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mRNA in the Spotlight as BioNTech Finally Makes a Splash in Cancer
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By now, everyone in the science community is aware of the effectiveness of the messenger RNA ( mRNA) vaccines developed by Moderna and Pfizer-BioNTech. Moderna and BioNTech are the big leaders in the field of infectious diseases, but Moderna has also been focusing on cancer therapeutics. An even larger segment of BioNTech’ s mRNA programs are focused on cancer, and they just made a major step in that direction.
At the Clinical Trials Plenary Session at the 2022 AACR Annual Meeting this weekend, Dr. John Haanen, M.D., Ph.D., of the Netherlands Cancer Institute ( NCI) in Amsterdam, Netherlands, presented data from BioNTech’ s ongoing first-in-human Phase I/II trial of its CAR-T cell therapy, BNT211, in patients with advanced solid tumors.
CAR T is short for chimeric antigen receptor T cells. The process involves collecting immune cells from the patient, engineering them in the laboratory to attack cancer cells, then infusing them back into the patient, where they grow and fight cancer. It’ s been very successful in blood cancers, but much less so in solid cancers.
BNT211 is made up of two drug products: an autologous CAR-T cell therapy that targets the oncofetal antigen Claudin-6 ( CLDN6) and a CLDN6-encoding CAR-T cell amplifying RNA vaccine ( CARVac), which leverages BioNTech’ s mRNA-lipoplex technology. The presentation Haanen gave included data from 16 patients who received the therapy, some with just the CLDN6 CAR-T and some combined with CARVac.
The tumor indications included testicular cancer, ovarian cancer, endometrial cancer, fallopian tube cancer, sarcoma and gastric cancer. Both cohorts showed the therapy was well tolerated and demonstrated encouraging indications of clinical activity. Some cytokine release syndrome was observed but apparently were manageable. There were mild indications of pancreatic toxicity.
The first assessment six weeks after infusion showed 6 of 14 evaluable patients had a partial response, and 5 had stable disease with their target lesions shrinking. One patient showed no change, and two patients were progressing. All four testicular cancer patients in the higher dose level demonstrated disease control and three showed objective responses, with one showing partial response after receiving the lowest CAR-T dose. Two patients with ovarian cancer demonstrated responses.
“ Seeing first anti-tumor effects even at the lowest CAR-T cell dose in this heavily pre-treated patient population is truly remarkable and points to the potential of our CAR design and our CARVac approach, ” said Dr. Ozlem Tureci, M.D., co-founder and chief medical officer of BioNTech.
In addition to being good news for BioNTech, it’ s a good proof-of-concept for mRNA technology outside the field of infectious diseases. BioNTech has programs outside of COVID-19 for infectious diseases, including for shingles, malaria, tuberculosis, HSV and HIV. But its oncology program is extensive as well, with at least five programs in Phase II and about a dozen in Phase I covering pancreatic cancer, non-small cell lung cancer, colorectal cancer, melanoma, HPV16+ head and neck cancer, prostate cancer and other solid tumors.
Similarly, Moderna has infectious disease programs ongoing for cytomegalovirus, HSV, Zika, Nipah, RSV, flu and others. But it is also developing mRNA therapeutics for autoimmune disorders and cancer, including a personalized cancer vaccine ( mRNA-4157), a KRAS vaccine ( mRNA-5671), a checkpoint vaccine ( mRNA-4359) and many others in the cancer space.
As recently as 2010, Bancel was skeptical of the mRNA technology, saying that “ It’ s impossible. ” Then he took the lead with the company in 2011. Overall, scientists viewed mRNA-based therapies as intriguing and exciting, but a very long way from being viable. Many thought that the reason the companies involved in this area focused on infectious disease vaccines was it was “ low-hanging fruit, ” much more likely to be possible than more complex diseases such as cancer.
Speaking about his presentation at AACR, Haanen said, “ I was quite skeptical at first because CAR T-therapy hadn’ t worked before in solid tumors, so we were very excited to see how the metastases disappeared and the patients improved. These patients had a wonderful partial response, and one patient had a complete remission that is still ongoing, lasting now for almost six months. ”
Despite the promise in cancer, it’ s still very early and the study population is quite small. There weren’ t signs of severe toxicity in the trial, but when they move into larger studies that is a potential problem, especially because in the smaller study there were some indications of pancreatic toxicity. Haanen noted, “ We don’ t know what would happen if we treat patients with a higher dose. That is something we still have to learn. ”
Other research is working to make CAR T work for other indications besides cancer — not just in hematological cancers, where it is quite successful, but in solid tumors, and in other indications. For example, research was published in January on using CAR T to recognize and treat scarring in the heart. Researchers at the University of Pennsylvania injected CD5-targeting lipid nanoparticles containing the mRNA instructions to reprogram T lymphocytes, which created CAR T cells inside the body. In a mouse model of heart disease, the approach successfully decreased fibrosis and restored cardiac function.
“ Fibrosis underlies many serious disorders, including heart failure, liver disease, and kidney failure, and this technology could turn out to be a scalable and affordable way to address an enormous medical burden, ” said senior author Dr. Jonathan A. Epstein, M.D., chief scientific officer for Penn Medicine, and executive vice dean and the William Wikoff Smith Professor of Cardiovascular Research in the Perelman School of Medicine. “ But the most notable advancement is the ability to engineer T cells for a specific clinical application without having to take them out of the patient’ s body. ”
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general
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What comes next in the COVID-19 pandemic?
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The COVID-19 pandemic is not over, but with collaboration and solidarity, we can transition to a manageable endemic disease state sooner and better mitigate the most severe health and socioeconomic impacts. In this third year of pandemic response, society needs to focus on improved implementation of effective interventions to end the acute phase. Governments and health authorities have the necessary knowledge and tools in hand, in the form of vaccines, diagnostics, and therapeutics, but equitable availability of these tools remains a challenge globally.
Today's decisions and efforts will continue to affect the pandemic's overall health, social, and economic toll. According to Our World in Data, 700 000 deaths were recorded as COVID-19 related between January and March, 2022, and only 14·5% of people in low-income countries have received at least one dose of a COVID-19 vaccine. SARS-CoV-2 variants continue to emerge as trust between governments and their constituents is tested, rendering sustained implementation of broad community-based interventions challenging. In many communities, crucial non-COVID-19 health services are yet to be fully restored to pre-pandemic levels.
The emergency phase of the COVID-19 pandemic will eventually end, but when will be determined by collective actions. Likewise, what is learned and how society grows from this experience can still be influenced. The next pandemic need not catch the world so unprepared.
The extraordinary nature of this pandemic calls for extraordinary analyses at global, national, and organisational levels. Society must reflect on what has been learnt about ourselves, our communities, our governance, and our preparedness and response systems. SARS-CoV-2 has caused too much harm in terms of death, morbidity, careers, relationships, finances, plans, and dreams for us to fall short of rigorous and independent after-action appraisal of the pandemic response. Communities have a right to understand why and how the pandemic response unfolded the way it did and to be assured improvements will be made. National and global leaders must use the knowledge gained from this pandemic and its reviews to ensure more robust multidisciplinary governance and equitable health and public health systems going forward.
A fresh approach to global health security is needed as well as the development of better measures of preparedness, with a greater emphasis on collaboration and equity. We call for improved funding of partners to enhance both preparedness efforts and alert and rapid response capabilities at both national and international levels. Sustained financing for institutions is necessary to train future leaders and build a global response workforce that embraces multidisciplinary scientific and public health networks as a core component. Immediate operational response needs at the country and local levels must be supported with sufficient resources.
Since its inception in 2000, the Global Outbreak Alert and Response Network ( GOARN) has grown to encompass 270 partners and has responded to almost every major national and international outbreak through deployment of more than 3500 experts to over 100 countries. Drawing from this experience, we offer recommendations in the appendix outlining important next steps at this stage of the COVID-19 pandemic that would enable communities to better mitigate the health and societal impacts of the next pandemic.
For Our World in Data COVID-19 deaths see https: //ourworldindata.org/grapher/cumulative-deaths-and-cases-covid-19For more on GOARN see https: //extranet.who.int/goarn/For Our World in Data COVID-19 vaccinations see https: //ourworldindata.org/covid-vaccinations? country=OWID WRL
For Our World in Data COVID-19 deaths see https: //ourworldindata.org/grapher/cumulative-deaths-and-cases-covid-19
For more on GOARN see https: //extranet.who.int/goarn/
For Our World in Data COVID-19 vaccinations see https: //ourworldindata.org/covid-vaccinations? country=OWID WRL
We declare no competing interests.
Download.pdf (.12 MB) Help with pdf files Supplementary appendix
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tech
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Lower oil prices pull down energy sector and TSX to start week
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Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
China's zero-tolerance policy toward COVID cases has resulted in extended lockdowns in Shanghai, its second-largest city with some 25 million people, following the reporting of record cases over the weekend.
`` We have seen air traffic in China decline so the impact for consumption of jet fuel, gasoline, etc., at least in the near-term is impacting the demand outlook. And really China is a big player in that space because it is the largest crude oil importer, '' said Angelo Kourkafas, investment strategist at Edward Jones.
The energy sector lost 2.6 per cent on the Toronto Stock Exchange with Cenovus Energy Inc. decreasing 5.8 per cent as crude prices fell to their lowest level since Feb. 25.
The May crude contract was down US $ 3.97 at US $ 94.29 per barrel and the May natural gas contract was up 36.5 cents at US $ 6.64 per mmBTU.
While lower crude prices provides some welcome relief for motorists, it pushed the S & P/TSX composite index to close down 83.86 points to 21,790.49.
In the U.S., stock markets lost ground as growth sectors like technology fell as bond yields rose to a three-year high in anticipation of aggressive monetary policy tightening. The 10-year treasury bond yield increased to as much as 2.793 per cent.
In New York, the Dow Jones industrial average was down 413.04 points at 34,308.08. The S & P 500 index was down 75.75 points at 4,412.53, while the Nasdaq composite was down 299.04 points at 13,411.96.
The 10-year Canadian government bond yield rose to as much as 2.178 per cent, its highest level since the end of 2013. The increase was in anticipation that the Bank of Canada will raise rates by half a percentage point on Wednesday. It follows Friday's labour market survey that showed Canada's unemployment rate fell to the lowest on record in March while wage growth is picking up.
`` We think both the Fed and the Bank of Canada are likely to deliver what I would say are supersized rate hikes, '' Kourkafas said in an interview.
While the tech sector fell 1.8 per cent in the U.S. it was down only slightly in Canada as losses were partially offset by shares of Shopify Inc. increasing 2.9 per cent after the Ottawa-based company announced a 10-for-one stock split.
Nine of the 11 major sectors on the TSX were lower.
Consumer staples and materials were higher, the latter helped by higher gold prices.
The June gold contract was up US $ 2.60 at US $ 1,948.20 an ounce and the May copper contract was down 9.1 cents at US $ 4.63 a pound.
The Canadian dollar traded for 79.23 cents US compared with 79.43 cents US on Friday.
Possible market catalysts this week are a U.S. inflation report on Tuesday and the Bank of Canada rate decision on Wednesday.
Investors will also be waiting for the start of earnings season with the reporting of first-quarter results by several U.S. banks.
`` There is expectation that all these companies, because the high input costs and higher labour costs, they're going to experience some margin pressures, so it's going to be interesting to see the resilience of the corporate sector, '' said Kourkafas.
`` So we may be in a little bit of holding pattern as we're waiting for these events to unfold. ''
Shopify announced a number of proposed changes to its governance and share structure on Monday.
An analyst who covers Canada’ s banks is warning of choppy waters ahead and is urging clients to take a more defensive approach as economic uncertainty threatens to send shares sharply lower.
Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
Traders are shunning technology stocks amid mounting risks from soaring Treasury yields and hawkish commentary from the U.S. Federal Reserve.
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general
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Hyperbaric oxygen therapy shows promise for opioid addiction treatment -- ScienceDaily
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The research team recruited participants enrolled in a local opioid treatment program to test the effects of hyperbaric oxygen therapy, a treatment that involves breathing pure oxygen in a pressurized environment.
Published in the Journal of Addictions Nursing, the first paper describes a pilot study of 31 participants that showed that those who had received hyperbaric oxygen therapy as part of a planned methadone taper were able to maintain a significantly larger dose reduction of 4.3 mg three months after the study, as compared to 0.25 mg in participants who did not receive the therapy. They also reported half the level of withdrawal symptoms experienced by control participants after only one day of hyperbaric oxygen therapy.
`` While methadone helps people with opioid addiction get stable and resume their normal lives, it's still an opioid that they are taking every day, '' said study co-author Matthew Layton, a professor in the WSU Elson S. Floyd College of Medicine and a former opioid treatment program medical director. `` About half of people in treatment want to get off of methadone for various reasons, yet many who have tried have failed and relapsed. Our findings suggest that hyperbaric oxygen therapy could potentially be used as a non-pharmacological tool to help people step down their methadone treatment. ''
The second study, which was published in Pain Management Nursing, was a small randomized controlled trial of eight participants that looked more closely at withdrawal symptom relief. It found that participants in the hyperbaric oxygen therapy treatment group reported lower pain intensity and drug cravings than control participants who had been given an oxygen mixture equivalent to room air delivered at normal atmospheric pressure. The researchers also saw improvements in other outcomes, such as sleep quality and mood.
`` While for some the challenge is to get off methadone, others struggle to stay in treatment early on because finding the right dose to stabilize symptoms can be difficult to achieve, '' said first author Marian Wilson, an associate professor in the WSU College of Nursing and an expert on pain management and opioid use disorder. `` As a result, a lot of people experience withdrawal symptoms in that adjustment period that can be severe enough to make them resume illegal drug use or drop out of treatment. ''
Based on the collective findings from the two studies, the researchers are pursuing funding for a clinical trial to confirm their findings in a larger sample of participants, who would be followed for several years.
The idea for the two studies came from earlier research by one of the WSU researchers that showed that hyperbaric oxygen therapy provided pain relief and reduced physical signs of opioid withdrawal in mice.
`` We were anxious to see if it would work in people, '' said study co-author Raymond Quock, a professor in the WSU College of Arts and Sciences, who led that work.
If their findings hold up in a larger clinical trial, hyperbaric oxygen therapy could become a non-pharmacological tool that providers can use to help people manage pain and potentially reduce their opioid use.
`` Last year, over 100,000 people died as a result of the opioid epidemic within the COVID-19 pandemic, '' said Layton. `` That shows us that opioid addiction is still a very big problem, and we need to have better ways to approach it. ''
In addition to Layton, Wilson, Quock and others at WSU, collaborators on these studies included Karen Stanek, the medical director for the Spokane Hyperbaric Center and Alvina Jesse, a program manager with the Spokane Regional Health District.
Funding for this work came from the State of Washington's Initiative Measure No. 171, which was administered through the university's Alcohol and Drug Abuse Research Program.
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science
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New survey highlights lingering COVID fears among Japan's nurses
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Around 80% of nursing staff working at institutions across Japan are fearful of contracting COVID-19, a new survey has shown, highlighting lingering fears among a key cog in the country’ s medical system as a fresh wave of the virus appears to be emerging.
The online survey, conducted by the Japanese Nursing Association on its members last autumn and released Saturday, obtained answers from around 5,100 members, with the response rate standing at 34.0%. The average age of respondents came to 41.3 and women accounted for 93.5% of all respondents. Of the respondents, 86.6% were nurses, while the rest were midwives and others.
The first COVID-19 infection case in Japan was confirmed in January 2020.
With multiple answers allowed, the survey asked the respondents to look back on the period between March 2020 and September 2021 and assess the effects of the spread of the coronavirus.
Those who cited fears and anxiety about contracting COVID-19 accounted for 78.6% of all respondents, while 48.8% said they felt their work environment had deteriorated.
The survey also showed that 19.6% said they had experienced discrimination or prejudice against them. The proportion of respondents who gave such answers was higher among those who were directly involved in the treatment of COVID-19 patients.
Furthermore, 64.5% said they were unable to feel a sense of fulfillment or enjoyment in their daily lives at the time of the survey, when compared with how they were in and before March 2020.
A total of 56.8% said they felt tired all the time. Nearly 50% of the respondents said they either felt anxious or irritated.
While almost 70% of all respondents said they wanted to continue to work as a nursing staff member, the proportion of those who gave the same answer among respondents in their 20s came to only 55.6%.
“ We believe that the protracted COVID-19 response has caused a long-term damage on the health conditions ” of nursing staff, the association said, adding, “ We’ d like to work on creating an environment that would allow staff members to continue working, based on the results of the survey. ”
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tech
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COVID-19 tracker: New cases in Tokyo rise week-on-week for fifth straight day
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Tokyo confirmed 4,562 new COVID-19 cases on Monday, seeing a week-on-week increase for the fifth consecutive day as health experts warn of another wave of infections.
The daily tally, up by about 180 from a week before, is still far smaller than the nearly 21,000 cases registered in early February at the pandemic’ s peak in the capital. However, the highly contagious BA.2 subvariant of the omicron strain has spread rapidly in many parts of the country.
The seven-day average of new cases in Tokyo came to 7,596.4, compared with 7,607.4 a week earlier.
The number of severe cases in Tokyo fell by one from Sunday to 28, while two deaths were reported on Monday.
Some infectious disease experts have said Japan, where the cumulative total of coronavirus cases topped 7 million on Saturday, is entering its seventh wave of infections, with government officials struggling to raise the rate of booster shots as it is especially low among younger people.
On Sunday, 49,172 new COVID-19 cases were reported nationwide, up by 1,839 from a week before, as prefectures with big populations, such as Kanagawa and Osaka, confirmed 4,098 and 3,652 infections, respectively.
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tech
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Japan detects first case of omicron XE variant
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The health ministry announced Monday that Japan had for the first time detected the XE “ recombinant variant ” of the omicron strain of the coronavirus during a routine check at an airport.
The XE variant was detected in a woman in her 30s who arrived at Narita Airport from the United States on March 26. The woman, whose nationality was not immediately identified, was asymptomatic, the ministry said.
The woman had received two shots of vaccine developed by Pfizer Inc., but she tested positive on arrival for the virus. The XE strain was detected through genetic sequencing tests taken using samples from the woman at the National Institute of Infectious Diseases.
She was treated at a facility for infected individuals before being released once her quarantine period ended.
The institute said two other samples taken from quarantined airport arrivals appeared to be mixtures of the genetic material of the omicron variant, but their type could not be specified.
The XE strain is a recombinant of the omicron variant’ s BA.1 and BA.2. subvariants. A recombinant variant occurs when an individual becomes infected with two or more variants at the same time, resulting in a mixing of their genetic material within the patient’ s body, according to the U.K. Health Security Agency.
According to the World Health Organization, early estimates based on limited preliminary data suggest that XE is about 1.1 times more transmissible than BA.2. However, the WHO has stressed that this finding requires further confirmation.
Around 1,100 cases of the XE variant had been confirmed in Britain as of April 5, although they accounted for less than 1% of infections in the country.
`` It has not become the dominant strain in Britain, where it was detected earlier, and it is unlikely that it will spread rapidly in Japan, '' said Kazushi Motomura, director of the public health department at the Osaka Institute of Public Health.
`` There is no need to be overly afraid at the moment, '' Motomura said. `` We must continue implementing basic measures to prevent infections, such as promoting additional vaccinations. ''
Hiroshi Nishiura, a mathematical modeling expert at Kyoto University, has said Japan should keep an eye on XE and other new variants.
“ XE’ s transmissibility is certainly higher than that for BA.1 or BA.2, ” Nishiura said last week. “ If people’ s international mobility increases, XE has a high chance of replacing the current omicron variants. But we still don’ t know the severity of symptoms among the infected people, so we need to examine the epidemiological impact of the variant closely. ”
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tech
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Japan cancels purchase of 40 million Astrazeneca vaccine doses
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Japan has canceled the purchase of about 40 million Astrazeneca PLC COVID-19 vaccine doses it agreed to buy last year, a health ministry official said in parliament on Monday.
The contract allowed the government to cancel a portion of the supply if it was unneeded, the official said in response to lawmakers’ questioning. Japan had originally agreed to buy 120 million of the shots, with the bulk made domestically by Daiichi Sankyo Co. and other local partners.
About 200,000 Astrazeneca doses have been supplied to local governments in Japan, while 63 million doses have been donated overseas, the official added.
Japan has predominantly relied on the mRNA-type vaccines developed by Pfizer Inc. and Moderna Inc. for its COVID-19 inoculations and boosters so far.
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tech
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Industry leaders worried over massive Alaskan sockeye salmon forecast
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The Alaskan fishing industry is being urged to boost its capacity ahead of a massive run of sockeye salmon that is forecast for Bristol Bay this summer.
Amid concerns that the fisheries industry in the Southwest Alaska region might not be able to keep up, the Bristol Bay Regional Seafood Development Association ( BBRSDA) has urged fleets to act to take advantage of the influx of sockeye salmon and prevent harm to future runs.
“ We’ re in unprecedented territory as far as what is forecast, so we never had a test like this to see how it would go, ” Andy Wink, executive director of BBRSDA, said.
Alaska’ s Department of Fish and Game has predicted that a record 75 million fish will return to Bristol Bay in the summer, with 60 million available for the fisheries industry to harvest. 15 commercial processors are set to buy 52 million Bristol Bay sockeye salmon, which would also be a record.
Wink has warned that the gap in the number of salmon expected to return and planned processing means that fishermen in the region could lose out on around $ 100 million ( €92 million).
“ Processors, fishermen, and fishery managers are gearing up to make the most of 2022, and those efforts are highly commendable but with such a large forecast it begs the question of what happens if processors and tenders can not keep up, ” BBRSDA warned back in February.
While there is concern among industry bodies, the general manager of Silver Bay Seafoods, Norm Van Vactor, called the situation a “ pleasant dilemma ” for the processor, adding that they are “ doing everything they can to maximize the efficiency and capability of plants in the region. ”
The region has recently benefited by strong salmon runs, with Bristol Bay reporting a record 66 million salmon returning last year, with 40 million being harvested, according to data released by the state’ s officials.
One of the challenges facing the region, as it seeks to cope with the substantial run, is finding enough workers to be employed during the summer to boost capacity after the Covid pandemic complicated staffing, Wink warned.
“ With the labor situation and how tight the labor market is, it will be challenge to keep processing capacity where it’ s been, ” the BBRSDA representative stated, adding that “ At the the end of the day, Mother Nature will dictate how this unfolds. ”
The US Departments of Labor and Homeland Security recently announced that they would increase the number of nonagricultural worker visas available in America during the summer by 35,000 to help sectors cope with increased seasonal demand.
“ With the tourism and fishing season right around the corner, and the economic fallout we have seen from COVID, it is vital to ensure Alaskans have the needed workers to supplement our local workforce, ” Alaska Senator Lisa Murkowski said on 31st March.
post @ salmonbusiness.com
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general
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At DesignCon: Analyst Says Chip Shortages Won't Last Forever
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At DesignCon: Analyst Says Chip Shortages Won't Last Forever | designnews.com
https: //www.designnews.com/sites/all/themes/penton subtheme designnews/images/logos/footer.png
Production capacity increases are expected to eventually result in a component surplus, according to analyst Michael Yang of Omdia.
Omdia analyst Michael Yang says expanding chip production capacity will catch up with demand over the next year and potentially create a surplus of parts.
The electronic component shortages that struck the industry over the past year have continued into 2022. While many analysts say there is no immediate end in sight, Omdia’ s Michael Yang believes the situation will turn around more rapidly than many currently believe. In fact, he thinks the industry could be on the other side of a boom-and-bust cycle in the foreseeable future.
Speaking during a session at the recent DesignCon Conference in Santa Clara, Yang noted that a number of new fabs are scheduled to open within the next few years. “ Supply is on the rise and demand will level off. ” He expects parts such as memory, controllers, processors, and displays could start seeing surplus conditions over the next year.
Yang added that the electronics industry has long undergone boom and bust cycles of robust demand and part shortages followed by falling demand and falling prices. He believes that while events such as COVID and various geopolitical events have affected the current shortages, OEMs have responded in a manner reminiscent of past cycles, such as double-booking orders.
Yang’ s seemingly bold prediction is not without precedent. At the beginning of this century when the dot come boom hit, several years of component shortages and rising prices were followed by an extended period of oversupply and falling prices. These events led to layoffs, falling profits, and supplier consolidation.
For now, semiconductor suppliers are basking in the glory of a seller’ s market, able to charge high prices for parts. There have been also reports of some suppliers imposing stringent purchase order regulations, such as minimum order sizes.
, with many reporting double-digit revenue increases. While robust demand from key markets such as automotive, smartphones and PCs have been largely responsible for much of the current situation, Yang does not see the boom times lasting forever.
Semiconductor vendors and foundries have reacted to the shortages by expanding production capacity, which Yang suggests should start to be felt by the industry over the coming year. With capital expenditures exceeding $ 120 billion annually, Yang noted, “ It is a good time to be a fab engineer. ”
In particular, some semiconductor makers, notably Intel, have responded to unstable geopolitical situations abroad by bolstering onshore production. Intel announced In January it would
. The company announced Monday the opening of its
in Hillsboro, OR, which will focus on leading-edge technologies.
Yang said the increasing diversification of manufacturing capacity will force the supply chain to reorient itself. He added that the key to the electronics industry’ s continued prosperity would be to protect itself from potential inefficiencies and oversupply.
According to Yang, there will be waning demand for products driven by COVID-19 changes, such as PCs to enable remote working. He expects demand growth in the automotive market to sustain, particularly as electric and hybrid vehicles increase. Large TVs and gaming consoles are expected to see normal levels of demand. For smartphones, Yang believes metaverse applications will drive demand.
Current and future application drivers for semiconductors.
The other concern, Yang noted, would be any fallout from the ongoing crisis in Ukraine, where neon gas, used in lasers for chip manufacturing, is found. The continuing conflict there could impact neon gas availability and contribute to part shortages, Yang noted.
Spencer Chin is a Senior Editor for Design News covering the electronics beat. He has many years of experience covering developments in components, semiconductors, subsystems, power, and other facets of electronics from both a business/supply-chain and technology perspective. He can be reached at
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business
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Billionaire Platt-Backed Engitix Inks $ 300 Million Takeda Deal
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The information you requested is not available at this time, please check back again soon.
The Takeda Pharmaceutical Co. logo is reflected in building windows near the company's global headquarters in Tokyo, Japan, on Wednesday, Dec. 5, 2018. Takeda received shareholder approval for its $ 62 billion acquisition of U.K.-listed Shire Plc, an endorsement of Chief Executive Officer Christophe Weber’ s strategy to transform the Japanese drugmaker into a global powerhouse. Photographer: Kiyoshi Ota/Bloomberg, Bloomberg
( Bloomberg) -- U.K.-based biotech firm Engitix Ltd. and Japanese drugmaker Takeda Pharmaceutical Co. have agreed to extend their existing partnership in a deal could be valued at as much as $ 300 million.
Engitix, whose backers include billionaire hedge fund manager Michael Platt, will work with Takeda to jointly develop novel therapeutics for fibrostenotic inflammatory bowel disease, or IBD, including Crohn’ s disease and ulcerative colitis, according to a statement seen by Bloomberg News.
As part of the new agreement, Takeda will have exclusive rights to develop and commercialize some clinical candidates while using Engitix’ s extracellular matrix discovery platform.
Engitix, led by Co-Founder and Chief Executive Officer Giuseppe Mazza, is poised to receive payments both upfront and later on as they achieve certain targets. The total value could reach as much as about $ 300 million based on the achievement of milestones as well as royalties on any future sales.
Earlier this year, the company raised $ 54 million in a series A funding round led by Netherton Investments, a fund allocating on behalf of Platt, and Italy-based Dompe Farmaceutici SpA. Engitix and Dompe also agreed to collaborate on new treatments for fibrosis and liver-associated solid tumors.
Shopify announced a number of proposed changes to its governance and share structure on Monday.
An analyst who covers Canada’ s banks is warning of choppy waters ahead and is urging clients to take a more defensive approach as economic uncertainty threatens to send shares sharply lower.
Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
Traders are shunning technology stocks amid mounting risks from soaring Treasury yields and hawkish commentary from the U.S. Federal Reserve.
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general
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Crew crisis hits P & O Cruises as company is forced to cancel sailings
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Carnival Corp subsidiary says it is unable to secure enough seafarers to operate all of its ships
UK-based P & O Cruises has had to scrub seven cruises scheduled for one of its ships after being forced to redeploy its crew to meet manpower shortages on other vessels.
The Carnival Corp subsidiary said over the weekend that it was delaying the return to service of the recently reactivated 84,300-gt cruise ship Arcadia ( built 2006) until 5 July due to “ crew availability issues ”.
“ The impact of Covid upon airlines and general disruption has necessitated the cancellations as we need to move crew from Arcadia to other ships in the fleet, ” the company said.
P & O Cruises did not disclose the types of seafarers it is struggling to bring on board — cruise ship crews are divided into deck, technical and hotel departments — but it highlights a problem for the revival of the cruise sector following a two-year shut down that left most its employees unemployed.
A senior executive at a Manila-based manning agency that supplies crew to the cruise industry said the sudden big demand cruise crews as ships are being reactivated for the summer season has created a tight labour market.
Speaking on the condition of anonyminity as she was not authorised to talk to the media, the manning agency representative said that many of the seaferers who had been laid off when the cruise sector shut down have “ moved on with their lives ”.
Deck and engine crew members, she said, have moved to other types of ships, while hotel department seafarers have found alternative employment ashore and are reluctant to return.
While qualified deck and engine staff are hard to find, she said that there is no shortage of willing new candidates for hotel department positions.
However, this has led to a bottlenecks at institutions in the Philippines that provide International Convention on Standards of Training, Certification and Watchkeeping for Seafarers ( STCW) training and certification, which is required by all seafarers no matter what their position on board.
Cruise industry sources said the war in Ukraine has exacerbated the situation as Russia and Ukraine were also important source markets for cruise crews but are now almost impossible to recruit seafarers from.
This is putting further pressure on other crewing source markets in Eastern Europe and Asia, where like in the Philippines, experienced seafarers have moved on to other types of ships or left the industry altogether.
P & O Cruises is not affiliated in any way with the DP World-owned P & O Ferries, which recently laid off hundreds of UK seafarers in an effort to replace them with cheaper contract workers.
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How to rejuvenate the immune system of elderly people and reduce their risk of infectious disease: Study results identify reason for why older adults are significantly more susceptible to infectious diseases -- ScienceDaily
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Study results also pave the way for new potential therapeutic targets to rejuvenate the immune system in older adults and thereby reduce their risk of infectious disease.
`` Through this study, we have gained a new understanding of why older adults are more susceptible to infectious diseases, which will enable us to identify potential new treatments, '' said senior author Michael Demetriou, MD, PhD, a professor of neurology at the UCI School of Medicine and chief of the Division of Multiple Sclerosis and Neuroimmunology at UCI. First author and assistant professor in the UCI Department of Pathology, Haik Mkhikian, MD, PhD, added, `` We 've identified a potential fountain of youth for the immune system. ''
The study, titled, `` Age-associated impairment of T cell immunity is linked to sex-dimorphic elevation of N-glycan branching, '' was published in Nature Aging.
T cell immunity declines with aging, thereby increasing severity and mortality from infectious disease. T cells are the quarterback of the immune system and coordinate immune responses to fight off infections. The addition of complex and branched carbohydrate chains ( 'glycans ') to proteins suppresses T cells function.
In this study, researchers show that the branched glycans increase with age in T cells from females more than in males due to age-associated increases in an important sugar metabolite ( N-acetylglucosamine) and signaling by the T cell cytokine interleukin-7.
`` Our research reveals that reversing the elevation in branched glycans rejuvenates human and mouse T cell function and reduces severity of Salmonella infection in old female mice, '' said Demetriou.
Mkhikian added, `` This suggests several potential novel therapeutic targets to revitalize old T cells, such as altering branched glycans or the age-triggered elevation in serum N-acetylglucosamine and IL-7 signaling. ''
Aging-associated immune dysfunction, referred to as immunosenescence, contributes to increased morbidity and mortality from both infectious and neoplastic diseases in adults aged 65 years and older. In the U.S, for example, around 89 percent of annual deaths from influenza are in people at least 65? years old, despite this age group representing only around 15 percent of the nation's population. More recently, the vulnerability of older adults to viral infections has been tragically highlighted by the recent emergence of severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2). Increased morbidity and mortality in older adults also occurs with common bacterial infections such as those caused by the enteric pathogen Salmonella. Furthermore, efficacy of immunizations declines with age, further increasing risk of infection in older adults. The rapidly aging population in the developed world exacerbates this issue and heightens the need for interventions that effectively target immunosenescence.
Previous studies examined transcriptome changes in highly purified aged T cell subsets. In this study, researchers analyzed T cell populations by age and sex, with results suggesting sex-specific differences that imply that effective interventions to reverse immune dysfunction in older adults may require sex-specific strategies.
The study was supported by funding from the National Institute of Allergy and Infectious Disease, the National Center for Complementary and Integrative health, The Burroughs Wellcome Fund and a predoctoral fellowship from the American heart Association.
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Shanghai Residents Remain Largely Under Lockdown Despite Easing
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( Bloomberg) -- The number of people released from Shanghai’ s lockdown is smaller than it initially seemed, with the vast majority of the city’ s 25 million residents still subject to tight movement restrictions which keep them in their homes or compounds.
On Monday Shanghai announced it was easing the lockdown for the 43% of compounds which had no virus infections in the past two weeks. However details released overnight showed that those 7,565 areas included not just residential complexes but also hotels, shopping malls and government buildings, many of which are located on the less-densely populated outskirts of the city.
The easing came as Shanghai is still struggling to stop transmission in the worst Covid outbreak in China in two years, with the control measures now weighing on the world’ s second-largest economy and beginning to disrupt global supply chains. There were 23,342 cases in the city Monday, a drop from Sunday’ s record but still up from about 5,000 just two weeks ago.
Although the government did not reveal the number of people who are now allowed to leave their homes and go for a walk, Monday’ s announcement of the easing measures is the first sign of a pathway out of the weeks-long lockdown that became a crisis as residents struggled to get basic food and medical care.
Shanghai’ s communist party chief Li Qiang on Monday pledged the city will continue with its strict lockdown rules to control the outbreak, according to a release on its official Wechat account.
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Thailand Ramps Up Vaccinations as Festival Seen Fueling Covid
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( Bloomberg) -- Thailand is rushing to vaccinate its elderly citizens and other vulnerable groups ahead of the local New Year celebrations as the festivities are seen fueling a surge in Covid cases and deaths, potentially derailing a tentative economic and tourism recovery.
Millions of Thais will travel to their hometowns this week from cities such as Bangkok to join families in celebrating Songkran, the first time they can do so without any travel curbs since the outbreak of the pandemic. That’ s prompted the Health Ministry to warn new daily cases could jump to as high as 100,000 a day from around 20,000 on Monday.
A booster-dose campaign for the elderly saw an estimated 500,000 people get inoculated in the past three weeks, taking the total number of those above 60 with three shots to 3 million. But there’ s a long way to close the gap as the Southeast Asian nation has an estimated 11 million senior citizens, Health Ministry data show.
With only about 35% of the 70 million Thai population receiving booster shots, Prime Minister Prayuth Chan-Ocha on Monday urged people to adhere to Covid protocols to prevent a spike in cases after the long holidays. That’ s key to the tourism-reliant nation’ s efforts to further relax visa rules for foreign visitors.
“ There will be a lot of parties and meetings during Songkran and we expect there will be a lot more infections, ” Health Minister Anutin Charnvirakul said last week. “ But vaccines can help reduce the risk and we are asking people to cooperate, so the nation can get over this risky period. ”
A flare-up in infections could potentially bring back more restrictions and scuttle a fragile economic recovery that’ s already facing headwinds triggered by the Russian invasion of Ukraine. Most economists have trimmed Thai growth forecasts in recent weeks while predicting a second straight year of current account deficit on a bleak outlook for a recovery in tourist arrivals.
“ We are concerned about a sharp rise in new infections after Songkran, ” said Nattaporn Triratanasirikul, an economist at Kasikornbank’ s research unit. “ The higher the cases, the longer it will take for the outbreak to stabilize and delay the plan to declare it as endemic. But the impact will be less than the forced lockdowns we faced in the previous years. ”
Even if new cases flare up, the nation’ s health care system will still be able to cope as the high rate of vaccination will prevent severe infections and the need for hospitalization, according to Chakkarat Pittayawonganon, director of the Bureau of Epidemiology. The bureau expects cases to stabilize in May.
Prayuth’ s government, which has followed a strategy of living with Covid since October by gradually ending most of the mobility restrictions, is seeking a balance between public health and the economy. It aims to declare the outbreak endemic by July if it can keep daily new infections to a few thousand and fatalities below 80 a day.
Canada joins U.S., U.K. in diplomatic boycott of Beijing games
Trudeau weighs auto-content rules as next U.S. trade flashpoint
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Brent Falls Below $ 100 as Supply Picture Brightens
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Brent oil prices fell below $ 100 on Monday as traders consider that the world might have adequate supply despite looming sanctions against Russia.
The June Brent futures contract closed $ 4.30 down at $ 98.48 per barrel on ICE Futures in Europe. In New York, the Nymex West Texas Intermediate futures contract for May delivery fell $ 3.97 to settle at $ 94.29/bbl. Trading volumes were moderate.
The future remains murky but the world has more supply than thought, and oil demand is hurting from strict Covid-19 lockdowns in China, high consumer prices and a slowdown in global economic growth.
The EU and Germany in particular are considering banning imports of Russian oil, which would increase the volumes Moscow would need to sell in the global market.
In a major shift of trade patterns, traders now expect that more Russian oil will flow to Asia as Russian producers offer up to $ 40 discounts to keep their volumes moving.
The question is whether Asian refiners have the capacity to absorb another 1 million barrels per day of Russian oil, as European refiners are shunning spot sales and have vowed not to renew term contracts when they end this year.
Asian refiners look for security of supply and have term offtake commitments that are hard to break.
Russian crude exports from its European ports have been holding up better than expected after a US ban and self-sanctioning in Europe disrupted flows following Russia’ s invasion of Ukraine in late February.
An estimated 600,000 b/d of spot Urals cargoes have been impacted, but have so far largely found a home thanks to steep discounts, heavy buying by international traders, low-profile trading, and diversion to storage or to Asia.
While Russian crude flows mostly continue, refined product exports took a hit in March and could be down as much as 850,000 b/d, according to shipping data, which is being especially felt in the global diesel and fuel oil markets.
High product prices and the need for European refiners to step up runs are supportive of crude prices. Refinery runs in Russia were down 670,000 b/d in March and are slowing more in April.
Despite the upward pressure, the potential release of 240 million barrels of oil from strategic petroleum reserves has eased some of the pressure in the spot market, and prices spreads show they are better supplied.
Spot Brent prices were trading up to $ 6 over the front-month futures contract a few weeks ago and are now $ 1.25 lower than the June contract. Also, the front-month premium over loadings in six months has narrowed to $ 2.85/bbl from a peak of $ 19 in March.
The potential for softer oil demand is a key reason for oil prices to relax, analysts say. Russian oil demand is down as sanctions have rattled its economy, and European and US consumers are reacting to higher prices by driving less.
China’ s lockdowns have forced domestic refiners to lower runs and allow for higher refined product exports, alleviating tightness in the regional product market.
Some analysts see oil demand growth slipping by 1 million b/d or more on the year, but consumers would still use 2 million b/d more in 2022 than a year earlier as the recovery from the Covid-19 pandemic continues.
Balances in the coming months are muddy, with the market thinking for now that supply will be sufficient. But to maintain crude supply in the coming years, more investment is needed, analysts say, and it could be more costly to pump new oil.
The back of the forward curve in the futures market is expressing that sentiment and has lifted the projected Brent price to $ 75/bbl in 2027 from less than $ 60/bbl a few months ago.
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Opec-Plus: Iraqi, Russian Troubles Exacerbate Capacity Question
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The Opec-plus group is increasingly straining to produce crude oil, particularly among its non-Opec members. Russian oil is now confronted with moral hazard risks, and Kazakhstan’ s main artery to global markets, the Caspian Pipeline ( CPC), has suffered a large outage. Iraq, meanwhile, has reached its capacity limit due to technical constraints, a senior official has told Energy Intelligence.
Even though five countries will see an increase in the base level in May, only three of them — Saudi Arabia, United Arab Emirates, Kuwait — will be able to actually lift production. This means the gap between the alliance’ s targeted production and actual output will only grow throughout the year.
However, renewed Covid-19 lockdowns in China, strategic oil releases by developed nations and a reduction in consumption due to high prices are mitigating any effects of Opec-plus’ dwindling production capacity.
In March, the 19 members of Opec-plus with a quota — Iran, Libya, Venezuela and Mexico are exempt — cranked out 37.98 million b/d of crude oil, a mere 86,000 b/d more than in February, according to Energy Intelligence’ s assessment. This was the worst month-on-month performance since August 2021, when Kazakhstan carried out major field work at its two largest fields, Tengiz and Kashagan.
The nine non-Opec members with a quota are the main reason for the lackluster month. Output by Russia, whose oil has become toxic for many traditional importing countries and is facing an outright US ban, fell by almost 50,000 b/d to 10.01 million b/d, while Kazakh output declined by an equal amount after storms knocked out two single-point mooring terminals in the Black Sea. Malaysian production dropped by 38,000 b/d on the month to 403,000 b/d.
In sum, the nine non-Opec producers posted a 140,000 b/d decline in March to 13.93 million b/d.
By contrast, the 10 Opec members managed to boost output for the month by 225,000 b/d to 24.05 million b/d. Alliance leader Saudi Arabia lifted production by 110,000 b/d to 10.34 million b/d, while Nigeria and Angola, which have grappled with natural declines and technical failures in recent months, together managed to increase output by nearly 110,000 b/d.
Total output by the Opec-plus 19 last month amounted to 37.98 million b/d. This is 1.56 million b/d short of the target of 39.54 million b/d for March. In other words, the alliance is four months behind schedule: what the 19 producers managed in March is what they should have achieved in November.
As a result of the underproduction, the compliance rate for the month was 161%, a level at which the whole notion of compliance becomes moot.
The situation is expected to get worse before it improves, particularly because of Russia. The alliance’ s second-largest producer should see a decline of some 800,000 b/d in April to 9.2 million b/d, our assessment shows, as more traders refuse to purchase Urals and domestic refinery runs are falling. Forecasting this fall is tricky, but Russian crude oil output could hit a nadir of 8.5 million this summer.
Opec-plus 19 production is projected to fall to 36.6 million b/d by July. At that point, the rift between targeted and actual production would grow to 4.5 million b/d, which could put significant upward pressure on global prices.
A senior Iraqi official has said that the country, which produced 4.26 million b/d in March, has effectively reached its output capacity. The limit for Basrah exports is now considered 3.3 million b/d, a level that might not be sustained given various technical issues that continually arise, the official explained. In March, Basrah exports amounted to 3.24 million b/d.
Due to geopolitical constraints, Russia will not be able to reach its assessed capacity of 10.2 million b/d; in fact, the country’ s capacity might fall if the war drags on and producers are forced to shut in output due to a dearth of storage capacity. Even at a $ 40 discount, Russian producers can still make money on Urals exports, but reduced netbacks will compel them to pick and choose will wells to operate.
Kazakhstan now has some 190,000 b/d in additional capacity, but no doubt the country will try to bring all this back on line in June after CPC operations are repaired. Beyond that, there are some small pockets of spare capacity in places like Oman and Algeria.
The bulk of spare capacity lies with the Opec trio of Saudi Arabia, UAE and Kuwait. Together they have 2.1 million b/d, or 90% of all alliance spare capacity. Kuwait is expected to drop off the list in upcoming months as output plateaus at 2.7 million b/d. At that juncture, all spare capacity sits with only two producers.
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Marriott Says Loyalty Program Driving New Wave of Growth in Asia
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Peden Doma Bhutia, Skift
April 11th, 2022 at 9:30 AM EDT
Even as uncertainty continues to weigh on travel plans, Marriott is offering personalized experiences through its loyalty program in Asia. The hotel chain currently has more than 55 million Marriott Bonvoy members in Asia Pacific.
Peden Doma Bhutia
Living with the pandemic prompted travelers to reevaluate travel priorities, and Marriott International used this as a favorable opportunity to reimagine ways to cultivate loyalty among customers.
Mariott Bonvoy — the hotel chain’ s loyalty program — is listed as one of the main ingredients in the group’ s recipe for success in Asia Pacific. “ Marriott Bonvoy really is at the heart of our consumer strategy and we are doing everything we can to grow the program, ” said Bart Buiring, chief sales and marketing officer for Asia Pacific at Marriott International.
With more than 55 million Marriott Bonvoy members in the Asia Pacific, Marriott is hoping that inspires new commitments to itravel.
As part of this growth strategy, Marriott last year launched Korea’ s first-ever co-branded hotel credit cards and two new co-branded cards were launched this year in Japan. The food and beverage offering — Marriott Bonvoy on Wheels — currently available at over 75 hotels in India in over 20 cities, has been recently launched in Indonesia and Thailand.
Marriott International will also be integrating into Grab’ s platform in phases — food delivery, payment, transport, loyalty and rewards, as well as advertising. “ The access to Grab’ s sizable customer base via GrabFood, GrabPay, and GrabAds, will enable us to serve a growing pool of customers who are increasingly transacting online, ” Buiring said.
There are also the partnerships with digital ecosystems through joint ventures like the one with Alibaba in China.
The Rakuten partnership, Buiring said, is an industry-first collaboration allowing Marriott to strategically capture a greater share of a strong Japanese travel market and connect these travelers to its portfolio of global brands.
Marriott International operates 30 brands globally, more than two-thirds of them with a presence in Asia Pacific. However, the hotel chain has no plans to introduce a new brand in the region, even as it prepares to open up with its 1,000th property in Asia Pacific in late 2022, said Buiring.
The company expects to open nearly 100 properties in Asia Pacific this year, with Greater China alone witnessing 50 hotel openings.
“ Greater China, which forms 50 percent of the company’ s Asia Pacific business, will welcome its 500th hotel around early 2023, ” said Buiring adding that over the last three years, Marriott has added an average of 40 hotels per year in the region.
Calling the opportunity in the China market “ very substantial, ” Buiring said this was the first market where Marriott witnessed recovery post Covid in 2020. “ We saw a lot of domestic travel in the form of staycations as well as business travel and that helped us recover really quickly. ”
Cut to 2022 and with its zero-Covid policy firmly in place, China is still battling lockdowns. However, Buiring dubbed the current situation as a minor blip and sounded confident about things looking up by May.
“ Whenever we have seen cases go down in Chinese cities, it has been extraordinary to see how quickly business recovers. There is real demand for people to meet face-to-face, ” he said adding that Marriott continued to witness a strong growth trajectory in China in 2021 as well.
As far as China outbound is concerned, Buiring expects that to return towards the end of the third or fourth quarter. “ We’ re obviously watching with a lot of interest how the Chinese government is going to look at travel into the future, and whether the zero-Covid policy will remain, or whether that may evolve over time. ”
As different markets adapt and recover differently, the hotel chain has also opted for a staggered rollout of its “ Power of Travel ” campaign. “ In marketing one needs to be relevant and has to deliver timely messages to customers where there is opportunity, ” observed Buiring.
With its approach to marketing being hyper localized, Marriott is now developing phase two of the “ Power of Travel ” campaign for China, while it will be launched in the rest of Asia Pacific just before summer.
“ The team has biweekly marketing investment meetings where they look at the demand indicators — flights, flight capacity, flight occupancy, search data — and on the basis of that big picture we then make marketing investments, ” he noted.
For a company that started 95 years ago with a nine-tool root beer stand in Washington DC, food and beverage still forms a core aspect of Marriott’ s business. Having ventured into the restaurant business as early as 1927, it wasn’ t until 1957 that the company opened its first Marriott hotel.
Food and beverage forms 40 percent of the hotel chain’ s business in Asia Pacific where Marriott operates more than 2800 restaurants and bars, said Buiring.
“ In fact, customers are often introduced to the Marriott portfolio of hotels while on their visit to one of the restaurants at these properties. ”
What’ s more, the hotel chain has now added food and beverage earning capabilities that allow visitors to earn Marriott Bonvoy points for their restaurant visits. These points can then be later redeemed for a stay at any of the Marriott properties. “ Food and beverage is very important to Marriott, particularly in the luxury space, where up to 50 percent of our revenues can be F & B, ” said Buiring.
As part of its commitment towards 2025 Sustainability and Social Impact Goals, Buiring said Marriott has laid out some very aggressive goals in terms of carbon neutrality and the reduction of single-use plastic in all its properties.
Guided by its sustainability and social impact platform Serve 360: Doing Good in Every Direction, the hotel chain has piloted Good Travel with Marriott Bonvoy at 15 hotels across Asia Pacific in January 2021.
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Rethinking Boosters and Personal Responsibility as Pandemic Enters New Phase
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Although the COVID-19 pandemic is still raging in parts of the world, it appears to be edging toward an endemic phase. As such, the U.S. Food and Drug Administration and other regulators are looking at revising the current vaccine strategy and emphasizing that individuals need to start considering their own risk tolerance in their personal behaviors. For that and more, continue reading.
Now that, in the U.S. at least, a fourth shot of the COVID-19 vaccines from Moderna and Pfizer-BioNTech is being recommended for some parts of the population, immunologists, vaccine experts and public health officials are starting to caution that this is not sustainable.
“ We simply can’ t be boosting people as frequently as we are, ” stated the FDA’ s Dr. Peter Marks, M.D., Ph.D., speaking to the agency’ s Vaccines and Related Biological Products Advisory Committee. Marks is the director of the FDA’ s Center for Biologics Evaluation and Research ( CBER).
Part of this talk was to describe a way forward to include vaccines that target more than one strain of SARS-CoV-2 and highlight how the public may have to accept vaccines that decrease severe disease and death but don’ t necessarily prevent every infection. The target is having it ready by the fall. The FDA meeting was to discuss what those approaches and vaccines should look like, with all agreeing that repeatedly giving the same “ monovalent ” vaccine against the original Wuhan strain has diminishing returns.
Dr. Peter Chin-Hong, a U.C. San Francisco infectious disease expert, echoed the idea, saying, “ If we settle down to one shot per year that combines COVID and flu, I think that will be sustainable. Nobody will want to get a vaccine every six months. So we have to change the strategy. ”
Germany’ s 4TEEN4 pharmaceuticals GmbH announced that its biomarker DPP3 will be leveraged in a biomarker-guided study in severe COVID-19. The trial will use two biomarkers, bioactive adrenomedullin ( bio-ADM) and dipeptidyl peptidase 3 ( DPP3) to stratify patients in a study of adrecizumab. Patients with severe COVID-19 produce several different biomarkers associated with different clinical pathways. One is loss of endothelial function associated with worsening lung function. Another is the uncontrolled release of DPP3 from cell injury causing loss of organ function and “ hemodynamic instability. ” Bio-ADM is associated with loss of endothelial function and DPP3 is associated with loss of heart function. Adrecizumab is designed to treat endothelial barrier dysfunction. DPP3 is out-licensed to SphingoTec GmbH.
While urging Congress to continue funding COVID-19 testing and therapeutics, Dr. Anthony Fauci, M.D., director of the National Institute of Allergy & Infectious Diseases and the White House chief medical advisor, also told ABC’ s “ This Week ” that people need to determine their own risk tolerance.
“ What’ s going to happen is that we’ re going to see that each individual is going to have to make their calculation of the amount of risk that they want to take in going to indoor dinner or going to functions even within the realm of a green zone. It’ s going to be a person’ s decision about the individual risk they’ re going to take. We’ re at that point where in many respects … we’ re going to have to live with some degree of virus in the community. ”
The Centers for Disease Control and Prevention has labeled most of the U.S. a “ green zone, ” indicating a low level of infection concern.
Last weekend, 72 people tested positive for COVID-19 after attending the Gridiron Dinner in Washington, DC. It was the first Gridiron Dinner since 2019. It was a white-tie-and-gowns event that included about 630 guests, including members of Congress, the Cabinet, diplomats, military and business leaders. Proof of vaccination was required. Notables who tested positive include Attorney General Merrick Garland, Commerce Secretary Gina Raimondo, Agriculture Secretary Tom Vilsack, Rep. Joaquin Castro ( D-Texas), Adam Schiff ( D-Calif.), Sen. Susan Collins ( R-Maine) and many others.
More than two years into the COVID-19 pandemic, experts are starting to push for another way to minimize the risk of COVID-19 — better ventilation.
“ The challenge for organizations that improve air quality is that it’ s invisible, ” said Joseph Allen, director of the Healthy Buildings Program at the Harvard T.H. Chan School of Public Health.
But studies suggest that indoors, as much as 3-4% of the air you’ re breathing just came from the lungs of other people in the room. This is at least one reason why it’ s safer from COVID-19 outdoors. However, people spend about 90% of their time indoors, so public health officials and others are pushing organizations and governments to improve indoor ventilation to prevent the further spread of COVID-19 and any future airborne diseases.
The U.S. military has been active during the COVID-19 pandemic, operating hospital ships in New York City and Los Angeles, setting up hospital and inoculation sites in convention centers and parking lots, and deploying medical teams to assist overwhelmed hospitals across the country during the Omicron surge. The Pentagon is evaluating the efficacy of its efforts, which were sometimes underutilized, and creating plans to handle the next pandemic more effectively. And one of the things they’ re looking at is the U.S. supply chain for medical equipment.
Gen. Glen VanHerck, who heads the U.S. Northern Command and is responsible for homeland defense, said, “ If we’ re relying on getting those from a foreign manufacturer and supplier, then that may be something that is a national security vulnerability that we have to address. ”
They are also working on better predicting the need for personnel, equipment and protective gear. In addition, they found that there was a need for mental health care for the military personnel.
“ The level of sickness and death in the civilian sector was scores more than what anyone had experienced back in the Army, ” said Lt. Col. Suzanne Cobleigh, leader of an Army medical team that had been sent to Michigan to help during the Omicron surge.
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Camila Cabello Wore Sheer Lingerie with Gucci Shorts and a Blazer
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She finished the outfit with a Gucci choker to get all the trends in there.
Camila Cabello brought all her style game to her Friday appearance on The Tonight Show Starring Jimmy Fallon.
The `` Señorita '' singer, who debuted her new album, Familia, last Friday, seemed to hit every hot trend with her haute couture look: shorts with a blazer, a Y2K choker, and lingerie as everyday clothing.
Cabello stepped out in a sheer black lingerie top under a stunning Gucci blazer and teeny leather-trimmed shorts. The head-to-toe look by the Italian fashion house also included a choker and slingback pumps in the brand's signature beige-and-ebony original GG print from the Aria collection, inspired by Tom Ford's Gucci era.
During her appearance on the show, Cabello talked about her album, the importance of family, and the effects the COVID-19 pandemic has had on her. She also took a tequila shot and bit into a lime wedge to celebrate the drop, with host Fallon doing the same.
`` We all deserve a shot! '' she told the cheering audience.
The star later shared an Instagram post in which she included photos of her ensemble. `` # FallonTonight tune in tonight 🌚 11:35pm est on @ nbc @ fallontonight, '' she wrote in the caption.
The look was a big change for Cabello, who off the red carpet is often seen around town in casual streetwear or athleisure, or at the beach relaxing in a swimsuit.
Today, Cabello—who has previously discussed her mental health struggles and insecurity stemming from social media—opened up about her current state of mind on her Instagram Story. `` Me habitually going on Tik Tok but closing it every time I open it so I don't see anything that accidentally hurts my feelings, '' she wrote over a photo of herself with a horn filter. `` Releasing an album is vulnerable I forgot about that part lmao. ''
The pop singer is set to appear on NBC's TODAY show tomorrow morning, confirming via Instagram that she will perform three songs.
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Is it time for a recessionary investment factor tilt?
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I have featured Research Affiliates articles before and I have discussed factor-based investing tilts before. It would seem we are on the cusp of a shift in the underlying economy into a recessionary or at least slow growth phase. What type of stocks historically add value in this part of the cycle? In recent weeks, I’ ve been suggesting that it’ s time to make your portfolios a little more boring. All should be familiar with the four stages of the business cycle. There has been a lot of debate about a stagflationary slowdown or possible recession given the inverted yield curve. If this is where we are heading, it would be helpful to know what market factors can help you weather the storm.
