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Monthly Archives: November 2021

U.S. Cyber Monday Sales Fall For The First Time Ever

Jonathan Ponciano wrote . . . . . . . . .

Consumer spending on Cyber Monday fell for the first time ever this year, Adobe analysts said Monday, pointing to record sales growth earlier in the month as a sign retailers and consumers are adjusting to lingering supply chain constraints by placing less of an emphasis on the year’s biggest online shopping holiday.

Americans spent a total of about $10.7 billion on Cyber Monday, down 1.4% from 2020 in the first yearly decline ever, according to the Adobe Digital Economy Index on Tuesday morning.

The figures came in at the low end of Adobe’s projections for the holiday, which nabbed $10.8 billion in sales last year and were expected to climb up to $11.3 billion this year.

In an email, Adobe’s Taylor Schreiner said the decline was “fueled by growing awareness of supply chain challenges and product availability,” which encouraged some consumers to spread out e-commerce spending across the months of October and November.

Despite the Monday decline, which mirrored a 1.3% yearly decline in Black Friday sales, this holiday season is still on track to break online shopping records, Schreiner said, pointing out consumers have already spent $109.8 billion this month, soaring 11.9% over last year.

In a Tuesday email, market analyst Adam Crisafulli of Vital Knowledge Media said Cyber Monday sales growth would have been difficult this year given how the country “was still in the throes of the pandemic” one year ago, limiting in-person retail options (more so than this year) and forcing more Americans to shop online.

CRUCIAL QUOTE

“With early deals in October, consumers were not waiting around for discounts on big shopping days like Cyber Monday and Black Friday,” Schreiner said.

KEY BACKGROUND

A growing number of retailers have blamed pandemic-induced supply chain challenges for lower-than-expected profits this year, despite near-record consumer spending in recent months. A sign of retailer woes, the prevalence of out-of-stock messages was up 8% compared to a week before on Cyber Monday, according to Adobe. And in the month of November, the prevalence of out-of-stock messages has soared 169% versus prepandemic levels. Meanwhile, Adobe points out consumers are racking up bigger orders, with average order prices jumping 13.9% on Cyber Monday, reflecting both higher inflation and bigger-ticket item purchases.

SURPRISING FACT

Despite its decline, Cyber Monday remains the biggest online shopping day of the year by far, Adobe says. In the day’s peak shopping hour, starting at 11 p.m. EST, consumers spent an average $12 million every minute.


Source : Forbes


Charts: Eurozone Core and Headline Inflation Saw Sharp Increase in November 2021

Source : Goldman Sachs and Bloomberg

Moderna Boss Predicts Current Vaccines May be Less Effective Against Omicron

Julia Kollewe, Graeme Wearden and Peter Beaumont wrote . . . . . . . . .

The chief executive of the US drugmaker Moderna has predicted that existing vaccines will be less effective against Omicron than they have been against the Delta coronavirus variant, a comment that sharply lowered global stock markets.

Stéphane Bancel said it would take two weeks to get data on how the existing vaccines performed against the new Covid variant and whether it caused severe disease – but it would take several months to tweak vaccines to tackle it.

“There is no world, I think, where [the effectiveness] is at the same level … we had with Delta,” he told the Financial Times.

Other leading voices, however, moved to try to calm fears. The maker of the Pfizer vaccine and the University of Oxford predicted existing jabs would continue to prevent severe disease.

“We think it’s likely that people will have substantial protection against severe disease caused by Omicron,” said Uğur Şahin, the chief executive and co-founder of Pfizer’s German partner BioNTech, who defined severe disease as cases requiring hospital treatment.

“To my mind there’s no reason to be particularly worried. The only thing that worries me at the moment is the fact that there are people that have not been vaccinated at all.”

The two companies said on Friday that they could produce and ship an updated version of their vaccine within 100 days if the new Covid variant detected in southern Africa was found to evade the current one.

