#which in this case was the context of canada over the last 50-70 years

[thehardkandy]

it's been over 7 years but if im being honest i still miss doing my BA. my classes were all so good... even the worst profs i had still left me with SOMETHING. and it was so good going through all sorts of courses for things that i would never do in my spare time. like man. english degree kicked ass. part of me would like to just take more high level classes but i know that would be 300% irrelevant to my life

[himbeaux-on-ice]

Hello! I was wondering if you could please explain to me what Robin Lehner said yesterday about vaccination and competitive edge? English isn't my 1st language and from what I gathered NHL and PA promised VGK that if they get vaccinated the restrictions on them will lessen and they can freely leave their houses. And when they players got vaccines, NHL changed their promise and said players can't do that until all of the teams across the league are evenly vaccinated (shitty move from NHL, 1/2

2/2 as always). But what did Robin mean talking about competitive edge? I rewatched the video 3 times and I still don't understand :( Did the league make it a competition between the teams? "The sooner you all get vaccinated, the sooner there'll be no resctions on you?" I hope, I'm not completely missing the point, sorry about that. Big respect for Robin for speaking up and calling out the league. I'm really happy seeing players speaking up for themselves and their teams

Hi anon! I’ve spoken about this already a bit here and here, in case you haven’t seen those yet and think they might answer some of your questions. But I’m happy to elaborate further! I hope I can clear this up for you.

First, just as a note: Right now it doesn’t seem to exactly be clear what the NHL and NHLPA did or didn’t promise players in terms of easing restrictions, but it seems like Lehner was definitely given the impression by somebody that a team getting fully or mostly vaccinated was the ticket to not being under such strict isolation. The NHL for their part seems to be claiming they promised no such thing, but it’s hard to know right now whether that’s just them covering ass, or if there was just a misunderstanding somewhere in which what they actually said was not fully clear to the players. [Elliotte Friedman voice] More news may be yet to come on this.

Right. So as far as “competitive edge” goes, I can definitely explain that. You’re only a little off the mark. What he means in this case is that the NHL is concerned that letting more fully vaccinated teams live under a less intensely restrictive set of internal rules (regarding things like dining together, exercising together, sitting next to each other on planes and busses, having more group off-ice social time, sharing hotel rooms, having in-person coaching meetings again, etc) will lead to that group having an on-ice advantage in their play over other teams who are less vaccinated and still have to live under full restrictions.

Because the NHL is intensely obsessed with “parity of sport” (trying to make the conditions of competition the same for all teams regardless of outside factors wherever possible), they always in as many situations as possible want to eliminate any potential leg up one team could have over others. This is why we have things like the salary cap, rules about scouting players, rules about how draft picks are distributed that try to make sure struggling teams have a chance to draft well, rules against signing your best players for 20-year contracts so nobody else can have them, etc.

In general theory, being parity-oriented is good! It aims to make sure that the success of teams on the ice and in the standings is determined by the hockey play/skill alone as much as possible, not by franchise wealth or other things they did to get an unfair jump on the competition. And that should make the games more fun and less boring/predictable in most cases! As far as sports leagues go, the NHL has pretty good parity of play overall — there are only a few REALLY good teams and only a few REALLY bad ones, and everybody else performs within a pretty similar range most years. This is why back-to-back Cup wins are so rare in the current era, because due to all the rules to enforce parity there are relatively few teams that are THAT dominant over the competition for a long stretch of multiple seasons in a row, and the odds of any given team winning each year are much more similar. (As compared to like that period in the late 70’s when it was like “who won the Cup? oh surprise surprise it’s the Habs AGAIN 🙄” lol).

However, sometimes the NHL gets unrealistic in its pursuit of making sure everything is exactly the same for all teams. We’ve seen it already this season with the stubborn insistence on making sure the Canucks play a full 56 game season like everybody else, regardless of whether it is safe or reasonable to do so in the time they have left.

This time, the fixation on parity seems to be rearing its head in the form of the League insisting that even if a team has most or all of their players and staff vaccinated, they still have to maintain the same intense restrictions within team spaces as other teams which may be WAY further behind in getting everyone vaccinated, rather than getting to benefit from the lowered risk that being thoroughly vaccinated brings within a closed group like that. And they seem to be insisting on this not because it would be unsafe to change things for vaccinated teams, but rather because of concern that doing so might make that team perform better as a hockey team.

That’s the key part here: The NHL seems to consider getting to (safely) return to a mode of team life that is somewhat more similar to what these guys have been habitually used to pre-pandemic, to be something that could translate into an unfair on-ice advantage in the quality of their play, over other teams who are still doing it all “the hard way” under strict restrictions because they haven’t been vaccinated yet. And because of trying for parity, they want avoid giving teams that “advantage” by basing restriction changes around each team’s individual situation, and instead plan to ease restrictions for all teams at the same time at some point once all teams are similar levels of vaccinated.

Now, US teams seem to be getting vaccinated faster and faster every day, but Canadian teams probably have not started vaccinating their players or any team employees under age 50 at all yet, because Canada’s vaccination process has been painfully slow. So waiting on them to catch up could leave US teams who are already mostly/fully vaccinated still stuck in those restrictive mentally draining conditions for quite some time before the other teams catch up — again, not because it isn’t COVID safe to ease their restrictions if done properly (that doesn’t seem to be a problem), but because the League sees the improvements to their mental state and team morale/cohesion that would come from living a less restricted life together and getting to return to familiar off-ice hockey routines as gaining a “competitive edge” over unvaccinated teams, which would lead to them playing better hockey to a level that can’t be matched as a result.

Which, Lehner is right, is a pretty fucked up way to look at it! “It’s an unfair advantage for you to not be miserably alone and depressed by that and frustrated and doing everything with 16 extra steps you’re still not used to, it’s an unfair advantage to get to actually act like a team off the ice when playing a team sport, so no, we’re not gonna let you eat lunch together or share hotel rooms or whatever” is not exactly a compassionate argument!

Anon I’m also really glad Robin said something about it, and I was glad to see VGK captain Mark Stone put full and vocal team support behind him when asked about it last night on the broadcast too. The mental price of these intense restrictions is something that has been weighing on my mind ever since I first heard they would have to spend all their time on the road locked in hotel rooms alone when not playing and thought “oh god, five months of that is going to be psychologically devastating”. It’s a relief to hear it acknowledged.

I’m not fully sure what the best solution is here, but that mental wellbeing factor absolutely must be discussed in all decisions. It would be fucked up if the League is treating that as something purely technical to be controlled like the salary cap, rather than as a key determinant of health and life (in the short and long term) that is just as important as COVID safety. The old hockey culture of “just suck it up” cannot cut it anymore.

Aside: I think it’s also worth mentioning while we’re here, that I think I do understand why players may be angry about have been talked into getting the vaccine because they thought it would lead to eased personal restrictions, and why I don’t believe that anger necessarily represents an “anti-vaxx” mindset. There are reasons they may not have planned on getting vaccinated just yet which aren’t necessarily “anti-vaxx” cult thinking (though that doesn’t mean they’re smart reasons lol) and would likely seem reasonable to players in-context. I’m gonna put that under a cut though bc this is already really long!

First, there’s the fact that we don’t know what medical conditions some players may or may not have which could make them hesitant to get some of the vaccines out of an abundance of caution. More prominently you also gotta remember, these guys are athletes currently competing their way through an extremely intense and extremely important part of the season as they try to secure playoff spots, playing sometimes as many as 4 games a week. Looking at it that way, it’s understandable why some of them would be hesitant about getting a shot at this particular time which we all know is going to whammy you with a nasty little bout of mild-moderate side effects that hit you like a bad cold for as much as a week. They probably don’t feel they can afford to be laid up with muscle aches, sinus suffering, fatigue, and all the other little fun (and eventually harmless in the end!) things that your body runs through while activating that initial immune response — because in the couple of days that it throws them off for, their team could play 3 or more REALLY important playoff-clinching games, which they could end up underperforming in or having to sit out.

If that is the situation you’re in, and you already feel like the current League restrictions are doing enough to protect you, you can see why you would say “I think I’ll wait and get it during the offseason/during the week break between regular season and playoffs, and just suck it up for these last few weeks dealing with the same ol lonely isolation restrictions I’ve already gotten used to dealing with all season long, rather than be hit with that curveball of possible temporary vaccine side-effects during this time when I need to give it my all every game.” That may sound like a selfish mindset, but I wouldn’t be surprised if that is how at least some of these athletes are approaching it, especially ones who may be single guys without families at home to worry about protecting. (Lehner, for the record, has a wife and two young kids).

BUT, if the League told you (or it sounded like the League told you) “Hey, if enough of your team gets vaccinated quickly, we’ll be able to lift some of the internal restrictions for you guys and let you like hang out and do stuff together within the team again”, and if you were REALLY struggling with the mental stress of that isolated living style, you might weigh the two options against each other and say “Okay, I’m willing to power through a week of potential side-effects and get vaccinated with the fellas if it means I won’t have to be so goddamn miserable and depressed every day.” and then you get the shot(s).

And if you did that, and THEN the League said “lol no, even though your team is fully immunized you still have to sit in your room alone every night and eat by yourself and not leave your house, because it’s not fair to other teams if you guys are no longer mentally miserable like them”, well now you find yourself in the worst of both worlds — still stuck in isolation, AND you’ve still got to play through all the potential vaccine side-effects that will leave you a little off your game during some of the most crucial games of the year.

Plus, that leaves you not feeling like you got to give informed consent — you agreed to get vaccinated (ie undergo a medical treatment) under the expectation that there would be certain rewards to be gained in terms of relief for your mental health, which made you decide it was worth the potential dent in your performance for a few games and any other worries you had about the vaccine, because the prospect of that relief was so worth it. And now, you are told by the League “that payoff you expected never existed, we never promised that, what are you talking about? we can’t change things for your mental health because that might make you better at hockey than the depressed unvaccinated teams”. I can understand how that turn of events could leave someone, as Robin expressed, feeling like they were “tricked” or “forced” into making a choice that they may have done differently otherwise. They felt that they were promised something in return that they didn’t get.

