#Hong Kong risk reporting

[darkautomaton]

Integrating Risk Management into Corporate Culture in Hong Kong

As regulatory complexity and economic uncertainty continues rising across Hong Kong and mainland China markets, establishing risk-aware cultures has become pivotal for corporations seeking to embed resilience against crises. Beyond building risk monitoring systems, companies today need to drive mindset shifts from the leadership down to infuse vigilance and responsibility towards hazard identification at all levels.

Cultivating Risk Intelligence Starts at the Top

For most organizations, the cultural transformation necessary to view enterprise risk oversight as a shared culture rather than just a compliance activity starts with Asia regional leaders and Hong Kong senior executives. This means not only investment into formal governance through appointing Chief Risk Officers but also having CXOs like Chief Finance, Information and HR Officers spearhead training to their teams around prevailing risk landscapes and vigilance necessary in day-to-day decision making.

Incentivizing Risk Reporting from the Ground Up

Middle managers and frontline analysts will then carry this risk-aware DNA through the organizational bloodstream into daily processes. This demands establishing transparent reporting channels, securing anonymity and anti-retaliation policies to encourage surfacing of suspected risks through what-if questioning or flagging incidents that seemed“off” without fear. Especially around integrity hazards like fraud/bribery, safety hazards like harassment or mental health situations, or regulatory hazards like IP/data transfer violations, removing stigma is key.

Aligning Strategy and Operations with Risk Perspectives

Ultimately, for a risk-informed culture to stick, considerations around financial, reputational and regulatory exposures should drive strategy planning as well as operational enhancements across everything from supply chain design to cybersecurity to financial controls. Key risk indicators must be integrated into dashboards at multiple levels with drilling down to understand root causes. Frameworks like ISO 31000 or COSO provide blueprints here from setup to ongoing assessments into mitigation tracking.

With leadership setting the tone, transparency enabling ground up risk reporting without repercussions, and strategy/operations reflecting risk learnings - global companies can align around managing uncertainty as Hong Kong/China markets, regulations and technologies rapidly evolve. Risk management thereby transforms from restrictive compliance activity to enabler of sustainable advantage and resilience.

[mariacallous]

Georgians are in the streets fighting for their democracy. The Georgian Dream party, which is working to align Tbilisi with Moscow’s interests, declared victory in the country’s Oct. 26 election before the votes were even counted. Voters and election observers were harassed by Russian-funded gangs and mobsters; just after the election, protesters holding European Union flags were sprayed with water from high-powered hoses. And the person who has the iron will necessary to lead the charge against Russian-inspired authoritarianism in Georgia? A woman: President Salome Zourabichvili.

This is no accident. Across the world, women have, and are, playing incredible roles as bulwarks against the rise of authoritarianism. Moldovan President Maia Sandu is standing up to a tsunami of Russian disinformation. In Poland, women played a critical role in the effort to oust the right-wing populist Law and Justice (PiS) party. In Hong Kong, women continue to be the practical and normative face of resistance to Chinese authoritarian rule.

These are the freedom fighters of the 21st century. And yet, the U.S. national security community tends to view women’s issues as a domestic concern, frivolous, or irrelevant to “hard” security matters. For example, in 2003, discussions of securing Iraq excluded women, with a top U.S. general stating, “When we get the place secure, then we��ll be able to talk about women’s issues.” More recently, the role of women in the military has been reduced to discussions of diversity, equity, and inclusion, rather than a focus on how women have been vital to solving the United States’ most wicked national security problems—from serving on the front lines in combat to providing essential intelligence analysis. But if the overall aim of U.S. national strategy is to shore up democracy and democratic freedoms, the treatment of women and girls cannot be ignored.

Globally, women’s rights are often eroding in both policy and practice, from the struggles of the Iranian and Afghan women who exist under gender apartheid to the Kenyan women experiencing the harsh backlash of the rise of the manosphere. In tandem, there’s been a sharp rise in reports of online harassment and misogyny worldwide.

National security analysts explore issues and psychologies through any number of prisms, but Women, Peace, and Security (WPS) remains an underutilized one. One of the national security community’s core tasks is discerning signals from noise in the global strategic environment, and regressive ideas on gender and gender equality can be a useful proxy metric for democratic backsliding and authoritarian rise.

The United States’ 2023 Strategy and National Action Plan on Women, Peace and Security provides the backbone for the United States to leverage WPS to counter authoritarianism. It highlights that displays of misogyny online are linked to violent action. The plan also points out that formally incorporating gendered perspectives is essential for maintaining democratic institutions at home and modeling them aboard. This includes recognizing misogyny—online or in policy—as an early indicator of authoritarian rise.

Unfortunately, WPS is often misread as simply including more women in the national security workforce. But it is more than that. It offers a framework for understanding why it is useful to take gendered perspectives into account when assessing how the actions of individuals or groups enhance national security, which is especially important at a time when authoritarian regimes are weaponizing gender in ways that strengthen their grip on power domestically and justify their aggression abroad.

In Russia, President Vladimir Putin has argued that he is the guardian of traditional Christian values, telling women that they should be back at home raising children, and has been rolling back domestic violence laws at the same time. Days before invading Ukraine in February 2022, Putin said, “Like it or don’t like it, it’s your duty, my beauty,” which was widely interpreted within Russia as a reference to martial rape. Russia’s own army is built on a foundation of hierarchical hazing in which “inferior” men are degraded by their comrades. With that kind of rhetoric from the top, is it any wonder that Russian soldiers’ war crimes have included the rapes of women and children?

But Putin isn’t alone. In Hungary, Prime Minister Viktor Orban has consolidated media outlets to censor women’s voices, in the name of protecting traditional values. He has also used coercive financial practices to push women out of the workforce and positions of political power and into more traditional roles of wife and mother. In Belarus, President Alexander Lukashenko attempted to force the deportation of the most prominent woman opposition leader and imprisoned her after she tore up her passport to prevent it. In China, where women were once told they “hold up half the sky,” President Xi Jinping has worked to undo decades of Chinese Communist Party policy on gender equality. Chinese women are now being encouraged to return home and become mothers, while feminists have been targeted legally and socially.

The WPS agenda provides the U.S. national security community with three opportunities to recognize, understand, and counter early-stage authoritarianism.

First, the United States can do a much better job of supporting women’s groups around the world as a central aspect of its national security strategy. Women’s groups are often a bellwether for authoritarian rise and democratic backsliding—as currently on display in Russia, China, Hungary, Georgia, and Belarus, where women inside and outside their respective regimes have been specifically targeted or attacked.

Women have also found innovative ways to resist the rise of authoritarian norms. In places like Moldova, women have acted as bulwarks against authoritarianism despite vicious disinformation campaigns targeting women leaders. Yet when it comes to formulating and executing strategies on national security, women’s groups are often left in the margins and their concerns dismissed.

Second, gender perspectives are essential to more fulsome intelligence gathering and analysis. The U.S. intelligence community can do a much better job of integrating gender—particularly as it relates to the treatment of the most vulnerable—as an indicator of societal and democratic health. This includes understanding how both masculinities and femininities influence decision-making and how, in turn, lived experiences act as necessary analytical tools. Training collectors and analysts of intelligence to recognize gendered indicators will provide a more robust view of the geopolitical landscape and fill critical holes in national security decision-making.

Finally, the United States must improve the participation of its national security community in WPS and feminist foreign-policy discussions. For too long, the “hard” security sector has distanced itself from more “human” security-focused endeavors and treated women’s rights as something that’s just nice to have.