Oxford University, which makes the AstraZeneca vaccine, said in a statement: “We will carefully evaluate the implications of the emergence of [Omicron] for vaccine immunity.

“Despite the appearance of new variants over the past year, vaccines have continued to provide very high levels of protection against severe disease and there is no evidence so far that Omicron is any different.”

Israel’s health minister expressed cautious optimism. Nitzan Horowitz was speaking on Tuesday after another two cases of Omicron were identified in the country, bringing its total to four.

Without citing any data or reason for his optimism, he told reporters: “In the coming days we will have more accurate information about the efficacy of the vaccine against Omicron, but there is already room for optimism and there are initial indications that those who are vaccinated with a vaccine still valid or with a booster, will also be protected from this variant.”

The remarks come amid conflicting information about how effective various vaccines and therapies are likely to be against the new variant. The German pharmaceutical Merck said it expected its Covid drug to be effective.

Bancel suggested pharmaceutical companies would struggle between targeting Omicron and the existing Covid variants, and said it would be risky to shift Moderna’s entire production capacity to an Omicron-specific jab.

He said there might be a case for giving more potent boosters to elderly people or those with compromised immune systems.

He said the high number of mutations on Omicron’s spike protein, which the virus uses to infect human cells, and the rapid spread of the variant in South Africa, suggested there could be a “material drop” in effectiveness.

The Moderna comments fuelled further falls in share prices around the world, adding to Friday’s sell-off. The Hong Kong stock index closed at its lowest level in more than a year, falling 1.6%. The FTSE 100 index in London fell by 1.5% to its lowest level in seven weeks, before closing down 50 points or 0.7% at 7059 points after the BioNTech comments.

The FTSE 100 recorded its worst month in more than a year, trading down about 2.5% in November, the biggest drop since October 2020, when it lost nearly 5%, just before successful vaccine trials prompted a global rally in November 2020.

Mohit Kumar, the managing director of Jefferies, said Bancel’s comments were concerning. “The comments probably reflect the reality of the current situation and the uncertainty surrounding the Omicron impact. We should get more clarity in a couple of weeks, but the market would remain subject to headline risk till then.”


Source : The Guardian

香港管治成敗 責在建制

作者: 張炳良 . . . . . . . . .

若說過去泛民主派在立法會雖為少數,卻有機可乘,常陷議會於拖拉甚至癱瘓,致施政不順,那麼今後建制派既全面主宰立法會,能如何另闢新局,中央密切注視。管治成敗,除行政班子外,全看建制陣營的能力——即能否選賢與能,當選後能否做出成效。

何謂建制派?

政界及媒體常區分建制派vs.反對派/非建制派:建制派指(最終)支持政府的黨派,非建制派指常站在政府對立方的反對陣營。

九七回歸前,被港英「行政吸納」的工商專業精英,輔助(不是制衡)官僚施政,乃建制派,那時親中的傳統愛國左派,以及新興的民主派,皆反殖批殖,屬非建制派。回歸後,愛國左派自然地成為特區的建制派,但由港英繼承下來的「港官」,仍在中央委任的行政長官(後加上政治團隊)領導下執政,體現中央意旨,延續「行政主導」,而原港英建制精英,成功過渡為新朝建制派,泛民定位於反對派,構成早期穩定體制之四大板塊。

新選舉制下,有意見認為,只有支持「一國兩制」及《基本法》既定建制的參選人,始能通過資格審查,故皆屬建制派,並無非建制派。這近似英式議會「忠誠反對派」的邏輯,即忠誠於既有憲政秩序。所有選委和議員,經確認為「愛國者」,皆忠誠於建制,但毋須清一色,當中有捍衛政府者,也可有批判政府的反對派。

