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Oxygen for all, during COVID-19 (coronavirus) and beyond

Oxygen for all, during COVID-19 (coronavirus) and beyond

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© Save the Children
Laila*, holds an oxygen mask to the face of her son, Sohai*, two, at Save the Children's primary healthcare centre (PHCC) in Cox's Bazaar, Bangladesh.

In his first interview after leaving the hospital treating him for COVID-19 (coronavirus), UK Prime Minister Boris Johnson recounted the desperate moments when his life hung in the balance. I was going through liters and liters of oxygen,” he recalled, adding about his recovery: I was a very lucky man.”

It was a comment that highlighted the critical importance of medical oxygen. Without it, the Prime Minister’s brush with COVID-19 might have had a tragically different ending.

Oxygen is all around us in the air we breathe. Perhaps that’s why we sometimes forget it is also a life-saving essential medicine.  Medical oxygen is a key treatment for severe pneumonia, malaria, sepsis and meningitis. Yet it is seldom available to the children and mothers whose lives are at risk. Where it is available, it is often unaffordable to the poorest and most disadvantaged.

Media coverage of the COVID-19 pandemic has created a moral panic over shortages of ventilators available in Africa. Those shortages are real. But increasing the stock of ventilators without fixing oxygen systems is a prescription for avoidable fatalities.   Medical oxygen is the primary treatment for the majority of patients who are suffering severe COVID-19 symptoms. That’s why the WHO recommends that all countries focus on the development of medical oxygen systems and provision of pulse oximeters to measure blood oxygen levels. 

Following that advice will help build a more equitable health system, one that’s equipped to respond not only to the viral pneumonia threatening adults with COVID-19, but also to the viral and bacterial pneumonia that is now the biggest infectious killer of children. This is a disease that claims over 800,000 young lives every year. Never mind ventilators: many of these children are left fighting for breath without even the most basic oxygen therapy. Yet as the Every Breath Counts Coalition points out, the COVID-19 response so far has largely overlooked the importance of medical oxygen supply and diagnostic tools for identifying hypoxemia.

Last year I visited rural health clinics and hospitals across northwest Nigeria, an area marked by endemic malnutrition, childhood pneumonia and malaria. Medical oxygen was almost entirely absent from health facilities. Doctors in one referral hospital told me they were regularly forced to ration access to oxygen between children in desperate need, based on judgments about their survival prospects. And this is a microcosm of experience across the poorest countries. Modeling suggests that improving oxygen access could avert 148,000 deaths of children under 5 each year in the 15 countries that have the highest pneumonia burden. So why are we losing so many lives that could be saved?

Medical oxygen supplies starkly illustrate health inequalities between and within countries.  The UK hospital that treated Boris Johnson for COVID-19 is supplied with industrial quantities of high-grade liquid oxygen, with storage facilities linked to patients through miles of piping and complex valves. Bulk purchases reduce costs. Meanwhile, public financing of the National Health Service means patients receive oxygen free of charge.

Contrast this with the situation in poorer countries. Most hospitals are supplied by cylinders filled at industrial gas plants and transported by truck. Patients are typically charged directly for the cost of refilling. Treating a child with severe pneumonia over 3-4 days can require anything from 4,000 to 8,000 cubic liters of oxygen at a cost of $40-60. For the poorest households, that prospective bill represents a huge barrier to treatment – if the child is able to get to a hospital with oxygen at all.

The challenge is to increase the supply of medical oxygen while reducing cost so that it’s accessible where it’s needed most, free at the point of use. It will take increased investment and commitment to put oxygen at the center of strategies for universal health coverage. 

Market management can help. Pooling demand can help generate economies of scale and drive down prices. In Kenya, a social enterprise, Hewa Tele, has established three oxygen production plants, each serving a cluster of hospitals. The plants have cut hospital purchase costs by around one-third.

Similar models are being developed in other countries. In Ethiopia, a coalition of companies, philanthropic foundations, UN agencies, and not-for-profit actors – the United4Oxygen Alliance – is working with the government to implement Africa's first national plan for universal access to medical oxygen.  

