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Daily Archives: March 24, 2022

Chart: Fertilizer Prices Surge Amid the Ukraine War

Russia’s invasion of Ukraine puts a massive portion of the world’s fertilizer supply at risk.

Source : Bloomberg

Chart: U.S. Durable Goods Order MoM Declined in February 2022

Source : Bloomberg

Music Video: I Heard It Through The Grapevine

Stroke Tied to Higher Risk for Depression and Other Mood Disorders

Thor Christensen wrote . . . . . . . . .

Stroke survivors may have a higher risk of developing depression or another mood disorder within the first year, according to new research that compared their risk to the general public as well as people who survived a heart attack.

Past research shows depression is common after stroke, affecting nearly one-third of survivors. For the new study, researchers wanted to dig deeper and see how stroke impacts other mental disorders.

The study, published in the American Heart Association journal Stroke, focused on 86,111 people in Danish hospitals from 2004 to 2018 with no history of mental health disorders who had a stroke.

It found that stroke survivors had a 15% risk of developing a mood disorder, primarily depression, within the first year. This risk corresponded to an approximately 2.3-fold increased risk compared with matched individuals from the Danish general population. Stroke survivors also had an increased risk for other mental health problems, including substance abuse disorders and stress and anxiety disorders, as well as brain disorders such as dementia. But these conditions were less common.

“Prevention of these outcomes has obvious importance. But unfortunately, that is easier said than done,” said Nils Skajaa, the study’s lead author. He called for increased recognition of post-stroke mental disorders and early interventions, including counseling.

“Although risks tended to be higher after severe stroke, risks were still increased in patients with mild stroke – which emphasizes a need for mental health evaluation even in patients with seemingly full physical recovery,” said Skajaa, a Ph.D. student in clinical epidemiology at Aarhus University Hospital in Denmark.

The study also showed stroke survivors’ chances of developing depression are nearly 70% higher than people who survive a heart attack. A U.S. study published last year in the journal Neurology came to a similar conclusion: Stroke patients were 50% more likely than heart attack patients to develop depression.

Skajaa said the study was limited by the use of hospital data, which might have missed mild cases, and by surveillance bias – the idea that hospitalization and follow-up care might lead to an increased probability of a diagnosis for a mental disorder. While the study was conducted in Denmark, he said the findings also are applicable in the U.S.

Dr. Laura K. Stein, who was not involved in the research, said the study “gives us more insight into the mental health complications following stroke, which may be, at least in part, related to biological changes in the brain. It expands what we know about mental health disorders after stroke and shows us just how much more likely patients with stroke are to develop mental health disorders than people in the general population.”

Stein, an assistant professor of neurology at the Icahn School of Medicine at Mount Sinai in New York City, called for future research to uncover the biological and psychosocial factors that might contribute to post-stroke depression. She also would like to see studies on the best methods of treating post-stroke depression – not just with medication, but with counseling, cognitive behavioral therapy, exercise and other lifestyle interventions.

Stein pointed out that while post-stroke depression is most common in the first year after a stroke, patients are still at risk for a long time after that.

“Patients, family members and caregivers need to be on the lookout for any signs of depression or other mental health disorders. They need to have a conversation with their doctors about any change in someone’s post-stroke trajectory,” said Stein, who also is an attending physician at the Mount Sinai and Mount Sinai Queens stroke centers.

“Post-stroke depression and other mental health disorders are treatable illnesses. If we take them seriously and investigate all causes and treatment options, it will improve the outcomes and quality of life for stroke survivors in the U.S. and around the world.”

Source: American Heart Association

Infographic: Russia-Ukraine War & Its Consequences

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Chart: Gasoline Prices Around the World

Germany was the most expensive major European economy in terms of gas prices most recently, as a gallon was going for US$9.12.

The most expensive gallon of gas included in the ranking was being sold in Hong Kong at US$10.90, which would typically cause filling up even a small car to break the US$100 barrier.

Some oil producers are offering gasoline to its citizens for less than the price of bottled water. The most drastic examples for this are Venezuela, Libya and Iran, where gasoline only costs a couple of cents per gallon.

Source : Statista

COVID’s Fifth Wave Shows Us How to Live With the Virus

Therese Raphael and Sam Fazeli wrote . . . . . . . . .

Covid cases are on the rise in several European countries. Upticks are visible again in France, Italy and the U.K. Infection rates in both Austria and Germany eclipse previous waves of the virus (based on cases per million). China is grappling with new highs in terms of case counts. The U.S. may soon follow.

