Western firms’ Chinese red lines are not their own

 Beijing’s anti-Covid rules have triggered the biggest domestic protests since the Tiananmen Square uprising of 1989. While the Chinese government looks set to ease some health measures, the episode has got Western corporate boards pondering what to do in case of an escalation. Yet companies’ red lines on China are out of their hands.

Undeterred by growing geopolitical tensions and slowing Chinese growth, several Western companies have this year intensified the rate at which they bet on the People’s Republic. Foreign direct investments by German carmakers, which last year represented about 40% of all European Union investments into China, reached 4.6 billion euros by the end of September 2022. That’s 42% higher than those for the whole of 2021 and the biggest amount in a year since 2000, Rhodium Group data show. In recent years, most European inflows have come from a handful of big companies.

The upshot is stark. Volkswagen, General Motors, Toyota Motor and Tesla derived between 20% and 40% of their global sales from China last year, according to Goldman Sachs analysts. At 10.2%, their average net profit margins in China were significantly above the 7.7% recorded at group level. Luxury giants including LVMH and Kering, which collectively made 21% of their global sales in China last year, opened 55% of all new global stores in the Middle Kingdom. China is forecast to become the world’s largest bling market by 2025.

All this creates an obvious economic incentive to overlook human rights concerns and East-West political sniping. Using the sanctions currently imposed against Russia as a blueprint, companies and investors are working out scenarios that envisage China facing similar penalties, one senior Western executive told Reuters Breakingviews. Yet the negative impact of a Chinese blockade would be so massive that no contingency plan would really work. Western groups that have curbed their China presence, including Stellantis and CNH Industrial, tend to be players with less exposure.

Western boards can try to contain some of the risk by building production slack or seeking alternative suppliers, perhaps in India, to allow continued manufacturing outside the People’s Republic. But that has limited impact. And there’s no upside to pre-emptive self-sanctioning.

If Western states decide to impose sanctions, boards would have their red lines decided for them. Until that happens, their main strategy is just to assume such a step won’t happen, as the ramifications would be too seismic. Western companies will keep betting on the Middle Kingdom, until their governments stop them.

Reacting to anti-lockdown protests, China is set to announce a nationwide reduction of the frequency of mass testing and will allow some people infected with Covid and some close contacts to isolate at home under certain conditions, sources familiar with the matter told Reuters on Dec. 1.

German foreign direct investments into China totalled 5.49 billion euros during the first three quarters of this year, 15% up from 4.8 billion euros during the whole of 2021 and the highest level of investment in a single year since 2000, data from the Rhodium Group showed.

China’s domestic sales of luxury goods grew 36% to 471 billion renminbi ($67 billion) in 2021 from a year earlier, representing a 21% share of theglobal market according to a report by Bain & Company. The report predicts China will become the largestglobal marketfor luxury goods by 2025.

https://www.nasdaq.com/articles/western-firms-chinese-red-lines-are-not-their-own

'U.S. expects reduced tempo in Ukraine fighting to continue for months'

 U.S. intelligence expects the reduced tempo in fighting in Ukraine to continue in the next several months and sees no evidence of a reduced Ukrainian will to resist, despite attacks on its power grid and other critical winter infrastructure, the Director of National Intelligence said on Saturday.

"We're seeing a kind of a reduced tempo already of the conflict ... and we expect that's likely to be what we see in the coming months," Avril Haines told the annual Reagan National Defense Forum in California.

She said both the Ukrainian and Russian militaries would be looking to try to refit and resupply to prepare for a counter-offensive after the winter, but there was a question as to what that would look like, and added:

"We actually have a fair amount of skepticism as to whether or not the Russians will be in fact prepared to do that. I think more optimistically for the Ukrainians in that timeframe."

Asked about the effects of Russian attacks on Ukraine's power grid and other civilian infrastructure, Haines said Moscow's aim was partly to undermine the will of Ukrainians to resist, and added: "I think we're not seeing any evidence of that being undermined right now at this point."

She said Russia was also looking to affect Ukraine's capacity to prosecute conflict and added that Kyiv's economy had been suffering very badly.

"It can over time, obviously, have an impact. How much of an impact will be dependent on how much they go after, what they're capable of doing, the resilience of that critical infrastructure, our capacity to help them defend it."

"Ukraine's economy is suffering very badly. It's been devastating, and ... obviously taking down the grid will have an impact on that as well."

