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Could US lockdowns slam the breaks on this market rally?

Could US lockdowns slam the breaks on this market rally?



The COVID-19 data coming out of the US is grim and getting grimmer. My concern is that many investors have been pricing in an increasingly positive economic recovery, which may not eventuate if governments in the US need to re-introduce lockdowns. And that spells danger for share prices in the US – and other markets as well.

Major equity markets have recovered between half to two thirds of their losses since the height of the global COVID-19 pandemic fears and the lows in late March. This is on the back of the aggressive fiscal and monetary response from governments, as well as an increasing expectation that the impact and lockdowns will be shorter in duration. In the last week, an acceleration in the number of new confirmed COVID-19 cases in the US has seen markets become more nervous that there could be a second wave coming, with a consequent impact on economic activity.

If we look at the number of confirmed cases in the US, plotted on a logarithmic scale to visually show the percentage rate of change in confirmed case numbers, we can see a slight acceleration in the rate of new cases in the last week, with the line steepening marginally.

Figure 1: Total COVID-19 Cases in the US

Screen Shot 2020-06-29 at 2.02.59 pm

Source: CDC and state-based agencies

The chart above does not appear to show a major change in the rate of new cases, but this data needs to be disaggregated to understand where the threat exists. The epicentre of the initial outbreak in the US was the tri-state area around New York City.

At the end of April, New York state, New Jersey and Connecticut accounted for 42 per cent of total US confirmed cases despite representing around 10 per cent of the total US population. Since then, sustained lockdown requirements combined with an aggressive testing regime have resulted in a slowing of the rate in new cases.

The recent acceleration in new cases is coming from outside these three states.

Figure 2: Total COVID-19 Cases in the US – Combined NY/NJ/CT Vs the rest of the US

Screen Shot 2020-06-29 at 2.03.27 pm

Source: CDC and state-based agencies

If we break this down even further, the acceleration in confirmed cases is primarily occurring in a handful of states such as Florida, Arizona and Texas. To help with comparability given the population differences of the various states, the chart compares the figures on the basis of the number of confirmed cases per 1,000 people resident in the state.

Figure 3: Total COVID-19 Cases per 1,000 Residents

Screen Shot 2020-06-29 at 2.03.57 pm

Source: CDC and state-based agencies

This chart shows the material acceleration in case numbers in Florida and Arizona in particular.

However, as we noted back in February, confirmed case volumes are only one measure of the current situation. What we are trying to identify is the extent of the spread of the infection in the broader community. This is where understanding the data in the context of testing volumes becomes important.

If there is not a broader level of spread through the population, the data should show a falling percentage of tests coming back positive as testing volumes are increased and testing is undertaken more broadly throughout the population.

While the US was generally seen as being slow to ramp up testing in order to identify and quarantine cases in the broader community, there was also a very big difference between the timing and scale of the ramp-up in testing between New York, New Jersey and Connecticut and the rest of the US as shown in the chart below. This chart shows that NY/NJ/CT were testing at around two to three times the rate per capita relative to the rest of the country during late May and most of June. If you don’t test, you don’t see the extent of the problem and have no ability to contain it.

Figure 4: Total COVID-19 Tests per Million Residents – 3 Day Average

Screen Shot 2020-06-29 at 2.04.24 pm

Source: CDC and state-based agencies

If we look at the problem states in isolation, we see that testing is starting to be ramped up, but remains below the levels of NY/NJ/CT.

Figure 5: Total COVID-19 Tests per Million Residents – 3 Day Average

Screen Shot 2020-06-29 at 2.04.53 pm

Source: CDC and state-based agencies

As noted earlier, if there is no broader issue of unidentified community spread of the disease, you would expect the percentage of tests that come back positive to fall as the number and breadth of testing increases. This has been the case for NY/NJ/CT as testing volumes increased through May. The concern in states like Florida and Arizona is that the data shows a considerable increase in the percentage of tests coming back positive in the last couple of weeks despite the almost doubling of test volumes. This could be indicating that there is a much larger spread of the disease throughout the population than previously thought.

