
<p><strong>Young African football stars are embracing the opportunity presented by Major League Soccer in North America as a stepping stone to the best clubs in Europe. FORBES AFRICA was in St Louis in Missouri in the United States for these exclusive interviews, and the numbers are big.</strong></p>



<p>The recent arrival of Lionel Messi has distorted the image somewhat but the reality of Major League Soccer (MLS) in North America is it’s a league of rapidly growing potential, with increasingly promising talent and a stepping stone to the top leagues of Europe.</p>



<p>Football is finding increasing traction in a market where it used to be considered a minor sport and the MLS is changing its image from a league that was seen as the parking lot for fading superstars coming to the end of their careers and looking for a final pay day, to one where the dreams of young players can be realized.</p>



<p>As a result, many young Africans are embracing the opportunity.</p>



<p>“To be honest, I had doubts in my mind because I thought the style of football was not anything like we do back home,” Njabulo Blom, the 23-year-old South African international midfielder who was sold by Kaizer Chiefs to St Louis City at the start of the season, tells FORBES AFRICA.</p>



<p>“I know that the MLS is not rated among the best leagues in the world but the standard of football is very good. It’s not what people think outside,” Blom adds from St Louis, the Midwestern city in the United States (US) where the local club have just joined the MLS and are making waves.</p>



<p>The numbers back him up. As per <em>Forbes</em>, the values of MLS franchises have jumped, since 2019, by 85% on average, with defending champions Los Angeles FC now valued at around $1 billion, breaking into the top 20 in the world. Another example is the value of Seattle Sounders has increased from $405 million to $850 million in just four years, with the team recently becoming the first American side to participate at the Club World Cup.</p>



<p>Revenues have reportedly grown continuously, by 16.6% on average per year between 2007 and 2018 but the spectacular progress is reflected in the price of what new franchises are paying to join the league.</p>



<p>The 10 original clubs invested $10 million each when the league kicked off in 1996 but Portland and Vancouver paid $35 million in 2011. For Charlotte FC, who arrived in 2022, the bill amounted to $325 million.</p>



<p>Average attendances are around 22,000 spectators, a figure similar to France. The record for a single game is the 82,110 that turned out in July at the Rose Bowl in Pasadena to watch the Los Angeles derby, dubbed ‘El Trafico’.</p>



<p>This year’s expansion side St Louis City are setting new standards with their sell-out stadium, a brand-new venue and a state-of-the-art training facility next door.</p>



<p>They are coached by Johannesburg- born Bradley Carnell, who played for South Africa at the 2002 World Cup and had a successful career in the German Bundesliga after starting out as a 16-year- old professional at the University of the Witwatersrand in South Africa.</p>



<p>He later earned his coaching stripes as an assistant at Free State Stars and Orlando Pirates.</p>



<p>“They said the expansion job is one of the most difficult in any American sport, so good luck. I was like, ‘Ok’,” Carnell says.</p>



<p>“Then I met the ownership group and spoke to them about vision, passion and what we stand for. There was just too many similarities and synergy there for I think either party. Looking in hindsight, everything just panned out,” he adds.</p>



<p>St Louis are the first new team in MLS history to win their opening five matches and are well-placed for the end of season playoffs.</p>



<p>But Carnell, in a long interview with FORBES AFRICA, insists on patience.</p>



<p>“Short-term, it’s about getting infrastructure, academy, style of play— check those boxes. Mid-term, be competitive — we’re checking that box as well. Now, long-term, can we be really successful? The goal is to be compared, one day, to those great teams in the league already.”</p>



<p>In his playing days, Carnell had a chance to move overseas after being spotted as a teenager when he was competing for South Africa at the under-20 level at a tournament in France.</p>



<p>He thinks MLS offers the same chance to African players, especially those in South Africa’s Premier Soccer League, which MLS clubs are now showing much more interest in. “We just have to lead by example,” he says of the growing South African numbers in the league.</p>



<p>“If we can now, you know, just be key ambassadors for our product back home, and to put other guys on the map because now there is slowly more chatter; there’s a couple of players that are on the radar.”</p>



<p>Last year Minnesota United bought Bongokuhle Hlongwane from Maritzburg United and in recent months the teenager Olwethu Makhanya has moved to Philadelphia Union, while the exciting Mamelodi Sundowns striker Cassius Mailula is now at Toronto FC. </p>



<p>The attraction of these players is their age. MLS rules allow clubs to take on more foreign players, as long as they are aged under-23, and it is here where Africans are in demand. Other top signings in recent months include Richard Odada (Kenya) and Prince Owusu, a German of</p>



<p>Ghanaian descent, and all can expect to be in contention to move onto a club in Europe in a few years, if they perform.</p>



<p>All can be assured they are on a stage that offers a chance to move on to bigger and better vistas in Europe.</p>



<p>According to the league, in 2022, MLS paid $175 million in transfer/acquisition fees, and for the fourth consecutive year it set a new high for fees paid, double the amount of five years ago. Revenue generated for outgoing players in 2022 was around $100 million. This does not include sell- on fees for the likes of Leeds United’s Brenden Aaronson or Crystal Palace’s Chris Richards.</p>



<p>The figures for 2023 will be higher, especially the sales of players to clubs in Europe.</p>



<p>Blom’s advice to compatriots offered the chance to play in the MLS is: “Come play, because it’s really a great stepping stone to grow. It’s like an introduction to a high level of football.”</p>



<p>Mailula, for one, heeded the advice even though he had become a regular with Mamelodi Sundowns and could have a comfortable time at home, where he had become an almost overnight star after just one season with the Pretoria club. “It was not an easy decision to take, but I feel like I need to get out of my comfort zone, to explore, to get closer to Europe,” he explains. “This is the right decision for my career, for my family also.”</p>



<p>With each excellent performance, of which there have been many this season, the South African players shine a further spotlight on the domestic league and will have more scouts looking at Africa as a fertile ground for young talent.</p>



<p>Hlongwane hit the headlines with his rush of goals in the Leagues Cup for Minnesota, appearing alongside Messi when they were joint top scorers in the competition.</p>



<p>How many South African players in the past have had such a platform? Very few, and certainly none in the last two decades.</p>



<p>The US has a reputation as a land of opportunity, with rags-to-riches tales possible. Football is the new platform for that and with the South African players earning upwards of R500,000 ($26,150) a month at their young age, they are living that dream.</p>


saas

‘Come Play’: Where African Stars Are In Demand


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Greenpeace is facing a major new legal threat in the form of a $2.1 million lawsuit from oil giant Shell,&nbsp;<a href="https://www.reuters.com/sustainability/climate-energy/shell-sues-greenpeace-21-million-after-boarding-oil-vessel-2023-11-09/" target="_blank" rel="noreferrer noopener">multiple outlets</a>&nbsp;<a href="https://www.theguardian.com/business/2023/nov/09/shell-sues-greenpeace-over-fossil-fuel-protest-in-north-sea" target="_blank" rel="noreferrer noopener">reported</a>&nbsp;Thursday, after the environmental advocacy group’s protestors occupied a floating oil platform in January in what one spokesperson called an “unlawful and extremely dangerous” stunt.</p>



<p>Greenpeace activist Yeb Saño holds aloft a flag on a rib after attempting to board a Shell oil&nbsp;&#8230; [+]<small>GETTY IMAGES</small></p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>U.K.-based Shell filed a claim against Greenpeace UK and Greenpeace International in London&#8217;s High Court alleging the&nbsp;<a href="https://www.theguardian.com/environment/2023/jan/31/greenpeace-protesters-board-shell-platform-bound-for-shetland" target="_blank" rel="noreferrer noopener">occupation</a>&nbsp;of a floating oil production vessel by protesters earlier this year cost the company money in shipping delays and forced it to hire extra security,&nbsp;<a href="https://www.reuters.com/sustainability/climate-energy/shell-sues-greenpeace-21-million-after-boarding-oil-vessel-2023-11-09/" target="_blank" rel="noreferrer noopener">Reuters</a>&nbsp;reported.</p>



<p>Shell has asked the court to stop any future protests on the company’s infrastructure at sea or in port, according to the&nbsp;<a href="https://www.theguardian.com/business/2023/nov/09/shell-sues-greenpeace-over-fossil-fuel-protest-in-north-sea" target="_blank" rel="noreferrer noopener"><em>Guardian</em></a>, and threatened to file further claims on behalf of contractors that could be worth as much as $8.6 million.</p>



<p>Greenpeace has accused Shell of trying to silence any legitimate protests of its fossil fuel operations, but Shell has said the lawsuit is focused only on protests at sea and is designed partly to protect the safety of protesters.</p>



<p>A spokesperson for Shell said in an email to&nbsp;<em>Forbes</em>&nbsp;that the protest was &#8220;unlawful and extremely dangerous.&#8221;</p>



<p>In a&nbsp;<a href="https://www.greenpeace.org/international/press-release/63522/shell-hits-greenpeace-with-intimidation-lawsuit-threatening-8-6m-damages-claim-and-protest-ban-to-silence-climate-demands/" target="_blank" rel="noreferrer noopener">statement</a>&nbsp;posted to its website Thursday, Greenpeace called the lawsuit an attempt “to silence growing dissent over moves by Shell’s chief executive” and said Shell has offered to settle for $1.4 million if Greenpeace vows to never again stage a protest “at its infrastructure” at sea or in port.</p>



<p>Greenpeace said it would only comply with the request if Shell &#8220;agreed to stop wrecking the climate&#8221; and comply with a Dutch court order to reduce its emissions by 45% by 2030.</p>



<p>Greenpeace activists hold a billboard during a protest outside Shell headquarters amid the companies&nbsp;&#8230; [+]<small>CHRIS J RATCLIFFE FOR GREENPEACE VIA GETTY IMAGES</small></p>



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<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>“The right to protest is fundamental and we respect it absolutely. But it must be done safely and lawfully,” Shell’s statement reads. “Shell and its contractors are entitled to recover the significant costs of responding to Greenpeace’s dangerous actions.”</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Climate activists used ropes to hoist themselves onto a floating production storage and offloading vessel from inflatable boats they used to chase the Shell ship. The protestors boarded the vessel just north of the Canary Islands and rode it for 13 days,&nbsp;<a href="https://www.greenpeace.org/international/press-release/63522/shell-hits-greenpeace-with-intimidation-lawsuit-threatening-8-6m-damages-claim-and-protest-ban-to-silence-climate-demands/" target="_blank" rel="noreferrer noopener">according to Greenpeace</a>. No arrests were made. The vessel was bound for the not-yet-operational Penguins oil and gas field in the North Sea, and protestors were imploring the company to stop drilling for new oil and gas and &#8220;instead take responsibility for causing climate breakdown.” The Penguins platform is the first new northern North Sea project for Shell in 30 years and&nbsp;<a href="https://www.shell.com/about-us/major-projects/penguins.html" target="_blank" rel="noreferrer noopener">is expected</a>&nbsp;to yield 45,000 barrels of oil per day.</p>