The opportunities are vast, but innovation is needed to reach the most vulnerable. One initiative – FREO2 – has developed ingenious technologies to concentrate and store oxygen in health centers that lack electricity. Investing in the maintenance of concentrators and adapting them for use across 4-5 children through simple plastic tubing is another low-tech solution that can save lives.

Medical oxygen has been recognized as an essential medicine for well over a century. Yet it remains beyond the reach of desperately vulnerable children.  It has not figured in the priorities of the global development organizations. There are no major global campaigns or disease days to galvanize action on medical oxygen, despite the suffering caused by its absence of supply. The fact that the poorest and most disadvantaged children bear the brunt of the medical oxygen deficit adds to the urgency for action.

COVID-19 is a public health crisis without parallel in recent history. But it is also an opportunity to turn the spotlight on medical oxygen as one of the defining health equity issues of our age.  Universal access to oxygen is not a vague aspiration. We lack neither the finance nor the technology. The need is self-evident. What has been missing is political leadership and international cooperation – and those are deficits we can fix.

Save the Children is a member of Every Breath Coalition, who alongside with partners organized the world’s first Global Forum on Childhood Pneumonia earlier this year.

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Zinc Outlook 2022: Analysts Expect Small Refined Deficit

Click here to read the previous zinc outlook. After an uncertain 2020, zinc rose steadily in 2021, hitting a 14 year high in the second half of the year.The power crisis and increasing demand for the base metal as strict COVID-19-related lockdown restrict

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Click here to read the previous zinc outlook.

After an uncertain 2020, zinc rose steadily in 2021, hitting a 14 year high in the second half of the year.

The power crisis and increasing demand for the base metal as strict COVID-19-related lockdown restrictions were lifted supported prices for zinc during the 12 month period.

As the new year begins, the Investing News Network (INN) caught up with analysts to find out what’s ahead for zinc supply, demand and prices. Read on to learn what they had to say.


Zinc outlook 2022: 2021 in review


Zinc prices kicked off 2021 above the US$2,800 per tonne mark after rallying for most of the second half of 2020. A recovery in the steel sector helped the base metal throughout the first half of 2021 as COVID-19 lockdown measures eased, supporting demand for zinc.

Commenting on the main trends seen in the market in 2021, Helen O’Cleary of CRU Group told INN zinc’s demand recovery was stronger than expected in the US and Europe, but lagged in Asia excluding China.

In October, zinc prices hit their highest level in 14 years, hovering around the US$3,800 mark on the back of the power crisis and costs associated with carbon emissions.

“Zinc’s price outperformed expectations in 2021 on the back of strong demand and smelter disruption, particularly in Q4, when European smelters started to cut back due to record high energy prices,” O’Cleary said.

One of the world’s top zinc smelters, Nyrstar (EBR:NYR), said back in October that it was planning to cut production at its European smelter operations. Mining giant Glencore (LSE:GLEN,OTC Pink:GLCNF) also said it was adjusting production to reduce exposure to peak power pricing periods during the day.

Speaking with INN, Carlos Sanchez of CPM Group said zinc has been in recovery since prices bottomed out in 2020, helped in part by vaccination efforts globally and also by supply disruptions around the world.

“The most recent issue is the concern about high energy input costs into smelters in Europe — that's been pushing prices higher recently,” he said. Even though prices could not sustain that level until the end of the year, zinc remained above US$3,500 on the last trading day of 2021.

Zinc outlook 2022: Supply and demand


As mentioned, demand for base metals took an upward turn in 2021 as the world economy recovered on the back of stimulus plans and as vaccination rollouts took place in many parts of the world.

Looking at what’s ahead for zinc demand in 2022, CRU is expecting Chinese demand growth to slow to 1.1 percent year-on-year as the effects of stimulus wane.

“In the world ex-China we expect demand to grow by 2.4 percent, with the ongoing auto sector recovery partially offsetting the construction sector slowdown in Europe and the US,” O’Cleary said.