Yet national security is an essentially human endeavor, and gender is a central component of what it means to be human. This is something that needs to be appreciated to better understand the many dimensions of the conflict—disinformation, online influence campaigns, and lawfare—that authoritarian regimes are waging against the United States and its allies.

[azlia-iconoclast]

All that is confirmed will be modified:

the abortion ban that already exist to state level and killed teens on texas because they got denied even in a SA situationa will now be nationwide

ending any chance to integrate minorities and just letting the hate and discrimination run rampant again without institutions to keep watch

allowing states to ban diverse number of Healthcare treatments and medications which go from gender hormones to the morning after pills

tariffs are gonna have backlash and cause countertarrifs ending many of our trade deals and evaluating the dollars

the billionares that backed trump like the ultraconservative Timothy mellon, the heritage foundation with the hyper religious agaenda or elon musk that is obsessed with hating public transport and trans people are going to have free reign to do as they please.

the ending of several institution and more privatization which includes less education subsidies for poor families, help for disabled people, subsidies for Healthcare, the weather system and report, the department of education shrinking and allowing old religious policies, the watch for the compliance of the civil rights act is going to disappear , the department of health is also going to shirk, the watch for compliance for climate change is going to disappear the DEI, EPA, and the ACA will be erased with many more, just to name the ones that are going to affect directly the most

as consequence of the mentioned institutions disappearing hate speech will basically be legal again affecting the culture and the amount of religious propaganda, discrimination while hiring and helping disable people get a job will be legally impossible

completing the genocide in gaza and continuing funding Israel expansion into Lebanon not to mention he's dividing Ukraine in 2 with a neutral zone which will cause a second bigger war because nobody is going to be conformed with that.

the peace attempts that were happening with china over Taiwan and Hong kong are now going to be closed leaving war as only option for the long future

The SCOTUS will now have 5 of 9 Supreme Court LIFETIME seats filled by Trump and the damage will be generational given the justices are young for the lifelong position and all 5 are part of the Christian nationals. Any attempt to undo what trump is going to damage with his policies will be blocked by their majority specially the medical bans and the freedom corporations will now have, so not only our full generation will suffer trump legacy but your kids and their kids

when trump took the confidential documents boxes to mar a lago when he lost last election it made him look to NATO and the 5 eyes intelligence institution (fuck them both hypocrite imperialists) complain for the security risk which means the allies will not want to share intel with the us now that he's back forcing America to have the old interventionist spionage role to get it's own, which will increase world tensions.

whether people voted for trump to punish dems not fulfilling their promises or being part of such mentioned genocides, because they hate the lgbtq and DEI or they really want to go back to the dark ages culturally and socially with christian nationalism ideology, all of them just shot themselves and everyone kids future.

Adieu à jamais Amérique, je croyais que tu changeais mais ceci est ton cœur et ton vrai visage, je pensais vivre ici plus d'un siècle et t'aider à te transformer, mais il est clair que tu choisis la Cruauté. J'ai de toute façon un dernier coup à tirer, si cela se brise au moins je mourrai enfin avant que tu ne commences ton interventionnisme mondial comme dans les années 50 encore.

[madamepestilence]

H5N1: What to know before fear spreads

What is H5N1?

H5N1 is a 1996 strain of the Spanish or Avian Flu first detected in Chinese birds before spreading globally across various avian species. H5N1 is similar to H1N1, but spreads slower and has a much higher mortality rate.

H5N1 may also be referred to as Influenza A. The American Association of Bovine Practitioners has seen fit to rename H5N1 to Bovine Influenza A Virus, or BIAV, and are encouraging others to use the same terminology.

I would not be surprised if the colloquial name among the public becomes Bovine Flu or American Flu in the coming months, and may be referred to as the Chinese Flu by the same folks who took the spark of the SARS-CoV-2 (COVID-19) pandemic as an excuse to be publicly racist to East Asian people without social repercussions.

BIAV is a virus, meaning that it is a (probably) non-living packet of self-replicating infectious material with a high rate of mutation. BIAV is structured similarly to SARS-CoV-2, having a packet of infectious material encased in a spherical shell with a corona, or crown, of proteins that can latch to living cells to inject RNA.

Image source with interactive model: ViralZone - H5N1 subtype

What is the history of BIAV?

In 1996 and 1997, an outbreak of BIAV occurred among poultry and infected 18 people in Hong Kong, 6 of which died. This seemingly isolated incident then infected ~860 people with a >50% death rate.

At the time, BIAV was known as Highly Pathogenic Avian Influenza, or HPAI, and killed nearly 100% of chickens within a 48 hour period.

From 2003 to 2005, continual outbreaks occurred in China and other East Asian countries, before spreading to Cambodia, the Netherlands, Thailand, and Vietnam.

From 2014 to 2016, it began being detected in American fowl, as well as mutating the H5N6 (lethal in birds, no human to human transmission) and H5N8 (largely spread through turkeys, ducks had immunity) viruses.

BIAV has since evolved into a clade known as 2.3.4.4b, and was first detected in 2021 in wild American birds. This then caused outbreaks in 2022 among wild and domesticated birds (such as chickens) alike, but was largely being overshadowed by the pressing SARS-CoV-2 pandemic at the time.

From 2022 to 2023, it was observed to be spreading among various mammals, including humans. Now, in 2024, we're having the most concerning rapid outbreak of BIAV since 2003.

BIAV is known to spread from mammal to mammal, particularly between cows and humans. BIAV may also be spread from cow to cow (highly likely, but not confirmed - this is likely the reason the virus has spread to Idaho from Texan cattle), and is known to be lethal to domestic cats and birds within 48 hours.

How does BIAV spread?

BIAV spreads through fomites - direct contact with infected animals or infected surfaces and then touching parts of your face or other orifices - as well as through airborne particulates, which may be inhaled and enter the sinuses and lungs.

BIAV is known to spread through:

Asymptomatic Ducks, geese, swans, various shorebirds

Symptomatic, may be lethal Foxes, bears, seals, sea lions, polar bears, domestic cats, dogs, minks, goats, cows, (potentially human to human, but unconfirmed - there have only been 8 potential human to human cases in 2024).

How can I protect against BIAV?

As BIAV is a type of Influenza A, existing protocols should do fine.

Current recommendations are to wash your hands vigorously after interacting with birds (I would also recommend doing this with mammals), avoid touching your face or other open orifices, and wear N95 masks.

Avoid sick or dead animals entirely - I would also recommend reporting them to your local Animal Control or veterinary centre and warning them about the infection risk. People who work with animals are recommended to also wear full PPE such as N95 masks, eye protection, gloves, and partake in vigorous hand washing.

If you suspect you've caught BIAV, seek medical attention immediately. Existing medications such as oseltamivir phosphate, zanamivir, peramivir, and baloxavir marboxil can reduce BIAV's ability to replicate.

Standard flu shots will not protect against BIAV. Remember - symptoms of BIAV may not manifest for between 2 to 8 days, and potentially infected people should be monitored for at least 10 days.

How far has BIAV spread?

BIAV is currently a global virus, though the current infection location of note is the United States.

Image Key: Dark red - Countries with humans, poultry and wild birds killed by H5N1 Deep red - Countries with poultry or wild birds killed by H5N1 and has reported human cases of H5N1 Light red - Countries with poultry or wild birds killed by H5N1

Image source: Wikipedia - Influenza A virus subtype H5N1 - File: Global spread of H5N1 map

Image source: Metro.co.uk - Map shows where bird flu is spreading in US amid new warning - File: The Centers for Disease Control and Prevention’s H5N1 bird flu detections map across the United States

Should I be afraid?

You needn't be afraid, just prepared. BIAV has a concerningly high lethality, but this ironically culls its spread somewhat.

