-CoV-2 vaccine, were symptomatic, and logged a positive symptomatic PCR or lateral flow result for SARS-CoV-2 during the study period. The primary outcome was the likelihood of developing a given symptom ( of the 32 monitored in the app) or hospital admission within 7 days before or after the positive test in participants infected during omicron prevalence compared with those infected during delta prevalence.
Between June 1, 2021, and Jan 17, 2022, we identified 63 002 participants who tested positive for SARS-CoV-2 and reported symptoms in the ZOE app. These patients were matched 1:1 for age, sex, and vaccination dose, across two periods ( June 1 to Nov 27, 2021, delta prevalent at > 70%; n=4990, and Dec 20, 2021, to Jan 17, 2022, omicron prevalent at > 70%; n=4990). Loss of smell was less common in participants infected during omicron prevalence than during delta prevalence ( 16·7% vs 52·7%, odds ratio [ OR ] 0·17; 95% CI 0·16–0·19, p < 0·001). Sore throat was more common during omicron prevalence than during delta prevalence ( 70·5% vs 60·8%, 1·55; 1·43–1·69, p < 0·001). There was a lower rate of hospital admission during omicron prevalence than during delta prevalence ( 1·9% vs 2·6%, OR 0·75; 95% CI 0·57–0·98, p=0·03).
The prevalence of symptoms that characterise an omicron infection differs from those of the delta SARS-CoV-2 variant, apparently with less involvement of the lower respiratory tract and reduced probability of hospital admission. Our data indicate a shorter period of illness and potentially of infectiousness which should impact work–health policies and public health advice.
On Nov 26, 2021, WHO designated the SARS-CoV-2 variant B.1.1.529 ( omicron), first seen in South Africa, as a new variant of concern.1Hu J Peng P Cao X et al.Increased immune escape of the new SARS-CoV-2 variant of concern omicron.Cell Mol Immunol. 2022; 19: 293-295Google Scholar Of the many mutations detected in omicron, more than 30 are in the spike protein and 15 are in the receptor-binding domain, which could affect transmission, disease presentation, and natural or vaccine-induced protective immunity.1Hu J Peng P Cao X et al.Increased immune escape of the new SARS-CoV-2 variant of concern omicron.Cell Mol Immunol. 2022; 19: 293-295Google Scholar In the subsequent weeks, omicron spread to over 80 countries and became the dominant SARS-CoV-2 variant in the UK, overtaking the previously dominant delta variant ( B.1.617.2) on Dec 20, 2021.2UK Health Security AgencyOmicron daily overview.https: //assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment data/file/1043098/20211221 OS Daily Omicron Overview.pdfDate: 21 December 2021Date accessed: February 10, 2022Google Scholar Early reports suggested infection with omicron was less severe than with previous variants.3WHO Regional Office for AfricaOmicron spreads but severe cases remain low in South Africa.https: //www.afro.who.int/news/omicron-spreads-severe-cases-remain-low-south-africaDate accessed: January 24, 2022Google Scholar, 4Kim M-K Lee B Choi YY et al.Clinical characteristics of 40 patients infected with the SARS-CoV-2 omicron variant in Korea.J Korean Med Sci. 2022; 37: e31Google Scholar, 5Wolter N Jassat W Walaza S et al.Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: a data linkage study.Lancet. 2022; 399: 437-446Google Scholar, 6Maslo C Friedland R Toubkin M Laubscher A Akaloo T Kama B Characteristics and outcomes of hospitalized patients in South Africa during the COVID-19 omicron wave compared with previous waves.JAMA. 2022; 327: 583-584Google Scholar A small ( n=40) South Korean study4Kim M-K Lee B Choi YY et al.Clinical characteristics of 40 patients infected with the SARS-CoV-2 omicron variant in Korea.J Korean Med Sci. 2022; 37: e31Google Scholar described the clinical presentation of omicron cases; there were no severe cases. Hospital admission rates in South Africa for cases infected with this variant have been significantly lower than for previous waves, in which other variants of concern were dominant.5Wolter N Jassat W Walaza S et al.Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: a data linkage study.Lancet. 2022; 399: 437-446Google Scholar, 6Maslo C Friedland R Toubkin M Laubscher A Akaloo T Kama B Characteristics and outcomes of hospitalized patients in South Africa during the COVID-19 omicron wave compared with previous waves.JAMA. 2022; 327: 583-584Google Scholar, 7Davies M-A Kassanjee R Rousseau P et al.Outcomes of laboratory-confirmed SARS-CoV-2 infection in the omicron-driven fourth wave compared with previous waves in the Western Cape Province, South Africa.medRxiv. 2022; ( published online Jan 12.) ( preprint).https: //doi.org/10.1101/2022.01.12.22269148Google Scholar, 8Jassat W Karim SA Mudara C et al.Clinical severity of COVID-19 patients admitted to hospitals in Gauteng, South Africa during the omicron-dominant fourth wave.medRxiv. 2021; ( published online Dec 29.) ( preprint).https: //doi.org/10.2139/ssrn.3996320Google Scholar Similarly, a study9Houhamdi L Gautret P Hoang VT Fournier P-E Colson P Raoult D Characteristics of the first 1119 SARS-CoV-2 omicron variant cases, in Marseille, France, November-December 2021.J Med Virol. 2022; ( published online Jan 20.) https: //doi.org/10.1002/jmv.27613Google Scholar investigating the first 1119 omicron cases in France reported significantly lower rates of hospitalisation, need for intensive care, and mortality compared with 3075 delta cases.9Houhamdi L Gautret P Hoang VT Fournier P-E Colson P Raoult D Characteristics of the first 1119 SARS-CoV-2 omicron variant cases, in Marseille, France, November-December 2021.J Med Virol. 2022; ( published online Jan 20.) https: //doi.org/10.1002/jmv.27613Google Scholar However, no detailed published reports have investigated symptom prevalence and acute symptom duration, and how these compare to the delta variant.
Research in contextEvidence before this studyWe searched PubMed for articles published up to Jan 24, 2022, using the terms “ SARS-CoV-2 omicron symptoms ” and “ SARS-CoV-2 omicron hospitalisation ”. We found several published papers and preprints covering differences in viral load, neutralising antibody responses among vaccinated individuals, and the description of prevalence in various regions ( eg, Florida, Norway, and South Africa). Several studies from South Africa indicated that infection with the omicron variant was significantly less severe than with the previous dominant variants, with lower rates of hospital admission. A cohort study at IHU Méditerranée Infection investigated the first 1119 omicron cases in France and reported significantly lower rates of hospitalisation, need for intensive care, or mortality compared with 3075 delta cases. A small study from Korea ( n=40) showed that symptoms for omicron were mild and no patients needed supplemental oxygen. However, the general presentation of symptoms compared with delta and how the duration and risk of hospitalisation vary in patients who have received two or three vaccine doses has not been reported on a large prospective population scale.Added value of this studyThis is a larger, more detailed, generalisable, and less confounded study than attempted previously. We report that the symptoms characterising an omicron breakthrough infection differ from those of the delta SARS-CoV-2 variant. Since we matched on age, sex, and number of vaccine doses, these factors are unlikely to confound our observation.Implications of all the available evidenceOur study substantiates previous suggestions that the omicron SARS-CoV-2 variant has a different clinical presentation to that of previous waves of COVID-19 in vaccinated individuals. However, this might not be the case in unvaccinated individuals. The different clinical presentation is important for selection of test-triggering symptoms. The shorter presentation of symptoms suggests ( pending confirmation from viral load studies) that the period of infectiousness might be shorter, which would in turn impact workplace health policies and public health guidance.
We searched PubMed for articles published up to Jan 24, 2022, using the terms “ SARS-CoV-2 omicron symptoms ” and “ SARS-CoV-2 omicron hospitalisation ”. We found several published papers and preprints covering differences in viral load, neutralising antibody responses among vaccinated individuals, and the description of prevalence in various regions ( eg, Florida, Norway, and South Africa). Several studies from South Africa indicated that infection with the omicron variant was significantly less severe than with the previous dominant variants, with lower rates of hospital admission. A cohort study at IHU Méditerranée Infection investigated the first 1119 omicron cases in France and reported significantly lower rates of hospitalisation, need for intensive care, or mortality compared with 3075 delta cases. A small study from Korea ( n=40) showed that symptoms for omicron were mild and no patients needed supplemental oxygen. However, the general presentation of symptoms compared with delta and how the duration and risk of hospitalisation vary in patients who have received two or three vaccine doses has not been reported on a large prospective population scale.
This is a larger, more detailed, generalisable, and less confounded study than attempted previously. We report that the symptoms characterising an omicron breakthrough infection differ from those of the delta SARS-CoV-2 variant. Since we matched on age, sex, and number of vaccine doses, these factors are unlikely to confound our observation.
Our study substantiates previous suggestions that the omicron SARS-CoV-2 variant has a different clinical presentation to that of previous waves of COVID-19 in vaccinated individuals. However, this might not be the case in unvaccinated individuals. The different clinical presentation is important for selection of test-triggering symptoms. The shorter presentation of symptoms suggests ( pending confirmation from viral load studies) that the period of infectiousness might be shorter, which would in turn impact workplace health policies and public health guidance.
We aimed to quantify the differences in symptoms, risk of hospital admission, and duration following infection with the omicron or delta variants among people vaccinated ( two or three doses) in a large community cohort from the UK drawn from the ZOE COVID Study app.
The study design and analytical pipeline to generate the study samples can be found in the appendix ( p 4).
We collected prospective longitudinal observational data using the ZOE COVID Study, previously known as the COVID Symptoms Study App.10Menni C Valdes AM Freidin MB et al.Real-time tracking of self-reported symptoms to predict potential COVID-19.Nat Med. 2020; 26: 1037-1040Google Scholar The app enables self-reported information related to SARS-CoV-2 infection to be captured. Upon enrolment, users provided baseline demographic and health information. Subsequently, participants provided daily updates on symptoms experienced, SARS-CoV-2 test results, vaccines administered, and if they were self-quarantining or seeking health care, including the level of intervention and related outcomes. Users can also proxy-report for others. Ethical approval for use of the app for research purposes in the UK was obtained from King's College London Ethics Committee ( LRS-19/20-18210), and all users provided consent for non-commercial use.
We included data from all UK participants aged 16–99 years ( including proxy-reported individuals), with a body-mass index between 15 and 55 kg/m2, who had at least two doses of any SARS-CoV-2 vaccine, were symptomatic, and logged a positive symptomatic PCR or lateral flow antigen test ( LFAT) for SARS-CoV-2 between June 1, 2021, and Jan 17, 2022. For more details on inclusion and exclusion criteria, see the appendix ( pp 2, 4). The full list of symptoms queried is presented in the appendix ( pp 6–7).
Our primary outcomes were the likelihood of developing a given symptom ( from the 32 monitored in the app) within 7 days before or after the positive LFAT or PCR in those infected in the omicron-dominant period compared with in those infected in the delta-dominant period, the likelihood of reporting any of the classic symptoms ( fever, loss of smell, or persistent cough10Menni C Valdes AM Freidin MB et al.Real-time tracking of self-reported symptoms to predict potential COVID-19.Nat Med. 2020; 26: 1037-1040Google Scholar), and the likelihood of hospital admission within the disease period in the same populations.
Our secondary outcome was symptoms duration for omicron versus delta. Acute symptom duration was calculated as the difference between the onset date ( date of reported symptoms, unhealthy log: “ I am not feeling quite right ”) and recovery date ( the first day where users reported feeling normal, healthy log: “ I feel physically normal ”, which was not followed by a day with reported symptoms for at least one week). For this secondary analysis, we included a subset of individuals who reported at least weekly from first symptom report until symptom-freedom and had recovered within 21 days, to allow us to include sufficient individuals.
Statistical analysis was done using Python version 3.8.10 ( pandas, NumPy, SciPy, statsmodel).
We compared data from two time periods: June 1, to Nov 27, 2021, when the delta variant was dominant in the UK ( prevalence > 70%); and Dec 20, 2021, to Jan 17, 2022, when omicron became dominant in the UK ( prevalence > 70%). Through a Euclidean distance-based algorithm,11Spiel C Lapka D Gradinger P et al.A Euclidean distance-based matching procedure for nonrandomized comparison studies.Eur Psychol. 2008; ( published online Aug 26.) https: //doi.org/10.1027/1016-9040.13.3.180Google Scholar participants infected during omicron prevalence were matched 1:1 to participants infected during delta prevalence on age, sex, and vaccination doses. We were unable to match for SARS-CoV-2 prevalence, tiered lockdown restrictions, or vaccination rates, which varied widely across the community and over time during this study.
Baseline characteristics are presented as the number (%) for categorical variables and the mean ( SD) for continuous variables.
We employed multivariable ordinary logistic regressions, as implemented in the Python package statsmodel ( formula.api), to investigate the odds of developing symptoms and of having a severe outcome in participants infected during omicron prevalence compared with participants infected during delta prevalence, adjusting for age, sex, presence of comorbidities ( cancer, diabetes, heart disease, lung disease, kidney disease, or use of immunosuppressants), vaccination status ( 2 vs 3 doses), and multiple testing ( using Benjamini Hochberg correction, false discovery rate < 0·005). We assessed risk of developing specific symptoms within 7 days either side of the positive test. Multivariable ordinary logistic regression adjusting for covariates was also employed to investigate whether symptom duration significantly differed between those infected during omicron prevalence versus those infected during delta prevalence. For this analysis, we compared the odds of symptoms lasting for over 7 days with the odds of symptoms lasting less than 7 days. See the appendix ( p 3) for the script.
We did sensitivity analyses stratifying according to the number of vaccine doses to minimise the influence of confounding by vaccination status in the clinical presentation of the two variants. It was not possible to match for the same timespan since vaccination given the two different periods of dominance of the variants, nor could we run comparable matched analyses in the unvaccinated or in those who had received only one dose due to the small number of these individuals in the study population.
The funders had no role in design or interpretation of the data. ZOE, funded by the Department of Health and Social Care, made the app available for data collection as a not-for-profit endeavour. Employees from ZOE carried out the statistical analyses. Representatives of ZOE approved the final manuscript for submission.
We included 63 002 app users who tested positive for SARS-CoV-2 by PCR or LFAT between June 1, 2021, and Jan 17, 2022; reported symptoms within the requisite timeframes; and logged at least weekly, from first symptom report until returning to symptom-freedom for calculation of illness duration. Of these, 33 785 users tested positive when delta was dominant, and 29 217 users tested positive when omicron was dominant. After 1:1 matching, the total number of participants in each of the two groups reduced to 4990. The demographic characteristics of the study population are presented in table 1.Table 1Participant demographicsOverall1:1 matched sampleOmicronDeltaOmicronDeltaTotal ( n) 29 21733 78549904990SexFemale18 709 ( 64%) 21 296 ( 63%) 3302 ( 66%) 3302 ( 66%) Male10 506 ( 36%) 12 489 ( 37%) 1688 ( 34%) 1688 ( 34%) Age range, years16–9816–9816–9316–93Mean ( SD) age by number of vaccine doses, yearsTwo doses40·35 ( 14·10) 52·40 ( 12·19) 40·35 ( 14·10) 40·58 ( 13·79) Three doses54·84 ( 13·50) 59·29 ( 13·27) 59·29 ( 13·27) 59·29 ( 13·27) BMI, kg/m2, mean ( SD) 26·62 ( 5·41) 26·99 ( 5·55) 26·07 ( 5·47) 26·3 ( 5·73) Health-care workers1922 ( 7%) 1519 ( 4%) 256 ( 5%) 387 ( 8%) Comorbidities5309 ( 18%) 6292 ( 19%) 638 ( 13%) 967 ( 19%) Two vaccine doses3929 ( 13%) 32 724 ( 97%) 3929 ( 79%) 3929 ( 79%) Three vaccine doses25 288 ( 87%) 1061 ( 3%) 1061 ( 21%) 1061 ( 21%) Number of distinct symptoms, median ( IQR) 7 ( 5–11) 9 ( 6–13) 8 ( 5–12) 9 ( 6 −13) EthnicityWhite27 930 ( 96%) 32 540 ( 96%) 4699 ( 95%) 4771 ( 96%) Other1287 ( 4%) 1245 ( 4%) 291 ( 5%) 219 ( 4%) Recovered within 21 days7139 ( 24%) 16 034 ( 47%) 1257 ( 25%) 1257 ( 25%) Average symptom duration, days, mean ( SD) 8·06 ( 4·84) 9·90 ( 5·14) 6·87 ( 5·21) 8·89 ( 5·04) Data are n (%) unless otherwise specified. BMI=body-mass index. Patients with BMI less than 15 or over 55 were excluded from the analysis. Comorbidity numbers reflect the number of people presenting with at least one comorbidity ( cancer, diabetes, heart disease, lung disease, kidney disease, or use of immunosuppressants). Open table in a new tab
Data are n (%) unless otherwise specified. BMI=body-mass index. Patients with BMI less than 15 or over 55 were excluded from the analysis. Comorbidity numbers reflect the number of people presenting with at least one comorbidity ( cancer, diabetes, heart disease, lung disease, kidney disease, or use of immunosuppressants).
Among participants reporting one or more potential symptoms of COVID-19 in the matched group and testing positive when delta was dominant, the most frequently reported symptoms from 4990 individuals were runny nose ( 4073 [ 81·6% ]), headache ( 3888 [ 77·9% ]), sneezing ( 3529 [ 70·7% ]), sore throat ( 3033 [ 60·8% ]), and loss of smell ( 2631 [ 52·7% ]). Among those testing positive when omicron was dominant, the most frequently reported symptoms were runny nose ( 3818 [ 76·5% ] of 4990 individuals), headache ( 3729 [ 74·7% ]), sore throat ( 3517 [ 70·5% ]), sneezing ( 3143 [ 63·0% ]) persistent cough ( 2486 [ 49·8% ]), and hoarse voice ( 2145 [ 42·6% ], figure 1A). In the matched sample, the median number of symptoms was lower in the omicron prevalent group than in the delta prevalent group ( table 1). The breakdown of symptoms prevalence in the 7 days before and after the positive test is depicted in figure 1A. Symptom prevalence in this 1:1 matched subset was consistent with overall prevalence in the larger set of 63 002 cases ( appendix p 5), although we observed a slight discrepancy with respect to gastrointestinal symptoms.Figure 1Symptoms in patients with delta or omicron SARS-CoV-2 infectionShow full caption ( A) Prevalence of symptoms reported by individuals infected during omicron or delta prevalence. Data are percentage prevalence in the 1:1 matched sample. Error bars indicate 95% CI. ( B) Association between symptoms and COVID-19 infection in 4990 participants who tested positive for SARS-CoV-2 when omicron was dominant and 4990 participants who tested positive when delta was dominant. Data are odds ratios comparing omicron and delta prevalence. Error bars indicate 95% CI.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
( A) Prevalence of symptoms reported by individuals infected during omicron or delta prevalence. Data are percentage prevalence in the 1:1 matched sample. Error bars indicate 95% CI. ( B) Association between symptoms and COVID-19 infection in 4990 participants who tested positive for SARS-CoV-2 when omicron was dominant and 4990 participants who tested positive when delta was dominant. Data are odds ratios comparing omicron and delta prevalence. Error bars indicate 95% CI.
We then assessed the difference in the prevalence of the various symptoms by deriving an odds ratio ( OR) for omicron versus delta in the matched group ( ie, the odds of a symptom being detected in participants infected during omicron prevalence compared with people infected during delta prevalence; figure 1B). Of the 32 symptoms assessed, 12 were significantly less prevalent ( false discovery rate p < 0·05) among individuals infected during omicron prevalence than among those infected during delta prevalence ( loss of smell OR 0·17, 95% CI 0·16–0·19 [ p < 0·001 ]; altered sense of smell 0·54, 0·50–0·59 [ p < 0·001 ]; sneezing 0·70, 0·65–0·76 [ p < 0·001 ]; runny nose 0·73, 0·67–0·81 [ p < 0·001 ]; brain fog 0·78, 0·71–0·85 [ p < 0·001 ]; eye soreness 0·81, 0·74–0·88 [ p < 0·001 ]; headache 0·84, 0·77–0·93 [ p < 0·001 ]; fever 0·87, 0·80–0·94 [ p < 0·001 ]; hair loss 0·52, 0·37–0·75 [ p < 0·001 ]; blistering on feet 0·52, 0·31–0·86 [ p=0·01 ]; ear ringing 0·86, 0·78–0·96 [ p=0·005 ]; and dizzy or light headed 0·88, 0·81–0·96 [ p=0·003 ]). However, sore throat and hoarse voice were significantly more likely to be present during omicron prevalence than during delta prevalence ( sore throat OR 1·55, 95% CI 1·43–1·69 [ p < 0·001 ]; hoarse voice 1·24, 1·14–1·34 [ p < 0·001 ]). Participants infected during omicron prevalence were less likely to display at least one out of the three classic COVID-19 symptoms ( fever, loss of smell, and persistent cough) compared with individuals infected with delta ( OR 0·56, 95% CI 0·51–0·61; p < 0·001, figure 2A).Figure 2Classic symptoms, hospital admission, and symptom duration in patients infected with SARS-CoV-2 during delta and omicron prevalenceShow full caption ( A) Association between type of SARS-CoV-2 prevalence ( omicron or delta) and presentation of classic symptoms ( defined as at least one of loss of smell, fever, or persistent cough) in 4990 participants who tested positive for SARS-CoV-2 when omicron was dominant and 4990 participants who tested positive when delta was dominant. Error bars indicate 95% CI. ( B) Self-reported hospital admission by SARS-CoV-2 variant prevalence in the same subset as ( A). ( C) Acute symptom duration. Proportion of participants self-reporting symptoms to the ZOE COVID Study app within 21 days after infection with SARS-CoV-2 in ( i) the overall matched set, ( ii) participants who received two doses of any SARS-CoV-2 vaccine, and ( iii) participants who received three doses of any SARS-CoV-2 vaccine.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
( A) Association between type of SARS-CoV-2 prevalence ( omicron or delta) and presentation of classic symptoms ( defined as at least one of loss of smell, fever, or persistent cough) in 4990 participants who tested positive for SARS-CoV-2 when omicron was dominant and 4990 participants who tested positive when delta was dominant. Error bars indicate 95% CI. ( B) Self-reported hospital admission by SARS-CoV-2 variant prevalence in the same subset as ( A). ( C) Acute symptom duration. Proportion of participants self-reporting symptoms to the ZOE COVID Study app within 21 days after infection with SARS-CoV-2 in ( i) the overall matched set, ( ii) participants who received two doses of any SARS-CoV-2 vaccine, and ( iii) participants who received three doses of any SARS-CoV-2 vaccine.
We also did a sub-analysis assessing the ORs by vaccination status, which showed consistent results ( appendix pp 8–11). We found that participants who had received two or three vaccine doses had a lower risk of hospitalisation during omicron prevalence ( omicron 94 [ 1·9% ] of 4990 individuals, delta 130 [ 2·6% ] of 4990; OR 0·75, 95% CI 0·57–0·98; p=0·03, figure 2B). Given the small number of patients admitted to hospital in this community-based study, this effect did not reach statistical significance in the separate two-dose and three-dose groups, but the effects were similar in both ( figure 2B).
In a subset of participants that recovered within 21 days, we compared the number of days spanned until resolution of acute symptoms in matched delta-infected and omicron-infected individuals ( 1530 in each group). We found that the duration of acute symptoms was longer for delta ( mean duration 8·89 days, 95% CI 8·61–9·17; median duration 8·0 days, IQR 5·0–12·0) than for omicron ( mean duration 6·87 days, 6·58–7·16; median duration 5·0 days, IQR 3·0–9·0; p < 0·0001, figure 2C). This difference appeared less marked among individuals who had received only two doses of the vaccine ( delta mean duration 9·57 days, 9·22–9·92; median duration 9·00 days, 6·00–13·00; omicron mean duration 8·30 days, 7·96–8·65; median duration 7·00, 4·00–11·00 days; p < 0·0001, figure 2C) and more marked in individuals who had received three doses of the vaccine ( delta mean duration 7·71 days, 7·26–8·15; median duration 7·00 days, 4·00–10·00; omicron mean duration 4·40 days 3·98–4·82, median duration 3·0 days, IQR 2·00–5·00; p < 0·0001, figure 2C). Finally, in this same subset of individuals we investigated the odds of recovering within 7 days of the onset of symptoms during omicron prevalence compared with during delta prevalence. We obtained an OR ( adjusted for age, sex, presence of comorbidities, and vaccine doses) of 2·49 ( 95% CI 2·10–2·95) indicating that people infected during omicron prevalence are twice as likely to recover within one week of the onset of symptoms than were those infected during delta prevalence.
The symptoms that characterise an omicron infection differ moderately from those of the delta SARS-CoV-2 variant. The two symptoms that were consistently more prevalent among omicron than among delta cases ( regardless of vaccination status) were sore throat and hoarse voice. Four of the 32 symptoms assessed were significantly less prevalent during omicron prevalence than during delta prevalence in both vaccination groups ( loss of smell, altered smell, eye soreness, and sneezing) and 12 out of the 32 symptoms were significantly less prevalent overall during omicron prevalence than during delta prevalence. The most striking difference was observed for loss of sense of smell, a pathognomonic feature of earlier waves of SARS-CoV-2 infection,10Menni C Valdes AM Freidin MB et al.Real-time tracking of self-reported symptoms to predict potential COVID-19.Nat Med. 2020; 26: 1037-1040Google Scholar now present in less than 20% of cases. Moreover, many debilitating symptoms such as brain fog, eye burning, dizziness, fever, and headaches were all significantly less prevalent in omicron cases.
Additionally, hospital admission was significantly lower in patients infected during omicron prevalence than in patients infected during delta prevalence. This supports previous findings from South Africa and South Korea,4Kim M-K Lee B Choi YY et al.Clinical characteristics of 40 patients infected with the SARS-CoV-2 omicron variant in Korea.J Korean Med Sci. 2022; 37: e31Google Scholar, 5Wolter N Jassat W Walaza S et al.Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: a data linkage study.Lancet. 2022; 399: 437-446Google Scholar, 6Maslo C Friedland R Toubkin M Laubscher A Akaloo T Kama B Characteristics and outcomes of hospitalized patients in South Africa during the COVID-19 omicron wave compared with previous waves.JAMA. 2022; 327: 583-584Google Scholar, 7Davies M-A Kassanjee R Rousseau P et al.Outcomes of laboratory-confirmed SARS-CoV-2 infection in the omicron-driven fourth wave compared with previous waves in the Western Cape Province, South Africa.medRxiv. 2022; ( published online Jan 12.) ( preprint).https: //doi.org/10.1101/2022.01.12.22269148Google Scholar which showed the omicron variant to be milder in terms of severity. Finally, the duration of acute symptoms was shorter during omicron prevalence than during delta prevalence, with the average presentation of omicron being 2 days shorter than that of delta. Furthermore, a third dose of vaccine was associated with a greater reduction in symptom duration in participants infected during omicron prevalence compared with those infected during delta prevalence.
SARS-CoV-2 is known to affect various organs in addition to the respiratory tract, leading to dermatological complications, myocardial dysfunction, gastrointestinal symptoms, neurological illnesses, hepatic injury, and renal injury.12Guan W-J Ni Z-Y Hu Y et al.Clinical characteristics of coronavirus disease 2019 in China.N Engl J Med. 2020; 382: 1708-1720Google Scholar, 13Thakur V Ratho RK Kumar P et al.Multi-organ involvement in COVID-19: beyond pulmonary manifestations.J Clin Med. 2021; 10: 446Google Scholar Multiple organ involvement is particularly noticeable in severe cases.14Mokhtari T Hassani F Ghaffari N Ebrahimi B Yarahmadi A Hassanzadeh G COVID-19 and multiorgan failure: a narrative review on potential mechanisms.J Mol Histol. 2020; 51: 613-628Google Scholar Our data indicate a narrower spectrum and faster resolution of symptoms with omicron, along with a milder presentation than with delta, all of which concur with the view that omicron seems to be much more transmissible than previous variants,15Torjesen I Covid-19: omicron may be more transmissible than other variants and partly resistant to existing vaccines, scientists fear.BMJ. 2021; 375n2943Google Scholar but less severe in vaccinated populations.16Ledford H How severe are omicron infections?.Nature. 2021; 600: 577-578Google Scholar This is also consistent with in vitro studies17Hui KPY Ho JCW Cheung M-C et al.SARS-CoV-2 omicron variant replication in human bronchus and lung ex vivo.Nature. 2022; ( published online Feb 1.) https: //doi.org/10.1038/s41586-022-04479-6Google Scholar that report that omicron replicates faster than all other SARS-CoV-2 variants in the bronchus but less efficiently in the lung parenchyma, and appears to enter human cells by a different route than other variants.17Hui KPY Ho JCW Cheung M-C et al.SARS-CoV-2 omicron variant replication in human bronchus and lung ex vivo.Nature. 2022; ( published online Feb 1.) https: //doi.org/10.1038/s41586-022-04479-6Google Scholar Our finding that the odds of hospitalisation are 25% lower for omicron than for delta are consistent with reports by the South African private health insurer Discovery Health in Johannesburg,16Ledford H How severe are omicron infections?.Nature. 2021; 600: 577-578Google Scholar which announced that risk of hospital admission is 29% lower among people infected with omicron than those infected with delta.
The genome of SARS-CoV-2 omicron virus has some deletions and more than 30 mutations from the original sequence.18The GISAID initiativeGISAID—hCov19 variants.https: //www.gisaid.org/hcov19-variants/Date accessed: January 27, 2022Google Scholar Several mutations overlap with those present in the previous variants of concern and are known to increase transmissibility; other omicron mutations with known effects confer an increase in transmissibility and affect binding affinity.19Greaney AJ Starr TN Gilchuk P et al.Complete mapping of mutations to the SARS-CoV-2 spike receptor-binding domain that escape antibody recognition.Cell Host Microbe. 2021; 29: 44-57.e9Google Scholar However, the effects of most of the remaining omicron mutations are not known.20Karim SSA Karim QA Omicron SARS-CoV-2 variant: a new chapter in the COVID-19 pandemic.Lancet. 2021; 398: 2126-2128Google Scholar Characterising the differences in the clinical presentation of infection by omicron versus delta is not only of direct public health relevance as the public and clinicians are aware of what symptoms to look out for, but will also assist in understanding the potential effects of future variants of concern.
Our study has several strengths, including the one-to-one matched study design, whereby individuals infected during delta and omicron prevalence were matched for age, sex, and vaccination status; the community nature of the study; and the use of a mobile app for daily logging. This allowed us to assess the duration and risk of hospital admission and of acute symptoms in community cases logging prospectively, rather than a biased sample that would be derived retrospectively from a secondary health-care setting.
We also note some study limitations. First, we were unable to compare symptoms, risk of hospital admission, or duration of infection by the two variants in unvaccinated individuals, as most study participants were vaccinated. Also, hospital admission was not ascertained from surveillance systems, but was self-reported. Second, infection with omicron and delta were assigned based on the prevalence in the UK population at the time and not on individual sequencing from these individuals, and our use of self-reported data can introduce information bias. Although this factor might introduce some misclassification, over 70% of SARS-CoV-2 sequenced cases by TaqPath laboratories ( by daily reports from the UK Health Security Agency3WHO Regional Office for AfricaOmicron spreads but severe cases remain low in South Africa.https: //www.afro.who.int/news/omicron-spreads-severe-cases-remain-low-south-africaDate accessed: January 24, 2022Google Scholar) were either delta or omicron according to the assigned period. Third, some participants might be more likely to report symptoms than others, and participants using the app were a self-selected group and not representative of the general population, although we have previously found that our self-reported data aligns well with surveys designed to be representative of the population.21Varsavsky T Graham MS Canas LS et al.Detecting COVID-19 infection hotspots in England using large-scale self-reported data from a mobile application: a prospective, observational study.Lancet Public Health. 2021; 6: e21-e29Google Scholar, 22Bowyer RCE Varsavsky T Thompson EJ et al.Geo-social gradients in predicted COVID-19 prevalence in Great Britain: results from 1 960 242 users of the COVID-19 Symptoms Study app.Thorax. 2021; 76: 723-725Google Scholar Fourth, our populations were matched for age, vaccination status, and sex but not for any other potential confounders. This might also explain the slight discrepancies we observe in gastrointestinal symptoms between our overall sample and matched sample. Gastrointestinal symptoms queried could be influenced by a variety of lifestyle factors, none more so than dietary intake; by matching the sample, we could reduce some of this confounding lifestyle effect.23Mathur R Rentsch CT Morton CE et al.Ethnic differences in SARS-CoV-2 infection and COVID-19-related hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform.Lancet. 2021; 397: 1711-1724Google Scholar Fifth, we were unable to assess the role of previous infection on clinical presentation due to insufficient sample size. Sixth, our data are limited by the initial UK vaccine roll-out's focus on health-care workers, older people, and the clinically vulnerable.24UK Health Security AgencyCOVID-19 vaccination: booster dose resources.https: //www.gov.uk/government/publications/covid-19-vaccination-booster-dose-resourcesDate: 2021Date accessed: January 27, 2022Google Scholar In addition, symptoms present at the time of infection might be related to viral or bacterial co-infections at the time of the SARS-CoV-2 infection. Finally, although the study design was matched for vaccination status ( two or three doses), we could not match for time elapsed since vaccination. However, this would probably bias the data in terms of presenting a more severe clinical picture for omicron than if individuals had been matched for time since vaccination,25Menni C May A Polidori L et al.COVID-19 vaccine waning and effectiveness and side effects of boosters: a prospective community study from the ZOE COVID study.SSRN. 2021; ( published online Dec 8.) ( preprint).https: //doi.org/10.2139/ssrn.3980542Google Scholar and we believe that this would strengthen the robustness of our key finding, that omicron has a less severe clinical presentation than delta.
Using a matched design we report that among vaccinated individuals, the clinical symptoms associated with symptomatic infection by the SARS-CoV-2 omicron variant are different, milder, and of shorter duration than those presented by the delta variant among vaccinated individuals. Furthermore, loss of smell, so central in the clinical presentation of COVID-19, is much less frequently reported by those infected with omicron.
JW, TDS, SO, and CJS were responsible for funding acquisition. CM, AMV, TDS, CJS, and MA were responsible for conceptualisation. LP, AM, SP, and JC were responsible for formal analysis. JC did data curation. PL, CHS, JCF, AN, LC, MFÖ, BF, SPD, MA, MM, AH, ATC, CH, and EM were responsible for resources. LP, AM, SP, and JC verified the underlying data. CM, LP, SP, and AMV wrote the original draft. All authors contributed to review and editing. CM, TDS, JC, AM, and LP had access to the raw data. All authors had access to all data in the study and the corresponding author had final responsibility for the decision to submit for publication.
Anonymised research data are shared with third parties via the centre for Health Data Research UK ( HDRUK.ac.uk). US investigators are encouraged to coordinate data requests through the Coronavirus Pandemic Epidemiology ( COPE) consortium ( www.monganinstitute.org/cope-consortium). Data updates can be found on https: //covid.joinzoe.com
TDS, AMV, CJS, and SO are consultants to ZOE. JW, AM, LP, SP, and JC are employees of ZOE. All other authors declare no competing interests.
Department of Health and Social Care. This research was funded in whole, or in part, by the Wellcome Trust ( WT212904/Z/18/Z; WT203148/Z/16/Z). For the purpose of open access, the authors have applied a CC BY public copyright to any Author Accepted Manuscript version arising from this submission. The Department of Twin Research receives grant support from the Wellcome Trust, the Medical Research Council ( MRC) /British Heart Foundation Ancestry and Biological Informative Markers for Stratification of Hypertension ( MR/M016560/1), the National Institute for Health Research ( NIHR) and MRC as part of the COVID-19 Longitudinal Health and Wealth–National Core Study, Versus Arthritis, EU Horizon 2020, Chronic Disease Research Foundation ( CDRF), ZOE, National Institutes for Health, and NIHR Clinical Research Network and Biomedical Research Centre based at Guy's and St Thomas ' NHS Foundation Trust in partnership with King's College London. SO and MM are supported by the UK Research and Innovation ( UKRI) London Medical Imaging and Artificial Intelligence Centre for Value Based Healthcare. SO is also funded by the Wellcome/ Engineering and Physical Sciences Research Counci ( EPSRC) Centre for Medical Engineering ( WT203148/Z/16/Z), Wellcome Flagship Programme ( WT213038/Z/18/Z). CM and LC are supported by the Wellcome Trust ( 215010/Z/18/Z). AN and PL are funded by the CDRF. CHS is an Alzheimer's Society Junior Fellow ( AS-JF-17-011) and is supported by the National Core Studies, an initiative funded by UKRI, NIHR, and the Health and Safety Executive and the COVID-19 Longitudinal Health and Wellbeing National Core Study that was funded by the MRC ( MC PC 20059). The BMEIS is supported by the Wellcome EPSRC Centre for Medical Engineering at King's College London ( WT 203148/Z/16/Z) and the Department of Health via the NIHR comprehensive Biomedical Research Centre award to Guy's and St Thomas ' NHS Foundation Trust in partnership with King's College London and King's College Hospital NHS Foundation Trust. ATC is the Stuart and Suzanne Steele Massachusetts General Hospital ( MGH) Research Scholar. ATC is also supported by the Massachusetts Consortium on Pathogen Readiness. AMV is funded by UKRI/MRC Covid-Rapid Response grant MR/V027883/1. EM is funded by an MRC Skills Development Fellowship Scheme at King's College London. CHS is supported by the National Core Studies, an initiative funded by UKRI, NIHR, and the Health and Safety Executive, and funded by MRC ( MC PC 20030). We express our sincere thanks to all the participant users of the app, including study volunteers enrolled in cohorts within the COPE consortium. We thank the staff of ZOE, the Department of Twin Research at King's College London, and the Clinical & Translational Epidemiology Unit at MGH for their tireless work in contributing to the running of the study and data collection.
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Smart apps for self-reporting clinical informationThe global COVID-19 pandemic has placed unprecedented health, economic, and social pressures on nations worldwide. Following the initial Wuhan-Hu-1 variant, various genetic lineages of SARS-CoV-2 have emerged and circulated around the world, most notably the five successive variants of concern, alpha ( B.1.1.7), beta ( B.1.351), gamma ( P.1), delta ( B.1.617.2), and omicron ( B.1.1.529).1,2 Full-Text PDF | tech |
Enteropathogen spectrum and effect on antimycobacterial pharmacokinetics among children with tuberculosis in rural Tanzania: a prospective cohort study | BackgroundEnteropathy is prevalent in tuberculosis-endemic areas, and it has been shown to impair intestinal absorptive function; therefore, enteropathogen burden might negatively affect antimycobacterial pharmacokinetics, particularly among malnourished children. We sought to quantify enteropathogen burden among children initiating tuberculosis treatment in rural Tanzania and determine the effect of enteropathogen burden on serum antimycobacterial pharmacokinetics.MethodsWe performed a prospective cohort study at one site in rural Tanzania as an exploratory substudy of a large multicountry cohort study. We included children younger than 15 years of age with confirmed or probable tuberculosis undergoing treatment with first-line tuberculosis therapy; children were excluded from the study if they were unable to undergo sample collection. Participants were consecutively recruited from the inpatient paediatric wards or the outpatient tuberculosis clinic at Haydom Lutheran Hospital, Tanzania. The main outcome was to quantify symptomatic enteropathogen burden and the effect on serum antimycobacterial pharmacokinetics. We quantified enteropathogen burden ( defined as the sum of distinct enteropathogens detected in stool) using a multipathogen PCR capable of simultaneous detection of 37 bacterial, viral, and parasitic species or species groups from stool collected within 72 h of treatment initiation. Comprehensive clinical assessment, including presence of gastrointestinal symptoms, was performed at baseline, and serum was collected approximately 2 weeks after treatment initiation at steady state and throughout the dosing interval with concentrations of isoniazid, rifampicin, pyrazinamide, and ethambutol measured by liquid chromatography with a tandem mass spectrometry assay to quantify peak ( Cmax) and total area under the concentration curve ( AUC0–24), as determined by non-compartmental analysis. Enteropathogen burden was compared with pharmacokinetic measurements using bivariable and multivariable linear regression.Findings58 children were assessed for eligibilty and enrolled between June 25, 2016, and Feb 6, 2018; 44 had complete stool testing and serum pharmacokinetic data, and they were included in the analyses. 20 ( 45%) were female, and 24 ( 55%) were male. 37 ( 84%) had moderate or severe malnutrition. A mean of 2·1 ( SD 1·3) enteropathogens were detected per participant. Target peak concentrations of rifampicin were reached in eight ( 18%) of 44 participants, isoniazid in 24 ( 54%) of 44 participants, pyrazinamide in 28 ( 74%) of 38 participants, and ethambutol in six ( 15%) of 39 participants. Compared with controlled comparisons, each summative additional bacterial enteropathogen detected was associated with a 40% lower rifampicin Cmax ( 95% CI −62 to −5) and a 36% lower ethambutol Cmax ( −52 to −14), while viral pathogens were associated with a 51% lower isoniazid Cmax ( −75 to −7). The combination of gastrointestinal symptoms and detection of an additional enteropathogen was associated with a 27% reduction in rifampicin AUC0–24 ( 95% CI −47 to −1).InterpretationTanzanian children undergoing tuberculosis treatment rarely attained pharmacokinetic targets; enteropathogen carriage was common and enteropathogen burden was associated with significant reductions in the concentrations of some antimycobacterial drugs. Further research should explore mechanistic relationships of individual pathogens and antimycobacterial pharmacokinetics in larger cohorts, or determine if screening for and treating enteropathogens at tuberculosis treatment initiation improves pharmacokinetic target attainment.FundingNational Institute of Allergy and Infectious Diseases, National Institutes of Health.
Enteropathy is prevalent in tuberculosis-endemic areas, and it has been shown to impair intestinal absorptive function; therefore, enteropathogen burden might negatively affect antimycobacterial pharmacokinetics, particularly among malnourished children. We sought to quantify enteropathogen burden among children initiating tuberculosis treatment in rural Tanzania and determine the effect of enteropathogen burden on serum antimycobacterial pharmacokinetics.
We performed a prospective cohort study at one site in rural Tanzania as an exploratory substudy of a large multicountry cohort study. We included children younger than 15 years of age with confirmed or probable tuberculosis undergoing treatment with first-line tuberculosis therapy; children were excluded from the study if they were unable to undergo sample collection. Participants were consecutively recruited from the inpatient paediatric wards or the outpatient tuberculosis clinic at Haydom Lutheran Hospital, Tanzania. The main outcome was to quantify symptomatic enteropathogen burden and the effect on serum antimycobacterial pharmacokinetics. We quantified enteropathogen burden ( defined as the sum of distinct enteropathogens detected in stool) using a multipathogen PCR capable of simultaneous detection of 37 bacterial, viral, and parasitic species or species groups from stool collected within 72 h of treatment initiation. Comprehensive clinical assessment, including presence of gastrointestinal symptoms, was performed at baseline, and serum was collected approximately 2 weeks after treatment initiation at steady state and throughout the dosing interval with concentrations of isoniazid, rifampicin, pyrazinamide, and ethambutol measured by liquid chromatography with a tandem mass spectrometry assay to quantify peak ( Cmax) and total area under the concentration curve ( AUC0–24), as determined by non-compartmental analysis. Enteropathogen burden was compared with pharmacokinetic measurements using bivariable and multivariable linear regression.
58 children were assessed for eligibilty and enrolled between June 25, 2016, and Feb 6, 2018; 44 had complete stool testing and serum pharmacokinetic data, and they were included in the analyses. 20 ( 45%) were female, and 24 ( 55%) were male. 37 ( 84%) had moderate or severe malnutrition. A mean of 2·1 ( SD 1·3) enteropathogens were detected per participant. Target peak concentrations of rifampicin were reached in eight ( 18%) of 44 participants, isoniazid in 24 ( 54%) of 44 participants, pyrazinamide in 28 ( 74%) of 38 participants, and ethambutol in six ( 15%) of 39 participants. Compared with controlled comparisons, each summative additional bacterial enteropathogen detected was associated with a 40% lower rifampicin Cmax ( 95% CI −62 to −5) and a 36% lower ethambutol Cmax ( −52 to −14), while viral pathogens were associated with a 51% lower isoniazid Cmax ( −75 to −7). The combination of gastrointestinal symptoms and detection of an additional enteropathogen was associated with a 27% reduction in rifampicin AUC0–24 ( 95% CI −47 to −1).
Tanzanian children undergoing tuberculosis treatment rarely attained pharmacokinetic targets; enteropathogen carriage was common and enteropathogen burden was associated with significant reductions in the concentrations of some antimycobacterial drugs. Further research should explore mechanistic relationships of individual pathogens and antimycobacterial pharmacokinetics in larger cohorts, or determine if screening for and treating enteropathogens at tuberculosis treatment initiation improves pharmacokinetic target attainment.
National Institute of Allergy and Infectious Diseases, National Institutes of Health.
Before the start of the COVID-19 pandemic in 2020, tuberculosis was the leading cause of death by a single infectious disease worldwide.1WHOGlobal tuberculosis report 2019.https: //www.who.int/publications/i/item/9789241565714Date: 2019Date accessed: June 8, 2020Google Scholar In 2018, 10 million people were diagnosed with tuberculosis, with over 1 million cases in children younger than 15 years; despite the availability of a first-line treatment regimen with more than 90% efficacy in controlled settings, tuberculosis was the cause of death in over 200 000 children. Pharmacokinetic variability is an important driver of treatment failure; and low serum drug concentrations have been associated with a delayed response to treatment, poor outcomes, and acquired drug resistance.2Pasipanodya JG McIlleron H Burger A Wash PA Smith P Gumbo T Serum drug concentrations predictive of pulmonary tuberculosis outcomes.J Infect Dis. 2013; 208: 1464-1473Google Scholar, 3Srivastava S Pasipanodya JG Meek C Leff R Gumbo T Multeistant tuberculosis not due to noncompliance but to between-patient pharmacokinetic variability.J Infect Dis. 2011; 204: 1951-1959Google Scholar Most first-line tuberculosis medications are concentration dependent in their activity, with peak ( Cmax) and total area under the concentration time curve ( AUC) predictive of microbial kill rate and prevention of acquired resistance.4Alffenaar JC Gumbo T Dooley KE et al.Integrating pharmacokinetics and pharmacodynamics in operational research to end tuberculosis.Clin Infect Dis. 2020; 70: 1774-1780Google Scholar Although in 2014 the WHO updated their guidelines for weight-based dosing in paediatric tuberculosis treatment, there is continued evidence of poor attainment of target Cmax and AUC values in children undergoing tuberculosis treatment.5WHOGuidance for national tuberculosis programmes on the management of tuberculosis in children.https: //apps.who.int/iris/bitstream/handle/10665/112360/9789241548748 eng.pdf; jsessionid=15F070C2FF9EEE9C1BE549B5ECDDA24F? sequence=1Date: 2014Date accessed: June 8, 2020Google Scholar, 6Kwara A Enimil A Gillani FS et al.Pharmacokinetics of first-line antituberculosis drugs using WHO revised dosage in children with tuberculosis with and without HIV coinfection.J Pediatric Infect Dis Soc. 2016; 5: 356-365Google Scholar, 7Justine M Yeconia A Nicodemu I et al.Pharmacokinetics of first-line drugs among children with tuberculosis in rural Tanzania.J Pediatric Infect Dis Soc. 2020; 9: 14-20Google Scholar We previously showed that among 28 children undergoing tuberculosis treatment in rural Tanzania, none achieved target peak serum Cmax for rifampicin, isoniazid, pyrazinamide, and ethambutol simultaneously, and 54% did not reach target Cmax for any drug.7Justine M Yeconia A Nicodemu I et al.Pharmacokinetics of first-line drugs among children with tuberculosis in rural Tanzania.J Pediatric Infect Dis Soc. 2020; 9: 14-20Google Scholar In addition to drug dose, malnutrition was associated with lower drug concentration in multivariable models. In the past decade, multicountry cohorts have associated specific enteropathogen frequency with childhood malnutrition and growth trajectories,8Rogawski ET Liu J Platts-Mills JA et al.Use of quantitative molecular diagnostic methods to investigate the effect of enteropathogen infections on linear growth in children in low-resource settings: longitudinal analysis of results from the MAL-ED cohort study.Lancet Glob Health. 2018; 6: e1319-e1328Google Scholar but enteropathogen burden has not been investigated in children treated for tuberculosis.
Research in contextEvidence before this studyWe searched PubMed from database inception, without language restrictions for studies of enteropathogen prevalence in tuberculosis patients using the keywords “ enteropathogen ” AND “ tuberculosis ” before June 28, 2020, which returned 16 results. Of these, only one study attempted to quantify prevalence of enteropathogens among people with tuberculosis; this study was performed in adults with HIV or tuberculosis, and it was only evaluated for parasitic pathogens. A second search using the keywords “ enteropathogen ” AND “ tuberculosis ” AND “ pharmacokinetics ” returned no results.Added value of this studyAmong a subset of children with tuberculosis participating in a prospective pharmacokinetic cohort study, we performed broad-spectrum stool polymerase chain reaction for enteropathogens, we obtained full pharmacokinetic profiles of each of the first-line antimycobacterial drugs, and we measured biomarkers of enteropathy. This is the first study to quantify enteropathogen burden and species composition among children with tuberculosis. These results add to a growing body of data showing suboptimal serum target attainment among children with tuberculosis in endemic areas; yet, they are the first to demonstrate a negative association between enteropathogen burden and antimycobacterial pharmacokinetic target.Implications of all the available evidenceThese findings indicate that enteropathogens are an important and overlooked aspect of clinical care in children with tuberculosis. Given the heavy enteropathogen burden seen in this cohort and the documented global prevalence of enteropathogen carriage in tuberculosis endemic areas, further resources should be devoted to the investigation of the pathogenesis and consequences of enteropathogen and tuberculosis coinfection. Moreover, these findings strongly suggest that enteropathogens play an antagonistic role in the pharmacotherapy of childhood tuberculosis; and these findings provide insight into enteropathogen species and individual drug relationships that can be targeted for further mechanistic or interventional studies.
We searched PubMed from database inception, without language restrictions for studies of enteropathogen prevalence in tuberculosis patients using the keywords “ enteropathogen ” AND “ tuberculosis ” before June 28, 2020, which returned 16 results. Of these, only one study attempted to quantify prevalence of enteropathogens among people with tuberculosis; this study was performed in adults with HIV or tuberculosis, and it was only evaluated for parasitic pathogens. A second search using the keywords “ enteropathogen ” AND “ tuberculosis ” AND “ pharmacokinetics ” returned no results.
Among a subset of children with tuberculosis participating in a prospective pharmacokinetic cohort study, we performed broad-spectrum stool polymerase chain reaction for enteropathogens, we obtained full pharmacokinetic profiles of each of the first-line antimycobacterial drugs, and we measured biomarkers of enteropathy. This is the first study to quantify enteropathogen burden and species composition among children with tuberculosis. These results add to a growing body of data showing suboptimal serum target attainment among children with tuberculosis in endemic areas; yet, they are the first to demonstrate a negative association between enteropathogen burden and antimycobacterial pharmacokinetic target.
These findings indicate that enteropathogens are an important and overlooked aspect of clinical care in children with tuberculosis. Given the heavy enteropathogen burden seen in this cohort and the documented global prevalence of enteropathogen carriage in tuberculosis endemic areas, further resources should be devoted to the investigation of the pathogenesis and consequences of enteropathogen and tuberculosis coinfection. Moreover, these findings strongly suggest that enteropathogens play an antagonistic role in the pharmacotherapy of childhood tuberculosis; and these findings provide insight into enteropathogen species and individual drug relationships that can be targeted for further mechanistic or interventional studies.
97% of tuberculosis cases occur in low-income and middle-income countries, where enteropathy is an important contributor to childhood morbidity.1WHOGlobal tuberculosis report 2019.https: //www.who.int/publications/i/item/9789241565714Date: 2019Date accessed: June 8, 2020Google Scholar, 9Kosek MN Ahmed T Bhutta Z et al.Causal pathways from enteropathogens to environmental enteropathy: findings from the MAL-ED birth cohort study.EBioMedicine. 2017; 18: 109-117Google Scholar Enteropathogen burden—ie, the number of concurrent pathogens detected in stool—is known to adversely impact small bowel absorptive capacity, which has been measured by functional mannitol excretion tests in children without tuberculosis.10Lee GO McCormick BJJ Seidman JC et al.Infant nutritional status, feeding practices, enteropathogen exposure, socioeconomic status, and illness are associated with gut barrier function as assessed by the lactulose mannitol test in the MAL-ED birth cohort.Am J Trop Med Hyg. 2017; 97: 281-290Google Scholar It has also been shown that adult patients with tuberculosis ( without known enteropathogen infection) also have impaired small bowel absorptive function, and they have lower serum rifampicin and isoniazid levels compared with healthy controls.11Pinheiro VG Ramos LM Monteiro HS et al.Intestinal permeability and malabsorption of rifampin and isoniazid in active pulmonary tuberculosis.Braz J Infect Dis. 2006; 10: 374-379Google Scholar Importantly, orally administered isoniazid, pyrazinamide, and ethambutol are preferentially absorbed in the small bowel, whereas oral rifampicin is also absorbed in the stomach.12Mariappan TT Singh S Regional gastrointestinal permeability of rifampicin and isoniazid ( alone and their combination) in the rat.Int J Tuberc Lung Dis. 2003; 7: 797-803Google Scholar Thus, pathogens leading to inflammation along the upper gastrointestinal tract can affect antimycobacterial drug absorption and subsequent pharmacokinetic parameters; the impact might also be driven by individual drug-pathogen effects.
To quantify enteropathogen burden and determine the association between this burden and antimycobacterial pharmacokinetics, we used a multipathogen PCR array card for simultaneous detection of 37 bacterial, viral, and parasitic species or species groups among children undergoing tuberculosis treatment in rural Tanzania as part of a prospective pharmacokinetic study.13Liu J Gratz J Amour C et al.Optimization of quantitative PCR methods for enteropathogen detection.PLoS One. 2016; 11e0158199Google Scholar We hypothesised that those with evidence of symptomatic enteropathogen infection ( ie, gastrointestinal symptoms) and high enteropathogen burden would have a lower serum Cmax and AUC of first-line tuberculosis medication than those without evidence of enteropathogen infection.
We performed a pharmacokinetic cohort study at one hospital in rural Haydom, Tanzania, that included children and enteropathogen burden as an exploratory analysis of a larger multicountry pharmacokinetic trial regarding pharmacokinetics of tuberculosis treatment, with prespecified pharmacokinetic parameters. The larger trial was not assessing enteropathogen burden. Haydom was selected due to the known coburden of malnutrition. Haydom was also the only paediatric site. Participants were consecutively recruited from the inpatient paediatric wards or the outpatient tuberculosis clinic at Haydom Lutheran Hospital from June 25, 2016, to Feb 6, 2018. Children were included if they were younger than age 15 years with confirmed or probable tuberculosis ( defined by the National Institutes of Health consensus case definitions for tuberculosis research in children) and within 72 h of starting first-line tuberculosis treatment.14Graham SM Ahmed T Amanullah F et al.Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel.J Infect Dis. 2012; 205: S199-S208Google Scholar Children were excluded from the study if they were unable to undergo sample collection of blood or stool by a treating physician, if their parent or guardian was unable to consent, and if they were unable to attend for follow-up. Follow-up for the primary outcome occurred at 2 weeks. Additional follow-up for clinical outcomes occurred at 4, 8, 24, 48, 72, and 96 weeks after treatment initiation; these outcomes are not described here as they do not relate to this study. All parents or guardians gave written informed consent and children older than 7 years provided assent. All study patients were enrolled in Haydom, with a protocol approved by the institutional review boards for human subjects research at the University of Virginia and the Tanzania National Institute for Medical Research. Reporting is in accordance with STROBE guidelines for cohort studies where applicable.
The study protocol is available at ClinicalTrials.gov, NCT03559582.
Data on demographics and anthropometrics, including age, sex, height, weight, presence of abdominal pain or diarrhoea, presence and duration of fever, and previous medical history were collected by trained study staff at baseline. The primary outcomes were to quantify the symptomatic enteropathogen burden and determine the effect of this burden on the pharmacokinetic parameters of serum Cmax and AUC over 24 h ( AUC0–24) for isoniazid, rifampicin, pyrazinamide, and ethambutol. The secondary outcomes were to determine the effect of individual enteropathogens on rifampicin, isoniazid, pyrazinamide, and ethambutol Cmax and AUC0–24. To quantify the enteropathogen burden stool samples from participants were collected at baseline by study nurses in sterile containers, stored at −80°C, and shipped to the Kilimanjaro Clinical Research Institute, Tanzania, where entero pathogen burden was assessed by real-time PCR using a TaqMan Array Card ( TAC) ( Thermo Fisher, Carlsbad, CA, USA) as described elsewhere13Liu J Gratz J Amour C et al.Optimization of quantitative PCR methods for enteropathogen detection.PLoS One. 2016; 11e0158199Google Scholar ( appendix pp 3–4). JG, JL, and ERH assessed the data.
QIAamp Fast Stool DNA Mini Kit ( Valencia, CA, USA) was used to extract nucleic acids, which were mixed with AgPath-ID One-Step RT-PCR buffer ( Thermo Fisher, CA, USA) and nuclease-free water, and were run on a custom-designed TAC. Organisms included on the TAC were Campylobacter spp, Shigella spp, enteroaggregative Escherichia coli, typical and atypical enteropathogenic E coli, enterotoxigenic E coli, shiga-toxin-producing E coli, Salmonella enterica, Aeromonas spp, Plesiomonas shigelloides, Helicobacter pylori, Clostridioides difficile, Mycobacterium tuberculosis, rotavirus, norovirus, adenovirus 40 and adenovirus 41, astrovirus, sapovirus, Cryptosporidium, Giardia, Enterocytozoon bieneusi, Trichuris, Encephalitozoon intestinalis, Cyclospora, Isospora, Entamoeba histolytica, Ancyclostoma, Ascaris, Necator, and Strongyloides. A measure of stool pathogen burden was calculated for each participant, defined as the sum of all enteropathogens detected in stool. M tuberculosis was excluded in the summation, as detection in stool was thought to represent sputum ingestion. Summative measures of bacterial, viral, and parasitic enteropathogen burden were also calculated. Testing was performed in batch, and stool results were not available to treating clinicians.
To quantify the pharmacokinetic parameters procedures were completed as inpatients, or for those patients previously discharged or enrolled as outpatients, procedures were completed at the research facility of the hospital. Each patient received weight-based dosing of oral antimicrobials: rifampicin, isoniazid, pyrazinamide, and ethambutol while fasted, as per Tanzanian national guidelines.15National Tuberculosis and Leprosy ProgrammeNational guidelines for the management of tuberculosis in children.3rd edn. United Republic of Tanzania Ministry of Health and Social Welfare, Dar es Salaam, Tanzania2016Google Scholar Pyrazinamide and ethambutol were not administered in some instances at the discretion of the treating physicians. If paediatric dispersible tablets were not available, adult formulations were substituted ( appendix pp 2–3).
Blood samples were collected 14 days after the tuberculosis medication was started; this was to allow for rifampicin autoinduction of clearance and steady-state kinetics. The study team, including a study nurse and doctor, observed drug dosing and administration the day before blood samples were collected to ensure consumption of the medicine. The following day, blood samples were collected at 1, 2, and 6 h after observed morning medication administration, to collect capture peak and elimination phase for the oral tuberculosis medication, and serum was stored at −80°C until batch shipment to the University of Florida Infectious Diseases Pharmacokinetics Laboratory, USA, where drug concentrations were measured by a validated liquid chromatography with a tandem mass spectrometry assay.7Justine M Yeconia A Nicodemu I et al.Pharmacokinetics of first-line drugs among children with tuberculosis in rural Tanzania.J Pediatric Infect Dis Soc. 2020; 9: 14-20Google Scholar
Additional outcomes included assessing physiological perturbance in addition to pathogen presence, two biomarkers to determine the magnitude of gut inflammation and permeability were tested on baseline stool. Concentrations of stool myeloperoxidase ( Alpco, Salem, NH, USA), a marker of intestinal inflammation,9Kosek MN Ahmed T Bhutta Z et al.Causal pathways from enteropathogens to environmental enteropathy: findings from the MAL-ED birth cohort study.EBioMedicine. 2017; 18: 109-117Google Scholar and α1-antitrypsin ( Biovendor, Candler, NC, USA), a marker of intestinal permeability, were determined by ELISA. Assays were performed as described in the package insert, except initial dilutions for the myeloperoxidase assay were performed at 1:500.
A formal sample size calculation was not performed for this analysis given the exploratory nature of this study as part of a larger pharmacokinetic trial. Demographic characteristics were determined by simple frequencies. Mann-Whitney U test was used for continuous variables and Fisher's exact test was used for categorical variables. Cmax and estimated AUC0–24 were determined by non-compartmental analysis using Phoenix WinNonlin version 8.0 ( Certara USA, Princeton, NJ, USA); and AUC0–24 was calculated using the trapezoidal rule with at least two samples, with one in the elimination phase. Pharmacokinetic parameters were descriptively compared with targets from previous studies, which determined drug concentrations predictive of long-term treatment outcomes ( isoniazid minimum targets of Cmax ≥3 mg/L, AUC0–24 ≥52 mg × h/L; rifampicin minimum targets of Cmax ≥8 mg/L, AUC0–24 ≥35 mg × h/L; pyrazinamide minimum targets of Cmax ≥20 mg/L, AUC0–24 ≥363 mg × h/L; ethambutol minimum targets of Cmax ≥2 mg/L, AUC0–24 target not defined).4Alffenaar JC Gumbo T Dooley KE et al.Integrating pharmacokinetics and pharmacodynamics in operational research to end tuberculosis.Clin Infect Dis. 2020; 70: 1774-1780Google Scholar, 16Alsultan A Peloquin CA Therapeutic drug monitoring in the treatment of tuberculosis: an update.Drugs. 2014; 74: 839-854Google Scholar
For the primary comparison of the drug exposure with the number of stool pathogens identified and the outcome of serum pharmacokinetic measurements, log-Cmax and log-AUC0–24 values for each drug were modelled as functions of enteropathogen burden using multivariable linear regression with percentage change in Cmax or AUC0–24 per each pathogen detected ( 95% CI) as the estimated effect size. To account for asymptomatic carriage of pathogens, and to estimate associations among individuals with gastrointestinal symptoms, we included a binary term indicating the presence of gastrointestinal symptoms ( ie, diarrhoea or abdominal pain at the time of stool sample collection). Models were further adjusted for mg/kg drug dose, sex, age, and body-mass index ( BMI) Z score. All participants were kept in the models. Models that used the presence of an abnormal faecal myeloperoxidase or α1-antitrypsin rather than gastrointestinal symptoms were also constructed. An exploratory analysis evaluating associations between individual pathogens and serum drug exposure was performed using the same framework as described above; whereas log-Cmax and log-AUC0–24 were modelled as functions of the presence of individual enteropathogens, with percentage change in Cmax or AUC0–24 if the pathogen was detected ( 95% CI) as the estimated effect size. Data were analysed in R ( version 3.6.1). Statistical controls were included in the models to control for potential confounding variables including age, sex, drug dose, and malnutrition. Partipants lost to follow-up were not included in analysis. Not all children had ethambutol and pyrazinamide pharmackinetics if they were not treated with these medicines ( table 2); these children were not included in models in which ethambutol or pyrazinamide was the dependent variable.Table 2Summary of pharmacokinetic measurementsRifampicin ( n=44) Isoniazid ( n=44) Pyrazinamide ( n=38) * Pyrazinamide and ethambutol were not administered in some instances at the discretion of the treating physicians.Ethambutol ( n=39) * Pyrazinamide and ethambutol were not administered in some instances at the discretion of the treating physicians.Cmax, mg/LConcentration4·5 ( 2·6–7·4) 3·2 ( 2·1–5·5) 30·2 ( 20·2–40·5) 0·9 ( 0·7–1·7) Number at target†Target Cmax defined as ≥8 mg/L for rifampicin, ≥3 mg/L for isoniazid, ≥20 mg/L for pyrazinamide, ≥2 mg/L for ethambutol.168 ( 18%) 24 ( 54%) 28 ( 74%) 6 ( 15%) AUC0–24, mg×hr/LConcentration22·7 ( 12·6–39·0) 13·0 ( 7·1–21·3) 276·0 ( 181·8–391·4) 9·4 ( 5·1–13·7) Number at target‡Target AUC0–24 defined as ≥35 mg × h/L for rifampicin, ≥52 mg × h/L for isoniazid, ≥363 mg × h/L for pyrazinamide.413/37 ( 35%) 2/40 ( 5%) 11/34 ( 32%).. Dose, mg/kg11·8 ( 9·2–13·9) 6·0 ( 4·6–7·0) 30·4 ( 23·5–36·5) 21·2 ( 16·6–25·6) Data are n (%) or median ( IQR) unless otherwise specified. Cmax=peak serum concentration. AUC0–24=area under the concentration curve from 0–24 hours. * Pyrazinamide and ethambutol were not administered in some instances at the discretion of the treating physicians.† Target Cmax defined as ≥8 mg/L for rifampicin, ≥3 mg/L for isoniazid, ≥20 mg/L for pyrazinamide, ≥2 mg/L for ethambutol.16Alsultan A Peloquin CA Therapeutic drug monitoring in the treatment of tuberculosis: an update.Drugs. 2014; 74: 839-854Google Scholar‡ Target AUC0–24 defined as ≥35 mg × h/L for rifampicin, ≥52 mg × h/L for isoniazid, ≥363 mg × h/L for pyrazinamide.4Alffenaar JC Gumbo T Dooley KE et al.Integrating pharmacokinetics and pharmacodynamics in operational research to end tuberculosis.Clin Infect Dis. 2020; 70: 1774-1780Google Scholar Open table in a new tab
Data are n (%) or median ( IQR) unless otherwise specified. Cmax=peak serum concentration. AUC0–24=area under the concentration curve from 0–24 hours.
The funder had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
58 children undergoing tuberculosis treatment with first-line therapy were enrolled between June 25, 2016, and Feb 6, 2018. Stool samples were provided by 51 participants at the time of enrolment. Pharmacokinetic data ( blood samples) were collected in 44 participants ( four were lost to follow-up, two died before pharmacokinetic sampling, and we were unable to obtain adequate serum sampling in one); these 44 were included in the final analysis. The median age of participants was 2·25 years ( IQR 1·28–5·23), 20 ( 45%) were female, 24 ( 55%) were male ( gender was reported by the child's guardian), and 37 ( 84%) had moderate or severe malnutrition, with median weight-for-age Z scores of −3·42, median height-for-age Z scores of–2·37, and median BMI Z scores of −1·98 ( table 1). 32 ( 73%) had gastrointestinal symptoms and 41 ( 93%) received non-dispersible drug formulations. All children were negative for HIV.Table 1Baseline characteristics and enteropathogen detectionParticipants ( n=44) Age, years2·25 ( 1·28–5·23) SexFemale20 ( 45%) Male24 ( 55%) Moderate or severe malnutrition * Moderate or severe malnutrition defined as weight-for-age, height-for-age or BMI-for-age Z score less than −2.37 ( 84%) Weight-for-age Z score−3·42 ( −4·38 to −2·01) Height-for-age Z score−2·73 ( −4·17 to −1·47) BMI Z score−1·98 ( −3·06 to −0·73) Haemoglobin, mg/dL9·6 ( 8·15–11·05) Previous history of tuberculosis3 ( 7%) Microbiological confirmation†Microbiological confirmation by positive sputum GeneXpert.29 ( 66%) HIV positive0Fever for 1 week40 ( 91%) Gastrointestinal symptoms‡Gastrointestinal symptoms defined as presence of abdominal pain or diarrhoea at the time of stool collection.32 ( 73%) Abdominal pain1 ( 25%) Diarrhoea27 ( 61%) Antibiotic use before stool collection40 ( 91%) Non-dispersible ( crushed) tuberculosis drug preparation41 ( 93%) Number of enteropathogens detected per participant06 ( 14%) 17 ( 16%) 213 ( 30%) 314 ( 32%) 42 ( 5%) 51 ( 2%) 61 ( 2%) Enteropathogens detected2·1 ( 1·3) Bacterial enteropathogens1·3 ( 1·0) Enteroaggregative Escherichia coli28 ( 64%) Clostridioides difficile23 ( 52%) Campylobacter9 ( 20%) Typical enteropathogenic E coli9 ( 20%) Enterotoxigenic E coli8 ( 18%) Shigella3 ( 7%) Atypical enteropathogenic E coli3 ( 7%) Helicobacter pylori2 ( 5%) Shiga-toxin-producing E coli1 ( 2%) Salmonella1 ( 2%) Viral enteropathogens0·4 ( 0·5) Sapovirus9 ( 20%) Norovirus8 ( 18%) Adenovirus2 ( 5%) Astrovirus2 ( 5%) Parasitic enteropathogens0·5 ( 0·6) Giardia16 ( 34%) Cryptosporidium4 ( 9%) Enterocytozoon bieneusi3 ( 7%) Data are n (%), mean ( SD), or median ( IQR) unless otherwise specified. Enteropathogens not depicted were not detected. BMI=body mass index. * Moderate or severe malnutrition defined as weight-for-age, height-for-age or BMI-for-age Z score less than −2.† Microbiological confirmation by positive sputum GeneXpert.‡ Gastrointestinal symptoms defined as presence of abdominal pain or diarrhoea at the time of stool collection. Open table in a new tab
Data are n (%), mean ( SD), or median ( IQR) unless otherwise specified. Enteropathogens not depicted were not detected. BMI=body mass index.