CPM is also expecting zinc demand to remain healthy in 2022, both inside and outside of China, including demand from developing countries. “One thing that remains uncertain is what will happen with COVID,” Sanchez said.

Moving onto the supply side of the picture, the analyst expects that if everything remains status quo, disruptions are unlikely to happen.

“There are going to be some blips here and there, but there have been some labor issues in Peru; yes, there's been some energy problems in Europe and China, but that's a fact in zinc output and in demand to an extent,” Sanchez said. “But really the catalyst that we don't know, and how it can affect prices, is how COVID will impact industries.”

For her part, O’Cleary is expecting most disruptions to happen in the first quarter, with CRU currently having a disruption allowance of 55,000 tonnes for that period.

“But this may well tip over into Q2,” she said. CRU is expecting mine supply to grow by 5.1 percent year-on-year in 2022, and for the concentrates market to register a 190,000 tonne surplus.

Meanwhile, smelter output is forecast to grow by less than 1 percent year-on-year in 2022, according to the firm, which is currently forecasting a small refined zinc deficit in 2022.

“Should smelter disruption exceed our 55,000 tonne allowance the deficit could grow,” O’Cleary said. “But high prices and a tight Chinese market could lead to further releases of refined zinc from the State Reserve Bureau stockpile, which could push the market towards balance or even a small surplus.”

Similarly, CPM is expecting the market to shift into a deficit in 2022. “That's due to the strong demand, recovering economies of COVID and its financial economic effects,” Sanchez said.

Zinc outlook 2022: What’s ahead


Commenting on how zinc might perform next year, O’Cleary said prices are likely to remain high in Q1 due to the threat of further energy-related cutbacks in Europe during the winter heating season.

O’Cleary suggested investors keep an eye on high prices and inflation, as they could hamper zinc demand growth.

Similarly, CPM expects prices to stay above current levels and to average around US$3,400 for the year. “I wouldn't be surprised to see zinc top US$4,000,” Sanchez said. “But at the same time, I don't think it holds above there; you'd have to have really strong fundamentals for that to happen, stronger than what's happening now.”

The CPM director suggested zinc investors should keep an eye on COVID-19 developments and be quick movers, taking a position whether it's short or long.

Looking ahead, FocusEconomics analysts see prices for zinc cooling markedly next year before falling further in 2023, as output gradually improves and new mines come online.

“Moreover, fading logistical disruptions and easing energy prices will exert additional downward pressure, although solid demand for steel will continue to support prices,” they said in their December report, adding that pandemic-related uncertainty is clouding the zinc outlook.

Panelists recently polled by the firm see prices averaging US$2,827 in Q4 2022, and US$2,651 in Q4 2023.

Don’t forget to follow us @INN_Resource for real-time news updates.

Securities Disclosure: I, Priscila Barrera, hold no direct investment interest in any company mentioned in this article.

Editorial Disclosure: The Investing News Network does not guarantee the accuracy or thoroughness of the information reported in the interviews it conducts. The opinions expressed in these interviews do not reflect the opinions of the Investing News Network and do not constitute investment advice. All readers are encouraged to perform their own due diligence.

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Dr. Peter McCullough: Official COVID “Narrative Has Crumbled”

Dr. Peter McCullough: Official COVID "Narrative Has Crumbled"

Authored by Art Moore via WND.com,

Dr. Peter McCullough – a renowned cardiologist and highly published medical scientist whose confrontation of the government’s COVID-19 policies.

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Dr. Peter McCullough: Official COVID "Narrative Has Crumbled"

Authored by Art Moore via WND.com,

Dr. Peter McCullough – a renowned cardiologist and highly published medical scientist whose confrontation of the government's COVID-19 policies has drawn more than 40 million views on Joe Rogan's podcast – told WND in a video interview Thursday night the official pandemic narrative that has been fiercely guarded by establishment media and social-media censors is "completely crumbling."