回歸後治港實驗挫敗

特區建制陣營的構成,有不同「血統」、黨派,從來非鐵板一塊。論地區組織力和選戰力,由傳統愛國力量蛻變而成的參選黨派表現較強,過去乃議會建制派的中流砥柱。

按中央原先接納的議會發展路徑,若建制派能佔立法會大多數(實際上也確如此),並有效支持特首及其班子施政,形成穩定可靠的管治同盟,泛民當少數反對派,可構成既利於行政主導、又存在選舉競爭的有節制之「港人治港」模式,結合社會上下左右的參與,中央毋須直接介入管治。

時移世易,至2020年,這個政治實驗被視作挫敗。其原因複雜,包括過去10年泛民陣營的變化(見上篇文章),以及建制派的困局:一是新舊及不同背景愛國者之間的矛盾,二是議會建制派與政府團隊之間的矛盾,三是建制派在民氣及地區普選和部分功能直選(註)上不及泛民。

管治同盟力不從心。建制派過去雖佔立法會近三分之二大多數,卻乏善足陳,常讓泛民操縱議事和程序。中央看在眼裏,不明所以,例如2019年10月起大半年任由泛民拖延而無法選出立法會內務委員會正副主席,直至國務院港澳辦和中聯辦介入,才急急解決。

2019年動亂,中央認定泛民蘊藏反中亂港勢力,更驚覺建制力量對局面失控,特區政府領導薄弱、建制黨派穩定不了社會,最終要中央出手。回歸前,中央以為延續官僚管治,加上新舊精英結合,便可順利治港。這設想未見兌現,令中央重估治港形勢和策略,最後以由上而下手段去「完善」治港制度。不過,處理了「投入」(input)元素,並不保證「產出」(output)質素,關鍵在於系統內轉化效能。

愛國力量的變化和暗湧

近年不單泛民,愛國力量也在起變化。2014年「佔中」後,出現藍營、藍絲,不少並非來自傳統愛國左派或北京重視的建制精英。時勢造英雄,2019年黃藍對壘,新興藍營群組和KOL(意見領袖)積極「勤王」,除勇於跟泛民、攬炒派、分離主義等鬥爭外,也批判官員(特別是所謂「AO黨」),以及他們視為不夠硬淨、指稱已被泛民「中和」的舊建制派。深藍對建制精英尤其不滿。

不少討論聚焦新選舉制下泛民的去路,其實建制派何嘗不是處於十字路口?他們須走出原來的運作舒適圈、適應改寫的遊戲規則。新冒起反西方的民族主義,漸主導藍營政治論述,帶引風向,具強烈的另類民粹主義和政治正確性,對傳統建制派構成壓力和競爭。

中央重整「治港」建制,須考慮起用什麼人,並超越從前圈子和路徑。目前看分四方面:傳統愛國左派、資本家及工商專業精英、回歸後培育的愛國專業和青年精英,及新興藍絲;當然還有一些過渡性人物。在議會「去政黨主導」下,建制派大黨難再獨當一面,但若各據山頭、誰也不服誰,會否製造體制新的暗湧?建制派大黨曾嘗試走既堅持愛國又爭取本土認同之路,現在是否成疑?

建制派競相爭取有為

新局下,反對派不振,看似建制安穩、能成大事,但上述三大困擾仍在。

收緊提名機制後之出選者,理應具相當質素,政見應有實在內涵,可是現時立法會競選,仍有候選人只泛泛而談,拙於公共政策,甚至對香港制度毫無信心,只求內地救港、或搬內地一套,短視和膚淺之處與從前的民粹無別。

新時期議會建制派,政治任務有二:支持政府、監督政府。「支持」不可盲目,「監督」不應為反而反、但求爭取不問實際。從中央看,若泛民干擾已成過去,建制派毋須「護航」,應展現新的負責任、鏗鏘有力的問政風格,如何鍛煉出這能力,乃一大挑戰,不是改制就自動到位,一切靠認真競爭。