In summarizing the results, Research Affiliates ( RA) analyzed the relationship across six geographic regions and over all four economic stages of growth, slowdown, recession, and recovery to discover the historical nature of that relationship. The majority of the eight factors ( including the market factor which is the return above risk-free) that they examined produced a positive and significant total return over the full study period. Three components drive the total return: changes in fundamentals, changes in valuation, and valuation rebalancing. One could argue today, the equity markets still close to all time highs, have yet to adjust, though many would agree that the worst start to the year in decades for the traditional 60:40 portfolio suggests that it’ s likely underway.
Fewer factors produced meaningful returns when considering a factor’ s structural return, the portion of the return that is indefinitely repeatable. Over the study period, the value factor has the highest structural return. The higher economically leveraged ( cyclical) factors—market, size, value, and illiquidity—perform better during the positive economic stages of recovery and growth, and perform poorly during the negative economic stages of recessions and slowdowns. The opposite applies to the less economically leveraged factors—low beta and profitability.
The table summarizes results. Let’ s focus on the low beta and profitability factors.
Scanning the ETF world, we came across some high dividend ( typically means good profitability) and low volatility ETFs. We compared returns since 12/31/19 ( pre-COVID) against the broad US market returns ( VTI – Vanguard total US market ETF). Clearly the broad market won with a higher average return.
But on a YTD basis, the higher dividend and lower beta ETFs have done much better than the broader markets as we are starting to price in a more difficult economic outcome.
The first ETFs focusing on the profitability factor were only launched a few months ago. Dimensional Advisors, a factor based asset manager, launched a US and International profitability factor ETF in February. So far, it’ s looking a lot like the market return, but we should keep a close eye on this one.
Like we have in recent weeks, this week on our Spring 2022 virtual Berman’ s Call roadshow, we will take a deep dive on how to incorporate investment factor thinking in to your portfolios. Join us weekly ( Thursday 7 p.m. ET) through April 28. Keep an eye on The Investor’ s Guide to Thriving website for more information on how to sign up for notifications. The theme this year is Berman’ s Call deep dives. More in-depth looks on combining fundamentals and technicals to mine for investment ideas. Should be a great series. If you have learned a few things over the years from our educational segments, please consider supporting one of my favourite charities. Dementia and Alzheimer’ s research at the Baycrest Hospital/Rotman Research Institute is world class. Each year I raise money for this cause and match all BNN Bloomberg viewer donations. In the past nine years we have raised almost $ 500,000 thanks to you. Please consider sponsoring here.
Shopify announced a number of proposed changes to its governance and share structure on Monday.
An analyst who covers Canada’ s banks is warning of choppy waters ahead and is urging clients to take a more defensive approach as economic uncertainty threatens to send shares sharply lower.
Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
Traders are shunning technology stocks amid mounting risks from soaring Treasury yields and hawkish commentary from the U.S. Federal Reserve.
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Wheat firm as Ukraine war raises supply fears; corn ends mixed
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- U.S. wheat futures rose nearly 3% on Monday and hit a two-week high on worries about U.S. crop prospects and concern that fighting in Ukraine will continue to disrupt Black Sea region exports, analysts said.
But soybeans fell as COVID-19 lockdowns in China, the top importer of the oilseed, raised worries about demand for soy as well as other commodities including crude oil.
Corn futures ended mixed, with nearby contracts lower and back months higher.
Chicago Board of Trade May wheat settled up 29-3/4 cents at $ 10.81-1/4 per bushel after rising to $ 10.91-3/4, the contract's highest since March 28.
`` We added more war premium today, and fears that we were going to see the ( U.S. winter wheat) crop ratings go down, '' said Don Roose, president of Iowa-based U.S. Commodities.
Ukraine said it expects Russia to begin an offensive soon in the eastern Donbas region as Moscow shifts its focus to seizing territory there after its invasion force was driven from the gates of Kyiv this month.
Tightening global wheat supplies and the conflict between Ukraine and Russia, two major world wheat exporters, have cast a spotlight on U.S. winter wheat production, particularly as drought persists in the Plains, the core U.S. wheat region.
However, after the close of the CBOT, the U.S. Department of Agriculture rated 32% of U.S. winter wheat in good to excellent condition, up two percentage points from a week ago, bucking analyst expectations for no change. The wheat ratings are still among the poorest on record for this time of year.
For corn, the USDA said planting was 2% complete, unchanged from the previous week as farmers wait for conditions to improve, and behind the average analyst estimate of 4%.
`` You do have snow up in North Dakota, the ( Mississippi River) Delta is too wet, the Midwest is cool and wet. It's not an ideal start to the planting season, '' Roose said.
CBOT May corn futures settled down 4-1/4 cents at $ 7.64-1/2 per bushel, but new-crop December corn ended up 2 cents at $ 7.18 after setting a life-of-contract high at $ 7.23-3/4.
May soybeans finished down 33-3/4 cents at $ 16.55-1/4 per bushel. ( Reporting by Julie Ingwersen; additional reporting by Michael Hogan in Hamburg and Enrico Dela Cruz in Manila; editing by Susan Fenton and Sam Holmes)
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business
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Wout van Aert uncertain for Paris-Roubaix as cobblestone countdown commences
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Jumbo-Visma won’ t commit to whether Wout van Aert will be racing Paris-Roubaix just yet.
Van Aert was forced to skip his Amstel Gold Race defense last weekend and might still be on the sidelines for Sunday’ s “ Hell of the North ” as he returns from a recent brush with COVID.
“ I can’ t say anything certain about Roubaix, ” team boss Richard Plugge told Het Laatste Nieuws. “ Wout is training and now we have to see how he develops.
“ We follow his training closely. Before we decide, we will do extensive testing, to see if everything is OK with his heart and such. We look at it day by day. But one thing is certain – we are not taking any risks with the health of our riders. ”
Van Aert was zapped by COVID just days ahead of the Tour of Flanders at the turn of the month, forcing him out of De Ronde and Sunday’ s Amstel Gold Race.
He made a rapid return to riding after what Jumbo-Visma described as “ light symptoms, ” but there’ s no guarantee we’ ll see “ WvA ” on the start line Sunday.
Plugge said the team is prioritizing long-term health over short-term goals given the potential cardiological hangover associated with coronavirus.
“ There are still goals to come, ” Plugge said Sunday. “ Later this year and for years to come. I’ d rather he take two weeks off now, or three weeks, or five weeks for my part, if that’ s necessary to be able to race normally again afterward. ”
Van Aert has unfinished business and big ambition for Roubaix after he left last year’ s mud-splattered edition out of the frame and frustrated with seventh place.
Should he not make the start in Compiègne on Sunday, it will be down to Tiesj Benoot, Christophe Laporte, and Mike Teunissen to fly the flag for Plugge’ s Jumbo-Visma crew.
As one of the many victims of COVID’ s first wave, Plugge’ s ultra-cautious approach with his racers is tinted with personal experience.
“ I myself had very bad COVID two years ago, in the first wave. Until today I still feel the effects of that when I exercise. I am of course of a completely different level than our riders, but I have experienced what the impact of COVID can be, ” he told HLN.
“ We have made a very clear agreement with our medical management that we are more cautious than cautious, also because we do not know the effects of COVID in the longer term. Your heart, your muscle metabolism, your lungs can all be affected. ”
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general
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Analysis: After health scare, will Sonny Colbrelli race again?
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Sonny Colbrelli, shown here at Kuurne-Brussel-Kuurne, faces an uncertain future. Photo: Bas Czerwinski/Getty Images
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Sudden cardiac death ( SCD) is a rare but devastating event, often affecting apparently healthy athletes with no prior heart problems. In fact, the typical victim has no suspicion that they are at risk, and prior to the SCD event may have even felt that they were in peak form.
Sonny Colbrelli, last year’ s Paris-Roubaix winner and current European champion, can now be counted among the estimated 1 in 40,000 to 1 in 80,000 young athletes per year to experience SCD, after his dramatic resuscitation following Stage 1 of the Volta a Catalunya. He was quickly transported to the Hospital Universitari de Girona after being defibrillated on-site for treatment of a life-threatening arrhythmia.
Initial tests were “ inconclusive ” in terms of a specific cause of the event, and fortunately showed “ no sign of compromised heart function. ” Following advanced evaluation at the University of Padua Medical School, he underwent subcutaneous defibrillator ( S-ICD) implantation to protect him from further malignant heart arrhythmias.
Most resuscitated SCD victims, like Colbrelli, receive “ device ” therapy with an implantable cardioverter-defibrillator ( ICD) prior to hospital discharge – unless there is a clearly reversible problem identified, which when corrected, eliminates with certainty the risk of SCD recurrence.
ICDs are potentially life-saving devices which are placed in the chest to detect and treat life-threatening heart rhythms – specifically ventricular tachycardia ( VT) and ventricular fibrillation ( VF) – which can result in SCD. The ICD itself consists of a pulse generator ( lithium battery and electronics) contained in a stainless-steel case about the size of a small stopwatch, which is implanted under the skin just below the collar bone.
Most ICDs have one or more long, flexible electrodes or “ leads ” which are attached to the pulse generator, inserted through the veins toward the heart, and rest in direct contact with the inner surface of the heart muscle. Colbrelli’ s S-ICD ( subcutaneous ICD) is a unique, less invasive alternative now available for younger patients, whereby the electrode “ lead ” of the system rests beneath the skin along the breastbone, eliminating certain complications associated with entering the blood vessels or heart itself.
Either type of ICD continuously monitors the heartbeat and can deliver electric shocks – defibrillating the heart when a potentially lethal rhythm problem is detected – thereby restoring a regular heart rhythm.
It’ s not surprising that doctors gave Colbrelli an ICD because as resuscitated SCD survivor – who was defibrillated in the field – there is no way to predict whether or not this will happen again. Subsequent events can be completely random and unpredictable. CPR alone – which Colbrelli also received at the finish line – provides some circulatory support for a SCD victim, but the only effective approach for terminating that lethal rhythm is defibrillation.
Because of its high success rate, and documented improvement in survival rates, ICD implantation is considered the first-line option for treatment of subsequent SCD in resuscitation survivors.
The question that many cyclists and fans are undoubtedly asking is – why did this happen to Sonny Colbrelli – apparently so randomly – after many years and thousands of kilometers of racing with no prior issue, and indeed even with a proactive UCI cardiac screening program in place? His near-fatal collapse – less than six months after his highly emotional Paris Roubaix win – although shocking, unfortunately represents a pretty typical storyline in these cases.
Based on information released to the media and statements generated by his team, there appears to be no obvious cause behind Colbrelli’ s SCD. ( Specific medical details are lacking, since press releases are often given in laymen’ s terms — with perhaps some important details omitted due to patient confidentiality — but we know that he received care at a recognized center of excellence in Padua, implying that no stone was left unturned in his evaluation).
Without knowing the specific details, some type of hitherto unrecognized congenital structural problem is typically the culprit in young athletes like Colbrelli. Two such conditions – called hypertrophic cardiomyopathy and anomalous coronary artery origin – are the predominant causes, though a disorder known as arrhythmogenic right ventricular cardiomyopathy ( ARVC) is frequently observed in individuals of Mediterranean origin.
Additional possible causes for SCD in young athletes include primary heart rhythm disorders in otherwise normal hearts ( sometimes called channelopathies). Some of these inherited conditions may go completely undetected, even if the person is subjected to sophisticated screening. Sometimes, despite comprehensive testing, no specific diagnosis can be made, and the episode is termed “ idiopathic ”. Therefore, at least based on the available public information and the paucity of objective findings thus far, it seems that Colbrelli fits into this category.
Coronavirus, still fresh on everyone’ s radar, has led to speculation that Colbrelli’ s collapse could be related to COVID 19 – which, as we have previously noted is capable of causing serious heart issues. Colbrelli withdrew from Paris-Nice after Stage 1, reportedly due to issues stemming from “ bronchitis. ”
In hindsight, one could speculate that there might have been more going on here than a typical upper respiratory infection; there often can be misinterpreted symptoms prior to a significant cardiac event. But myocarditis due to COVID-19, a potentially reversible process, should be easily diagnosed by an abnormal echocardiogram or cardiac MRI scan – and a team statement said that there were “ no signs of compromised heart function. ”
Returning to competition following an instance of SCD is very complicated. Athletes who suffer SCD generally receive ICDs. In certain instances, if SCD occurs due to short-lived inflammation ( myocarditis) or sometimes from severe electrolyte disorders, the athlete may not ultimately require an ICD. If they remain free of recurrent arrhythmias for three months after resolution of the inflammatory process, they may be considered for re-evaluation with clearance to compete.
In all other cases, where an ICD is implanted, participation in low-intensity sports such as golf, bowling or curling would be reasonable, if the athlete remained free of arrhythmia for three months with no ICD shocks.
The decision to compete in higher intensity sports, however, has much higher stakes, and should only be made after a thorough consideration of the fact that an ICD can deliver both appropriate shocks – to restore normal heart activity in the event of a life-threatening arrhythmia, and inappropriate ICD shocks – that can sometimes result from “ normal ” elevated heart rates during intense competition.
Despite the sophistication of ICDs, most are simply triggered by specific heart rate cut-off zones programmed into the device and are not “ smart ” enough to actually diagnose the specific heart rhythm. S-ICDs like Colbrelli’ s can actually evaluate the heart rhythm, but tend to have difficulty doing so at very high heart rates, as is typically seen in competition.
Therefore, if the heart rate is elevated for any other reason – even if it’ s not life-threatening – the device will nonetheless deliver a shock if the programmed cut-off is exceeded. Patients say that an ICD discharge feels like getting “ kicked in the chest by a mule ” – so imagine the implications if Colbrelli were contesting a nerve-wracking sprint finish and was taken down to the tarmac due to an inappropriate ICD shock.
Sometimes, after a thorough discussion with family and appropriate physicians, an athlete may return to higher intensity competition, with a detailed contingency plan in place in the event that the unthinkable were to happen again. One top-flight European footballer, Christian Eriksen, who last year experienced a similar SCD, had an ICD implanted and has already returned to action – apparently successfully – in the Premier League. However, the risk profile is a little different for Colbrelli.
If Eriksen were to suffer a recurrence while on the pitch, he might collapse onto the grass; if Colbrelli experienced a recurrence while racing down the Tourmalet or mixing it up in a bunch sprint, it would be a totally different situation. Most cardiologists would thus be very nervous to “ clear ” his return to professional racing.
And in cycling, it’ s not only the potential safety implications for Colbrelli, but for the other riders in the peloton who might also be drawn into a dangerous pileup if he were to lose consciousness mid-race. His situation is analogous to some ICD patients in the general public — such as airline pilots and commercial truck drivers —who typically must forfeit their licenses after SCD events due to public safety concerns.
Even though the public does not have access to detailed health records, Colbrelli’ s case is clearly very serious. And because of his SCD event and the subsequent ICD implant, it seems likely that Colbrelli’ s career in bike racing is at an end.
In addition, although the UCI has no formal policy, there is an Italian law which effectively prohibits athletes from competing in elite sports if they have an ICD – an additional barrier to his return.
“ It’ s already a miracle that I’ m alive, ” Colbrelli himself told La Gazzetta dello Sport, adding that “ it would take another one to get me back on the saddle. ”
Dr. William Apollo, MD, FACC, an amateur bike racer and runner, is a Harrisburg, Pennsylvania-based cardiologist, and co-medical director of UPMC Central PA Sports Cardiology.
Steve Maxwell is co-editor of The Outer Line, and a frequent contributor to VeloNews.
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China is just one of the headaches facing Australia’ s next prime minister
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Australia is heading to a national vote on May 21 with the center-right Liberal National coalition government campaigning for a fourth term in office after grappling with a pandemic and a slew of climate change-related disasters.
Prime Minister Scott Morrison is hoping to woo voters with an economy that’ s looking strong as the government seeks a come-from-behind win off a narrative of solid economic management. However the opposition Labor Party, led by Anthony Albanese, is currently far ahead in opinion polling.
The number one election issue mentioned by Australian voters in most opinion polls is rising cost-of-living pressures. Prices are still rising due to Russia’ s invasion of Ukraine. Some economists expect inflation to rise above 4% later this year, the highest it has been since 2008 and far above the current wage growth.
The government included payments for low-income households and a cut to the petrol tax in the recent budget as a way to ease living cost pressures, but both are temporary measures. The Labor Party has promised to increase wages without really saying how it is going to do this.
All of this is in addition to rising rents, which hit their highest annual growth last year since 2007, according to CoreLogic. When combined with expected interest rate rises before the end of 2022, former Liberal Party leader John Hewson said there was an economic “ time-bomb ” waiting for the next government. “ A big cost-of-living risk is that inflation is much worse than they’ ve projected and the Reserve Bank reacts even more, puts interest rates up even more, ” he said.
It isn’ t just Australian households struggling to keep debt down. The government is having the same problem.
Australia adopted an expansionary policy during the pandemic, investing in businesses and workers to soften the economic blow from COVID-19. It has worked well, with unemployment now down to 4% and growth on track to rebound to pre-pandemic levels.
But it has left the government with debt on track to exceed more than 1 trillion Australian dollars ( $ 751 billion) by 2023-24. While the budget estimates showed debt peaking earlier and shrinking faster, it was mostly due to to surging commodity prices.
Just weeks out from the election, Australia’ s Pacific neighbor the Solomon Islands is on the brink of signing a security deal with China, a sign of just how complicated the region is expected to get for the next prime minister.
China is Australia’ s largest trading partner but in the past few years their relationship has deteriorated rapidly, to the point where both countries have almost no high-level contact publicly. Both sides of politics are in favor of taking a tough line on China, with Morrison making national security a central part of his re-election platform and Labor desperate to avoid looking weak on foreign policy.
Whoever wins will have to face a complicated relationship, with trade restrictions still in place on Australian exports to China. Australia is investing heavily in the U.S., partnering with it in both the “ Quad ” security agreement and the AUKUS nuclear submarine deal with the U.K.
The major parties are in lockstep on these moves, but former Liberal leader Hewson said there was “ no maturity ” in Australia’ s debate on China. He said since Beijing would be a major global player over coming decades, either Morrison or Albanese would “ have to work collaboratively with them. ”
“ I don’ t see that either side is prepared to say anything like that, ” Hewson said.
Climate change has a dramatic effect on Australia, and the losses keep getting greater. | BLOOMBERG
Australian health authorities are warning of a surge in COVID-19 cases over the southern hemisphere’ s winter months, in addition to a potentially deadly influenza season. The government has rolled out a fourth COVID-19 vaccine dose to senior citizens to boost their immunity ahead of the winter outbreak, but Deputy Health Officer Sonya Bennett said they were still expecting a rise in cases.
“ We haven’ t had experience with transmission in winter with COVID yet, ” she said at a press conference last month. Australia only lifted its “ COVID zero ” policy during the summer months in late 2021 while both the U.S. and the U.K. saw rapid rises in COVID-19 infections during their winter.
Australia is on the front lines of global warming. It is one of the world’ s largest coal exporters and is also experiencing devastating natural disasters. There were the 2019/20 fires, which eradicated huge tracts of bushland across the east coast, and this year’ s flooding in New South Wales and Queensland. The Great Barrier Reef is currently undergoing its sixth major bleaching event.
The Morrison government claims Australia is well on its way to meeting its climate action obligations and has said Australia will hit net zero emissions by 2050. Labor is promising to reduce emissions faster than the government if it wins office, cutting them by 43% by 2030.
Neither side is promising a rapid move away from burning or exporting fossil fuels though. Jill Sheppard, a political analyst at Australian National University, said any major change in climate policy was unlikely in the near future. “ Probably the best hope for climate action would be a hung parliament or at least a very strong Greens Party cross bench, ” she said.
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We need better COVID-19 booster shots, not more of the same
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In the U.S., COVID-19 cases in the Northeast are increasing again, which has some people worried about yet another surge.
This is also one of the most heavily vaccinated parts of the country. While the COVID-19 vaccines have been very effective at stopping hospitalization and death, it’ s now clear they haven’ t ended the pandemic.
And yet the scientists I spoke with in the early part of 2021 were nearly unanimous in thinking they would end the pandemic through herd immunity. Why did they get it so wrong?
Two major reasons: First, scientists vastly underestimated the ability of the virus to mutate quickly. And second, they overestimated their ability to tweak the mRNA vaccines into forms that could conquer new variants. But we can learn from our mistakes, and rather than expect the public to `` live with the virus ” protected by leaky vaccines, scientists need to keep improving our vaccines, possibly exploiting the more than 100 candidates already part or all the way through clinical trials.
Coronaviruses usually don’ t mutate very fast. They don’ t carry their genetic material in easily swapped out segments the way influenza viruses do — requiring a reformulated vaccine every year. And coronaviruses have a proofreading mechanism that slows the mutation process.
What makes COVID-19 different is the fact that its massive spread has given it so many more chances to evolve. `` We 'd all said that we didn't see rapid viral evolution as a threat, ” said immunologist Danny Altmann of the Imperial College, London. `` Why are we so stupid? We were so stupid because we 've thought about viruses on the scale of SARS or MERS. We haven't thought about viruses in the lungs of millions or billions of people. ”
COVID-19’ s evolution has also taken an unexpectedly convoluted path. Last summer, scientists assumed that any new variants would branch off the wildly transmissible delta variant, in which case a delta-specific vaccine might improve the situation and perhaps still allow us to end the pandemic. Instead, omicron branched off from a pocket of the original strain still simmering in Africa, making it far removed from delta.
The Pfizer and Moderna vaccines were supposed to be easy to update, and they are, but scientists got disappointing news when they tested omicron-specific boosters in animals and found they worked no better than the original boosters. Although the existing boosters are pretty good, they are not nearly good enough to prevent thousands of breakthrough infections, some of them pretty nasty.
The reason that the omicron-specific booster didn’ t work better might come down to a problem with our immune systems — a phenomenon that Altmann calls immune imprinting and others have called original antigenic sin. In a worst-case scenario, vaccines could actually make an infection worse by prompting the production of ineffective antibodies. That’ s happened with Dengue fever vaccines. It’ s not out of the question that a future variant could render our current vaccines a liability. It's not clear yet whether natural infection or vaccination with other kinds of vaccines will lead to the same problem.
Altmann thinks a second booster shot makes sense right now, especially in the United States, where we might see a new wave of the omicron subvariant BA.2. And he agrees with the FDA decision to authorize a second shot for those over 50. There’ s enough evidence out of Israel showing the second booster can offer at least a couple of months of increased protection against severe disease and death.
But he does foresee the potential for longer-term problems. He said that asking people to take the same booster every 4 to 6 months for a changing virus `` isn’ t good immunology or vaccinology or public health. ”
One problem is that there’ s no data one way or another whether the booster will do anything to prevent mild or asymptomatic infections and therefore it’ s unclear whether young, healthy people should get boosted to protect the community — or to avoid long Covid.
And while CDC Director Rochelle Walensky has recently said that an infection with omicron can substitute for one shot, the level of protection from a previous infection is complex and hard to predict. As Altmann points out, there are different forms of natural immunity — to the original virus, alpha, beta, delta and omicron.
Some experts quoted in the New York Times recently suggested that the reason BA.2 is spreading slower in the U.S. than it did in the U.K. comes down to the fact that the U.S. had many more omicron infections with the other subvariant, BA.1, over the winter. But that’ s speculation. Altmann said he’ s seen a number of people get re-infected with omicron once or even twice, suggesting this variant doesn’ t provide good immunity even to itself. The situation is now extraordinarily complex, with most of the population having very different immunity profiles from a hodgepodge of infections, shots and boosters.
What would be a better public health strategy? He suggested we keep exploring the more than 100 vaccines that have gone partway through clinical testing, looking for one that might have broader protection against parts of the virus that aren’ t changing as fast as the spike protein, and that show better durability. `` We’ ve known for more than 100 years how to make durable vaccines, ” he said, citing the attenuated viral vaccine for yellow fever as an example.
Gregory Poland, director of vaccine researcher at the Mayo Clinic, agrees and is working on a vaccine candidate that might work more broadly against current and future variants — and even might protect against other coronaviruses. He also thinks second boosters make sense for people over 50, given our current BA.2 threat and fewer nonpharmaceutical precautions.
And now there’ s a threat from new hybrid variants, including one dubbed XE that surfaced in China. It may fizzle or it may grow — experts now are reluctant to predict. With so many past predictions proving false, their reluctance is easy to understand.
It’ s become clear that our current vaccines won’ t end the pandemic. But that’ s no reason to give up hope; a vaccination campaign with better vaccines still might.
Faye Flam is a Bloomberg Opinion columnist and host of the podcast Follow the Science.
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Prince Harry and Duchess Meghan to Attend Invictus Games Together
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The Sussexes made their first public appearance as a couple at the Invictus Games in 2017.
As founder, Prince Harry considers the Invictus Games to be one of, if not the most, important event on his working calendar. And this week, he will make his trip to the sporting event in the Netherlands even more special by bringing along his wife, Meghan, Duchess of Sussex.
A spokesperson for the Sussexes confirms to BAZAAR.com that Meghan will join Harry in The Hague this weekend, marking their first joint visit to Europe since stepping back from their working royal roles in 2020.
The duchess is expected to spend the first few days of the games alongside the Duke of Sussex, who will remain in the country for the duration of the international competition, which runs from April 16 to 22.
💛🖤| Prince Harry, The Duke of Sussex, is getting ready for the Netherlands with some Dutch lessons. We look forward to giving him a warm welcome in # TheHague. As we all prepare for The Games, our thoughts are with Team Ukraine, as well as their friends & family. # InvictusGames pic.twitter.com/HD7kRr3ZX7
This is the fifth Invictus Games and will see teams from 20 different countries—including South Korea, Estonia, Canada, Australia, Poland, Iraq, and the United States—compete in events such as athletics, archery, wheelchair basketball, cycling, powerlifting, swimming, sitting volleyball, and indoor rowing. The Netherlands was originally due to host the games in 2020, but the event had to be delayed due to the COVID-19 pandemic.
The games—one of the largest sporting events, akin to the Paralympics—were launched by Harry in 2014 and provide a chance for sick or injured military personnel and veterans to compete.
Harry and Meghan made their first public appearance as a couple at the Invictus Games in Toronto in 2017, where they were seen walking hand in hand. And in 2018, the pair watched the games in Sydney, Australia.
Prince Harry surprised @ InvictusGamesNL's # TeamGB at their final training camp. Next week the team ( captained by @ RachWilliamson0) will depart for The Hague. `` No one's got any excuses for not being fit now, you 've had two years to prepare! '' he teased.https: //t.co/QFCDYXmNG2 pic.twitter.com/TrrBCUbUV5
Last week, Harry surprised Team UK athletes at their final training camp before they travel this week to The Hague. The duke made a video call to members, including 33-year-old team captain and British Royal Air Force veteran Rachel Williamson, wishing them luck.
`` For a lot of you, you 've already, as far as I 'm concerned, you 've already won gold by just getting to this point, '' he told them via Zoom. `` The fact that you are sitting there now wearing that strip and you are able to wear the Union Jack on your arm again, that means so much to every single one of you. ''
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U.S. stocks fall as Treasury 10-year yield tops 2.75%
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Stocks and bonds retreated Monday as investors focused on inflation and the impact of policy tightening by central banks.
All major groups in the S & P 500 fell, while the tech-heavy Nasdaq 100 lost more than 2 per cent. Ten-year Treasury yields climbed through 2.75 per cent for the first time since March 2019 after the Federal Reserve last week signaled sharp rate hikes and balance-sheet reduction to curb price pressures. Oil sank as China’ s largest coronavirus outbreak in two years heightens concerns about demand. Bitcoin traded near US $ 40,000.
Market sentiment continues to be shaped by a hawkish Fed, commodity disruptions caused by Russia’ s invasion of Ukraine and the prospect of an economic slowdown. China’ s COVID-19 outbreak continues to spread despite an extended lockdown of Shanghai’ s 25 million people, with the restrictions straining global supply chains. Investors are awaiting earnings reports this month to restore confidence in the outlook for equities.
“ Inflation, monetary policy jitters, Shanghai shutdown, and Russian invasion of Ukraine hold markets hostage, ” wrote John Stoltzfus, chief investment strategist at Oppenheimer. “ Markets remain prone to rotation and rebalancing for now as multiplicities of uncertain outcomes cause volatility and no shortage of pondering and projection. ”
Charles Evans, the Fed Bank of Chicago president who has long been one of the more dovish U.S. policy makers, said an accelerated pace of rate hikes to combat inflation is worth debating. The central bank is doing all it can to avoid “ collateral damage ” from raising interest rates, a “ brute-force tool ” that can act as a “ hammer ” on the economy, Governor Christopher Waller said.
The credit derivatives market ruled Russian Railways JSC to be in default after missing an interest payment last month. Russia said it would halt bond sales for the rest of the year and take legal action if sanctions force it into a sovereign default.
Shopify announced a number of proposed changes to its governance and share structure on Monday.
An analyst who covers Canada’ s banks is warning of choppy waters ahead and is urging clients to take a more defensive approach as economic uncertainty threatens to send shares sharply lower.
Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
Traders are shunning technology stocks amid mounting risks from soaring Treasury yields and hawkish commentary from the U.S. Federal Reserve.
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Tesla China exports only 60 cars in March as Covid hits auto sector
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Shanghai is home to Tesla’ s multibillion-dollar “ giga-factory ”, which the company calls its main export hub.
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Tesla exported only 60 China-made cars in March, a trade body said Monday, with the domestic market absorbing most of its production while virus curbs in areas like Shanghai and Jilin hurt deliveries in the auto industry.
Shanghai is home to Tesla’ s multibillion-dollar “ giga-factory ”, which the company calls its main export hub and has the capacity to produce hundreds of thousands of vehicles per year.
But the factory — like much of the country’ s auto industry — has been hit by pandemic-related disruptions.
While Tesla China delivered 65,814 cars at its factory last month, only 60 were exported, the China Passenger Car Association ( CPCA) said Monday, without giving further details.
In comparison, the company had exported 33,315 vehicles in February.
Tesla’ s slump is part of a wider trend across China, which saw car sales fall 10.5 percent from a year ago to 1.6 million vehicles on the back of strict measures to curb renewed virus flare-ups that have hit logistics and retail sales.
However, the new-energy sector appears to be the rare bright spot, with deliveries of the vehicles jumping 137.6 percent, compared to March 2021, and reaching 445,000 units, the CPCA said.
Despite a chip shortage and high lithium prices, CPCA’ s secretary-general Cui Dongshu said China’ s share of the world’ s auto market has “ reached a new high of 36 percent ” in the first two months of the year.
All eyes will be on Tesla’ s numbers in April, given that its Shanghai factory has reportedly suspended production since March 28 amid the city’ s virus lockdowns.
Beijing’ s zero-Covid policy to stamp out clusters has been increasingly strained as the country battles its worst wave of infections since the start of the pandemic
Chinese electric vehicle maker Nio said Saturday it has suspended vehicle production due to hard lockdowns across the country, and warned of delays in making deliveries.
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.
The huge lockdown, which has required 26 million people to stay home has become unworkable.
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A Ukrainian mother fell to her knees, clawing the earth behind a razed petrol station.
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Heart Complications in Children & Young Adults After COVID-19 Are Uncommon – But More Research Needed
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Heart complications are uncommon, yet treatable for children and young adults after COVID-19 disease or SARS-CoV-2 infection, according to a new scientific statement from the American Heart Association that details what has been learned about how to treat, manage, and even prevent cardiovascular complications from the SARS-CoV-2 virus in youth. The statement published today ( April 11, 2022) in the Association’ s flagship journal Circulation.
The latest data also indicate returning to sports and strenuous physical activities after heart symptoms resolve is safe, though additional screening may be considered for youth who experience more severe symptoms.
The new statement also calls for more research, including studies looking at the long-term cardiovascular effects from COVID-19 in children and young adults. The volunteer writing group’ s extensive research on the latest data found children with congenital heart disease ( heart disease or defects present at birth) have low rates of infection and complications from SARS-CoV-2, the virus that causes COVID-19 disease. A scientific statement from the American Heart Association is an expert analysis of current research and may inform future guidelines.
“ Two years into the pandemic and with vast amounts of research conducted in children with COVID-19, this statement summarizes what we know so far related to COVID-19 in children, ” said Chair of the statement writing group Pei-Ni Jone, M.D., FAHA, director of 3D Echocardiography, the Kawasaki Disease Clinic and Quality in Echocardiography at Children’ s Hospital Colorado in Aurora, Colorado. “ We focused on the effects of this virus for those with congenital or other heart disease, as well as the latest data about the potential association of the COVID-19 vaccines with heart complications in children and young adults. While there is a lot we know, this public health emergency needs ongoing research to understand the short- and long-term impacts on children. ”
Analysis of the latest research indicates children generally have mild symptoms from SARS-CoV-2 infection. In the U.S., as of Feb. 24, 2022, children have accounted for 17.6% of total COVID-19 cases and about 0.1% of deaths from the virus. In addition, young adults, ages 18 to 29, have accounted for 21.3% of cases and 0.8% of deaths from COVID-19. Studies suggest a few factors may help to explain why children may be less susceptible to severe COVID-19 infection: 1) cells in children’ s bodies have fewer receptors to attach to the SARS-CoV-2 virus and 2) children may have a lower immune response due to a different cytokine response compared to adults and trained immunity from other vaccines and viral infections.
While children with congenital heart disease have had low infection and mortality rates from SARS-CoV-2 infection, having an underlying genetic syndrome, such as trisomy 21 ( also known as Down syndrome), appears to be associated with an increased risk of severe COVID-19.
The statement outlines available treatments for children with COVID-19, though there are no specific COVID-19 antiviral therapies. These include remdesivir and dexamethasone for children in certain age groups. Remdesivir is the only antiviral drug currently approved by the U.S. Food and Drug Administration ( FDA) for treatment of people ages 12 and older hospitalized with COVID-19 who have risk factors for severe disease and the need for supplemental oxygen, and it is most effective when given as soon as possible after symptoms began. Dexamethasone, which has been shown to reduce risk of death in adults with COVID-19, is suggested for children with more severe disease who require breathing support.
Heart-related complications in children with COVID-19 are uncommon. Case reports of cardiac complications include:
Sudden cardiac death and death following intensive medical and life support treatment has occurred in children with severe COVID-19 that affected the heart.
Since the start of the COVID-19 pandemic, a new multisystem inflammatory syndrome in children ( MIS-C) was identified around the world, with as many as half of the cases involving inflammation of the heart muscle or heart arteries. During the first year of the pandemic, one of every 3,164 children with SARS-CoV-2 infection developed MIS-C.
For children who develop MIS-C, intravenous immunoglobulin ( IVIG) has been administered alone or as dual therapy with infliximab or other immunomodulatory agents. Most children’ s hearts recovered well within 1 to 4 weeks of MIS-C diagnosis. The risk of long-term complications and death from MIS-C is estimated to be 1.4-1.9%.
The majority of MIS-C cases were among children identified in medical records as Black race or Hispanic ethnicity. Additional research about MIS-C is needed to learn why people from diverse racial or ethnic groups may be disproportionately affected and to understand the risk factors for this condition.
For children and young adults who have had COVID-19, the return to sports and strenuous physical activity has been an area of targeted research and examination. The latest data suggests those who had mild COVID-19 infection or infection without symptoms are safe to return to sports after recovery from all symptoms. For youth with more serious SARS-CoV-2 infection or who develop MIS-C, it is reasonable to consider select cardiovascular screenings, such as an echocardiogram, blood tests for heart enzyme levels and other heart function screening, before returning to sports.
The COVID-19 vaccines can prevent patients from getting COVID-19 and decreases the risk of MIS-C by 91% among children 12-18 years of age. Some have expressed concern about the risk of heart inflammation after the mRNA COVID-19 vaccines. The data indicate the benefits of getting the vaccines outweigh the risk of potentially developing vaccine-associated myocarditis. For example, for every 1 million doses of the mRNA COVID-19 vaccines in males ages 12 to 29 years ( the highest risk group for vaccine-associated myocarditis), it is estimated that 11,000 COVID-19 cases, 560 hospitalizations and 6 deaths would be prevented, whereas 39 to 47 cases of myocarditis would be expected. The FDA has granted Emergency Use Authorization for the mRNA vaccine manufactured by Pfizer-BioNTech for children ages 5 and older, and it has full approval for all individuals ages 16 and older.
Viral infection is the most common cause of myocarditis in children. About 1 to 2 in every 100,000 children are diagnosed annually in the U.S. with myocarditis prior to the COVID-19 pandemic, according to data from the U.S. Centers for Disease Control and Prevention. Children are also more likely than adults to develop myocarditis as the result of a viral infection such as COVID-19. The CDC is continuing to follow myocarditis in children and young adults closely, particularly a possible connection to the mRNA COVID-19 vaccines.
More research is needed to better understand the mechanisms and optimal treatment approaches for SARS-CoV-2 infection, vaccine-associated myocarditis, the long-term outcomes of both COVID-19 and MIS-C, and the impact of these various conditions on the heart in children and young adults. In addition, the development of new antiviral therapies need to be tested in clinical trials focused on children.
“ Although much has been learned about how the virus impacts children’ s and young adult’ s hearts, how to best treat cardiovascular complications and prevent severe illness and continued clinical research trials are needed to better understand the long-term cardiovascular impacts, ” Jone said. “ It is also important to address health disparities that have become more apparent during the pandemic. We must work to ensure all children receive equal access to vaccination and high-quality care. ”
Reference: 11 April 2022, Circulation. DOI: 10.1161/CIR.0000000000001064
This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association’ s Council on Lifelong Congenital Heart Disease and Heart Health in the Young ( Young Hearts); the Council on Hypertension; and the Council on Peripheral Vascular Disease. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific Statements outline what is currently known about a topic, and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’ s official clinical practice recommendations.
Co-authors are Vice Chair Sarah D. de Ferranti, M.D., M.P.H., FAHA; Anitha John, M.D., Ph.D.; Matthew E. Oster, M.D., M.P.H., FAHA; Kiona Allen, M.D.; Adrianna H. Tremoulet, M.D., M.A.S., FAHA; Elizabeth V. Saarel, M.D., FAHA; Linda M. Lambert, A.P.R.N., FAHA; and Shelley D. Miyamoto, M.D., FAHA. Authors’ disclosures are listed in the manuscript.
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Stocks Set for Mixed Start Amid Bond, Oil Selloff: Markets Wrap
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The information you requested is not available at this time, please check back again soon.
A pedestrian wearing a protective mask is reflected in an electronic stock board outside a securities firm in Tokyo, Japan, on Monday, Jan. 4, 2021. Asian stocks climbed to a new record, as technology shares remained strong in the first session of 2021. Photographer: Noriko Hayashi/Bloomberg, Bloomberg
( Bloomberg) -- Stocks in Asia are set for a cautious start Tuesday amid a selloff in bonds and oil as economic threats from high inflation, tightening monetary policy and China’ s Covid lockdowns ripple across markets.
Equity futures slipped in Japan and Australia, while U.S. contracts wavered, after a broad S & P 500 retreat and another slump in the tech-heavy Nasdaq 100, which has shed over $ 1 trillion in value in the past five sessions.
Hong Kong futures bucked the gloom, potentially reflecting China’ s approval of the first batch of new video game licenses since July. That step may ease some of the worst concerns about Beijing’ s gaming-sector crackdown.
Longer-maturity U.S. Treasuries slumped, taking the 10-year yield to 2.78%, as the global bond rout continued. A dollar gauge cemented its longest winning streak since 2020. Both trends reflect expectations that the Federal Reserve will implement its fastest policy tightening since 1994.
Oil steadied after a tumble that saw crude erase most of the gains sparked by Russia’ s invasion of Ukraine. China’ s virus outbreaks and mobility curbs, in pursuit of a controversial Covid-zero strategy, are imperiling demand.
The next major test for markets looms later Tuesday, when the U.S. is expected to unveil an inflation print for March of more than 8%. While that could mark the peak, there are fears that price pressures will remain elevated. The Ukraine war is disrupting flows of essential commodities, and China’ s lockdowns are straining supply chains.
“ What we’ re faced with this year is stagflation, ” Kathryn Rooney Vera, head of global macro research at Bulltick LLC, said on Bloomberg Television. “ It’ s a very complicated environment that the Fed has found itself in ” and the market is pricing in potentially 50 basis points of hikes at each of the next two policy meetings, she added.
Charles Evans, the Fed Bank of Chicago president who has long been one of the more dovish U.S. policy makers, said an accelerated pace of rate hikes to combat inflation is worth debating.
The central bank is doing all it can to avoid “ collateral damage ” from raising interest rates, a “ brute-force tool ” that can act as a “ hammer ” on the economy, Fed Governor Christopher Waller said.
Meanwhile, the credit derivatives market ruled Russian Railways JSC to be in default after missing an interest payment last month. Russia said it would halt bond sales for the rest of the year and take legal action if sanctions force it into a sovereign default.
Elsewhere, Bitcoin sank, part of broad weakness in cryptocurrencies, pushing the world’ s largest digital token below $ 40,000.
Shopify announced a number of proposed changes to its governance and share structure on Monday.
An analyst who covers Canada’ s banks is warning of choppy waters ahead and is urging clients to take a more defensive approach as economic uncertainty threatens to send shares sharply lower.
Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
Traders are shunning technology stocks amid mounting risks from soaring Treasury yields and hawkish commentary from the U.S. Federal Reserve.
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Australia PM Bets on Strong Economy for Re-election as Inflation Concerns Grow
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Scott Morrison, Australia's prime minister, speaks during a news conference in Sydney, Australia, on Friday, May 7, 2021. For Morrison, Tuesday’ s annual budget can’ t come soon enough as he tries to put a torrid opening to the year behind him and focus voter attention on the strength of the economic recovery., Bloomberg
( Bloomberg) -- Prime Minister Scott Morrison has put economic stewardship at the center of his bid for a come-from-behind win in Australia’ s May 21 ballot.
On paper, he has a good story to tell: the $ 1.6 trillion economy is larger than before the pandemic and set to expand 4.25% this fiscal year; unemployment is expected to hit 3.75% in the third quarter, a level unseen since the early 1970s; and soaring property prices mean households are wealthier than ever.
But the economy is also his Achilles Heel, with rising rents underscoring the gap between accelerating inflation and still slow wage growth. There have also been stumbles ranging from a delayed vaccination rollout to a bungled, politicized response to recent floods that have eroded public support.
“ There is a lot of frustration that wages have not risen in a meaningful way over the past decade, ” said Brendan Coates of the Grattan Institute, a think tank. “ There are big concerns about cost of living right now. ”
Coates adds that if the Reserve Bank responds to surging inflation with higher interest rates as expected, “ the government is going to take a lot of heat. ”
Most economists predict the central bank will raise its cash rate by 15 basis points to 0.25% in June, while financial markets see some chance of a move next month, or right in the middle of the campaign.
Morrison sought to soothe the economic pain of higher prices and weak pay gains in the March 29 budget with cash handouts and a six-month cut in gasoline excise. While the budget was fairly well received, it doesn’ t seem to have significantly improved the government’ s standing in opinion polls.
Many Australians now expect rate rises after more than a decade without them. Market pricing shows a series of rapid RBA hikes from July to December to take the cash rate to 2% by year’ s end, with it then reaching 3% by April 2023.
That scale of increase would put an immense burden on households who have nearly A $ 2 trillion in outstanding mortgages. Bloomberg economist James McIntyre warned that some borrowers would buckle under the strain if traders’ expectations came to pass.
“ The rates market is pricing such an incredibly unrealistic degree of tightening, ” he said, adding it would make the higher repayment buffers lenders are required to use to assess applications almost redundant. “ It will blow through the prudential regulator’ s lending standards. ”
House prices across Australia have soared in response to ultra-loose monetary policy designed to support the economy through the pandemic. While that has boosted the wealth of homeowners, it has exacerbated affordability issues for first-time buyers and lower income earners.
Many of Morrison’ s difficulties are reminiscent of those faced by his Liberal-National predecessor, John Howard, in the 2007 election. Howard opened his campaign pledging a jobless rate with a “ 3 ” in front, was hit with a rate hike in the middle of it and struggled to win back voters angered by rising costs.
While very low unemployment is positive as it gets people on the fringes of the labor market back into work, at a political level the faster inflation associated with it tends to alienate voters and often outweighs the social benefit.
History repeating itself isn’ t confined to the conservative side. The opposition Labor party, which leads in opinion polls, may find that if victorious it will be constrained from doing much additional spending. The budget deficit remains large, the national debt is at a record and repayments will climb together with interest rates, while inflation further argues against additional fiscal outlays.
That continues a history dating back 50 years that has hamstrung incoming Labor administrations. In the early 1970s, it was the oil-price shock and stagflation; in the early 1980s, it was a double-dip recession; and in 2007, it faced the global financial crisis in 12 months. The current outlook suggests a new left-wing government would have to err on the side of fiscal restraint.
Another issue for both sides is pandemic fallout on women and young people, as well as sectors such as tourism, the arts and small business.
A report by Australian Catholic University found demand for social service providers in Victoria state, which endured some of the longest coronavirus lockdowns in the world, has surged. The number of people with no income seeking “ emergency relief ” by the end of 2021 was more than double pre-pandemic levels, it found.
That’ s despite massive government spending during the pandemic that forced Morrison to dump a long-cherished goal of returning the budget to surplus.
Anne Tiernan, adjunct professor of politics at Griffith Business School said the government has “ lost the benefit ” of being focused on budget surpluses.
“ So, it’ ll be interesting, after 12 years of talking about debt and deficit, to what extent will the opposition’ s critique of the quality of recent government spending will cut through the prime minister’ s claims about superior economic management, ” she said.
Canada joins U.S., U.K. in diplomatic boycott of Beijing games
Trudeau weighs auto-content rules as next U.S. trade flashpoint
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NHS England announces plans for £240M federated data platform
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NHS England has unveiled plans to develop a federated data platform ( FDP), with an estimated procurement value of £240 million.
It has published a prior information notice for potential suppliers ahead of an open procurement.
According to the notice, the FDP will be “ an ecosystem of technologies and services ” and “ an essential enabler to transformational improvements across the NHS ”. It will be built around five major use cases: population health and person insight, care co-ordination, elective recovery, vaccines and immunisation, and the supply chain.
The notice says the scope of the procurement will comprise two lots: one for the FDP itself, with integrated care system ( ICS) integration and consultancy and communications support for ICS implementation and adoption, the other for privacy-enhancing technology.
A supplier briefing will take place on 13 April 2022, with the publication of the contract notice planned for 6 June 2022.
Data federation is a software process that allows multiple databases to function as one. The virtual database takes data from a range of sources and converts them to a common model, providing a single source of data for front-end applications.
This can facilitate access to sensitive health data, offering a potential solution to address the issue of siloed health data and barriers to data sharing.
The move follow’ s UK health secretary Sajid Javid’ s recent announcement of a technological agenda for the NHS, which includes plans to “ level up the digital provision all across health and social care. ”
According to Digital Health News, the front-runner for the FDP contract is widely assumed to be US software firm Palantir Technologies, which partnered with NHSE, alongside Microsoft and Amazon to develop a data platform to inform the COVID-19 response.
Last year tech-justice firm Foxglove issued a lawsuit on behalf of openDemocracy over the £23.5 million NHS data deal with Palantir.
Peter Wilson, public sector industry architect at software company Pegasystems, said: “ It’ s heartening to see the announcement by NHS, of the intention to run an open tender for the development of a federated data platform, to enable their transformation ambitions, albeit I and many others will be keen to hear more details of the proposition at a supplier day on 13th April.
“ The terminology is quite specific in industry terms and it’ s an important step to accept that structures like an ICS will always have a multitude of patient ( and other) data stores, but that having a means to provide a consolidated view of them is long overdue.
“ However, I’ ve been advocating for a while now that this is only part of the story. Equally important is the ability to recognise that there will be times when it’ s also necessary to coordinate and orchestrate a “ patient journey ” across the organisational components of an ICS, because frankly that’ s the point of taking a consolidated view of the data. ”
Alastair Allen, chief technology officer at Better, said: “ The potential of a federated data platform across the NHS is incredibly exciting as it should enable multiple, distributed data stores to function independently but also together as one. Such a platform could help manage a range of challenges including care coordination, population health management and elective recovery.
“ For this to work it’ s essential to have a common data model that is understood across all applications. Without this we will simply repeat mistakes of the past in establishing more distributed silos of data that don’ t talk to each other as they don’ t share a common language. ''
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Are European healthcare systems ready for the cyber threat?
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The war in Ukraine has been accompanied by talk of a growing cybersecurity threat. Electronic health records ( EHRs), data sharing, telehealth and ICT have become common in healthcare, making the field more interdependent, and hackers have increasingly targeted healthcare organisations.
In February, one day after the invasion of Ukraine, the American Hospital Association issued a warning about potential cyber threats from Russia, stating that hospitals could be directly targeted or become collateral damage in a malware attack. For Dr Sabina Magalini, a senior surgeon of emergency trauma at the Gemelli University Hospital in Rome, the nature of the threat has changed, moving away from individuals seeking financial gain. “ The intent now is not to do ransomware but it is to do harm, ” she said.
Magalini, who was recently involved in an EU-funded cybersecurity project called Panacea, says that healthcare professionals are busy, and IT departments work in different siloes from their medical colleagues. While medicine increasingly relies on digitisation and AI, cyber-hygiene is uneven, she explained. “ I always say, if you were working in a nuclear power plant, maybe you would be more compliant with the requirements. Working in healthcare, cybersecurity is not your chief focus. ”
A system failure in healthcare can be catastrophic. The Irish healthcare system lost access to phone and email communications after a ransomware attack last May, when a staff member opened a malicious MS Excel file. In 2020, a cyber-attack in Germany led to the death of a patient when treatment was delayed.
The EU is expected to update its strategy for enhancing cybersecurity across the EU, the NIS directive, later this year. Europe’ s agency for cybersecurity, Enisa, has published a report on how pseudonymisation can help protect patients’ data, and offers training webinars to improve workforce skills. Enisa says more than 350,000 cybersecurity positions are unfilled across the continent.
The rapid digitisation of healthcare during the COVID-19 pandemic created two different security weaknesses, according to Alessandro Ortalda, a researcher at the Vrije Universiteit in Brussels who has advised governments and public institutions on cybersecurity. One is the potential for cyber-criminals to jeopardise patient safety by hacking connected devices. The other is that they would obtain patient data and sell it or hold it to ransom.
Of the two, data breaches are more critical, Ortalda says. “ If you target a specific medical device you are targeting one person or a small group of people. But if you target a database that hosts data from hundreds or maybe thousands of people, the potential gain is much, much higher. And accessing these kinds of databases is way easier than violating a medical device. ”
Regulations like GDPR provide a solid framework for data protection but can be hard to comply with, Ortalda said. “ One of the aspects that often is difficult for security personnel is how to translate these high principles into actionable requirements at the implementation level. ”
Although awareness of the cyber-threat is growing across healthcare, experts say that financing is an issue. Better resourcing, and the creation of new data protection officer roles ( DPOs) —a position envisaged by the GDPR—would help healthcare institutions be prepared, Ortalda suggests. “ Right now DPOs and privacy departments are heavily understaffed and heavily under-resourced. This is a huge problem for organisations like hospitals or pharmaceutical companies. ”
Meanwhile, both defence and attack strategies will evolve, he said. “ The one ahead is always the attacker. It’ s always easier to attack than to defend. ”
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John O'Connell's Top Picks: April 11, 2022
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Investors continue to reassess the prospects for economic growth as central banks begin the process of allowing interest rates to reflect economic reality rather than pandemic-induced life support. That economic growth will slow materially is generally accepted, the degree of moderation ranges from those calling for a recession within a year to those who expect a mid cycle pause continues. The inflation debate and the pace of its moderation also is subject to a great deal of uncertainty. The manner that companies are able to navigate these difficulties will be the major considerations for investors for the balance of the year. The coming earnings season these next few weeks will set the tone for the balance of the year.
John O'Connell, CIO and CEO of Davis Rea, discusses his top picks: Accenture, Amazon, and Home Depot.
Accenture is a global leader in the consulting business and its growth profile is being powered by the growth of business needing to move their operations towards the digital cloud.
Their clients span multiple industries, protecting the company from exposure to any one idiosyncratic negative slowdown. The company continues to gain market share and count 89 of the fortune 100 as clients.
The company has a shareholder-friendly strategy of allocating its growing profitability 1/3 toward each of growth investments, dividend growth and share repurchases. We believe Accenture is the kind of business that investors can own for generations and watch capital compound at highly attractive after-tax rates.
What can be said about Amazon other than to acknowledge that it was one of the companies that allowed the pandemic to be a bit more manageable. The sign of a truly valuable franchise. We believe Amazon will continue to grow its business in a highly disciplined and rapid manner. From nowhere five years ago, it has gone unnoticed by many, that its advertising business has grown to a scale that is now larger than YouTube.
Home Depot is the kind of company that can grow its net earnings at the seven to eight per cent compounding growth rates for years to come. The company has a good growth strategy and disciplined management that is constantly innovating to drive efficiencies for its business and its clients. The demographics for hiome construction and renovation for many years to come make HD a superb long-term compounder
John O'Connell, CIO and CEO of Davis Rea, discusses his top picks: Thermo Fisher, Synopsys, and Amazon.
Shopify announced a number of proposed changes to its governance and share structure on Monday.
An analyst who covers Canada’ s banks is warning of choppy waters ahead and is urging clients to take a more defensive approach as economic uncertainty threatens to send shares sharply lower.
Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
Traders are shunning technology stocks amid mounting risks from soaring Treasury yields and hawkish commentary from the U.S. Federal Reserve.
More than 18,000 Etsy sellers have pledged to join a strike protesting a 30% increase in fees that takes effect today.
There has been a lot of debate about a stagflationary slowdown or possible recession given the inverted yield curve. If this is where we are heading, it would be helpful to know what market factors can help you weather the storm.
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.
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Industrials Down on Inflation, Chinese Lockdown Concerns — Industrials Roundup
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Shares of industrial and transportation companies fell as rising inflation and lockdowns in major Chinese manufacturing centers spurred concerns about the outlook for economic growth.
Shares of Chinese auto makers, including those of electric-vehicle manufacturers, fell sharply in Hong Kong on worries over potential production halts and weak sales due to strict Covid-19 curbs in China. Car sales in China dropped 10.5% year-over-year in March to 1.58 million vehicles as measures to contain the coronavirus outbreaks halted auto factories, slowed down car shipments, and kept consumers from visiting car dealerships, the China Passenger Car Association said.
Public expectations for the level of inflation a year from now hit a record in March, according to the latest survey from the Federal Reserve Bank of New York. Meanwhile, the impact of 2020 and '21 fiscal stimulus packages is set to run out after the current tax season, said one brokerage.
`` After two years of unprecedented fiscal actions, the fading impact of fiscal policy is weighing on growth, '' said strategists at brokerage Goldman Sachs Group, in a note to clients.
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business
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Bond Investors: Mind Your Overseas Currency Exposure
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Currency risk can make your international bonds go wild.
A version of this article was published in the February 2022 issue of Morningstar FundInvestor. Download a complimentary copy of FundInvestor by visiting the website.
Over the past 15 years, global-bond benchmarks with non-U.S.-dollar exposure have been much more volatile, as measured by standard deviation, and underperformed their U.S.-dollar-hedged global-bond counterparts. Sometimes this volatility can prove beneficial, which was the case from April 2007 to mid-2014. However, volatility is not always your friend; since mid-2014, non-U.S.-dollar exposure has hurt results.
Last year was no exception. After another strong year for the U.S. dollar, bond funds with exposures to currencies that declined versus the greenback felt some pain in 2021. This pain continued for some foreign currencies in the first quarter of 2022 as the Russia-Ukraine War led investors to flee for the relative safety of the world's main reserve currency, the U.S. dollar. Among the fixed-income Morningstar Categories, non-U.S.-dollar exposure is the highest for world-bond and emerging-markets bond funds. That said, overseas currency exposure routinely shows up within intermediate core-plus, multisector, and nontraditional bond funds. For example, scores of core-plus bond strategies have sported high-single-digit to low-teens stakes in overseas debt and nondollar currencies in recent years.