The prevalence of individual enteropathogens as determined by stool PCR is shown in table 1. Of note, C difficile was detected in 23 ( 52%) participants; rates of other enteropathogens detected were otherwise consistent with studies from the past decade of children 2 years or younger without tuberculosis, conducted at the same location.8Rogawski ET Liu J Platts-Mills JA et al.Use of quantitative molecular diagnostic methods to investigate the effect of enteropathogen infections on linear growth in children in low-resource settings: longitudinal analysis of results from the MAL-ED cohort study.Lancet Glob Health. 2018; 6: e1319-e1328Google Scholar After excluding enteroaggregative E coli—which was detected in the majority of participants, can frequently be asymptomatic,17Walker CLF Rudan I Liu L et al.Global burden of childhood pneumonia and diarrhoea.Lancet. 2013; 381: 1405-1416Google Scholar, 18Gurumurthy P Ramachandran G Hemanth Kumar AK et al.Malabsorption of rifampin and isoniazid in HIV-infected patients with and without tuberculosis.Clin Infect Dis. 2004; 38: 280-283Google Scholar and nearly always co-occurred with a second enteropathogen that could better explain gastrointestinal symptoms—38 ( 86%) participants had one or more enteropathogens detected in stool, with a mean of 2·1 pathogens ( SD 1·3) per participant. Bacterial enteropathogens were most commonly detected, with a mean of 1·3 pathogens ( 1·0) per participant, followed by parasitic pathogens with a mean of 0·5 ( 0·6), and viral pathogens with a mean of 0·4 ( 0·5).
A summary of serum pharmacokinetic measurements is shown in table 2. Target peak concentrations of rifampicin were reached in eight ( 18%) of 44 participants, isoniazid in 24 ( 53%) of 44 participants, pyrazinamide in 28 ( 62%) of 38 participants, and ethambutol in six ( 15%) of 39 participants. Antimycobacterial Cmax and AUC0–24 values were modelled as functions of enteropathogen burden and shown in figure 1, including all 44 children in the model. There were a few significant results, including decreased rifampicin AUC0–24 associated with detection of any additional enteropathogen, rifampicin Cmax and ethambutol Cmax with bacterial pathogens, and isoniazid Cmax with viral pathogens. Detection of each additional enteropathogen of any type among individuals with gastrointestinal symptoms was associated with a 27% reduction in rifampicin AUC0–24 ( 95% CI −47 to −1) ( figure 1). Each additional bacterial pathogen among individuals with gastrointestinal symptoms was associated with a 40% lower rifampicin Cmax ( 95% CI −62 to −5) and a 36% lower ethambutol Cmax ( 95% CI −52 to −14), while each additional viral pathogen was associated with a 51% lower isoniazid Cmax ( 95% CI −75 to −7).Figure 1Combined effect of enteropathogen burden and gastrointestinal symptoms on Cmax and AUC0–24Show full captionCmax=peak drug concentration. AUC0–24=total exposure area under the concentration curve over 24 hs ( A) Percentage change in Cmax per pathogen detected. ( B) Percentage change in AUC0–24 per pathogen detected. Log-Cmax and log-AUC0–24 were modelled as functions of enteropathogen burden and the presence of gastrointestinal symptoms. Estimates were back-transformed to calculate the relative change in Cmax or AUC0–24. Estimates were adjusted for mg/kg drug dose, age, sex, and body-mass index Z score. 95% CIs are shown and are truncated above 100%. Results from bivariable analysis without adjustment for covariates are available in the appendix pp 5–6.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Cmax=peak drug concentration. AUC0–24=total exposure area under the concentration curve over 24 hs ( A) Percentage change in Cmax per pathogen detected. ( B) Percentage change in AUC0–24 per pathogen detected. Log-Cmax and log-AUC0–24 were modelled as functions of enteropathogen burden and the presence of gastrointestinal symptoms. Estimates were back-transformed to calculate the relative change in Cmax or AUC0–24. Estimates were adjusted for mg/kg drug dose, age, sex, and body-mass index Z score. 95% CIs are shown and are truncated above 100%. Results from bivariable analysis without adjustment for covariates are available in the appendix pp 5–6.
To further characterise enteropathy, faecal myeloperoxidase and α1-antitrypsin were quantified in 43 ( 98%) participants ( table 3). Myeloperoxiase and α1-antitrypsin was not quantified in one participant due to assay failure. Median stool myeloperoxidase concentration was 1574 ng/mL ( IQR 597–3806; normal range < 2000 ng/mL) and median α1-antitrypsin was 217 μg/mL ( 146–438; normal range < 270 μg/ml). 19 ( 44%) had elevated myeloperoxidase and 15 ( 35%) participants had elevated α1-antitrypsin concentrations. Of 31 participants with gastrointestinal symptoms, 19 ( 61%) had at least one abnormal biomarker, compared with four ( 33%) of 12 without gastrointestinal symptoms ( p=0·10). Relationships of stool pathogen burden and either myeloperoxidase or α1-antitrypsin concentrations were not observed in bivariable regression ( appendix p 7).Table 3Stool myeloperoxidase and α1-antitrypsin concentrationsAll participants ( n=43) Gastro-intestinal * Gastrointestinal symptoms of diarrhoea or abdominal pain. symptoms ( n=31) No gastro-ntestinal symptoms ( n=12) p-value†Comparisons between results in those with gastrointestinal symptoms and those without gastrointestinal symptoms were calculated by Mann-Whitney U test for continuous variables and by Fisher's exact test for categorical variables.MyeloperoxidaseConcentration, ng/mL1574 ( 597–3806) 2225 ( 812–4033) 663 ( 295–2335) 0·088Number elevated‡Defined as myeloperoxidase > 2000 ng/mL.19 ( 44%) 16 ( 52%) 3 ( 25%) 0·11α1-antitrypsinConcentration, μg/mL217 ( 146–438) 257 ( 142–475) 211 ( 186–261) 0·80Number elevated§Defined as α1-antitrypsin > 270 μg/mL.15 ( 35%) 13 ( 42%) 2 ( 17%) 0·12Total number of elevated myeloperoxidase or α1-antitrypsin23 ( 53%) 19 ( 61%) 4 ( 33%) 0·10Data are n (%) or median ( IQR) unless otherwise specified. * Gastrointestinal symptoms of diarrhoea or abdominal pain.† Comparisons between results in those with gastrointestinal symptoms and those without gastrointestinal symptoms were calculated by Mann-Whitney U test for continuous variables and by Fisher's exact test for categorical variables.‡ Defined as myeloperoxidase > 2000 ng/mL.§ Defined as α1-antitrypsin > 270 μg/mL. Open table in a new tab
Data are n (%) or median ( IQR) unless otherwise specified.
Detection of each additional enteropathogen among children with an abnormal myeloperoxidase or α1-antitrypsin ( rather than gastrointestinal symptoms) demonstrated similar inverse associations with Cmax and AUC0–24, although most did not reach statistical significance ( supplemental figure 3; appendix p 8). Additionally, gastrointestinal symptoms or pathogen burden alone did not significantly affect pharmacokinetic measurements independently of each other in controlled comparisons ( appendix pp 9–10), suggesting pathogen burden has a negative association with drug concentrations but only in the setting of clinical findings consistent with enteropathy.
Given the variety of individual pathogens detected, relationships of individual pathogens with pharmacokinetic measurements were considered exploratory but were modelled using the same approach ( figure 2). The detection of typical enteropathogenic E coli among individuals with gastrointestinal symptoms was associated with a 79% reduction in rifampicin Cmax ( 95% CI −93 to −36), a 63% lower isoniazid Cmax ( −84 to −13), a 68% lower ethambutol Cmax ( −85 to −30), and a 71% lower rifampicin AUC0–24 ( 95% CI −91 to −4) compared with patients with gastrointestinal symptoms but without typical enteropathogenic E coli. Enterotoxigenic E coli was associated with a 70% lower rifampicin Cmax ( −91 to −4), sapovirus with a 69% lower rifampicin Cmax ( −90 to −5), norovirus with a 72% lower isoniazid AUC0–24 ( −90 to −24·4), and Giardia was associated with a 65% lower pyrazinamide Cmax ( −86 to −12).Figure 2Combined effect of individual enteropathogens and gastrointestinal symptoms on Cmax and AUC0–24Show full captionE Coli=Escherichia coli. C difficile=Clostridiodies difficile. Cmax=peak drug concentration. AUC0–24=total exposure area under the concentration curve over 24 hs. ( A) Percentage change in Cmax associated with pathogen detection. ( B) Percentage change AUC0–24 associated with pathogen detection. Log-Cmax and log-AUC0–24 were modelled as functions of enteropathogen burden and the presence of gastrointestinal symptoms. Estimates were back-transformed to calculate the relative change in Cmax or AUC0–24. Estimates were adjusted for mg/kg drug dose, age, sex, and body-mass index Z score. 95% CIs are shown and are truncated above 100%.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
E Coli=Escherichia coli. C difficile=Clostridiodies difficile. Cmax=peak drug concentration. AUC0–24=total exposure area under the concentration curve over 24 hs. ( A) Percentage change in Cmax associated with pathogen detection. ( B) Percentage change AUC0–24 associated with pathogen detection. Log-Cmax and log-AUC0–24 were modelled as functions of enteropathogen burden and the presence of gastrointestinal symptoms. Estimates were back-transformed to calculate the relative change in Cmax or AUC0–24. Estimates were adjusted for mg/kg drug dose, age, sex, and body-mass index Z score. 95% CIs are shown and are truncated above 100%.
Although a growing evidence base suggests that optimal pharmacokinetic exposure is critical for successful treatment of tuberculosis, our understanding of the determinants of pharmacokinetic variability remains incomplete, particularly among paediatric populations. In this study of children undergoing first-line tuberculosis treatment in rural Tanzania, we found that the majority of participants had antimycobacterial drug concentrations below target and that intestinal pathogens were common. Enteropathogen burden was identified as a significant risk factor for decreased serum antimycobacterial drug concentrations among participants with symptoms consistent with enteropathy, these participants represented the majority of the study population.
Despite a relatively small number of participants, we found that each additional enteropathogen was negatively associated with rifampicin AUC0–24, that bacterial enteropathogens were associated with decreased rifampicin and ethambutol peak concentrations, and that viral enteropathogens were associated with lower isoniazid Cmax peak concentrations among participants with gastrointestinal symptoms. Suboptimal serum isoniazid concentrations in this study can partly be explained by the low median dose of 6 mg/kg despite a recommended dose of 10 mg/kg,5WHOGuidance for national tuberculosis programmes on the management of tuberculosis in children.https: //apps.who.int/iris/bitstream/handle/10665/112360/9789241548748 eng.pdf; jsessionid=15F070C2FF9EEE9C1BE549B5ECDDA24F? sequence=1Date: 2014Date accessed: June 8, 2020Google Scholar which was a consequence of the intermittent availability of paediatric fixed-dose combinations that matched the updated guidelines at the time of study. However, rifampicin, pyrazinamide, and ethambutol were adequately dosed, yet target Cmax and AUC0–24 were still infrequently achieved.
The identification of enteropathogen burden as a risk factor for suboptimal antimycobacterial pharmacokinetics has far-reaching implications. Diarrhoeal disease is globally recognised as a major cause of childhood illness, and despite improvements in global mortality within the past decade, it continues to be a major cause of childhood morbidity, particularly in low-income and middle-income countries where the prevalence of paediatric tuberculosis is greatest.17Walker CLF Rudan I Liu L et al.Global burden of childhood pneumonia and diarrhoea.Lancet. 2013; 381: 1405-1416Google Scholar The low attainment of target drug concentrations in our work is consistent with a growing number of pharmacokinetic studies performed among children with tuberculosis in endemic areas.6Kwara A Enimil A Gillani FS et al.Pharmacokinetics of first-line antituberculosis drugs using WHO revised dosage in children with tuberculosis with and without HIV coinfection.J Pediatric Infect Dis Soc. 2016; 5: 356-365Google Scholar, 7Justine M Yeconia A Nicodemu I et al.Pharmacokinetics of first-line drugs among children with tuberculosis in rural Tanzania.J Pediatric Infect Dis Soc. 2020; 9: 14-20Google Scholar Our findings suggest that enteropathogen burden might play a previously under recognised, antagonistic role in the pharmacotherapy of paediatric patients with tuberculosis, and warrants further study in larger and more diverse paediatric settings in tuberculosis endemic regions.
Our hypothesis that enteropathogen burden would affect serum drug concentrations assumed a primary mechanism of malabsorption due to intestinal infection. Both enteropathogen burden and tuberculosis disease are independently associated with impaired small bowel absorptive function,10Lee GO McCormick BJJ Seidman JC et al.Infant nutritional status, feeding practices, enteropathogen exposure, socioeconomic status, and illness are associated with gut barrier function as assessed by the lactulose mannitol test in the MAL-ED birth cohort.Am J Trop Med Hyg. 2017; 97: 281-290Google Scholar, 11Pinheiro VG Ramos LM Monteiro HS et al.Intestinal permeability and malabsorption of rifampin and isoniazid in active pulmonary tuberculosis.Braz J Infect Dis. 2006; 10: 374-379Google Scholar and malabsorption has been implicated in causing low concentrations of rifampicin and isoniazid among patients with HIV, tuberculosis disease, and diarrohea.18Gurumurthy P Ramachandran G Hemanth Kumar AK et al.Malabsorption of rifampin and isoniazid in HIV-infected patients with and without tuberculosis.Clin Infect Dis. 2004; 38: 280-283Google Scholar We found that faecal myeloperoxidase ( a marker of intestinal inflammation) and α1-antitrypsin ( a marker of intestinal permeability) were commonly above the normal range in this study; 19Praharaj I Revathy R Bandyopadhyay R et al.Enteropathogens and gut inflammation in asymptomatic infants and children in different environments in southern India.Am J Trop Med Hyg. 2018; 98: 576-580Google Scholar, 20Prata MM Havt A Bolick DT Pinkerton R Lima A Guerrant RL Comparisons between myeloperoxidase, lactoferrin, calprotectin and lipocalin-2, as fecal biomarkers of intestinal inflammation in malnourished children.J Transl Sci. 2016; 2: 134-139Google Scholar although, we did not find these markers to be directly associated with pharmacokinetic measurements.
Several of the individual pathogens identified as associated with poor pharmacokinetics are also notable causes of intestinal inflammation or permeability. Typical enteropathogenic E coli was associated with decreased rifampicin, isoniazid, and ethambutol peak concentrations, as well as a reduction in rifampicin AUC0–24, and particularly among young children it is a cause of gastroenteritis and malabsorption.21Hu J Torres AG Enteropathogenic Escherichia coli: foe or innocent bystander?.Clin Microbiol Infect. 2015; 21: 729-734Google Scholar Sapovirus and norovirus were associated with significant reductions in isoniazid exposure and rifampicin Cmax, respectively, and additional presence of any viral species significantly reduced isoniazid Cmax. Peak concentrations of isoniazid might be specifically blunted with viral pathogens as isoniazid is more diffusely absorbed throughout the small bowel and not in the stomach, which is the primary site for rifampicin absorption.12Mariappan TT Singh S Regional gastrointestinal permeability of rifampicin and isoniazid ( alone and their combination) in the rat.Int J Tuberc Lung Dis. 2003; 7: 797-803Google Scholar Commonly detected viral pathogens in this study, norovirus and the related sapovirus of the Caliciviridae family, lead to primary inflammation in the jejunum but notably spare the stomach.22Schreiber DS Blacklow NR Trier JS The mucosal lesion of the proximal small intestine in acute infectious nonbacterial gastroenteritis.N Engl J Med. 1973; 288: 1318-1323Google Scholar That inflammatory process can lead to gastric emptying, which would more severely affect isoniazid absorption compared with pyrazinamide ( a drug that is exceedingly well absorbed) or rifampicin.23Meeroff JC Schreiber DS Trier JS Blacklow NR Abnormal gastric motor function in viral gastroenteritis.Ann Intern Med. 1980; 92: 370-373Google Scholar, 24Chirehwa MT McIlleron H Rustomjee R et al.Pharmacokinetics of pyrazinamide and optimal dosing regimens for drug-sensitive and -resistant tuberculosis.Antimicrob Agents Chemother. 2017; 61: e00490-e00517Google Scholar
Giardia was the most frequently detected parasitic pathogen; yet, unexpectedly we observed a negative association between Giardia carriage and pyrazinamide Cmax levels, but not with rifampicin, isoniazid, or ethambutol concentrations. It would be unusual for malabsorption of any cause to affect pyrazinamide but not the other first-line drugs. Yet, one possible explanation is increased metabolism of pyrazinamide in children with giardiasis. Xanthine oxidase, which converts pyrazinamide into 5-hydroxypyrazinamide, is expressed in the liver and is also found in high concentrations in the gut.25Auscher C Amory N van der Kemp P Delbarre F Xanthine oxidase activity in human intestines. Histochemical and radiochemical study.Adv Exp Med Biol. 1979; 122B: 197-201Google Scholar The immunopathogenesis of Giardia infection is complex and differs from other pathogens detected in this cohort; paradoxically, it has been associated with a decreased risk for diarrhoea as well as reductions in faecal myeloperoxidase and systemic C-reactive protein.26Rogawski ET Bartelt LA Platts-Mills JA et al.Determinants and impact of Giardia infection in the first 2 years of life in the MAL-ED birth cohort.J Pediatric Infect Dis Soc. 2017; 6: 153-160Google Scholar Importantly, Giardia induces a lymphocytic inflammation with a prominent increase in interferon-γ,27Ebert EC Giardia induces proliferation and interferon gamma production by intestinal lymphocytes.Gut. 1999; 44: 342-346Google Scholar which is among the strongest inducers of xanthine oxidase.28Page S Powell D Benboubetra M et al.Xanthine oxidoreductase in human mammary epithelial cells: activation in response to inflammatory cytokines.Biochim Biophys Acta. 1998; 1381: 191-202Google Scholar Giardiasis might therefore alter pyrazinamide metabolism via these immunomodulatory changes but would require a dedicated experimental design to best investigate.
This study had other limitations. First, although stool samples were collected and enteropathogen burden was quantified at the time of treatment initiation, serum drug concentrations were not measured until the second week of treatment. Bacterial pathogen carriage could have been altered with rifampicin administration, or new enteropathogens could have been acquired before pharmacokinetic measurement; in addition, some children had been on antimicrobials for up to 72 h before stool collection. Second, the high rates of C difficile found in this study must be interpreted cautiously; although the assay used a toxin-specific nucleic acid target, confirmatory assays were not performed. Children ultimately diagnosed with tuberculosis disease frequently undergo several rounds of antibiotic therapy before diagnosis, which likely contributes to gut microbiome dysbiosis and allows C difficile proliferation. While often overlooked in tuberculosis endemic areas, C difficile has been recognised as an important cause of hospital-acquired and nosocomial diarrhoea in resource-limited settings,29Roldan GA Cui AX Pollock NR Assessing the burden of Clostridium difficile infection in low- and middle-income countries.J Clin Microbiol. 2018; 56: e01747-e01817Google Scholar and it has increasingly been recognised as a complication of tuberculosis therapy.30Obuch-Woszczatyński P Dubiel G Harmanus C et al.Emergence of Clostridium difficile infection in tuberculosis patients due to a highly rifampicin-resistant PCR ribotype 046 clone in Poland.Eur J Clin Microbiol Infect Dis. 2013; 32: 1027-1030Google Scholar Third, a functional investigation ( such as lactulose mannitol excretion tests) would be better than myeloperoxidase and α1-antitrypsin to characterise gut disruption and absorptive capacity and establish a mechanistic link between enteropathogen burden and pharmacokinetics. Fourth, N-acetyltransferase 2 ( NAT2) genotyping, which can be predictive of isoniazid metabolism was not included, but it might have less impact in younger children for whom NAT2 enzymatic maturation is incomplete.31Rogers Z Hiruy H Pasipanodya JG et al.The non-linear child: ontogeny, isoniazid concentration, and nat2 genotype modulate enzyme reaction kinetics and metabolism.EBioMedicine. 2016; 11: 118-126Google Scholar Fifth, the study analyses included 44 participants, although this was sufficient to describe several significant effects of enteropathogen burden on antimycobacterial drug concentrations, to determine generalisability these findings will require confirmation in other comparable cohorts; to determine the impact of individual pathogens these findings will require confirmation with larger cohorts; and to allow more complete assessment of total serum exposures these findings will require confirmation with more extensive sampling strategies and at different days within the total treatment duration. Finally, given the exploratory nature of the study, a large number of analyses were performed without adjustment for multiple comparisons, further necessitating confirmatory studies.
In summary, children treated for tuberculosis disease in rural Tanzania rarely attained pharmacokinetic targets. Enteropathogen burden was identified as a risk factor for subtarget serum concentrations of rifampicin, isoniazid, and ethambutol. Future work should involve further characterisation of the mechanistic explanations of these findings, confirmation within larger and more diverse cohorts of children from other tuberculosis endemic settings, and lastly testing of interventions to ameliorate enteropathogen burden to improve antimycobacterial pharmacokinetic target attainment or to personalise tuberculosis treatment based on point-of-care knowledge of an individual's pharmacokinetics.
SKH, TAT, ERH, and DVA conceptualised and designed the study. DVA, MJ, TAT, and SKH verified the source data. MJ, EM, and SGM managed patient recruitment and oversaw the study sites. MHA and CAP collected and analysed pharmacokinetic data. DVA, BM, AM, JG, MK, and JL contributed to data collection. DVA, MK, JL, ETRM, ERH, TAT, and SKH interpreted the data. DVA and ETRM performed statistical analysis. DVA wrote the first draft of the manuscript and produced the figures. All authors revised and edited the final version of the manuscript. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.
The primers list for multiplex PCR of enteropathogens are available in the appendix pp 3–4. Other metadata and standard operating procedures for PCR testing are available upon request to the corresponding author.
We declare no competing interests.
This work was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health ( NIH). SKH and ERH received grant U01AI115594 from the National Institute of Allergy and Infectious Diseases of the NIH. DVA received training grant, T32AI007046, from the National Institute of Allergy and Infectious Diseases of the NIH. We are grateful to the community of Haydom, Tanzania, and the Haydom Lutheran Hospital; and we are indebted to the parents, guardians, and participants for their generosity in participating in the study.
Download.pdf ( 2.71 MB) Help with pdf files Supplementary appendix
The association between enteropathogens and antimycobacterial drug pharmacokinetics in childrenThere were an estimated 1·09 million incident tuberculosis cases resulting in 226 000 deaths in children globally in 2020.1 The COVID-19 pandemic is reversing recent progress, meaning tuberculosis remains a major public health problem in children.1,2 First-line tuberculosis treatment relies on rifampicin, isoniazid, pyrazinamide, and ethambutol.3 In response to evidence of low exposures to first-line tuberculosis drugs in children, WHO recommended paediatric doses of rifampicin, isoniazid, and pyrazinamide were increased in 2010; 3 however, even with the recommended higher doses, studies continue to demonstrate low exposures to these drugs in children, especially for the crucial drug rifampicin. Full-Text PDF Open Access | tech |
A Conversation with Achim Steiner on Competing Crises, Fragility, and UNDP's Role in a Changing World | Members of the international community will soon gather in Washington and online for World Bank - International Monetary Fund Spring Meetings. Conversations will focus on the climate crisis, COVID-19 response and recovery, and shrinking fiscal space—all with the world in upheaval over Ukraine, Afghanistan, and other crises and strained further by a pandemic that is far from over.
Please join us for a conversation between the United Nations Development Programme Administrator Achim Steiner and CGD President Masood Ahmed, who will explore UNDP's role in helping to address today’ s global challenges.
Please submit questions to events @ cgdev.org, Tweet @ CGDev # CGDTalks, or send comments via YouTube. | general |
ABIONYX Pharma Reports Positive Interim Results From Phase 2a Clinical Trial Evaluating CER-001 in the Treatment of Septic Patients at High Risk of Developing Acute Kidney Injury | TOULOUSE, France & LAKELAND, Mich. -- ( BUSINESS WIRE) -- Regulatory News:
ABIONYX Pharma ( FR0012616852 – ABNX – PEA PME eligible), a new generation biotech company dedicated to the discovery and development of innovative therapies for patients, today reported positive interim results of an open-label Phase 2a clinical trial evaluating CER-001 as a treatment for septic patients at high risk of developing Acute Kidney Injury ( AKI).
The RACERS study aims to include 20 patients with gram-negative sepsis who are at high risk for acute kidney injury due to high levels of endotoxin activity and decline in function of one or more organ systems. Completion of the study has been delayed due to the COVID pandemic, which has limited availability of critical care beds and medical staff for non-COVID patients, since the first study patient was enrolled in June 2021. To date, thirteen patients have been enrolled and seven remain to be recruited. An interim review for the first ten patients to complete the study has been performed.
Compared to standard of care therapy, CER-001 rapidly improved biomarkers of inflammation including leukocytosis, and endothelial dysfunction, preventing septic patients’ decline into acute kidney injury. CER-001 treatment was well tolerated at all dose levels ( 5, 10 and 20 mg/kg, twice a day). No treatment-related serious side effects were seen in this critically ill patient population.
Loreto Gesualdo, full Professor, Head of the Nephrology, Dialysis and Transplantation unit, University of Bari Aldo Moro, Italy and lead investigator of the RACERS study stated: “ This is the first study in humans using a recombinant Bio-HDL to treat acutely ill septic patients. The results to date with CER-001 are consistent with the known pleiotropic effects of HDL, scavenging endotoxin, reversing the cytokine cascade and improving endothelial function. Response to CER-001 treatment was rapid, relative to standard of care therapy, with clinical benefit demonstrated as soon as Day 3. These preliminary data reproduce the results we observed in our pre-clinical swine model of sepsis-induced AKI. We look forward to completing the study and using the results to design the phase 2/3 study. ”
Connie Peyrottes, Senior VP clinical development at ABIONYX Pharma, added: “ We believe the interim results from the RACERS study represent a unique opportunity for ABIONYX in the sepsis landscape, and suggest that CER-001 may have utility as a safe and effective treatment for critical illnesses marked by inflammation and organ failure across different high mortality clinical indications with high unmet medical needs. ”
Cyrille Tupin CEO of ABIONYX concluded: “ The promising interim results of this Phase 2a study confirm that CER-001 could potentially fill a void that exists in treating sepsis and other severe, acute inflammatory diseases. If consistent results are found in the remaining patients, these results, along with the recently published results in COVID-19, support our strategic decision to develop bio-HDL as short-term therapy for acute conditions. ”
Next financial press release: Annual Results, April 28th 2022 | general |
OPEC+ crude production falls as sanctions take bite out of Russia: S & P Global survey | Ira Joseph, directora de gas y electricidad de Platts Analytics, y Ryan Ouwerkerk, director de...
Brazil's Buzios crude is set to make further inroads into China in the coming months, as production...
OPEC is more bullish on the global economic recovery for next year, projecting world oil demand to...
Gap between oil output, quotas grows to a record 1.24 mil b/d
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Crude oil production by OPEC and its allies fell in March from February for the first time in more than a year, the latest S & P Global Commodity Insights survey found, contributing to a tightening market thrown in flux by the Russia-Ukraine war.
Western sanctions began biting into primary non-OPEC partner Russia's oil flows, and sizable disruptions in Kazakhstan and Libya also led the coalition's production lower, the survey found.
OPEC's 13 members raised output by 60,000 b/d to 28.73 million b/d, but that was more than offset by a 160,000 b/d decline by the bloc's nine allies, who pumped 13.91 million b/d.
With the net decline of 100,000 b/d, the widening gap between the OPEC+ production and quotas jumped to a record-high 1.24 million b/d—casting further doubt on the group's ability to meet growing global oil demand, which many analysts expect to return to pre-pandemic levels in 2022.
The drop was the first since February 2021, when Saudi Arabia instituted a unilateral voluntary 1 million b/d cut to help prop up the market that at the time was still wobbly from resurgent coronavirus cases.
Since August, with the global economy on firmer footing, the producer group has stuck to a plan of gradually raising quotas by 400,000 b/d each month but has faced mounting pressure from the US, India, Japan, and other major oil-consuming nations for accelerated supplies to cool off rising energy prices.
But several countries have not hit their output targets in months, and March's shortfall resulted in a compliance figure of 148% for the 19 members with quotas, according to S & P Global calculations. Iran, Libya, and Venezuela are exempt from quotas under the OPEC+ agreement.
Concerns over OPEC+ production capabilities, in combination with the Russia-Ukraine war and recovering oil demand, have helped lift the Platts Dated Brent benchmark to nearly $ 140/b in recent weeks, although it dropped to $ 98.28/b April 7 as the International Energy Agency announced a 120 million barrel stock release from strategic petroleum reserves, led by the US. OPEC+ officials have attributed the volatility to geopolitics, and not market fundamentals.
OPEC kingpin Saudi Arabia, one of just a handful of countries that appears to hold significant spare capacity, kept its production steady in March at 10.25 million b/d, the survey found. Ship-tracking data indicated its exports fell during the month, but several analysts surveyed cited increased refinery runs and said storage volumes may have also increased.
Non-OPEC leader Russia, hit by western sanctions targeting its financial sector, saw its crude production fall to 10.04 million b/d, the survey found. Many traders have stopped transacting with Russian commodities, and analysts expect production shut-ins to build up in April and May, though some flows are shifting to Asian customers.
Both Saudi Arabia and Russia had quotas of 10.33 million b/d for the month.
Neighboring Kazakhstan saw the biggest fall in production, with storm damage to the loading terminal of the CPC pipeline causing major disruptions. Kazakh output was 1.55 million b/d in March, and officials have warned of further impacts in April from the outage.
Libyan output fell 50,000 b/d in March, with the country's largest oil field, Sharara, shut from March 3-8 due to civil unrest. The Elephant, or El Feel, field remains offline due to sabotage, officials have said.
Among the gainers, Iraq saw the largest rise, pumping 4.34 million b/d, slightly under its quota of 4.37 million b/d.
The country brought back its giant West Qurna 2 field from maintenance about two weeks early in early March and also saw its Nassiriya field disrupted for a few days at the start of the month because of protests. Sources and satellite data indicated considerable inventory builds.
Venezuela posted a 40,000 b/d gain in March, the survey found, benefitting from the arrival of two cargoes of Iranian condensate that enabled a production rebound in the Orinoco Belt. Extracting the region's extra-heavy crude requires diluent, which US sanctions have made it difficult for Venezuela to obtain, although Iran has been sending cargoes under a bilateral agreement.
The survey figures, which measure wellhead production, are compiled using information from oil industry officials, traders, and analysts, as well as reviewing proprietary shipping, satellite, and inventory data.
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New Zealand Households Are Spending Less as Cost of Living Rises | The information you requested is not available at this time, please check back again soon.
Pedestrians walk past cafes and restaurants in Auckland, New Zealand, on Sunday, Dec. 5, 2021. New Zealand’ s largest city has exited lockdown, bringing relief to its residents but also signaling the likely spread of Covid-19 to the rest of the country., Bloomberg
( Bloomberg) -- New Zealanders are starting to spend less in response to rising fuel prices and other living costs, according to a survey of Westpac customers.
Surging inflation is the biggest financial concern for consumers ahead of the impact of Covid-19 and the war in Ukraine, Westpac said in a statement released Friday in Wellington. The survey found that 44% of people are already spending less on petrol, 43% are cutting back on takeaways and dining out, and 41% have reduced grocery costs.
New Zealand’ s economy is set to slow in 2022 as the central bank raises interest rates to combat the surge in inflation, which has climbed to the highest in more than 30 years. Evidence that the rising cost of living is curbing consumer spending adds to signs that the slowdown could be sharper than expected, with some economists warning growth may stall in the first half of the year.
Still, 69% of those surveyed reported they are confident they can cope with the cost of living increase, and 58% have already cut back on unnecessary or wasteful spending, Westpac said.
The survey of 1,618 Westpac customers was conducted March 17-23. It found 36% of New Zealanders have asked or are planning to ask for a pay rise, while 41% are considering looking for a higher-paying job.
Here are nine things you need to know about Budget 2022.
The federal government is taking sharper aim at real estate investors and property flippers in a bid to help halt the country’ s long-standing – and worsening – housing affordability problem.
The Liberal government is scaling back its strategy to single out Canada's most profitable banks and insurers with targeted tax measures, resulting in about $ 4 billion less in revenue than originally planned. | general |
Trudeau Hits Canadian Banks and Insurers With Billions in Taxes | The information you requested is not available at this time, please check back again soon.
Bank towers stand in the financial district of Toronto., Bloomberg
( Bloomberg) -- Finance Minister Chrystia Freeland is imposing a one-time windfall levy on Canada’ s major banks and permanently increasing their income tax rate, fulfilling an election promise that has raised the ire of the industry’ s top executives.
The measures will force banks and insurance companies to pay an additional C $ 6.1 billion ( $ 4.8 billion) in tax over five years, according to Freeland’ s budget plan released Thursday. The new taxes are virtually certain to be implemented because Prime Minister Justin Trudeau has already secured the support of a left-leaning opposition party to pass the budget law.
The government said that massive, government-funded Covid-19 support programs have helped the financial sector recover faster than other parts of the economy, and now it’ s time to pay some back.
Trudeau’ s plan to hit finance with a larger tax bill has been met sharp criticism from executives, who have said it will take capital away from lending and harm investors’ perception of Canada.
“ Not only is the bank tax a knee-jerk reaction that sends the wrong message to the global investment community, it is ultimately a tax on you, our shareholders -- approximately 70% of whom are Canadian, ” Bank of Nova Scotia CEO Brian Porter said in remarks prepared for the bank’ s annual meeting this week. He didn’ t end up delivering the speech because he came down with Covid-19.
The windfall tax of 15% applies to taxable income earned last year by banks and insurers in Canada over C $ 1 billion. That will force them to pay about C $ 4.1 billion, sliced into payments from 2022 to 2027, according to budget documents.
But the government did not go quite as far in increasing the banks’ income tax rate as Trudeau had threatened to during last year’ s election campaign. The prime minister had pledged to increase the maximum federal income rate for financial institutions to 18% from 15%.
Instead, Freeland is lifting it to 16.5%, but lowering the threshold at which the new rate will apply. That measure will mean about C $ 2 billion in additional taxes over five years, government estimates show.
This U.S. legislation is a game changer: Curaleaf executive chairman
U.S. democratic senators to unveil draft cannabis reform bill on Wednesday: Report | general |
War in Ukraine Is Adding to Humanitarian Needs Elsewhere. Diverting Aid to Ukraine Will Make That Worse. | International focus is understandably on the shocking return of armed conflict in Europe. But alongside that crisis, there are already dire humanitarian crises around the world which are being exacerbated by price spikes in oil and food. There will be dire consequences for millions of people who depend on humanitarian support if the international community neglects the conflict’ s wider risks by only responding to the immediate crisis in Ukraine.
In this blog, we take a critical look at humanitarian needs around the world, consider how heightened food and energy prices are exacerbating those crises, identify existing and new countries at risk, and look at the major donors’ resources to respond to those needs. We find that resources and attention are being diverted to Ukraine, rather than expanded, and argue that policymakers must recognise the severity of the crises beyond Ukraine and take urgent steps to avert human suffering and contribute to stability.
Although global extreme poverty continued to fall steadily until COVID-19 hit, the number of people facing acute risks to their welfare increased over the last decade. In the last decade, the unresolved conflicts in Syria, Libya, and Yemen, grave ongoing problems in the Horn of Africa, a sharply deteriorating situation in the Lake Chad Basin and central Sahel, and high levels of ongoing need in the Democratic Republic of the Congo ( exacerbated by repeated Ebola outbreaks) have sent humanitarian needs to new highs. More recently, the war in northern Ethiopia, the collapse in Afghanistan, and now the invasion of Ukraine have only added to the number of crisis spots. Analysis of the UN’ s annual humanitarian overview report from 2017 to 2022 makes clear the rising trend in people in need. COVID has made things worse in the most vulnerable places, and added others to the UN’ s list of humanitarian focus countries. But the trend predates COVID and is driven mostly by conflict and climate change.
Figure 1. Global humanitarian assistance needs and UN humanitarian response, 2017-2022
As Figure 1 illustrates, UN humanitarian responses have not kept up with growing need. The ratio of people in need covered by UN response plans declined from 72 percent in 2017 to 67 percent in 2022, including a historic low of 65 percent in 2020. Since 2020, the socioeconomic impacts of COVID-19, combined with conflict and a spate of extreme climate events, have raised the number of people at risk of famine. These needs are highly concentrated: In 2022, half of the people in need of humanitarian assistance are in just ten countries ( Afghanistan, DRC, Ethiopia, Nigeria, Pakistan, Sudan, South Sudan, Syria, Venezuela, Yemen).
As the number of people in need of humanitarian assistance more than doubled in the last six years, financial appeals by the UN followed a similar growth path, increasing from $ 24 billion in 2017 to $ 43 billion in 2022. The international community has struggled to match this rise in need and the share of those appeals that have been met by donors dropped from 62 percent in 2017 to 50 percent in 2021.
Humanitarian responses in Ukraine have focused on support for those fleeing to become refugees ( primarily in neighbouring countries), people displaced inside the country ( mostly moving from areas in the east affected by fighting to safer locations further west), and civilians trapped and unable to escape the violence. Little help has so far reached those in the last category, largely because the Russians have failed to provide relief agencies with the normal guarantees of safe access.
So far, most of the burden has been shouldered by public bodies and host families in neighbouring states. But the UN, Red Cross, and international nongovernmental organisations ( NGOs) are scaling up quickly. Substantial amounts have been pledged, with the US alone announcing over $ 5 billion.
But there are two causes for concern. First, there are the spillover effects from the price spikes in food and oil and the effect of economic sanctions; and second, humanitarian aid is being diverted to Ukraine from other places, which risks making the situation in those places even worse.
Not all countries are equally exposed or vulnerable to the wider food security impacts of the invasion of Ukraine. Identifying these countries is important to prioritise support. Here we consider low- and middle-income countries that are exposed to the rising cost of grain imports, and then further filter this list to those which are also vulnerable due to pre-existing food insecurity.
We identify countries with significant exposure as those who would have to spend at least an additional 0.5 percent of gross national income ( GNI) to maintain their levels of wheat and maize imports despite rising prices. An alternative criterion is also used: annual wheat and maize imports exceeding 50kg per person ( equivalent to almost 500 calories per day). This captures additional countries which are significantly dependent on grain imports for survival, even if the rise in costs of these imports are less macroeconomically significant.
We also measure vulnerability as the share of the population already living under conditions of acute food insecurity, according to the Integrated Food Security Phase Classification ( specifically at phase 3 or higher: “ IPC3+ ”).
Table 1 below presents these exposed and vulnerable countries. It highlights 15 countries that are exposed to rising global grain prices and are known to have a population already facing acute food insecurity ( 11 of which are additional to the ten countries with the greatest humanitarian need already listed above).
Table 1. Low- and middle-income countries exposed * to rising grain prices and vulnerable with pre-existing food insecurity
* Exposure to rising global grain prices is defined as either: ( i) annual combined wheat and maize imports ≥50kg per person ( equivalent to almost 500 calories per day, assuming 3500 calories per kilogram of grain; note the L/MIC median is 52kg); or ( ii) an increase in the cost of wheat and maize imports ≥0.5% GNI, assuming no change in quantity imported ( capturing the upper quartile of L/MICs). * * Due to the 71% rise in the price of wheat and 29% rise in the price of maize between 2021 and March 2022. * * * Lebanon & Syria are missing IPC data, though they are known to have significant populations living under food insecurity.
Note: Some countries of concern are missing the import data needed to assess exposure, including Eritrea, Palestine, Somalia, and South Sudan.
Yemen and Afghanistan already face major humanitarian emergencies, and are now also exposed to rising grain prices. But beside those well-known cases are similarly exposed and vulnerable countries which may be overlooked. In Namibia, a quarter of households were assessed last October to be in urgent need of action to reduce malnutrition and protect livelihoods. In Central America, El Salvador, Honduras, and Guatemala are also highly dependent on grain imports, and significant shares of their population already face acute food insecurity. Smaller African countries like Djibouti, Lesotho and Eswatini are in a similar position, but risk escaping the notice of the international community.
An alternative lens to look at the vulnerability of countries exposed to sharp increases in food prices is whether they have the fiscal space to adequately respond to the crisis. Below we present countries macroeconomically exposed to rising grain prices, yet which we consider to have limited fiscal space based on the IMF’ s Debt Sustainability Analyses or our own stylized measure of ‘ fiscal strain’.
Egypt’ s exposure to imported wheat and its implications for government expenditure are well-understood, and the IMF and Saudi Arabia have provided support. But our analysis identities 15 other low- and middle-income countries with macroeconomic exposure to rising grain prices and fiscal challenges. Table 2 presents those countries with an increase in import costs of over 0.5 percent of GNI and which are either at risk of debt distress according to the IMF or are facing ‘ fiscal strain’ ( which we define as above-median government debt and a fiscal balance in the top quartile, limiting their ability to respond fiscally).
Table 2. Other low- and middle-income countries exposed * to rising grain prices and vulnerable with limited fiscal space
* Exposure to rising global grain prices is here defined as an increase in the cost of wheat and maize imports ≥0.5% GNI, assuming no change in quantity imported ( capturing the upper quartile of L/MICs). Note that an additional 13 L/MICs which do not meet this exposure criteria still have annual combined wheat and maize imports ≥50kg per person and either a risk of debt distress assessed to be moderate or greater, or are assessed to be facing fiscal strain. The full analysis is linked to below in this blog. * * Due to the 71% rise in the price of wheat and 29% rise in the price of maize between 2021 and March 2022. * * * In order to cover countries whose risk of debt distress is not analysed by the IMF, fiscal strain is here defined as above median government debt ( ≥60% GDP) combined with a fiscal balance in the top quartile of concern ( ≤-9% GDP). Sources: FAOSTAT Food Balances, World Bank Pink Sheet ( April 2022), World Bank World Development Indicators, IMF List of LIC DSAs for PRGT-Eligible Countries as of January 31, 2022, World Bank: A Cross-Country Database of Fiscal Space
These countries may face challenges in providing social support to their populations in response to price increases. Four countries with fiscal challenges can expect price increases of 1 percent of GNI or higher, and the IMF considers two of these as at high risk of debt distress: Mauritania and Tajikistan. For the latter, remittances are also projected to decline by 3.4 percent of GDP in 2022 as result of sanctions on Russia, further exacerbating food security concerns there. All told, we identify the top 15 countries whose acute humanitarian needs are likely to be significantly exacerbated due to the invasion of Ukraine ( Table 1), as well as a further 15 countries likely to face fiscal constraints in responding to the crisis ( Table 2). Many on this list have been neglected in discussion of the wider impacts of the invasion of Ukraine, though they should be prioritised for international support. The humanitarian and economic response to the food price crisis will need to go beyond the countries which currently draw most attention.
The full data and analysis behind tables 1 and 2 can be found here.
As illustrated by Figure 2, four donors have accounted for the vast majority of humanitarian funding in response to UN humanitarian appeals in recent years. In 2021, the United States, Germany, the United Kingdom and the European Commission represented close to 70 percent of the global response to the annual UN appeal. Drastic reductions in UK humanitarian funding as a result of the government’ s aid cuts have so far been partially offset by stronger efforts from the other big three. Overall, funding for the UN’ s humanitarian appeals grew from $ 14 billion in 2017 to $ 20 billion in 2020, but last year it stagnated even as needs grew–hence the increasing gap between the number of people in need and the number actually helped.
Figure 2. Largest sources of response to humanitarian appeals, 2017-2022
In the EU and UK, there are no new resources for Ukraine, so other humanitarian support will be reduced as funds are diverted. In the EU’ s case the budget covers a seven-year period, allowing the European Commission to frontload its budget from the following years to tackle the crisis in Ukraine. However, in the UK’ s case this may mean further cuts in places like South Sudan and Syria, on top of those already implemented since 2020. In the US, new support for Ukraine is significant, but the remaining humanitarian budget has been cut by $ 1 billion relative to 2021. On 16th March, the German government released a new draft budget for 2022, which approves a reallocation of €39 million for Ukraine and its neighbouring countries. Therefore, it appears that these four main funders will provide less in non-Ukraine humanitarian support in 2022 than they have in past years.
With the major donors stepping back, the recent pledging conferences for Afghanistan and Yemen fell well short in funding commitments. Donors will need to make sure that their humanitarian support is not limited to the urgent needs in Ukraine, and that pre-existing crises do not suffer from an “ attention deficit ”. Thus far, 53 percent of UN appeals for Ukraine have been funded, compared to 4 percent for all other countries.
As donors gather at the IMF and World Bank spring meetings this month, we urge them to expand their focus beyond just Ukraine to also address the wider food security and economic fallout from the crisis. They should undertake a joint comprehensive assessment of the risks of extreme suffering, responding with crisis-type funding, including from the World Bank’ s IBRD and the IMF for credit-worthy countries. For less-creditworthy countries, resources should be brought forward and disbursed from IDA, the more concessional arm of the World Bank. IDA also needs to make greater use of partnership arrangements with UN agencies, NGOs, and the Red Cross of the sort they have adopted in Somalia and Yemen and have been exploring for Afghanistan. And for the most vulnerable countries we have identified, high-income countries will need to expand their humanitarian budgets.
The food security impacts of the invasion of Ukraine will be felt well beyond the conflict area. A combination of higher global food prices, humanitarian budgets reallocated to address needs in Ukraine, and attention diverted from pre-existing crises puts many places in extreme peril. The international community needs to act now, or risk the Ukraine conflict expanding into a global humanitarian crisis.
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions. | general |
Covid Raises Clotting Risks for Months After Even Mild Infection | The information you requested is not available at this time, please check back again soon.
A healthcare worker inspects intravenous tubes in the ICU ward at the General University Hospital in Prague, Czech Republic, on Friday, March 26, 2021. The Czech Republic, which has suffered more than most parts of the eastern Europe region, is set to prolong a state of emergency on Friday. Photographer: Milan Jaros/Bloomberg, Bloomberg
( Bloomberg) -- The risk of developing serious bleeding or potentially deadly blood clots is elevated for months after experiencing even a mild Covid infection, Swedish researchers found.
While the dangers of post-Covid clotting are well known, it’ s less clear how long the risk lasts and what should be done to prevent it. The researchers compared the medical records of 1 million people who tested positive for the virus between February 2020 and May 2021 in Sweden to 4 million of their peers who weren’ t infected.
Bleeding rates were elevated for two months after testing positive for the virus, while there was significant risk of developing blood clots deep in the legs for 70 days after Covid-19. The danger of pulmonary embolism, when a clot travels to the lungs and can kill, was significantly higher for almost four months, according to the report published in the BMJ, a British medical journal.
“ Despite the potential for new variants of concern, most governments are removing restrictions and shifting their focus to determining how best to ‘ live with Covid’, ” Frederick Ho and Jill Pell from the University of Glasgow’ s Institute of Health and Wellbeing, wrote in an editorial. The finding “ reminds us of the need to remain vigilant to the complications associated with even mild SARS-CoV-2 infection, ” they wrote.
What We Know About Omicron and Its Subvariant BA.2: QuickTake
The results support the use of blood thinners to prevent clotting, especially for high-risk patients, and underscores the need for vaccination, the researchers concluded. The study also found that the risks declined over time, as subsequent outbreaks of Covid caused fewer of the complications than the initial wave of disease.
The risk of bleeding was almost twice as high for Covid patients in the month after they were infected, while clots called deep vein thrombosis were almost five times higher, the study found. Pulmonary embolism was the greatest risk, with 1,761 events occurring in the 30 days after infection, compared to just 171 among the larger group of people who didn’ t contract the virus.
While the danger was highest for those with other health conditions and the most severe infections, the fact that many more people develop mild cases means they should also remain alert, the experts said. Vaccination may help alleviate the issue of clotting, the experts said.
“ Vaccination could reduce the overall risk both by preventing infection and by reducing its severity when it does occur, ” they wrote. | general |
Moonshot in a Minute | For the past 20 years, the Center for Global Development has distinguished itself by turning innovative ideas backed by rigorous research into action. As the world has changed over the past two decades, the Center for Global Development has been there with cutting-edge solutions. Whether it was helping to establish a new full-service development finance institution in the United States or devising a global blueprint - called Advance Market Commitments – to speed up vaccine access in low- and middle-income countries that is being applied to the COVID-19 crisis, the Center for Global Development was pushing ideas before they became popular, simply because they were good policy. In our Moonshot in a Minute video series, CGD experts have 60 seconds to share their big ideas to change minds, change policy, and change the world.
Last year, women spent three times as many hours as men doing additional unpaid childcare.
CGD is working to identify the best policies and practices to improve the global care economy. Our evidence-based proposals are already being adopted by some of the influential decision makers - from the World Bank to the US government.
800 million children around the world with dangerously high levels of lead in their blood—harming their health, stymying their learning, and preventing them from reaching their full human potential.
Yet here’ s the good news: the almost complete elimination of lead poisoning in the US and Europe shows this is a solvable problem. With better research, more funding, parent/community awareness, and policymaker prioritization, we think the world could dramatically reduce—and eventually even eliminate—lead poisoning as a threat to all children. And we think we owe it to the world’ s children to get started immediately. | general |
Late U.S. Rebound to Lift London Stocks | London Stocks Seen Opening Higher
0648 GMT - The FTSE 100 is expected to open around 71.7 points higher, according to IG, having closed Thursday at 7551.81, reversing some of the previous day's falls and catching up with late gains in U.S. stocks. `` Asian markets are mostly higher this morning with China underperforming as Covid and weak macro data are pressuring relative performance, '' analysts at Danske Bank say in a note. Markets remain concerned about events in Ukraine and the prospect of U.S. interest-rate rises. Defensive stocks have outperformed recently as investors are unwilling to buy bonds but are too concerned about the economic outlook to buy cyclical stocks, Danske says. Individual stocks in focus include sustainable-technologies company Johnson Matthey after it said it expects the full year to be in line with market views but sees disruption in 2023. ( jessica.fleetham @ wsj.com)
Hollywood Bowl to Resume Dividend as FY 2022 Performance Ahead of Views
Hollywood Bowl Group PLC said Friday that its full-year performance will be ahead of expectations and that it intends to reinstate the dividend after a strong first half.
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Ferrexpo 1Q Production Fell 11% as Russia-Ukraine War Hit Operations
Ferrexpo PLC on Friday reported that its iron-ore pellet production fell 11% on quarter in the first quarter as a result of Russia's invasion of Ukraine.
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Johnson Matthey Expects FY 2022 in Line With Market Views; Sees Disruption in FY 2023
Johnson Matthey PLC said Friday that it expects its underlying performance for fiscal 2022 to meet market expectations, and that it foresees further disruption in fiscal 2023.
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Jet2 Sees FY 2022 Adjusted Pretax Loss of Up to GBP383 Mln
Jet2 PLC said Friday that it expects to report an adjusted pretax loss for fiscal 2022 of between 378 million and 383 million pounds ( $ 494.2 million- $ 500.7 million) after a year marked by travel restrictions linked to Covid-19 and new variants of the disease.
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Premier Miton 2Q Assets Under Management Declined Amid Geopolitical Uncertainty
Premier Miton Group PLC on Friday reported a decline in assets under management in the second quarter of fiscal 2022 as a result of geopolitical uncertainty.
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Ramsdens Holdings Expects Swing to 1H Pretax Profit
Ramsdens Holdings PLC said Friday that its performance for the first half of fiscal 2022 was strong across each of its divisions and it expects to swing to a pretax profit for the period.
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Unite Group says 1Q Portfolio Value Rose, Advance Sales Strong
Unite Group PLC said Friday that the like-for-like valuation of its property portfolio inched up in the first quarter, and it has recorded strong advance sales for the upcoming academic year.
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Sound Energy No Longer Plans Merger With Angus Energy
Sound Energy PLC said Friday that it no longer plans to make an offer for Angus Energy PLC following a due diligence review, and after careful consideration.
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Marwyn Acquisition Says it is Assessing Platform Acquisition Opportunities
Marwyn Acquisition Company PLC said Friday that it continues to evaluate potential platform acquisition opportunities.
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VP PLC Sees FY 2022 Results Ahead of Expectations on Increased Demand
VP PLC said Friday that it expects to report full-year results ahead of expectations as performance since the publication of its interim report has been driven by increased demand.
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Zephyr Energy Says 1Q Williston Basin Production Beat Expectations -- Energy Comment
Zephyr Energy PLC said Friday that first-quarter hydrocarbon production from its new Williston-Basin assets in North Dakota was ahead of expectations. Here's what the Rocky Mountain-focused oil-and-gas company had to say:
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CMC Markets Expects FY 2022 Net Operating Income at Top End of Guidance
CMC Markets PLC said Friday that it expects to report net operating income for fiscal 2022 at the top end of its guidance.
Contact: London NewsPlus; paul.larkins @ wsj.com
( END) Dow Jones Newswires
04-08-22 0309ET | business |
Early signs of cooling housing market seen in some U.S. cities, Redfin says | Among those early tells, according to Redfin: Google searches for `` homes for sale '' dropped by double digits in Baltimore, Boston, San Francisco and Los Angeles in the second week of March from a year earlier; tours of homes for sale in California were down 21% as of March 31 from the first week of 2022, data from ShowingTime shows; Redfin agents in San Francisco, Los Angeles, Washington DC, Boston and Seattle reported a drop in requests for homebuying help at the start of this year compared with last year, even as requests nationwide surged; and agents in California say they are seeing fewer offers on each home than previously.
Home prices nationwide have risen about 35% in the two years since the COVID-19 pandemic slammed the nation and the Federal Reserve slashed short-term interest rates to near zero, the Zillow Home Value Index shows.
The Fed last month began raising its policy rate to bring down decades-high inflation as the economy reopened, and longer-term borrowing costs have climbed swiftly in anticipation of more aggressive rate hikes ahead.
The average interest rate on a 30-year-fixed mortgage, the most popular U.S. home loan, rose last week to 4.9%, a fresh three year high, data from the Mortgage Bankers Association ( MBA) showed this week.
The U.S. housing market is still hot, however, even in cooling California cities. The average home in Los Angeles, for instance, is sold for 5% over its asking price, with a record share selling within a week of listing, Redfin said.
But the signs are there already, the report said, of a price slowdown in coming months.
By Ann Saphir | business |
Amazon to fight union's win in NY labor election | Hi, what are you looking for?
Amazon told a federal agency it will file “ substantial ” objections to last week’ s worker election in New York that established the company’ s first union.
By
Published
Amazon told a federal agency it will file “ substantial ” objections to last week’ s worker election in New York that established the company’ s first union in the United States, according to a filing released Thursday.
In a letter to the National Labor Relations Board ( NLRB), the retail giant requested more time to compile and present evidence about alleged problematic election conduct on the part of the union and the board’ s officials.
“ This election involves more than 8,300 eligible voters, and voting spanned over 50 polling hours, ” Amazon attorneys with the firm Hunton Andrews Kurth said in a motion to the NLRB.
“ It is simply infeasible for Amazon to sufficiently investigate the myriad of objectionable conduct within five business days. ”
The NLRB granted Amazon until April 22 to present proof, but the company still must file its objections by Friday night, an official said.
On April 1, more than 55 percent of the votes at the Staten Island, New York JFK8 warehouse sided with Amazon Labor Union ( ALU), handing the bootstrap labor organization a surprise victory that has cheered the American labor movement and drew kudos from President Joe Biden.
The filing accuses union backers of intimidating workers, and said the NLRB administration of the vote led to “ inordinately ” long wait times that depressed turnout.
But the document did not provide evidence of these allegations, saying the company needed more time “ to further compile, review and outline evidence ” to support the claims.
Eric Milner, an attorney representing ALU, dismissed as “ absurd ” Amazon’ s complaints.
“ The employees have spoken and their voices have been heard, ” Milner told AFP.
“ Amazon is choosing to ignore that, and instead engage in stalling tactics to avoid the inevitable; coming to the bargaining table and negotiating for a contract on behalf of the fulfillment center associates at JFK8. ”
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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Walmart boosts industry-leading U.S. trucker pay to $ 110,000, starts retraining program | Qualified drivers -- who tend to be in their late 40s and 50s, according to government and industry officials -- remain in short supply. Federal limits on daily working hours, the COVID-19 pandemic and other hurdles have prompted many truck drivers to quit.
Walmart Inc is also following rival Amazon.com Inc in incentivizing employees in other roles to retrain for in-demand transportation jobs required to ease supply chain bottlenecks and support their online operations.
Walmart's drivers were already among the best compensated in the nation. Now the world's biggest retailer is upping the ante by resetting truck drivers ' starting salaries to $ 95,000 to $ 110,000 a year, from $ 87,500 previously.
That far exceeds 2020's median pay of $ 47,130 for American big-rig drivers, whose `` real '' earnings have lagged inflation and effectively remain at about 70% of what they were in the 1970s, according to the U.S. Bureau of Labor Statistics. About 1.9 million big-rig drivers ply the nation's roads, according to the bureau.
Walmart's move could strengthen its competitive advantage at a time when safe, experienced 18-wheeler drivers are in short supply and as Amazon builds its own network of trucking contractors.
`` We're proud to announce pay raises to ensure Walmart remains one of the best companies in the world to drive for, '' said Karisa Sprague, Walmart's senior vice president for supply chain human resources said in a statement.
Consumer demand for everything from food to furniture soared during the pandemic. That overwhelmed resources -- from truck availability and seaport capacity to warehouse and distribution space -- snarling the flow of goods and fueling higher costs.
At Walmart alone, supply chain costs were $ 400 million higher than expected in the fourth quarter ending Jan. 28 that included the all-important holiday shopping season, the company said.
Recent data suggests pandemic demand may be cooling.
Commerce Department data released last week suggested that pandemic-fueled purchases of physical goods may have peaked as consumers resume spending on travel and entertainment. [ Graphic: https: //tmsnrt.rs/3IPvXEI ]
Walmart continues to invest aggressively in Walmart.com, and is following Amazon in creating a pathway for employees to shift to transportation jobs to support e-commerce logistics.
Walmart's 12-week, in-house trucking training program enables employees to earn their commercial driver's license and become full-fledged Private Fleet Walmart drivers. Walmart picks up the roughly $ 4,000 to $ 5,000 cost of that training.
The company, which pays signing bonuses that can exceed $ 10,000, hired a record 4,500 truck drivers last year, bringing its trucker workforce to around 12,000. It already has graduated 17 new drivers from classes in Texas and Delaware, and plans to expand the program this year with the goal of training between 400 and 800 drivers to move goods to its more than 5,300 U.S. Walmart and Sam's Club stores.
( Reporting by Lisa Baertlein in Los Angeles and Arriana McLymore in New York; editing by Jonathan Oatis)
By Lisa Baertlein and Arriana McLymore | business |
Taiwan March exports hit new record, Ukraine war clouds outlook | Exports last month jumped 21.3% from a year earlier to $ 43.5 billion, the Ministry of Finance said on Friday, the highest monthly figure on record.
A Reuters poll of analysts had forecast a 21% rise for the month, compared with a 34.8% leap in February.
The ministry attributed the March growth to strong demand for electronic components as well as semiconductors, and companies increasing orders to ensure supplies to customers.
Exports of electronics components rose 35.6% in March to $ 18.24 billion, also a monthly record, with semiconductor exports surging 38.2% from a year earlier.
Many companies expect global chip shortages to last at least for the rest of the year, which will continue to fill Taiwanese semiconductor firms ' order books.
Firms such as TSMC, the world's largest contract chip-maker, are major suppliers to Apple Inc and other global tech giants, as well as providers of chips for auto companies and lower-end consumer electronics.
Earlier on Friday, TSMC reported March sales of T $ 171.97 billion ( $ 5.95 billion), up 33.2% from the same period last year.
The finance ministry said `` enormous '' demand for chips would continue to drive exports, but warned of uncertainty over the COVID-19 pandemic, the ongoing war in Ukraine, supply chain bottlenecks and inflation.
Ministry official Beatrice Tsai said the second quarter would likely continue to see double-digit growth, but that it was `` hard to see '' rapid growth continuing in the second half.
March exports to China, Taiwan's largest trading partner, grew an annual 13.4% to $ 18.03 billion, compared with a 39.9% on-year rise in February, while exports to the United States jumped 36.6%, slightly slower than the 40.3% rise recorded the previous month.
Imports leapt 20.3%, in line with economists ' expectations of a 20.5% rise, after an increase of 35.3% in February.
Taiwan could see April exports increase in the range of 13% to 17% from a year earlier, the finance ministry said.
( $ 1 = 28.8830 Taiwan dollars)
( Reporting by Jeanny Kao and Ben Blanchard; Editing by Jan Harvey) | business |
Exclusive-AIG looks at cutting insurance for Russia, Ukraine -sources | AIG is looking at adding exclusion clauses to policies for businesses operating in the region across a range of policies, according to the two sources who declined to be identified.
Other major insurers are also looking to exclude Russia, Ukraine and even Belarus from a range of policies, the sources said, citing some insurers and policyholders.
Reuters could not determine if the potential reduction in cover would apply across all AIG policies in the countries. The insurer declined to comment.
`` What we are now seeing are the underwriters starting to introduce Russia, Ukraine wording into their policies, '' said Meredith Schnur, managing director, U.S. and Canada cyber brokerage leader at insurance broker Marsh, declining to name the insurers.
Brokers such as Marsh act as intermediaries between corporate customers and insurers, and sometimes get involved in drawing up policies.
If AIG were to cut back cover for businesses and companies operating in Russia and Ukraine it would be the first major insurer to do so, potentially paving the way for others to follow suit.
While Russia has become a no-go zone for many companies due to sanctions imposed in the wake of Moscow's invasion of Ukraine, some multinationals continue to do business there as well as in Ukraine in sectors ranging from agriculture to energy. They require insurance to keep their businesses open.
Local companies also rely on insurance for damage to goods, buildings and vehicles and for injury or loss of life of employees. Reuters could not determine how much of AIG's business in Russia and Ukraine was focused on domestic firms.
AIG, which recorded net written premiums in general insurance totalling more than $ 26 billion last year, has operations in Russia, according to its website, and is a major global player in sectors such as energy, construction and cyber.
'NON-NEGOTIABLE '
Sanctions on Russia are already forcing insurers to pull back from coverage of restricted Russian entities and individuals, while UK and European sanctions on aviation insurance extend beyond individual companies to all Russian firms.
Insurance brokers such as Aon and Willis Towers Watson have frozen operations in Russia, while reinsurers Munich Re and Swiss Re are among companies which have said they will not write new business in the country, whether potential policyholders are sanctioned or not.
But AIG and other underwriters are looking at going further, adding wordings into insurance policies to exclude cover for Ukraine, Belarus and the Russian and Ukrainian operations of Western businesses, industry sources say.
Insurers are concerned about reputational damage of doing business in Russia and they are also worried about property damage and delayed payments in Ukraine, where the economy has been pulverized by the war.
Some policyholders are already struggling to find insurance.
François Malan, chief risk and compliance officer at French engineering firm Eiffage, said last week that he was forced to accept an insurance exclusion for transporting cargo in waters near Ukraine.
`` It was non-negotiable, it was not a question of price - it was non-covered, '' he said.
Ships sailing into waters around the Black Sea and Sea of Azov, which include Ukraine's coast, need to have additional war risk insurance which means paying a separate premium.
Some insurers are also cutting provision of this type of insurance due to the growing perils, which include being hit by projectiles or floating mines, marine insurance sources say.
PANDEMIC PLAYBOOK
Insurers generally add certain types of exclusion in policies exposed to potential conflict, such as during the South Korea winter Olympics, but do not usually exclude entire regions, as in the case of the Ukraine crisis.
The move to exclude risky areas of their business mirrors insurers ' behaviour following the COVID-19 pandemic.
Faced with losses estimated at $ 100 billion, insurers rushed to exclude first COVID-19 and then all pandemics from policies.
After also putting up premium rates, many of them reported strong profits in 2021, the second full year of the pandemic. Some industry sources say losses were smaller than originally anticipated as a result of those actions.
S & P Global last week estimated commercial insurers ' losses from the Russia-Ukraine conflict could total as much as $ 35 billion.
S & P said the insurance sectors likely to be most impacted were aviation, trade credit, political risk such as nationalisation, cyber, political violence and marine war.
Swiss Re said on Thursday that insurance and reinsurance losses from the invasion were likely to come in around the same as a medium-sized natural catastrophe loss such as from a hurricane.
( Additional reporting by Jonathan Saul; Editing by Emelia Sithole-Matarise)
By Noor Zainab Hussain and Carolyn Cohn | business |
The State of Jobs: Better | In March, the U.S. economy created 431,000 jobs, raising the number of employees on nonfarm payrolls to 151 million, 1.6 million shy of February 2020’ s number. That’ s getting better, though sector recovery paths differ a lot.
Some sectors—trade, transportation, utilities, professional and business services, information, financial—have bounced back. Jobs that make e-commerce hum or in technical fields like research and development and data processing have boomed. The number of temporary-help workers is 7% higher than in February 2020, probably a result of pandemic uncertainty.
Meanwhile, jobs in mining and logging—albeit small industries—are 16% below prepandemic levels. Jobs in construction, manufacturing, education, health services, and government trail prepandemic levels, too.
The biggest shortfall: leisure and hospitality, off about 8% —some 1.5 million people—from February 2020. Hotels, in particular, are still down 19%, compared with February 2020. Still, with winter ending and Covid fading, leisure and hospitality accounted for over a quarter of all jobs created in March. Restaurants and bars added 61,000 jobs; hotels, 25,000; amusements, gambling, and recreation, 16,000. Over the past year, leisure and hospitality hiring has been up some 16% —tops among sectors.
Some pandemic effects have faded. Workers on temporary layoff, at 787,000 in March, have nearly returned to the 780,000 prepandemic level, while permanent job losses—1.4 million—are slightly above February 2020’ s 1.3 million. Still, labor-force participation, at 62.4%, trails the prepandemic 63.4%.
Running Out of Gas
All eyes were on the inverted yield curve Monday, and continued so for the week. Elon Musk revealed a 9.2% stake in
Twitter
,
making him its largest shareholder, and the shares popped 27%; he was invited to join the board. Other techs also rallied. But oil rose on new Russia sanction fears, Federal Reserve minutes signaled bond reductions of $ 95 billion a month, and stocks fell. Jobless claims hit a new low, but the week ended down. The
Dow Jones Industrial Average
slipped 0.28%, to 34,721.12; the
S & P 500
fell 1.28%, to 4488.28; and the Nasdaq Composite shed 3.86%, to 13711.
Retrenchment in Ukraine
The Russian retreat revealed hundreds of civilian deaths, with some victims in mass graves, and renewed charges of atrocities. Russia dismissed the claims as fake. President Biden called for a war crimes trial, and the U.S. imposed new sanctions, hitting Russian banks and trade, and blocking Russian bond payments through U.S. banks. The European Union ended imports of Russian coal, and Germany seized a Gazprom gas storage unit. Ukrainian President Zelensky demanded Russia’ s removal from the U.N. Security Council; instead, the General Assembly kicked Russia off the Human Rights Council. Much of the fighting shifted to the Donbas region.