Note at the end of all this: Again, we still don’t know whether the NHL and NHLPA actually made any promises, or if they simply weren’t clear enough in communicating expectations to teams and the players misunderstood what was said to mean something else. Regardless, using the idea that being freed from having to be miserably isolated to an even greater degree than most of the US general public is an “unfair competitive advantage” to now justify not allowing reasonable adjustments to the restrictions for fully vaccinated teams is fucked up, and treats mental wellbeing as just another gameplay-impacting factor to be controlled rather than a deeply impactful part of a person’s overall wellbeing which can even threaten their life. The players must be treated as people.

[lairofsentinel]

i'm looking at the stuff you're showing about chile and tbh. i just. why are cops always on the side of the government, and never on the side of the very fucking people they're supposed to protect and whose money is used to pay them. why do they always beat up people. why are they like that in pretty much every single protest ever every fucking where. literally why. (tho yours are especially fucking bad, they sure as hell are using the fact that it won't get as much reporting or punishments)

In a oversimplified way to answer this: because the system allows the accumulation of power and resources of a small group [rich people, bourgeoisie, corporations, external interests, pick the one you want, in all cases, all of them are part of the 90% of the political system/parliament/executive power of the country, so this idea of democracy has always been a lie] and they are  protected by their "dogs" [cops, military shit, soldier crap]. Those dogs are also poor people who are paid to beat, kill, and rape other poor people in order to protect the group with accumulated power/resources.

This show of power is Shock Doctrine in its finest. This is all about keeping the masses filled with fear and paralysed [after all, poor people are a LOT more massive than rich groups and could seize a whole country with a massive coordination of disobedience]. Powerful groups know this. And they FEAR this. This is why they use a lot of money in security that reinforces all types of fears and fear to retributions.Of course, their first step is propaganda.

First, they want you to convince you with capitalist propaganda that this is the ONLY system which gives you happiness if you work hard enough, and "freedom" and "peace" and a lot of crap so you focus on it. You keep breaking your bones with three or more jobs so you can “reach” happiness, eventually, since you are working hard like hell. This system also reinforces the individuality, the self-made man [you need to behead everyone to be successful, no matter the cost] and tries to isolate you [this is why the system hates unions and cooperatives or any action that means empathy and cooperation with others].

A lot of poor people share this idea and defend it. This is explained in a sentence by Simon de  Beauvoir: “the oppressor would not be so strong if he did not have accomplices among the oppressed themselves”. That's why they want to engrave such propaganda in everyone, it guarantees “social peace” at the expense of many many social groups under terrible living conditions. However, things can't be endured forever, and they explode. And when that happens, you need to install fear in the masses, in order to paralyse them and make them betray each other [Shock Doctrine again. Remember this doctrine was crafted in Canada and USA around the 50-60's and applied, first, in Birmania, aka Vietnam with the terrible war there, and later in South America under the several dictatorships in the region.]

Latinoamerica never liked neoliberalism. This is why the Plan Condor was applied all over the region: to force the neoliberalism in all of its countries. Chile could return to "democracy" with a neoliberal system around 1990 [check dates, I'm rounding everything]. Chile was a social-democracy before their dictatorship, so you can see why it was needed a dictatorship with gringo puppeteers that wanted to destroy “the red”.[A lot of people will say it was communist or some other bullshit... “opinions” go wild here depending of how much History you read].

During the terrorism of State [please, don't call it dirty war – a terrible translation used in books of History written in English, NOT by chance--, it was never 2 armed sides in a battlefield, it was the state [army] massacring and torturing its population], the level of torture and the torture systems used and the dire perversion in it that our parents suffered is something that I CANNOT explain [not because I dont know, I read a lot of heavy stuff related to it, and I tell you, it's impossible to speak these things without feeling your humanity breaking into pieces]. It's because it's too horrible for someone who is not asking details. If you read Shock Doctrine from Naomi Klein, she narrates the slightest versions of it. If you want to know about it from raw material, check just one page of the book Nunca más (Never Again), a report of how the Gov. went savage against their own people. Chile, Brasil and Argentina have a book of this type narrating the atrocities that each dictatorship did on their people, since in those countries it was where the dictatorship was more brutal.

What these pacos [these military shit] is doing is just reopening the fear of all that [as you can imagine, this is more than simple fear. It’s terror.]. Our parents are the traumatised one, and all of them are feeling the looming threat that it was supposed to be closed by now. There is a deep deep scar in South America social memory on this matter. and they are using it to spread fear, and also, to revive the old methods of torture that latinoamerican millenials only read [after all, our parents were the one who lived those shitty times].

Police and military never were supposed to "protect" people in south america. They are sustained by the gov. to repress people. They are the tool for the foreign interests and the bourgeoisie to control the massive poor people. I want to make this clear: they never were meant to defend people. Like gringo army was never meant to “defend” democracies elsewhere.

Military here [in Chile, in Brasil, in Argentina] were instructed in the 70′s in the School of Americas, a fucked up gringo military school where they learnt all the torture system that they used back then [they kept using it in Afghanistan and in Guantanamo, so it’s not “ancient history”].  It's not by chance that Chile had been sending military in the last 5 or 8 years to the SCHOOL OF AMERICAS again! [now under the fancy fucked up name of The Western Hemisphere Institute for Security Cooperation (WHINSEC) . They are supposed to “teach” our army to “defend democracy and life and freedom” and all that shit. You can see it. Lol. No latinoamerican will believe that shit that says wikipedia about them.

So, you can see the context. Military and cops never were meant to protect people. They have never been trained for that. They are meant to protect the bourgeoisie, the corporations, the big companies that are preying on Chile, on its sea and mining resources, on its water, on its mountains.That’s why this phtoshop is so on spot:

Tell a latino that cops protects them... they will laugh [if they are adult enough to understand the dark layers of our History]

[by the way, just to clarify, I'm not from Chile, but the country beside them: Argentina. Still, everything that's happening in Chile is touching a LOT this side too because both countries share the same scars with the same level of dehumanisation [and to be honest, this country has been boiling shit for a long time and it's just a matter of time to explode too]. I'm just trying to spread the word of my Chilean fellows. And considering how their media blockage is working, I'm afraid many people around the world are receiving a gov. version of the disaster happening there. Something that also happened during the dictatorship times, and before anything, I defend human rights. And what's happening there is a total massive violation of the human rights, and opening festering wounds that are hitting us all.]

[effieworldwide]

Winner Spotlight: “You Should Play 6/49” by Loto-Québec & Sid Lee

2019 Effie Awards Canada GRAND EFFIE GOLD – Sustained Success – Services

December 12, 2019

Lotto 6/49 is Canada’s most popular national lottery game and has been offering Canadians a chance to win daily since 1982.  

In Quebec, over 70% of Lotto 6/49 tickets were being sold to the over 50 crowd. Millennials were less enthusiastic, associating the lottery more with its poor odds of winning than the promise of riches. So Loto-Québec, which runs Lotto 6/49 in the province, saw an opportunity to inspire this segment to play.

In 2015, Loto-Québec and agency partner Sid Lee launched an integrated campaign “You Should Play 6/49” that highlighted everyday moments of luck (for instance, catching every green traffic light) as evidence that anyone is lucky enough to win, and expanded on the ubiquitous phrase, “You should play the lottery,” to turn these moments into purchase occasions.

In the three years since its launch, “You Should Play 6/49” has successfully reassociated its brand with luck, resulting in increased brand health metrics and sales among the millennial segment. Along with a Gold win for Sustained Success, the campaign earned the Grand Effie at the inaugural Effie Awards Canada competition in 2019.

Below, Alex Bernier, Executive Creative Director at Sid Lee, shares more insight behind this effective work.

Effie: What were your objectives for the “You Should Play 6/49” campaign?

AB: People, specifically young adults, didn’t believe in their chances of winning anymore. Our main goal was to shift the way millennials perceived lottery games such as Lotto 6/49 and inspire them to feel lucky enough to play the lottery.

Effie: What was the strategic insight that led to the big idea?

AB: While Millennials did not seem to believe in their odds of winning the lottery, they clearly seemed to believe in their odds of winning in everyday life. We found that they revealed themselves to be an amazingly positive generation. As we pushed our thinking further, we realized Millennials’ optimism and positive outlook on the future could completely change the reason why they play Lotto 6/49.

Luck emerged when we put our optimist Millennial hat on. The world became a place filled with luck. It is everywhere and it happens all the time. How is it that one morning, we can hit every green light on our way to work? How is it that our flight to Paris is on time when all others were cancelled? How could we have met our future husband or wife on a subway ride? As a matter of fact, big or small, many of life’s most beautiful things happen by chance.

To truly benefit from this insight, we needed to find a way to make Millennials think of Lotto 6/49 when luck occurs.

Effie: How did you bring the idea to life?

AB: This idea works well across applications, including web, TV, radio, newspapers, displays and experiential. We can think of a million different scenarios that show how lucky we are every day. The creation goes beyond the scenes we film. We can show originality through both traditional media as well as online advertising. For example, we placed a “You Should Play 6/49” media message above the article for the first baby of the year, and we had displays in metro stations when the last train passed to remind passengers that they were lucky they caught it. We also did a few activations. For example, we sent real four-leaf clovers to PyeongChang to support Team Canada, and we helped festivalgoers find their lost items at Montreal’s Osheaga Festival, to name just a few.

Effie: How has the campaign evolved since its initial launch?

AB: Each year we had different goals.

Year 1: Launch the new expression and entrench it into the culture First, we needed to show everyday moments of luck that would remind people of the expression. Due to cultural and language factors in Quebec, we favoured television as it remained the best medium with which to reach Millennials and others. We created a flexible platform of short TV spots that recreated situations that people could relate to, whether they happened to them personally or not, creating endless possibilities to pick up on new moments of luck.

Year 2: Extend usage to more situations & contexts The second year, Lotto 6/49 emphasized a few moments of luck Millennials would most likely engage with. In Quebec, hockey players hitting the post is a notorious moment of luck, usually the mark of a crucial play in NHL games. Lotto 6/49 created ad banners that appeared on hockey fans’ TV screens only on those occasions.

Year 3: Make moments of luck feel even more personal The third year, Lotto 6/49 looked for ways to create genuine moments of luck Millennials could encounter. Every August in northern Quebec, a shooting-star spectacle lights up the night sky. While most Quebecers know about it, few are able make the trip to see it in person. Lotto 6/49 went on location to broadcast it on Facebook Live. Every time a shooting star appeared, a banner prompted viewers to make a wish with a purchase. In only three hours, it reached 1 in 10 Quebecers.

Effie: How did you know the work worked? Were there any surprises in the results you achieved?