<p>Greenpeace activists hang a banner on July 24, 2014 in front of a Shell gas station in Santiago,&nbsp;&#8230; [+]<small>AFP VIA GETTY IMAGES</small></p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>$39.9 billion. That&#8217;s how much money&nbsp;<a href="https://www.cnbc.com/2023/02/02/shell-earnings-oil-giant-reports-record-annual-profits.html#:~:text=Shell%20reported%20adjusted%20earnings%20of,2021%20profit%20of%20%2419.29%20billion." target="_blank" rel="noreferrer noopener">Shell reported in adjusted earnings&nbsp;</a>in 2022, more than double its 2021 profit of $19.29 billion.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>This isn’t the first time Shell and Greenpeace have butted heads. The two famously faced off back in 1995 when the oil company, known at the time as Royal Dutch Shell, proposed it would get rid of its decommissioned rig called the Brent Spar <a href="https://www.greenpeace.org/international/story/47744/brent-spar-the-sea-is-not-a-dustbin/" target="_blank" rel="noreferrer noopener">by sinking it</a> in the North Atlantic Ocean. Greenpeace activists occupied the tanker for three weeks and organized a boycott of service stations worldwide while claiming the vessel Shell was trying to sink had 5,500 tons of oil on board. The estimate was vastly higher than what Shell claimed and what later proved to be true—Greenpeace ultimately issued an apology. Shell withdrew its plan to sink the Brent Spar. Greenpeace later successfully protested Shell&#8217;s <a href="https://www.greenpeace.org/international/story/7022/you-did-it-shell-abandons-arctic-drilling/" target="_blank" rel="noreferrer noopener">2006 plan</a> to drill for oil in the Arctic. Two years ago, Greenpeace was involved in a <a href="https://www.reuters.com/business/energy/shell-wins-court-case-start-seismic-surveys-offshore-south-africa-2021-12-03/" target="_blank" rel="noreferrer noopener">failed attempt</a> to stop the company from looking for oil in humpback whale breeding grounds on South Africa&#8217;s coast.</p>


Shell Posts Quarterly Profits

Shell Sues Greenpeace For $2 Million After Protest On Moving Oil Platform — The Latest Clash Between The Two


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>The Food and Drug Administration gave&nbsp;<a href="https://www.fda.gov/vaccines-blood-biologics/coronavirus-covid-19-cber-regulated-biologics/novavax-covid-19-vaccine-adjuvanted#:~:text=Novavax%20COVID-19%20Vaccine%2C%20Adjuvanted%20is%20available%20under%20emergency%20use,years%20of%20age%20and%20older" target="_blank" rel="noreferrer noopener">emergency use authorization</a>&nbsp;on Tuesday to Novavax’s new Covid vaccine designed to target the coronavirus’ dominant XBB sublineage, which is fueling a spike in cases, hospitalizations and deaths across the country.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>At&nbsp;<a href="https://www.ama-assn.org/delivering-care/public-health/updated-covid-vaccine-who-should-get-it-and-when-it-will-be-available" target="_blank" rel="noreferrer noopener">$130</a>&nbsp;a dose, the vaccine was approved for those 12 years and older—for those already vaccinated with any vaccine, one dose can be given at least two months after a person’s last Covid shot, and two doses administered three months apart can be given to the unvaccinated.</p>



<p>Novavax’s approval follows the&nbsp;<a href="https://www.forbes.com/sites/willskipworth/2023/09/11/fda-approves-new-covid-vaccines-to-target-latest-strains/?sh=1be38e906e09">approval</a>&nbsp;of Moderna and Pfizer-BioNTech’s monovalent vaccines targeting new coronavirus variant, which were also given emergency use authorization last month by the FDA for those six months and older.</p>



<p>This comes after the agency&nbsp;<a href="https://www.fda.gov/media/169591/download?attachment" target="_blank" rel="noreferrer noopener">encouraged</a>&nbsp;Moderna, Pfizer and Novavax to create new monovalent vaccines that target the XBB lineage, which makes up the majority of the variants circulating in the U.S.</p>



<p>The Novavax vaccine&nbsp;<a href="https://ir.novavax.com/press-releases/US-CDC-and-Advisory-Committee-Recommend-Use-of-Authorized-and-Approved-2023-2024-Monovalent-XBB-COVID-19-Vaccines" target="_blank" rel="noreferrer noopener">received approval</a>&nbsp;from an advisory committee of the Centers for Disease Control and Prevention last month, though it still awaits approval from the agency’s director.</p>



<p>This is the first time since the shots were commercialized that they won’t be free, and both&nbsp;<a href="https://apnews.com/article/science-health-business-covid-medicare-1a5d65356ebc7b5bc76524ae99deb55e" target="_blank" rel="noreferrer noopener">Pfizer</a>&nbsp;and&nbsp;<a href="https://www.reuters.com/business/healthcare-pharmaceuticals/moderna-expects-price-its-covid-vaccine-about-130-us-2023-03-20/" target="_blank" rel="noreferrer noopener">Moderna</a>&nbsp;estimate their shots will cost between $110 and $130 a dose.</p>



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<p>By signing up, you accept and agree to our&nbsp;<a href="https://www.forbes.com/terms-and-conditions" target="_blank" rel="noreferrer noopener">Terms of Service</a>&nbsp;(including the class action waiver and arbitration provisions), and&nbsp;<a href="https://www.forbes.com/privacy" target="_blank" rel="noreferrer noopener">Privacy Statement</a>.</p>



<p>Though most insurance companies are expected to cover the cost of Covid boosters, the CDC’s&nbsp;<a href="https://www.hhs.gov/about/news/2023/07/13/cdc-launch-bridge-access-program-fall-2023-provide-free-covid-19-vaccines-treatments-uninsured-underinsured-adults.html" target="_blank" rel="noreferrer noopener">Bridge Program</a>&nbsp;is set to launch this fall, providing Covid vaccine coverage to the uninsured.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Covid-related deaths and hospitalizations have increased since the start of the summer and are expected to keep rising as fall and winter kick into gear. Deaths increased by 8% between September 17 and September 23, and hospitalizations stood at 19,079 during this period, according to the CDC’s most recent data. EG.5, or the “Eris” variant—part of the XBB lineage—is the dominant strain in the U.S., making up 29.4% of all cases between September 17 and September 30. As of June, the XBB omicron subvariants made up 95% of all Covid cases in the U.S., according to an FDA&nbsp;<a href="https://www.fda.gov/media/169591/download?attachment" target="_blank" rel="noreferrer noopener">report</a>. The existing bivalent boosters offer about 50% protection against XBB variants in most adults and about 33% protection in those 65 years and older, according to a January&nbsp;<a href="https://www.cdc.gov/mmwr/volumes/72/wr/mm7205e1.htm?s_cid=mm7205e1_w" target="_blank" rel="noreferrer noopener">study</a>&nbsp;conducted by the CDC. Moderna&nbsp;<a href="https://investors.modernatx.com/news/news-details/2023/Moderna-Clinical-Trial-Data-Confirm-Its-Updated-COVID-19-Vaccine-Generates-Robust-Immune-Response-in-Humans-Against-Widely-Circulating-Variants/default.aspx" target="_blank" rel="noreferrer noopener">said</a>&nbsp;its new booster may be effective at protecting against the Eris variant, Novavax&nbsp;<a href="https://www.cnbc.com/2023/08/22/covid-novavax-vaccine-eris-variant.html" target="_blank" rel="noreferrer noopener">said</a>&nbsp;its shot provided a broad immune response against Eris in small animals and Pfizer&nbsp;<a href="https://www.reuters.com/business/healthcare-pharmaceuticals/pfizers-updated-covid-shot-effective-against-eris-variant-mice-study-2023-08-17/" target="_blank" rel="noreferrer noopener">reported</a>&nbsp;its new shot protected against the variant when tested on mice. Because the current bivalent boosters don’t specifically protect against XBB, some experts&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=447d21af438b">recommend</a>&nbsp;waiting until the new monovalent boosters release before getting an updated shot.</p>



<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



<p>An earlier round of updated Covid boosters provided additional protection against previous variants, but only&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#vaccination-states-jurisdictions" target="_blank" rel="noreferrer noopener">17%</a>&nbsp;of the U.S. has received at least one booster.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>A new Covid variant called BA.2.86, or “Pirola,” is a descendant of the BA sublineage and has begun circulating in the U.S. Although there aren’t enough cases for it to appear on the CDC’s variant tracker, the World Health Organization has&nbsp;<a href="https://twitter.com/WHO/status/1692255671687794902" target="_blank" rel="noreferrer noopener">labeled</a>&nbsp;it as a variant under monitoring. This is because Pirola has 36 more&nbsp;<a href="https://slides.com/jbloom/new_2nd_gen_ba2_variant?ftag=YHF4eb9d17#/3" target="_blank" rel="noreferrer noopener">mutation spikes</a>&nbsp;than XBB.1.5—the dominant strain in the U.S. earlier this year—and 34 additional mutations compared to BA.2. Pirola isn’t a descendant of the XBB sublineages, so there may be concern they won’t protect against Pirola. However, Moderna&nbsp;<a href="https://www.forbes.com/sites/roberthart/2023/09/06/modernas-updated-covid-vaccine-is-effective-against-pirola-variant-as-concern-over-new-strain-grows/?sh=3f334501a06c">said</a>&nbsp;Wednesday its new booster provided an 8.7-fold increase in neutralizing antibodies against Pirola in its clinical trial.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.nbcnews.com/health/health-news/fda-green-light-new-covid-boosters-early-friday-rcna103379" target="_blank" rel="noreferrer noopener">FDA could green light new Covid boosters as early as Friday</a>&nbsp;(NBC)</p>



<p><a href="https://www.forbes.com/sites/roberthart/2023/09/06/modernas-updated-covid-vaccine-is-effective-against-pirola-variant-as-concern-over-new-strain-grows/?sh=3f334501a06c">Moderna’s Updated Covid Vaccine Is Effective Against Pirola Variant—As Concern Over New Strain Grows</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=447d21af438b">New Covid Boosters Expected This Fall: Why Some Doctors Suggest Holding Off On Getting Your Next Booster Until Then</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/09/01/its-ok-to-get-your-covid-flu-and-rsv-shots-at-the-same-time-experts-say/?sh=486139df3099">It’s Okay To Get Your Covid, Flu And RSV Shots At The Same Time, Experts Say</a>&nbsp;(Forbes)</p>


Vaccinations at Egoli Township as Omicron Cases Spread

FDA Approves Novavax’s New Covid Vaccine Designed To Protect Against The Latest Strain