The Ripple Effect
Fallout from the war spread. Peru imposed curfews in Lima to limit protests over high fertilizer and fuel costs, then was forced to lift them. The Sri Lankan ruling family tottered, as protests continued over a deepening economic crisis. And Greece saw a nationwide one-day strike over rising prices.
China Concedes on Audits
Trying to keep its companies from being delisted in the U.S., China said it would alter secrecy rules to provide financial information to foreign regulators. The concession follows months of talks and comes as China attempts to shore up flagging growth.
Labor Pains
Amazon
lost a labor election for the first time, when a Staten Island warehouse voted to unionize. Amazon is appealing the vote. Some 16
Starbucks
store have voted to unionize—six did so last week—as founder Howard Schulz returned for a third stint as CEO. Schulz, no fan of unions, said he is suspending share buybacks to invest in growth and employees.
Jackson Makes the Court
The Senate confirmed Katanji Brown Jackson to the Supreme Court, 53-47. She became the first Black woman justice.
Annals of Deal Making
Softbank liquidated nearly all its holdings in inhouse hedge fund, SB Northstar, which lost some $ 4.6 billion in bad derivative trades. Akshay Nabeta, a former Deutsche Bank trader based in Dubai who ran the group, left Softbank on March 31…
JetBlue
topped Frontier’ s bid to buy
Spirit Airlines
,
with a $ 3.6 billion
offer... Berkshire Hathaway
bought a $ 4.2 billion stake in HP.
Write to
Evie Liu at
evie.liu @ barrons.com | business |
India to widen COVID booster effort to all adults from Sunday | - India will offer booster doses of COVID-19 vaccine to all adults from Sunday, although free third doses will be limited to frontline workers and those older than 60 who get them at government centers.
The country has given 1.85 billion vaccine doses among its population of 1.35 billion. Of these, 82% are the AstraZeneca dose made domestically and called Covishield.
Those older than 18 who received a second dose nine months ago will be eligible for the `` precaution '' dose, the health ministry said https: //www.pib.gov.in/PressReleaseIframePage.aspx? PRID=1814804, using the government's term for boosters.
`` Adding an extra layer of safety, '' Health Minister Mansukh Mandaviya said in a Twitter post flagging the decision.
The booster program started in January, limited to frontline workers and the elderly, administering a total of 24 million doses.
When the program is extended on Sunday, those outside these two priority categories will have to pay for the shots at privately run facilities, with no mixing and matching of vaccines allowed.
Other vaccines used in India are the domestically developed Covaxin and Corbevax, and Russia's Sputnik V.
In March Reuters reported India was considering making all adults eligible for booster doses, at a time of growing infections in some countries while some Indians found it hard to travel abroad without a third dose.
( Reporting by Nivedita Bhattacharjee in Bengaluru and Krishna N. Das in New Delhi; Editing by Shounak Dasgupta and Clarence Fernandez) | business |
LIMS Software Market Size Worth Over USD 1001.7 Million by 2028 and growth of 5.7% CAGR during the forecast period spread across 113 pages | Hi, what are you looking for?
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In 2022, the global LIMS Software market is projected to expand at a CAGR of 5.7%. The growing use of LIMS Software in recycling processes across a variety of sectors is driving up market demand. As a result, the market is expected to reach USD 1001.7 Mn in 2028.
Global “ LIMS Software Market ” to grow with a impressive CAGR over the forecast period from 2022-2028. The report on LIMS Software provides the clients with a comprehensive analysis of crucial driving factors, consumer behavior, growth trends, product utilization, key player analysis, brand positioning and price patterns. The information on pricing patterns is obtained by analyzing product prices of key players as well as emerging market players. Furthermore, LIMS Software market research report provides valuable insights on market overview, market segmentation and strategies for established and emerging players.
This study specially analyses the impact of Covid-19 outbreak on the LIMS Software, covering the supply chain analysis, impact assessment to the LIMS Software market size growth rate in several scenarios, and the measures to be undertaken by LIMS Software companies in response to the COVID-19 epidemic.
Final Report will add the analysis of the impact of COVID-19 on this industry.
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The LIMS Software report also offers information on the factors impeding the market growth which shall offer valuable data to vendors for strategic planning. It is crucial to understand these factors as they help in identifying the market growth opportunities. Moreover, market research analysts at 360 Research Reports offer timely assistance in understanding eccentric market parameters in a better way.
The research covers the current LIMS Software market size of the market and its growth rates based on 6-year records with company outline of Key players/manufacturers:
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Brief Description About LIMS Software Market:
Market Analysis and Insights: Global LIMS Software Market
The global LIMS Software market size is projected to reach USD 1001.7 million by 2028, from USD 676.5 million in 2021, at a CAGR of 5.7% during 2022-2028.
Fully considering the economic change by this health crisis, Cloud Based accounting for% of the LIMS Software global market in 2021, is projected to value USD million by 2028, growing at a revised% CAGR in the post-COVID-19 period. While Medical Industry segment is altered to an% CAGR throughout this forecast period.
China LIMS Software market size is valued at USD million in 2021, while the North America and Europe LIMS Software are USD million and USD million, severally. The proportion of the North America is% in 2021, while China and Europe are% and% respectively, and it is predicted that China proportion will reach% in 2028, trailing a CAGR of% through the analysis period. Japan, South Korea, and Southeast Asia are noteworthy markets in Asia, with CAGR%,%, and% respectively for the next 6-year period. As for the Europe LIMS Software landscape, Germany is projected to reach USD million by 2028 trailing a CAGR of% over the forecast period.
With industry-standard accuracy in analysis and high data integrity, the report makes a brilliant attempt to unveil key opportunities available in the global LIMS Software market to help players in achieving a strong market position. Buyers of the report can access verified and reliable market forecasts, including those for the overall size of the global LIMS Software market in terms of revenue.
Overall, the report proves to be an effective tool that players can use to gain a competitive edge over their competitors and ensure lasting success in the global LIMS Software market. All of the findings, data, and information provided in the report are validated and revalidated with the help of trustworthy sources. The analysts who have authored the report took a unique and industry-best research and analysis approach for an in-depth study of the global LIMS Software market.
Global LIMS Software Scope and Market Size
LIMS Software market is segmented by players, region ( country), by Type and by Application. Players, stakeholders, and other participants in the global LIMS Software market will be able to gain the upper hand as they use the report as a powerful resource. The segmental analysis focuses on revenue and forecast by Type and by Application for the period 2017-2028.
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Report further studies the market development status and future LIMS Software Market trend across the world. Also, it splits LIMS Software market Segmentation by Type and by Applications to fully and deeply research and reveal market profile and prospects.
On the basis of product type this report displays the production, revenue, price, market share and growth rate of each type, primarily split into:
On the basis of the end users/applications this report focuses on the status and outlook for major applications/end users, consumption ( sales), market share and growth rate for each application, including:
Geographically, this report is segmented into several key regions, with sales, revenue, market share and growth Rate of LIMS Software in these regions, from 2017 to 2028, covering
Some of the key questions answered in this report:
If you have any question on this report or if you are looking for any specific Segment, Application, Region or any other custom requirements, then Connect with an expert for customization of Report.
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Major Points from Table of Contents
Table of Content
1 LIMS Software Market Definition and Overview1.1 Objectives of the Study1.2 Overview of LIMS Software1.3 LIMS Software Market Scope and Market Size Estimation1.4 Market Segmentation1.4.1 Types of LIMS Software1.4.2 Applications of LIMS Software1.5 Market Exchange Rate
2. Research Method and Logic2.1 Methodology2.2 Research Data Source
3. Market Competition Analysis3.1 Market Performance Analysis3.2 Product and Service Analysis3.3 Strategies for Company to Deal with the Impact of COVID-193.4 Sales, Value, Price, Gross Margin 2017-20223.5 Basic Information
4 Market Segment by Type, Historical Data and Market Forecasts4.1 Global LIMS Software Production and Value by Type4.1.1 Global LIMS Software Production by Type 2017-20224.1.2 Global LIMS Software Market Value by Type 2017-20224.2 Global LIMS Software Market Production, Value and Growth Rate by Type 2017-20224.3 Global LIMS Software Production and Value Forecast by Type4.4 Global LIMS Software Market Production, Value and Growth Rate by Type Forecast 2022-2028
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5 Market Segment by Application, Historical Data and Market Forecasts5.1 Global LIMS Software Consumption and Value by Application5.2 Global LIMS Software Market Consumption, Value and Growth Rate by Application 2017-20225.3 Global LIMS Software Consumption and Value Forecast by Application5.4 Global LIMS Software Market Consumption, Value and Growth Rate by Application Forecast 2022-2028
6 Global LIMS Software by Region, Historical Data and Market Forecasts6.1 Global LIMS Software Sales by Region 2017-20226.2 Global LIMS Software Market Value by Region 2017-20226.3 Global LIMS Software Market Sales, Value and Growth Rate by Region 2017-20226.3.1 North America6.3.2 Europe6.3.3 Asia Pacific
6.3.4 South America6.3.5 Middle East and Africa6.4 Global LIMS Software Sales Forecast by Region 2022-20286.5 Global LIMS Software Market Value Forecast by Region 2022-20286.6 Global LIMS Software Market Sales, Value and Growth Rate Forecast by Region 2022-20286.6.1 North America6.6.2 Europe6.6.3 Asia Pacific6.6.4 South America6.6.5 Middle East and Africa
7. Market Dynamic Analysis and Development Suggestions7.1 Market Drivers7.2 Market Development Constraints7.3 PEST Analysis7.3.1 Political Factors7.3.2 Economic Factors7.3.3 Social Factors7.3.4 Technological Factors7.4 Industry Trends Under COVID-197.4.1 Risk Assessment on COVID-197.4.2 Assessment of the Overall Impact of COVID-19 on the Industry7.4.3 Pre COVID-19 and Post COVID-19 Market Scenario7.5 Market Entry Strategy Analysis7.5.1 Market Definition7.5.2 Client7.5.3 Distribution Model7.5.4 Product Messaging and Positioning7.5.5 Price7.6 Advice on Entering the Market
Continued….
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A cargo airplane broke up during an emergency landing in Costa Rica on Thursday.
In the U.S., owners of Apple devices who hold a driver’ s license can now add them to their digital wallets. Is this a good...
The Thursday confirmation of Ketanji Brown Jackson to the US Supreme Court marks an undeniable success for Joe Biden.
Britain is sending Ukraine more Starstreak anti-aircraft missiles and 800 anti-tank missiles after an attack on a train station.
COPYRIGHT © 1998 - 2022 DIGITAL JOURNAL INC. Digital Journal is not responsible for the content of external sites. Read more about our external linking. | general |
China stocks end higher on stimulus expectations amid COVID surge | - China stocks closed higher on Friday, buoyed by expectations of further policy easing measures to support a slowing economy hit by the country's worst COVID-19 outbreak in two years.
The blue-chip CSI 300 Index rose 0.5% to 4,230.77, while the Shanghai Composite Index gained 0.5% to 3,251.85.
The Hang Seng index rose 0.3% to 21,872.01, while the China Enterprises Index lost 0.1% to 7,490.37.
* * For the week, the CSI 300 Index dropped 1.1%, while the Hang Seng index fell 0.8%.
* * `` Range-bound sentiment continues amid concerns on macro recovery, COVID-19 management and tightening liquidity globally, '' Morgan Stanley said in a note. `` Earnings estimate reductions further accelerated. ''
* * Real estate developers surged 2.7%, financial firms gained 1.3%, and construction engineering stocks jumped 4.1%.
* * Energy and resources shares added 1.3% and 1.6%, respectively.
* * China reported 1,576 new confirmed COVID-19 cases and 22,648 new asymptomatic cases on April 7.
* * Economists expect Beijing to take imminent monetary easing measures to prop up the economy and make sure China remains on track to hit its around 5.5% growth target for this year.
* * `` China's virus prevention and lockdown measures continue to have a negative impact on the economy and the job market, and markets expect the authorities to cut interest rates or take other easing measures as early as next week, '' economists at OCBC Wing Hang Bank said in a note.
* * Tech giants listed in Hong Kong fell 1.2% on worries over China-U.S. relations, with index heavyweights Alibaba Group, Meituan and Tencent Holdings down between 1.3% and 1.8%.
* * China said on Thursday it would take strong measures if U.S. House of Representatives Speaker Nancy Pelosi visited Chinese-claimed Taiwan on her trip, responding to reports she was planning to go.
* * Pelosi's spokesman later in the day said the Democratic leader has tested positive for COVID-19 and is currently asymptomatic, and the congressional delegation trip to Asia she had planned to lead has been postponed.
* * `` China shows willingness on collaboration on the audit dispute but more confirmation is needed from the U.S. side, '' said Morgan Stanley analysts.
* * The China Securities Regulatory Commission last week proposed revising confidentiality rules involving offshore listings, removing a legal hurdle to Sino-U.S. cooperation on audit oversight.
* * The Hang Seng Finance Index rose 1.1%, with insurer AIA Group up 2.6% to become the biggest point contributor lifting the Hang Seng benchmark.
* * The Hang Seng Mainland Properties Index gained 2.5%, even though trading in many developers ' stocks are suspended. ( Reporting by Shanghai Newsroom; Editing by Subhranshu Sahu) | business |
Moderna recalls thousands of COVID vaccine doses in Europe | Moderna Inc said on Friday it was recalling 764,900 doses of its COVID-19 vaccine made by its contract manufacturer Rovi after a vial was found contaminated by a foreign body.
No safety issues have been identified, Moderna said about the lots that were distributed in Norway, Poland, Portugal, Spain and Sweden in January.
The drugmaker said the contamination was found in just one vial, and it was recalling the whole lot out of `` an abundance of caution ''. It did not disclose what was found in the vial.
Japanese authorities last year suspended the use of some doses of the vaccine, which Moderna later recalled, after an investigation found stainless steel contaminants in some vials.
Over 900 million doses of the Moderna COVID-19 vaccine have been administered worldwide to date.
Moderna said on Friday it did not believe the contamination posed a risk to other vials in the lot. ( Reporting by Manas Mishra in Bengaluru; Editing by Shinjini Ganguli) | business |
Twitter employees to meet with new board member Musk | Hi, what are you looking for?
Twitter plans to hold a meeting for employees concerned about Tesla Chief Executive Elon Musk’ s influence on the company’ s board.
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Twitter plans to hold a meeting for employees concerned about Tesla Chief Executive Elon Musk’ s influence on the company’ s board, a Twitter spokesperson said Friday.
The Twitter official did not disclose the timeframe or format for the meeting.
The social media company named Musk to the board on Tuesday after the outspoken and polarizing executive disclosed he had acquired a more than nine percent stake in the company, making him Twitter’ s largest shareholder.
In announcing the appointment, Twitter Chief Executive Parag Agrawal said he was “ excited ” to name Musk, calling him “ a passionate believer and intense critic of the service which is exactly what we need. ”
Musk said he looked forward to soon making “ significant improvements to Twitter. ”
The Tesla chief began polling his followers on whether to add an “ edit ” button the service, a long-discussed tweak.
But Musk is a break-the-mold figure in American business. On Thursday, he tweeted a photo of himself smoking marijuana on a Joe Rogan podcast in 2018, with the caption, “ Twitter’ s next board meeting is gon na be lit. ”
His antics often raise eyebrows and occasionally draw condemnation, as when Jewish groups blasted his tweet comparing Canadian leader Justin Trudeau to Adolf Hitler over Covid-19 vaccine mandates. Musk later deleted the tweet without apologizing.
The appointment has sparked misgivings among some employees, according to a Washington Post report.
Workers at the California-based social media company cited worries about Musk’ s statements on transgender issues and his reputation as a difficult and driven leader, according to statements on Slack reviewed by the Post.
His arrival has cheered some Wall Street analysts, who have been frustrated by Twitter’ s difficulty in meaningfully monetizing its business.
But skeptics have pointed out that Musk has bullied critics in the investment community and fired or penalized workers who have spoken out or tried to unionize.
A California agency has sued Tesla, alleging discrimination and harassment against Black workers. The electric carmaker has rejected the charges, saying it opposes discrimination.
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.
A cargo airplane broke up during an emergency landing in Costa Rica on Thursday.
In the U.S., owners of Apple devices who hold a driver’ s license can now add them to their digital wallets. Is this a good...
The Thursday confirmation of Ketanji Brown Jackson to the US Supreme Court marks an undeniable success for Joe Biden.
Britain is sending Ukraine more Starstreak anti-aircraft missiles and 800 anti-tank missiles after an attack on a train station.
COPYRIGHT © 1998 - 2022 DIGITAL JOURNAL INC. Digital Journal is not responsible for the content of external sites. Read more about our external linking. | general |
'Tip of the iceberg ': Taiwan's spy catchers hunt Chinese poachers of chip talent | - Taiwan's spy catchers have launched probes into around 100 Chinese companies suspected of illegally poaching semiconductor engineers and other tech talent, a senior official at the island's Investigation Bureau told Reuters.
That comes on top of seven prosecuted since the start of last year and includes 27 which have either been raided or whose owners have been summoned for questioning by the bureau, the official said.
Home to industry giant TSMC and accounting for 92% of the world's most advanced semiconductor manufacturing capacity, Taiwan possesses what China needs - chip expertise in spades.
A global chip shortage and Beijing's avowed goal of achieving self-reliance in advanced chips - more forcefully promoted by Chinese President Xi Jinping after a trade war with the former Trump administration - has only intensified the scramble for engineering talent.
Taiwan responded with the creation in December 2020 of a task force within the justice ministry's Investigation Bureau - its main spy catching organization - to tackle poaching.
Cases where it has taken action with raids or questioning represented `` the tip of the iceberg, '' the official said, asking to remain anonymous so that investigations are not impeded.
The Investigation Bureau said the official's comments represented its views.
Heightened military pressure from China, which claims Taiwan as its territory, has only strengthened Taipei's determination to protect its chip supremacy - an asset also strategically important to the United States as much of its chip manufacturing is outsourced to the island.
Last month the bureau conducted its biggest operation to date - a raid of eight companies aimed at countering what it said was `` the Chinese Communist Party's illegal activities of talent-poaching and secret-stealing. ''
China's Taiwan Affairs Office did not respond to a Reuters request for comment.
TRICKS EMPLOYED
It is not illegal per se for Chinese firms to hire Taiwanese engineers. Taiwanese law, however, prohibits Chinese investment in some parts of the semiconductor supply chain including chip design and requires reviews for other areas such as chip packaging, making it very difficult for Chinese chip firms to operate on the island legally.
Taiwanese engineers are also free to go to China, but many prefer the quality of life on the island, especially while COVID-19 restrictions make travel harder.
One case under investigation involves a firm that purports to be a Taiwanese data analysis company but which authorities believe is an arm of a Shanghai-based chip firm sending chip design blueprints to China, according to the official and another colleague who spoke with Reuters.
In mid-March, after nearly a year of surveillance, the bureau summoned the firm's owner for questioning. The owner has since been released on bail, they said, declining to identify the company as charges have yet to be laid.
Other tricks employed include incorporating units in tax havens such as the Cayman Islands, making it harder to identify money inflows from China.
Beijing-based Starblaze Technology, an integrated circuit ( IC) design house, has been accused of running an R & D center in the tech hub of Hsinchu without approval. It allegedly conducted job interviews via Zoom and used a Hong Kong company to handle payroll and insurance, according to court documents reviewed by Reuters. The trial is ongoing.
Tongfu Microelectronics, a Chinese state-affiliated company, was accused of having an illegal office whose employees received salaries in U.S. dollars in offshore accounts wired via a Hong Kong-based subsidiary. The defendants were found guilty in January.
Starblaze and Tongfu did not respond to Reuters requests for comment.
THE MOST WANTED
Lucy Chen, vice president of Taipei-based Isaiah Research, says that last year Chinese chip firms came wooing with salary offers two to three times local levels. Among the most sought-after employees are IC designers, who can work remotely.
While it is difficult to compete on salary, local firms aim to provide more secure long-term career development and perks such daycare centers, massages and gyms on site, said an executive at a Hsinchu chip company, declining to be identified.
Those willing to be poached risk not finding work again at Taiwanese tech firms as well as public shaming. Several senior TSMC executives who went to work for SMIC in China have been branded as traitors in Taiwanese press.
Authorities are also working to increase penalties for poaching. Maximum prison sentences are set to be increased to three years from one year and maximum fines from $ 5,200 to $ 520,525.
In a related move, the government has proposed making the leaking of core chip technologies a breach of national security law.
But there are concerns that tougher rules might hinder President Tsai Ing-wen's drive to build a supply chain spanning materials to chip manufacturing.
`` What if we put off legitimate foreign investors and damage our national economy due to overly strict regulation? '' said the Investigation Bureau senior official.
`` It's a dilemma and we need to strike an appropriate balance in between. ''
( $ 1 = 28.6090 Taiwan dollars)
( Reporting by Yimou Lee and Sarah Wu; Additional reporting by Beijing newsroom; Editing by Edwina Gibbs and Frank Jack Daniel) | business |
Avivagen: Announces AGM Results and Update to Shareholders Record Year of Progress for OxC-betaTM Adoption Worldwide | Ottawa, ON /Business Wire/ April 8, 2022 / Avivagen Inc. ( TSXV: VIV, OTCQB: VIVXF) ( `` Avivagen '' or the `` Company ''), a life sciences corporation focused on developing and commercializing products for livestock, companion animal and human applications that safely enhances feed intake and supports immune function, thereby supporting general health and performance, today announced the results of its annual general meeting of shareholders and highlighted the significant progress made in the Corporation's efforts to drive further adoption of OxC-betaTM worldwide.
At the Company's AGM held today, Avivagen's Corporation's shareholders voted to support all of the resolutions that came before the meeting. The resolutions included the election of directors and the reappointment of McGovern Hurley LLP as Avivagen's auditor.
The voting results in respect of the election of directors are detailed below:
`` Like every business we 've had to overcome the challenges that the extended Covid-19 pandemic brought over the past year, but our growth since early 2021 is a testament to the opportunities for OxC-betaTM, '' says Kym Anthony, Chief Executive Officer, Avivagen. `` The past year has seen a series of important milestones, including growth throughout the countries we service in the Americas and Asia, new customer wins and distribution agreements, important leadership appointments and strong recognition from the scientific and investment communities. Avivagen is in its strongest position yet, and we 've only scratched the surface of the potential for OxC-betaTM adoption. ''
The past 12 months have seen a series of key milestones achieved in furthering adoption of OxC-betaTM in markets worldwide, including:
Distribution Agreements and Market Development Efforts In October 202, Avivagen struck an eight-year supply agreement with AB Vista, a leading global animal nutrition technology company. The agreement saw AB Vista become the exclusive distributor of OxC-betaTM for use with poultry, swine, ruminants and aquaculture in the United States, Brazil and Thailand, and also presents opportunities to collaborate on development efforts. It is believed that the agreement will drive greater adoption of OxC-betaTM in two of the world's three largest feed production markets.
In July 2021 Avivagen retained the services of industry leader Lesley Nernberg as a technical sales and marketing consultant focused on accelerating adoption of OxC-betaTM in Asia. Avivagen also secured regulatory approval for use of the Corporation's oxidized carotenoid-based feed additive product in Vietnam in February 2022, creating new market opportunities.
In February 2021, Avivagen signed an agreement with Meyenberg International Group to expand its OxC-betaTM sales efforts into five Central and South American markets. Meyenberg has been instrumental in securing new customer interest, driving trails of OxC-betaTM locally and finalizing new and recurring sales throughout Mexico, with continued progress in Central and South America.
Record Orders and Large Recurring Customers In April 2021 Avivagen secured the largest OxC-BetaTM order to date ( 4.4 metric tonnes) with long-standing customer UNAHCO in the Philippines. This was later followed up by another record 6.3 tonne order, as UNAHCO continues to gain market share despite current difficult economic conditions.
The Corporation has also secured and fulfilled first purchase orders with a number of landmark customers over the past year, including sales with a large integrated producer in Asia, and an initial order with a large, influential and industry-leading poultry producer in Mexico. Avivagen believes that the order size and volume of initial orders signals an opportunity for growth in OxC-betaTM adoption over the coming years.
Recognition from the Scientific Community and Trials The growing interest and demand for new and innovative solutions for replacing AGP's ( Antibiotics as Growth Promoters) in feeds, has led to a number scientific papers from Avivagen being accepted and published in top-tier scientific publications over the past year. Of note, scientific papers written by Avivagen representatives have appeared recently in such esteemed publications as Poultry Science, the British Journal of Nutrition, Food and Chemical Toxicology, the Canadian Journal of Chemistry and the New Zealand Veterinary Journal.
The scientific community is now recognizing what distribution partners and customers have seen firsthand via trials of OxC-betaTM over the past several years - that the safety and utility of using OxC-betaTM in broilers, swine and cows is conclusive. Trials with several AB Vista customers in Brazil are currently underway which, if successful, could lead to a pipeline of new customer activity. Trials by two of Mexico's most important and influential livestock fed and dairy production associations, Asociación Nacional de Fabricantes de Alimentos Para Consumo Animal. S.C ( ANFACA) and Asociación Mexicana de Productores de Alimentos, A.C. ( AMEPA), are also underway.
Results from a dairy trial in New Zealand showing positive outcomes for use against sub-clinical mastitis were published in the New Zealand Veterinary Journal and have played a key role in driving purchasing decisions for customers as far away as Mexico. Similar trials with large industry leaders have also returned positive results that are expected to lead to continued adoption over the coming years.
Positive Corporate Developments Along with continued customer and market success for OxC-betaTM, Avivagen has focused on strengthening its leadership and financials over the past year. The Corporation announced the appointment of James ( Jamie) Nickerson, PhD as President of Avivagen in January 2022 after 15 years of success in roles supporting the Corporation's business development and innovation efforts.
Avivagen also completed a bought deal financing of $ 7.5 million in February 2021, and a private placement of debentures and shares for gross proceeds of $ 5.678 million in March 2022. The proceeds from the debenture and share offering were used by Avivagen to retire principal and interest outstanding pursuant to existing debentures and for transaction expenses.
About Avivagen Avivagen is a life sciences corporation focused on developing and commercializing products for livestock, companion animal and human applications. By unlocking an overlooked facet of β-carotene activity, a path has been opened to safely and economically support immune function, thereby promoting general health and performance in animals. Avivagen is a public corporation traded on the TSX Venture and OTCQB® Venture Market exchanges under the symbols VIV and VIVXF, and is headquartered in Ottawa, Canada, based in partnership facilities of the National Research Council of Canada and Charlottetown, Prince Edward Island. For more information, visit www.avivagen.com. The contents of the website are expressly not incorporated by reference in this press release.
About OxC-beta™ Technology and OxC-beta™ Livestock Avivagen's OxC-beta™ technology is derived from Avivagen discoveries about β-carotene and other carotenoids, compounds that give certain fruits and vegetables their bright colours. Through support of immune function the technology provides a non-antibiotic means of promoting health and growth. OxC-beta™ Livestock is a proprietary product shown to be an effective and economic alternative to the antibiotics commonly added to livestock feeds. The product is currently available for sale in the United States, Mexico, Philippines, Taiwan, New Zealand, Thailand, Australia and Malaysia.
Avivagen's OxC-beta™ Livestock product is safe, effective and could fulfill the global mandate to remove all in-feed antibiotics as growth promoters. Numerous international livestock trials with poultry and swine using OxC-beta™ Livestock have proven that the product performs as well as, and, sometimes, in some aspects, better than in-feed antibiotics.
Forward Looking Statements
This news release includes certain forward-looking statements that are based upon the current expectations of management. Forward-looking statements involve risks and uncertainties associated with the business of Avivagen Inc. and the environment in which the business operates. Any statements contained herein that are not statements of historical facts may be deemed to be forward-looking, including those identified by the expressions `` aim '', `` anticipate '', `` appear '', `` believe '', `` consider '', `` could '', `` estimate '', `` expect '', `` if '', `` intend '', `` goal '', `` hope '', `` likely '', `` may '', `` plan '', `` possibly '', `` potentially '', `` pursue '', `` seem '', `` should '', `` whether '', `` will '', `` would '' and similar expressions.
Statements set out in this news release relating to the market opportunities for the Company, the expectation that Avivagen's current position positions it for future growth, expectation as to further adoption of or orders for the Company's products, the possibility that trials underway could lead to additional orders in the future and the possibility for OxC-beta™ Livestock to replace antibiotics in livestock feeds as growth promoters are forward-looking statements. These forward-looking statements are subject to a number of risks and uncertainties that could cause actual results or events to differ materially from current expectations. For instance, unforeseen factors could limit the growth of the Company and the adoption of its products, customers are under no obligation to make additional orders and may not order increasing quantities of the Company's products, partnerships may not be as successful as hoped, trials may not be successful or may not lead to additional adoption of the Company's products, Avivagen's products may not gain market acceptance or regulatory approval in new jurisdictions or for new applications and may not be widely accepted as a replacement for antibiotics as growth promoters in livestock feeds, all of which could occur due to many factors, many of which are outside of Avivagen's control. Readers are referred to the risk factors associated with the business of Avivagen set out in Avivagen's most recent management's discussion and analysis of financial condition available at www.SEDAR.com. Except as required by law, Avivagen assumes no obligation to update the forward-looking statements, or to update the reasons why actual results could differ from those reflected in the forward-looking statements.
Neither TSX Venture Exchange nor its Regulation Services Provider ( as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.
For more information:
Avivagen Inc. Drew Basek Director of Investor Relations 100 Sussex Drive, Ottawa, Ontario, Canada K1A 0R6 Phone: 416-540-0733 E-mail: d.basek @ avivagen.com
Kym Anthony Chief Executive Officer 100 Sussex Drive, Ottawa, Ontario, Canada K1A 0R6 Head Office Phone: 613-949-8164 Website: www.avivagen.com Copyright © 2022 Avivagen Inc. OxC-beta™ is a trademark of Avivagen Inc.
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Avivagen Inc. published this content on 08 April 2022 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 08 April 2022 21:29:33 UTC. | business |
Housing Crisis: Why 40-Year Mortgages Might Help Delinquent Borrowers | About the author: Patrick Harker is the president and CEO of the Federal Reserve Bank of Philadelphia.
The Covid-19 pandemic is not over. But many of the pandemic assistance programs associated with it are done, or soon will be.
Mortgage forbearance, which began after passage of the Cares Act, is a case in point. Throughout the pandemic, federal and private programs have allowed borrowers to stay in their homes and stop mortgage payments for up 18 months with no negative impact on their credit scores.
The number of loans in forbearance now stands at around 680,000 mortgages. That’ s a whole lot of people, but it in fact represents a steep decline. All told, more than 8.5 million borrowers entered forbearance at some point during the Covid-19 pandemic, north of 15% of the total mortgage market.
Simple arithmetic suggests that nearly 8 million households who were in forbearance no longer are. Temporary protections against foreclosure have expired as well. Which is to say, this is a real-time “ stress test ” not only for borrowers but for lenders as well.
So what has become of this sizable chunk of homeowners and their families? Researchers at the Federal Reserve Bank of Philadelphia have been tracking these data and have made important findings.
The first bit of good news is obvious to anyone perusing listings on Zillow: The American housing market is exceptionally strong. While this has had undeniably negative impacts on those seeking to enter the housing market, it does ensure that most past-due borrowers can avoid losing their homes and that banks won’ t suffer losses large enough to meaningfully affect their capital positions. Homeowners are sitting on more than $ 10 trillion of tappable equity – a record. Other borrowers coming off forbearance who are unable to resume their payments likely have the option to extract equity from their properties.
The contrast with the Great Recession is remarkable. Recall that back then nearly half of all distressed borrowers were “ underwater, ” meaning they owed more on their mortgages than their houses were worth.
Also, as of today, nearly three-quarters of those who have exited forbearance have voluntarily paid off or are current on their mortgages, many making use of payment deferrals or loan modifications. For borrowers able to resume timely payment, a deferral creates a no-interest, second loan out of their missed payments not due until the loan is paid off. This is significant because payments missed during forbearance do not disappear: Borrowers will still have to pay them back eventually. Tacking them onto the end of a primary loan is a smart way to ease this burden.
Loan modifications, meanwhile, work like a no-cost, cash-out refinance. Borrowers are offered lower rates and extended loan terms while being allowed to forgo immediate payback of their past-due arrears, resulting in reductions in their monthly mortgage payments of 20% or more. Deferrals and loan modifications are the two major types of Covid-19 loss mitigation options on offer.
But many American borrowers continue to face heavy burdens.
Nearly one million mortgages are seriously delinquent, split evenly between those classified by servicers as in loss mitigation and those not. Most borrowers who remain seriously delinquent and not in loss mitigation never entered forbearance at all and were in nonpayment before the pandemic struck.
And of the borrowers classified as in loss mitigation, three-quarters are still in process and have not, as of yet, resumed timely payment on their mortgages. The burdens are not distributed equitably. Black and Hispanic borrowers have much higher shares of nonpayment — either being in forbearance or delinquency.
Losing one’ s home is a profoundly destabilizing event with potentially lifelong consequences. It’ s a heavy burden to lenders as well: Foreclosures are expensive and time-consuming to service. Lenders should be thinking hard about how to keep people in their homes and to minimize their own losses.
One solution being pursued is for the Federal Housing Administration to offer 40-year terms for their modifications, just as the two government sponsored enterprises, Fannie Mae and Freddie Mac, do now. This would lower the monthly mortgage payment even more than when extending beyond the currently offered 30-year term, providing more relief to borrowers. The Department of Housing and Urban Development placed a proposed rule into the Federal Register on April 1 to increase the term for loan modifications to 40 years for FHA-insured mortgages. We are now in a 60-day comment period.
Longer term, lenders should think of ways to improve communication with their customers. Our data suggest millions of distressed borrowers who qualified for forbearances never took advantage of them. A study from my colleagues at the Federal Reserve Bank of Philadelphia found that millions of borrowers— disproportionately Black or low-to-moderate income—did not apply to refinance their mortgages during the pandemic, when they could have enjoyed significant savings. This was a missed opportunity.
With a fairly weak public social safety net for Americans, houses are not only our shelters — they are a significant source of our household wealth and retirement savings as well. Let’ s do what we can to make sure people don’ t lose this most vital asset.
Watch Philadelphia Fed President Patrick Harker on Barron’ s Roundtable, airing on Fox Business at 10 a.m. and 11:30 a.m. ET, on Saturday, April 9, and Sunday, April 10. | business |
No shoving or biting! Unruly U.S. airline passengers get big fines | Since January 2021 when the Federal Aviation Administration ( FAA) imposed a zero-tolerance policy, the agency has proposed fines of about $ 7 million for disruptive passengers. Two new fines issued Friday were the highest yet.
The FAA proposed a $ 81,950 fine for an American Airlines passenger on a July flight from Dallas, Texas to Charlotte, North Carolina, alleging the passenger `` threatened to hurt the flight attendant that offered help to the passenger after she fell into the aisle. The passenger then pushed the flight attendant aside and tried to open the cabin door. ''
The FAA added `` two flight attendants tried to restrain the passenger, but she repeatedly hit one of the flight attendants on the head. After the passenger was restrained in flex cuffs, she spit at, headbutted, bit and tried to kick the crew and other passengers. ''
The agency also proposed a $ 77,272-fine for a Delta passenger on a July Las Vegas to Atlanta flight, alleging the passenger `` attempted to hug and kiss the passenger seated next to her; walked to the front of the aircraft to try to exit during flight; refused to return to her seat; and bit another passenger multiple times. ''
Delta said Friday it `` has zero tolerance for unruly behavior at our airports and on our flights as nothing is more important than the safety of our customers and people. ''
The FAA imposed its zero-tolerance mandate when unruly passenger incidents escalated around the time of the Jan. 6, 2021, attack on the U.S. Capitol. Incidents remained elevated after President Joe Biden's administration imposed a mandate requiring passengers to wear masks on airplanes and in airports because of COVID-19 cases in February 2021.
The FAA said neither incident that led to Friday's fines involved passengers who objected to wearing masks.
U.S. Transportation Secretary Pete Buttigieg told ABC's `` The View '' Friday that the administration's mandate requiring masks on airplanes and in public transport will either expire or be renewed on April 18.
`` We all want to get to where there are fewer restrictions. We just need to get to a point where it is safe to do that, '' Buttigieg said. `` Air travel is a little different than a lot of other environments but we would love to get there. ''
Airlines and Republicans in Congress are pressing the White House to end the mask mandate and some lawmakers sent a new letter https: //republicans-transportation.house.gov/uploadedfiles/2022-04-08 -- letter to biden re mask mandate april.pdf? utm campaign=197014-345 on Friday to Biden.
The FAA said since January 2021, there have been a record 7,060 unruly passenger incidents reported - and 70% involved masking rules - but the rate has declined 60% since its high in 2021.
The FAA said in February it has referred 80 unruly airplane passengers to the FBI for potential criminal prosecution.
Buttigieg said the administration and Congress are still looking at a `` no-fly '' list for unruly passengers.
( Reporting by David ShepardsonEditing by Chizu Nomiyama and David Gregorio)
By David Shepardson | business |
Biden eyes political rebound after historic Supreme Court triumph | Hi, what are you looking for?
The Thursday confirmation of Ketanji Brown Jackson to the US Supreme Court marks an undeniable success for Joe Biden.
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The Thursday confirmation of Ketanji Brown Jackson to the US Supreme Court marks an undeniable success for Joe Biden, with the American president in dire need of fresh political uplift months before midterm elections.
The 79-year-old Democrat has made clear he intends to thoroughly capitalize on the historic appointment, which fulfills a top campaign promise: placing a Black woman for the first time onto the nation’ s highest court, a nine-justice bench where America’ s most pressing social debates are decided.
Biden hosted the highly respected judge at the White House on February 25 when he unveiled her as his nominee. Then he made it publicly known he called her up to offer encouragement ahead of marathon US Senate confirmation hearings before the judiciary committee that he himself once chaired as a senator.
On Thursday the White House ushered photographers into a room in the presidential mansion where they found Biden and Jackson watching the Senate confirmation vote live on television.
If that wasn’ t enough, Biden posted a selfie of the occasion on the presidential Twitter account.
– Reception –
Finally, on Friday Biden and Vice President Kamala Harris will fete Jackson at an event on the White House lawn.
With the rapid approach of the midterm elections, traditionally difficult for the incumbent president’ s political party, Biden is desperate to build some political momentum.
His administration may be highlighting the US economy’ s rapid rebound and a booming job market following coronavirus pandemic doldrums, but none of that is working.
American households see only their hard-earned dollars being swallowed up at the gas pump and the supermarket checkout counter due to galloping inflation.
The president’ s job approval rating is hovering around 41 or 42 percent — dismal, with little signs of improvement.
If there was a slight uptick after Russia launched its invasion of Ukraine, which saw Biden take the reins of the Western response, it hardly lasted, with the nation’ s partisan divides pushed to breaking point by previous president Donald Trump.
Such division played out during the Jackson hearings, even as the nominee herself has proven popular with the public.
“ The Republicans want to win back the majority ( in Congress), and so they were asking a lot, I think, of irrelevant questions, ” said University of Richmond law professor Carl Tobias.
He also noted that while three Republicans broke ranks and voted to confirm Jackson, it was nothing like the bipartisan mood that surrounded Stephen Breyer, the justice whom Jackson is replacing.
He was confirmed 87-9 by the Senate in 1994; Biden’ s nominee earned a 53-47 vote.
– Rejuvenation –
If he can not jolt large swaths of voters to his side, Biden can at least hope the Jackson confirmation lights a fire under a crucial slice of the electorate: African Americans.
He owed them for the 2020 election, not just for getting him into the White House, but for securing a razor-thin Senate majority, after intense fieldwork by Black community leaders in Georgia helped wrest two seats away from Republicans.
But after the euphoria of those victories ebbed, many activists criticized Biden for abandoning some promises he made to minority voters, notably on addressing police brutality and defending voting rights.
Jackson’ s appointment to the court could at least temporarily assuage the sting of previous disappointments. She has been praised by luminaries including former first lady Michelle Obama, as well as Martin Luther King III — son of the slain civil rights icon — and Stacey Abrams, the charismatic Black candidate for governor in Georgia.
In the end though, what really could spoil Friday’ s party at the White House is Covid-19; infections have exploded in recent days in Washington and its small world of politics and media.
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.
A cargo airplane broke up during an emergency landing in Costa Rica on Thursday.
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Zoos across North America are moving their birds indoors and away from people and wildlife as avian flu hits.
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Brant Daugherty talks about his Hallmark film ' A Royal Runaway Romance ' | Hi, what are you looking for?
Actor Brant Daugherty chatted about starring in the new original Hallmark film “ A Royal Runaway Romance. ”
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Actor Brant Daugherty chatted about starring in the new original Hallmark film “ A Royal Runaway Romance. ”
He plays opposite Philippa Northeast ( “ Home and Away ”), and their characters take a cross-country road trip. “ A Royal Runaway Romance ” is a new original movie that premieres tomorrow on Saturday, April 9 on the Hallmark Channel, as part of the network’ s “ Spring into Love ” programming event. “ I really believe in this movie and I thought it was so cool, ” he said.
On being a part of the Hallmark family, he exclaimed, “ It’ s amazing. I understand how important that is, especially with Hallmark, since I believe in their messaging and what they are doing and what they are putting out in the world. I am a very lucky man. ”
“ The entire shoot was such a treat, ” he admitted. “ It was such a positive experience overall. My favorite part was getting to work with Philippa Northeast, this is her first project for an American audience. She was a real treat to work with, she is such a talented actress and she is so sweet. I can’ t wait for everyone to be introduced to her in this film. ”
“ We got along amazingly well, and Philippa made it such an amazing experience from start to finish, ” he added.
The synopsis of the film is as follows: Just as Princess Amelia ( Philippa Northeast) is preparing to take over as Queen once her mother Ava ( Sarah Jane Redmond) steps down in a year, she finds herself falling for Wes ( Andre Anthony) the American artist commissioned to paint her royal portrait.
The Queen makes it clear that she doesn’ t think Wes is the right match for Amelia, so when the artist returns home to Chicago, Amelia devises another reason to travel to the states – her Uncle Andreas’ ( Vincent Gale) upcoming birthday. It’ s the perfect plan…except that Andreas’ Beverly Hills home is nowhere near Chicago, and Wes isn’ t able to meet her there.
Complicating matters further, her mother insists on traveling with her and confiscates her passport, making a quick flight to Chicago impossible. And perhaps the biggest hurdle is when Amelia learns that Grady Beck ( Brant Daughtery), Andreas’ trusted bodyguard, is now assigned to stay with her at all times. Not easily deterred from her plans to see Wes, Amelia decides to “ borrow ” Grady’ s car to drive to Chicago.
When the handsome bodyguard catches onto her plan and tells her uncle, Andreas agrees to help Amelia on one condition – Grady must go with her. Heading out with Grady in Andreas’ classic convertible, America-obsessed Amelia gets the cross-country trip she’ d always dreamed of – and perhaps her last chance to be free before assuming the responsibilities of being Queen.
Along the way, Amelia and Grady open up to each other and find that they have more in common and more fun together than either expected. With every state line they cross, each will learn that in road trips and romance, the destination is less important than the journey and the person you share it with.
“ Playing Grady was a treat, he is such a proactive and strong character, ” he said. “ I love the strong and silent type because they are so fun to play. Grady is a man of a few words and I gravitate towards that. Getting into Grady’ s head was really fun. I love the way their relationship develops, and I love his emotional core. ”
“ Grady has a strong and silent exterior but he has a really deep well of unresolved emotion with his father and he is not really sure how to get past that. Grady is such a rich character and there is so much to dive into. I enjoyed playing him so thoroughly, ” he added.
“ A Royal Runaway Romance ” is from Crown Media Productions, LLC. David Weaver directed the film from a screenplay by Jake Helgren. “ Jake is a good dude, I worked with him four times before and he always does a phenomenal job, ” he said.
Regarding his daily motivations as a content creator, Daugherty said, “ I have loved telling stories ever since I can remember, and anyway I can be a part of that is amazing to me. The fact that my acting career has taken me as far as it has is just humbling. I want to make stories that are meaningful and impactful. ”
On being an actor in the digital age, Daugherty remarked, “ It’ s amazing. There is a wealth of opportunities out there, it’ s the greatest thing. To have all of these outlets as a writer, director, and actor is so cool. ”
For young and aspiring actors, he said, “ Learn your craft through and through from as many angles as you can and not just acting. Study writing, study directing, study editing, theatre, and playwrights. Get a wide grasp of it as much as you can. Ultimately, that’ s how I found my way into the craft of acting. ”
On his experience on “ Pretty Little Liars, ” he said, “ It was great, they spoiled us so thoroughly. To have a show that has been so impactful was like being a part of another family. It was hard when it ended. As an actor, it was a treat to be a part of something like that, and I was very fortunate to have such great experiences in my career. ”
Daughterty recalled his time on the NBC daytime drama “ Days of Our Lives, where he played Brian, and he opened up about how he handled being dialogue-heavy ( where he had to learn many pages of scripts). “ One day, they sent me 37 pages of dialogue, and it was a challenge but we got through it, ” he said with a laugh. “ As a result, I was able to handle anything that was thrown at me after that. ”
On being a part of “ Fifty Shades Freed, ” he said, “ It was one of my craziest experiences, and I mean that in a positive way. I was able to shoot slowly and thoughtfully. We really took our time, and it was an absolute treat. The cast and the crew were phenomenal people. ”
A defining moment for him was when he did “ Dancing with the Stars ” and did a dance from a memorable year. Daugherty chose to do a dance from the year that his father passed away.
“ That was the year that my entire life changed and I did a dance where I paid tribute to my father. That was a turning point in my career since I learned how to take a new medium like dance and I was able to put my acting techniques into it. I felt so proud of that moment, ” he elaborated.
On the title of the current chapter of his life, he responded, “ Expansion. ” “ I am moving into all facets of entertainment. I have my hands in a little bit of everything right now, it’ s a nice place to be ” he said.
If he were to have any superpower, Daugherty revealed that it would be “ flying. ” “ That would be so freeing, ” he admitted.
On his definition of the word success, Daugherty said, “ As I get older, success becomes more about my relationships. It’ s about being able to take care of the people that I love and doing what I love. It’ s not necessarily the big house on the hill and the fancy cars, it’ s about feeling good about what I am doing and being able to provide for my family doing it. ”
Daughtery concluded about “ A Royal Runaway Romance, ” “ This movie is so much fun. There is so much beauty, humor, emotion, and humanity. I really can’ t wait for everyone to see it. This is my favorite Hallmark movie thus far, and I hope that the fans all agree. ”
To learn more about actor Brant Daugherty, follow him on Instagram and check out his IMDb page.
Markos Papadatos is Digital Journal's Editor-at-Large for Music News. Papadatos is a Greek-American journalist and educator that has authored over 17,000 original articles over the past 16 years. He has interviewed some of the biggest names in music, entertainment, lifestyle, magic, and sports. He is a six-time consecutive `` Best of Long Island '' winner, and in the past three years, he was honored as the `` Best Long Island Personality '' in Arts & Entertainment, an honor that has gone to Billy Joel six times.
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Metaverse Crimes: How is the Virtual World Evaluating Misbehavior | OpenAI’ s DALL.E 2 is an advanced text-to-image generation AI model
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Computers once occupied huge spaces, but they’ ve contracted until we got things like pocket-sized cell phones that you continually associate with. The Metaverse takes this a step further, causing the real environment you interact with virtual, eliminating the point of interaction of computers completely. A vision for the next step in the internet’ s evolution, the Metaverse refers to digital worlds in which people will gather to work, play and hang out. Some of those online spaces will be immersive 3D experiences and require fancy goggles to enjoy. Others will play out on a computer screen.
According to the experts, the metaverse is the next stage in the development of the internet. Especially during the time when people interact with each other online by going to websites such as social media platforms or using messaging applications. The idea of the metaverse is that it will create new online spaces in which people’ s interactions can be more multi-dimensional, where users are able to immerse themselves in digital content rather than simply viewing it.
The accelerated interest in the metaverse can be seen as a result of the COVID-19 pandemic. As more people have started working and going to school remotely, there has been an increased demand for ways to make online interaction more lifelike.
As life in the metaverse becomes more complex, there will be more opportunities for crime to occur. Crimes are not only related to privacy breaches that companies commit by selling personal data that was the last section but also about companies being hacked and user data being leaked. More complex systems end up with more security holes to block.
People should prepare themselves for user-on-user crimes as well, including cyber trespassing, deception, violence, obscenity, and harassment. People do all of these things already on the internet, there’ s no reason they will not continue to do so in the metaverse. So, expect to be targeted and harassed for your race, gender, beliefs, support of a sports team, your choice of Android or Apple, political stands, and just about any thought or belief you choose to express. Already there are reports of sexual assaults occurring in the early days of the metaverse, and debates have already started. Can your avatar be molested count as actual molestation? Is it an overreaction of sorts, or should we truly embrace the metaverse as an extension of our lives, and consider things done in the metaverse as a crime, if those would be a crime in the real world?
Envision assuming a gathering of men were to encompass a lady in the city of your town, swarm around her, not permitting her to move away, and begin utilizing foul language to threaten and startle her, conveying intimidations of assault and attack. Surely that counts as sexual assault, right? Presently assuming the equivalent were done to a female person in the metaverse, is that wrongdoing? Shouldn’ t it be? Who chooses? Do we have police watches in the metaverse now, to stop such a revolting way of behaving? Do we have metaverse prisons to rebuff hoodlums for illicit ways of behaving how intently do we believe it should impersonate reality?
There is an age-old saying that every coin has two sides. And, same is the case with metaverse too. While many talks about the positives and how transcending into a more connected and AR-oriented world would benefit us. There are a select few who dare to look on the flipside and act upon what they are witnessing by making attempts to draft certain regulations. This brings us to the topic of laws and how they are and will be defined in the metaverse.
There are a lot of concerns regarding the technology of Metaverse and what kind of legal implications it will have. From the issue of the groping of a female avatar to the selling off assets in millions, Metaverse has thrown a plethora of challenges. At the same time, this is just the beginning of the revolution of the internet, and full implications of the technology of Metaverse will be realised only in 10-15 years. However, lawmakers will have to be active in ensuring that the technology of Metaverse is in sync with the norms of data protection. This calls for an early draft of the law for Metaverse so that technology also evolves with boundaries set by law. | tech |
Bài học cho lãnh đạo Trung Quốc từ cuộc chiến giữa Nga và Ukraina | Kể từ khi có những tiếng nổ đầu tiên trên bầu trời Ukraina hôm 24/2, đánh dấu cuộc xâm lược của Nga vào quốc gia Đông Âu, Trung Quốc vẫn luôn cố gắng giữ thái độ trung lập và làm mờ nhạt vai trò của mình trong cuộc xung đột này. Được cho là đối tác gần gũi – người duy nhất có khả năng lay chuyển Vladimir Putin, Tập Cận Bình thẳng thắn từ chối yêu cầu của phương Tây đứng ra làm bên thứ ba giảng hoà, tạo lối thoát cho khủng hoảng Ukraina. Cho đến nay, Trung Quốc vẫn không gọi hành động của Nga tại Ukraina là xâm lược mà chỉ là “ chiến dịch quân sự đặc biệt ”. Giới truyền thông Trung Quốc theo chân tuyên truyền của Nga về cuộc chiến.
Thay vì lên án tội ác chiến tranh, kênh truyền hình quốc gia Trung Quốc tố cáo Ukraina dàn dựng hình ảnh về thảm sát ở Bucha. Trong một video dài hơn 3 phút của kênh truyền hình CGTN bản tiếng Pháp do Nhà nước Trung Quốc quản lý, biên tập viên giải thích “ hành động tự vệ ” của Nga là do những lần thất hứa của Liên Minh Bắc Đại Tây Dương ( NATO) và nguy cơ khối này mở rộng ra sườn đông châu Âu, nhất là liên quan đến một nước từng là một quốc gia sở hữu vũ khí hạt nhân. Bắc Kinh cho rằng chính Hoa Kỳ và NATO phải chịu trách nhiệm về chiến tranh Ukraina.
Trung Quốc cũng phản đối các lệnh trừng phạt của phương Tây làm tê liệt kinh tế Nga. Trong một cuộc họp báo ngày 06/04, được AP trích dẫn, phát ngôn viên bộ Ngoại Giao Trung Quốc Triệu Lập Kiên ( Zhao Lijian) cho rằng điều này chỉ đổ thêm dầu vào lửa:
“ Kể từ khi xung đột giữa Nga và Ukraina nổ ra, Mỹ đã gia tăng các biện pháp trừng phạt đơn phương đối với Nga và ép buộc các nước khác đứng về phía mình. Báo cáo của viện nghiên cứu tài chính Chonyang của Trung Quốc, chỉ ra rằng từ 2014 đến nay, một nhóm các quốc gia mà dẫn đầu là Hoa Kỳ đã áp đặt 8.068 lệnh trừng phạt đối với Nga - vượt qua Iran, Nga trở thành quốc gia bị trừng phạt nhiều nhất trên thế giới. Chiến tranh và các trừng phạt dẫn đến hâụ quả là các dòng người di cư, dòng vốn chảy ra ( captial outflow) và thiếu hụt năng lượng ở châu Âu, tuy nhiên Mỹ lại là bên thu lợi, kiếm lời từ đó. ”
Trên thực tế, Trung Quốc rơi vào thế khó xử khi một mặt phải duy trì “ tình bạn sắt son ” với đối tác chiến lược Nga, mặt khác, lại phải dè dặt trong các phát biểu của mình để không làm phật lòng đối tác thương mại hàng đầu - phương Tây mà Bắc Kinh không thể từ bỏ. Công luận quốc tế cho rằng trước các lệnh trừng phạt, Nga có thể tìm cách cứu vớt nền kinh tế bị tê liệt bằng cách dựa lưng vào thị trường 1,4 tỷ dân của Trung Quốc.
Tuy nhiên, cho đến nay, Bắc Kinh dường như chưa tỏ ra sẵn sàng giúp Nga lách các trừng phạt, mà thay vào đó là “ bắt cá hay hai tay ”, vừa muốn hợp tác kinh doanh bình thường với cả Nga và Ukraina vừa tìm cách tránh suy giảm quan hệ với Mỹ và châu Âu. Một số ngân hàng quốc gia Trung Quốc đã bắt đầu giảm các giao dịch với Nga, thuận theo các lệnh trừng phạt từ Mỹ. Trung Quốc muốn duy trì tăng trường kinh tế bằng mọi giá, nhất là khi nước này đang chật vật trong giai đoạn phục hồi sau đại dịch.
Trong bài phân tích đăng trên trang the Diplomat, mà RFI trích dịch, chuyên gia nghiên cứu về quan hệ quốc tế tại trung tâm tư vấn - Trường Nghiên cứu Quốc tế Singapore ( S. Rajaratnam School of International Studies – RSIS, thuộc đại học công nghệ Nam Dương ( Nanyang), Singapore, tiến sỹ Dương Tử ( Zi Yang) cho rằng việc Nga xâm lược Ukraina đưa ra những bài học đắt giá cho giới lãnh đạo Trung Quốc trong chính sách đối với giới tinh hoa, hay chính sách đối ngoại và ngoại giao, trong bối cảnh Nga đã “ vỡ mộng ” trên nhiều mặt trận trong “ chiến dịch quân sự đặc biệt ” của mình.
Đầu tiên đó là bài học về chính sách đối phó với giới tinh hoa, tiến sỹ Dương Tử nêu ra mối đe doạ về chủ nghĩa cá nhân. Ông nhận định cách thức cai trị của Trung Quốc phụ thuộc vào những gì xảy ra ở “ cấp tinh hoa ”.
Mặc dù các chính sách tuyên truyền và những người có ảnh hưởng mang tư tưởng dân tộc chủ nghĩa ở Trung Quốc, đã đưa ra những bài tuyên truyền thân Nga để cổ vũ dân chúng chống lại một nước Mỹ được ví như một con quái thú đáng sợ, nhưng điều này không qua mắt được giới tinh hoa – điều hành Trung Quốc, có lẽ đã nhìn nhận rõ ràng tình hình hiện tại. Quyết định xâm lược Ukraina của Putin cho thấy mức độ huỷ diệt của chủ nghĩa cá nhân khi quyền lãnh đạo tập thể bị thay thế bởi cả một hệ thống - xoay quanh một người duy nhất và người này không phải đối mặt với cơ chế kiểm soát và đối trọng ( phân lập quyền lực).
Gần đây, tình báo Hoa Kỳ cho biết, vì lo sợ Putin lên cơn thịnh nộ, cấp dưới của ông đã cung cấp thông tin sai lệch, củng cố nhận thức sai lầm của ông về cuộc chiến. Nga bị rơi vào vòng luẩn quẩn, dẫn đến quyết định tiến hành “ chiến dịch quân sự đặc biệt ”.
Trong thập kỷ qua, trước nỗ lực cá nhân hoá nền chính trị Trung Quốc của Tập Cận Bình, việc Nga tấn công Ukraina dường như đã làm tái sinh các phe phái tinh hoa ở Trung Quốc, dám lên tiếng phản đối chủ nghĩa cá nhân. Hôm 28/03, Bí thư tỉnh uỷ Hồ Bắc Ứng Dũng - một trong những thân tín của Tập Cận Bình - đã bị cách chức và cho về hưu sớm khi dịch Covid-19 bùng phát. Đây là một dấu hiệu cho thấy sự kháng cự chống lại tình trạng tập trung quyền lực của ông Tập. Vụ việc khiến nhiều người ngạc nhiên vì Ứng Dũng được cho là sẽ đảm nhận những vị trí cao hơn trong hệ thống chính trị và pháp luật Trung Quốc – giám sát một mạng lưới rộng lớn cảnh sát giữ gìn trật tự và mật vụ của Trung Quốc.
Trước thềm Đại hội Đảng lần thứ 20 diễn ra vào cuối năm nay, kết quả thảm hại của chủ nghĩa Putin ở Nga sẽ mang lại thêm động lực và lý do cho đối thủ của ông Tập, để chống lại động thái tương tự đối với chủ nghĩa cá nhân ở Trung Quốc. Trong khi khó có thể làm trật bánh công cuộc củng cố quyền lực của Tập Cận Bình và ông có thể vẫn là nhà lãnh đạo tối cao của Trung Quốc, thì Bộ Chính Trị mới cùng Ban Thường Vụ tiếp tục phản ánh sự đa dạng phe phái, hơn là sự thống trị của những người trung thành với ông Tập.
Trong bài phân tích, nhà nghiên cứu Dương Tử cho rằng bài học thứ hai mà Trung Quốc có thể rút ra đó là thận trọng trong chính sách ngoại giao.Trong cuộc chiến giữa Nga và Ukraina, chiến lược của Trung Quốclà để phương Tây và Nga suy yếu còn mình trung dung, ở giữa thu lợi nhiều nhất.
Trung Quốc một mặt nâng cao quan hệ đối tác giữa Nga và Ukraina, mặt khác thì ký kết các thoả thuận với phương Tây và đổi lại là cam kết không trợ giúp Nga trong cuộc chiến này. Các tuyên bố gần đây của các nhà ngoại giao Trung Quốc cho thấy Bắc Kinh diễn vở khác nhau tuỳ theo ai là khán giả.
Trong cuộc gặp với ngoại trưởng Nga Sergei Lavrov, đồng nhiệm Trung Quốc Vương Nghị đưa ra luận điệu về tình hữu nghị “ không có giới hạn ” giữa hai nước. Tuy nhiên, trước khán giả Hoa Kỳ, trên kênh truyền hình Phoenix TV, đại sứ Trung Quốc tại Mỹ, Tần Cương ( Qin Gang), nhấn mạnh rằng, quan hệ giữa “ Trung Quốc và Nga dẫu sao vẫn có những ranh giới cuối cùng ( bottom line) đó là những nguyên tắc được thiết lập trong Hiến Chương của Liên Hiệp Quốc ”. Theo đó, Bắc Kinh giữ khoảng cách với các hành động của Matxcơva.
Trung Quốc sẽ theo đuổi lợi ích riêng hơn là phải chọn phe và tham gia vào cuộc chiến. Điều này có nghĩa là chính sách ngoại giao trong tương lai sẽ thận trọng hơn nữa vì bất cứ động thái phi lý nào có thể khiến Bắc Kinh phải trả giá đắt. Bài học chiến tranh cho chính sách ngoại giao của Trung Quốc đó là thận trọng thay vì hiếu chiến. Bè phái “ chiến binh sói ” đang trỗi dậy bên trong bộ Ngoại Giao Trung Quốc, mà hiện thân là phát ngôn bộ Ngoại Giao Triệu Lập Kiên - có khả năng sẽ mất đi sức ảnh hưởng do chiến tranh, những người ủng hộ các cách thức ngoại giao truyền thống có thể có được sức mạnh nhờ vào tính nhạy cảm của giai đoạn này.
Và cuối cùng, ngoại giao là nghệ thuật tính toán, suy tính thiệt hơn và đưa ra thoả hiệp. Trung Quốc phải chèo lái một tình huống phức tạp để tối ưu hoá lợi ích quốc gia trong giai đoạn đầy thử thách. Do đó, Trung Quốc sẽ chủ trương duy trì thận trọng trong chính sách đối ngoại từ giờ tới khi cuộc chiến kết thúc.
Từ cuộc chiến cuối cùng năm 1979, với bài học từ chiến tranh của các quốc gia khác, Quân Giải phóng Nhân Dân Trung Quốc có lẽ bị sốc bởi sự kém cỏi của quân đội Nga. Có vẻ như cỗ máy chiến tranh hùng mạnh đã bị phá hỏng một cách có hệ thống, bao gồm việc binh lính và sĩ quan đào ngũ, nổi loạn, tự bắn giết nhau. Phải nói đến con số gây sốc về tướng lĩnh Nga bị chết hay mạng lưới C4ISR ( chỉ huy, kiểm tra, thông tin, máy tính, tình báo, giám sát, do thám) bị đánh sập. Điều này cho thấy quân đội Nga đã mục rữa từ nhiều năm qua và khả năng sẵn sàng chiến đấu còn xa vời.
Trong khi người ta đổ lỗi cho lãnh đạo, cho chiến lược, hậu cần hay tinh thần, thì cuối cùng, tất cả những thất bại này trở này minh chứng cho quá trình cải cách quân sự nửa vời của Nga. Điều này khiến lãnh đạo quân đội Trung Quốc phải xem xét lại chính các cải cách của mình. Mặc dù các cải cách quân sự của Trung Quốc đi xa hơn các dự án của Nga, nhưng thực lực thật sự của quân đội Trung Quốc, nếu xảy ra chiến tranh, vẫn là một bí ẩn.
Các cuộc tập trận không cho phép kiểm tra khả năng thực sự của quân đội vì thường tuân theo kịch bản có sẵn. Trong khi đó, nhiệm vụ tiên quyết là bảo vệ Nhà nước và Đảng, quân đội phải sẵn sàng cho trường hợp xung đột, đe doạ đến tính hợp pháp của chế độ. Ví dụ như căng thẳng ở eo biển Đài Loan | general |
The Chip Sector Has a New Worry in Plant Shutdown for Key PFAS Chemicals | The fragile semiconductor supply chain has one more thing to worry about.
Chips have been relatively scarce throughout the pandemic, with Covid-19 periodically triggering plant shutdowns, and demand soaring along with sales of PCs, smartphones, electric vehicles, and other electronic goods. The market has recently been worried about a shortage of neon and other rare gases used in chipmaking, triggered by the Russian invasion of Ukraine.
This time, the issue involves a class of chemical called PFAS, an acronym for “ perfluoroalkyl and polyfluoroalkyl substances. ” Semiconductor manufacturers use PFAS as coolants in the etching process, a crucial step in chip production.
The vast majority of semiconductor-grade PFAS is produced by 3M ( ticker: MMM), primarily at a plant in Zwijndrecht, Belgium. Recently, 3M’ s plant there has stopped PFAS production to implement emissions controls that have been demanded by the Belgian government.
On March 30, 3M announced plans to invest €150 million ( equal to about $ 163 million) “ to proactively advance remedial actions for the Zwijndrecht community to address legacy manufacturing and disposal ” of PFAS. “ 3M has engineered and activated a wastewater treatment system that has helped significantly reduce PFAS discharges from its site in Zwijndrecht, while continuing to work with relevant authorities to resolve the wastewater discharge permit modification issues that impact the facility’ s operations, ” it said.
In a statement this week, 3M told Barron’ s that “ the timeline to resolve the situation is uncertain and, in several aspects, not in 3M’ s control. We have communicated with our customers about the potential for disruption. ”
In a research note this week on the issue, the supply-chain monitoring company Resilinc noted that 3M accounts for 90% of the global supply of coolant for the chip industry, saying 80% of that comes from the single plant in Belgium, while the rest is produced in the U.S. The remaining 10% of global supply comes from Solvay, a Belgian chemical company that produces the material in a plant in Italy, Resilinc said.
Resilinc reported that 3M sells the coolants under the brand names Fluorinert and Novec.
Customers for PFAS include companies with substantial chipmaking operations, like Intel, Micron, SK Hynix, Samsung, and Taiwan Semiconductor, among others.
In response to a query from Barron’ s, Intel said it was keep close tabs on the issue. “ Intel has assessed the possible impact of the coolant production halt at the 3M Belgium facility on its supply chain, ” the company said in a statement. “ While we work with 3M regarding coolant supply and their restart strategy, we do not foresee immediate disruption to our operations. However, we are monitoring the situation carefully and working with our suppliers closely to mitigate our risks. ”
Likewise, SK Hynix said it “ expects to utilize the remaining inventory for short- to mid-term usage. We’ re considering plans to diversify our sources of coolant material in case this situation becomes a long-term issue, and will ensure no disruption occurring to our production. ”
Micron has a similar position. “ We do not expect any negative impact to our near-term production volumes, but this is a dynamic situation, and we remain vigilant, ” Micron said in response to a query from Barron’ s. “ We are taking steps to secure additional supply for a longer period. We are focused on ensuring continuity of supply for our customers. ”
Samsung and Taiwan Semiconductor didn’ t immediately respond to requests for comment on the 3M issue. | business |
The Dollar’ s Reserves of Strength by Gene Frieda | The US-China trade war and the recent freezing of much of Russia’ s official foreign-exchange reserves have again raised fears of an exodus from the dollar. But no one should write the greenback’ s obituary just yet.
LONDON – The freezing of much of Russia’ s official foreign reserves has inevitably led some again to predict the imminent demise of the dollar’ s “ exorbitant privilege ” as the world’ s reserve currency of choice. But we should not write the greenback’ s obituary just yet.
On its own, the sanctioning of Russia’ s reserves will likely reinforce the primacy of the dollar as the backbone of the fiat currency system. Only if the United States were regularly to use such financial sanctions as an offensive foreign-policy weapon might a more rapid erosion in the dollar’ s status occur.
True, in the past four years – a period marked by a US-China trade war and the COVID-19 pandemic – the dollar has accounted for only 40% of new reserve accumulation, compared to 23% for the euro. The Chinese renminbi’ s share of new reserves has jumped to 10%, while the Japanese yen and British pound have gained ground as well.
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Cryptocurrencies and blockchain-based technologies are here to stay. But what will their next chapter look like?
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Writing for PS since 2011 14 Commentaries
Gene Frieda, a global strategist at PIMCO, is a senior visiting fellow at the London School of Economics.