This fifth wave of the virus is likely to be mercifully short-lived in many areas, but the picture varies around the world. This divergence gives us something of a report card on the efficacy of the Covid policies in place.

The new wave is mostly being driven by countries removing pandemic restrictions right around when the more transmissible omicron BA.2 subvariant began to spread. In the U.K., the end of mask mandates on public transport and required self-isolation if infected has led many people to drop their cautionary behavior and allowed BA.2 infections to gather pace.

From this week, Britain has made 5 million older and more vulnerable residents eligible for a fourth jab. Health Secretary Sajid Javid has suggested over-50s may be offered a fourth shot from the autumn. That may be sensible, but just as with earlier boosters, any effect will likely be short-lived — we’ll see a three- to four-month reduction in cases, rather than a fundamental change.

Data from Denmark and Sweden, the two countries where BA.2 got an early foothold, suggest that waning immunity isn’t so much driving the rise in infections as BA.2’s superior ability to infect people. Denmark experienced an early, massive omicron wave; that arguably provided a high level of immunity against BA.1 and BA.2, preventing its resurgence. But even Sweden, which had a smaller wave of BA.2 infections, is not seeing a bounce in infections now. Both have similar vaccination coverage. The infection curve would look very different if what we were seeing was waning immunity rather than the arrival of BA.2.

Although hospitalizations from Covid are rising in the U.K. and other places where BA.2 has spread fast, the rate of hospitalizations and ICU admissions per case remains low and there is no evidence so far that the BA.2 subvariant is leading to any increased severity of illness. Javid said Monday that the government has not changed its view and noted that 60% of those in the hospital with Covid had not been hospitalized for Covid, suggesting many are incidental cases.

The picture in the U.S. is less clear. In the past two Covid waves, the trajectory of U.S. infections lagged Europe’s by a few weeks, so the same thing may happen this time too. For now, the percentage of BA.2 omicron cases in the U.S. is between 10% and 15%, the same level as the U.K. in early February. As the subvariant proliferates, infections will likely start rising again.

One factor in the U.S.’s favor is that the BA.1 omicron wave probably infected a larger proportion of the U.S. population than in most European countries, so the immunity from that could limit the duration of the BA.2 wave as well as its severity. However, the U.S. can’t afford to be too relaxed. Its vaccine coverage is not as good as that in most European countries.

The more transmissible subvariant will also be better at finding pockets of unvaccinated people, keeping U.S. severe disease rates at higher levels compared with Europe. Congress just cut $15 billion in coronavirus funding. Less testing and fewer treatments could make it harder especially for more vulnerable parts of the population. “Without funding, the United States will not have enough additional boosters or variant specific vaccines, if needed, for all Americans,” said the White House in a statement. “The federal government is unable to purchase additional life-saving monoclonal antibody treatments and will run out of supply to send to states as soon as late May.”

Rising infections pose the most serious challenge to countries such as China that pursued zero-Covid policies. Those highly restrictive regimes prevented infections from earlier variants and kept death rates low, but their vaccines have been less effective against the more transmissible omicron variant and its faster-spreading BA.2 subvariant.

In New Zealand, strong vaccine coverage is helping manage disease severity, with deaths per million at a relatively low level. That’s in sharp contrast to the picture in Hong Kong, where a rapid rise in infections is translating into one of the highest death rates, at close to 40 per million.

The difference there is vaccines. Hong Kong mostly used the Chinese vaccine Sinovac and has only managed to deliver booster shots to 26.8% of its population. New Zealand, which mostly used mRNA vaccines, has boosted 50% of its population. China is in a very similar situation as Hong Kong: Zero-Covid policies resulted in low levels of population immunity, plus there are insufficient rates of vaccination (especially among the elderly) and relatively less effective vaccines. That’s left higher levels of severe disease and puts enormous pressures on the health care system.

And yet even in countries with high levels of immunity and vaccination, high rates of infection come with costs even where there are low rates of hospitalization and death. Although vaccination has been shown to reduce the risk of Long Covid or Post Acute Sequelae of Covid (PASC), it doesn’t eliminate it. It’s also not clear whether there’s a residual risk of Long Covid when an infection has been curtailed through the use of treatments such as oral antivirals and monoclonal antibodies.

Mild to moderate Covid infections are often not cost-free either. Across Britain and other countries, testing positive is already leading to lost school days and lower productivity. These things add up. Higher infection numbers also increase the chance of new variants emerging.

The current Covid wave should reassure us that vaccines and treatments remain our best defense against an evolving virus. But it is also a reminder that while we are learning to live with Covid, we can’t ignore it.

Source : Bloomberg