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Campus outbreaks of COVID-19 were almost guaranteed

Campus outbreaks of COVID-19 were almost guaranteed

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Parents help students move out of Bragaw Hall at North Carolina State University on Aug. 27, 2020 in Raleigh, N.C., after COVID cases continued to rise on campus. Gerry Broome/AP Photo

Scientists have learned a few things over the past six months as the COVID-19 pandemic has continued. We’ve learned that the virus that causes COVID-19 transmits particularly well when a group of people are together in a small, poorly ventilated area. We’ve learned that young people are just as susceptible as older people to infection. We’ve learned that if there is widespread community transmission, the virus will find its way to the very places we don’t want it go.

So, it’s not surprising to us, researchers who study diseases that can be prevented by vaccines, that with schools and colleges reopening, the virus is spreading.

These are places designed around the idea of bringing lots of people to one place. Many of them bring people together from all over the world. They are perfect places for disease to spread.

A freshman male walks with his parents toward his dorm.
A student arrives with his parents at the University of Alabama on Saturday, Aug. 15, 2020, in Tuscaloosa, Ala. Vasha Hunt/AP Photo

How we got here

Back in March, colleges and universities closed down like everything else except essential businesses. They sent students home. There was a rough transition to online instruction. Students weren’t happy, faculty weren’t happy. And so, they started to come up with plans on how to reopen for in-person instruction for the fall semester.

Many places installed plexi-glass barriers in classrooms, considered mask mandates and worked out physical distancing in lecture halls. Most people realized that professors who taught large classes should plan for remote learning.

University administrators and public health experts started making these plans in the spring. Back then, we scientists and public health researchers all operated under the assumption that community spread would be under some sort of control by fall. We all thought that the country would increase testing capacity, and we have. Then, once new cases dropped to a low level, we could institute contact tracing, the way other countries had.

But that part hasn’t happened. And so now these same colleges and universities are facing huge increases in cases, including at the University of North Carolina, Notre Dame and the University of Alabama. Many universities that have opted to return to in-person classes are also having a surge in cases. These outbreaks will inevitably spread to the wider communities in which the campuses are located.

It seems that for many of these institutions, the priority was on financial concerns, which involved a return to a normal fall semester to the greatest extent possible. They then developed plans that they thought would make this possible. Faculty at many institutions and at least one ethics committee have argued that the priority should have been the safety of students, faculty and the surrounding communities.

While schools across the country have different priorities, enrollments, campus size, and student demographics, many schools share one thing in common: making no real contingency plans around reopening amid COVID-19, other than going remote if governors mandated it.

The schools that did spend the summer figuring out how to deliver high quality education remotely, or how to safely provide housing and access to services for the most vulnerable students, are less likely to have their fall semester disrupted. However, the College Crisis Initiative’s data dashboard found that only 7% of 1,442 four-year schools surveyed were planning on a fully online fall semester.

A female student walks in front of a sign at the University of Miami in Coral Gables, Fla.
A pedestrian walks past a sign on campus at the University of Miami in Coral Gables, Fla. Wilfredo Lee/AP Photo

The challenge ahead

And so, the inevitable has come to pass. Now, many college campuses will struggle to control their outbreaks, because there are a lot of unique challenges inherent to COVID-19 in this population.

Colleges are not nursing homes or prisons. Some are trying to limit contact with the broader community.

But in general, students are not kept under lock and key. They have visitors from other schools. They go back and forth to their parents’ homes. And, yes, they go to parties. To us, blaming students for wanting a normal-ish college experience when the schools themselves have set the tone for trying hard to return to normal isn’t fair.

It’s also true that not all of the contact students have is as irresponsible as some have suggested. Many students hold jobs in the communities that surround the school. And most of these jobs aren’t typically the work-from-home type of job. In our undergraduate careers we both worked at jobs that had high contact rates with the community. And often, when your job is waiting tables at a local pizza place or manning a library desk, most of your colleagues are students as well. All of these factors will make contact tracing very hard.

