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Hope Springs Eternal, or at least enough to Lift Risk Taking Today

Overview:  The animal spirits have been reanimated today.  Encouraged by the dramatic reversal in oil and gas prices, a deal in the US that pushes off the debt ceiling for a few weeks and talk of a new bond-buying facility in the euro area spurred…

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Overview:  The animal spirits have been reanimated today.  Encouraged by the dramatic reversal in oil and gas prices, a deal in the US that pushes off the debt ceiling for a few weeks and talk of a new bond-buying facility in the euro area spurred further risk-taking today, ahead of tomorrow's US employment report.  The sharp upside reversal in US shares yesterday carried over in Asia and Europe today.  The Hang Seng, battered lately, jumped over 3%, and the Nikkei posted its first rise in nine sessions.  Taiwan, South Korea, and Indian indices rose more than 1%.  Europe's Dow Jones Stoxx 600 is also up about 1%, and US index futures are seeing follow-through buying.  Meanwhile, the US 10-year yield is hovering around 1.52% after pulling back from 1.57% yesterday.  European benchmark yields are also softer after testing three-month highs yesterday.  The dollar has a softer profile against most major currencies, though the yen and the Norwegian krone are struggling, and the leaders, like the Antipodeans, are up a modest 0.2%.  Emerging market currencies are firmer, with the JP Morgan EM FX index posting its first gain of the week.  Note that the World Health Organization announced its first vaccine for malaria yesterday.  Gold is near the middle of its $1.745-$1770 range,  while the industrial metals are also higher.  November WTI posted a key reversal yesterday by making new highs before reversing lower and settling below the previous session's low. Continued selling today has returned the contract to the week's low near $75.  It had approached $80 yesterday.  The US Nov Natgas contract also posted a key reversal yesterday, and it too is seeing follow-through selling today as it tests the 20-day moving average (~$5.38), which it has not closed below since late August.  The CRB Index fell yesterday for only the second time since the FOMCmeeting last month.  

Asia Pacific

After reportedly meeting for six hours yesterday, US National Security Adviser Sullivan and China's senior foreign policy official Yang managed to make some headway toward a Biden-Xi formal virtual meeting later this year. However, it is not clear what to make of it.  On the one hand, without a strong sense of a positive outcome, there seems little reason to have such talks. But, on the other hand, neither side has changed its behavior.  China continues to send large numbers of military planes into Taiwan's air identification zone and claims large parts of the South China Sea, encroaching on the territorial waters of Malaysia and the Philippines, for example.  At the same time, the US has offered to share nuclear technology with Australia and does not hide that it wants to lead an alliance to check China's assertiveness in the region and is discouraging investment in China.  

The Golden Week holiday is winding down, and mainland markets re-open tomorrow.  Ahead of it, China reported its reserves fell for the second consecutive month.  The $31.5 bln decline is the second largest of the year and likely primarily reflects valuation adjustments.  Recall that the other reserve currencies fell against the dollar in September, with the euro off nearly 2% and the bonds sold off.  The US 10-year yield, for example, rose almost 18 bp.  Meanwhile, estimates suggest domestic travel during the Golden Week has been sluggish, and tomorrow the Caixin service and composite PMIs will be reported.  Recall that in August, both were below the 50 boom/bust level.  Lastly, when the mainland markets closed before the holiday, the dollar settled slightly below CNH6.45.  It is now trading around CNH6.4535. That suggests little change in the onshore yuan, against which the dollar closed a little below CNY6.4450.  

The dollar is in a narrow range of less than a third of a yen so far today, mostly below JPY111.50, where an option for about $760 mln expires today.  The price action is within yesterday's range. There is another option for $865 bln at JPY111.00 that also rolls off today.  It takes a break of the JPY110.80 area to signal anything important.  Yesterday's high near JPY111.80 looks safe.  The Australian dollar recovered from testing the $0.7220 yesterday and returned to its nemesis around $0.7300.  It has been repeatedly probed since mid-September but has failed to close above it even once.  Even if it does, the $0.7325 area is the next important hurdle. 