Sharp declines in non-U.S. currencies can easily erode or wipe out income streams and can therefore have a significant impact on a bond fund's risk/return profile. Last year was a tough one for the euro and yen, which were down roughly 7% and 10%, respectively, versus the dollar. In strong dollar years, emerging-markets currencies can post even larger losses, making them among the most potent tools available to fixed-income managers. Last year, some of the largest losers versus the greenback were the Turkish lira ( negative 44%), Argentine peso ( negative 18%), and Chilean peso ( negative 16%). Still, non-U.S. currencies can help as well. As seen in Exhibit 1, currency exposure can lead to much better or worse returns
Of course, avoiding currency risk altogether is possible with a strict, U.S.-only mandate. Another path is to buy a fund that fully hedges non-U.S. currency exposure back to the U.S. dollar. Pimco International Bond ( U.S. Dollar-Hedged) ( PFOAX) and its unhedged sibling ( Pimco International Bond ( PFUIX)) nicely illustrate the hedging impact. In addition to non-U.S. currencies, duration has also had a tough start to 2022, causing Pimco International Bond ( U.S. Dollar Hedged) to lose 3.7%. However, the unhedged version of this strategy slid 6.3%. Over the medium and long terms, the unhedged version's max drawdown was at least twice as painful as its U.S.-dollar-hedged sibling's. Notably, from November 2008 to mid-2009, it plunged 21% versus 9% for the hedged version.
Within the intermediate core-plus bond category, there are several strategies that incorporate a combination of unhedged overseas bond positions ( both from developed and emerging markets) as well as modest long or short currency positions in their investment processes. For instance, the team at Western Asset Core Plus Bond ( WACPX) has been one of the more avid investors in volatile emerging-markets fare. Its emerging-markets debt stake stood at 13% at the end of 2021, with the team citing the real yield ( which is adjusted for inflation) differential between emerging and developed markets as well as valuations as key drivers. The strategy's roughly 15% in non-U.S.-dollar exposure included small stakes in the yen and Australian dollar, though it was predominantly in emerging-markets currencies such as the Russian ruble and Mexican peso. That, as well as the strategy's longer duration relative to its core-plus bond category peers, took a toll and contributed to the fund's 8.8% loss for the first quarter of 2022, which lagged nearly all peers.
While corporates and securitized debt constitute the bulk of PGIM Total Return Bond's ( PDBAX) portfolio, it also regularly uses non-U.S. debt and currencies. The fund held 5% in foreign developed-markets government and 6% in emerging-markets issues at year-end, both of which have fluctuated in recent years based on the team's adjustments to the overall credit exposure. The strategy's currency exposure is well diversified across roughly 30 modest long and short positions ( less than 50 basis points apiece). Still, that nondollar exposure, as well as significantly longer duration than its core-plus bond category peers, contributed to the fund's 6.5% loss that landed near the bottom decile of peers for the first quarter of 2022.
Both strategies have experienced some larger drawdowns at times compared with peers, partly owing to the inclusion of more-volatile currencies. And they could continue to experience steeper losses as they did in the emerging-markets currency selloff in mid-2018 and the coronavirus downturn in early 2020.
Non-U.S. currencies are generally meant to be minor drivers of return for core bond funds. These managers have a lot of other levers to pull to offset air pockets like we 've seen in recent years, but it's crucial to invest with teams that have the depth and breadth of support required for this volatile tool.
Mike Mulach does not own ( actual or beneficial) shares in any of the securities mentioned above. Find out about Morningstar’ s editorial policies.
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Queen Elizabeth Celebrates Hospital Unit with Virtual Appearance
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The monarch will be skipping a major royal event in the coming days.
Queen Elizabeth will be skipping a royal tradition in the coming days, but she made sure to virtually attend the official opening of the Royal London Hospital's Queen Elizabeth Unit.
`` Her Majesty joined a video call with staff and patients to hear about their experiences during the pandemic, '' the royal family wrote on Twitter today.
As Patron of the @ RoyalLondonHosp, The Queen has marked the official opening of the Queen Elizabeth Unit, which was built in just 5 weeks in response to Covid-19.👇 Her Majesty joined a video call with staff and patients to hear about their experiences during the pandemic. pic.twitter.com/p5SzMaG4di
The monarch has been expressing her support for National Health Service workers, and in the past several days spent time speaking with hospital staff who have cared for the community amid the ongoing COVID-19 pandemic.
`` It's amazing, isn't it, what can be done, when needs be? '' the queen said in the video call. `` It's been very nice to join you, and also to hear about what happened, and how well it has been achieved. Thank you very much indeed, all of you. ''
At the event, Sir Kenneth Olisa, the Lord-Lieutenant of Greater London, unveiled a plaque on behalf of the queen, marking the official opening of her hospital unit, which takes up floors 14 and 15 of the hospital. With 155 beds, it is one of the biggest critical care spaces in the United Kingdom.
On 6 April, Her Majesty the Queen formally opened The Queen Elizabeth Unit at @ RoyalLondonHosp more than year after it received its first patient.The ceremony took place on the unit with Her Majesty joining virtually from Windsor Castle. @ RoyalFamily👉 https: //t.co/NQZTCS41Py pic.twitter.com/vtOoxiUVf5
The queen's virtual visit comes ahead of the Royal Maundy service, which will take place on Thursday. The monarch—who has been working mostly from her home, Windsor Castle, since she recovered from COVID-19 earlier this year—has pulled out of the event for the first time and will instead be represented by son Prince Charles and his wife, Duchess Camilla, Buckingham Palace announced.
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Physical Vapor Deposition Market Size & Growth Report to 2030
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Find market research and analysis that is reliable and actionable. A comprehensive business intelligence repository that covers established as well as evolving market trends.
Fact.MR’ s industry-wide market research solutions are comprehensive. We go beyond one sector, and analyze the market from various perspectives.
Global physical vapor deposition market is set for a positive growth trajectory at 6% CAGR during the forecast period ( 2020 - 2030). Advancements in data storage capacity of computers and smartphones, stimulate a need for physical vapor deposition on hybrid internal memory circuits.
Prevalence of cost-efficient electromagnetic shields for lightweight components is heightening demand for physical vapor deposition processes. Increasing adoption of solar energy by manufacturing units and consumers alike is facilitating continuous adoption of physical vapor deposition of photovoltaic products.
Expanding spectrum of Internet of Things ( IoT) enabled smart devices, requires the device to record, store, and transfer data efficiently. Hence, consumer adoption of smart devices and IoT products will further the demand of physical vapor deposition on memory components of these smart products.
Physical vapor deposition in the microelectronic sector accounts for a majority share of over 39% of the total market value. This can be accredited to the increasing need for microelectronics by manufacturers of home automation, artificial intelligence ( AI), and machine learning ( ML) smart devices. Data storage applications of physical vapor deposition accounts for the second largest market value share of more than 23%.
A surge in demand for increased storage capacity of devices and enhanced processing speeds demands the high performance of storage devices such as solid state drives ( SSD). These high-performance storage devices warrant physical vapor deposition to ensure the smooth functioning and durability of products.
Medical equipment offers the highest growth opportunity with a stellar 8.7% CAGR during the projection period. The Proliferation of interconnecting medical equipment amid heightening healthcare expenditure will continue to nourish demand from this segment.
North America accounts for the largest market value share of over 26%. Advancements in medical equipment are creating demand for high performance devices with physical vapor deposition coatings. East Asia is accredited with more than 22% of the total market value share.
Surging industrial production in countries such as China, Japan, and South Korea supports the two-fold growth in these regions. Since manufacturers are eyeing enhanced product durability offered by physical vapor deposition, manufacturers will witness an upsurge in demand for coating services and products.
Expulsion of all non-essential trade between countries has cost many businesses a significant share of quarter 1 revenues. Government health institutions around the world are overwhelmed by the mass-outbreak of COVID-19. The deadly virus has affected more than 1.6 Mn consumers in just a few months of being declared a global pandemic. Hence, it is natural for governments to contain the spread of coronavirus by preventing mass gatherings.
This means a considerable drop in offline sales of electronics that employ physical vapor deposition in their components. The impact of COVID-19 has a two pronged effect on the automotive sector. Both, production and sales of light weight conventional and electric vehicles are witnessing loss of proposed revenues.
This further depletes an otherwise strong growth trajectory of the physical vapor deposition market. Market players are targeting early recovery tropical countries such as Singapore, and Indonesia on the back of low number of COVID-19 cases. Effective and efficient recovery steps taken by the Chinese government presents a favorable development.
As many electric components are sourced from China, market players are focused on tracking and monitoring the developments in China’ s COVID-19 spread. Physical vapor deposition market will continue on a healthy growth trajectory after the COVID-19 Pandemic is contained and usual trade routes will resume import and export.
The development of new coating materials with low coefficient of friction energizes the adoption of physical vapor deposition products and services. Consumer demand for low carbon emission, lightweight materials in automotive promote physical vapor deposition on cutting tools and automotive components.
The global physical vapor deposition market is segmented on the basis of category, application and region.
This taxonomy and the detailed TOC prepared are confidential and intended exclusively for the individual or entity with whom it is being shared. Reading, disseminating, distributing, or copying this to any party other than the addressee ( s) is unauthorized and prohibited.
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Shanghai starts easing lockdown in some neighbourhoods
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Shanghai eased restrictions on some neighbourhoods after mounting outcry over Covid-19 rules that have locked down 25 million people,
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Shanghai eased restrictions on some neighbourhoods Monday after mounting outcry over inflexible Covid-19 rules that have locked down 25 million people, caused food shortages and left thousands in quarantine.
Authorities said they would gradually begin to allow those in areas with the least number of virus cases to leave their communities, although it was unclear how many people will be allowed out of their homes or when.
China has stuck to a policy of “ zero Covid ”, aiming to eliminate infections through rigid lockdowns, mass testing and travel restrictions.
Shanghai has been placed under some of the most severe measures since the virus emerged in Wuhan in 2019, with a strict lockdown leaving many struggling to get enough food and thousands sent to centralised quarantine centres.
Officials said they would categorise communities across the city into three levels based on the number of infections.
“ Differentiated prevention and control ( measures) ” would refect the “ actual circumstances ” on the ground, Shanghai official Gu Honghui said Monday, in a move that appeared aimed at defanging rising anger over authorities’ handling of the virus.
Those in “ closed control areas ” or “ controlled management areas ” would continue to be locked down in their homes or limited to their compounds.
Residential communities which have recorded no cases in the past 14 days will allow residents to leave their homes.
But as the news filtered across Shanghai, residents scrambled to decipher the precise details from their neighbourhood committees.
One southern district which falls into the category for the lowest number of cases said it would now allow residents out once a day to buy supplies.
State news agency Xinhua said people in the least restricted areas would be “ allowed in principle ” to move inside their sub-districts with “ strict restrictions on the scale of gathering. ”
Shanghai resident Chris Miller said he had been told he was now free to leave the maternity centre where he has been staying with his wife since the birth of their son shortly before lockdown.
“ I was the first of our building to go out, ” he told AFP.
“ There’ s basically nothing open. I went to a pharmacy and… a lot of shelves had been picked clean but there were a few things I needed that I was able to pick up. ”
He said the streets were very empty but he planned to go out again.
“ One of the other fathers here wants to go out for some beer, ” he said.
The move appeared to divide opinions online, with some expressing concerns about spreading the virus further in the community.
But one resident posted pictures of a small queue forming at the gate to her community as residents waited to be let out.
Another unverified video showed a couple hugging in the middle of a car-less road as relieved residents started to wander around the street.
There were 27,509 new cases reported in China on Monday — the vast majority in Shanghai.
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.
The huge lockdown, which has required 26 million people to stay home has become unworkable.
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Alamos Gold Announces Groundbreaking for Phase III
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April 11, 2022 18:23 ET | Source: Alamos Gold Inc. Alamos Gold Inc.
DUBREUILVILLE, Ontario, April 11, 2022 ( GLOBE NEWSWIRE) -- Alamos Gold Inc. ( TSX: AGI; NYSE: AGI) ( “ Alamos ” or the “ Company ”) today announced the groundbreaking for the Island Gold Mine expansion. Already one of the most profitable mines in Canada, the expansion will increase production, lower costs, and be an economic engine for the Algoma region. The expansion will also best position the operation to benefit from additional exploration success.
John A. McCluskey, President and Chief Executive Officer, stated: “ When we first acquired the Island Gold Mine we were aware of its potential. It had 1.8 million ounces of Mineral Reserves and Resources, and through exploration investment we have increased this high-grade deposit to 5.1 million ounces of Mineral Reserves and Resources. By further investing in the Phase III expansion, we will more than double the mine life. This mine will be an economic engine for this region for years to come, and positively impact the closest town of Dubreuilville and surrounding communities. ”
The Honourable Greg Rickford, Ontario Minister of Northern Development, Mines, Natural Resources and Forestry, stated: `` The Island Gold expansion will help to strengthen the Algoma economy and is the latest in a series of recent success stories in Ontario's mining sector—successes that our government is proud to support. The project will bring good-paying jobs and prosperity throughout the region including northern and Indigenous communities. ''
The Honourable Todd Smith, Ontario Minister of Energy, stated: “ Our government has reduced electricity prices for large industrial customers like Alamos Gold by 15 per cent through our Comprehensive Electricity Plan. We are pleased to support expansions like today’ s at Alamos Gold that will support good-paying jobs for communities in the north. ”
A photo accompanying this announcement is available at https: //www.globenewswire.com/NewsRoom/AttachmentNg/e329f3ff-d9f8-4aa0-b38c-5303c05c835d
Chris Bostwick, FAusIMM, Alamos Gold’ s Senior Vice President, Technical Services, has reviewed and approved the scientific and technical information contained in this news release. Chris Bostwick is a Qualified Person within the meaning of Canadian Securities Administrator’ s National Instrument 43-101 ( “ NI 43-101 ”). For further information pertaining to the 2020 Phase III Expansion Study, please see press release titled “ Alamos Gold Announces Phase III Expansion of Island Gold to 2,000 tpd ”, dated July 14, 2020, and the corresponding technical report, both available under the Company's profile on SEDAR at www.sedar.com and on the Alamos website at www.alamosgold.com.
Alamos is a Canadian-based intermediate gold producer with diversified production from three operating mines in North America. This includes the Young-Davidson and Island Gold mines in northern Ontario, Canada and the Mulatos mine in Sonora State, Mexico. Additionally, the Company has a significant portfolio of development stage projects in Canada, Mexico, Turkey, and the United States. Alamos employs more than 1,700 people and is committed to the highest standards of sustainable development. The Company’ s shares are traded on the TSX and NYSE under the symbol “ AGI ”.
Scott K. ParsonsVice President, Investor Relations ( 416) 368-9932 x 5439
All amounts are in United States dollars, unless otherwise stated.
The TSX and NYSE have not reviewed and do not accept responsibility for the adequacy or accuracy of this release.
This news release contains or incorporates by reference “ forward-looking statements ” and “ forward-looking information ” as defined under applicable Canadian and U.S. securities laws. All statements, other than statements of historical fact, which address events, results, outcomes or developments that the Company expects to occur are, or may be deemed to be, forward-looking statements and are generally, but not always, identified by the use of forward-looking terminology such as `` expect '', “ is expected ”, “ assume ”, “ inferred ”, “ potential ”, “ outlook ”, “ on track ”, “ continue ”, “ ongoing ”, `` will '', “ believe ”, “ anticipate ”, `` intend '', `` estimate '', `` forecast '', `` budget '', “ target ”, “ plan ” or variations of such words and phrases and similar expressions or statements that certain actions, events or results “ may '', “ could ”, “ would ”, `` might '' or `` will '' be taken, occur or be achieved or the negative connotation of such terms. Forward-looking statements contained in this news release are based on expectations, estimates and projections as of the date of this news release.
Forward-looking statements in this news release include, but may not be limited to, information as to strategy, plans, expectations or future financial or operating performance resulting from the Phase III expansion at the Island Gold mine, such as expectations regarding: increased production levels; lower costs; potential exploration successes; extended mine life; timing of completion of the Phase III expansion; timing of the release of a mine plan and its potential optimization; increases to the value of the operation; increases to mining rates; reduction to diesel consumption and greenhouse gas emissions; the positive impact to the Algoma region, the Town of Dubreuilville and surrounding communities including but not limited to anticipated job creation; and other statements that express management's expectations or estimates of future performance.
The Company cautions that forward-looking statements are necessarily based upon a number of factors and assumptions that, while considered reasonable by management at the time of making such statements, are inherently subject to significant business, economic, technical, legal, political and competitive uncertainties and contingencies. Known and unknown factors could cause actual results to differ materially from those projected in the forward-looking statements, and undue reliance should not be placed on such statements and information.
Such factors and assumptions underlying the forward-looking statements in this news release, include, but are not limited to: changes to current estimates of Mineral Reserves and Resources; changes to production estimates ( which assume accuracy of projected ore grade, mining rates, recovery timing and recovery rate estimates and may be impacted by unscheduled maintenance, weather issues, labour and contractor availability and other operating or technical difficulties); operations may be exposed to new diseases, epidemics and pandemics, including the effects and potential effects of the global COVID-19 widespread pandemic and its impact on the broader market and the trading price of the Company’ s shares; provincial, state and federal orders or mandates ( including with respect to mining operations generally or auxiliary businesses or services required for the Company’ s operations) in Canada, Mexico, the United States and Turkey; the duration of regulatory responses to the COVID-19 pandemic; government and the Company’ s attempts to reduce the spread of COVID-19 which may affect many aspects of the Company’ s operations including the ability to transport personnel to and from site, contractor and supply availability and the ability to sell or deliver gold doré bars; fluctuations in the price of gold or certain other commodities such as, diesel fuel, natural gas and electricity; changes in foreign exchange rates ( particularly the Canadian dollar, U.S. dollar, Mexican peso and Turkish Lira); the impact of inflation; changes in the Company’ s credit rating; any decision to declare a dividend; employee and community relations; labour and contractor availability ( and being able to secure the same on favourable terms); litigation and administrative proceedings; disruptions affecting operations; availability of and increased costs associated with mining inputs and labour; expansion delays with the Phase III expansion project at the Island Gold mine; inherent risks and hazards associated with mining and mineral processing including environmental hazards, industrial accidents, unusual or unexpected formations, pressures and cave-ins; the risk that the Company’ s mines may not perform as planned; uncertainty with the Company's ability to secure additional capital to execute its business plans; the speculative nature of mineral exploration and development, including the risks of obtaining and maintaining necessary licenses, permits and authorizations; contests over title to properties; expropriation or nationalization of property; political or economic developments in Canada, Mexico, the United States, Turkey and other jurisdictions in which the Company may carry on business in the future; increased costs and risks related to the potential impact of climate change; changes in national and local government legislation, controls or regulations ( including tax and employment legislation) in jurisdictions in which the Company does or may carry on business in the future; the costs and timing of construction and development of new deposits; risk of loss due to sabotage, protests and other civil disturbances; disruptions in the maintenance or provision of required infrastructure and information technology systems, the impact of global liquidity and credit availability and the values of assets and liabilities based on projected future cash flows; risks arising from holding derivative instruments; and business opportunities that may be pursued by the Company.
For a more detailed discussion of such risks and other factors that may affect the Company's ability to achieve the expectations set forth in the forward-looking statements contained in this news release, see the Company’ s latest 40-F/Annual Information Form and Management’ s Discussion and Analysis, each under the heading “ Risk Factors ” available on the SEDAR website at www.sedar.com or on EDGAR at www.sec.gov. The foregoing should be reviewed in conjunction with the information and risk factors and assumptions found in this news release.
The Company disclaims any intention or obligation to update or revise any forward-looking statements whether as a result of new information, future events or otherwise, except as required by applicable law.
Alamos prepares its disclosure in accordance with the requirements of securities laws in effect in Canada. Unless otherwise indicated, all Mineral Resource and Mineral Reserve estimates included in this news release have been prepared in accordance with National Instrument 43-101 - Standards of Disclosure for Mineral Projects ( “ NI 43-101 ”) and the Canadian Institute of Mining, Metallurgy and Petroleum ( the “ CIM ”) - CIM Definition Standards on Mineral Resources and Mineral Reserves, adopted by the CIM Council, as amended ( the “ CIM Standards ”). NI 43-101 is a rule developed by the Canadian Securities Administrators, which established standards for all public disclosure an issuer makes of scientific and technical information concerning mineral projects. Mining disclosure in the United States was previously required to comply with SEC Industry Guide 7 ( “ SEC Industry Guide 7 ”) under the United States Securities Exchange Act of 1934, as amended. The U.S. Securities and Exchange Commission ( the “ SEC ”) has adopted final rules, to replace SEC Industry Guide 7 with new mining disclosure rules under sub-part 1300 of Regulation S-K of the U.S. Securities Act ( “ Regulation S-K 1300 ”) which became mandatory for U.S. reporting companies beginning with the first fiscal year commencing on or after January 1, 2021. Under Regulation S-K 1300, the SEC now recognizes estimates of “ Measured Mineral Resources ”, “ Indicated Mineral Resources ” and “ Inferred Mineral Resources ”. In addition, the SEC has amended its definitions of “ Proven Mineral Reserves ” and “ Probable Mineral Reserves ” to be substantially similar to international standards.
Investors are cautioned that while the above terms are “ substantially similar ” to CIM Definitions, there are differences in the definitions under Regulation S-K 1300 and the CIM Standards. Accordingly, there is no assurance any mineral reserves or mineral resources that the Company may report as “ proven mineral reserves ”, “ probable mineral reserves ”, “ measured mineral resources ”, “ indicated mineral resources ” and “ inferred mineral resources ” under NI 43-101 would be the same had the Company prepared the mineral reserve or mineral resource estimates under the standards adopted under Regulation S-K 1300. U.S. investors are also cautioned that while the SEC recognizes “ measured mineral resources ”, “ indicated mineral resources ” and “ inferred mineral resources ” under Regulation S-K 1300, investors should not assume that any part or all of the mineralization in these categories will ever be converted into a higher category of mineral resources or into mineral reserves. Mineralization described using these terms has a greater degree of uncertainty as to its existence and feasibility than mineralization that has been characterized as reserves. Accordingly, investors are cautioned not to assume that any measured mineral resources, indicated mineral resources, or inferred mineral resources that the Company reports are or will be economically or legally mineable.
Note that for purposes of this section, GAAP refers to IFRS. The Company believes that investors use certain non-GAAP and additional GAAP measures as indicators to assess gold mining companies. They are intended to provide additional information and should not be considered in isolation or as a substitute for measures of performance prepared with GAAP.
“ Cash flow from operating activities before changes in non-cash working capital ” is a non-GAAP performance measure that could provide an indication of the Company’ s ability to generate cash flows from operations, and is calculated by adding back the change in non-cash working capital to “ Cash provided by ( used in) operating activities ” as presented on the Company’ s consolidated statements of cash flows. “ Free cash flow ” is a non-GAAP performance measure that is calculated as cash flows from operations net of cash flows invested in mineral property, plant and equipment and exploration and evaluation assets as presented on the Company’ s consolidated statements of cash flows and that would provide an indication of the Company’ s ability to generate cash flows from its mineral projects. “ Mine site free cash flow ” is a non-GAAP measure which includes cash flow from operating activities at, less capital expenditures at each mine site. Return on Equity is defined as Earnings from Continuing Operations divided by the average Total Equity for the current and previous year. “ Mining cost per tonne of ore ” and “ Cost per tonne of ore ” are non-GAAP performance measures that could provide an indication of the mining and processing efficiency and effectiveness of the mine. These measures are calculated by dividing the relevant mining and processing costs and total costs by the tonnes of ore processed in the period. “ Cost per tonne of ore ” is usually affected by operating efficiencies and waste-to-ore ratios in the period. “ Total cash costs per ounce ”, “ all-in sustaining costs per ounce ”, and “ mine-site all-in sustaining costs ” as used in this analysis are non-GAAP terms typically used by gold mining companies to assess the level of gross margin available to the Company by subtracting these costs from the unit price realized during the period. These non-GAAP terms are also used to assess the ability of a mining company to generate cash flow from operations. There may be some variation in the method of computation of these metrics as determined by the Company compared with other mining companies. In this context, “ total cash costs ” reflects mining and processing costs allocated from in-process and doré inventory associated and associated royalties with ounces of gold sold in the period. Total cash costs per ounce are exclusive of exploration costs. “ All-in sustaining costs per ounce ” include total cash costs, exploration, corporate and administrative, share based compensation and sustaining capital costs. “ Mine-site all-in sustaining costs ” include total cash costs, exploration, and sustaining capital costs for the mine-site, but exclude an allocation of corporate and administrative and share based compensation.
Additional GAAP measures that are presented on the face of the Company’ s consolidated statements of comprehensive income and are not meant to be a substitute for other subtotals or totals presented in accordance with IFRS, but rather should be evaluated in conjunction with such IFRS measures. This includes “ Earnings from operations ”, which is intended to provide an indication of the Company’ s operating performance, and represents the amount of earnings before net finance income/expense, foreign exchange gain/loss, other income/loss, and income tax expense. Non-GAAP and additional GAAP measures do not have a standardized meaning prescribed under IFRS and therefore may not be comparable to similar measures presented by other companies. A reconciliation of historical non-GAAP and additional GAAP measures are available in the Company’ s latest Management’ s Discussion and Analysis available online on the SEDAR website at www.sedar.com or on EDGAR at www.sec.gov and at www.alamosgold.com.
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Singapore to Tighten Policy Amid Inflation Fight: Decision Guide
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The Monetary Authority of Singapore building in Singapore, on Wednesday, Oct. 27, 2021. Singapore is seeking to cement itself as a key player for cryptocurrency-related businesses as financial centers around the world grapple with approaches to handle one of the fastest growing areas of finance., Bloomberg
( Bloomberg) -- Singapore’ s central bank is expected to tighten monetary policy as global inflation sweeps into the city-state, fueled by geopolitical and supply-chain tensions and as Federal Reserve officials remove Covid-era support.
The Monetary Authority of Singapore, which uses the exchange rate rather than interest rates to stabilize prices, will signal Thursday that it’ s seeking a stronger local dollar to buffer imported inflation, according to all 16 economists surveyed by Bloomberg.
While a predicted tightening at the April meeting was unanimous, economists were divided on which of the three currency band tools the MAS will use.
All but one of the respondents expect the central bank to raise the slope of its policy band, a move that gradually strengthens the Singapore dollar against trading partners. Half expect the entire band will be moved higher -- known as re-centering -- which is a more sudden and sharp effort to boost the currency.
Lastly, three predict policy makers will widen the band within which it guides the currency, allowing the local dollar greater scope to swing from the baseline policy goal. Only two of 16 respondents expect the MAS to use all three tools.
Central banks around the world led by the Fed are raising interest rates to combat inflation amid risks from Russia’ s invasion of Ukraine and worsening supply-chain disruptions. Singapore, which began tightening policy late last year and followed through with a rare out-of-turn move in January, is experiencing price growth well above the 2.5% -3.5% range forecast this year, even as the economy’ s recovery from Covid-19 is on track.
“ Tightening resource pressures in the economy and upside inflation risks mean the MAS has to be more forceful in normalizing monetary policy, ” said Khoon Goh, Singapore-based head of Asia research for Australia & New Zealand Banking Group Ltd., who sees the authority tightening “ aggressively ” by re-centering and steepening the slope Thursday.
Closely watched will be any tweaks to MAS’ s forecast for price growth this year. Besides the 2.5% -3.5% overall inflation projection in January, the authority then saw core inflation averaging 2% -3% in 2022.
Singapore’ s economy is in better shape than some emerging markets in Asia whose growth recoveries are more fragile, complicating policy makers’ timeline for combating soaring inflation through rate hikes. So far in 2022, Indonesia, Thailand, Malaysia, and the Philippines have each held their benchmark rates while acknowledging rising prices.
India has signaled a hawkish turn in response to soaring prices, and China’ s higher-than-expected inflation prints could prompt policy action soon.
First-quarter advance estimates of Singapore’ s gross domestic product growth, also due Thursday morning from the Ministry of Trade & Industry, will help illustrate the city-state’ s health as fresh domestic and border re-opening measures took effect.
The MAS most recently projected the economy would expand 3% -5% this year after it grew 7.6% last year.
Even as Singapore begins to shake off Covid-era restrictions, officials have warned that the healing could be gradual, including in tourism-related sectors that face labor shortages as foreign workers trickle back. The Covid-induced dearth of overseas workers should ease over the next few months, Finance Minister Lawrence Wong said at the start of March.
Shopify announced a number of proposed changes to its governance and share structure on Monday.
An analyst who covers Canada’ s banks is warning of choppy waters ahead and is urging clients to take a more defensive approach as economic uncertainty threatens to send shares sharply lower.
Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
Traders are shunning technology stocks amid mounting risks from soaring Treasury yields and hawkish commentary from the U.S. Federal Reserve.
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French Greens face crisis after failed presidential bid
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France’ s Green party were facing a financial and political crisis on Monday after a deeply disappointing presidential election.
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France’ s Green party were facing a financial and political crisis on Monday after a deeply disappointing presidential election saw their candidate finish sixth and struggle to put climate change on the national agenda.
Yannick Jadot from the Europe Ecology-The Greens party ( EELV) was eliminated in Sunday’ s first round with a score of around 4.6 percent, following a campaign that never gathered momentum.
Under French campaign financing rules, only candidates who score above 5.0 percent have their expenses reimbursed by the state, leaving the Greens with a huge hole in their accounts.
“ The situation is critical and the fact that we came below the bar of five percent puts us in a very, very difficult situation, ” national secretary Julien Bayou told France Inter radio on Monday.
He appealed for donations from those who backed the party, as well as others “ who would have liked to vote for Yannick Jadot and perhaps voted for another candidate. ”
“ We need this support to be able to continue to ensure the ecology movement lives on, ” Bayou added.
President Emmanuel Macron finished top in Sunday’ s vote on around 27.6 percent followed by far-right leader Marine Le Pen on 23.4 percent, with the pair set to contest a run-off vote scheduled for April 24.
EELV was not the only party appealing for financial help on Monday, with the once-mighty right-wing Republicans also facing a 7.0-million-euro ( $ 7.6 million) hole in their finances after their candidate, Valerie Pecresse, scored just under 5.0 percent on Sunday.
The performance from Jadot, a former Greenpeace executive, spelled bitter disappointment for his party which was hoping to build on successes in local elections last year which saw them sweep major cities from Lyon to Bordeaux.
Germany’ s historically more powerful Green party entered government after elections last year and controls several ministries and key posts in the cabinet, including the foreign minister role.
– ‘ Enormous disappointment’ –
Jadot scored slightly better than the last ecologist candidate to stand — Eva Joly with 2.3 percent in 2012 — but less well than Noel Mamere in 2002 who secured 5.25 percent despite the stakes for the planet being much higher in 2022.
In a concession speech on Sunday night, Jadot said his programme sought to respond to the challenges posed by climate change, as well as growing economic inequalities in France.
“ It’ s an understatement to say that these vital challenges — vital for our country, vital for us and our children — were largely ignored in a campaign that was confiscated, ” he said.
The Covid-19 pandemic overshadowed the start of campaigning before Russia’ s invasion of Ukraine changed the dynamic completely, making foreign policy and the rocketing cost of living key issues for voters.
Jadot was also eclipsed by hard-left candidate Jean-Luc Melenchon, who put a big emphasis on the environment during his campaign and finished third, only narrowly missing out on a place in the run-off.
Remi Lefebvre, a French political scientist at the University of Lille in northeast France, told AFP before the vote that the Greens had been “ the enormous disappointment of this campaign. ”
“ The problem with the greens is its social base, ” he explained. “ They can’ t reach working-class people because the greens are not seen as reassuring. ”
Low-income families often see their pitch as boiling down to “ they’ re going to ask us to tighten our belts even more ”, Lefebvre said, while the educated, urban middle classes tended to vote for Macron.
Jadot called on his 1.5 million voters on Sunday to back Macron in the second round to bar the far-right from power, while pointing out his differences with the president.
He said the vote “ is not approval for your responsibility in the fracturing of the country due to your inaction on the climate, your social failures, conformism and democratic contempt. ”
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.
The huge lockdown, which has required 26 million people to stay home has become unworkable.
A Ukrainian mother fell to her knees, clawing the earth behind a razed petrol station.
Nearly 50 wounded and elderly patients were transported from the east in a hospital train by medical charity Doctors Without Borders ( MSF) - Copyright...
Wearing a hat and carrying a blue and yellow Ukrainian flag, the 43-year-old is the first face that many Ukrainians see as they cross...
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Due to rapid urbanization and growth of passenger vehicle
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Increasing Car Ownership and Reduction of Import Tax: Vietnamese government has proposed various regulations since FY'18 to improve the ecosystem of the automotive industry and making it to convenient for the consumers to purchase private vehicles by reducing the import tax to 0% for cars imported from ASEAN region, which brings down the price of the final product. Government initiatives to strengthen Vietnam's road infrastructure along with the increased awareness on health and hygiene brought about by the advent of COVID-19 is expected to increase the prospect of vehicle ownership in the future. There has been a gradual surge in vehicle parcs in recent times, expanding at a CAGR of ~25.7% in between FY'15 and FY'20. Growth of car ownership in Vietnam stood at ~10.5% in FY'20, which was comparatively higher than its South East Asian counterparts. Increasing car ownership acts as catalyst for the aftermarket services industry which is expected to grow at a significant rate in coming years.
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Rapid Urbanization and Fast Growing Middle Class: Rapid urbanization over the years is contributing to the growth of automotive market in Vietnam, as more and more consumers are migrating to urban cities. It is estimated that in FY'20, the urbanization rate stood at ~37.3% of its overall population compared to ~36.6% rate in FY'19. Urbanization serves as one of the growth drivers for the aftermarket service industry as consumers migrate for better payment opportunity in the cities, it allows them to have the financial means to avail private transport thereby increasing the prospect of aftermarket services. To curb excessive traffic jams in the cities, Hanoi, a major city in the Northern Region of Vietnam has proposed to ban motorcycles by 2030, thereby enhancing the opportunity of passenger vehicle sales for the country's fast growing middle class in coming years.
Enhancing Online Ecosystem: Aftermarket service companies in Vietnam has not been able to adapt to the growing significance of the online ecosystem over the years. However, the advent of COVID-19 has changed the perception of consumers towards the utilization of online space. More consumers are utilizing digital medium for buying and selling products as well as booking services through online medium. Similarly, there exist a shift in aftermarket service industry wherein consumers are preferring to book slots for their vehicle services online. Therefore, the automotive aftermarket service and spare parts companies are expanding their presence in the online space for better visibility among consumers and compete on the basis of brand integration. Servicing companies have initiated the process of online booking to enhance customer's convenience. This also helps the servicing companies to maintain COVID protocols such as curb in overcrowding in public places as set by the Vietnamese government.
Increased Awareness on Health and Hygiene: With the advent of COVID-19, consumers were witnessed to be more concerned on maintaining personal health and hygiene. Therefore they are preferring the option of private transportation rather than availing public transport system. The change in consumer's behavior and preference is expected to act as an opportunity for the automotive aftermarket service industry in Vietnam. As more and more consumers prefer availing private transportation medium, the demand for new cars would surge in the coming years. With the surge in the vehicle parc, consumers would also require to periodically maintain their vehicle every 18 months as prescribed by the government of Vietnam, thereby the demand for aftermarket services would enhance. Therefore the future prospect of the industry looks strong wherein OEM and multi brand workshops in the market could utilize this opportunity to integrate the domain.
Integration of Electric Vehicles: In order to curb the rising impact of climate change, governments all over the world have pledged to reach zero net carbon emissions by 2050. Hence, there is a greater deliberation of replacing fuel operated vehicles with electric vehicles ( EVs) to minimise pollution. `` National Automobile Development Strategy by 2025 '' adopted by the Vietnamese government aims to stimulate manufacturing and increase the volume of use of EVs in the coming years. With the integration of EVs in the market, vehicle service companies will have to update their equipment's and train their mechanics for servicing electric cars which would require huge investment by these companies thus, impacting their business financials. Unorganized workshops will face challenge in servicing EVs as they operate on lower budget than required to cater to the demand of EV ecosystem.
Lack of Technological Adoption and Dependence on Imports: Domestic automotive and aftermarket services industry has not been able to invest in core and high end technology products such as transmission system. Localized parts required for vehicle servicing and production are mostly of low technology products such as tires, mirrors, glasses, batteries and plastic products. Therefore, aftermarket services industry in Vietnam remains largely dependent on imported components and spare parts, which increases their cost of operating their business.
The report titled '' Vietnam Automotive Aftermarket: OEM, Multi-brand Outlet Services and the Spare Parts Market - Outlook to 2025: Driven by Rapid Urbanization and Growth of Vehicle Sales; fueled by Fast Growing Middle Class population and the growing preference for private vehicles in the post-COVID scenario '' by Ken Research suggested that the automotive aftermarket service industry in Vietnam is expected to grow further in the near future, with the surge in vehicle parc due to increased awareness on health and hygiene followed by the aftermath of COVID-19, thus showcasing a change in consumer preference from availing public transport to private transportation medium. As more consumers shift from availing motorbikes which has historically been the dominant form of transportation in Vietnam to availing four wheeler vehicles, the demand for aftermarket services would increase in coming years. Rapid urbanization coupled with fast growing middle class would act as major growth drivers for the aftermarket service industry in Vietnam. The market is expected to register a positive CAGR of 8% in terms of revenue during the forecast period of FY'20-FY'25E.
Indonesia's automotive aftermarket service industry revenue stood at USD ~ billion in 2021 and recorded a CAGR of 5.4% during 2015-2021. The multi-brand workshops dominate the Indonesian automotive aftermarket service industry due to their cheaper service fee and generalized service offerings. ~% of the after-sales care service market is captured by the multi-brand service centers owing to its low service & spare parts cost and high preference by post warranty car owners. OEM car service centers in Indonesia witness the majority of the pre-warranty cars visiting their centers. High-quality service, genuine spare parts and more reliability on the OEM service centers are other reasons why a customer prefers the OEM service centers in Indonesia.
Malaysia automotive aftermarket service industry revenue stood at USD ~ Bn in 2020 and recorded a CAGR of 2.9% during 2015-2020. Multi-brand car service centers are majorly preferred by the users with out-of-warranty cars. Lower cost of multi-brand service centers & Availability of quality spares from reputed suppliers is leading to the growth of multi-brand car service centers in Malaysia. OEM car service centers in Malaysia witness the majority of the pre-warranty cars visiting their centers. High-quality service, genuine spare parts, and more reliability of the OEM service centers are other reasons why a customer prefers the OEM service centers in Malaysia.
The report also covers the trade scenario, trends and developments, issues and challenges, SWOT analysis, regulatory landscape, end user analysis, value chain analysis, PESTLE analysis, COVID-19 impact on automotive & spare parts transportation industry, decision making process, snapshot on control tower market, snapshot on pre-delivery inspection market, COVID-19 impact on automotive & spare parts warehousing industry, technological advancements & innovations, comparative landscape including cross comparison of major players operating in KSA automotive & spare parts logistics market and cross comparison of major players operating in KSA automotive market. The report concludes with future market projections on the basis of overall logistics and automotive & spare parts logistics revenue, by service mix and analyst recommendations highlighting the major opportunities and cautions.
Covid-19 pandemic has drastically affected the supply chain in automotive sector and dampened the consumer spending in these countries, resulting in reduced sales. The growth over the years in these countries has been gradual. In Bhutan, the CAGR over the years has been positive which expounds the expansion of automotive sector in the country. Although, government in Bhutan is trying to discourage the use of private vehicles in order to meet its sustainability goals and preserve the rich environment of country by increasing the taxes. Whereas, in Bangladesh government has heavily incentivized the sector by reducing taxes; the result has been a healthy growth of the sector.
Contact Us: -Ken ResearchAnkur Gupta, Head Marketing & CommunicationsSupport @ kenresearch.com+91-9015378249
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More Multi-Brand Players Plan Foray into the Singapore Used
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Increasing Used Car Sales due to Covid-19: The pandemic made owning a car an inevitable aspect of an individual's life as travelling via public transport can be hazardous. People who preferred public transport during the pre-Covid times are now the potential customers of the used cars market. Since, the pandemic does not seem to completely subside soon, the demand for used cars will keep increasing. Since most of these people could not afford a car in the first place, they would prefer the most optimal solution available, that is, purchasing a pre-owned car.
Growing Car Prices: There has been a shrinkage in the supply of Cost of Entitlement ( COE) certificates since the number of de-registrations of cars, which is a chief determinant of COE supply rate, saw major decline in 2021. COE Premium for cars has been increasing; hence, leading to an increase in the overall cost of cars. The car market is therefore skewing towards higher income families and the sales of used cars is increasing.
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Rising popularity of Digital Showrooms: The online space in the used cars market has been gaining traction over time on account of Covid-19 protocols that forced several dealers to introduce virtual showrooms. These digital platforms help facilitate minimum in-person contact during the process of selling a car by providing 360-degree view of the interiors of the car to enhance digital experience of consumers. Use of advanced technologies such as AI is helps to valuate car online by providing pictures.
Increased Focus on Value-Added Services: Since there are a higher proportion of organized players in the used cars segment, more dealers have shifted their focus on providing value-added services to survive the increasing competition. While it is quite common for the DDSAs ( Direct Dealership Sales Agents) to provide such services, several multi-brand dealers too have started providing additional services such as extended warranty, insurance, after sales services, assistance in paperwork, etc., to become a 'one-stop ' destination for used car buyers.
Organized Segment's Share to Rise: An organized dealer is defined as an authorized or a multi brand dealership with higher inventory or a greater number of physical outlets in Singapore or an accredited dealership. Organized segment contributes to majority of the market share in the used cars space basis the number of dealers spread across the country. The share of organized dealers is expected to further rise in the future as more and more organized players enter the market. Moreover, buying used cars from organized players comes with the added advantage of availing maximum value-added services which are not provided by the unorganized players.
Analysts at Ken Research in their latest publication '' Singapore Used Car Market Outlook To 2025: The Pandemic Incited Increased Demand for Used Cars coupled with Increased Internet Penetration provides for Resilience in the Used Cars Market during the Economic Crisis '' observed that Singapore is in a growth phase in the used car market in South East Asia and is gradually recovering from the economic crisis after the pandemic. The increasing E-Commerce penetration is giving a boost to this industry. Going forward, the industry is expected to demonstrate further growth in the short-medium term fueled by the growth of online used car platforms that provide convenience to both buyers and sellers. Singapore Used Car Market is expected to grow at a CAGR of 8.5% on the basis of sales volume over the forecast period 2020 – 2025.
The Used Car industry in Indonesia has grown at a CAGR of 4.5% on the basis of gross transaction value over the period 2014-2019 and at a CAGR of 2.0% on the basis of sales volume. The overall economic slowdown, as well as the slowdown of the automotive industry due to a reduction in purchasing power of consumers, contributed to the decline in sales during 2016-2017. The entry of various financing companies in the used car industry, as well as the launch of OEM-certified used car programs, has been the major growth drivers of the industry. The boom in the number of online auto-classified platforms and the traction of the consumers towards online platforms is contributing to the inclining used car sales in the country.
The used car industry in Saudi Arabia has grown at a CAGR of 0.8% on the basis of gross transaction value over the period 2014-2019 and declined at a CAGR of -2.4% on the basis of sales volume. The departure of expats from the country and the economic instability contributed to the decline in sales during 2016-2017. The addition of women drivers and the high levels of disposable income in the country are one of the major growth drivers of the industry. Boom in the number of online auto-classified platforms and the traction of the consumers towards online platforms is contributing to the inclining used car sales in the country.
Malaysia's Used Car sector is in the late growth phase, having grown at a CAGR of ~1% during 2015-2020. Increasing demand for private vehicles, increasing purchasing power, easy availability of finance, increased govt. incentives to ensure the sale of new cars are the main reasons behind positive growth in used car revenue. Other major drivers include drop-in use of public transport due to the pandemic and emergence of online players which have made the overall process of selling and buying used cars smoothly, thus boosting sales.
India, the world's 6th largest economy by nominal GDP and the 3rd largest by PPP, is characterized as a middle-income developing market economy. 2- and 3- Wheelers that account for close to 50% share dominate the Indian urban mobility modal share. EVs are slowly gaining traction with less than 2% of vehicles deployed as EVs in India. The charging infrastructure in India is currently quite under-developed with as many as 26 EVs per charger available in the country, compared to only 8 in China and 17 in the US. There are ~300 community charging stations in India, of which 22 were fast-charging points in 202. However, India EV Charging Equipment Market gained significant momentum after the implementation of the FAME India scheme. The Department of Heavy Industry ( DHI) also planned to incentivize 1,000+ charging stations with 6,000+ chargers, which is the major growth driver for the market. Lack of Space, Infrastructure, and Manpower for Setting-Up along with High Initial Cost of Charging Equipment and Installation are the major challenges in India EV Charging Equipment Market.
Vietnam's automotive aftermarket service industry has been expanding at a CAGR of ~14.9% during FY'15 and FY'20. Historically, motor bikes remain the top choice among the consumers due to high concentration of population belonging to rural regions having low purchasing power. However, due to rapid urbanization and fast growing middle class, the demand for passenger cars has been growing significantly in recent times which in turn is contributing to the growth of automotive aftermarket service industry. Since FY'18, a surge in the number of auto service and repair workshops has been witnessed throughout the country, especially in the two cities of Hanoi and Ho Chi Minh City complemented by the reduction in import tax to 0% for cars imported from ASEAN region. The growth of vehicle parc serve as one of the major growth drivers for the aftermarket industry in Vietnam in recent years. It has been estimated that vehicle parc expanded with a CAGR of ~4.2% in between FY'15 and FY'20. Most number of vehicles serviced in FY'20 were in the city of Hanoi, followed by Ho Chi Minh, Haiphong and Can Tho. Large multi brand workshops dominate the automotive aftermarket in terms of revenue generated due lower priced services they offer compared to OEM's. However, in terms of number of vehicles serviced, small/unorganized workshops dominate the market owing to lower spare parts cost and high preference by post warranty car owners. Vehicle servicing through OEM workshops are preferred during warranty period. Also, consumers who demand high quality service and genuine spare parts prefer OEM servicing companies over multi brands and unorganized workshops.
Ken ResearchAnkur Gupta, Head Marketing & Communicationssupport @ kenresearch.com +91-9015378249
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Citgo Chairman Luis Giusti Ousted After Less Than a Year in Job
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The Citgo sign stands near Boston University in Boston, Massachusetts, U.S., on Monday, April 20, 2020. College financial aid offices are bracing for a spike in appeals from students finding that the aid packages they were offered for next year are no longer enough after the coronavirus pandemic cost their parents jobs or income. Photographer: Adam Glanzman/Bloomberg, Bloomberg
( Bloomberg) -- Citgo Petroleum Corp., the U.S. oil refiner controlled by the Venezuelan opposition, ousted chairman Luis Giusti Lugo less than a year after appointing him.
Giusti, a 24-year veteran of the oil industry, was dismissed Friday by the board of parent company Citgo Holding Inc., according to people familiar with the matter who asked not to be identified because the decision isn’ t public. The reasons for his removal weren’ t immediately clear. His biographical page on the company’ s website has been removed.
Giusti was appointed chairman of the fuelmaker last year, replacing Carlos Jorda. His dismissal comes as Citgo struggles with lawsuits seeking its sale to pay down debts. The refiner has been through several board reshuffles since 2019, when the Venezuelan opposition took control of the company following escalating U.S. sanctions against the regime of Nicolas Maduro.
The opposition takeover has also sparked a legal battle with creditors, including Crystallex International Corp, seeking compensation for a gold mine seized a decade ago. The U.S. government has been shielding Citgo from claims by banning transactions of a key bond that’ s backed by Citgo’ s shares.
Representatives for Citgo did not immediately respond to requests for comments. Opposition leader Juan Guaido’ s office, in control of PDVSA assets in the U.S., did not immediately respond to a request for comment.
This U.S. legislation is a game changer: Curaleaf executive chairman
U.S. democratic senators to unveil draft cannabis reform bill on Wednesday: Report
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OPEC Tells EU That Russia Oil Crisis Is Beyond Its Control
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Mohammad Sanusi Barkindo, secretary general of the Organization of Petroleum Exporting Countries ( OPEC), speaks during the 2022 CERAWeek by S & P Global conference in Houston, Texas, U.S., on Tuesday, March 8, 2022. CERAWeek returned in-person to Houston celebrating its 40th anniversary with the theme `` Pace of Change: Energy, Climate, and Innovation. '', Bloomberg
( Bloomberg) -- OPEC’ s top diplomat told European Union officials that the current crisis in global oil markets caused by Russia’ s invasion of Ukraine is beyond the group’ s control.
Russian oil supply losses stemming from current and future sanctions or a boycott by customers could potentially exceed 7 million barrels a day, OPEC Secretary General Mohammad Barkindo said on Monday. That would be far beyond the group’ s capacity to replace, he told EU Energy Commissioner Kadri Simson, who had asserted the cartel’ s responsibility to balance the market.
Simson said that the oil-producers group could tap its existing spare output capacity to assist in the crisis, according to an OPEC document seen by Bloomberg. Barkindo said that markets are being swayed by political factors rather than supply and demand, leaving little for the organization to do.
“ These crises have compounded to create a highly volatile market, ” Barkindo said, according to the text of his opening remarks. “ I must point out, however, that these are non-fundamental factors that are totally out of our control at OPEC. ”
The two representatives spoke during the regular dialogue between the EU and the Organization of Petroleum Exporting Countries.
Oil prices continue to trade near $ 100 a barrel as many refiners shun Russian supplies following the attack on its neighbor. The price rally has bolstered fuels like diesel, adding to the inflationary pressures and cost-of-living crisis hitting many consumers.
OPEC nations such as Saudi Arabia have rebuffed calls from major consumers like the U.S. to fill in the gap left by Russia. Besides their view of the market, the kingdom and its allies may have other reasons for holding back.
Riyadh jointly leads an alliance of global producers with Moscow known as OPEC+, and may also be keen to preserve its political ties with the Kremlin, which have helped the Saudis lessen their reliance on the U.S.
Shopify announced a number of proposed changes to its governance and share structure on Monday.
An analyst who covers Canada’ s banks is warning of choppy waters ahead and is urging clients to take a more defensive approach as economic uncertainty threatens to send shares sharply lower.
Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
Traders are shunning technology stocks amid mounting risks from soaring Treasury yields and hawkish commentary from the U.S. Federal Reserve.
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White House warns of 'extraordinarily elevated ' March inflation
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The already-high US inflation rate likely climbed even further last month, the White House warned Monday, amid a spike in energy prices caused by Russia’ s invasion of Ukraine.
“ We expect March headline inflation to be extraordinarily elevated, ” White House Press Secretary Jen Psaki told reporters ahead of the Tuesday release of the closely watched consumer price index ( CPI) data.
The world’ s largest economy has seen prices rise at record rates as it recovers from the Covid-19 pandemic, with CPI increasing 7.9 percent over the 12 months to February, its fastest rate in four decades.
A range of factors have propelled the price hikes, including component and labor shortages, shipping delays and strong consumer demand spurred by government stimulus policies.
The March report will be the first to fully encompass the fallout from Russia’ s invasion of its neighbor and the sanctions imposed by the West in retaliation, which have combined to cause a spike in prices for energy, including gasoline.
Calling it the “ Putin price hike, ” Psaki said she expected to see “ a large difference ” between headline inflation and “ core ” CPI, which excludes volatile food and energy prices.
Economists say the annual inflation rate could be close to 8.5 percent, the highest seen since late 1981.
According to the median forecast of analysts, monthly CPI growth will accelerate to 1.2 percent compared to February when the gain was 0.8 percent rate, while core CPI will remain unchanged at 0.5 percent.
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.
The huge lockdown, which has required 26 million people to stay home has become unworkable.
Wearing a hat and carrying a blue and yellow Ukrainian flag, the 43-year-old is the first face that many Ukrainians see as they cross...
A Ukrainian mother fell to her knees, clawing the earth behind a razed petrol station.
Proudly donning majestic feathered headdresses, models sing an ode to the rain while a makeup artist draws geometric patterns on their faces.
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Atom Physics Staffing is Revolutionizing Critical Support
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Broomfield, CO, USA, April 11, 2022 ( GLOBE NEWSWIRE) -- Radiation oncology departments across the United States are grappling with a growing problem: cancer rates are rising each year while the number of trained and board-certified physicists – those responsible for the technical supervision and operation of every radiation therapy center in the US – is dwindling.
Medical physicists are an essential part of the team that delivers radiation therapy services. Without a physicist, cancer patients would not receive life-saving radiation treatments. Physicists are in high demand and radiation therapy departments may have difficulty filling these positions – and keeping them filled. What if there were a way to help fill these essential roles in non-traditional ways that are more cost-effective for the hospitals and more attractive to the physicists?
Atom Physics Staffing fulfills that mission, connecting hospitals and radiation therapy centers with experienced, highly-trained physicists – in a traditional locum ( on-site) role or with the flexibility of remote services or a combination of the two in a hybrid model. It is a model that delivers benefits to both the hospital and the physicist.
“ There is a traditional setup of what we call a locum physicist. A locum may work at a hospital temporarily because a physicist is leaving a position or taking a vacation, ” Adam Evearitt, Founder, says. “ It takes time to fill a physics position, so we fill that gap while they are hiring somebody else. ”
Through his continuing clinical work, Evearitt reached an important realization. Not only was there a growing need for medical physicists, but the demand for board-certified physicists was more than the educational pipeline could possibly support. And with a global pandemic impacting hospital staffing, Evearitt saw another solution.
Although traditionally, physicists work full-time on-site in the hospital, COVID-19 protocols have forced healthcare leadership to become more flexible and creative with their staffing – which is where Evearitt says Atom Physics Staffing can truly make a difference.
“ Hospitals have become familiar with how to set up a physicist to work from a home office and to remotely login into these really specialized programs and software packages that we use in radiation therapy, ” Evearitt says. “ So, we found we could fulfill a lot of the needs with a remote or partially-remote physicist rather than jump straight into the cost of a full-time on-site locum physicist. ”
“ It is attractive to the physicists who want to work from home, and it’ s a cost-saving measure for the hospitals. ”
By offering hybrid and remote services, Atom Physics Staffing has enabled healthcare facilities, especially rural hospitals who may have an especially hard time hiring, to continue providing the highest level of care for their patients. And with a network of physicists based across the country, they are positioned to help any medical office, whenever they need it.
“ I have a physicist in North Carolina who serves facilities in Florida, and with our hybrid model, he spends a few days a month doing quality control testing on the machines on-site but spends the rest of the time providing remote support to the facility from his home office, ” Evearitt says. “ We are also doing a hybrid model for a hospital in the Upper Peninsula of Michigan. The physicist in that department is sort of all by himself out there, so I remote in and share the duties, and once a month I travel up there so he can take some time off. ”
As they continue to partner with hospitals across the United States, Evearitt foresees Atom Physics Staffing becoming the model to address a pressing need in the healthcare industry. And because of his successful career as a board-certified medical physicist, Evearitt is uniquely positioned to help facilities find the most qualified professionals to fit their needs.
“ Unlike other staffing companies, we have actual expertise in doing the work, ” Evearitt says. “ We know exactly the questions to ask the departments and the potential physicists. ”
As a board-certified medical physicist with over two decades of clinical experience, Adam Evearitt understands this problem better than perhaps anyone in the country. He has spent most of his career finding solutions to industry problems, founding and growing a business to support imaging equipment and then expanding to provide medical physics in hospitals and cancer centers nationwide.
He launched Atom Physics in the Denver, Colorado area in response to a growing need for qualified technicians to inspect, service, and upgrade imaging machines in healthcare facilities. Although he began by providing inspections for local offices himself, Evearitt discovered that the demand for inspectors and service technicians quickly exceeded a one-man enterprise. Evearitt grew Atom Physics by himself for 6 years before bringing on business partner, Pam Arroway. Atom Physics has grown to have two divisions: Atom Physics X-ray and Atom Physics Staffing.
Atom Physics Staffing is dedicated to helping hospitals and healthcare facilities find the best medical physicists to fulfill their needs. To learn more, please visit www.atomphysicsstaffing.com.
To learn more about Atom Physics X-ray, please visit www.atomphysics.com. Contact Information: Adam Evearittinfo @ atomphysics.com
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general
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UCI Cyclocross World Championships
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Get access to more than 30 brands, premium video, exclusive content, events, mapping, and more.
Get access to more than 30 brands, premium video, exclusive content, events, mapping, and more.
Go down memory lane with Marianne Vos and each of her cyclocross world titles, from her first in 2006 to her eighth in 2022.
Enthusiastic crowds, excellent conditions, fast racing, and fun times at the 2022 world cyclocross championships.
The Dutch woman has dominated cycling for almost two decades and took an unprecedented eighth cyclocross world title in Fayetteville.
Lars van der Haar of the Netherlands and Eli Iserbyt of Belgium round out the podium, well behind the Olympic mountain bike champion Pidcock.
Shirin Van Anrooij and Fem Van Empel round out the Dutch domination in Fayetteville, Arkansas.
Belgian Aaron Dockx and Brit Nathan Smith round out the podium, with American A.J. August in fifth.