<p>&#8216;Sustained crisis’. I came across this terminology in a <em>Harvard Business Review </em>article recently, and it immediately struck a chord with my struggles running my company and also with what I see in the world around me.</p>



<p>The Covid-19 pandemic was a global crisis that came out of the blue, and we were all in it together. It did not matter which country we lived in or what our backgrounds were. It was a common fight.</p>



<p>But post-pandemic, we are dealing with a world that has become economically volatile for varying reasons, and it is becoming clearer that each country will first protect its own people and its own interests. Likewise, it has hit the interdependence of certain structures with a fragility like never before. And this has not abated since 2020.</p>



<p>For countries that are largely donor-dependent for their development needs and for humanitarian aid spending, vulnerabilities have increased. The aid narrative comes with its own politics and interests.</p>



<p>Several studies point to the fact that foreign aid is not as generous as it used to be.</p>



<p>In 2022, Ukraine accounted for a large chunk of foreign aid. And now many donor countries are facing pressures of their own from the post Covid-19 economic downturn to geopolitical vulnerabilities and political instabilities that have persisted over a long time.</p>



<p>Developing economies struggle with unsustainable debt burdens, rising food costs and liquidity crises. It is estimated by the World Bank that 7% of the world’s population will still be living in poverty by 2030.</p>



<p>For entrepreneurs in many countries, the ecosystem has changed significantly. Inflation persists and markets continue to shrink. Doing business has become costlier and more complex and negotiating the scale of challenges more difficult.</p>



<p>With increased advanced technological interface in business operations, the ecosystem demands a different resilience that government and business leaders must adopt and adapt to at a faster pace.</p>



<p>The common man is forced to navigate his needs confronted with higher prices, declining savings, more borrowing and employment loss. </p>



<p>In Nepal, where I am, the middle- and lower-income demographic is struggling with job cuts, unpaid salaries, cutdown on consumer expenditure and access to loans. There is a relentless outflow of Nepali youth entering the international labor market. The country’s central bank macroeconomic report shows that in the first 10 months of the current fiscal year, the government has issued permits for over 660,000 Nepalis to work abroad. This number excludes Nepalis going to India for work and the migration of students. </p>



<p>When young people see no future to build their lives in their country, it hurts the productivity and pride of the nation; but there is nothing to hold them back.</p>



<p>A crisis response is effective within a contained timeframe but when there is a prolonged state of crisis, the response needs to be inspired by a wider and more inclusive approach.</p>



<p>I ask what then is the lifeblood that will enable countries to navigate what is now a sustained crisis? Can countries do it alone?</p>



<p>Does this mark the departure of multilateralism? Why are the terms ‘deglobalization’ and ‘dedollarization’ increasingly making the rounds of panel discussions and economic reports?</p>



<p>The lifeblood perhaps lies in our ability to pause, reflect and continue. I believe that sustained crisis can only be overcome by sustained action. However, action must come from deeper values of integrity, innovation and compassion in the unfolding world order. It requires leaders – government and business – to be focused, flexible and decisive. Economic growth and social progress must be given equal emphasis. It requires citizens across the world to be more aware about their choices and actions. This is, perhaps, each one’s obligation and opportunity to create a meaningful world.</p>



<p><em><strong>A writer-photographer from Nepal who keeps the values of freedom and compassion at the core of her work</strong></em></p>


Kathmandu, city view

‘Sustained Crisis Can Only Be Overcome By Sustained Action’


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Paxlovid—Pfizer’s antiviral Covid-19 treatment—is 37% effective at preventing hospitalization or death in high-risk patients compared with no treatment, according to <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2809779" target="_blank" rel="noreferrer noopener">a study</a> published Thursday in the <em>JAMA Network Open</em>, well below the 88% effectiveness rate Pfizer and regulators <a href="https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-oral-antiviral-treatment-covid-19" target="_blank" rel="noreferrer noopener">reported</a> in clinical trials in 2021—though it remains very effective at staving off death.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>The study found that when excluding hospitalizations and looking at death alone, the drug is 84% effective.</p>



<p>The observational study analyzed electronic health records from thousands of patients at the Cleveland Clinic Health System in 2022 and early 2023 to determine Paxlovid’s effectiveness, using real-world data rather than the clinical trials that were used before.</p>



<p>The study also found another antiviral Covid-19 treatment, Merck’s Lagevrio, was 42% effective in preventing hospitalization or death and 77% effective against death alone.</p>



<h2 class="wp-block-heading" id="h-what-we-don-t-know">WHAT WE DON’T KNOW</h2>



<p>Why the effectiveness has fallen. The study authors noted the clinical trials were conducted among unvaccinated patients who had limited natural immunity, whereas this study was conducted in a real-world population including vaccinated and previously infected patients who had some other defenses against the coronavirus. They also noted the original clinical studies were completed when the Delta variant was the most common strain of the virus while their study was conducted when the Omicron variant was, suggesting that the drug could work differently with different strains.</p>



<h2 class="wp-block-heading" id="h-news-peg">NEWS PEG</h2>



<p>While they note the effectiveness has fallen, the study’s authors still say these drugs are useful tools in fighting Covid-19, arguing both drugs can be used in nonhospitalized Covid-19 patients to prevent the most severe outcomes.</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>Paxlovid is still “definitely recommended for high-risk patients,” said University of North Carolina professor Danyu Lin, one of the study’s authors, according to&nbsp;<a href="https://www.bloomberg.com/news/articles/2023-09-21/paxlovid-study-shows-effectiveness-against-covid-has-declined?srnd=premium" target="_blank" rel="noreferrer noopener">Bloomberg</a>.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Paxlovid, a course of oral pills, first&nbsp;<a href="https://www.pfizer.com/news/press-release/press-release-detail/pfizers-paxlovidtm-receives-fda-approval-adult-patients#:~:text=PAXLOVID%20has%20been%20available%20in,remain%20consistent%20with%20the%20EUA." target="_blank" rel="noreferrer noopener">became available</a>&nbsp;in December 2021 and is to be taken early in a patient’s infection. They’re designed to prevent patients who already have Covid-19 from becoming hospitalized or dying, particularly patients who are at an elevated risk of severe Covid-19 due to age or medical conditions. New information on Paxlovid’s effectiveness comes amid fears of a new wave of Covid-19 this fall. In the week ending September 9, 20,538 people were hospitalized for Covid-19, a 7.7% increase over the week prior, according to the&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#maps_percent-covid-deaths" target="_blank" rel="noreferrer noopener">Centers for Disease Control and Prevention</a>. Since the onset of the pandemic, 1.14 million people have died of the virus.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2809779" target="_blank" rel="noreferrer noopener">Nirmatrelvir or Molnupiravir Use and Severe Outcomes From Omicron Infections</a>&nbsp;(JAMA Network Open)</p>



<p><a href="https://www.forbes.com/sites/brianbushard/2023/05/25/pfizers-paxlovid-covid-pill-granted-full-fda-approval/?sh=385c6c1014ec">Pfizer’s Paxlovid Covid Pill Granted Full FDA Approval</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/roberthart/2022/04/21/who-endorses-pfizers-antiviral-pill-paxlovid-for-high-risk-covid-patients-but-says-benefits-trivial-for-low-risk-groups/?sh=14dd5ff3623b">WHO Endorses Pfizer’s Antiviral Pill Paxlovid For High-Risk Covid Patients But Says Benefits ‘Trivial’ For Low-Risk Groups</a> (Forbes)</p>


Covid Drug Paxlovid Now Less Effective Than In Early Trials—But It’s Still Great At Preventing Death


<p><strong>South Africa remains resolute in hosting the AGOA summit despite prior tensions with the US. The upcoming event, slated for November, signifies renewed commitment to strengthen trade ties. South Africa&#8217;s call for a decade-long AGOA extension underscores the pivotal role this partnership plays in fostering economic growth and cooperation.</strong></p>



<p>South Africa is set to host the African Growth and Opportunity Act (AGOA) Summit later this year, despite recent diplomatic tensions between the country and the United States (US). In June this year, US legislators called for the relocation of the summit due to controversy surrounding alleged arms shipments to Russia by South Africa. Cleared of any wrongdoing by an internal judicial panel, the US has reaffirmed its commitment to shared growth with South Africa.</p>



<p>“The AGOA Forum is an opportunity for the United States to build upon the success of the Africa Leaders’ Summit and further our economic partnership with AGOA countries,” stated US Ambassador Katherine Tai in a statement announcing this year&#8217;s summit from Washington.</p>



<p>South African President Cyril Ramaphosa not only celebrated the country&#8217;s hosting of the summit but also called for the renewal of the agreement for another decade. The current format of AGOA is set to expire in 2025. Emphasizing the importance of South Africa-US relations, Ramaphosa declared: &#8220;The US remains a very important economic partner in trade and investment, with great potential to further expand economic ties,&#8221; in a press release.</p>



<p>AGOA currently benefits eligible sub-Saharan countries by providing access to US markets for several thousand products, including duty-free access for some exports. South Africa continues to be the largest exporter in the agreement, generating approximately $2.7 billion in revenue for the country as of 2021, primarily from vehicles, jewelry, and metals.</p>



<p>The controversy surrounding the visit of a Russian ship, the Lady R, docking at a South African military base in December 2022, led to the politicization of the AGOA agreement by bipartisan representatives in the US. However, a subsequent South African investigation cleared the country of exporting arms to Russia as part of the incident, resulting in a restored commitment by representatives of both countries to mend strained relations.</p>



<p>The AGOA summit, scheduled for early November in South Africa, will bring together key delegations from all member countries, regional economic entities, as well as representatives from the private and public sectors. The goal is to strengthen trade and economic ties between the US and sub-Saharan Africa.</p>



<p>The summit will also feature a ‘Made in Africa’ exhibition, specifically focused on demonstrating regional value chains on the continent.</p>



<p>“AGOA has helped promote the export of African goods to the United States, and we believe there is scope to deepen its impact on African industrialization,&#8221; said South Africa&#8217;s Minister of Trade and Industry, Ebrahim Patel, reaffirming Ramaphosa&#8217;s commitment to extending the deal. &#8220;Extending it beyond 2025 will promote inward investment in Africa and support our efforts to increase growth through the African Continental Free Trade Area (AfCFTA), which will cover 54 countries and 1.4 billion people.”</p>


Untitled design (33)

Renewed Commitment: South Africa To Host AGOA Summit Amid Calls for Extension


<p><strong>The tech behemoth’s latest iPhone features a new USB-C charging port and titanium frame for its higher-end models.</strong></p>



<p>Apple has unveiled the iPhone 15, with the base models 15 and 15 Plus priced at $799 and $899 respectively, in its most anticipated product event of the year. The higher-end 15 Pro and 15 Pro Max will be priced at $999 and $1,199 respectively.</p>