Haines said she thought Russian President Vladimir Putin had been surprised that his military had not accomplished more.

https://www.yahoo.com/news/u-expects-reduced-tempo-ukraine-234914756.html

Shanghai Eases Covid Rules as China’s Policy Shift Expands

 Shanghai eased some of its Covid restrictions, joining other top-tier Chinese cities as authorities accelerate a shift toward reopening the economy after thousands of demonstrators took to the streets last weekend to voice their anger at the nation’s stringent policies.

The financial hub will scrap PCR testing requirements to enter outdoor public venues such as parks as well as ride public transit effective Monday, city authorities said in a statement Sunday. Measures will “continue to be optimized and adjusted” in line with national policy and the situation, according to the statement.

Shanghai, which saw a grueling two-month lockdown earlier in the year, joins other metropolises such as Beijing, Shenzhen and Guangzhou in relaxing curbs in recent days. Top government officials over the past week signaled a transition away from the harshest containment measures, which have weighed on the economy and triggered anti-lockdown protests as public discontent grew.

The rapid unwinding of requirements has led to a sharp drop in the number of testing booths in some cities, causing unusually-long queues. Authorities in Beijing’s Chaoyang District, one of the Chinese capital’s worst-hit areas in the current outbreak, on Saturday said they were “deeply sorry” for inadequate coordination that led to excessively long waiting times and restored some sites.

China reported 30,889 new local Covid cases on Saturday, down from 32,206 the day before, according to the latest official data.

Restrictions are also being rolled back in Zhengzhou city, home to Apple Inc.’s largest manufacturing site in China. Authorities announced on Sunday the immediate end of mandatory Covid testing to enter buses, subway, taxis and other public venues besides for those who depart from the city or go to karaoke bars and internet cafes.

https://www.yahoo.com/now/more-china-cities-ease-curbs-041834787.html

Not Even N95 Masks Work To Stop Covid

 by Ian Miller via the Brownstone Institute,

“The Experts™” have repeatedly tried to deflect from the failure of their policies with misdirection.

The reason lockdowns didn’t work in the United States or the United Kingdom is because they weren’t strict enough, according to many in the expert community.

Of course, their excuses have been conveniently ignored as China’s repressive zero COVID lockdowns have continued, with horrific consequences.

Now that mass protests have broken out in the country that “The Experts™” revered for their COVID handling, there’s a massive effort to disregard their own previous advocacy.

This is perhaps best exemplified by Canadian Prime Minister Justin Trudeau, who clearly used authoritarian measures to suppress the protests in his own country, while now supporting Chinese demonstrations.

The bewildering lack of awareness of their own hypocrisy seems to be a feature of COVID-obsessed politicians and public health authorities.

Another similar, oft-repeated assertion is that the failure of universal masking can be explained by the type of masks being used by the public.

Even though the CDC and Dr. Fauci explicitly claimed that wearing anything to cover your face would be effective at preventing transmission, many have now quietly dismissed that messaging.

Fauci specifically said that “cloth coverings work,” not just surgical or N95s. Former Surgeon General Jerome Adams famously suggested that rolling up a t-shirt in front of your face would be effective protection.

Yet public health departments and the media are now highlighting the importance of “high quality,” “well-fitted” masks. 

Their desperation to justify masking has led to remarkably poor studies being released to support their anti-science messaging.

There is new research that has been released showing that masks are ineffective, regardless of type.

And it’s not just new research, it’s high quality research.

Finally, Another RCT on Mask Wearing

The Annals of Internal Medicine just published a randomized controlled trial comparing the ability of medical masks to prevent COVID infection to fit-tested N95s.

Importantly, this trial was conducted on healthcare workers who would be most likely to use masks appropriately.

To determine whether medical masks are noninferior to N95 respirators to prevent COVID-19 in health care workers providing routine care.

That trial design was also important as it was meant to determine whether or not N95 respirators were superior to “regular” surgical masks.

They examined 29 different health care facilities on multiple continents, from North America to Asia and Africa.

The percentage of healthcare workers testing positive for COVID in each group was tracked to determine how effective or ineffective higher-quality masking was in preventing infection.

Unsurprisingly, the results confirmed that there is essentially zero difference between surgical or N95 respirators when it comes to tests results.