A 16.3lb bike with internal cable routing, drain holes, and a top tube shaped for shouldering.
Vos and Brand power away from the field, each unable to drop the other. After some cat and mouse, Vos takes the sprint for the rainbow jersey.
Front of the race was a Dutch-Belgian battle, with the UK's Cameron Mason also in the mix.
A new Pinarello Crossista, Bart Simpson, and world champions a-plenty in Fayetteville.
The reigning world champ and Fayetteville World Cup winner says course changes have made it harder since the fall.
Riders were all business and all smiles as they previewed the 'cross worlds course in a mixed team relay race.
Team relay squads comprised of elite female and male racers, plus female and male junior or under-23 riders.
In North America, FloBikes will stream the races in Canada, and GCN's app will broadcast the races in the United States.
Heavily favored Belgian 'crossers hoping to avoid road worlds fiasco as absence of van Aert, van der Poel levels the playing field.
The coronavirus pandemic is here to stay, for a little while longer at least. How will it impact races and riders in 2022?
America's first female junior’ cross world medalist is fresh off a European block of racing and training.
Updated: the UCI confirmed it will reduce participation rules due to several teams seeing rosters depleted by COVID-19.
Brook Watts laid the foundation for the Fayetteville’ cross worlds from 2019 to 2021. Transgender legislation in Arkansas prompted a severing of the relationship.
Familiar faces in the kitchen for American athletes in Fayetteville this weekend.
Get the latest race news, results, commentary, and tech, delivered to your inbox.
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general
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U.S. Engineers, Judges Get Younger as Teachers and Farmers Age in Covid Workforce Reshuffle
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The information you requested is not available at this time, please check back again soon.
A farmer drives a Deere & Co. tractor while planting corn outside Henry, Illinois, U.S., on Monday, April 20, 2020. Corn and sugar futures tumbled to the lowest in more than a decade as the meltdown in crude oil cascaded through agricultural markets. Photographer: Daniel Acker/Bloomberg, Bloomberg
( Bloomberg) -- The pandemic has shaken up the age profile of workers in some key areas of the U.S. economy.
The median age of the country’ s aerospace engineers, journalists and judges has dropped sharply since 2019, according to the latest data from the Bureau of Labor Statistics. But the typical high school teacher is significantly older now, and farming is another profession increasingly dominated by older Americans.
The changes reflect a reshuffling of the U.S. workforce since Covid-19 arrived. Many older employees opted for early retirement, while in some industries -- like education -- acute labor shortages led to changes in hiring practice.
On net, recent changes largely cancel each other out, leaving the overall median age of the U.S worker little changed from a decade ago at just over 42.
That masks some significant shifts, though. In U.S. courts, for example, the judges are getting younger. The median age was 53.1 last year, meaning that they were born around 1968 and form part of the cohort known as Generation X. Before the pandemic, the median judge was close to 56, and a member of the Boomer generation.
Journalism is another profession where the median age is falling -- by more than 3 years since 2019. That may reflect a narrowing of job opportunities, according to Martha Steffens, a professor of business and financial journalism at the University of Missouri.
“ The pandemic was particularly hard on local news, as the usual advertisers closed stores and restaurants, ” resulting in layoffs, Steffens says. Many older journalists may have moved into public-relations work, potentially one reason why the median age in that field jumped by about two-and-a-half years, she says.
The age of the typical aerospace engineer dropped by more than six years from 2019 to 2021, and the share of that workforce that is over 55 dropped from 37% to 28%, depriving the industry of a wealth of experience. The pandemic travel slump, which hit demand at airlines, may be one reason for the shift.
At the other end of the scale, teaching was one of the professions to age the fastest, with the median high school teacher now almost 50 years old -- up from 45 in 2019. State and local-government education remains one of the biggest labor-market shortfalls of the Covid era, still down by more than 300,000 jobs. Some states like Ohio responded with measures to help draw former teachers back into the workforce.
Other professions where the median age climbed include tailoring and dressmaking, laundry and dry-cleaning -- as younger employees left trades where demand has weakened because more people now work from home in casual clothes. Priests and other religious officials are getting older too, with the median age rising to 52 from 48 in 2019.
The graying demographic is most prominent in U.S. agriculture, where almost one-third of farmers, ranchers and other managers are over 65.
This U.S. legislation is a game changer: Curaleaf executive chairman
U.S. democratic senators to unveil draft cannabis reform bill on Wednesday: Report
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general
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Chinese electric car company Nio hikes prices, suspends production
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In this article
BEIJING — Chinese electric car company Nio said over the weekend it is raising prices and suspending production as the latest Covid wave added to supply chain challenges.
The company's Hong Kong-listed shares fell nearly 9% in Monday morning trading.
Nio announced Sunday it would raise the prices for its three SUVs — the ES8, ES6 and EC6 — by 10,000 yuan ( $ 1,572), effective May 10. Prices for the recently launched ET7 and ET5 sedans would remain the same.
Raw material prices, particularly those for batteries, have risen `` too much '' this year with no downward trend in sight for the near term, CEO William Li said as part of the announcement, according to a CNBC translation of the Chinese statement.
`` Originally [ we ] thought we could bear it, but now with this pandemic it's even harder to bear, '' he said. `` We have no alternative but to raise prices. Please be understanding. ''
A day earlier, on Saturday, Nio said it suspended production due to Covid-related restrictions in the last several weeks that halted production at suppliers ' factories.
`` Due to the impact of Covid on Changchun and Hebei, the supply of some of our auto parts has been cut off since mid-March, '' Li said. The company's production `` managed to rely on auto parts inventory until last week. ''
He added that as a result of recent Covid outbreaks in Shanghai and Jiangsu province, many suppliers can't provide parts either.
The company began deliveries of its first sedan, the ET7, in late March. A second sedan, the ET5, is set to begin deliveries in September.
In terms of monthly deliveries, Nio has lagged behind those of rival start-ups Xpeng — whose cars sell in a lower price range — and Li Auto — whose only model on the market comes with a fuel tank for charging the battery. All three companies delivered more cars in March than February despite supply chain challenges.
Nio was the last of the three start-ups to raise prices.
In March, Xpeng hiked prices for its cars by 10,100 yuan to 20,000 yuan, while Li Auto raised prices by 11,800 yuan. The moves follow Tesla and other electric car companies in the country that have raised prices in the last several weeks.
Raising a kid is getting expensive in China — buy these global stocks to cash in, Jefferies says
Credit Suisse picks Chinese 'little giant ' stocks, says the start-ups are a growing force
JPMorgan says 3 stocks could be winners if U.S.-listed Chinese stocks avert delisting
Covid-related disruptions have hit traditional automakers as well.
Volkswagen said Thursday its factories in Anting on the outskirts of Shanghai and Changchun in the northern province of Jilin remained closed through Friday, April 8.
China's producer price index rose by 1.1% in March from a month earlier and gained 8.3% from a year ago, according to official figures released Monday. The year-on-year increase topped expectations for a 7.9% increase forecast by a Reuters poll.
— CNBC's Arjun Kharpal contributed to this report.
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business
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Seeking a Short-Term Solution to the Container Backup
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Logistics experts are busy considering ways in which their supply chains can be redesigned so as to avoid the kind of congestion that has brought international goods movement to a virtual halt at major ports. That could take years to bring about, but in the meantime, the system is crying out for some form of immediate relief.
The solution can be summed up in one word: space. Thousands of import containers coming off ships at U.S. ports need a place to go. They can’ t stay on the docks; the ports of Los Angeles and Long Beach have threatened to impose a dwell fee on boxes remaining in marine terminals for more than a few days. And railyards and warehouses are similarly operating at capacity. So somewhere in the supply chain, room must be made.
The answer, at least for now, lies in the creation of “ pop-up ” container yards — land that’ s currently sitting unused and can accommodate the stacks of boxes that are waiting for the path to final destination to clear. One such program is underway at the Port of Savannah, which is making use of nearby yard space provided by the Norfolk Southern and CSX railways. The latter’ s yard in Atlanta will be able to handle volumes of up to 1,200 containers per month, according to the Georgia Ports Authority.
On the West Coast, where the current congestion crisis began, California Governor Gavin Newsom has ordered state agencies to find properties that could be used for temporary container storage. A competitive bid went out in January of this year, and the winner was Chunker, a provider of short-term warehouse space in California.
The process was surprisingly smooth, according to Chunker chief executive officer Brad Wright. “ Nothing really happens that fast when it comes to government, ” he says. But it did this time. Chunker was awarded two-year leases for six properties that will accommodate overflow volumes from the ports of Los Angeles, Long Beach and Oakland. The company was looking to begin storing boxes there around the first of April.
Two of the parcels are state fairgrounds, portions of which haven’ t been used for years, says Wright. They include vacant land in the high desert city of Lancaster. In Stockton, Chunker is taking over some 66 acres that used to be a horse racing track. Three other sites are National Guard armories.
Preparing the properties for containers entails more than putting up a fence or unlocking a gate. They need to be equipped with cranes and mobile offices, and Chunker must obtain the necessary permits and business licenses. Security will also be a major concern. As of mid-March, the company was on track with its timetable for making the facilities fully operational. In fact, says Wright, it had begun the process even before winning the leases, “ hoping that we would get it. ”
On site, containers will be grounded and stacked, to maximize use of the land. Some chassis might also be stored there, but the emphasis will be on housing the boxes, Wright says. Together, he adds, the six Chunker-managed sites will be able to store up to 30,000 containers. Decisions on where they will actually go are up to ocean shipping lines, third-party logistics providers, freight forwarders and in some cases cargo owners.
For shippers, creation of the overflow yards generates yet another charge for moving cargo through a system that’ s becoming increasingly expensive to navigate. But until volumes begin to decline, possibly due to an abatement of COVID-19 and its many variants, they have little choice but to shoulder the additional cost.
In the months ahead, shippers and cargo handlers will continue to seek new locations for storing and processing containers and trailers. Some are turning to shuttered stores and malls that can be repurposed as distribution centers, in areas close to demanding online shoppers. But a long-term solution to the congestion crisis requires a far broader effort that addresses all nodes and modes of transportation, from marine terminals to intermodal railyards, trucking operations and warehouses that deploy sophisticated automation systems.
Wright suggests that the pop-up concept might not prove as “ temporary ” as planned. Freight handlers could find themselves getting comfortable with the solution. “ We initially went into it assuming that it was going be short-term, ” he says. “ But all said, once you get rolling and get into the workflow, this could go on forever. ”
Timely, incisive articles delivered directly to your inbox.
All content copyright ©2022 Keller International Publishing Corp All rights reserved. No reproduction, transmission or display is permitted without the written permissions of Keller International Publishing Corp
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general
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Watch: Has the Pandemic Permanently Changed Last-Mile Delivery?
|
Final-mile delivery will not go back to pre-pandemic levels, says Khaled Naim, chief executive officer and co-founder of Onfleet. Shippers need to make adjustments.
The changes that retailers thought would take place in e-commerce over the next seven to 10 years accelerated during the COVID-19 pandemic, and there’ s no going back, Naim says.
“ I think they will last for the foreseeable future, ” he says. “ Retailers have to adapt to survive in this new environment. They can't rely on foot traffic anymore. We're seeing an incredibly rapid adoption of same-day delivery and the necessary e-commerce technologies. The changes are here to stay. ”
Among those changes, Naim says, is the imperative to begin last-mile delivery. Not only are people ordering more online, they have huge expectations around what that experience looks like. “ People place orders on demand and expect deliveries to show up within an hour, if not half an hour. So that's a completely new sector that we didn't see a couple of years ago. It didn't even exist a couple of years ago, but this kind of quick commerce space is a new one that we saw emerge during the pandemic. And I think it’ s here to stay. Consumers expect to be able to order something as small as a $ 50 basket size and have it show up same day. ”
The technology infrastructure needed includes routing and dispatching, real-time tracking and customer-facing communications, Naim says. Driver supply also is critical. Vital questions include: “ How do you staff up a fleet of drivers? How do you train them and onboard them to provide that kind of experience? Or do you work with third parties, and how do you rely on those third parties to provide that experience? ”
Timely, incisive articles delivered directly to your inbox.
All content copyright ©2022 Keller International Publishing Corp All rights reserved. No reproduction, transmission or display is permitted without the written permissions of Keller International Publishing Corp
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general
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Seeking a Short-Term Solution to the Container Backup
|
Logistics experts are busy considering ways in which their supply chains can be redesigned so as to avoid the kind of congestion that has brought international goods movement to a virtual halt at major ports. That could take years to bring about, but in the meantime, the system is crying out for some form of immediate relief.
The solution can be summed up in one word: space. Thousands of import containers coming off ships at U.S. ports need a place to go. They can’ t stay on the docks; the ports of Los Angeles and Long Beach have threatened to impose a dwell fee on boxes remaining in marine terminals for more than a few days. And railyards and warehouses are similarly operating at capacity. So somewhere in the supply chain, room must be made.
The answer, at least for now, lies in the creation of “ pop-up ” container yards — land that’ s currently sitting unused and can accommodate the stacks of boxes that are waiting for the path to final destination to clear. One such program is underway at the Port of Savannah, which is making use of nearby yard space provided by the Norfolk Southern and CSX railways. The latter’ s yard in Atlanta will be able to handle volumes of up to 1,200 containers per month, according to the Georgia Ports Authority.
On the West Coast, where the current congestion crisis began, California Governor Gavin Newsom has ordered state agencies to find properties that could be used for temporary container storage. A competitive bid went out in January of this year, and the winner was Chunker, a provider of short-term warehouse space in California.
The process was surprisingly smooth, according to Chunker chief executive officer Brad Wright. “ Nothing really happens that fast when it comes to government, ” he says. But it did this time. Chunker was awarded two-year leases for six properties that will accommodate overflow volumes from the ports of Los Angeles, Long Beach and Oakland. The company was looking to begin storing boxes there around the first of April.
Two of the parcels are state fairgrounds, portions of which haven’ t been used for years, says Wright. They include vacant land in the high desert city of Lancaster. In Stockton, Chunker is taking over some 66 acres that used to be a horse racing track. Three other sites are National Guard armories.
Preparing the properties for containers entails more than putting up a fence or unlocking a gate. They need to be equipped with cranes and mobile offices, and Chunker must obtain the necessary permits and business licenses. Security will also be a major concern. As of mid-March, the company was on track with its timetable for making the facilities fully operational. In fact, says Wright, it had begun the process even before winning the leases, “ hoping that we would get it. ”
On site, containers will be grounded and stacked, to maximize use of the land. Some chassis might also be stored there, but the emphasis will be on housing the boxes, Wright says. Together, he adds, the six Chunker-managed sites will be able to store up to 30,000 containers. Decisions on where they will actually go are up to ocean shipping lines, third-party logistics providers, freight forwarders and in some cases cargo owners.
For shippers, creation of the overflow yards generates yet another charge for moving cargo through a system that’ s becoming increasingly expensive to navigate. But until volumes begin to decline, possibly due to an abatement of COVID-19 and its many variants, they have little choice but to shoulder the additional cost.
In the months ahead, shippers and cargo handlers will continue to seek new locations for storing and processing containers and trailers. Some are turning to shuttered stores and malls that can be repurposed as distribution centers, in areas close to demanding online shoppers. But a long-term solution to the congestion crisis requires a far broader effort that addresses all nodes and modes of transportation, from marine terminals to intermodal railyards, trucking operations and warehouses that deploy sophisticated automation systems.
Wright suggests that the pop-up concept might not prove as “ temporary ” as planned. Freight handlers could find themselves getting comfortable with the solution. “ We initially went into it assuming that it was going be short-term, ” he says. “ But all said, once you get rolling and get into the workflow, this could go on forever. ”
|
general
|
Watch: Has the Pandemic Permanently Changed Last-Mile Delivery?
|
Final-mile delivery will not go back to pre-pandemic levels, says Khaled Naim, chief executive officer and co-founder of Onfleet. Shippers need to make adjustments.
The changes that retailers thought would take place in e-commerce over the next seven to 10 years accelerated during the COVID-19 pandemic, and there’ s no going back, Naim says.
“ I think they will last for the foreseeable future, ” he says. “ Retailers have to adapt to survive in this new environment. They can't rely on foot traffic anymore. We're seeing an incredibly rapid adoption of same-day delivery and the necessary e-commerce technologies. The changes are here to stay. ”
Among those changes, Naim says, is the imperative to begin last-mile delivery. Not only are people ordering more online, they have huge expectations around what that experience looks like. “ People place orders on demand and expect deliveries to show up within an hour, if not half an hour. So that's a completely new sector that we didn't see a couple of years ago. It didn't even exist a couple of years ago, but this kind of quick commerce space is a new one that we saw emerge during the pandemic. And I think it’ s here to stay. Consumers expect to be able to order something as small as a $ 50 basket size and have it show up same day. ”
The technology infrastructure needed includes routing and dispatching, real-time tracking and customer-facing communications, Naim says. Driver supply also is critical. Vital questions include: “ How do you staff up a fleet of drivers? How do you train them and onboard them to provide that kind of experience? Or do you work with third parties, and how do you rely on those third parties to provide that experience? ”
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general
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Zhenro’ s Unit Investors to Vote on Repayment: Evergrande Update
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The information you requested is not available at this time, please check back again soon.
Residential buildings at a Zhenro Properties Group Ltd. development in the Jinshan district of Shanghai, China, on Thursday, Feb. 24, 2022. Zhenro is asking bondholders for more time to pay back about $ 1 billion in debts due to mature this year, citing liquidity pressure. Photographer: Qilai Shen/Bloomberg, Bloomberg
( Bloomberg) -- A key offshore unit of Zhenro Properties Group Ltd. will ask investors to vote on a proposal to extend repayment of a 627 million yuan ( $ 98.4 million) ABS tranche at a two-day virtual meeting starting Tuesday.
The firm’ s first default weighed on investor sentiment after the debt-laden Chinese developer said it was unable to pay interest on two dollar bonds before a grace period ended Saturday. Trading of its debt securities are suspended on Tuesday.
The news came as Premier Li Keqiang told some local officials that China will adopt stronger economic policies as needed, state television reported. Li also said China must stabilize the economy via better implementation of existing macroeconomic policy.
China Onshore Corporate Bond Spreads Tighten ( 9:50 a.m. HK)
Chinese three-year AA-rated onshore corporate bond spreads tightened to the narrowest since Nov. 2020. Builders’ high yield notes fell amid concerns over the impact of Shanghai’ s Covid lockdown on sales.
CIFI Proposes Additional Issue of HK $ 588m 6.95% Conv. Bonds ( 6:22 a.m. HK)
The proposed additional sale of HK $ 588 million of convertible bonds due 2025 will be consolidated and form a single series with its HK $ 1.96 billion 6.95% convertible debt, developer CIFI Holdings said in an exchange filing.
China Offshore Corporate-Bond Defaults Hit $ 8B ( 2:07 p.m. HK, April 11)
China’ s offshore corporate-bond defaults have climbed to $ 8 billion this year, data compiled by Bloomberg showed, including 25 dollar-denominated bonds and one hongkong dollar-denominated bond.
The Bank of Canada is widely expected to hike its key lending rate by half a percentage point Wednesday, bringing its overnight rate to one per cent.
Realtors and economists alike see a shifting tide after Canada’ s home prices surged by more than 50 per cent over the past two years.
U.S. consumer prices rose in March by the most since late 1981, evidence of a painfully high cost of living and reinforcing pressure on the Federal Reserve to raise interest rates even more aggressively.
Former Bank of Canada Governor David Dodge suggested on the eve of the central bank's policy decision that there's no time to waste if Governor Tiff Macklem wants to `` break the psychology '' of runaway prices.
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general
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International Trade Professionals Programme Trade Insights from TFG - Page 3 of 4
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The ITPP gives international trade professionals the chance to write for TFG’ s publications. The top 10 writers from this year’ s group will also be enrolled onto an LIBF certified trade finance course, a globally recognised benchmark of professionalism. During these unchartered times, ITPP is also open to furloughed and currently unemployed professionals within the trade finance sector.
Participants will work closely with TFG’ s editorial team to plan, scope and produce a journalistic piece of content on a pre-agreed topic within international trade and finance. Top articles may also be in with the chance of being published in TFG’ s flagship publication, ‘ Trade Finance Talks’.
Collective action by sector players concentrating on continuing education, enabling women’ s access to financial markets, and directing women to more value-added businesses can be a solution to remove barriers and promote women in trade.
Considering the stakes involved in managing the AML/KYC compliances are high, banks/ FI should carefully assess the options available with them and look holistically to mitigate the risk.
SMEs need to explore innovative financing options like trade credit insurance as they plan and prepare for the “ new normal ”.
By leveraging technology for insights, a banker can make well-informed decisions, in compliance with audit and ethics, which are in the best interest of the bank.
Debtor Finance is a simple, viable alternative to consider for relatively quick access to working capital funding.
The magnitude and complexity of the OBOR project creates numerous policy challenges for countries in the region seeking to benefit from its implementation thus, the need for policy cooperation.
Banks, fintechs, and other vendors have a pivotal role to play in this situation to support communities and try to help the economy moving in the short and long term.
Correspondent Banking should in the future reinvent itself to accompany to be an ideal companion to technical assistance and be a key milestone potential ahead for the Africa market.
This article argues that the EU falls short of maintaining ‘ mutual solidarity’ and that the stark economic differences between many EU nations leads to conflicting energy policies with Russia.
The pandemic can be an opportunity for TFTA Member States to weaponise cooperation not only for fighting against COVID-19, but also to achieve deeper integration which in the long run will boost intra-Tripartite trade.
If we could picture the TIR system being implemented in the post-Covid era, it will be a step way forward in going paperless, reducing trade barriers, as well as adding value to existing transit transportation systems.
Trade digitization and electronic documents will be the new-norm as a result of the COVID19 pandemic which will accelerate the transformation process.
The value of Trade Finance Programs, which if combined with regulatory and technological innovation, is destined to hasten the closing trade finance gap and bring broader positive economic outcomes for nations.
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general
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BOJ cuts assessment for Japan regions and warns of fallout from Ukraine crisis
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The Bank of Japan on Monday cut its assessment for most regional economies in the country and its governor warned of “ very high uncertainty ” over the fallout from the Ukraine crisis, underscoring heightening risks to the economic recovery.
In a quarterly report analyzing regional Japanese economies, the central bank offered a bleaker view than in January for eight of the country’ s nine regions as a resurgence in COVID-19 cases and lingering supply constraints hit growth.
Gov. Haruhiko Kuroda said the national economy continues to pick up, but warned of the potential fallout from rising commodity costs and the war in Ukraine.
“ There’ s very high uncertainty on how developments in Ukraine could affect Japan’ s economy and prices, ” he said in a speech to a meeting of the BOJ’ s branch managers.
The BOJ’ s quarterly regional report will be among factors the central bank will scrutinize in releasing fresh quarterly growth and inflation projections at its next policy meeting on April 27-28.
Kuroda also said that higher energy prices and raw material costs will accelerate Japan’ s inflation in the coming months, with the core consumer price index excluding volatile fresh food items likely to rise “ clearly. ”
“ As downward pressure on service consumption and the impact of supply shortages diminish, a pickup in overseas demand, accommodative monetary policy, and the government’ s economic stimulus will likely help the Japanese economy recover despite being affected by rising commodity prices, ” he added.
Currently, Japan does not have any COVID-19 curbs in place after lifting quasi-emergencies last month but Prime Minister Fumio Kishida has warned of a rebound in infections.
Soaring fuel and commodity prices since Russia’ s invasion of Ukraine that began late February have cast a shadow over resource-scarce Japan.
Corporate sentiment, both among big manufacturers and nonmanufacturers, worsened for the first time in seven quarters in the most recent Tankan survey for March.
The yen’ s rapid depreciation, especially against the U.S dollars., has inflated import costs, prompting some corporate executives to warn of its negative impact on the economy.
The recent depreciation of the yen comes amid the prospect of diverging policy paths for the BOJ, still far from its 2% inflation target, and the U.S. Federal Reserve, which has entered a rate hike cycle to fight inflation that neared 8% in February.
Kuroda has said commodity inflation is unlikely to prompt the BOJ to change its monetary policy because it will not last long. But he told parliament that the yen’ s fall has been “ somewhat rapid, ” in his strongest yet warning since it tumbled to an over six-year low in March.
The core CPI in Japan rose 0.6% in February as higher fuel costs outweighed the drag from sharply lower mobile communication fees.
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tech
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It's still not time to invest in China, argues Bank of America. Here's why.
|
China was the worst-performing of the major markets in the first quarter — with the Shanghai Composite
SHCOMP,
-2.61%
dropping by 14% — but value-minded investors such as Charlie Munger are tempted. After all, China is still growing fast, and authorities have begun to temper their regulatory zeal. What could go wrong?
In a note to clients, Bank of America strategist Winnie Wu said it’ s still too early for Chinese stocks.
“ While valuation has become more attractive, earnings forecasts will probably continue to be revised down, ” she said. China’ s credit cycle typically leads the gross domestic product cycle by 12 to 18 months, and corporate earnings trend broadly in line with nominal GDP growth. Credit growth has only just bottomed, meaning GDP, and therefore earnings growth, won’ t turn around until the first half of 2023.
And while China isn’ t tightening the screws on companies further, it hasn’ t been loosening them, either.
“ Policy noises is lower compared to 2H21, but there are no coordinated, strong easing measures either, ” she said.
“ Geopolitical risks remain, with uncertainty on the ADR delisting situation. More recently, the rise in COVID cases and the sharply tightened lockdown measures in Shanghai and other parts of China, will probably take a toll on the economy in 2Q22 and undermine market confidence. ”
The note was written in advance of NIO saying lockdowns would affect production.
“ We are cautious on the sectors that could be more vulnerable to the lockdown measures, ie real estate, consumer discretionary ( auto, hotels, apparels), and transportation infrastructure. We have also become more negative on insurance and media sectors, for their weak earnings momentum, ” said Wu. What the bank does like are tech hardware and semiconductor, healthcare, diversified financials and chemicals.
The buzz
Twitter
TWTR,
+1.69%
shares fell 3% after Elon Musk, the chief executive of Tesla,
abruptly reversed his decision
to join the social-media service company’ s board after becoming its top shareholder. Twitter CEO Parag Agrawal said the decision was Musk’ s, but also noted that his joining the board was subject to a background check and “ formal acceptance. ”
NIO
NIO,
-1.50%
slumped 10%, after saying it will have to suspend production due to COVID-19 restrictions disrupting its supply chain. Tesla
TSLA,
-4.83%
fell 5%.
Shopify
SHOP,
+2.35%
announced a 10-for-1 stock split.
SailPoint Technologies
SAIL,
+29.16%
announced it was being bought by Thomas Bravo for $ 6.9 billion, or $ 65.25 per share.
AT & T
T,
+7.74%
rose after completing the spinoff of WarnerMedia.
French President Emmanuel Macron will take on far-right challenger Marine Le Pen for the second straight election, as various polling groups show a tight race, with Macron in the lead.
Russia was downgraded to selective default by S & P, as European companies Société Générale
GLE,
+4.96%
,
Nokian
TYRES,
-15.54%
and Ericsson
ERIC,
-3.21%
each announced plans to leave the country.
The markets
U.S. stock futures
ES00,
-0.05%
NQ00,
-0.02%
continued to feel the pressure on Monday as bond yields soared to new highs.
The yield on the 10-year Treasury
TMUBMUSD10Y,
2.827%
was 2.75% ahead of inflation data due on Tuesday.
Top tickers
Here were the most active stock-market tickers as of 6 a.m. Eastern.
Ticker
Security name
TSLA,
-4.83%
Tesla
GME,
+0.51%
GameStop
AMC,
+2.63%
AMC Entertainment
NIO,
-1.50%
Nio
MULN,
+5.98%
Mullen Automotive
DWAC,
-1.81%
Digital World Acquisition Company
TWTR,
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Random reads
Here’ s an
interesting if terrifying interview
with a longtime Russian presidential adviser on the invasion of Ukraine.
Julian Lennon sang his father’ s song “ Imagine ”
for the first time ever
in a fundraiser for Ukrainian refugees.
Cloud formations in Alaska
prompt UFO talk
.
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business
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Beyond India’ s Lockdown: PMGKY Benefits During the COVID-19 Crisis and the State of Digital Payments
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India imposed a lock-down in response to the COVID-19 pandemic in March 2020 and began a gradual re-opening in June. A telephonic survey in April examined the early effectiveness of information and the massive PMGKY social protection program ( Policy Paper 217). This paper analyzes a second-round survey, conducted six months later. Logistical and information constraints had relaxed, and incomes and jobs had begun to stabilize for some. There were not strong indications of differential access to benefits by income or location, but constraints to providing public employment had tightened in the face of increased demand, resulting in greater job rationing. Men made more use of digital channels, with a clear smartphone ownership hierarchy between men and women; this divide carried over into the growing autonomous use of digital payments which is conditioned on access to smartphones. Survey results confirm strong local agglomeration effects in digital payments, mirroring the general pattern with higher use in states hosting India’ s major technology hubs. At the same time, trust-based concerns reduced the use of assisted digital cash-outs through agents.
You may use and disseminate CGD’ s publications under these conditions.
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general
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AACR: The Weekend Winners - Amgen, Bicycle and BioNTech
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Data presented at the American Association for Cancer Research ( AACR) Annual Meeting over the weekend will likely lead to continued stock jumps for Amgen, Bicycle Therapeutics and BioNTech. Each of the companies ended April’ s first full week with a boost in stock valuations and trade volumes.
Follow-up data from Amgen’ s CodeBreaK 100 Phase 1/2 trial was presented at the meeting. The trial sought to investigate the long-term use of Lumakras ( sotorasib) in patients with KRAS G12C-mutated advanced non-small cell cancer ( NSCLC). The Lumakras treatment was approved by the FDA in 2021, however, long-term efficacy hadn’ t yet been demonstrated.
Over the course of two years, researchers collected data from 174 patients, including an ORR of 40.7%, and a DCR of 83.7%. They measured the median duration of response at 12.3 months. Progression-free survival averaged at 6.3 months, while overall, patients survived for 12.5 months under treatment. Safety was demonstrated, as no new signals emerged from the CodeBreaK trial.
Amgen Executive Vice President of Research and Development Dr. David Reese stated his pride in the extensive approvals already granted to the therapeutic.
`` With regulatory approvals in nearly 40 countries and thousands of patients treated, LUMAKRAS, the only approved KRASG12C inhibitor, is a transformative targeted therapy for the treatment of patients living with KRAS G12C-mutated NSCLC, '' he said.
Bicycle Therapeutics gave an oral presentation of interim data from a Phase I/II clinical trial investigating the company’ s therapeutic targeting urothelial carcinoma ( UC) solid tumors, BT8009. The drug targets nectin cell adhesion molecule 4 ( Nectin-4), which plays a role in cell proliferation, adhesion, and migration.
Results from the trial support the efficacy and safety of BT8009. Even in dosages as low as 5 mg/m2, participants showed preliminary responses. Overall, half of the 34 participants demonstrated a complete or partial response to BT8009. The disease control rate ( DCR) was measured at 75%. Further trials will examine how BT8009 works alone and in combination with chemotherapeutic nivolumab.
Owing in part to successes at AACR and to the development of a COVID-19 therapeutic, Bicycle stock showed an uptick on the day of the presentation. The antiviral treatment uses a similar small molecule technology as all others being developed by Bicycle. The company primarily works to develop therapeutics utilizing the proprietary synthetic technology that is referred to as Bicycles, which can be adapted to suit targets.
BioNTech’ s CAR-T cell therapeutic, BNT211, was showcased at the AACR after showing Phase I efficacy when stimulated by a combination with mRNA vaccine technology. The hypothesis is that, when paired with antigen-encoding nanoparticulates from mRNA, efficacy will be higher or longer-lasting. BioNTech named the mRNA vaccine CARVac.
The study, conducted at the Netherlands Cancer Institute ( NCI), theorized that BNT211 and CARVac paired are effective in targeting Claudin-6, seen on solid tumors. Five patients in the trial showed tumor shrinkage, while the overall objective response rate ( ORR) was 43%. Long-term, deeper analysis will be required before confidence can be achieved.
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Stronger Pricing Means U.S. Is an Attractive Home for Copper Now
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( Bloomberg) -- The U.S. has become a more attractive market for copper traders—and for the actual metal.
Copper futures on the Comex have been trading at a premium to those on the London Metal Exchange in recent weeks, attracting more copper cathode, especially from South America, the world’ s largest producing region. Imports of cathode to the U.S. from Chile rose 37% during the first three months of the year from the prior quarter, according to data from S & P Global.
The stronger pricing in New York points to a robust economy in the U.S., where the Federal Reserve is now laser-focused on bringing down rising inflation, as well as the ongoing logistics woes that still keep materials from going to where they’ re immediately needed.
“ The U.S. economy is relatively performing better than other economies, certainly than Europe, ” said Bart Melek, global head of commodity strategy at TD Securities.
Commodities including copper are caught in the turmoil of Russia’ s war on Ukraine. Even before the invasion, prices of raw materials rallied, with demand surging and supplies choked up due to pandemic-triggered supply chain woes. Europe’ s energy crisis, which is being worsened by the war in Ukraine, has also seen factories curtailing or closing capacity due to higher power costs.
With recent Covid-19 flare-ups in Shanghai, there are further concerns that port congestion will cause more delays in getting materials to where they’ re needed.
“ The flows are slowing down from Asia and Rotterdam, ” Melek said. Along with the difference in demand, that means that relative prices in North America are stronger, he said.
Investors are also moving at least part of their trade to the Comex copper contract in the wake of the London Metal Exchange’ s nickel-trading crisis, according to traders.
Open interest in Comex copper contracts has increased 15% since the LME reopened nickel trading in mid-March. That compared with a trader exodus across the LME’ s six main metals following the unprecedented short squeeze in the exchange’ s nickel contracts.
“ It’ d be logical to say that for risk mitigation reasons, you might want to be taking some hedging somewhere else, ” Melek said.
Shopify announced a number of proposed changes to its governance and share structure on Monday.
An analyst who covers Canada’ s banks is warning of choppy waters ahead and is urging clients to take a more defensive approach as economic uncertainty threatens to send shares sharply lower.
Crude oil prices fell to their lowest level since before the Russian invasion of Ukraine as a spike of COVID-19 cases in China pulled down the energy sector and Canada's main stock index to start the trading week.
Traders are shunning technology stocks amid mounting risks from soaring Treasury yields and hawkish commentary from the U.S. Federal Reserve.
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The Top 5 Happy Eco News Stories for April 11, 2022
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This week we have two guests posts. The first post is by Felicitas Taube, Blogger on Eco Warrior who tells us about her experience protecting seabirds in Cape Town. The second post is by Job van Hooijdonk, co-founder of Regreener who tells us about the dos and don’ ts about becoming a sustainable company. We also have stories about the UN’ s ocean treaty, the solution to ethical eating called invasivorism, a forest in Rio de Janeiro coming back to life, the possibility of not eating meat by 2035, and an aircraft that produces no emissions.
If you enjoy the Happy Eco News each week and can afford to support our work, please consider becoming a patron.
Happy Eco News also now accepts donations via PayPal. You can choose any amount you like, one-time or recurring, with any payment method you prefer.
Thank you for your support and for taking action.
When it comes to Seabirds many of us will think of that one Seagull that was brave enough to steal the chips we so desperately wanted after a long day at the beach. But did you ever think about what might happen to them if they eat bad food? Do they get food poisoning just like us? Is there something like a hospital that helps them to regain their strength? Yes there is! At least in Cape Town, where I spent a day at the SANCCOB Sanctuary.
SANCCOB stands for “ The Southern African Foundation for the Conservation of Coastal Birds ” and has been saving Seabirds since 1968. A remarkable woman called Althea Louise Burman Westphal started the project in her own home. She treated oiled penguins after the first major oil spill from Esso Essen and started rehabilitating 60 penguins. She scrubbed them with water and soap in her bathtub, gave them fish every few hours and provided a home in her garden. Even though the penguins had a pool in the garden she still drove two or three times a week to the beach so that the penguins could swim in a tide pool for an hour… [ read more ].
Despite a huge drop in global emissions in 2020 as a result of the Covid-19 pandemic, emissions made their comeback and climbed to a record high in 2021. Limiting global warming to 1.5 degrees Celsius is becoming an increasingly unlikely scenario. Only if the world comes up with much more ambitious plans to reduce emissions, the Paris Agreement’ s goal is still feasible, concludes the UN climate panel IPCC in a report that was released last week.
On a positive note, we see more and more businesses taking their responsibility. The time for pointing fingers is over. Companies realize that they will lose their raison d’ être if they do nothing. However, although awareness is there, we also see that lots of companies are afraid to actually start acting “ green ”. Their biggest fear? Being accused of greenwashing.
The term greenwashing is like the game over button in fighting climate change. Greenwashing is defined as “ the intersection of two firm behaviors: poor environmental performance and positive communication about environmental performance ” … [ read more ].
2. Welcome to Invasivorism, the Boldest Solution to Ethical Eating Yet
3. In Rio de Janeiro, a Forest Slowly Returns to Life, One Species at a Time
4. CEO Says It’ s Possible Nobody Will Eat Meat by 2035
5. The Air Force Just Soared Past an Electric Aircraft Milestone
If you enjoy Happy Eco News, please share this email with friends and family. You can follow, like our posts, and share us on social media too. It all helps. You can also find us on Instagram, Twitter, and Facebook.
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esg
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Hounding scammers with litigation
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Over the last few years we’ ve seen a rise in bad actors using the internet for illegal activities, and we see it in our work. Every single day we stop more than 100 million harmful emails from reaching our users, and we routinely work with law enforcement to combat nefarious actors. But across the web, people are caught in romance scams, loan scams, and investment scams every day — and older Americans are often the most vulnerable.
Raising public awareness can help people avoid becoming victims. But for more emergent illicit behaviors and scams, lawsuits are an effective tool for establishing a legal precedent, disrupting the tools used by scammers, and raising the consequences for bad actors. That’ s why last December we used our resources to file a lawsuit to combat illegal activity in the botnet industry and have used legal action to defend small businesses from scammers masquerading as Google. With these actions, we establish legal precedent to help stop similar cyber threats and scams.
Today, we’ re building on this work by taking legal action against an actor who was operating fraudulent websites and using Google products as a part of their scheme. The actor used a network of fraudulent websites that claimed to sell basset hound puppies — with alluring photos and fake customer testimonials — in order to take advantage of people during the pandemic.
This type of scheme follows a similar script to many online scams where malicious actors pretend to be someone they are not to convince victims to give them money for something they will never receive. The Better Business Bureau recently announced that pet scams now make up 35% of all online shopping scams reported to them, and this particular scam targeted people at their most vulnerable, just as the pandemic led to a record spike in people wanting to own pets. ( According to Google Search Trends, searches for “ Adopt a Dog ” spiked at the start of the pandemic as people spent more time at home. By the end of 2020, 70% of Americans reported owning a pet.)
Sadly, this scam disproportionately targeted older Americans, who can be more vulnerable to cyberattacks. The FTC and FBI report that older people are scammed out of an estimated $ 650 million per year.
That’ s why we’ re taking proactive action to set a legal precedent, protect victims, disrupt the scammer’ s infrastructure, and raise public awareness. Of course, legal action is just one way we work to combat these types of scams. We build our security into all of our products and use machine learning to filter new threats, and our CyberCrime Investigation Group investigates misconduct and sends referrals to various law enforcement agencies including the Department of Justice to combat nefarious actors engaging in a wide range of scams including pets, covid relief, romance, and tech support scams.
We will continue to work with federal and state agencies and law enforcement to ensure our consumers are better protected from fraud online.
Some actions we're taking to provide charitable support, promote information quality and cybersecurity, protect colleagues and more.
Let’ s stay in touch. Get the latest news from Google in your inbox.
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tech
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Next-Gen Partnerships: The Ascent of Advanced Therapies
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Biopartnering activity between large pharmaceutical and biotechnology companies in 2021 hit record levels. A record 1,968 deals were announced last year, and the total value of these ventures for which financial details were disclosed was $ 213.6 billion, up from $ 198.2 billion in 2020.1 While deals involving oncology assets continue to take the largest share of the pharma dealmaking investment pie, the desire to access technology platforms that are anticipated to drive the development of the next generation of blockbuster drugs underpinned some large deals in the RNA technology and cell and gene therapy fields.
Successful development of mRNA vaccines during the COVID-19 pandemic and the approval of RNAi-based medicines in recent years have catalyzed the desire at life sciences companies to get access to and develop RNA-based platforms through partnerships and acquisitions.
British multinational pharma AstraZeneca established two potentially lucrative partnerships ( see Figure 1 below). In the largest preclinical deal of 2021, potentially worth in excess of $ 5 billion, AZ reached an agreement to collaborate with Imperial College spinout VaxEquity for the discovery, development, and commercialization of a self-amplifying RNA ( saRNA) therapeutics platform developed at the university.2 AZ also entered into a new global development and commercialization agreement with Ionis Pharmaceuticals for eplontersen, a liver-targeted antisense therapy in Phase III development for the treatment of transthyretin amyloidosis, a systemic, progressive, and fatal condition.3
Under the terms of the saRNA deal, AZ will support VaxEquity with research and development funding. Should the pharma giant advance any of the research programs into its pipeline, VaxEquity also could receive development, approval, and sales-based milestones totalling up to $ 195 million and royalties in the mid-single digits per program. AZ has the option to collaborate with VaxEquity on up to 26 as yet undisclosed drug targets and will make an investment in the company to further the development of the saRNA platform.
In its deal with Ionis, AZ will provide the company an upfront payment of $ 200 million and additional conditional payments of up to $ 485 million following regulatory approvals. It also will pay up to $ 2.9 billion of sales-related milestones based on sales thresholds between $ 500 million and $ 6 billion, plus royalties in the range of low double-digit to mid-20s percentage, depending on the region.
AZ and Ionis will jointly develop and commercialize eplontersen in the US, while the British pharma will develop and commercialize it in the rest of the world, except in Latin America.
Hereditary amyloid transthyretin polyneuropathy ( ATTR-PN) is expected to be the first indication for which the companies will seek regulatory approval for eplontersen, with the potential to file a new drug application with FDA by the end of 2022.
Often partnerships can pave the way to outright acquisition of the innovating partner. Indeed, two of the largest pharma M & A transactions last year—2021 was a relatively quiet year for pharma M & A—were focused on RNA companies. Novo Nordisk acquired RNAi-based drug developer Dicerna Pharmaceuticals for $ 3.3 billion,4 while Sanofi scooped up mRNA vaccine developer Translate Bio for $ 3.2 billion.5
Novo Nordisk and Dicerna had been working together since 2019,6 when the companies started to collaborate on the discovery and development of novel treatments of liver-related cardio-metabolic diseases, including chronic liver disease, nonalcoholic steatohepatitis ( NASH), type 2 diabetes, obesity, and rare diseases, like endocrine disorders and bleeding disorders, using Dicerna’ s proprietary GalXC™ RNAi platform technology. By acquiring Dicerna, Denmark-based Novo Nordisk expects to expand its usage of RNAi technology.
Building on Sanofi’ s establishment of its $ 400 million mRNA Center of Excellence,7 the French pharma multinational acquired Translate Bio to unlock the potential of mRNA in other strategic areas such as immunology, oncology, and rare diseases, in addition to vaccines. Sanofi and Translate Bio had been collaborating since June 2018,8 initially to develop mRNA vaccines, but further expanded in 2020 to broadly address current and future infectious diseases.9 On the therapeutic side, Translate Bio was developing an early stage pipeline in cystic fibrosis and other rare pulmonary diseases, with discovery work in diseases that affect the liver.
Translate Bio’ s MRT™ platform may also be applied to various classes of treatments, such as therapeutic antibodies or vaccines in areas such as oncology.
Earlier in 2021, Sanofi had acquired Tidal Therapeutics, a privately owned, preclinical-stage biotech company with a novel mRNA-based approach for in vivo reprogramming of immune cells. It had an upfront payment of $ 160 million and up to $ 310 million upon achievement of certain milestones, to expand its mRNA research capabilities in both immuno-oncology and inflammatory diseases.10
Cell and gene therapy platforms were also an attractive target for large pharma dealmakers, with Roche and Takeda being among the most active ( see Figures 2 and 3 below). Indeed, nearly 15% of the deal value in 2021, about $ 31.2 billion, was earmarked for cell and gene therapy efforts.11 These therapies are addressing typically underserved patient populations, such as those with rare diseases—for example, spinal muscular atrophy and inherited retinal dystrophies such as retinitis pigmentosa and Leber’ s congenital amaurosis—and certain oncology indications.
In the cell therapy field, Roche group company Genentech entered into a strategic collaboration and license agreement with British cell therapy developer Adaptimmune to develop and commercialize allogeneic cell therapies to treat multiple oncology indications.12 Meanwhile, in the gene therapy space, the Swiss parent entered into a multitarget strategic alliance and license agreement with Shape Therapeutics to advance the US biotech’ s adeno-associated viruses ( AAVs) -based RNA editing technology to discover potentially transformative treatment options for people living with Alzheimer’ s disease, Parkinson’ s disease, and rare diseases.13
Under the terms of the Adaptimmune deal, which will focus on the development of allogeneic T-cell therapies for up to five shared cancer targets as well as the development of personalized allogeneic T-cell therapies, using the UK biotech’ s induced pluripotent stem cell ( iPSC) -derived allogeneic platform to produce T-cells, Genentech paid $ 150 million upfront and could pay an additional $ 150 million over five years. Adaptimmune may be eligible to receive research, development, regulatory, and commercial milestones payments potentially exceeding $ 3 billion in aggregate value, as well as receiving tiered royalties on net sales in the mid-single to low-double digits.
In the gene therapy deal with Roche, ShapeTherapeutics will conduct preclinical research to identify and deliver development candidates discovered by its AI-powered platforms RNAfix™ and, potentially, AAVid.™ Shape Therapeutics is eligible to receive an initial payment as well as development, regulatory, and sales milestones payments, potentially exceeding $ 3 billion in aggregate value. Roche will be responsible for the development and worldwide commercialization of any potential products resulting from the collaboration, while Shape Therapeutics will be eligible to receive tiered royalties on future sales of products resulting from the collaboration.
Potentially the largest gene therapy partnership signed in 2021 was a research collaboration and exclusive license agreement inked by Japanese Takeda Pharmaceutical and Poseida Therapeutics.14 The partnership underpins Takeda’ s commitment to investing in next-generation gene therapy approaches that it believes have the potential to deliver functional cures to patients with rare genetic and hematologic diseases.
Under the terms of the deal, which will involve Takeda utilizing Poseida’ s piggyBac, Cas-CLOVER, biodegradable DNA and RNA nanoparticle delivery technology, and other proprietary genetic engineering platforms for up to eight gene therapies, Poseida received $ 45 million upfront and is eligible for preclinical milestones that could exceed $ 125 million, if milestones for six programs are achieved.
Poseida is also eligible to receive future milestones of up to $ 2.7 billion if milestones for all six programs are achieved, or up to $ 3.6 billion if the milestones related to two optional programs are also achieved.
Takeda also had a busy 2021 building up its cell therapy expertise. It signed partnerships, both valued at up to $ 900 million, with Immusoft, to discover and develop cell therapies for rare neurometabolic disorders,15 and KSQ Therapeutics, to research, develop, and commercialize novel immune-based therapies for cancer.16
The Immusoft collaboration will utilize the US cell therapy company’ s Immune System Programming technology platform, which modifies a patient’ s B cells and instructs the cells to deliver gene-encoded therapies, and will focus on delivering protein therapeutics across the blood-brain barrier. KSQ granted Takeda an exclusive, worldwide, royalty-bearing license to develop, manufacture, and commercialize cell and non-cell therapy products that modulate targets identified using its CRISPRomics technology, focusing on two T-cell targets previously identified and validated by KSQ, with the potential to introduce two additional T-cell targets to the collaboration.
Also, in a bid to expand its immuno-oncology and innate immune cell therapy portfolio with novel platforms, Takeda hit the acquisition trail by exercising its right to acquire GammaDelta Therapeutics for an undisclosed pre-negotiated upfront and future potential milestones.17
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Myopericarditis after COVID-19 vaccination: unexpected but not unprecedented - The Lancet Respiratory Medicine
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In the midst of the devastating COVID-19 pandemic, rapid development of highly effective vaccines was enthusiastically welcomed. Unfortunately, myopericarditis after COVID-19 vaccination was an unanticipated adverse event. In The Lancet Respiratory Medicine, Ryan Ruiyang Ling and colleagues commendably review the risk of this adverse event in the context of risk after other vaccines.1Ling RR Ramanathan K Tan FL et al.Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis.Lancet Respir Med. 2022; ( published online April 11.) https: //doi.org/10.1016/S2213-2600 ( 22) 00059-5Google Scholar Their study provides an important perspective on the historical global experience with cardiac adverse events after vaccination.
Ling and colleagues applied rigorous statistical analyses to the available literature and confirmed the conclusions of other reviewers. Specifically, the overall incidence of myopericarditis after COVID-19 vaccination ( 18·2 cases [ 95% CI 10·9–30·3 ] per million doses) is not higher than expected outside of the context of vaccination, and not significantly higher than the incidence of myopericarditis reported after the standard immunisations included in the study, such as influenza vaccines ( 1·3 [ 0·0–884·1 ], p=0·43 vs COVID-19 vaccines). There is, however, an important demographic and vaccine-related component to this adverse event that is obscured in reporting the overall incidence. The risk of myopericarditis in young males after their second dose of mRNA COVID-19 vaccine is remarkably higher than expected.
This pattern has been seen before. As Ling and colleagues found when they reviewed the extant literature, myopericarditis risk is well established after receipt of live-replicating smallpox vaccine. Notably, in a study by Oster and colleagues2Oster ME Shay DK Su JR et al.Myocarditis cases reported after mRNA-based COVID-19 vaccination in the US from December 2020 to August 2021.JAMA. 2022; 327: 331-340Google Scholar of myocarditis after mRNA COVID-19 vaccination, the rate of myocarditis reported in the highest-risk group of recipients ( 105·86 cases [ 95% CI 91·65–122·27 ] per million doses in males aged 16–17 years receiving a second dose) approached the historical rate of myopericarditis after smallpox vaccination ( 132·1 cases [ 81·3–214·6 ] per million doses) according to Ling and colleagues ' study.1Ling RR Ramanathan K Tan FL et al.Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis.Lancet Respir Med. 2022; ( published online April 11.) https: //doi.org/10.1016/S2213-2600 ( 22) 00059-5Google Scholar US military professionals, who are very familiar with adverse events following smallpox vaccination, were among the first to observe myocarditis cases after mRNA COVID-19 vaccines,3Montgomery J Ryan M Engler R et al.Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military.JAMA Cardiol. 2021; 6: 1202-1206Google Scholar most likely because the US military includes a large number of young men who received two doses of COVID-19 vaccine very early in the 2021 pandemic vaccine rollout.
Although there are common demographic and clinical features between the myopericarditis cases that followed smallpox vaccine and those that followed mRNA COVID-19 vaccines, better understanding of the pathophysiology of these adverse events following vaccination is an important area for future research. Because smallpox vaccination has very limited global application in the modern era, the experience of mRNA COVID-19 vaccination must now propel the field forward. Analyses of the pathology and immunological mechanisms behind these demographic-dependent adverse events following vaccination are likely to advance our understanding of cardiology and immunology.4Kiblboeck D Klingel K Genger M et al.Myocarditis following mRNA COVID-19 vaccination: call for endomyocardial biopsy.ESC Heart Fail. 2022; ( published online Feb 23.) https: //doi.org/10.1002/ehf2.13791Google Scholar, 5Mormile R Myocarditis and pericarditis following mRNA COVID-19 vaccination in younger patients: is there a shared thread?.Expert Rev Cardiovasc Ther. 2022; 20: 87-90Google Scholar, 6Hajjo R Sabbah DA Bardaweel SK Tropsha A Shedding the light on post-vaccine myocarditis and pericarditis in COVID-19 and non-COVID-19 vaccine recipients.Vaccines ( Basel). 2021; 91186Google Scholar These advances could spur the development of safer vaccines or precision vaccination practices.7Kennedy RB Ovsyannikova IG Palese P Poland GA Current challenges in vaccinology.Front Immunol. 2020; 111181Google Scholar
Ling and colleagues ' analysis1Ling RR Ramanathan K Tan FL et al.Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis.Lancet Respir Med. 2022; ( published online April 11.) https: //doi.org/10.1016/S2213-2600 ( 22) 00059-5Google Scholar also raises important questions about whether cardiac adverse events following vaccination have historically been well evaluated outside of the realm of smallpox vaccine. In a literature review spanning 75 years, it is remarkable that the study team identified only five publications addressing myocarditis following immunisations other than smallpox or COVID-19 vaccination. The 7 million vaccine doses described in these publications represent a small fraction of the billions of vaccinations administered globally every year.8Strategic Advisory Group of Experts on ImmunizationThe Global Vaccine Action Plan 2011–2020. Review and lessons learned ( WHO/IVB/19.07). World Health Organization, Geneva2019Google Scholar This challenge might impact the interpretation of the results. Among the populations who received billions of vaccine doses after which myopericarditis was not observed or very rarely observed, published literature might not exist; reassuring data from background populations would not be captured in analyses of the literature, such as those conducted by Ling and colleagues. The safety signal observed after COVID-19 vaccination is, therefore, even more important to fully investigate.9Arnaud M Bégaud B Thurin N Moore N Pariente A Salvo F Methods for safety signal detection in healthcare databases: a literature review.Expert Opin Drug Saf. 2017; 16: 721-732Google Scholar
Reports of unexpected adverse events—albeit rare and limited to a specific subset of vaccine recipients—have the potential to damage vaccine confidence at a crucial point in the pandemic response. Like Ling and colleagues, all professionals who have described myopericarditis following COVID-19 vaccination have emphasised that the benefits of vaccination far outweigh the risks during the current pandemic. Nonetheless, scientific knowledge and public health strategies must continue to evolve. Alternative vaccine platforms, vaccine doses, or vaccine schedules could reduce the risk of rare adverse events and must be explored in the context of changing infection risk.10Shiri T Evans M Talarico CA et al.The population-wide risk-benefit profile of extending the primary COVID-19 vaccine course compared with an mRNA booster dose program.Vaccines ( Basel). 2022; 10: 140Google Scholar Vaccine confidence is one our most valuable resources, and it is dependent upon trust in public health. Trust is a fragile commodity that is strengthened by reporting challenges transparently and addressing these challenges with scientific rigour and appropriate concern.
We declare no competing interests.
Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysisThe overall risk of myopericarditis after receiving a COVID-19 vaccine is low. However, younger males have an increased incidence of myopericarditis, particularly after receiving mRNA vaccines. Nevertheless, the risks of such rare adverse events should be balanced against the risks of COVID-19 infection ( including myopericarditis). Full-Text PDF
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Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis - The Lancet Respiratory Medicine
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BackgroundMyopericarditis is a rare complication of vaccination. However, there have been increasing reports of myopericarditis following COVID-19 vaccination, especially among adolescents and young adults. We aimed to characterise the incidence of myopericarditis following COVID-19 vaccination, and compare this with non-COVID-19 vaccination.MethodsWe did a systematic review and meta-analysis, searching four international databases from Jan 1, 1947, to Dec 31, 2021, for studies in English reporting on the incidence of myopericarditis following vaccination ( the primary outcome). We included studies reporting on people in the general population who had myopericarditis in temporal relation to receiving vaccines, and excluded studies on a specific subpopulation of patients, non-human studies, and studies in which the number of doses was not reported. Random-effects meta-analyses ( DerSimonian and Laird) were conducted, and the intra-study risk of bias ( Joanna Briggs Institute checklist) and certainty of evidence ( Grading of Recommendations, Assessment, Development and Evaluations approach) were assessed. We analysed the difference in incidence of myopericarditis among subpopulations, stratifying by the type of vaccine ( COVID-19 vs non-COVID-19) and age group ( adult vs paediatric). Among COVID-19 vaccinations, we examined the effect of the type of vaccine ( mRNA or non-mRNA), sex, age, and dose on the incidence of myopericarditis. This study was registered with PROSPERO ( CRD42021275477).FindingsThe overall incidence of myopericarditis from 22 studies ( 405 272 721 vaccine doses) was 33·3 cases ( 95% CI 15·3–72·6) per million vaccine doses, and did not differ significantly between people who received COVID-19 vaccines ( 18·2 [ 10·9–30·3 ], 11 studies [ 395 361 933 doses ], high certainty) and those who received non-COVID-19 vaccines ( 56·0 [ 10·7–293·7 ], 11 studies [ 9 910 788 doses ], moderate certainty, p=0·20). Compared with COVID-19 vaccination, the incidence of myopericarditis was significantly higher following smallpox vaccinations ( 132·1 [ 81·3–214·6 ], p < 0·0001) but was not significantly different after influenza vaccinations ( 1·3 [ 0·0–884·1 ], p=0·43) or in studies reporting on various other non-smallpox vaccinations ( 57·0 [ 1·1–3036·6 ], p=0·58). Among people who received COVID-19 vaccines, the incidence of myopericarditis was significantly higher in males ( vs females), in people younger than 30 years ( vs 30 years or older), after receiving an mRNA vaccine ( vs non-mRNA vaccine), and after a second dose of vaccine ( vs a first or third dose).InterpretationThe overall risk of myopericarditis after receiving a COVID-19 vaccine is low. However, younger males have an increased incidence of myopericarditis, particularly after receiving mRNA vaccines. Nevertheless, the risks of such rare adverse events should be balanced against the risks of COVID-19 infection ( including myopericarditis).FundingNone.