Europe

The ECB was buying sovereign bonds before the pandemic struck.  The Asset Purchase Program had strict parameters in terms of the capital key and country limits.  It was and continues to buy about 20 bln euros a month.  It was too limited to serve the purposes of the emergency. However, the Pandemic Emergency Purchase Program is to wind down at the end of Q1 22.  Talk of modifying the APP has been circulating for several months.  The new reports are part of this discussion.  A more flexible facility is sought by some, but the problem that has gone unobserved in these new reports is that the APP's limitations are why it passed constitutional muster.  Making it more flexible such as deviating from the capital key, could spur legal challenges.  The ECB meets later this month (October 28), but a decision on APP is not expected until December at the earliest.  Moreover, because the ECB will continue to buy bonds, it is not clear that the PEPP needs to wind down like the Fed's planned tapering. 

Following the surprisingly poor factory orders (-7.7%) seen yesterday,  Germany reported an equally dismal industrial production performance today.  Rather than fall by 0.5% as the median forecast in Bloomberg's survey anticipated, German industrial output tumbled by 4%, leaving the year-over-year advance at a modest 1.7%, down from 6% in July.  The downside surprise will prompt economists to cut Q3 GDP forecasts.  Manufacturing (autos) and construction were hit hard.  Auto output contracted by 15.7% in August.  The aggregate estimate for the eurozone is due next week.  Recall that Spain's August industrial production was reported yesterday as having fallen by 0.3%.  The median forecast in Bloomberg's survey was for a 0.9% gain.  Rising energy costs and the semiconductor shortage are the main culprits. 

The reversal of energy prices may have been spurred by Putin's apparent offer to make more gas supply available, the larger increase than expected in US inventories, and the suggestion the US could release more oil from its strategic reserves.  Europe's energy commissioner seemed sympathetic to calls from Spain and Italy to move toward joint energy purchases.  Out of crisis comes greater efforts of coordination and unification. 

The euro has been confined to about a quarter of a cent range above $1.1550. Yesterday's low and now the low for the year was slightly below $1.1530.  The market seems reluctant to push it much now ahead of tomorrow's US jobs report.  The week's high was set on Monday near $1.1640.  Today is the first session of the year that the euro has not traded above $1.16, and there is a 1.6 bln euro option that expires there today.  Sterling is also consolidating in a narrow range of about a third of a cent (~$1.3570-$1.3605).  The market does not appear to have the appetite to push it outside of yesterday's range (~$1.3545-$1.3635).   Sterling is slightly firmer near midday in Europe and has risen in four of the past five sessions.  

America

The Republicans have offered not to block an extension in the debt ceiling into early December. Instead, they will agree to a fixed dollar amount to cover the necessary spending.  This will ease the immediate threat of disruption and change the T-bills that are being avoided. However, the underlying challenge is not addressed, and the drama will continue to play out.  The problem is that the Democratic Party is not united.  If it were, the GOP obstruction could be overcome.  In addition, Democratic leadership insists on GOP support for lifting the debt ceiling, but this is a nice to have and not a must-have as the parliamentarian has ruled it could be covered by the reconciliation process.  When Biden was a Senator, the Democrats did the same thing to the Republicans, i.e., forcing them to lift the debt ceiling without their support.  This is the same dance with many of the same partners, but the other is leading now, which may help explain why most investors seem to be looking through the brinkmanship.  

US weekly jobless claims have risen for the past three weeks.  Economists continue to look for a decline, and the median guesstimate is for a 14k fall to 348k.  A Bloomberg report claims the whisper number is a little higher, but it is unclear what a whisper number really means here.  It is a water cooler conversation?  Is it a serious forecast, and why isn't it picked up in the survey?  Different newswires and economic groups conduct their own surveys, and the medians often converge as would expect. Still, clams of a whisper number cannot be verified, and its purpose and impact are suspect.

Canada reports its Ivey Purchasing Managers Index today.   It has been choppy this year after finishing 2020 at 46.7.  The year's peak was in March at 72.9.  It fell to 60.6 in April, and in June, it was back near 72.0.  It fell in July to 56.4 and rebounded in August to 66.0.  Canada's September jobs data will be reported tomorrow, and the median forecast (Bloomberg) calls for a 60k increase in jobs and the unemployment rate to dip below 7%.  Mexico reports September CPI figures, and the headline is expected to accelerate to 6%.  The core rate is expected to have also accelerated.  The central bank meets on November 11 and is expected to hike rates again.