Public health experts also expect a relatively high proportion of college-aged students to be either completely asymptomatic or to only have very mild symptoms. Without universal testing, these students won’t know they’re sick. They may not isolate if they have mild symptoms. But they will still be able to spread the virus to others. Symptom and temperature screenings may not recognize these individuals as those who need to stay away from campus buildings.

A different kind of campus test

Which brings us to testing. Some places are doing universal testing of students, multiple times per week. But, given the state of testing in the U.S., that is not a realistic possibility for most schools.

Let’s look at our university as an example. The University of Michigan has an undergraduate population of 30,000 students. Let’s assume that two-thirds of them came back to campus. That means 40,000 tests per week just for University of Michigan undergraduate students. Right now the entire state of Michigan is doing a little more than 200,000 diagnostic tests per week. Some schools have developed their own tests to handle this huge increase in capacity. But many university labs are involved in testing for large health systems and the rest of the state too. In these places it becomes very difficult for 1 in 5 tests available in an entire state to be dedicated to the students at a single university.

A scale-up of rapid, at-home antigen tests could be one approach to make testing on this scale feasible. These types of tests have the advantage of detecting highly infectious individuals – making them a good screening tool – but many are not approved by the Food and Drug Administration because they aren’t as sensitive as the standard PCR-based diagnostic test.

[The Conversation’s science, health and technology editors pick their favorite stories. Weekly on Wednesdays.]

If transmission on campus continues to happen mostly outside of the classroom, simply going remote will not solve the problem. Keeping students on campus will be risky. Many students will be attempting to navigate social distancing guidelines without a traditional social support network.

As much as possible, we believe students need to be able to safely return to their homes. But this can’t be done haphazardly. Bringing them to campus was a predictable risk – so is sending them home. As colleges inevitably move back to online instruction, plans must be put in place to minimize the risk of seeding epidemics. Dismissing all students, some of whom are infectious, back to their home communities risks spreading the virus further across the country, a bad outcome for all.

The unique epidemiology of COVID-19 in young adults, along with the contact patterns on college campuses and the inability to effectively screen through symptom reports or diagnostic testing, have left college campuses with few options for safely operating with in-person classes. We know that few wanted an all-remote fall semester, but it’s becoming clear that was probably our best bet.

Ryan Malosh receives partial salary support from the Centers for Disease Control and Prevention (CDC), the National Institute for Allergy and Infectious Disease (NIAID), and the Simons Foundation.

Nina Masters does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Analyst reviews Apple stock price target amid challenges

Here’s what could happen to Apple shares next.

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They said it was bound to happen.

It was Jan. 11, 2024 when software giant Microsoft  (MSFT)  briefly passed Apple  (AAPL)  as the most valuable company in the world.

Microsoft's stock closed 0.5% higher, giving it a market valuation of $2.859 trillion. 

It rose as much as 2% during the session and the company was briefly worth $2.903 trillion. Apple closed 0.3% lower, giving the company a market capitalization of $2.886 trillion. 

"It was inevitable that Microsoft would overtake Apple since Microsoft is growing faster and has more to benefit from the generative AI revolution," D.A. Davidson analyst Gil Luria said at the time, according to Reuters.

The two tech titans have jostled for top spot over the years and Microsoft was ahead at last check, with a market cap of $3.085 trillion, compared with Apple's value of $2.684 trillion.

Analysts noted that Apple had been dealing with weakening demand, including for the iPhone, the company’s main source of revenue. 

Demand in China, a major market, has slumped as the country's economy makes a slow recovery from the pandemic and competition from Huawei.

Sales in China of Apple's iPhone fell by 24% in the first six weeks of 2024 compared with a year earlier, according to research firm Counterpoint, as the company contended with stiff competition from a resurgent Huawei "while getting squeezed in the middle on aggressive pricing from the likes of OPPO, vivo and Xiaomi," said senior Analyst Mengmeng Zhang.