Figure 6: Percentage of Daily COVID-19 that are Positive – 3 Day Average

Screen Shot 2020-06-29 at 2.05.19 pm

Source: CDC and state-based agencies

More broadly across the US excluding New York, New Jersey and Connecticut, the data is showing an increase in the percentage of tests that are coming back positive at the same time the volume of tests per capita is increasing.

Figure 7: Percentage of Daily Positive COVID-19 Tests Vs Volume of Tests – US Excluding NY/NJ/CT

Screen Shot 2020-06-29 at 2.05.48 pm

Source: CDC and state-based agencies

The concern is that there is the potential for the rest of the US to catch up to the per capita case rate of the NY/NJ/CT area. This could see COVID-19 case numbers triple in the US.

Figure 8: Total Cases Per 1,000 Residents – NY/NJ/CT vs the Rest of the US

Screen Shot 2020-06-29 at 2.06.14 pm

Source: CDC and state-based agencies

If the rest of the US were to reach the number of COVID-19 cases per capita as NY/NJ/CT, the total number of cases in the US would increase from yesterday’s figure of 2.5 million to around 6.3 million cases.

Of course, the number of cases per capita in NY/NJ/CT does not represent a ceiling. It is possible that that the spread of the disease could easily exceed these levels. A number of the states that are now of concern, were slow to lock down the population and quick to open up again. Additionally, their populations are arguably more resistant to measures that would constrain the strain of the disease than NY/NJ/CT, and it is likely to be harder to get residents to return to lockdown conditions due to lockdown fatigue and discontent with the impact on their lifestyles.

The flipside positives against the eventual spread being worse than the current level of infection per capita in the NY/NJ/CT are that not all states are experiencing the same accelerating in new cases and testing volumes are higher than in the early stages of the outbreak in March.

The implications of a second wave for equity markets are clearly not positive given the market has been pricing an increasingly positive outcome and recovery in that last two months.

If governments need to re-introduce lockdowns, the ability to support the economy through fiscal policy measures will be more limited this time. The existing support measures are not sustainable in the long term given the rapid growth in borrowing to required fund them. Additionally, a material proportion of that support is due to expire in the coming months. This might be extended, but this can only go on for so long. Therefore, a second wave spike in cases carries significant risk to economic activity and equity markets.

However, there are some factors that would reduce the impact on economic activity. The main risk to the economy comes if the healthcare is swamped by the reacceleration in new cases, forcing another lockdown.

A second wave through the rest of the US is likely to have a proportionally smaller impact on hospitalisation rates for a couple of reasons. First, the outbreaks to date in states like Arizona and Florida are more skewed to younger people due to their return to hospitality venues. Hospitalisation rates are lower for younger people with the disease. But this could see some re-imposition of restrictions applied to hospitality venues, with negative implications for stocks exposed to the industry such as gaming stocks.

Additionally, treatments are also likely to have improved, reducing the rate at which cases deteriorate to critical levels.

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Delivering aid during war is tricky − here’s what to know about what Gaza relief operations may face

The politics of delivering aid in war zones are messy, the ethics fraught and the logistics daunting. But getting everything right is essential − and…




Palestinians on the outskirts of Gaza City walk by buildings destroyed by Israeli bombardment on Oct. 20, 2023. AP Photo/Ali Mahmoud

The 2.2 million people who live in Gaza are facing economic isolation and experiencing incessant bombardment. Their supplies of essential resources, including food and water, are quickly dwindling.

In response, U.S. President Joe Biden has pledged US$100 million in humanitarian assistance for the citizens of Gaza.

As a scholar of peace and conflict economics who served as a World Bank consultant during the 2014 war between Hamas and Israel, I believe that Biden’s promise raises fundamental questions regarding the delivery of humanitarian aid in a war zone. Political constraints, ethical quandaries and the need to protect the security of aid workers and local communities always make it a logistical nightmare.