AB: When “You Should Play Lotto 6/49” became part of Quebec’s popular culture, we knew that it worked. Having people share with us their moment of luck and seeing how the campaign really evolved into something bigger than the promotion was really a positive surprise.

Effie: What are the biggest learnings you took away from this case?

AB: My first lesson would be that at the end of day, it’s all about collaboration and being open-minded. This is a perfect example of how strategy, media, and creation are equally important in the deployment and execution of a campaign. Ideas can come from anyone on the team, from the client side, from other disciplines, and even from just walking down the street. They can come from everywhere. My second one is easy: have fun! We had a lot of fun together as a team and it showed in the final result.

Alex Bernier, Executive Creative Director & Partner, Sid Lee Now creative director, Alex joined Sid Lee as a copywriter fresh out of school (even though he thought he was an Art Director – that’s how green he was). Whatever brand he touches he brings to the next level, namely because of the high-quality standards he imposes on himself and his team. It’s probably that same reason that led him to become the youngest president of the 9th edition of the Créa, an award show celebrating advertising in the province of Quebec.

Read more Winner Spotlight interviews >

[biomedgrid]

Biomed Grid | The Future of Diagnostic Laboratory Testing in Healthcare

Introduction

The challenge of medicine, including diagnostic laboratory medicine, is to implement new tools and technologies in a costeffective and sustainable manner to improve patient care. In the 1960’s researchers realized that the potential infinite demands of healthcare could not be accommodated by the finite resources available [1]. The evolving trends and circumstances of modern medicine may be considered an ‘innovative disruption’ to the practice of laboratory medicine [2]. Such evolving circumstances include but are not limited to technological advances, demographic changes, complexity of care, and increases in the expectations of well-informed patients [3]. With careful, thoughtful, and deliberate guidance, this disruption can lead to the betterment of healthcare and serve the interests of the patient. Achieving this balance is challenging and will require a paradigm shift in the perspectives and practices of laboratory testing to keep costs from increasing exponentially and to mitigate potential consequences.

Contributing Factors

Demand plays an important role in the practice of ordering laboratory tests. Both direct and indirect pressures on physicians to order a broad range of tests, and in many cases repeat these tests, arise from multiple sources including researchers, manufacturers, government, and often from patients themselves. In today’s medical culture, ordering tests and procedures is often interpreted by patients as synonymous with sign of a thorough doctor [4] and due diligence. These expectations create demands for testing which may in some circumstances be premature.

Test ordering patterns are further influenced by physician realities. Factors such as a desire for certainty and a natural behavioral tendency for risk aversion influence the physician’s decision on the necessity and cost-benefit balance of laboratory tests. Physicians are weary to omit any test due to fears of missing a diagnosis, patient dissatisfaction, and litigation. While the magnitude of these factors is unprecedented, the physician’s core dilemma of balancing autonomy of the patient and avoiding maleficence through overdiagnosis remains unchanged. As societies expectations of physicians to detect disease earlier, cure disease and treat all aspects of health and wellbeing continue to grow exponentially, as will the implications that these expectations have on the efficiency, quality, and justice of the healthcare system.

Awareness of the Problem

The awareness of the ubiquity of over testing is pervasiveness in healthcare throughout North America. Despite the dilemmas presently associated with the choice of laboratory tests, everyone involved in medical care today is aware that there are situations in which inappropriate (excessive or unnecessary) laboratory testing occurs [5]. Approximately 25% of Canadians report that their physician ordered a test that they considered unnecessary [4]. Furthermore, about one third did not follow their physician’s advice and did not get the test performed [4]. Despite differences in funding structure, no considerable differences were found in the use of laboratory testing in Canada and the United States [6]. In 2014, more than 70% of American physicians reported that they believe the average doctor orders at least one unnecessary test or treatment per week [4].

The perceived normality and status quo of these practices leads to further propagation of demand. In the past decade, the volume of laboratory tests being performed has been increasing at a rate of 6-8% per year [7], while per capita laboratory costs have increased 8-34% over 5 years [8]. With an aging population of baby boomers, this increase in tests and treatments being administered without a clear corresponding improvement in health is of considerable concern [4].

Strategies Currently in Place

Realizing the dangers of inappropriate and unnecessary testing, various initiatives have been established to mitigate the problem. Efforts such as clinical auditing [99] and administrative interventions [10] have shown limited practicability with questionable sustainability. In our previous work, we have shown the utility of TSH alone during the screening of thyroid disorders, thereby eliminating unnecessary T3 and T4 tests in diagnosis [11] and optimizing treatment [12]. This has been tremendously effective in optimizing testing of specific thyroid markers. However, to create a widespread impact on laboratory testing in all areas of medicine, a change in perspective is necessary. Examples of efforts to change perspectives on laboratory testing include Choosing Wisely, which aims to facilitate conversations between patients and physicians around choosing only care that is necessary and avoiding harm [4]. On a more administrative level, Lean methodology has been applied to healthcare with the objective to reduce waste, improve quality and create a supportive network through management strategies [13].

As the accessibility of laboratory results and health related data through online portals is increasing, conversations about the meaning and individual context of test results and effects on treatment are becoming increasingly important [14]. Despite the influence that expectation and pressures may have, laboratory utilization is the responsibility of the medical profession. We must accept that we are responsible for our present situation and lead the way in rectifying the current trajectory of laboratory medicine.

Minimizing Non-Contributory Medical Practices

The purpose of laboratory medicine is to provide evidence of the current state of a patient’s health to inform the prevention, treatment or management of an existing or impending disease or condition [15]. Despite previous efforts, the unnecessary maximization and overutilization of tests continues in areas that are not fruitful. This has lasting maladaptive consequences on the allocation of laboratory resources. As doctors are pressured to order more tests, increases in testing practices continues to have an associated increase in costs on the medical system. As costs continue to rise, funding agencies are applying pressure on doctors to decrease the magnitude of test being performed. These pressures will undoubtedly continue to have significant impacts on the clinical practice of ordering laboratory tests.

Although the accuracy of laboratory tests continues to progress, false positives and false negatives still occur. When careful application and reflection is overlooked in the practice of laboratory testing, overdiagnosis is likely to take place. Even with the best of intentions, over-testing is not in the best interest of the patient and may lead to overdiagnosis, unnecessary costs on the healthcare system and suffering on the part of the patient [4]. As stated by Dr. Martin “If over-testing and overtreatment were a disease, we would declare it an international epidemic” [4].

When ordering any test, the physician should pre-emptively consider the implications that the result will have on treatment and communicate these considerations to the patient. When multiple tests are ordered without adequate clinical justification, each unnecessary test adds data pollution, and reduces the signal to noise ratio [16] and may produce results that unnecessarily complicate the clinical situation. Ensuring that sound clinical reasoning is at the core of every decision to order each laboratory test would likely alleviate a considerable portion of the roughly 30% of laboratory tests ordered that is currently attributed to repeat testing [16]. This would enable more allocation of resources to sustainable strategies that contribute to patient care.

Maximizing Imperative Medical Practices

Essential components of patient care must be maintained and strengthened, regardless of pressures, political agendas and funding restrictions. Despite the widespread tendency to over test, the opposite also exists - situations in which appropriate laboratory testing does not occur [5]. As new laboratory test technology moves us toward a preventative approach to maintaining health, rather than being limited to the reactive disease management approach of the past, the definition of essential components of patient care is evolving. Examples of such transitions toward a preventative approach in laboratory medicine is seen in diseases such as leukemia, breast cancer and heart disease with new technology including genome, proteome and cellulome guided disease management [17]. The role of laboratory medicine in the new era of clinical care continues to expand to encompass more screening and early diagnosis as well as determining disease susceptibility and confirming a state of well-being. Studies have found that these new applications represent more than 50% of the current laboratory workload [18]. While this may seem unnecessary at present but will have lasting benefits for the medicine of tomorrow.

At a population level, disease susceptibility studies inform what diseases are unlikely and need not be tested for at as regular of intervals in certain groups, thereby avoiding unnecessary tests in these low risk segments of the population. In at-risk segments of the population, it will inform what risk factors are to be avoided and the interval at which particularly likely diseases should be screened for. This information allows for prevention at the primordial and primary levels and allows for the safest most effective treatment. If prevention cannot be achieved, the appropriate medical judgement to take the necessary steps to ensure a proper diagnosis is made at the first manifestation of disease. Tailored treatments can then be delivered to the individual, resulting in an overall increase in the efficiency of the medical system. Appropriate application is key to the implementation of early diagnoses and aggressive treatments as well as the use of expensive tests and procedures [4]. These standards of practice will support physicians in providing quality medical care while also acting as a cost-conscious healthcare participant.

At an individual level, therapeutic decisions will rely less on comparisons of the concentration of single molecular markers to reference values of a healthy, yet not necessarily relatable, subset of the population. Instead, therapeutic decisions will be informed more by changes of the patient’s individualized profile of markers [19]. This will allow for comparisons between the patient’s status and physiological circumstances to the expected response of a particular patient to a particular treatment. This movement has the potential to produce more accurate diagnoses, safer tailored treatments leading to faster and more effective recovery and decrease costs in the long run [19]. As new technology brings about this era of personalized medicine, it will become increasingly important to strengthen collaborations among clinicians with pathologists and medical laboratories to ensure accurate implementation and interpretation of laboratory tests.

Conclusion

The path towards optimizing the utilization of diagnostic laboratory tests in this new era must include strategies to reduce the current unnecessary and non-contributory testing as well as strategies to ensure the protection and advancement of essential services. Reducing non-contributory laboratory testing practices will allow us to build and strengthen strategies in disease prevention and early diagnosis. This transition in the practice of laboratory testing will require a change in the culture of medicine as well as communication between patients, physicians, administrators, funding agencies, lawmakers, and manufacturers. Only through a common understanding among each of these stakeholders can we achieve progress in optimizing the health of the population in a cost-effective and sustainable manner.

Conflict of Interest

There are no conflicts of interest to declare.

Read More About this Article: https://biomedgrid.com/fulltext/volume5/the-future-of-diagnostic-laboratory-testing-in-healthcare.000883.php

For more about: Journals on Biomedical Science :Biomed Grid | Current Issue

[squirrelsave]

Covid-19: Has Fear Run Ahead of Markets?