建制派並非執政派,也難與美式同一政黨控制國會及出任總統時出現的Unified Government(合一政府)相提並論,而就算在美國也存在不間斷的行政立法角力。議會欲「有為」,往往積極與行政議價,不像英式議會般由多數黨的內閣擺佈。

另一挑戰是整合建制派成穩定施政的力量,必要時一錘定音。誰有能力發號施令,還是讓各自發揮?建制派3類議員(選舉委員會、功能組別、地區直選)的定位和表現自會不同,有政黨背景的跟單幹的也不會一樣,協調需要權威與實力。

建制派過去靠頂住泛民為團結基礎,現已失掉。將來會突顯監督制衡,競相爭取有為,尤其是來自地區選舉的政黨議員,無懼把矛頭指向政府團隊及公務員,以展示問政勇猛、為民請命、為民消氣。政府並非摸不得之老虎屁股,若問政有道,也助提升管治表現。

成也選委會、敗也選委會

中央認為過去直選普選之路只利於泛民及民粹主義,影響議會質素,故傾向精英議政,重設選委會議席,且佔44%大多數。新制能否如願產生賢能、開啟新風,讓社會叫好,自是考驗。可謂成也選委會、敗也選委會。

選委會議員理應不受局部或行業、地區利益左右,較為看重全港和國家發展需要,但不等於政府的天然支持者、對政府提出的照單全收;他們不欠政府,除非中央有強烈表示。部分循選委會出線的新人,議政或屬初哥,但具專業行業地位,及社會和公共服務資歷,其挑戰行政的力度不容輕視。

因此,改制後建制派主打的議會跟政治官僚的角力,不一定比過去建制vs.泛民大小二分天下時期為少,變數仍多,政治不會消失。


註:部分以個人選民直選而非公司/團體票選舉的功能議席。


Source : Ming Pao

Why the Wind Behind the Chinese Yuan’s Strength Is Likely to Die Down in 2022

Neal Kimberley wrote . . . . . . . . .

Even without a pandemic, rebalancing an economy the size of China’s would be no easy task. But that’s what Beijing aims to do. Monetary policy support from the People’s Bank of China will help keep Chinese economic growth on track. The yuan also has a part to play, but it will be a changing role.

The currency market may choose to recalibrate its view of China’s currency in 2022. Yuan strength could then begin to wane.

The prevailing wind in the currency market has been behind the yuan in 2021, lending it strength even as the Chinese economy has been navigating troubled waters amid problems in the property sector, an energy crunch and the resulting power cuts and, most recently, an uptick in Covid-19 cases.

To a large extent, present renminbi strength is a reflection of the foreign exchange market’s view that, despite China’s own problems, it is still a better bet than a lot of other economies.

The fact that yield differentials have favoured the yuan, as the PBOC took a more nuanced approach to monetary policy support than many other central banks, has also played no small part in enhancing the renminbi’s allure.

This prevailing wind may blow a while longer. Noting the possibility of an improvement in China-US trade relations, and feeling that “Chinese exporters have yet to restore their (foreign exchange) conversion ratios to levels seen before trade tensions, so they still have excess (US dollar) savings to unload”, HSBC reassessed its view on the yuan last week. It lowered its first-quarter 2022 forecast for the US dollar/Chinese yuan exchange rate to 6.40 from the previous 6.60.

HSBC also made the point that China’s current account surplus continues to underpin the yuan’s value.

Meanwhile the pandemic-related absence of outbound tourism from China, which necessarily results in selling of the renminbi, continues to remove a factor from the equation that would ordinarily weigh on the value of the Chinese currency.

Additionally, the strong yuan is a useful ally for Beijing in partially offsetting the impact of increases in US dollar-denominated energy prices that have been evident globally in recent months.

To the extent that yuan strength seems to currently suit Beijing, but where China’s economic interests seem best served by continuing with supportive monetary policy settings, the PBOC will have to make deft use of the policy levers at its disposal.