“Although the iPhone 15 is a great device, it has no significant upgrades from the previous version, so consumers feel fine holding on to the older-generation iPhones for now," he said.

A man scrolling through Netflix on an Apple iPad Pro. Photo by Phil Barker/Future Publishing via Getty Images.

Future Publishing/Getty Images

Big plans for China

Counterpoint said that the first six weeks of 2023 saw abnormally high numbers with significant unit sales being deferred from December 2022 due to production issues.

Apple is planning to open its eighth store in Shanghai – and its 47th across China – on March 21.

Related: Tech News Now: OpenAI says Musk contract 'never existed', Xiaomi's EV, and more

The company also plans to expand its research centre in Shanghai to support all of its product lines and open a new lab in southern tech hub Shenzhen later this year, according to the South China Morning Post.

Meanwhile, over in Europe, Apple announced changes to comply with the European Union's Digital Markets Act (DMA), which went into effect last week, Reuters reported on March 12.

Beginning this spring, software developers operating in Europe will be able to distribute apps to EU customers directly from their own websites instead of through the App Store.

"To reflect the DMA’s changes, users in the EU can install apps from alternative app marketplaces in iOS 17.4 and later," Apple said on its website, referring to the software platform that runs iPhones and iPads. 

"Users will be able to download an alternative marketplace app from the marketplace developer’s website," the company said.

Apple has also said it will appeal a $2 billion EU antitrust fine for thwarting competition from Spotify  (SPOT)  and other music streaming rivals via restrictions on the App Store.

The company's shares have suffered amid all this upheaval, but some analysts still see good things in Apple's future.

Bank of America Securities confirmed its positive stance on Apple, maintaining a buy rating with a steady price target of $225, according to Investing.com

The firm's analysis highlighted Apple's pricing strategy evolution since the introduction of the first iPhone in 2007, with initial prices set at $499 for the 4GB model and $599 for the 8GB model.

BofA said that Apple has consistently launched new iPhone models, including the Pro/Pro Max versions, to target the premium market. 

Analyst says Apple selloff 'overdone'

Concurrently, prices for previous models are typically reduced by about $100 with each new release. 

This strategy, coupled with installment plans from Apple and carriers, has contributed to the iPhone's installed base reaching a record 1.2 billion in 2023, the firm said.

More Tech Stocks:

Apple has effectively shifted its sales mix toward higher-value units despite experiencing slower unit sales, BofA said.

This trend is expected to persist and could help mitigate potential unit sales weaknesses, particularly in China. 

BofA also noted Apple's dominance in the high-end market, maintaining a market share of over 90% in the $1,000 and above price band for the past three years.

The firm also cited the anticipation of a multi-year iPhone cycle propelled by next-generation AI technology, robust services growth, and the potential for margin expansion.

On Monday, Evercore ISI analysts said they believed that the sell-off in the iPhone maker’s shares may be “overdone.”

The firm said that investors' growing preference for AI-focused stocks like Nvidia  (NVDA)  has led to a reallocation of funds away from Apple. 

In addition, Evercore said concerns over weakening demand in China, where Apple may be losing market share in the smartphone segment, have affected investor sentiment.

And then ongoing regulatory issues continue to have an impact on investor confidence in the world's second-biggest company.

“We think the sell-off is rather overdone, while we suspect there is strong valuation support at current levels to down 10%, there are three distinct drivers that could unlock upside on the stock from here – a) Cap allocation, b) AI inferencing, and c) Risk-off/defensive shift," the firm said in a research note.

Related: Veteran fund manager picks favorite stocks for 2024

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Major typhoid fever surveillance study in sub-Saharan Africa indicates need for the introduction of typhoid conjugate vaccines in endemic countries

There is a high burden of typhoid fever in sub-Saharan African countries, according to a new study published today in The Lancet Global Health. This high…

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There is a high burden of typhoid fever in sub-Saharan African countries, according to a new study published today in The Lancet Global Health. This high burden combined with the threat of typhoid strains resistant to antibiotic treatment calls for stronger prevention strategies, including the use and implementation of typhoid conjugate vaccines (TCVs) in endemic settings along with improvements in access to safe water, sanitation, and hygiene.

