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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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3 years ago

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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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Tesla rival Stellantis unveils its lowest price electric vehicles

The Big Three automaker unveils details on its low-priced electric vehicles that will be delivered over the next two years.

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23 hours ago

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October 18, 2023

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Electric vehicle manufacturers have realized that the prices of their cars are making it more difficult for many of them to compete against makers of lower-priced internal combustion engine vehicles.

Tesla saw its third quarter deliveries fall below market estimates, prompting Elon Musk's company in early October to lower the list price of the Model 3 from $40,240 to $38,990 and its industry leading seller Model Y has recently fallen from $47,740 to $43,990.

Related: Tesla Japanese rivals debut concept vehicles in latest challenge

Tesla top rival Ford already cut the price of its all-electric Mustang Mach-E by up to $4,000 in May and its F-150 Lightning by about $10,000 in July.

Stellantis revealing entry-level electric cars

Stellantis  (STLA) - Get Free Report has been busy revealing low-priced entry-level electric vehicles that it plans to begin selling in 2024 to compete with French automaker Renault in Europe as well as Chinese EV companies. The company in August said it would unveil a second new entry-level Fiat-branded electric vehicle in July 2024 that will be priced less than €25,000 or about $27,390. The company, however, didn't say when the vehicle might be sold in the U.S.

The company said in June that it will deliver the new Citroën e-C3 electric car to Europe in early 2024. The Citroën e-C3 was expected to have a range of 186 miles on a charge and would be among lowest priced EVs on the market. Stellantis had already said it would bring Fiat's best-selling EV, the Fiat 500e, to the U.S. market in 2024 to compete against Tesla and the growing U.S. EV market.

Citroën e-C3 all-electric subcompact hatchback.

Stellantis

Big Three automaker unveils its low-priced electric vehicles

Stellantis on Oct. 17 revealed its updated all-new, all-electric Citroën e-C3, which is its first European-designed, European-built B-segment, or subcompact, EV hatchback. The new vehicle is now estimated to have a 199-mile range, charging 20% to 80% of capacity in as little as 26 minutes. The EV accelerates 0 to 62 mph in 11 seconds with a provisional top speed of 84 mph for everyday driving and traffic in urban and suburban areas.

The company estimates that the vehicle will be priced below £23,000 ($27,900) in the UK. No word yet if the Citroën e-C3 will roll out in the U.S.

In 2025, Stellantis will offer a Citroën e-C3 with a 200 km- or 124-mile range and priced at €19,990 or $21,068, the company said. That price would be lower than any new EV sold in the U.S. today. General Motors  (GM) - Get Free Report Chevy Bolt's lowest manufacturer suggest retail price is $26,500, while the 2024 Nissan  (NSANY) - Get Free Report Leaf has a starting price of $28,140.

The new Citroën e-C3 will be available in three versions You, Plus and Max. The You version's standard equipment includes LED headlights, Citroën Advanced Comfort Suspension, Active Safety Brake, the new Citroën Head Up Display, ‘My Citroen Play with Smartphone Station’ for infotainment, electric door mirrors, auto lighting, rear parking radar, rear spoiler, cruise control, manual air conditioning, and six airbags.

Plus vehicles include 17-inch alloy wheels, Citroën’s two-tone paint with contrasting roof, decorative roof rails, front and rear skid plates, the 10.25-inch color touchscreen with smartphone mirroring, Citroën Advanced Comfort Seats, auto wipers, power-folding and heated door mirrors, leather-effect steering wheel, 60/40 folding second-row seat, and driver seat adjustment.

The premium Max version additionally has LED rear lights, rear privacy glass, enhanced seat textiles, automatic air conditioning, 3D navigation, wireless charging, rear camera, electrochrome rear-view mirror, and rear power windows.

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Putin, Xi In Beijing Pitch For ‘Alternative World Order’ As Biden Departs A Burning Middle East

Putin, Xi In Beijing Pitch For ‘Alternative World Order’ As Biden Departs A Burning Middle East

As a Rabobank note has highlighted, the main…

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24 hours ago

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October 18, 2023

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Putin, Xi In Beijing Pitch For 'Alternative World Order' As Biden Departs A Burning Middle East

As a Rabobank note has highlighted, the main theme on display during Xi Jinping and Vladimir Putin's Wednesday talks in Beijing was one of "common threats" bringing the two "dear friends" closer, according to a press readout. Observed Rabobank earlier in the day, "Meanwhile, as the Middle East rages and the West recoils, Xi Jinping welcomes Russia’s Putin and a host of Global South leaders, ex-India, to his Beijing Belt and Road Forum to talk about what an alternative world order might look like. The ‘global’ Western press mostly failed to even cover it."

Putin said at a media briefing following the meeting with his Chinese counterpart, "We discussed in detail the situation in the Middle East." He added: "I informed Chairman (Xi) about the situation that is developing on the Ukrainian track, also quite in detail." The Russian leader then emphasized: 

"All these external factors are common threats, and they strengthen Russian-Chinese interaction."

AFP/Getty Images

CNN subsequently called it a "pitch for a new world order" at a moment crisis has gripped the Middle East.

Yet, almost simultaneously, Bloomberg reported that Biden is overseeing a fast unfolding disaster in the Middle East:

President Joe Biden’s 7.5-hour trip to Tel Aviv signaled full US backing for Israel but fell short on another key goal: winning over Arab leaders.

Amid growing signs the conflict may be spinning out of control, Biden made plain that the US will protect its ally, sending a clear message to rivals in the region like Iran to stay out of the fight. With one US aircraft carrier in the area and another on the way, Biden promised a new package of “unprecedented support.”