In the intention-to-treat analysis, RT-PCR–confirmed COVID-19 occurred in 52 of 497 (10.46%) participants in the medical mask group versus 47 of 507 (9.27%) in the N95 respirator group (hazard ratio [HR], 1.14 [95% CI, 0.77 to 1.69]). An unplanned subgroup analysis by country found that in the medical mask group versus the N95 respirator group RT-PCR–confirmed COVID-19 occurred in 8 of 131 (6.11%) versus 3 of 135 (2.22%) in Canada (HR, 2.83 [CI, 0.75 to 10.72]), 6 of 17 (35.29%) versus 4 of 17 (23.53%) in Israel (HR, 1.54 [CI, 0.43 to 5.49]), 3 of 92 (3.26%) versus 2 of 94 (2.13%) in Pakistan (HR, 1.50 [CI, 0.25 to 8.98]), and 35 of 257 (13.62%) versus 38 of 261 (14.56%) in Egypt (HR, 0.95 [CI, 0.60 to 1.50]). There were 47 (10.8%) adverse events related to the intervention reported in the medical mask group and 59 (13.6%) in the N95 respirator group.

52 of 497 participants who wore medical masks got COVID-19, and 47 of 507 in the N95 group got COVID-19. 

No matter how “high quality” your mask is, it’s entirely irrelevant.

The researchers also took pains to ensure that the control and treatment groups shared as many similarities as possible.

They excluded workers who could not pass a fit test, had laboratory-confirmed COVID, or “had received 1 or more doses of a COVID-19 vaccine with greater than 50% efficacy for the circulating strain.”

Yet none of that mattered; there was no difference in outcomes between the medical and N95 level masks.

The N95s in use were even specifically fit tested and approved respirators, far from the KN95s commonly used by the general public.

“Health care workers randomly assigned to the N95 respirator group were instructed to use a fit-tested National Institute for Occupational Safety and Health–approved N95 respirator when providing routine care to patients with COVID-19 or suspected COVID-19.”

It didn’t matter.

Even more importantly, these disappointing results were from facilities with universal masking policies in place.

Everyone, in each health care facility, “for all activities,” was required to wear masks. 

The intervention included universal masking, which was the policy implemented at each site. This refers to the use of a mask when in the health care facility for all activities, whether patient related or not, including in workrooms, meetings, and treating persons that were not suspected or known to be positive for COVID-19.

It still didn’t work.

They even tracked potential exposure points, whether at home, in the community or in hospital exposures.

There was no difference.

What’s even more impressive about the futility of masking is that outside of Egypt, the observed results occurred before the more contagious Omicron variant emerged.

There were substantial differences in results between countries, which indicates the impact of N95s might have been further muted had it covered the Omicron period.

Canada, which was observed pre-Omicron, showed the biggest “benefit” to N95s, while post-Omicron Egypt was nearly identical. 

It’s possible that the mild difference in Canada could have been erased entirely if subjected to the Omicron era.

On top of being functionally useless, N95s were substantially more likely to result in adverse effects.

According to the results page, there were significantly more reported issues in the respirator group:

“There were 47 (10.8%) adverse events related to the intervention reported in the medical mask group and 59 (13.6%) in the N95 respirator group.”

This becomes even more noteworthy since compliance with respirator masking was lower.

“Adherence with the assigned medical mask or N95 respirator was self-reported as “always” in 91.2% in the medical mask group versus 80.7% in the N95 respirator group and as “always” or “sometimes” in 97.7% in the medical mask group versus 94.4% in the N95 respirator group.”

While still extremely high, health care workers “always” wore N95s 80.7% of the time instead of 91.2% for medical masks.

This is one of the many issues the “experts” now pushing for (now disproven) “higher-quality” masking should address.

Health care professionals who are trained to use N95s can’t always use them yet experience higher rates of adverse effects.

Imagine how much worse compliance would be among the general public, especially if 13% are suffering significant side effects.

Results Show Expert Incompetence

This is yet another randomized controlled trial to show that masks do not work.

It also confirms the DANMASK study conducted earlier in the pandemic, which proved there was no benefit from masking in COVID prevention.

Even the Bangladeshi study, comparing villages, showed there was no benefit to masking at a population level. They used statistical misdirection and purposeful p-hacking to try and generate a positive result, and still could only get to a ~10% reduction for those over 50.

No matter the quality, no matter the compliance, masks are entirely ineffective at preventing transmission or infection.

The participants in this examination lived and worked in environments where universal masking was a requirement.

It didn’t matter.

This also examined health care workers, who, in theory, would be using and disposing of medical or N95 level masks properly. 

There was no difference. 

Now imagine how much worse the results would look for mask fanatics if it examined the Fauci-approved cloth coverings. 

If “The Experts™” actually cared about following “the science,” or “the evidence,” this would once again be the nail in the coffin for masking.

More like the 40th nail in the coffin.

We have observational evidence through population-level comparisons that masks do not prevent the spread of COVID.

We also now have multiple randomized controlled trials confirming that masks do not prevent the spread of COVID.