With that in mind, as other major economies appear on the cusp of tightening monetary policy that will erode yield differentials currently favouring the yuan, the PBOC might be inclined to avoid exacerbating the situation with cuts in China’s reserve requirement ratio in the coming months. Rather, it may prefer to use liquidity injections to support the economy.

The fact is that, with rising consumer price inflation having become an issue in economies such as Australia, Britain, Canada and the United States, it is now just a question of how far, rather than whether, their central banks will tighten monetary policy.

As yield differentials that have previously favoured the yuan narrow, the currency market might logically infer that there are more reasons to hold the currencies of countries such as the US that have tightened monetary policy, and, by extension, fewer reasons to hold the renminbi.

Higher yields on US Treasuries also mean lower prices for those same bonds. If, along with this process, markets also perceived that China-US relations were on the mend, they might also envisage a situation where Beijing again becomes an active Treasuries buyer.

That could then add a layer of support for the US dollar versus the renminbi. It might even suit Beijing and Washington to allow such a perception to build.

On the assumption that either an increase in energy supply or – less welcome economically – evidence of energy demand destruction will eventually curtail the fossil fuel inflationary pressures, then going into 2022, policymakers are likely to turn their attention to how to take advantage of any normalisation in global economic activity.

In such circumstances, Beijing might feel that China’s still-critical export sector could benefit from a degree of yuan weakness without it harming the Chinese economy as a whole. Meanwhile, Washington might see a degree of renminbi weakness, at least temporarily, as a price worth paying to obtain some imported disinflation.

All currencies wax and wane, even the yuan. Next year might see the renminbi wane a little.


Source : MSN

Charts: U.S. Pending Homes Sales Up in October 2021

Source : Bloomberg

In Pictures: Dishes of Central in Lima, Peru

Contemporary Peruvian Cuisine

No.4 of the World’s Best 50 Restaurants 2021

In China, People Are Risking Everything for a Box of Ritalin

Ni Dandan wrote . . . . . . . . .

They came for Jiang Ruiyang on Sept. 2. Ten police officers burst into the factory where he was working in north China’s Shanxi province, told him he was being detained on drugs-related charges, and marched him across the shop floor in handcuffs.

The 25-year-old’s crime: buying a few boxes of Ritalin on the internet.

Similar scenes have played out across China in recent months, as hundreds of people with attention deficit hyperactivity disorder (ADHD) have become unexpected targets in the country’s war on drugs.

The wave of police raids is the result of a series of policy failures that have left people with ADHD feeling increasingly desperate. For years, China’s health system has made it extremely challenging for adults with the disorder to access vital medication. Many have turned to the black market as a result, but that’s now putting them in the police’s crosshairs.

Stimulants like Ritalin, Concerta, and Adderall are strictly controlled in China, and anyone found buying them illegally can be prosecuted for drug trafficking. Patients like Jiang are effectively being forced to risk a prison sentence to protect their health.

“I still can’t figure out why they did this to me,” says Jiang, who spoke with Sixth Tone using a pseudonym for privacy reasons. “I’m just sick, but they treated me like a criminal.”

Though there’s a widely held assumption in China that ADHD only affects children, millions of Chinese adults have the condition. Lu Zheng, director of clinical psychiatry at the Shanghai Mental Health Center and a specialist who helped draft China’s clinical guidelines for adult ADHD, says the prevalence among Chinese adults is 2.8% — roughly consistent with the global average.

But the epidemic is almost entirely invisible. China’s health system has no designated centers for diagnosing and treating adult ADHD, and Lu estimates only 5% to 10% of Chinese adults with the disorder receive a diagnosis.

“Most ADHD patients have other psychiatric comorbidities, such as anxiety, depression, and bipolar disorder,” says Lu. “These disorders can make ADHD very hidden. And very few specialists are aware of adult ADHD.”

Failing to treat ADHD only makes the condition more serious. Studies have found that people living with untreated ADHD can suffer lifelong harm: They are more likely to be unemployed, experience addiction and mental health issues, and go to prison.