Greed & Fear…

In all my investing experience, greed and fear are the driving forces behind buying and selling decisions. Yet, I realized that it is when there is excessive greed that we buy (fixated on unrealized profit and reluctant to sell) and when there is excessive fear that we sell (no holding power or reluctant to buy). This investing pattern is similar to gambling.

…data & AI to improve investment outcomes

In 2016, when I decided to leverage artificial intelligence (AI) to improve investment outcomes, I was already looking for the next black swan event. Based on my human experience, investment markets experienced sudden sharp corrections every 10 to 11 years. For example, the 1987 Oct crash, the 1997 Asian Financial Crisis, the 2008 Global Financial Crisis, and now the Covid-19 Crisis.

Between these big movements were bouts of market volatility, such as the 1991-92 US recession, the dotcom bust of 2000 and Euro Debt crisis which peaked in 2010-2012, to name a few.

Looking at market crises in the context

For those who lived through these crises, it will be useful to compare and contrast our memories during and after each depressing experience. In short, the comparison is similarly of dread and fear as we witness markets gyrating wildly and falling. The contrast is that every crisis of fear gave way to recovery of hope within 2 to 3 years.

What strikes me is that all the crises have moved from being local to more global - due to the growth in international capital flows, and now, internet connectivity and intertwined global supply chains.

Let’s examine the current Covid-19 Crisis. Without a doubt, it is global. As in the past, there is now widespread fear – which threatens to overcome sensibility and data-driven evidence. Otherwise, how do we explain the brawls over toilet paper?

The impact of Covid-19

The Covid-19 epidemic is becoming a global pandemic. Global markets have taken a tumble. The S&P 500 index of US companies fell by 11.5% in the week commencing 24 Feb 2020, the worst week since the 2007-2009 Global Financial Crisis.

The economic impact is already more severe than SARS or MERS. In 2003, SARS infected about 8,000 people and killed 774, taking USD 50 billion off the global economy. In 2015, MERS infected 200 people and killed 38, and cost the global economy USD 8.5 billion.

To be clear, the Covid-19 outbreak has been in the media spotlight since its December 2019 discovery in China. Yet, in recent days, we see a rachet up in Covid-19 concerns in the Western hemisphere. In early March, the World Health Organization has declared COVID-19 a public health emergency citing a mortality rate of 3.4%.

We are witnessing cracks in public health systems and political structures across the globe, with health workers bearing the brunt, proliferation of fake news, racism, hoarding, and even political leaders in denial playing the blame game.

It is easily forgotten how China bought time for the world to prepare when it undertook draconian containment measures in the form of “quarantine by decree” – hard for any country to follow – at great cost to its own economy.

China has done a commendable job. The data shows a slowdown in the Covid-19 spread within China. But the outbreak has spread to South Korea, Iran, Italy, and now possibly in the USA.

By 1 Mar 2020, the number of new cases outside China exceeded the cases in China.

As of 1 Mar 2020, China is still the main caseload with the total number of confirmed COVID-19 cases at 80,565 (3,015 deaths) and 14,768 confirmed cases (267 deaths) in the rest of the world.

COVID-19 CASES

Source: Statista

Looking ahead, there may be the first vaccine test, but a safe and effective vaccine may only be available in 2021 – assuming the genetic makeup of the virus does not change. In the interim, Covid-19 has to be contained. In Africa, the WHO has set up 40 testing labs across 35 countries (from zero) to achieve early Covid-19 detection and control.

Covid-19 Fears in Overdrive…

It is likely for Covid-19 to go endemic if not pandemic. As the number infected is most likely under-reported due to lack of test kits and similar symptoms to the prevalent flu, overall Covid-19 death rates are likely to be lower than actual. Bear in mind that data from many countries is not reliable due to poor testing, political incompetence and uncertain clinical definitions of symptoms.

Alarming data may, in fact, be less cause for alarm. Like Singapore, infected cases in South Korea shot up because over 70,000 people were tested. In contrast, Japan and Thailand did fewer than 2,000 tests. The lack of testing is even more alarming in the USA. In Indonesia, there were until recently, no cases.

So far, the Covid-19 data shows a high concentration of cases, as in Wuhan (China), Daegu (South Korea) and Lombardy (Italy). This suggests that containment and effective contact tracing are critical in fighting Covid-19.

Positioning for Recovery

Covid-19 is less fatal than SARS and MERS with a fatality rate of 0.9%, versus Flu’s 0.1%. Covid-19 seems more lethal for people with pre-existing conditions or over 60 years of age.

Examining market reactions for past ‘viral scares’, the same patterns are being repeated. Using 10 Year Treasury yields as a proxy for risk deleveraging, the peak panic lasted 30-40 days in the past 5 viral scares. Arguably, the market selloff may be exacerbated by deleveraging and margin calls.

Data during the past virus scare point to sharp recoveries over a span of 9 months. For example, during the SARS crisis, the HK market saw a 70% rebound over 9 months. During the H1N1 virus scare, US stocks recovered close to 70% in 9 months.

Nonetheless, the economic cost of Covid-19 will be very high due to the multiplier effect of consumer demand and international travel collapsing. In response, various governments are resorting to fiscal spending and monetary easing.

The likelihood of a global recession has led central banks to slash interest rates at a pace not seen since the Global Financial Crisis of 2007-2009. On 3 Mar 2020, the US Federal Reserve lowered its policy rate by 0.5 percentage points, two weeks ahead of its monetary policy meeting. Central banks in Australia, Canada and Indonesia have also cut rates. The European Central Bank and the Bank of England are expected to follow.

Economic stimulus measures in response to Covid-19

Source: The Economist

Conclusion

We continue to watch Covid-19 unfold. As I said at the outset, we need to recognize the greed and fear that drive our investment decisions. Fear currently dominates. Therefore, I see an opportunity for recovery in the next 9 months.

Instead of human emotion limiting calls, I am confident of our data driven SquirrelSave AI investment approach. Our SquirrelSave portfolios have seen higher allocations to cash assets and alternative assets such as real estate and gold. The sharpest market drop since the Global Financial Crisis has just occurred. Though our SquirrelSave portfolio performance is impacted, we stay the course and continue to apply our SquirrelSave AI approach for better investment outcomes, as long as you are comfortable with the risks you are taking. We are.

--

Originally posted on SquirrelSave's blog

https://squirrelsave.com.sg/blog/covid-19-fear-run-ahead-of-market.html

[selfcaredoc]

The Wellness Home. A Global Solution

"The greatest wealth is health."  -- Virgil

In not much more than a generation, we have transitioned from a world in which infectious diseases were the greatest health challenge to one in which multiple chronic illnesses are the biggest global health threat Over 70% of deaths are attributed to chronic diseases. Although the U.S. leads the world in chronic diseases and pharmaceutical consumption this is a global problem.

   According to the World Health Organization, chronic diseases are the leading causes of death and disability worldwide. Disease rates from these conditions are accelerating globally and advancing across every region and pervading all socioeconomic classes. Currently, 33% of adults worldwide suffer from two or more chronic conditions also known as Multiple Chronic Conditions (MCC).

The Americas have the world’s highest prevalence of overweight and obesity, which is a leading risk factor for chronic conditions, especially diabetes. This overweight and obesity epidemic is largely due to an increasing trend toward unhealthy diets consisting of highly processed foods high in fat and sugar, and few fruits and vegetables.

The four major chronic diseases, cardiovascular disease, cancers, diabetes, and chronic respiratory disease will account for approximately 81 percent of deaths in Latin America and the Caribbean by 2030 according to the Population Reference Bureau on Latin America.

The World Economic Forum on Health and Healthcare recently announced that the long-term goal of healthcare should be focused on prevention. I suggest that this should be the immediate goal and a revolution to self care and its principles are undeniably needed right now.

Chronic diseases and conditions, such as heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis are among the most common, costly, and preventable of all health problems. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) estimate that as high as 80% of our world’s biggest killers can be prevented. I concur and am of the belief that just a few simple self care principles can lead to a vibrant heathy life.

As self care advocates and part of our International Wellness Community it is our goal to empower people everywhere to be Healthy by Choice. In this context, we talk about four causative factors for chronic disease and solutions that we all can implement to be Healthy by Choice.  

1.     Deydration

According to a recent study 75% of Americans suffer from chronic dehydration. Meaning most of us are not giving our body the right level of water it requires daily. It’s not just in the United States, this is a problem seen at varying degrees in Australia (80%) France (75%) and Germany (50%), and the UK (80%).

Dehydration has been called the Mother of all Epidemics and the first step we all need to take in addressing chronic disease. Failure to drink enough water can lead to fatigue, headaches, joint pain, weight gain, diabetes, ulcers, cardiovascular and kidney disease.

Water is not just a beverage choice? It is an essential nutrient.

We can live for months even decades without many other nutrients, but only a few days without water! Drink half our body weight in ounces of water per day, or 3.3% your body weight in kilograms in liter per day.

 2.     Sleep Deficiency

Many of us walk around every day sleep deprived. One reason is that many of us consider sleep as an unproductive endeavor, when it is our most productive physiological activity. This too is a global problem that can lead to many chronic diseases. The average amount of hours slept per night in the U.S. is 6.5 hours.

Here are the average hours of sleep in other countries:

Mexico 7.1 hours

Canada 7.1 hours

Germany 7 hours

UK 6.8 ours

Japan 6.4 hours

Source: National Sleep Foundation

 Although 7 hours of sleep sounds good, it is a chronic recipe for sleep deficiency and related poor health issues.

 Most sleep experts agree that we need 8 to 9 hours of sleep a night for good health.

What is the recycle rate of a human being? In other words, how long can we last without sleep before we start to see declines in brain function or impairments within our bodies? It seems to be about 16 hours. Once we get past 16 hours, research shows that’s when we see mental and physiological deterioration in the body. Take look at Dr. Matthew Walker’s informative five minute video, “Why We Sleep”.

 3.     Weight Matters

A recent study in The Lancet (April 2016) reported for the first time in human history obese people outnumber underweight people. These statistics were gathered from 200 countries and nearly 20 million people for over 20 years. According to the Organization for Economic Cooperation and Development, the United States is the most obese nation in the world, just ahead of Mexico. Their report states 2/3rd’s of U.S. adults are overweight or obese (69 percent) and one out of three are obese (36 percent) and 1/3rd of children are overweight. If trends continue unabated, by 2030, estimates predict that roughly half of all American men and women will be obese.