In the event human to human transmission of BIAV is confirmed, this will likely mainly affect marginalized communities, poor people, and homeless people, who are likely to have less access to medical care, and a higher likelihood of working in jobs that require frequent close human contact, such as fast food or retail jobs.

Given the response to SARS-CoV-2, corporations - and probably the government - may shove a proper response under the rug and refuse to participate in a full quarantine, which may leave people forced to go to work in dangerous conditions.

If this does spread into an epidemic or pandemic, given our extensive knowledge about Influenza, and the US having a backup vaccine for a prior strain of H5N1, a vaccine should be able to be developed relatively quickly and would hopefully be deployed freely without charge - we won't have to worry about a situation like The Stand.

Wash your hands, keep clean, avoid large social gatherings where possible, wear an N95 mask if you can afford them (Remember: Cloth masks are the least protective, but are better than nothing. If you can't afford N95 masks, I recommend wearing a well-fitted cloth mask with a disposable face mask over it to prevent pneumonia from moisture buildup in the disposable mask), support the disabled, poor, and homeless, and stay educated.

We can do better this time.

Further things to check out:

YouTube: MedCram - H5N1 Cattle Outbreak: Background and Currently Known Facts (ft. Roger Seheult, M.D.)

Wikipedia - Influenza A virus subtype H5N1

Maine.gov - Avian Influenza and People

CDC.gov - Technical Report: Highly Pathogenic Avian Influenza A(H5N1) Viruses

Wikipedia - H5N1 genetic structure

realagriculture - Influenza infection in cattle gets new name: Bovine Influenza A Virus (BIAV)

[covid-safer-hotties]

The Long-term Complications of Covid-19 Infection - Published Sept 13, 2024

Context.— As the Covid-19 pandemic continues into its 4th year, reports of long-term morbidity and mortality are now attracting attention. Recent studies suggest that Covid-19 survivors are at increased risk of common illnesses, such as myocardial infarction, diabetes mellitus and autoimmune disorders. Mortality may also be increased. This article will review the evidence that supports some of these observations and provide an opinion about their validity and their relevance to insured cohorts.

Background Many Covid-19 survivors report protracted symptoms, sometimes lasting 3 years or more. These are collectively called post-acute sequelae of SARS-CoV-2 infection (PASC) or long Covid. They have been frequently described.1–4 In the past year, reports of long-term complications such as atrial fibrillation, heart failure, stroke and pulmonary embolism have emerged. In some reports these established disease entities are erroneously described as long Covid, generating confusion. The distinction is important: illness reported in Covid survivors are not restricted to the long Covid cohort. Thus, they are relevant to the majority of the North American population who have been infected by SARS-CoV-2, and not just the estimated 5-10% of individuals who belong to the long Covid cohort. This paper will examine the reports of increased incidence of cardiovascular diseases in both and will examine the reported long-term increase in mortality.

Cardiovascular disease after 1 and 2 years Multiple studies have reported an increased risk of cardiovascular events at 1 year. A February 2022 analysis of 153,760 US veterans, followed for 1 year after Covid-19 infection, reported an increased risk of cerebrovascular disease (HR 1.53), ischemic heart disease (HR 1.66), thromboembolic disease (HR 2.39) and atrial fibrillation (HR 1.71).5 Risk was greatest in those hospitalized and those with pre-morbid illnesses. However, risk was also elevated in outpatients, who constituted the vast majority of the cohort. These findings have been corroborated in 2 further studies. In a 2023 analysis of 690,000 Covid-19 survivors, drawn from the TriNetX database–self-described as the world’s largest global Covid-19 dataset–there was an increased risk of cerebrovascular disease (HR 1.6), ischemic heart disease (HR 2.8), thromboembolic disease (HR 2.6) and atrial fibrillation (HR 2.4) at 1 year.6 In contrast to the VA study which examined a predominantly older male population, the subjects in this study were younger, with mean age 44, and 57% were female. Risk was higher in the >65 age group and was not limited to inpatients. In a May 2023 Lancet retrospective analysis of 535,000 Hong Kong (HK) and 16,000 UK Covid 19 survivors, similar hazard ratios were recorded for stroke (HR 1.2), ischemic heart disease (HR 1.32), atrial fibrillation (HR 1.31) and deep venous thrombosis (HR 1.74).7 However, it is worth noting that while follow-up was described as 28 months for the HK cohort and 17 months for the UK cohort, the median follow-up for the HK group was 146 days and was 243 days for the UK cohort, somewhat limiting the conclusions of true impact at 1 year. Contradicting these studies, a prospective analysis of 17,000 Covid-19 survivors in the UK Biobank, did not document an increased risk of cardiovascular outcomes amongst outpatients, with the exception of thromboembolic disease (HR 2.7).8 An August 2023 analysis of 138,000 VA Covid-19 survivors followed for 2 years– the longest follow-up period to date– reported that the risk of complications in outpatients had returned to baseline at 6 months.9 In contrast, the risk for multiple cardiovascular and thromboembolic complications in the hospitalized cohort remained elevated at 2 years. None of these 5 studies was limited to individuals with long Covid, but similar findings have been reported in this group: a recent analysis of 13,435 individuals who had been diagnosed with long Covid, based on a typical array of symptoms, reported increased risks at 1 year for ischemic heart disease (HR 1.7), ischemic stroke (HR 2.1) and pulmonary embolism (HR 3.6).10

These studies document a fairly consistent, increased risk of cardiovascular complications among Covid-19 survivors. However, important questions remain. Amongst these: does increasing population immunity and vaccination change the risk? Is the magnitude of risk similar for all SARS CoV-2 variants? Does reinfection increase the risk? Answers to some are available. Vaccination appears to attenuate the risk: a Korean study of 592,000 individuals post-Covid-19 infection, showed that vaccination decreased the risk of heart attack and stroke by approximately 50%.11 This finding was replicated in a large US cohort where major adverse cardiovascular events were reduced by a similar amount for full vaccination, and by 25% for partial vaccination.12 Thus, while vaccination does not eliminate long-term complications, it appears to provide a substantial protective effect.

Reinfection may increase the risk of sequelae. In a large US VA cohort of 440,000 Covid survivors, of whom 40,000 had one or more SARS-CoV-2 reinfections, the risk of cardiovascular disorders was increased (HR 3.02), when compared to a single infection.13 Moreover, this risk was not modified by vaccination.

The impact of different variants is less clear. Most of the described studies were conducted in 2020-2021 when delta and pre-delta variants predominated. It is unclear whether similar outcomes would characterize infection with Omicron variants, which remain dominant in most countries since November 2021. Interestingly, the risk of cardiovascular complications in the cohort of Hong Kong survivors described above, where the Omicron was the prevalent strain, was no different than among the comparator UK Biobank cohort, where pre-Omicron strains were prevalent.7

Is there extra long-term mortality after Covid-19 infection? Extra mortality has been reported by several studies.6,8,14–18 A 2021 US analysis of 400 Covid-19 survivors, documented increased mortality (HR 2.5) at 1 year.14 The additional risk was confined to individuals who had been hospitalized. In 2022, 3 studies reported excess mortality in 3 different countries. The first, an Estonian whole-population study of 66,000 Covid-19 survivors, of whom 8% were hospitalized, reported a 3-fold increase in mortality at 12 months.15 Mortality was particularly elevated in the first 5 weeks following infection. For those over age 60, increased mortality persisted until 12 months (HR 2.8). However, for those less than age 60, mortality was not increased after 35 days. The second, an analysis of 690,000 Covid-19 survivors from the TriNetX database also reported increased 1-year mortality risk (HR 1.6).6 This was largely explained by excess deaths in individuals over age 65; below age 45 risk was not increased. For the outpatient cohort the risk of mortality was lower than that of the comparison group (HR 0.46). The third, a study of 25,000 Covid-19 survivors drawn from the UK Biobank, reported increased mortality risk at 20 months, for those with severe Covid infection (HR 14.7), but also an increased risk for those with mild disease (HR 1.23).16 Stratification by age was not provided.