The US dollar eked out a small gain against the Canadian dollar yesterday.  It was the first gain in five sessions.  It is trading with a slightly heavier bias today.  The greenback is holding below CAD1.2600.  The week's low was set on Tuesday near CAD1.2545.  While this offers initial support, the key may be the CAD1.2495-CAD1.2515 band that holds last month's low and the 200-day moving average.  The greenback reversed low after trading above MXN20.88, a six-month high.  It closed near MXN20.5550, and follow-through selling has seen the US dollar slip below MXN20.50.  A break could see MXN20.35-MXN20.40.  The dollar filled its open gap against the Brazilian real yesterday but still settled outside of Tuesday's range.  It may re-enter it today. The low on Tuesday was around BRL5.4255, which may offer support today.  



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Biden Suffers Worst Approval Ratings Plunge Of Any President Since World War II 

Biden Suffers Worst Approval Ratings Plunge Of Any President Since World War II 

President Biden’s job approval rating has fallen the most since the start of his term than any other president since World War II. 

A new Gallup poll was…

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Biden Suffers Worst Approval Ratings Plunge Of Any President Since World War II 

President Biden's job approval rating has fallen the most since the start of his term than any other president since World War II. 

A new Gallup poll was released Friday, polling Americans between Oct. 1-19 shows Biden's approval rating plunged from 56% in Q1 to 44.7% in Q3, a whopping 11.3 percentage points that any president hasn't seen in over 75 years. 

"Biden began his term with relatively solid approval ratings, ranging between 54% and 57% from January through June. His approval dropped to 50% in July and 49% in August as coronavirus infections surged in the U.S. The chaotic U.S. withdrawal from Afghanistan in late August, which included the deaths of more than a dozen U.S. military personnel in a terrorist attack at the Kabul airport, was likely the reason Biden's September job approval rating fell further to 43%," Gallup said. 

We noted in June that Gallup data showed Biden's "honeymoon period" was over and said if the president cannot "tame inflation" could result in further rating declines. And, oh boy, were we right...

Biden also faces an increasing disillusionment among Americans that he can't fix the border crisis, snarled supply chains, high gas prices, soaring inflation, consumer goods shortages, and the coronavirus pandemic, among a whole list of other things. 

His ratings suggest no improvement in Democrat support, declining support among Independents, and only 4% of Republicans polled approve of the job he's done - that figure is likely to go to zero if things don't turn around for the president. 

The 88% partisan gap in job approval is extraordinarily high considering Biden campaigned on "unity." During his inauguration, he said: 

"We can join forces, stop the shouting and lower the temperature. For without unity there is no peace, only bitterness and fury. No progress, only exhausting outrage. No nation, only a state of chaos. This is our historic moment of crisis and challenge, and unity is the path forward."

While Democrats are desperately trying to salvage their $3.5 trillion Build Back Better infrastructure plan, Americans are increasingly becoming confused about what exactly that means and how that will affect them. Repbulicans have requested the president to fix broken supply chain before more social spending. 

Souring support suggests Democrats could be on track to lose big in next year's midterms. 

Tyler Durden Sat, 10/23/2021 - 14:00

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Fauci Funded ‘Cruel’ Puppy Experiments Where Sand Flies ‘Eat Them Alive’; Vocal Cords Severed

Fauci Funded ‘Cruel’ Puppy Experiments Where Sand Flies ‘Eat Them Alive’; Vocal Cords Severed

While recent attention has been focused on Dr. Anthony Fauci’s National Institutes of Health funding the genetic manipulation of bat coronaviruses..

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Fauci Funded 'Cruel' Puppy Experiments Where Sand Flies 'Eat Them Alive'; Vocal Cords Severed

While recent attention has been focused on Dr. Anthony Fauci's National Institutes of Health funding the genetic manipulation of bat coronaviruses in the same town as the bat coronavirus pandemic emerged, a bipartisan group of lawmakers have demanded answers over 'sick' experiments on drugged puppies, according to The Hill.

"Our investigators show that Fauci’s NIH division shipped part of a $375,800 grant to a lab in Tunisia to drug beagles and lock their heads in mesh cages filled with hungry sand flies so that the insects could eat them alive," writes nonprofit organization the White Coat Waste Project. "They also locked beagles alone in cages in the desert overnight for nine consecutive nights to use them as bait to attract infectious sand flies."