That narrative, he said, included "false statements regarding asymptomatic spread, reliance on lockdown and masks – which obviously didn't work – the suppression of early treatment, the mass promotion of vaccines that failed."

"And now here we are, almost in complete free fall," McCullough said, referring to the record number of COVID-19 cases as officials acknowledge the vaccines don't prevent infection or transmission.

McCullough noted that in California, with the more contagious but much milder omicron variant now dominant, health care workers who tested positive for COVID-19 and had symptoms were told to go back to work.

"With that, I think that's it. I think that's the end. The narrative has crumbled. People don't want these vaccines," McCullough said.

"The vaccines should be pulled off the market. They clearly are not solving the problem."

The focus, he said, should be on "treating high-risk patients who develop symptoms" with some of the early treatments that he and other physicians around the world have found to be effective, including ivermectin and a new drug granted emergency use authorization by the FDA, Paxlovid.

McCullough cited a study from Denmark and data from the U.K.'s health agency showing that the vaccines have zero effectiveness against omicron.

Completing this poll entitles you to WND news updates free of charge. You may opt out at anytime. You also agree to our Privacy Policy and Terms of Use.

"That's not misinformation," he said. "I'm just quoting the data. All of this can be looked up. Fact-checkers can look at it. I know I'll never have any problems with allegations of misinformation, because I just quote the data."

President Biden clearly had McCullough in mind when on Thursday he urged social media companies and media outlets to "please deal with the misinformation and disinformation that's on your shows. It has to stop."

McCullough pointed out his work has been relied upon by courts across the nation, including the U.S. Supreme Court, and he has testified to the U.S. Senate and will be back there later this month.

"I think America knows who is giving them the straight story."

In the half-hour video interview with WND (embedded below), McCullough also discussed:

  • The punishment of physicians who counter the official COVID narrative and use clinically indicated, FDA-approved drugs off-label such as ivermectin to treat COVID-19 patients, including a colleague in Maine whose was ordered to undergo a psychological examination after her license was suspended;

  • His participation in a rally in Washington, D.C., on Jan. 23 protesting vaccine mandates;

  • The Supreme Court's rulings Thursday on vaccine mandates;

  • The possibility that omicron could spell the end of the pandemic, serving as a "universal booster";

  • Data showing that vaccination has backfired, making the pandemic worse in nations with high vaccine intake;

  • The lethality of the mRNA vaccines;

  • His view on Biden's mass testing program;

  • His take on new FDA-approved treatments and his simple, inexpensive, over-the-counter protocol for treating omicron;

  • The unwillingness of so many doctors to "come off the sidelines" and treat patients for COVID-19;

  • The "crisis of competence" among top government health officials;

  • Where to find resources and support for physicians and patients, and for employees confronting mandates.

"I think Americans are going to understand that their individual choice is really what's going to matter in the end," he McCullough told WND in conclusion. "If Americans decide that they're not going to take any boosters or any more vaccines, it doesn't matter how many mandates or how many court decisions that happen. The vaccine program is going to crumble. I think it's just a matter of saying no."

He emphasized that the vaccines are still "research."

"No one can be forced into it," he said of vaccination. "And they're not turning out to be safe or effective. So, if  everybody just stands firm and declines the vaccines, I think that will be the quickest way for us to get out of this."

See the WND interview with Dr. Peter McCullough:

McCullough, in a video interview with WND in December, called for a "pivot" from the current policies to early treatment and "compassionate care" for those who have COVID or have suffered vaccine injuries, which have included myocarditis, neurological issues and blood clotting.

"Now is the time for doctors to step up. Now is not a time for rhetoric or harsh statements regarding scientific discourse," he said.