Myopericarditis is a rare complication of vaccination. However, there have been increasing reports of myopericarditis following COVID-19 vaccination, especially among adolescents and young adults. We aimed to characterise the incidence of myopericarditis following COVID-19 vaccination, and compare this with non-COVID-19 vaccination.
We did a systematic review and meta-analysis, searching four international databases from Jan 1, 1947, to Dec 31, 2021, for studies in English reporting on the incidence of myopericarditis following vaccination ( the primary outcome). We included studies reporting on people in the general population who had myopericarditis in temporal relation to receiving vaccines, and excluded studies on a specific subpopulation of patients, non-human studies, and studies in which the number of doses was not reported. Random-effects meta-analyses ( DerSimonian and Laird) were conducted, and the intra-study risk of bias ( Joanna Briggs Institute checklist) and certainty of evidence ( Grading of Recommendations, Assessment, Development and Evaluations approach) were assessed. We analysed the difference in incidence of myopericarditis among subpopulations, stratifying by the type of vaccine ( COVID-19 vs non-COVID-19) and age group ( adult vs paediatric). Among COVID-19 vaccinations, we examined the effect of the type of vaccine ( mRNA or non-mRNA), sex, age, and dose on the incidence of myopericarditis. This study was registered with PROSPERO ( CRD42021275477).
The overall incidence of myopericarditis from 22 studies ( 405 272 721 vaccine doses) was 33·3 cases ( 95% CI 15·3–72·6) per million vaccine doses, and did not differ significantly between people who received COVID-19 vaccines ( 18·2 [ 10·9–30·3 ], 11 studies [ 395 361 933 doses ], high certainty) and those who received non-COVID-19 vaccines ( 56·0 [ 10·7–293·7 ], 11 studies [ 9 910 788 doses ], moderate certainty, p=0·20). Compared with COVID-19 vaccination, the incidence of myopericarditis was significantly higher following smallpox vaccinations ( 132·1 [ 81·3–214·6 ], p < 0·0001) but was not significantly different after influenza vaccinations ( 1·3 [ 0·0–884·1 ], p=0·43) or in studies reporting on various other non-smallpox vaccinations ( 57·0 [ 1·1–3036·6 ], p=0·58). Among people who received COVID-19 vaccines, the incidence of myopericarditis was significantly higher in males ( vs females), in people younger than 30 years ( vs 30 years or older), after receiving an mRNA vaccine ( vs non-mRNA vaccine), and after a second dose of vaccine ( vs a first or third dose).
The overall risk of myopericarditis after receiving a COVID-19 vaccine is low. However, younger males have an increased incidence of myopericarditis, particularly after receiving mRNA vaccines. Nevertheless, the risks of such rare adverse events should be balanced against the risks of COVID-19 infection ( including myopericarditis).
Globally, more than 10 billion doses of COVID-19 vaccines have been administered as of March, 2022.1Johns Hopkins UniversityCOVID-19 dashboard by the Center for Systems Science and Engineering.https: //www.arcgis.com/apps/dashboards/bda7594740fd40299423467b48e9ecf6Date accessed: September 26, 2021Google Scholar The side-effects of vaccination are usually mild and self-limiting; however, myopericarditis is increasingly being reported after COVID-19 vaccination.2Barda N Dagan N Ben-Shlomo Y et al.Safety of the BNT162b2 mRNA COVID-19 vaccine in a nationwide setting.N Engl J Med. 2021; 385: 1078-1090Google Scholar It has been postulated that the mRNA in the vaccine might activate aberrant innate and acquired immune responses that potentially trigger myocardial inflammation as part of a systemic reaction. Although a number of mechanisms have been suggested, the actual mechanism for the pathogenesis of post-vaccine myopericarditis has not been established.3Dursun AD Saricam E Sariyildiz GT Iscanli MD Cantekin ÖF The evaluation of oxidative stress in the young adults with COVID-19 mRNA vaccines induced acute pericarditis–myopericarditis.Int J Gen Med. 2022; 15: 161-167Google Scholar, 4Heymans S Cooper LT Myocarditis after COVID-19 mRNA vaccination: clinical observations and potential mechanisms.Nat Rev Cardiol. 2022; 19: 75-77Google Scholar, 5Kadkhoda K Post RNA-based COVID vaccines myocarditis: proposed mechanisms.Vaccine. 2022; 40: 406-407Google Scholar, 6Kounis NG Mplani V Koniari I Velissaris D Hypersensitivity myocarditis and COVID-19 vaccines.Kardiol Pol. 2022; 80: 109-110Google Scholar, 7Milano G Gal J Creisson A Chamorey E Myocarditis and COVID-19 mRNA vaccines: a mechanistic hypothesis involving dsRNA.Future Virol. 2021; ( published online Dec 6.) https: //doi.org/10.2217/fvl-2021-0280Google Scholar, 8Tsilingiris D Vallianou NG Karampela I Liu J Dalamaga M Potential implications of lipid nanoparticles in the pathogenesis of myocarditis associated with the use of mRNA vaccines against SARS-CoV-2.Metabol Open. 2022; 13100159Google Scholar, 9Marrama D Mahita J Sette A Peters B Lack of evidence of significant homology of SARS-CoV-2 spike sequences to myocarditis-associated antigens.EBioMedicine. 2022; 75103807Google Scholar
Myopericarditis is a rare complication of vaccination against viruses, and has previously been linked only to smallpox vaccination.10Dudley MZ Halsey NA Omer SB et al.The state of vaccine safety science: systematic reviews of the evidence.Lancet Infect Dis. 2020; 20: e80-e89Google Scholar A study in Israel, however, suggested that mRNA COVID-19 vaccines significantly increase the risk of myocarditis, particularly in males and in people aged 16–39 years.11Dagan N Barda N Balicer RD Adverse effects after BNT162b2 vaccine and SARS-CoV-2 infection, according to age and sex.N Engl J Med. 2021; 3852299Google Scholar In addition, numerous case reports and series have been published on myopericarditis in people vaccinated against COVID-19.12Das BB Moskowitz WB Taylor MB Palmer A Myocarditis and pericarditis following mRNA COVID-19 vaccination: what do we know so far?.Children ( Basel). 2021; 8: 607Google Scholar, 13Montgomery J Ryan M Engler R et al.Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military.JAMA Cardiol. 2021; 6: 1202-1206Google Scholar Whether these findings reflect a true increase in incidence or merely improved reporting and recall bias remains inconclusive.14Munro C COVID-19: boys are more at risk of myocarditis after vaccination than of hospital admission for COVID.BMJ. 2021; 374n2251Google Scholar We conducted a systematic review and meta-analysis comparing the incidence of myopericarditis following vaccination against COVID-19 with that following vaccination against other diseases to explore the risk of myopericarditis in subpopulations receiving COVID-19 vaccinations and to quantify the incidence of myocarditis, pericarditis, and mortality after receiving a vaccine.
Research in contextEvidence before this studyThe risk of myopericarditis following COVID-19 vaccination has been subject to considerable scrutiny both by the scientific community and the general population given the increased reporting of such events, especially in young adults. In some studies, the risk of myopericarditis was up to three times higher than that of controls. Notably, myopericarditis has been associated with mRNA COVID-19 vaccines, and multiple immunological mechanisms have been proposed for this. We searched four international databases between Jan 1, 1947, and Dec 31, 2021, for studies reporting on myopericarditis among people receiving vaccines using the keywords “ vaccines ”, “ myocarditis ”, and “ pericarditis ”, without any language restrictions. We identified 4919 studies from the search strategy, of which 22 observational studies were relevant to our study. Although we found previous systematic reviews that pooled the incident cases of myopericarditis following vaccination, we did not identify any meta-analyses evaluating the proportion of people who develop myopericarditis following vaccination.Added value of this studyOur meta-analysis was conducted to determine if the increased reporting of myopericarditis was a true increase in incidence or a result of improved reporting systems and recall bias. Among 260 million people who received more than 405 million vaccine doses as reported in studies and databases, we found that the incidence of myopericarditis was not elevated after COVID-19 vaccination ( 18 cases per million vaccine doses) when compared with after non-COVID-19 vaccination ( 56 cases per million vaccine doses) or relative to the background pre-pandemic incidence rate of myopericarditis. In people who received a COVID-19 vaccine, a significantly higher incidence of myopericarditis was found in males ( vs females), those younger than 30 years ( vs those aged 30 years or older), those receiving a second dose of vaccine ( vs a first or third dose), or those receiving an mRNA vaccine ( vs a non-mRNA vaccine). Using robust-variance estimation methods to account for intra-study correlation, decreasing age ( excluding people younger than 12 years) was associated with an increased incidence of myopericarditis.Implications of all the available evidenceIn the general population, the risk of myopericarditis after receipt of COVID-19 vaccination is low. The incidence of myopericarditis from COVID-19 vaccination also appears to be lower than that from COVID-19 infection. However, the incidence of myopericarditis for young men after mRNA COVID-19 vaccination appears higher than expected. These findings might be of interest to policy makers determining national vaccination protocols, particularly as many countries will be encouraging a booster dose of vaccination during 2022. Finally, our findings inform the general public of the rarity of myopericarditis, placing the risks into perspective and allowing for a more informed decision regarding COVID-19 vaccination.
The risk of myopericarditis following COVID-19 vaccination has been subject to considerable scrutiny both by the scientific community and the general population given the increased reporting of such events, especially in young adults. In some studies, the risk of myopericarditis was up to three times higher than that of controls. Notably, myopericarditis has been associated with mRNA COVID-19 vaccines, and multiple immunological mechanisms have been proposed for this. We searched four international databases between Jan 1, 1947, and Dec 31, 2021, for studies reporting on myopericarditis among people receiving vaccines using the keywords “ vaccines ”, “ myocarditis ”, and “ pericarditis ”, without any language restrictions. We identified 4919 studies from the search strategy, of which 22 observational studies were relevant to our study. Although we found previous systematic reviews that pooled the incident cases of myopericarditis following vaccination, we did not identify any meta-analyses evaluating the proportion of people who develop myopericarditis following vaccination.
Our meta-analysis was conducted to determine if the increased reporting of myopericarditis was a true increase in incidence or a result of improved reporting systems and recall bias. Among 260 million people who received more than 405 million vaccine doses as reported in studies and databases, we found that the incidence of myopericarditis was not elevated after COVID-19 vaccination ( 18 cases per million vaccine doses) when compared with after non-COVID-19 vaccination ( 56 cases per million vaccine doses) or relative to the background pre-pandemic incidence rate of myopericarditis. In people who received a COVID-19 vaccine, a significantly higher incidence of myopericarditis was found in males ( vs females), those younger than 30 years ( vs those aged 30 years or older), those receiving a second dose of vaccine ( vs a first or third dose), or those receiving an mRNA vaccine ( vs a non-mRNA vaccine). Using robust-variance estimation methods to account for intra-study correlation, decreasing age ( excluding people younger than 12 years) was associated with an increased incidence of myopericarditis.
In the general population, the risk of myopericarditis after receipt of COVID-19 vaccination is low. The incidence of myopericarditis from COVID-19 vaccination also appears to be lower than that from COVID-19 infection. However, the incidence of myopericarditis for young men after mRNA COVID-19 vaccination appears higher than expected. These findings might be of interest to policy makers determining national vaccination protocols, particularly as many countries will be encouraging a booster dose of vaccination during 2022. Finally, our findings inform the general public of the rarity of myopericarditis, placing the risks into perspective and allowing for a more informed decision regarding COVID-19 vaccination.
This study was registered with PROSPERO ( CRD42021275477) and conducted in accordance with the PRISMA statement ( appendix p 3).15Page MJ McKenzie JE Bossuyt PM et al.The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.BMJ. 2021; 372: n71Google Scholar The study protocol is available online.
We searched four databases ( MEDLINE via Pubmed, Embase, Cochrane, and Scopus) for relevant studies, published in English, using the keywords “ vaccines ”, “ myocarditis ”, and “ pericarditis ”, from Jan 1, 1947, to Dec 31, 2021 ( appendix p 6). Grey literature was searched by reviewing the reference lists of included studies and review articles. Observational studies reporting on people in the general population who had myopericarditis in temporal relation to receiving vaccines were included in our review. We excluded randomised controlled trials, case reports, studies that reported on a specific subpopulation of patients, non-human studies, and studies in which the number of doses was not reported.
Data were collected using a prespecified data extraction form ( appendix p 7). Where data were not explicit, we calculated the incidence using the reported number of patients with myopericarditis, the number of vaccine doses and types administered, and the incidence rate, as appropriate. Intra-study risk of bias was rated using the Joanna Briggs Institute ( JBI) checklist for prevalence studies.16Munn Z Moola S Lisy K Riitano D Tufanaru C Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data.Int J Evid-Based Healthc. 2015; 13: 147-153Google Scholar Overall certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations ( GRADE) approach. The screening of studies, data collection, and risk of bias assessment were done independently in duplicate by RRL, FLT, and KR; disagreements were resolved by consensus.
The primary outcome was the incidence of myopericarditis after any vaccination; secondary outcomes included the incidence of myocarditis, pericarditis, and mortality after any vaccination. Given the heterogeneity in reporting of individual cases of myopericarditis and pericarditis, we define in our review myopericarditis as an umbrella term describing myocarditis, pericarditis, or cases with features of both myocarditis and pericarditis, as reported in the databases or defined within the individual studies. Among studies that reported on myocarditis and pericarditis individually, we pooled the incidence rates of both conditions accordingly. Statistical analyses were done using R version 4.0.1. We conducted random-effects meta-analyses ( DerSimonian and Laird) and computed 95% CIs with the Clopper-Pearson method.17Clopper CJ Pearson ES The use of confidence or fiducial limits illustrated in the case of the binomial.Biometrika. 1934; 26: 404-413Google Scholar, 18DerSimonian R Laird N Meta-analysis in clinical trials.Control Clin Trials. 1986; 7: 177-188Google Scholar Although we initially intended to use the Freeman-Tukey double arcsine transformation, several concerns about its use in meta-analyses of rare events were raised, and hence we opted instead to use the logit transformation for our analyses.19Nyaga VN Arbyn M Aerts M Metaprop: a Stata command to perform meta-analysis of binomial data.Arch Public Health. 2014; 72: 39Google Scholar, 20Schwarzer G Chemaitelly H Abu-Raddad LJ Rücker G Seriously misleading results using inverse of Freeman-Tukey double arcsine transformation in meta-analysis of single proportions.Res Synth Methods. 2019; 10: 476-483Google Scholar We also did a sensitivity analysis excluding any database and preprint data and studies with high risks of bias ( JBI score < 7) to assess the impact of intra-study risk of bias on the reporting of myopericarditis. Publication bias was assessed by visual inspection of funnel plots as well as by Egger's test.
We analysed the difference in incidence of myopericarditis among prespecified subpopulations including the type of vaccine ( COVID-19 and non-COVID-19 vaccines, and mRNA COVID-19 vaccine and non-mRNA COVID-19 vaccine) and age ( paediatric [ < 18 years ] and adult [ ≥18 years ]) using the random-effects Q test. We further investigated the differences between individual non-COVID-19 vaccines ( smallpox, influenza, and mixed [ defined by the individual studies and including varicella; yellow fever; oral polio vaccine; measles, mumps, and rubella; meningococcal; and diphtheria, pertussis, and tetanus ]) with COVID-19 vaccines. As there have been concerns about myopericarditis being more common in young men receiving their second dose of COVID-19 vaccination,21Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar we compared its incidence by sex ( male and female), age group ( < 30 or ≥30 years), and dose ( first, second, and third) specifically for COVID-19 vaccines.
As inter-study heterogeneity between observational studies of large sample sizes tends to be overestimated by I2 statistics, we assessed the heterogeneity as part of the GRADE approach, accounting for both quantitative heterogeneity ( using I2 statistics, exploring for sources of heterogeneity using subgroup analysis and meta-regression) and qualitative heterogeneity ( distribution of the point estimates and degree of overlap of the 95% CIs of studies in the forest plots).22Guyatt GH Oxman AD Kunz R et al.GRADE guidelines: 7. Rating the quality of evidence—inconsistency.J Clin Epidemiol. 2011; 64: 1294-1302Google Scholar, 23Iorio A Spencer FA Falavigna M et al.Use of GRADE for assessment of evidence about prognosis: rating confidence in estimates of event rates in broad categories of patients.BMJ. 2015; 350: h870Google Scholar p < 0·05 was considered to indicate significance in our analysis. The pooled incidence of myopericarditis and mortality are presented as cases per million vaccine doses.
Given the amount of attention myopericarditis in COVID-19 vaccination among younger people ( particularly males) has received, we did an inverse-variance weighted meta-regression between the age and the incidence of myopericarditis among four studies that provided age-stratified data for vaccinees.21Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar To account for intra-subject correlation, we estimated SEs using robust-variance estimates, incorporating a random-effects term for each study, and a moderator term for age, which was modelled as a continuous variable.27Pustejovsky JE Tipton E Meta-analysis with robust variance estimation: expanding the range of working models.Prev Sci. 2021; ( published online May 7.) https: //doi.org/10.1007/s11121-021-01246-3Google Scholar We clustered the pooled estimates around each unique study identifier to derive the robust-variance estimates for SE. In addition, we evaluated differences in the incidences of myocarditis and pericarditis between COVID-19 and non-COVID-19 vaccines. Finally, to estimate the baseline incidence of myopericarditis from COVID-19 infection, we did a rapid review of the literature and pooled the incidence of myopericarditis among patients with COVID-19 infection ( appendix p 8). We included studies with at least ten adult patients with COVID-19 reporting on myopericarditis, and excluded any case reports, reviews, post-mortem studies or studies that did not report the number of patients with COVID-19. In the event of overlapping studies, we included the largest study and excluded other studies.
There was no funding source for this study.
Of 4919 studies, 156 full-text publications were reviewed. 22 observational studies totalling 405 272 721 vaccine doses were included in the meta-analysis ( figure 1; appendix pp 10–17).13Montgomery J Ryan M Engler R et al.Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military.JAMA Cardiol. 2021; 6: 1202-1206Google Scholar, 21Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 28Arness MK Eckart RE Love SS et al.Myopericarditis following smallpox vaccination.Am J Epidemiol. 2004; 160: 642-651Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar, 30Diaz GA Parsons GT Gering SK Meier AR Hutchinson IV Robicsek A Myocarditis and pericarditis after vaccination for COVID-19.JAMA. 2021; 326: 1210-1212Google Scholar, 31Eckart RE Love SS Atwood JE et al.Incidence and follow-up of inflammatory cardiac complications after smallpox vaccination.J Am Coll Cardiol. 2004; 44: 201-205Google Scholar, 32Engler RJ Nelson MR Collins Jr, LC et al.A prospective study of the incidence of myocarditis/pericarditis and new onset cardiac symptoms following smallpox and influenza vaccination.PLoS One. 2015; 10e0118283Google Scholar, 33Grabenstein JD Winkenwerder Jr, W US military smallpox vaccination program experience.JAMA. 2003; 289: 3278-3282Google Scholar, 34Hansen J Goddard K Timbol J et al.Safety of recombinant influenza vaccine compared to inactivated influenza vaccine in adults: an observational study.Open Forum Infect Dis. 2020; 7ofaa179Google Scholar, 35Health InfoBase CanadaReported side effects following COVID-19 vaccination in Canada.https: //health-infobase.canada.ca/covid-19/vaccine-safety/Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 36Husby A Hansen JV Fosbøl E et al.SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study.BMJ. 2021; 375e068665Google Scholar, 37Kuntz J Crane B Weinmann S Naleway AL Myocarditis and pericarditis are rare following live viral vaccinations in adults.Vaccine. 2018; 36: 1524-1527Google Scholar, 38Mayet A Haus-Cheymol R Bouaiti EA et al.Adverse events following vaccination in the French armed forces: an overview of surveillance conducted from 2002 to 2010.Euro Surveill. 2012; 1720193Google Scholar, 39McMahon AW Zinderman C Ball R Gupta G Braun MM Comparison of military and civilian reporting rates for smallpox vaccine adverse events.Pharmacoepidemiol Drug Saf. 2007; 16: 597-604Google Scholar, 40McNeil MM Cano M Miller ER Petersen BW Engler RJ Bryant-Genevier MG Ischemic cardiac events and other adverse events following ACAM2000 ( ®) smallpox vaccine in the Vaccine Adverse Event Reporting System.Vaccine. 2014; 32: 4758-4765Google Scholar, 41Medicines & Healthcare Products Regulatory AgencyCoronavirus ( COVID-19) vaccine adverse reactions.https: //www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions/coronavirus-vaccine-summary-of-yellow-card-reportingDate: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 42Millman AJ Reynolds S Duffy J Chen J Gargiullo P Fry AM Hospitalizations within 14 days of vaccination among pediatric recipients of the live attenuated influenza vaccine, United States 2010-2012.Vaccine. 2017; 35: 529-535Google Scholar, 43Singapore Health Sciences AuthorityHSA's safety update # 8: COVID-19 vaccines ( 30 December 2020 – 30 November 2021).https: //www.hsa.gov.sg/docs/default-source/hprg-vcb/safety-update-on-covid19-vaccines/hsa-safety-update-no-8-on-covid-19-vaccines- ( 30-november-2021).pdfDate accessed: December 31, 2021Google Scholar, 44Sniadack MM Neff LJ Swerdlow DL Schieber RA McCauley MM Mootrey GT Follow-up of cardiovascular adverse events after smallpox vaccination among civilians in the United States, 2003.Clin Infect Dis. 2008; 46: S251-S257Google Scholar 11 studies reported on 395 361 933 doses of COVID-19 vaccines,13Montgomery J Ryan M Engler R et al.Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military.JAMA Cardiol. 2021; 6: 1202-1206Google Scholar, 21Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar, 30Diaz GA Parsons GT Gering SK Meier AR Hutchinson IV Robicsek A Myocarditis and pericarditis after vaccination for COVID-19.JAMA. 2021; 326: 1210-1212Google Scholar, 35Health InfoBase CanadaReported side effects following COVID-19 vaccination in Canada.https: //health-infobase.canada.ca/covid-19/vaccine-safety/Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 36Husby A Hansen JV Fosbøl E et al.SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study.BMJ. 2021; 375e068665Google Scholar, 41Medicines & Healthcare Products Regulatory AgencyCoronavirus ( COVID-19) vaccine adverse reactions.https: //www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions/coronavirus-vaccine-summary-of-yellow-card-reportingDate: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 43Singapore Health Sciences AuthorityHSA's safety update # 8: COVID-19 vaccines ( 30 December 2020 – 30 November 2021).https: //www.hsa.gov.sg/docs/default-source/hprg-vcb/safety-update-on-covid19-vaccines/hsa-safety-update-no-8-on-covid-19-vaccines- ( 30-november-2021).pdfDate accessed: December 31, 2021Google Scholar six studies reported on 2 900 274 doses of smallpox vaccines,28Arness MK Eckart RE Love SS et al.Myopericarditis following smallpox vaccination.Am J Epidemiol. 2004; 160: 642-651Google Scholar, 31Eckart RE Love SS Atwood JE et al.Incidence and follow-up of inflammatory cardiac complications after smallpox vaccination.J Am Coll Cardiol. 2004; 44: 201-205Google Scholar, 33Grabenstein JD Winkenwerder Jr, W US military smallpox vaccination program experience.JAMA. 2003; 289: 3278-3282Google Scholar, 39McMahon AW Zinderman C Ball R Gupta G Braun MM Comparison of military and civilian reporting rates for smallpox vaccine adverse events.Pharmacoepidemiol Drug Saf. 2007; 16: 597-604Google Scholar, 40McNeil MM Cano M Miller ER Petersen BW Engler RJ Bryant-Genevier MG Ischemic cardiac events and other adverse events following ACAM2000 ( ®) smallpox vaccine in the Vaccine Adverse Event Reporting System.Vaccine. 2014; 32: 4758-4765Google Scholar, 44Sniadack MM Neff LJ Swerdlow DL Schieber RA McCauley MM Mootrey GT Follow-up of cardiovascular adverse events after smallpox vaccination among civilians in the United States, 2003.Clin Infect Dis. 2008; 46: S251-S257Google Scholar two studies on 1 521 782 doses of influenza vaccines,34Hansen J Goddard K Timbol J et al.Safety of recombinant influenza vaccine compared to inactivated influenza vaccine in adults: an observational study.Open Forum Infect Dis. 2020; 7ofaa179Google Scholar, 42Millman AJ Reynolds S Duffy J Chen J Gargiullo P Fry AM Hospitalizations within 14 days of vaccination among pediatric recipients of the live attenuated influenza vaccine, United States 2010-2012.Vaccine. 2017; 35: 529-535Google Scholar and three studies on a variety of non-COVID-19 vaccines ( such as varicella; yellow fever; oral polio vaccine; measles, mumps, and rubella; meningococcal; diphtheria, pertussis, and tetanus; BCG; hepatitis; and typhoid; 5 488 732 doses).32Engler RJ Nelson MR Collins Jr, LC et al.A prospective study of the incidence of myocarditis/pericarditis and new onset cardiac symptoms following smallpox and influenza vaccination.PLoS One. 2015; 10e0118283Google Scholar, 37Kuntz J Crane B Weinmann S Naleway AL Myocarditis and pericarditis are rare following live viral vaccinations in adults.Vaccine. 2018; 36: 1524-1527Google Scholar, 38Mayet A Haus-Cheymol R Bouaiti EA et al.Adverse events following vaccination in the French armed forces: an overview of surveillance conducted from 2002 to 2010.Euro Surveill. 2012; 1720193Google Scholar Across the nine studies that specified the type of COVID-19 vaccine, 290 730 653 doses of mRNA vaccines and 51 969 677 doses of non-mRNA vaccines were administered. Definitions of pericarditis, myocarditis, and myopericarditis in individual studies or databases are summarised in the appendix ( pp 10-17). The intra-study risk of bias and GRADE assessment are also provided in the appendix ( pp 18–20); apart from one study,25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar all studies were of good quality ( JBI score > 7).Figure 1Flow diagram of study identification and inclusionView Large Image Figure ViewerDownload Hi-res image Download ( PPT)
The overall incidence of myopericarditis was 33·3 cases ( 95% CI 15·3–72·6) per million vaccine doses ( high certainty, Egger's test p=0·12; figure 2; appendix p 21). Sensitivity analyses excluding studies with high risks of bias and databases found that the pooled incidence of myopericarditis for COVID-19 and non-COVID-19 vaccines did not change significantly ( appendix p 22).Figure 2Incidence of myopericarditis following vaccination in studies investigating COVID-19 and non-COVID-19 vaccinesShow full captionThe pooled incidence of myopericarditis following vaccination was 18·2 cases per million doses of COVID-19 vaccine and 56·0 cases per million doses of non-COVID-19 vaccine ( p=0·20).View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
The pooled incidence of myopericarditis following vaccination was 18·2 cases per million doses of COVID-19 vaccine and 56·0 cases per million doses of non-COVID-19 vaccine ( p=0·20).
The overall incidence of myopericarditis in the general population did not differ significantly after receipt of COVID-19 vaccines ( 18·2 cases [ 10·9–30·3 ] per million doses, high certainty) compared with non-COVID-19 vaccines ( 56·0 [ 10·7–293·7 ], moderate certainty, p=0·20; figure 2). Comparing COVID-19 vaccines with each type of non-COVID-19 vaccine found a significant difference between subpopulations ( global p < 0·0001). The incidence of myopericarditis was 132·1 ( 81·3–214·6) per million doses of smallpox vaccine ( p < 0·0001 vs COVID-19 vaccines), 1·3 ( 0·0–884·1) per million doses of influenza vaccine ( p=0·43), and 57·0 ( 1·1–3036·6) per million doses for studies reporting on a variety of vaccines ( p=0·58; appendix p 23). Between the adult subgroup ( 26·0 cases [ 11·8–57·4 ] per million doses; 298 508 729 doses, 14 studies) and paediatric subgroup ( 18·4 [ 4·7–72·9 ]; 12 145 663 doses, six studies), the incidence of myopericarditis did not differ significantly ( p=0·67; appendix p 24).
Among COVID-19 vaccines, the incidence of myopericarditis was significantly higher ( p=0·0010) among those who received mRNA vaccines ( 22·6 cases [ 12·2–42·0 ] per million doses; 290 730 653 doses, nine studies; figure 3) than among those who received non-mRNA vaccines ( 7·9 [ 7·2–8·7 ]; 51 969 677 doses, three studies). Furthermore, incidence of myopericarditis was significantly higher in people younger than 30 years than in people aged 30 years or older, in those receiving a second dose of vaccination than in those receiving a first or third dose, and in males than in females ( table; appendix pp 25–27). Among people younger than 30 years, the incidence of myopericarditis was approximately ten times higher in males than in females; for people older than 30 years, the incidence was around three times as high in males than in females ( table; appendix pp 28–29). Further details on the demographic and clinical characteristics of patients with myopericarditis following vaccination are summarised in the appendix ( pp 30–35). Time from vaccination to symptom onset was reported heterogeneously and hence these data were not pooled; nonetheless, most studies reported a window of 1–2 weeks before symptom presentation.Figure 3Incidence of myopericarditis following vaccination in studies investigating mRNA and non-mRNA COVID-19 vaccinesShow full captionThe pooled incidence of myopericarditis following COVID-19 vaccination was 22·6 cases per million doses of mRNA vaccine and 7·9 cases per million doses of non-mRNA vaccine ( p=0·0010).View Large Image Figure ViewerDownload Hi-res image Download ( PPT) TableSubgroup analyses among people who received COVID-19 vaccinesStudies, nVaccine doses, nMyopericarditis cases per million vaccine doses ( 95% CI) p valueType of vaccine...... 0·0010mRNA913Montgomery J Ryan M Engler R et al.Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military.JAMA Cardiol. 2021; 6: 1202-1206Google Scholar, 21Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar, 35Health InfoBase CanadaReported side effects following COVID-19 vaccination in Canada.https: //health-infobase.canada.ca/covid-19/vaccine-safety/Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 36Husby A Hansen JV Fosbøl E et al.SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study.BMJ. 2021; 375e068665Google Scholar, 41Medicines & Healthcare Products Regulatory AgencyCoronavirus ( COVID-19) vaccine adverse reactions.https: //www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions/coronavirus-vaccine-summary-of-yellow-card-reportingDate: Dec 24, 2021Date accessed: December 31, 2021Google Scholar290 730 65322·6 ( 12·2–42·0).. non-mRNA335Health InfoBase CanadaReported side effects following COVID-19 vaccination in Canada.https: //health-infobase.canada.ca/covid-19/vaccine-safety/Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 36Husby A Hansen JV Fosbøl E et al.SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study.BMJ. 2021; 375e068665Google Scholar, 41Medicines & Healthcare Products Regulatory AgencyCoronavirus ( COVID-19) vaccine adverse reactions.https: //www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions/coronavirus-vaccine-summary-of-yellow-card-reportingDate: Dec 24, 2021Date accessed: December 31, 2021Google Scholar51 969 6777·9 ( 7·2–8·7).. Age * Data extracted from the Therapeutic Goods Administration ( Australian Government Department of Health) 26 on Dec 31, 2021, were not amenable for these analyses; therefore, we opted to use data from our previous most recent update ( Oct 15, 2021), in which data of sufficient granularity were provided; all other analyses were conducted on the basis of data extracted on Dec 31, 2021....... < 0·0001 > 30 years321Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar143 154 7562·9 ( 1·8–4·7).. ≥30 years521Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar30 564 46440·9 ( 18·4–90·9).. Dosing * Data extracted from the Therapeutic Goods Administration ( Australian Government Department of Health) 26 on Dec 31, 2021, were not amenable for these analyses; therefore, we opted to use data from our previous most recent update ( Oct 15, 2021), in which data of sufficient granularity were provided; all other analyses were conducted on the basis of data extracted on Dec 31, 2021....... < 0·0001First dose813Montgomery J Ryan M Engler R et al.Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military.JAMA Cardiol. 2021; 6: 1202-1206Google Scholar, 21Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar, 30Diaz GA Parsons GT Gering SK Meier AR Hutchinson IV Robicsek A Myocarditis and pericarditis after vaccination for COVID-19.JAMA. 2021; 326: 1210-1212Google Scholar, 35Health InfoBase CanadaReported side effects following COVID-19 vaccination in Canada.https: //health-infobase.canada.ca/covid-19/vaccine-safety/Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 36Husby A Hansen JV Fosbøl E et al.SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study.BMJ. 2021; 375e068665Google Scholar54 971 4737·2 ( 3·8–14·0).. Second dose813Montgomery J Ryan M Engler R et al.Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military.JAMA Cardiol. 2021; 6: 1202-1206Google Scholar, 21Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar, 30Diaz GA Parsons GT Gering SK Meier AR Hutchinson IV Robicsek A Myocarditis and pericarditis after vaccination for COVID-19.JAMA. 2021; 326: 1210-1212Google Scholar, 35Health InfoBase CanadaReported side effects following COVID-19 vaccination in Canada.https: //health-infobase.canada.ca/covid-19/vaccine-safety/Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 36Husby A Hansen JV Fosbøl E et al.SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study.BMJ. 2021; 375e068665Google Scholar46 754 68631·3 ( 14·1–69·8).. Third dose135Health InfoBase CanadaReported side effects following COVID-19 vaccination in Canada.https: //health-infobase.canada.ca/covid-19/vaccine-safety/Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar2 643 2033·0 ( 1·5–6·1).. Sex * Data extracted from the Therapeutic Goods Administration ( Australian Government Department of Health) 26 on Dec 31, 2021, were not amenable for these analyses; therefore, we opted to use data from our previous most recent update ( Oct 15, 2021), in which data of sufficient granularity were provided; all other analyses were conducted on the basis of data extracted on Dec 31, 2021....... 0·0019Female521Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 35Health InfoBase CanadaReported side effects following COVID-19 vaccination in Canada.https: //health-infobase.canada.ca/covid-19/vaccine-safety/Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar123 336 6155·1 ( 2·3–11·5).. Male521Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 35Health InfoBase CanadaReported side effects following COVID-19 vaccination in Canada.https: //health-infobase.canada.ca/covid-19/vaccine-safety/Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar110 454 18223·0 ( 8·9–59·4).. Sex by age group * Data extracted from the Therapeutic Goods Administration ( Australian Government Department of Health) 26 on Dec 31, 2021, were not amenable for these analyses; therefore, we opted to use data from our previous most recent update ( Oct 15, 2021), in which data of sufficient granularity were provided; all other analyses were conducted on the basis of data extracted on Dec 31, 2021.Age < 30 years...... < 0·0001Male521Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar14 532 52759·7 ( 29·8–119·4).. Female421Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google Scholar16 161 9575·3 ( 3·6–8·0).. Age ≥30 years...... 0·034Male321Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar66 729 8014·0 ( 2·4–6·8).. Female321Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar76 424 9551·7 ( 0·9–3·1).. Forest plots of the studies included in these subgroup analyses are provided in the appendix ( pp 25–29). * Data extracted from the Therapeutic Goods Administration ( Australian Government Department of Health) 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar on Dec 31, 2021, were not amenable for these analyses; therefore, we opted to use data from our previous most recent update ( Oct 15, 2021), in which data of sufficient granularity were provided; all other analyses were conducted on the basis of data extracted on Dec 31, 2021. Open table in a new tab
The pooled incidence of myopericarditis following COVID-19 vaccination was 22·6 cases per million doses of mRNA vaccine and 7·9 cases per million doses of non-mRNA vaccine ( p=0·0010).
Forest plots of the studies included in these subgroup analyses are provided in the appendix ( pp 25–29).
Meta-regression among five studies based on the age-stratified incidence of myopericarditis after COVID-19 vaccination using robust variance estimates found that age was negatively associated with myopericarditis ( regression coefficient −0·069 [ 95% CI −0·094 to −0·045 ], p=0·0030, figure 4).21Mevorach D Anis E Cedar N et al.Myocarditis after BNT162b2 mRNA vaccine against COVID-19 in Israel.N Engl J Med. 2021; 385: 2140-2149Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar, 25Fleming-Nouri A Haimovich AD Yang D Schulz WL Coppi A Taylor RA Myopericarditis in young adults presenting to the emergency department after receiving a second COVID-19 mRNA vaccine.Acad Emerg Med. 2021; 28: 802-805Google Scholar, 26Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-24-12-2021Date: Dec 24, 2021Date accessed: December 31, 2021Google Scholar, 29Chua GT Kwan MYW Chui CSL et al.Epidemiology of acute myocarditis/pericarditis in Hong Kong adolescents following Comirnaty vaccination.Clin Infect Dis. 2021; ( published online Nov 28.) https: //doi.org/10.1093/cid/ciab989Google ScholarFigure 4Effect of age on incidence of myopericarditis following COVID-19 vaccinationShow full captionStrata-level meta-regression between age and logit-transformed robust-variance estimated incidence of myopericarditis following COVID-19 vaccination. Bubble sizes correspond to the weights of each study, which are computed as an inverse of the SE of the strata-level pooled estimate. Horizontal error bars correspond to the range of ages that each strata represents. Excluding people younger than 12 years, for whom few data were reported in the studies included, the incidence of myopericarditis increases as the mean age of each subgroup decreases.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Strata-level meta-regression between age and logit-transformed robust-variance estimated incidence of myopericarditis following COVID-19 vaccination. Bubble sizes correspond to the weights of each study, which are computed as an inverse of the SE of the strata-level pooled estimate. Horizontal error bars correspond to the range of ages that each strata represents. Excluding people younger than 12 years, for whom few data were reported in the studies included, the incidence of myopericarditis increases as the mean age of each subgroup decreases.
A post-hoc analysis was done to investigate the incidence of myopericarditis in patients with COVID-19 ( appendix pp 8–9, 36–37). Of 6181 studies, we assessed 393 full-text records and included 21 studies with 2 453 491 patients hospitalised with COVID-19 and had clinical or radiological suspicion for myopericarditis,45Bhatia KS van Gaal W Kritharides L Chow CK Bhindi R The incidence of cardiac complications in patients hospitalised with COVID-19 in Australia: the AUS-COVID study.Med J Aust. 2021; 215: 279Google Scholar, 46Boehmer TK Kompaniyets L Lavery AM et al.Association between COVID-19 and myocarditis using hospital-based administrative data—United States, March 2020–January 2021.MMWR Morb Mortal Wkly Rep. 2021; 70: 1228-1232Google Scholar, 47Buckley BJR Harrison SL Fazio-Eynullayeva E Underhill P Lane DA Lip GYH Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients.Eur J Clin Invest. 2021; 51e13679Google Scholar, 48Clark DE Parikh A Dendy JM et al.COVID-19 Myocardial pathology evaluation in athletes with cardiac magnetic resonance ( COMPETE CMR).Circulation. 2021; 143: 609-612Google Scholar, 49Cordeanu EM Duthil N Severac F et al.Prognostic value of troponin elevation in COVID-19 hospitalized patients.J Clin Med. 2020; 94078Google Scholar, 50Cuomo G Puzzolante C Iadisernia V et al.Development of post-COVID-19 cardiovascular events: an analysis of clinical features and risk factors from a single hospital retrospective study.Infez Med. 2021; 29: 538-549Google Scholar, 51Daniels CJ Rajpal S Greenshields JT et al.Prevalence of clinical and subclinical myocarditis in competitive athletes with recent SARS-CoV-2 Infection: results from the Big Ten COVID-19 Cardiac Registry.JAMA Cardiol. 2021; 6: 1078-1087Google Scholar, 52Daugherty SE Guo Y Heath K et al.Risk of clinical sequelae after the acute phase of SARS-CoV-2 infection: retrospective cohort study.BMJ. 2021; 373n1098Google Scholar, 53Deng Q Hu B Zhang Y et al.Suspected myocardial injury in patients with COVID-19: evidence from front-line clinical observation in Wuhan, China.Int J Cardiol. 2020; 311: 116-121Google Scholar, 54Doyen D Dupland P Morand L et al.Characteristics of cardiac injury in critically ill patients with coronavirus disease 2019.Chest. 2021; 159: 1974-1985Google Scholar, 55Finn A Jindal A Selvaraj V Authelet N Gutman NH Dapaah-Afriyie K Presentations and outcomes of severe cardiac complications in COVID-19: Rhode Island experience.R I Med J. 2021; 104: 8-13Google Scholar, 56Hendrickson BS Stephens RE Chang JV et al.Cardiovascular evaluation after COVID-19 in 137 collegiate athletes: results of an algorithm-guided screening.Circulation. 2021; 143: 1926-1928Google Scholar, 57Knight DS Kotecha T Razvi Y et al.COVID-19: myocardial injury in survivors.Circulation. 2020; 142: 1120-1122Google Scholar, 58Kunal S Sharma SM Sharma SK et al.Cardiovascular complications and its impact on outcomes in COVID-19.Indian Heart J. 2020; 72: 593-598Google Scholar, 59Laganà N Cei M Evangelista I et al.Suspected myocarditis in patients with COVID-19: a multicenter case series.Medicine ( Baltimore). 2021; 100e24552Google Scholar, 60Linschoten M Peters S van Smeden M et al.Cardiac complications in patients hospitalised with COVID-19.Eur Heart J Acute Cardiovasc Care. 2020; 9: 817-823Google Scholar, 61Mostafavi A Tabatabaei SAH Zamani Fard S Majidi F Mohagheghi A Shirani S The incidence of myopericarditis in patients with COVID-19.J Cardiovasc Thorac Res. 2021; 13: 203-207Google Scholar, 62Trimaille A Ribeyrolles S Fauvel C et al.Cardiovascular characteristics and outcomes of young patients with COVID-19.J Cardiovasc Dev Dis. 2021; 8: 165Google Scholar, 63Wang H Li R Zhou Z et al.Cardiac involvement in COVID-19 patients: mid-term follow up by cardiovascular magnetic resonance.J Cardiovasc Magn Reson. 2021; 23: 14Google Scholar, 64Weckbach LT Curta A Bieber S et al.Myocardial inflammation and dysfunction in COVID-19-associated myocardial injury.Circ Cardiovasc Imaging. 2021; 14e012220Google Scholar, 65Zeng JH Wu WB Qu JX et al.Cardiac manifestations of COVID-19 in Shenzhen, China.Infection. 2020; 48: 861-870Google Scholar among whom there were 48 904 cases of myopericarditis ( 1·1% [ 95% CI 0·5–2·2 ]; appendix p 37).
Across all vaccines, the incidence of myocarditis was 16·0 cases ( 95% CI 8·2–31·2) per million doses ( 180 995 007 doses, seven studies, moderate certainty; appendix p 38). The incidence of myocarditis was significantly lower ( p < 0·0001) among those receiving COVID-19 vaccines ( 8·9 [ 6·7–11·8 ]; 179 664 350 doses, five studies) than those receiving non-COVID-19 vaccines ( 79·4 [ 63·6–99·0 ]; 1 330 657 doses, two studies).
Pericarditis had an incidence across all vaccines of 16·7 cases ( 5·8–48·0) per million doses ( 169 138 458 doses, seven studies, moderate certainty; appendix p 39), and did not differ significantly ( p=0·64) between COVID-19 vaccines ( 10·1 [ 5·8–17·4 ], 166 286 019 doses, three studies) and non-COVID-19 vaccines ( 20·0 [ 1·2–328·5 ]; 2 852 439 doses, four studies; appendix p 39).
The pooled all-cause mortality following vaccination was 7·8 deaths ( 95% CI 1·8–34·7) per million doses ( 240 709 487 doses, ten studies, high certainty), and overall mortality was similar ( p=0·93) between COVID-19 vaccines ( 8·4 [ 2·0–35·9 ]; 238 540 345 doses, five studies) and non-COVID-19 vaccines ( 7·2 [ 0·2–217·5 ]; 2 169 142 doses, five studies; appendix p 40).
Our systematic review and meta-analysis shows that the incidence of myopericarditis in people who received COVID-19 vaccines was not significantly different from that in people who received non-COVID-19 vaccines in general, and was lower than that in people who received smallpox vaccines. Thus, the overall risk of myopericarditis appears to be no different for this very new group of vaccines against COVID-19 than for traditional vaccines against other pathogens. We also found that young men have a higher incidence of myopericarditis than others receiving mRNA COVID-19 vaccinations.
Among the general population, the background pre-pandemic incidence of myopericarditis varies greatly depending on age and sex,66Li X Ostropolets A Makadia R et al.Characterising the background incidence rates of adverse events of special interest for COVID-19 vaccines in eight countries: multinational network cohort study.BMJ. 2021; 373n1435Google Scholar, 67Halsell JS Riddle JR Atwood JE et al.Myopericarditis following smallpox vaccination among vaccinia-naive US military personnel.JAMA. 2003; 289: 3283-3289Google Scholar, 68Lin AH Phan HA Barthel RV et al.Myopericarditis and pericarditis in the deployed military member: a retrospective series.Mil Med. 2013; 178: 18-20Google Scholar and it is possible that it has been underestimated because of the existence of subclinical myopericarditis.69WHOWHO pharmaceuticals newsletter—N°4, 2021.https: //www.who.int/publications/i/item/who-pharmaceuticals-newsletter-n-4-2021Date: Aug 24, 2021Date accessed: January 21, 2022Google Scholar Overall, the background incidence of myopericarditis is estimated to be between 9·5 and 21·6 per million people per month,67Halsell JS Riddle JR Atwood JE et al.Myopericarditis following smallpox vaccination among vaccinia-naive US military personnel.JAMA. 2003; 289: 3283-3289Google Scholar, 68Lin AH Phan HA Barthel RV et al.Myopericarditis and pericarditis in the deployed military member: a retrospective series.Mil Med. 2013; 178: 18-20Google Scholar whereas the expected incidence of myopericarditis in vaccine recipients was 2·4 to 550 per million vaccinees.70Gubernot D Jazwa A Niu M et al.U.S. population-based background incidence rates of medical conditions for use in safety assessment of COVID-19 vaccines.Vaccine. 2021; 39: 3666-3677Google Scholar In our meta-analysis, the incidence of myopericarditis following vaccination was 18·2 cases ( 95% CI 10·9–30·3; 8·9 cases of myocarditis and 10·1 cases of pericarditis) per million COVID-19 vaccine doses and 56·0 ( 10·7–293·7) per million doses of non-COVID-19 vaccines. The background incidence of myocarditis is 8·3–16·7 per million people per month69WHOWHO pharmaceuticals newsletter—N°4, 2021.https: //www.who.int/publications/i/item/who-pharmaceuticals-newsletter-n-4-2021Date: Aug 24, 2021Date accessed: January 21, 2022Google Scholar and of pericarditis is 4·78–21·67 per million people per month.71Kumar N Pandey A Jain P Garg N Acute pericarditis-associated hospitalization in the USA: a nationwide analysis, 2003-2012.Cardiology. 2016; 135: 27-35Google Scholar, 72Mody P Bikdeli B Wang Y Imazio M Krumholz HM Trends in acute pericarditis hospitalizations and outcomes among the elderly in the USA, 1999–2012.Eur Heart J Qual Care Clin Outcomes. 2018; 4: 98-105Google Scholar Notably, the specific incidence of myopericarditis after smallpox vaccination was significantly higher than after COVID-19 vaccines, and the incidence following influenza and other vaccines was similar to that following COVID-19 vaccines. The studies reporting on smallpox vaccination were primarily done in US military personnel, most of whom would be young men, and could account for the increased incidence of myopericarditis in smallpox vaccinees. The increased incidence of myopericarditis after non-COVID-19 vaccination might suggest that myopericarditis is a side-effect of the inflammatory processes induced by vaccination and is not uniquely a result of exposure to SARS-CoV-2 spike proteins through COVID-19 vaccination or infection. The risks of such infrequent adverse events are outweighed by the benefits of vaccination, which include a lower risk of infection, hospitalisation, severe disease, and death from COVID-19.73McNamara LA Wiegand RE Burke RM et al.Estimating the early impact of the US COVID-19 vaccination programme on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 65 years and older: an ecological analysis of national surveillance data.Lancet. 2022; 399: 152-160Google Scholar, 74Tenforde MW Self WH Adams K et al.Association between mRNA vaccination and COVID-19 hospitalization and disease severity.JAMA. 2021; 326: 2043-2054Google Scholar In people aged 30 years or older, the incidence of post-vaccination myopericarditis was 2·9 cases ( 95% CI 1·8–4·7) per million vaccine doses. Being aware of a possible association between COVID-19 vaccination and myopericarditis, clinicians might have had an inherently lower threshold for investigating a patient with non-specific chest pain after COVID-19 vaccination, eventually leading to a diagnosis of myopericarditis. Additionally, given current robust vaccine surveillance systems and the fact that COVID-19 vaccines have received a much higher degree of scrutiny than previous vaccines, the possibility of relative under-reporting of adverse events following non-COVID-19 vaccinations can not be excluded, despite mass vaccination of more than 6 billion people in the past year.
Our analysis found that myopericarditis was more common among those who were male and under the age of 30 years. The findings of our analysis appear to be concordant with the literature: male sex and younger age groups are more susceptible to myopericarditis after COVID-19 vaccination.11Dagan N Barda N Balicer RD Adverse effects after BNT162b2 vaccine and SARS-CoV-2 infection, according to age and sex.N Engl J Med. 2021; 3852299Google Scholar, 24Bozkurt B Kamat I Hotez PJ Myocarditis with COVID-19 mRNA vaccines.Circulation. 2021; 144: 471-484Google Scholar Previous studies have shown that myocarditis after the second dose of an mRNA COVID-19 vaccine occurs clinically in approximately one in 10 000 young males,75Therapeutic Goods AdministrationAustralian Government Department of HealthCOVID-19 vaccine weekly safety report—02-12-2021.https: //www.tga.gov.au/periodic/covid-19-vaccine-weekly-safety-report-02-12-2021Date accessed: January 19, 2022Google Scholar which is approximately 50–100 times higher than expected ( based on claims made in 2017–19 from the IBM MarketScan Commercial Research Database).76Oster ME Shay DK Su JR et al.Myocarditis cases reported after mRNA-based COVID-19 vaccination in the US from December 2020 to August 2021.JAMA. 2022; 327: 331-340Google Scholar In the general population before the COVID-19 pandemic, the incidence of myocarditis was generally higher in males, and highest in young adults.77Kytö V Sipilä J Rautava P The effects of gender and age on occurrence of clinically suspected myocarditis in adulthood.Heart. 2013; 99: 1681-1684Google Scholar, 78Wang X Bu X Wei L et al.Global, regional, and national burden of myocarditis from 1990 to 2017: a systematic analysis based on the Global Burden of Disease Study 2017.Front Cardiovasc Med. 2021; 8692990Google Scholar Thus far, guidelines for COVID-19 vaccine-induced myopericarditis have mainly focused on early diagnosis and treatment,79Public Health EnglandCOVID-19 vaccination: myocarditis and pericarditis information for healthcare professionals.https: //www.gov.uk/government/publications/covid-19-vaccination-myocarditis-and-pericarditis-information-for-healthcare-professionalsDate: Aug 23, 2021Date accessed: October 17, 2021Google Scholar, 80Australian Government Department of HealthCOVID-19 vaccination—guidance on myocarditis and pericarditis after mRNA COVID-19 vaccines.https: //www.health.gov.au/resources/publications/covid-19-vaccination-guidance-on-myocarditis-and-pericarditis-after-mrna-covid-19-vaccinesDate: Sept 24, 2021Date accessed: October 17, 2021Google Scholar, 81WHOCOVID-19 subcommittee of the WHO Global Advisory Committee on Vaccine Safety ( GACVS): updated guidance regarding myocarditis and pericarditis reported with COVID-19 mRNA vaccines.https: //www.who.int/news/item/09-07-2021-gacvs-guidance-myocarditis-pericarditis-covid-19-mrna-vaccinesDate: July 9, 2021Date accessed: October 17, 2021Google Scholar, 82US Centers for Disease Control and PreventionClinical considerations: myocarditis and pericarditis after receipt of mRNA COVID-19 vaccines among adolescents and young adults.https: //www.cdc.gov/vaccines/covid-19/clinical-considerations/myocarditis.htmlDate: Aug 23, 2021Date accessed: October 17, 2021Google Scholar while some have recommended avoiding strenuous exercise for 2 weeks following vaccination.83Ministry of Health SingaporeExpert committee on COVID-19 vaccination: updates of assessment on myocarditis and pericarditis following vaccination with mRNA COVID-19 vaccines.https: //www.moh.gov.sg/news-highlights/details/expert-committee-on-covid-19-vaccination-updates-of-assessment-on-myocarditis-and-pericarditis-following-vaccination-with-mrna-covid-19-vaccinesDate: July 5, 2021Date accessed: October 17, 2021Google Scholar Several national guidelines also highlight the indications and contraindications for vaccine subtypes in this context.80Australian Government Department of HealthCOVID-19 vaccination—guidance on myocarditis and pericarditis after mRNA COVID-19 vaccines.https: //www.health.gov.au/resources/publications/covid-19-vaccination-guidance-on-myocarditis-and-pericarditis-after-mrna-covid-19-vaccinesDate: Sept 24, 2021Date accessed: October 17, 2021Google Scholar, 83Ministry of Health SingaporeExpert committee on COVID-19 vaccination: updates of assessment on myocarditis and pericarditis following vaccination with mRNA COVID-19 vaccines.https: //www.moh.gov.sg/news-highlights/details/expert-committee-on-covid-19-vaccination-updates-of-assessment-on-myocarditis-and-pericarditis-following-vaccination-with-mrna-covid-19-vaccinesDate: July 5, 2021Date accessed: October 17, 2021Google Scholar Although the prognosis of this self-limiting condition is generally good, long-term outcomes for affected patients after 3 months and 6 months are currently awaited.84Puchalski M Kamińska H Bartoszek M Brzewski M Werner B COVID-19-vaccination-induced myocarditis in teenagers: case series with further follow-up.Int J Environ Res Public Health. 2022; 193456Google Scholar
In people who received a COVID-19 vaccine, our results showed that myopericarditis was nearly four times as common in those receiving an mRNA vaccine than a non-mRNA vaccine and in those receiving their second dose of vaccine compared with a first or third dose. Similarly, a large study from Israel showed that mRNA COVID-19 vaccination was associated with a higher risk of myocarditis than the background population rate ( risk ratio 3·24 [ 95% CI 1·55–12·44 ]). Over 90% of people with myocarditis after mRNA COVID-19 vaccination were male, with a median age of 25 years ( IQR 20–34). The authors also highlighted an increased risk of myocarditis following COVID-19 infection ( risk ratio 18·28 [ 95% CI 3·95–25·12 ]).2Barda N Dagan N Ben-Shlomo Y et al.Safety of the BNT162b2 mRNA COVID-19 vaccine in a nationwide setting.N Engl J Med. 2021; 385: 1078-1090Google Scholar A study of cardiac MRI in young athletes recovered from COVID-19 showed a prevalence of myocarditis of 2·1%,85Daniels CJ Rajpal S Greenshields JT et al.Prevalence of clinical and subclinical myocarditis in competitive athletes with recent SARS-CoV-2 infection: results from the Big Ten COVID-19 Cardiac Registry.JAMA Cardiol. 2021; 6: 1078-1087Google Scholar whereas our post-hoc analysis of myopericarditis in patients hospitalised with COVID-19 with radiological or clinical suspicion of myopericarditis found a prevalence of 1·1% ( 95% CI 0·5–2·2).