As The Hill's Christian Spencer writes:

The White Coat Waste Project, the nonprofit organization that first pointed out that U.S. taxpayers were being used to fund the controversial Wuhan Institute of Virology, have now turned its sights on Anthony Fauci on another animal-testing-related matter — infecting dozens of beagles with disease-causing parasites to test an experimental drug on them.

House members, most of whom are Republicans, want Fauci to explain himself in response to allegations brought on by the White Coat Waste Project that involve drugging puppies.

According to the White Coat Waste Project, the Food and Drug Administration does not require drugs to be tested on dogs, so the group is asking why the need for such testing. 

White Coat Waste claims that 44 beagle puppies were used in a Tunisia, North Africa, laboratory, and some of the dogs had their vocal cords removed, allegedly so scientists could work without incessant barking. -The Hill

The concerned lawmakers are led by Rep. Nancy Mace (R-SC), who said in a letter to the NIH that cordectomies are "cruel" and a "reprehensible misuse of taxpayer funds." Mace is joined by reps Cindy Axne (D-Iowa), Cliff Bentz (R-Ore.), Steve Cohen (D-Tenn.), Rick Crawford (R-Ark.), Brian Fitzpatrick (R-Pa.), Scott Franklin (R-Fla.), Andrew Garbarino (R-N.Y.), Carlos Gimenez (R-Fla.), Jimmy Gomez (D-Calif.), Josh Gottheimer (D-N.J.), Fred Keller (R-Pa.), Ted Lieu (D-Calif.), Lisa McClain (R-Mich.), Nicole Malliotakis (R-N.Y.), Brian Mast (R-Fla.), Scott Perry (R-Pa.), Bill Posey (R-Fla.), Mike Quigley (D-Ill.), Lucille Roybal-Allard (D-Calif.), Maria E. Salazar (R-Fla.), Terri Sewell (D-Ala.), Daniel Webster (R-Fla.) and Del. Eleanor Holmes Norton (D-D.C.) via The Hill.

How will Fauci spin this?

Tyler Durden Sat, 10/23/2021 - 15:00

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COVID-19 pandemic shifted patient attitudes about colorectal cancer screening

Key takeaways Credit: American College of Surgeons Key takeaways A survey of adults eligible for colorectal cancer screening patterns found a preference for at-home fecal occult blood testing (FOBT) versus colonoscopy during the COVID-19 pandemic. Survey.

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Key takeaways

Credit: American College of Surgeons

Key takeaways

  • A survey of adults eligible for colorectal cancer screening patterns found a preference for at-home fecal occult blood testing (FOBT) versus colonoscopy during the COVID-19 pandemic.
  • Survey respondents reported less use of colonoscopy during the pandemic compared to pre-pandemic levels, with factors related to both COVID-19 infection concerns and the financial strain of having copays.
  • FOBT shows potential as an alternative to screening colonoscopy to improve access to colorectal cancer screening in the context of COVID-19 safety and economic concerns.

CHICAGO: The impact of the COVID-19 pandemic on patients’ willingness to keep appointments for non-COVID-19 illnesses has been well documented, but a team of researchers at Virginia Commonwealth University report that for people hesitant to come into the hospital or an outpatient center to get a colonoscopy, home-administered fecal occult blood tests (FOBT) may provide a useful workaround tool. About 30 percent more survey respondents completed home-based test during the pandemic than before.

Kristine Kenning, MD, MS, presented findings from a survey of adults age-eligible for screening at the virtual American College of Surgeons (ACS) Clinical Congress 2021. “The key message from our findings is that barriers to screening have increased during the pandemic, and we have to find a way to work with the community to increase those rates,” said Dr. Kenning, chief general surgery resident at Virginia Commonwealth University (VCU) School of Medicine, Richmond. “Our study found that people are compliant with, and willing to do, home-based fecal occult blood testing. This test provides a very important way for us to increase screening for colorectal cancer.”

The American College of Gastroenterology clinical guidelines recommend colonoscopy for colorectal cancer evaluation and following a positive FOBT with a colonoscopy.1 About 148,000 cases of colorectal cancers are newly diagnosed in the United States each year, the American Cancer Society reports, and they account for 53,000 deaths.2

About the survey

The cross-sectional survey involved 765 people age 50 years and older. Dr. Kenning and colleagues found that their respondents reported a higher completion of stool tests pre-COVID than the American Cancer Society reported,2 32 percent vs. 11 percent. During the pandemic, 50 percent of respondents said they completed the FOBT. By contrast, 44 percent of survey respondents who said they had colon screening during the pandemic underwent a colonoscopy. This practice appears to demonstrate substitution of stool-based testing for colonoscopy, Dr. Kenning noted. 