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The US dollar issue looms in the shadow of economist Friedrich Hayek and his book `` The Denationalisation of Money ''. Hayek advocated `` the establishment of competitively issued private moneys, where he speculated that rather than entertaining an unmanageable number of currencies, markets would converge on one or only a limited number of monetary standards, on which institutions would base the issue of their notes. `` The concept of one currency hinges on having the correct value. One currency should have multiple values based on its supply and demand within national markets.To understand the correct value, a look at the wrong value is seen in the IMF fixed cross rates. An example of International Monetary Fund ( IMF) fixed cross rates is seen clearly on the 10th August 2021. The exchange rate between the US dollar and British Sterling pound on the 10th of August 2021 was £1 per US $ 1.385. This `` 1.385 '' cross rate appears in the US dollar and British Sterling pound of other national currencies as if they have the same US dollar/British Sterling pound liquidity in their national money markets to justify such an IMF fixed cross rate.For example the British Sterling pound exchange rate against the Japanese Yen on the said date was ¥152.878 per £1 against ¥110.371 gives a cross rate of 1.385. The Chinese Yuan Renminbi value against the British Sterling pound was ¥8.973 per British Sterling pound and ¥6.478 per US dollar gives a cross of 1.385. The North Korean Won against the British Sterling pound stood at W1,245.795 against W899.978 against the US dollar gives a cross rate of 1.385.The Euro against the British Sterling pound stood at €1.179 against €0.8519 per US dollar to give a cross rate of 1.385.The Canadian dollar against the British Sterling pound stood at C $ 1.739 and C $ 1.256 per US dollar to give a cross rate of 1.385.The Swedish Krona value in British Sterling pound stood at kr12.055 against kr8.7048 per US dollar giving a cross rate of 1.385. The Indian Rupee Sterling pound value on the 10 the August 2021 stood at R102.967 against R74.36 per US dollar giving a cross rate of 1.385. The South African Rand Sterling value stood at R20.422 against R14.752 per US dollar giving a cross rate of 1.385.The Zambian Kwacha Sterling pound value on the 10th August 2021 stood at K26.7427 per Sterling pound and the US dollar value stood at K19.3069 per US dollar giving a IMF cross rate of 1.385.Does it mean that North Korea, the European Union, Japan, Canada, China, India etc all have US dollar and Sterling pound liquidity within their money markets to justify the IMF fixed cross rates day in and day out? Therefore the concept of having just `` one value '' undermines the concept of real value driven by markets.One currency can have multiple values in a Free Floating Cross Rate System. A case in point as noted by the IMF managing director Mr. M. Gutt at Harvard University on the 13th February 1948, when he presented a paper `` The Practical Problem of Exchange Rates ''.Then the official direct Sterling-US dollar rate ruling in Britain and the United States is one Sterling pound to US $ 4, but the Lira-Sterling and Lira-US dollar direct rates are such that the Sterling pound-US dollar cross-rate in Italy is one Sterling pound to US $ 2.6. Americans found it cheaper to purchase goods from the UK via Italy until the IMF stepped in and imposed the IMF fixed cross-rate system in favor of the UK and not Italy nor the US. It is here that Hayek wrote about `` issuing of currencies '' by companies should be varying value of the US dollar between national currencies within money market in let currency arbitrage equal quotations between markets. The `` issuing of value '' determined by markets will place the value of the US dollar at varying levels in the economic multiverse of national markets to counteract the Triffin Dilemma.
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Faced with populist demagogues, the judiciary often must choose between bending the knee or defiantly asserting the supremacy of fundamental legal norms. Ketanji Brown Jackson took the latter route in her recent Supreme Court confirmation hearing; but she will now join an institution that has come to be regarded as political through and through.
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Crescent Energy: REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM - Form 8-K | REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
Board of Directors and Shareholders
Contango Oil & Gas Company
Opinion on the financial statements
We have audited the accompanying consolidated balance sheets of Contango Oil & Gas Company ( a Texas corporation) and subsidiaries ( the `` Company '') as of December 31, 2020 and 2019, the related consolidated statements of operations, cash flows, and shareholders ' equity for each of the two years in the period ended December 31, 2020, and the related notes ( collectively referred to as the `` financial statements ''). In our opinion, the financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2020 and 2019, and the results of its operations and its cash flows for each of the two years in the period ended December 31, 2020, in conformity with accounting principles generally accepted in the United States of America.
Basis for opinion
These financial statements are the responsibility of the Company's management. Our responsibility is to express an opinion on the Company's financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board ( United States) ( `` PCAOB '') and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits we are required to obtain an understanding of internal control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company's internal control over financial reporting. Accordingly, we express no such opinion.
Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion.
Critical audit matter
The critical audit matter communicated below is a matter arising from the current period audit of the financial statements that was communicated or required to be communicated to the audit committee and that: ( 1) relates to accounts or disclosures that are material to the financial statements and ( 2) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.
Depletion expense and impairment of oil and gas properties impacted by the Company's estimation of proved reserves
As described further in Notes 2 and 5 to the financial statements, the Company accounts for its oil and gas properties using the successful efforts method of accounting which requires management to estimate reserve volumes and future net revenues to record depletion expense and to assess if there are indications the carrying value of certain properties exceed the fair value and if so, determine the fair value of its oil and gas properties to measure impairment. To estimate the volume of reserves and future net revenues, management makes significant estimates and assumptions including forecasting the production decline rate of producing properties, and forecasting the timing and volume of production associated with the Company's development plan for undeveloped properties. In addition, the estimation of reserves is also impacted by management's judgments and estimates regarding the
1
financial performance of wells associated with reserves to determine if wells are expected, with reasonable certainty, to be economical under the pricing assumptions required in the estimation of depletion expense and impairment evaluation and measurements. We identified the estimation of proved reserves of oil and gas properties, due to its impact on depletion expense and the evaluation and measurement of impairment, as a critical audit matter.
The principal consideration for our determination that the estimation of reserves is a critical audit matter is that relatively minor changes in certain inputs and assumptions, which require a high degree of subjectivity necessary to estimate the volume and future revenues of the Company's reserves, could have a significant impact on the measurement of depletion or impairment expense. In turn, auditing those inputs and assumptions required subjective and complex auditor judgment.
Our audit procedures related to the estimation of proved reserves included the following, among others.
We evaluated the level of knowledge, skill and ability of the Company's reservoir engineering specialists and their relationship to the Company, made inquiries of those reservoir engineers regarding the process followed and judgments made to estimate the Company's proved reserves, and read the reserve reports prepared by the Company's reservoir engineering specialists.
We tested the accuracy of the Company's depletion calculations and impairment evaluation and measurement that included these proved reserve reports.
We evaluated sensitive inputs and assumptions used to determine reserve volumes and other cash flow inputs and assumptions derived from the Company's accounting records. These assumptions included historical pricing differentials, current and future operating costs, estimated future capital costs, and ownership interests. We tested management's process for determining the assumptions, including examining the underlying support on a sample basis for reasonableness and accuracy. Specifically, our audit procedures involved testing management's assumptions as follows:
Compared the estimated pricing differentials used in the reserve reports to realized prices related to revenue transactions recorded in the current year and examined contractual support for the pricing differentials;
Evaluated models used to estimate the future operating costs in the reserve reports and compared amounts to historical operating costs;
Evaluated the method used to determine the future capital costs and compared estimated future capital costs used in the reserve reports to amounts expended for recently drilled and completed wells;
Tested the ownership interests used in the reserve reports by inspecting land and title records;
Evaluated the Company's evidence supporting the amount of proved undeveloped properties reflected in the reserve reports by examining historical conversion rates and support for the Company's ability to fund and intent to develop the proved undeveloped properties; and
Applied analytical procedures to the forecasted production in the reserve reports by comparing to historical actual results and to the prior year or preceding period reserve reports.
/s/ GRANT THORNTON LLP
We have served as the Company's auditor since 2002.
Houston, Texas
March 10, 2021
2
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
( in thousands, except shares)
CURRENT ASSETS:
Cash and cash equivalents
Accounts receivable, net
Prepaid expenses
Current derivative asset
Inventory
Deposits and other
Total current assets
PROPERTY, PLANT AND EQUIPMENT:
Oil and natural gas properties, successful efforts method of accounting:
Proved properties
Unproved properties
Other property and equipment
Accumulated depreciation, depletion, amortization and impairment
Total property, plant and equipment, net
OTHER NON-CURRENT ASSETS:
Investments in affiliates
Long-term derivative asset
Right-of-use lease assets
Debt issuance costs
Deposits
Total other non-current assets
TOTAL ASSETS
CURRENT LIABILITIES:
Accounts payable and accrued liabilities
Current derivative liability
Current asset retirement obligations
Total current liabilities
NON-CURRENT LIABILITIES:
Long-term debt
Long-term derivative liability
Asset retirement obligations
Lease liabilities
Total non-current liabilities
Total liabilities
COMMITMENTS AND CONTINGENCIES ( NOTE 14)
SHAREHOLDERS ' EQUITY:
Series C convertible preferred stock, $ 0.04 par value, no shares authorized, issued and outstanding at December 31, 2020 and 2,700,000 shares authorized, issued and outstanding at December 31, 2019
Common stock, $ 0.04 par value, 400 million shares authorized, 173,830,390 shares issued and 173,737,816 shares outstanding at December 31, 2020, 128,985,146 shares issued and 128,977,816 shares outstanding at December 31, 2019
Additional paid-in capital
Treasury shares at cost ( 92,574 shares at December 31, 2020 and 7,330 shares at December 31, 2019)
Accumulated deficit
Total shareholders ' equity
TOTAL LIABILITIES AND SHAREHOLDERS ' EQUITY
The accompanying notes are an integral part of these consolidated financial statements.
3
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
( in thousands, except per share amounts)
REVENUES:
Oil and condensate sales
Natural gas sales
Natural gas liquids sales
Fee for service revenues
Total revenues
EXPENSES:
Operating expenses
Exploration expenses
Depreciation, depletion and amortization
Impairment & abandonment of oil and natural gas properties
General and administrative expenses
Total expenses
OTHER INCOME ( EXPENSE):
Gain ( loss) from investment in affiliates ( net of income taxes)
Gain from sale of assets
Interest expense
Gain ( loss) on derivatives, net
Other income
Total other income
NET LOSS BEFORE INCOME TAXES
Income tax provision
NET LOSS ATTRIBUTABLE TO COMMON STOCK
NET LOSS PER SHARE:
Basic
Diluted
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING:
Basic
Diluted
The accompanying notes are an integral part of these consolidated financial statements.
4
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
( in thousands)
CASH FLOWS FROM OPERATING ACTIVITIES:
Net loss
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation, depletion and amortization
Impairment of oil and natural gas properties
Exploration expenditures - dry hole costs
Amortization of debt issuance costs
Deferred income taxes
Gain on sale of assets
Gain from investment in affiliates
Stock-based compensation
Unrealized loss ( gain) on derivative instruments
Changes in operating assets and liabilities:
Decrease ( increase) in accounts receivable & other
Decrease ( increase) in prepaid expenses
Increase in inventory
Increase ( decrease) in accounts payable & advances from joint owners
Increase ( decrease) in other accrued liabilities
Decrease ( increase) in income taxes receivable, net
Increase ( decrease) in income taxes payable, net
Deposits and other
Net cash provided by operating activities
CASH FLOWS FROM INVESTING ACTIVITIES:
Oil & natural gas exploration & development expenditures
Acquisition of oil & natural gas properties
Additions to furniture & equipment
Sale of oil and natural gas properties
Net cash used in investing activities
CASH FLOWS FROM FINANCING ACTIVITIES:
Borrowings under Credit Agreement
Repayments under Credit Agreement
Payroll Protection Program Loan
Net proceeds from equity offerings
Purchase of treasury stock
Debt issuance costs
Net cash provided by financing activities
NET CHANGE IN CASH AND CASH EQUIVALENTS
CASH AND CASH EQUIVALENTS, BEGINNING OF PERIOD
CASH AND CASH EQUIVALENTS, END OF PERIOD
The accompanying notes are an integral part of these consolidated financial statements.
5
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
CONSOLIDATED STATEMENT OF SHAREHOLDERS ' EQUITY
For the twelve months ended December 31, 2020
( in thousands, except share amounts)
Balance at December 31, 2019
Equity offering - common stock
Treasury shares at cost
Restricted shares activity
Stock-based compensation
Net loss
Balance at March 31, 2020
Equity offering - common stock
Conversion of preferred stock to common stock
Treasury shares at cost
Restricted shares activity
Stock-based compensation
Net loss
Balance at June 30, 2020
Equity offering - common stock
Treasury shares at cost
Restricted shares activity
Stock-based compensation
Net loss
Balance at September 30, 2020
Equity offering - common stock
Treasury shares at cost
Restricted shares activity
Stock-based compensation
Net loss
Balance at December 31, 2020
The accompanying notes are an integral part of these consolidated financial statements.
6
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
CONSOLIDATED STATEMENT OF SHAREHOLDERS ' EQUITY
For the twelve months ended December 31, 2019
( in thousands, except share amounts)
Balance at December 31, 2018
Equity offering - common stock
Treasury shares at cost
Restricted shares activity
Stock-based compensation
Net loss
Balance at March 31, 2019
Equity offering - common stock
Treasury shares at cost
Restricted shares activity
Stock-based compensation
Net loss
Balance at June 30, 2019
Equity offering - preferred stock
Equity offering - common stock
Treasury shares at cost
Treasury shares reissuance
Stock-based compensation
Net loss
Balance at September 30, 2019
Equity offering - preferred stock
Equity offering - common stock
Conversion of preferred stock to common stock
Treasury shares at cost
Restricted shares activity
Stock-based compensation
Will Energy and Juneau acquisitions
Net loss
Balance at December 31, 2019
The accompanying notes are an integral part of these consolidated financial statements.
7
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
1. Organization and Business
Contango Oil & Gas Company ( collectively with its subsidiaries, `` Contango '' or the `` Company '') is a Fort Worth, Texas based independent oil and natural gas company. The Company's business is to maximize production and cash flow from its offshore properties in the shallow waters of the Gulf of Mexico ( `` GOM '') and onshore properties primarily located in Oklahoma, Texas, Wyoming and Louisiana and use that cash flow to explore, develop and acquire oil and natural gas properties across the United States.
The following table lists the Company's primary producing areas as of December 31, 2020:
Location
Formation
Offshore Gulf of Mexico
Central Oklahoma
Western Anadarko
West Texas
Other Onshore ( TX, LA, WY)
Impact of the COVID-19 Pandemic
A novel strain of the coronavirus ( `` COVID-19 '') surfaced in late 2019 and has spread, and continues to spread, around the world, including to the United States. In March 2020, the World Health Organization declared COVID-19 a pandemic, and the President of the United States declared the COVID-19 pandemic a national emergency. The COVID-19 pandemic has significantly affected the global economy, disrupted global supply chains and created significant volatility in the financial markets. In addition, the COVID-19 pandemic has resulted in travel restrictions, business closures and other restrictions that have disrupted the demand for oil throughout the world and, when combined with the oil supply increase attributable to the battle for market share among the Organization of Petroleum Exporting Countries ( `` OPEC ''), Russia and other oil producing nations, resulted in oil prices declining significantly beginning in late February 2020. While there has been a modest recovery in oil prices, the length of this demand disruption is unknown, and there is significant uncertainty regarding the long-term impact to global oil demand, which negatively impacted the Company's results of operations and planned 2020 capital activities. Due to the extreme volatility in oil prices and the impact of COVID-19 on the financial condition of our upstream peers, the Company suspended its drilling program in the Southern Delaware Basin in the first quarter of 2020 and focused on certain measures that included, but were not limited to, the following:
work from home initiatives for all but critical staff and the implementation of social distancing measures;
a company-wide effort to cut costs throughout the Company's operations;
utilization of the Company's available storage capacity to temporarily store a portion of its production for later sale at higher prices when advantageous to do so ( such as the approximate 50,000 barrels of second quarter oil production we stored and sold during the third quarter of 2020 at higher oil prices);
suspension of any further plans for operated onshore and offshore drilling in 2020;
pursuit of additional `` fee for service '' opportunities similar to the Management Services Agreement entered into in June 2020 with Mid-Con Energy Partners, LP ( `` Mid-Con '') ( NASDAQ: MCEP), which was terminated at the closing of the Mid-Con Acquisition ( as defined below) between the Company and Mid-Con on January 21, 2021); and
potential acquisitions of PDP-heavy assets, with attractive, discounted valuations, in stressed/distressed scenarios or from non-industry owners, such as the Silvertip Acquisition ( as defined below).
8
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
From the Company's initial entry into the Southern Delaware Basin in 2016 and through early 2019, the Company was focused on the development of its initial 6,500 net acre position in Pecos County, Texas ( `` Bullseye ''), and in December 2018, the Company purchased an additional 4,200 gross operated ( 1,700 net) acres and 4,000 gross non-operated ( 200 net) acres to the northeast of its existing acreage ( `` NE Bullseye ''). Contango's 2019 drilling program included the completion of one well previously drilled in the Bullseye area, the drilling and completion of a second Bullseye well, and the drilling and completion of three wells in the NE Bullseye area. In December 2019, the Company began completion operations on its fourth NE Bullseye well, which began producing in January 2020, and then suspended further drilling in the area in response to the dramatic decline in oil prices. As of December 31, 2020, the Company was producing from 18 wells over its approximate 16,200 gross operated ( 7,500 company net) acre position in West Texas, prospective for the Wolfcamp A, Wolfcamp B and Second Bone Spring formations.
In September 2019, the Company entered into unrelated purchase agreements with Will Energy Corporation ( `` Will Energy '') and White Star Petroleum, LLC and certain of its affiliates ( collectively, `` White Star '') to purchase certain producing assets and undeveloped acreage, primarily in Oklahoma. These transactions closed during the three months ended December 31, 2019, ( the `` Will Energy Acquisition '' and `` White Star Acquisition '') and were transformative, as production from these acquisitions represented approximately 70% of the Company's total net production for the year ended December 31, 2020. See Note 4 - `` Acquisitions and Dispositions '' for more information. In conjunction with the White Star Acquisition, the Company entered into a new revolving credit agreement with JPMorgan Chase Bank, N.A. and other lenders ( the `` Credit Agreement ''). In connection with the entry into the Credit Agreement, the Company repaid all obligations outstanding on, and terminated, its previous credit agreement with Royal Bank of Canada, which matured on October 1, 2019. The Credit Agreement has since been amended to increase the number of lenders from three to nine, and among other things, to adjust the borrowing base to $ 130.0 million on January 21, 2021 and $ 120.0 million on March 31, 2021. See Note 13 - `` Long-Term Debt '' for more information.
The Company completed two stock offerings in the third quarter of 2019. The Company completed an underwritten public offering ( the `` September 2019 Public Offering '') of 51,447,368 shares of common stock ( of which 5,524,498 were reissued treasury shares) for net proceeds of approximately $ 46.2 million, after deducting the underwriting discount and fees and expenses. Net proceeds from the September 2019 Public Offering were used to fund the cash portion of the purchase price for the Will Energy Acquisition and to repay borrowings outstanding under the Company's former revolving credit facility to provide incremental liquidity to support the Company's planned acquisition efforts. In conjunction with the September 2019 Public Offering, the Company also entered into a purchase agreement with affiliates of John C. Goff, a director and significant shareholder, and current chairman of the Company, to issue and sell in a private placement ( the `` Series A Private Placement '') 789,474 shares of Series A contingent convertible preferred stock, which resulted in net proceeds of approximately $ 7.5 million.
The Company completed two additional stock offerings in the fourth quarter of 2019. In connection with the closing of the White Star Acquisition in November 2019, the Company completed a private placement of 1,102,838 shares of Series B contingent convertible preferred stock of the Company, which resulted in net proceeds of approximately $ 21.0 million ( the `` Series B Private Placement ''). Net proceeds from the Series A Private Placement were used to fund a portion of the purchase price and related transaction expenses for the Will Energy Acquisition, and net proceeds from the Series B Private Placement were used to fund a portion of the purchase price and related transaction expenses for the White Star Acquisition. In December 2019, the Company also completed a private placement of 19,000,000 shares of common stock for net proceeds of approximately $ 45.7 million, after deducting the underwriting discount and fees and expenses ( the `` December 2019 Offering ''). In conjunction with the December 2019 Offering, the Company also completed a private placement of 2,340,000 shares of Series C contingent convertible preferred stock ( the `` Series C Private Placement '') with affiliates of Mr. Goff, Wilkie S. Colyer, Jr., the Company's chief executive officer, and others, which resulted in net proceeds of approximately $ 5.6 million. An additional 360,000 Series C contingent convertible preferred shares were issued in a private placement to the placement agents for the December 2019 Offering and Series C Private Placement, as partial consideration for their services in those offerings. Net proceeds from the December 2019 Offering and Series C Private Placement were used for general corporate purposes, including capital expenditures under the Company's Joint Development Agreement with Juneau Oil & Gas, LLC ( discussed below).
9
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
In December 2019, the Company obtained approval from the holders of a majority of the voting power of the Company's capital stock to increase the number of common shares authorized for issuance from 100,000,000 to 200,000,000 common shares, at which time the Series A preferred shares automatically converted into 7,894,740 shares of common stock, the Series B preferred shares automatically converted into 11,028,380 shares of common stock, and the outstanding preferred shares were cancelled.
In December 2019, the Company entered into a Joint Development Agreement with Juneau Oil & Gas, LLC ( `` Juneau ''), which provides the Company the right to acquire an interest in up to six of Juneau's exploratory prospects located in the Gulf of Mexico. The first such exploratory prospect acquired by the Company, located in the Grand Isle Block 45 Area in the shallow waters off of the Louisiana coastline, was determined to be unsuccessful in June 2020. The Company is currently evaluating for future testing a number of exploratory prospects included in the Joint Development Agreement, including its Boss Hogg prospect located in the Eugene Island 298 Area in the shallow waters off of the Louisiana coastline. The Company's strategy and timing on the testing of the Boss Hogg will be determined during the year based on regulatory considerations, some of which are fluid at this time, and on operational considerations, including the availability of appropriate equipment.
Following the reduction in the Company's drilling program in the latter half of 2019, which then led to the suspension of onshore drilling in the first quarter of 2020, the Company continued to identify opportunities for cost reductions and operating efficiencies in all areas of its operations, while also searching for new resource acquisition opportunities. Acquisition efforts have been, and will continue to be, focused on PDP-heavy assets where the Company might also be able to leverage its geological and operational experience and expertise to reduce operating expenses, enhance production and identify and develop additional drilling opportunities that the Company believes will enable it to economically grow production and add reserves.
On June 5, 2020, the Company announced the addition of a new corporate business line that includes offering a property management service ( or a `` fee for service '') for oil and natural gas companies with distressed or stranded assets, or companies with a desire to reduce administrative costs by engaging a contract operator of its oil and natural gas assets. As part of this service offering, the Company entered into a Management Services Agreement ( `` MSA '') with Mid-Con, effective July 1, 2020, to provide services as contract operator of record on Mid-Con's oil and natural gas properties, along with certain administrative and management services, in exchange for an annual services fee of $ 4 million, paid ratably over the twelve month period, plus reimbursement of certain costs and expenses, a deferred fee of $ 166,666 per month for each month that the agreement is in effect ( not to exceed $ 2 million), to be paid in a lump sum upon termination of the agreement, and warrants to purchase a minority equity ownership in Mid-Con. In connection with the Company's acquisition of Mid-Con on January 21, 2021, the MSA was terminated, the deferred fee obligation was forgiven, and the warrants were cancelled. See Note 4 - `` Acquisitions and Dispositions '' for more information. The Company recorded $ 2.0 million in revenue during the year ended December 31, 2020 related to this MSA with Mid-Con, which is included in `` Fee for services revenue '' in the Company's consolidated statements of operations.
On June 8, 2020, the stockholders of the Company, at the Company's 2020 Annual Meeting of Stockholders, approved an amendment ( the `` Charter Amendment '') to its Amended and Restated Certificate of Formation with the Secretary of State of the State of Texas to increase the number of authorized shares of common stock, par value of $ 0.04 per share, of the Company from 200,000,000 shares to 400,000,000 shares, and also approved the conversion of the 2,700,000 shares of the Series C contingent convertible preferred stock, par value $ 0.04 per share, into 2,700,000 shares of the Company's common stock. On June 10, 2020, the Company filed the Charter Amendment with the Secretary of State of the State of Texas.
On June 24, 2020, the Company entered into an Open Market Sale Agreement ( the `` Sale Agreement '') among the Company and Jefferies LLC ( the `` Sales Agent ''). Pursuant to the terms of the Sale Agreement, the Company may sell, from time to time through the Sales Agent in the open market, subject to satisfaction of certain conditions, shares of the Company's common stock, having an aggregate public offering price of up to $ 100,000,000 ( the `` Shares '') ( the `` ATM Program ''). The Company intends to use the net proceeds from any sales through the ATM Program, after deducting the Sales Agent's commission and the Company's offering expenses, to repay borrowings under its Credit Agreement and for general corporate purposes, including, but not limited to, acquisitions and exploratory drilling. Under the ATM Program, the Company sold 163,929 shares during the year ended December 31, 2020 for net proceeds of $ 0.5 million.
10
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
On October 25, 2020, the Company and Mid-Con entered into an agreement and plan of merger providing for the acquisition by the Company of Mid-Con in an all-stock merger transaction in which Mid-Con would become a direct, wholly owned subsidiary of Contango ( the `` Mid-Con Acquisition ''). On October 30, 2020, the Company entered into the Third Amendment ( the `` Third Amendment '') to its Credit Agreement under which, among other things, would increase the Company's borrowing base from $ 75 million to $ 130.0 million, effective upon the closing of the Mid-Con Acquisition, with an automatic $ 10.0 million reduction in the borrowing base on March 31, 2021. The Mid-Con acquisition closed on January 21, 2021, with a total of 25,409,164 shares of Contango common stock issued. Upon closing of the Mid-Con Acquisition, the MSA was terminated, and the Company's borrowing base was increased to $ 130.0 million. See Note 4 - `` Acquisitions and Dispositions '' and Note 13 - `` Long-Term Debt '' for further details.
Concurrently with the announcement of the Mid-Con Acquisition, the Company announced the execution of an agreement with a select group of institutional and accredited investors to sell 26,451,988 shares of common stock, which was completed on October 27, 2020. After deducting the underwriting discount and fees and expenses, the net proceeds were approximately $ 38.8 million, which were used for the Mid-Con Acquisition and for general corporate purposes, including the repayment of debt outstanding under the Company's Credit Agreement.
On November 27, 2020, the Company entered into a purchase and sale agreement ( the `` Purchase Agreement '') with an undisclosed seller to acquire certain oil and natural gas properties located in the Big Horn Basin in Wyoming and Montana, in the Powder River Basin in Wyoming and in the Permian Basin in Texas and New Mexico ( collectively the `` Silvertip Acquisition '') for aggregate consideration of approximately $ 58 million. In connection with the execution of the Purchase Agreement, the Company paid $ 7.0 million as a deposit for its obligations under the Purchase Agreement, which is included in the consolidated balance sheet as of December 31, 2020. The Silvertip Acquisition closed on February 1, 2021, for a net consideration of approximately $ 53.2 million ( including the $ 7.0 million deposit previously paid), after customary closing adjustments, including the results of operations during the period between the effective date of August 1, 2020 and the closing date. See Note 4 - `` Acquisitions and Dispositions '' for more information.
On December 1, 2020, the Company completed another private placement of 14,193,903 shares of common stock for net proceeds of approximately $ 21.7 million, after deducting the underwriting discount and fees and expenses. The net proceeds were used to fund the Silvertip Acquisition and for general corporate purposes, including the repayment of debt outstanding under the Company's Credit Agreement.
2. Summary of Significant Accounting Policies
Basis of Presentation
The Company's consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America ( `` GAAP '') and include the accounts of Contango Oil & Gas Company and its subsidiaries, after elimination of all material intercompany balances and transactions. All wholly-owned subsidiaries are consolidated.
Other Investments
The Company has two seats on the board of directors of Exaro and has significant influence, but not control, over the company. As a result, the Company's 37% ownership in Exaro is accounted for using the equity method. Under the equity method, the Company's proportionate share of Exaro's net income increases the balance of its investment in Exaro, while a net loss or payment of dividends decreases its investment. In the consolidated statements of operations, the Company's proportionate share of Exaro's net income is reported as a single line-item in `` Gain from investment in affiliates '' ( net of income taxes).
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Use of Estimates
The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting periods.
Revenue Recognition
Sales of oil, condensate, natural gas and natural gas liquids ( `` NGLs '') are recognized at the time control of the products are transferred to the customer. Based upon the Company's past experience with its current purchasers and expertise in the market, collectability is probable, and there have not been payment issues with the Company's purchasers over the past year or currently. Generally, the Company's gas processing and purchase agreements indicate that the processors take control of the Company's gas at the inlet of the plant, and that control of residue gas is returned to the Company at the outlet of the plant. The midstream processing entity gathers and processes the natural gas and remits proceeds to the Company for the resulting sales of NGLs. The Company delivers oil and condensate to the purchaser at a contractually agreed-upon delivery point at which the purchaser takes custody, title and risk of loss of the product.
When sales volumes exceed the Company's entitled share, a production imbalance occurs. If production imbalance exceeds the Company's share of the remaining estimated proved natural gas reserves for a given property, the Company records a liability. Production imbalances have not had and currently do not have a material impact on the financial statements.
Generally, the Company's contracts have an initial term of one year or longer but continue month to month unless written notification of termination in a specified time period is provided by either party to the contract. The Company receives purchaser statements from the majority of its customers, but there are a few contracts where the Company prepares the invoice. Payment is unconditional upon receipt of the statement or invoice.
The Company records revenue in the month production is delivered to the purchaser. Settlement statements may not be received for 30 to 90 days after the date production is delivered, and therefore the Company is required to estimate the amount of production delivered to the purchaser and the price that will be received for the sale of the product. Differences between the Company's estimates and the actual amounts received for product sales are generally recorded in the following month that payment is received. Any differences between the Company's revenue estimates and actual revenue received historically have not been significant. The Company has internal controls in place for its revenue estimation accrual process. The Company will continue to review all new or modified revenue contracts on a quarterly basis for proper treatment.
Cash Equivalents
Cash equivalents are considered to be highly liquid investment grade debt investments having an original maturity of 90 days or less. As of December 31, 2020, the Company had $ 1.4 million in cash and cash equivalents, after transferring cash balances at the end of each day to reduce outstanding debt under the Company's revolving Credit Agreement to minimize debt service costs. Under the Company's cash management system, checks issued but not yet presented to banks by the payee frequently result in book overdraft balances for accounting purposes and are classified in accounts payable in the consolidated balance sheets. At December 31, 2020, accounts payable included $ 2.9 million in outstanding checks that had not been presented for payment. At December 31, 2019, accounts payable included $ 6.1 million in outstanding checks that had not been presented for payment.
Accounts Receivable
The Company sells oil, natural gas and NGLs to a limited number of customers. In addition, the Company participates with other parties in the operation of oil and natural gas wells. Substantially all of the Company's accounts receivables are due from either purchasers of oil, natural gas and NGLs or participants in oil and natural gas wells for which the Company serves as the operator. Generally, operators of oil and natural gas properties have the right to offset future revenues against unpaid charges related to operated wells.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
The allowance for doubtful accounts is an estimate of the losses in the Company's accounts receivable. The Company periodically reviews the accounts receivable from customers for any collectability issues. An allowance for doubtful accounts is established based on reviews of individual customer accounts, recent loss experience, current economic conditions and other pertinent factors. Amounts deemed uncollectible are charged to the allowance.
Accounts receivable allowance for doubtful accounts was $ 2.3 million and $ 1.0 million as of December 31, 2020 and 2019, respectively. At December 31, 2020 and 2019, the carrying value of the Company's accounts receivable approximated fair value.
Oil and Natural Gas Properties - Successful Efforts
The Company follows the successful efforts method of accounting for its oil and natural gas activities. The Company's application of the successful efforts method of accounting for its oil and natural gas exploration and production activities requires judgment as to whether particular wells are developmental or exploratory, since lease acquisition costs and all developmental costs are capitalized, whereas exploratory drilling costs are continuously capitalized until the results are determined. If proved reserves are not discovered, the drilling costs are expensed as exploration costs. Other exploratory costs, such as seismic costs and other geological and geophysical expenses, are expensed as incurred.
The results from a drilling operation can take considerable time to analyze, and the determination that commercial reserves have been discovered requires both judgment and application of industry experience. Wells may be completed that are assumed to be productive and actually deliver oil and natural gas in quantities insufficient to be economic, which may result in the abandonment of the wells at a later date. On occasion, wells are drilled which have targeted geologic structures that are both developmental and exploratory in nature, and in such instances an allocation of costs is required to properly account for the results. Delineation seismic costs incurred to select development locations within a productive oil or natural gas field are typically treated as development costs and capitalized, but often these seismic programs extend beyond the proved reserve areas, and therefore, management must estimate the portion of seismic costs to expense as exploratory. During the quarter ended June 30, 2020, the Company drilled an unsuccessful exploratory well in the Gulf of Mexico, resulting in a charge of $ 10.5 million for drilling and prospect costs included in `` Exploration expenses '' in the Company's consolidated statements of operations for the year ended December 31, 2020.
The evaluation of oil and natural gas leasehold acquisition costs included in unproved properties requires management's judgment of exploratory costs related to drilling activity in a given area. Drilling activities in an area by other companies may also effectively condemn leasehold positions.
Depreciation, depletion and amortization ( `` DD & A '') is calculated on a field basis using the unit of production method. Lease acquisition costs are amortized over remaining total proved reserves, and capitalized drilling and development costs of producing oil and natural gas properties, including related support equipment and facilities net of salvage value, are amortized over estimated proved developed oil and natural gas reserves. Upon sale or retirement of properties, the cost and related accumulated DD & A are eliminated from the accounts, and the resulting gain or loss, if any, is recognized. Unit of production rates are revised whenever there is an indication of a need, but at least annually. Revisions are accounted for prospectively as changes in accounting estimates.
Other property and equipment are depreciated using the straight-line method over their estimated useful lives which range between three and 10 years.
Impairment of Oil and Natural Gas Properties
Pursuant to GAAP, when circumstances indicate that proved properties may be impaired, the Company compares expected undiscounted future cash flows on a field-by-field basis to the unamortized capitalized cost of
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
the assets in that field. If the estimated future undiscounted cash flows, based on the Company's estimate of future reserves, oil and natural gas prices, operating costs and production levels from oil and natural gas reserves, are lower than the unamortized capitalized cost, then the capitalized cost is reduced to its fair value. The factors used to determine fair value include, but are not limited to, estimates of proved, probable and possible reserves, future commodity prices, the timing of future production and capital expenditures and a discount rate commensurate with the risk reflective of the lives remaining for the respective oil and natural gas properties. Additionally, the Company may use appropriate market data to determine fair value.
In the first quarter of 2020, the COVID-19 pandemic and the resulting deterioration in the global demand for oil, combined with the failure by OPEC and Russia to reach an agreement on lower production quotas until April 2020, caused a dramatic increase in the supply of oil, a corresponding decrease in commodity prices, and reduced the demand for all commodity products. The remainder of 2020 was further adversely affected by the continuation of the COVID-19 pandemic and the actions and measures that countries, states, localities, central banks, international financing and funding organizations, stock markets, businesses and individuals have taken to address the spread of the coronavirus and associated illnesses, the continued volatility of the oil and gas market, and the failure of OPEC and Russia to consistently and fully adhere to the quotas delineated in their agreement. Consequently, during the three months ended March 31, 2020, the Company recorded a $ 143.3 million non-cash charge for proved property impairment of its onshore properties related to the dramatic decline in commodity prices, the `` PV-10 '' ( present value, discounted at a 10% rate) of its proved reserves, and the associated change in its current development plans for its proved undeveloped locations. In the fourth quarter of 2020, the Company recorded an additional $ 21.1 million non-cash charge for proved property impairment, of which $ 15.6 million related to its offshore properties as a result of performance revisions in reserves and the decline in gas prices and production yield. The total non-cash proved property impairment recorded during the year ended December 31, 2020 was $ 164.4 million.
For the year ended December 31, 2019, the Company recognized non-cash proved property impairment expense of $ 117.8 million due to reserve revisions which resulted from the negative impact of performance and price related revisions to the present value of the Company's year-end proved reserves, and the relationship of that value to the historical carrying cost of its assets on the balance sheet. Included in the impairment charge was $ 34.5 million related to the Company's proved offshore Gulf of Mexico properties, primarily a result of performance revisions associated with the re-evaluation of the projected field costs and recoverable condensate volumes. In addition, the Company recognized onshore proved property impairment expense of $ 83.3 million. The onshore impairment was due primarily to price and performance revisions, which led to the re-evaluation of the economics and future drilling plans for the proved undeveloped locations, which then resulted in the elimination of certain proved undeveloped locations due to the SEC's five-year development rule for such locations.
Unproved properties are reviewed quarterly to determine if there has been an impairment of the carrying value, with any such impairment charged to expense in the period. During the year ended December 31, 2020, the Company recorded a $ 4.3 million non-cash charge for unproved impairment expense related to undeveloped leases in its Central Oklahoma, Western Anadarko and Other Onshore regions. The Company recorded $ 2.6 million of this impairment expense in the first quarter of 2020, primarily related to leases the Company acquired from White Star and Will Energy in the fourth quarter of 2019, which were expiring in 2020, and the remaining $ 1.7 million of the impairment expense was recorded in the fourth quarter of 2020, due to leases expiring in 2021, all of which the Company has no plans to extend or develop as a result of the current commodity price environment and the Company's continued focus on cost saving and production enhancing strategic initiatives.
During the year ended December 31, 2019, the Company recognized impairment expense of approximately $ 9.2 million related primarily to lease expirations, and near-term expirations, in the Company's West Texas region.
Asset Retirement Obligations
Asset Retirement and Environmental Obligations ( `` ASC 410 '') requires that the fair value of an asset retirement cost, and corresponding liability, should be recorded as part of the cost of the related long-lived asset and subsequently allocated to expense using a systematic and rational method. The Company records an asset retirement obligation ( `` ARO '') to reflect the Company's legal obligation related to future plugging and abandonment of its oil
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
and natural gas wells, platforms and associated pipelines and equipment. The Company estimates the expected cash flows associated with the obligation and discounts the amounts using a credit-adjusted, risk-free interest rate. At least annually, the Company reassesses the obligation to determine whether a change in the estimated obligation is necessary. The Company evaluates whether there are indicators that suggest the estimated cash flows underlying the obligation have materially changed. Should these indicators suggest the estimated obligation may have materially changed on an interim basis, the Company will accordingly update its assessment. Additional retirement obligations increase the liability associated with new oil and natural gas wells, platforms, and associated pipelines and equipment as these obligations are incurred. The liability is accreted to its present value each period, and the capitalized cost is depleted over the useful life of the related asset. The accretion expense is included in DD & A expense.
The estimated liability is based on historical experience in plugging and abandoning wells. The estimated remaining lives of the wells is based on reserve life estimates and federal and state regulatory requirements. The liability is discounted using an assumed credit-adjusted risk-free rate.
Revisions to the liability could occur due to changes in estimates of plugging and abandonment costs, changes in the risk-free rate, changes in the remaining lives of the wells or if federal or state regulators enact new plugging and abandonment requirements. At the time of abandonment, the Company recognizes a gain or loss on abandonment to the extent that actual costs do not equal the estimated costs. This gain or loss on abandonment is included in impairment and abandonment of oil and natural gas properties expense. See Note 12 - `` Asset Retirement Obligation '' for additional information.
Income Taxes
The Company follows the liability method of accounting for income taxes under which deferred tax assets and liabilities are recognized for the future tax consequences of ( i) temporary differences between the tax basis of assets and liabilities and their reported amounts in the financial statements and ( ii) operating loss and tax credit carryforwards for tax purposes. Deferred tax assets are reduced by a valuation allowance when, based upon management's estimates, it is more likely than not that a portion of the deferred tax assets will not be realized in a future period. The Company reviews its tax positions quarterly for tax uncertainties. The Company did not have significant uncertain tax positions as of December 31, 2020. As described in Note 16 - `` Income Taxes '' with respect to Section 382 Ownership Change, the amount of unrecognized tax benefits did not change materially from December 31, 2019. The amount of unrecognized tax benefits may change in the next twelve months; however, the Company does not expect the change to have a significant impact on its financial position or results of operations. The Company includes interest and penalties in interest income and general and administrative expenses, respectively, in its consolidated statements of operations.
The Company files income tax returns in the United States and various state jurisdictions. The Company's federal and state tax returns for 2009 - 2020 remain open for examination by the taxing authorities in the respective jurisdictions where those returns were filed.
Concentration of Credit Risk
Substantially all of the Company's accounts receivable result from oil and natural gas sales or joint interest billings to a limited number of third parties in the oil and natural gas industry. This concentration of customers and joint interest owners may impact the Company's overall credit risk in that these entities may be similarly affected by changes in economic and other conditions. See Note 3 - `` Concentration of Credit Risk '' for additional information.
Debt Issuance Costs
Debt issuance costs incurred are capitalized and subsequently amortized over the term of the related debt. On September 17, 2019, the Company entered into the new revolving Credit Agreement with JPMorgan Chase Bank, N.A. and other lenders and incurred $ 1.8 million of arrangement and upfront fees in connection with the Credit Agreement. On November 1, 2019, the Credit Agreement was amended to add two additional lenders and increase the borrowing base thereunder, and the Company incurred an additional $ 1.6 million of debt issuance costs.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
On June 9, 2020, the Credit Agreement was amended to, among other things, reduce the borrowing base. No fees were incurred for the Second Amendment; however, during the three months ended June 30, 2020, the Company expensed $ 1.0 million of the debt issuance costs discussed above which originally were to be amortized over the life of the loan, due to the reduction in the borrowing base per the Second Amendment. On October 30, 2020, the Company entered into the Third Amendment to the Credit Agreement under which, among other things, increased the Company's borrowing base from $ 75.0 million to $ 130.0 million, effective upon the closing of the Mid-Con Acquisition on January 21, 2021. The Company initially incurred $ 0.1 million in fees related to the Third Amendment during the three months ended December 31, 2020. During the year ended December 31, 2020, the Company amortized debt issuance costs of $ 1.6 million related to its Credit Agreement, including the $ 1.0 million mentioned above. As of December 31, 2020, the remaining balance of these debt issuance costs was $ 1.8 million, which will be amortized through September 17, 2024, with amortization expense included in the interest expense line item in the Company's consolidated statements of operations.
In January 2021, the Company incurred an additional $ 0.9 million in fees related to the Third Amendment becoming effective on January 21, 2021, in connection with the closing of the Mid-Con Acquisition. These fees will also be amortized over the remaining term of the loan.
Stock-Based Compensation
The Company applies the fair value based method to account for stock based compensation. Under this method, compensation cost is measured at the grant date based on the fair value of the award and is recognized over the requisite service period, which generally aligns with the award vesting period. The Company classifies the benefits of tax deductions in excess of the compensation cost recognized for the options ( excess tax benefit) as financing cash flows. The fair value of each restricted stock award is estimated as of the date of grant. The fair value of the performance stock units is estimated as of the date of grant using the Monte Carlo simulation pricing model.
Inventory
Inventory consists primarily of casing and tubing stored temporarily, which will be used for drilling or completion of wells. Inventory is recorded at the lower of cost or market using specific identification method.
Derivative Instruments and Hedging Activities
The Company accounts for its derivative activities under the provisions of ASC 815, Derivatives and Hedging ( `` ASC 815 ''). ASC 815 establishes accounting and reporting requirements that every derivative instrument be recorded on the balance sheet as either an asset or liability measured at fair value. From time to time, the Company hedges a portion of its forecasted oil and natural gas production. Derivative contracts entered into by the Company have consisted of transactions in which the Company hedges the variability of cash flow related to a forecasted transaction using variable to fixed swaps and collars. The Company elected to not designate any of its derivative positions for hedge accounting. Accordingly, the net change in the mark-to-market valuation of these positions as well as all payments and receipts on settled derivative contracts are recognized in `` Gain ( loss) on derivatives, net '' on the consolidated statements of operations for the years ended December 31, 2020 and 2019. Derivative instruments with settlement dates within one year are included in current assets or liabilities, whereas derivative instruments with settlement dates exceeding one year are included in non-current assets or liabilities. The Company calculates the asset or liability for current and non-current derivative instruments for each counterparty based on the settlement dates within the respective contracts. See Note 6 - `` Derivative Instruments '' for additional information.
Subsidiary Guarantees
Contango Oil & Gas Company, as the parent company ( the `` Parent Company ''), filed a registration statement on Form S-3 with the SEC to register, among other securities, debt securities that the Parent Company may issue from time to time. Contango Resources, Inc., Contango Midstream Company, Contango Operators, Inc., Contaro Company, Contango Alta Investments, Inc. and any other of the Company's future subsidiaries specified in the prospectus supplement ( each a `` Subsidiary Guarantor '') are Co-Registrants with the Parent Company under the registration statement, and the registration statement also registered guarantees of debt securities by the Subsidiary
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Guarantors. The Subsidiary Guarantors are wholly-owned by the Parent Company, either directly or indirectly, and any guarantee by the Subsidiary Guarantors will be full and unconditional. The Parent Company has no assets or operations independent of the Subsidiary Guarantors, and there are no significant restrictions upon the ability of the Subsidiary Guarantors to distribute funds to the Parent Company. Finally, the Parent Company's wholly-owned subsidiaries do not have restricted assets that exceed 25% of net assets as of the most recent fiscal year end that may not be transferred to the Parent Company in the form of loans, advances or cash dividends by such subsidiary without the consent of a third party.
Leases
The Company recognizes a lease liability, which is a lessee's obligation to make lease payments arising from a lease, measured on a discounted basis; and a right-of-use asset, which is an asset that represents the lessee's right to use, or control the use of, a specified asset for the lease term on the Company's consolidated balance sheet. The Company does not include leases with an initial term of twelve months or less on the balance sheet. The Company recognizes payments on these leases within `` Operating expenses '' on its consolidated statements of operations. The Company accounts for lease and non-lease contract components as a lease. The Company has procedures to review any new or modified contracts which contain a physical asset on a quarterly basis and determine if an arrangement is, or contains, a lease and determines the proper treatment. See Note 9 - `` Leases '' for additional information.
Recent Accounting Pronouncements
In June 2016, the FASB issued ASU 2016-13 - Financial Instruments - Credit Losses ( `` Topic 326 ''): Measurement of Credit Losses on Financial Instruments ( `` ASU 2016-13 '') related to the calculation of credit losses on financial instruments. All financial instruments not accounted for at fair value will be impacted, including the Company's trade and joint interest billing receivables. Allowances are to be measured using a current expected credit loss model as of the reporting date that is based on historical experience, current conditions and reasonable and supportable forecasts. This is significantly different from the current model that increases the allowance when losses are probable. Initially, ASU 2016-13 was effective for all public companies for fiscal years beginning after December 15, 2019. The FASB subsequently issued ASU 2019-04 ( `` ASU 2019-04 ''): Codification Improvements to Topic 326, Financial Instruments - Credit Losses, Topic 815, Derivatives, and Topic 825, Financial Instruments and ASU 2019-05 ( `` ASU 2019-05 ''): Financial Instruments - Credit Losses ( Topic 326) - Targeted Transition Relief. ASU 2019-04 and ASU 2019-05 provide certain codification improvements related to the implementation of ASU 2016-13 and targeted transition relief consisting of an option to irrevocably elect the fair value option for eligible instruments. In November 2019, the FASB issued ASU 2019-10 - Financial Instruments - Credit Losses ( Topic 326), Derivatives and Hedging ( Topic 815), and Leases ( Topic 842): Effective Dates. This amendment deferred the effective date of ASU 2016-13 from January 1, 2020 to January 1, 2023 for calendar year-end smaller reporting companies, which includes the Company. The Company plans to defer the implementation of ASU 2016-13, and the related updates.
In November 2019, the FASB issued ASU 2019-12 - Income Taxes ( `` Topic 740 ''): Simplifying the Accounting for Income Taxes ( `` ASU 2019-12 ''). The amendments in ASU 2019-12 are part of an initiative to reduce complexity in accounting standards and simplify the accounting for income taxes by removing certain exceptions from Topic 740 and making minor improvements to the codification. The amendments in this update are effective for public entities for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2020. The provisions of this update are not expected to have a material impact on the Company's financial position or results of operations.
In March 2020, the FASB issued ASU 2020-04 - Reference Rate Reform ( `` Topic 848 ''): Facilitation of the Effects of Reference Rate Reform on Financial Reporting ( `` ASU 2020-04 ''). ASU 2020-04 provides optional guidance, for a limited period of time, to ease the potential burden in accounting for ( or recognizing the effects of) reference rate reform on financial reporting. The amendments in ASU 2020-04 provide optional expedients and exceptions for applying US GAAP to contracts, hedging relationships and other transactions affected by reference rate reform if certain criteria are met. The amendments in this ASU apply only to contracts, hedging relationships and other transactions that reference LIBOR, or another reference rate, expected to be discontinued because of reference rate reform. The Company is currently assessing the potential impact of ASU 2020-04 on its consolidated financial statements.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
3. Concentration of Credit Risk
The customer base for the Company is concentrated in the oil and natural gas industry. The Company's largest three purchasers contributed approximately 36% of the Company's total production revenues for the year ended December 31, 2020. The Company's sales to these purchasers are not secured with letters of credit, and in the event of non-payment, the Company could lose up to two months of revenues. The loss of two months of revenues would have a material adverse effect on the Company's financial position. However, we believe our current purchasers could be replaced by other purchasers under contracts with similar terms and conditions.
4. Acquisitions and Dispositions
Mid-Con Acquisition
On October 25, 2020, the Company entered into an Agreement and Plan of Merger ( the `` Merger Agreement ') with Mid-Con and Mid-Con Energy GP, LLC, the general partner of Mid-Con ( `` Mid-Con GP ''), pursuant to which Mid-Con will merge with and into Michael Merger Sub LLC, a Delaware limited liability company and a wholly-owned, direct subsidiary of the Company. The Mid-Con Acquisition, which closed on January 21, 2021, was unanimously approved by the conflicts committee of the board of directors of Mid-Con, by the full board of directors of Mid-Con, by the disinterested directors of the board of directors of the Company and was subject to shareholder and unitholder approvals and other customary conditions to closing. At the effective time of the Mid-Con Acquisition ( the `` Effective Time ''), each common unit representing limited partner interests in Mid-Con issued and outstanding immediately prior to the Effective Time ( other than treasury units or units held by Mid-Con GP) was converted automatically into the right to receive 1.75 shares of the Company's common stock. A total of 25,409,164 shares of Contango common stock were issued at the closing of the Mid-Con Acquisition. As of January 21, 2021, John C. Goff, Chairman of the Board of Directors of the Company, beneficially owned approximately 56.4% of the common units of Mid-Con, and Travis Goff, John C. Goff's son and the President of Goff Capital, Inc., served on the board of directors of the general partner of Mid-Con. The Company's senior management team will run the combined company, and Contango's board of directors will remain intact as the board of directors of the combined company. The combined company is headquartered in Fort Worth, Texas.
The Mid-Con acquisition will be accounted for as a business combination. Therefore, the purchase price will be allocated to the assets acquired and the liabilities assumed based on their estimated acquisition date fair values based on then currently available information. A combination of a discounted cash flow model and market data was used by the Company in determining the fair value of the oil and gas properties. Significant inputs into the calculation included future commodity prices, estimated volumes of oil and gas reserves, expectations for the timing and amount of future development and operating costs, future plugging and abandonment costs, and a risk adjusted discount rate. The Company expects to complete the purchase price allocation during the twelve-month period following the acquisition date. The following table sets forth the Company's preliminary allocation of the purchase price to the assets acquired and liabilities assumed as of the acquisition date.
Consideration:
Cash
Exchange ratio of Contango shares for Mid-Con common units
Contango common stock to be issued to Mid-Con unitholders
Issue price
Total consideration
Liabilities Assumed:
Accounts payable
Other current liabilities
Revolving credit facility
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Asset retirement obligations
Total liabilities assumed
Assets acquired:
Cash and cash equivalents
Accounts receivable
Current derivative asset
Prepaid expenses
Proved oil and natural gas properties
Other property and equipment
Other non-current assets
Total assets acquired
The following unaudited pro forma combined condensed financial data for the years ended December 31, 2020 was derived from the historical financial statements of the Company after giving effect to the Mid-Con acquisition, as if it had occurred on January 1, 2020. The below information reflects pro forma adjustments based on available information and certain assumptions that the Company believes are reasonable, including the depletion of the fair-valued proved oil and natural gas properties acquired from Mid-Con. The pro forma results of operations do not include any cost savings or other synergies that may result from the acquisition or any estimated costs that have been or will be incurred by the Company to integrate the assets acquired. The pro forma consolidated statement of operations data has been included for comparative purposes only, is not necessarily indicative of the results that might have occurred had the acquisition taken place on January 1, 2020 and is not intended to be a projection of future results.
( In thousands except for per share amounts)
Year Ended December 31, 2020
Revenues
Net loss
Basic Earnings per share
Diluted earnings per share
Silvertip Acquisition
On November 27, 2020, the Company entered into the Purchase Agreement with an undisclosed seller to acquire certain oil and natural gas properties located in the Big Horn Basin in Wyoming and Montana, in the Powder River Basin in Wyoming and in the Permian Basin in Texas and New Mexico, for aggregate consideration of approximately $ 58 million in cash. In connection with the execution of the Purchase Agreement, the Company paid $ 7.0 million as a deposit for its obligations under the Purchase Agreement, which is included in the consolidated balance sheet as of December 31, 2020. The Silvertip Acquisition closed on February 1, 2021, and a balance of $ 46.2 million was paid upon closing, after customary closing adjustments, including the results of operations during the period between the effective date of August 1, 2020 and the closing date.
Juneau Joint Development Agreement
On December 23, 2019, the Company entered into a Joint Development Agreement with Juneau for aggregate consideration of $ 6.0 million, consisting of $ 1.69 million in cash and 1,725,000 shares of common stock of the Company. This agreement provides the Company the right to acquire an interest in up to six of Juneau's exploratory prospects located in the Gulf of Mexico. The first such exploratory prospect acquired by the Company was the Iron Flea prospect located in the Grand Isle Block 45 Area in the shallow waters off of the Louisiana coastline, which was determined to be unsuccessful in June 2020. The Company is currently evaluating for future testing a number of exploratory prospects included in the Joint Development agreement, including the Boss Hogg prospect, located in the Eugene Island 298 Area in the shallow waters off of the Louisiana coastline. Management considers this Boss Hogg prospect to be an excellent complement to its PDP-oriented acquisition strategy and believes it could provide a very compelling economic value proposition, even in the current low oil price environment. The Company is currently working through regulatory considerations and operational factors, including the availability of appropriate equipment, in determining the ultimate strategy for, and timing on, the testing of that prospect.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
White Star Acquisition
On September 30, 2019, the Company entered into an asset purchase and sale agreement with White Star to acquire certain assets and liabilities, including approximately 306,000 net acres located in the STACK, Anadarko and Cherokee operating districts in Oklahoma. The closing of the White Star Acquisition occurred on November 1, 2019, for a total aggregate consideration of $ 132.5 million. Following adjustments for the results of operations for the period between the effective and closing dates, and other estimated, customary closing adjustments, the net consideration paid was approximately $ 95.7 million in cash.
The White Star Acquisition was accounted for as a business combination. Therefore, the purchase price was allocated to the assets acquired and the liabilities assumed based on their estimated acquisition date fair values based on then currently available information. A combination of a discounted cash flow model and market data was used by a third-party specialist in determining the fair value of the oil and natural gas properties. Significant inputs into the calculation included future commodity prices, estimated volumes of oil and natural gas reserves, expectations for the timing and amount of future development and operating costs, future plugging and abandonment costs, and a risk adjusted discount rate. The following table sets forth the Company's allocation of the purchase price to the assets acquired and liabilities assumed as of the acquisition date.
Consideration:
Cash
Total consideration
Liabilities Assumed:
Accounts payable
Revenue and royalties payable
Suspended revenue and royalties
Lease liabilities
Total liabilities assumed
Assets acquired:
Accounts receivable
Other current assets
Proved oil and natural gas properties
Unevaluated properties
Right-of-use lease assets
Other assets
Total assets acquired
The purchase price allocated to the assets acquired increased to $ 139.1 million from the previously reported $ 138.5 million due to an increase in the value of inventory acquired of $ 1.0 million and a decrease in the value of unevaluated properties acquired of $ 0.4 million. Approximately $ 21.4 million of revenues and $ 16.3 million of direct operating expenses attributed to the White Star Acquisition are included in the Company's consolidated statements of operations for the period of the closing date on November 1, 2019 through December 31, 2019.
The following unaudited pro forma combined condensed financial data for the year ended December 31, 2019 was derived from the historical financial statements of the Company after giving effect to the White Star Acquisition, as if it had occurred on January 1, 2018. The below information reflects pro forma adjustments for the private placement of the Company's Series B contingent convertible preferred stock and an increase in borrowings under the Company's Credit Agreement, the proceeds of which were used to pay the purchase price of the White Star Acquisition, as well as pro forma adjustments based on then currently available information and certain assumptions that the Company believed were reasonable, including the depletion of the fair-valued proved oil and natural gas properties acquired from White Star and the exclusion of acquisition-related costs incurred by the
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Company of approximately $ 1.9 million for the year ended December 31, 2019. The pro forma results of operations do not include any cost savings or other synergies that may have resulted from the acquisition or any estimated costs that have been or will be incurred by the Company to integrate the assets acquired. In addition, the results of operations include non-cash impairment expense for White Star based on historical costs and not the fair value of the oil and natural gas properties acquired as reflected in the allocation of the purchase price. The pro forma financial data does not include the pro forma results of operations for any other acquisitions made during the periods presented, as they were not deemed material. The pro forma consolidated statements of operations data has been included for comparative purposes only, is not necessarily indicative of the results that might have occurred had the acquisition taken place on January 1, 2018 and is not intended to be a projection of future results.
( In thousands except for per share amounts)
Year Ended December 31, 2019
Revenues
Net loss
Basic Earnings per share
Diluted earnings per share
Will Energy Acquisition
On September 12, 2019, the Company announced it entered into a contribution and purchase agreement with Will Energy to acquire approximately 155,900 net acres located in North Louisiana ( 8,000 net acres) and the Western Anadarko Basin in Western Oklahoma and the Texas Panhandle ( 147,900 net acres). Closing of the Will Energy Acquisition occurred on October 25, 2019, for a total aggregate consideration of $ 23 million. Following adjustments for sales of non-core, non-operated Louisiana properties by Will Energy prior to closing, the results of operations for the period between the effective and closing dates, and other estimated, customary closing adjustments, the net consideration paid consisted of $ 14.0 million in cash and 3.5 million shares of common stock.
Non-Core Assets Sales
During the years ended December 31, 2020 and 2019, the Company completed certain non-core asset sales to enhance its liquidity, eliminate marginal assets and reduce administrative costs. These asset sales provide some immediate liquidity and improve the Company's balance sheet by removing future asset retirement obligations.
On June 1, 2020, the Company closed on the sale of certain producing and non-producing properties located in its Central Oklahoma and Western Anadarko regions. These non-core, marginally economic properties were a minor portion of the value of properties acquired from Will Energy and were sold in exchange for the buyer's assumption of the plugging and abandonment liabilities of these properties and revenue held in suspense. The Company recorded a gain of $ 4.2 million as a result of the buyer's assumption of the asset retirement obligations associated with the sold properties.
On April 1, 2020, the Company closed on the sale of certain non-producing properties located in its Central Oklahoma region. These properties were a minor portion of the value of properties acquired from White Star and were sold for approximately $ 0.5 million. The Company recorded a gain of $ 0.2 million as a result of the buyer's assumption of the asset retirement obligations associated with the sold properties.
On July 1, 2019, the Company sold certain minor, non-core operated assets located in Frio and Zavala counties, Texas in exchange for the buyer's assumption of the plugging and abandonment liabilities of the properties. The Company recorded a gain of $ 0.2 million after removal of the asset retirement obligations associated with the sold properties.
On June 10, 2019, the Company sold certain minor, non-core operated assets located in Lavaca and Wharton counties, Texas in exchange for the buyer's assumption of the plugging and abandonment liabilities of the properties. The Company recorded a gain of $ 0.4 million related to the buyer's assumption of the asset retirement obligations associated with the sold properties.
21
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
5. Fair Value Measurements
Pursuant to ASC 820, Fair Value Measurements and Disclosures ( `` ASC 820 ''), the Company's determination of fair value incorporates not only the credit standing of the counterparties involved in transactions with the Company resulting in receivables on the Company's consolidated balance sheets, but also the impact of the Company's nonperformance risk on its own liabilities. ASC 820 defines fair value as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date ( exit price). ASC 820 establishes a fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy assigns the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities ( Level 1) and the lowest priority to unobservable inputs ( Level 3). Level 2 measurements are inputs that are observable for assets or liabilities, either directly or indirectly, other than quoted prices included within Level 1. The Company utilizes market data or assumptions that market participants would use in pricing the asset or liability, including assumptions about risk and the risks inherent in the inputs to the valuation technique. These inputs can be readily observable, market corroborated or generally unobservable. The Company classifies fair value balances based on the observability of those inputs.
As required by ASC 820, a financial instrument's level within the fair value hierarchy is based on the lowest level of input that is significant to the fair value measurement. The Company's assessment of the significance of a particular input to the fair value measurement requires judgment and may affect the valuation of fair value assets and liabilities and their placement within the fair value hierarchy levels. There have been no transfers between Level 1, Level 2 or Level 3.
Derivatives are recorded at fair value at the end of each reporting period. The Company records the net change in the fair value of these positions in `` Gain ( loss) on derivatives, net '' in the Company's consolidated statements of operations. The Company is able to value the assets and liabilities based on observable market data for similar instruments, which resulted in the Company reporting its derivatives as Level 2. This observable data includes the forward curves for commodity prices based on quoted market prices and implied volatility factors related to changes in the forward curves. See Note 6 - `` Derivative Instruments '' for additional discussion of derivatives.
During the year ended December 31, 2020, the Company's derivative contracts were with counterparties that are creditworthy institutions deemed by management as competent and competitive market makers. As such, the Company was exposed to credit risk to the extent of nonperformance by the counterparties in the derivative contracts discussed above; however, the Company did not anticipate any nonperformance. The Company did not post collateral under any of these contracts as they are secured under the Credit Agreement or under unsecured lines of credit with non-bank counterparties.
Estimates of the fair value of financial instruments are made in accordance with the requirements of ASC 825, Financial Instruments. The estimated fair value amounts have been determined at discrete points in time based on relevant market information. These estimates involve uncertainties and can not be determined with precision. The estimated fair value of cash, accounts receivable and accounts payable approximates their carrying value due to their short-term nature. The estimated fair value of the Company's Credit Agreement approximates carrying value because the interest rate approximates current market rates and are re-set at least every three months. See Note 13 - `` Long-Term Debt '' for further information.
Fair value estimates used for non-financial assets are evaluated at fair value on a non-recurring basis and include oil and natural gas properties evaluated for impairment when facts and circumstances indicate that there may be an impairment. If the unamortized cost of properties exceeds the undiscounted cash flows related to the properties, the value of the properties is compared to the fair value estimated as discounted cash flows related to the risk-adjusted proved, probable and possible reserves related to the properties. Fair value measurements based on these inputs are classified as Level 3.
Impairments
Contango tests proved oil and natural gas properties for impairment when events and circumstances indicate a decline in the recoverability of the carrying value of such properties, such as a downward revision of the reserve
22
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
estimates or lower commodity prices. The Company estimates the undiscounted future cash flows expected in connection with the oil and natural gas properties on a field-by-field basis and compares such future cash flows to the unamortized capitalized costs of the properties. If the estimated future undiscounted cash flows are lower than the unamortized capitalized cost, the capitalized cost is reduced to its fair value. The factors used to determine fair value include, but are not limited to, estimates of proved and probable reserves, future commodity prices, the timing of future production and capital expenditures and a discount rate commensurate with the risk reflective of the lives remaining for the respective oil and natural gas properties. Additionally, the Company may use appropriate market data to determine fair value. Because these significant fair value inputs are typically not observable, impairments of long-lived assets are classified as a Level 3 fair value measure.
Unproved properties are reviewed quarterly to determine if there has been impairment of the carrying value, with any such impairment charged to expense in the period.
Asset Retirement Obligations
The initial measurement of ARO at fair value is calculated using discounted cash flow techniques and based on internal estimates of future retirement costs associated with oil and natural gas properties. The factors used to determine fair value include, but are not limited to, estimated future plugging and abandonment costs and expected lives of the related reserves. As there is no corroborating market activity to support the assumptions used, the Company has designated these liabilities as Level 3 at inception.
6. Derivative Instruments
The Company is exposed to certain risks relating to its ongoing business operations, such as commodity price risk. Derivative contracts are utilized to hedge the Company's exposure to price fluctuations and reduce the variability in the Company's cash flows associated with anticipated sales of future oil and natural gas production. The Company typically hedges a substantial, but varying, portion of anticipated oil and natural gas production for future periods. The Company believes that these derivative arrangements, although not free of risk, allow it to achieve a more predictable cash flow and to reduce exposure to commodity price fluctuations. However, derivative arrangements limit the benefit of increases in the prices of oil, natural gas and natural gas liquids sales. Moreover, because its derivative arrangements apply only to a portion of its production, the Company's strategy provides only partial protection against declines in commodity prices. Such arrangements may expose the Company to risk of financial loss in certain circumstances. The Company continuously reevaluates its hedging programs in light of changes in production, market conditions and commodity price forecasts.
As of December 31, 2020, the Company's oil and natural gas derivative positions consisted of `` swaps ''. Swaps are designed so that the Company receives or makes payments based on a differential between fixed and variable prices for oil and natural gas. The Company has also, from time to time, entered into `` costless collars '' derivative positions. A costless collar consists of a sold call, which establishes a maximum price the Company will receive for the volumes under contract, and a purchased put, which establishes a minimum price.
It is the Company's practice to enter into derivative contracts only with counterparties that are creditworthy institutions deemed by management as competent and competitive market makers. The Company did not post collateral under any of these contracts as they are secured under the Credit Agreement or under unsecured lines of credit with non-bank counterparties.
The Company has elected not to designate any of its derivative contracts for hedge accounting. Accordingly, derivatives are carried at fair value on the consolidated balance sheets as assets or liabilities, with the changes in the fair value included in the consolidated statements of operations for the period in which the change occurs. The Company records the net change in the mark-to-market valuation of these derivative contracts, as well as all payments and receipts on settled derivative contracts, in `` Gain ( loss) on derivatives, net '' on the consolidated statements of operations. See Note 5 - `` Fair Value Measurements '' for additional information.
The Company currently has derivative contracts in place to cover production periods through the first quarter of 2023, which include the hedges novated from Mid-Con and the additional hedges entered into in the first quarter of
23
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
2021, as discussed below. These contracts include oil hedges for 2.1 MMBbls of 2021 production with an average floor price of $ 54.85 per barrel and 1.4 MMBbls of 2022 production with an average floor price of $ 50.24 per barrel. For natural gas, the Company's derivative contracts include 12.4 Bcf of 2021 production with an average floor price of $ 2.62 per MMBtu and 10.1 Bcf of 2022 production with an average floor price of $ 2.60 per MMBtu. Approximately 97% of the Company's hedges are swaps, and the Company has no three-way collars or short puts.
The Company had the following financial derivative contracts in place as of December 31, 2020:
Commodity
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Total net fair value of derivative instruments ( in thousands)
Based on West Texas Intermediate oil prices.
Based on Henry Hub NYMEX natural gas prices.
The Company had the following financial derivative contracts in place as of December 31, 2019:
Commodity
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
24
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Commodity
Oil
Oil
Oil
Oil
Oil
Oil
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Total net fair value of derivative instruments ( in thousands)
Based on West Texas Intermediate oil prices.
Based on Henry Hub NYMEX natural gas prices.
In addition to the above financial derivative instruments, the Company also had a costless swap agreement with a Midland WTI - Cushing oil differential swap price of $ 0.05 per barrel of oil. The agreement fixed the Company's exposure to that differential on 12,000 barrels of oil per month for January 2020 through June 2020 and 10,000 barrels per month for July 2020 through December 2020. The fair value of this costless swap agreement was in a liability position of $ 0.1 million as of December 31, 2019.
The following summarizes the fair value of commodity derivatives outstanding on a gross and net basis as of December 31, 2020 ( in thousands).
Assets
Liabilities
Represents counterparty netting under agreements governing such derivatives.
Derivatives listed above are recorded in `` Current derivative asset or liability '' and `` Long-term derivative asset or liability '' on the Company's consolidated balance sheet and include swaps that are carried at fair value.
25
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
The following summarizes the fair value of commodity derivatives outstanding on a gross and net basis as of December 31, 2019 ( in thousands).
Assets
Liabilities
Represents counterparty netting under agreements governing such derivatives.
Derivatives listed above are recorded in `` Current derivative asset or liability '' and `` Long-term derivative asset or liability '' on the Company's consolidated balance sheet and include swaps and costless collars that are carried at fair value.