<p>As usual, the iPhone 15 will come equipped with a better camera and upgraded processing power, but it will also feature a significant change: a USB-C port for charging and data transfers. Apple was forced to do away with its Lightning port in iPhones after the European Union passed a law last year that requires all mobile devices to accommodate a common&nbsp;<a href="https://www.forbes.com/sites/siladityaray/2022/10/26/weve-no-choice-apple-says-iphones-will-switch-over-to-usb-c-chargers-to-comply-with-new-eu-law/?sh=786790cabcde">USB-C&nbsp;</a>charger.</p>



<p>The consumer tech giant also announced two new makes of the Apple Watch: the Apple Watch Series 9, which it said was its first carbon neutral product ever, and the Apple Watch Ultra 2. Sustainability was one of the central themes of the event, where Apple detailed its increased use of recycled materials like cobalt in the battery and energy efficient manufacturing and transportation practices to produce the Apple Watch Series 9. This comes ahead of the company’s goal to achieve carbon neutrality by 2030.</p>



<p>With inconspicuous changes in design and appearance, the screen sizes for the standard iPhone 15 models are the same as before (6.1 inch and 6.7 inch), but the iPhone 15 Pro and Pro Max have a slightly larger display as their bezels are thinner than previous iPhones, the company announced. The Pro iPhones are built with Grade 5 titanium frames for the first time rather than stainless steel, making them the lightest Pro phones Apple has ever built.</p>



<p>Similar to its predecessor, iPhone 15 has a matte finish, but the edges of the phone are more rounded than before. The regular models are available in pink, yellow, green, blue and black while the Pro models come in black, blue and white titanium. All new phones have the “Dynamic Island,” an interface that was first added to iPhone 14 Pro that lets users see notifications in the black pill-shaped notch at the top of the display.</p>



<p>Apple touted the phone’s upgraded camera capabilities: a 48-megapixel camera sensor is replacing the 12-megapixel and lets users zoom into photos while capturing minute details and nuances. The new Pro phones come with a feature that uses machine learning to detect when a person is in the photo, enabling you to automatically switch to portrait mode even after a photo has been taken.</p>



<p>If you’re on a call using the iPhone 15 Pro, a machine learning-based feature called “voice isolation” prioritizes the speaker’s voice and drowns out background voice. The phones are also enabled with an emergency SOS service and roadside assistance while off the grid.</p>



<p>The pricier models come with a performance edge, thanks to a new A17 chip. All new iPhones are embedded with a new ultrawide-band semiconductor, a technology that uses radio waves to send and receive signals, to make location tracking on the Find My app more accurate.</p>



<p>The ring/mute slide switch, which has never changed since Apple launched the original iPhone in 2007, has been replaced in iPhone 15 Pro models with an “Action Button” that can be customized to set different functionalities like starting a voice recording, launching the camera or opening the flashlight.</p>



<p>For the Apple Watch Series 9 and a second generation of the Apple Watch Ultra , the look and design for the new watches has remained consistent, but their guts have gotten an upgrade, with 30% faster processing speed and brighter screens. The two new Apple Watches are equipped with a feature that lets users double tap their index finger and thumb to carry out actions like accepting or ending a call, and playing or pausing music with just one hand.</p>



<p>Apple’s latest product reveal comes at a crucial time for the company. Demand for smartphones is&nbsp;<a href="https://www.bloomberg.com/news/newsletters/2023-08-06/apple-iphone-15-comes-amid-us-sales-slowdown-tim-cook-q3-earnings-comments-lkzfs14u" target="_blank" rel="noreferrer noopener">slowing</a>&nbsp;down across the industry, and Apple’s iPhone sales dropped about 2% year over year in the third quarter of 2023. Core to its business, iPhones, Apple Watches and AirPods accounted for about 60% of Apple’s $394.3 billion annual revenue in 2022.</p>



<p>Although more mainstream, the new iPhone and Apple Watches aren’t the only products that Apple announced this year. In June, alongside new Macs, Apple introduced the <a href="https://www.forbes.com/sites/johnpaczkowski/2023/06/07/this-is-what-its-like-to-use-apples-new-vision-pro-mixed-reality-headset/?sh=43c3323539e4">Apple Vision Pro</a> mixed-reality headset, its first major new product category since the Apple Watch made waves in 2015. The iPhone 15 lets users create photos and videos that are compatible with the Apple Vision Pro.</p>


Apple Holds Product Unveiling Event

Apple Kills Lightning In iPhone 15 And Announces Carbon Neutral Apple Watches


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Apple and Nvidia stocks tanked for the second consecutive trading session Thursday, a rare down stretch for the Silicon Valley titans this year fueled by concerns about each of their explosive sales.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>Apple shares slipped 3.4% by 2:25 p.m. Eastern time after Bloomberg&nbsp;<a href="https://www.bloomberg.com/news/articles/2023-09-07/china-plans-to-expand-iphone-ban-to-some-state-backed-firms-in-blow-to-apple?srnd=premium" target="_blank" rel="noreferrer noopener">reported</a>&nbsp;China is considering banning iPhone usage among some government workers and employees at state-owned corporations, casting doubt on Apple’s strength in the country which accounts for roughly a fifth of its sales.</p>



<p>The slide comes a day after Apple shed 3.6% – its 6.9% dip since Tuesday marks the steepest two-day loss for the world’s most valuable company since November.</p>



<p>Nvidia shares also dropped about 3% Thursday, bringing its two-day loss to 5.5% as the S&amp;P 500’s best-performer of 2023 suffered a rare tumble.</p>



<p>The artificial intelligence leader’s stock slump came as a dubious conspiracy theory&nbsp;<a href="https://twitter.com/JesseCohenInv/status/1699307464619876691" target="_blank" rel="noreferrer noopener">proliferated&nbsp;</a>on X, the social media site formerly known as Twitter, suggesting that Nvidia has artificially inflated revenue in its AI segment by lying about its sales to CoreWeave, a Nvidia-backed cloud computing startup&nbsp;<a href="https://www.bloomberg.com/news/articles/2023-08-30/coreweave-said-to-seek-stake-sale-at-up-to-8-billion-valuation" target="_blank" rel="noreferrer noopener">reportedly</a>&nbsp;valued at about $8 billion.</p>



<p>That theory is “nonsense,” Bernstein analyst Stacy Rasgon wrote in a Thursday note to clients he “very grudgingly” sent out, encouraging investors to not get “your investment thesis from Twitter randos.”</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>$250 billion. That’s how much market capitalization Apple and Nvidia shed over the last two days.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Apple and Nvidia are two of the seven tech stocks&nbsp;<a href="https://www.forbes.com/sites/dereksaul/2023/04/10/these-7-tech-stocks-command-almost-90-of-the-sp-500s-gains-signaling-market-rally-may-not-be-so-healthy/?sh=65e0aafc65d5">accounting for</a>&nbsp;a large majority of major stock indexes’ gains this year, leading to lingering questions about the depth of the strong market (Alphabet, Amazon, Meta, Microsoft and Tesla round out the super seven). Both Apple and Nvidia set all-time high share prices this year, but on far different trajectories. Apple rode a steady 42% gain this year, just ahead with the tech-heavy Nasdaq’s 32% rise, thanks to&nbsp;<a href="https://www.forbes.com/sites/dereksaul/2023/05/04/apple-beats-quarterly-profit-sales-estimates-despite-interest-rate-headwinds/?sh=77f139f03637">solid</a>&nbsp;5% and 6% earnings beats during the first and second quarters, respectively, while Nvidia more than tripled in share price due to&nbsp;<a href="https://www.forbes.com/sites/dereksaul/2023/08/23/nvidia-earnings-stock-soars-as-ai-giant-again-smashes-quarterly-expectations/">exploding</a>&nbsp;expectations about its AI business, which grew by 141% just last quarter.</p>



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<p>By signing up, you accept and agree to our&nbsp;<a href="https://www.forbes.com/terms-and-conditions" target="_blank" rel="noreferrer noopener">Terms of Service</a>&nbsp;(including the class action waiver and arbitration provisions), and&nbsp;<a href="https://www.forbes.com/privacy" target="_blank" rel="noreferrer noopener">Privacy Statement</a>.</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>“The Nasdaq is sinking as one bad Apple spoils a bunch of mega-cap tech stocks,”&nbsp;<a href="https://www.marketpulse.com/" target="_blank" rel="noreferrer noopener">Oanda</a>&nbsp;analyst Edward Moya wrote Thursday. The index is down 2% over the last two days, steeper than the S&amp;P 500’s 1% loss.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.bloomberg.com/tosv2.html?vid=&amp;uuid=14d8c1fa-4dad-11ee-bf85-ff6800d7a7ae&amp;url=L25ld3MvYXJ0aWNsZXMvMjAyMy0wOS0wNy9jaGluYS1wbGFucy10by1leHBhbmQtaXBob25lLWJhbi10by1zb21lLXN0YXRlLWJhY2tlZC1maXJtcy1pbi1ibG93LXRvLWFwcGxlP3NybmQ9cHJlbWl1bQ==" target="_blank" rel="noreferrer noopener">BLOOMBERG<strong>Bloomberg</strong></a></p>



<p><strong></strong><a href="https://www.forbes.com/sites/dereksaul/2023/08/23/nvidia-earnings-stock-soars-as-ai-giant-again-smashes-quarterly-expectations/" target="_blank" rel="noreferrer noopener">MORE FROM FORBES<strong>Nvidia Earnings: Stock Soars As AI Giant Again Smashes Quarterly Expectations</strong><small>By&nbsp;<strong>Derek Saul</strong></small></a></p>



<p><a href="https://www.theverge.com/2023/8/8/23824661/coreweave-nvidia-debt-gpu-ai-chips-collateral" target="_blank" rel="noreferrer noopener">THE VERGE<strong>How to get your startup a loan with one easy computer part</strong></a></p>


Apple Ahead Of The IPhone 15 Launch

Apple And Nvidia’s Losses This Week Hit $250 Billion


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>The Food and Drug Administration&nbsp;<a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating" target="_blank" rel="noreferrer noopener">gave its approval</a>&nbsp;for emergency use Monday to new updated Covid-19 vaccines from Pfizer-BioNTech and Moderna that are specially designed to protect against the latest dominant strain of the coronavirus, Omicron variant XBB.1.5—the latest effort of drugmakers, regulators and doctors to keep up with the virus’ ever evolving nature.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>Anyone 5 or older is eligible to receive a single booster dose of the newly updated vaccines regardless of how many shots they’ve received before, as long as it’s at least 2 months since the last dose they received of any Covid-19 vaccine, the FDA announced.</p>



<p>Children between the ages of six months and four years are eligible to receive one or two doses of the new vaccines if they’ve been vaccinated against Covid-19 before, but if they’ve never received a vaccine, they’re eligible to receive three doses of the new Pfizer-BioNTech shot or two doses of Moderna, the FDA said.</p>