“Our study looked at attitudes toward colorectal cancer screening and how they were impacted during the pandemic, both related to concerns about the pandemic as well as to economic impacts,” senior author Emily B. Rivet, MD, MBA, FACS, said. “What we learned is that fecal occult blood testing was seen by patients as a viable alternative to conventional screening colonoscopy.” Dr. Rivet is an associate professor in the department of surgery, division of colorectal surgery, and an affiliated professor of internal medicine at VCU School of Medicine.

Patient concerns about copays

Notably, a greater percentage of respondents indicated being unemployed during the pandemic than the year prior: 7.4 vs. 2.6 percent. In addition, 41 percent of respondents expressed concerns about copays; 57.6 percent of those respondents said this was a factor for delaying screening. Dr. Kenning noted that she is working with Carrie Miller, PhD, MPH, the principal investigator of the larger survey, on a follow-up assessment of the pandemic-related impact on attitudes toward colorectal cancer screening. Dr. Miller is post-doctoral fellow with VCU’s department of health behavior and policy.

Other screening delays

Copays were not the only deterrent to getting scheduled colorectal screenings during the pandemic, the study found. Almost two-thirds of respondents—65.9 percent—confirmed concerns about COVID-19 exposure when scheduling colonoscopies; and 59 percent of them said this caused them to delay their screening. 

To address those concerns, respondents endorsed that being offered protective equipment (gloves and masks), visits to smaller offices, or weekend screening appointments would increase their likelihood of following through with the colonoscopy; respectively, 30.7 percent for each of the two former factors and 19.7 percent for weekend screening. However, 48.1 percent of respondents said they were willing to do an at-home FOBT as an alternative to colonoscopy, among whom 93 percent indicated they would be willing to undergo a follow-up colonoscopy if the FOBT was positive. 

Lessons learned from the pandemic

“Even pre-pandemic, the rates for colorectal screening in the United States were very far from 100 percent, so I think the lessons that we are learning from this pandemic and working with patients to find alternatives to what the conventional approaches have been in the past are going to be applicable to care moving forward. This approach applies even if we do eventually enter a post-pandemic state, which is, of course, what we are all hoping for,” Dr. Rivet said.

Dr. Kenning said the survey results show that there is still much work to do to improve colorectal screening. “Colorectal cancer screening has decreased significantly during the pandemic and still hasn’t improved to the rate that it was before,” Dr. Kenning said. “Making sure that we’re offering all of the options to patients is very important so that, whatever form of screening they’re comfortable with, they’ll start down that pathway in order to get the screening they need.”

The survey results also underscore the need to tailor colorectal cancer screening to each patient’s concerns and needs, Dr. Rivet said. “It’s important to have a conversation about all of these different alternatives and what the different positives and negatives are,” she said.

Study coauthors are Dr. Miller and Bernard F. Fuemmeler, PhD, MPH, also with the department of health behavior and policy at VCU; and Jaime L. Bohl, MD, FACS, with the department of surgery at VCU.

“FACS” designates that a surgeon is a Fellow of the American College of Surgeons.

The study authors have no relevant financial relationships to disclose. The survey was funded as part of a larger survey led by Dr. Miller on colorectal cancer and funded, in part, through support of an institutional training grant awarded by the National Cancer Institute (T32CA093423).

Citation: Kenning K. et al, COVID-19 Pandemic Impact on Colorectal Cancer Screening. Scientific Forum Presentation. American College of Surgeons Clinical Congress 2021.

______________ 

  1. Shaukat A, Kahi C, Burke CA, Rabeneck L, Sauer BG, Rex DK. ACG Clinical Guidelines: Colorectal Cancer Screening 2021. Amerc J Gastroenterol. 2021;116(3):458-479. doi: 10.14309/ajg.0000000000001122
  2. American Cancer Society. Colorectal Cancer Facts & Figures 2020-2022. Atlanta: American Cancer Society; 2020:22. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2020-2022.pdf 

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.


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