In this specific predicament, U.S. officials have to choose a strategy to deliver the aid without the perception of benefiting Hamas, a group the U.S. and Israel both classify as a terrorist organization.


When aiding people in war zones, you can’t just send money, a development strategy called “cash transfers” that has become increasingly popular due to its efficiency. Sending money can boost the supply of locally produced goods and services and help people on the ground pay for what they need most. But injecting cash into an economy so completely cut off from the world would only stoke inflation.

So the aid must consist of goods that have to be brought into Gaza, and services provided by people working as part of an aid mission. Humanitarian aid can include food and water; health, sanitation and hygiene supplies and services; and tents and other materials for shelter and settlement.

Due to the closure of the border with Israel, aid can arrive in Gaza only via the Rafah crossing on the Egyptian border.

The U.S. Agency for International Development, or USAID, will likely turn to its longtime partner on the ground, the United Nations Relief and Works Agency, or UNRWA, to serve as supply depots and distribute goods. That agency, originally founded in 1949 as a temporary measure until a two-state solution could be found, serves in effect as a parallel yet unelected government for Palestinian refugees.

USAID will likely want to tap into UNRWA’s network of 284 schools – many of which are now transformed into humanitarian shelters housing two-thirds of the estimated 1 million people displaced by Israeli airstrikes – and 22 hospitals to expedite distribution.

Map of Gaza and its neighbors
Gaza is a self-governing Palestinian territory. The narrow piece of land is located on the coast of the Mediterranean Sea, bordered by Israel and Egypt. PeterHermesFurian/iStock via Getty Images Plus


Prior to the Trump administration, the U.S. was typically the largest single provider of aid to the West Bank and Gaza. USAID administers the lion’s share of it.

Since Biden took office, total yearly U.S. assistance for the Palestinian territories has totaled around $150 million, restored from just $8 million in 2020 under the Trump administration. During the Obama administration, however, the U.S. was providing more aid to the territories than it is now, with $1 billion disbursed in the 2013 fiscal year.

But the White House needs Congress to approve this assistance – a process that requires the House of Representatives to elect a new speaker and then for lawmakers to approve aid to Gaza once that happens.


The United Nations Relief and Works Agency is a U.N. organization. It’s not run by Hamas, unlike, for instance, the Gaza Ministry of Health. However, Hamas has frequently undermined UNRWA’s efforts and diverted international aid for military purposes.

Hamas has repeatedly used UNRWA schools as rocket depots. They have repeatedly tunneled beneath UNRWA schools. They have dismantled European Union-funded water pipes to use as rocket fuselages. And even since the most recent violence broke out, the UNRWA has accused Hamas of stealing fuel and food from its Gaza premises.

Humanitarian aid professionals regularly have to contend with these trade-offs when deciding to what extent they can work with governments and local authorities that commit violent acts. They need to do so in exchange for the access required to help civilians under their control.

Similarly, Biden has had to make concessions to Israel while brokering for the freedom to send humanitarian aid to Gaza. For example, he has assured Israel that if any of the aid is diverted by Hamas, the operation will cease.

This promise may have been politically necessary. But if Biden already believes Hamas to be uncaring about civilian welfare, he may not expect the group to refrain from taking what they can.

Security best practices

What can be done to protect the security of humanitarian aid operations that take place in the midst of dangerous conflicts?

Under International Humanitarian Law, local authorities have the primary responsibility for ensuring the delivery of aid – even when they aren’t carrying out that task. To increase the chances that the local authorities will not attack them, aid groups can give “humanitarian notification” and voluntarily alert the local government as to where they will be operating.

Hamas has repeatedly flouted international norms and laws. So the question of if and how the aid convoy will be protected looms large.

Under the current agreement between the U.S., Israel and Egypt, the convoy will raise the U.N. flag. International inspectors will make sure no weapons are on board the vehicles before crossing over from Arish, Egypt, to Rafah, a city located on the Gaza Strip’s border with Egypt.