In 2023 4 further studies reported similar, but at times quantitatively different results. Two analyses drew on the UK Biobank cohort. In the first, a prospective evaluation of 7,800 SARS-CoV-2 PCR positive individuals, increased mortality was reported for the study group at 18 months (HR 5.0), when compared to both a contemporary and an historical cohort.17 For the non-severe cases the mortality risk remained elevated (HR 4.8). The second study, already described above– a comparative analysis of 7600 Covid survivors from the UK Biobank and 530,000 Covid survivors in Hong Kong–reported increased mortality (HR 4.16) after 17 months for the former and 28 months for the latter.7 The risk of mortality was higher in the UK than the HK cohort, a difference the authors posited was due to Omicron being the dominant variant in HK during the study period. The risk remained elevated, but less so, for younger cohorts and for mild Covid-19 infections.

Finally, 2 large US studies recently reported mortality at 2 years. In the first, an analysis of 138,000 US veteran Covid-19 survivors with 5.9 million controls, the risk of death for the hospitalized cohort remained elevated at 2 years (HR 1.29).8 In contrast, the risk of death for the outpatient cohort returned to baseline at 6 months. Breakdown of risk by age-group was not provided. The second study, also of US veterans, reported similar findings. In a cohort of 280,000 Covid-19 survivors the risk of death remained elevated at 2 years (HR 2.0).18 The risk was highest in the first 90 days (HR 6.3) and decreased at 6 months (HR 1.18). Thereafter, the risk in Covid-19 survivors was slightly less than the control group (HR 0.89). A post-hoc subgroup analysis examined and refuted the possibility that accelerated mortality in the control group could have explained the lower mortality in Covid-19 survivors. The risk of death in hospitalized individuals remained elevated at 2 years (HR 1.22).

How Plausible is this Information? The studies described above command attention by virtue of their size and the consistency of their findings in different populations, and in different countries. They are also supported by the observations of long-term pathophysiologic abnormalities following SARS-CoV-2 infection, such as ongoing inflammation, persistence of virus, and immune system dysfunction. However, the negative ledger is also substantial. Observational studies such as these, no matter how well-designed, remain open to many types of bias. Reliance on diagnostic codes, prescription records, laboratory results and tallies of clinical visits, to establish disease incidence, is intrinsically error-prone and makes cross-study comparisons difficult. Perhaps more importantly, the cohorts described above were different in many respects, varying from the older, male-predominant cohort of the US VA system to the younger healthier cohort of the UK Biobank. Further, cohorts were constituted during the first year of the pandemic, at a time when healthcare delivery was disrupted, lockdowns were in effect, vaccination and antivirals were largely unavailable, and population immunity levels were low. Thus, it could be argued that the observed outcomes are better explained by an evolving pandemic, rather than solely SARS-CoV-2 infection. This could also explain the most recent reports that after 2 years of follow-up, the risk of both Covid-19 complications and mortality, in most of those infected (i.e., the non-hospitalized), is no longer elevated. It also evident that most of the reported extra mortality is occurring in the early months following infection, where survival curves separate rapidly.6,10,15,18

Are these findings relevant to an insured population? ‘Partially’ is probably the best answer. The most important observation is that hospitalization, and in-particular an intensive care unit admission, is the dominant risk factor for both morbidity and mortality. This risk appears to persist up to 2 years. The second important risk element is the presence of comorbid conditions. This observation raises the interesting question of what exactly causes the extra mortality. Is it due to ‘protracted’ SARS-Co-V-2 infection or is it caused by a recognized complication of Covid-19, such as pulmonary fibrosis or acute kidney injury? Or is it explained by an aggravation of a comorbid illness? Or is it a complication of long Covid? There is a likelihood that all these mechanisms were at play in the cohorts under study.

For non-hospitalized individuals, and those that are healthy, the evidence for extra morbidity and mortality after the first 3-6 months is far from conclusive. For the long Covid cohort, the evidence for additional mortality requires further supporting evidence. As the prevalence of co-morbid conditions is lower in insured populations, one might reasonably expect, based on current evidence, that longer-term morbidity and mortality due to Covid-19 infection will be minimally affected.

References 1.Davis H, McCorkell L, Vogel, J. et al Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol 21, 133–146 (2023). doi.org/10.1038/s41579-022-00846-2

2.Meagher T. Long COVID - An Early Perspective. J Insur Med. 2021 Jan 1;49(1):19–23. doi: 10.17849/insm-49-1-1-5.1. PMID: 33784738.

3.Meagher T. Long COVID – One year On. J Insur Med. 2022 Jan 1;49:1–6. doi: 10.17849/insm-49-3-1-6.1. PMID: 33561352.

4.Meagher T. Long Covid - Into the Third Year. J Insur Med 2023;50(1):54–58. doi.org/10.17849/insm-50-1-54-58.1

5.Xie Y, Xu E, Bowe B et al Long-term cardiovascular outcomes of COVID-19. Nat Med 28, 583–590 (2022). doi.org/10.1038/s41591-022-01689-3

6.Wang W, Wang CY, Wang SI et al Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks. eClinicalMedicine. 2022 Nov;53:101619. doi: 10.1016/j.eclinm.2022.101619

7.Lam I, Wong C, Zhang, R et al Long-term post-acute sequelae of COVID-19 infection: a retrospective, multi-database cohort study in Hong Kong and the UK. eClinicalMedicine Vol. 60 Published: May 11, 2023. doi: doi.org/10.1016/j.eclinm.2023.102000

8.Raisi-Estabragh Z, Cooper J, Salih A, et al Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank Heart 2023;109:119–126.

9.Bowe, B., Xie, Y. & Al-Aly, Z. Postacute sequelae of COVID-19 at 2 years. Nat Med 29, 2347–2357 (2023). doi.org/10.1038/s41591-023-02521-2

10.DeVries A, Shambhu S, Sloop S et al One-Year Adverse Outcomes Among US Adults With Post–COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database. JAMA Health Forum. 2023;4(3):e230010. doi:10.1001/jamahealthforum.2023.0010

11.Kim Y, Huh K, Park Y et al Association Between Vaccination and Acute Myocardial Infarction and Ischemic Stroke After COVID-19 Infection. JAMA. 2022;328(9):887–889. doi:10.1001/jama.2022.12992

12.Jiang J, Chan L, Kauffman J, et al Impact of Vaccination on Major Adverse Cardiovascular Events in Patients With COVID-19 Infection. J Am Coll Cardiol. 2023 Mar, 81(9):928–930. doi.org/10.1016/j.jacc.2022.12.006

13.Bowe B, Xie, Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med 28, 2398–2405 (2022). doi.org/10.1038/s41591-022-02051-3

14.Mainous AG, Rooks BJ, Wu, et al COVID-19 post-acute sequelae among adults: 12 month mortality risk. Front Med (Lausanne). 2021;8:778434. doi:10.3389/fmed.2021.778434

15.Uuskula A, Jurgenson T, Pisarev H et al Long-term mortality following SARS-CoV-2 infection: A national cohort study from Estonia. The Lancet Regional Health - Europe 2022;18:100394 Published online 29 April 2022. doi.org/10.1016/j.lanepe.2022.100394