It is well recognised that such rare adverse reactions are unlikely to be identified in phase 3 trials because sample sizes are not large enough to capture these events. Following the initial publication of results from phase 3 trials of mRNA vaccines, post-marketing evaluation, including those by the US Vaccine Adverse Event Reporting System, provides opportunities to implement vaccine programmes with more precision. As of December, 2021, the omicron variant is spreading rapidly around the world and is set to be the dominant variant globally in early 2022. Consequently, vaccination and booster vaccines will be of considerable importance,86Accorsi EK Britton A Fleming-Dutra KE et al.Association between 3 doses of mRNA COVID-19 vaccine and symptomatic infection caused by the SARS-CoV-2 omicron and delta variants.JAMA. 2022; 327: 639-651Google Scholar, 87Omer SB Malani PN Booster vaccination to prevent COVID-19 in the era of omicron: an effective part of a layered public health approach.JAMA. 2022; 327: 628-629Google Scholar particularly for mRNA vaccines, which can be manufactured rapidly.88Burki TK Omicron variant and booster COVID-19 vaccines.Lancet Respir Med. 2022; 10: e17Google Scholar Just as different population groups have been found to be more susceptible to thrombosis with thrombocytopenia syndrome ( TTS) after COVID-19 vaccination,89Long B Bridwell R Gottlieb M Thrombosis with thrombocytopenia syndrome associated with COVID-19 vaccines.Am J Emerg Med. 2021; 49: 58-61Google Scholar different population groups ( in our analysis, those of male sex and younger age) are more susceptible to myopericarditis. Just as there are appropriate strategies to address TTS, reasonable policies—such as preferentially offering a non-mRNA vaccine to males, particularly those younger than 18 years—could be considered to manage the risk of myopericarditis, while considering the overall benefits and harms of the vaccines. These policies will become more crucial as more countries begin offering booster doses of COVID-19 vaccines to more people under the age of 30 years. However, the risk and benefit calculations on such policy-making decisions must take into account the local epidemiology ( ie, the incidence rate of COVID-19 infection at the time and location that the decision is being made), whether there are other non-mRNA COVID-19 vaccines available, and the risk of morbidity from COVID-19 infection for that particular group, while recognising that such factors and decisions will be dynamic during a pandemic. It is also important to interpret the risks and benefits in the context of the background incidence of myopericarditis across subpopulations—ie, the risk of myopericarditis will depend on the prevailing prevalence of COVID-19 locally and at the time of vaccination.
There are three main strengths of our study. First, with a sample size of more than 400 million vaccine doses, to our knowledge, this study is the largest to quantify the incidence of myopericarditis post-vaccination. Second, we compared the incidence of myopericarditis between COVID-19 and non-COVID-19 vaccines, which gives an indication of whether COVID-19 vaccines increase the rate of myopericarditis compared with other routine non-COVID-19 vaccinations. Third, the analyses between subpopulations within those receiving COVID-19 vaccines help to clarify potential at-risk populations and could contribute to driving better vaccination policy-making decisions.
Nonetheless, we recognise several limitations of our analysis. Most of the studies included in our review did not report on outcomes of patients younger than 12 years receiving vaccination against COVID-19, as vaccination of this younger age group is relatively recent. As such, the findings of our review are not generalisable to children in that age group. Additionally, the comparisons made between COVID-19 and non-COVID-19 vaccines were made indirectly across studies from different time periods. There are far more sensitive tools ( eg, MRI, widespread echocardiography, or biopsy) being used currently that did not play as large a role in diagnosing myopericarditis previously in people receiving non-COVID-19 vaccines. This disparity introduces heterogeneity to the reporting and treatment of myopericarditis, which results in potential confounders within our analysis. There are other important vaccines ( including, but not limited to, those against hepatitis, Haemophilus influenzae, pneumococcus, and diphtheria, pertussis, and tetanus) that were under-represented in our analysis, suggesting that cases of myopericarditis after these commonly used vaccines occurred very rarely. Furthermore, the 95% CIs for the pooled estimate of non-COVID-19 vaccines were relatively wide, most likely due to two main factors: heterogeneity and variability in the type of vaccine ( for which we conducted a subgroup analysis of non-COVID-19 vaccine subtypes to explore as a potential source of heterogeneity), and imprecision resulting from a smaller sample size than that for COVID-19 vaccines. Because COVID-19 vaccines were developed in response to a new global pandemic, they have been administered at an unprecedented rate, with millions of doses given within a short period, unlike any of the comparator non-COVID-19 vaccines. As such, the relative incidence of myopericarditis following COVID-19 vaccination should be interpreted in this context, although it is probably more accurate than the incidence of non-COVID-19 vaccines. Our analysis is also based on study-level data, which limited our analysis of subpopulations. Although we were able to partially account for this by conducting a strata-level meta-regression analysis by age, more granular data are required to better guide the clinical decision-making process. Our analysis also uses data from registries and databases, which are inherently limited by the lack of longitudinal data, and some of the coded cases of myopericarditis might turn out to not have myopericarditis following further investigation of the symptoms. Some studies only reported the number of doses of vaccines that were administered. As a result, we had to analyse the incidence of myopericarditis by doses and not patients. Most of the studies included in our analysis did not report on myocarditis or pericarditis specifically, but grouped both complications under the umbrella term myopericarditis. Nonetheless, these remain the best data available on myopericarditis following vaccination. Additionally, myopericarditis occurring in temporal relation with COVID-19 vaccination can not always confirm a diagnosis of vaccine-induced myopericarditis, as it is difficult to distinguish it from myopericarditis due to other causes. Finally, our review was unable to account for the disease burden or severity of myopericarditis, which, while usually mild and self-limiting, can take a more fulminant course eventually requiring mechanical circulatory support. There are also other side-effects that were not addressed in this study that might influence a person's decision to receive a vaccination.
In conclusion, this meta-analysis of more than 400 million doses of vaccines suggests that the overall incidence of myopericarditis following COVID-19 vaccination is similar to that in the published literature on its incidence after influenza vaccination, and is lower than the incidence after live smallpox vaccination. The incidence of myopericarditis in younger males after mRNA COVID-19 vaccination is higher than expected by comparison with other age groups. The scale of mass global vaccination and enhanced surveillance might account for the increased reporting of this adverse event in the context of COVID-19 vaccination. Nonetheless, certain subpopulations—those of male sex or younger age and those receiving an mRNA vaccine, particularly the second dose—appear to be at increased risk of myopericarditis following COVID-19 vaccination. These findings are important additions to the conversation when weighing the risks and benefits of COVID-19 vaccination during this pandemic. Although the results of our analysis place the risks of COVID-19 vaccination into perspective, the decision to vaccinate should be informed by appropriately weighing the benefits and harms of COVID-19 vaccination, the local risk of exposure to COVID-19 infection at the time, and the risk of myopericarditis from COVID-19 infection itself.
KR and RRL designed the study and drafted the manuscript. RRL, KR, and FLT contributed to the search strategy, screening of articles, and data collection. RRL and FLT contributed to the risk of bias assessment and made the tables and figures. RRL, BCT, and KR contributed to data analysis and interpretation. KR, RRL, GM, JS, DF, and BCT contributed to critical revision of manuscript for intellectually important content. All authors provided critical conceptual input, interpreted the data analysis, and read and approved the final draft of the manuscript. RRL, FLT, and KR accessed and verified the data. RRL and KR were responsible for the decision to submit the manuscript for publication.
This manuscript makes use of publicly available data from the included studies and their supplementary information files; therefore, no original data are available for sharing.
KR has received honoraria for webinars unrelated to the topic from Baxter. All other authors declare no competing interests.
We thank Suei Nee Wong ( Medical Library, National University of Singapore) for her assistance with the search strategy and Megan Ruien Ling ( Yong Loo Lin School of Medicine, National University of Singapore) for her assistance with the screening of studies and data collection.
Download.pdf (.81 MB) Help with pdf files Supplementary appendix
Myopericarditis after COVID-19 vaccination: unexpected but not unprecedentedIn the midst of the devastating COVID-19 pandemic, rapid development of highly effective vaccines was enthusiastically welcomed. Unfortunately, myopericarditis after COVID-19 vaccination was an unanticipated adverse event. In The Lancet Respiratory Medicine, Ryan Ruiyang Ling and colleagues commendably review the risk of this adverse event in the context of risk after other vaccines.1 Their study provides an important perspective on the historical global experience with cardiac adverse events after vaccination. Full-Text PDF
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Biden tests negative for COVID again, White House says
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President Joe Biden has tested negative again for COVID-19, the White House said Monday. That result comes as a number of
officials in Washington, D.C.
, have tested positive for COVID in recent days, raising concerns at a time when the Biden administration's narrative is that the pandemic is under control. The daily averages for new COVID-19 cases, hospitalizations and deaths
all have ticked higher
. Biden also tested
negative on Friday
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'This can not last ': residents in locked down Shanghai scream from their balconies – video
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Shanghai, China's financial hub, started easing its lockdown in some areas on Monday, despite reporting a record high of more than 25,000 new Covid-19 infections, as authorities sought to get the city moving again after more than two weeks.
Pressure has been building on authorities in the country's most populous city – also one of its wealthiest – from residents growing increasingly frustrated as the curbs dragged on, leaving some struggling to find enough food and medicine.
Footage circulating online showed people screaming from their balconies, with the person filming claiming it was because people had grown tired of China's strict lockdown rules.
Source: As credited
Mon 11 Apr 2022 16.12 BST Last modified on Mon 11 Apr 2022 23.59 BST
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Jumbo-Visma stopping Wout van Aert from sharing Strava rides: 'We want to prevent speculation '
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Jumbo-Visma have asked Wout van Aert not to share his training data on Strava ahead of Paris-Roubaix at the weekend, with the Belgian returning to training after testing positive for Covid-19 on March 31.
General manager Richard Plugge clarified this decision, telling Het Laatste Neiuws ( opens in new tab): “ We want to prevent speculation. ''
Plugge said the decision on whether Van Aert will race the Monument depends on the extensive testing he will undergo in the coming days, which will determine his race fitness and capabilities. While he understands asking Van Aert not to share his training data on Strava makes everyone - fans and media alike - extra curious, Plugge also doesn't want to place any extra pressure on Van Aert to return at Paris-Roubaix.
The Belgian missed the opportunity to defend his Amstel Gold Race title yesterday ( Sunday), and would love to return on the cobbles of northern France. In the past week, doctors and pundits have both weighed into the debate on whether the Jumbo-Visma rider should compete in the race.
However, Plugge declined to comment on his return date, citing the effects Covid-19 can have on someone's health while addressing outside opinions.
`` We have made a very clear agreement with our medical management that we are more cautious than cautious. Also because we do not know the effects of Covid in the longer term. Your heart, your muscle metabolism, your lungs: it can all be affected.
“ I can't say anything sensible about it [ stating Van Aert's schedule ]. Wout is training and now we have to see how he develops. I read online that someone said he has a fifty-fifty chance. Well, it is, either he drives or he doesn't. ''
For now, Jumbo-Visma are studying the training Van Aert is completing and the subsequent rest he requires. Ensuring he is in a top physical condition is more important from the team's perspective than potentially challenging for the top step of the Paris-Roubaix podium, thus making his involvement in the race currently up in the air.
`` We follow his training closely, '' Plugge said. `` Before we decide, we will do extensive testing: to see if everything is okay with his heart and such. We look at it day by day. But one thing is certain: we are not taking any risks with the health of our riders. ”
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Citigroup Hires Feldkamp, Feige for North America ECM Business
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( Bloomberg) -- Citigroup Inc. hired two managing directors for its North America equity capital markets business from JPMorgan Chase & Co. and Barclays Plc, according to a memo obtained by Bloomberg.
Geoff Feldkamp, based in New York, joins from Barclays and will lead the bank’ s real estate and financial ECM business alongside Alex Ivanov, the memo shows.
Gregor Feige, most recently co-head of Asia ex-Japan ECM at JPMorgan, will co-lead the technology and communications ECM operations with Josh Li. He will be based in San Francisco.
Feldkamp and Feige will start in June and report to Paul Abrahimzadeh and Russell Chong, co-heads of North America ECM.
A representative for Citigroup confirmed the contents of the memo.
Citigroup collected $ 2.43 billion in equity underwriting fees last year, a 53% increase from a year earlier, as the frenzy in special purpose acquisition companies fueled business for the Wall Street giant.
The bank has increased its ECM headcount in North America by about 40% since the start of the coronavirus pandemic, Chong had said in an earlier interview.
Feldkamp worked at Barclays for more than 20 years in ECM. Feige relocated to Hong Kong with JPMorgan in 2019. He has covered technology, media and telecommunications ECM at the U.S. bank, as well as for Barclays.
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What Is Supply Chain Management Doing in 2022?
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MPO offers the world’ s only natively unified cloud platform for Multi-Party Orchestration. The platform complements existing…
It’ s been more than two years since the start of Covid-19 and the pandemic upended daily life as we know it.
While many countries, particularly more developed economies, are on the road to recovery, global supply chains remain severely disrupted - partly due to the pandemic, but also due to tensions around trade.
It’ s proven difficult to easily adapt to the disruptions in the supply chain: 84% of CFOs at organizations with annual revenue between $ 100 million to $ 3 billion see supply chain disruptions as either a moderate or severe risk.
In fact, the disruptions to the supply chain rank higher than all other threats, including talent shortages and even the resurgence of Covid-19.
From the rise in material and transportation costs to constant delays and shortages, it’ s become increasingly difficult for companies to exceed, let alone meet the demands of consumers, while still remaining profitable.
Faced with more bottlenecks, supply chains have become less reliable as companies try to toe the line between responding to and matching supply and demand.
One thing is clear: supply chain management will continue to face disruptions in 2022, and as executives continue to prioritize digital transformation, here are the key ways that supply chain cloud platforms are helping organizations build resilience and balance costs while meeting consumer demands.
Over the course of the pandemic, a lack of diversification caused many supply chains to be less resilient in the face of delays and cost increases.
Shipping costs have risen by as much as 600%. Most buyers with global supply chains primarily source their suppliers from China; having no alternatives, their supply chains face sudden, costly, and sometimes long-lasting, disruptions.
By putting all their eggs in one basket, businesses risk having a single point of failure that negatively impacts revenue. Diversifying the pool of available suppliers across various regions reduces production and sourcing costs and improves resilience.
While diversification can not happen overnight, and can often be challenging for organizations heavily dependent on certain regions, businesses can rely on Multi-Enterprise Supply Chain Business Network ( MESCBN) Technology to make the integration and onboarding process easier.
Supply chain software that unites multiple supplier networks into one platform also enables efficient supply management through continuous performance optimization over inbound management for faster and higher ROI.
Despite supply chain disruption, most businesses still rely on the just-in-time ( JIT) model, which attempts to minimize delays and costs by moving materials right before consumer demand requires it. By doing so, companies have traditionally been able to decrease costs both on storage and the transport process.
However, lean inventories require an intimate knowledge of the organization’ s supply chain, and an improper balance could lead to unwanted surprises on the consumer side. Businesses often attempt to offset the downside of a JIT supply chain model with safety stock, but the pandemic has shown that ensuring sufficient safety stock has been less than optimal, let alone being able to adapt to demand increases.
As businesses optimize their inventory management ( particularly within industries such as tech or automotive), it will require a custom-tailored approach to their current lean inventory strategy.
Supply chain cloud platforms can provide invaluable assistance for inventory optimization, particularly as organizations expand and work with multiple parties. With a centralized overview of all inventory, even if it’ s in transit or in 3rd-party locations, decision-makers can make dynamic changes to their supply chain in real-time. With increased insights, businesses can better forecast stock, allocate inventory to specific demographics, and proactively match supply through dynamic order planning.
As mentioned earlier, the costs of shipping and logistics are forecasted to continue rising in 2022. A combination of inflation, pandemic recovery, other global events, and increased shipping demand has led to sharp rises in contract rates across the freight sector. In fact, for parcel delivery services, the rate increase is the highest it’ s been in almost a decade. No matter the form of shipment, transportation demand will likely continue to increase throughout the rest of the year, if not into 2023.
With most, if not all, of the leverage lying in the hands of the freight sector, companies are aiming to become more resilient by managing costs through tighter control of daily operations. For example, multi-party control tower platforms offer extensive cost control capabilities with granular, real-time visibility into each node of the supply chain, continuous optimization across order planning and execution, and dynamic invoice matching.
With increased insight and control over finances – from customs to duties to handling – logistics managers can better understand their cost-to-serve and improve margins.
While many organizations’ immediate efforts are focused on mitigating supply chain disruptions, there is a rising trend towards incorporating sustainability in supply chains growth strategies, particularly as economies transition towards a post-pandemic outlook. In fact, 64% of CFOs believe that an Environmental, Social, and Governance ( ESG) program can improve their company’ s financial performance.
Given that many supply chains are still attempting to balance costs and services in the face of supply chain volatility, sustainability standards tend to happen on a high-level basis for now, instead of being incorporated on a daily operational level. This needn’ t be the case, as supply chain cloud platforms offer incredible opportunities to execute greener order flows and even calculate to reduce environmental impact per order.
Sustainable practices can also be built into the returns experience: With embedded intelligence, supply chain cloud platforms leverage smart business rules to optimize around return time windows or alternative carriers across the repair and replacement flow management.
As supply chains move past the initial impacts of the pandemic, it’ s likely that some organizations will quickly fall back into their old habits. But with trade tensions still present, it’ s almost certain that vulnerabilities to the supply chain will remain and resurface. By taking a proactive approach towards adopting resilience with the aid of multi-party orchestration supply chain platforms, organizations can be better prepared to withstand continuous disruptions.
The MPO Multi-Party Orchestration Platform enables dynamic and optimized supply chain management to help organizations regain control of their supply chain. By uniting multiple parties, systems, and processes on one single platform, businesses achieve end-to-end visibility, collaboration, and optimization across inventory, orders, logistics, and transportation, so they can better serve customers while lowering costs. Learn more about how your team can leverage such a solution to better manage supply chain complexity by downloading the whitepaper below.
MPO was named `` Visionary '' in Gartner's 2021 Magic Quadrant for Multienterprise Supply Chain Business Networks. To learn more about the platform's revolutionary approach to supply chain orchestration, download a complimentary copy of our white paper The “ Multi-Multi ” Supply Chain Problem That No One Is Talking About. You can also get in touch by reaching out to [ email protected ] or requesting a demo today!
The “ Multi-Multi ” Supply Chain Problem That No One Is Talking About In this white paper, we examine why the average organization is losing significant profits from supply chain disruptions and why we need to understand the deeper problem to change the outcome. Download Now!
The Age of the Multi-Enterprise Supply Chain Business Network This white paper offers insight into leveraging your network to derive the greatest possible value under any circumstance, such as through a Supply Chain Orchestration platform that can automate and streamline a wide range of your business needs. Download Now!
Multi-Party Orchestration Platform In this brochure, you 'll find a guide to MPO's unified cloud platform for multi-party orchestration, including its rich and flexible solutions: Control Tower, Supply Chain Visibility, Digital Order Management, Transportation Management, Network Inventory Management, Returns Management, Spare Parts Management, and Supply Management. Download Now!
OpenText™ operates the world’ s leading B2B network. Built on the strength…
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general
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INDUSTRIAL TECH ACQUISITIONS II, INC. Management's Discussion and Analysis of Financial Condition and Results of Operations. ( form 10-K)
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References to the `` Company, '' `` us, '' `` our '' or `` we '' refer to Industrial Tech Acquisitions II, Inc. The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our audited financial statements and related notes included herein.
Cautionary Note Regarding Forward-Looking Statements
All statements other than statements of historical fact included in this Report including, without limitation, statements under this `` Management's Discussion and Analysis of Financial Condition and Results of Operations '' regarding the Company's financial position, business strategy and the plans and objectives of management for future operations, are forward- looking statements. When used in this Report, words such as `` anticipate, '' `` believe, '' `` estimate, '' `` expect, '' '' intend '' and similar expressions, as they relate to us or the Company's management, identify forward-looking statements. Such forward-looking statements are based on the beliefs of management, as well as assumptions made by, and information currently available to, the Company's management. Actual results could differ materially from those contemplated by the forward- looking statements as a result of certain factors detailed in our filings with the SEC. All subsequent written or oral forward-looking statements attributable to us or persons acting on the Company's behalf are qualified in their entirety by this paragraph.
The following discussion and analysis of our financial condition and results of operations should be read in conjunction with the financial statements and the notes thereto contained elsewhere in this Report. Certain information contained in the discussion and analysis set forth below includes forward-looking statements that involve risks and uncertainties.
As of December 31, 2021, we had not commenced any operations. All activity for the period from January 4, 2021 ( inception) through December 31, 2021 relates to our formation and the initial public offering. We have neither engaged in any operations nor generated any revenues to date. We will not generate any operating revenues until after the completion of our initial business combination, at the earliest. We will generate non-operating income in the form of interest income and unrealized gains from the cash and marketable securities held in the trust account. We expect to incur increased expenses as a result of being a public company ( for legal, financial reporting, accounting and auditing compliance), as well as for due diligence expenses.
For the period from January 4, 2021 ( inception) through December 31, 2021, we had net loss of $ 3,758, which consisted of formation and operating costs of $ 3,768, partially offset by bank interest income of $ 10.
Liquidity, Going Concern and Capital Resources
As of December 31, 2021, we had $ 19,542 in our operating bank account, and working capital deficit of $ 191,888 ( excluding deferred offering costs). Our liquidity needs up to December 31, 2021 had been satisfied through a payment from the sponsor of $ 25,000 for the founder shares and proceeds from a promissory note to our sponsor.
Subsequent to the annual period covered by this annual report on Form 10-K, we consummated the initial public offering and private placement. Of the net proceeds from the initial public offering and private placement, $ 175,950,000 of cash was placed in the trust account and $ 1,319,675 of cash was held outside of the trust account and is available for working capital purposes.
In addition, in order to finance transaction costs in connection with a business combination, the sponsor or an affiliate of the sponsor, or certain of our officers and directors may, but are not obligated to, provide us working capital loans. As of December 31, 2021, there were no amounts outstanding under any working capital loans.
Based on the foregoing, management believes that we have alleviated the substantial doubt about our ability to continue as a going concern and has sufficient working capital and borrowing capacity to meet its needs through the earlier of the consummation of a business combination or one year from this filing. Over this time period, we will be using these funds to pay existing accounts payable, identifying and evaluating prospective initial business combination candidates, performing due diligence on prospective target businesses, paying for travel expenditures, selecting the target business to merge with or acquire, and structuring, negotiating and consummating the business combination.
Off-Balance Sheet Financing Arrangements
We did not have any off-balance sheet arrangements as of December 31, 2021, as defined in Item 303 ( a) ( 4) ( ii) of Regulation S-K.
As of December 31, 2021, we did not have any long-term debt, capital or operating lease obligations.
We have agreed to pay an affiliate of the sponsor a total of $ 10,000 per month for office space, utilities and secretarial and administrative support commencing on the date of the initial public offering. Upon completion of the initial business combination or liquidation, we will cease paying these monthly fees.
Management's discussion and analysis of our results of operations and liquidity and capital resources are based on our financial information. We describe our significant accounting policies in Note 2 - Significant Accounting Policies, of the Notes to Financial Statements included in this report. Our financial statements have been prepared in accordance with U.S. GAAP. Certain of our accounting policies require that management apply significant judgments in defining the appropriate assumptions integral to financial estimates. On an ongoing basis, management reviews the accounting policies, assumptions, estimates and judgments to ensure that our financial statements are presented fairly and in accordance with U.S. GAAP. Judgments are based on historical experience, terms of existing contracts, industry trends and information available from outside sources, as appropriate. However, by their nature, judgments are subject to an inherent degree of uncertainty, and, therefore, actual results could differ from our estimates.
Deferred offering costs consist of legal, accounting and other expenses incurred through the balance sheet date that were directly related to the initial public offering. Should the initial public offering prove to be unsuccessful, these deferred costs, as well as additional expenses to be incurred, will be charged to operations.
Derivative Financial Instruments
We do not use derivative instruments to hedge exposures to cash flow, market, or foreign currency risks. We evaluate all of our financial instruments, including issued stock purchase warrants to determine if such instruments are derivatives or contain features that qualify as embedded derivatives, pursuant to ASC 480 and ASC 815, `` Derivatives and Hedging '' ( `` ASC 815 ''). The classification of derivative instruments, including whether such instruments should be recorded as liabilities or as equity, will be re-assessed at the end of each reporting period. Derivative warrant liabilities will be classified as non-current liabilities as their liquidation is not reasonably expected to require the use of current assets or require the creation of current liabilities.
We account for private placement warrants for shares of our common stock that are not indexed to our own shares as liabilities at fair value on the balance sheet. The private placement warrants are subject to remeasurement at each balance sheet date and any change in fair value is recognized as a component of other income ( expense), net on the statement of operations. We will continue to adjust the liability for changes in fair value until the earlier of the exercise or expiration of the warrants. At that time, the portion of the warrant liability related to the warrants will be reclassified to additional paid-in capital.
Class A Common Stock Subject to Possible Redemption
Our Class A common stock that was sold as part of the units in the initial public offering contains a redemption feature which allows for the redemption of such public shares in connection with the our liquidation, or if there is a stockholder vote or tender offer in connection with the initial business combination. In accordance with ASC 480-10-S99, we classify such public shares subject to redemption outside of permanent equity as the redemption provisions are not solely within the control of us. The public shares sold as part of the units in the initial public offering was issued with other freestanding instruments ( i.e., public warrants) and as such, the initial carrying value of public shares classified as temporary equity was the allocated proceeds determined in accordance with ASC 470-20. The public shares are subject to ASC 480-10-S99 and are currently not redeemable as the redemption is contingent upon the occurrence of events mentioned above. According to ASC 480-10-S99-15, no subsequent adjustment is needed if it is not probable that the instrument will become redeemable.
Net loss per common share is computed by dividing net loss by the weighted average number of shares of common stock outstanding during the period, excluding common stock subject to forfeiture. Weighted average shares were reduced for the effect of an aggregate of 562,500 shares of common stock that were subject to forfeiture if the over-allotment option was not exercised by the underwriters. At December 31, 2021, we did not have any dilutive securities and other contracts that could, potentially, be exercised or converted into common stock and then share in the earnings of us. As a result, diluted loss per common share is the same as basic loss per common share for the period presented.
In August 2020, the Financial Accounting Standards Board ( `` FASB '') issued Accounting Standards Update ( `` ASU '') 2020-06, Debt - Debt with Conversion and Other Options ( Subtopic 470-20) and Derivatives and Hedging - Contracts in Entity's Own Equity ( Subtopic 815-40) ( `` ASU 2020-06 '') to simplify accounting for certain financial instruments. ASU 2020-06 eliminates the current models that require separation of beneficial conversion and cash conversion features from convertible instruments and simplifies the derivative scope exception guidance pertaining to equity classification of contracts in an entity's own equity. The new standard also introduces additional disclosures for convertible debt and freestanding instruments that are indexed to and settled in an entity's own equity. ASU 2020-06 amends the diluted earnings per share guidance, including the requirement to use the if-converted method for all convertible instruments. ASU 2020-06 is effective on January 1, 2024 for small reporting company and should be applied on a full or modified retrospective basis, with early adoption permitted beginning on January 1, 2021. We are currently assessing the impact, if any, that ASU 2020-06 would have on our financial position, results of operations or cash flows.
Management does not believe that any recently issued, but not effective, accounting pronouncements, if currently adopted, would have a material effect on our financial statements.
Factors That May Adversely Affect Our Results of Operations
Our results of operations and our ability to complete an initial business combination may be adversely affected by various factors that could cause economic uncertainty and volatility in the financial markets, many of which are beyond our control. Our business could be impacted by, among other things, downturns in the financial markets or in economic conditions, increases in oil prices, inflation, increases in interest rates, supply chain disruptions, declines in consumer confidence and spending, the ongoing effects of the COVID-19 pandemic, including resurgences and the emergence of new variants, and geopolitical instability, such as the military conflict in the Ukraine. We can not at this time fully predict the likelihood of one or more of the above events, their duration or magnitude or the extent to which they may negatively impact our business and our ability to complete an initial business combination.
© Edgar Online, source Glimpses
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business
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Japan's wholesale inflation stays near record on Ukraine war, weak yen
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While rising wholesale prices will help accelerate consumer inflation toward the central bank's elusive 2% target, it could hurt an economy still reeling from the coronavirus pandemic, analysts say.
The corporate goods price index ( CGPI), which measures the price companies charge each other for their goods and services, rose 9.5% in March from a year earlier, data showed.
That followed a revised 9.7% spike in February, which was the fastest pace on record, and exceeded a median market forecast for a 9.3% gain. The March index, at 112.0, was the highest level since December 1982, the Bank of Japan ( BOJ) said.
`` With raw material costs rising so much, companies won't be able to make money unless they raise prices. The days of discount war are over, '' said Takeshi Minami, chief economist at Norinchukin Research Institute.
`` Core consumer inflation may accelerate to around 2.5% later this year and stay above 2% for longer than initially expected, weighing on consumption and the economy, '' he said.
The yen-based import price index jumped 33.4% in March from a year earlier, the data showed, a sign the yen's recent declines are inflating the cost of imports for Japanese firms.
Japanese companies have been slow in passing on rising costs to households as soft wage growth weighed on consumption, keeping consumer inflation well below the BOJ's 2% target.
But analysts expect core consumer inflation to accelerate around 2% from April due to surging fuel costs and the dissipating effect of past cellphone fee cuts.
The rising inflationary pressure heightens the chance the BOJ will revise up its inflation forecast at its next quarterly review due April 28, analysts say. The bank's current forecast is for core consumer inflation to hit 1.1% in the year that began in April.
( Reporting by Leika Kihara; Editing by Sam Holmes)
By Leika Kihara
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business
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Dosing interval strategies for two-dose COVID-19 vaccination in 13 middle-income countries of Europe: Health impact modelling and benefit-risk analysis - The Lancet Regional Health – Europe
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BackgroundIn settings where the COVID-19 vaccine supply is constrained, extending the intervals between the first and second doses of the COVID-19 vaccine may allow more people receive their first doses earlier. Our aim is to estimate the health impact of COVID-19 vaccination alongside benefit-risk assessment of different dosing intervals in 13 middle-income countries ( MICs) of Europe.MethodsWe fitted a dynamic transmission model to country-level daily reported COVID-19 mortality in 13 MICs in Europe ( Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Bulgaria, Georgia, Republic of Moldova, Russian Federation, Serbia, North Macedonia, Turkey, and Ukraine). A vaccine product with characteristics similar to those of the Oxford/AstraZeneca COVID-19 ( AZD1222) vaccine was used in the base case scenario and was complemented by sensitivity analyses around efficacies similar to other COVID-19 vaccines. Both fixed dosing intervals at 4, 8, 12, 16, and 20 weeks and dose-specific intervals that prioritise specific doses for certain age groups were tested. Optimal intervals minimise COVID-19 mortality between March 2021 and December 2022. We incorporated the emergence of variants of concern ( VOCs) into the model and conducted a benefit-risk assessment to quantify the tradeoff between health benefits versus adverse events following immunisation.FindingsIn all countries modelled, optimal strategies are those that prioritise the first doses among older adults ( 60+ years) or adults ( 20+ years), which lead to dosing intervals longer than six months. In comparison, a four-week fixed dosing interval may incur 10.1% [ range: 4.3% - 19.0%; n = 13 ( countries) ] more deaths. The rapid waning of the immunity induced by the first dose ( i.e. with means ranging 60-120 days as opposed to 360 days in the base case) resulted in shorter optimal dosing intervals of 8-20 weeks. Benefit-risk ratios were the highest for fixed dosing intervals of 8-12 weeks.InterpretationWe infer that longer dosing intervals of over six months could reduce COVID-19 mortality in MICs of Europe. Certain parameters, such as rapid waning of first-dose induced immunity and increased immune escape through the emergence of VOCs, could significantly shorten the optimal dosing intervals.FundingWorld Health Organization.
In settings where the COVID-19 vaccine supply is constrained, extending the intervals between the first and second doses of the COVID-19 vaccine may allow more people receive their first doses earlier. Our aim is to estimate the health impact of COVID-19 vaccination alongside benefit-risk assessment of different dosing intervals in 13 middle-income countries ( MICs) of Europe.
We fitted a dynamic transmission model to country-level daily reported COVID-19 mortality in 13 MICs in Europe ( Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Bulgaria, Georgia, Republic of Moldova, Russian Federation, Serbia, North Macedonia, Turkey, and Ukraine). A vaccine product with characteristics similar to those of the Oxford/AstraZeneca COVID-19 ( AZD1222) vaccine was used in the base case scenario and was complemented by sensitivity analyses around efficacies similar to other COVID-19 vaccines. Both fixed dosing intervals at 4, 8, 12, 16, and 20 weeks and dose-specific intervals that prioritise specific doses for certain age groups were tested. Optimal intervals minimise COVID-19 mortality between March 2021 and December 2022. We incorporated the emergence of variants of concern ( VOCs) into the model and conducted a benefit-risk assessment to quantify the tradeoff between health benefits versus adverse events following immunisation.
In all countries modelled, optimal strategies are those that prioritise the first doses among older adults ( 60+ years) or adults ( 20+ years), which lead to dosing intervals longer than six months. In comparison, a four-week fixed dosing interval may incur 10.1% [ range: 4.3% - 19.0%; n = 13 ( countries) ] more deaths. The rapid waning of the immunity induced by the first dose ( i.e. with means ranging 60-120 days as opposed to 360 days in the base case) resulted in shorter optimal dosing intervals of 8-20 weeks. Benefit-risk ratios were the highest for fixed dosing intervals of 8-12 weeks.
We infer that longer dosing intervals of over six months could reduce COVID-19 mortality in MICs of Europe. Certain parameters, such as rapid waning of first-dose induced immunity and increased immune escape through the emergence of VOCs, could significantly shorten the optimal dosing intervals.
Research in context Evidence before this studyWe searched PubMed with the search terms “ ( COVID-19 OR coronavirus OR SARS-CoV-2) AND ( vaccine) AND ( delay second dose OR late second dose) ” on 8 November 2021 with no language restrictions. This returned 89 articles, of which 16 articles were relevant to inferring the health impact of different dosing intervals in high-income country settings. Based on the evidence synthesis of the relevant articles, we infer that optimal timing of dosing intervals for two-dose COVID-19 vaccines depends on multiple factors, including pre-existing naturally acquired immunity, serological response after first and second doses, vaccine efficacy and effectiveness after first and second doses, waning dynamics of vaccine-induced immunity, vaccination coverage, vaccine supply rates, variants of concern characteristics and country-specific vaccine prioritisation plans. Added value of this studyTo the best of our knowledge, this is the first health impact and benefit-risk assessment study of dosing interval strategies for two-dose COVID-19 vaccination outside of high-income settings. We assessed the health impact of COVID-19 vaccination for strategies using different dosing interval approaches after fitting to the COVID-19 mortality data for 13 middle income countries of Europe. We found that the strategy of prioritising the first dose coverage in older adults or adults was the optimal strategy to minimise COVID-19 mortality. Specific variants or vaccine characteristics, such as faster waning duration of the first dose, could significantly modify this conclusion – in which case, fixed dosing intervals between 8 and 20 weeks would be optimal. Implications of all the available evidenceThe optimal dosing intervals for two-dose COVID-19 vaccines are context-specific, depend on the underlying SARS-CoV-2 epidemiology in each country, and are sensitive to variants and vaccine characteristics. We showed that increasing the first dose coverage is key to minimising COVID-19 mortality. However, new evidence on parameters such as variants of concern's transmissibility and severity and ( vaccine- or infection-induced) protection waning rate should be incorporated into consideration as they emerge.
We searched PubMed with the search terms “ ( COVID-19 OR coronavirus OR SARS-CoV-2) AND ( vaccine) AND ( delay second dose OR late second dose) ” on 8 November 2021 with no language restrictions. This returned 89 articles, of which 16 articles were relevant to inferring the health impact of different dosing intervals in high-income country settings. Based on the evidence synthesis of the relevant articles, we infer that optimal timing of dosing intervals for two-dose COVID-19 vaccines depends on multiple factors, including pre-existing naturally acquired immunity, serological response after first and second doses, vaccine efficacy and effectiveness after first and second doses, waning dynamics of vaccine-induced immunity, vaccination coverage, vaccine supply rates, variants of concern characteristics and country-specific vaccine prioritisation plans.
To the best of our knowledge, this is the first health impact and benefit-risk assessment study of dosing interval strategies for two-dose COVID-19 vaccination outside of high-income settings. We assessed the health impact of COVID-19 vaccination for strategies using different dosing interval approaches after fitting to the COVID-19 mortality data for 13 middle income countries of Europe. We found that the strategy of prioritising the first dose coverage in older adults or adults was the optimal strategy to minimise COVID-19 mortality. Specific variants or vaccine characteristics, such as faster waning duration of the first dose, could significantly modify this conclusion – in which case, fixed dosing intervals between 8 and 20 weeks would be optimal.
The optimal dosing intervals for two-dose COVID-19 vaccines are context-specific, depend on the underlying SARS-CoV-2 epidemiology in each country, and are sensitive to variants and vaccine characteristics. We showed that increasing the first dose coverage is key to minimising COVID-19 mortality. However, new evidence on parameters such as variants of concern's transmissibility and severity and ( vaccine- or infection-induced) protection waning rate should be incorporated into consideration as they emerge.
By October 2021, 22 COVID-19 vaccines were in use globally.1Shrotri M. Swinnen T. Kampmann B. et al.An interactive website tracking COVID-19 vaccine development.The Lancet Global Health. 2021; 9: e590-e592Google Scholar However, vaccine supply has struggled to meet the global demand. Low- and middle-income countries ( LMICs) faced delays in vaccine roll-out. These constraints are expected to ease in late 2022 as additional production capacity becomes available.2CEPI, Gavi, UNICEF, WHO. COVAX global supply forecast [ Internet ]. 2021 [ cited 2021 Sep 16 ]. Available from: https: //www.gavi.org/news/document-library/covax-global-supply-forecastGoogle Scholar In the interim, it is vital that countries can maximise the health impact of the available vaccine supplies based on context-specific COVID-19 epidemiology and SARS-CoV-2 transmission dynamics, pre-existing immunity, and COVID-19 vaccine safety, immunogenicity, and efficacy.3Russell F.M. Greenwood B. Who should be prioritised for COVID-19 vaccination?.Hum Vaccin Immunother. 2021; 17: 1317-1321Google Scholar
Most of the available vaccines involve two doses with recommended between-dose intervals as tested in clinical trials. These dosing intervals are generally 3-4 weeks, although they may differ by vaccine product. However, in practice, countries may use dosing intervals longer than recommended due to a wide range of factors, including but not limited to administrative and logistic constraints ( e.g. vaccine clinic capacity), vaccine shortages, and the comparable and potentially higher vaccine efficacy using certain extended dosing intervals.4Voysey M. Clemens S.A.C. Madhi S.A. et al.Safety and efficacy of the ChAdOx1 nCoV-19 vaccine ( AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.Lancet. 2021; 397: 99-111Google Scholar Particularly, countries need to consider the tradeoff between partial protection ( induced by one dose) of a larger number of individuals versus full protection ( induced by two doses) of fewer individuals.
However, existing evidence on these tradeoffs has been limited and almost exclusively based on high-income settings.5Iacobucci G. Mahase E. Covid-19 vaccination: what's the evidence for extending the dosing interval?.BMJ. 2021; 372: n18Google Scholar Additionally, such evidence is either not based on observed epidemic history6Tuite A.R. Zhu L. Fisman D.N. et al.Alternative dose allocation strategies to increase benefits from constrained COVID-19 vaccine supply.Ann Intern Med. 2021; 174: 570-572Google Scholar, 7Paltiel A.D. Zheng A. Schwartz J.L. Speed versus efficacy: quantifying potential tradeoffs in COVID-19 vaccine deployment.Ann Intern Med. 2021; 174: 568-570Google Scholar, 8Moghadas S.M. Vilches T.N. Zhang K. et al.Evaluation of COVID-19 vaccination strategies with a delayed second dose.PLoS Biol. 2021; 19e3001211Google Scholar, 9Saad-Roy C.M. Morris S.E. Metcalf C.J.E. et al.Epidemiological and evolutionary considerations of SARS-CoV-2 vaccine dosing regimes.Science. 2021; 372: 363-370Google Scholar, 10Romero-Brufau S. Chopra A. Ryu A.J. et al.Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study.BMJ. 2021; 373: n1087Google Scholar ( and thus do not incorporate realistic existing immunity level, which is crucial to vaccine strategies) or only based on epidemic history in high-income settings11Silva P.J.S. Sagastizábal C. Nonato L.G. Struchiner C.J. Pereira T. Optimized delay of the second COVID-19 vaccine dose reduces ICU admissions.Proc Natl Acad Sci USA. 2021; 118Google Scholar; have not considered comprehensive vaccine effect mechanisms ( e.g., prevention of onward-transmission) or immune dynamics ( e.g., the potential waning after the first dose) 6Tuite A.R. Zhu L. Fisman D.N. et al.Alternative dose allocation strategies to increase benefits from constrained COVID-19 vaccine supply.Ann Intern Med. 2021; 174: 570-572Google Scholar, 7Paltiel A.D. Zheng A. Schwartz J.L. Speed versus efficacy: quantifying potential tradeoffs in COVID-19 vaccine deployment.Ann Intern Med. 2021; 174: 568-570Google Scholar, 8Moghadas S.M. Vilches T.N. Zhang K. et al.Evaluation of COVID-19 vaccination strategies with a delayed second dose.PLoS Biol. 2021; 19e3001211Google Scholar,10Romero-Brufau S. Chopra A. Ryu A.J. et al.Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study.BMJ. 2021; 373: n1087Google Scholar,11Silva P.J.S. Sagastizábal C. Nonato L.G. Struchiner C.J. Pereira T. Optimized delay of the second COVID-19 vaccine dose reduces ICU admissions.Proc Natl Acad Sci USA. 2021; 118Google Scholar; have not accounted for the effects of variants of concern ( VOCs) emergence6Tuite A.R. Zhu L. Fisman D.N. et al.Alternative dose allocation strategies to increase benefits from constrained COVID-19 vaccine supply.Ann Intern Med. 2021; 174: 570-572Google Scholar, 7Paltiel A.D. Zheng A. Schwartz J.L. Speed versus efficacy: quantifying potential tradeoffs in COVID-19 vaccine deployment.Ann Intern Med. 2021; 174: 568-570Google Scholar, 8Moghadas S.M. Vilches T.N. Zhang K. et al.Evaluation of COVID-19 vaccination strategies with a delayed second dose.PLoS Biol. 2021; 19e3001211Google Scholar, 9Saad-Roy C.M. Morris S.E. Metcalf C.J.E. et al.Epidemiological and evolutionary considerations of SARS-CoV-2 vaccine dosing regimes.Science. 2021; 372: 363-370Google Scholar, 10Romero-Brufau S. Chopra A. Ryu A.J. et al.Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study.BMJ. 2021; 373: n1087Google Scholar, 11Silva P.J.S. Sagastizábal C. Nonato L.G. Struchiner C.J. Pereira T. Optimized delay of the second COVID-19 vaccine dose reduces ICU admissions.Proc Natl Acad Sci USA. 2021; 118Google Scholar; or have only tested for resource-abundant vaccine supply conditions applicable to high-income settings.7Paltiel A.D. Zheng A. Schwartz J.L. Speed versus efficacy: quantifying potential tradeoffs in COVID-19 vaccine deployment.Ann Intern Med. 2021; 174: 568-570Google Scholar,8Moghadas S.M. Vilches T.N. Zhang K. et al.Evaluation of COVID-19 vaccination strategies with a delayed second dose.PLoS Biol. 2021; 19e3001211Google Scholar
Moreover, there are concerns about the benefits of the COVID-19 vaccine versus the harms from adverse events following immunisation ( AEFI) depending on the age of the vaccinated individuals, which may change conclusions of the overall health benefits of vaccination.
The World Health Organisation commissioned this work to specifically generate country-level evidence outside of high-income settings to address this evidence gap. We used a mathematical modelling approach that incorporated two-dose dynamics to assess the health impacts ( i.e. COVID-19 mortality) of different dosing intervals in middle-income countries ( MICs) in Europe between March 2021 and December 2022. We aim to identify the optimal dosing interval strategy that minimises cumulative mortality or maximises the benefit-risk ratio. The evidence generated could inform COVID-19 vaccine policies as vaccines roll out - rapid shifts in policies have been shown feasible.12Department of Health, Northern IrelandIntroduction of Shorter Interval between Vaccine Doses. Department of Health, 2021https: //www.health-ni.gov.uk/news/introduction-shorter-interval-between-vaccine-dosesGoogle Scholar As the MICs in Europe represent a wide range of population age structures and epidemic histories, the evidence could be valuable to vaccine policies in LMICs elsewhere in the world facing similar issues.
We explored country-level dosing interval policy approaches: ( 1) by setting fixed dosing intervals of different lengths; ( 2) by setting coverage targets ( e.g. to first cover the entire adult population with the first dose). In the baseline scenario, we based the vaccine characteristics on those of the Oxford/AstraZeneca COVID-19 vaccine AZD1222 ( hereafter AZD1222, which accounts for the largest share in the COVAX initiative that aims at accelerating global access to COVID-19 vaccines).13GAVICOVAX Crosses Milestone of 500 Million Donated doses Shipped to 105 Countries. Gavi, the Vaccine Alliance, 2022https: //www.gavi.org/news/media-room/covax-crosses-milestone-500-million-donated-doses-shipped-105-countriesGoogle Scholar We followed up with extensive sensitivity analyses for vaccine characteristics similar to other COVID-19 vaccines.
We adapted CovidM, an existing transmission dynamic model of SARS-CoV-2, which has already been extensively described elsewhere,14Davies N.G. Kucharski A.J. Eggo R.M. et al.Centre for the Mathematical Modelling of Infectious Diseases COVID-19 working groupEffects of non-pharmaceutical interventions on COVID-19 cases, deaths, and demand for hospital services in the UK: a modelling study.Lancet Public Health. 2020; 5: e375-e385Google Scholar, 15Sandmann F.G. Davies N.G. Vassall A. et al.Centre for the Mathematical Modelling of Infectious Diseases COVID-19 working groupThe potential health and economic value of SARS-CoV-2 vaccination alongside physical distancing in the UK: a transmission model-based future scenario analysis and economic evaluation.Lancet Infect Dis. 2021; 21: 962-974Google Scholar, 16Davies N.G. Abbott S. Barnard R.C. et al.Estimated transmissibility and impact of SARS-CoV-2 lineage B.1.1.7 in England.Science. 2021; 372: eabg3055Google Scholar, 17Davies N.G. Barnard R.C. Jarvis C.I. et al.Association of tiered restrictions and a second lockdown with COVID-19 deaths and hospital admissions in England: a modelling study.Lancet Infect Dis. 2021; 21: 482-492Google Scholar, 18Barnard RC, Davies NG, Jit M, et al. Updated roadmap assessment – prior to delayed Step 4. London School of Hygiene and Tropical Medicine, 7 July 2021. Available from: https: //www.gov.uk/government/publications/lshtm-updated-roadmap-assessment-prior-to-delayed-step-4-7-july-2021Google Scholar, 19Liu Y. Morgenstern C. Kelly J. Lowe R. Jit M. CMMID COVID-19 Working GroupThe impact of non-pharmaceutical interventions on SARS-CoV-2 transmission across 130 countries and territories.BMC Med. 2021; 19: 40Google Scholar to estimate the health impact of COVID-19 vaccination. We attach the complete parameter table ( relevant for the entire Methods) and their references in Supplemental Table S1.
In brief, CovidM is an SEIR-type ( susceptible, exposed, infectious, and recovered) compartmental model consisting of 16 age groups ( 0-4 to 75+ years with five-year increments) to incorporate age-specific susceptibility, clinical fractions, population sizes, and contact patterns. Thirteen compartments were used to capture the population dynamics within and between age group ( Figure 1).Figure 1The conceptual diagram describes the underlying mathematical models of SARS-CoV-2 transmission dynamics and COVID-19 vaccination impact. S - susceptible; V1 - individuals protected by the first dose only; V2 - individuals protected by both doses; Sw - individuals who have received their first dose but the protection has waned; E - exposed; Ev1 - exposed progressed from individuals in V1; Ev2 - exposed progressed from individuals in V2; Ip - pre-clinical infectious individuals; Ic - clinical individuals; Is - subclinical individuals; R - recovered; Rv1 - previously infected individuals whose infection-induced immunity has yet to wane and who have received the first dose; Rv2 individuals whose infection-induced immunity has yet to wane and who have received both doses.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Compared to a classic SEIR model, this framework has several unique features. First, individuals protected by one and two doses are modelled separately ( V1 and V2 in Figure 1), allowing for the incorporation of dose-specific dynamics. Second, as evidence suggests,4Voysey M. Clemens S.A.C. Madhi S.A. et al.Safety and efficacy of the ChAdOx1 nCoV-19 vaccine ( AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.Lancet. 2021; 397: 99-111Google Scholar,20Voysey M. Costa Clemens S.A. Madhi S.A. et al.Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 ( AZD1222) vaccine: a pooled analysis of four randomised trials.Lancet. 2021; 397: 881-891Google Scholar we accounted for potential waning among those who have only received their first doses ( Sw in Figure 1). Leaving this element out would introduce a strong bias for longer dosing intervals. Third, recovered individuals could receive vaccinations ( Rv1 and Rv2 in Figure 1), which could help us explore how the existing prevalence of infection-induced immunity affect the optimal vaccine dosing strategy. In Europe, antibody tests have not been used to qualify individuals for vaccination. Some evidence suggests that previously infected individuals may have higher neutralising antibody responses.21Sasikala M. Shashidhar J. Deepika G. et al.Immunological memory and neutralizing activity to a single dose of COVID-19 vaccine in previously infected individuals.Int J Infect Dis. 2021; 108: 183-186Google Scholar However, the model has left out breakthrough infections among those with infection and vaccination history for dose accounting purposes ( i.e. making sure all individuals receive 0-2 doses). Fourth, to account for the significant deviation from the public's pre-pandemic routine, we used Google Community Mobility Index ( hereafter `` mobility index '') to adjust the contact matrices.22GoogleCOVID-19 Community Mobility Reports. Google, 2021https: //www.google.com/covid19/mobility/Google Scholar This scaling method has been previously presented elsewhere.23Liu Y. Sandmann F.G. Barnard R.C. et al.Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study.Lancet Reg Health Eur. 2022; 12100267Google Scholar A brief description can be found in the Supplemental Methods p22.
This model was fitted to the country-level daily reported COVID-19 deaths before March 2021 in 13 MICs in Europe: Albania, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Bulgaria, Georgia, Republic of Moldova, Russian Federation, Serbia, North Macedonia, Turkey, and Ukraine for three variables: infection introduction date, basic reproduction number, and under-reporting rate. Among these variables, the under-reporting rate is particularly relevant outside of high-income settings due to potential testing and reporting capacity constraints.
Country-specific fitted results can be found in the GitHub repository attached to this study. We did not fit the model to the remaining seven LMICs with the same WHO Region due to data availability ( n = 1), data sparsity issues ( < 10 deaths/ day throughout the fitting period, n = 4) or significant changes in ways tallying COVID-19 mortality ( n = 2). Country characteristics are captured by population age structures, age-specific contact patterns, changes in the mobility index, epidemic history, and immunity levels before vaccine introduction.
The objective of the fitting process is to reproduce daily COVID-19 mortality time-series by country, assuming each observed daily COVID-19 mortality count is sampled from an underlying Poisson distribution. The final model selected maximised the overall likelihood of the entire fitting window. The parameter set associated with the optimal model was identified using differential evolution algorithms for each country.24Mullen K. Ardia D. Gil D. et al.deoptim: an r package for global optimization by differential evolution.J Stat Softw. 2011; 40Google Scholar More details on the fitting process have been described in detail elsewhere.23Liu Y. Sandmann F.G. Barnard R.C. et al.Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study.Lancet Reg Health Eur. 2022; 12100267Google Scholar
Given this study's relatively short time horizon, we modelled COVID-19 severe cases and mortality as processes, apart from the population dynamics presented in Figure 1 ( i.e., there is no removal of individuals from the modelled population). The total COVID-19 severe case incidence and mortality is the product of age-specific infection counts, infection-hospitalisation risks/infection-fatality risks, and functions describing the delay between infection and hospitalisation/ mortality. Equations describing these processes can also be found in the Supplemental Methods p23.
In the base case scenario, we considered a vaccine product with characteristics similar to AZD1222 and incorporated five types of vaccine effects ( i.e. infection-, disease-, severe case-, mortality-, and onward transmission-reducing) into the model ( Figure 2, a). For the rationale behind specific parameters used, please refer to Supplemental Table S3.18Barnard RC, Davies NG, Jit M, et al. Updated roadmap assessment – prior to delayed Step 4. London School of Hygiene and Tropical Medicine, 7 July 2021. Available from: https: //www.gov.uk/government/publications/lshtm-updated-roadmap-assessment-prior-to-delayed-step-4-7-july-2021Google ScholarFigure 2 ( a) Vaccine efficacy by effect type, respectively describing onward transmission blocking, infection-, disease-, severe case- and mortality-reducing vaccine efficacies. ( b) Sensitivity analysis parameter set that describes a condition where longer dosing interval is associated with larger incremental change incurred by the second doses in infection- and disease-reducing vaccine efficacies. ( c) Vaccine supply and allocation conditions by dose. We assume a 24-week delay between the supply of first and second doses. We did not show strategies A2, A3 and A4 as they reflect incremental changes between A1 and A5. Each line represents a country. Refer to Table 1 for descriptions of vaccination strategies.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Given the substantial uncertainty around the estimates of vaccine efficacies and the possibility that a country may use other ( or multiple) vaccine products, we conducted sensitivity analyses over four dimensions around the values for infection- and disease-reducing vaccine efficacies for the first and second doses ( Supplemental Methods p24). This parameter space account for our best understanding of all vaccine products available ( e.g., mRNA vaccines). There is also limited evidence that suggests higher vaccine efficacy after the second dose when the dosing interval is longer than label recommendations.20Voysey M. Costa Clemens S.A. Madhi S.A. et al.Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 ( AZD1222) vaccine: a pooled analysis of four randomised trials.Lancet. 2021; 397: 881-891Google Scholar We explored how this may affect the optimal dosing strategy ( Figure 2, b).
We implemented a 14-day delay between vaccination ( i.e. doses administered) and immunisations ( i.e. protection developed).
There is evidence showing the potential waning of the first dose when the second dose has not been administered promptly.4Voysey M. Clemens S.A.C. Madhi S.A. et al.Safety and efficacy of the ChAdOx1 nCoV-19 vaccine ( AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.Lancet. 2021; 397: 99-111Google Scholar,20Voysey M. Costa Clemens S.A. Madhi S.A. et al.Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 ( AZD1222) vaccine: a pooled analysis of four randomised trials.Lancet. 2021; 397: 881-891Google Scholar In this study, we assume this waning process ( loss of protection from the vaccine) follows exponential decay with an average duration of 360 days. If this waning process occurs faster than expected ( e.g., due to VOC emergence), a shorter waning duration of 120 days was tested as a worst-case scenario sensitivity analysis. Additional sensitivity analyses tested even shorter waning durations as characteristics of future VOC are largely uncertain.
This study used two approaches to set dosing intervals ( Table 1) as some countries may choose to fix an n week dosing interval between the first and second doses for all individuals while others may aim to cover all individuals with the first dose before vaccinating anyone with the second dose. We expanded these two general approaches into seven dosing interval strategies ( Figure 2, c). We assume protection following the first dose may wane before the second dose is given; protection following the second dose, however, is assumed not to wane regardless of the dosing interval.Table 1Vaccination strategies.StrategyDescriptionA1Individuals will receive their 2nd doses 4 weeks after their first doses.A2Individuals will receive their 2nd doses 8 weeks after their first doses.A3Individuals will receive their 2nd doses 12 weeks after their first doses.A4Individuals will receive their 2nd doses 16 weeks after their first doses.A5Individuals will receive their 2nd doses 20 weeks after their first doses.B1Older adults will receive their 2nd doses after all older adults receive their first doses. Young adults will receive their 1st doses after older adults uptake targets are reached. Young adults will only receive 2nd doses when all young adults have received their 1st doses.B2Older adults will receive their 2nd doses after all individuals ( older adults + young adults) receive their first doses; young adults will receive their 2nd doses after older adults uptake targets are reached, and all young adults have received their first doseDefinitions of vaccine dosing strategies. Older adults: those above 60 years of age; young adults: those between 20 and 59 years of age. Open table in a new tab
Definitions of vaccine dosing strategies. Older adults: those above 60 years of age; young adults: those between 20 and 59 years of age.