The aid convoy will likely cross without militarized security. This puts it at some danger of diversion once inside Gaza. But whether the aid convoy is attacked, seized or left alone, the Biden administration will have demonstrated its willingness to attempt a humanitarian relief operation. In this sense, a relatively small first convoy bearing water, medical supplies and food, among other items, serves as a test balloon for a sustained operation to follow soon after.

If the U.S. were to provide the humanitarian convoy a military escort, by contrast, Hamas could see its presence as a provocation. Washington’s support for Israel is so strong that the U.S. could potentially be judged as a party in the conflict between Israel and Hamas.

In that case, the presence of U.S. armed forces might provoke attacks on Gaza-bound aid convoys by Hamas and Islamic jihad fighters that otherwise would not have occurred. Combined with the mobilization of two U.S. Navy carrier groups in the eastern Mediterranean Sea, I’d be concerned that such a move might also stoke regional anger. It would undermine the Biden administration’s attempts to cool the situation.

On U.N.-approved missions, aid delivery may be secured by third-party peacekeepers – meaning, in this case, personnel who are neither Israeli nor Palestinian – with the U.N. Security Council’s blessing. In this case, tragically, it’s unlikely that such a resolution could conceivably pass such a vote, much less quickly enough to make a difference.

Topher L. McDougal 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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Diagnosis and management of postoperative wound infections in the head and neck region

“The majority of wound infections often manifest themselves immediately postoperatively, so close followup should take place […]” Credit: 2023 Barbarewicz…



“The majority of wound infections often manifest themselves immediately postoperatively, so close followup should take place […]”

Credit: 2023 Barbarewicz et al.

“The majority of wound infections often manifest themselves immediately postoperatively, so close followup should take place […]”

BUFFALO, NY- October 20, 2023 – A new research perspective was published in Oncoscience (Volume 10) on October 4, 2023, entitled, “Diagnosis and management of postoperative wound infections in the head and neck region.”

In everyday clinical practice at a department for oral and maxillofacial surgery, a large number of surgical procedures in the head and neck region take place under both outpatient and inpatient conditions. The basis of every surgical intervention is the patient’s consent to the respective procedure. Particular attention is drawn to the general and operation-specific risks. 

Particularly in the case of soft tissue procedures in the facial region, bleeding, secondary bleeding, scarring and infection of the surgical area are among the most common complications/risks, depending on the respective procedure. In their new perspective, researchers Filip Barbarewicz, Kai-Olaf Henkel and Florian Dudde from Army Hospital Hamburg in Germany discuss the diagnosis and management of postoperative infections in the head and neck region.

“In order to minimize the wound infections/surgical site infections, aseptic operating conditions with maximum sterility are required.”

Furthermore, depending on the extent of the surgical procedure and the patient‘s previous illnesses, peri- and/or postoperative antibiotics should be considered in order to avoid postoperative surgical site infection. Abscesses, cellulitis, phlegmone and (depending on the location of the procedure) empyema are among the most common postoperative infections in the respective surgical area. The main pathogens of these infections are staphylococci, although mixed (germ) patterns are also possible. 

“Risk factors for the development of a postoperative surgical site infection include, in particular, increased age, smoking, multiple comorbidities and/or systemic diseases (e.g., diabetes mellitus type II) as well as congenital and/ or acquired immune deficiency [10, 11].”


Continue reading the paper: DOI: 

Correspondence to: Florian Dudde


Keywords: surgical site infection, head and neck surgery


About Oncoscience

Oncoscience is a peer-reviewed, open-access, traditional journal covering the rapidly growing field of cancer research, especially emergent topics not currently covered by other journals. This journal has a special mission: Freeing oncology from publication cost. It is free for the readers and the authors.