Many of McCullough's 600 peer-reviewed publications have appeared in top-tier journals such as the New England Journal of Medicine, Journal of the American Medical Association and The Lancet. He testified to the U.S. Senate in November 2020 against what he described as the federal government's politicization of health care during the pandemic, curbing or blocking the availability of cheap, effective treatments. In a speech in September, he told of having been stripped of the editorship of a Swiss-based journal after having lost his position with a major health system, "with no explanation and no due process." Baylor University Medical Center fired him in February. And Texas A&M College of Medicine, Texas Christian University and University of North Texas Health Science Center School of Medicine have cut ties with McCullough, accusing him of spreading misinformation.

"I've been stripped of every title that I've ever had in that institution. I've received a threat letter from the American College of Physicians, [and] a threat letter from the American Board," he said in September.

All because of his "lawful" participation "in a topic of public importance."

He said there are "powerful forces at work, far more powerful than we can possibly think of, that are influencing anybody who is in a position of authority."

McCullough is the chief medical adviser for the Truth for Health Foundation, a physician-founded charity that says it is "dedicated to following the Oath of Hippocrates to serve individual patients to the best of our ability and judgement and to uphold the highest standards of medical ethics."

*  *  *

Last year, America's doctors, nurses and paramedics were celebrated as frontline heroes battling a fearsome new pandemic. Today, under Joe Biden, tens of thousands of these same heroes are denounced as rebels, conspiracy theorists, extremists and potential terrorists. Along with massive numbers of police, firemen, Border Patrol agents, Navy SEALs, pilots, air-traffic controllers, and countless other truly essential Americans, they're all considered so dangerous as to merit termination, their professional and personal lives turned upside down due to their decision not to be injected with the experimental COVID vaccines. Biden’s tyrannical mandate threatens to cripple American society – from law enforcement to airlines to commercial supply chains to hospitals. It's already happening. But the good news is that huge numbers of "yesterday’s heroes" are now fighting back – bravely and boldly. The whole epic showdown is laid out as never before in the sensational October issue of WND's monthly Whistleblower magazine, titled "THE GREAT AMERICAN REBELLION: 'We will not comply!' COVID-19 power grab ignites bold new era of national defiance."

SUPPORT TRUTHFUL JOURNALISM. MAKE A DONATION TO THE NONPROFIT WND NEWS CENTER. THANK YOU!

Tyler Durden Mon, 01/17/2022 - 23:50

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Zinc Outlook 2022: Small Refined Zinc Deficit Ahead

Click here to read the previous zinc outlook. Following an uncertain 2020, zinc prices steadily rose throughout 2021 to hit a 14 year high in the second half of the year.The power crisis and an increasing demand for the base metal as the strict lockdown..

Published

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Click here to read the previous zinc outlook.

Following an uncertain 2020, zinc prices steadily rose throughout 2021 to hit a 14 year high in the second half of the year.

The power crisis and an increasing demand for the base metal as the strict lockdown restrictions were lifted supported prices during the 12 month period.

As the new year begins, the Investing News Network (INN) caught up with analysts to find out what’s ahead for zinc supply, demand and prices.


Zinc outlook 2022: 2021 in review


Prices kicked off the year above the US$2,800 per tonne mark after rallying for most of the second half of 2020. The recovery in the steel sector helped the base metal throughout the first half of 2021 as COVID-19 lockdown measures eased, supporting demand for zinc.

Commenting on the main trends seen in the market in 2021, Helen O’Cleary of CRU Group told INN zinc’s demand recovery was stronger than expected in the US and Europe but lagged in Asia excluding China.

In October, zinc prices hit their highest level in 14 years, hovering around the US$3,800 mark on the back of the power crisis and cost associated with carbon emissions.

“Zinc’s price outperformed expectations in 2021 on the back of strong demand and smelter disruption, particularly in Q4 when European smelters started to cut back due to record high energy prices,” O’Cleary said.

One of the world’s top zinc smelters, Nyrstar (EBR:NYR), said in October it was planning to cut production at its European smelter operations. Mining giant Glencore (LSE:GLEN) also said it was adjusting production to reduce exposure to peak power pricing periods during the day.

Speaking with INN about zinc’s performance, Carlos Sanchez of CPM Group said zinc has been in recovery since prices bottomed out in 2020, helped in part by vaccination globally and also by supply disruptions around the world.