Typhoid Conjugate Vaccine Introduction in Madagascar vaccination

Credit: IVI

There is a high burden of typhoid fever in sub-Saharan African countries, according to a new study published today in The Lancet Global Health. This high burden combined with the threat of typhoid strains resistant to antibiotic treatment calls for stronger prevention strategies, including the use and implementation of typhoid conjugate vaccines (TCVs) in endemic settings along with improvements in access to safe water, sanitation, and hygiene.

 

The findings from this 4-year study, the Severe Typhoid in Africa (SETA) program, offers new typhoid fever burden estimates from six countries: Burkina Faso, Democratic Republic of the Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria, with four countries recording more than 100 cases for every 100,000 person-years of observation, which is considered a high burden. The highest incidence of typhoid was found in DRC with 315 cases per 100,000 people while children between 2-14 years of age were shown to be at highest risk across all 25 study sites.

 

There are an estimated 12.5 to 16.3 million cases of typhoid every year with 140,000 deaths. However, with generic symptoms such as fever, fatigue, and abdominal pain, and the need for blood culture sampling to make a definitive diagnosis, it is difficult for governments to capture the true burden of typhoid in their countries.

 

“Our goal through SETA was to address these gaps in typhoid disease burden data,” said lead author Dr. Florian Marks, Deputy Director General of the International Vaccine Institute (IVI). “Our estimates indicate that introduction of TCV in endemic settings would go to lengths in protecting communities, especially school-aged children, against this potentially deadly—but preventable—disease.”

 

In addition to disease incidence, this study also showed that the emergence of antimicrobial resistance (AMR) in Salmonella Typhi, the bacteria that causes typhoid fever, has led to more reliance beyond the traditional first line of antibiotic treatment. If left untreated, severe cases of the disease can lead to intestinal perforation and even death. This suggests that prevention through vaccination may play a critical role in not only protecting against typhoid fever but reducing the spread of drug-resistant strains of the bacteria.

 

There are two TCVs prequalified by the World Health Organization (WHO) and available through Gavi, the Vaccine Alliance. In February 2024, IVI and SK bioscience announced that a third TCV, SKYTyphoid™, also achieved WHO PQ, paving the way for public procurement and increasing the global supply.

 

Alongside the SETA disease burden study, IVI has been working with colleagues in three African countries to show the real-world impact of TCV vaccination. These studies include a cluster-randomized trial in Agogo, Ghana and two effectiveness studies following mass vaccination in Kisantu, DRC and Imerintsiatosika, Madagascar.

 

Dr. Birkneh Tilahun Tadesse, Associate Director General at IVI and Head of the Real-World Evidence Department, explains, “Through these vaccine effectiveness studies, we aim to show the full public health value of TCV in settings that are directly impacted by a high burden of typhoid fever.” He adds, “Our final objective of course is to eliminate typhoid or to at least reduce the burden to low incidence levels, and that’s what we are attempting in Fiji with an island-wide vaccination campaign.”

 

As more countries in typhoid endemic countries, namely in sub-Saharan Africa and South Asia, consider TCV in national immunization programs, these data will help inform evidence-based policy decisions around typhoid prevention and control.

 

###

 

About the International Vaccine Institute (IVI)
The International Vaccine Institute (IVI) is a non-profit international organization established in 1997 at the initiative of the United Nations Development Programme with a mission to discover, develop, and deliver safe, effective, and affordable vaccines for global health.

IVI’s current portfolio includes vaccines at all stages of pre-clinical and clinical development for infectious diseases that disproportionately affect low- and middle-income countries, such as cholera, typhoid, chikungunya, shigella, salmonella, schistosomiasis, hepatitis E, HPV, COVID-19, and more. IVI developed the world’s first low-cost oral cholera vaccine, pre-qualified by the World Health Organization (WHO) and developed a new-generation typhoid conjugate vaccine that is recently pre-qualified by WHO.