One of the main problems is excess sugar consumption. To put this into context, the average daily consumption of sugar by Americans in 1822 was 9 grams a day. It is currently 153 grams a day per individual. This is nearly a 17-fold increase in less than 200 years. We change very slowly biologically, yet we have drastically altered what we are eating and the amount of sugar we are consuming.

Americans aren’t alone in their addiction to sugar.

      Top SUGAR LOVING Nations in the World

Sugar is highly addictive. The best way to break this addiction is to read labels and monitor your daily sugar consumption.  Read food labels and avoid those with added sugars. Also note that sugar content is expressed in grams per serving and that four grams of sugar is equal to about one teaspoon of sugar. Limit consumption to 25 grams (6 teaspoons) a day for women and 36 grams (or 9 teaspoons) a day for men.

Protein Helps

Eating protein is an easy way to curb sugar cravings. High-protein foods digest more slowly, keeping you feeling full for longer. Protein doesn't make your blood sugar spike the way refined carbs and sugars do. Pick proteins like lean chicken, eggs, nuts, or beans. Protein shakes are ideal for breaking the sugar addiction and can also provide essential and beneficial nutrients.

4.     Environmental Toxicity (The Body Burden)

I think we would all agree the world is a toxic place. There are over 85,000 chemicals in the marketplace, and we come in contact with them in one way or another every day.  There is no such thing as a pristine environment. Toxins are in the air we breathe, the water we drink and the food we eat. Decades of research and countless studies have contributed to our understanding that we carry a burden of toxic chemicals in our body’s, our Body Burden. Environmental toxin have been linked to many chronic diseases, including ADD/ADHD, autism, autoimmune diseases, cancer, heart disease, stroke, diabetes and chronic respiratory diseases just to name a few.

Many countries have been pro-active in limiting the use and development of environmentally toxic chemicals. Here in the U.S. that is not the case. Many times, we feel powerless to combat this onslaught, but there are things we can do. We as individuals can make choices to help our bodies eliminate them and choices to avoid accumulating more.  As Dr. Andrew Weil advises, “The best way to detoxify is to stop putting toxic things into the body and depend upon its own mechanisms.”

We can filter our drinking and bathing water. Filter our air in our homes and offices. Sleep on non-toxic bedding. Consume foods and supplements that help detoxify and cleanse our bodies.

The Solution- The Nikken Wellness Home

This is the concept and functionality of the Nikken Wellness Home. Whether we live in New York, London, Paris, Bogota, or Mexico City, as Nikken consultants and self care advocates we can be of service to people anywhere to Be Healthy by Choice.  A Nikken Wellness Home is designed to address many concerns, including environmental toxins, contagions, dehydration, poor sleep quality, weight matters and nutrition. In a practical sense, the Wellness Home creates an environment that enables us to make healthier choices every day.

We invite you to join our International Wellness Community and our mission to make Every Home a Wellness Home.

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.” Margaret Mead

[babymilkaction]

French and US Trade delegations put child health at risk

CLICK  HERE for PDF in Spanish

French and US Trade delegations put child health at risk

39th Codex Alimentarius Nutrition Committee (CCNFSDU), Berlin, Germany

4th – 8th December 2017

The nutrition committee of the WHO/FAO Codex Alimentarius Commission – the UN body that sets standards for the global trade of foods and commodities – met in Berlin last week [1].  The mandate of Codex is ostensibly to protect consumer health and facilitate fair trade, however, these aims were threatened once again by the commercial and political interests of producer countries, and the Conflict of Interest rules that do not safeguard these aims effectively.   This year the United States (US) and France were the most problematic countries. Only through the strong representation from other governments, including many from developing countries, alongside WHO, UNICEF, the International Baby Food Action Network (IBFAN) and other civil society organisations, were consumer protective safeguards retained.

Of the 350 delegates listed in the report, 40% (143) were from industries and their front groups that represent the agro-chemical industry and manufacturers of highly-processed foods, drinks, additives and supplements.   The priorities of these corporations is to extend the shelf life of products, protect and promote their global trade, and, if possible, portray all this as being in the best interests of the poor [2].   Their impact on the environment and involvement  in  deforestation, mono-cropping, land and sea grabbing and risky technologies is rarely mentioned. [3]

Not content with sitting at the back of the room with other Observer organisations,  over 60 industry representatives managed to persuade  governments to include them on their delegations, so gaining easy and privileged opportunities to push their deregulatory trade agendas. [4]  Such inappropriate commercial involvement at Codex is largely ignored even though it includes a range of tactics, for example the funding of “technical” side events, dinners and receptions for participants, the promotion of industry-funded research. All have the aim of weakening standards so that the food industry’s capacity for trade is not compromised. [5]

IBFAN has participated in Codex meetings since 1995 for the very different purpose of protecting infant and young child health. IBFAN is now renewing its call that Codex and governments end the Conflicts of Interest that affect all aspects of the Codex standard-setting process. [6] One straightforward step would be to ensure that no industry participants sit on government delegations and that all are clearly listed in the Official Report. Dozens, including the Policy and Intelligence Manager of Danone (second to Nestlé in the global baby food market) are not listed at all because they attend wearing  public badges. Some 40 countries seem to have responded to this call and many have now reduced industry presence or are industry free – a step in the right direction to protect the independence of policy making.

Some examples: This year China had just one industry person on its 15-member delegation.  In 2006, when it had nine from industry and just two from the Government, it repeatedly supported industry positions and opposed health safeguards. Similarly, India stopped including industry representatives in its delegation in 2011 and consistently advocates safeguards to protect breastfeeding and child health.

This year the European Union (EU) led the calls to lower sugar levels in formulas for babies 12-36 months.  However,  in 2006, when it was represented by an industry-friendly delegate (who has since retired)  it joined the US in successfully opposing a call from Thailand  to reduce sugar levels in baby foods. [7]

In 2016 the US, unusually, had just one person from industry on its 13-person-delegation and did not oppose the consensus view that a key World Health Assembly Resolution (WHA 69/9) , passed in 2016, should be included in the text under discussion. [8]  This year with five industry people on its 15-person-delegation, the US and France (with three of it 4-person delegation from industry) cast doubt on the global consensus achieved for that Resolution and went on to call for the removal of references to recommendations of the World Health Organisation generally (as cited in the Report of the meeting: “It was not the role of Codex to include references to WHO policies and some WHA resolutions that may go beyond the scope of the standard and the mandate of Codex, and such inclusion could set a risky precedent and could undermine the credibility of Codex standards”.

At the same time as the Codex meeting, Salmonella contamination was discovered in French-made formulas. [French recall due to Salmonella contamination of formula].Unlike the UK, France does not legally require that powdered formulas carry the preparation instructions recommended by WHO –that water must be boiled and left to cool to no less than 70 degrees before reconstitution, a safeguard that would reduce the risk of babies becoming ill. Prof M Guelaye Sall, speaking for Senegal, emphasised the importance of breastfeeding and the difficulty of preparing formula safely in his country.

WHO, one of the parent organisations of Codex, gave a strong response that was supported by many other Member States and civil society organisations.[4]  WHO noted that no Member State had disassociated itself from WHA69.9 at the Assembly, that the approval of Resolutions is expressed by many different phrases such as ‘adopts, approves, endorses, welcomes, noted with appreciation and notes’ that all lie ‘on a spectrum expressing approval’.  WHO stressed that  ‘there is one thing which is common to all these resolutions and decisions and that is they are the resolutions and decisions of the WHA which is the highest Governing Body of WHO’.   Many WHA Resolutions and Codex Commission decisions have called for Codex to take proper account of WHA decisions [10]. IACFO commented that the Resolution and Guidance had in fact been weakened to ensure consensus, and that conflict of interest safeguards are embedded in all WHO policies and recommendations, and are highly relevant for the standard-setting procedures of Codex.  Since WHO safeguards have been embedded in Codex texts for decades, the change proposed by the US would necessitate a complete overhaul of all the standards on baby foods and many other products and would be a major setback for global consumer protection and child survival.

The only reason that producer countries are pushing weak rules at Codex is to put pressure on countries to accept products that they may not want or need, in this case the countries where the risk to child health is greatest. IBFAN will be working to stop such a U-turn being taken by the Committee. The consensus position from last year’s meeting was that references to WHA Resolutions,  including WHA 69.9, should be included so that the  marketing and labelling of formulas for babies 6-36 months can be controlled.

IBFAN members attended the Berlin meeting on the observer delegations of the International Association of Consumer Food Organisations (IACFO) and the International Lactation Consultants Association (ILCA).  For more information:

Elizabeth Sterken – IBFAN (Canada) esterken@infactcanada.ca

Patti Rundall – IACFO (UK)  prundall@babymilkaction.org (+44 7786 523493   )

Dr J.P Dadhich – IBFAN (India) jpdadhich@bpni.org

Dr Marina Rea (invited to join the Brazilian delegation) marifrea@usp.br

Maryse Arendt – ILCA  (Luxembourg): maryse.arendt@pt.lu

___________________

Some of the main issues on the agenda in Berlin

Revision of the Follow-up Formula Standard (milks for babies 6-36 months) [11] : WHO, UNICEF, IBFAN,  and several other Civil Society organisations [5] made strong interventions in support of the many Member States (including Philippines, Nepal, Indonesia, India, Kenya, Sudan, Nigeria, South Africa, Brazil, Chile, Senegal, Togo, Egypt, Mali,  Sri Lanka, Burkina Faso and Equador) to retain key safeguards from WHA resolutions in the revised standard, stressing that the product is not necessary. IACFO reminded the Committee that developing countries – where the market growth of these products is strongest and where the risks of improper use are the greatest – should be listened to most. These countries need to assess the risks, safety and appropriateness of these products in the local context before allowing their import and not rely on the assurances of the exporters.

The US resisted the strong calls from WHO, the EU, IBFAN, IACFO  and many countries for much lower levels of sugar. There is global consensus and concern amongst the world health community that these expensive, sweetened and flavored milks are not only unnecessary,  but that they contribute to childhood obesity; affect the development of a child’s taste palate and undermine breastfeeding. Nevertheless they now account for 50% of absolute growth in a formula market that is set to rise by 55% from US$45 billion to US$70 billion by 2019. [12]   An attempt to reach consensus on these difficult issues will resume next year.