16.Xiang Y, Zhang R, Qiu G. et al Association of Covid-19 with risks of hospitalization and mortality from other disorders post-infection: A study of the UK Biobank. medRxiv doi: doi.org/10.1101/2022.03.23.22272811

17.Wan E, Mathur S, Zhang R et al Association of COVID-19 with short- and long-term risk of cardiovascular disease and mortality: a prospective cohort in UK Biobank, Cardiovascular Research, Volume 119, Issue 8, June 2023, 1718–1727. doi.org/10.1093/cvr/cvac195

18.Iwashyna TJ, Seelye S, Berkowitz TS, et al Late Mortality After COVID-19 Infection Among US Veterans vs Risk-Matched Comparators: A 2-Year Cohort Analysis. JAMA Intern Med. Published online August 21, 2023. doi:10.1001/jamainternmed.2023.3587

[tomorrowusa]

Rodrigo Duterte, autocratic former president of the Philippines, has been arrested and is being flown to The Hague to face charges of crimes against humanity. 👍🏼

Philippine police have arrested former President Rodrigo Duterte after the International Criminal Court (ICC) issued a warrant accusing him of crimes against humanity over his deadly "war on drugs". The 79-year-old was taken into police custody shortly after his arrival at Manila airport from Hong Kong. He has offered no apologies for his brutal anti-drugs crackdown, which saw thousands of people killed when he was president of the South East Asian nation from 2016 to 2022, and mayor of Davao city before that. [ ... ]

The ICC earlier said that it has jurisdiction in the Philippines over alleged crimes committed before the country withdrew as a member. But activists called the arrest a "historic moment" for those who perished in his drug war and their families, the International Coalition for Human Rights in the Philippines (ICHRP) said. "The arc of the moral universe is long, but today, it has bent towards justice. Duterte's arrest is the beginning of accountability for the mass killings that defined his brutal rule," said ICHRP chairman Peter Murphy. Duterte had been in Hong Kong to campaign for the upcoming 12 May mid-term elections, where he had planned to run again for mayor of Davao. Footage aired on local television showed him walking out of the airport using a cane. Authorities say he is in "good health" and is being cared for by government doctors.

Holding rogue leaders accountable is essential if there is to be such a thing as the rule of law. The arrest of Duterte is a major step forward.

Duterte's arrest marks the "beginning of a new chapter in Philippine history", said Filipino political scientist Richard Heydarian. "This is about rule of law and human rights," he said.

As president he may have killed as many as 6,000 people without trial. And that doesn't count his time as mayor of Davao.

Duterte served as mayor of Davao, a sprawling southern metropolis, for 22 years and has made it one of the country's safest from street crimes. He used the city's peace-and-order reputation to cast himself as a tough-talking anti-establishment politician to win the 2016 elections by a landslide. With fiery rhetoric, he rallied security forces to shoot drug suspects dead. More than 6,000 suspects were gunned down by police or unknown assailants during the campaign, but rights groups say the number could be higher. A previous UN report found that most victims were young, poor urban males and that police, who do not need search or arrest warrants to conduct house raids, systematically forced suspects to make self-incriminating statements or risk facing lethal force. Critics said the campaign targeted street-level pushers and failed to catch big-time drug lords. Many families also claimed that the victims - their sons, brothers or husbands - were simply in the wrong place at the wrong time. Investigations in parliament pointed to a shadowy "death squad" of bounty hunters targeting drug suspects. Duterte has denied the allegations of abuse. "Do not question my policies because I offer no apologies, no excuses. I did what I had to do, and whether or not you believe it... I did it for my country," Duterte told a parliament investigation in October.

Duterte took the law into his own hands. Now he's in the hands of the law.

Donald Trump can't be too happy about the arrest of Duterte and that of impeached President Yoon Suk Yeol of South Korea.

Duterte idolized Trump and Putin and appeased China.

His populist rhetoric and blunt statements earned him the moniker "Donald Trump of the East". He has called Russian President Vladimir Putin his "idol" and under his administration, the Philippines' pivoted their foreign policy to China away from the US, its long-standing ally. Marcos restored Manila's ties with Washington and criticised the Duterte government for being "Chinese lackeys" as the Philippines is locked in sea dispute with China.

Duterte's daughter Sara is the current vice president of the Philippines. She is being impeached for corruption and for making death threats against President Ferdinand "Bongbong" Marcos Jr..

Philippines feud escalates as lawmakers vote to impeach vice-president

The arrest of wannabe dictators should make Trump look over his shoulder more often.

[wyrmbringer]

Global Cybersecurity Breach Tied to Sunburst Computers Raises Concerns Over Privacy

(AP) Hong Kong— A massive cybersecurity breach linked to budget computer manufacturer Sunburst Computers has exposed sensitive personal data from millions of users worldwide, intensifying scrutiny over the company's controversial business practices. According to cybersecurity experts, a network of anonymous hackers known as Incognito has exploited vulnerabilities in Sunburst’s hardware and software, siphoning financial records, internet histories, and even webcam footage from unsuspecting customers.

The breach, first detected by independent security researchers, appears to be part of a broader pattern of exploitation that extends beyond digital threats. Sunburst, a subsidiary of multinational conglomerate Pentex, has long faced allegations of environmental destruction, exploitative labor conditions, and deliberate obsolescence in its product lines. Consumer advocacy groups have criticized the company for producing machines with substandard parts that frequently fail outside of warranty coverage, forcing users into a costly cycle of repairs and outsourced technical support.

At the heart of the latest controversy is Incognito, a decentralized hacking collective with a history of launching coordinated harassment campaigns and denial-of-service attacks. Investigators say the group has weaponized Sunburst’s security flaws to build extensive databases of potential victims, using stolen personal information to intimidate, manipulate, or outright ruin targets. "This is not just about cybercrime. It is psychological warfare," said Alex Chen, a cybersecurity analyst based in Singapore. "The people behind this aren’t motivated by financial gain alone. They take pleasure in destruction."

Sunburst has denied any wrongdoing, issuing a statement that dismissed the allegations as "baseless speculation" and claiming the company is committed to "customer security and ethical business practices." However, reports from labor watchdog organizations suggest otherwise. Journalists embedded in Sunburst's facilities have documented harrowing conditions, including workers subjected to shifts exceeding 20 hours and living in squalid company housing. Incidents of substance abuse, workplace injuries, and suicides have risen sharply among Sunburst's workforce, raising concerns that the company's rapid expansion has come at a human cost.

Meanwhile, environmental groups have condemned Sunburst’s supply chain, alleging the company uses plastics and non-biodegradable materials that contaminate local ecosystems. "They market themselves as a 'green' company, but their products are an ecological disaster from the moment they leave the factory to the day they’re dumped in a landfill," said Dr. Elaine Foster, a researcher with the Global Environmental Protection Initiative.

Authorities across multiple countries have launched investigations into Sunburst’s potential regulatory violations, but some watchdog groups fear the company's deep ties to powerful corporate interests could stall any meaningful action. As the breach continues to unfold, cybersecurity experts warn that even Sunburst's high-end machines remain vulnerable to Incognito's infiltration, leaving consumers at risk.

"This is bigger than just one company," Chen said. "It is an entire system built on exploitation, deception, and control. The real question is: how deep does this go?"

(AP)

[pscottm]

“In New York and London, owners of gleaming office towers are walking away from their debt rather than pouring good money after bad. The landlords of downtown San Francisco’s largest mall have abandoned it. A new Hong Kong skyscraper is only a quarter leased,” Bloomberg reports. “The creeping rot inside commercial real estate is like a dark seam running through the global economy. Even as stock markets rally and investors are hopeful that the fastest interest-rate increases in a generation will ebb, the trouble in property is set to play out for years.”