<p>This comes after the new XBB lineage of coronavirus, a group of new variants that emerged in late 2022, became the most common strain.</p>



<p>After the emergence of this new lineage, the FDA encouraged Pfizer-BioNTech, Moderna and Novavax to create new vaccines specialized to defend against it.</p>



<p>These will be the first Covid-19 vaccines that aren’t free and paid for by the U.S. government, with&nbsp;<a href="https://apnews.com/article/science-health-business-covid-medicare-1a5d65356ebc7b5bc76524ae99deb55e" target="_blank" rel="noreferrer noopener">Pfizer</a>&nbsp;and&nbsp;<a href="https://www.reuters.com/business/healthcare-pharmaceuticals/moderna-expects-price-its-covid-vaccine-about-130-us-2023-03-20/" target="_blank" rel="noreferrer noopener">Moderna</a>&nbsp;both estimating their shots will cost between $110 and $130 per dose, though many health insurances plans will cover it and the&nbsp;<a href="https://www.cdc.gov/vaccines/programs/bridge/index.html" target="_blank" rel="noreferrer noopener">CDC’s Bridge Program</a>&nbsp;will pay for some uninsured Americans’ vaccines.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Drugmakers have released a number of new iterations after the first Covid-19 vaccines were administered in late 2020. In fall 2021, the first booster shots were authorized by the FDA and were meant to help replenish waning immunity to the virus months after people received their initial doses. Then, after a new variant of the virus called Omicron, which was more resistant to the original vaccines, sparked a vicious new wave of the pandemic, drugmakers released a modified “bivalent” booster shot in fall 2022. That vaccine was designed to protect against both the original virus as well as Omicron. This new booster will attempt to do what that bivalent booster did with Omicron, but with the new XBB strains.</p>



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<p>By signing up, you accept and agree to our&nbsp;<a href="https://www.forbes.com/terms-and-conditions" target="_blank" rel="noreferrer noopener">Terms of Service</a>&nbsp;(including the class action waiver and arbitration provisions), and&nbsp;<a href="https://www.forbes.com/privacy" target="_blank" rel="noreferrer noopener">Privacy Statement</a>.</p>



<h2 class="wp-block-heading" id="h-what-to-watch-for">WHAT TO WATCH FOR</h2>



<p>Now that the FDA has approved the drugs, the Centers for Disease Control and Prevention is&nbsp;<a href="https://www.federalregister.gov/documents/2023/08/25/2023-18288/advisory-committee-on-immunization-practices" target="_blank" rel="noreferrer noopener">scheduled to meet</a>&nbsp;on Tuesday to decide whether it will recommend people receive the new booster shots, an additional standard regulatory step that each of the previous iterations of the vaccines have had to complete. People won’t be able to receive the new vaccines until the CDC gives its signoff.</p>



<h2 class="wp-block-heading" id="h-surprising-fact">SURPRISING FACT</h2>



<p>While Pfizer-BioNTech and Moderna’s new vaccines were approved on Monday, the FDA still hasn’t approved Novavax’s. The company, which was a late entry into the Covid-19 vaccine market, had its&nbsp;<a href="https://www.yalemedicine.org/news/covid-19-vaccine-comparison#:~:text=Status%3A%20The%20vaccine%20was%20authorized,it%3A%20People%2012%20and%20older." target="_blank" rel="noreferrer noopener">first vaccines approved</a>&nbsp;in July 2022. Its vaccines, unlike Pfizer-BioNTech and Moderna’s do not use mRNA technology, but rather are subunit vaccines that use a piece of the virus to invigorate a body’s immune response. The company said in an email Monday its vaccines have already arrived in the U.S. and, despite not being approved alongside Pfizer-BioNTech and Moderna’s, are still awaiting FDA approval. The company reiterated that its vaccines will be widely available across the country, but “timing is ultimately at the discretion of the FDA.” By 2:45 p.m. Eastern Time, Novavax’s stock price had fallen 10% to around $8 a share. Neither Pfizer nor Moderna’s stock moved significantly. Both fell less than 1.5%.</p>



<h2 class="wp-block-heading" id="h-news-peg">NEWS PEG</h2>



<p>This comes as Covid-19 hospitalizations begin to rise across the U.S. In the week ending August 27, the most recent data available, hospital admissions for Covid-19 were up 15.7%, according to&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#maps_new-admissions-rate-county" target="_blank" rel="noreferrer noopener">the CDC</a>. That’s 17,418 hospital admissions during that week, and while that is still a far cry from the peak in January 2022, when there were around 150,000 hospitalizations a week, doctors believe it signals that a new wave could be coming in the fall.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>These new vaccines follow doctors’ long held predictions that Covid-19 vaccines will likely become similar to the influenza vaccine, where a new iteration is released annually to keep up with new strains of the virus. At a September 2022 White House briefing, Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases and the leader of the federal government’s response to the pandemic, said: “We likely are moving towards a path with a vaccination cadence similar to that of the annual influenza vaccine, with annual updated Covid-19 shots matched to the currently circulating strains for most of the population.”</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/09/01/its-ok-to-get-your-covid-flu-and-rsv-shots-at-the-same-time-experts-say/?sh=7a857a4c3099">It’s Okay To Get Your Covid, Flu And RSV Shots At The Same Time, Experts Say</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/roberthart/2023/09/06/modernas-updated-covid-vaccine-is-effective-against-pirola-variant-as-concern-over-new-strain-grows/?sh=18b82c3a1a06">Moderna’s Updated Covid Vaccine Is Effective Against Pirola Variant—As Concern Over New Strain Grows</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/09/06/fda-may-approve-new-covid-boosters-by-friday-as-deaths-spike-report-says/?sh=5bc3a51b54f2">FDA May Approve New Covid Boosters By Friday As Deaths Spike, Report Says</a> (Forbes)<a href="https://www.forbes.com/sites/willskipworth/"></a></p>


Injection of the third dose of the covid 19 vaccine at a Covid-19 vaccination center in Dinan, Brittany

FDA Approves New Covid Vaccines To Target Latest Strains


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>The death toll from extreme flooding in Libya over the weekend is estimated to be at least 250 by the Red Crescent of Benghazi, though one of the country’s officials said thousands could be dead from the catastrophic storm,&nbsp;<a href="https://www.cnbc.com/2023/09/11/storm-and-floods-kill-at-least-150-people-in-libya-says-red-crescent.html" target="_blank" rel="noreferrer noopener">reports</a><a href="https://apnews.com/article/derna-disaster-zone-libya-storm-daniel-floods-8fac4fe35b962242568ff219456c6870" target="_blank" rel="noreferrer noopener">&nbsp;say</a>.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>The Red Crescent&nbsp;<a href="https://www.reuters.com/world/africa/powerful-storm-rolls-through-eastern-libya-killing-least-three-2023-09-11/" target="_blank" rel="noreferrer noopener">told</a>&nbsp;Reuters on Monday morning that the flooding caused by Mediterranean storm Daniel killed a confirmed 150 people in Derna, a coastal city in eastern Libya, over the weekend, but the organization expects the death toll to increase to 250.</p>



<p>Ossama Hamad, prime minister of the parliament-supported government in Libya, said in a phone interview with a local television station on Monday that he fears 2,000 are dead in Derna, the city hit the hardest by the floods, and thousands more are missing, the Associated Press&nbsp;<a href="https://apnews.com/article/derna-disaster-zone-libya-storm-daniel-floods-8fac4fe35b962242568ff219456c6870" target="_blank" rel="noreferrer noopener">reported</a>.</p>



<p>Water levels in Derna, which was declared a disaster zone, reached as high as 10 feet over the weekend, and the storm also hit the Libyan cities of Benghazi, Susa, Bayda and al-Marj.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Last week, the storm hit parts of Turkey, Greece and Bulgaria, killing at least 15—with two still missing—and causing the “most intense rain storm” in almost a century, Reuters&nbsp;<a href="https://www.reuters.com/world/europe/three-more-bodies-found-after-greece-storm-raising-toll-14-2023-09-10/#:~:text=ATHENS%2C%20Sept%2010%20(Reuters),since%20records%20began%20in%201930." target="_blank" rel="noreferrer noopener">reported</a>. More than 4,250 people were evacuated from Greece as of early Monday, authorities said, due to rivers overflowing and damaging villages beyond the aftermath of the storm. On Sunday, Bloomberg&nbsp;<a href="https://www.bloomberg.com/news/articles/2023-09-10/greek-premier-to-request-eu-support-for-country-s-flood-damage?utm_campaign=socialflow-organic&amp;cmpid=socialflow-twitter-business&amp;utm_content=business&amp;utm_medium=social&amp;utm_source=twitter" target="_blank" rel="noreferrer noopener">reported</a>&nbsp;that Greece&#8217;s prime minister will meet with the head of the European Commission on Tuesday to ask for support from the EU.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://apnews.com/article/derna-disaster-zone-libya-storm-daniel-floods-8fac4fe35b962242568ff219456c6870" target="_blank" rel="noreferrer noopener">AP NEWS<strong>Libyan prime minister says 2,000 people believed dead in flooding in eastern Libya following storm</strong></a><a href="https://www.reuters.com/world/africa/powerful-storm-rolls-through-eastern-libya-killing-least-three-2023-09-11/" target="_blank" rel="noreferrer noopener">REUTERS<strong>Storm and floods kill at least 150 people in Libya-Red Crescent</strong></a></p>


Death toll in Derna city tops 2,000 after floods hit eastern Libya

Hundreds Dead In Libya After Devastating Floods, But Official Warns It Could Be Thousands


<p>In a significant development for Africa&#8217;s digital landscape, Lagos-based Itana, formerly known as Talent City, has announced that it secured $2 million in pre-seed funding.</p>



<p>The investment is led by backers, including LocalGlobe, Amplo, Pronomos Capital and Future Africa, marking a step toward realizing Africa&#8217;s inaugural Digital Free Zone.</p>



<p>Founded by Luqman Edu, Coco Liu, and Iyinoluwa Aboyeji, this funding is pivotal in realizing their vision to enhance Nigeria&#8217;s ease-of-doing-business index, stimulate foreign direct investment, and catalyze employment opportunities within the nation.</p>



<p>As of early 2022, the self-described charter city, backed by Charter Cities Institute and Pronomos Capital, a Peter Thiel-backed venture fund, had secured over $10 million for the project situated within Alaro City, in the Lekki Free Zone, just outside of Nigeria&#8217;s largest city, Lagos.</p>



<p>&#8220;We are building an online jurisdiction that allows global companies to remotely incorporate and operate in a Nigerian Digital Free Zone in partnership with Nigeria Export Processing Zones Authority to develop relevant policies for a groundbreaking &#8216;virtual city.&#8217; Itana Free Zone will be powered by a one-stop-shop platform for business and government services, including taxation, business visas, banking, capital repatriation, and supportive legislation for businesses. We will also be building a business marketplace, working with trusted service providers including legal, tax, banking, and more. We hope to help the businesses in our zone navigate the business landscape and operations with transparency and clarity to enable growth,&#8221; Itana tweeted on the announcement.</p>