We have previously shown that an age-based vaccine prioritisation strategy that targets older adults first ( i.e. 60+) and then moves on to young adults ( i.e. 20–59) consistently performs comparably or better than other age-based vaccine prioritisation strategies.23Liu Y. Sandmann F.G. Barnard R.C. et al.Optimising health and economic impacts of COVID-19 vaccine prioritisation strategies in the WHO European Region: a mathematical modelling study.Lancet Reg Health Eur. 2022; 12100267Google Scholar All dosing intervals we tested were in addition to this age-based vaccine prioritisation strategy.
We additionally assume the uptake goal for older adults is 90% and for young adults 70%. In other words, when the uptake level has reached 90% among those above 60 years, the vaccination program is considered complete for that age group and will move on to vaccinating adults. These two uptake thresholds are feasible based on age-specific uptake levels in countries with relatively fast vaccine roll-out in older adults.
We assumed the starting date of vaccination programs to be 01 March 2021 in LMICs from WHO press releases. Based on the COVAX vaccine supply forecast to inform vaccine supply,2CEPI, Gavi, UNICEF, WHO. COVAX global supply forecast [ Internet ]. 2021 [ cited 2021 Sep 16 ]. Available from: https: //www.gavi.org/news/document-library/covax-global-supply-forecastGoogle Scholar we set the vaccine supply targets of the first doses to be 3% of the total population by mid-2021 and 20% of the total population by the end of 2021. With a slightly faster rate, we assume this program will cover 50% of the population with their first dose by the end of 2022. In this study, we assume that the rate of vaccine supply captures both the availability of vaccine doses and limits on the resources needed to deliver the vaccine doses to vaccinees which constrain the speed of vaccine roll-out.
The roll-out timelines specified above are consistent with the slowest adaptors among MICs considered ( Supplemental Fig. S1). With these vaccination objectives, we explored the difference between strategies B1 and B2. When vaccine supply is much lower than explored here, B1 and B2 may lead to the same results as their algorithms only diverge after all older adults have been vaccinated with the first doses.
To investigate the impacts of vaccine supply delay, we assume the second dose will become available 24 weeks after their initial inoculation dates. As sensitivity analyses, we also explored supply delay levels at 12 and 52 weeks.
As vaccines roll out, contact levels within the population may recover. This study assumes contacts gradually recover to near pre-pandemic levels ( i.e. 90% recovery) over a year from March 2021 following a sigmoid function. We do not account for reactive public health and social measures in response to surging infections as the action threshold ( i.e. the definition of `` surging infections '') and the action intensity ( e.g. a lockdown or a face mask mandate) may vary significantly by country.
The emergence of VOCs may reduce the efficacy of vaccines. We investigated the potential effects of VOC emergence by modifying disease dynamics and vaccine efficacy. To reflect the impact of variants, we applied a 1.5x multiplier to transmissibility.16Davies N.G. Abbott S. Barnard R.C. et al.Estimated transmissibility and impact of SARS-CoV-2 lineage B.1.1.7 in England.Science. 2021; 372: eabg3055Google Scholar,18Barnard RC, Davies NG, Jit M, et al. Updated roadmap assessment – prior to delayed Step 4. London School of Hygiene and Tropical Medicine, 7 July 2021. Available from: https: //www.gov.uk/government/publications/lshtm-updated-roadmap-assessment-prior-to-delayed-step-4-7-july-2021Google Scholar,25Mishra S. Mindermann S. Sharma M. et al.Changing composition of SARS-CoV-2 lineages and rise of Delta variant in England.EClinicalMedicine. 2021; 39101064Google Scholar This effectively increases the reproduction number by 50% while other factors that influence the realized effective reproduction number ( e.g. contacts) remain constant. To capture the potential increase in severity, we implemented 50% increases in infection fatality and hospitalisation ratios regardless of vaccination status. We included a 40% reduction in infection-reducing vaccine efficacy to account for potential immune escape. This reduction in efficacy may also be interpreted as the rapid loss of infection-reducing protection after a potential VOC introduction. Other vaccine effect pathways ( i.e. disease-, severe cases- mortality-, onward transmission-reducing) were assumed to remain unchanged despite VOC emergence. These characteristics have been assumed based on current evidence around the Delta variant.18Barnard RC, Davies NG, Jit M, et al. Updated roadmap assessment – prior to delayed Step 4. London School of Hygiene and Tropical Medicine, 7 July 2021. Available from: https: //www.gov.uk/government/publications/lshtm-updated-roadmap-assessment-prior-to-delayed-step-4-7-july-2021Google Scholar,26Lopez Bernal J. Andrews N. Gower C. et al.Effectiveness of Covid-19 vaccines against the B.1.617.2 ( Delta) variant.N Engl J Med. 2021; 385: 585-594Google Scholar All changes described were introduced into the simulation processes on 15 April 2021 simultaneously, broadly aligning with the approximate timing of the large-scale emergence of the Delta variant in western Europe.27Callaway E. Delta Coronavirus variant: scientists brace for impact.Nature. 2021; 595: 17-18Google Scholar,28GISAIDGISAID-hCov19 Variants. GISAID, 2021https: //www.gisaid.org/hcov19-variants/Google Scholar
We used the cumulative mortality between 01 March 2021 and 31 December 2022 COVID-19 as the primary decision-making metric. The optimal dosing interval strategy minimises the cumulative mortality. As discussed above, COVID-19 mortality is the product of age-specific infection counts, infection-fatality ratios, and a temporal delay function representing the interval between becoming infected and dying of COVID-19 ( Supplemental Methods p23). We compare dosing interval strategies by calculating the percentage difference in cumulative mortality relative to the reference strategy B1.
In line with the previous parameterisation based on AZD1222, we quantified the risk of fatal AEFI based on major thromboembolic events ( blood clots) with low platelet count ( thrombocytopenia) as reported for the AZD1222. In the UK, up to 01 September 2021, there have been 416 cases in total, of which 45 cases occurred after the second dose.29UK GovernmentCoronavirus Vaccine - Weekly Summary of Yellow Card Reporting. UK Government, 2021https: //www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions/coronavirus-vaccine-summary-of-yellow-card-reportingGoogle Scholar A total of 72 deaths occurred, with 6 deaths reported after the second dose. Given the different number of doses given by age in the UK, the age-specific gradient of the risk of developing these serious AEFIs is about 20.5 per 1 million doses in individuals aged 18–49 years and 10.9 per 1 million doses in individuals aged ≥ 50 years after the first dose; and 0.9 per 1 million doses and 1.9 per 1 million doses after the second dose, respectively.29UK GovernmentCoronavirus Vaccine - Weekly Summary of Yellow Card Reporting. UK Government, 2021https: //www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions/coronavirus-vaccine-summary-of-yellow-card-reportingGoogle Scholar
Based on the results of the different dosing intervals in the main analysis, we used these age-specific rates of occurrence after the first and second dose, respectively, times the proportion of fatalities after the first and second dose to estimate the total number of fatal AEFIs based on the number of vaccine doses used in each country.
We then traded off the age-specific mortality from COVID-19 versus the age-specific mortality caused by AEFIs. We took the worst-performing dosing strategy in terms of mortality as the baseline to estimate the benefit-risk ratios, which quantify the benefit of additional deaths prevented by the vaccines versus the harm from additional deaths caused by AEFIs. For this analysis, strategy A1 is taken as the baseline to obtain positive results for the benefits ( and the benefit-risk ratios) to facilitate interpretation. If one was to consider a no-vaccination strategy ( which is highly unlikely for COVID-19 in general, and in particular for the countries included here), then all of the benefit-risk ratios against no-vaccination are expected to be greater than 1.0 given the estimated much larger rate of outcomes in SARS-CoV-2 positive cases among unvaccinated individuals than vaccinated individuals.30Hippisley-Cox J. Patone M. Mei X.W. et al.Risk of thrombocytopenia and thromboembolism after Covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study.BMJ. 2021; 374: n1931Google Scholar
All the program code and data used in the study are publicly accessible online at https: //github.com/yangclaraliu/COVID Vac Delay.
The funders were involved in study design, data collection, data analysis, data interpretation, writing of the report, and the decision to submit for publication. We had discussions and received feedback from the members of the WHO Strategic Advisory Group of Experts on Immunization ( SAGE) Working group on COVID-19 vaccine impact modelling and Immunisation, and Vaccines related Implementation Research Advisory Committee ( IVIR-AC). All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. This study was approved by the ethics committee ( Ref 26318) of the London School of Hygiene & Tropical Medicine.
With a 24-week delay in vaccine supply, under strategies A1 and A5, individuals could receive their second doses at the dosing interval prescribed ( i.e. 4-20 weeks). Under strategies B1 and B2, the second doses are not provided based on a fixed dosing interval - but on conditions that coverage targets have been met in target populations. The mean dosing intervals under strategy B1 range between 24 and 29 weeks and the median between 22 and 34 weeks. The mean dosing intervals under strategy B2 range between 45 and 57 weeks and the median between 43 and 56 weeks ( Figure 3). Under strategy B1, dosing intervals are bi-modally distributed, with the first peak representing the dosing intervals of older adults and the second peak representing the dosing intervals of young adults. The mean dosing interval among older adults under strategy B1 is comparable to strategy A5 in most countries and even strategy A4 in some countries ( e.g. Azerbaijan and Turkey).Figure 3COVID-19 dosing intervals under strategies B1 and B2. These dosing strategies do not prescribe fixed dosing intervals. Vaccine allocations depend on whether or not coverage goals have been met in specific target groups. The distributions are outputs from dose allocation algorithms that capture such conditional relationships. Refer to Table 1 for descriptions of vaccination strategies.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
In the sensitivity analysis with supply delay of 12 weeks, the dosing intervals for older adults under B1 were significantly shortened; with a supply delay of 52 weeks, the dosing intervals for the entire population were longer than baseline ( i.e. 24 weeks) ( See Supplemental Figs. S2 and S3 and Supplemental Table S4 for more details). Due to population age structure, the relationship between vaccine supply and population-level dosing intervals under B1 and B2 are not linear.
At the beginning of the simulated vaccine roll-out processes ( i.e. 01 March 2021), from model fitting, we estimated immunity levels in 13 MICs in the WHO European region to range from 5.89% to 30.8%.
Assuming VOC emergence and a mean first-dose waning duration of 360 days, B1 and B2 were optimal strategies for minimising COVID-19 mortality in all countries investigated and were comparable with each other ( Figure 4 a). Strategy A1 may be associated with on average 10.1% higher cumulative mortality between 01 March 2021 and 31 December 2022 [ range: 4.3% - 19.0%; n = 13 ( countries) ]. There is a negative association between dosing interval and relative cumulative mortality. Sensitivity analyses around vaccine supply delay show that under a severe delay ( i.e. 52 weeks), A5 emerged as the optimal strategy for a small number of countries, although in these cases, the difference between A5, B1 and B2 remained small ( i.e. within 5%) ( see Supplemental Fig. S4).Figure 4Percentage difference in mortality for different vaccination strategies relative to strategy B1. Each line represents a country. Detailed descriptions of the vaccine dosing strategies can be found in Table 1. Mean dosing intervals are presented as the second rows of x-axes labels ( unit = weeks). Results from sensitivity analyses around the first dose waning durations ( 360 days vs 120 days) and the emergence of variants of concern ( VOCs) are also presented.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Without VOC emergence, the advantages of strategy B1 are more evident ( Figure 4 b). The negative association between dosing interval and COVID-19 mortality is also observed. However, strategy B2 is worse off than B1 in Albania, Azerbaijan, and Turkey by more than 2.5% ( using the mortality under B1 as the denominator). Strategy A1 is associated with an average of 20.1% increase in cumulative mortality between 01 March 2021 and 31 December 2022 [ range: 0% –45.4%; n = 13 ]. Note that in countries where no additional outbreak occurs during this period, the proportional difference between any strategies relative to strategy B1 is 0. The superiority of B1 is robust to changes in supply delay levels tested in the sensitivity analyses ( see Supplemental Fig. S4).
Assuming a mean first-dose waning duration of 120 days, the superiority of strategy B1 is no longer evident. Optimal dosing strategies are shifted towards the range of A2 to A5 ( 8 to 20 weeks, Figure 4, c, d). We conducted additional sensitivity analyses using mean waning duration of 60 and 90 days and found that these parameters may further shift the optimal dosing intervals in some countries to as short as eight weeks ( see Supplemental Fig. S5).
There is still considerable uncertainty around the relationship between dosing interval and the vaccine efficacy achievable after the second dose of the COVID-19 vaccines.31Flaxman A. Marchevsky N.G. Jenkin D. et al.Reactogenicity and immunogenicity after a late second dose or a third dose of ChAdOx1 nCoV-19 in the UK: a substudy of two randomised controlled trials ( COV001 and COV002).Lancet. 2021; 398: 981-990Google Scholar In this study, we examined the extreme case where vaccine efficacy incrementally increases as dosing interval gets longer ( Figure 1, b). We fixed the first dose infection-reducing vaccine efficacy at 65% to make it comparable to the results from the base case scenarios.
With VOC emergence, the comparative advantage of strategy B1 and B2 compared to strategies A1-A5 becomes slightly higher ( Supplemental Fig. S6). Without VOC emergence, however, the advantage of strategy B1 and B2 over A1-A5 are of smaller magnitude if we consider the positive association between dosing interval and post-second-dose VEs.
While varying four dimensions of vaccine efficacy ( i.e. first and second doses infection- and disease-reducing effects), we found that strategies B1 and B2 were comparable ( within 5% difference) and advantageous for all countries investigated, consistent with the baseline results ( Supplemental Fig. S7).
The additional deaths prevented by dosing strategies compared to the reference strategy A1 was always greater than the additional deaths due to fatal adverse events caused by these strategies. Most benefit-risk ratios of vaccination strategies in comparison to reference strategy A1 were greater than the additional harms ( 97.8%; n=178/182, with and without VOC combined); in four ratios, the benefits of strategy A2 or B2 were smaller than those of strategy A1 ( A2 in Bosnia and Herzegovina, Serbia and Ukraine and B2 in Serbia). The additional benefits for strategies A2 and A3 were much greater than the additional harms among all other vaccination strategies, favouring a dosing interval of 8-12 weeks ( compared to 4 weeks). The dominant benefit of strategy A3 was even more pronounced in the absence of VOC emergence ( Figure 5 B).Figure 5Benefit-risk ratios of vaccination strategies. Benefit-risk ratios of the different dosing interval strategies in comparison to strategy A1 are presented. Strategies A1-A5 and B1-B2 are arranged broadly based on mean effective dosing intervals. Each line represents one country. The benefit-risk ratios quantify the change in deaths prevented by the vaccines versus caused by AEFIs as compared to strategy A1. Refer to Table 1 for descriptions of vaccination strategies.View Large Image Figure ViewerDownload Hi-res image Download ( PPT)
Although we did not include the health and societal benefits of avoiding non-fatal SARS-CoV-2 positive cases, the general trend of additional population health outcomes ( i.e., cases and severe disease, Supplemental Figs. S8 and S9) follows a similar trend as mortality, which indicates that including additional benefits should result in similar findings as shown in Figure 5.
We explored the health implications of different COVID-19 vaccine dosing interval scenarios in 13 middle-income countries in Europe. We explored seven strategies that involved either fixed dosing intervals of between 4 weeks and 20 weeks or a conditional policy that depended on vaccination goals being met. We found that vaccinating all older adults or adults with the first dose ( strategies B1 and B2) resulted in the lowest COVID-19 cumulative mortality, while a dosing interval of 4 weeks ( strategy A1) resulted in the largest number of cumulative mortality. Small cumulative mortality was associated with an early increase in the proportions of the population vaccinated with the first dose.
The optimal dosing strategies we have identified are all significantly longer than label recommendations ( i.e. 3-4 weeks), which were based on clinical trial designs. In future vaccine development efforts during a pandemic, besides biological and logistic factors, implementation factors may also be factored in when designing dosing intervals for trials. Additional dosing schedules that allow for vaccine policy flexibility should be explored as soon as possible.
The results we have observed are robust to different vaccine characteristics assumptions of vaccine efficacy estimates versus dosing interval relationships and to different vaccine supply delays tested in this study. We conservatively assumed baseline vaccine characteristics based on AZD 1222. Using vaccine candidates with potentially slower first dose waning profile ( e.g. mRNA vaccines),32Vasileiou E. Simpson C.R. Shi T. et al.Interim findings from first-dose mass COVID-19 vaccination roll-out and COVID-19 hospital admissions in Scotland: a national prospective cohort study.Lancet. 2021; 397: 1646-1657Google Scholar the advantage of strategies B1 and B2 will be even more evident.
Under the circulation of the wildtype and subsequently the Delta variant as modelled in this study, there is a negative association between dosing intervals and cumulative mortality when mean dosing intervals range between 4 and 26 weeks. This association may not persist with even longer dosing intervals of 43-56 weeks ( as in strategy B2). While longer-than-currently recommended dosing intervals may be beneficial in reducing COVID-19 mortality, exceptionally long dosing intervals should be cautioned against. In this study, we tested a set of VOC characteristics approximating the Delta variant ( by transmissibility and severity) assumed based on existing literature.16Davies N.G. Abbott S. Barnard R.C. et al.Estimated transmissibility and impact of SARS-CoV-2 lineage B.1.1.7 in England.Science. 2021; 372: eabg3055Google Scholar,18Barnard RC, Davies NG, Jit M, et al. Updated roadmap assessment – prior to delayed Step 4. London School of Hygiene and Tropical Medicine, 7 July 2021. Available from: https: //www.gov.uk/government/publications/lshtm-updated-roadmap-assessment-prior-to-delayed-step-4-7-july-2021Google Scholar,25Mishra S. Mindermann S. Sharma M. et al.Changing composition of SARS-CoV-2 lineages and rise of Delta variant in England.EClinicalMedicine. 2021; 39101064Google Scholar There is additional uncertainty around these parameters that are not captured in our study. Such uncertainty and other characteristics of VOCs may alter our results. A faster waning of the protection derived by the first dose made strategies with shorter, fixed dosing intervals ( i.e., A2-4) more favourable. A more transmissible yet less severe VOC ( like Omicron) will likely shrink the relative difference between different dosing interval strategies – at which point, other factors ( e.g., operational) should drive decisions.
When trading off the benefits of the vaccines in preventing deaths versus the harm from deaths caused by adverse events following immunisation, we found that the additional benefits of the strategies compared to strategy A1 exceeded the additional risks for most dosing interval scenarios. The ratio of benefits to risks was highest for strategies A2-A3 ( intervals of 8-12 weeks), following the age-dependent rates of ( prevented) deaths from COVID-19 and adverse events. Including additional outcomes and benefits for society is expected to lead to similar results.
Related studies in high-income country settings of Canada, Netherlands, the United Kingdom, and the United States also found that delaying the second dose of a two-dose COVID-19 vaccine series is beneficial.8Moghadas S.M. Vilches T.N. Zhang K. et al.Evaluation of COVID-19 vaccination strategies with a delayed second dose.PLoS Biol. 2021; 19e3001211Google Scholar,33Appelman B. van der Straten K. Lavell A.H.A. et al.Time since SARS-CoV-2 infection and humoral immune response following BNT162b2 mRNA vaccination.EBioMedicine. 2021; 72103589Google Scholar, 34Yassi A. Grant J.M. Lockhart K. et al.Infection control, occupational and public health measures including mRNA-based vaccination against SARS-CoV-2 infections to protect healthcare workers from variants of concern: a 14-month observational study using surveillance data.PLoS ONE. 2021; 16e0254920Google Scholar, 35Parry H. Bruton R. Stephens C. et al.Extended interval BNT162b2 vaccination enhances peak antibody generation.NPJ Vaccines. 2022; 7: 14Google Scholar Moghadas et al. used an agent-based model to compare two strategies of either vaccinating more individuals with the first dose and delaying the second dose or administering the 2-dose series according to the recommended dose spacing for Pfizer-BioNTech ( BNT162b2) and Moderna ( mRNA-1273) vaccines.8Moghadas S.M. Vilches T.N. Zhang K. et al.Evaluation of COVID-19 vaccination strategies with a delayed second dose.PLoS Biol. 2021; 19e3001211Google Scholar They suggested that depending on pre-existing immunity levels, additional hospitalisations and deaths could be averted by delaying the second dose due to vaccine prioritisation of individuals at higher risk of severe outcomes. Romero-Brufau et al. conducted a similar study to assess the cumulative public health impact over 6 months for delaying the second dose of Pfizer-BioNTech and Moderna vaccines and inferred that the delayed second-dose strategy for people under 65 years was a favourable strategy.10Romero-Brufau S. Chopra A. Ryu A.J. et al.Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study.BMJ. 2021; 373: n1087Google Scholar Based on evidence synthesis of related studies36Hill E.M. Keeling M.J. Comparison between one and two dose SARS-CoV-2 vaccine prioritization for a fixed number of vaccine doses.J R Soc Interface. 2021; 1820210214Google Scholar, 37Nam A, Ximenes R, Yeung MW, et al. Modelling the impact of extending dose intervals for COVID-19 vaccines in Canada. medRxiv. 2021; ( published online Apr 10.) ( preprint) https: //doi.org/10.1101/2021.04.07.21255094.Google Scholar, 38Matrajt L. Eaton J. Leung T. et al.Optimizing vaccine allocation for COVID-19 vaccines shows the potential role of single-dose vaccination.Nat Commun. 2021; 12: 3449Google Scholar and our study, we infer that for two-dose vaccines, the optimal dosing interval depends on multiple factors, including vaccine efficacy and effectiveness, waning dynamics of vaccine-induced immunity, vaccination coverage, vaccine supply rates, pre-existing naturally acquired immunity, and country-specific vaccine prioritisation plans.
In our study, we fitted a dynamic transmission model using reported daily COVID-19 mortality in 13 middle-income countries of Europe. We incorporated important epidemic dynamics, including VOC emergence and dosing dynamics ( e.g. post-first-dose waning and the co-existence between natural infection and vaccination history). We explored a wide range of dosing interval strategies of prime interest to countries that may face constraints in vaccine supply. We performed extensive sensitivity analyses around key epidemiological parameters like the emergence of variants of concern and vaccine efficacy estimates. We extended the analysis by trading off the vaccines ' benefits against the potential harm from adverse events following immunisation with the COVID-19 vaccines.
We captured between-country variability through population age structure, contact matrices, mobility and government response stringency index. However, the effect of these variables on SARS-CoV-2 transmission may differ between countries due to additional factors that we were not able to capture. For example, the Google mobility index we used to represent mobility may be less representative in countries with lower smartphone usage. The relationship between the mobility index and interpersonal contacts was established using data from the United Kingdom, which may be partially representative of other countries.
We could not extend the fitting window of this study further into 2021 or include spatial diffusion component ( as did Cot et al.39Cot C. Cacciapaglia G. Islind A.S. et al.Impact of US vaccination strategy on COVID-19 wave dynamics.Sci Rep. 2021; 11: 10960Google Scholar) due to data availability issues ( e.g. age-specific vaccine uptake, vaccine products in-use, strain-specific test positive rates, number of travellers between countries). Such data, have they become available, could improve model fit for future research. We have not incorporated reactive public health and social measures ( e.g. lockdown enacted due to surging infections) as the specific implications are uncertain and country-specific. We were unable to capture breakthrough infections or vaccine waning among vaccinated individuals who have experienced previous infections. These pathways are biologically sound but would make it challenging to track vaccine allocations ( e.g. making sure everyone only receives two doses). Given that these mechanisms are not widely characterised by empirical data, we did not include them in this study. We also did not explicitly look into the effect of vaccine reformulations with Omicron-specific strains that may become available later in 2022.
Our study shows that a dose-specific roll-out strategy that led to an average six-month dosing interval, which is substantially longer than the current label recommendation for most vaccine products available in the European market, may be able to minimise COVID-19 mortality in the MICs in Europe. Countries included in this study have diverse population age structures, contact patterns, and epidemic histories – the overall conclusions are valuable to COVID-19 vaccine dosing policy-making in LMICs elsewhere in the world.
YL, FGS, MJ, and KA conceptualised the study. YL, CABP, and FGS developed the model and conducted the health impact assessment and benefit-risk analysis. RCB compiled the evidence on vaccine efficacy estimates. JHK and SF interpreted the comparative analysis of dosing interval strategies. YL wrote the original draft, and all authors contributed to reviewing and editing the manuscript for important intellectual content and have approved the final version.
We declare no competing interests.
We are grateful for the helpful discussions and feedback from Nicholas Grassly ( Imperial College London), Raymond Hutubessy ( World Health Organization), Sarah Pallas ( Centers for Disease Control and Prevention), and members of the WHO Strategic Advisory Group of Experts on Immunization ( SAGE) Working group on COVID-19 vaccine impact modelling and Immunisation and Vaccines related Implementation Research Advisory Committee ( IVIR-AC). We thank Nicholas G Davies ( LSHTM) for his work on CovidM, upon which this analysis has been built upon. We thank the reviewers for their feedback, which helped us improve this manuscript.
We thank the following agencies for their support: World Health Organization ( 202683881, 202604060), Bill & Melinda Gates Foundation ( INV-009125, INV-003174, OPP1184344), European Commission ( 101003688), Medical Research Council ( MC PC 19065), National Institute of Health Research ( 200929), Foreign, Commonwealth and Development Office ( UK) /Wellcome Trust ( 221303/Z/20/Z), Wellcome Trust ( 208812/Z/17/Z). FGS and MJ were supported by the NIHR Health Protection Research Unit ( HPRU) in Modelling and Health Economics, a partnership between Public Health England ( PHE), Imperial College London, and the London School of Hygiene & Tropical Medicine ( LSHTM; grant code NIHR200908). MJ was supported by the NIHR HPRU in Immunisation at LSHTM in partnership with PHE ( grant reference code NIHR200929).
We would like to acknowledge the support we received from the CMMID Working Group members: Christopher I Jarvis, Rachael Pung, C Julian Villabona-Arenas, Katharine Sherratt, Kerry LM Wong, Simon R Procter, Katherine E. Atkins, Paul Mee, Samuel Clifford, Hamish P Gibbs, Oliver Brady, David Hodgson, James D Munday, Nikos I Bosse, Timothy W Russell, Nicholas G. Davies, Sebastian Funk, William Waites, Emilie Finch, Joel Hellewell, Sam Abbott, Adam J Kucharski, Lloyd A C Chapman, Ciara V McCarthy, Yalda Jafari, Amy Gimma, Gwenan M Knight, Alicia Rosello, Billy J Quilty, Rachel Lowe, Graham Medley, Mihaly Koltai, Matthew Quaife, Kathleen O'Reilly, Sophie R Meakin, Stéphane Hué, Akira Endo, Damien C Tully, W John Edmunds, Kiesha Prem, Rosalind M Eggo.
They are partly funded by the Bill & Melinda Gates Foundation ( INV-001754: MQ; INV-003174: KP; INV-016832: SRP; NTD Modelling Consortium OPP1184344: GFM; OPP1139859: BJQ; OPP1191821: KO ' R). CADDE MR/S0195/1 & FAPESP 18/14389-0 ( PM). EDCTP2 ( RIA2020EF-2983-CSIGN: HPG). ERC Starting Grant ( # 757699: MQ). ERC ( SG 757688: CJVA, KEA). This project has received funding from the European Union's Horizon 2020 research and innovation programme - project EpiPose ( 101003688: AG, KLM, KP, WJE). This research was partly funded by the Global Challenges Research Fund ( GCRF) project ‘ RECAP’ managed through RCUK and ESRC ( ES/P010873/1: CIJ). HDR UK ( MR/S003975/1: RME). HPRU ( This research was partly funded by the National Institute for Health Research ( NIHR) using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author ( s) and not necessarily those of the NIHR or the UK Department of Health and Social Care200908: NIB). MRC ( MR/N013638/1: EF; MR/V027956/1: WW). Nakajima Foundation ( AE). NIHR ( 16/136/46: BJQ; 16/137/109: BJQ; 1R01AI141534-01A1: DH; NIHR200908: AJK, LACC, RME; NIHR200929: CVM, NGD; PR-OD-1017-20002: AR, WJE). Royal Society ( Dorothy Hodgkin Fellowship: RL). Singapore Ministry of Health ( RP). UK DHSC/UK Aid/NIHR ( PR-OD-1017-20001: HPG). UK MRC ( MC PC 19065 - Covid 19: Understanding the dynamics and drivers of the COVID-19 epidemic using real-time outbreak analytics: NGD, RME, SC, WJE; MR/P014658/1: GMK). UKRI ( MR/V028456/1: YJ). Wellcome Trust ( 206250/Z/17/Z: AJK, TWR; 206471/Z/17/Z: OJB; 208812/Z/17/Z: SC; 210758/Z/18/Z: JDM, JH, KS, SA, SFunk, SRM; 221303/Z/20/Z: MK). No funding ( DCT, SH)
All data used in this study is publicly available and can be accessed via the references cited. All code used in this study can be found on GitHub: https: //github.com/yangclaraliu/COVID Vac Delay.
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tech
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Microsoft Stock Slips on Concern About Growth for Office 365
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Microsoft Office is one of the company's biggest businesses.
Dreamstime
Microsoft
shares are under pressure from concerns about how the company might be affected by slowing growth in the PC market. In particular, there are worries about what comes next for the robust growth the software giant has been generating for Office 365, its flagship productivity software.
As
Barron’ s
reported earlier
, new data from IDC show that global PC shipments fell 5.1% from a year ago in the March quarter, following the spike in demand over the past two years that resulted from the Covid-19 pandemic. The figures underscore other recent data suggesting that demand for consumer PCs, in particular, will soften as more people return to working from offices.
UBS analyst Karl Keirstead pointed out in a research note Monday that the Microsoft ( ticker: MSFT) Office 365 business is expected to have $ 35.1 billion in sales for the June 2022 fiscal year, having grown between 19% and 21% over each of the past six quarters. Office is now Microsoft’ s second-largest business, after Azure, its cloud computing platform, he said.
The “ Office 365 juggernaut is likely to begin a gentle deceleration, ” given the high penetration rate among commercial PC users and the fading work-from-home benefit supplied by the pandemic, he wrote after speaking with industry sources. The company didn’ t immediately respond to a request for comment.
Keirstead wrote that the evidence suggests Microsoft has crushed
Alphabet
’ s
efforts to compete with Microsoft with the Google G Suite. “ Our checks argue that the Google Cloud leadership has all but given up on the goal to displace Microsoft Office 365 in the enterprise segment and has instead shifted its efforts to boost [ Google Cloud’ s ] competitiveness against Azure, ” he wrote.
Still, he said, Microsoft’ s huge success in the office productivity market has reduced the remaining growth opportunity. His financial model now reflects commercial Office 365 revenue growth of 17.4% for fiscal 2023, down from 19.1% previously.
The analyst said he is also trimming his estimates for a few other elements of Microsoft’ s business, including Windows, to reflect “ higher risk of a PC growth slowdown. ” And he now sees a possibility that management’ s guidance for the June quarter could be lower than Wall Street expects. His new forecast for June quarter revenue is $ 52.569 billion, down from a previous estimate of $ 53.226 billion, and below the Street consensus call of at $ 52.89 billion.
That said, Keirstead repeated his Buy rating and $ 360 target price on Microsoft shares. The stock is likely to be viewed as a haven in the event of a downturn in the economy later this year or early next year, he said.
Microsoft was down 3.3%, to $ 287.33 on Monday afternoon.
Write to Eric J. Savitz at
eric.savitz @ barrons.com
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business
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India Hopes ‘ Pharma City’ Will Break China’ s Grip on Industry
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Tablets are scanned on the production line at a Laurus Labs manufacturing facility in Visakhapatnam. Photographer: Dhiraj Singh/Bloomberg, Photographer: Dhiraj Singh/Bloomberg
( Bloomberg) -- On the edge of Hyderabad in southern India, a vast patch of arid shrub-land the size of about 14,000 football fields is becoming a testing ground for a model that could help wean the world off its dependence on Chinese drug ingredients.
This empty site of the Hyderabad Pharma City, marked out by scuffed sign posts and a rubble-strewn access road is expected to attract about $ 8.4 billion and employ 560,000 people in hundreds of sprawling plants. Within two years once land is allotted, officials say, it will be rolling out vital raw ingredients for medicines like penicillin, ibuprofen and anti-malarials that make their way around the world.
At the heart of the endeavor is India’ s race to wrest control from China, which supplies almost 70% of the active pharmaceutical ingredients -- or the bread-and-butter chemicals -- that go into the medicines produced by the Indian pharmaceutical industry. It’ s a vast project that shows how governments are growing increasingly concerned about China’ s stranglehold over drug supplies -- as well as the challenges they face in loosening it.
India’ s ability to secure not just its own drug supply but that of Africa, the Americas and Europe is at stake, since it supplies most of the generics sold in American pharmacies and hundreds of countries globally. India’ s reliance on China to keep raw material supply going is increasingly fraught, because the two countries often engage in skirmishes along the border and China has in recent years increasingly used its trade advantages against other countries during political disagreements.
Prime Minister Narendra Modi has eagerly promoted his country as the “ pharmacy of the world, ” but the glaring dependence of India’ s $ 42 billion drug manufacturing industry -- much of which is headquartered in Hyderabad -- was exposed at the start of the Covid-19 pandemic. In early 2020, China locked down Hubei province, its own medicine manufacturing heartland, as the coronavirus spread outside of Wuhan. That caused missed shipments and shortages, with API prices surging as much as 100% in India and around the world.
“ Supply chains got completely disrupted, China shut down, ” recalls Samina Hamied, the vice president of Cipla Ltd., one of India’ s largest drugmakers. “ We had to deal with distorted supply chains on one end, and, obviously, on the ground craziness on the other. ”
China accounted for 28% of the $ 236.7 billion global API market in 2018, according to data compiled by Dongguan Securities Co. China hasn’ t ever halted drug supplies for political reasons, and kept them flowing even at the height of the trade war with the U.S. Yet, Western countries have grown increasingly uneasy over the fact that supply of their commonly used medications are reliant on a major geopolitical rival amid an ever-widening ideological rift.
U.S. lawmakers have recently introduced a batch of legislation to protect the country’ s pharmaceutical supply chains from China. “ It’ s time to bolster onshore manufacturing of pharmaceuticals to ensure Americans never have to rely on China for lifesaving medicine, ” Senator Tom Cotton, an Arkansas Republican, said last week.
Multiple Indian efforts to redress the South Asian country’ s reliance have sprouted, from the Hyderabad facility which is an effort of the state government, to a plan by Modi’ s administration for three parks.
The state government’ s plan is the farthest along with 19,000 acres already acquired. Companies including Sun Pharmaceutical Industries Ltd., Dr. Reddy’ s Laboratories Ltd. and Zydus Lifesciences Ltd. have already said they will consider building plants there, and officials say about 450 Indian and international companies have expressed interest.
The Indian city of Hyderabad is a sprawling metropolis spread across hills and picturesque lakes, and has been at the forefront of attempts to transform the country into a scientific research hub. The planned Pharma City, set about 22 miles south of Hyderabad’ s airport, will focus on bulk drugs and promises to ram through India’ s treacle-like web of red tape around environmental clearance and land-acquisition by providing drugmakers plots with ready-made approvals for the heavily polluting industry.
The man leading the initiative is Shakthi Nagappan, a slight, bespectacled 36-year-old government employee. Working out of an administrative office in central Hyderabad, Nagappan spouts the jargon of a start-up founder. The walls of his side office are decorated with inspirational quotes and canvas-print portraits of figures like Barack Obama and Elon Musk..
Over cups of sugary tea, Nagappan sketches out how he wants the massive project to emulate the success of Genome Valley, a research and development cluster set up two decades ago to the north of Hyderabad, which now houses labs for companies including Novartis AG. Nagappan says the upcoming Pharma City to the south will compete with China’ s ability to drive down costs.
The main idea is to help India pharma companies cut costs and become more competitive on price by providing them with land where environmental clearances are sorted, waste disposal facilities are already built and other infrastructure is ready.
“ When we started planning Pharma City, we started looking at various regions, including China. What makes China more attractive? ” he says, citing various advantages from cheaper capital and infrastructure, along with the ability to stream-line approvals. “ Within Pharma City we’ ve brought in elements that can bring down capital and operating costs for the industries in a range of anywhere between 25% and 30%. ”
Some Indian companies have largely pulled away from making pharmaceutical ingredients in recent years as the Chinese API industry gained an inherent advantage because of economies of scale and support from its government in the form of financial incentives.
But after the Hubei shutdown of 2020, the Modi government drew up plans to allot land for three major bulk drug parks. It also sought to provide more than $ 1 billion in funding to encourage companies to manufacture ingredients domestically, part of Modi’ s nationalistic “ Make in India ” campaign that now looks to capitalize on firms searching for an alternative to China.
Still, progress has been slow on both the state and national fronts, mired in tender processes and missed deadlinesThe Pharma City plan was announced in 2015, and it will supply finished products only some years down the line.
There’ s also a shortage of applicants wanting to make a number of “ critical ” active pharma ingredients, the kind that China churns out. “ The chemical industry can not be conquered in a year, you need decades of investment to do that, ” says Satyanarayana Chava, the head of Laurus Labs Ltd., one of India’ s biggest makers of API. “ The entire world’ s dependence on China will continue. ”
Some delays are indicative of the wider challenges around getting infrastructure projects done at speed in India. It will likely take the country a number of decades to reach Modi’ s goal of self-reliance, says one Western diplomat. Right now it’ s easier for Indian pharma firms exporting to Western markets to buy ingredients from China that have already been approved by foreign regulators, rather than spend millions of dollars running clinical trials, they added.
In Hyderabad itself some of India’ s biggest pharma tycoons are openly blunt about Modi’ s drive.
“ As far as commerce goes, nationalism doesn’ t work, ” says G.V. Prasad, the co-chair of Dr Reddy’ s Laboratories Ltd. “ If China is offering something cheaper, we’ ll buy from China, ” he says, pointing out the Chinese-made furniture in his office. “ In the end it’ s business. ”
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general
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European Natural Gas Prices Fall Again on Stable Supplies – LNG Recap
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European natural gas prices fell for a seventh consecutive day on Monday as an armada of liquefied natural gas ( LNG) vessels makes its way toward the continent and pipeline imports remain stable despite fighting in Ukraine.
The May Title Transfer Facility ( TTF) contract slipped by more than $ 1 to finish near $ 32/MMBtu Monday. The market has shrugged off Russia’ s demand that European natural gas deliveries be paid for in rubles when bills come due later in the month. Natural gas also continues to dodge Western sanctions after it was excluded from a fifth round of punitive measures last week, when Europe banned Russian coal imports.
Russian gas shipments to Europe dipped over the weekend, but had bounced back Monday. Warmer weather is also forecast for northern Spain, France, Germany and the British Isles over the next five-day period, according to Maxar’ s weather desk. Temperatures are also expected to be higher in the UK, France and Spain over the next 10-day period.
Europe remains the premium market for LNG cargoes, with prices there expected to be higher through the remainder of the year as the continent looks to displace Russian volumes and replenish depleted storage inventories.
European LNG imports jumped by 43% sequentially in the first quarter, when prices skyrocketed ahead of Russia’ s invasion of Ukraine, according to Tudor, Pickering, Holt & Co. Asian volumes fell 5% sequentially over the same time after buyers stocked up ahead of winter.
But buying in Asia is firming as the spring restocking season begins and competition for the super-chilled fuel increases. Japan is aiming to curb some of its Russian energy imports and early spot buying for winter cargoes has reportedly increased in recent days.
“ JKM Asian LNG prices will likely receive some support going forward after Japan said last week that it plans to cut coal imports from Russia, which is expected to increase the demand for LNG cargoes, ” said Schneider Electric analyst Nate Nuttapon Komsai. “ However, the increase in JKM prices will be weighted down as China is cutting overseas purchases of LNG and instead maximizing cheaper domestic supply. ”
Reuters reported Monday that Japan’ s government has asked utilities to strengthen LNG reserves and sell any spare gas to other buyers in the country. The mandate comes as Europe is looking for additional LNG cargoes this year to help replace Russian pipeline imports.
Energy demand in Asia has been clouded by Covid-19 lockdowns in China. Brent crude dipped below $ 100/bbl Monday as “ the threat to demand is increasingly in focus ” amid rising case counts, Schneider analysts said.
In the United States, meanwhile, supply concerns heading into injection season and strong overseas demand found Henry Hub trading at its highest levels since 2008 on Monday. The May contract was up nearly 30 cents at around $ 6.60/MMBtu Monday afternoon.
Weather models turned cooler over the weekend, but natural gas production estimates are near year-to-date highs of 94.5 Bcf/d. LNG exports are also off the peaks of last month amid ongoing maintenance, creating uncertainty over how high Henry Hub can go in the near term.
“ The big question is, with production a little higher, ” and LNG export volumes down because of ongoing maintenance, “ will this be enough to turn the tide in sentiment any, and allow prices to stage a meaningful pullback? ” said Bespoke Weather Services in a Monday note to clients. “ That is a tough guess. ”
Feed gas nominations to U.S. export terminals were at 12.63 Bcf on Monday, below highs of more than 14 Bcf/d last month.
Freeport LNG said in a filing last week with the Texas Commission on Environmental Quality that it would conduct maintenance though April 21. About half of the available feed gas capacity serving the terminal, or 1.4 Bcf/d, was being utilized Monday, according to NGI’ s U.S. LNG Export Tracker. Fog has also limited some vessel traffic along the Gulf Coast in recent days.
In other news, Dow Inc. said Monday it would take a minority stake in Hanseatic Energy Hub GmbH in Northern Germany. The LNG import terminal is part of Germany’ s plan to fast-track natural gas infrastructure to help cut reliance on Russian energy imports.
The 12 billion cubic meters ( Bcm) /year terminal would be located in Stade near Dow’ s facilities. Other shareholders in the project include Buss Group GmbH & Co. KG, Fluxys Belgium SA and private equity firm Partners Group Holding AG.
German utility EnBW Energie Baden-Württemberg AG said earlier this month that it had signed a memorandum of understanding to possibly buy 3 Bcm of LNG annually from the hub.
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It was off to the races for natural gas futures prices Monday as a bump in production did little to assuage growing concerns about supply later this year, especially in light of the latest weather data. With chilly weather seen boosting demand for most of this month, the May Nymex futures contract exploded 36.5 cents…
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general
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The Daily Chase: Big changes at Shopify; Musk not joining Twitter's board
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The information you requested is not available at this time, please check back again soon.
Shopify is making some high-level changes to its share structure as it aims to empower Tobi Lutke for long-term thinking and position the company to capitalize on growth opportunities. In short, here’ s what it boils down to: a new “ founder share ” is being created that will effectively ensure Lutke has 40 per cent of all voting power among Shopify’ s shareholders. As well, Shopify announced its board wants to split the company’ s Class A and B shares on a 10-for-1 basis.
Our focus is flipping from fiscal to monetary policy this week, as we gear up for what’ s expected to be the Bank of Canada’ s first half-point rate hike in almost 22 years. We know there’ s a broad consensus among economists that the central bank should raise its main policy rate by 50 basis points, and market is showing a 77-per-cent probability of that happening. We’ ll tee up the stakes for the currency, housing markets across the country, and highly indebted consumers.
Elon Musk is no longer joining Twitter’ s board of directors. The company’ s CEO, Parag Agrawal, announced the abrupt change in plans in a tweet late last night. “ I believe this is for the best, ” he wrote, adding Twitter will “ remain open ” to Musk’ s input as a shareholder, while also acknowledging “ there will be distractions ahead. ” So now the simple question: What’ s Musk’ s next move? Keep in mind that the agreement appointing Musk to the board came with a commitment to not raise his stake in Twitter to more than 14.9 per cent; presumably, that commitment is now toast.
The price of oil has started the week on soft footing, with West Texas Intermediate falling as much as three per cent amid ongoing concern that the latest waves of COVID in China will hurt demand. In equity markets, futures are suggesting it will be a weak open, particularly for the Nasdaq, as traders remain focused on the Fed’ s next move.
Joe Manchin, the Democrat senator from West Virginia who has wielded his clout since U.S. President Joe Biden took office, is due in Canada’ s energy heartland today. A release from the province on Friday stated Manchin would visit Alberta today and tomorrow for meetings with “ energy stakeholders ” in Calgary and to visit energy facilities. This comes at a time when the White House is leading a coordinated release of oil from sovereign reserves, and when it’ s wanting more oil from Canada — just not via Keystone XL.
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general
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Del Monte plans operational changes to hit net zero emissions by 2050
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Last November, countries gathered in Scotland to discuss climate change and ways to strengthen their emissions pledges.
Nearly six months later, the issue remains a hot-button topic, especially among consumers, and companies appear to be remaining vigilant about curtailing their own impact on the environment. Before Del Monte's announcement this week, several other companies have pledged to hit net-zero emissions targets, in many cases using similar same tactics.
Mondelēz International has committed to achieving net-zero emissions by 2050 across its value chain by focusing on sustainable ingredients sourcing, adopting renewable energy and improving the efficiency of its distribution logistics, among other measures. Nestlé has set goals of halving its emissions by 2030 and reaching net-zero by 2050, while Mars strives to hit net-zero emissions by 2050 in part through shifts in its agricultural supply chain. Similar commitments have been made by Mexican food giant Grupo Bimbo and Unilever.
A nearly 3,000-page report last week released by the United Nations ' climate panel said about a quarter of the greenhouse gas cuts needed to prevent the worst impacts of climate change could come from food and agriculture. The authors specifically highlighted protecting forests, changing diets and altering farming methods.
Del Monte underscored many of the efforts it has undertaken already to reduce its carbon footprint.
These include streamlining its operations to maximize output and eliminate unnecessary emissions from facilities operating at less than full capacity; doubling its capital investment in production operations to add automation and other technologies for improved efficiency and reduced waste; investing in renewable energy; and cutting food waste.
The company said it has taken steps to reduce transportation emissions. Del Monte upped the use of rail by 20% over the past year while optimizing truck transportation by increasing average truck miles per gallon by 14.3%, according to a statement.
Last year, Del Monte announced what it said is the industry’ s first canned vegetable product to be certified by the Upcycled Food Association under its new upcycled certification program. The company's Blue Lake Petite Cut and Blue Lake Farmhouse Cut Green Beans are made with 100% upcycled and sustainably grown green beans from Wisconsin and Illinois.
Del Monte is pledging to reach its 2050 net-zero emissions goal by making changes on its own rather than purchasing carbon credits generated by other groups.
`` It’ s exciting to be aligned with the most aggressive path to net-zero, '' Molly Laverty, environmental, social and governance senior manager at Del Monte Foods, said in a statement. `` The food industry has an important role to play in reducing greenhouse gas emissions. ''
Companies have little choice but to do more as consumers increasingly vote with their pocketbooks at the grocery store. In many cases, shoppers are willing to pay more for offerings that mirror their own personal values.
A study from Mondelēz International found the majority of consumers are incorporating their values into what snacks they want to buy. And a separate study this year from Cargill said 55% of global consumers are more likely to purchase a packaged food item that is labeled with a sustainability claim, up four points from the company's last survey in 2019.
Topics covered: logistics, freight, operations, procurement, regulation, technology, risk/resilience and more.
The retailer's acquisition of a middle- and final-mile carrier as the COVID-19 pandemic took hold has allowed it to take more control over its delivery process.
The acquisition has contributed to an approximately 35% reduction in delivery times, executives said on an earnings call.
Topics covered: logistics, freight, operations, procurement, regulation, technology, risk/resilience and more.
Topics covered: logistics, freight, operations, procurement, regulation, technology, risk/resilience and more.
The retailer's acquisition of a middle- and final-mile carrier as the COVID-19 pandemic took hold has allowed it to take more control over its delivery process.
The acquisition has contributed to an approximately 35% reduction in delivery times, executives said on an earnings call.
Topics covered: logistics, freight, operations, procurement, regulation, technology, risk/resilience and more.
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Oil slumps as China’ s worsening outbreak raises demand concerns - News for the Energy Sector
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Oil resumed its decline as China’ s virus resurgence worsened, raising concerns about demand from the world’ s biggest crude importer.
West Texas Intermediate futures fell below $ 97 a barrel after climbing 2.3% on Friday, the first gain in four sessions. Virus cases continue to rise in Shanghai and there is no clarity on when restrictions will be lifted. The flare-up has led to disruptions at ports and prompted some refiners to trim operating rates.
Oil has now given up most of the gains seen since Russia’ s invasion of Ukraine in late February following a tumultuous period of trading. The war has fanned inflation and prompted the US and its allies to release strategic reserves to cool prices. Fighting continues despite diplomatic efforts for a cease-fire.
Shanghai reported a record of more than 26,000 new cases on Sunday, with China struggling to halt the spread of the highly infectious omicron variant as it pursues its Covid Zero strategy. Oil analysts are continuing to cut their demand forecasts as the outbreak curbs travel.
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United States Trade Insights from TFG - Page 2 of 6
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Welcome to Trade Finance Global. Browse and read the latest news, stories and educational insights from the world of trade and receivables finance. Stay up to date with the latest products, services and innovations in the market, bought to you by the Trade Finance Global team.
This article posits that human rights due diligence is the most practical approach to addressing climate change concerns and achieving other sustainable development goals.
Eighteen months into the COVID-19 pandemic and shipping bottlenecks are challenging companies to meet demand. The global outlook is uncertain, however, that does not mean doom and gloom, making way for a new thought process.
The Department for International Trade has recently published its Global Trade Outlook report. TFG summarised of the key points from the report, outlining what could be in store for global trade between now and 2050.
Your morning coffee briefing from TFG. Exports of intermediate goods sustain gains in Q1 of 2021 after rebound from pandemic, job slow down could lead the Federal Reserve to continue with stimulus, inflation could spark new financial crisis, China says US tensions threaten fight against climate change and UK labour crisis could last up to two years, CBI warns.
The impact of the March 2021 incident of the container ship M.V. Ever Given with around 18,300 containers onboard running aground in the Suez Canal has generated international attention and its consequences will continue to unravel for years to come.
Your morning coffee briefing from TFG. COVID-19 vaccine transporter Reftrade secures major export win, lockdown-easing helps SMEs recover despite rising insolvencies, emerging economies can not afford ‘ taper tantrum’ repeat, says IMF’ s Gopinath, business confidence in UK at four-year high but staff shortages a concern and UK launches £450m fund for energy network innovation.
World trade of goods has declined some 12% in the last year, representing a loss of $ 22 trillion USD of trade. Is it all doom and gloom for trade, or will we see a resurgence?
Your morning coffee briefing from TFG. Goods Barometer hits record high, confirming strength of trade recovery, UKEF backs first ever £430 million green transition loan, new World Economic Forum survey shows a mix of polarisation about the benefits of globalisation, global economic data disappointments add to rising growth angst, United States gives USD 600,000 to boost negotiating capacities in developing countries, Contour announces partnership with GSBN to drive digitisation in the global shipping industry and the UK rejects industry plea for visas for EU truck drivers.
Your morning coffee briefing from TFG. Service trade slump continues as travel wanes, however, some sectors appear to be recovering
Your morning coffee briefing from TFG. US gas exporters face a tightening of European anti-pollution rules, Commercial Banking Applications prepares banks for SWIFT 2021
The virtual Summit on the New Global Sanctions Regime organised by City & Financial Global is taking place on the 12th of July of 2021.
On the 11th June, the Group of Seven Nations ( G7) met to discuss current global economic concerns and plans, where US president Joe Biden proposed that all countries have an agreed floor of corporation tax.
Your morning coffee briefing from TFG. Global inflation troughed last summer, and has risen markedly since. Britain, Ireland agree to work together to smooth post-Brexit trade and the US Colonial pipeline resumes operations following ransomware attack.
By the end of 2021, it’ s anticipated that LIBOR rates will be discontinued, transitioning to the SONIA or SOFR. But what does this mean for trade finance? ITFA explains
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Measuring the intangible economy to address policy challenges
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The purpose of the first work package of the MICROPROD project was to improve the firm-level data infrastructure, expand the measurement of intangible assets and enable cross-country analyses of these productivity trends.
This Working Paper is an output from the MICROPROD project, which received funding from the European Union’ s Horizon 2020 research and innovation programme under grant agreement no. 822390.
European economies exhibit the so-called ‘ productivity puzzle, whereby investments’ in digital technologies and intangible assets have not delivered the hoped-for productivity gains. Explanations for this puzzle lie in the unequal ability of companies to make use of these technologies, and resulting patterns of market concentration, productivity divergence and dampened business dynamism. Access to firm-level data is essential to properly understand these rich dynamics. The purpose of the first work package of the MICROPROD project was to improve the firm-level data infrastructure, expand the measurement of intangible assets and enable cross-country analyses of these productivity trends. The MICROPROD researchers developed the Micro Data Infrastructure ( MDI), a centralised platform that harmonises access to the firm-level data gathered by national statistical institutes. The data infrastructure developed through this work package offers valuable insights into the evolution of productivity across the European Union and into the effects of digitalisation and globalisation. It can thus generate important evidence for designing policies to support the European Commission’ s policy objectives, especially for achieving the digital and green transitions. In addition, the research enabled by this data infrastructure and carried out within the context of MICROPROD can provide valuable lessons about the response of European economies to the COVID-19 pandemic and its aftermath.
Le Mouel, M. ( 2022) ‘ Measuring the intangible economy to address policy challenges’, Working Paper 03/2022, Bruegel
While the end of the pandemic is still far, the economy will have to restart.
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United States Trade Insights from TFG - Page 3 of 6
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Welcome to Trade Finance Global. Browse and read the latest news, stories and educational insights from the world of trade and receivables finance. Stay up to date with the latest products, services and innovations in the market, bought to you by the Trade Finance Global team.
The first estimates for the factoring industry worldwide in 2020 have been announced today by the FCI’ s Peter Mulroy. Factoring declines were recorded in most regions except Asia Pacific.
After Covid-19 crippled global commerce, the World Trade Organization said March 31 that it expected the planet’ s merchandise trade to increase 8% in 2021 after contracting 5.3% in 2020.
Factoring, as an important method to extend credit, is a type of financial transaction where the creditor assigns its receivables to an assignee at a discount. In recent years, there has been a large growth of factoring transactions around the world.
The trade consequences of Brexit already include a dramatic shrinking of commerce with the EU, an expansion of trade with other allies, and redrawing of supply chains for companies.
The first half of 2021 should be similar to the year 2020, marked by the strongest global recession since the end of the Second World War.
President-Elect Biden – once he assumes office – will inherit the US trading power, which over the last 4 years has solidified itself as a force to be reckoned with after its aggressive approach to trade.
TFG heard from the CFTC’ s Heath P. Tarbert, on CFTC’ s tremendous accomplishments in achieving integrity through sound derivatives regulation.
TFG heard from Elitsa Garnizova, Senior Project Manager and Researcher, London School of Economics on the current updates and what we can expect in this UK-EU-US economic relationship.
There is immense synergy to be unlocked between SMEs and trade finance funds by working closely together and developing relationships that allow for a level of comfort on both sides of the coin to be developed over time.
SMEs need to explore innovative financing options like trade credit insurance as they plan and prepare for the “ new normal ”.
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ICC Digitalisation TFG Hub
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A recent 2020 study and supplementary Covid-19 survey by TFG and WTO reveals the biggest challenges facing DLT trade-related firms when it comes to implementation of their solutions within corporates and banks.
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REVIV3 PROCARE CO MANAGEMENT 'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS ( form 10-Q)
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The following discussion of our financial condition and results of operations should be read in conjunction with, and is qualified in its entirety by, the condensed financial statements and notes thereto included in Item 1 in this Quarterly Report on Form 10-Q.
Our Management's Discussion and Analysis contains not only statements that are historical facts, but also statements that are forward-looking. Forward-looking statements are, by their very nature, uncertain and risky. Forward-looking statements are often identified by words like: `` believe '', `` expect '', `` estimate '', '' anticipate '', `` intend '', `` project '' and similar expressions, or words that, by their nature, refer to future events. You should not place undue certainty on these forward-looking statements, which apply only as of the date of this Quarterly Report on Form 10-Q. These forward-looking statements are subject to certain risks and uncertainties that could cause actual results to differ materially from historical results or our predictions. These risks and uncertainties include international, national, and local general economic and market conditions; our ability to sustain, manage, or forecast growth; our ability to successfully make and integrate acquisitions; new product development and introduction; existing government regulations and changes in, or the failure to comply with, government regulations; adverse publicity; competition; the loss of significant customers or suppliers; fluctuations and difficulty in forecasting operating results; change in business strategy or development plans; business disruptions; the ability to attract and retain qualified personnel; the ability to protect technology; the risk of foreign currency exchange rate; and other risks that might be detailed from time to time in our filing with the Securities and Exchange Commission. Our actual results could differ materially from those discussed in the forward-looking statements. Factors that could cause or contribute to these differences include those discussed below and elsewhere in this Quarterly Report on Form 10-Q.