The following table summarizes the effect of derivative contracts on the Consolidated Statements of Operations for the years ended December 31, 2020 and 2019 ( in thousands):
Contract Type
Crude oil contracts
Natural gas contracts
Realized gain
Crude oil contracts
Natural gas contracts
Unrealized gain ( loss)
Gain ( loss) on derivatives, net
In conjunction with the closing of the Mid-Con Acquisition in January 2021, the Company acquired the following additional derivative contracts via novation from Mid-Con:
Commodity
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Based on West Texas Intermediate oil prices.
26
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
In the first quarter of 2021, the Company entered into the following additional derivative contracts:
Commodity
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Oil
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Natural Gas
Based on West Texas Intermediate oil prices.
Based on Henry Hub NYMEX natural gas prices.
27
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
7. Stock Based Compensation
Effective January 1, 2014, the Company implemented performance-based long-term bonus plans under its compensation plan at the time ( the `` 2009 Plan '') for the benefit of all employees through a Cash Incentive Bonus Plan ( `` CIBP '') and a Long-Term Incentive Plan ( `` LTIP ''). The specific targeted performance measures under these sub-plans are approved by the Compensation Committee and/or the Company's board of directors ( the `` Board ''). Upon achieving the performance levels established each year, bonus awards under the CIBP and LTIP will be calculated as a percentage of base salary of each employee for the plan year. The CIBP and LTIP plan awards for each year are expected to be disbursed in the first quarter of the following year. Employees must be employed by the Company at the time that awards are disbursed to be eligible.
The CIBP awards will be paid in cash while LTIP awards will consist of restricted common stock, performance stock units and/or stock options. The number of shares of restricted common stock and the number of shares underlying the stock options granted will be determined based upon the fair market value of the common stock on the date of the grant.
Third Amended and Restated 2009 Incentive Compensation Plan
As of December 31, 2020, the Company had in place the Contango Oil & Gas Company Third Amended and Restated 2009 Incentive Compensation Plan ( `` the Third Amended 2009 Plan '') which allows for stock options, restricted stock or performance stock units to be awarded to officers, directors and employees as a performance-based award.
On March 21, 2017, the Board amended and restated the Company's then existing incentive compensation plan through the adoption of the Second Amended 2009 Plan. The Second Amended 2009 Plan provides for both cash awards and equity awards to officers, directors, employees or consultants of the Company. On June 8, 2020 the Board amended and restated the Second Amended 2009 Plan through the adoption of the Third Amended 2009 Plan, which, among other things, increased the number of shares of the Company's common stock authorized for issuance pursuant to the Third Amended 2009 Plan by 9,000,000 shares and increased the maximum aggregate number of shares of common stock that may be granted to any individual during any calendar year from 250,000 to 1,000,000. Awards made under the Third Amended 2009 Plan are subject to such restrictions, terms and conditions, including forfeitures, if any, as may be determined by the Board.
Under the terms of the Third Amended 2009 Plan, shares of the Company's common stock may be issued for plan awards. Stock options under the Third Amended 2009 Plan must have an exercise price of each option equal to or greater than the market price of the Company's common stock on the date of grant. The Company may grant officers and employees both incentive stock options intended to qualify under Section 422 of the Internal Revenue Code of 1986, as amended, and stock options that are not qualified as incentive stock options. Stock option grants to non-employees, such as directors and consultants, can only be stock options that are not qualified as incentive stock options. Options granted generally expire after five or ten years. The vesting schedule for all equity awards varies from immediately to over a three-year period. As of December 31, 2020, the Company had approximately 6.2 million shares of equity awards available for future grant under the Third Amended 2009 Plan, assuming performance stock units are settled at 100% of target.
2005 Stock Incentive Plan
The 2005 Plan was adopted by the Company's Board in conjunction with the merger with Crimson Exploration, Inc. This plan expired on February 25, 2015, and therefore, no additional shares are available for grant.
28
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Stock Options
A summary of stock options as of and for the years ended December 31, 2020 and 2019 is presented in the table below ( dollars in thousands, except per share data):
Outstanding, beginning of the period
Exercised
Expired / Forfeited
Outstanding, end of year
Aggregate intrinsic value
Exercisable, end of year
Aggregate intrinsic value
Available for grant, end of the period *
Weighted average fair value of options granted during the period
Assumes performance stock units are settled at 100% of target.
During the years ended December 31, 2020 and 2019, the Company did not issue any stock options. During the years ended December 31, 2020 and December 31, 2019, 1,117 and 12,673 stock options previously issued were forfeited by former employees, respectively.
As of December 31, 2020, there were 19,847 stock options vested and exercisable under the 2005 Plan. The exercise price for such options ranges from $ 28.96 to $ 60.33 per share, with an average remaining contractual life of 0.2 years.
Under the fair value method of accounting for stock options, cash flows from the exercise of stock options resulting from tax benefits in excess of recognized cumulative compensation cost ( excess tax benefits) are classified as financing cash flows. For the years ended December 31, 2020 and 2019, there was no excess tax benefit recognized. See Note 2 - `` Summary of Significant Accounting Policies ''.
Compensation expense related to employee stock option grants are recognized over the stock option's vesting period based on the fair value at the date the options are granted. The fair value of each option is estimated as of the date of grant using the Black-Scholes options-pricing model.
During the years ended December 31, 2020 and 2019, the Company did not recognize any stock option expense. The aggregate intrinsic value of stock options exercised/forfeited during each of the years ended December 31, 2020 and 2019 was zero.
Restricted Stock
During the year ended December 31, 2020, the Company issued 1,041,365 restricted stock awards to new and existing employees, which vest over three years, as part of their overall compensation package. During the year ended December 31, 2020, the Company issued 152,248 restricted stock awards to the members of the board of directors, which vest on the one-year anniversary of the date of grant, as well as an additional 50,914 restricted stock awards, in lieu of cash fees earned for the third quarter of 2020, which vested immediately. During the year ended December 31, 2020, 55,064 restricted stock awards were forfeited by former employees. The weighted average fair value of the restricted shares granted during the year was $ 2.22, with a total grant date fair value of approximately $ 2.8 million with no adjustment for an estimated weighted average forfeiture rate.
During the year ended December 31, 2019, the Company issued 307,650 restricted stock awards to new and existing employees, which vest over three years, plus an additional 80,410 restricted stock awards to the members of the board of directors, which vest on the one-year anniversary of the date of grant, as part of their overall compensation package. During the year ended December 31, 2019, 91,346 restricted stock awards were forfeited by former employees. The weighted average fair value of the restricted shares granted during the year was $ 2.91, with a total grant date fair value of approximately $ 1.1 million with no adjustment for an estimated weighted average forfeiture rate.
29
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Restricted stock activity as of December 31, 2020 and 2019 and for the years then ended is presented in the table below ( dollars in thousands, except per share data):
Outstanding, beginning of the period
Granted
Vested
Canceled / Forfeited
Not vested, end of the period
The Company recognized approximately $ 1.3 million and $ 1.9 million in restricted stock compensation expense during the years ended December 31, 2020 and 2019, respectively, for restricted shares granted to its officers, employees and directors. The lower 2020 expense is primarily related to the issuance of stock in the third quarter of 2020 as compared to stock issued in the first quarter of 2019. As of December 31, 2020, there were 1,303,048 shares of unvested restricted stock outstanding, and an additional $ 2.3 million of compensation expense related to restricted stock remains to be recognized over the remaining vesting period of 2.1 years.
Performance Stock Units
Performance stock units ( `` PSUs '') represent the opportunity to receive shares of the Company's common stock at the time of settlement. The number of shares to be awarded upon settlement of the PSUs may range from 0% to 300% of the targeted number of PSUs stated in the award agreements, contingent upon the achievement of certain share price appreciation targets compared to share appreciation of a specific peer group or peer group index over a three-year period. The PSUs vest at the end of the three-year performance period, with the final number of shares to be issued determined at that time, based on the Company's share performance during the period compared to the average performance of the peer group.
Compensation expense associated with PSUs is based on the grant date fair value of a single PSU as determined using the Monte Carlo simulation model, which utilizes a stochastic process to create a range of potential future outcomes given a variety of inputs. As the Compensation Committee intends to settle the PSUs with shares of the Company's common stock after three years, the PSU awards are accounted for as equity awards, and the fair value is calculated on the grant date. The simulation model calculates the payout percentage based on the stock price performance over the performance period. The concluded fair value is based on the average achievement percentage over all the iterations. The resulting fair value expense is amortized over the life of the PSU award.
During the year ended December 31, 2020, the Company granted 2,846,140 PSUs to executive officers and certain employees as part of their overall compensation package. The performance period will be measured between May 1, 2020 and April 30, 2023. These granted PSUs were valued at a weighted average fair value of $ 4.90 per unit. All fair value prices were determined using the Monte Carlo simulation model. In January 2020, 77,485 shares of the PSUs granted in 2017 vested, of which 22,972 PSUs were withheld for taxes, and are included with the restricted stock activity in the consolidated statement of shareholders ' equity. In December 2020, 68,476 shares of the PSUs granted in 2018 vested, of which 18,284 PSUs were withheld for taxes and are included with the restricted stock activity in the consolidated statement of shareholders ' equity. No PSUs were forfeited during the year ended December 31, 2020. The Company recognized approximately $ 3.0 million in stock compensation expense related to PSUs during 2020. As of December 31, 2020, an additional $ 11.7 million of compensation expense related to PSUs remained to be recognized over the remaining vesting period of 2.3 years.
During the year ended December 31, 2019, the Company granted 117,105 PSUs to executive officers and employees as part of their overall compensation package, which will be measured between January 1, 2019 and December 31, 2021, and were valued at a weighted average fair value of $ 6.42 per unit. All fair value prices were
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
determined using the Monte Carlo simulation model. During the year ended December 31, 2019, 71,945 PSUs were forfeited by former employees, including 49,773 PSU forfeitures due to the resignations of the Company's former Senior Vice President of Exploration and Senior Vice President of Operations and Engineering in February 2019. The Company only recognized approximately $ 0.5 million in stock compensation expense related to PSUs during 2019, primarily due to the expiration of PSUs which failed to meet their target as of December 31, 2018 and the above referenced forfeitures.
8. Share Repurchase Program
In September 2011, the Company's board of directors approved a $ 50 million share repurchase program. All shares are to be purchased in the open market or through privately negotiated transactions. Purchases are made subject to market conditions and certain volume, pricing and timing restrictions to minimize the impact of the purchases upon the market, and when the Company believes its stock price to be undervalued. Repurchased shares of common stock become authorized but unissued shares and may be issued in the future for general corporate and other purposes. No shares were purchased during the years ended December 31, 2020 and 2019. As of December 31, 2020, the Company had $ 31.8 million available under the share repurchase program for future purchases; however, repurchases could be limited by provisions of the Company's Credit Agreement.
9. Leases
As of January 1, 2019, the Company adopted Accounting Standards Codification Topic 842 - Leases ( `` ASC 842 ''), which requires lessees to recognize a lease liability, which is a lessee's obligation to make lease payments arising from a lease, measured on a discounted basis, and a right-of-use asset, which is an asset that represents the lessee's right to use, or control the use of, a specified asset for the lease term on the Company's consolidated balance sheet.
During the year ended December 31, 2020, the Company entered into new compressor contracts with lease terms of twelve months or more, which qualify as operating leases. The Company also entered into new contracts for vehicles and office equipment with lease terms of twelve months or more, which qualify as finance leases. As of December 31, 2020, the Company's operating leases were for compressors and office space for two corporate offices and three field offices, while the Company's finance leases were for vehicles and office equipment. These leases do not have a material net impact on the Company's consolidated financial statements.
The following table summarizes the balance sheet information related to the Company's leases as of December 31, 2020 and December 31, 2019 ( in thousands):
Operating lease right of use asset ( 1)
Operating lease liability - current ( 2)
Operating lease liability - long-term ( 3)
Total operating lease liability
Financing lease right of use asset ( 1)
Financing lease liability - current ( 2)
Financing lease liability - long-term ( 3)
Total financing lease liability
Included in `` Right-of-use lease assets '' on the consolidated balance sheet.
Included in `` Accounts payable and accrued liabilities '' on the consolidated balance sheet.
Included in `` Lease liabilities '' on the consolidated balance sheet.
The Company's leases generally do not provide an implicit rate, and therefore the Company uses its incremental borrowing rate as the discount rate when measuring operating lease liabilities. The incremental borrowing rate represents an estimate of the interest rate the Company would incur at lease commencement to borrow an amount equal to the lease payments on a collateralized basis over the term of a lease. For operating leases existing prior to January 1, 2019, the incremental borrowing rate as of January 1, 2019 was used for the remaining lease term.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
The table below presents the weighted average remaining lease terms and weighted average discount rates for the Company's leases as of December 31, 2020 and December 31, 2019:
Weighted Average Remaining Lease Terms ( in years):
Operating leases
Financing leases
Weighted Average Discount Rate:
Operating leases
Financing leases
Maturities for the Company's lease liabilities on the consolidated balance sheet as of December 31, 2020, were as follows ( in thousands):
2021
2022
2023
2024
Total future minimum lease payments
Less: imputed interest
Present value of lease liabilities
The following table summarizes expenses related to the Company's leases for the three months ended December 31, 2020 and December 31, 2019 ( in thousands):
Operating lease cost ( 1) ( 2)
Financing lease cost - amortization of right-of-use assets
Financing lease cost - interest on lease liabilities
Administrative lease cost ( 3)
Short-term lease cost ( 1) ( 4)
Total lease cost
This total does not reflect amounts that may be reimbursed by other third parties in the normal course of business, such as non-operating working interest owners.
Costs related to office leases and compressors with lease terms of twelve months of more.
Costs related primarily to office equipment and IT solutions with lease terms of more than one month and less than one year.
Costs related primarily to drilling rigs, generators and compressor agreements with lease terms of more than one month and less than one year.
The following table summarizes expenses related to the Company's leases for the years ended December 31, 2020 and December 31, 2019 ( in thousands):
Operating lease cost ( 1) ( 2)
Financing lease cost - amortization of right-of-use assets
Financing lease cost - interest on lease liabilities
Administrative lease cost ( 3)
Short-term lease cost ( 1) ( 4)
Total lease cost
This total does not reflect amounts that may be reimbursed by other third parties in the normal course of business, such as non-operating working interest owners.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Costs related to office leases and compressors with lease terms of twelve months of more. Higher costs in 2020 due to additional leases related to the properties acquired from Will Energy and White Star during the three months ended December 31, 2019.
Costs related primarily to office equipment and IT solutions with lease terms of more than one month and less than one year.
Costs related primarily to drilling rigs, generators and compressor agreements with lease terms of more than one month and less than one year.
There were $ 3.2 million and $ 0.9 million in cash payments related to operating leases and financing leases, respectively, during the year ended December 31, 2020. There were $ 0.8 million and $ 0.1 million in cash payments related to operating leases and financing leases, respectively, during the year ended December 31, 2019.
10. Other Financial Information
The following table provides additional detail for accounts receivable, prepaids and accounts payable and accrued liabilities which are presented on the consolidated balance sheets ( in thousands):
Accounts receivable:
Trade receivables
Receivable for Alta Resources distribution
Joint interest billings
Income taxes receivable
Other receivables
Allowance for doubtful accounts ( 1)
Total accounts receivable
Prepaid Expenses:
Prepaid insurance
Other ( 2)
Total Prepaid Expenses
Accounts payable and accrued liabilities:
Royalties and revenue payable
Legal suspense related to revenues ( 3)
Advances from partners ( 4)
Accrued exploration and development ( 4)
Trade payables
Accrued general and administrative expenses ( 5)
Accrued operating expenses
Accrued operating and finance leases
Other accounts payable and accrued liabilities
Total accounts payable and accrued liabilities
Increase in 2020 primarily due to the additional properties acquired from Will Energy and White Star.
Other prepaids primarily includes software licenses.
Suspended revenues primarily relate to amounts for which there is some question as to valid ownership, unknown addresses of payees or some other payment dispute.
Decrease in 2020 due to a decrease in drilling and completion activity. In response to the dramatic decline in commodity prices in the first quarter of 2020, the Company suspended further operated drilling in its West Texas area, and in its other onshore areas.
The December 31, 2019 balance includes an accrual of $ 6.3 million for a legal judgment that was paid in April 2020. See Note 14 - `` Commitment and Contingencies '' for further information.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Included in the table below is supplemental cash flow disclosures and non-cash investing activities during the years ended December 31, 2020 and 2019, in thousands:
Cash payments:
Interest payments
Income tax payments, net of cash refunds
Non-cash items excluded from investing activities in the consolidated statements of cash flows:
Increase ( decrease) in accrued capital expenditures
11. Investment in Exaro Energy III LLC
Through the Company's wholly-owned subsidiary, Contaro Company ( `` Contaro ''), the Company committed to invest up to $ 67.5 million in Exaro for an ownership interest of approximately 37%. The aggregate commitment of all the Exaro investors was approximately $ 183 million. The Company did not make any contributions during the year ended December 31, 2020 and has no plans to invest additional funds in Exaro, as the commitment to invest in Exaro expired on March 31, 2017. As of December 31, 2020, the Company had invested approximately $ 46.9 million. Contango's share in the equity of Exaro at December 31, 2020 was approximately $ 6.8 million.
The Company's share in Exaro's results of operations recognized for the years ended December 31, 2020 and 2019 was a gain of approximately $ 27,000, net of zero tax expense and a gain of approximately $ 1.0 million, net of zero tax, respectively.
12. Asset Retirement Obligation
The Company accounts for its retirement obligation of long lived assets by recording the net present value of a liability for an ARO in the period in which it is incurred. When the liability is initially recorded, the Company increases the carrying amount of the related long-lived asset. Over time, the liability is accreted to its present value each period, and the capitalized cost is depreciated over the useful life of the related asset. Upon settlement of the liability, the Company either settles the obligation for its recorded amount or incurs a gain or loss upon settlement.
Activities related to the Company's ARO during the years ended December 31, 2020 and 2019 were as follows ( in thousands):
Balance as of the beginning of the period
Liabilities incurred during period
Liabilities settled during period
Accretion
Sales
Acquisitions
Change in estimate
Balance as of the end of the period
All of the total liabilities incurred during the years ended December 31, 2020 and 2019 were related to new wells drilled during the period. All of the total liabilities settled during the years ended December 31, 2020 and 2019 were related to wells plugged and abandoned during the period. The acquisitions refer to new liabilities assumed from the properties acquired in 2019 from White Star and Will Energy. The change in estimate relates to year-end adjustments for updated estimated plugging and abandonment costs, primarily in the Company's Central Oklahoma and Western Anadarko regions.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
13. Long-Term Debt
Credit Agreement
On September 17, 2019, the Company entered into its new revolving Credit Agreement with JPMorgan Chase Bank, N.A. and other lenders, which established a borrowing base of $ 65 million.
The borrowing base is subject to semi-annual redeterminations which will occur on or around May 1st and November 1st of each year. The Credit Agreement was amended on November 1, 2019, in conjunction with the closing of the Will Energy Acquisition and White Star Acquisition, to add two additional lenders and increase the borrowing base thereunder to $ 145 million. On June 9, 2020, the Company entered into the Second Amendment to the Credit Agreement ( the `` Second Amendment ''). The Second Amendment redetermined the borrowing base at $ 95 million, among other things, pursuant to the regularly scheduled redetermination process. The Second Amendment also provided for further $ 10 million automatic reductions in the borrowing base on each of June 30, 2020 and September 30, 2020. On October 30, 2020, the Company entered into the Third Amendment to the Credit Agreement, which became effective on January 21, 2021, upon the satisfaction of certain conditions, including the consummation of the Mid-Con Acquisition. See Note 4 - `` Acquisitions and Dispositions '' for more information. The Third Amendment provided for, among other things, ( i) a 25 basis point increase in the applicable margin at each level of the borrowing base utilization-based pricing grid, ( ii) an increase of the borrowing base to $ 130.0 million on the effective date of the Third Amendment with a $ 10.0 million automatic stepdown in the borrowing base on March 31, 2021, ( iii) certain modifications to the Company's minimum hedging covenant including requiring hedging for at least 75% of the Company's projected PDP volumes for 24 full calendar months on or prior to 30 days after the effective date of the Third Amendment and on April 1 and October 1 of each calendar year, ( iv) addition of three new lenders to the lender group. As of December 31, 2020, the borrowing base was $ 75 million. In connection with the closing of the Mid-Con Acquisition on January 21, 2021, the borrowing base increased automatically to $ 130.0 million. The next regularly scheduled borrowing base redetermination is on or before May 1, 2021.
Initially, the Company incurred $ 1.8 million of arrangement and upfront fees in connection with the Credit Agreement and incurred an additional $ 1.6 million in fees for the first amendment to the Credit Agreement, all to be amortized over the remaining term of the Credit Agreement. No fees were incurred for the Second Amendment; however, during the three months ended June 30, 2020, the Company expensed $ 1.0 million of the debt issuance costs discussed above, which originally were to be amortized over the life of the loan, due to the reduction in the borrowing base per the Second Amendment. The Company initially incurred $ 0.1 million in fees related to the Third Amendment during the three months ended December 31, 2020. During the year ended December 31, 2020, the Company amortized debt issuance costs of $ 1.6 million related to the Credit Agreement, including the $ 1.0 million mentioned above. As of December 31, 2020, the remaining balance of these fees was $ 1.8 million, which will be amortized through September 17, 2024. In January 2021, the Company incurred an additional $ 0.9 million in fees related to the Third Amendment that became effective on January 21, 2021, in connection with the closing of the Mid-Con Acquisition. These fees will also be amortized over the remaining term of the loan.
As of December 31, 2020, the Company had $ 9.0 million outstanding under the Credit Agreement and $ 1.9 million in outstanding letters of credit. As of December 31, 2019, the Company had $ 72.8 million outstanding under the Credit Agreement and $ 1.9 million in outstanding letters of credit. As of December 31, 2020, borrowing availability under the Credit Agreement was $ 64.1 million.
The Credit Agreement is collateralized by liens on substantially all of the Company's oil and natural gas properties and other assets and security interests in the stock of its wholly owned and/or controlled subsidiaries. The Company's wholly owned and/or controlled subsidiaries are also required to join as guarantors under the Credit Agreement.
Borrowings under the Credit Agreement bear interest at LIBOR, the U.S. prime rate, or the federal funds rate, plus a 1.75% to 3.75% margin, dependent upon the amount outstanding. Total interest expense under the Company's Credit Agreement, including commitment fees, the additional $ 1.0 million in expensed loan fees discussed above and other financing fees was approximately $ 5.0 million for the year ended December 31, 2020. Total interest expense under the Company's current and previous credit agreements, including commitment fees and other financing fees, was approximately $ 8.6 million for the year ended December 31, 2019.
35
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
The weighted average interest rates in effect at December 31, 2020 and December 31, 2019 were 2.9% and 4.3% under the Credit Agreement, respectively.
The Credit Agreement contains customary and typical restrictive covenants. The Credit Agreement requires a Current Ratio of greater than or equal to 1.0 and a Leverage Ratio of less than or equal to 3.50, both as defined in the Credit Agreement. The Second Amendment includes a waiver of the Current Ratio requirement until the quarter ending March 31, 2022. Additionally, the Second Amendment, among other things, provides for an increase in the Applicable Margin grid on borrowings outstanding of 50 basis points, and includes provisions requiring monthly aged accounts payable reports and typical anti-cash hoarding and cash sweep provisions with respect to a consolidated cash balance in excess of $ 5.0 million. The Credit Agreement also contains events of default that may accelerate repayment of any borrowings and/or termination of the facility. Events of default include, but are not limited to, a going concern qualification, payment defaults, breach of certain covenants, bankruptcy, insolvency or change of control events. As of December 31, 2020, the Company was in compliance with all of its covenants under the Credit Agreement.
Paycheck Protection Program Loan
On April 10, 2020, the Company entered into a promissory note evidencing an unsecured loan in the amount of approximately $ 3.4 million ( the `` PPP Loan '') made to the Company under the Paycheck Protection Program ( the `` PPP ''). The PPP was established under the Coronavirus Aid, Relief, and Economic Security Act ( `` CARES Act ''), signed into law on March 27, 2020, and is administered by the U.S. Small Business Administration. The PPP Loan to the Company is being made through JPMorgan Chase Bank, N.A and is included in `` Long-Term Debt '' on the Company's consolidated balance sheet.
The PPP Loan matures on the two-year anniversary of the funding date and bears interest at a fixed rate of 1.00% per annum. Monthly principal and interest payments, less the amount of any potential forgiveness ( discussed below), will commence after the six-month anniversary of the funding date. The promissory note evidencing the PPP Loan provides for customary events of default, including, among others, those relating to failure to make payment, bankruptcy, breaches of representations and material adverse effects. The Company may prepay the principal of the PPP Loan at any time without incurring any prepayment charges.
Under the terms of the CARES Act, PPP loan recipients can apply for and be granted forgiveness for all or a portion of the loans granted under the PPP, subject to an audit. Under the CARES Act, loan forgiveness is available, subject to limitations, for the sum of documented payroll costs, covered mortgage interest payments, covered rent payments and covered utilities during either: ( 1) the eight-week period beginning on the funding date; or ( 2) the 24-week period beginning on the funding date. Forgiveness is reduced if full-time employee headcount declines, or if salaries and wages for employees with salaries of $ 100,000 or less annually are reduced by more than 25%. The Company utilized the PPP Loan amount for qualifying expenses during the 24-week coverage period, and on September 30, 2020, submitted its application for forgiveness of all of the PPP Loan in accordance with the terms of the CARES Act and related guidance. The Company is currently awaiting a response from the Small Business Administration. In the event the PPP Loan or any portion thereof is forgiven, the amount forgiven is applied to the outstanding principal.
14. Commitments and Contingencies
Contango leases its office space, compressors, vehicles and certain other equipment, which are considered operating and finance leases. See Note 9 - `` Leases '' for more information. The Company also incurs commitments on its oil and natural gas leases, such as delay rentals, surface damage payments and rental payments associated with salt water disposal contracts.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
As of December 31, 2020, minimum future operating and finance lease payments and other commitments listed above for Contango's fiscal years are as follows ( in thousands):
Fiscal years ending December 31,
2021
2022
2023
2024
2025 and thereafter
Total
The amounts incurred under operating and finance leases and payments related to delay rentals, surface use and salt water disposal contracts during the years ended December 31, 2020 and 2019 were approximately $ 4.3 million and $ 1.5 million, respectively. The increase in 2020 payments is due to the properties acquired in the Will Energy Acquisition and the White Star Acquisition.
Throughput Contract Commitment
The Company had a signed a throughput agreement with a third-party pipeline owner/operator that constructed a natural gas gathering pipeline in Southeast Texas that allowed the Company to defray the cost of building the pipeline itself. Beginning in late 2016, the Company was unable to meet the minimum monthly gas volume deliveries through this line in Southeast Texas and continued to not meet the minimum throughput requirements under the agreement through the expiration of the throughput commitment on March 31, 2020. As of December 31, 2019, the Company recorded a $ 1.0 million loss contingency through the end of the contract in March 2020, which was paid in three equal monthly installments in 2020. As the remaining throughput commitment fees of $ 1.0 million were accrued during the year ended December 31, 2019, the Company incurred no expense related to this commitment in 2020.
Legal Proceedings
From time to time, the Company is involved in legal proceedings relating to claims associated with its properties, operations or business or arising from disputes with vendors in the normal course of business, including the material matters discussed below.
On November 16, 2010, a subsidiary of the Company, several predecessor operators and several product purchasers were named in a lawsuit filed in the District Court for Lavaca County in Texas by an entity alleging that it owns a working interest in two wells that has not been recognized by the Company or by predecessor operators to which the Company had granted indemnification rights. In dispute is whether ownership rights were transferred through a number of decades-old poorly documented transactions. Based on prior summary judgments, the trial court entered a final judgment in the case in favor of the plaintiffs for approximately $ 5.3 million, plus post-judgment interest. The Company appealed the trial court's decision to the applicable state Court of Appeals, and in the fourth quarter of 2017, the Court of Appeals issued its opinion and affirmed the trial court's summary decision. In the first quarter of 2018, the Company filed a motion for rehearing with the Court of Appeals, which was denied, as expected. The Company filed a petition requesting a review by the Texas Supreme Court, as the Company believes the trial and appellate courts erred in the interpretation of the law. In early October 2019, the Texas Supreme Court notified the Company that it would not hear this case. The Company engaged additional legal representation to assist in the preparation of an amended petition requesting that the Texas Supreme Court reconsider its initial decision to not review the case. That amended petition was filed, and in mid-March 2020, the Texas Supreme Court decided they would not re-hear the case. Consequently, during the three months ended December 31, 2019, the Company recorded a $ 6.3 million liability for the judgment, interest and fees, with $ 3.5 million of such liability related to suspended funds reflected in `` Accounts payable and accrued liabilities '' on the Company's consolidated balance sheet for the year ended December 31, 2019. The judgment, interest and fees were paid in April 2020.
On January 14, 2016, the Company was named as the defendant in a lawsuit filed in the District Court for Harris County in Texas by a third-party operator. The Company participated in the drilling of a well in 2012, which experienced serious difficulties during the initial drilling, which eventually led to the plugging and abandoning of the wellbore prior to reaching the target depth. In dispute is whether the Company is responsible for the additional
37
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
costs related to the drilling difficulties and plugging and abandonment. In September 2019, the case went to trial, and, in October 2019, the court ruled in favor of the plaintiff. Prior to the judgment, the Company had approximately $ 1.1 million in accounts payable related to the disputed costs associated with this case. As a result of the judgment, during the three months ended September 30, 2019, the Company recorded an additional $ 2.1 million liability for the final judgment plus fees and interest. The Company also prepared and filed an appeal with the appellate court for a review of the initial trial court decision The plaintiff petitioned the appellate court for an extension of time to file briefs with the court until late in the fourth quarter of 2020. On January 23, 2021, the appellate court notified both parties that it would begin reviewing the merits of the case beginning on February 23, 2021. On March 3, 2021, the appellate court affirmed the trial court's decision. The Company plans to appeal the decision to the Supreme Court.
While many of these matters involve inherent uncertainty and the Company is unable at the date of this filing to estimate an amount of possible loss with respect to certain of these matters, the Company believes that the amount of the liability, if any, ultimately incurred with respect to these proceedings or claims will not have a material adverse effect on its consolidated financial position as a whole or on its liquidity, capital resources or future annual results of operations. The Company maintains various insurance policies that may provide coverage when certain types of legal proceedings are determined adversely.
15. Net Loss Per Common Share
A reconciliation of the components of basic and diluted net loss per common share for the years ended December 31, 2020 and 2019 is presented below ( in thousands):
Basic Earnings per Share:
Net loss attributable to common stock
Diluted Earnings per Share:
Effect of potential dilutive securities:
Weighted average of incremental shares ( stock options, restricted stock and PSUs)
Net loss attributable to common stock
Basic Earnings per Share:
Net loss attributable to common stock
Diluted Earnings per Share:
Effect of potential dilutive securities:
Weighted average of incremental shares ( stock options, restricted stock and PSUs)
Net loss attributable to common stock
The numerator for basic earnings per share is net loss attributable to common stockholders. The numerator for diluted earnings per share is net loss available to common stockholders.
Potential dilutive securities ( stock options, restricted stock and PSUs) have not been considered when their effect would be antidilutive. The potentially dilutive shares would have been 529,508 shares and 613,506 shares for the years ended December 31, 2020 and 2019, respectively.
16. Income Taxes
Income taxes are provided for the tax effects of transactions reported in the financial statements and consist of taxes currently payable plus deferred income taxes related to certain income and expenses recognized in different periods for financial and income tax reporting purposes. Deferred income taxes are measured by applying currently enacted tax rates to the differences between financial statements and income tax reporting. Numerous judgments and
38
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
assumptions are inherent in the determination of deferred income tax assets and liabilities as well as income taxes payable in the current period. The Company is subject to taxation in several jurisdictions, and the calculation of its tax liabilities involves dealing with uncertainties in the application of complex tax laws and regulations in various taxing jurisdictions.
Income Tax Computation
Actual income tax expense differs from income tax expense computed by applying the U.S. federal statutory corporate rate of 21 percent for the years ended December 31, 2020 and 2019, respectively, to pretax income as follows ( dollars in thousands):
Benefit at statutory tax rate
State income tax provision, net of federal benefit
State deferred tax benefit
Permanent differences
Stock based compensation
Valuation allowance
Other
Income tax provision
The effective tax rate for the years ended December 31, 2020 and 2019 varies from the statutory rate primarily as a result of recording a valuation allowance.
The provision ( benefit) for income taxes for the periods indicated are comprised of the following ( in thousands):
Current tax provision ( benefit):
Federal
State
Total
Deferred tax benefit:
Federal
State
Total
Total tax provision ( benefit):
Federal
State
Total
Included in gain from investment in affiliates
Total income tax provision
The Federal income tax expense results from an adjustment in the previous period of the credit for Alternative Minimum Tax ( `` AMT '') paid in prior years. As a result of the tax reform in 2017, the corporate AMT was repealed, and any AMT credit was made refundable. The first half of the credit was refunded when the Company filed its 2018 federal income tax return, and the second half of the credit was refunded when the Company filed its 2019 federal tax return. The CARES Act modified the timing of these refunds, allowing the Company to request an expedited refund of $ 0.3 million during the quarter ended June 30, 2020. This amount was previously accounted for as an income tax benefit when the corporate AMT was repealed. State income tax expense relates to income taxes for the quarter and the nine months which are expected to be owed to the states of Louisiana and Oklahoma resulting from activities within those states and, in each case, that are not shielded by existing Federal tax attributes.
39
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
Additionally, under the CARES Act, the Company will benefit from an amendment to Internal Revenue Code Section 163 ( j) that temporarily increases deductible interest expense limitations. Specifically, the CARES Act increases the 30% Adjusted Taxable Income ( `` ATI '') limitation to 50% of ATI for taxable years beginning in each of 2019 and 2020. This will have the effect of allowing the Company to use a Section 163 ( j) carryover from the prior year that was not limited by Section 382 ( discussed below). The Company does not expect to benefit from any other income tax-related provisions of the CARES Act.
The net deferred tax is comprised of the following ( in thousands):
Deferred tax assets:
Net operating loss carryforward
Deferred compensation
Derivative instruments
State deferred tax assets
Oil and gas properties
Investment in affiliates
Recognized built in loss carryforward
163 ( j) Carryforward
Other
Total deferred tax assets before valuation allowance
Valuation allowance
Net deferred tax assets
Deferred tax liability:
Deferred compensation
Derivative instruments
Deferred tax liability
Total net deferred tax
Accounting for uncertainty in income taxes prescribes a recognition threshold and a measurement attribute for the financial statement recognition and measurement of income tax positions taken or expected to be taken in an income tax return. For those benefits to be recognized, an income tax position must be more-likely-than-not to be sustained upon examination by taxing authorities.
In assessing the realizability of deferred tax assets, the Company considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. The Company considers the scheduled reversal of deferred tax liabilities, projected future taxable income and tax planning strategies in making this assessment. Based upon the amount of deferred tax liabilities, level of historical taxable income and projections for future taxable income over the periods in which the deferred tax assets are deductible, the Company believes it is not more-likely-than-not that it will realize the benefits of these deductible differences and has recorded a valuation allowance for federal and state purposes of approximately $ 138.8 million and approximately $ 6.5 million, respectively.
As of December 31, 2020, the Company had federal net operating loss ( `` NOL '') carryforwards of approximately $ 404.7 million and state NOLs of $ 26.4 million. The Federal NOL carryforwards are made up of: ( i) those acquired in the merger with Crimson Exploration, Inc. ( `` Crimson '') in 2013 ( the `` Merger '') and ( ii) from subsequent taxable losses during the years 2014 through 2020 due to lower commodity prices and utilization of various elections available to the Company in expensing capital expenditures incurred in the development of oil and natural gas properties. Generally, these NOLs are available to reduce future taxable income and the related income tax liability subject to the limitations set forth in Internal Revenue Code Section 382 related to changes of more than 50% of ownership of the Company's stock by 5% or greater shareholders over a three-year period ( a Section 382 Ownership Change) from the time of such an ownership change. Recently passed legislation, however, temporarily suspends the Section 172 limitation for NOLs arising in a tax year beginning in 2018, 2019 or 2020 and also allows these NOLs to be carried back five years.
40
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
On November 19, 2018, the Company completed a follow-on offering ( the `` 2018 Offering '') of 7.5 million additional shares of common stock. Prior to December 18, 2018, the underwriters exercised their Green Shoe option purchasing an additional approximate 1.1 million shares, resulting in a total of approximately 8.6 million primary shares issued in the Offering. This issuance resulted in a Section 382 Ownership Change ( the `` 2018 Ownership Change '') which limits the Company's future ability to use its NOLs. As such, the Company is limited in use of NOLs for amounts incurred prior to November 20, 2018 in an amount estimated to be approximately $ 2.4 million per year ( plus any recognized built in gains during the next five years) or until expiration of each annual vintage of NOL ( generally, 20 years for each annual vintage of NOLs incurred prior to 2018).
On September 12, 2019, as discussed in Note 1 - `` Organization and Business '', the Company completed the September 2019 Public Offering which also resulted in a Section 382 Ownership Change on that date ( the `` 2019 Ownership Change '' and, together with the 2018 Ownership Change, the `` Ownership Changes ''). Due to changing market conditions, the Company's ability to utilize pre-2018 NOLs on that date could be limited to $ 700,000 a year ( in pre-tax dollars). This lower annual limitation resulting from the 2019 Ownership Change effectively eliminates the ability to utilize these tax attributes in the future.
The Company is also affected by the limitation in Section 163 ( j) on interest taken in any given tax year. As of December 31, 2020, the Company had a limitation of $ 2.4 million which will carry over indefinitely. Additionally, the Company's post-2017 NOLs of $ 132.7 million are also not subject to expiration, but are limited to offsetting 80% of the Company's taxable income in any year of usage after December 31, 2020. These carryovers are subject to any applicable Section 382 limitation ( discussed above).
As a result of the Ownership Changes, the Company has recorded a valuation allowance against substantially all of its NOLs and other deferred tax assets. The valuation allowance balance at December 31, 2020 is $ 145.3 million.
ASC 740, Income Taxes ( `` ASC 740 '') prescribes a recognition threshold and a measurement attribute for the financial statement recognition and measurement of income tax positions taken or expected to be taken in an income tax return. For those benefits to be recognized, an income tax position must be more-likely-than-not to be sustained upon examination by taxing authorities. As a result of the Merger, the Company acquired certain tax positions taken by Crimson in prior years. These positions are not expected to have a material impact on results of operations, financial position or cash flows. A reconciliation of the beginning and ending amount of unrecognized income tax benefits is as follows ( in thousands):
Balance at December 31, 2019
Additions based on tax positions related to the current year
Additions based on tax positions related to prior years
Additions due to acquisitions
Reductions due to a lapse of the applicable statute of limitations
Change in rate due to remeasurement
Balance at December 31, 2020
The Company's policy is to recognize interest and penalties related to uncertain tax positions as income tax benefit ( expense) in the Company's consolidated statements of operations. The Company had no interest or penalties related to unrecognized tax benefits for the year ended December 31, 2020 or any prior years. The total amount of unrecognized tax benefit, if recognized, that would affect the effective tax rate was zero.
Generally, the Company's income tax years of 2009 through 2020 remain open and subject to examination by Federal tax authorities, and the tax years of 2009 through 2020 remain open and subject to examination by the tax authorities in Texas, Louisiana and Oklahoma, which are the jurisdictions where the Company carries its principal operations. These audits can result in adjustments of taxes due or adjustments of the NOL carryforwards that are available to offset future taxable income. The Company currently has no ongoing tax audits and has not been
41
CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS ( Continued)
notified of pending activity by taxing jurisdictions. The Company does not anticipate that the total unrecognized tax benefits will significantly change due to the settlement of audits and the expiration of the statute of limitations prior to December 31, 2020.
17. Subsequent Events
Mid-Con Acquisition
On January 21, 2021, the Company closed the Mid-Con Acquisition in an all-stock merger transaction. At the time of close, each common unit representing limited partner interests in Mid-Con issued and outstanding ( other than treasury units or units held by Mid-Con GP) was converted automatically into the right to receive 1.75 shares of the Company's common stock. A total of 25,409,164 shares of Contango common stock were issued at the closing of the Mid-Con Acquisition. See Note 4 - `` Acquisitions and Dispositions '' for more information.
Silvertip Acquisition
On February 1, 2021, the Company closed the Silvertip Acquisition to acquire certain oil and natural gas properties located in the Big Horn Basin in Wyoming and Montana, in the Powder River Basin in Wyoming and in the Permian Basin in Texas and New Mexico, for aggregate consideration of approximately $ 58 million in cash. The Company previously paid a $ 7.0 million deposit during the three months ended December 31, 2020, in connection with the execution of the purchase agreement, and a balance of $ 46.2 million was paid upon closing of the Silvertip Acquisition, after customary closing adjustments, including the results of operations during the period between the effective date of August 1, 2020 and the closing date. See Note 4 - `` Acquisitions and Dispositions '' for more information.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
SUPPLEMENTAL OIL AND GAS DISCLOSURE ( Unaudited)
In accordance with U.S. GAAP for disclosures regarding oil and natural gas producing activities, and SEC rules for oil and natural gas reporting disclosures, we are making the following disclosures regarding our oil and natural gas reserves and exploration and production activities.
Capitalized Costs Related to Oil and Natural Gas Producing Activities
The following table presents information regarding our net capitalized costs related to oil and natural gas producing activities as of the date indicated ( in thousands):
Proved oil and gas properties
Unproved oil and gas properties
Less accumulated depreciation, depletion, amortization and impairment
Net capitalized costs
Costs Incurred
The following table presents information regarding our net costs incurred in the purchase of proved and unproved properties and in exploration and development activities for the periods indicated ( in thousands):
Property acquisition costs:
Unproved
Proved
Exploration costs
Development costs
Total costs incurred
Oil and Natural Gas Reserves
Proved reserves are the estimated quantities of oil, natural gas and natural gas liquids which geological and engineering data demonstrate with reasonable certainty to be recoverable in future years from known reservoirs under existing economic and operating conditions and current regulatory practices. Proved developed reserves are proved reserves which are expected to be produced from existing completion intervals with existing equipment and operating methods.
Proved oil and natural gas reserve quantities at December 31, 2020, 2019 and 2018, and the related discounted future net cash flows before income taxes are based on estimates prepared by William M. Cobb & Associates, Inc. and Netherland, Sewell & Associates, Inc. All estimates have been prepared in accordance with guidelines established by the Securities and Exchange Commission.
43
The below table summarizes the Company's net ownership interests in estimated quantities of proved oil, natural gas and natural gas liquids ( `` NGLs '') reserves and changes in net proved reserves as of December 31, 2020, 2019 and 2018, all of which are located in the continental United States.
Proved Developed and Undeveloped Reserves as of:
December 31, 2018
Sale of minerals in place
Acquisitions
Extensions and discoveries
Revisions of previous estimates
Production
December 31, 2019
Sale of minerals in place
Acquisitions
Extensions and discoveries
Revisions of previous estimates
Production
December 31, 2020
Proved Developed Reserves as of:
December 31, 2018
December 31, 2019
December 31, 2020
Proved Undeveloped Reserves as of:
December 31, 2018
December 31, 2019
December 31, 2020
During the year ended December 31, 2020, our proved reserves decreased by approximately 18.5 MMBoe primarily due to a 21.1 MMBoe decrease related to negative revisions related to lower commodity prices, a 1.0 MMBoe decrease related to property sales in our Central Oklahoma and Western Anadarko regions and 2020 production of 6.1 MMBoe, partially offset by a 7.5 MMBoe increase related to positive performance revisions primarily in our Central Oklahoma and West Texas regions and a 2.3 MMBoe increase attributable to new PUD locations in our West Texas area.
During the year ended December 31, 2019, our proved reserves increased by approximately 30.7 MMBoe primarily due to the 32.1 MMBoe increase related to the White Star Acquisition and Will Energy Acquisition, as well as an increase in total reserves attributable to our recently drilled wells in the NE Bullseye area of West Texas, offset by 2019 production and a downward revision in Bullseye PUDs in West Texas related to the impact of the low commodity price environment on economics in the area, and the related timeline for expected development of those PUD locations over the next five years.
Standardized Measure
The standardized measure of discounted future net cash flows relating to the Company's ownership interests in proved oil and natural gas reserves as of December 31, 2020 and 2019 are shown below ( in thousands):
Future cash inflows
Future production costs
Future development costs
Future income tax expenses
Future net cash flows
10% annual discount for estimated timing of cash flows
Standardized measure of discounted future net cash flows
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Future cash inflows represent expected revenues from production and are computed by applying certain prices of oil and natural gas to estimated quantities of proved oil and natural gas reserves. Prices are based on the first-day-of-the-month prices for the previous 12 months. As of December 31, 2020, future cash inflows were based on unadjusted prices of $ 39.57 per barrel of oil, $ 2.14 per MMBtu of natural gas and $ 12.43 per barrel of NGL. As of December 31, 2019, future cash inflows were based on unadjusted prices of $ 55.69 per barrel of oil, $ 2.52 per MMBtu of natural gas and $ 16.95 per barrel of NGL.
Realized Prices
The average realized prices for the year ended December 31, 2020 production were $ 37.31 per barrel of oil, $ 1.65 per MCF of gas and $ 13.54 per barrel of NGL. Sales are based on market prices and do not include the effects of realized derivative hedging gains of $ 25.3 million for the year ended December 31, 2020.
The average realized prices for the year ended December 31, 2019 production were $ 56.55 per barrel of oil, $ 2.35 per MCF of gas and $ 15.39 per barrel of NGL. Sales are based on market prices and do not include the effects of realized derivative hedging gains of $ 2.6 million for the year ended December 31, 2019.
Future production and development costs are estimated expenditures to be incurred in developing and producing the Company's proved oil and natural gas reserves based on historical costs and assuming continuation of existing economic conditions. Future development costs relate to compression charges at our platforms, abandonment costs, recompletion costs and additional development costs for new facilities.
Future income taxes are based on year-end statutory rates, adjusted for tax basis and applicable tax credits. A discount factor of 10 percent was used to reflect the timing of future net cash flows. The standardized measure of discounted future net cash flows is not intended to represent the replacement cost or fair value of the Company's oil and natural gas properties. An estimate of fair value would also take into account, among other things, the recovery of reserves not presently classified as proved, anticipated future changes in prices and costs and a discount factor more representative of the time value of money and the risks inherent in reserve estimates of oil and natural gas producing operations.
Change in Standardized Measure
Changes in the standardized measure of future net cash flows relating to proved oil and natural gas reserves are summarized below ( in thousands):
Changes in standardized measure due to current year operation:
Sales of oil and natural gas produced during the period, net of production expenses
Extensions and discoveries
Net change in prices and production costs
Changes in estimated future development costs
Revisions in quantity estimates
Purchase of reserves
Sale of reserves
Previously estimated development costs incurred
Accretion of discount
Changes in income taxes
Change in the timing of production rates and other
Net change
Beginning of year
End of year
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During the year ended December 31, 2020, our proved reserves decreased by approximately 18.5 MMBoe, and our standardized measure decreased by approximately $ 142.3 million. This decrease is primarily attributable to lower commodity prices and the sales of non-core producing assets.
During the year ended December 31, 2019, our proved reserves increased by approximately 30.7 MMBoe, and our standardized measure increased by approximately $ 38.9 million. This increase is primarily attributable to the Will Energy Acquisition and White Star Acquisition.
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CONTANGO OIL & GAS COMPANY AND SUBSIDIARIES
QUARTERLY RESULTS OF OPERATIONS ( Unaudited)
Quarterly Results of Operations
The following table sets forth the results of operations by quarter for the fiscal years ended December 31, 2020 and 2019 ( in thousands, except per share amounts):
Year ended December 31, 2020:
Revenues
Operating Loss ( 1)
Net loss attributable to common stock ( 2)
Net loss per share ( 3):
Basic:
Diluted:
Year ended December 31, 2019:
Revenues
Operating Loss ( 1)
Net loss attributable to common stock ( 2)
Net loss per share ( 3):
Basic:
Diluted:
Represents oil, natural gas and NGL sales and fee for service revenues, less operating expenses, exploration expenses, depreciation, depletion and amortization, lease expirations and relinquishments, impairment of oil and natural gas properties and general and administrative expense.
Represents oil, natural gas and NGL sales, less operating expenses, exploration expenses, depreciation, depletion and amortization, lease expirations and relinquishments, impairment of oil and natural gas properties, general and administrative expense, and other income and expense after income taxes.
The sum of the individual quarterly earnings per share may not agree with year-to-date earnings per share as each quarterly computation is based on the income for that quarter and the weighted average number of common shares outstanding during that quarter.
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Attachments
Disclaimer
Crescent Energy Co. published this content on 08 April 2022 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 08 April 2022 21:58:15 UTC. | business |
Hudbay Minerals: Update to Management Information Circular filed April 5, 2022 - Form 6-K/A | Update to Management Information Circular filed April 5, 2022
Two directors, Igor Gonzales and Daniel Muñiz Quintanilla, serve on the board of directors of Gatos Silver, Inc. ( `` Gatos ''). A management cease trade order was issued in respect of Gatos on April 1, 2022. This updated Management Information Circular includes information about the order.
HUDBAY MINERALS INC. NOTICE OF ANNUAL AND SPECIAL MEETING OF SHAREHOLDERS
NOTICE IS HEREBY GIVEN that an annual and special meeting of shareholders ( the `` Meeting '') of Hudbay Minerals Inc. ( `` Hudbay '') will be held by way of a virtual meeting, accessible at https: //web.lumiagm.com/238156442, on Tuesday, May 10, 2022 at 2:00 p.m. ( Eastern Time), for the following purposes:
1.to receive Hudbay's audited consolidated financial statements for the years ended December 31, 2021 and 2020 and the auditor's report thereon;
2.to elect the directors of Hudbay;
3.to appoint Deloitte LLP as Hudbay's auditor for the ensuing year and to authorize the Board of Directors, upon the recommendation of the Audit Committee, to fix the auditor's remuneration;
4.to consider and, if deemed appropriate, to approve a non-binding advisory resolution on executive compensation; and
5.to transact such other business as may properly come before the Meeting or any postponement or adjournment thereof.
The specific details of the matters proposed to be put before the Meeting are set forth in the `` Matters to be Acted Upon at the Meeting '' in Hudbay's Management Information Circular dated April 5, 2022 ( the `` Circular '').
Important Notice Regarding the Availability of Proxy Materials for the Meeting
We are using `` notice and access '' to deliver to shareholders the Circular, Hudbay's audited consolidated financial statements for the years ended December 31, 2021 and 2020 and management's discussion and analysis related thereto and any other proxy-related materials ( collectively, the `` Proxy-Related Materials '') by providing electronic access to such documents instead of mailing paper copies. Notice and access is an environmentally friendly and cost-effective way to distribute these materials since it reduces printing, paper and postage.
The Proxy-Related Materials are available on our website at www.hudbayminerals.com/disclosure-centre, on the website of our transfer agent, TSX Trust Company, at https: //docs.tsxtrust.com/2219 and under our profile on SEDAR at www.sedar.com and EDGAR at www.sec.gov/edgar.shtml. Please be sure to review the Circular before voting.
Should you wish to receive a paper copy of the Proxy-Related Materials or if you have any questions about notice and access, please contact our transfer agent, TSX Trust Company, by toll-free telephone at 1-866-600-5869 or by email at TMXEInvestorServices @ tmx.com. Paper copies of the Proxy-Related Materials will be made available free of charge. A paper copy will be sent to you within three business days of receiving your request if received in advance of the Meeting or within ten calendar days if a request is received on or after the date of the Meeting and within one year of date the Proxy-Related Materials were filed on SEDAR. If you wish to receive a paper copy of any of these documents before the May 6, 2022 voting deadline, please contact TSX Trust Company by April 29, 2022.
Important Notice Regarding the Virtual Meeting
Hudbay is once again holding the Meeting as a completely virtual meeting, which will be conducted via live webcast, where all shareholders regardless of geographic location will have an opportunity to participate at the Meeting.
Shareholders may vote their common shares online or by mail according to the directions on the form of proxy or voting instruction form, as applicable. Registered shareholders and duly appointed proxyholders will be able to attend, participate and vote at the Meeting online at https: //web.lumiagm.com/238156442. Non-registered shareholders ( being shareholders who hold their Shares through a broker, investment dealer, bank, trust company, custodian, nominee or other intermediary) who have not duly appointed themselves as proxyholder will not be able to vote at the Meeting. However, such non-registered shareholders may still attend the Meeting as guests.
Shareholders who are unable to attend the virtual Meeting are requested to complete, date, sign and return their form of proxy so that as large a representation as possible may be had at the Meeting.
Shareholders who wish to appoint a person other than the management nominees identified on the form of proxy or voting instruction form ( including a non-registered shareholder who wishes to appoint themselves to attend) must carefully follow the instructions in the Circular and on their form of proxy or voting instruction form. These instructions include the additional step of registering such proxyholder with our transfer agent, TSX Trust Company, after submitting their form of proxy or voting instruction form. Failure to register the proxyholder with our transfer agent will result in the proxyholder not receiving a Control Number to participate in the Meeting and only being able to attend as a guest.
Hudbay's Board of Directors has fixed the close of business on March 21, 2022 as the record date, being the date for the determination of the registered holders of Hudbay common shares entitled to receive notice of and vote at the Meeting or any postponement or adjournment thereof. Shareholders who acquire common shares after March 21, 2022 should make arrangements with the selling shareholder to direct how such common shares will be voted at the Meeting.
Proxies to be used or acted upon at the Meeting or any postponement or adjournment thereof must be deposited with Hudbay's transfer agent, TSX Trust Company, by completing and delivering the form of proxy in accordance with the instructions indicated thereon, no later than 2:00 p.m. ( Eastern Time) on May 6, 2022 or 48 hours ( excluding Saturdays, Sundays and holidays) before any postponement or adjournment of the Meeting. Late proxies may be accepted or rejected by the Chair of the Meeting in his discretion, and the Chair is under no obligation to accept or reject any particular late proxy. Note that non-registered holders should ensure that their voting instruction form is submitted in accordance with the timeline provided therein, which may be a date prior to the deadline on which proxies must be deposited.
DATED at Toronto, Ontario this 5th day of April, 2022.
By Order of the Board of Directors
Cheryl Fiebelkorn Assistant Corporate Secretary
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TABLE OF CONTENTS
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LETTER TO SHAREHOLDERS FROM THE CHAIR OF THE BOARD
Dear Shareholder,
2021 was a pivotal year for Hudbay as our management completed approximately US $ 250 million of brownfields investments. In Manitoba, we finished the refurbishment of the New Britannia gold mill ahead of schedule, with first gold production in August. The refurbishment is a critical part of Phase 3 of our Snow Lake gold strategy, in which we have transitioned into a primary gold producer in Manitoba. In Peru, we received permits and entered into land use agreements early in the year, which allowed us to achieve first production at our Pampacancha satellite deposit in April. These investments are expected to result in consolidated copper production growing to 133,500 tonnes by 2024, a 34% increase from 2021 levels. Similarly, gold production is expected to increase to over 300,000 ounces in 2024, which represents an increase of 59% from 2021. We expect to see significant EBITDA and cash flow growth over this period in what we hope will be a time of sustained high metals prices.
Focus on Copper
At the same time, we are looking to the future with our attractive portfolio of development and exploration assets. We believe that copper has the best long-term supply/demand fundamentals in the mining sector, as current global mine supply will be unable to meet demand for copper from global decarbonization initiatives. In 2021, we aggressively pursued exploration at our Copper World project in Arizona, leading to the release of an initial resource estimate late in the year. We plan to release a preliminary economic assessment ( `` PEA '') on Copper World in the next few months and a pre-feasibility study by the end of the year. Copper World includes a series of near-surface deposits that would support an operation entirely on our private land. It also offers potential synergies with our nearby Rosemont project.
In 2021, we also released a very promising PEA for our Mason copper project in Nevada and enjoyed substantial exploration success near our operations in Peru and Manitoba. It's impressive that our management team was able to achieve all of this in 2021 along with strong operating performance and cash flow generation while facing supply chain and labour constraints caused by the COVID-19 pandemic. Unfortunately, we also suffered a fatality at our Lalor mine, and we will continue to focus on maintaining our strong safety culture and ensuring the safety of everyone at our operations.
Continuous Improvement at our Operations
In 2022, while advancing our future growth opportunities, we will also focus on improving and perpetuating our operations. At our Lalor mine in Manitoba, we plan to continue to optimize New Britannia, while undertaking a project to improve recoveries at our Stall base metal mill in expectation of ramping up Lalor's production to 5,300 tonnes per day. In Peru, we are applying smart technologies to improve ore sorting and mill performance. We are also in discussions with local communities about gaining access to prospective exploration properties near our Constancia mine that have the potential to enhance and extend our operations.
Emphasis on ESG
While we are looking to the future, we also know it is the end of an era, as the upcoming closure of our 777 mine will mark the end of over 90 years of continuous mining in Flin Flon, Manitoba. We acknowledge the disruption to the community caused by the closure, and as we transition our workforce to Snow Lake, we remain hopeful we will be able to restart operations in Flin Flon before long. Along with nearby exploration opportunities, we are examining the possibility of reprocessing the tailings from our facility in Flin Flon. If it proves economic and we are able to bring it into operation, it would be of significant benefit to the community, and it has potential environmental benefits through reducing the amount of legacy tailings and acid-generating rock in the facility.
We are committed to considering the environmental and social impacts of our operations along with their economics. We know shareholders demand this focus on ESG and we are listening. As part of the Board's oversight responsibility, the Audit Committee oversees a rigorous risk management program where management's risk assessments and mitigation plans are regularly presented. All of the top tier risks are allocated among the Board's committees, including key ESG risks. For instance, management's mitigation plans for tailings management are reviewed and overseen by the Board's Technical Committee, and safety and community relations are overseen by the Environment, Health, Safety and Sustainability ( `` EHSS '') Committee. The EHSS Committee and Board have tasked management with defining and publishing our greenhouse gas reduction roadmap in 2022, with a target of reducing emissions by 50% by 2030 and a commitment of net zero emissions by 2050. We intend to design and develop our Copper World/Rosemont, Mason and Flin Flon tailings growth opportunities with these targets in mind.
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Enhancing our Governance
Our commitment to responsible and sustainable mining starts with the Board of Directors. We are constantly looking for ways to improve our performance as a Board, and in 2021 and early 2022 our Corporate Governance and Nominating Committee canvassed the market for new Director candidates with skills that would complement our Board. We are pleased to nominate George E. Lafond for election to the Board at our upcoming shareholders ' meeting. George is an experienced social and business development advisor, with expertise in working with federal and provincial governments to advance opportunities available to First Nations. As a member of the Muskeg Lake Cree Nation, we expect George will bring unique insights as we seek to further engage with our First Nations stakeholders.
Engaging with our Shareholders
In late 2021 and early 2022, I and a number of my fellow directors were pleased to meet with several of our largest shareholders as part of the Board's shareholder engagement program. Our shareholders were interested in hearing our perspectives on company strategy, growth opportunities, diversity and inclusion and other ESG initiatives. We do our best to consider the interests of all our stakeholders, including shareholders, governments and community members. I 'd be remiss if I didn't acknowledge the efforts of another key group of stakeholders in 2021, namely our employees. We thank you for all your hard work and dedication throughout the year and we wish you the very best in 2022 as we pursue the Company's goals while remaining focused on having everyone make it home safely each day.
We encourage you to vote at our annual and special meeting of shareholders and we thank you for your continued support.
Stephen A. Lang
Chair, Board of Directors
2022 MANAGEMENT INFORMATION CIRCULAR |3
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MANAGEMENT INFORMATION CIRCULAR
This management information circular ( `` Circular '') is furnished in connection with the solicitation of proxies by and on behalf of the management of Hudbay Minerals Inc. for use at the Annual and Special Meeting of Shareholders ( the `` Meeting '') to be held on May 10, 2022 at 2:00 p.m. ( Eastern Time), or at any postponement or adjournment thereof. The Meeting has been called for the purposes set forth in the Notice of Annual and Special Meeting of Shareholders ( the `` Notice of Meeting '') that accompanies this Circular.
The Meeting will be held as a completely virtual meeting, which will be conducted via live webcast at https: //web.lumiagm.com/238156442. Shareholders will not be able to attend the Meeting in person. A summary of the information shareholders will need to attend and participate at the Meeting online is provided in this Circular.
References in this Circular to `` we '', `` us '', `` our '' and similar terms, as well as references to `` Hudbay '', the `` Company '' and the `` Corporation '', refer to Hudbay Minerals Inc. and references to `` Board '' refer to our board of directors. Unless otherwise indicated, the information in this Circular is given as at April 5, 2022 and all dollar references in this Circular are to Canadian dollars, unless otherwise stated.
GENERAL PROXY INFORMATION
This Circular provides the information you need to vote at the Meeting.
To reduce printing and mailing costs and waste, Hudbay will use the `` notice and access '' delivery model ( `` Notice and Access '') to conduct the solicitation of proxies in connection with this Circular. Proxies may also be solicited by telephone or other form of correspondence. The cost of preparing this Circular and other materials relating to the Meeting and the cost of soliciting proxies has been or will be borne by us. Hudbay will also pay the fees and costs of intermediaries for their services in transmitting proxy-related material in accordance with National Instrument 54-101 - Communication with Beneficial Owners of Securities of a Reporting Issuer ( `` NI 54-101 ''). This cost is expected to be nominal.
NOTICE AND ACCESS
Hudbay is using Notice and Access for both registered and non-registered owners of Hudbay Shares, which allows the Company to furnish proxy materials online to shareholders instead of mailing paper copies of such materials. Using Notice and Access, the Company can deliver proxy-related materials by ( i) posting this Circular ( and other proxy related materials) on a website other than SEDAR and ( ii) sending a notice informing shareholders that this Circular and proxy related materials have been posted and explaining how to access such materials ( the `` N & A Notice '').
On or around April 7, 2022, the Company will send to holders of Hudbay Shares of record as of the record date a notice package containing the N & A Notice and the relevant voting document ( a form of proxy or VIF, as applicable). The N & A Notice will contain basic information about the Meeting and the matters to be voted on, instructions on how to access the proxy materials, including this Circular and Hudbay's audited consolidated financial statements for the years ended December 31, 2021 and 2020 and management's discussion and analysis related thereto ( together with this Circular, the `` Proxy-Related Materials ''), an explanation of the Notice and Access process and details of how to obtain a paper copy of the Proxy-Related Materials upon request at no cost.
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The Proxy-Related Materials are available on our website at www.hudbayminerals.com/disclosure-centre, on the website of our transfer agent, TSX Trust Company, at https: //docs.tsxtrust.com/2219, and under our profile on SEDAR at www.sedar.com and EDGAR at www.sec.gov/edgar.shtml. Shareholders who want to receive a paper copy of the Proxy-Related Materials or who have questions about Notice and Access may contact our transfer agent, TSX Trust Company, by toll-free telephone at 1-866-600-5869 or by email at TMXEInvestorServices @ tmx.com. In order to receive a paper copy in time to vote before the Meeting, requests should be received by April 29, 2022.
VOTING INFORMATION
VOTING MATTERS
At the Meeting, shareholders are voting on the:
WHO CAN VOTE
The record date for the Meeting is March 21, 2022. Our transfer agent has prepared a list, as of the close of business on the record date, of the registered holders of Hudbay Shares. A holder of Hudbay Shares whose name appears on such list is entitled to vote the shares on such list at the Meeting. Each Hudbay Share entitles the holder to one vote on each item of business identified in the Notice of Meeting.
VOTING YOUR COMMON SHARES AND PARTICIPATING AT THE MEETING
This year we are once again holding the Meeting as a completely virtual meeting, which will be conducted via live webcast, where all shareholders regardless of geographic location will have an opportunity to participate at the Meeting.
Shareholders are strongly advised to carefully read the voting and participation instructions below that are applicable to them as well asthe Virtual AGM User Guide on page 97 of this Circular.
Registered Shareholders
If you were a registered shareholder on the record date, you may vote online at the virtual Meeting at https: //web.lumiagm.com/238156442. Click on ' I have a Control Number ' and you will be prompted to enter your twelve digit TSX Control Number and the password hudbay2022 ( case sensitive). You must be connected to the internet at all times to be able to vote and it is your responsibility to make sure you stay connected for the entire Meeting. Registered shareholders on the record date who voted prior to the Meeting do not need to vote again during the Meeting.
Alternatively, you may give another person authority to represent you and vote your shares online at the virtual Meeting, as described below under the heading `` Voting Your Common Shares by Proxy ''.
If a Registered Shareholder would like to ask a question, login using your TSX Control Number and select the messaging icon. Messages can be submitted at any time during the Q & A session up until the Chair closes the session. Type your message within the chat box at the bottom of the messaging screen. Once you are happy with your message click the send button.
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Non-Registered Shareholders
It is possible that your Hudbay Shares are registered in the name of an intermediary, which is usually a trust company, securities broker or other financial institution. If your shares are registered in the name of an intermediary, you are a non-registered shareholder. Your intermediary is entitled to vote the Hudbay Shares held by it and beneficially owned by you on the record date. However, it must first seek your instructions as to how to vote your Hudbay Shares or otherwise make arrangements so that you may vote your Hudbay Shares directly. An intermediary is not entitled to vote the Hudbay Shares held by it without written instructions from the beneficial owner. You may vote your Hudbay Shares through your intermediary or online at the virtual Meeting by taking the appropriate steps, which are the same for objecting beneficial owners ( `` OBO '') and non-objecting beneficial owners ( `` NOBO '') of Hudbay Shares. You are an OBO if you have not allowed your intermediary to disclose your ownership information to us. You are a NOBO if you have provided instructions to your intermediary to disclose your ownership information to us.
Please note that if you are a NOBO or an OBO and you wish to vote online at the virtual Meeting, you will not be recognized at the Meeting for the purpose of voting Hudbay Shares registered in the name of an intermediary unless you appoint yourself as a proxyholder and register with our transfer agent, TSX Trust Company, by emailing tsxtrustproxyvoting @ tmx.com the `` Request for Control Number '' form, which can be found at https: //tsxtrust.com/resource/en/75 ( see `` Appointing a Proxyholder '' below). In order to appoint yourself as proxyholder, you should follow the instructions on the VIF and, in so doing, specify your own name as the person whom you are appointing as proxy for the purposes of voting your Hudbay Shares. You are reminded that any voting instructions should be communicated to your intermediary in accordance with the procedures set out in the VIF well in advance of the May 6, 2022 deadline for the receipt of proxies.
If a Non-Registered Shareholder would like to ask a question, login using the TSX Control Number you received when you appointed yourself a proxyholder and registered with our transfer agent, TSX Trust Company. Questions can be submitted at any time during the Q & A session up until the Chair closes the session by using the messaging icon. Type your message within the chat box at the bottom of the messaging screen. Once you are happy with your message click the send button.
Non-registered shareholders who have not duly appointed themselves as proxyholder will not be able to vote or ask questions at the Meeting, however such non-registered shareholders may still attend the meeting as guests through the live webcast at https: //web.lumiagm.com/238156442.
NOBOs and OBOs
NOBOs and OBOs should carefully review the instructions provided to them by their intermediary regarding how to provide voting instructions or how to obtain a proxy with respect to their Hudbay Shares. Such shareholders may also wish to contact their intermediary directly in order to obtain instructions regarding how to vote Hudbay Shares that they beneficially own. Proxy-related materials will be sent by the Company indirectly to `` non-objecting beneficial owners '' and the Company intends to pay for intermediaries to deliver proxy-related materials and Form 54-101F7 ( the request for voting instructions) to `` objecting beneficial owners '', in accordance with NI 54-101.
VOTING YOUR COMMON SHARES BY PROXY
If you will not be able to attend and vote online at the virtual Meeting, you may vote in advance by using the form of proxy or VIF that has been provided to you. A proxy or VIF must be properly completed in writing and must be executed by you or by your attorney authorized in writing.