<p>Aboyeji, one of the co-founders, emphasizes the importance of creating a conducive environment for Nigerian tech companies to thrive locally.</p>



<p>&#8220;In 2016 when I incorporated @theflutterwave, my first Delaware company, I never imagined incorporating a Delaware company would become the default for Nigerian companies looking to go global. For me, it was just a clever hack. But it became a movement.</p>



<p>&#8220;Post SVB crash crisis, incorporating a Delaware company and getting a bank account from Nigeria has quietly become a little more stressful. With the ascension of one of our own, @bosuntijani, as Minister, it has become imperative to bring our tech companies home. However, to do so, we need the right regulatory environment with the right benefits and opportunities that allow them to compete globally from right here in Nigeria,” tweeted Aboyeji. &#8220;This is why I’m so grateful for @ItanaAfrica and the incredible cast of mentors and investors who have come together to make this possible. If you are a Nigerian company and you want to come home, head on to itana.africa and incorporate your FZE today. Super excited to welcome you home.&#8221;</p>



<p>The announcement of Itana&#8217;s funding has garnered enthusiastic support from the tech community.</p>



<p>Pronomos Capital tweeted: &#8220;We&#8217;ve been working with the @ItanaAfrica team for 3 years now, and we love them, their concept, and its traction. Also big fans of @iaboyeji&#8217;s leadership, and since co-founders Luqman &amp; @cocobliu joined, it&#8217;s been build mode beast time!&#8221; Victor Ndukwe tweeted: &#8220;Super proud to be a part of the dream team. Building the gateway to the digital economy in Africa is audacious, and with the right kind of folks around, it becomes one of the most exciting journeys. Cheers to a prosperous Africa as we build to expand its trillion-dollar economy!&#8221;</p>


Luqman Edu and Iyinoluwa Aboyeji marking a step toward realizing Africa’s inaugural Digital Free Zone; Image supplied

$2 Million Pre-Seed Funding For Africa’s First Digital Free Zone


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Google plans to require verified election advertisers to make “clear and conspicuous” disclosures when their advertisements contain AI-generated content, according to a&nbsp;<a href="https://support.google.com/adspolicy/answer/13755910?hl=en&amp;ref_topic=29265" target="_blank" rel="noreferrer noopener">blog post</a>&nbsp;from the tech giant, which will institute the changes as artificial intelligence becomes more commonplace in the leadup to the 2024 presidential election.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>The update to Google’s political content policy will arrive in mid-November and will require disclosures to be placed in clear locations on images and videos.</p>



<p>Audio content is included in the disclosure requirements, though AI generated content “inconsequential to the claims made in the ad,” such as color corrections, image resizing and cropping, are exempt.</p>



<p>Videos uploaded to YouTube that aren’t paid advertising are also exempt, even if the content is uploaded by political campaigns.</p>



<p>Election advertisers who want to run election ads through Google are already required to go through a&nbsp;<a href="https://support.google.com/adspolicy/troubleshooter/9973345" target="_blank" rel="noreferrer noopener">verification process</a>&nbsp;requiring basic information from applicants.</p>



<p>A mix of human and tech tools will be used to enforce the disclosure requirements.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Google is one of several tech companies that has faced scrutiny over its handling of misinformation. YouTube, which was acquired by Google in 2006, faced backlash after announcing this year it would&nbsp;<a href="https://www.nbcnews.com/tech/tech-news/youtube-will-stop-removing-false-claims-2020-election-fraud-rcna87503" target="_blank" rel="noreferrer noopener">stop taking down content</a>&nbsp;containing false claims about the 2020 presidential election—when former President Donald Trump baselessly claimed voter fraud was rampant in an election he still considers rigged. YouTube said in a blog post it made the decision to protect its “community” and provide “a home for open discussion and debate.” The company was also criticized in 2020 for slowly removing or labeling videos with election misinformation.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>X, formerly known as Twitter, does not have specific guidelines for AI-generated ad content. Meta, the owner of Instagram and Facebook, does not have similar policies either, though it does have a ban against “<a href="https://about.fb.com/news/2020/01/enforcing-against-manipulated-media/" target="_blank" rel="noreferrer noopener">manipulated media</a>” such as deepfakes—videos that typically use digital alterations to copy someone&#8217;s likeness and convey false information.</p>



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<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.nbcnews.com/tech/tech-news/youtube-will-stop-removing-false-claims-2020-election-fraud-rcna87503" target="_blank" rel="noreferrer noopener">YouTube will stop removing false claims about 2020 election fraud</a>&nbsp;(NBC News)</p>



<p><a href="https://www.axios.com/2023/09/06/google-ai-election-ads-disclosure" target="_blank" rel="noreferrer noopener">Google to require disclosure for AI in election ads</a> (Axios)</p>


In this photo illustration, a woman holds a smartphone with

Google Will Require Advertisers To Add Disclosures For AI-Generated Election Ads


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>With a potential winter and fall surge of the flu, Covid and RSV, some experts recommend getting all three shots at the same time, while limited research shows doing so might cause rare side effects.=</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>It’s “acceptable” to get the new respiratory syncytial virus (RSV) vaccine co-administered with other vaccines, including the flu and Covid vaccines,&nbsp;<a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-06-21-23/07-RSV-Adults-Britton-508.pdf" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the Centers for Disease Control and Prevention.</p>



<p>For the first time, two RSV vaccines have been greenlit by the FDA to protect&nbsp;<a href="https://www.forbes.com/sites/mollybohannon/2023/05/03/fda-approves-first-ever-rsv-vaccine-after-brutal-2022-season/?sh=3dd0ac5910b2">older Americans</a>&nbsp;and&nbsp;<a href="https://www.forbes.com/sites/roberthart/2023/08/21/fda-approves-first-rsv-vaccine-for-kids-given-to-pregnant-moms-heres-what-to-know/?sh=75ffd2ab813e">infants</a>&nbsp;against the virus, which are expected to be available this fall, and the agency also approved an&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/03/first-rsv-vaccine-for-infants-approved-by-cdc-and-fda-other-top-vaccines-and-their-effectiveness/?sh=7a5031872040">antibody shot</a>&nbsp;for infants and toddlers in August.</p>



<p>New monovalent&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=18f37e73438b">Covid boosters</a>&nbsp;to protect against variants of the dominant XBB lineage are being developed by Moderna, Pfizer and Novavax at the request of a Food and Drug Administration panel and also are predicted to be available this fall.</p>



<p>As the fall and winter seasons approach, there are concerns another respiratory virus “tripledemic”—caused by a simultaneous rise in flu, Covid and RSV cases, causing hospitals to become overwhelmed—may happen again this year.</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>It’s “more probable that we&#8217;ll have a high viral season” this year with people getting Covid, the flu and RSV around the same time, so getting vaccinated is an important preventative step, Sharon Nachman, the chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, told&nbsp;<em>Forbes.</em></p>



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<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p><a href="https://covid.cdc.gov/covid-data-tracker/#variant-proportions" target="_blank" rel="noreferrer noopener">Covid</a>&nbsp;hospitalizations in recent weeks ticked up, increasing by almost 19% between August 13 and August 19, while deaths increased almost 18% between July 8 and August 26, as EG.5, or the Eris variant, made up the majority of cases. Though national&nbsp;<a href="https://www.cdc.gov/surveillance/nrevss/images/trend_images/RSV14Num_Nat.htm" target="_blank" rel="noreferrer noopener">RSV cases</a>&nbsp;have increased slightly since June—they went from 149 cases in the week of June 17 to 423 cases the week of August 26—cases were over four times higher around this time last year.&nbsp;<a href="https://www.cdc.gov/flu/about/season/index.html" target="_blank" rel="noreferrer noopener">Flu cases</a>&nbsp;aren’t witnessing a spike just yet, as flu season is expected to begin in October, but updated vaccines are available for the upcoming season.</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>50,000. That’s how many people in the U.S. died from Covid infection between November 2022 and March 2023,&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#maps_deaths-total" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the CDC. The&nbsp;<a href="https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm" target="_blank" rel="noreferrer noopener">flu</a>&nbsp;accounted for around 58,000 deaths during last year’s tripledemic and&nbsp;<a href="https://www.cdc.gov/rsv/research/rsv-net/dashboard.html" target="_blank" rel="noreferrer noopener">RSV</a>&nbsp;killed 10,000 people—mostly seniors—and caused twice as many hospitalizations than in prepandemic years.</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>A good number of patients last year were admitted into Nachman’s hospital with “more than one virus” at a time. So, she recommends those who are eligible to first get their doctors’ approval and then get all three shots in preparation for the upcoming seasons. Other than approving the co-administration of the RSV shot with other vaccines, the CDC also&nbsp;<a href="https://www.cdc.gov/flu/prevent/coadministration.htm" target="_blank" rel="noreferrer noopener">endorses</a>&nbsp;co-administration of the Covid and flu vaccines. Nachman said there’s a “better immune response” when more than one vaccine is administered at the same time. A&nbsp;<a href="https://www.sciencedirect.com/science/article/pii/S0264410X22015687" target="_blank" rel="noreferrer noopener">study</a>&nbsp;published in&nbsp;<em>Elsevier&nbsp;</em>found dual vaccination of Covid and the flu saw a reduced risk of infection than in unvaccinated people.</p>