In Jiang’s case, his untreated ADHD almost killed him. As a child growing up in Shanxi, he often found it difficult to concentrate and stay calm. But it wasn’t until he finished college and started working at a local state-run factory that he realized he may have a mental disorder.

“My parents never took it seriously,” he says. “They believed it was just a problem with me.”

The wake-up call came in November 2018, after Jiang — then aged 22 — was involved in a near-fatal accident at the factory. As he was fixing some faulty equipment on the production line, a mechanical failure occurred. Jiang failed to react, surviving only because his colleagues pulled him to safety.

“I lost my attention at that moment,” says Jiang. “My subconscious was telling me something was wrong … but my brain was receiving too much other information.”

The incident convinced Jiang to consult a psychiatrist, but doing so was easier said than done. In Shanxi, there are only two hospitals able to diagnose and treat ADHD — and neither accept adult patients.

This is far from rare in China. Only a handful of facilities nationwide will help adults with ADHD, and they’re all located in major cities such as Beijing, Shanghai, and Nanjing. Very few officially cater to adults; they are overwhelmingly pediatrics wards that make exceptions for some over-14s out of compassion.

There are several reasons behind the lack of provision, Lu says. Few mental health specialists have experience with adult ADHD, which tends to be a difficult disorder to diagnose. Chinese hospitals, meanwhile, are reluctant to keep methylphenidate — the stimulant used in Ritalin and Concerta — in stock. Use of the drug, which is chemically similar to cocaine, is heavily restricted.

“Methylphenidate can be made use of by criminals,” says Lu. “That’s why even some hospitals that meet the criteria to use the medication are unwilling to: There are large legal risks involved.”

Jiang had to travel to Beijing’s Peking University Sixth Hospital to find a specialist willing to see him. The three-hour train ride from Shanxi was just the start of his problems. Arriving on a freezing winter afternoon, Jiang found there were no appointments available that day — a common issue, as millions of patients travel from all over the country to see doctors in the capital.

He decided to spend a miserable night on the hospital’s doorsteps, to make sure he was first in line the next morning. But even that wasn’t enough: The following day’s appointments had all been booked up, too. Jiang eventually had to buy a ticket from a scalper for several hundred yuan.

After over 24 hours of waiting, Jiang finally saw a specialist and was diagnosed with ADHD. In hindsight, he mainly feels fortunate that the doctor agreed to see him at all.

“It was out of her sense of responsibility that she decided to diagnose me,” says Jiang. “I’m very grateful.”

Access to treatment remains highly insecure and unpredictable for most adults with ADHD. Bai Yichu, a 38-year-old from the eastern city of Hangzhou, visited Hangzhou Seventh People’s Hospital in the hope of receiving a diagnosis in September. But despite the facility having a reputation for helping non-minors with ADHD, the staff there turned her away.

“I visited them because another patient told me they’d just got a diagnosis there in August,” says Bai. “But the doctor said the hospital had standardized its procedures and banned the practice of receiving adults in the pediatrics department.”

Bai eventually managed to see a mental health specialist at Xinhua Hospital in Shanghai, who diagnosed her with ADHD. But she’s convinced that the disorder has already done irrevocable damage to her life. After nearly two decades of mental health issues — she has also had depression since the age of 20 — Bai finds herself single, jobless, and over 200,000 yuan ($31,300) in debt.

“I’ve likely been affected by the condition (ADHD) for decades,” she says. “I’ve had dozens of jobs, but none of them kept me for more than three months. I’m extremely impulsive — any small thing in life can make me furious or emotional.”

Medication like Ritalin and Concerta can help, but accessing it can also be challenging. Even when patients have been diagnosed with ADHD, they’re not guaranteed to receive a regular prescription due to the insecure nature of being an adult patient in a pediatrics department.