The global trade of Ready to Use Therapeutic Foods (RUTF) [13] for malnourished babies is also a highly contentious issue. Many developing countries, supported by IBFAN and others, called for: the current high sugar levels of 25% (used by manufacturers to maintain palatability and long shelf life) to be lowered, for safeguards to restrict use to emergency use, a prohibition on misleading labelling (promotional claims), marketing and retail sale. IACFO supported India’s call that governments who do not use RUTF and do not want imports should not come under pressure to do so. The majority of countries called for a preamble that would outline the appropriate  context for any use of these products as well as the need to protect breastfeeding and the use of more sustainable biodiverse and culturally appropriate foods. ILCA asked for clarification and got a clear reassurance from the secretariat that these products are not for sale. A point that was anchored in the report.

Transparency: the Nutrition Meetings when held in Germany are notorious for their lack of transparency. The Chair has used German privacy and phone tapping laws to forbid recording of the  proceedings,  so the report is written entirely from recall, which is often disputed. This year IACFO asked that the meeting be webcast as many other Codex meetings are. The Secretariat promised to explore this possibility but refused to include the request in the Report of the meeting.

Biofortification: This term is being promoted by International Food Policy Research Institute (IFPRI). The EU insisted that could not be supported because within the EU there were legally binding regulations on the term “bio” where it is understood to be associated with organic production. IBFAN and IACFO opposed the term because it is promotional and deceptive; opens the door to Genetic Modification and other risky technologies and to corporate takeovers of agriculture;  promotes the single nutrient approach and undermines biodiverse and more sustainable systems of agriculture and nutrition.  

Scientific substantiation: WHO explained its efforts to evaluate the quality of evidence in a more systematic manner and why it would no longer use the term ‘convincing.’  The quality of evidence is now required to be done through Grading of Recommendations Assessment, Development and Evaluation (GRADE). IBFAN and IACFO have long questioned the scientific basis of Codex Standards and called for consistency and the replacement of meaningless terms such as ‘science-based’  ‘generally accepted’ or ‘ history of safe use.’

Transfats: IACFO called for warnings and prohibitions on the use transfats rather than health and nutrition claims that can mask other harmful ingredients.  

Independence: IACFO and many countries supported the EU, who called for warnings on labels that formula products should only be used on the advice of  ‘independent health professionals.’  One Delegation (Thailand) supported by the Chair (and with applause from the industry observers) said that the word was unnecessary because he claimed  all health professionals are independent.

  Notes:

[1]  Since 1995 when the World Trade Organisation determined that Codex Standards should be the bench marks in Trade Disputes, IBFAN has attended Codex with the aim of integrating WHO recommendations.  While governments  have the sovereign right and duty to protect health –  the prospect of a legal challenge that its laws are a barrier to trade because they are more trade restrictive than those specified  in Codex is a clear disincentive.  Despite its importance of global health,  trade, sustainable development and farming, Codex is largely overlooked by the media and civil society.

[2] 2011 The Business of malnutrition: breaking down trade rules to profit from the poor,  Bad Soden, Frankfurt, IBFAN Press Release, November 2011.

[3] Carbon Footprint due to milk formula.  A study from selected countries in the Asia Pacific region.  IBFAN BPNI report. 2015,  Click Here

[4]  REPORT OF THE THIRTY-NINTH SESSION OF THE CODEX COMMITTEE ON NUTRITION AND FOODS FOR SPECIAL DIETARY USES Berlin, Germany 4 – 8 December 2017.  Participants on Government, Observer or UN delegations are listed in Appendix 1 on pages 19-48. A further 60 or so people (including Danone’s Policy and Intelligence Manager from its Global Affairs Unit) wore public badges and do not appear on the list.

Governments listed with industry representatives:  Australia: 3 of 6 (Aspen Pharmacare, Fonterra, Nestlé plus a consultant from the Lipid Research Centre); Brazil: 1 of 6 (Brazilian Association of Food Industries); Chile: 1 of 2 (DSM Nutritional Products); China: 2 of 15 (Synlait, China Nutrion and Health Food Association); Colombia: 1 of 2 (Food and Nutrition Industry Mead Johnson); Denmark: 1 of 3 (Danish Agriculture and Food Council); Egypt:  2 or 3 of 4 (Hero, Wyeth/Nestle plus a consultant); France: 3 of 4 (SFNS and two from Nutriset) Germany: 8 or 9 of 13 (Diaetverband, Specialised Nutrition Europe, Federation of German Dietetic Foods, Dupont; Indonesia:  3 of 4 APPNIA (Asia Pacific Young Child Feeding Products); GAPMMI, the Indonesian Food and Beverages Association); Japan: 1 of 6 (Japan Health & Nutrition Food Association); Kenya: 1 of 3 (Nestlé); Malaysia: 2 of 4 (Federation of Malaysian Manufacturers/Mead Johnson, Malaysia Palm Oil Board); Mexico: 6 of 7 (ANIPRON, Abbott, CANILEC); Morocco: 4 of 7 (l’AMNI, Nestlé, Society of Mineral Water); New Zealand: 2 of 4 (Fonterra, Dairy Goat Cooperative); Philippines: 1 of 2 (Infant Nutrition Association of the Philippines Infant Nutrition Association) ; Poland: 1 of 3 (Polish Federation of Food Industry Union of Employers); Switzerland: 4 of 5 (DSM, SANI, Nestle, Nutricia/Danone, ); Thailand: 1 of 5 (Thai Industries/MeadJohnson); Uganda: 1 of 2 (Reco Industries); US: 5 of 17  (Abbott, International Dairy Foods Association, Mead Johnson, Gage, International Formula Council); Vietnam: 8 of 9 (Vinamilk x2, Eneright Vietnam Corporation, Abbott, Mead Johnson, Vietnam Food Administration, Vietnam Dairy Association x2).

[5] Interference in public health policy: examples of how the baby food industry uses tobacco industry tactics, World Nutrition, [S.l.], v. 8, n. 2, p. 288-310, dec. 2017. ISSN 2041-9775. Available at: https://worldnutritionjournal.org/index.php/wn/article/view/155 

[6]  IBFAN and Helen Keller International (HKI)  held briefings for participants.

[7] CLICK HERE 2006 EU and US block Thailand’s proposal to reduce sugar in baby foods,  Codex meeting in Chiang Mai, Thailand, IBFAN Press Release, Nov 2006.   [Click Here]

[8] Global standard-setting committee puts child health before trade, IBFAN Press Release, December 2016.

 WHO Guidance on ending the inappropriate promotion of foods  for infants and young children A69/7 Add. 1 May 2016. “The purpose of this document is to provide guidance on ending the inappropriate promotion of foods for infants and young children, with the aim to promote, protect and support breastfeeding, prevent obesity and noncommunicable diseases, promote healthy diets , and ensure that caregivers receive clear and accurate information on feeding.”    WHA 39.28 is also important because its states that these products are not necessary.

Chart showing the number of countries calling for the inclusion of the Guidance. Baby Milk Action April 2017

[9]  CLICK HERE  for the report of the  French Government recall of Lactalis formula due to Salmonella contamination.

[10] Para 14 of the CX/CAC 16/39/11 report states:  “Given that the membership of Codex is almost identical to the membership of FAO and WHO, the Commission is invited to note the importance of ensuring that all relevant policies, strategies and guidelines of FAO/WHO receive appropriate consideration in the work of Codex.”    

[11] IBFAN Policy Brief on the Revision of the Codex Follow-up Formula standard. (Codex Stan 156-1987) CLICK HERE

[12]  IBFAN/ ICDC’s global monitoring report, Breaking the Rules, Stretching the Rules 2017,  CLICK here 

[13] IBFAN Policy Brief on Ready to Use Therapeutic Foods (RUTF)  CLICK HERE

.

    French and US Trade delegations put child health at risk was originally published on Baby Milk Action

[l-in-c-future]

Meltdown on the roof: From genocide to ecocide in Tibet it reflected the biggest misjudgments ever made

“As a political matter Tibet’s importance both ideologically and strategically is very limited. Because of its geographical remoteness, the primitive character of its government and society and the limited character of its contacts with the outside world Tibet’s orientation toward the West cannot be counted upon to endure an ideological basis unless supported by far reaching practical measures. If we cannot take these practical measures, recognition in itself would not hold Tibet in an alignment with the West and might in fact work against our long run interests.....Unless rare minerals are found in Tibet, the Army does not regard Tibet as of strategical significance.” “The answer to what measures of a practical nature can be taken appears to lie largely with India which now controls Tibet’s access to the west....” -excerpt from Memorandum to the Division of China Affairs by R Bacon, State Department’s Office of Far Eastern Affairs 12 April 1949.

70 years ago, two countries considered that this remote plateau had ‘little strategic value’ because of its ‘lack of rare minerals’. But that was not the same in the eyes of those who self-claimed themselves as ‘the liberators’. In massive military invasion and 70 years of high pressure hands rule, the ‘liberators’ not only conquered the roof of the world, they had tapped and are still tapping the vast varieties of natural resources there through their logging, endless hydro electric power plant projects in the name of ‘green energies’, oil and gas extraction, mining, and salt lake exploitations and the long lists of the hunting down of wildlives to their extinction, extraction of plants, herbs that serious damages to the flora and fauna ecosystems permanently. 

In the meanwhile, the indigenous inhabitants-the Tibetans have been watched and demonised as ‘separatists’ by the autocrats. If they ever talk anything about their homeland, their culture and the change to their homeland’s landscapes or just anything about the land where they have been living for many centuries to the outside world, they will be detained, tortured, vanished, imprisoned as ‘leaking the state secrets’ or serving as ‘foreign spies’. If they do anything to protect the environment, their own homes, lands, nomadic grassland, lakes, mountains, rivers, basins, plateaus, valleys and livestocks, their protests will be treated as ‘subversions’ or “indicting the overturn of the “People’s” Republic. They have no help other than living as an intensively watched ‘separatists’, or imprisoned at their own lands as the highest level security watched ‘dangerous dissidents’ or chose to immolate to escape the brutal oppression. In this vast piece of remote land, even the Budha has to decide not to reincarnate through Dala Lama anymore as the last resort to guard the purity and integrity of the Divine and the religion, not falling to the defile by ideological agendas. 