<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



<p>Epidemiologist Richard Reithinger told&nbsp;<em>Forbes</em>, “People are a little bit more cautious” about getting the RSV vaccines at the same time as the other two because they were only recently approved by the FDA this year. There is limited evidence on whether the new RSV vaccines negatively interact with the Covid and flu vaccines. However, there were rare instances in a clinical trial where people developed severe side effects after getting the RSV and flu shots at the same time. Two 71-year-old participants developed acute disseminated encephalomyelitis (<a href="https://www.ninds.nih.gov/health-information/disorders/acute-disseminated-encephalomyelitis#:~:text=Acute%20disseminated%20encephalomyelitis%20(ADEM)%20is,helps%20with%20electrical%20nerve%20signaling." target="_blank" rel="noreferrer noopener">ADEM</a>), a neurological disorder that causes widespread swelling in the brain and spinal cord that damages the nerves’ protective coating, according to a&nbsp;<a href="https://www.cdc.gov/mmwr/volumes/72/wr/pdfs/mm7229a4-H.pdf" target="_blank" rel="noreferrer noopener">report</a>&nbsp;by a CDC advisory committee. One of these instances resulted in death. However, researchers aren’t sure if these cases were a result of the vaccines being administered together, or just a coincidence. The study also found that RSV and flu antibodies were slightly lower when administered together, though the “clinical significance is unknown.” If people are unsure about getting all three vaccines at once, it’s okay to “just take the flu vaccine [right now] and then wait for the Covid-19 and RSV” vaccines to be released later this year, according to Reithinger. Although he believes getting all three vaccines at the same time is safe, he ultimately recommends people consult with their doctors on timing.</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=18f37e73438b">New Covid Boosters Expected This Fall: Why Some Doctors Suggest Holding Off On Getting Your Next Booster Until Then</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2022/12/20/heres-why-there-is-a-shortage-for-childrens-tylenol-advill-and-motrin-and-what-to-do-about-it/?sh=3a6e33ce28f4">Here’s Why There Is A Shortage For Children&#8217;s Tylenol, Advil And Motrin—And What To Do About It</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/mollybohannon/2023/05/03/fda-approves-first-ever-rsv-vaccine-after-brutal-2022-season/?sh=3dd0ac5910b2">FDA Approves First-Ever RSV Vaccine After Brutal 2022 Season</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/roberthart/2023/08/21/fda-approves-first-rsv-vaccine-for-kids-given-to-pregnant-moms-heres-what-to-know/?sh=75ffd2ab813e">FDA Approves First RSV Vaccine For Kids—Given To Pregnant Moms—Here’s What To Know</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/03/first-rsv-vaccine-for-infants-approved-by-cdc-and-fda-other-top-vaccines-and-their-effectiveness/?sh=7a5031872040">First RSV Shot For Infants Approved By CDC And FDA: Other Top Shots And Their Effectiveness</a> (Forbes)</p>


It’s Okay To Get Your Covid, Flu And RSV Shots At The Same Time, Experts Say


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Officials in New York City this week&nbsp;<a href="https://www.dailymail.co.uk/health/article-12471305/NYC-Health-Department-tells-New-Yorkers-MASKING-Labor-Day-good-idea-new-Covid-variants-drive-infection-rates.html" target="_blank" rel="noreferrer noopener">reportedly</a>&nbsp;urged residents to wear masks in public as a new strain of Covid-19 continues to spread throughout the country, while some hospitals and schools have also reimplemented mask mandates, though medical experts say masking requirements might not last long, and might not be necessary for the entire population.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>New York City Health Commissioner Dr. Ashwin Vasan this week warned the virulent Ba.2.86 variant is “likely to evade immunity that has developed from vaccination or prior infection,” while a city health official told the Daily Mail it would be a “good idea” to mask up in crowded indoor places over the holiday weekend.</p>



<p>In Atlanta, Morris Brown College—a historically Black university—implemented a&nbsp;<a href="https://www.fox5atlanta.com/news/morris-brown-college-implements-two-week-covid-19-mask-mandate-as-cases-climb" target="_blank" rel="noreferrer noopener">two-week mask mandate</a>&nbsp;for all students and faculty last week as students move back on campus, also re-imposing social distancing amid “reports of positive cases among students.”</p>



<p>California-based healthcare facility Kaiser Permanente&nbsp;<a href="https://www.pressdemocrat.com/article/news/kaiser-permanente-reinstates-covid-19-mask-mandate-amid-spike-in-cases-but/" target="_blank" rel="noreferrer noopener">reinstated</a>&nbsp;its mask mandate at its facilities in Santa Rosa, California last week “amid an uptick in patients testing positive,” while in New York, a group of hospitals also imposed mask mandates,&nbsp;<a href="https://www.fox4news.com/news/citing-rising-covid-cases-these-us-hospital-systems-have-now-reinstated-mask-mandates" target="_blank" rel="noreferrer noopener">including</a>&nbsp;United Health Services, Auburn Community Hospital and University Hospital in Syracuse, New York.</p>



<p>In Santa Monica, California, Hollywood studio<strong>&nbsp;</strong>Lionsgate<strong>&nbsp;</strong>also&nbsp;<a href="https://www.hollywoodreporter.com/movies/movie-news/hollywood-studio-covid-rates-mask-mandates-back-1235571466/" target="_blank" rel="noreferrer noopener">requested</a>&nbsp;employees wear masks in certain parts of its facilities in response to a rise in cases last month.</p>



<p>A mask mandate is also in effect in&nbsp;<a href="https://sf.gov/information/know-when-masks-are-needed#:~:text=There%20are%20no%20longer%20masking,or%20people%20living%20in%20jails." target="_blank" rel="noreferrer noopener">San Francisco</a>&nbsp;for healthcare workers when around patients, as well as for employees at jails.</p>



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<h2 class="wp-block-heading" id="h-contra">CONTRA</h2>



<p>Officials have been torn on mask mandate policies since the start of the pandemic, while studies have found mandates might not be a guaranteed safeguard from community-wide spread. George Washington University Dr. Leana Wen told&nbsp;<a href="https://www.cnn.com/2023/08/31/health/labor-day-coronavirus-increase-wellness/index.html" target="_blank" rel="noreferrer noopener">CNN</a>&nbsp;this week the decision to mask up also depends on an array of factors, including a person’s age and whether they’re at high risk of contracting the virus—she also said children in schools who are at low risk should not be required to mask up. When asked about Labor Day weekend precautions, Wen added people who didn’t cancel their plans last year probably don’t need to cancel them either, despite cases being on the rise.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>Vaccine boosters from drugmakers Pfizer, Moderna and Novavax are&nbsp;<a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=6d037a70438b">expected</a>&nbsp;to be ready for use later this month and widely available in October, though they are still pending Food and Drug Administration approval. Those boosters, unlike their predecessors, target newer coronavirus strains, including the Eris strain and other XBB subvariants, adding to Americans’ arsenal to combat Covid, though only 17% of Americans have received the current bivalent booster shot,&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-booster-percent-pop5" target="_blank" rel="noreferrer noopener">according to</a>&nbsp;the Centers for Disease Control and Prevention.</p>



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



<p>15,067. That’s the number of Covid hospitalizations in the U.S. over the week ending August 19, an increase of 18.8% from the week before, according to&nbsp;<a href="https://covid.cdc.gov/covid-data-tracker/#maps_new-admissions-rate-county" target="_blank" rel="noreferrer noopener">CDC data</a>. More than 6.27 million people in the U.S. have been hospitalized since the outbreak of the pandemic more than three years ago.</p>



<h2 class="wp-block-heading" id="h-chief-critic">CHIEF CRITIC</h2>



<p>Despite the rise in cases, Republican lawmakers have slammed Covid mask mandates, with Mississippi Gov. Tate Reeves (R)&nbsp;<a href="https://mailchi.mp/5dd152f9c1de/governor-tate-reeves-mask-mandates?e=ae3824fee2" target="_blank" rel="noreferrer noopener">swearing off</a>&nbsp;potential mask orders, saying, “MIssissippians will not and should not submit to fear again.” In a&nbsp;<a href="https://truthsocial.com/@realDonaldTrump/posts/110979968873429026" target="_blank" rel="noreferrer noopener">video</a>&nbsp;posted on his social media platform Truth Social, former President Donald Trump argued mask mandates amounts to “fear mongering,” calling lawmakers “Covid tyrants,” and vowing: “We will not shut down our schools, we will not accept your lockdowns, we will not abide by your mask mandates and we will not tolerate your vaccine mandate.”</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/ariannajohnson/2023/08/21/new-covid-boosters-expected-this-fall-why-some-doctors-suggest-holding-off-on-getting-your-next-booster-until-then/?sh=6d037a70438b">New Covid Boosters Expected This Fall: Why Some Doctors Suggest Holding Off On Getting Your Next Booster Until Then</a>&nbsp;(Forbes)</p>



<p><a href="https://www.forbes.com/sites/williamhaseltine/2023/08/25/wastewater-analysis-update-on-ba286-in-the-united-states-its-here-be-careful/?sh=6ab2e5353cc0">Wastewater Analysis Update On BA.2.86 In The United States: It’s Here, Be Careful</a> (Forbes)</p>


Business owner setting up face mask required sign in cafe window

Will Covid Mask Mandates Return? Here’s Where They’re Making A Comeback


<p class="has-drop-cap">According to <em>MedicineNet</em>, at least 10% of the world’s population is affected by chronic pain. Eight out of those 10 patients are affected by depression, and lower back pain is the most common chronic condition, globally. It’s no wonder that pain clinics are popping up everywhere, some of them being called ‘pill mills’, one-stop shops for the medicine that specialists are becoming cautious of prescribing.</p>



<p>“Are they really clinics? My answer is no,” says Dr Marnin Romm, a specialist interdisciplinary pain management clinician and assistant and associate professor based in Boston, United States (US), but born in South Africa.</p>



<p>“A true pain clinic, by definition, is interdisciplinary.”</p>



<p>For Romm, one of the biggest problems with pain management is the commercial side of the business. “It’s ludicrous. Where’s the sustainability of the practitioner?” he asks. “Pain is more complex than just cracking your back, or going to a physiotherapist and feeling okay for a day or two until the pain comes back with a vengeance and you have to go back. That tells me you’re not managing the patient properly, you’re not doing the right treatment and if you keep doing the same thing day in and day out, where’s the ethics?”</p>



<p>Based on his training, clinical experience and work as an academic, Romm believes that pain management is about self-management.</p>



<p>His goal is to help his patients, many of whom have gone down the Dr Google rabbit hole, to stop relying on healthcare providers – including himself.</p>



<p>“It’s for the greater purpose of the good of the patient,” he explains. “I’m not here to fix them. I’m here to guide and navigate in terms of their self-management to different modalities, different tools, and a mixture of different tools, a mix of pharmacology.”</p>



<p>According to Romm, there has been a shift in terms of understanding the physiological and molecular mechanisms underlying chronic pain. Instead of understanding the pathophysiology underlying chronic pain, healthcare providers use pharmacological agents and invasive interventions.</p>



<div class="wp-block-media-text is-stacked-on-mobile" style="grid-template-columns:33% auto"><figure class="wp-block-media-text__media"><img loading="lazy" decoding="async" width="681" height="1024" src="https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-681x1024.jpeg" alt="" class="wp-image-59398 size-full" srcset="https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-681x1024.jpeg 681w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-200x300.jpeg 200w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-768x1154.jpeg 768w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-1022x1536.jpeg 1022w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-1363x2048.jpeg 1363w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/Dr-Marnin-Romm-scaled.jpeg 1703w" sizes="auto, (max-width: 681px) 100vw, 681px" /></figure><div class="wp-block-media-text__content">
<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">
<p>“IN MEDICAL SCHOOL, THE AVERAGE AMOUNT OF TIME SPENT TRAINING DOCTORS OR PHYSIOTHERAPISTS (OR ANYONE INVOLVED IN PAIN) OVER THE SPAN OF SEVEN YEARS IS FOUR HOURS… FOUR HOURS. FOR A PANDEMIC. SO, YOU’RE SAYING YOU CAN LEARN EVERYTHING YOU NEED TO KNOW ABOUT PAIN MECHANISM IN FOUR HOURS? THAT’S IMPOSSIBLE.”</p>
<cite><strong>—Dr Marnin Romm</strong></cite></blockquote>
</div></div>