Deadline for Proxies
Any proxy to be used at the Meeting must be received by Hudbay's transfer agent, TSX Trust Company, prior to 2:00 p.m. ( Eastern Time) on May 6, 2022, or 48 hours ( excluding Saturdays, Sundays and holidays) before any postponement or adjournment of the Meeting. Late proxies may be accepted or rejected by the Chair of the Meeting in his discretion, and the Chair is under no obligation to accept or reject any particular late proxy.
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Registered shareholders may provide their voting instructions by any of the following means:
Non-registered shareholders may provide their voting instructions by mail, by telephone or online at www.proxyvote.com by following the instructions provided to them in their VIF.
Your Proxy Vote
On the form of proxy, you can indicate how you want to vote your Hudbay Shares, or you can let your proxyholder decide for you.
All Hudbay Shares represented by properly completed proxies received by Hudbay's transfer agent, TSX Trust Company, no later than 2:00 p.m. ( Eastern Time) on May 6, 2022 or 48 hours ( excluding Saturdays, Sundays and holidays) before any postponement or adjournment of the Meeting will be voted for, against or withheld from voting, in accordance with your instructions as specified in the proxy. Late proxies may be accepted or rejected by the Chair of the Meeting in his discretion, and the Chair is under no obligation to accept or reject any particular late proxy.
If you give directions on how to vote your Hudbay Shares on your form of proxy, your proxyholder must vote your Hudbay Shares according to your instructions. If you have not specified how to vote on a particular matter on your form of proxy, your proxyholder can vote your Hudbay Shares as he or she sees fit. If neither you nor your proxyholder gives specific instructions, your Hudbay Shares will be voted as follows:
Appointing a Proxyholder
A proxyholder is the person you appoint to act on your behalf at the Meeting ( including any postponement of the Meeting or continuation after an adjournment of the Meeting) and to vote your Hudbay Shares. You have the right to appoint a person or company other than the Hudbay representatives named as proxyholders to represent you at the Meeting. To do so, simply fill in the proxyholder's name in the blank space provided on the enclosed form of proxy. If you leave the space in the form of proxy blank, the persons designated in the form, who are our Chair and our President and Chief Executive Officer, are appointed to act as your proxyholder.
Shareholders who wish to appoint a person other than the management nominees identified on the form of proxy or VIF ( including a non-registered shareholder who wishes to appoint themselves to attend) must carefully follow the instructions in the Circular and on their form of proxy or VIF. These instructions include the additional step of registering such proxyholder with our transfer agent, TSX Trust Company, by emailing tsxtrustproxyvoting @ tmx.com the `` Request for Control Number '' form, which can be found at https: //tsxtrust.com/resource/en/75, after submitting their form of proxy or VIF. Failure to register the proxyholder with our transfer agent will result in the proxyholder not receiving a Control Number to vote and participate at the Meeting. Such an unregistered proxyholder will only be able to attend the Meeting as a guest.
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Revoking your Proxy
If you submit a form of proxy, you may revoke it at any time before it is used by doing any one of the following:
If as a registered shareholder you are using your control number to log in to the Meeting, you will be provided the opportunity to vote by online ballot at the appropriate time on the matters put forth at the Meeting. If you have already voted by proxy and you vote again during the online ballot during the Meeting, your online vote during the Meeting will revoke your previously submitted proxy. If you have already voted by proxy and do not wish to revoke your previously submitted proxy, do not vote again during the online ballot vote.
Only registered holders have the right to revoke a proxy. Non-registered holders who wish to change their vote must make appropriate arrangements with their respective dealers or other intermediaries.
Late proxies may be accepted or rejected by the Chair of the Meeting in his discretion, and the Chair is under no obligation to accept or reject any particular late proxy.
ADDITIONAL MATTERS PRESENTED AT THE MEETING
The form of proxy or VIF confers discretionary authority upon the persons named as proxyholders therein with respect to any amendments or variations to the matters identified in the Notice of Meeting and with respect to other matters that may properly come before the Meeting or any postponement or adjournment thereof. Our management is not aware of any matters to be considered at the Meeting other than the matters described in the Notice of Meeting, or any amendments or variations to the matters described in such notice.
If you sign and return the VIF, your Hudbay Shares will be voted in accordance with your instructions and, with respect to any matter presented at the Meeting, or at any postponement or adjournment thereof, in addition, or as an amendment or variation to the matters described in the Notice of Meeting, in accordance with the discretionary authority provided therein.
You have the right to appoint a person or company other than the Hudbay representatives named as proxyholders to represent you at the Meeting. If you sign and return the form of proxy and do not appoint a proxyholder by filling in a name, the Hudbay representatives named as proxies will vote in their best judgment.
VOTING SHARES AND PRINCIPAL HOLDERS
The Hudbay Shares are the only shares which entitle shareholders to vote at the Meeting. The holders of Hudbay Shares are entitled to one vote per share. The presence of at least two people holding or representing by proxy at least 25% of the total number of votes attached to the issued common shares entitled to vote at the Meeting is necessary for a quorum at the Meeting.
As at March 15, 2022, 261,886,655 Hudbay Shares were issued and outstanding.
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To the knowledge of the directors and executive officers of Hudbay, based upon filings made with Canadian and United States securities regulators on or before the date of this Circular, the persons who beneficially own, or control or direct, directly or indirectly, voting securities carrying more than 10% of the voting rights attached to any class of our voting securities are as follows:
1.According to Waterton Global Resource Management, Inc.'s System for Electronic Disclosure by Insiders report as of March 15, 2022.
2.According to GMT Capital Corp.'s Schedule 13G dated December 31, 2021 filed on EDGAR.
NOTICE TO UNITED STATES SHAREHOLDERS
The solicitation of proxies by Hudbay is not subject to the requirements of Section 14 ( a) of the United States Securities Exchange Act of 1934, as amended ( the `` U.S. Exchange Act ''), by virtue of an exemption applicable to proxy solicitations by `` foreign private issuers '' as defined in Rule 3b-4 promulgated under the U.S. Exchange Act. Accordingly, this Circular has been prepared in accordance with the applicable disclosure requirements in Canada. Shareholders in the United States should be aware that such requirements are different than those of the United States applicable to proxy statements under the U.S. Exchange Act.
MATTERS TO BE ACTED UPON AT THE MEETING
1. FINANCIAL STATEMENTS
Our audited consolidated financial statements for the years ended December 31, 2021 and 2020 and the auditor's report thereon will be presented at the Meeting.
2. ELECTION OF DIRECTORS
Our articles provide that the Board may consist of a minimum of six and a maximum of thirteen directors. Our board is currently composed of ten directors. The Board has determined to nominate each of the eleven persons listed below for election as a director at the Meeting. All of the nominees other than George E. Lafond are current members of our Board ( See `` Nominees for Election as Directors '' below). The Board recommends that shareholders vote FOR the election of each of the eleven nominees as directors.
Each director elected at the Meeting shall hold office until the close of the next annual meeting of shareholders or until a successor has been elected or appointed in accordance with our articles and by-laws.
Majority Voting Policy and Advance Notice By-Law
Pursuant to our Corporate Governance Guidelines ( a copy of which can be found at Schedule `` A ''), we have adopted a majority voting policy governing the election of directors. Pursuant to such policy, a nominee proposed for election as a director who receives a greater number of votes `` withheld '' than votes `` for '' his or her election must immediately offer to tender his or her resignation ( which would be effective upon acceptance by the Board) to the Chair of the Board. The Corporate Governance and Nominating Committee ( the `` CGN Committee '') will expeditiously consider, and make a recommendation to the Board whether to accept, that offer to resign. The Board of Directors will accept the offer to resign, absent exceptional circumstances, within 90 days following the meeting of shareholders. The Corporate Governance Guidelines provide that a director who offers to tender his or her resignation in this context should not participate in the deliberations of the Board or any of its Committees pertaining to such resignation. This policy applies only in circumstances involving an uncontested election of directors, being one in which the number of director nominees does not exceed the number of directors to be elected and in respect of which no proxy material is circulated in support of one or more nominees who are not part of the slate supported by the Board.
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In addition, our Advance Notice By-Law ( a copy of which is available on SEDAR at www.sedar.com), ensures that all shareholders receive adequate notice of director nominations and sufficient time and information regarding nominees to make informed voting decisions. The Advance Notice By-Law fixes a deadline by which holders of record of Common Shares must submit director nominations to our secretary prior to any annual or special meeting of shareholders and sets forth the specific information that a shareholder must include in the written notice for an effective nomination to occur. Our Advance Notice By-Law is intended to facilitate an orderly and efficient process for the election of directors.
Each of the ten incumbent nominees listed below was elected as a director of Hudbay at our annual and special meeting of shareholders held on May 17, 2021 ( the `` 2021 meeting ''). We received proxies representing 198,406,327 Hudbay Shares in connection with the 2021 meeting representing 75.896% of our outstanding Common Shares. Based on these proxies, each director received the following favourable votes cast by proxy:
Nominees for Election as Directors
The CGN Committee considered the current composition of the Board, along with its skills, experience and diversity and thereafter the Committee recommended, and the Board has nominated, George E. Lafond for election. Mr. Lafond's experience leading First Nations engagement and community development initiatives will strengthen the Board's ESG expertise and increase the diversity of perspectives on the Board and be of great value as we seek to grow Hudbay in accordance with our values ( See `` Board Composition and Skills '' and `` Diversity and Inclusion '' below).
Unless authority to do so with respect to one or more directors is withheld, the persons named in the form of proxy intend to vote FOR the election of each of the eleven nominees whose names are set forth below:
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We do not contemplate that any of the nominees will be unable to serve as a director, but if that should occur for any reason prior to the Meeting or any postponement or adjournment thereof, it is intended that discretionary authority shall be exercised by the persons named in the accompanying form of proxy to vote any proxy for the election of the remaining nominees and any other person or persons in place of any nominee or nominees unable to serve.
The following tables set forth biographical and other information on each proposed nominee.
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ARC Resources Ltd. ( 2021 to Present)
Euro Ressources S.A. ( 4) ( 2009 to 2010; 2014 to 2019)
4.Euro Ressources S.A. is an indirect, majority owned subsidiary of IAMGOLD.
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Principal Occupation: Chief Operating Officer of Appian Capital
Mr. Gonzales is from Cusco, Peru and has more than 30 years of experience in the mining industry. He joined Appian Capital as Chief Operating Officer in June 2020 following over three years as President and CEO of Sierra Metals. Prior to that, he was with Compañia de Minas Buenaventura S.A.A. from November 2014 to May 2017, serving as Vice President of Operations, and Barrick Gold Corporation from 1998 to 2013, serving as President of Barrick Gold South America for seven years, and later as Executive Vice President and Chief Operating Officer. Between 1980 and 1996, Mr. Gonzales served in various roles with Southern Peru Copper Corporation.
Mr. Gonzales has a Bachelor of Science degree in Chemical Engineering from the University of San Antonio Abad in Cusco, Peru, and was a Fulbright Scholar at the New Mexico Institute of Mining and Technology, where he earned a Master of Science degree in Extractive Metallurgy.
Gatos Silver, Inc. ( 2020 to Present)
Harte Gold Corporation ( 2020 to 2021)
Sierra Metals Inc. ( 2013 to 2020)
Compañia de Minas Buenaventura S.A. ( 2014 to 2017)
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Principal Occupation: Corporate Director
Mr. Howes retired as the President and Chief Executive Officer of Dundee Precious Metals after serving in that role for seven years. He is a Professional Mining Engineer with over 40 years ' experience in the mining industry. He is a visionary leader in mining, organizational innovation and transformation to create competitive advantage and was recognized as the Outstanding Innovator of 2016 by the International Mining Technology Hall of Fame. Throughout his career, Mr. Howes has been closely associated with the practices that make for world-class mining operations, including Inco's North Mine, which won the 2006 Ryan Award as the safest mine in Canada. His extensive industry experience includes progressive technical, operating, management and project roles in many of the largest underground mines and mining companies throughout Canada and internationally. He is currently Chair of the Board of Torex Gold and an independent director on the Board of Anaconda Mining.
Mr. Howes attended Queen's University where he earned a Bachelor of Science in Mining Engineering. He is also a member of The Institute of Corporate Directors.
Anaconda Mining Inc. ( 2021 to Present)
Torex Gold Resources Inc. ( 2020 to Present)
Dundee Precious Metals Inc. ( 2012 to 2020)
Sabina Gold and Silver ( 2018 to 2020)
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Principal Occupation: Corporate Director
Sarah B. Kavanagh is an experienced public company director. She has more than 30 years of capital markets experience and business leadership built over a long career in both senior investment banking and senior corporate financial roles in the United States and Canada.
Ms. Kavanagh is a corporate director and a former Commissioner at the Ontario Securities Commission, where she served from 2011 to 2016. Between 1999 and 2010, Ms. Kavanagh served in a number of senior investment banking roles at Scotia Capital Inc. She has also held senior financial positions in the corporate sector.
Ms. Kavanagh currently serves as a director of Bausch Heath Companies, a director and Chair of the Audit Committee and the Nominating and Governance Committee of Cymax Technology Group, a director and Chair of the Audit Committee of AST and a director and Chair of the Audit Committee of Sustainable Development Technology Canada.
Ms. Kavanagh was awarded a leadership award by Women in Capital Markets in 2008 and was recognized as one of Canada's Most Powerful Women: Top 100 in the director category in 2015.
Ms. Kavanagh graduated from Harvard Business School with a Master's in Business Administration and received a Bachelor of Arts degree in Economics from Williams College in Williamstown, Massachusetts. Ms. Kavanagh completed the Directors Education Program at the Institute of Corporate Directors in 2011.
Bausch Heath Companies Inc. ( 2016 to Present)
WPT Industrial Real Estate Investment Trust ( 2013 to October 2021)
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Principal Occupation: Corporate Director
Carin S. Knickel has over 30 years ' of experience in the energy industry, holding senior operating, planning and business development positions throughout her career in the US and Europe, and leading the integration of businesses, processes and people following transactions.
Ms. Knickel spent over 30 years at ConocoPhillips, the world's largest independent exploration and production company, where she most recently served as Corporate Vice President, Global Human Resources from 2003 until her retirement in May 2012. She joined ConocoPhillips in 1979 and held various senior operating positions in wholesale marketing, refining, transportation and commercial trading as well as leadership roles in planning and business development throughout her career in the U.S. and Europe. She also transformed the human resources function from a disparate organization of five pre-merger companies to a global shared-service organization, delivering more than US $ 30 million in merger synergies. Prior to that, Ms. Knickel held roles as President of Specialty Businesses where she managed a portfolio of technology-based businesses with revenues of US $ 2.1 billion, and also served as Vice President, Carbon Businesses, where she was appointed to lead a start-up carbon fiber business, overseeing the first US $ 200 million demonstration plant.
Ms. Knickel currently serves as a director on the board of Vermilion Energy Inc. She also serves as a Trustee for the Colorado/Wyoming Chapter of the National Multiple Sclerosis Society and previously served as Chair. She holds a Bachelor of Science, Marketing from the University of Colorado and a Master of Science in Management from the Massachusetts Institute of Technology.
Vermillion Energy Inc. ( 2018 to Present)
Whiting Petroleum Corp. ( 2015 to 2020)
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Principal Occupation: President and Chief Executive Officer, Hudbay Minerals Inc.
Peter Kukielski was appointed President and Chief Executive Officer in January 2020 after serving as Interim Chief Executive Officer since July 2019. Mr. Kukielski has more than 30 years of extensive global experience within the base metals, precious metals and bulk materials sectors, having overseen operations across the globe for companies.
Mr. Kukielski was President and Chief Executive Officer of Nevsun Resources Ltd. from May 2017 until the acquisition of Nevsun in December 2018. From 2013 to 2017, Mr. Kukielski was Chief Executive Officer of Amenka Resources, a private company backed by Warbug Pincus to invest in global mining assets. From 2008 to 2013, he was the Chief Executive, Mining for ArcelorMittal, responsible for 27 operating mines and three major development projects, within 12 countries. From 2006 to 2008, Mr. Kukielski was the Chief Operating Officer of Teck Resources, responsible for the copper, zinc, gold and the metallurgical coal operations and projects. From 2001 to 2006, he was with Falconbridge ( originally Noranda) in senior roles, including Chief Operating Officer, and in years prior he had various increasingly senior roles with other major mining companies, including experience in engineering, commissioning and operating significant mines in a wide variety of international jurisdictions.
Mr. Kukielski has a Master's of Science degree in Civil Engineering from Stanford University in California.
Norsk Hydro ASA ( 2019 to Present)
Nevsun Resources Ltd. ( 2017 to 2018
South32 Limited ( 2015 to 2017)
5.Certain of the Hudbay Shares indicated as held by Mr. Kukielski are beneficially owned, directly or indirectly, by Mr. Kukielski's wife and have been included in this table for consistency with Mr. Kukielski's insider reporting of shares over which he may have `` direction or control '' pursuant to National Instrument 55-104. These shares have been excluded for purposes of determining compliance with our Share Ownership Guidelines, as described in our Compensation, Discussion & Analysis.
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Principal Occupation: Independent Indigenous Advisor
Mr. Lafond is an experienced business, education and social development advisor, known for successfully leading executive teams on strategic initiatives leading to First Nations engagement and achievement. He has experience with national, provincial, regional and local governments and entities in supporting innovation in First Nations governments, corporations, business associations and public offices.
Mr. Lafond has held many leadership positions in business and community development. He was appointed by the Government of Canada as the Treaty Commissioner of Saskatchewan, a role involving public education, neutral convening and dialogue with Treaty parties, and durable resolution of conflict relating to Treaty rights and responsibilities. Mr. Lafond currently advises the Saskatchewan Indian Institute of Technology to support innovative research, learning and education achievement, based on the direction and input of First Nations governments.
Mr. Lafond holds a Bachelor of Education degree from the University of Saskatchewan and undertakes ongoing professional development and training in business, administration, negotiation and economic prosperity.
Mr. Lafond is a citizen of the Saskatchewan Muskeg Lake Cree Nation in Treaty Six Territory, and works with the community to support reconciliation, wellness, economic development, and innovation. In 2016 he received the Saskatchewan Order of Merit.
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Principal Occupation: Corporate Director
Stephen A. Lang was appointed Chair of Hudbay's board of directors in October 2019. Stephen has over 40 years of experience in the mining industry, including engineering, development and production at gold, copper, coal and platinum group metals operations. He was Chief Executive Officer of Centerra Gold Inc. from 2008 to 2012 and served as Centerra's Board Chair from 2012 to 2019. Mr. Lang has also held senior operating positions at Stillwater Mining Company, Barrick Gold Corporation, Rio Algom Limited and Kinross Mining Corporation.
Mr. Lang holds a Bachelor of Science degree and a Master's degree in mining engineering from the University of Missouri-Rolla.
Hycroft Mining Holding Corporation ( 2021 to Present)
Argonaut Gold Inc. ( 2020 to Present)
Bear Creek Mining Corporation ( 2014 to Present)
International Tower Hill Mines Ltd. ( 2014 to Present)
Alio Gold Inc. ( 2014 to 2020)
Centerra Gold Inc. ( 2007 to 2020)
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Principal Occupation: Corporate Director
Daniel Muñiz Quintanilla was formerly Managing Director and Executive Vice President of Americas Mining, the holding company of the Mining Division of Grupo Mexico, which has operations in Peru, Mexico, US and Spain.
Until July 2018, he was a member of the Board of Directors and Executive Vice President of Southern Copper, a subsidiary of Americas Mining, where he led several successful M & A, joint venture and other similar transactions leading to the acquisition and integration of several world-class assets into Grupo Mexico. Mr. Muñiz Quintanilla previously acted as Executive President & Chief Executive Officer of Industrial Minera Mexico S.A. de C.V., the Underground Mining Division of Grupo Mexico. He also acted as Chief Financial Officer of Grupo Mexico, during which time he successfully raised more than $ 10 billion for the company through a variety of securities, including bonds, structured bonds and project finance.
Mr. Muñiz Quintanilla holds a Masters degree in Business Administration from Instituto de Empresa in Madrid, Spain and a Masters degree in Financial Law from Georgetown University in Washington D.C. He also holds a Law Degree from Universidad Iberoamericana in Mexico City, Mexico.
Gatos Silver, Inc. ( 2021 to Present)
Brookfield Infrastructure Partners LP ( 2019 to Present)
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Principal Occupation: President and CEO, Samuel, Son & Co.
Colin Osborne is President and Chief Executive Officer of Samuel, Son & Co., Limited, a position he has held since 2019. In this role, Mr. Osborne is responsible for the development and leadership of the Company's long-term strategy and growth plans. Within Samuel, Mr. Osborne has held a number of other roles, including President & Chief Operating Officer, President - Samuel Service Centers and Automotive and President - Samuel Manufacturing Division. Before joining Samuel in 2015, Mr. Osborne was President and Chief Executive Officer of Vicwest Inc, a publicly traded industrial products company with operations in North America, Europe, South America and installations on six continents. Earlier in his career, Mr. Osborne held senior leadership positions at Stelco Inc. including COO and EVP Strategy. Mr. Osborne has extensive board experience and previously sat on the boards of numerous public and private equity run businesses, including Strongco Inc. and TMS International. Mr. Osborne has also been active in the community, serving as Board Director of both Mohawk College and McMaster Innovation Park.
He holds a Bachelor of Engineering degree from McGill University and has completed the Executive Management Program from the Smith School of Business at Queen's University.
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Principal Occupation: Corporate Director
David S. Smith is a Corporate Director who has had a career on both the finance and the supply sides of business within the mining sector, with extensive international exposure.
Mr. Smith has more than 35 years of financial and executive leadership experience. Mr. Smith served as the Chief Financial Officer and Executive Vice President of Finning International Inc., a major equipment supplier to the mining industry with significant operations in Canada and South America, from 2009 to 2014. Prior to joining Finning, Mr. Smith served as Chief Financial Officer and Vice President of Ballard Power Systems, Inc. from 2002 to 2009. Previously, he spent 16 years with Placer Dome Inc. ( now Barrick) in various senior positions and 4 years with PriceWaterhouseCoopers.
Mr. Smith is currently a director of IAMGOLD Corp and Northwest Copper Corp and is the Chair of the Board of Governors of Collingwood School. Mr. Smith has previously served on other public mining company boards of directors, specifically, Pretium Resources Inc. ( acquired by Newcrest Mining), Nevsun Resources Ltd. ( acquired by Zijin Mining Group Limited), Dominion Diamonds Corp. ( acquired by the Washington Companies) and Paramount Gold Nevada.
Mr. Smith holds a Bachelor's of Science degree in Business Administration, Accounting from California State University, Sacramento and has completed the Institute of Corporate Directors, Directors Education Program ( ICD.D).
NorthWest Copper Corp. ( March 2022 to Present)
IAMGOLD Corporation ( February 2022 to Present)
Pretium Resources Inc. ( 2017 to 2022)
Nevsun Resources Ltd. ( 2017 to 2018)
Paramount Gold Nevada Corp. ( 2015 to 2018)
Dominion Diamond Corporation ( 2016 to 2017)
1. The Hudbay Shares indicated for each Hudbay Nominee are those beneficially owned, directly or indirectly, or over which control or direction is exercised, by the nominee as at March 15, 2022. The information about Hudbay Shares over which control or direction is exercised, not being within the knowledge of Hudbay, has been furnished by the respective Hudbay Nominee. Unless otherwise indicated, beneficial ownership is direct and the Hudbay Nominee has sole voting and investment power.
2. Based on the $ 9.43 closing price of Hudbay Shares on the Toronto Stock Exchange on March 15, 2022.
3. A shaded bullet indicates a high level of experience or expertise in the subject area and an unshaded bullet indicates some or limited experience in the subject area.
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Corporate Cease Trade Orders or Bankruptcies
Other than as disclosed below, to the best of our knowledge, no nominee is, or has been within ten years before the date of this Circular, a director, chief executive officer or chief financial officer of any company that was:
•subject to an order that was issued while the nominee was acting in the capacity as director, chief executive officer or chief financial officer;
•subject to an order that was issued after the nominee ceased to be a director, chief executive officer or chief financial officer and which resulted from an event that occurred while that person was acting in the capacity as director, chief executive officer or chief financial officer;
•is, or has been within the ten years before the date of this Circular, a director or executive officer of any company that, while the nominee was acting in that capacity, or within a year of the nominee ceasing to act in that capacity, became bankrupt, made a proposal under any legislation relating to bankruptcy or insolvency or was subject to or instituted any proceedings, arrangement or compromise with creditors or had a receiver, receiver manager or trustee appointed to hold its assets; or
•has, within the ten years before the date of this Circular, become bankrupt, made a proposal under any legislation relating to bankruptcy or insolvency, or become subject to or instituted any proceedings, arrangement or compromise with creditors, or had a receiver, receiver manager or trustee appointed to hold the assets of the nominee.
Stephen A. Lang was a director of Hycroft Mining Corporation ( `` Hycroft ''), ( formerly Allied Nevada Gold Corp.) which, on March 10, 2015, together with certain of its direct and indirect subsidiaries, filed voluntary petitions of relief under Chapter 11 of the U.S. Bankruptcy Code in the United States Bankruptcy Court for the District of Delaware ( the `` Delaware Bankruptcy Court ''). On October 8, 2015, Hycroft's Plan of Reorganization was approved by the Delaware Bankruptcy Court, and effective October 22, 2015, Hycroft completed its financial restructuring process and emerged from Chapter 11 bankruptcy.
Carin S. Knickel was a director of Whiting Petroleum Corporation ( `` Whiting ''), which together with certain subsidiaries, commenced voluntary Chapter 11 cases under the United States Bankruptcy Code on March 31, 2020. On September 1, 2020, Whiting announced that it had successfully completed its financial restructuring and emerged from Chapter 11 protection. Whiting officially concluded its reorganization after completing all required actions and satisfying the remaining conditions to its Plan of Reorganization.
Igor Gonzales and Daniel Muñiz Quintanilla are directors of Gatos Silver, Inc. ( `` Gatos ''). On April 1, 2022, the Ontario Securities Commission issued a management cease trade order against the CEO and CFO of Gatos ordering each such executive officer to cease trading in the securities of Gatos until Gatos completed its annual continuous disclosure filings for the year ended December 31, 2021 as required by Ontario securities laws.
Penalties or Sanctions
To the best of our knowledge, no nominee has been subject to ( i) any penalties or sanctions imposed by a court relating to securities legislation or by a securities regulatory authority or has entered into a settlement agreement with a securities regulatory authority, or ( ii) any other penalties or sanctions imposed by a court or regulatory body that would likely be considered important to a reasonable investor in deciding whether to vote for the nominee.
3. APPOINTMENT OF AUDITOR
Unless authority to do so is withheld, the persons named in the accompanying form of proxy intend to vote FOR the appointment of Deloitte LLP ( `` Deloitte ''), as our auditor until the close of our next annual meeting of shareholders and the authorization of the Board, upon the recommendation of the Audit Committee, to fix the remuneration of the auditor.
Deloitte was first appointed as our auditor on May 6, 2005. For the year ended December 31, 2021, Deloitte was paid $ 2,405,438 for audit services, $ 202,539 for audit-related services and $ 80,000 for other services. Deloitte was not paid any fees for tax-related services in 2021. All non-audit services provided by Deloitte are subject to pre-approval by our Audit Committee. Additional information regarding the compensation of Deloitte is contained in our Annual Information Form for the year ended December 31, 2021 under the heading `` Audit Committee Disclosure ''. Our Annual Information Form may be found on our website at www.hudbay.com, on SEDAR at www.sedar.com and EDGAR at www.sec.gov/edgar.shtml.
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The Board recommends that shareholders vote FOR the appointment of Deloitte as Hudbay's auditor and the authorization of the Board, upon the recommendation of the Audit Committee, to fix the auditor's remuneration.
4. SAY ON PAY ADVISORY VOTE
Hudbay's compensation model is designed to: ( i) provide competitive compensation to attract and retain talented high-achievers and appropriately incent them to achieve our strategic and operational objectives; and ( ii) align the interests of our executives with the long-term interests of our shareholders. Detailed disclosure of Hudbay's executive compensation program can be found under the heading `` Statement of Executive Compensation '' found later in this Circular.
The Board has adopted a non-binding advisory vote relating to executive compensation to solicit feedback from shareholders on our approach to executive compensation. As a formal opportunity to provide their views on the disclosed objectives of Hudbay's compensation model, shareholders are asked to review and vote in a non-binding, advisory manner, on the following resolution:
`` BE IT RESOLVED, on an advisory basis and not to diminish the role and responsibilities of the Board, that the shareholders accept the approach to executive compensation disclosed in the Circular. ''
As an advisory vote, the resolution will not be binding on the Board. However, the Compensation and Human Resources Committee and the Board will take the results of the vote into account, as appropriate, when considering future compensation policies, procedures and decisions, all of which are to be consistent with Hudbay's compensation philosophy ( see the `` Statement of Executive Compensation '' for details).
Hudbay will disclose the results of the Say-on-Pay advisory vote as part of its report on voting results for the meeting.
The Board recommends that shareholders vote FOR the advisory resolution approving Hudbay's approach to executive compensation.
STATEMENT OF CORPORATE GOVERNANCE PRACTICES
Our Board believes that sound corporate governance practices are essential to the effective management of Hudbay and the protection of its employees, shareholders and other stakeholders. Our Board oversees the management of our business and affairs with a view to ensuring that shareholder value is enhanced without compromising our commitment to environmental, social and governance ( `` ESG '') principles, and the highest standards of ethical conduct are adhered to.
Our Board has adopted corporate governance policies and procedures to assist it in fulfilling this oversight role. The Board fulfills its mandate directly and through its Committees. The directors are kept informed of our operations at regular and special Board and Committee meetings as well as through reports and discussions with management. We believe Hudbay is best served by a Board that functions independently of management and is informed and engaged.
We regularly monitor our corporate governance policies and procedures with a view to ensuring that they continue to guide the Board and management to act in the best interests of Hudbay and our stakeholders.
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Our Corporate Governance Guidelines ( including the Board Charter), which were updated in 2022, are set out in Schedule `` A '' to this Circular and can be viewed at our website at www.hudbay.com. The following is a description of Hudbay's corporate governance practices as approved by the Board.
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BOARD OF DIRECTORS: THE ROLE OF THE BOARD
The Board mandate has been formalized in a written Board Charter that sets out specific responsibilities, which include:
•satisfying itself as to the integrity of the Chief Executive Officer and other senior officers and that the Chief Executive Officer and other senior officers create a culture of integrity throughout the Company;
•reviewing and approving the strategic plan and business objectives that are submitted by senior management and monitoring the implementation by senior management of the strategic plan;
•reviewing the principal strategic, operational, reporting, ESG and compliance risks for Hudbay and overseeing, with the assistance of the Audit Committee, the implementation and monitoring of appropriate risk management systems and monitoring of risks;
•ensuring, with the assistance of the CGN Committee, the effective functioning of the Board and its Committees in compliance with applicable corporate governance requirements, and that such compliance is reviewed periodically by the CGN Committee;
•ensuring internal controls and management information systems are in place and are evaluated and reviewed periodically on the initiative of the Audit Committee;
•assessing the performance of senior management, including monitoring the establishment of appropriate systems for succession planning ( including the development of policies and principles for Chief Executive Officer selection and performance reviews) and periodically monitoring the compensation levels of the members of senior management based on the determinations and recommendations made by the Compensation and Human Resources Committee;
•ensuring we have in place a policy for effective communication with shareholders, other stakeholders and the public generally; and
•reviewing and, where appropriate, approving the recommendations made by the various Committees, including the selection of nominees for election to the Board, appointment of directors to fill vacancies on the Board, appointment of members of the various Committees and establishing the form and amount of director compensation.
Independence
For a director to be considered independent under the policies of the Canadian Securities Administrators, he or she must have no direct or indirect material relationship with us, being a relationship that could, in the view of the Board, reasonably be expected to interfere with the exercise of his or her independent judgment, and must not be in any relationship deemed to be not independent pursuant to such policies. To assist in determining the independence of directors for purposes that include compliance with applicable legal and regulatory requirements and policies, the Board has adopted certain categorical standards, which are part of our Corporate Governance Guidelines.
With the assistance of the CGN Committee, the Board has considered the relationship to Hudbay of each of the nominees for election by the shareholders and has determined that ten of the eleven directors nominated for election at the Meeting are independent. The following table sets out the relationship of the nominees for election as directors to Hudbay.
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Restrictions on Board Membership at Other Entities
Our Corporate Governance Guidelines prohibit our directors from having more than one interlocking directorship ( being one in which two or more of our directors sit together on the board of another reporting issuer), without the approval of our CGN Committee. Only two of our directors have an interlocking directorship and sit together on the board of another reporting issuer.
Our Corporate Governance Guidelines do not restrict the number of public company boards on which our directors may sit. However, our Code of Business Conduct and Ethics requires that the Chair approve any other directorships held by our directors. In addition, directors are expected to devote the required time and effort to discharge their obligations as members of the Board. Currently, only one of our directors sits on the boards of more than two other reporting issuers.
For more information about the nominees for election at the Meeting, including a listing of the reporting issuers on whose boards our nominee directors sit, see above under the heading `` Election of Directors - Nominees for Election as Directors ''.
Independent Chair
In addition to having a majority of independent directors, the Board has adopted a variety of procedures to allow for the independent functioning of the Board from management. Those procedures include having a Chair who is an independent director with a formal mandate to assist the Board in fulfilling its duties effectively, efficiently and independent of management. The responsibilities of the Chair include acting as a liaison between the Board and the Chief Executive Officer, working with the Chief Executive Officer to ensure that the Board is appropriately involved in approving and supervising Hudbay's strategy and recommending procedures to enhance the work of the Board. The Board has also adopted a position description for the Chair of each of the Board Committees. The full position descriptions of the Board Chair and the Chair of each Committee, including a complete list of their responsibilities, which have been approved by the Board, are available on our website at www.hudbay.com.
CEO Position Description
The Board has approved a position description for the Chief Executive Officer ( available on our website at www.hudbay.com), which delegates to the CEO the responsibility for providing strategic leadership and vision by working with the Board and the senior management team to establish, implement and oversee our long-range goals, strategies, plans and policies, subject to the direction and oversight of the Board. The Chief Executive Officer reports formally to the Board, as well as less formally through discussions with members of the Board, to advise the Board on a timely basis of management's current and proposed courses of action. The Board exercises its responsibility for oversight through the approval of all material decisions and initiatives affecting Hudbay.
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Board Composition and Skills
The CGN Committee, which is composed entirely of independent directors, assists the Board in identifying skills and areas of expertise that are desirable to add to the Board, assists the Board by identifying individuals qualified to become members of the Board, and recommends to the Board nominees for election to the Board in annual meetings, and directors to be appointed to each Committee and as the Chair of each Committee.
In assessing individual director nominees, the CGN Committee considers, in addition to the skills and expertise highlighted in the Board skills matrix, the following criteria: ( i) judgment and character; ( ii) diversity of the Board, including diversity of gender, viewpoints, backgrounds, experiences and other demographics ( and the target for at least 30% women directors as described in our Diversity Policy below); and ( iii) the extent to which the interplay of a nominee's expertise, skills, knowledge and experience with that of other members of the Board will build a Board that is effective, collegial and responsive to our needs.
It was in this context that the CGN Committee decided to recommend George E. Lafond as a new director nominee. Mr. Lafond is a member of the Saskatchewan Muskeg Lake Cree Nation and has extensive experience as a senior advisor to companies and governments with First Nations engagement and community development initiatives. The Board believes Mr. Lafond will strengthen the Board's ESG expertise, increase the diversity of perspectives on the Board and contribute to the Board's overall effectiveness. With three female directors at our company, Mr. Lafond's addition to the Board as our 11th director will result in the number of female directors being slightly less than the 30% target contained in our Diversity Policy. The Board intends to address this the next time changes are made to the Board.
The following Board skills matrix sets out the skills and expertise that the Board considers important to fulfill its oversight role in respect of Hudbay, the specific skills and expertise of each director nominee and the current strengths of the Board as a whole. Each director is required to complete a self-assessment of his or her skills and such data is compiled into the matrix. The Board skills matrix is maintained to identify and evaluate the competencies and skills of its members based on the individual experience and background of each director and to identify areas for strengthening the Board, if any, and address them through the recruitment of new members.
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1.⬤ Indicates a high degree of experience or expertise in the subject area.
2.O Indicates some or limited experience in the subject area.
Board and Committee Evaluations
Annually, under the supervision of the CGN Committee, the directors conduct a formal evaluation of the performance and effectiveness of the Board and its Committees. As part of this process, each director and members of senior management are interviewed by a member of the CGN Committee to assess the performance of the Board, its Committees and the individual directors, the independence of the Board, its relationship with senior management, the performance of the Chair, the Board's role in shaping company culture and any other issues of concern. The results of these interviews were reviewed by the CGN Committee at its meeting on January 19, 2022, then reported to the Board by the Chair of the CGN Committee. A formal written report is circulated to the directors and members of senior management, and the Chair of the CGN Committee, the Board Chair and the President and CEO work to ensure the recommendations contained in the report are implemented.
Members of each Committee are also provided questionnaires that deal with the performance of the Committee and its Chair and ask the Committee members to raise any matters of concern. The results of these questionnaires are discussed during in camera sessions of the Committees.
Age and Term Limits; Focus on Board Renewal
We do not have age or term limits for service on the Board. Instead, the Board focuses on renewal, as evidenced by the nomination of George E. Lafond at this year's Meeting, the addition of five new directors in the past three years and the fact that only three directors have served longer than five years. As part of this focus on board renewal, the Board is vigilant in monitoring the performance of each director and will ask directors who are no longer able to contribute effectively to step down from the Board.
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Related Party Transactions
Our Corporate Governance Guidelines were recently updated to delegate responsibility to the CGN Committee to review transactions between the Company and any related party, regardless of whether the transactions are reportable pursuant to securities regulations. After considering advice from the CGN Committee, the Board shall review, and, if appropriate, approve or ratify, such related party transactions. For purposes of the guidelines, a `` related party transaction '' is any transaction in which the Company was or is to be a participant and in which any related party has a direct or indirect material interest, other than transactions that ( i) are available to all employees generally, ( ii) involve compensation of executive officers or directors duly authorized by the appropriate Board committee, or ( iii) involve reimbursement of expenses in accordance with the Company's established policies.
Board and Committee Meetings and Attendance
The Board meets a minimum of four times per year and as otherwise required. Most Committees meet quarterly, or more frequently as deemed necessary by the applicable committee. The frequency of meetings and nature of each meeting agenda depend on the business and affairs that Hudbay faces from time to time. The table below provides details regarding director attendance at Board and committee meetings held during the year ended December 31, 2021.
In Camera Sessions without Management
The independent members of the Board meet without management in in camera sessions at all regular Board meetings. During the year ended December 31, 2021, the Board held in camera sessions of the independent directors at ten Board meetings. In addition, all of the committees hold in camera sessions without the presence of management at each regular meeting.
Director Orientation and Continuing Education
Senior management, working with the Board, provides appropriate orientation and education for new directors to familiarize them with Hudbay and its business. New directors are provided with a comprehensive series of documents which includes, among other things, information about the duties and obligations of directors ( including copies of the Code of Business Conduct and Ethics, Governance Guidelines and Board Charter, Committee charters and Hudbay policies), descriptions of our organizational structure, operational reports, strategic plans, compensation plans, investor presentations and copies of our most recent core public disclosure documents. New directors are expected to meet with members of senior management and attend site visits at our key properties within a short period after joining the Board. New directors are also invited to sit in on meetings of Committees of which they are not a member to get a sense of how these Committees operate.
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Our directors are encouraged to attend third party educational programs and our Board members receive a membership with the Institute of Corporate Directors, where they have access to educational materials and are invited to training seminars throughout the year. In addition, we frequently include a director education topic on the agenda at Board meetings and dinners. This typically involves presentations to the Board by members of management and third party advisors in respect of our business and operations, corporate development, strategy, legal and regulatory matters, ESG topics and industry trends and practices.
The following were among the educational and strategic presentations made to our Board in 2021:
The following were among the training and education the Board Committees received in 2021:
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See `` Committees of the Board '', below, for information on the members of each Committee.
STRATEGIC PLANNING
The Board recognizes that one of its primary responsibilities is to provide direction and oversight to management in pursuit of the Company's strategy. Senior management, led by the CEO, is responsible for presenting strategy plans to the Board for approval, and pursuing strategic opportunities and business objectives. The Board recognizes that consideration of the Company's strategy and strategic opportunities must be an ongoing conversation with management and company strategy is discussed with management at every regular Board meeting. In addition, the Board held a meeting in August 2021 that focused solely on strategy.
RISK MANAGEMENT
A key element of the Board's responsibilities is to review the principal strategic, operational, ESG, reporting and compliance risks for the Company and oversee, with the assistance of the Audit Committee, the implementation and monitoring of appropriate risk management systems and the monitoring of risks, including ESG-related risks.
The Board provides overall governance of the risk management function by:
•approving the Company's risk management policy;
•setting the risk appetite associated with Hudbay's strategy and corporate objectives;
•ensuring, with the assistance of the Audit Committee, that senior management has instituted and is operating a system that identifies, assesses, mitigates and communicates the principal risks the Company faces; and
•monitoring, with the assistance of the Board's committees, the management of the Company's principal risks.
The Audit Committee oversees the design and ongoing review of the Company's risk management system. In this capacity, the Audit Committee is responsible for reviewing and overseeing our risk management policy and approving a formalized, disciplined and integrated enterprise risk management process that is developed by senior management and, as appropriate, the Board and its Committees, to monitor, manage and report principal risks.
Each of the Board's committees are responsible for monitoring the critical risks assigned to each of them by the Board, periodically reviewing with management how those risks are being managed ( including the actions that have been taken by management to mitigate the risks) and communicating findings to the full Board. By way of example, cyber security risk is overseen by the Audit Committee, as it has responsibility for reviewing and monitoring the information technology risks facing the Company. The allocation of risk oversight responsibility among the Board and its committees is summarized below:
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Among its responsibilities, Hudbay management is responsible for:
•Conducting business in accordance with the risk appetite set by the Board,
•Integrating risk management into strategic business planning, budget and resource allocation, operating performance, and human resources, financial and compliance processes, and
•Actively monitoring and managing principal business risks.
In addition, our Vice President, Risk Management is responsible for establishing a flexible, risk-based annual internal audit plan to determine the priorities of the internal audit function, consistent with Hudbay's strategic plan and aligned with the enterprise risk management program, including but not limited to risk registers and risk appetite and tolerance levels. The Audit Committee approves the annual internal audit plan.
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DIVERSITY AND INCLUSION
Our Corporate Governance Guidelines ( a copy of which can be found at Schedule `` A '') include a written policy for the identification and nomination of director candidates who are diverse in many respects, including gender. The Board has also approved a standalone written Diversity Policy to supplement our Corporate Governance Guidelines.
Our Diversity Policy seeks to ensure a diverse representation of women and other designated groups ( Aboriginal peoples, persons with disabilities and visible minorities) among the members of our Board and senior management. To ensure sustained progress in this regard, the Diversity Policy was updated in early 2021 to include a target for the Company to have at least 30% women directors on the Board. This policy confirms the Board's commitment to diversity and inclusion as part of our core values and to setting a `` tone at the top '' that leads to greater diversity on the Board, in senior management and across the organization.
One aspect of this policy is enhancing the representation of other designated groups, including Indigenous peoples, on the Board. With this in mind, the Board has nominated George E. Lafond for election as a director at the Meeting. Mr. Lafond is a member of the Muskeg Lake Cree Nation in Saskatchewan and will, in addition to strengthening the Board's ESG expertise, increase the diversity of the Board and contribute to the Board's overall effectiveness. At the same time, the Board recognizes that the addition of Mr. Lafond as a director will temporarily reduce the percentage of women directors to below the 30% target set forth in the Diversity Policy. The Board remains committed to a target for the Company to have at least 30% women directors on the Board as part of its overall commitment to diversity and inclusion and intends to address this the next time changes are made to the Board.
The CGN Committee is responsible for ensuring the objectives of our Diversity Policy are applied in identifying and evaluating candidates for the Board and the CEO is tasked with ensuring this with respect to senior management positions. Pursuant to our Diversity Policy, in assessing individual director nominees, the CGN Committee considers, among other things, relevant skills and expertise, judgment and character, diversity ( including diversity of gender, viewpoints, backgrounds, experiences and other demographics, such as the representation of Aboriginal peoples, persons with disabilities and visible minorities), and the extent to which the interplay of an individual's expertise, skills, knowledge and experience with that of other members of the Board will build a board that is effective, diverse, collegial and responsive to the needs of the Company.
Although we do not have specific targets regarding directors and executive officers for each of the designated groups, we have a target of at least 30% women directors and believe that our Diversity Policy and Corporate Governance Guidelines, together with our other diversity and inclusion initiatives described below, encourage our CGN Committee and management to consider the current number of women and members of other designated groups when selecting director candidates and members of senior management.
Diversity and Inclusion Initiatives
In 2020, Hudbay management formed a Diversity and Inclusion Committee ( the `` D & I Committee ''). The D & I Committee was formed shortly after Hudbay's President and Chief Executive Officer, Peter Kukielski, joined other senior executives in Canada in signing a pledge ( known as the BlackNorth Pledge) to end systemic racism and create opportunities for all of those in the underrepresented BIPOC ( Black, Indigenous and People of Colour) community. The D & I Committee consists of a group of employees at the corporate office that expressed a desire to foster and advance Hudbay's commitment to diversity, equity and inclusion throughout the organization. Over the course of 2021, the D & I Committee developed a Diversity and Inclusion Policy ( `` D & I Policy ''), arranged for targeted charitable corporate donations and worked collaboratively with the HR group and business units on various diversity, equity and inclusion initiatives. These initiatives have included online Indigenous awareness training, employee engagement surveys and guest speakers. In 2022, we intend to deliver to all of our employees and directors mandatory online diversity and inclusion training focused on diversity and inclusion in the workplace, micro-aggressions and unconscious biases, and communicate the CEO's commitment to diversity, equity and inclusion through the adoption of the D & I Policy.
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In 2021, our Peru Business Unit launched a formal, robust diversity, equity and inclusion ( `` DE & I '') program called `` Nuestras Voces '' ( Our Voices), an acronym that represents each focus area:
•Values - Our values in action foster a DE & I work environment
•Openness - We promote being a role model in inclusive leadership
•Inclusion - All communities and interest groups are valued
•Confident - Develop a psychologically safe environment
•Education - Promote, develop and generate opportunities through education
•Sustainable - Empower schools in the Chumbivilcas province through access to quality learning
The program aims to support the overall people strategy goal of creating a more diverse, equitable and inclusive organization and increasing the percentage of women in the workforce to 30%. One initiative launched under this program - Hatun Warmi ( which translates from Quechua to `` Great Women '') - is aimed exclusively at providing women from the local communities near the Constancia mine with the training necessary to obtain an operator's license for mining equipment. During the program, participants received a monthly stipend, and upon completion, all participants will have the opportunity to work at Hudbay and will have the necessary skills should they choose to work at other mining companies.
To promote gender diversity in the Manitoba Business Unit, the Hudbay Women's Network ( `` HBWN ''), was founded in 2018 by two female employees in our Manitoba Business Unit. The HBWN's founding principle is gender inclusion, and its goal is to support, connect and empower Hudbay employees by providing a vehicle for professional growth and a strong voice. The HBWN is supported by our female directors, who have met with the HBWN to share their experiences and provide mentoring.
Measuring our Success
Hudbay intends to measure the effectiveness of its Diversity Policy and our other diversity and inclusion initiatives by looking at the increase in female representation and representation of other designated groups on the Board and in senior management positions over time and assessing the input received from employees through our engagement surveys.
The Board presently has three female directors, Carol T. Banducci, Sarah B. Kavanagh and Carin S. Knickel, and, if all our nominees are elected at the Meeting, will have three additional directors that identify as part of other designated groups.
The Board and senior management recognize the need for increased diversity among senior management, including greater representation of female and BIPOC individuals. Consideration of executive appointments occurs in the context of our succession planning framework, which identifies potential successors for our current executives. While we are committed to ensuring diverse candidates are considered for executive roles, this will best be achieved by bringing in diverse and talented people to all levels of our organization and ensuring that they are given every opportunity to flourish and advance within the organization. This is evidenced by the recent promotion of Candace Brûlé, who has been with Hudbay in progressively senior roles for several years and was recently promoted to Vice President, Investor Relations.
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The number and percentage of our eleven nominee directors who are women or identify as a member of a designated group is as follows:
The number and percentage of our fourteen executive officers who are women or identify as a member of another designated group is as follows:
SUCCESSION PLANNING FOR EXECUTIVE OFFICERS
Hudbay has a formal process for succession planning for its executive officers. The Chief Executive Officer is responsible for overseeing the succession planning process for all executive roles and critical skills roles below the CEO level. As part of this process, an employee's manager-once-removed ( the manager of the employee's manager) is accountable for planning, assessing and monitoring the identification and development of successors to management and other key roles. Results are compiled by the Human Resources group and discussed among senior management, following which a formal succession plan is prepared and reported to the Compensation and Human Resources Committee and Board.
The robust nature of our succession planning process was demonstrated in November 2021 when Cashel Meagher announced his resignation as our COO. The Board immediately, and in accordance with its succession plan, appointed André Lauzon as our new COO.
CEO succession planning is discussed during in camera meetings of the Compensation and Human Resources Committee and the full Board. At these meetings, the Compensation and Human Resources Committee and Board consider candidates with long-term potential to serve as Hudbay's CEO and they also identify candidates who could step into the role immediately in the event the CEO departs unexpectedly or becomes temporarily incapacitated.
ESG GOVERNANCE
Hudbay believes that continuously improving how we manage the social, environmental and economic risks, impacts and opportunities associated with our activities is critical for our long-term success. Our focus on sustainability helps us meet stakeholder expectations, benefit from positive developments and manage challenging circumstances.
Social, environmental and economic sustainability are embedded into Hudbay's overall management approach, and governance of these matters starts at the Board level. The EHSS Committee has been delegated oversight authority over the Company's human rights, community relations, environmental, health and safety and climate change policies, programs and systems and other committees have been delegated oversight of other ESG matters such as tailings, water management, diversity and inclusion and corporate governance. Senior management has responsibility for the Company's overall sustainability governance processes while Business Unit and operations leaders are responsible for achieving and maintaining sustainable operations. Each operation has specialist personnel who are dedicated to the day-to-day management of health, safety, environmental, community relations and other social and human rights matters.
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Climate Change Governance
In 2021, we undertook to define a pathway for each Hudbay operation to achieve a 2030 GHG emissions targets that is consistent with the objective of limiting global warming to well below 2°C ( above pre-industrial levels). Drawing on our many years of data on our GHG footprint, we began work on a 10-year GHG Reduction Roadmap to identify our best options for approaching and achieving sustainable GHG reductions. The roadmap will focus on key sources and drivers of emissions, including Scope 3 emissions, and identify the nature of the changes - operational or technical - that will be required to make the step changes necessary to contribute to global reduction targets. With this information, the corporate office and each business unit will determine specific action plans to shape future operational choices and capital investments to support sustainable reductions that are intended to ensure we achieve our targets for 2030 and 2050. The Board's EHSS Committee provides oversight of our GHG Reduction Roadmap and regularly receives reports from management on our progress.
Tailings Governance
As a member of the Mining Association of Canada, Hudbay participates in its Towards Sustainable Mining ( `` TSM '') program, a leading sustainability standard in the mining industry. The TSM program is based on guiding principles and supported by a set of tools and performance indicators to ensure key mining risks are effectively managed. Participation in TSM supports accountability, transparency and credibility by evaluating and publicly reporting our performance across the following protocols and frameworks:
The TSM protocols and frameworks are incorporated into our overall management systems and company standards. Although we are only required to implement the program at our Canadian operations, we commit to implementing the program at all of our operations. The goal is for each facility to achieve a minimum of Level A - which is considered good performance and demonstrates that commitments and accountabilities are in place and consistent with the protocol - in all performance areas.
Our Tailings Governance Charter specifies the governance that supports the safe management of tailings facilities. Each site or business unit employs a tailings management system that supports the day-to-day activities - such as planning, monitoring, risk identification and reporting - associated with the safe management of tailings design, construction and operation.
One important requirement in the TSM protocol is that a company's governance defines and documents accountability and responsibility for tailings management. Our Accountable Executive Officer ( `` AEO ''), who is our Chief Operating Officer, has the authority and responsibility to engage with Hudbay's Board on any issues related to tailings management. Each business unit Vice President has similar accountabilities to the AEO for facilities within their business unit. A Tailings Governance Team ( `` TGT ''), composed of individuals from the business units and relevant corporate functions, serves in a monitoring and advisory role to assist the AEO in the design and implementation of appropriate processes to carry out the required third-party reviews and provide information to the AEO.
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Key third-party roles include the following:
•Independent peer review board ( `` IPRB '') - a panel of qualified and experienced individuals, who have not been directly involved with the design or operation of the facility, evaluates the technical aspects of TSFs at least annually ( and typically twice per year - one being a site visit and the other a teleconference) throughout the mine lifecycle. The IPRB's findings are reported by management to the Board's Technical Committee and the Technical Committee Chair may elect to meet with management and the IPRB as needed.
•Engineer of record ( `` EOR '') - a qualified individual who carries out the design and verifies that the facilities are designed, constructed and performing in accordance with performance objectives and all applicable guidelines, standards and regulatory requirements.
•Dam safety review provider - an external expert conducts dam safety reviews ( `` DSRs ''), independent of the IPRB and EOR, every five years, as per the recommendation of the Canadian Dam Association's Dam Safety Guidelines.
Annual tailings management reviews at our operating sites assess compliance with our Tailings Governance Charter and the TSM protocol. The review findings are reported to our Board.
Sustainability Reporting
Hudbay has long believed that transparently disclosing our sustainability performance is good business and essential to earning and maintaining stakeholder trust. We have published an Annual Sustainability Report since 2004. Our 2021 Annual Sustainability Report will be published in the second quarter of 2022 and our 2020 report is available on our website at www.hudbay.com.
For several years, Hudbay has published its ESG disclosures in accordance with the GRI ( Global Reporting Initiative) guidelines and standards. We have also participated in CDP's annual questionnaires on our greenhouse gas emissions, water management practices and forest-related risks and opportunities.
For many years, the GRI and CDP have been considered two of the most credible and widely adopted sustainability/ESG reporting frameworks. However, two other frameworks have recently emerged that reflect how reporting is evolving to include issues of interest to investors and other stakeholders. The Sustainability Accounting Standards Board ( `` SASB '') created a standardized methodology for reporting sustainability information that is material to investors and for allowing stakeholders to compare peer performance within an industry. The Task Force on Climate-related Financial Disclosures ( `` TCFD '') framework seeks to provide stakeholders in the financial markets ( e.g., investors, lenders, insurers and regulators) climate-related information useful to decision making.
As investor interest in ESG matters increases, SASB and TCFD are emerging as equally credible standards and frameworks to GRI. As a result, our 2021 Annual Sustainability Report disclosures will continue to be mapped to the GRI, the SASB Metals & Mining industry standard and the TCFD. In addition, we continue to monitor the implementation of proposed National Instrument 51-107 by the Canadian securities regulators and will meet climate-related disclosure obligations in our regulatory filings once the rule is finalized.
Because the multiple frameworks may have an unintended result of creating complexity and becoming onerous, there are several efforts underway to converge the various sustainability reporting standards into a single reporting framework. We are monitoring these developments, as well as the proposal from securities regulators to disclose climate-related information in our continuous disclosure filings, as we continuously improve our reporting disclosures and transparency on our performance.
ETHICAL BUSINESS CONDUCT
As part of its commitment to maintaining the highest ethical standards, the Board has adopted a Code of Business Conduct and Ethics, which was updated in March 2022 following a comprehensive review of the Company's anti-bribery and compliance policies. The Code applies to all of our directors, officers and employees, our subsidiaries and affiliates and other persons in similar relationships with those entities. The Code addresses such matters as compliance with laws, conflicts of interest, confidential information, protection and proper use of Hudbay assets, fair dealing, rules and regulations and the reporting of illegal and unethical behaviour, including laws prohibiting improper payments to government officials.
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In addition, we have adopted a Certification Policy, in accordance with which new employees must read the Code when hired or appointed and acknowledge that they will abide by the Code. The Certification Policy also requires that all directors, officers and active employees across the organization annually certify their understanding of the Code and acknowledge that they will abide by the Code. We regularly conduct training sessions across the organization relating to applicable laws prohibiting bribery, to ensure that employees, especially those who may interact with government and other third parties, understand such laws and know how to comply with them. In early 2022, we completed an online certification campaign in which all active employees were provided copies of the Code and our key compliance policies ( including anti-corruption policies) and asked to e-sign the policies to certify their understanding of the policies and their compliance therewith. In addition, targeted compliance training was carried out by our Peruvian business unit's compliance function in 2021, which training included virtual training of members of the community relations, government relations and institutional relations teams, as well as specific training in relation to the recruitment and onboarding of former government employees.
The Board has also adopted a Statement on Anti-Corruption, which was updated in March 2022, to further demonstrate our commitment to conducting business honestly, ethically and in compliance with the laws of the jurisdictions in which we operate and have assets. In addition, our Global Supplier Due Diligence Policy, our Supplier Code of Conduct and Ethics and recently adopted Customer Code of Conduct and Ethics are intended to ensure that we and our subsidiaries transact with suppliers and customers who share our expectations for ethical conduct and compliance with laws.
We encourage personnel who become aware of a conflict or potential conflict or departure from the Code to bring it to the attention of a supervisor or department head. The Board has adopted a Whistleblower Policy for employees and others to report concerns regarding, among other things, violations of the Code or anti-bribery legislation or concerns regarding financial statement disclosure issues, accounting, internal accounting controls or auditing matters. These concerns may be reported to the Chair of the Audit Committee, who will promptly conduct or assign an individual, who may be a member of senior management or another person, to conduct a thorough investigation of the complaint. In addition, under the Whistleblower Policy, Hudbay has a third-party hotline and website that allows individuals to report any concerns about inappropriate business conduct confidentially and anonymously. These concerns can be reported online, by mail or by phone.
The Board, through the Audit Committee, monitors compliance with the Code. Hudbay's Vice President and General Counsel provides day-to-day management over Hudbay's global compliance with the Code and other core policies, including management of our Whistleblower Policy and program, and reporting quarterly on such matters to the Audit Committee.
Any waivers of the Code for directors or members of senior management may only be granted by the Board. The Board did not grant any waiver of the Code in 2021. In the unlikely event of such a waiver, it will be disclosed to shareholders as required by applicable law.
A copy of the Code may be accessed on our website at www.hudbay.com or on Hudbay's profile on SEDAR at www.sedar.com and EDGAR at www.sec.gov/edgar. Copies of the Whistleblower Policy, Supplier Code of Conduct and Ethics and the Statement on Anti-Corruption may be accessed on our website at www.hudbay.com.
OVERSIGHT OF COVID-19 RISKS
In 2021, the Board worked with senior management to ensure risks relating to COVID-19 were being properly monitored and the mitigation plans that were put in place continued to be effective. In addition to the normal risk management process, the Board held bi-weekly update calls with management during the early stages of the pandemic in 2020, which gradually transitioned to periodic updates once mitigation plans were in place.
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Management's crisis management team, a multi-disciplinary group of head office employees, was initially activated and tasked with coordinating regular calls with the business units to receive updates and share knowledge on COVID-19 issues. Accountability for these matters gradually transitioned to the HR group, which engaged an epidemiologist and public health expert to advise on the corporate office reopening plan and provided oversight and support to the business units as they developed their own plans based on local circumstances and public health guidelines. Over the course of 2021, the focus of these efforts expanded to include mental health and wellness initiatives and employee engagement.
SHAREHOLDER ENGAGEMENT
We communicate with our shareholders in a wide variety of ways, including through our website, news releases and other public disclosure documents, investor presentations, industry conferences and meetings with our shareholders. We also hold conference calls in respect of quarterly earnings releases and major corporate developments and such calls are open to be heard by the public. Details of the notice of time, place, general substance and method of accessing any such call and instructions as to where the public will be able to access archived audio webcasts of the call are broadly disseminated.
The Board of Directors is committed to engaging in constructive communications with our shareholders and the Board maintains a Shareholder Engagement Policy, which is available on our website at www.hudbay.com. In addition to our annual general meeting, during which shareholders have the opportunity to interact with our directors, the policy expresses our directors ' interest in meeting with key shareholders to discuss specific matters of mutual interest and concern. As part of these efforts, in 2021, our Board Chair reached out to our 20 largest shareholders and offered to meet with such shareholders without management present to discuss governance topics of interest. This resulted in meetings between our Board Chair and certain members of our CGN, and Compensation and Human Resources and EHSS Committees with shareholders representing, in aggregate, approximately 15% of the Corporation's outstanding shares.
Shareholders may also initiate communication directly with the Board by contacting our Chair by mail or email at:
Hudbay Minerals Inc. Attention: Chair of the Board 25 York Street, Suite 800 Toronto, Ontario, Canada M5J 2V5 Email: Chair @ hudbay.com
Our Chair and other members of our Board and management team continue to be in frequent contact with many of our shareholders and remain committed to constructive engagement with all shareholders.
DISCLOSURE POLICY
In addition to our timely and continuous disclosure obligations under applicable law, we also have a formal policy for dealing with analysts, shareholders and the media. Our Disclosure Policy is intended to ensure that we provide timely disclosure of material information in a manner that is broadly accessible on a non-exclusionary basis by all market participants.
Hudbay's management has established a Disclosure Committee that is responsible for ensuring that information is disclosed in accordance with the Disclosure Policy and otherwise in accordance with applicable securities laws. The members of the Disclosure Committee generally include the President and Chief Executive Officer, the Senior Vice President and Chief Financial Officer, the Senior Vice President and Chief Operating Officer, the Senior Vice President, Corporate Development and Strategy, the Vice President and General Counsel, the Vice President, Investor Relations and such other members of senior management deemed appropriate from time to time by the Disclosure Committee.
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The Disclosure Committee reviews and supervises the preparation of all news releases and public filings prior to their release and assists Hudbay management with their evaluation of the effectiveness of our disclosure controls. In addition, the Board gives final approval of material disclosure items and all news releases and public filings disclosing Hudbay's financial performance are reviewed by the Audit Committee, which ultimately recommends such disclosure for approval by the Board.
COMMITTEES OF THE BOARD
The Board has established five standing Committees to assist it in discharging its mandate. The roles of the five standing Committees are outlined below and their charters may be viewed on our website at www.hudbay.com.
Independence of Committees
The members of the Board's Committees are appointed by the Board upon the recommendation of the CGN Committee. All of our directors who are currently members of Committees of the Board are independent directors within the meaning of applicable securities laws and the categorical standards set out in our Corporate Governance Guidelines.
Audit Committee
Members: Carol Banducci ( Chair), Daniel Muñiz Quintanilla and Colin Osborne.
The duties of the Audit Committee include making recommendations to the Board with respect to our quarterly and annual financial results, including management's discussion and analysis thereof, and reporting to the Board any issues of which the Audit Committee is aware respecting the quality or integrity of our financial statements, any significant financial reporting issues and judgments made in connection with the preparation of our financial statements and the adequacy of our internal controls. The Audit Committee also oversees the performance of our independent auditor and the scope of its audit, as well as our internal audit function and our enterprise risk management, information technology, cyber security and insurance programs. The Audit Committee receives regular reports from management on internal audit, risk management, information technology, cyber security, tax strategy, insurance, litigation, compliance with our Code of Business Conduct and Ethics ( the `` Code ''), pension plans and other matters. In addition, the Audit Committee is responsible for overseeing investigations into any complaints received by our third-party whistleblower service and for ensuring that appropriate resources are allocated to such investigations.
The Audit Committee meets at least quarterly and meets separately with senior management, the independent auditor and internal audit group as appropriate. All regular meetings of the Audit Committee include a session at which only members of the Audit Committee are present, a session at which the head of internal audit is present with the Audit Committee without other members of management and a session at which only representatives of the independent auditor are present with the Audit Committee.
None of the members of the Audit Committee may serve on the audit committee of more than three reporting issuers in addition to Hudbay without the prior approval of the Audit Committee, the CGN Committee and the Board. No member of the Audit Committee serves on the audit committee of more than one other reporting issuers.
Information about the remuneration of the independent auditor for the last two years is contained in Hudbay's Annual Information Form ( `` AIF '') for the year ended December 31, 2021 under the heading `` Audit Committee Disclosure '' and a copy of the Audit Committee's charter is attached as Schedule `` C '' to the AIF. Our AIF may be found on SEDAR at www.sedar.com and EDGAR at www.sec.gov/edgar.
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Compensation and Human Resources Committee
Members: Carin S. Knickel ( Chair), Richard Howes, Stephen A. Lang and David S. Smith.
The Compensation and Human Resources Committee assists the Board in discharging its responsibilities relating to recruitment, development and retention of senior management, performance evaluations and compensation of senior management, senior management and critical skills succession planning, compensation structure for the Board and senior management, including salaries, annual and long-term incentive plans and share ownership guidelines.
In 2021, the Committee's activities included making recommendations to the Board respecting André Lauzon's compensation as COO, receiving updates from management on the negotiation and finalization of new collective bargaining agreements with our unionized employees in Manitoba and Peru and reviewing the Corporation's human resources and organizational effectiveness strategy.
For a detailed discussion of the role of the Compensation and Human Resources Committee and its activities in 2021, including its review of Hudbay's 2021 performance against the corporate scorecard and the resulting executive compensation decisions, see `` Statement of Executive Compensation ''.
Corporate Governance and Nominating Committee
Members: David S. Smith ( Chair), Sarah Kavanagh, Carin Knickel and Stephen A. Lang.
The CGN Committee makes recommendations to the Board as to the size of the Board, standards for director independence, nominees for election as directors, the composition of Committees and development of appropriate corporate governance policies and guidelines. In addition, it is responsible for administering the Code and the Confidentiality and Insider Trading Policy, conducting annual interviews of the Board and senior management and reporting on their conclusions to the Board as part of the Board evaluation process, managing the Board's shareholder engagement activities, reviewing the relationship between the Board and senior management and undertaking such other initiatives that may be necessary or desirable to enable the Board to provide effective corporate governance. The CGN Committee views its most important role as assessing the Board's ability to make effective decisions and ensuring the effective governance of Hudbay.
The CGN Committee's activities over the past year included recommending the nomination of George E. Lafond as a new director, recommending the adoption of certain new governance policies, including updates to our Corporate Governance Guidelines, Disclosure Policy, codes of conduct and Diversity Policy and coordinating meetings with shareholders representing, in aggregate, approximately 15% of the Corporation's outstanding shares, as part of the Board's ongoing shareholder engagement efforts, and reviewing the Corporation's foreign private issuer status.
Environmental, Health, Safety and Sustainability Committee
Members: Sarah Kavanagh ( Chair), Carol Banducci, Igor Gonzales and Daniel Muñiz Quintanilla.
The purpose of the Environmental, Health, Safety and Sustainability Committee ( the `` EHSS Committee '') is to assist the Board in discharging its responsibilities relating to its oversight of our policies, programs and systems relating to environment, health and safety, human rights, community relations and sustainability ( including climate change), and monitoring legal and regulatory issues to ensure our compliance with applicable legislation, rules and regulations and management best practices. Other Committees have been delegated oversight over certain other ESG matters such as tailings, water management, diversity and inclusion and corporate governance.
The EHSS Committee receives quarterly reports from management, which include reports on health and safety incidents that occurred during the quarter across all of our operations, as well as measures taken to reduce the likelihood of such incidents occurring in the future, any non-compliances with applicable environmental regulations, and any internal and external environmental, health and safety audits conducted during the quarter. In addition, it is responsible for ensuring management promotes a culture of environmental and community responsibility and ensuring that, with respect to matters under our control, we operate in a climate that fosters the improvement of socio-economic conditions in the communities in which we operate. The EHSS Committee also oversees environmental and health and safety risks as part of our enterprise risk management, receives regular reports on our management systems at our operations and reviews and recommends our Annual Sustainability Report for approval.
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In 2021, the EHSS Committee's activities included receiving a detailed report on the tragic fatality that took place at the Lalor mine and management's efforts to improve safety culture, receiving an educational presentation on TSM from the Mining Association of Canada, receiving a presentation from the Manitoba business unit's indigenous liaison officer to increase the Committee's awareness of indigenous issues, reviewing the updated Flin Flon closure plan and receiving reports from management on the development of a greenhouse gas reduction strategy.