Remember kiddies, it's OK to walk away from you debts! A lender will present payments as a moral obligation but as demonstrated by businesses, they are not. Lenders assume risk and sometimes lose as do you.

Except for student loans. Congress made those non-dischargable during bankruptcy into law.

[vergess]

Let's all remember that despite the temptation, this isn't actually funny. These people went to a concert, and were blinded en masse.

This is horrific.

The organizers of this concert need to be held accountable for maiming an entire audience, as well as possibly the performers.

I don't know literally anything about Hong Kong law, but if it is in any way possible, this needs to be pursued as what it is: negligence leading to a mass maiming.

After all, this is a known risk that concert organizers are supposed to be aware of. It has happened before.

However, as of this time, the "lab grade UV-C lamp" thing seems to be a rumour. The only lab which has investigated this incident (on the event organizer's payroll), says this was caused by a malfunctioning UV-A lamp.

It is unknown if the blindness will be permanent or temporary at this time.

[darkautomaton]

Best Practices in Corporate Risk Management in Hong Kong

With an increasingly complex legal, regulatory, economic, and technological environment, effectively managing organizational risks is critical for companies striving towards sustainable growth in Hong Kong. By taking a strategic approach to identifying key risk exposures and establishing governance policies to address vulnerabilities, both local and multinational corporations can enhance resilience.

Conduct Extensive Risk Assessments

The foundation for building robust risk oversight is to regularly conduct enterprise-wide assessments, tapping perspectives from leaders across functions on risks emerging within main business units, as well as at the corporate level. Special focus should be placed on emerging risks - from supply chain disruptions to fast-evolving cybersecurity threats. Risks posed by Hong Kong regulations and legal responsibilities around data, employment, IP, taxation and import/export controls should also be incorporated.

Appoint Centralized Risk Leadership

While business heads are accountable for risks within their domains, oversight at the core by a Chief Risk Officer and/or risk management committee provides critical independence and cross-functional coordination. Responsibilities span creating risk reporting procedures to keeping senior leadership and board directors appraised, to aligning mitigation plans with corporate strategy. Risk managers also liaise with insurance providers to secure proper coverage against financial hazards.

Implement Key Risk Policies

Findings from risk assessments should drive key policy changes, be it business continuity planning to address operational crises, instituting ethics training to reduce fraud and corruption, or enacting information handling protocols to avoid data leaks, hacking and illegal trading incidents that would undermine Hong Kong stock listings. Anti-money laundering and sanctions/export controls compliance also need special attention in Hong Kong as a gateway between China and global trade.

Monitor External Signals

In addition to internal risk monitoring, closely follow legislative or law enforcement policy shifts, as well as economic/political disruptions arising locally as well as in mainland China that stand to impact operations. Participate in trade groups and maintain contacts in agencies like InvestHK to receive critical market updates. Regular stress tests help evaluate Hong Kong megaprojects like the Greater Bay Area growth plan or One Belt One Road initiative - and gauge ensuing risk reprioritizations.

By approaching risk oversight as an integrated corporate capability monitoring both internal weaknesses and external threats, companies gain enhanced visibility into vulnerabilities which allows preemptively strengthening of operations against cascading Hong Kong/China hazards - thereby boostinglong-term performance and valuation for shareholders.

[mariacallous]

In 2024, increased adoption of biometric surveillance systems, such as the use of AI-powered facial recognition in public places and access to government services, will spur biometric identity theft and anti-surveillance innovations. Individuals aiming to steal biometric identities to commit fraud or gain access to unauthorized data will be bolstered by generative AI tools and the abundance of face and voice data posted online.

Already, voice clones are being used for scams. Take for example, Jennifer DeStefano, a mom in Arizona who heard the panicked voice of her daughter crying “Mom, these bad men have me!” after receiving a call from an unknown number. The scammer demanded money. DeStefano was eventually able to confirm that her daughter was safe. This hoax is a precursor for more sophisticated biometric scams that will target our deepest fears by using the images and sounds of our loved ones to coerce us to do the bidding of whoever deploys these tools.

In 2024, some governments will likely adopt biometric mimicry to support psychological torture. In the past, a person of interest might be told false information with little evidence to support the claims other than the words of the interrogator. Today, a person being questioned may have been arrested due to a false facial recognition match. Dark-skinned men in the United States, including Robert Williams, Michael Oliver, Nijeer Parks, and Randal Reid, have been wrongfully arrested due to facial misidentification, detained and imprisoned for crimes they did not commit. They are among a group of individuals, including the elderly, people of color, and gender nonconforming individuals, who are at higher risk of facial misidentification.

Generative AI tools also give intelligence agencies the ability to create false evidence, like a video of an alleged coconspirator confessing to a crime. Perhaps just as harrowing is that the power to create digital doppelgängers will not be limited to entities with large budgets. The availability of open-sourced generative AI systems that can produce humanlike voices and false videos will increase the circulation of revenge porn, child sexual abuse materials, and more on the dark web.

By 2024 we will have growing numbers of “excoded” communities and people—those whose life opportunities have been negatively altered by AI systems. At the Algorithmic Justice League, we have received hundreds of reports about biometric rights being compromised. In response, we will witness the rise of the faceless, those who are committed to keeping their biometric identities hidden in plain sight.

Because biometric rights will vary across the world, fashion choices will reflect regional biometric regimes. Face coverings, like those used for religious purposes or medical masks to stave off viruses, will be adopted as both fashion statement and anti-surveillance garments where permitted. In 2019, when protesters began destroying surveillance equipment while obscuring their appearance, a Hong Kong government leader banned face masks.

In 2024, we will start to see a bifurcation of mass surveillance and free-face territories, areas where you have laws like the provision in the proposed EU AI Act, which bans the use of live biometrics in public places. In such places, anti-surveillance fashion will flourish. After all, facial recognition can be used retroactively on video feeds. Parents will fight to protect the right for children to be “biometric naive”, which is to have none of their biometrics such as faceprint, voiceprint, or iris pattern scanned and stored by government agencies, schools, or religious institutions. New eyewear companies will offer lenses that distort the ability for cameras to easily capture your ocular biometric information, and pairs of glasses will come with prosthetic extensions to alter your nose and cheek shapes. 3D printing tools will be used to make at-home face prosthetics, though depending on where you are in the world, it may be outlawed. In a world where the face is the final frontier of privacy, glancing upon the unaltered visage of another will be a rare intimacy.

[kelpeigh]

I was at one of the few shows in which he played Jackboot Jump.

He made a little speech beforehand that I don't remember verbatim (there's probably video out there; NYC 11/2019) except for the last two words but it went along the lines of:

I've been struggling to find a balance writing protest music. I'm constantly trying to get important messages across in my work. If I weave them into art, people will be more receptive to hearing the message in the first place. The more subtle I am, the more people I reach. But I look around and see students and reporters being brutalized in shopping malls for daring to speak up and all I can think is... fuck subtlety.

For context, this was amid the Hong Kong protests of 2019 and there had recently been some particularly gruesome accounts in the news

So yeah, Jackboot Jump was a calculated risk. It's not a surprise that it didn't blow up ("fuck subtlety", no studio recording release, not on an album). It's doubly a shame because all royalties are diverted to BLM (at least they were, I'm only assuming they still are). But it and the rest of this post go to show he's not a musician who's also an activist sometimes; his discography is saturated with activism.

🙃 Regular reminder that while Hozier has amazing love songs, he is ALSO very outspoken about his leftist politics, specifically anti-fascism, anti-racism, reproductive rights, Palestinian rights and more.