<p>“And it’s not their fault. The reason for this is that in medical school, the average amount of time spent training doctors or physiotherapists (or anyone involved in pain) over the span of seven years is four hours,” he says. “Four hours. For a pandemic. So, you’re saying you can learn everything you need to know about pain mechanism in four hours? That’s impossible.”</p>



<p>Romm, who spent two years in London doing a master’s degree in pain neuroscience, says that the reason healthcare practitioners find it difficult to treat chronic pain is because they’re unable to identify what mechanisms are at play.</p>



<p>“In my assessments, I find out what is going on in the body and then target those mechanisms. Whether the treatment is pharmacological, more invasive, or psychological to reduce stress and anxiety or even exercise-based, but one of the biggest problems in pain management now is that’s still not the case,” adds Romm.</p>



<h4 class="wp-block-heading has-text-align-center" id="h-making-money-off-pain">MAKING MONEY OFF PAIN</h4>



<p>There’s no question that opioids are both oversupplied and overprescribed in high-income countries. Patrick Radden Keefe’s 2021 exposé about Purdue Pharma and the opioid epidemic, <em>Empire of Pain</em>, pinpointed the Sackler family’s marketing strategy to generate billions of dollars – which resulted in millions of addicts.</p>



<p>In sub-Saharan Africa, there has been a sharp increase in treatment admission trends for opioids and opioid-related disorders. A <em>BBC </em>investigative documentary called <em>Sweet Sweet Codeine </em>uncovered corruption at major pharmaceutical companies in Nigeria with staff running drug syndicates to meet the high demands of the black market. A few years after banning cough syrup containing codeine, the National Agency for Food and Drug Administration and Control (NAFDAC) reportedly shut down three pharmaceutical firms. Whether used to combat pain or recreationally, the United Nations (UN) put in a report that west, north and central Africa jointly account for 87% of all pharmaceutical opiates seized globally.</p>



<p>Another problem sub-Saharan Africa faces is the use of fake or substandard medications. Drugs are big business which means counterfeits and poorly-made medication benefits the pharmaceutical company that doesn’t know these products are infiltrating their supply chain and the street vendors who knowingly peddle these drugs.</p>



<p>A report from the UN Office on Drugs and Crime showed that 267,000 deaths in Sahel countries (Burkina Faso, Chad, Mali, Mauritania and the Niger) were linked to fake or below-par antimalarial medication. Just under 170,000 deaths have been linked to falsified antibiotics used to treat severe pneumonia in children. Sahel countries rely on imports of medical products due to their own pharmaceutical industries being in the earlier stages of development.</p>



<p>It is believed the counterfeit drugs are imported from pharmaceutical exporters (like Belgium, France, China and India), and diverted from the legal supply chain, or manufactured in neighboring countries.</p>



<p>An alternative to opioids is cannabidiol, or CBD. Different to tetrahydrocannabinol (THC) which also comes from cannabis plants, CBD is non-intoxicating in its pure form. While regulations around the world differ due to the insufficiency of solid evidence to establish its benefit versus the risks, there are many countries that have approved its use for pain. A <em>Forbes </em>Health survey found that 60% of the adults who use CBD in America do so for its pain relief effects. When it comes to cancer pain, Canada has given the thumbs up for CBD and so has the UK to treat the pain that comes with multiple sclerosis stiffness and spasms. In Lesotho, marijuana has become a cash crop as the small landlocked country grows and exports medical cannabis to Europe. In South African President Cyril Ramaphosa’s State of the Nation Address, he said that the legal hemp and cannabis sector has the potential to create over 130,000 new jobs in the country – the pharmaceutical market has been estimated at over R100 billion ($53 million) a year. </p>



<h3 class="wp-block-heading has-text-align-center" id="h-brain-training-and-tech-to-track-and-treat-pain">BRAIN TRAINING AND TECH TO TRACK AND TREAT PAIN</h3>



<p>There’s more to the business of pain management than drugs, pharmaceuticals and otherwise. Exciting technology such as AI tools to monitor and track pain with big data to non-invasive devices that stimulate nerve fibers are being researched. Telemedicine has also become a big part of chronic pain care as some patients cannot travel to see specialists but still need to consult a doctor.</p>



<p>Another type of technology that’s up-and-coming in the pain space is virtual reality (VR) distraction therapy for pain relief. Dr David Binder, the director of innovation at Spaulding Rehabilitation Hospital in Boston, US, has been studying VR for a number of years. He explains that stimuli can distract the brain from receiving pain signals. In a paper for <em>Harvard Health Publishing</em>, he writes: “We already take advantage of this wiring all the time. For example, if you hit your elbow by accident, and it hurts, you rub the elbow and it feels better. You’re tricking the brain by producing the sensory reaction of touching the elbow, which cancels some pain signals.”</p>



<p>Dr Todd Maddox is part of AppliedVR, a company in Texas in the US that makes prescription VR-based therapeutics for chronic pain management. “One of the ways people learn to deal with chronic pain is with breathing mechanisms – this deals with a part of the brain that learns behavior and the goal is to engage those centers in the brain,” he explains.</p>



<p>Maddox explains chronic pain (and where technology fits in) as something that gets worse over time because the brain gets you into a habit that you cannot break out of. Chronic pain is not only about issues with the tissues as muscles, as one example, usually heal within six to 12 weeks, it’s how your brain processes information.</p>


<div class="wp-block-image">
<figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="576" src="https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-1024x576.jpeg" alt="" class="wp-image-59396" srcset="https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-1024x576.jpeg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-300x169.jpeg 300w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-768x432.jpeg 768w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-1536x864.jpeg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2023/08/AppliedVR-2048x1152.jpeg 2048w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /><figcaption class="wp-element-caption"><strong>AppliedVR makes prescription VR-based therapeutics for chronic pain management</strong></figcaption></figure></div>


<p>“So much of how we approach chronic pain is cognitive… but the behavior centers in the brain don’t listen to the cognitive centers very well,” says Maddox. This is why talking to someone and telling them what to do with chronic pain doesn’t always work – someone may do the exercises recommended by a physiotherapist but they also might not.</p>



<p>“Here’s what VR does: it broadly engages the brain. It engages your sensory and perception centers – the parts of the brain that say you’re there. It engages cognitive centers, emotional centers, you get motivated, excited and are poised for behavior change…” The research behind this non-pharmacologic form of chronic relief is exciting but it’s something that depends on good content which costs money to create. There’s also the fact that at this point, VR for pain isn’t covered by insurance unless you’re in a nursing home in America and on a CareWell plan. The alternative to what a company like AppliedVR offers is a patient buying their own VR headset and downloading a meditation app like TRIPP which combines tried- and-tested relaxation techniques with binaural audio – it just won’t be supervised by a specialist and the content won’t be specifically designed around pain relief.</p>



<p>Smartphones have given rise to numerous apps to track pain and others that take a more multidisciplinary approach, pairing users with a health coach who can create customized care plans. </p>



<p>One piece of wearable tech that is making the rounds on social media is Healy, an expensive, palm-sized device which delivers mild electrical currents to the wearer. Robyn Gilbert, a mom of two, discovered Healy from a friend. “I have pain from an autoimmune condition and Healy can mitigate it almost completely,” she says. “It has also improved my sleep, my overall energy levels, and my general sense of emotional wellbeing.” While Gilbert doesn’t feel the current – in fact, it is recommended to keep the stimulation levels low so the user doesn’t feel it – she says she felt a mental shift straight away. “People experience profound changes in many different ways, from the cessation of pain to an overall sense of wellbeing on an emotional and mental level,” she adds. Healy was invented by Marcus Schmieke, founder of the Existential Consciousness Research Institute. It isn’t approved by the FDA but that hasn’t stopped over 300,000 people from buying a device.</p>



<h3 class="wp-block-heading has-text-align-center">‘IT’S ALL IN YOUR… GUT?’</h3>



<p>Chronic pain may be common but it’s complex and the idea that it’s all ‘in your head’ is something not every doctor agrees on.</p>



<p>Dr Sarette Zecharia is a clinical psychologist who works with alternative forms of pain management, including traditional Chinese medicine and Ayurveda, and is on the board of the Association for Comprehensive Energy Psychology. “Medication is a quick fix but the issue is that it’s foreign to the body and you end up taking more medication to cover up the side effects,” she says. “What I recently heard is that for each decade you’re in, you have to be on two medications and if </p>



<p>you’re not, it’s mind-boggling. It’s no longer normal to not be on medication.”</p>



<p><img loading="lazy" decoding="async" width="20" height="20" src="">Zecharia has seen incredible (and less expensive) results with her pain patients by simply managing diet, using food as fuel. “In modern science, it’s very easy to find the one thing that’s the cause of everything – and medicate. Pain is in every single system, the energetic system, the physical system, the mental system, the emotional system, the spiritual system, and it has to be dealt with on all of those levels,” she adds.</p>



<p>New research from the Massachusetts Institute of Technology has shown that there is a connection between the gut and chronic pain because the bacteria living</p>



<p>in our gut can influence some neurological diseases – when the microbiome is disrupted, the communication between the gut and brain is disrupted. There is also research in the <em>Nature </em>science journal which validates that an out-of-balance microbiome can lead to chronic inflammatory disease. “If you think about all these psychotropic medications that people are given, it disrupts the gut and the gut is where you make the majority of your neurotransmitters. That’s where your mood comes from and that’s why food is so important,” she adds.</p>



<p>“Food is not important to people whose mood is regulated, but the moment your mood isn’t regulated, you start to realize the importance of food.”</p>



<p>The connection between pain, food and diet culture is complicated and can be attributed to various factors, including societal pressure, media influence and individual experiences. Living a ‘healthy lifestyle’ comes at a cost and the diet industry globally is worth billions ($282.53 billion by 2028 per <em>GlobeNewswire</em>), profiting off those who struggle with their relationship with food and body image.</p>



<p>While Zecharia does believe food is fuel and has seen regenerative diets work for those in pain, she says making money off pain is easy because you can charge people a fortune and “keep giving them stuff that’s just knocking them more off their center line”.</p>



<p>Where does the spend stop and relief begin? For those dealing with pain, chronic or acute, finding a quick fix can take a dark turn but as the field expands and researchers across different disciplines collaborate, there is hope. Says Zecharia: “I’m not saying don’t take psychotropic medication if you need it. The problem is when someone gets medication from a healthcare provider who doesn’t really know what they have. And if it doesn’t work, you keep upping the dosage, messing up your gut biome…”</p>


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