Technical Committee
Members: Colin Osborne ( Chair), Igor Gonzales, Richard Howes and Stephen A. Lang.
The Technical Committee assists the Board in its oversight of technical and operational matters, including receiving regular updates from management on key technical and operational issues and initiatives, overseeing reserve/resource calculations, reviewing operational budgets, receiving reports on production and cost performance, assessing our systems and processes for reviewing technical risks and technical controls in place at our operations, and discussing with management the technical merits of proposed acquisition targets and significant operational initiatives proposed to be undertaken.
In 2021, the Technical Committee's activities included monitoring the refurbishment and ramp-up of the New Britannia mill, receiving regular reports on the status of exploration activities at the Copper World project, reviewing the preliminary economic assessment of the Mason project, receiving an educational presentation on National Instrument 43-101, reviewing the results of management's due diligence on certain corporate development opportunities and reviewing the technical merits of those opportunities, and a special session during which management provided a detailed review of its potential development plans for Copper World and possible synergies with Rosemont.
THE NEW YORK STOCK EXCHANGE CORPORATE GOVERNANCE LISTING STANDARDS
We, as a `` foreign private issuer '' in the United States, may rely on home jurisdiction listing standards for compliance with the New York Stock Exchange ( `` NYSE '') Corporate Governance Listing Standards but must comply with the following NYSE rules: ( i) the requirement ( Section 303A.06) that the Audit Committee meet the standards of Rule 10A 3; ( ii) the requirement ( Section 303A.11) that we disclose in our annual report or on our website any significant differences between our corporate governance practices and the NYSE listing standards; ( iii) the requirement ( Section 303A.12 ( b)) that our CEO notify the NYSE in writing after any executive officer becomes aware of any non-compliance with the applicable provisions of NYSE Corporate Governance Listing Standards; and ( iv) the requirement ( section 303A.12 ( c)) that we submit an executed annual written affirmation affirming our compliance with audit committee requirements of Rule 10A 3 or, as may be required from time to time, an interim written affirmation to the NYSE in the event of certain changes to the Audit Committee membership or a member's independence.
As required by the NYSE, a statement of the significant differences between our current corporate governance practices and those currently required for U.S. companies listed on the NYSE is available on our website at www.hudbay.com.
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STATEMENT OF EXECUTIVE COMPENSATION
MESSAGE FROM THE CHAIR OF THE COMPENSATION AND HUMAN RESOURCES COMMITTEE
Fellow Shareholders,
The Compensation and Human Resources Committee is pleased to provide you with an overview of Hudbay's performance in 2021 and a summary of our approach to determining the compensation of our executives.
Strong Performance in a Challenging Year
By early 2021, we had settled into a new normal where the individual health risks from COVID-19 were reduced thanks to extensive safety protocols. The rollout of vaccines to our workforce helped with this, but we were not entirely prepared for the disruption caused to our workforce and supply chain by the Omicron variant late in the year.
Notwithstanding these challenges, our operations performed well throughout the year and generated strong cash flow as we benefited from higher metals prices. In Peru, we met our production guidance for copper and exceeded our production guidance for gold. In Manitoba, zinc production was impacted by the challenging conditions at our 777 mine as it approaches closure, and gold production was below guidance as we decided to resequence some gold ore production from Lalor so that we could benefit from higher recoveries by processing it at our New Britannia mill in the future. Like the rest of our peers, we experienced cost inflation and incurred additional costs due to COVID-19 that were largely beyond our control.
Our strong operating performance in 2021 was further supported by the completion of two significant capital projects that will allow for substantial near-term copper and gold production growth. We made investments of approximately $ 250 million to bring our higher-grade Pampacancha deposit into production in Peru and complete the refurbishment of the New Britannia mill as part of our Snow Lake gold strategy. We will realize immediate returns from these investments as our consolidated copper and gold production are expected to increase by 34% and 59%, respectively, from 2021 to 2024. We have also made progress toward securing our long-term future with the discovery of Copper World, a series of near-surface copper deposits located on our private land near our Rosemont project in Arizona and the completion of a positive preliminary economic assessment for our Mason project in Nevada. We published an initial resource estimate on Copper World in late 2021 and are preparing financial studies that we expect will demonstrate strong economics for the project.
The end of the year also saw changes in our senior leadership and given the Committee and Board's regular engagement in succession planning, the leadership succession was able to be thoughtfully implemented with great confidence of the capability of the new leaders in each of those roles.
2021 Compensation Decisions and Outcomes
Our short-term incentive ( `` STIP '') awards are based on a combination of corporate and individual performance. The corporate score is determined based on performance against a corporate scorecard, which was established in early 2021. The scorecard includes a range of performance categories, including production and operating cost performance, strategic and growth objectives, and ESG metrics such as community relations and safety. The overall score in our scorecard was 113/100. Our strongest performance was in categories reflecting operating cash flow, community relations, reserves and resources, and exploration. This was balanced against the production and operating cost categories, where our solid performance was tempered by results that fell outside of the guidance ranges for zinc, gold and silver production in Manitoba, and our operating costs in Peru. Unfortunately, in 2021 we suffered our first fatality in many years, which resulted in a zero score being attributed for Manitoba safety performance.
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It is worth pointing out that the Committee did not apply discretion to adjust the scores in any category in the scorecard to reflect operational impacts caused by the COVID-19 pandemic. This is a testament to the efforts of our operating teams as they were forced to deal with significant personnel and supply chain issues as a result of the pandemic.
In 2022 our corporate scorecard will have a similar mix of operational, strategic and ESG objectives. Of note is our new ESG objective of adopting greenhouse gas reduction targets that will see emissions reduced by 50% by 2030 with a commitment of net zero emissions by 2050.
CEO Performance Objectives
In past years, we evaluated our CEO's performance for STIP purposes entirely based on the results of the corporate scorecard, given that he has overall accountability for all aspects of our business. In 2021, we worked with our CEO, Peter Kukielski, to develop personal objectives that supplemented the corporate objectives in the scorecard and would help him continue to develop in his role. Peter's individual objectives focused on enhancing our investor relations, reviewing strategy, advancing ESG initiatives and enhancing our company culture. While these objectives represent ongoing undertakings, the Committee determined that Peter performed well against them in 2021 and he received a score of 115/100.
Building a Strong Culture
We recognize that a strong company culture is as important as strategy and leadership in driving the success of our organization, and the Committee and the Board are committed to working with Peter and his team to define and enhance Hudbay's culture. Having a common set of positive attitudes, beliefs and behaviours throughout the organization will ensure we have the conditions in which our employees are engaged, work effectively together and willingly give their best in a manner consistent with our values of dignity and respect, caring, openness and trustworthiness. In furtherance of this overarching objective, management completed its first company-wide employee engagement survey and action plans for improvement in key areas are being developed and implemented. In addition, the Committee is overseeing management's people-related initiatives, including diversity and inclusion, recruitment and retention, succession planning, and leadership development.
Shareholder Engagement
Last year, our advisory vote on executive compensation received approval from over 95% of our shareholders. We appreciate the support and believe that having an executive compensation program that rewards performance and is linked to the shareholder experience is critical, and we welcome the opportunity to discuss it with our shareholders. I was pleased to join other Hudbay directors in meetings with some of our top shareholders in 2021 as part of the Board's shareholder engagement program. The Committee welcomes further dialogue. You can feel free to reach out to us directly any time and we will be available at our annual shareholders ' meeting to answer any of your questions.
Sincerely,
Carin S. Knickel
Chair of the Compensation and Human Resources Committee
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Executive Summary
Below we provide an overview of our approach to executive compensation and summaries of 2021 pay decisions and changes to our executive and director compensation programs for 2022. Please refer to the Compensation Discussion and Analysis, starting at page52 for further details.
COMPENSATION PHILOSOPHY
Our executive compensation philosophy is to:
Accordingly, our compensation program is structured with the following elements in mind:
COMMITMENT TO TRANSPARENCY, GOOD GOVERNANCE AND RISK MITIGATION
The Compensation and Human Resources Committee and the Board are committed to good governance, transparent disclosure and a productive dialogue with our shareholders about our executive compensation program. The Committee considers the risks associated with our compensation policies and practices and is comfortable that they are not likely to have a material adverse effect on Hudbay.
The following list highlights key policies and practices that have been adopted by Hudbay, which we believe are in the best interest of shareholders and align with corporate governance best practices:
What We Do
✓Say on Pay: We hold an annual advisory `` Say on Pay '' vote on executive compensation
✓Shareholder Engagement: The Board has adopted a Shareholder Engagement Policy and is committed to maintaining an active dialogue with our shareholders about executive compensation
✓Performance Objective Setting: The Board's oversight of the performance objective setting process reduces the possibility of excessive risk taking and ensures performance objectives are aligned with corporate strategy
✓Corporate Scorecard: The Board adopts an annual corporate scorecard, including a scoring system with specific financial, operating, ESG and growth targets for assessing Hudbay's performance
✓Balanced Scorecard: A balanced number of annual performance objectives limits the impact any particular activity could have on the overall corporate performance score
✓Equity Incentives Emphasize Longer-Term Performance: PSU and RSU awards vest after three years and options remain exercisable for seven years; this motivates longer-term performance
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✓Independent Compensation Consultant: The Committee engages an independent compensation consultant who helps the Committee ensure our compensation levels and practices are reasonable and prudent while remaining competitive
✓Anti-Hedging Policy: Our Confidentiality and Insider Trading Policy prohibits our executives from hedging against declines in their equity-based compensation and trading during our blackout periods
✓Double Trigger on Change of Control: A `` double trigger '' is included in our executive employment agreements so that severance payments are due upon a Change of Control only if employment is also terminated
✓Equity Ownership Guidelines: Executives are required to comply with our equity ownership guidelines including a requirement for the CEO to own equity equal to at least 3x his base salary
✓Clawback Policy: The Board has adopted an updated `` clawback '' policy in order to allow the Board to require the reimbursement of excess incentive-based compensation received by certain executive officers in the event of ( i) materially non-compliant financial statements; or ( ii) a wrongful act by the executive officer
SUMMARY OF KEY ELEMENTS OF EXECUTIVE COMPENSATION
Our executives ' `` total direct compensation '' consists of base salary, an annual short-term incentive cash bonus ( STIP) and long-term equity-based incentives ( LTIP).
In 2021, 79% of our CEO's and an average of 69% of our non-CEO NEOs ' target total direct compensation was variable and at-risk.
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PAY OUTCOMES FOR 2021
Our corporate scorecard, used to determine a corporate performance score that is applied in the calculation of STIP payments, includes performance categories based on operational, ESG, financial and growth/strategic performance. The table below summarizes the results for Hudbay's 2021 corporate scorecard. More details can be found in `` Components of Hudbay's Executive Compensation Program - Short-Term Incentive Plan ( STIP) ''.
Note:
1.Safety score reflects that Manitoba received a score of zero for safety due to the fatality that occurred in 2021.
Notwithstanding the challenges of the COVID-19 pandemic and its impact on our operations and workforce, no discretion was applied to adjust the objectively-measured categories in our 2021 corporate scorecard.
Our corporate score for 2021 was 113/100. In 2020, our corporate score was 127/100 and in 2019 it was 81/100.
For 2022, our corporate scorecard will again include a combination of performance categories based on operations, ESG, financial performance and growth/strategy, with an increased emphasis on ESG performance, as the Board has tasked management with adopting greenhouse gas reduction targets to reduce emissions by 50% by 2030 with a net-zero commitment by 2050.
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Long-Term Incentive Plan Design
The Compensation and Human Resources Committee oversees our long-term incentive program ( LTIP) with the objective of ensuring the alignment of our LTIP outcomes with the shareholder experience and our mid- to long-term performance and strategic goals.
For the LTIP award made in February 2021, the Board approved a grant comprising:
CEO COMPENSATION
2021 Compensation
Peter Kukielski's target compensation as President and CEO was set with reference to the median compensation paid to the CEOs in our compensation benchmarking group. The actual total direct compensation received by Mr. Kukielski in respect of 2021 is shown in the table below:
1.The LTIP value is comprised of 50% PSUs, 25% RSUs and 25% Options, as described in `` 2021 CEO LTIP Award '', below.
80% of our CEO's STIP is based on the corporate score, with 20% based on his individual performance objectives focused on enhancing investor relations, reviewing strategy, advancing ESG initiatives and enhancing our company culture. His performance against these objectives was assessed as 115/100 which, when combined with the corporate performance score, resulted in a combined score of 113.4%.
Mr. Kukielski's total equity ownership, consisting of Hudbay shares, RSUs, PSUs and deferred share units ( `` DSUs ''), had an aggregate market value of $ 9,559,493 as at March 15, 2022.
FOCUS ON OUR PEOPLE
Along with executive compensation, the Compensation and Human Resources Committee is responsible for overseeing the human resources policies, plans and programs that are of strategic significance to the Company, including succession planning, workforce planning, talent management, recruitment and retention, leadership development and diversity and inclusion. The Committee is committed to working with management to ensure systems and programs are in place to enable a shared organizational culture in which the Company's employees are engaged and willingly give their best.
In addition, the Committee receives regular updates from management on labour relations. In 2022, management concluded new collective agreements with unionized employees in Peru and Manitoba. The agreements with the six unions in Manitoba also provide for the workforce transition that will occur when our 777 mine closes in mid-2022 and a substantial number of employees will move from our Flin Flon operations to Snow Lake, where our Lalor mine is located.
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Compensation Discussion and Analysis
COMPENSATION AND HUMAN RESOURCES COMMITTEE
Membership and Relevant Experience
The members of the Compensation and Human Resources Committee ( the `` Committee '') are Carin S. Knickel ( Chair), Richard Howes, Stephen A. Lang and David S. Smith. Each member is independent within the meaning of National Instrument 58-101 - Disclosure of Corporate Governance Practices. In addition, each member brings relevant and diverse experience, which provides the Committee with the proper context to assess the suitability of our compensation policies and practices.
Committee Mandate
The Committee assists the Board in discharging its responsibilities relating to recruitment, development and retention of senior management, officer appointments, performance evaluations of senior management, succession planning, compensation structure for the Board and senior management, including salaries, annual and long-term incentive plans and share ownership guidelines.
The responsibilities of the Committee, as set forth in its Charter, are available on our website at www.hudbay.com.
EXECUTIVE COMPENSATION OVERVIEW
Named Executive Officers
For 2021, our Named Executive Officers, referred to as our NEOs, were:
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Mr. Meagher resigned from Hudbay effective January 4, 2022. In accordance with the Company's succession plan, which is regularly updated and discussed with the Committee and the Board, André Lauzon was appointed as Senior Vice President and Chief Operating Officer effective upon Mr. Meagher's departure. Mr. Lauzon was previously Vice President of Hudbay's Arizona Business Unit. He has over 25 years of mining industry experience and, since joining Hudbay in 2016 has led key growth projects in Manitoba and Arizona.
Compensation Philosophy
Our executive compensation philosophy is to:
Accordingly, and as outlined throughout this Compensation Discussion & Analysis, our compensation program is structured with the following elements in mind:
Compensation Comparator Group
The compensation comparator group shown below is the same as the prior year and was approved by the Committee in 2020, for the purpose of determining where our executives were compensated in relation to their peers to facilitate decisions for 2021 target pay levels. Compensation for our Vice Presidents ( including Mr. Donnelly, our VP and General Counsel) was determined using industry surveys and internal considerations.
The criteria used to develop the compensation comparator group are as follows:
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Compensation Governance
Committee Activities
Since July 2020, the Committee has undertaken the following activities related to the 2020 and 2021 compensation process:
Executive and Director Compensation Benchmarking Review
Compensation Recommendations
Annual Cash Incentive ( STIP)
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Long-Term Incentives ( LTIP)
Compensation Disclosure
Leadership and Organizational Effectiveness
Risk Oversight
In Camera Sessions
Roles of Management and Independent Advisor
The Committee works closely with our management team and the Committee's independent advisor in overseeing the activities outlined below.
Management
Members of senior management assist the Committee by compiling information to be used in its determinations, including:
The Committee also relies on the CEO to review the performance of his direct reports and make recommendations to the Committee in this regard.
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Independent Advisor
To assist in carrying out its duties, the Committee has the authority to retain and receive advice from legal and other advisors as it determines necessary, including the use of compensation consultants.
Since 2009, the Committee has retained Hugessen Consulting Inc. to provide it with independent advice on executive and director compensation, incentive plan design, and related governance matters. The nature and scope of services provided by Hugessen to the Committee in 2021 included:
The Committee reviews and considers the information and advice provided by Hugessen, among other factors, when it makes its recommendations to the Board for approval. The Board, however, makes the ultimate decisions with respect to executive compensation after considering the Committee's recommendations. Hugessen does not provide any services to management directly and work conducted by Hugessen raises no conflicts of interest. Any services provided by Hugessen requires Committee pre-approval and the Chair of the Committee approves all invoices for work performed by Hugessen. The Committee reviews Hugessen's performance at least annually.
The table below outlines the fees paid to Hugessen over the last two years for executive compensation related services. Hugessen did not provide any other services in either year.
Compensation Risk Management
Commitment to Transparency, Good Governance, and Risk Mitigation
The Committee and the Board are committed to good governance, transparent disclosure and a productive dialogue with our shareholders regarding our executive compensation program. The Committee considers the risks associated with our compensation policies and practices and is comfortable that they are not likely to have a material adverse effect on Hudbay.
Our Audit Committee has been tasked by the Board with overseeing our Enterprise Risk Management program. As part of this program, key risks that could impact us are identified and assessed, and mitigation plans are put in place. Succession planning, recruitment and retention have been identified as key risks and the Compensation and Human Resources Committee receives quarterly updates on the risk drivers and mitigation plans in respect of these risks.
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Clawback Policy
The Board has adopted an incentive-based compensation clawback policy ( a `` clawback policy '') to further align the interests of management and our shareholders, as follows:
Element
Our Policy
Incentive-Based Compensation subject to Clawback
Eligible Executive Officers
Lookback Period
Excess Incentive-Based Compensation
Triggering Events
•materially non-compliant financial Statements; or
•if the Board determines in its sole discretion that the Executive Officer has been involved in any wrongful act
Equity Ownership Guidelines
To align executive and shareholder interests, the Board has established a policy that requires executives to own a minimum number of Hudbay shares and share units, as follows:
Element
Our Policy
Ownership Requirement
Units Counted and Basis of Valuation
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Timeframe to meet Ownership Requirement
Equity ownership guidelines also apply to our directors, as described under `` Director Compensation '' below.
Our current NEOs ' progress in meeting our share ownership guidelines as at March 15, 2022 is shown in the following table:
1.Includes the grant date value of share units held and the acquisition value of Hudbay Shares held. In the case of Mr. Kukielski, the total under `` Share Units '' includes deferred share units that he was awarded prior to his appointment as permanent CEO in early 2021 and the total under `` Hudbay Shares '' excludes those shares directly or indirectly owned by his wife.
2.Mr. Meagher resigned as of January 4, 2022 and is not included in this table.
COMPONENTS OF HUDBAY 'S EXECUTIVE COMPENSATION PROGRAM
Summary of Elements of Executive Compensation
The following table provides a summary of the key elements of our executive compensation program, which we believe form an appropriate mix of compensation:
Compensation Element
Description and Rationale
Fixed Compensation
Base Salary
Retirement Benefits
Variable Compensation
Short-Term Incentive Plan ( STIP)
Long-Term Incentive Plan ( LTIP)
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Other
Employee Share Purchase Plan
Perquisites and Other Benefits
Base Salary
The Committee believes that our executives ' base salaries must be sufficiently competitive to enable recruitment and encourage retention. However, reflecting our emphasis on variable and at-risk compensation, our executives ' base salaries remain a relatively low portion of their overall total direct compensation. The Committee generally targets our NEOs ' base salaries at the median of the comparator group.
In February 2022, the Board approved a 3.0% increase in base salary for Messrs. Kukielski, Douglas and Donnelly, and 4.0% for Mr. Lei. This range of increases is consistent with the increases provided to the broader employee base depending on their positioning against market comparators.
1.Mr. Meagher resigned as of January 4, 2022 and is not included in this table.
Short-Term Incentive Plan ( STIP)
The STIP is an annual cash bonus based on a combination of corporate and individual performance throughout the year. Target STIP awards are denominated as a percentage of base salary and actual awards can range from 0% of target for performance outcomes that fall significantly below expectations to 200% of target for superior performance.
Corporate performance in a given year is measured using our Corporate Scorecard, as described in more detail below. Our CEO's annual STIP award is based 80% on corporate performance and 20% on individual performance. In previous years, our CEO's STIP was based entirely on the corporate score, given the CEO's responsibility for all aspects of corporate performance. Starting in 2020, the Committee added an individual component worth 20% of the CEO's STIP in order to be more consistent with market practice and to facilitate tracking and assessment of individual KPIs for Mr. Kukielski.
Before 2020, our non-CEO NEOs ' STIP was based 60% on corporate performance and 40% on individual performance. This was adjusted to 70% corporate and 30% individual starting with the 2020 STIP grant in order to be consistent with market practice. Individual performance is assessed each year by the Committee, in consultation with the CEO. A summary of our NEOs ' individual performance assessments can be found in `` Determination of 2021 Individual Performance Scores ''.
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2021 Corporate Scorecard
At the start of each year, the Board, upon the recommendation of the Committee, adopts the Corporate Scorecard, which sets forth key performance objectives that guide and motivate our executives as they carry out Hudbay's strategy over the course of the year. Performance is monitored throughout the year and, at year-end, the Committee assesses the Company's performance against each scorecard objective and considers all relevant factors, both positive and negative. While the Committee retains discretion to ensure that scorecard results are fair, they use this discretion cautiously and, where practical, use scorecard metrics that are objectively measurable so the use of discretion can be minimized.
Our 2021 corporate scorecard included performance categories based on operational, ESG, financial and growth/strategic performance. By early 2021, the individual health risks from COVID-19 were reduced thanks to extensive safety protocols and the rollout of vaccines to our employees and contractors. However, the pandemic continued to cause significant disruption to our workforce availability and supply chain. The challenges were largely outside of management's control. Nonetheless, the Company's performance remained strong and there was minimal impact to our operations and pursuit of strategic and growth initiatives. In light of this the Committee did not apply discretion to adjust the scores in any category of the corporate scorecard to reflect impacts of COVID-19.
The company's strongest performance was in categories reflecting operating cash flow, community relations, reserves and resources, and exploration. Our performance against the operating metrics was impacted by results that fell outside of the guidance ranges for zinc, gold and silver production in Manitoba, and our operating costs in Peru. Unfortunately, in 2021 we suffered our first fatality in many years, which resulted in a zero score being attributed for Manitoba safety performance.
The overall score in our corporate scorecard for 2021 was 113/100, which the Committee believes appropriately reflects the Company's strong overall performance in 2021, especially in light of the challenges posed by COVID-19. The 2021 Corporate Scorecard and the key factors that influenced the scores in each performance category are set forth below.
1.Cost Performance is based upon the Company's Combined Unit Operating Costs per tonne of ore. Combined Unit Cost is a non-IFRS financial performance measure with no standardized definition under IFRS. For further information and a detailed reconciliation of the Company's Combined Unit Costs, please see the discussion under the heading `` Non-IFRS Financial Performance Measures '' on page 56 of Company's management's discussion and analysis of results of operations and financial condition for the year ended December 31, 2021 dated February 23, 2022, copies of which are available on SEDAR.
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To be assessed subjectively, including the following considerations: • Outcome of Rosemont appeal • Outcome of 404 jurisdictional determination • Public disclosure of private land plan • Complete /significant advancement of strategic joint venture
Significant increase to Rosemont's consensus analyst NAV
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Long-Term Incentive Plan ( LTIP)
Overview of Design
As stated in our compensation philosophy, the Committee believes that long-term, equity-based compensation should form a significant portion of our NEOs ' overall compensation in order to provide a strong link between compensation, performance and total shareholder returns.
The Compensation and Human Resources Committee oversees our LTIP with the objective of ensuring the alignment of our LTIP outcomes with the shareholder experience and our mid- to long-term performance and strategic goals. Our LTIP design includes a mix of equity incentives for our NEOs involving PSUs, RSUs and share options ( `` options '').
For the grant made to our NEOs in February 2021 ( and February 2020), the percentage of the overall grant allocated to each of these LTIP vehicles was as follows:
Performance Share Units ( `` PSUs '')
Restricted Share Units ( `` RSUs '')
Options
LTIP awards are granted at a target value, being a percentage of base salary determined by the Board. The award is then multiplied by the percentage of the overall LTIP grant allocated to PSUs, RSUs, and options, then divided by ( in the case of PSUs and RSUs) the share price at the time of grant, or ( in the case of options) the price of an option at the time of grant ( as determined by the Committee using a Black-Scholes valuation methodology). An example of how the target LTIP grant applies to Mr. Kukielski's 2021 award is as follows:
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Mr. Kukielski's 2021 Compensation
$ 912,900
Mr. Kukielski's 2021 Base Salary
250%
( $ 2,282,250)
Mr. Kukielski's 2021 Target LTIP Grant as a% of Base Salary
50%
Target PSU Mix of LTIP
Share Price at Date of Grant:
$ 10.04
Target PSU Grant Size:
113,658 units
x
x
25%
Target RSU Mix of LTIP
÷
=
Target RSU Grant Size:
56,829 units
25%
Target Option Mix of LTIP
Option Price at Date of Grant:
$ 6.06
Target Option Grant Size:
94,152 units
Performance Share Units
PSUs are notional units that are redeemable for a Hudbay common share or a cash amount equal to the value of a common share at the vesting date. PSUs will vest at the end of three years. The units are subject to performance and vesting conditions such that all units will be forfeited if a threshold level of performance is not met. Conversely, additional units will be granted ( to a maximum of 200% of the initial grant) if performance over the three-year vesting period is above the target. The performance conditions are based ( as to 75% of the PSUs) on total shareholder return compared to a peer group ( Relative TSR) and ( as to 25%) return on invested capital ( ROIC). The Committee believes that the use of Relative TSR and ROIC in the PSUs will align pay outcomes with the shareholder experience and encourage effective capital allocation.
Relative TSR Multiplier ( 75% of PSUs)
The number of PSUs that vest is determined in part by reference to total shareholder return ( `` Hudbay TSR '') generated by the Company over the performance period, as compared to a peer group ( the `` Performance Peer Group ''). The Performance Peer Group consists of the following base metals mining issuers:
2021 Performance Peer Group
Antofagasta plc
Capstone Mining Corp.
Copper Mountain
Ero Copper Corp.
First Quantum Minerals Ltd.
Freeport McMoran
Imperial Metals Corporation
Lundin Mining Corporation
Nexa Resources S.A.
Oz Minerals Limited
Taseko Mines
Teck Resources
Turquoise Hill Resources Ltd.
2022 MANAGEMENT INFORMATION CIRCULAR |65
The Relative TSR multiplier will be calculated over the performance period with reference to both the annual Relative TSR and a three-year cumulative Relative TSR, on a combined basis as follows:
The calculation of the Hudbay TSR and the peer group TSR will include the appreciation of the price of the respective shares along with payments of dividends and other returns of value.
The Relative TSR Multiplier for a specific period is calculated as follows, linearly interpolated for performance between the specified levels:
Performance Level
Performance Objective
Relative TSR Multiplier
Maximum
Hudbay TSR is 25% or more above the median TSR of the Performance Peer Group
200%
Target
Hudbay TSR is equal to the median TSR of the Performance Peer Group
100%
Minimum
Hudbay TSR is 25% or more below the median TSR of the Performance Peer Group
0%
Return on Invested Capital ( ROIC) Multiplier ( 25% of PSUs)
ROIC is determined by way of a single three-year average, calculated as follows:
ROIC =
Σ ( 3 years of Adjusted NOPAT)
/ 3
13-quarter average Invested Capital
Where `` Adjusted NOPAT '' is equal to:
Net Income ( loss) for the year
Add: tax expense, less cash taxes paid
Add: net finance expense
Add: exploration expense
Adjust for: impairment losses/reversals ( in the discretion of the Committee)
Adjust for: other gains/losses and non-recurring items ( in the discretion of the Committee)
and `` Invested Capital '' is equal to:
Property, plant & equipment
Add: goodwill on depreciable assets
Subtract: exploration and evaluation assets
Subtract: capital works in progress
Add: current assets
Subtract: current liabilities
Subtract: cash and short-term investments
The ROIC Multiplier for a specific period shall be calculated as follows:
Performance Level
Performance Objective
ROIC Multiplier
Maximum
Hudbay's ROIC is equal to or greater than 10%
200%
Target
Hudbay's ROIC is equal to 6.5%
100%
Threshold
Hudbay's ROIC is equal to 5%
50%
Minimum
Hudbay's ROIC is less than 5%
0%
66| 2022 HUDBAY MINERALS INC.
The ROIC Multiplier will be linearly interpolated for amounts between ( a) 5% and 6.5%, and ( b) 6.5% and 10%. Targets were set with reference to current and past performance and a view to improve return on invested capital. The targets will be reviewed each year.
Restricted Share Units
Restricted Share Units are like PSUs in that they are notional units that are redeemable for a Hudbay common share or a cash amount equal to the value of a common share at the vesting date. However, they are not subject to performance conditions that can increase or decrease the number of units that vest. Instead, the only vesting condition is time in that the units vest at the end of three years provided the recipient remains employed by the Company at the time of vesting.
Options
Share options are widely used as a minority component in an LTIP program, both among our mining peers and among TSX60 issuers. The Committee believes using share options as a balanced component of the LTIP mix will support the attraction and retention of members of the executive and broader management team.
The options vest in equal installments over three years and will remain exercisable for seven years.
The PSUs and RSUs granted in early 2021 were granted under Hudbay's Long-Term Equity Plan and the options were granted under our Share Option Plan. Summaries of these plans are included at Schedule `` B ''.
2022 LTIP Grant
For the LTIP grant made to our NEOs in February 2022, the grants involved the same blend of PSUs, RSUs and options as were issued in 2021, in each case with the same terms as in 2021.
Other Compensation and Perquisites
Retirement Benefits
In addition to rewarding employees for long service to Hudbay, the Committee recognizes that retirement benefits are required to make our compensation program competitive. For details on our retirement plans, see `` Description of Pension Plans ''.
Employee Share Purchase Plan
We maintain an Employee Share Purchase Plan ( `` ESPP '') for our executives and other eligible employees. Pursuant to the ESPP, participants may contribute between 1% and 10% of their pre-tax base salary to acquire Hudbay shares, which are acquired through open-market purchases. We make a matching contribution of 75% of the participant's contribution, one-third of which is immediately applied toward the tax withholding obligation on our contribution. Shares purchased with our contribution may not be sold for 12 months and participants are subject to further restrictions on the number of transactions they may make and changes in their elected contribution.
Perquisites and Other Benefits
Perquisites and other benefits are intentionally limited and may include fitness memberships, comprehensive medical examinations, life and accident insurance, parking and other subsidies and entitlements for executives who relocate at Hudbay's request.
2022 MANAGEMENT INFORMATION CIRCULAR |67
CEO COMPENSATION
2021 Compensation
Mr. Kukielski's target compensation as President and CEO was set with reference to the median compensation paid to the CEOs in our compensation benchmarking group. The actual total direct compensation received by Mr. Kukielski in respect of 2021 is shown in the table below:
Name
Base Salary
Target STIP
(%)
Target LTIP
(%)
Combined Performance Score
Actual STIP
( $)
LTIP Value
( $)
Actual Total Direct Compensation
Peter Kukielski
$ 912,900
120%
250%
113.4%
$ 1,242,274
$ 2,282,250
$ 4,437,424
1.Mr. Kukielski's actual STIP award is based on his weighted average performance score, being 20% individual and 80% corporate. Mr. Kukielski's weighted average performance score for 2021 STIP was 113.4%
2.The LTIP value is comprised of 50% PSUs, 25% RSUs and 25% Options, as described in `` 2021 CEO LTIP Award '', below.
80% of our CEO's STIP is based on the corporate score, with 20% based on his individual performance. For 2021, Mr. Kukielski's objectives focused on enhancing investor relations, reviewing strategy, advancing ESG initiatives and enhancing our company culture. His performance against these individual performance objectives was assessed as 115/100 which, when combined with the corporate performance score, resulted in a combined score of 113.4%.
The factors underlying Mr. Kukielski's performance score are as follows:
Name
Individual Performance Scores
Decision Factors
Peter Kukielski
115/100
68| 2022 HUDBAY MINERALS INC.
2021 CEO STIP Award
The following table shows the target and actual STIP awarded to Mr. Kukielski with respect to his 2021 performance.
Name ( 1)
2021 Base Salary
2021 Target STIP
Annual Performance Score
Weighted Average Performance Score
2021 STIP Award
% of Base Salary
Target STIP $
Corporate Performance Score
( 80%)
Individual Performance Score
( 20%)
[ A ]
[ B ]
[ C ] = [ A ] x [ B ]
[ D ]
[ C ] x [ D ]
Peter Kukielski
$ 912,900
120%
$ 1,095,480
113%
115%
113.4%
$ 1,242,274
2021 CEO LTIP Award
The table below shows the forward-looking LTIP grant made to Mr. Kukielski in early 2021 as part of his 2021 compensation.
Name
2021
Base Salary
Target LTIP
Amount of Target Allocated to PSUs
Amount of Target Allocated to RSUs
Amount of Target Allocated to Options
# PSUs Granted
# RSUs Granted
# Options Granted
% of Base Salary
Target LTIP ( $)
[ A ]
[ B ]
[ C ] = [ A ] x [ B ]
Peter Kukielski
$ 912,900
250%
$ 2,282,250
$ 1,141,125
$ 570,563
$ 570,563
113,658
56,829
94,152
1.The unit price to determine the number of RSUs and PSUs granted was $ 10.04 and was based on the trailing five-day average price of the Hudbay Shares.
2.The unit price to determine the number of options granted was $ 6.06 and was based upon a Black-Scholes valuation methodology. The exercise price of the options is $ 10.42 per share.
COMPENSATION OF NON-CEO NEOS
2021 Target Total Direct Compensation
The table below shows the target total direct compensation for Messrs. Douglas, Meagher, Lei, and Donnelly for 2021.
Name
Base Salary
Target STIP
(%)
Target Total Cash Compensation
Target LTIP
(%)
Target Total Direct Compensation
Steve Douglas
$ 612,000
90%
$ 1,162,800
170%
$ 2,203,200
Cashel A. Meagher
$ 612,000
90%
$ 1,162,800
170%
$ 2,203,200
Eugene Lei
$ 473,821
80%
$ 852,878
150%
$ 1,563,609
Patrick Donnelly
$ 441,515
70%
$ 750,576
120%
$ 1,280,394
2022 MANAGEMENT INFORMATION CIRCULAR |69
Determination of 2021 Individual Performance Scores
The individual performance score for each of our non-CEO NEOs is weighted at 30% of their overall annual performance score. For 2021 ( and 2020), the Committee reduced the individual component of the STIP from 40% to 30% to reflect market practice and in recognition of the impact our senior executives can have on overall corporate performance. In determining individual performance scores, the Committee considers recommendations made by the CEO with reference to key elements of their performance within their respective areas of responsibility.
The table below shows the individual performance score of each non-CEO NEO, as well as the decision factors that were considered by the Committee in determining such scores. Mr. Meagher resigned effective January 4, 2022. His STIP payment in respect of 2021 was assessed at 100% of his target given the corporate score and his individual performance had not yet been assessed at the time of his departure.
Name
Individual Performance Scores
Decision Factors
Steve Douglas
110/100
Eugene Lei
125/100
Patrick Donnelly
125/100
70| 2022 HUDBAY MINERALS INC.
2021 STIP Award
The non-CEO NEOs ' STIP award is based 70% on the corporate performance score and 30% on individual performance. The following table shows the actual STIP awarded to Messrs. Douglas, Meagher, Lei and Donnelly with respect to their 2021 performance.
Name ( 1)
2021 Base Salary
2021 Target STIP
Annual Performance Score
Weighted Average Performance Score
2021 STIP Award
% of Base Salary
Target STIP ( $)
Corporate Performance Score ( 70%)
Individual Performance Score ( 30%)
[ A ]
[ B ]
[ C ] = [ A ] x [ B ]
[ D ]
[ C ] x [ D ]
Steve Douglas
$ 612,000
90%
$ 550,800
113%
110%
112.1%
$ 617,447
Cashel A. Meagher ( 1)
$ 612,000
90%
$ 550,800
100%
100%
100%
$ 550,800
Eugene Lei
$ 473,821
80%
$ 379,057
113%
125%
116.6%
$ 441,980
Patrick Donnelly
$ 441,515
70%
$ 309,061
113%
125%
116.6%
$ 360,364
1.Mr. Meagher resigned effective January 4, 2022. His STIP for 2021 was assessed at 100% of target given the corporate score and his individual performance had not yet been assessed at the time of his departure.
2021 LTIP Awards
While the STIP payment made to our senior executives was made in early 2022, it is based on achievement of corporate and individual performance objectives in 2021 and therefore is considered compensation in respect of 2021. LTIP grants on the other hand are forward-looking, in that they are meant to encourage performance over the period in which the grant remains outstanding. As a result, the LTIP grant made to our executives in early 2021 is considered to be 2021 compensation.
Name
2021 Base Salary
Target LTIP
Amount of Target Allocated to PSUs
Amount of Target Allocated to RSUs
Amount of Target Allocated to Options
# PSUs Granted
# RSUs Granted
# Options Granted
% of Base Salary
Target LTIP ( $)
[ A ]
[ B ]
[ C ] = [ A ] x [ B ]
Steve Douglas
$ 612,000
170%
$ 1,040,400
$ 520,200
$ 260,100
$ 260,100
51,813
25,906
42,921
Cashel A. Meagher
$ 612,000
170%
$ 1,040,400
$ 520,200
$ 260,100
$ 260,100
51,813
25,906
42,921
Eugene Lei
$ 473,821
150%
$ 710,731
$ 355,366
$ 177,683
$ 177,683
35,395
17,697
29,321
Patrick Donnelly
$ 441,515
120%
$ 529,818
$ 264,909
$ 132,454
$ 132,454
26,385
13,193
21,857
1.The unit price to determine the number of RSUs and PSUs granted was $ 10.04 and was based on the trailing five-day average price of the Hudbay shares.
2.The unit price to determine the number of options granted was $ 6.06 and was based upon a Black-Scholes valuation methodology. The exercise price of the options is $ 10.42 per share.
3.Mr. Meagher resigned as of January 4, 2022 and forfeited his LTIP award.
2022 MANAGEMENT INFORMATION CIRCULAR |71
2021 Total Direct Compensation
The table below shows the actual total direct compensation for Messrs. Douglas, Meagher, Lei, and Donnelly for 2021.
Name
2021 Base Salary
Actual STIP
Total Cash Compensation
LTIP Value
( $)
Total Direct Compensation
Steve Douglas
$ 612,000
$ 617,447
$ 1,229,447
$ 1,040,400
$ 2,269,847
Cashel A. Meagher
$ 612,000
$ 550,800
$ 1,162,800
$ 1,040,400
$ 2,203,200
Eugene Lei
$ 473,821
$ 441,980
$ 915,801
$ 710,731
$ 1,626,532
Patrick Donnelly
$ 441,515
$ 360,364
$ 801,879
$ 529,818
$ 1,331,697
1.The LTIP value is comprised of 50% PSUs, 25% RSUs and 25% Options, as described in `` 2021 LTIP Awards '', above.
Compensation Changes for 2022
For 2022, the Board approved a 3.0% increase in base salary for Messrs. Kukielski, Douglas and Donnelly, and 4.0% for Mr. Lei, all of which were in line with increases provided to the broader employee base, depending on their positioning against benchmarks. There were no changes to the NEO's target STIP or LTIP.
72| 2022 HUDBAY MINERALS INC.
PERFORMANCE GRAPHS
Shareholder Experience
The following graph compares the yearly percentage change in the cumulative total shareholder return on the Toronto Stock Exchange for $ 100 invested in Hudbay Shares on December 31, 2016 against the cumulative total shareholder return of the S & P/TSX Composite Index, relative year-over-year changes in copper price, and the median performance of a custom index consisting of the following peers: Antofagasta, Capstone Mining, Copper Mountain, Ero Copper, First Quantum, Freeport McMoRan, Imperial Metals, Lundin Mining, Nexa Resources, Oz Minerals, Taseko Mines, Teck Resources and Turquoise Hill.
( in Cdn. $)
2016
2017
2018
2019
2020
2021
Hudbay Minerals Inc. ( TSX)
100
145
85
71
118
121
S & P/TSX Composite Index
100
109
99
122
129
161
Custom Group ( median performance)
100
132
80
87
189
228
Copper Price ( USD)
100
130
108
111
140
176
The trend shown in this graph is generally consistent with the realized and realizable compensation of our executive officers over the same period, as the value of LTIP awards is directly linked to our share price performance. In addition, in 2017, 2020 and 2021, we achieved positive total shareholder returns and the corporate score used to determine our executives ' STIP and, in the case of 2017, LTIP awards was 104%, 127% and 113%, respectively. In 2018 and 2019 we had negative total shareholder returns and our corporate score for those years was below target - 93.5% and 81% respectively - thereby reducing the target STIP and LTIP that would have otherwise been awarded in respect of those years.
2022 MANAGEMENT INFORMATION CIRCULAR |73
Executive Compensation Tables
Summary Compensation Table
The following table shows the compensation received in or in respect of the financial years ended December 31, 2021, 2020 and 2019 by each of the NEOs. In the annual incentive plan column of our Summary Compensation Table, the awards disclosed for 2021, 2020 and 2019 are the STIP amounts approved by the Board and awarded in early 2022, 2021 and 2020, respectively, in respect of the prior year's performance.
As described above under `` Long-Term Incentive Plan ( LTIP) '', following the changes to our LTIP design in early 2020, LTIP awards are granted at their target value and the ultimate value to be realized from LTIP awards is based entirely on the Company's future performance, starting in the grant year. As such, the `` Share-based awards '' and `` Option awards '' in the Summary Compensation Table for 2020 and 2021 represent the grant date value of the RSUs and PSUs ( in the case of share-based awards) and share options ( in the case of option awards) that were granted in February 2020 and February 2021, respectively, and are considered part of each NEO's 2020 and 2021 compensation.
Prior to 2020, LTIP awards were granted exclusively in the form of RSUs and the target value of the grant was adjusted upwards or downwards based on the same corporate and individual performance score that was used to determine the NEO's STIP award in respect of that year, as well as a modifier based on our total shareholder returns. To align with our current LTIP design and approach to executive compensation, the 2019 `` Share-based awards '' disclosed in this Summary Compensation Table reflect the grant date value of the RSU awards made to our NEOs in early 2019, notwithstanding that those awards were affected by the prior year's performance ( i.e., 2018) and may be considered compensation in respect of the prior year. Although this is an imperfect comparison, management believes it provides the best view of the overall compensation received by our senior executives on a year over year basis.
Name and principal position
Year
Salary ( $)
Share- based awards ( 5) ( $)
Option awards ( $)
Non-equity incentive plan compensation
Pension Value ( 1) ( $)
All other compensation ( 2) ( $)
Total compensation ( $)
Annual incentive plan ( $)
Long-term incentive plan ( $)
Peter Kukielski
President and CEO ( 6)
2021
2020
2019
912,900
896,860
444,135
1,711,688
1,678,125
-
570,563
559,375
-
1,242,274
1,370,424
-
-
-
-
109,548
102,973
-
123,178
600,411
578,010
4,670,151
5,208,168
1,022,145
Steve Douglas
Senior Vice President and CFO ( 3)
2021
2020
2019
612,000
302,275
-
780,300
765,000
-
260,100
255,000
-
617,447
341,850
-
-
-
-
73,440
36,273
-
76,370
25,776
-
2,419,657
1,726,174
-
Cashel A. Meagher
Senior Vice President and COO ( 4)
2021
2020
2019
612,000
596,500
581,950
780,300
760,536
919,890
260,100
253,512
-
550,800
670,525
505,947
-
-
-
176,734
170,060
151,531
145,397
102,322
54,752
2,525,331
2,553,455
2,214,070
Eugene Lei
Senior Vice President, Corporate Development and Strategy
2021
2020
2019
473,821
464,530
453,200
533,048
452,917
547,816
177,683
150,972
-
441,980
475,307
357,484
-
-
-
160,257
163,401
130,240
108,758
169,967
58,119
1,895,547
1,877,094
1,546,859
Patrick Donnelly
Vice President and General Counsel
2021
2020
2019
441,515
432,860
422,300
397,363
389,572
453,093
132,454
129,857
-
360,364
382,992
291,471
-
-
-
110,967
120,506
108,257
72,068
80,502
39,657
1,514,731
1,536,289
1,314,778
1.Mr. Kukielski was not entitled to a pension while serving as Interim CEO. He became entitled to pension benefits when he was appointed President and CEO on January 22, 2020 and participates in the Company's defined contribution pension plan.
2.None of the NEOs received perquisites in 2021 that in the aggregate amounted to greater than $ 50,000. Only Mr. Kukielski, received perquisites in 2020 that in the aggregate amounted to greater than $ 50,000. Mr. Kukielski received the following perquisites during 2020 in connection with his appointment as permanent CEO which totaled C $ 238,190.41: relocation payments, relocation costs and life and long-term disability insurance. Mr. Kukielski and his spouse enjoyed the following perquisites during 2019 while Mr. Kukielski was serving as Interim CEO, which totaled C $ 73,850.18: life and long-term disability insurance, furnished accommodation and hotels in Toronto and return travel to and from their former home in Vancouver. In addition to perquisites, amounts in this column include vacation pay, company contributions under our Employee Share Purchase Plan, and the payment of dividend equivalents on share units held by the NEOs. In the case of Mr. Kukielski, the amount in this column also includes the DSU compensation he received in his capacity as an independent director and interim CEO up to January 22, 2020 and the additional DSUs he received in 2020 worth $ 250,138 upon being appointed permanent CEO. In the case of Mr. Lei, the amount in this column also includes the $ 100,000 in compensation he received for acting as interim CFO in 2020 prior to the appointment of Mr. Douglas.
74| 2022 HUDBAY MINERALS INC.
3.Mr. Douglas was appointed Senior Vice President and Chief Financial Officer effective June 30, 2020. Upon hiring, Mr. Douglas received share-based awards and options as part of his 2020 LTIP grant dated June 30, 2020.
4.Mr. Meagher resigned as Senior Vice President and Chief Operating Officer as of January 4, 2022.
5.Share-based awards represent RSUs and PSUs in respect of 2021 and 2020 and RSUs only in respect of 2019. PSUs are subject to a multiplier based on future performance as discussed under `` Long Term Incentive Plan ( LTIP) ''.
6.Mr. Kukielski's salary in 2020 includes $ 55,000, representing the pro-rated monthly compensation he received as interim CEO up to January 22, 2020 when he was appointed permanent CEO, and the pro-rated amount of his annual salary as CEO for the remainder of 2020.
Incentive Plan Awards
The following table provides information regarding the incentive plan awards for each NEO outstanding as of December 31, 2021.
Outstanding Option-based Awards and Share-based Awards
Name
Grant Date
Option-based Awards
Share-based Awards
Number of securities underlying unexercised options
( #) ( 3)
Option exercise price
( $)
Option expiration date
Value of unexercised in-the-money options
( $) ( 1)
Number of shares or units of shares that have not vested ( #) ( 2) ( 7)
Market or payout value of share-based awards that have not vested
( $) ( 1) ( 7)
Market or payout value of vested share- based awards not paid out or distributed
( $)
Peter Kukielski ( 6)
25-Feb-2021
94,152
10.42
25-Feb-2028
Nil
113,658 PSUs
$ 1,561,661
-
+ 56,829 RSUs
170,487 SUs
25-Feb 2020
184,612
3.76
25-Feb-2027
$ 996,905
281,093 PSUs
$ 3,862,213
-
+ 140,546 RSUs
421,639 SUs
Steve Douglas ( 7)
25-Feb-2021
42,921
10.42
25-Feb-2028
Nil
51,813 PSUs
$ 711,906
-
+ 25,906 RSUs
77,719 SUs
30-Jun 2020
123,188
3.92 ( 4)
25-Feb-2027
$ 645,505
127,393 PSUs
$ 1,762,787
-
+ 65,051 RSUs
192,444 SUs
Cashel Meagher ( 5)
25-Feb-2021
42,921
10.42
25-Feb-2028
Nil
51,813 PSUs
$ 711,906
-
+ 25,906 RSUs
77,719 SUs
25-Feb 2020
83,668
3.76
25-Feb-2027
$ 451,807
103,102 PSUs
$ 1,775,199
-
+ 63,697 RSUs
193,799 SUs
Eugene Lei
25-Feb-2021
29,321
10.42
25-Feb-2028
Nil
35,395 PSUs
$ 486,323
-
+ 17,697 RSUs
53,092 SUs
25-Feb 2020
74,739
3.76
25-Feb-2027
$ 403,591
75,865 PSUs
$ 1,042,390
-
+ 37,933 RSUs
113,798 SUs
Patrick Donnelly
25-Feb-2021
21,857
10.42
25-Feb-2028
Nil
26,385 PSUs
$ 362,534
-
+ 13,193 RSUs
39,578 SUs
25-Feb 2020
42,858
3.76
25-Feb-2027
$ 231,433
65,255 PSUs
$ 896,599
-
+ 32,627 RSUs
97,882 SUs
1.Based on the closing price of Hudbay Shares on the Toronto Stock Exchange of $ 9.16 on December 31, 2021.
2.Reflects the number of PSUs and RSUs that have not vested. The actual number of PSUs that vest on the applicable entitlement date may be greater or less than the number presented in this table based on the multiplier effect described in this CD & A. Excludes the share units that vested on December 31, 2021. `` SUs '' refer to share units, being the sum of PSUs and RSUs.
2022 MANAGEMENT INFORMATION CIRCULAR |75
3.Excludes options which have been exercised.
4.Mr. Douglas ' options granted effective June 30, 2020 have an exercise price of $ 3.92.
5.Mr. Meagher forfeited any outstanding options and share units when he resigned on January 4, 2022.
6.In the case of Mr. Kukielski, this excludes the value of vested DSUs he was awarded prior to his appointment as permanent CEO.
7.With respect to the award granted on February 25, 2020 to Messrs. Kukielski, Meagher, Lei and Donnelly, the PSUs and RSUs, which cliff vest in three years, will vest on February 25, 2023. The PSUs and RSUs awarded on February 25, 2021 will cliff vest in three years on February 25, 2024. With respect to Mr. Douglas ' June 30, 2020 award grant, his PSUs and RSUs will vest on June 30, 2023.
Incentive Plan Awards Vested, Earned or Realized in 2021
The following table provides information regarding the value on pay-out or vesting of incentive plan awards for the financial year ended December 31, 2021.
Name
Value vested during the year ( $)
Non-equity incentive plan compensation - Value earned during the year ( 1) ( $)
Value vested and value earned during the year ( $)
Total Share- Based Awards ( 2)
Options ( 3)
Peter Kukielski
-
$ 554,759
$ 1,242,274
$ 1,797,033
Steve Douglas
-
$ 177,801
$ 617,447
$ 795,248
Cashel A. Meagher
$ 949,383
$ 251,420
$ 550,800
$ 1,751,603
Eugene Lei
$ 565,380
$ 149,727
$ 441,980
$ 1,157,087
Patrick Donnelly
$ 467,620
$ 128,786
$ 360,364
$ 956,770
1.Represents the annual STIP awarded in respect of 2021.
2.Represents the 2019 RSUs awarded in the LTIP grant that vested on December 31, 2021, based on the closing price of Hudbay Shares on the Toronto Stock Exchange of $ 9.16. RSUs were the only share unit awarded as part of the 2019 LTIP grant.
3.The amount represents the aggregate dollar value that would have been realized if the options had been exercised on the vesting date, based on the difference between the closing price of Hudbay Shares on the Toronto Stock Exchange on the vesting date and the exercise price. The vesting date for one third of the 2020 options that were granted to Messrs. Kukielski, Meagher, Lei and Donnelly's was February 25, 2021 where the closing price was $ 9.77 and the exercise price was $ 3.76. For Mr. Douglas, the vesting date for one third of his 2020 grant of Options was June 30, 2021 where the closing price was $ 8.25 and the exercise price was $ 3.92.
76| 2022 HUDBAY MINERALS INC.
Pension Plan Benefits: Defined Benefit Plan
Name ( 1)
Number of years credited service ( #)
Annual benefits
Opening present value of defined benefit obligation ( $)
Compensatory change ( $)
Non- Compensatory change ( $)
Closing present value of defined benefit obligation ( $)
At year end ( $)
At age 65 ( $)
Peter Kukielski
-
-
-
-
-
-
-
Steve Douglas
-
-
-
-
-
-
-
Cashel A. Meagher ( 2)
13.1
150,631
150,631 ( 3)
2,790,151
176,734
( 1,236,674)
1,730,211
Eugene Lei
9.3
81,899
271,520
1,609,777
148,138
( 210,784)
1,547,131
Patrick Donnelly
13.1
107,563
232,939
1,969,922
110,967
( 190,138)
1,890,138
1.The Company's defined benefit plan was previously closed to new entrants. As such, Messrs. Kukielski and Douglas participate in the Company's defined contribution plan, as described below.
2.Mr. Meagher resigned as Senior Vice President and Chief Operating Officer effective January 4, 2022.
3.As a result of Mr. Meagher's resignation, his projected pension to age 65 is equal to the accrued benefit as at December 31, 2021 as no future accrual beyond the date of resignation is expected.
Defined Contribution Plans ( 1) ( 2)
Name
Accumulated value at start of year ( $)
Compensatory change in value ( $)
Non-Compensatory change in value ( $)
Accumulated value at year end ( $)
Peter Kukielski
106,718
109,458
8,824
225,109
Steve Douglas
38,170
73,350
9,087
120,697
Cashel A. Meagher
-
-
-
Eugene Lei
76,743
12,119
1,017
89,879
Patrick Donnelly
-
-
-
1.NEOs may make a one-time irreversible election to receive all or a portion of their future annual incentive bonuses as supplementary pension credits under the supplemental pension plan - see `` Summary of Elements of Executive Compensation - Retirement Benefits. '' The amounts included for Mr. Lei represent the compensatory change in value in respect of the amount of his annual incentive bonus that he has elected to receive as a supplementary pension credit.
2.For Messrs. Kukielski and Douglas, this represents their pension benefits under the defined contribution plan, known as the MPP, including top-up amounts credited to a supplemental plan in respect of employer contributions that exceed the statutory maximum. See `` Summary of Elements of Executive Compensation - Retirement Benefits ''.
RETIREMENT BENEFITS - DESCRIPTION OF PENSION PLANS
Messrs. Lei and Donnelly participate in our defined benefit pension plan, which was closed to new participants in 2015. The defined benefit plan is based on 2% of the average of the member's earnings during the 36 consecutive months of continuous service within the ten-year period immediately preceding the member's retirement, death or termination of continuous service in which the highest average is attained, multiplied by the member's credited service. The benefit is normally payable at age 62 but can be paid up to 10 years earlier on a reduced basis ( reduction of 4.8% per year for each year that retirement precedes age 62). Members in the pension plan may elect to make optional ancillary contributions to the plan in order to enhance the ancillary features of their pension. The cost of additional benefits is fully paid by the member and contributions can not exceed an annual maximum of the lesser of 9% of the member's earnings, or $ 22,126 for 2021.
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The formula contains a partial offset for the Canada Pension Plan benefit. The pension is payable for life with a guaranteed period of five years. Pensions in excess of the Income Tax Act ( Canada) maximum pension limits are provided under the defined benefit component of our supplemental pension plan. Our defined benefit plan has been closed off to new entrants and all new non-unionized employees and executives in Canada participate in our defined contribution pension plan.
Mr. Kukielski, and Mr. Douglas participate in our Money Purchase Plan ( `` MPP ''), a defined contribution pension plan. Under the MPP, they receive an annual employer contribution equal to 12% of their base salaries. The MPP does not permit voluntary contributions by executives. When the statutory annual maximum contribution is reached, the balance of the employer contribution is credited to a notional account that is indexed to actual fund performance and secured by a letter of credit.
NEOs may also make a one-time irreversible election to reduce their eligibility to participate in all or a portion of the annual incentive bonus plan ( STIP) in exchange for eligibility for supplementary pension credits under the defined contribution component of our supplemental pension plan. Supplementary pension credits are determined and awarded at the same time as annual incentive bonuses. The accounts are notional accounts which are secured with a letter of credit held in trust by a financial institution. The accounts are credited with interest equal to the annual yield rate of Government of Canada marketable bonds with average yields over 10 years. We do not match or otherwise make contributions to this defined contribution component of the supplemental pension plan.
Employment Agreements
Each of our current NEOs is party to an employment agreement with our Company. The NEOs ' employment agreements establish their base salary and right to participate in our annual incentive bonus, long-term incentive, pension and benefit plans. The tables below summarize the payments and benefits to which our CEO and other NEOs are entitled under their respective employment agreements following their involuntary termination without cause, or resignation for certain specified events, defined as `` good reason '', including but not limited to a substantial change in the employment conditions or duties of the NEO that adversely affects the extent, nature or status of his responsibilities, any material reduction in the NEO's base salary, any transaction that results in a change in the status of Hudbay as a publicly-listed entity to one that is privately held, following which he is not appointed to continue in the same role, or any requirement that the NEO relocate. Under the NEOs ' employment agreements, a termination without cause following a change of control is not treated differently than a termination without cause in other circumstances.
Each of our NEOs is required by their respective employment agreements to not solicit officers, employees or agents of Hudbay for 12 months following the termination of their employment and they are also required to maintain the confidentiality of our confidential information. In addition, Messrs. Kukielski and Douglas are subject to a non-compete provision, which requires that, for six months following their voluntary or involuntary departure from the Company, neither will serve as an officer, employee, contractor or service provider to a competitor in the jurisdictions where the Company carries on business.
Termination Entitlements: CEO
Payment/Benefit
CEO's Entitlement on Termination
Salary and STIP to the date of termination
All salary earned and not paid to the date of termination, plus a prorated STIP grant at target for the period from January 1 of the year of termination to the date of termination
Base salary
24 months ' base salary
78| 2022 HUDBAY MINERALS INC.
Lump sum payment ( STIP)
An amount equal to: ( a) two times the average annual incentive bonus earned over the two most recently completed fiscal years immediately preceding the termination date, but only if he has been employed by the Company for such two year period; or ( b) two times the annual incentive bonus paid or payable for the fiscal year completed prior to the termination date, if the date of termination occurs between January 1, 2021 and December 31, 2021
Pension and benefit plans
Entitled to continue to receive benefits for 24 months ( except for those in respect of which the applicable plans do not permit ongoing participation following the termination of employment)
Vesting of equity awards
All unvested RSUs and PSUs shall become immediately vested and any previously vested options shall remain exercisable for 60 days; provided that all unvested RSUs, PSUs and options granted in respect of 2020 will vest on a prorated basis to the termination date
Termination Entitlements: Non-CEO NEOs
Payment/Benefit
NEOs ' Entitlement on Termination
Salary and STIP to the date of termination
All salary earned and not paid to the date of termination, plus a prorated STIP grant at target for the period from January 1 of the year of termination to the date of termination
Lump sum payment ( base salary)
An amount equal to 24 months ' base salary
Lump sum payment ( STIP)
Messrs. Lei and Donnelly are entitled to an amount equal to two times the average annual incentive bonus earned over the two most recently completed fiscal years immediately preceding the termination date. Mr. Douglas is entitled to a STIP severance amount which is two times the average annual incentive bonus earned over the two most recently completed fiscal years immediately preceding the termination date; unless the date of termination is between January 1, 2021 and December 31, 2021, in which case he is entitled to two times the annual incentive bonus paid or payable for the fiscal year completed prior to the termination date
Pension and benefit plans
Messrs. Douglas, Lei and Donnelly are entitled to continue to participate for 24 months or receive a lump sum payment equal to the premium contributions and pension entitlements during the 24 month period
Vesting of equity awards
Except in the case of Mr. Douglas, all unvested RSUs, PSUs and options shall become immediately vested and any vested options shall remain exercisable for 60 days. Mr. Douglas ' RSUs, PSUs and options vest on the same terms as the CEO's equity awards, as described in the table above.
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Payments on Termination
The following table provides details regarding the estimated payments to each of the NEOs as at December 31, 2021 assuming termination without cause on that date:
Name
Pro-rated STIP to Date of Termination ( $)
Severance ( Multiple of Base Salary) ( $)
Severance ( Multiple of Average Bonus) ( $)
Severance ( Value of Benefits) ( $)
Value of Immediately Vested Share Units ( $) ( 1) ( 2)
Total ( $)
Peter Kukielski
$ 1,095,480
$ 1,825,800
2,740,848 ( 3)
$ 246,520
$ 4,801,501
$ 10,710,149
Steve Douglas
$ 550,800
$ 1,224,000
683,700 ( 4)
$ 169,786
$ 2,290,120
$ 4,918,406
Cashel A Meagher ( 5)
$ 550,800
$ 1,224,000
610,663
$ 338,803
$ 3,164,810
$ 5,889,076
Eugene Lei
$ 379,057
$ 947,642
458,644
$ 219,267
$ 1,932,303
$ 3,936,913
Patrick Donnelly
$ 309,061
$ 883,030
371,678
$ 247,895
$ 1,606,278
$ 3,417,942
1.For the non-CEO NEOs other than Mr. Douglas, this represents the market value of the share unit ( RSU and PSU) awards and the `` in the money '' value of all unexercised options, in each case, granted in 2021 and 2020, based on the closing price of the Hudbay Shares on the Toronto Stock Exchange of $ 9.16 on December 31, 2021. The LTIP grant made in 2019 vested in the normal course on December 31, 2021 and is not included.
2.For Messrs. Kukielski and Douglas, this represents ( i) in the case of the 2020 LTIP grant, the market value of the prorated share unit ( RSU and PSU) awards and the `` in the money '' value of all unexercised prorated options; and ( ii) in the case of the 2021 LTIP grant, the market value of all share unit ( RSU and PSU) awards, in each case, based on the closing price of the Hudbay Shares on the Toronto Stock Exchange of $ 9.16 on December 31, 2021. This table does not include the DSUs Mr. Kukielski received for serving as an independent director and interim CEO until January 2020. The DSUs were vested at the time of grant and become payable following his departure from the Company.
3.Mr. Kukielski is entitled to a STIP severance amount which is two times the average annual incentive bonus earned over the two most recently completed fiscal years immediately preceding the termination date; unless the date of termination is between January 1, 2021 and December 31, 2021, in which case he is entitled to two times the annual incentive bonus paid or payable for the fiscal year completed prior to the termination date. The amount reflected in this table assumes termination on January 1, 2021 and a STIP severance amount equal to two times his 2021 STIP award.
4.Mr. Douglas is entitled to a STIP severance amount which is two times the average annual incentive bonus earned over the two most recently completed fiscal years immediately preceding the termination date; unless the date of termination is between January 1, 2021 and December 31, 2021, in which case he is entitled to two times the annual incentive bonus paid or payable for the fiscal year completed prior to the termination date. The amount reflected in this table assumes termination on January 1, 2021 and a STIP severance amount equal to two times his 2021 STIP award.
5.Mr. Meagher resigned as of January 4, 2022.
Double-Trigger Payment on Termination
None of our NEOs are entitled to any payments or accelerated vesting of equity based awards in a circumstance where there is a change of control and they are not terminated or they do not resign for `` good reason '', as described in more detail under `` Employment Agreements '' above. Such entitlements will only arise if their employment is terminated.
Director Compensation
Our director compensation program compensates non-executive directors ( for purposes of this section, `` Directors '') for the time and effort they are expected to devote to Company matters. Executive directors ( currently only our CEO) are compensated in their capacity as executives only and do not receive additional compensation for serving on the Board.
2021 Director Compensation
In 2021, the Committee conducted its biennial review of director compensation levels and structure. The last such review was conducted in 2019, following which our directors ' compensation was increased to bring pay levels into line with the median of the peer group ( which is the peer group used for 2021 NEO benchmarking - see `` Executive Compensation Overview - Compensation Comparator Group ''). No changes were made to our directors ' compensation following the 2021 review, as the Committee concluded Hudbay's directors were fairly paid and increases to director compensation structure were not advisable.
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The fees payable to our directors are shown in the table below:
Pay Component
Component
2021 Compensation Policy
Director Fees
Annual Cash Retainer
$ 85,000
Annual Equity Retainer
$ 116,000
Board Chair Fees
Annual Cash Retainer
$ 157,500
Annual Equity Retainer
$ 157,500
Committee Chair Retainers
Audit
$ 30,000
Compensation & HR
$ 20,000
Corporate Governance
$ 15,000
Technical
$ 25,000
EHSS
$ 15,000
Equity-based compensation for our Directors is awarded in the form of deferred share units ( DSUs). DSUs, which are granted pursuant to our Directors ' Deferred Share Unit Plan, track the value of the Hudbay Shares. DSUs are vested at the time of grant but they are not paid out until after a Director departs from the Board, at which time they are paid out in cash equal to the number of DSUs held multiplied by the price of the Hudbay Shares at the time the DSUs are paid. When dividends are paid on our Hudbay Shares, holders of DSUs receive dividend equivalents, which entitle the holder to a number of additional DSUs equal to the number of DSUs held multiplied by the per share amount of the dividend, divided by the price of our common shares at the time the dividend is paid. Ensuring that Directors have an equity interest in Hudbay helps to align the interests of our Directors with the long-term interests of our shareholders and is consistent with our desire to implement best practices in our compensation programs. To further align their interests with those of our shareholders, Directors may elect to have all or a portion of their cash retainer and other fees payable to them in DSUs.
Director Compensation Table
The following table sets out the compensation paid to each of our Directors in respect of the year ended December 31, 2021.
Name
Fees earned
( $) ( 1)
Share-based awards
( $) ( 2)
All other compensation
( $) ( 3)
Total
( $)
Carol T. Banducci
-
231,000
2,694
233,694
Igor Gonzales
85,000
116,000
1,972
202,972
Richard Howes
63,750
137,250
1,419
202,419
Sarah B. Kavanagh
100,000
116,000
1,972
217,972
Carin S. Knickel
-
221,000
3,821
224,821
Stephen A. Lang
97,500
217,500
1,251
316,251
Daniel Muñiz Quintanilla
85,000
116,000
771
201,771
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Colin Osborne
-
226,000
2,250
228,250
David S. Smith
100,000
116,000
771
216,771
1.Represents fees and retainers paid in cash. Directors can elect to have all or a portion of their cash retainers and meeting fees paid to them in DSUs.
2.Represents fees and retainers paid in DSUs. The DSUs are vested at the time of grant and become payable to the directors upon their departure from the Board.
3.Represents amounts paid in additional DSUs as dividend equivalents following payments of our $ 0.01 per share dividend on March 26 and September 24, 2021.
Value on Pay-Out or Vesting of Incentive Plan Awards
Name
Option-based awards - Value vested during the year ( $)
Share-based awards - Value vested during the year ( $) ( 1)
Carol T. Banducci
-
231,000
Igor Gonzales
-
116,000
Richard Howes
-
137,250
Sarah B. Kavanagh
-
116,000
Carin S. Knickel
-
221,000
Stephen A. Lang
-
217,500
Daniel Muñiz Quintanilla
-
116,000
Colin Osborne
-
226,000
David S. Smith
-
116,000
1.Represents the amount of DSUs granted to each director in respect of 2021 pursuant to our Directors ' DSU plan ( excluding amounts paid in additional DSUs as dividend equivalents). DSUs are vested at the time of grant. For greater certainty, DSUs are not paid out until a Director departs from the Board. No share options have been granted to the current Directors and, accordingly, none of the Directors hold unvested equity awards.
Outstanding Share-Based Awards
The following table provides information regarding the share-based awards for each director outstanding as of December 31, 2021.