The tight restrictions on methylphenidate make things even more difficult. In April, China’s health authorities finally added adult ADHD to the official list of conditions for which Concerta can be prescribed. (Before then, all prescriptions for adult ADHD patients had technically been illegal.) But even now, doctors can only prescribe two weeks’ worth of pills at a time.

For working-class patients like Jiang, the two-week limit is a huge problem. Jiang had to travel from Shanxi to Beijing twice a month to pick up his medication — a trip that cost him around 1,500 yuan each time.

“Maybe that’s an acceptable sum for wage earners in big cities,” says Jiang. “But for people like me, who earn just under 6,000 yuan a month, it’s a huge expense.”

Jiang did his best to make things work. For several months, he continued to make regular trips to Peking University Sixth Hospital, taking pills only when he was on shift or needed to study to make the packs last longer. But he soon began to feel the arrangement was financially unsustainable.

So when he found out it was possible to buy methylphenidate directly from overseas vendors, Jiang leapt at the opportunity. In a chat group for adults with ADHD, several members said they’d done it, and the pills were just 30 yuan each — around one-third of the cost of buying them in Beijing. From early 2019, he began buying all his medication online.

“I bought the pills via a platform using bitcoin,” says Jiang. “In March, I purchased 30 pills, and then another 120 in May … These are quick-release pills and last for around four hours. I took them when I needed to focus.”

The transactions were illegal, but at the time, Jiang was only vaguely aware that he could face criminal charges for his actions. Chinese patients have begun buying cheap medication for all sorts of conditions from overseas in recent years. When the police raided Jiang’s factory this September, he was shocked.

“I was simply purchasing the drugs online because they’re cheaper,” he says. “I didn’t think that much.”

The arrest has destroyed Jiang’s reputation at work. His colleagues don’t really understand his disorder, but they all saw the police accuse him of taking drugs. They’ve come to their own conclusions.

“Rumors have spread among hundreds of staff here that I’m a drug addict and my mental illness is a result of me taking too many drugs,” says Jiang. “But, despite all the gossip, I have to go to work. Otherwise, how can I afford my medication?”

After showing the police the documents confirming his ADHD diagnosis and taking several drugs tests, Jiang was released on bail. He is now waiting for the authorities to confirm a date for his trial. His main hope is that he avoids going to prison.

“When I told other patients about this experience, some told me the best result would be the police dropping the case, since I can prove I’m truly ill,” says Jiang. “In other cases, some patients were given suspended sentences.”

Lu, the Shanghai Mental Health Center specialist, says several of his patients have encountered similar legal troubles. He’s currently working to set up China’s first dedicated clinic for adult ADHD, which would be a major step toward helping more patients access treatment legally. But it’ll be a long, complex process, and he’s still uncertain when any potential clinic might be able to open, he says.

“We’ll have to set up strict and standardized mechanisms for diagnosis — two or even more specialists will need to diagnose and confirm each case together,” says Lu. “We’ll also need to consult the drug regulators and public security authorities while creating our procedures, to ensure our well-intentioned efforts don’t end in failure.”

Jiang, meanwhile, is struggling to keep his head above water. He has been experiencing severe depression and recently broke up with his girlfriend. But he hasn’t returned to Beijing to ask for more medication yet. He can’t afford any more pills, he says.

“I just want to live well,” says Jiang. “But life seems hopeless.”


Source : Sixth Tone

Charts: The Rapid Spread of Omicron to Countries

Rate of spread compared with Delta

Delta is the only dominant variant currently in the world

Source : Nikkei



Updated on December 2, 2021

So far it has been detected in South Africa, Botswana and Zimbabwe, as well as in travelers to Australia, Austria, Belgium, Brazil, Czech Republic, Denmark, Finland, France, Ghana, Greece, Hong Kong, India, Ireland, Italy, Japan, the Netherlands, Nigeria, Norway, Réunion, Saudi Arabia, Singapore, South Korea, Sweden, Switzerland, the United Arab Emirates and the United States.