For 70 years, the world ignores this remote place because of the myth that it is of little strategic importance. From ethnic persecutions to ethnic genocides only inviting blind eyes and deaf ears to the outside world, at least to those in the UN. Now there are episodes of ecocides occurring on the Tibetan Plateau and the Himalaya region. This time, the meltdowns won’t be just some irrelevances, it is the meltdown of the roof of the world that have massive regional disastrous consequences including: flooding, drought, famine, disturbed weather patterns that bring more severe storms, earthquakes. It is about the life and death of BILLIONS and BILLONS of people in Asia. It is about the common existential threats confronting the Asian civilization’s survival. But more, it is the survival of the whole Northern Hemisphere in a climatic context. 

All because the Tibetan Plateau and the Himalaya Region bears a very important strategic role in ecological and climatic context: it is Third Pole of the world. It’s most precious and sacred natural resource, as the Buddhists indigenous people-the Tibetans-have always known-is water. Water stored in the forms of snow and glaciers covering their mountains, lakes and valleys. Tibet has the largest locked freshwater in the world and the glaciers are the sources of numerous major rivers that have been nurturing civilizations of a large part of Asia for ages (as shown in the first figure). 

These mighty rivers flowing down streams are the main grandfather feeders of important river basins in Southern and SE Asian river basins. At the end of their routes, their floodings created major deltas in SE Asia, South Asia across the oceans and seas. The fertile lands feed MANY BILLIONS of people in the Asia and South Asia continent for millenniums-they are the cradles of many civilizations (as shown in the second and third pictures).

Unfortunately, these have been taken as granted. No longer it is the case. The Tibet Plateau, in fact the Himalaya matters A LOT.

90% of the run off from Tibetan river systems flows downstream into China, Vietnam, Cambodia, Laos, Thailand, Burma, Bangladash, India, Nepal, Bhutan, and Pakistan. At the tail ends of those rivers lie the world’s largest deltas. 

Close to 2 billion people rely on Tibet’s waters, for drinking, agriculture, fishing and industry.

The global supply of freshwater is dwindling at an alarming rate. According to the latest release Earth Security Report, the disappearance of glaciers will lead to tensions between nations over shared water resources, social unrests and wars are the likely consequences in the absence of sustainable water management and co-operation between nations.

Tibet is often referred to as the “Third Pole” because it is the third largest source of water locked in ice and snow. As show in the first three diagrams, Tibet is the source of major headwaters for the rivers of Asia and the Himalayas provides additional key tributaries or feeders for other major river systems, river basins and deltas in Asia, there is no parallel to this situation in the world.

Tibet’s ecosystem is very vulnerable to climate change because two largest emerging economies China and India are the biggest fossil fuel burners in the world, adding tonnes of greenhouse gases into the atmosphere that directly threaten this water tower on the roof of this planet. 

That doesn’t even include increase Himalaya tourism activities of all sorts that aggregate the pollutions to mountains, lakes and rivers. Just imagine how much rubbish are added to the routes of conquering the Mt. Everest. The Himalaya mountain countries are heavily depending on such tourism as major income. Ironically, short-sightedness expedient the death of the golden goose.

China is aggravating the situation because Chinese hydro consortiums are damming the heck out of the rivers of Tibet, blocking the flows. 

Extensive mining by Chinese companies is degrading the land, which further worsening the rivers’ pollution at the sources, along their courses and downstreams.

The grasslands of Tibet are being encroached by desert because Chinese rampant the land to harvest herbs as well as mining, logging and oil extractions.

Biodiversity of wildlife has been significant decreased, species had been extinguished in the last 70 years. 

Massive clearance of forests in Tibet and expanding desertfication of grasslands has severely impacted regional ecosystem and in turn influence extreme weather patterns in Asia, for example, the monsoons in the Indian Ocean.

Fossil burning, endless hydro dam constructions, mining, and other reckless unsustainable natural resource extractions have put pressure on the permafrost of the Tibet Plateau (the 4th Figure). As the permafrost starts to thaw, it releases significant amounts of carbon dioxide and methane into the atmosphere, the latter is 20 times stronger greenhouse gas than CO2. 

From 1950s to 1980, 50% of glaciers in the Tibet region were retreating, that rose to 95% in the early 21st. Chinese scientists believe that 40% of Tibet’s glaciers will be gone by 2050.

Who had been benefited from such massive ecological destructions?

Lured by billions of profits, big Western hydraulic companies such as ABB, ALstom, General Electric and Siemens, not only ‘partner’ with China to build the initial hydro power plants in the name of ‘green and renewable’ energies for ‘environmental purpose’, they agreed to the requirements of transfer of production technologies in the JV contracts. They pocketed lots of money for a certain period of time, but they also laid down HUGE time bombs to Asia and to the whole Northern Hemisphere in terms of climate impacts. 

Other Western countries such as Canada’s Bombardier and Power Corp and Nortel Network helped China to build the Tibet railway and communication lines on the permafrost that speeding up the melting of this layer.

However, the biggest winners are China’s State Owned Enterprise, mainly controlled by Li Peng (the former Premier) and his galaxies of hydraulic technocrats such as Huaneng Group (run by Li’s son Li Xiaopeng) and China Power International Development (controlled by Li’s daughter Li Xiao Lin) and Jiang Zemin (the former State and CCP head) and his galaxies of petroleum technocrats. 

Many, if not most, of the hydro dam constructions and fossil fuels related extractions in China and all over the world are under the umbrella of these two galaxies. They lived above all ‘environmental laws’, even though such laws are already primitive enough. These dam projects didn’t necessarily have any environmental impact analysis. Hammer of approval is through massive scale of corruption, nepotism and cronyism.  The projects’ sites are heavily guarded by military or paramilitary against any local communities, let alone massive forced relocations of population and subversion of cities, towns and villages under water in the construction processes.  Xi Jing Ping’s regime window dressed this as the “Chinese characteristic” model of ‘effective democracy’ to justify their continual ransacking the environment of other countries and the exploitation of local communities and indigenous people along his ‘big dream’ along the new Silk Road and Belt. It is ‘effective’ because the project deals are signed between dozens of autocratic, authoritarian, and corruptive regimes like China behind the doors without consulting anybody but at the expenses of everybody.

What are the disastrous impacts of the melting down on the roof of our planet? Try to think of what will happen to your home if the roof of your house has many big and small holes and it is at the brink of collapse.  What has been happening to the Tibet Plateau and the Himalaya region is that roof of our planet, only the extent of damages are much bigger and the consequences are more lethal.

Apart from droughts, floods (induced by melting of glaciers formed glacier lakes burst out), famine, pollution, extreme weathers, landslides, mudslides, vicious cycle of black soot greenhouse impacts that bring new diseases to the vulnerable communities, there are dangers of earthquakes because some of the dams are constructed on the axis of fault line earthquake zones where the India subcontinent submerges under China. 

The large reservoirs created by dam projects, especially megadams carry colossal weight and size behind a dam has been linked to triggering reservoir induced seismicity. The mountains parts of Sichuan and Yunnan provinces are known to be very sensitive seismically active regions. Fan Xiao ( Chief engineer at the Sichuan Geology and Mineral Bureau) warned against the construction of Zipingpu Dam on the Min River, a Yangtze tributary in Sichuan, due to seismic risk. As expected, his voices met with total deafen ears and the project went ahead. Its reservoir holding 315 million tons of water, lying directly on a major seismic fault zone. The megadam has been implicated in the great Sichuan earthquake in 2008, trashed thousands of buildings, leaving 85000 people dead or missing and another 5 million people homeless. The dam lies just 3.5 miles from the earthquakes’s epicenter: the weight of the reservoir and the subterranean seepage (lubricating fault lines) may have either triggered the earthquake or might had magnified what could have been a minor earthquake. Yet, the Chinese officials denied any correlation between Zipingpu Dam and the Sichuan earthquake. That said, another earthquake hits Sichuan’s famous tourist area Jiuzhaigou this year, forcing the Chinese government to close up some of the affected scenery sites in foreseeable futures. (You don’t expect many words under Xi’s total censorship state.) In a totalitarian world, ideologies, lies and propaganda and cover ups prevail TRUTH, FACTS and SCIENCE. People’s lives, nope,  ALL sorts of lives are just nothing but the white rats in the experiment labs of the autocrats.

According to a 2012 report published by Probe International, 48.2% of the hydraulic dams in China are sited in zones of high moderate seismic activity. Only 1.4% are found in zones of low seismic activity. By constructing more than 130 large dams in a region of known high seismicity, China is embarking on a major experiment with potentially disastrous consequences for its economy and its citizens. What if one of these megadams are suddenly burst due to an earthquake? All in the path of the dam would be swept away in a wall of water. Even scarier: Chinese engineers favour the building of dam cascades at the edge of the Tibetan Plateau. If an upper dam were to burst, the wall of water would inevitably take out other dams in the cascade, like an inland tsunami, swallowing many mega cities further down the courses. 

Look at China’s hydro dams plans in the last diagram. Think about the potential scale of these tsunamis. It will the Noah’s day the collapse of ‘the windows in heaven’ that drowned the whole world. Only that this time it will be the collapse of the roof of the planet Earth. Ironically, the communists used to be very suspicious of Kuomingtang’s “scorching the earth” policies (blasted the major dams to flood major cities in order to bury oneself and the enemies together) if they lost the civil war but it is now the communists’ regime who had created many deadly foolish scenarios. 

Nobody needs to wait till the Noah’s day acquacalytical ends, the bursting of glacier lakes induced floodings have already become a recurring reality in other Himalaya countries such as Nepal and Bhutan. In the last 70 years, there were more than 30 of glacier lake outburst floods in Nepal while 25 glacier lakes in Bhutan are at extremely high risk of bursting. The rapid expansion of glacier lakes are visible mirrors reflecting the extent and speeds of glaciers’ meltdown.

We only have one Tibetan Plateau, one Himalaya and PRACTICALLY one roof of this Planet Earth serving as the water tower for Asia as well as the climate stabilizer for the whole Northern Hemisphere. Ridiculously and ironically enough, in the last 70 years, the world has turned blinded eyes and deaf ears to this significance and allowed ONLY ONE AUTOCRATIC POWER to dominate and do whatever they did on the roof. The global and regional powers played out their geopolitical Great Games in the 19th century with only one objective: to seize more territories and natural resources. The aftermath of the Great Games still carries deep scars to numerous people: Tibetans, Rohinya people, a torn apart India after independence and a super locked up “autonomy” region where people live their lives in a de facto status as “North Korea” within China. This place’s name is Tibet. It has become a horrible chanted taboo word for anybody to mention because nobody wants to offend an autocracy. Over the time, even Himalaya becomes a little black hole of the planet Earth because nobody cares the small countries and small people other than the Mt Everest climbing induced tourism that links it to the outside world through a closed circle of mountain fans.  The Great Tibetan Plateau had been chopped into pieces out of the Great Games and the civil war of China, fallen into fragmented political, religious and ideological controls of two regional powers-China and India.