To learn more about Oncoscience, visit and connect with us on social media:

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Biden’s Student Loan Forgiveness Plan Makes the Poor Pay for the Rich

A year after the Supreme Court struck down President Biden’s student loan forgiveness plan, he presented a new scheme to the Department of Education…



A year after the Supreme Court struck down President Biden’s student loan forgiveness plan, he presented a new scheme to the Department of Education on Tuesday. While it is less aggressive than the prior plan, this proposal would cost hundreds of billions of taxpayer dollars, doing more harm than good. 

As the legendary economist Milton Friedman noted, “One of the great mistakes is to judge policies and programs by their intentions rather than their results.” 

Higher education in America is costly, and this “forgiveness” would make it worse. 

Signing up for potentially life-long student loans at a young age is too normalized. At the same time, not enough borrowers can secure jobs that offer adequate financial support to pay off these massive loans upon graduation or leaving college. These issues demand serious attention. But “erasing” student loans, as well-intentioned as it may be, is not the panacea Americans have been led to believe.

Upon closer examination, the President’s forgiveness plan creates winners and losers, ultimately benefiting higher-income earners the most. In reality, this plan amounts to wealth redistribution. To quote another top economist, Thomas Sowell described this clearly: “There are no solutions, only trade-offs.” 

Forgiving student loans is not the end of the road but the beginning of a trade-off for a rising federal fiscal crisis and soaring college tuition. 

When the federal government uses taxpayer funds to give student loans, it charges an interest rate to account for the cost of the loan. To say that all borrowers no longer have to pay would mean taxpayers lose along with those who pay for it and those who have been paying or have paid off their student loans.

According to the Committee for a Responsible Federal Budget, student debt forgiveness could cost at least $360 billion. 

Let’s consider that there will be 168 million tax returns filed this year. A simple calculation suggests that student loan forgiveness could add around $2,000 yearly in taxes per taxpayer, based on the CRFB’s central estimate. 

Clearly, nothing is free, and the burden of student loan forgiveness will be shifted to taxpayers.

One notable feature of this plan is that forgiveness is unavailable to individuals earning over $125,000 annually. In practice, this means that six-figure earners could have their debts partially paid off by lower-income tax filers who might not have even pursued higher education. This skewed allocation of resources is a sharp departure from progressive policy.

Data show that half of Americans are already frustrated with “Bidenomics.” 

Inflation remains high, affordable housing is a distant dream, and wages fail to keep up with soaring inflation. Introducing the potential of an additional $2,000 annual tax burden at least for those already struggling, mainly to subsidize high-income earners, adds insult to injury.

Furthermore, it’s vital to recognize that the burden of unpaid student loans should not fall on low-income earners or Americans who did not attend college. Incentives play a crucial role in influencing markets. 

By removing the incentive for student loan borrowers to repay their debts, we may encourage more individuals to pursue higher education and accumulate debt without the intention of paying it back. After all, why would they when it can be written off through higher taxes for everyone?

The ripple effect of this plan could be far-reaching. 

It may make college more accessible for some, opening the floodgates for students and the need for universities to expand and hire more staff, leading to even higher college tuition. This perverse incentive will set a precedent that will create a cycle of soaring tuition, which would counteract the original goal of making higher education more affordable.

While the intention behind President Biden’s student loan forgiveness may appear noble (in likelihood, it is a rent-seeking move), the results may prove detrimental to our nation’s economic stability and fairness. And if the debt is monetized, more inflation will result.

Forgiving student loans will exacerbate existing problems, with the brunt of the burden falling on lower-income Americans. Instead of improving the situation, it will likely create an intricate web of financial consequences, indirectly affecting the very people it aims to help. But that is the result of most government programs with good intentions.



Vance Ginn, Ph.D., is president of Ginn Economic Consulting, chief economist or senior fellow at multiple state thinks across the country, host of the Let People Prosper Show, and previously the associate director for economic policy of the White House’s Office of Management and Budget, 2019-20. Follow him on @VanceGinn.


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