Britain, Canada, Germany, Iceland, Israel, Norway, Portugal and Spain have also reported small numbers of cases in people who did not travel internationally.


Source : The New York Times

COVID-19 Omicron May Be More Infectious, Deadlier Than Delta

Kevin Kavanagh wrote . . . . . . . . .

If the infectivity, lethality, and immune avoidance of the Omicron variant is confirmed, it will be of utmost importance that all who can, become vaccinated. In addition, antiviral medications will become of prime importance.

The world’s swift and urgent reaction to the appearance of the Omicron variant might be an indication of just what sort of threat this new iteration of COVID-19 presents. As countries race to stop Omicron—or B.1.1.529—initial data available from the South African National Institute for Communicable Diseases show the concern to be well-founded. Omicron appears to be much more transmissible than the Delta variant. It is already spreading around the globe and is reported to be increasing exponentially in regions where it has taken hold. The epicenter of the Omicron variant is in Gauteng Province, South Africa. As can be seen from the graph at the top, hospitalizations tripled in just 2 weeks.

Almost 10% of those hospitalized in Gauteng Province (610) are in the ICU, with almost 20% requiring oxygen and 3.8% on the ventilator. It is not known if all of these patients have the Omicron variant, but the increase in hospitalizations is a major concern. In Kentucky, (where this author lives), 818 individuals are hospitalized with 25% of those in the ICU and 13% on the ventilator. However, in Gauteng Province, South Africa, only 20% of those hospitalized require oxygen, and that may be an indication that they have a much lower threshold for hospitalization than in the United States.

The Omicron variant has over 30 mutations of its spike protein, which has raised concerns that it may evade the vaccine and monoclonal antibody treatments. Vaccines are likely to retain some efficacy and boosters are critical to increase antibody responses in both vaccinated and those with previous viral infections. A recent preprint study published on medRxiv by Alexis R. Demonbreun, et al., has found that post second dosage of their vaccination, those with previous COVID-19 saw anti-spike proteins increased over 30 times. Vaccinated patients who did not have COVID-19 had a 25-fold increase in antibodies post-booster. It is hoped that a portion of these antibodies will also be active against Omicron. However, monoclonal antibody efficacy may not fare as well since they are composed of only 1 type of antibody or 2 in the case of cocktails.

If the Omicron variant evades immunity, antiviral medications will become of prime importance. Initial reports regarding Pfizer’s protease inhibitor, paxlovid, has observed over an 89% efficacy in avoidance of hospitalizations and no deaths have occurred. Merck’s new medication, molnupiravir, has not fared as well with a reduction in its efficacy in avoidance of hospitalizations of 30%. Since the mechanism of action for these medications is not based on the spike protein, their efficacy should not be affected with the emergence of new variants.

The emergence of the variant in South Africa underscores the importance of vaccinating the entire world. South Africa has only 24% of its country fully vaccinated. However, distribution is a major problem. According to Scott Gottlieb, MD, former FDA commissioner, South Africa has over 30 million doses; only 19 million have been administered. Gottlieb also believes that Omicron is already in the US.

As an initial goal in coping with COVID-19, we must prevent our health care system from being overrun. If the infectivity, lethality, and immune avoidance of the Omicron variant is confirmed, it will be of utmost importance that all who can, become vaccinated, including those who have had past COVID-19. Our pharmaceutical giants need time to manufacture and distribute antivirals along with developing a new vaccine, if one is needed. Travel bans are not designed to stop spread, but to delay the buildup of disease, buying time so countermeasures can be enacted. In addition, strict following of public health measures, with use of N95 masks, upgrading indoor ventilation along with frequent testing is of utmost importance. For the long-term we need to come to grips with the reality that this virus is here to stay and we must change the way we live. This includes expanded curbside and home delivery services along with avoidance of gathering in poorly ventilated settings with strangers.


Source : Infection Control Today