NOBODY REALLY HAS SUFFICIENT KNOWLEDGE OF THE SIGNIFICANCE OF THE THIRD POLE, THE ROOF OF OUR PLANET. Foolishly, the world has allowed just one country, an autocracy, to run the roof.

70 years ago USA, India and the rest of the world forsaken Tibetans’ cries.  Today, they turn blind eyes to the cries of the glaciers. Their logic was NK was more important than theTibet Plateau. In 70 years of time, there hasn’t been any breakthrough relating to NK whereas they lost Tibet. Nope, it is the world losing our common roof collectively with big misjudgments as to what is strategically important.

The problems will never be solved by more water politics, more ideological wars nor any cold wars. Neither can they be solved by one country shifting its problems to another country.

It can only be resolved when people can answer these 3 questions:

1. How can we create a world order that protects small countries from the aggression of stronger neighboring powers and big countries, in particular, the invasions and intimidations of super nations?

2. How can we create an economic system that can fairly and justly handles the allocation of resources?

3. How can human beings live in peace with the nature? 

Until then, human societies will never have peace, never solve inequalities, poverty and will never have any sustainable developments, until one day we won’t even have any chance of existence.

We do not see the global leadership, especially, the super powers demonstrate good examples in the last 70 years. There is no evidence that any of the current 3 super powers’ leaders have this integrity and vision. One is a climate denier, one is a climate ‘green’ false preacher and the other is a polar bear playing his opportunistic games. When the climate denier meets the false ‘climate’ and ‘green’ pretender right now, all they care is about more businesses that are selfishly centred on each side’s interests.

But will the world repeats the same BIG FUNDAMENTAL MISTAKES about the strategic importance of our COMMON ROOF TOP?

It is NOT about any Tibetan conspiracy ‘independence’ issue as the myth of excuse laid out by one autocracy to justify its sole monopolistic dominance.  If you don’t get it, imagine one day some people climb to the roof of your high rise building declaring the roof only belongs to them and therefore everyone else must hand off. They are digging holes and ransacking the roof of your building and foolishly the rest of the residents in the building dare not even say a word or do anything about the roof because they consider it is having ‘little’ strategic importance! 

IT IS HOW THE WORLD HAS BEEN LIVING IN THE LAST 70 years. No access. No mentioning. And recently the bandits dare to demand Cambridge University Press to withdraw a decent volume of scholarly articles relating to Tibet. Do you think we live in a ‘democratic’ world or we live in a dictatorship? Dictatorship by 5 countries at large, but more intimidated by the big 3.

Reference and source of diagrams: 

Goldstein, M. (2007). A History of Modern Tibet, Vol 2. The calm before storm (1951-1955). London: University of California Press. p.116-117.

Buckley, M. (2014).  Meltdown in Tibet. NY: Palgrave Macmillan Trade.

Disturbing questions: http://meltdownintibet.com/questions.htm

Environmental Justice https://ejatlas.org

https://www.internationalrivers.org/programs/china

[inerginc]

GTM Smart Grid http://ift.tt/2eJlQnQ

Gulf Power’s residential demand response program may be 20+ years old, but that doesn’t mean it hasn’t kept up with the times. In fact, last summer it was tapped twice to do something it wasn’t even designed for -- to help the utility’s distribution grid operators avoid blackouts or equipment overloads on a specific feeder. 

Here’s how Caroline Stickel, team leader at Gulf Power’s Energy Select program, described it in an interview at the Itron Utility Week conference in Houston this week. Twice last summer, her group got calls from Gulf Power’s distribution operations team, asking for immediate load reduction on a specific circuit, adjacent to another that needed to be taken out of action. 

Energy Select doesn’t usually dispatch its customers in this pinpoint fashion -- like most residential demand response, it’s typically used at a systemwide level. But over the years, it has tapped continuing waves of technology to communicate with its customers, from cellular-connected free programmable thermostats and load switches starting in 2000, to customer broadband-linked Wi-Fi thermostats and smartphones starting around 2011. 

Meanwhile, Gulf Power, along with its other Southern Company subsidiaries, had rolled out smart meters to its customers, allowing distribution grid operators to link Energy Select customer accounts with specific points on their geographic and grid software models. That came in handy last summer, when it sent out emergency price signals to several hundred customers it knew were served by the problem circuit. 

All but a handful of homes responded, between “immediately” and within half an hour, she said. A typical peak price event drives about 2.5 kilowatts of load reduction per customer, or anywhere between half and three-quarters of a megawatt in aggregate. That’s not much compared to what it gets out of its nearly 19,000 customers across the system. But in that moment, it was enough to avoid a blackout for many thousands of customers, as well as the risk of equipment blowing up. 

The demand-response-as-grid-asset business case, from Pensacola to Poughkeepsie 

Locational demand response is the term for this kind of pinpoint demand-side energy management trick, although lately it’s been going by the name of non-wires alternative (NWA). Beyond the fun of using the name of a seminal gangster rap group in a grid context, the term has caught on largely because it’s what New York is calling its first-of-a-kind projects to defer billions of dollars of infrastructure investments with distributed energy resources. 

The link between Gulf Power’s experience and New York’s Reforming the Energy Vision (REV) initiative comes via Comverge. Gulf Power started its 20-plus year partnership on residential demand response with a company called Scientific Atlanta, one of the two corporate divisions (the other from Lucent) that would eventually form Comverge. The company went public in 2007, but agreed to a buyout by private equity firm H.I.G. Capital in 2012 that reflected broader challenges in residential and commercial and industrial (C&I) demand response markets. 

H.I.G. then built a deal in 2014 to combine Comverge's C&I operations with Constellation Energy's CPower, itself created out of a former Comverge business line, and leave the residential and small business side exclusively to Converge. The company started to win big contracts, including a large-scale pilot project with New York utility Central Hudson Gas & Electric in 2015, to build a NWA to help avoid some major grid upgrades to maintain grid reliability for a region with about 50,000 customers. 

In May, Comverge was acquired by Itron, making its projects part of Itron’s smart meter and grid networking portfolio, and Evan Pittman part of Itron’s Distributed Energy Management business development and strategy team. While an associate director of corporate strategy at Comverge, he worked with Central Hudson for some time on finding the right combination of residential and C&I load to accomplish a demand-side alternative to upgrading a substation, reconductoring a feeder, or making an upgrade to an interconnected transmission line, each an expensive proposition. 

The utility isn’t saying just how much these capital improvements might cost -- that’s one of the figures it’s been permitted to keep confidential, he said during a Monday lunch session with reporters at Itron Utility Week. But he did say that, of the 16 megawatts of responsive load targeted for the program, “we’re about halfway there” -- an increase form the 5.9 megawatts of load it reported in April. 

On the cost side of the program, Central Hudson’s Peak Perks offers customers an $85 check, plus $50 or so paid out in annual bill benefits, along with free Wi-Fi thermostats (up to two) or a pool pump load switch. That’s a pretty hefty incentive, and has helped it reach greater than 30 percent customer participation rate in its targeted areas within six months, rather than the more typical three years or so. Simple Energy, which runs the utility’s CenHub platform, has also played a part in keeping customers engaged. 

But Comverge/Itron is aiming to capture an even greater share of customers, approaching 50 percent, in certain regions, Pittman said. That’s because it’s being asked to squeeze a lot more load per household, business, factory and farm than most demand response programs -- nearly 10 percent of the targeted region’s peak demand, compared to 1 to 2 percent share of peak load contributed by a typical demand response portfolio. 

At the same time, “our incentives are perfectly aligned,” he said. Any savings to come from the difference between paying for the program and its still-confidential deferred capital costs will be shared, with 30 percent going to utility shareholders and 70 percent going to customers. That provides an incentive to each side to achieve and exceed their goals. Comverge/Itron’s pay-for-performance contract also puts it on the hook for any shortfalls in load reduction, he added. 

Peak pricing, time-of-use rates and localizing demand response

Central Hudson’s demand response program differs from Gulf Power’s, in that the former is designed specifically with locational grid needs in mind, while the latter just happened to be available for the task last summer. But Gulf Power’s experience indicates that today’s technology, properly integrated into utility operations, has the ability to be localized to some extent.

The question then becomes how to incentivize them to do so. In the past, most utilities paid customers in advance for letting them turn their air conditioners off during the hottest days of the year. But Gulf Power from the beginning has used a tiered rate structure, combined with equipment that can respond automatically to its peak price spikes, to enlist customers, said Stickel. 

This Residential Service Variable Price (RSVP) rate has four tiers. Two are below retail rate about 85 percent of the time. The third a bit higher, and is called in for much of the remainder of that time. But the fourth, called only for a handful of hours per year, is way up there. Today, it’s at 74 cents, compared to the standard rate of 11.5 cents, she said. 

That’s much steeper than any of the time-of-use (TOU) rates being applied in mass-market programs, such as Canada’s Ontario province has implemented, or those being considered by California utilities under mandate to roll them out by 2019. But since it’s an opt-in rate, it self selects for people willing to take the risk in return for an overall lower electricity bill, according to Stickel. 

New York’s NWA projects to date have relied on a number of methods, from Central Hudson’s contract with Comverge to Con Edison’s auction for demand-side resources for its Brooklyn-Queens Demand Management project. Steve Hambric, vice president of Itron Distributed Energy Management, noted that his company is also working on a TOU pilot for Central Hudson, as well as a coming partnership with a commonly available smart thermostat vendor. 

The one thing that Central Hudson doesn’t have and Gulf Power does is smart meters. Like the rest of New York’s investor-owned utilities, the Fortis subsidiary has just begun to offer customers an Itron smart meter, currently under an opt-in program that comes with a cost of $5 per month. Not surprisingly, there hasn’t been much uptake yet. Itron is also rolling out 12,400 electric meters and 7,300 natural gas meters for New York State Electric and Gas. 

Itron is set to own a large share of the state’s unfolding smart meter markets, given that it’s in the midst of acquiring competitor Silver Spring Networks, the smart meter networking vendor of choice for New York City utility Con Edison and sister utility Orange & Rockland’s $1.3 billion, 5.2 million smart meter rollout.