The Bloomberg headline aptly reads, "Biden’s Whirlwind Israel Trip Fails to Calm Fears of Wider Middle East Conflict." At this time, Lebanon, Jordan, and Egypt are on edge - with Western and Saudi embassies reducing staff and issuing travel advisories. 

Meanwhile, related to Xi's Belt and Road (the purpose of the gathering in Beijing), Putin praised the potential for it to usher in a "fairer, multi-polar world" as Moscow and Beijing grow closer based on "deep friendship": 

In his speech at the opening ceremony, Putin hailed Xi’s flagship foreign policy Belt and Road Initiative as “aiming to form a fairer, multi-polar world,” while touting his country’s deep alignment with China.

Russia and China share an “aspiration for equal and mutually beneficial cooperation,” which includes “respecting civilization diversity and the right of every state for their own development model” – he added, in an apparent push back against calls for authoritarian leaders to promote human rights and political freedoms at home.

This is at a moment Putin is "wanted" by the International Criminal Court (ICC) and shunned and sanctioned by the West, while at the same time Global South countries are expressing growing anger at Israel's unrelenting bombing of the Gaza Strip, as the Palestinian death toll soars into the thousands.

Directly related to this, a Thursday UN Security Council resolution brought by Brazil and seeking a ceasefire in Gaza was shot down, given the US was the only "no" vote.

Also missed by the mainstream media was the following pro-China sentiment expressed by a top Palestinian official over a week ago:

China will soon lead the world, and it supports the “Palestinian position, whatever it may be,” according to Fatah’s Central Committee member Abbas Zaki.

In a public address that aired on Palestine TV on Sept. 29, Abbas Zaki called on the United States to “reconsider its stance” with regard to Israel or risk becoming irrelevant. The Israelis, he said, were “sons of bitches,” “murderers” and agents of instability, while the Palestinians are “messengers of peace.”

“I know that there is serious change in Europe and even in the United States,” said Zaki.

But, he added, “do not forget the emerging camp, which is on your side—the Chinese camp. China is going to lead the world, and it proclaims: ‘There can be no stability and progress without the liberation of Palestine, with East Jerusalem as its capital.'”

Putin too, has expressed more sympathies with the Palestinian side, days ago warning Israel of the "catastrophic" death toll its attacks on Gaza will result in. He has also held calls with Arab leaders, seeking to mediate peace and a possible two-state solution.

Tyler Durden Wed, 10/18/2023 - 19:40

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Survey delivers bleak news for remote workers

Remote work is increasingly under fire.

Published

24 hours ago

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October 18, 2023

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Covid-era alternative work solutions have come under fire as businesses increasingly deploy a carrot-and-stick approach to convincing employees to return to offices.

Technology titan Meta Platforms  (META) - Get Free Report, which owns Facebook, threatened poor performance reviews if workers failed to attend offices three times weekly. JP Morgan Chase  (JPM) - Get Free Report CEO Jamie Dimon recently suggested workers uncomfortable with returning to offices should look for employment elsewhere.

Workers don’t like the idea of giving up the flexibility afforded by remote work, but a recent survey shows that these workers may face an uphill battle if they hope to continue working from home.

A woman working on a laptop in a cafe, on Sept. 14, in Edmonton, Alberta, Canada. (Photo by Artur Widak/NurPhoto via Getty Images)

NurPhoto/Getty Images

Remote work loses its luster

Companies big and small rushed to offer flexible alternative work schedules like remote and hybrid work during Covid. Remote work quickly became a key benefit used to fill jobs created by those who took early retirement and newly created positions in response to demand growth fueled by easy-money policies.

Related: Facebook issues more tough-luck news to workers

Remote work initially appeared to be a win/win for companies and employees. It allowed businesses to source job candidates nationally rather than locally and sometimes save money by closing expensive offices. Meanwhile, workers could live in the suburbs rather than crowded cities and save money by eliminating expensive childcare costs.

Unfortunately, the love affair with remote work has soured over the past year.

Businesses, from technology to financial services, have rolled back remote work, citing a need for increased collaboration and greater productivity. Many companies have likely sought to reduce the number of remote workers as part of layoff plans or to fill otherwise vacant office spaces.

Businesses are winning the return-to-office battle

Worker surveys suggest employees prefer remote work. However, they’re losing the battle with employers demanding more office face time.

The Census Bureau’s latest Household Pulse Survey shows remote work has reached a new post-pandemic low, with declines seen in all 50 states, reports Bloomberg.

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The survey showed that fewer than 26% of households include someone who works remotely at least one day weekly. That’s a significant drop-off from the high of 37% in 2021. A total of 31 states had remote work rates above 33% at the peak. Now, only seven states exceed that hurdle.

States with the highest percentages of remote workers are typically Democratic states, mainly on the east and west coasts. Middle America and the South boast some of the lowest rates of remote work.

There’s also a more significant push for a return to office (RTO) in major metro markets where office building valuations are tumbling because of empty offices. During its recent quarterly conference call, Goldman Sachs  (GS) - Get Free Report told investors that it reduced valuations on office properties in its portfolio by 50%.

The impact of lower valuations on financial companies could contribute to the stricter return to office demands. Big banks like JP Morgan have been among the most vocal in demanding RTO, and they’re also heavily exposed to commercial real estate.

For instance, in addition to loans held on commercial properties, JP Morgan is building a new multibillion-dollar headquarters in New York City.

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