Name
Grant Date
Number of securities underlying options at the date of grant
( #)
Number of securities underlying unexercised options
( #)
Option exercise price
( $)
Option expiration date
Value of unexercised in-the- money options
( $)
Number of shares or units of shares that have not vested
( #)
Market or payout value of share- based awards that have not vested
( $)
Market or payout value of vested share-based awards not paid out or distributed
( $) ( 1)
Carol T. Banducci
-
-
-
-
-
-
-
-
1,411,538
Igor Gonzales
-
-
-
-
-
-
-
-
993,095
Richard Howes
-
-
-
-
-
-
-
-
749,189
Sarah B. Kavanagh
-
-
-
-
-
-
-
-
993,095
Carin S. Knickel
-
-
-
-
-
-
-
-
1,921,064
Stephen A. Lang
-
-
-
-
-
-
-
-
739,301
Daniel Muñiz Quintanilla
-
-
-
-
-
-
-
-
442,044
Colin Osborne
-
-
-
-
-
-
-
-
1,204,236
David S. Smith
-
-
-
-
-
-
-
-
442,044
1.Based on the closing price of Hudbay Shares on the Toronto Stock Exchange of $ 9.16 on December 31, 2021.
82| 2022 HUDBAY MINERALS INC.
EQUITY OWNERSHIP GUIDELINES FOR DIRECTORS
The Corporate Governance Guidelines adopted by the Board impose minimum equity ownership requirements on the directors, pursuant to which each director will be required to acquire Hudbay Shares or DSUs having an initial acquisition or grant date value equal to three times the aggregate value of his or her annual cash and equity retainer. For the purpose of determining the value of shares and share units held, the holdings will be based on the cost of acquisition or value at the time of grant. Directors are expected to achieve this level of ownership within five years from the date they become directors and when there is an increase to the annual retainer, directors are required to achieve the increased minimum equity ownership level within two years of the effective date of the increase. The Directors ' progress in meeting our equity ownership guidelines as at March 15, 2022is shown in the following table:
Name
Value of Equity Required
( $)
Total Equity Ownership ( 1)
( $)
In Compliance with Guidelines?
Carol T. Banducci
603,000
1,004,614
Yes
Igor Gonzales
603,000
736,343
Yes
Richard Howes
603,000
679,902
Yes
Sarah B. Kavanagh
603,000
736,343
Yes
Carin S. Knickel
603,000
1,514,277
Yes
Stephen A. Lang
945,000
702,235
Yes
Colin Osborne
603,000
990,829
Yes
Daniel Muñiz Quintanilla
603,000
336,169
Yes
David S. Smith
603,000
385,829
Yes
1.Includes the grant date value of DSUs held and the acquisition value of common shares held.
2.Messrs. Howes, Lang, Quintanilla and Smith joined the Board in 2019 and, as such, have until 2024 to achieve the required value of equity.
EQUITY COMPENSATION PLAN INFORMATION
The following table provides information concerning our equity compensation plans as at December 31, 2021.
Plan Category
Number of securities to be issued upon exercise of outstanding options, warrants and rights ( 2)
Weighted average exercise price of outstanding options, warrants and rights ( 3)
( $)
Number of securities remaining available for future issuance under equity compensation plans ( 2)
Equity compensation plans approved by securityholders ( 1)
4,872,156
$ 5.71
11,180,110
Equity compensation plans not approved by securityholders
-
-
-
Total
4,872,156
$ 5.71
11,180,110
1.Includes the Share Option Plan and LTEP, as approved by our shareholders at our 2008 and 2016 annual and special meetings, respectively.
2.Assumes that all of the outstanding share units under our LTEP will be settled by the issuance of Hudbay Shares.
3.Reflects the weighted average exercise price of the 1,661,784 options that were outstanding as at December 31, 2021.
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The annual burn rate ( 1) for each of our equity compensation plans over the past three fiscal years is set out in the table below:
Equity Compensation Plan
2021
2020
2019
Share Option Plan
0.19%
0.60%
0%
LTEP
0.35%
0.95%
0.41%
1.The annual burn rate in respect of each equity compensation plan is calculated according to Section 613 ( d) of the TSX Company Manual. The number of securities granted under the LTEP plan in the years ended December 31, 2021 and 2020 and used in the annual burn rate calculation could increase in the future as a result of the multiplier effect on the 1,506,232 Performance Share Units granted thereunder. See `` Long-Term Incentive Plan ( LTIP) ''.
If all of the 4,872,156 share units and options outstanding under our LTEP and Share Option Plan, respectively, as at December 31, 2021 were settled by the issuance of Hudbay Shares, the Hudbay Shares issued upon such settlement would have represented approximately 1.86% of our issued and outstanding Hudbay Shares as at such date.
INTEREST OF CERTAIN PERSONS IN MATTERS TO BE ACTED UPON
None of our directors or executive officers are aware of any material interest, direct or indirect, of any person who: ( i) has been a director or executive officer of Hudbay at any time since the beginning of the Company's last financial year; ( ii) is a proposed nominee for election; or ( iii) is an associate or affiliate of any person described in ( i) or ( ii), in any of the matters to be acted upon at the Meeting other than the election of directors.
INDEBTEDNESS OF DIRECTORS AND EXECUTIVE OFFICERS
None of our current or former directors, executive officers or employees or those of any of our subsidiaries had any indebtedness outstanding to Hudbay or any of our subsidiaries during the year ended December 31, 2021 or as at the date hereof. Additionally, Hudbay has not provided any guarantee, support agreement, letter of credit or other similar arrangement or undertaking in respect of any indebtedness of any such person to any other person or entity.
INTEREST OF INFORMED PERSONS IN MATERIAL TRANSACTIONS
To the knowledge of the directors and executive officers of Hudbay, no `` informed person '', any proposed nominee or any associate or affiliate of any informed person or proposed nominee, has had any material interest, direct or indirect, in any transaction since January 1, 2021, or has had any such interest in any proposed transaction that has materially affected us or would materially affect us or any of our subsidiaries. `` Informed Person '' means ( a) a director or executive officer of Hudbay, ( b) a director or executive officer of a person or company that is itself an informed person or subsidiary of Hudbay, ( c) any person or company who beneficially owns, or controls or directs, directly or indirectly, Hudbay Shares carrying more than 10% of the voting rights attached to all of the Hudbay Shares, and ( d) Hudbay, if we have purchased, redeemed or otherwise acquired any of our securities, for so long as we hold any of our securities.
DIRECTORS ' AND OFFICERS ' INSURANCE AND INDEMNIFICATION
We have purchased insurance for the benefit of the directors and officers of Hudbay and its subsidiaries against any liability incurred by them in their capacity as directors and officers, subject to certain limitations contained in the Canada Business Corporations Act. The annual premium for such insurance is US $ 2,319,625. The policy provides an annual aggregate coverage limit of US $ 80 million in the policy year.
84| 2022 HUDBAY MINERALS INC.
In accordance with the provisions of the Canada Business Corporations Act, our By-law provides that we will indemnify a director or officer, a former director or officer, or another individual who acts or acted at our request as a director or officer, or an individual acting in a similar capacity, of another entity, against all costs, charges and expenses, including an amount paid to settle an action or to satisfy a judgment, reasonably incurred in respect of any civil, criminal, administrative, investigative or other proceeding to which the individual is involved because of the association with us or other entity, if:
We have entered into indemnification agreements with each of our directors and officers, which agreements provide that we undertake and agree to indemnify the director or officer to the fullest extent permitted by law, against any reasonable expense that the director may suffer or incur in respect of any claim, action, suit or proceeding ( including, without limitation, any claim, demand, suit, proceeding, inquiry, hearing, discovery or investigation whether civil, criminal, administrative or investigative and whether brought by or on behalf of us or otherwise) involving the director or officer or to which the director or officer is made party and which arises as a direct or indirect result of the director or officer being or having been a director or officer of Hudbay, including any act or thing done or not done in the director's capacity as director or officer provided the director has acted as set out above in accordance with our By-law.
If we become liable under the terms of our By-law or the indemnification agreements, the insurance coverage will extend to such liability; however, each claim will be subject to a deductible of US $ 5 million.
WHERE YOU CAN FIND ADDITIONAL INFORMATION
We file reports and other information with the Canadian Securities Administrators. These reports and information are available to the public free of charge on SEDAR at www.sedar.com and EDGAR at www.sec.gov/edgar.shtml. Financial information is provided in our audited comparative consolidated financial statements and management's discussion and analysis for the year ended December 31, 2021, which can be found on SEDAR at www.sedar.com and EDGAR at www.sec.gov/edgar.shtml. Our shareholders may also request copies of these documents from our Vice President and General Counsel by telephone at ( 416) 362-8181 or by e-mail at info @ hudbay.com.
DIRECTORS ' APPROVAL
The contents of this Circular and the sending thereof to our shareholders have been approved by the Board of Directors of Hudbay Minerals Inc.
By Order of the Board of Directors
Stephen A. Lang, Chair April 5, 2022
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SCHEDULE `` A ''
HUDBAY MINERALS INC.
( the `` Company '')
CORPORATE GOVERNANCE GUIDELINES AND BOARD MANDATE
Introduction
The Board of Directors is committed to fulfilling its statutory mandate to supervise the management of the business and affairs of the Company with the highest standards of ethical conduct and in the best interests of the Company and its shareholders. The Board of Directors, acting on the recommendation of its Corporate Governance and Nominating Committee, has adopted these corporate governance guidelines to promote the effective functioning of the Board of Directors and its committees, to promote the interests of shareholders, and to establish a common set of expectations as to how the Board of Directors, its various committees, individual directors and senior management should perform their functions. These guidelines are intended to provide a flexible framework within which the Board of Directors may carry out these functions.
Guidelines
Board of Directors ' Responsibilities
The business and affairs of the Company are managed by or under the supervision of the Board of Directors in accordance with applicable legislation and regulatory requirements. The responsibility of the Board of Directors is to provide direction and oversight. The Board of Directors approves the strategic direction of the Company and oversees the performance of the Company's business and senior management. The senior management of the Company is responsible for presenting strategic plans to the Board of Directors for review and approval and for implementing the Company's strategic direction.
In performing their duties, the primary responsibility of the directors is to exercise their business judgment in what they reasonably believe to be the best interests of the Company and to perform their duties of care and loyalty. In discharging that obligation, directors should be entitled to rely on the honesty and the integrity of the Company's senior management and outside advisors and auditors. The directors also should be entitled to have the Company purchase reasonable directors ' and officers ' liability insurance on their behalf, and to the benefits of indemnification to the fullest extent permitted by applicable law and to exculpation as provided by applicable law.
In fulfilling its statutory mandate and discharging its duty of stewardship of the Company, the Board of Directors assumes responsibility for those matters set forth in its Charter ( which also is its mandate), a copy of which is attached as Schedule 1.
Board of Directors ' Size
It is the current view of the Board of Directors that the Board of Directors should consist of no more than 13 members to facilitate its effective functioning. The Board of Directors will annually assess, after consideration of any advice or input of the Corporate Governance and Nominating Committee, the appropriate number of directors.
Chair of the Board of Directors
The Chair should be a director who is independent and not a member of senior management who is appointed by the Board of Directors.
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Board Selection and Diversity
The Corporate Governance and Nominating Committee is responsible for identifying and recommending to the Board of Directors individuals qualified to become members of the Board of Directors. In assessing individual director nominees, the Corporate Governance and Nominating Committee considers:
The Corporate Governance and Nominating Committee will review the Board of Directors ' skills matrix to help identify areas for strengthening the Board of Directors, if any, and address them through the recruitment of new members. In addition to its own search for director nominees, the Corporate Governance and Nominating Committee may engage experienced and independent external consultants. When engaging the services of search consultants, the Corporate Governance and Nominating Committee instructs them to have broad selection criteria that include a mix of skills and expertise, and to identify candidates who are diverse in all aspects, including gender.
The Corporate Governance and Nominating Committee also will be responsible for initially assessing whether a candidate would be independent ( and in that process applying the Categorical Standards for Determining Independence of Directors that are appended to the Board of Directors Charter) and advising the Board of Directors of that assessment. The Corporate Governance and Nominating Committee also will be responsible for assessing from time to time, and shall conduct inquiries in that regard on no less than an annual basis, the independence of each member of the Board of Directors, and shall make recommendations to the Board of Directors in respect of the constitution of the Board of Directors and its committees resulting therefrom.
The Board of Directors, taking into consideration the recommendations of the Corporate Governance and Nominating Committee, will be responsible for selecting the nominees for election to the Board of Directors, for appointing directors to fill vacancies, and determining whether a nominee or appointee is independent.
Election of Directors
Each director should be elected by the vote of a majority of the shares represented in person or proxy at any meeting for the election of directors. If any nominee for election as director receives, from the shares voted at the meeting in person or by proxy, a greater number of votes `` withheld '' than votes `` for '' his or her election, the director must immediately tender his or her resignation to the Chair of the Board of Directors following the meeting, to take effect upon acceptance by the Board of Directors. The Corporate Governance and Nominating Committee will expeditiously consider the director's offer to resign and make a recommendation to the Board of Directors whether to accept that offer. The Board of Directors will accept the offer to resign absent exceptional circumstances and within 90 days of the meeting of shareholders, the Board of Directors will make a final decision concerning the acceptance of the director's resignation and announce that decision by way of a news release. Any director who tenders his or her resignation will not participate in the deliberations of the Board of Directors or any of its committees pertaining to the resignation. This process applies only in circumstances involving an `` uncontested '' election of directors - where the number of director nominees does not exceed the number of directors to be elected and where no proxy materials are circulated in support of one or more nominees who are not part of the slate supported by the Board of Directors for election at the meeting. If any director fails to tender his or her resignation as contemplated in this paragraph, the Board of Directors will not re-nominate that director. Subject to any corporate law restrictions, where the Board of Directors accepts the offer of resignation of a director and that director resigns, the Board of Directors may exercise its discretion with respect to the resulting vacancy and may, without limitation, leave the resultant vacancy unfilled until the next annual meeting of shareholders, fill the vacancy through the appointment of a new director whom the Board of Directors considers to merit the confidence of the shareholders, or call a special meeting of shareholders to elect a new nominee to fill the vacant position.
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Continuation as a Director
The Board of Directors does not believe it is appropriate to have an arbitrary age or term limit for service on the Board. Instead, the Board will focus on renewal and will be vigilant in monitoring the performance of each director and ask directors who are no longer able to contribute effectively due to age or other factors to step down from the Board.
When a director's principal occupation or business association changes substantially from the position he or she held when originally invited to join the Board of Directors ( determined by reference to factors such as country of principal residence, industry affiliation, etc.), that director should tender a letter of proposed resignation to the Chair of the Corporate Governance and Nominating Committee. The Corporate Governance and Nominating Committee will review that director's continuation on the Board of Directors and recommend to the Board of Directors whether, in light of all the circumstances, the Board of Directors should accept the proposed resignation or request that the director continue to serve.
Committee Membership
Directors are expected to sit on committees of the Board of Directors. Each of the Audit Committee, the Compensation and Human Resources Committee, the Corporate Governance and Nominating Committee, the Environmental, Health, Safety and Sustainability Committee and the Technical Committee will be composed of no fewer than three members, each of whom will satisfy the membership criteria set out in the relevant committee charter. Members of committees will be appointed by the Board of Directors upon the recommendation of the Corporate Governance and Nominating Committee. The Board of Directors, taking into account the recommendation of the Corporate Governance and Nominating Committee, generally will designate one member of each committee as chair of that committee. Membership on these committees, including the person serving as Chair, should be changed from time to time in order to allow for new perspectives, keeping in mind the skills required to serve on each committee.
Evaluating Board of Directors and Committee Performance
The Board of Directors and each committee under the guidance and direction of the Corporate Governance and Nominating Committee will:
Authority to make minor technical amendments to the Charter may be made by the head of the Legal group, who will report any such amendments to the Board of Directors, or the relevant committee, at its next regular meeting.
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Board of Directors and Committee Meetings
Quorum for the transaction of business at any meeting of the Board of Directors or committee, as the case may be, shall be a majority of the number of members or such greater number as the Board or committee shall by resolution determine. The powers of the board or committee, as the case may be, may be exercised at a meeting at which a quorum is present in person or by telephone or other electronic means or by a resolution signed by all members entitled to vote on that resolution. Each member ( including the Chair) is entitled to one ( but only one) vote in any proceedings.
Meetings of the Board of Directors or committee, as the case may be, shall be held from time to time and at such place as the Chair of the Board or committee ( or any two directors) may request upon 48 hours prior notice ( if the notice is mailed) or 24 hour notice ( if the notice is given personally or delivered by means of electronic communication). The notice period may be waived by a quorum of the Board or the committee.
An agenda for each meeting of the Board of Directors and each committee meeting will be provided to each director and each member of the relevant committee, respectively. Any director or member of a committee may suggest the inclusion of subjects on the agenda of meetings of the Board of Directors or a committee, respectively.
Each director and each member of a committee is free to raise, at any meeting of the Board of Directors or a committee, subjects that are not on the agenda for that meeting.
Materials provided to the directors for meetings of the Board of Directors and committee meetings should provide the information needed, and should be distributed sufficiently in advance, for the directors and members of the committee, respectively, to engage in informed discussion and make an informed judgment.
To ensure free and open discussion and communication among directors, the independent directors will meet in executive session ( with no members of senior management or non-independent directors present) after every regularly scheduled meeting of the Board of Directors and otherwise as those directors determine. The Chair will preside at these executive sessions, unless the directors present at such meetings determine otherwise. Any interested party may communicate directly with the Chair, who may invite such person to address an executive session.
Unless the Chair of a committee otherwise determines, the agenda, materials and minutes for each committee meeting will be available on request to all directors, and all directors will be free to attend any committee meeting. All meetings of a committee will have a session in which the members of the committee will meet with no non-committee members present and, at any time in a meeting of a committee, directors who are not members may be asked to leave the meeting to ensure free and open discussion and communication among members of the committee. Directors who are not members of a committee will not be compensated for attending meetings of that committee.
Director Compensation
As provided for in the Compensation and Human Resources Committee's Charter, the form and amount of director compensation will be determined by the Board of Directors upon the recommendation of the Compensation and Human Resources Committee from time to time. In discharging this duty, the Compensation and Human Resources Committee shall endeavor to adhere to the following principles: compensation should fairly pay non-employee directors for work required in a company of the Company's size and scope; compensation should align such directors ' interests with the long-term interests of the Company's shareholders; and the structure of non-employee director compensation should be simple, transparent and easy for shareholders to understand.
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Share Ownership Guidelines
Each director is required to acquire common shares of the Company having an initial acquisition value equal to three times his or her annual retainer. Directors are expected to achieve this level of ownership within five years from the date they become directors. Directors may apply the deferred share units that they receive as payment for all or part of their annual retainer towards this minimum equity ownership requirement. If the annual retainer is increased, all directors are required to achieve the increased minimum equity ownership level within two years of the effective date of the increase in the annual retainer. For greater certainty, the determination as to whether a director has met this minimum equity ownership level will be made with reference to the value of the common shares ( or deferred share units) at the time of their acquisition, and not the then current market price.
Expectations of Directors
The Board of Directors has developed a number of specific expectations of directors to promote the discharge by the directors of their responsibilities and to promote the efficient conduct of the Board of Directors.
Commitment and Attendance. All directors should strive to attend all meetings of the Board of Directors and the committees of which they are members. Attendance by telephone or video conference may be used when necessary to facilitate a director's attendance.
Participation in Meetings. Each director should be sufficiently familiar with the business of the Company, including its financial statements and capital structure, and the risks and the competition it faces, to ensure active and effective participation in the deliberations of the Board of Directors and of each committee on which he or she serves. Each director is expected to review meeting materials in advance of the meeting.
Loyalty and Ethics. In their roles as directors, all directors owe a duty of loyalty to the Company. This duty of loyalty mandates that the best interests of the Company take precedence over any other interest possessed by a director. Directors should conduct themselves in accordance with the Company's Code of Business Conduct and Ethics and other applicable policies and procedures.
Interlocking Directorships. Without the approval of the Corporate Governance and Nominating Committee, no director should serve on more than one other public company board of directors on which another director of the Company serves.
Succession Planning. The Board of Directors should conduct an annual review of management succession planning. The entire Board of Directors will work with the Compensation and Human Resources Committee to nominate and evaluate potential successors to the Chief Executive Officer. The Chief Executive Officer should at all times make available his or her recommendations and evaluations of potential successors, along with a review of any development plans recommended for such individuals.
Contact with Senior Management and Employees. All directors should be free to contact the Chief Executive Officer and other members of the Company's senior management at any time to discuss any aspect of the Company's business. The Board of Directors expects that there will be frequent opportunities for directors to meet with the Chief Executive Officer and other members of senior management in meetings of the Board of Directors and committees, or in other formal or informal settings.
Confidentiality. The proceedings and deliberations of the Board of Directors and its committees are confidential. Each director will maintain the confidentiality of information received in connection with his or her service as a director.
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Orientation and Continuing Education
Senior management, working with the Board of Directors, will provide appropriate orientation and education for new directors to familiarize them with the Company and its business, as well as the expected contribution of individual directors. All new directors will participate in this program orientation and education, which should be completed within four months of a director first joining the Board of Directors. In addition, senior management will schedule periodic presentations for the Board of Directors to ensure they are aware of major business trends and industry practices.
Shareholder Engagement
The Board of Directors is committed to engaging in constructive communications with the Company's shareholders. As a result, the Board of Directors, acting on the recommendation of the Corporate Governance and Nominating Committee, has adopted a Shareholder Engagement Policy in order to promote open and sustained dialogue with the Company's shareholders.
Review of Related Party Transactions
The Corporate Governance and Nominating Committee shall review transactions between the Company and any related party, regardless of whether the transactions are reportable pursuant to securities regulations. After considering advice from the Corporate Governance and Nominating Committee, the Board of Directors shall review, and, if appropriate, approve or ratify, such related party transactions. For purposes of these guidelines, a `` related party transaction '' is any transaction in which the Company was or is to be a participant and in which any related party has a direct or indirect material interest, other than transactions that ( i) are available to all employees generally, ( ii) involve compensation of executive officers or directors duly authorized by the appropriate Board committee, or ( iii) involve reimbursement of expenses in accordance with the Company's established policies.
For purposes of these guidelines, a `` related party '' is any person who is, or at any time since the beginning of the Company's last fiscal year was, an executive officer or director ( including in each case nominees for director), any shareholder owning in excess of five percent of the Company's outstanding common shares, or an immediate family member ( as defined in the Categorical Standards for Determining Independence of Directors) of an executive officer, director, nominee for director, or five percent shareholder.
Disclosure
These guidelines shall be made available on the Company's website.
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SCHEDULE `` 1 ''
HUDBAY MINERALS INC.
( the `` Company '')
BOARD OF DIRECTORS CHARTER
Purpose
The Board of Directors is elected by the Company's shareholders to supervise the management of the business and affairs of the Company, in the best interests of the Company. The Board of Directors shall:
Composition
The Board of Directors should be diverse in gender, viewpoints, backgrounds and other demographics and collectively should possess a broad range of skills, expertise, industry and other knowledge, and business and other experience useful to the effective oversight of the Company's business. A majority of the Board of Directors should meet the independence requirements of applicable legislation, regulatory requirements and policies of the Canadian Securities Administrators. The Board of Directors has adopted a set of categorical standards for determining whether directors satisfy those requirements for independence. A copy of those standards is attached as Appendix A. The Board of Directors, upon the recommendation of the Corporate Governance and Nominating Committee, shall designate the Chair by majority vote of the Board of Directors.
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Committees
The Board of Directors may delegate authority to individual directors and committees where the Board of Directors determines it is appropriate to do so. The Board of Directors expects to accomplish a substantial amount of its work through committees and shall form at least the following four committees: the Audit Committee, the Compensation and Human Resources Committee, the Corporate Governance and Nominating Committee and the Environmental Health, Safety and Sustainability Committee. The Board of Directors may, from time to time, establish or maintain additional standing or special committees as it determines to be necessary or appropriate. Each committee should have a written charter and should report regularly to the Board of Directors, summarizing the committee's actions and any significant issues considered by the committee.
Independent Advice
In discharging its mandate, the Board of Directors shall have the authority to retain ( and authorize the payment by the Company of) and receive advice from special legal, accounting or other advisors as the Board of Directors determines to be necessary to permit it to carry out its duties.
Flexible Framework
This Charter is a broad policy statement and is intended to be part of the Board of Directors ' flexible governance framework. While this Charter should comply with all applicable law and the Company's articles and by-laws, this mandate does not create any legally binding obligations on, the Board of Directors, any committee of the Board of Directors, any director or the Company.
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APPENDIX `` A ''
HUDBAY MINERALS INC.
( the `` Company '')
CATEGORICAL STANDARDS FOR DETERMINING INDEPENDENCE OF DIRECTORS
For a director to be considered independent under the policies of the Canadian Securities Administrators, he or she must have no direct or indirect material relationship with the Company, being a relationship that could, in the view of the Board of Directors, reasonably interfere with the exercise of a Director's independent judgment.
The Board of Directors, upon the recommendation of the Corporate Governance and Nominating Committee, has considered the types of relationships that could reasonably be expected to be relevant to the independence of a director of the Company. The Board of Directors has determined that:
1.A director's interests and relationships arising solely from his or her ( or any immediate family members ' 1) shareholdings in the Company are not, in and of themselves, a bar to independence.
2.Unless a specific determination to the contrary is made by the Corporate Governance and Nominating Committee as a result of there being another direct or indirect material relationship with the Company, a director will be independent unless currently, or at any time within the past three years, he or she or any immediate family member:
•Employment. Is ( or has been) an officer or employee ( or, in the case of an immediate family member, an executive officer) or ( in the case of the director only) an affiliate 2 of the Company or any of its subsidiaries or affiliates ( collectively, the `` Company Group '') or is actively involved in the day-to-day management of the Company;
•Direct Compensation. Receives ( or has received) direct compensation during any twelve-month period from the Company Group ( other than director fees and committee fees and pension or other forms of deferred compensation for prior service, provided it is not contingent on continued service) 3;
•Auditor Relationship. Is ( or has been) a partner or employee of a firm that is the Company's internal or independent auditor ( provided that in the case of an immediate family member, he or she participates in its audit, assurance or tax compliance ( but not tax planning practice)) and if during that time, he or she or an immediate family member was a partner or employee of that firm but no longer is such, he or she or the immediate family member personally worked on the Company's audit;
•Material Commercial Relationship. Has ( or has had), or is an executive officer, employee or significant shareholder of a person that has ( or has had), a significant commercial relationship with the Company Group.
Notes:
1.A ( i) spouse, parent, child, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, or ( ii) any person ( other than domestic employees) who shares that director's home.
2.A company is a subsidiary of another company if it is controlled, directly or indirectly, by that other company ( through one or more intermediaries or otherwise). An `` Affiliate '' of a person is a person that, directly or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with the first person.
3.Employment as an interim chair or an interim Chief Executive Officer need not preclude a director from being considered independent following the end of that employment. Receipt of compensation by an immediate family member need not preclude a director from being independent if that family member is a non-executive employee.
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•Cross-Compensation Committee Link. Is employed as an executive officer of another entity whose compensation committee ( or similar body) during that period of employment included a current executive officer of the Company.
•Material Association. Has ( or has had) a close association with an executive officer of the Company.
Notwithstanding the foregoing, no director will be considered independent if applicable securities legislation, rules or regulations expressly prohibit such person from being considered independent.
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SCHEDULE `` B ''
HUDBAY MINERALS INC.
( the `` Company '')
LONG TERM EQUITY PLAN ( `` LTEP '')
LONG-TERM EQUITY PLAN ( `` LTEP '')
Each grant of share units under the LTEP is evidenced by a grant letter, which may contain terms and conditions in addition to the terms and conditions of the LTEP.
The table below provides a summary of the principal terms of the LTEP. For additional detail, please refer to the full text of the LTEP, which can be found on SEDAR at www.sedar.com and EDGAR at www.sec.gov/edgar.shtml.
Provision
Description
Term / Entitlement Date
Although share units do not have a fixed term, the LTEP provides that the entitlement date, being the date on which share units vest and settle, is a date that is no later than December 31 of the third calendar year following the year in which the services corresponding to such share unit awards were performed.
Market Price
The LTEP provides that the market price of common shares ( the `` Market Price '') is the five day average of the closing price of the common shares on the TSX ending on the last trading day immediately preceding the grant date or entitlement date.
Settlement
Subject to the terms of the LTEP and the applicable share unit grant letter, on the entitlement date a share unit award will entitle the Participant to a payment in fully paid common shares or, at our option, the cash equivalent of such common shares.
The cash equivalent of common shares issuable pursuant to a share unit award is determined by multiplying the applicable number of share units by the Market Price on the applicable date.
Insider Participation Limit
The LTEP limits insider participation such that the maximum number of common shares ( i) issuable, at any time, and ( ii) issued within any one-year period, to insiders, under the LTEP and any other security based compensation arrangement of ours, is 10% of the total number of common shares then issued and outstanding.
Resignation and Termination
The LTEP provides that, in the event a participant who is an employee: ( A) is terminated without cause, all share units credited to such Participant immediately vest and become payable on the date of termination; or ( B) resigns or is terminated for cause, all share units credited to such Participant immediately terminate.
Change of Control
If a change of control occurs and a participant ceases to be an eligible employee within 12 months of such change of control ( other than in connection with a termination for cause or resignation), all outstanding share units of such Participant will immediately vest.
In the event of our wind-up, dissolution or liquidation, all share units outstanding will immediately vest.
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Provision
Description
Amendment Procedure
The LTEP provides that, without shareholder approval, the Board may make the following amendments to the LTEP:
( a) amendments of a housekeeping nature;
( b) an addition or a change to the vesting provisions of the LTEP;
( c) a change to the termination provisions of a share unit or the LTEP;
( d) amendments to reflect changes to applicable securities laws; and
( e) amendments to ensure that the share units granted under the LTEP comply with any provisions respecting income tax and other laws in force in any country or jurisdiction of which a participant to whom a share unit has been granted may from time to time be resident or a citizen.
All other amendments require shareholder approval.
Dividends
Each participant under the LTEP is granted additional share units equal to the aggregate amount of dividends that would have been paid to the participant if the share units in the participant's account, if any, had been common shares, based on the Market Price of a common share on such date.
Assignment
Except pursuant to a will or by the laws of descent and distribution, share units are not assignable or transferable.
SHARE OPTION PLAN SUMMARY
The table below provides a summary of the principal terms of our Share Option Plan. For additional detail, please refer to the full text of the plan, which can be found on SEDAR at www.sedar.com and EDGAR at www.sec.gov/edgar.shtml.
Provision
Description
Term/ Vesting
The Board shall receive recommendations of management and shall determine those Eligible Persons to whom Options should be granted, the number of Options to be granted, the vesting of the Options, the expiry of the Options and any other terms and conditions of the grant.
In the event the Board makes no specific determination as to the terms of an option, the default terms are as follows:
Market Price
The Option Plan provides that the exercise price of an Option shall not be less than the Market Price, which price is defined as the closing price of the common shares on the last trading date prior to the date on which the Option grant is approved by the Board; provided that if such Board approval occurs during a Blackout Period then such last trading date shall be deemed to be the trading date immediately preceding the date the Blackout Period expires.
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Cashless Exercise
The Company may permit an Optionee to elect to pay the Option Price by authorizing a third party to sell Shares ( or a sufficient portion of such Shares) acquired upon exercise of the Option and remit to the Company a sufficient portion of the sale proceeds to pay the entire Option Price and any tax withholding resulting from such exercise.
Insider Participation Limit
The Option Plan limits insider participation such that the maximum number of shares ( i) issuable at any time and ( ii) issued within any one-year period, to insiders under the Option Plan and any other security based compensation arrangement is 10% of the total number of common shares then issued and outstanding.
Termination and Retirement
The Option Plan provides that, in the event a participant is ( i) terminated without cause, any vested Options granted to such participant will cease to be exercisable within a period of 60 days after the termination date or such longer period as determined by the Board ( and the Board has the discretion to allow unvested Options to vest on the termination date or in accordance with any vesting schedule); and ( ii) terminated for cause, each Option will cease to be exercisable immediately upon the termination date.
The Option Plan is silent with respect to which of the above provisions applies in the event of Resignation.
The Option Plan provides that, in the event of Retirement, the Options shall continue to vest and be exercisable in the normal course during the term of the Option.
Change of Control
If the Board determines a change of control is imminent, the Company may give written notice to all Option holders advising them that, within 30 days of receiving such notice, each holder must advise the Board whether it desires to exercise its Options ( including those that have not yet vested) prior to the closing of the change of control transaction. If the holder fails to notify the Board of its intent to exercise within such 30 day period, all rights of the holder will terminate so long as the proposed transaction is completed within 180 days.
If a change of control occurs and the Option Plan remains in effect and an Option holder is subject to termination within 12 months ( other than `` for cause '' or as a result of Resignation), all Options outstanding shall immediately become exercisable.
If a change of control occurs and the Option Plan does not continue ( and isn't replaced), or in the event of a wind-up, dissolution or liquidation, all Options shall immediately become exercisable.
Amendment Procedure
Subject to receipt of any required regulatory approval, the Board may, in its sole discretion, make the following amendments to the Option Plan:
( a) amending typographical, clerical and grammatical errors;
( b) reflecting changes to applicable securities laws;
( c) changing the termination provisions of an Option or the Option Plan which do not entail an extension beyond the original expiry date;
( d) including the addition of a cashless exercise feature, payable in cash or securities, which provides for a full deduction of the number of underlying securities from the Plan reserve; and
( e) ensuring that the Options granted under the Plan will comply with any provisions respecting income tax and other laws in force in any country or jurisdiction of which a Optionee may from time to time be resident or a citizen.
Notwithstanding the foregoing, the Company shall obtain requisite shareholder approval in respect of amendments to the Option Plan, to the extent such approvals are required by any applicable laws or regulations.
Assignment
Upon written notice from an Eligible Individual, any Option that might otherwise be granted to that Eligible Individual will be granted, in whole or in part, to an RRSP or a Holding Company. Otherwise, an Option is personal to the Optionee and is non-assignable.
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VIRTUAL AGM USER GUIDE 2022
If you do not have a control number, you will not be able to participate, vote or ask questions at the Meeting. You may listen only as a Guest.
To obtain a control number, you must appoint yourself as a proxyholder and register with our transfer agent, TSX Trust Company, using the instructions set out in the management information circular.
Attending the Meeting:
This year we will be conducting a virtual AGM, giving you the opportunity to attend the AGM online, using your smartphone, tablet or computer. You will be able to view a live audio webcast of the meeting, ask the board questions and submit your votes in real time.
By participating online, registered holders, non-registered holders and guests will be able to listen to a live audio cast of the meeting. Registered holders and non-registered holders with a registered control number may also ask questions online.
If you have voting rights, select `` Login ''. and enter your Control Number provided on your form of proxy or voting information form ( `` VIF '').
Go to: https: //web.lumiagm.com/238156442.
Meeting ID: 238156442
Password: hudbay2022
Guests
If you do not have voting rights, select `` Guest '' and fill in the form.
Registered shareholders with voting rights
If you were a registered shareholder on the record date, you may vote online by clicking on ' I have a Control Number ' and entering your twelve digit TSX Control Number on your Form of Proxy and the password hudbay2022 ( case sensitive).
Non-registered shareholders with voting rights
If you are a non-registered holder ( being a shareholder who holds their shares through a broker, investment dealer, bank, trust company, custodian, nominee or other intermediary) you should carefully follow the instructions set out on your VIF and in the management information circular to appoint and register yourself as proxy.
You will not be recognized at the Meeting for the purpose of voting shares registered in the name of an intermediary unless you appoint yourself as a proxyholder and register with our transfer agent, TSX Trust Company, by emailing tsxtrustproxyvoting @ tmx.com the `` Request for Control Number '' form, which can be found at https: //tsxtrust.com/resource/en/75.
Participating at the Meeting:
When successfully authenticated, the info screen will be displayed. You can view company information, ask questions and watch the audio webcast.
Navigation
If you would like to watch the audio webcast press the broadcast icon. If viewing on a computer, the audio webcast will appear at the side automatically once the meeting has started.
Voting
Once the voting has opened, the resolutions and voting choices will be displayed.
To vote, simply select your voting direction from the options shown on screen. A confirmation message will appear to show that your vote has been received. To change your vote, simply select another direction. If you wish to cancel your vote, please press Cancel.
Questions
Any voting member attending the meeting is eligible to ask questions.
If you would like to ask a question, select the messaging icon. Messages can be submitted at any time during the Q & A session up until the Chair closes the session. Type your message within the chat box at the bottom of the messaging screen. Once you are happy with your message click the send button.
For assistance, please send an email to lumicanada @ lumiglobal.com or dial 1-866-449-3664.
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Attachments
Disclaimer
HudBay Minerals Inc. published this content on 08 April 2022 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 08 April 2022 21:58:14 UTC. | business |
Munich Re tightens up cyber insurance policies to exclude war | Russia's invasion of Ukraine has raised fears of cyber attacks, with the risk that Western businesses or government institutions could be targeted.
Most cyber policies cover companies against business interruption losses and the repair of hacked networks following a cyber attack, but exclude war. However, grey areas in the wordings leave insurers open to claims as a result of cyber war.
S & P Global said last week that insurance losses from the Ukraine conflict could total $ 35 billion, with cyber one of the classes of insurance most exposed.
Munich Re is seeking clearer war exclusion clauses in cyber policies, based on wording developed last year in the Lloyd's of London market.
The invasion of Ukraine was not a `` classic cyber war, '' said Juergen Reinhart, chief underwriter, cyber, at Munich Re, but he said it was best to be prepared.
`` Let's not wait... but act now. ''
Munich Re said last month it was winding down business in Russia.
AIG, one of the world's biggest commercial insurers, is considering cutting cover for Russia and Ukraine, Reuters reported on Friday.
Munich Re was looking to bring in new wordings on its direct cyber insurance products, Reinhart said. The reinsurer was also suggesting to its cyber insurer clients that they introduce similar clauses.
Ambiguous business interruption policy wordings led to a slew of court cases across the world in the past two years over whether or not the COVID-19 pandemic was covered by insurance.
`` We have learnt this lesson as an industry in respect of the pandemic - how painful it is if you have unclear wordings, '' said Reinhart.
`` Our intention is to have very, very clear wordings... and avoid surprises. ''
Julia Graham, chief executive of UK insurance buyers ' association Airmic, said clarity was needed.
`` There has been a lot of uncertainty among Airmic members around war exclusions, especially for their cyber policies, '' she said.
`` The lack of standardised policy wordings on cyber in the market has certainly not helped things. ''
By Carolyn Cohn and Noor Zainab Hussain | business |
As food prices hit an all-time high, more Americans have abandoned online grocery shopping and returned to supermarket aisles | More Americans are browsing again — in grocery-store aisles rather than online.
With U.S. states abandoning mask mandates in public places, and more retailers dropping requirements for masks — and the latest omicron wave that led to a spike in COVID-19 cases over the winter now receding — more people are feeling comfortable shopping in person and participating in public activities.
U.S. online grocery sales declined by 6% on the year to $ 8.7 billion in March, a sharp reversal from a record high of $ 9.3 billion online grocery sales in March 2020, according to the latest Grocery Shopping Survey carried out by Mercatus and Brick Meets Click, e-commerce analytics firms that work with grocery stores.
The ship-to-home segment saw the largest drop in sales, falling over 30% in March compared to a year ago, to $ 1.4 billion from $ 2.1 billion. This decline was driven by a 13% reduction in the number of orders placed by monthly active users combined with a 23% drop in the average order value, the survey released this week said.
However, many people still relied on delivery services for their groceries. Delivery sales increased 20% on the year to $ 3.5 billion in March from $ 2.9 billion a year earlier. David Bishop, partner at Brick Meets Click, said the “ aggressive expansion of third-party providers into grocery ” is helping people to shop online.
People still prefer to squeeze their fruit and vegetables before buying. Online grocery will only account for approximately 11% of $ 1.124 trillion in grocery sales this year, but that number is expected to rise to 20.5% of $ 1.285 trillion in grocery sales by 2026, a
separate report
released by Mercatus last year concluded.
Food prices reach all-time high
As the war in the Ukraine rages on, consumers have good reason to find the best prices for food. “ Conflict has driven up international prices for wheat, maize and vegetable oils, as war in the Black Sea region
spread shocks
through the markets trading in these staples, ” according to the United Nations food agency.
The Food and Agriculture Organization’ s ( FAO)
food price index
, which tracks the monthly changes in the most commonly traded food commodities, averaged 159.3 points in March versus a revised 141.4 for February, a record high. February already marked the highest the index had reached since 1990.
“ Driven by soaring wheat and coarse grain prices — largely as a result of the war in Ukraine — the FAO Cereal Price Index was 17.1 per cent higher in March than it was just a month earlier, ” the FAO said. For the last three years, Russia and Ukraine accounted for 30% and 20% respectively of global wheat and maize exports.
“ Expectations point to the European Union and India increasing wheat exports, while Argentina, India and the United States are likely to ship more maize — partially compensating for the loss of exports from the Black Sea region, ” the UN food agency’ s report added.
Other major increases included the vegetable oil price index, which rose 23.2%. “ Palm, soy and rapeseed oil prices also rose markedly as a result of the higher sunflower seed oil prices and the rising crude oil prices — with soy oil prices further underpinned by concerns over reduced South American exports, ” the FAO said.
In-person grocery shopping is less convenient and can result in impulse buys, but the prices on products are cheaper, according to
this head-to-head comparison,
and there’ s no delivery fee and tip for the driver on top of your bill.
See also:
Lower-income consumers will start tightening their belts by trading down to private label goods in 2022, analysts say | business |
Housing Crisis: Why 40-Year Mortgages Might Help Delinquent Borrowers | Illustration by Laurent Duvoux
About the author:
Patrick Harker
is the president and CEO of the Federal Reserve Bank of Philadelphia.
The Covid-19 pandemic is not over. But many of the pandemic assistance programs associated with it are done, or soon will be.
Mortgage forbearance, which began after passage of the Cares Act, is a case in point. Throughout the pandemic, federal and private programs have allowed borrowers to stay in their homes and stop mortgage payments for up 18 months with no negative impact on their credit scores.
The number of loans in forbearance now stands at around 680,000 mortgages. That’ s a whole lot of people, but it in fact represents a steep decline. All told, more than 8.5 million borrowers entered forbearance at some point during the Covid-19 pandemic, north of 15% of the total mortgage market.
Simple arithmetic suggests that nearly 8 million households who were in forbearance no longer are. Temporary protections against foreclosure have expired as well. Which is to say, this is a real-time “ stress test ” not only for borrowers but for lenders as well.
So what has become of this sizable chunk of homeowners and their families? Researchers at the Federal Reserve Bank of Philadelphia have been
tracking these data
and have made important findings.
Begin with the positive.
The first bit of good news is obvious to anyone perusing listings on
Zillow
: The American housing market is exceptionally strong. While this has had undeniably negative impacts on those seeking to enter the housing market, it does ensure that most past-due borrowers can avoid losing their homes and that banks won’ t suffer losses large enough to meaningfully affect their capital positions. Homeowners are sitting on more than $ 10 trillion of tappable equity – a record. Other borrowers coming off forbearance who are unable to resume their payments likely have the option to extract equity from their properties.
The contrast with the Great Recession is remarkable. Recall that back then nearly half of all distressed borrowers were “ underwater, ” meaning they owed more on their mortgages than their houses were worth.
Also, as of today, nearly three-quarters of those who have exited forbearance have voluntarily paid off or are current on their mortgages, many making use of payment deferrals or loan modifications. For borrowers able to resume timely payment, a deferral creates a no-interest, second loan out of their missed payments not due until the loan is paid off. This is significant because payments missed during forbearance do not disappear: Borrowers will still have to pay them back eventually. Tacking them onto the end of a primary loan is a smart way to ease this burden.
Loan modifications, meanwhile, work like a no-cost, cash-out refinance. Borrowers are offered lower rates and extended loan terms while being allowed to forgo immediate payback of their past-due arrears, resulting in reductions in their monthly mortgage payments of 20% or more. Deferrals and loan modifications are the two major types of Covid-19 loss mitigation options on offer.
But many American borrowers continue to face heavy burdens.
Nearly one million mortgages are seriously delinquent, split evenly between those classified by servicers as in loss mitigation and those not. Most borrowers who remain seriously delinquent and not in loss mitigation never entered forbearance at all and were in nonpayment before the pandemic struck.
And of the borrowers classified as in loss mitigation, three-quarters are still in process and have not, as of yet, resumed timely payment on their mortgages. The burdens are not distributed equitably. Black and Hispanic borrowers have much higher shares of nonpayment — either being in forbearance or delinquency.
Losing one’ s home is a profoundly destabilizing event with potentially lifelong consequences. It’ s a heavy burden to lenders as well: Foreclosures are expensive and time-consuming to service. Lenders should be thinking hard about how to keep people in their homes and to minimize their own losses.
One solution being pursued is for the Federal Housing Administration to offer 40-year terms for their modifications, just as the two government sponsored enterprises,
Fannie Mae
and
Freddie Mac
,
do now. This would lower the monthly mortgage payment even more than when extending beyond the currently offered 30-year term, providing more relief to borrowers. The Department of Housing and Urban Development placed a proposed rule into the Federal Register on April 1 to increase the term for loan modifications to 40 years for FHA-insured mortgages. We are now in a 60-day comment period.
Longer term, lenders should think of ways to improve communication with their customers. Our data suggest millions of distressed borrowers who qualified for forbearances never took advantage of them. A
study
from my colleagues at the Federal Reserve Bank of Philadelphia found that millions of borrowers— disproportionately Black or low-to-moderate income—did not apply to refinance their mortgages during the pandemic, when they could have enjoyed significant savings. This was a missed opportunity.
With a fairly weak public social safety net for Americans, houses are not only our shelters — they are a significant source of our household wealth and retirement savings as well. Let’ s do what we can to make sure people don’ t lose this most vital asset.
Watch Philadelphia Fed President Patrick Harker on
Barron’ s Roundtable
, airing on Fox Business at 10 a.m. and 11:30 a.m. ET, on Saturday, April 9, and Sunday, April 10.
Guest commentaries like this one are written by authors outside the Barron’ s and MarketWatch newsroom. They reflect the perspective and opinions of the authors. Submit commentary proposals and other feedback to ideas @ barrons.com. | business |
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Wout van Aert, center, celebrates an action-packed weekend with victory at Amstel Gold Race. Photo: Bas Czerwinski/Getty Images
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While Paris-Roubaix has been bumped from its traditional slot due to French national elections, you can still get your fill of bike racing this weekend.
Amstel Gold Race — besides being the only bike race on the pro calendar that’ s named for a beer is the only major, one-day race that is staged in The Netherlands — will take place on Sunday, April 10.
The women’ s race will crown a new winner as defending champion Marianne Vos is not on the start list. But there is no shortage of Dutch riders vying for victory in the Dutch race. Former world champion and Tokyo Olympic gold- and silver-medalist Annemiek van Vleuten looks to be the favorite, however, Chantal van den Broek-Blaak and Demi Vollering ( both SD Worx) will want the home-country win, as will Ellen van Dijk ( Trek-Segafredo Women).
The men’ s race will also see a new winner, as Wout van Aert ( Jumbo-Visma) is recovering from a COVID-19 infection. The very heavily favored Dutch racer Mathieu van der Poel ( Alpecin-Fenix), just off his second Tour of Flanders win, try to pad his palmarès ahead of compatriots Tom Dumolain ( Jumbo-Visma), the experienced Niki Terpstra ( TotalEnergies), and a slew of others seeking a win.
The parcours are very challenging, and while it’ s 254km for the men ( shorter than a monument-distance race) and 128km for the women, it serves up plenty of climbing on a very circuitous route. The men’ s race has 33 climbs in store while the women’ s race offers 19.
Cycling fans in the United States and Canada can stream the Amstel Gold Race to a web browser, or watch it in the FloBikes app. Coverage of the women’ s race kicks off at 6:35 a.m. EST. Live coverage of the men’ s Amstel Gold Race starts at 7:00 a.m. EST.
Viewers in the U.K. and most of Europe can watch the Amstel Gold Race on Eurosport Player or Discovery+. Eurosport 1 will offer the broadcast of the men’ s race from 13:00 local time and Sporza will broadcast the men’ s race from 14:15 local time.
Like North American viewers, Australians can watch the Amstel Gold Race race streamed through FloBikes. SBS will also broadcast the women’ s race from 21:00 AEST on SBS Viceland and SBS On Demand, while the men’ s race will be shown from 22:35 AEST.
Get the latest race news, results, commentary, and tech, delivered to your inbox. | general |
Nanotechnology-based optical sensors for faster, cheaper COVID tests | Apr 08, 2022
Nanotechnology-based optical sensors for faster, cheaper COVID tests ( Nanowerk News) A University of Georgia nanotechnology research group entered the race to develop a rapid test for COVID-19 in August 2020, running experiments on a new sensor for an American manufacturing company. The group, led by Yiping Zhao and Ralph Tripp, tested nanotechnology-based optical sensors designed for COVID-19 detection and saw the potential for their home-grown technology.
In March 2022, the group filed a patent application and published its first paper on rapid detection of COVID-19, using a localized surface plasmon resonance ( LSPR) virus sensor, developed based on human angiotensin-converting enzyme 2 protein ( ACE2) functionalized silver nanotriangle arrays.
The sensor has high sensitivity and specificity to the spike protein RBD of SARS-CoV-2 as well as human coronavirus NL63.
“ Right now, we already have rapid antigen test kits available on the market, though the big issue continues to be the high rate of false positives, around 60%, ” said Yanjun Yang, doctoral student in the UGA College of Engineering and lead author on the new paper ( Sensors and Actuators B: Chemical, Silver nanotriangle array based LSPR sensor for rapid coronavirus detection).
“ Our technology, also in a rapid kit but using a spectrometer to do the detection, is much more accurate. ”
The swab-based rapid test developed by the Zhao group uses a UV spectrometer for spike protein detection. The test will cover all COVID-19 variants, as well as any future variants.
“ The method we developed shall have a much better sensing performance than the rapid test kits, very close to the PCR tests currently in use, ” said Zhao, Distinguished Research Professor in the Franklin College of Arts and Sciences department of physics and astronomy. “ The setup and the operation of the sensor is very simple, and the test time essentially will be less than 10 minutes. ”
Zhao’ s lab is developing a detector based on this work within $ 10 and the sensor will link to a smartphone app.
“ The LSPR sensor has several advantages in rapid diagnostics of SARS-CoV-2 ( CoV2). Highly sensitive, specific, and able to detect CoV2 at picomolar concentrations in saliva, it’ s rapidity at less than 20 minutes is as good or better than current diagnostic platforms including RT-qPCR, also known as the ‘ gold standard’, ” said Tripp, professor and GRA Chair in Vaccine and Therapeutic Development in the College of Veterinary Medicine department of infectious diseases and co-author on the study. “ In addition, this method of detection is highly reproducible. This platform is a significant leap forward in diagnostics. ”
“ Working with biologists and developing this technology was a great experience, ” Yang said. “ I’ ve only done research in the lab, so I never knew how to make something become a product, so it’ s a really good opportunity to understand how we can tie our work to the practical issues and make it commercialized. ”
Source: By Alan Flurry, University of Georgia
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Peter Sagan to undergo health checks, doubtful for Paris-Roubaix | Get access to more than 30 brands, premium video, exclusive content, events, mapping, and more.
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The spring’ s not getting much brighter for Peter Sagan.
The Slovak megastar is a likely non-starter for next weekend’ s Paris-Roubaix as medics scramble to unpick medical problems that left him fatigued and flat-lining in recent weeks.
“ Peter is not well lately, his legs hurt a lot and he struggles to cope with the great efforts, ” Sagan’ s long-time press officer and confidante Gabriele Uboldi told Tuttobici.com on Friday. “ But in reality, that is nothing new compared to the last month. He is always exhausted, and after the races he is very sleepy. ”
Sagan was hit with a second bout of COVID this winter, setting the tone on a spring that saw him abandon Tirreno-Adriatico with illness, DNF at Gent-Wevelgem, and abandon a planned start at Tour of Flanders last weekend.
A mid-race abandon at Circuit de la Sarthe this week cranked the crisis to the point that Sagan is to undergo a battery of medical checks and will likely be on the sidelines for next weekend’ s Roubaix, a race he won in 2018.
“ I have been working with him for nine years and I have never seen him retire from a race except for some bad fall, ” Uboldi said. “ At the moment we do not know how his season will continue, he has the Paris-Roubaix scheduled but personally, I think it is difficult that he can be at the start in good condition, ”
Sagan was slated for a starring role at a reconfigured TotalEnergies squad this season but has so far failed to hit the mark. Instead, Anthony Turgis and Dries van Gestel have given sponsors some succor with podium-placings at Milan-San Remo and Gent-Wevelgem.
The clock is ticking fast – maybe too fast – for Sagan to shine in Roubaix.
After that, Sagan’ s next top target is the Tour de France. TotalEnergies has three months to unpick the puzzle.
“ There is certainly something wrong because Peter is never like this, even when he is out of condition, ” Uboldi said.
Get the latest race news, results, commentary, and tech, delivered to your inbox. | general |
I 'm 61, left my job due to medical reasons, and made $ 150,000 from the sale of my home. I 'd like to work for at least another 5 years. Can I still retire? If so, how? | Dear Quentin,
I recently sold my house and had to leave my job due to a medical issue that was easily resolved, and I am now fine. I have approximately $ 150,000 in my checking account from the sale of my house. I am unsure what to do with this and have considered contacting a financial adviser. I will be turning 62 in May.
I am renting a condo for $ 1,100 per month. Utilities are very affordable. I have COBRA health coverage available until the end of November 2023. It is approximately $ 700 per month.
I have very strong technical skills as I have worked as a business analyst in government and higher education for over 20 years. I am just really unsure how to proceed. I believe I would like to work until 65 or 67, for something to do and to receive health insurance, as I have a number of health concerns.
I have Social Security and a couple of pensions, as well as approximately $ 180,000 in a 403 ( b) account. Do you have any suggestions on how best for me to proceed based upon the information that I have provided? I am a single female and have one child who is a physician, married to a physician, with no grandchildren.
Thank you so very much for your time and consideration.
Unsure of What to Do Now
Dear Unsure,
You’ ve clearly been through an upheaval in your life — physically, financially and emotionally. I commend you for getting back on your feet and, rather than ruminating over things that are out of your control, taking a lay of land, and figuring out what’ s next. That’ s the kind of resilience that most people strive for, but often don’ t achieve. We are in a tight labor market, and your experience is worth its weight in gold. I’ ve said it before, and I’ ll say it again, I take my hat off to you.
Read:
Big pay raises and chance to work from home drive record job-hopping
I don’ t know the specific details of your medical and financial situation, but you now have $ 150,000 in the bank and $ 180,000 in a retirement account, relatively low expenses and you are still able to work, so you still have a lot going in your favor. You also have the added advantage of being highly skilled in a hot job market, so can look into jobs that allow you to scale up or down — and likely work remotely too. You need a team: a fee-only financial planner and/or your daughter to forecast your living costs.
Janet Lee Krochman, president of
Janet Lee Krochman, A Professional Corpo
ration in Costa Mesa, Calif., supports the idea of a part-time retirement. “ I have heard many a local story about someone in their 60s, headed toward ‘ traditional retirement’ when the concept of part-time work ‘ suddenly becomes available’ when the employer realizes the knowledge base that is about to leave out the front door, ” she says. “ Almost all of these arrangements are a win-win. ”
Read:
Don’ t burn bridges — companies are welcoming back older workers
“ Some would/could argue that without retirement, the next generation does not get to move up, ” she adds. “ With ‘ part-time retirement,’ positions still open up, the employee becomes essentially what the postretirement consultant role was 20 years ago. The employee continues to provide necessary knowledge for a few more years ( or more), they keep certain benefits, which they enjoy and it goes a long way to ease the employee into what will eventually be full time retirement. ”
Read:
‘ What do we do with all that talent?’ Older workers and the new economy
Chris Cooper
, a California licensed professional fiduciary, agrees that part-time work is a secure way to approach the next phase of your life. He says you may have a few obstacles to navigate in terms of your health insurance. Your health insurance with COBRA will run out before you are Medicare eligible, he says. ( You can read more on that
here
.) “ Hopefully, you live in a state with a strong Marketplace for the Affordable Care Act, ” he adds. “ If not, you will have less choice in insurers. ”
This is a good time for experienced workers. Almost 57 million people left jobs — many more than once — in the 14-month period from January 2021 to February 2022. And nearly 89 million people were hired in the past 14 months,
government data show
, reflecting a record number of job openings and a dire need for labor. During the COVID-19 pandemic, there has been a surge in people hiring remotely and working remotely, and that opens more opportunities for people in smaller towns and cities.
Let us know how you get on. And good luck with this next chapter.
Yo
u
can email The Moneyist with any financial and ethical questions related to coronavirus at qfottrell @ marketwatch.com, and follow Quentin Fottrell on
Twitter.
Check out
the Moneyist private Facebook
group, where we look for answers to life’ s thorniest money issues. Readers write in to me with all sorts of dilemmas. Post your questions, tell me what you want to know more about, or weigh in on the latest Moneyist columns.
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More from Quentin Fottrell
:
•
Do I resist refinancing my $ 160,000
federal student loan at a lower rate in the hope there will be loan forgiveness? What are the chances it will happen?
•
‘ I feel incredibly guilty’: My sister is unemployed and my brother makes $ 40,000. Should I offer to match their 529 plan contributions for their kids?
•
‘ My stepmother is crying poor, and selling everything of value. She’ s cut off all communication’: My father died without a will and I am his only child. What now? | business |
FTSE 100 Closes Higher Led by Mining, Energy Stocks | The FTSE 100 closed up 1.6% on Friday with strong performances from the mining, energy, healthcare and financial sectors despite rising inflation and expectations of higher interest rates. Miner Anglo American was the day's biggest riser closing up 4.8%, followed by Shell and BP which closed up 3.9% and 3.7%, respectively. `` The index has bounced back from Thursday's ex-dividend driven fall, and with mining stocks leading the way it is back on course for the recent highs, '' IG says. Leading the fallers was Dechra Pharmaceuticals which closed down 3.2%, followed by Intertek Group, which fell 3%.
Shares in Aminex PLC fell Friday after the company said it wasn't able to agree on a second exploration period for the Nyuni Area, offshore Tanzania.
RWS Holdings PLC said on Friday that Rod Day has been appointed as interim chief financial officer and will join the board on an interim basis effective today.
Broadband provider TalkTalk's shareholders are mulling potential offers for the company, Sky News reports.
Hollywood Bowl Group PLC said Friday that its full-year performance will be ahead of expectations and that it intends to reinstate the dividend after a strong first half.
Ferrexpo PLC on Friday reported that its iron-ore pellet production fell 11% on quarter in the first quarter as a result of Russia's invasion of Ukraine.
Johnson Matthey PLC said Friday that it expects its underlying performance for fiscal 2022 to meet market expectations, and that it foresees further disruption in fiscal 2023.
Jet2 PLC said Friday that it expects to report an adjusted pretax loss for fiscal 2022 of between 378 million and 383 million pounds ( $ 494.2 million- $ 500.7 million) after a year marked by travel restrictions linked to Covid-19 and new variants of the disease.
Premier Miton Group PLC on Friday reported a decline in assets under management in the second quarter of fiscal 2022 as a result of geopolitical uncertainty.
Ramsdens Holdings PLC said Friday that its performance for the first half of fiscal 2022 was strong across each of its divisions and it expects to swing to a pretax profit for the period.
Unite Group PLC said Friday that the like-for-like valuation of its property portfolio inched up in the first quarter, and it has recorded strong advance sales for the upcoming academic year.
Sound Energy PLC said Friday that it no longer plans to make an offer for Angus Energy PLC following a due diligence review, and after careful consideration.
Marwyn Acquisition Company PLC said Friday that it continues to evaluate potential platform acquisition opportunities.
VP PLC said Friday that it expects to report full-year results ahead of expectations as performance since the publication of its interim report has been driven by increased demand.
Zephyr Energy PLC said Friday that first-quarter hydrocarbon production from its new Williston-Basin assets in North Dakota was ahead of expectations. Here's what the Rocky Mountain-focused oil-and-gas company had to say:
CMC Markets PLC said Friday that it expects to report net operating income for fiscal 2022 at the top end of its guidance.
1129 GMT - Foresight Group Holdings ' trading update for the year ended March 31 leaves it on track to achieve its ambitious targets, especially after the past three months, Jefferies says. The infrastructure and private-equity manager's growth shows the durability of the group's fundraising machine, Jefferies says. `` With fiscal 2022 revenues and Ebitda both also set to meet or exceed expectations, FSG looks strongly-positioned to achieve its ambitious targets this time next year, '' the bank says. Jefferies has a buy recommendation on the stock, with a target price of 520 pence. Shares are up 8.2% at 395 pence.
Ithaca Energy Acquires Shell's Cambo Field Operator in $ 1.5 Bln Deal
1010 GMT - Ithaca Energy is acquiring U.K. North Sea oil-and-gas producer Siccar Point Energy for $ 1.1 billion plus $ 360 million in contingent payments. Siccar Point is the operator of the Cambo oil field, of which Shell holds a 30% interest. `` The development of the Cambo and Rosebank fields is a huge opportunity to not only help secure the U.K.'s energy future for at least another quarter of a century, but also to create thousands of direct and indirect jobs in the process, '' Ithaca's CEO Alan Bruce says. Cambo is expected to deliver up to 170 million oil-equivalent barrels during its operational life, according to Ithaca.
1009 GMT - Shares in Ferrexpo rise 8.8% after the Ukraine-focused iron ore pellet producer reported operational figures for the first quarter. The company's performance was surprisingly strong, with sales of 2.6 million tons meaning that it was able to sell almost all of its production for the quarter, Peel Hunt says. This was despite exports from the Pivdennyi port being suspended due to Russia's invasion of Ukraine. Exports continue with rail and barge sales to Europe, and operations are in a better position than Peel Hunt had feared, it says. Still, the brokerage retains a hold rating on Ferrexpo given the risk to the business.
0909 GMT - While EU pledges to wean the bloc off Russian gas have come with a long timetable, Russia is unlikely to find new buyers in time to make up for the lost demand, JPMorgan says. Europe imported around 186 billion cubic meters of Russian gas last year, of which 101 bcm goes to EU states which plan to phase out Russian imports. As most of it flows through pipelines, Russia would be unable to easily redirect such an amount. A lack of significant pipeline connections with China means Russia's closest partner would also not be a possible destination and Russian producers would have to shut in some wells to make up for losing around 100 bcm of demand, JPM says.
0859 GMT - Sterling could weaken in coming months if the Bank of England raises interest rates by less than the market expects due to the U.K.'s cost of living crisis, RBC Capital Markets says. RBC economists ' forecasts imply a further swing toward supporting economic activity over controlling inflation as the BOE's policy driver, RBC currency strategist Adam Cole says in a research note. `` They expect no changes in rates after a final hike in May, though with markets priced as they are, a significantly less dovish outlook than this would still be negative for GBP. '' GBP/USD falls 0.2% to 1.3048, after earlier hitting a seven-week low of 1.3026. EUR/GBP rises 0.1% to 0.8332.
0819 GMT - The new U.K. energy security strategy is a necessary step forward in the country's journey to net zero emissions, but it lacks silver bullets to reduce reliance on gas in the short and medium terms, ING says. This means Britain will continue to be vulnerable to volatility in power prices over the next few years, given the lack of alternatives to gas for power generation and residential heating, potential increases in gas demand from hydrogen production, and a very low gas storage capacity, the bank says. `` For the U.K. economy, the more pressing question is whether the government will offer further support for consumers and businesses while gas prices remain elevated, '' ING says.
Contact: London NewsPlus, Dow Jones Newswires; Write to Sarka Halas at sarka.halas @ wsj.com
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ADRs End Mixed; Adaptimmune Therapeutics, Genetic Technologies Trade Actively | International stocks trading in New York closed mixed on Friday.
The S & P/BNY Mellon index of American depositary receipts ticked down 0.1% to 155.61. The European index edged up 0.6% to 145.11. The Asian index lost 1.4% to 186.11. The Latin American index moved up 0.7% to 227.71, while the emerging-markets index retreated 1.1% to 320.30.
Adaptimmune Therapeutics Plc was among those whose ADRs traded actively.
The novel cancer immunotherapy products developer fell 2.7% after it said Friday that data from multiple solid tumor indications confirms that MAGE-A4 is a broadly expressed cancer target for SPEAR T-cell therapy.
Molecular diagnostics company Genetic Technologies moved down 3.8% after it provided its year to date results for the nine months ended March 31, noting that its product geneType Multi-Risk Test received approval for commercial release and that the U.S. Patent and Trademark Office granted a patent for the geneType Covid-19 Risk Test.
Write to Denny Jacob at denny.jacob @ wsj.com
Transparency is how we protect the integrity of our work and keep empowering investors to achieve their goals and dreams. And we have unwavering standards for how we keep that integrity intact, from our research and data to our policies on content and your personal data.
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We sell different types of products and services to both investment professionals and individual investors. These products and services are usually sold through license agreements or subscriptions. Our investment management business generates asset-based fees, which are calculated as a percentage of assets under management. We also sell both admissions and sponsorship packages for our investment conferences and advertising on our websites and newsletters.
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As COVID-19 cases decline in the U.S., White House officials face outbreak | House Speaker Nancy Pelosi ( D-Calif.) is the latest official
to test positive for COVID-19
after attending an event with President Joe Biden.
Her spokesperson announced the test on Thursday.
Politico reported Thursday
that dozens of White House aides and federal officials have tested positive for the virus in recent weeks, further raising concerns about an outbreak at a time when the administration’ s narrative is that the pandemic is under control.
Attorney General Merrick Garland and Commerce Secretary Gina Raimondo both announced positive tests this week, as did Reps. Joaquin Castro ( D-Texas), Katherine Clark ( D-Mass.), and Adam Schiff ( D-Calif.); Sens. Susan Collins ( R-Maine) and Raphael Warnock ( D-Ga.); Jamal Simmons, aide to Vice President Kamala Harris; Jill Biden’ s press secretary Michael LaRosa; and Valerie Biden Owens, Biden’ s sister,
according to NBC News
.
Biden
tested negative
for COVID-19 on Friday, White House officials said.
The cases
follow the Gridiron Club dinner
last Saturday. ( The Gridiron Club dinner is an annual event attended by journalists in Washington, D.C., and policy makers.) Dozens of attendees have since tested positive.
The city of Washington, D.C., is still largely reporting record lows of COVID-19 cases, though the number of new infections on Wednesday jumped to 717, the highest point since Jan. 31,
according to a New York Times tracker
.
Dr. Anthony Fauci, Biden’ s chief medical advisor and director of the National Institute of Allergy and Infectious Diseases,
told Bloomberg
on Wednesday that he expects to see an increase in
cases of Covid-19
over the next few weeks and believes another surge in the fall is likely.
“ Hopefully there is enough background immunity so that we don’ t wind up with a lot of hospitalizations, ” Fauci said.
Here’ s what else you should know about COVID-19 right now:
The COVID-19 vaccines prevented more than 2 million deaths, 17 million hospitalizations, and $ 899 billion in health care spending, according to a new
report
from the Commonwealth Fund.
A federal appeals court upheld a rule that all federal employees must be vaccinated, citing the fact that the president ordered the same type of requirement as private-sector CEOs,
reported the AP
.
Fluvoxamine, a generic antidepressant, likely reduces COVID-19 hospitalizations, according to a new
study
, published Wednesday in JAMA Network Open, that assessed data from three clinical trials. The study’ s researchers urged additional studies but noted that fluvoxamine could be a treatment option for people without access to the antivirals developed by Pfizer Inc.
PFE,
+0.02%
and Merck & Co. Inc.
MRK,
+1.01%
and Ridgeback Biotherapeutics.
Here’ s what the numbers say:
The seven-day average of new COVID-19 cases in the U.S. was 29,429 on Thursday,
according to a New York Time tracker
, though new infections have increased recently in about half of U.S. states and territories, particularly in the Northeast.
Meanwhile, the daily average of COVID-19 related hospitalizations fell to 15,096 on Thursday, from 15,266 the day before. This is the lowest level since April 1, 2020. The daily average for deaths declined to 564 from 599 on Wednesday, to the lowest total since Aug. 9, 2021.
Globally, the total number of cases rose to 496.42 million and deaths grew to 6,171,259. The U.S. has reported a total of 80.29 million cases and 984,571 deaths over the course of the pandemic, according to
data aggregated by Johns Hopkins University
.
—Tomi Kilgore | business |
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