Take Me To Church and Foreigner’s God are scathing critiques of organized religion, specifically the Catholic Church.

Moment’s Silence is about oral sex but it’s ALSO about how that specific sexual act is often distorted to a show of power rather than that of love.

Nina Cried Power is an homage to various civil rights activists from the US and Ireland and a call to follow their path.

Be specifically criticizes anti-migrant policies and Trump and his ilk.

Jackboot Jump is about the global wave of fascism.

Swan Upon Leda is about reproductive rights and the violent colonial oppression of Ireland and Palestine.

Eat Your Young is about the ruinous way the 1%/capitalism prioritizes short-term profit over everything else to the detriment of the youth/99%.

Butchered Tongue is about Irish and other indigenous languages being suppressed and erased by imperial powers.

If any of the above surprised you, please, please delve deeper into Hozier’s music, you’re missing such an important part of his work.

[ryanmcmunn]

China’s Influence in Global Trade

China is a very important actor in the global economy today. According to an Observatory of Economic Complexity (OEC) 2023 report, China was the second-largest economy in the world by GDP. It had the highest global exports that same year, while it was the second largest importer of any nation in the world. Some of China’s largest exports to other nations are broadcasting equipment, computers, integrated circuits, office machine parts, and batteries. The United States, Hong Kong, Japan, Germany, and South Korea are among China’s largest trade partners. China has been able to achieve this largely due to its enabling environment for businesses to thrive, strategic trade policies, as well as its strong infrastructure.

Other factors that have contributed to China becoming a respected trade powerhouse are its booming manufacturing industry, technological advances, extensive trade networks, and strategic agreements it has entered into. With regard to manufacturing, China is popularly described today as the “world’s factory.” This is because it produces a wide range of goods like electronics, textiles, and automobiles at significantly lower cost compared to other countries around the world. Also, China has recorded significant improvements in its technological capacity in the past few decades. For instance, China is known for investing in automation, 5G technology, renewable energy, and artificial intelligence. All of these have contributed to its ability to produce goods more efficiently.

China has established extensive trade networks and relationships with over 200 countries. This has been achieved in part through strategic trade agreements and initiatives like the Belt and Road Initiative (BRI) and the Regional Comprehensive Economic Partnership (RCEP). All of these initiatives come together to strengthen the country’s trading influence around the world.

China plays an important role in global trade, with several key industries driving its economic influence. The country is a leading exporter of electronics and technology, supplying everything from smartphones to semiconductors. Its automobile industry is also booming, particularly in the electric vehicle (EV) sector, where Chinese manufacturers are making significant advances. Additionally, China remains the world’s largest textile producer, supplying clothing and fabrics to top global brands.

Beyond consumer goods, China is a major supplier of raw materials and chemicals, including rare earth metals that are essential for electronics and renewable energy production. This dominance in resource supply gives China a strategic advantage in global manufacturing. Many multinational companies rely on China for both raw materials and large-scale production, making it a crucial part of international supply chains.

China’s manufacturing strength is built on efficiency and cost-effectiveness. The country’s ability to produce goods at relatively lower cost has benefited businesses and consumers worldwide. Additionally, China’s logistics and infrastructure, including world-class port facilities, high-speed rail networks, and streamlined customs processes, make it an indispensable hub for international trade.

However, recent global events have highlighted the risks of over-reliance on China. The COVID-19 pandemic and ongoing geopolitical tensions have caused major trade disruptions, prompting businesses to rethink their supply chain strategies. As companies explore diversification options, China continues to adapt, maintaining its role as a dominant force in global commerce.

[nursingwriter]