Although the forward-looking statements in this Quarterly Report reflect the good faith judgment of our management, such statements can only be based on facts and factors currently known by them. Consequently, and because forward-looking statements are inherently subject to risks and uncertainties, the actual results and outcomes may differ materially from the results and outcomes discussed in the forward-looking statements. You are urged to carefully review and consider the various disclosures made by us in herein and in our other reports as we attempt to advise interested parties of the risks and factors that may affect our business, financial condition, and results of operations and prospects.
Reviv3 Procare Company is engaged in the manufacturing, marketing, sale and distribution of professional quality hair and skin care products under various trademarks and brands. We have adopted and used the trademarks of our products for distribution throughout the United States, Canada, Europe, and Asia pursuant to the terms of twelve exclusive distribution agreements with various parties throughout our targeted market. Our manufacturing operations are outsourced and fulfilled by our co-packers and manufacturing partners. Currently, we produce seven products with sixteen separate stock-keeping units ( `` SKUs '') and look to expand our product lines over the next twelve months.
Jumpstart Our Business Startups Act of 2012 ( `` JOBS Act '')
On April 5, 2012, the Jumpstart Our Business Startups Act of 2012, or the JOBS Act, was enacted. Section 107 of the JOBS Act provides that an `` emerging growth company '' can take advantage of the extended transition period provided in Section 7 ( a) ( 2) ( B) of the Securities Act of 1933, as amended, or the Securities Act, for complying with new or revised accounting standards. In other words, an '' emerging growth company '' can delay the adoption of certain accounting standards until those standards would otherwise apply to private companies. We have irrevocably elected not to avail ourselves of this extended transition period and, as a result, we will adopt new or revised accounting standards on the relevant dates on which adoption of such standards is required for other public companies.
We are in the process of evaluating the benefits of relying on other exemptions and reduced reporting requirements provided by the JOBS Act. Subject to certain conditions set forth in the JOBS Act, as an `` emerging growth company, '' we intend to rely on certain of these exemptions from, without limitation, ( i) providing an auditor's attestation report on our system of internal controls over financial reporting pursuant to Section 404 ( b) of the Sarbanes-Oxley Act and ( ii) complying with any requirement that may be adopted by the Public Company Accounting Oversight Board ( PCAOB) regarding mandatory audit firm rotation or a supplement to the auditor's report providing additional information about the audit and the financial statements, known as the auditor discussion and analysis. We will remain an `` emerging growth company '' until the earliest of ( a) the last day of our fiscal year following the fifth anniversary of the closing of this offering, ( b) the last day of the first fiscal year in which our annual gross revenues exceed $ 1.07 billion, ( c) the last day of our fiscal year in which we are deemed to be a `` large accelerated filer '' as defined in Rule 12b-2 under the Securities Exchange Act of 1934, or Exchange Act ( which would occur if the market value of our equity securities that is held by non-affiliates exceeds $ 700 million as of the last business day of our most recently completed second fiscal quarter), or ( d) the date on which we have issued more than $ 1 billion in nonconvertible debt during the preceding three-year period.
For the Nine months Ended February 28, 2022 Compared to the Nine months Ended February 28, 2021
Sales for the nine months ended February 28, 2022 and 2021 were $ 1,809,472 and $ 1,277,480, respectively. Sales for the nine months ended February 28, 2022 increased by $ 531,992 or 42% over the same comparable period in 2021, primarily due to increase in sales generated from our direct- to-consumer sales.
Cost of sales consisted primarily of cost of product, freight-in costs, distribution and merchant fees. Cost of sales for the nine months ended February 28, 2022 and 2021 was $ 611,305 and $ 477,578 respectively. Cost of sales as a percentage of sales for the nine months ended February 28, 2022 and 2021 was 34% and 37%, respectively. Cost of sales as a percentage of sales decreased in 2022 for the respective periods as compared to the same comparable periods in 2021 primarily due to our continued expansion in the direct sales to consumer segment, which has higher profit margins. This reduction in cost of sales was countered by higher freight in cost due to supply chain constraints.
Gross profit for the nine months ended February 28, 2022 and 2021 was $ 1,198,167 and $ 799,902 respectively. Gross profit as a percentage of sales for the nine months ended February 28, 2022 was 66% as compared to 63% for the same comparable period in 2021. The increase in gross profit for the nine months ended February 28, 2022 was primarily attributable to the increase sales of products in the traditionally higher margin direct to consumer segment.
Operating expenses consisted of marketing and selling expenses, professional and consulting fees, compensation to employees and other general and administrative expenses. Operating expenses for the nine months ended February 28, 2022 and 2021 were $ 1,315,379 and $ 934,411, respectively. Operating expenses for the nine months ended February 28, 2022 increased in amount by $ 380,968 or 41% over the comparable period in 2021. This increase is primarily due to increase in marketing and advertising expense to promote the Company's product line and brand in the direct- to-consumer channels and higher shipping charges. Operating expenses as a percentage of sales for the nine months ended February 28, 2022 and 2021 remained constant at 73%.
Other income ( expense) consisted of gain on loan forgiveness, interest income, interest expense and other finance charges. Interest income for the nine months ended February 28, 2022 and 2021 was $ 28 and $ 31, respectively. Interest expense and finance changes for the nine months ended February 28, 2022 and 2021 were $ 4,968 and $ 4,461, respectively, primarily due to interest expense related to business credit card financing charges. The Company also received $ 25,000 pursuant to covid relief grant fund and $ 10,000 as EIDL loan forgiveness.
As a result of the above, we reported a net loss of $ 87,152 compared to a net loss of $ 122,626 for the nine months ended February 28, 2022 and 2021, respectively.
For the Three months Ended February 28, 2022 Compared to the Three months Ended February 28, 2021
Sales for the three months ended February 28, 2022 and 2021 were $ 476,384 and $ 364,966, respectively. Sales for the three months ended February 28, 2022 increased by $ 111,418 or 31% over the same comparable period in 2021, primarily due to increase in sales generated from our direct to consumer and distribution sales.
Cost of sales consisted primarily of cost of product, freight-in costs, distribution and merchant fees. Cost of sales for the three months ended February 28, 2022 and 2021 was $ 134,609 and $ 93,491 respectively. Cost of sales as a percentage of sales for the three months ended February 28, 2022 and 2021 was 28% and 26%, respectively. Cost of sales as a percentage of sales increased in 2022 for the respective periods as compared to the same comparable periods in 2021. This increase in cost of sales was primarily due to increase in freight-out costs due to the increased number of shipments in the direct sales to consumer sales and higher freight in cost due to supply chain constraints.
Gross profit for the three months ended February 28, 2022 and 2021 was $ 341,775 and $ 271,475 respectively. Gross profit as a percentage of sales for the three months ended February 28, 2022, was 72% as compared to 74% for the same comparable period in 2021. The decrease in gross profit for the three months ended February 28, 2022 was primarily attributable to the increase in freight in cost due to supply chain constraints.
Operating expenses consisted of marketing and selling expenses, professional and consulting fees, compensation to employees and other general and administrative expenses. Operating expenses for the three months ended February 28, 2022 and 2021 were $ 439,276 and $ 392,503, respectively. Operating expenses for the three months ended February 28, 2022, increased in amount by $ 46,773 or 12% over the comparable period in 2021. This increase is primarily due to increase in marketing and advertising expense to promote the Company's product line and brand in the direct- to-consumer channels and due to increase in delivery charges. Operating expenses as a percentage of sales for the three months ended February 28, 2022 and 2021 were 92% and 108%, respectively.
Other income ( expense) consisted of gain on debt forgiveness, interest income, interest expense and other finance charges. Interest income for the three months ended February 28, 2022 and 2021 was $ 10 and $ 12, respectively. Interest expense and finance changes for the three months ended February 28, 2022 and 2021 were $ 1,823 and $ 1,757, respectively, primarily due to interest expense related to business credit card financing charges. The Company recognized $ 16,313 gain on debt forgiveness during the three months ended February 28, 2021. There was no such gain recognized for the same comparable period in the current year.
As a result of the above, we reported a net loss of $ 99,314 and $ 106,460 for the three months ended February 28, 2022 and 2021, respectively.
Liquidity and Capital Resources
We are an emerging growth company and currently engaged in our initial product sales and development. We have an accumulated deficit and have incurred operating losses since our inception and expect losses to continue during the fiscal year 2022. We believe our current cash balances coupled with anticipated cash flow from operating activities will be sufficient to meet our working capital requirements in the short term. We continue to control our cash expenses as a percentage of expected revenue on an annual basis and thus may use our cash balances in the short-term to invest in revenue growth. We have and will continue to generate sufficient cash for our operational needs, including any required debt payments, for at least one year from the date of issuance of the accompanying financial statements. Management is focused on growing the Company's existing products offering, as well as its customer base, to increase its revenues. The Company can not give assurance that it can increase its cash balances or limit its cash consumption and thus maintain sufficient cash balances for its planned operations or future acquisitions. Future business demands may lead to cash utilization at levels greater than recently experienced. We may need to raise additional capital in the future. However, the Company can not assure that it will be able to raise additional capital on acceptable terms, or at all. Subject to the foregoing, management believes that the Company has sufficient capital and liquidity to fund its operations for at least one year from the date of issuance of the accompanying financial statements.
Net cash flows used in operating activities for the nine months ended February 28, 2022 was $ 90,873, attributable to a net loss of $ 87,152, depreciation of $ 6,603, bad debt expense of $ 3,012, gain on debt forgiveness of $ 35,000 and net change in operating assets and liabilities of $ 21,665 primarily due to decrease in accounts receivable and inventory, offset by a decrease in accounts payable and accrued expenses, customer deposits and an increase in prepaid expenses. Net cash flows provided by operating activities for the nine months ended February 28, 2021 was $ 74,212, attributable to a net loss of $ 122,626, gain on debt forgiveness of $ 16,313, depreciation of $ 7,622, bad debts expense of $ 574, stock based compensation expense of $ 66,400, non-cash lease expense of $ 1,714, and net change in operating assets and liabilities of $ 136,841 primarily due to a decrease in accounts receivable and increase in accounts payable, offset by an increase in inventory and prepaid expenses and other current assets and decrease in customer deposits.
Net cash flows used by investing activities for the nine months ended February 28, 2022 and 2021 was $ 0 and $ 15,408 respectively, attributable to purchase of property and equipment during the nine-month period ended February 28, 2021.
Net cash flows provided by financing activities for the nine months ended February 28, 2022 and 2021, amounted to $ 39,881 and $ 24,231, respectively. For the nine months ended February 28, 2022, we received $ 35,000 in covid relief loan funds, we received advances from a related party of $ 7,356 and we repaid $ 2,475 towards equipment financing. For the nine months ended February 28, 2021, we received advances from a related party of $ 20,406, proceeds from loan payable of $ 6,300 and repaid $ 2,475 towards equipment financing.
As a result of the activities described above, we recorded a net decrease in cash of $ 50,992 for the nine months ended February 28, 2022 and an increase in cash of $ 83,035 for the nine months ended February 28, 2021.
We currently have no external sources of liquidity, such as arrangements with credit institutions or off-balance sheet arrangements that will have or are reasonably likely to have a current or future effect on our financial condition or immediate access to capital.
We are dependent on our product sales to fund our operations and may require the sale of additional common stock to expand our operations. Our officers and directors have made no written commitments with respect to providing a source of liquidity in the form of cash advances, loans, and/or financial guarantees.
If we are unable to raise the funds required to fund our operations, we will seek alternative financing through other means, such as borrowings from institutions or private individuals. There can be no assurance that we will be able to raise the capital we need for our operations from the sale of our securities. We have not located any sources for these funds and may not be able to do so in the future. We expect that we will seek additional financing in the future. However, we may not be able to obtain additional capital or generate sufficient revenues to fund our operations. If we are unsuccessful at raising sufficient funds, for whatever reason, to fund our operations, we may be forced to cease operations. If we fail to raise funds, we expect that we will be required to seek protection from creditors under applicable bankruptcy laws.
Off-Balance Sheet Arrangements
We do not have any off-balance sheet arrangements that have or are reasonably likely to have a current or future effect on our financial condition, changes in financial condition, revenues or expenses, results or operations, liquidity, capital expenditures or capital resources that is material to investors.
The preparation of condensed financial statements in conformity with accounting principles generally accepted in the United States of America requires us to make a number of 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. Such estimates and assumptions affect the reported amounts of expenses during the reporting period. On an ongoing basis, we evaluate estimates and assumptions based upon historical experience and various other factors and circumstances. We believe our estimates and assumptions are reasonable in the circumstances; however, actual results may differ from these estimates under different future conditions.
We believe that the estimates and assumptions that are most important to the portrayal of our financial condition and results of operations, in that they require the most difficult, subjective or complex judgments, form the basis for the accounting policies deemed to be most critical to us. These critical accounting policies relate to revenue recognition, impairment of intangible assets and long-lived assets, inventory, stock compensation, and evaluation of contingencies. We believe estimates and assumptions related to these critical accounting policies are appropriate under the circumstances; however, should future events or occurrences result in unanticipated consequences, there could be a material impact on our future financial condition or results of operations.
Significant Accounting Policies
See the footnotes to our unaudited financial statements for the nine months ended February 28, 2022, included with this quarterly report.
For over two years, the effects of a new coronavirus ( `` COVID-19 '') and related actions to attempt to control its spread began to impact our business. The impact of COVID-19 on our operating results for the nine months ended February 28, 2022 was limited, in all material respects, on our sales in Europe and in China where the Chinese government mandated numerous measures, including closures of businesses, limitations on movements of individuals and goods, and the imposition of other restrictive measures, in its efforts to mitigate the spread of COVID-19 within the country.
On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Governments around the world have mandated, and continue to introduce, orders to slow the transmission of the virus, including but not limited to shelter-in-place orders, quarantines, significant restrictions on travel, as well as work restrictions that prohibit many employees from going to work. Uncertainty with respect to the economic effects of the pandemic has introduced significant volatility in the financial markets.
To the extent that COVID-19 continues or worsens, governments may impose additional restrictions or additional governments may impose restrictions. The result of COVID-19 and those restrictions could result in a number of adverse impacts to our business, including but not limited to additional disruption to the economy and consumers ' willingness and ability to spend, temporary or permanent closures by businesses that consume our products, such as salons and spas, additional work restrictions, and supply chains being interrupted, slowed, or rendered inoperable. As a result, it may be challenging to obtain and process raw materials and supply chains to support our business needs, and individuals could become ill, quarantined, or otherwise unable to work and/or travel due to health reasons or governmental restrictions. Also, governments may impose other laws, regulations or taxes which could adversely impact our business, financial condition or results of operations. Further, if our customers ' businesses or incomes are similarly affected, they might delay or reduce purchases from us. The potential effects of COVID-19 also could impact us in a number of other ways including, but not limited to, reductions to our profitability, laws and regulations affecting our business, the availability of future borrowings, the cost of borrowings, and credit risks of our customers and counterparties.
Given the evolving health, economic, social, and governmental environments, the potential impact that COVID-19 could have on our business remains uncertain and could be significant.
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Huawei Cloud, ULearning LMS help Dynamic DNA keep ICT learners on track through pandemic
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While the COVID-19 pandemic derailed and disrupted the education of many South African youths, training and skills development company Dynamic DNA was able to keep its learners’ education on track and actually improve efficiencies during lockdowns, thanks to a partnership with Huawei Cloud and ULearning.
Gauteng-based Dynamic DNA specialises in developing ICT skills among underprivileged learners. As a B-BBEE level two accredited, 51% black female-owned company, Dynamic DNA sees its mission as `` building the economy of South Africa one ICT youth at a time '', with a MICT SETA accredited ICT Academy that provides superior training and learnerships, full suite skills development solutions and expert partner ecosystems. Dynamic DNA is currently training around 500 young people for career streams like robotics, artificial intelligence, cyber security and UX/IX.
As an ICT-focused academy, Dynamic DNA had already been digitalised. However, during the early stages of the first lockdown, the institution sought scale, improved efficiencies and greater reliability from its learner management system ( LMS).
Tinashe Banya, Senior Academic Head and Portfolio Manager at Dynamic DNA, says the organisation’ s LMS was not able to cope with all students attending remote classes simultaneously, and there were limitations in terms of the collaboration features it offered. “ When groups had to collaborate on a project, for example, some had to paste lines of code on a Word document to send it to each other, ” he says.
Dynamic DNA partnered with ULearning and Huawei Cloud to roll out a comprehensive new LMS that offered security, reliability, the ability to scale and a host of new features that allowed the organisation to continue its training programmes without hitches.
ULearning LMS supports course creation, teaching, learning, management, examination, evaluation and data analytics, with AI-powered tools for smart classrooms and streaming, and even a powerful online test system allows teachers and school management to track students ' behaviour during the online exam using AI face verification and gesture analysis.
Says Banya: “ The AI for testing is a unique feature, which we use: it allows us to monitor for cheating and alerts us if a student opens another browser to cheat. ”
Jay Zhou, Managing Director of Huawei Cloud South Africa, says Dynamic DNA presented a unique case.
“ The pandemic has caused uncertainty in many areas of education, causing institutions to urgently seek solutions to the challenges that they have faced. From remote collaboration to finding tailored systems that will support their IT infrastructure, Dynamic DNA has been proactive in partnering with Huawei Cloud to offer excellent service consistency and scalability, ” said Zhou.
Other features the organisation has found useful during the pandemic are the ability to create a test bank of alternative supplementary exams for students who may have been ill during exams.
The LMS is a holistic solution to enable learners, trainers, facilitators and management, says Banya. “ It helps upgrade the threshold of teaching quality, empowers facilitators and also improves efficiency. Plus, management can pull comprehensive reports, ” he says.
“ With the Huawei Cloud, students can easily collaborate on projects and we were able to move away from manual SETA processes. All portfolios of evidence are in a cloud repository, to which we give SETA remote access for evaluation and verification. ”
The secure and scalable solution ensured that all learners were able to continue their training unhindered, and no staff lost income or jobs due to the lockdowns.
With support and training from the Huawei Cloud team, Dynamic DNA’ s staff transitioned smoothly.
“ The pandemic gave us all a serious test of mental health at first. But using the new LMS, I was able to pop in to any session and see what was going on, assess any challenges and adjust processes as necessary. Over time, our own IT team has found it easy to add any features we wanted to our system. Our facilitators, moderators and admin staff have adapted well and now welcome the new efficiencies they are enjoying, and even SETA has commended us for the smooth transition and adapting to the new way, ” he says.
To get in contact with Dynamic DNA, click here: www.dynamicdna.co.za.
Follow Huawei Cloud South Africa on Twitter, LinkedIn and YouTube or e-mail us at huaweicloudsa @ huawei.com.
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The right partner is crucial to riding the technology wave
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There can be no doubt that technology is evolving rapidly and that companies today need to partner with the right organisation if they want to ride the wave of technology development. A good example of this evolution is the manner in which the cloud has led to the shift from hosting most infrastructure on-premises to keeping everything in the cloud.
This shift has led to new providers arising and bringing new cloud services to the table, suggests Wayne D'Sa, CEO of CipherWave Business Solutions. He notes that the COVID-19 pandemic demonstrated the value of the cloud, as it enabled organisations to switch to remote working, while those working on a cure were able to use the cloud to process vast amounts of data rapidly.
“ The cloud makes it much easier to process large data subsets, as you are not hindered by the obvious limitations of on-premises processing capacity, and this in turn means results can be delivered quickly in order to enable rapid business decisions to be taken, ” he says.
“ Of course, while the major public cloud players have massive infrastructure and a global footprint, organisations that do not have the relevant expertise or understanding of the cloud to achieve their goals can not simply call an Amazon or Microsoft directly. This has opened up a space for niche cloud providers to step in and fill this gap for customers – either on the back of the public cloud, or by using their own private cloud to deliver the flexibility the customer needs. ”
He adds that the cloud itself is composed essentially of data, and in a digitising world, such data is increasing exponentially. Therefore, he says, security is equally critical and needs to be designed to suit the cloud environment. D’ Sa suggests that, just as a person withdrawing money from a bank would need to verify who they were by showing identification, the same occurs with the cloud.
“ It is vital to validate the individual seeking access to the data to ensure they are who they say they are. We always recommend utilising a zero trust framework, which only allows a user access to the minimum data their position requires them to see. In this way, it becomes possible to re-engineer your security processes to achieve a better outcome with regard to protecting your data. ”
Another example, he points out, where technology has advanced significantly in recent years, is in how fast the fibre landscape has grown. As the country has shaken off the telco monopoly of the past, so a host of new providers have been investing in fibre roll-out, he says, creating new and better connectivity options for customers.
“ We understand the need to part of this quantum growth, which is why we have ensured our organisation is connected to every fibre provider, enabling us to service our customers, regardless of whether the provider delivers fibre to the business ( FTTB) or fibre to the home ( FTTH), ” states D’ Sa.
“ In much the same way, we are now witnessing the rise of 5G, which will be especially effective in providing a better on-the-go experience. This is of enormous benefit to the gig economy, which is driven mostly by mobile connectivity. The right partner here will be one that works closely with the mobile providers to offer fixed-line access to these services for their remote workforce. ”
This ties in nicely with the concept of unified communications ( UC), he adds, explaining that UC is a result of how interconnected these various technologies are becoming. “ UC offers a rounded experience that takes telephony, traditional text and e-mail communications, bundles these together and uses best-of-breed solutions to deliver this all in a single offering that provides a seamless experience. ”
Most businesses simply can not find the time to learn about and understand the new technologies that are coming to the fore, which means they don’ t always realise the true benefits. Organisations need to be open to testing new technologies, which means creating an environment that can enable this.
“ It is for this reason we say that they need to ensure that their technology provider of choice is aligned to their planned journey and the goals they seek to achieve. So when choosing your provider, it is necessary to clearly understand exactly what technologies they are experts in, and how integrated they are into other vendors and providers. Such integration is critical if you are to achieve a truly seamless experience. ”
“ Ultimately, it’ s about evolving your business in a way that allows you to better service your end customers. Your technology partner will play a crucial role in ensuring you have the ability to utilise all the technologies mentioned above to improve your business efficiency and deliver exceptional customer service, ” he concludes.
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Openserve connects more SA homes through prepaid
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Local network infrastructure wholesale provider Openserve has introduced its Web Connect and Prepaid Connect fibre offerings to give customers the option to make flexible payments on fibre connectivity packages.
The Telkom-owned fibre network operator bills itself as SA’ s largest wholesale telecommunications infrastructure provider.
It offers wholesale products and services to other licensed telecoms service providers through an open access network, which covers more than 2.4 million households locally with fibre, either directly to the home or to the cabinet.
According to a statement, Openserve’ s Prepaid Connect offerscustomers a way to pay for a home fibre internet connection upfront, with no contracts or credit checks. Customers only pay for connectivity when they need to connect. The prepaid data bundles can be used for homes in underserved areas, providing an affordable alternative for internet connectivity.
Openserve chief commercial officer Phila Dube explains: “ Prepaid Connect provides households with the flexibility of how and when they pay for internet access. This is just one of the ways Openserve is making fibre more accessible, whilst creating a customised experience and giving customers more options to choose from. ”
The Prepaid Connect internet-only service can be ordered on the Openserve website or via that of an internet service provider partner network.
The COVID-19 pandemic increased the need for internet connectivity, as more South Africans took to online services, remote working and e-learning.
While the number of connected homes in SA continues to grow, there is still a vast amount of underserved areas.
Web Connect is part of Openserve's expanding national fibre deployment, backed by a national and international IP network. It is an end-to-end fibre solution provided at speeds of 10Mbps or 20Mbps, exclusively to Openserve clients who on-sell the product to their customers.
It provides end-users with access to uncapped fibre and is best suited for customers who use the internet for basic browsing purposes.
“ Through continuous innovative product development, as Openserve, we want to increase fibre connectivity rates across South Africa, especially in parts of our country that are underserved. By providing affordable fibre through Web Connect, we can connect more homes, giving access to seamless connectivity at a minimal cost, ” says Dube.
As part of its strategy to connect more South Africans to its network, Openserve says it has continued to revamp its service and fulfilment model, by launching multiple digital platforms, such as the Openserve Connect App that allows customers to engage, trouble-shoot connectivity issues and utilise self-service features while on the Openserve network.
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Vodacom, MTN lead as SA’ s most valuable brands
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MTN and Vodacom are South Africa’ s most valuable brands for the year 2022, coming first and second, respectively, out of the country’ s top 100 most valuable and strongest brands.
The latest annual report on the most valuable and strongest SA brands by Brand Finance says MTN recovered strongly from the impact of COVID-19 to extend its lead over second-ranked Vodacom.
The brand valuation consultancy says the leading telecoms brand value surged this year, returning to growth after a disappointing result in 2021.
MTN’ s value is up 5% to R29.9 billion, meaning its brand value is now worth almost exactly double that of Vodacom.
Every year, Brand Finance puts SA’ s most valuable and strongest brands to the test. The country’ s top brands are then included in a dedicated national ranking – the Brand Finance South Africa 100.
This year, Brand Finance says, all inclusive, the aggregate value of the top 50 South African brands grew by 15%, from R452 billion in 2021, to R519 billion in 2022.
Similarly, the consultancy says, the aggregate value of the top 100 South African brands grew by 17% this year, from R488 billion in 2021, to R570 billion in 2022.
MTN’ s brand value went up 34% to R59.8 billion, to retain the number one spot on the ranking of the most valuable South African brands in the world.
The report notes that while the introduction of new regulations in Nigeria have slowed growth in Nigeria, the number of MTN subscribers across the African continent increased by 2.9 million this year, to over 272 million subscribers globally.
It says MTN is delivering on its brand commitment by carrying significantly higher levels of data traffic and financial transactions on its Mobile Money ( MoMo) service.
Transaction volume of MTN’ s MoMo in Nigeria, its most lucrative market, rose by 167% to 137.5 million in the year ended December 2021, from an active user base of 9.4 million, up 102%.
“ South African brands are powering our economy, and as the world looks towards life after COVID-19, MTN has cemented its leadership role as our most valuable brand, ” says Jeremy Sampson, managing director, Brand Finance Africa. “
MTN’ s brand value has grown considerably. With the current refresh of the brand, it is well-positioned and reenergised for the future. ”
After MTN and Vodacom, the Brand Finance South Africa 100 2022 report’ s top 10 was dominated by banks, with Standard Bank edging ahead of First National Bank and Absa to be the most valuable banking brand.
Standard Bank’ s brand value surged 12% to just over R23.4 billion, marginally edging out First National Bank ( with brand value up 6% to just under R23.4 billion), to become the most valuable banking brand in SA for the first time in several years.
Standard Bank and First National Bank are the third and fourth most valuable South African brands on the list.
The report reads: “ Standard Bank’ s growth of 12% this year is a big improvement on its 5% growth last year and is connected with the South African economy growing by 4.9% this year as it rebounds from the pandemic.
“ While the pandemic recovery is being disrupted by new waves of infection, infrastructure limitations ( especially around reliable electricity) and social unrest are causing significant challenges.
“ Standard Bank’ s operations did face some direct disruption from the unrest in KwaZulu-Natal and Gauteng in July, but this was limited due to Standard Bank’ s brand reputation as a reliable business partner. This has enabled the bank to become the most valuable South African bank brand. ”
It adds Standard Bank and FNB remain ahead of Absa ( brand value up 3% to R21.3 billion) which was the third most valuable South African banking brand and fifth most valuable South African brand overall.
“ Absa’ s brand faced many of the same challenges as Standard Bank and FNB, but with its brand value increasing slightly to R21.3 billion, it has not yet returned to pre-pandemic levels. ”
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War in Ukraine, China lockdowns spur ' a step back ' for air cargo
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Russia's invasion of Ukraine and China's lockdown of Shanghai have strongly influenced conditions in an air cargo market that has yet to return to pre-pandemic capacity levels.
The war in Ukraine has forced affected carriers either to take lengthier routes in a period of high fuel costs or cancel flights. `` The international sanctions against Russian carriers, the closure of Russian airspace and the associated daily changes in circumstances are increasing the volatility of the market, '' DB Schenker said in an April 7 update.
Capacity between Europe and Northeast Asia specifically saw a 20% decline following the closure of airspace in Russia, according to Clive. And from March 21-27, Japan-to-Europe spot rates jumped nearly 50% higher from the weeks preceding the war.
Meanwhile, in Shanghai, China, lockdowns and staffing difficulties at ports have slowed port operations, reduced product availability and stymied truckers, according to an April 5 email update from Freightos.
`` With limited goods available to ship, air cargo demand out of Shanghai is decreasing quickly, '' per Freightos ' update. `` In response, air carriers are canceling flights. ''
The drop in capacity sparked an increase in rates, with Shanghai-Northern Europe rates jumping 43% the last week of March from the period before the recent COVID-19 outbreaks, according to the Freightos Air Index.
Carrier operations at Shanghai Pudong International Airport in particular have been challenged by the restrictions. A suspension of inbound dangerous goods cargo at the Shanghai Pudong International Airport Cargo Terminal announced April 2 will be in effect for two weeks, according to Crane Worldwide Logistics.
`` Cargo handling at PVG airport continues to be almost impossible, '' per an April 8 update on Crane's website. `` Cargo can not be delivered into or picked up from the PVG airport area. More airlines have announced flight cancellations. ''
Cargolux and Etihad Cargo announced flight cancellations to and from the airport, according to Crane. For Cargolux, flights are canceled April 8-14. For Etihad, freighter flights are canceled April 13-20.
Cargo is now shifting to other airports, with Zhengzhou, Qingdao, Tianjin and Beijing seeing higher volumes and reduced capacity, Crane added.
The disruption in Shanghai `` is not unexpected, '' but it adds to current air cargo staffing challenges due to COVID-19, van de Wouw said.
`` In the first two months of 2022, we were talking of growing resilience in the airfreight market and a recovery to pre-Covid levels, '' van de Wouw said. `` March data shows how quickly this can change. ''
Topics covered: logistics, freight, operations, procurement, regulation, technology, risk/resilience and more.
The retailer's acquisition of a middle- and final-mile carrier as the COVID-19 pandemic took hold has allowed it to take more control over its delivery process.
The acquisition has contributed to an approximately 35% reduction in delivery times, executives said on an earnings call.
Topics covered: logistics, freight, operations, procurement, regulation, technology, risk/resilience and more.
Topics covered: logistics, freight, operations, procurement, regulation, technology, risk/resilience and more.
The retailer's acquisition of a middle- and final-mile carrier as the COVID-19 pandemic took hold has allowed it to take more control over its delivery process.
The acquisition has contributed to an approximately 35% reduction in delivery times, executives said on an earnings call.
Topics covered: logistics, freight, operations, procurement, regulation, technology, risk/resilience and more.
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Philadelphia to reinstate indoor mask mandate amid surge in new COVID cases
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PHILADELPHIA — Philadelphia is reinstating its indoor mask mandate after reporting a sharp increase in coronavirus infections, the city’ s top health official announced Monday.
Confirmed COVID-19 cases have risen more than 50% in 10 days, the threshold at which the city’ s guidelines call for people to wear masks indoors, said Dr. Cheryl Bettigole, the health commissioner.
Philadelphia is the first major U.S. city to go back to requiring masks since cases declined at the beginning of the year.
The city is reporting more than 140 cases per day, a fraction of what it saw at the height of the omicron surge, and hospitalizations remain low. But Bettigole said the recent increase in infections indicates the city might be at the beginning of a new wave, and city officials are seeking to stay ahead of it by requiring indoor masking.
Health inspectors will start to enforce the mask mandate at city businesses starting April 18.
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United States Trade Insights from TFG - Page 4 of 6
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Welcome to Trade Finance Global. Browse and read the latest news, stories and educational insights from the world of trade and receivables finance. Stay up to date with the latest products, services and innovations in the market, bought to you by the Trade Finance Global team.
TFG heard from EXX Africa’ s Keri Leicher, on the economic, political and health crisis in Africa caused by Covid-19 pandemic. Keri spoke of Africa’ s high level of debt and silent attacks affecting the continent’ s security.
American consumers are currently sitting on a fairly huge nest egg. Equity is at a higher level than ever before, and the personal saving rate has risen to a considerable 7.9% according to NASDAQ figures.
Events such as Brexit, the US-China trade war, political unrest between China and Hong Kong dominated the headlines in 2019, have all had significant implications on global trade. However, it has not all been bad news – with increased levels of cooperation and technological innovation, the outlook for trade/finance moving into 2020 could be promising.
Trade Finance Global, in partnership with Finastra, sat down with 6 global experts in trade to get a low down of 2019, the key themes and trends, as well as what’ s been at the front of mind for practitioners in trade, receivables and supply chain finance.
Trade Finance Global spoke to Wenhui LIANG at the WTO Global Trade and Blockchain Forum, on the nature of the current state of the global trading and blockchain adoption in global trading.
TFG spoke to Stephen Renna, Chief Banking Officer at US Exim Bank at TXF CPRI in London, about the core priorities and focus for the bank in order to facilitate US exports, now that is has a wider remit to promote US SMEs.
With the development of more interconnected alternative finance options for businesses and the emergence of open banking in the marketplace, the option of Peer-to-Peer ( P2P) lending is seeing a great increase in popularity over the years among its SME audience.
Despite what economists, central bankers, and politicians may tell you, the evolution of the world economy is not a graceful one. Rarely does it feel cooperative, since getting a good look at how a single element impacts the whole can seem downright impossible. However, the past few days have shined a light on how trade helps shape the global economic landscape, make waves across markets, and set the tone for the future.
It seems nowadays unicorn businesses are emerging in the venture capital scene with accelerating frequency. With an increasingly mobile and technologically capable world, fin-tech companies and eCommerce startups are dominating most of the visible market now. Is startup growth really as proliferate and fast-paced as it may seem? The answer is an unsurprising, billion-dollar “ yes ”.
We interviewed Geoff Brady, Head of Global Trade & Supply Chain Finance ( GTS) at Bank of America Merrill Lynch. We talked about the physical and financial aspects of the supply chain management, about the importance of Blockchain Consortia in the trade finance space and the BAML’ s agenda for the rest of the year.
TFG heard Judd Holroyde, Head of Global Product Management, Wells Fargo. We talked about the changing payments landscape, about SWIFT and SWIFT Gpi and how the FinTech creativity can be used as a customer value proposition messenger.
Twitter has changed the way politics is portrayed. Not only has it arguably drifted political opinions further apart, but it has also given rise to issues like false information and hate speech in the political discourse.
The global trading system is in disarray. Global economic growth is slowing, half the G20 are now operating under openly protectionist agendas, and tensions between China and the United States remain high – despite faint promise of a truce earlier this year. But over in the UK, all of this is overshadowed by the continuing dispute over Brexit. The nation is bitterly divided, and we are fast approaching what could constitute a national crisis.
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Dow falls more than 400 points, Nasdaq finishes 2.2% lower as Treasury yields keep surging
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Dow industrials and the S & P 500 index book their biggest one-day declines since March on Monday, with energy, tech and other growth names bearing the brunt, as Treasury yields soared and investors braced for the next inflation reading and the kickoff of earnings season.
What happened
The Dow Jones Industrial Average
DJIA,
-1.19%
finished 413.04 points, or 1.2%, lower at 34,308.08. It was the Dow industrials’ largest one-day point and percentage drop since March 31, according to Dow Jones Market Data.
The S & P 500
SPX,
-1.69%
closed down by 75.75 points, or 1.7%, at 4,412.53. It was the index’ s largest one-day point and percentage decline since March 7.
The Nasdaq Composite
COMP,
-2.18%
finished 299.04 points, or 2.2%, lower at 13,411.96.
What drove markets
Investors continued to digest the implications of a likely half-point rate hike from the Federal Reserve in May, along with a more rapid unwinding of the central bank’ s balance sheet than in the past, as policy makers attempt to rein in inflation that’ s at a
40-year high
. Tuesday’ s annual headline inflation reading, contained in the consumer-price index report for March, is expected to exceed 8%.
Read:
Worries grow that 8% inflation, more Fed comments on balance-sheet runoff could ‘ scare the bond market witless again’
The yield on the 10-year Treasury
TMUBMUSD10Y,
2.824%
rose 6.6 basis points to 2.78%, its highest level since Jan. 18, 2019, according to Dow Jones Market Data. Meanwhile, the 30-year climbed 7.5 basis points to 2.82%, the highest since May 21, 2019. Ten- and 30-year rates are up, respectively, for the seventh and sixth straight trading days. Yields move in the opposite direction to prices.
Rising bond yields are acting as a headwind for stocks, particularly tech and other growth stocks in which valuations are based on expected profit and cash flow far into the future. Higher yields on risk-free Treasurys mean those future flows are less valuable in present terms.
“ Even if the US earnings season — which gets under way this week — reveals decent growth in profits, we doubt that expectations for earnings will continue to be revised higher, ” said Oliver Allen, markets economist for Capital Economics. “ This informs our forecast for meager gains in the U.S. stock market over the rest of this year, ” Allen wrote in a note on Monday.
Ahead of bank earnings and inflation data later in the week, traders were left focusing on the health of the market.
Read:
U.S. banks are facing body blows from Ukraine war and a slump in investment banking activity
Michael Darda, chief economist and market strategist at MKM Partners, said the S & P 500 is still above fair value even with the recent pullback. He said that for the equity risk premium — the earnings yield minus the bond yield — to move back to its five-year average, one of four things would have to happen: bond yields fall by around 100 basis points, earnings rise about 20%, the stock market falls about 17%, or some combination of the three.
“ Our valuation work shows that financials remain the most attractive cyclical sector while healthcare is the most attractive defensive sector. High valuation tech across the capitalization structure remains an ‘ avoid’ or a short, in our view, ” said Darda.
Need to Know:
It’ s still not time to invest in China, argues Bank of America. Here’ s why.
Meanwhile,
Charles Evans
, head of the Federal Reserve’ s regional bank in Chicago, said a 50 basis point rate hike in May could now be “ highly likely. ”
Stocks in focus
Elon Musk remained in the headlines after
Twitter Inc.
TWTR,
+1.69%
Chief Executive Parag Agrawal said the Tesla Inc.
TSLA,
-4.83%
chief
“ has decided not to join our board. ”
Twitter had announced last week that Musk would join the board after regulatory filings revealed that he had become the social-media platform’ s top shareholder. Twitter shares finished 1.7% higher.
Shares of
Shopify Inc.
SHOP,
+2.35%
finished 2.4% higher after the Canada-based e-commerce software company said it was planning for
a 10-for-1 split of its common stock
, in an effort to make its shares “ more accessible to all investors. ”
Veru Inc.
shares
VERU
rose 182.3% after the biopharmaceutical company
announced positive results
from a Phase 3 trial of its oral COVID-19 treatment.
SailPoint Technologies Inc.
shares
SAIL
closed up 29.2% after the cybersecurity company confirmed an agreement to be acquired by private-equity firm Thoma Bravo in
a deal valued at $ 6.9 billion
.
The impact of China’ s lockdowns were on display as electric-vehicle maker
Nio Inc.
NIO
said it would have to suspend production due to
disruptions to its supply chain
. Nio’ s American depositary shares closed down 1.5%.
How other assets performed
The ICE U.S. Dollar Index
DXY,
+0.06%
,
a measure of the currency against a basket of six major rivals, was up 0.2%.
Oil futures retreated, with West Texas Intermediate crude for May delivery
CLK22,
+1.13%
down $ 3.97, or 4%, to settle at $ 94.29 a barrel on the New York Mercantile Exchange. Gold for June delivery
GCM22,
+0.38%
rose $ 2.60, or 0.1%, to settle at $ 1,948.20 an ounce.
Bitcoin
BTCUSD,
-0.53%
slumped 7.7% to trade near $ 39,829, plunging below $ 40,000 for the first time since March.
The Stoxx Europe 600
SXXP,
-0.59%
and London’ s FTSE 100
UKX,
-0.67%
finished down by 0.6% and 0.7%, respectively.
Stocks slumped in Asia, with the Shanghai Composite
SHCOMP,
-2.61%
ending 2.6% lower, while the Hang Seng Index
HSI,
-3.03%
fell 3% in Hong Kong, and Japan’ s Nikkei 225
NIK,
-0.93%
shed 0.6%.
— Steve Goldstein contributed to this article.
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Tight Oil Supply, Russian Invasion Blamed for High Pump Prices, E & P Execs Tell Congress
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U.S. oil and natural gas producers don’ t set global commodity prices, nor are they attempting to gouge consumers, executives of the leading domestic explorers told Congress last Wednesday.
Top executives of BP America Inc., Chevron Corp., Devon Energy Corp., ExxonMobil, Pioneer Natural Resources Co. and Shell USA Inc. discussed the reasons for sustained high prices at the gasoline pump.
The exploration and production ( E & P) chiefs shared their insight into the myriad reasons for rising commodity prices during a hearing before the House Committee on Energy and Commerce. Also testifying was retired U.S. Army Lt. General H. R. McMaster, now a senior fellow at Stanford University’ s Hoover Institution.
[ Fundamental Matters: From drilling rig counts to pipeline projects, European demand for U.S. LNG exports to growing natural gas production in the Permian, cash flow impacts to inventory — this episode of NGI’ s Hub & Flow podcast gets you up to speed on what’ s impacting the industry, following the latest quarterly reports. Listen now. ]
Democrats blamed the high pump prices on producers during the hearing, while their Republican colleagues laid the blame at the feet of the Biden administration.
Neither a lack of production nor Biden energy policies are the reason pump prices are high, the executives said. All of them attempted to explain how oil prices are set. It’ s a complex process, they noted.
In the United States, the end of pandemic closures, combined with the impact of the Ukraine invasion, have created turmoil in the energy markets, ExxonMobil CEO Darren Woods testified.
“ As the world emerges from the impacts of the pandemic, we were already seeing a growing supply and demand imbalance in global oil and gas markets. The invasion of Ukraine increased the risk of insufficient supply – demonstrating how quickly global markets can be disrupted and impact the lives of every American.
“ The uncertainty of supply in a tight market with growing demand leads to significant price volatility, which is what we are seeing today, ” he said.
Russia “ provides roughly 10% of the oil needed to meet global demand, and about 30% of Europe’ s natural gas demand. ” The loss of those volumes “ would dwarf ” the impact of the 1973 Arab oil embargo “ and represent the largest supply disruption in the history of our industry, ” Woods said. “ The risk of this obviously puts upward pressure on oil and gas prices. ”
There is no quick fix, he noted. The answer in the near term, “ until there are more widely available and affordable alternatives, is straightforward. We need to increase the supply of oil and natural gas. And our industry has been doing just that. ”
E & Ps are in the “ depletion business, ” Woods noted. The industry makes “ significant investments just to keep production flat. On average, without investment, industry production declines roughly 7% per year. This requires a consistent commitment to investing across the commodity price cycle. ”
From the Permian Basin alone, ExxonMobil this year expects to deliver more than 550,000 boe/d, up 25% from 2021, when output also was 25% higher year/year.
“ Continued investment in new production to offset depletion and meet growing demand is the only way to achieve balanced markets and more affordable prices, bringing real relief at the pump, ” Woods said.
“ Government plays a critical role in this, ” he said. In addition, policies that reflect the importance of energy, create certainty and improve predictability, encourage industry investment, and ensure affordable and reliable supplies of energy.
“ Consistent, efficient and effective permitting processes, whether for leases, drilling or infrastructure such as pipelines, or export applications, will help spur further investment in U.S. oil and gas production. ”
BP America Chair David Lawler, like his colleagues, noted that the price of globally traded oil, gasoline and refined products are driven by international markets. Retail fuel prices are set competitively, not by the E & P. And most retail fuel stations are independently owned and operated.
Chevron CEO Mike Wirth repeated President Biden’ s recent comments that “ if we want lower gas prices, we need to have more oil supply right now. ” The San Ramon, CA-based major is working to do that, he told the House members.
“ Chevron has committed to increase its capital expenditure this year by 50%, with approximately half of that increase going to increasing oil and gas production and the other half going to renewable fuels and lower-carbon energy, ” Wirth said.
“ I want to be absolutely clear, ” he said. “ We do not control the market price of crude oil or natural gas, nor of refined products like gasoline and diesel fuel, and we have no tolerance for price gouging. ”
Oil and gas prices are impacted by “ factors that involve far more than one company or even one country, ” Wirth said. “ Gasoline prices are fundamentally a function of supply and demand. ”
Wirth attributed the higher pump prices to a variety of things, including increased demand as Covid-19 restrictions were lifted and the uncertainty about future supply related in part to Russian energy bans.
Devon CEO Richard Muncrief said the Oklahoma City-based independent “ began implementing our 2022 plan when events began unfolding in Ukraine. We are now seeing prices level off, but uncertainty creates volatility, and we are not out of the woods yet. ”
Like other E & P executives who testified, Muncrief said it is taking longer today to secure applications for permits to drill, or APDs. In addition, ” the process to complete a well and bring it to full production may mean that a significant number of weeks transpire before a well reaches its potential.
“ Now, with the significant delays in obtaining the materials needed to operate due to global supply chain constraints and a shortage of workers, the time has substantially increased and is now closer to six months, ” Muncrief said.
Pioneer Natural CEO Scott Sheffield, who has been called out by legislators on Tuesday and President Biden last week for vowing to not expand Permian oil production even if prices approached $ 200/bbl, defended his comments.
“ I understand the desire to find a quick fix for the recent spike in gasoline prices, but neither Pioneer nor any other U.S. producer can increase production overnight by turning on a tap. Pioneer and other U.S. shale operators sell their commodities when produced.
“ We do not have spare production capacity or a private strategic reserve with which to quickly increase oil deliveries in response to market disruptions. Such a response is only possible in countries such as Saudi Arabia and the United Arab Emirates, whose national oil companies can quickly add production to the world market from surplus supply capacity that exists today. ”
To plan, permit, drill and safely complete wells, along with building infrastructure, “ takes 18 to 24 months for our company. It used to take less time in the past – in some instances only six to 12 months – but this timing is especially negatively impacted today.
Sheffield cited “ increasing cost inflation, the loss of thousands of experienced oilfield workers over the past several years, the decommissioning of rigs and fracture fleets when oil prices were low in 2020, and significant shortages across our supply chain. ”
Shell USA President Gretchen Watkins in her testimony said price gouging is illegal, and Shell plc and its affiliates would not engage in those types of activities.
“ Numerous governmental and nongovernmental examinations, including by the Federal Trade Commission and the Energy Information Administration, have concluded that crude oil prices are the primary factor in determining gasoline prices, ” Watkins said.
“ Shell is therefore focused on providing the United States and the world with a stable, reliable, and accessible supply of the oil and gas needed to meet society’ s energy needs, which is the most direct and significant contribution we can make to stabilize energy prices in the near term. ”
© 2022 Natural Gas Intelligence. All rights reserved.
ISSN © 2577-9877 | ISSN © 2158-8023 |
Related topics: Oil prices Oil Production Ukraine-Russia Crisis
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email carolyn.davis @ naturalgasintel.com
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Massive price increases spurred by spring snow storms and pipeline maintenance lifted spot gas prices during the April 11-14 trading period, which covered gas flows through Tuesday because of the Good Friday holiday. NGI’ s Weekly Spot Gas National Avg. jumped 57.0 cents to $ 5.855/MMBtu. Futures continued to surge as well, with a lack of sustained…
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Channelling success: New growth in MSSP market
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The South African reseller channel has long been a playground for ambitious entrepreneurs. And while there are daily news reports of how many businesses have struggled to survive the past two years due to the pandemic, on the ground, I’ m noticing a groundswell of new energy.
Technology has shown its worth over the past two years, with remote work demanding momentum for cloud, and data breaches and hackers ensuring more focus on cyber security.
The missing ingredient was budget – and to some extent COVID was a convenient excuse. More than one of us has borne the brunt of delayed purchasing decisions, longer sales cycles and errant decision-makers over the past two years.
As we emerge and start rebuilding, we can see that technology alone will only bring us to the point where we should have been in 2022, without the pandemic.
What’ s emerging is a new wave of diversification. We’ re seeing resellers evolving into managed service providers, and particularly so in the cyber security industry. Managed security service providers ( MSSPs) are taking full advantage of the market by collaborating closely with technology vendors to provide almost-instant services which would not have been possible before.
With the cloud in their pockets and a market ripe for security, they’ re looking for turnkey solutions that will meet squeezed margins from their customers and help them find growth again – maybe even grow quickly enough to be noticed and acquired.
Existing MSPs and MSSPs are looking for technologies that allow them to break the chains of stagnant margins.
And don’ t be fooled, it’ s not only the smaller players. Larger IT service providers, systems integrators and established IT firms need to reinvent their offerings. Overheads are forever crushing the bottom line and shareholders are more and more demanding of aggressive margin growth.
It’ s stated the MSSP market will grow from $ 30.6 billion annually in 2020 to $ 46.4 billion in 2025. That’ s exciting growth – and we are certainly seeing it starting to play out in the US. Now it’ s whether it will come to our shores quickly enough.
One US example is a reseller that recently took on security services, but in a way that meant the least risk for it. The reseller didn’ t have the resources to invest, or the dedicated staffing it takes to set up a security operations centre. Instead it built its managed security service offerings by relying on the vendor to provide specific solutions and help it on the journey.
Building services from managing firewalls, e-mail security, endpoint security, security assessments, through to wireless network security, compliance and extended detection and response, it flourished and was soon up to 550 customers.
The story doesn’ t end there. As its considerable success built it very attractive margins, and a scalable model, it was soon noticed – and acquired by a managed service provider ( MSP) in Northeast USA with wide-ranging services, particularly based on the value served in cyber security.
It is interesting to note the secret sauce was a white-labelled, end-to-end cyber security platform which delivered SOC-as-a-service and appealed across industry – something the acquiring MSP had yet to build or offer.
There’ s a common theme emerging in this story. SMEs are looking for cost-effective ways of protecting themselves without costing the earth. Small to medium enterprises desperately need cyber defenses that are easy to install, manage and afford.
Existing MSPs and MSSPs are looking for technologies that allow them to break the chains of stagnant margins and allow margin growth again.
The perfect match is starting to happen between channel partners taking up services and offering them as easy conversions, while reaping better margins from their technology vendors. At the same time, they are saving their customers time and money, and providing real returns on investment in a short space of time.
Many businesses lack the resources and in-house expertise to adequately defend their network infrastructure against the myriad of threats in our cyber world.
ADT, for example, launched its ADT-IQ service based on an aiMSSP solution. An aiMSSP model provides SOC-as-a-service using artificial intelligence for much of the grunt work, saving time filtering logs and data. Through this white-labelled service, the platform lets ADT deliver affordable services to clients.
This example makes me wonder whether anyone could turn into an MSSP overnight – essentially insourcing the skills and resources from a larger vendor, white-labelling expertise and services, and finding an accelerated opportunity to market. It’ s a no-name brand model, which has worked well in other industries for years.
There’ s an added advantage that as the MSSP grows its customer base under this model, it grows its cyber security skills and expertise – something definitely in short supply on the continent.
I can’ t see a downside – if the vendor is solid and provides a good safety net, providing strong skills transfer and reinvesting the spoils into further research and development, surely this collaborative approach will help bolster growth?
Product director, Corr-Serve. Mark van Vuuren is product director at Corr-Serve. With more than 28 years in the IT industry, his experience spans software development, software quality assurance and cyber security for international and local organisations providing solutions to the public and private sectors. More recently, Van Vuuren has focused on helping organisations mature their security posture from development through to operations. He holds a BCom in Economics and Financial Accounting.
Mark van Vuuren is product director at Corr-Serve. With more than 28 years in the IT industry, his experience spans software development, software quality assurance and cyber security for international and local organisations providing solutions to the public and private sectors. More recently, Van Vuuren has focused on helping organisations mature their security posture from development through to operations. He holds a BCom in Economics and Financial Accounting.
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general
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Risk of heart problems from COVID-19 vaccine is relatively low, studies say
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The risk of developing inflammatory heart conditions after COVID-19 vaccination is relatively low, two large studies found, especially when compared with the
heart-related risks
from COVID-19 disease itself and from vaccines against other diseases.
One study, an analysis of 22 previous studies, found that the risk of the conditions including myocarditis in people who received a COVID-19 vaccine wasn’ t significantly different from that for non-COVID-19 vaccines such as those against flu, polio and measles. And the heart risk associated with COVID-19 shots was lower than the risk after smallpox vaccination. The results of the analysis, which included data on the effects of more than 400 million doses of various vaccines, were published online Monday by The Lancet Respiratory Medicine.
Another analysis published April 1 by the Centers for Disease Control and Prevention found that the risk of cardiac complications including myocarditis, an inflammation of heart muscle, was higher in people after COVID-19 infections than after receiving a COVID-19 vaccine.
“ The overall message is that you can never consider risk in isolation, ” said Jason Perry Block, an associate professor at Harvard Medical School and a co-author of the CDC’ s analysis.
Concerns over
potential side effects
from COVID-19 vaccines are one reason some eligible adults in the U.S. say they haven’ t gotten the shots, according to public-opinion surveys. About 70% of eligible Americans have been fully vaccinated against COVID-19, according to the CDC.
An expanded version of this report appears on WSJ.com.
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School reopening mess drives frustrated parents toward GOP.
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business
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Utviklingsøkonomi blir stadig mer relevant for landene i nord by Dani Rodrik
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CAMBRIDGE – « Produktiv dualisme » er et begrep som står sentralt i utviklingsøkonomi. Økonomene som grunnla dette forskningsfeltet, som den karibiske nobelprisvinneren W. Arthur Lewis, påpekte at økonomien til fattige land er delt mellom en smal « moderne » sektor, som anvender avansert teknologi, og en langt større « tradisjonell » sektor preget av svært lav produktivitet.
Økonomer har lenge ment at denne todelingen er et definerende trekk ved utviklingsland, i motsetning til utviklede land der avansert teknologi og høy produktivitet ble antatt å gjøre seg gjeldende gjennom hele økonomien. Dermed skilte utviklingsøkonomi seg ut som en egen studieretning, atskilt fra konvensjonell nyklassisk økonomi.
Utviklingspolitikk har tradisjonelt vektlagt behovet for å redusere forskjeller i inntekt, utdanning, helse og muligheter gjennom livet mer generelt. Målet var å få bukt med den produktive todelingen gjennom nye institusjonelle ordninger som ville endre hvordan markedet virker og gi folk flere produktive muligheter.
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Writing for PS since 1998 195 Commentaries
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Dani Rodrik, Professor of International Political Economy at Harvard University’ s John F. Kennedy School of Government, is President of the International Economic Association and the author of Straight Talk on Trade: Ideas for a Sane World Economy ( Princeton University Press, 2017).
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it is good to see that a mainstream economist starts talking reality, for a change.Reality is that the world population growth in the last 50 years is putting enormous pressures on all resources. What it means is that there is a relentless downward pressure on living standards in the developed countries and an invisible lid on the development for the developing countries. Markets translate these factors into inequality and the political systems translate this inequality into political resentment and instability.Likewise, population growth is responsible for greater susceptibility of populations to climate fluctuations. It is not carbon dioxide, but much greater population that creates huge crisis in response to the same drought or flood.Likewise, uneven population growth, concentrated in poorer countries, creates growing migration pressures. Not climate crisis. Wars are a factor, but wars do not happen without a reason. The answer, if there is one, is to put the problem in the open. For reasons that I do not fully understand the political and the economist class likes to talk about everything except this elephant in the room. We need substitutes for scarce resources. The technologies that give us alternatives need to be developed and the discussion needs to be how to develop them as fast as possible. Redistribution has it's place but you can't redistribute what you don't have. For instance, we need `` green new deal '' of some kind not because of the climate crisis, but because dependence on the fossil fuels is a dead end. Maybe politicians think that people are not able to handle the truth? Try them. If you don't, assorted demagogues will give them the truth of their own. It is the other guy that takes something away from you. A Jew, a Muslim, a different skin color, the works. War seems always to be the answer that demagogues have in mind and today it may very well be war with nukes on day one.
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Before Russian President Vladimir Putin’ s attack on Ukraine, Europe’ s recovery from the damage wrought by the COVID-19 pandemic was solidifying. But now European policymakers have exactly zero control over whether their economies ' rebound continues.
For 40 years, the United States has made a point of not saying whether it would defend Taiwan against a Chinese invasion, an approach that proved effective in deterring rash action by China and by pro-independence Taiwanese. But now that circumstances have changed, so, too, must America's strategy.
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