“The most recent issue is the concern about high energy input costs into smelters in Europe — that's been pushing prices higher recently,” he said.

Even though prices could not sustain that level until the end of the year, prices remained above US$3,500 on the last trading day of 2021.

Zinc outlook 2022: Supply and demand


As mentioned, demand for base metals saw an upward turn in 2021 as the world economy recovered on the back of stimulus plans and as vaccination rollouts took place in many parts of the world.

Looking at what’s ahead for demand in 2022, CRU is expecting Chinese demand growth to slow to 1.1 percent year-on-year as the effects of stimulus wane.

“In the world ex. China we expect demand to grow by 2.4 percent, with the ongoing auto sector recovery partially offsetting the construction sector slowdown in Europe and the US,” O’Cleary said.

CPM is also expecting demand to remain healthy in 2022, both in China and outside of China, including demand from developing countries.

“One thing that remains uncertain is what will happen with COVID,” Sanchez said.

Moving onto the supply side of the picture, the analyst expects that if everything remains status quo, disruptions are unlikely to happen.

“There are going to be some blips here and there, but there have been some labor issues in Peru, yes, there's been some energy problems in Europe and China, but that's a fact in zinc output and in demand to an extent,” Sanchez said. “But really the catalysts that we don't know, and how it can affect prices is how COVID will impact industries.”

For her part, O’Cleary is expecting most disruptions in Q1, with CRU currently having a disruption allowance of 55,000 tonnes for that period.

“But this may well tip over into Q2,” she said. CRU is expecting mine supply to grow by 5.10 percent year-on-year in 2022 and for the concentrates market to register a 190,000 tonnes surplus.

Meanwhile, smelter output is forecast to grow by less than 1 percent year-on-year in 2022, according to the firm, which is currently forecasting a small refined zinc deficit in 2022.

“Should smelter disruption exceed our 55,000 t allowance the deficit could grow,” O’Cleary said. “But high prices and a tight Chinese market could lead to further releases of refined zinc from the State Reserves Bureau stockpile, which could push the market towards balance or even a small surplus.”

Similarly, CPM Group is also expecting the market to shift into a deficit in 2022.

“That's due to the strong demand, recovering economies of COVID and its financial economic effects,” Sanchez said.

Zinc outlook 2022: What’s ahead


Commenting on how prices might perform next year, O’Cleary said prices are likely to remain high in Q1 due to the threat of further energy-related cutbacks in Europe during the winter heating season.

O’Cleary suggested investors to keep an eye on high prices and inflation, as these factors could hamper zinc demand growth.

Similarly, CPM Group is expecting prices to remain above current levels and to average around US$3,400 for the year.

“I wouldn't be surprised to see zinc top US$4,000,” Sanchez said. “But at the same time, I don't think it holds above there; you'd have to have really strong fundamentals for that to happen, stronger than what's happening now.”

The CPM director suggested zinc investors should keep an eye on COVID developments and be quick movers, taking a position whether it's short or long.

Looking ahead, for FocusEconomics analysts, prices for zinc are seen cooling markedly next year before falling further in 2023, as output gradually improves and new mines come online.

“Moreover, fading logistical disruptions and easing energy prices will exert additional downward pressure, although solid demand for steel will continue to support prices,” they said in their December report, adding that pandemic-related uncertainty clouds the outlook.

Panelists recently polled by the firm see prices averaging US$2,827 per metric tonne in Q4 2022 and US$2,651 per metric tonne in Q4 2023.

Don’t forget to follow us @INN_Resource for real-time news updates.

Securities Disclosure: I, Priscila Barrera, hold no direct investment interest in any company mentioned in this article.

Editorial Disclosure: The Investing News Network does not guarantee the accuracy or thoroughness of the information reported in the interviews it conducts. The opinions expressed in these interviews do not reflect the opinions of the Investing News Network and do not constitute investment advice. All readers are encouraged to perform their own due diligence.

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