Communicable disease outbreak (SARS) by doing the following: Describe the communicable disease outbreak. A community wide outbreak of severe acute respiratory syndrome (SARS) within the greater metropolitan area of Los Angeles County would represent one of the most dangerous and damaging health incidents in America's recent history. An extremely virulent manifestation of the human coronavirus SARS-CoV, SARS is known to cause severe fever in exposed patients which is typically accompanied by aches, chills, myalgia and other bodily symptoms. This extreme fever is soon worsened when "a lower respiratory phase begins with the onset of a dry, nonproductive cough or dyspnea, which might be accompanied by or progress to hypoxemia" (Los Angeles County Department of Public Health, 2011). Because the disease is so easily transmitted from patient to patient through physical contact, outbreaks of SARS are relatively common when proper precautions are not taken during the initial stages of exposure. 2. Describe the epidemiological indicators associated with the identified disease. During the initial stages of a SARS outbreak, it is critical that a community health nurse examine the epidemiological indicators associated with the disease and apply them to their patient population. One of the most reliable epidemiological indicators in the case of SARS has been observed to be "travel, including transit in an airport, (or close contact with an ill person with a history of travel), within 10 days of onset of symptoms to an area with current or recently documented or suspected community transmission of SARS (Mainland China, Hong Kong, or Taiwan in particular)" (Los Angeles County Department of Public Health, 2011). Because of the close association between travel to these areas and exposure to SARS, screening patients by their recent travel history and quarantining those who may be at risk is an important step towards containing a potential outbreak. Another prime epidemiological indicator for SARS is employment status as a health care worker, which means that I may have an increased risk of exposure to SARS in my capacity as a community health nurse. Considering the primary route of transmission for SARS, which is spread through direct contact with infectious respiratory excretions, the most common epidemiological indicator would obviously be close exposure to a person who is already infected with the disease. 3. Analyze the epidemiological data on the outbreak (see attached document). Following the devastating global SARS outbreak in 2003, the World Health Organization (WHO) undertook the enormous effort of compiling epidemiological data on the disease. The population cohorts most likely to contract the disease, mortality rates for those infected, and the identification of transmission chains are among the many factors that the WHO considered when compiling their research. Ultimately, the WHO concluded that "a cumulative total of 8422 probable cases, with 916 deaths, were reported from 29 countries during the outbreak" while observing that "the last chain of human transmission was broken on 5 July" (2003). It has also been reported that "of this total, 5327 cases and 349 deaths are reported from mainland China" while "a global case-fatality ratio of 11% was recorded at the end of the outbreak" (World Health Organization, 2003). The most likely precipitating factor prior to the contraction of SARS was found to be airline travel, because literally thousands of infected individuals travelled on cross-country and international flights prior to the disease's identification. Due to the close confines of commercial airline travel, infected individuals unwittingly spread SARS to those they sat near, flight attendants, and airline workers. 4. Discuss the route of transmission of the disease causing the outbreak. According to the Communicable Disease Manual, published by the Los Angeles County Department of Public Health, "the main route of transmission is direct contact, via the eyes, nose, and mouth, with infectious respiratory droplets" (2011) during a suspected SARS outbreak. Subsequent studies of SARS outbreaks have demonstrated that objects like clothing can also be contaminated by "infectious respiratory secretions or other body fluids" (Los Angeles County Department of Public Health, 2011), which means exposure to an infected individual through close physical contact is the most likely precipitating event for spreading the disease. While SARS was initially believed to be transferrable through airborne transmission or fecal-oral contact, nearly a decade of dedicated research has disproven this theoretical route of transmission. Patients infected with SARS are considered to be communicable almost immediately upon diagnosis, and because of this fact many nurses and health care workers become exposed to SARS during an outbreak. 5. Create a graphic representation of the outbreak's international pattern of movement or possible movement. In their comprehensive report entitled Spatio-Temporal Exploration of SARS Epidemic, researchers Arnaud Banos and Javier Lacasa developed the following graphic representation of the 2003 SARS outbreak and the disease's international pattern of movement. The relatively rapid spread of the disease through air travel, from China and neighboring Asian nations to Europe and the United States, is clearly demonstrated by the data collected by Banos and Lacasa: Part 2: Imagine that you are a community health nurse. You suspect that a family that has just returned from travel overseas has contracted SARS. Soon, several other community members present the same symptoms. Testing occurs in your health clinic and the presence of SARS is confirmed. Explain the appropriate protocol for reporting the possible outbreak. The role of a community health nurse is multifaceted and demanding, ranging from the personalized care delivered to individual families to maintaining the overall health of a large urban area. The ability to recognize the range of conditions which can precipitate an outbreak of communicable disease, such as the return of a person or family from a trip abroad, is an essential skill for a capable community health nurse. If I suspected that a family returning from overseas has unwittingly transmitted a potentially lethal disease like sudden acute respiratory syndrome (SARS) within my community, the first step would obviously involve comprehensive testing throughout the area. When the presence of SARS was conclusively confirmed, adherence to the established protocol for reporting potential outbreaks of communicable disease would be my paramount concern, because failure to properly manage a situation such as this could result in a health disaster of terrible proportion. The Los Angeles County Department of Public Health advises nurses and other health care workers to report suspected cases of SARS immediately by telephone, before completing the SARS Screening Form and other associated documentation. The first step in managing a potential SARS crisis would be the efficient identification and quarantine-based isolation of infected patients, because "the rapid spread of SARS, its unique capacity to infect health care workers, and its many unknown features in the early days of the outbreak" (Murphy, 2006) combine to make the disease especially prone to outbreak. The expedient establishment of neighborhood triage centers would also be necessary, in order to quickly screen patients for the symptoms of SARS and administer appropriate treatment. Owing to the lessons learned by Chinese doctors and nurses during the initial SARS outbreak of 2003, I would be mindful of providing ample room within these triage centers to give patients distance from one another, thus reducing the rate of transmission from infected patients to those who have not yet been exposed. Part 3: The news has just announced that the air quality index is poor. As the community health nurse, you are concerned about your clients who have asthma and other respiratory diseases. Discuss how you would modify their care to address the increased risk due to poor air quality. A competent and qualified community care nurse is capable of monitoring the overall health of the town or neighborhood they serve, while also paying special attention to the pressing needs of individual patients when atypical circumstances arise. For health care professionals practicing in the metropolitan heart of Los Angeles County, one of the most severe risks to the overall health of patients both young and old is the omnipresent layers of smog and other air pollutants which ring the city. Patients suffering from preexisting respiratory ailments such as asthma are known to experience higher rates of poor health episodes, and according to the Los Angeles County Department of Health Services "Among children 14 years and younger in Los Angeles County, asthma accounted for nearly 40,000 hospitalizations during the period 1995 -- 1997" (2001). As a community health nurse, I would be responsible for monitoring the news for updates on the Air Quality Index, which measures the air for particulate matter, ozone, and other pollutants, and reacting appropriately when the air may harmful to my patients. In order to effectively reduce the risk of poor air quality affecting my asthmatic patients, it would be advisable to construct a simple email chain with myself at the center, so that reductions in the Air Quality Index automatically generate notices which are sent to asthmatic patients, or any patient suffering from respiratory disease. Patients would be encouraged to forward these messages to friends and family with the same symptoms, so a maximum number of potential health hazards are avoided. I would include advisements from the South Coast Air Quality Management District, a government agency which assists in overseeing the Air Quality Index and recommends that "active children and adults, and people with lung disease, such as asthma, should avoid prolonged or heavy exertion outdoors" (2012) when the air quality is rated as poor. By counseling my asthmatic patients to remain indoors when possible during poor air days, and to reduce their physical exertion when they are forced outside, it is eminently possible to lower the number of lung-related cases handled by hospitals each year. References Banos, A., & Lacasa, J. (2007). Spatio-temporal exploration of SARS epidemic. Cybergeo: European Journal of Geography, 408. doi: 10.4000/cybergeo.12803. Retrieved from website: http://cybergeo.revues.org/12803?lang=en Los Angeles County Department of Health Services, (2001). Childhood asthma in los angeles county, 1999-2000. Retrieved from Los Angeles County Department of Health Services Public Health website: http://publichealth.lacounty.gov/ha/reports/habriefs/v3i6_asthma/asthm.pdf Los Angeles County Department of Public Health, Acute Communicable Disease Control. (2011).Communicable disease manual. Retrieved from website: http://www.publichealth.lacounty.gov/acd/procs/b73/B73Part4.pdf Murphy, C. (2006). The 2003 sars outbreak: Global challenges and innovative infection control measures. OJIN: The Online Journal of Issues in Nursing, 11(1), doi: 10.3912/OJIN.Vol11No01Man05 South Coast AQMD. South Coast Air Quality Management District, (2012). Air quality index. Retrieved from AQMD website: http://www.aqmd.gov/pubinfo/Publications/collaterals/air quality index.pdf World Health Organization, Department of Communicable Disease Surveillance and Response. (2003).Consensus document on the epidemiology of severe acute respiratory syndrome (sars). Retrieved from website: http://www.who.int/csr/sars/en/WHOconsensus.pdf Read the full article

[head-post]

Asian shares trim gains after Trump vows to push ahead with tariff hikes

Asian markets initially rallied on Monday but pared gains after US President Donald Trump reiterated his commitment to imposing additional tariffs on 2 April, according to AP News.

Trump’s comments, made during a conversation with journalists aboard Air Force One, underscored the ongoing uncertainty surrounding US trade policy and its global repercussions.

In China, stocks rose after the government reported stronger-than-expected industrial output and retail sales data for the first two months of the year. The Shanghai Composite index gained 0.2% to 3,426.13, while Hong Kong’s Hang Seng climbed 0.8% to 21,144.86. However, weakness in the property market, with home prices falling and real estate investment down nearly 10%, tempered optimism.

In Japan, the Nikkei 225 jumped 0.9% to 37,396.52. Meanwhile, in South Korea, the Kospi surged 1.7% to 2,610.69. In Australia, the S&P/ASX 200 rose 0.8% to 7,854.10. In Taiwan, the Taiex gained 0.7%.

On Friday, US stocks rebounded sharply, with the S&P 500 climbing 2.1% to 5,638.94, the Dow Jones Industrial Average rising 1.7% to 41,488.19, and the Nasdaq composite jumping 2.6% to 17,754.09. Despite the rally, the S&P 500 recorded its fourth consecutive weekly loss, marking its longest losing streak since August.

The rebound was driven by strong earnings from companies like Ulta Beauty, which surged 13.7%, and gains in Big Tech and AI-related stocks, including Nvidia (up 5.3%) and Apple (up 1.8%). However, concerns about the economic impact of Trump’s trade policies and potential government spending cuts weighed on investor sentiment.

Trump’s tariff plans and economic concerns

Trump’s insistence on moving forward with additional tariffs has raised fears about the potential for a prolonged trade war and its impact on global growth. The president’s focus on reshoring manufacturing jobs and reducing the size of the federal workforce has created uncertainty for businesses and households, leading to declines in consumer and business confidence.

Analysts warn that while stock prices may be adjusting to the anticipated April tariffs, concerns about the broader economic impact of Trump’s policies are likely to persist. The potential for reduced federal spending and its ripple effects on the economy remain key risks.

Meanwhile, US benchmark crude rose 48 cents to 67.66 per barrel, while Brent crude added 49 cents to 71.07 per barrel. The US dollar strengthened slightly to 148.93 Japanese yen, whereas the euro edged down to $1.0880.

As markets digest Trump’s tariff plans and their potential implications, investors will remain focused on economic data, corporate earnings, and developments in US trade policy.

Read more HERE