IVI is headquartered in Seoul, Republic of Korea with a Europe Regional Office in Sweden, a Country Office in Austria, and Collaborating Centers in Ghana, Ethiopia, and Madagascar. 39 countries and the WHO are members of IVI, and the governments of the Republic of Korea, Sweden, India, Finland, and Thailand provide state funding. For more information, please visit https://www.ivi.int.

 

CONTACT

Aerie Em, Global Communications & Advocacy Manager
+82 2 881 1386 | aerie.em@ivi.int


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US Spent More Than Double What It Collected In February, As 2024 Deficit Is Second Highest Ever… And Debt Explodes

US Spent More Than Double What It Collected In February, As 2024 Deficit Is Second Highest Ever… And Debt Explodes

Earlier today, CNBC’s…

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US Spent More Than Double What It Collected In February, As 2024 Deficit Is Second Highest Ever... And Debt Explodes

Earlier today, CNBC's Brian Sullivan took a horse dose of Red Pills when, about six months after our readers, he learned that the US is issuing $1 trillion in debt every 100 days, which prompted him to rage tweet, (or rageX, not sure what the proper term is here) the following:

We’ve added 60% to national debt since 2018. Germany - a country with major economic woes - added ‘just’ 32%.   

Maybe it will never matter.   Maybe MMT is real.   Maybe we just cancel or inflate it out. Maybe career real estate borrowers or career politicians aren’t the answer.

I have no idea.  Only time will tell.   But it’s going to be fascinating to watch it play out.

He is right: it will be fascinating, and the latest budget deficit data simply confirmed that the day of reckoning will come very soon, certainly sooner than the two years that One River's Eric Peters predicted this weekend for the coming "US debt sustainability crisis."

According to the US Treasury, in February, the US collected $271 billion in various tax receipts, and spent $567 billion, more than double what it collected.

The two charts below show the divergence in US tax receipts which have flatlined (on a trailing 6M basis) since the covid pandemic in 2020 (with occasional stimmy-driven surges)...

... and spending which is about 50% higher compared to where it was in 2020.

The end result is that in February, the budget deficit rose to $296.3 billion, up 12.9% from a year prior, and the second highest February deficit on record.

And the punchline: on a cumulative basis, the budget deficit in fiscal 2024 which began on October 1, 2023 is now $828 billion, the second largest cumulative deficit through February on record, surpassed only by the peak covid year of 2021.

But wait there's more: because in a world where the US is spending more than twice what it is collecting, the endgame is clear: debt collapse, and while it won't be tomorrow, or the week after, it is coming... and it's also why the US is now selling $1 trillion in debt every 100 days just to keep operating (and absorbing all those millions of illegal immigrants who will keep voting democrat to preserve the socialist system of the US, so beloved by the Soros clan).

And it gets even worse, because we are now in the ponzi finance stage of the Minsky cycle, with total interest on the debt annualizing well above $1 trillion, and rising every day

... having already surpassed total US defense spending and soon to surpass total health spending and, finally all social security spending, the largest spending category of all, which means that US debt will now rise exponentially higher until the inevitable moment when the US dollar loses its reserve status and it all comes crashing down.

We conclude with another observation by CNBC's Brian Sullivan, who quotes an email by a DC strategist...

.. which lays out the proposed Biden budget as follows:

The budget deficit will growth another $16 TRILLION over next 10 years. Thats *with* the proposed massive tax hikes.

Without them the deficit will grow $19 trillion.

That's why you will hear the "deficit is being reduced by $3 trillion" over the decade.

No family budget or business could exist with this kind of math.

Of course, in the long run, neither can the US... and since neither party will ever cut the spending which everyone by now is so addicted to, the best anyone can do is start planning for the endgame.

Tyler Durden Tue, 03/12/2024 - 18:40

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