And we have extremely well done comparisons of neighboring jurisdictions confirming it.

All the mask fanatics have is politically motivated wishful thinking, desperate advocacy from disproven CDC “studies,” and a commitment to avoiding reality.

Fauci and his health authority allies have lied to the public repeatedly about masking. The obsession with credentialism and appeals to authority within the media has resulted in tremendous, unjustified harm.

You’d hope that results like these would finally end their ridiculous posturing, but it’s abundantly clear they’re too dug in to ever relent.

But thankfully those paying attention now have even more ammunition in the fight for the inarguable scientific reality that masks do not work.

https://www.zerohedge.com/covid-19/not-even-n95-masks-work-stop-covid

China Traders Hunt for Long-Term Reopening Winners After Frenzy

 As China’s reopening starts to take shape, investor focus is increasingly seen shifting from frenzied stock bets to longer-term plays such as consumer and health-care shares.

Money managers are zeroing in on companies that’ll benefit from a reopening-led economic recovery instead of travel and catering firms whose shares have jumped sharply in the early days of the rally. Some are positioning for a full easing of Covid restrictions to take place by March, even if the journey toward that end may be bumpy.

“With the trajectory of the economy set to be back on track, it is time to shift focus from stocks primed to jump on short-term changes,” said Hua Tong, fund manager at Shenzhen Zhengyuan Investment Co. “We can now afford to take the longer-term view to seek out opportunities -- and the biggest unrealized opportunity is in the consumer sector.”

November’s historic rally is being seen as a gamechanger for Chinese equities after months of gut-wrenching swings fueled by rolling lockdowns that many said were the single-biggest drag on the market. Investors are seeking potential buys as Beijing gradually relaxes curbs that combined with a property crisis made key Chinese gauges the world’s worst performers for much of this year.

Recent measures from authorities include allowing some low-risk patients to isolate at home and loosening restrictions in select cities, with the official rhetoric on Covid also coalescing around a softer tone.

‘First Shot’

“The reopening trade will be led by consumption and health care in the coming months,” said Li Changmin, fund manager at Snowball Wealth. “Guangzhou’s surprise reopening, even with its high case count, has fired the first shot, and this could expedite the time line for ending Covid Zero.”

Li expects a full reopening to occur before China’s annual parliamentary meetings take place in March. “Life returning to normal would mostly benefit the blue-chip names which have suffered huge valuation discounts, whereas the upside for travel and airlines stocks has been mostly priced in,” he said.

The CSI 300 Consumer Staples Index is trading close to 22 times its one-year forward earnings, compared to an average of almost 27 times over the past three years. Heavyweights such as liquor manufacturer Kweichow Moutai Co. and dairy product maker Inner Mongolia Yili Industrial Group Co. are down about 40% from last year’s peaks.

The initial leg of the reopening trade has seen more volatile stocks lead the charge. Shares linked to the travel, catering and pharmaceutical industries have been among the prime beneficiaries.

For example, Xi’an Tourism Co. jumped 37% in November while hotpot chain Haidilao International Holding Ltd. rallied 64% in Hong Kong. Shanghai Shenqi Pharmaceutical Investment Management Co. surged as much as 100% in November on speculation that a drug manufactured by the firm would be used to treat Covid patients.

Meanwhile, Moutai and Yili ended the month with gains of about 18% and 14%, respectively.

Sportswear, Cars

More broadly, the Hang Sang China Enterprises Index soared 29% in Hong Kong in November, the most since 2003. China’s benchmark CSI 300 Index jumped almost 10% in its best performance since July 2020. The rally has eased since, with the gauges little changed over two sessions in December.

Paul Pong, managing director at Pegasus Fund Managers Ltd. favors consumer stocks such as sportswear and car makers which are expected to beat their peers when spending picks up. “Big tech firms that have been laggards, like Alibaba and Tencent, will also outperform as they have high beta and benefit directly from a consumption recovery.”

To be sure, some still see room for a further rally in the traditional cohort of reopening plays. Manishi Raychaudhuri, Asian equity strategist at BNP Paribas, says that stocks related to tourism, restaurant chains, e-commerce, Macau gaming and retail-focused REITs may notch up more gains.

“Other Asian markets, like Thailand, also offer interesting exposures to this theme – through airports and hotel chain stocks,” he said.

Long Game

All said, an increasing number of investors are setting their sights on the longer-term play even though China’s exit from Covid Zero may be fraught with challenges.

“Reversing course is going to be like walking on a tightrope, full of adjustments in both directions in the search for the most desirable solution,” said Liu Xiaodong, partner at Shanghai Power Asset Management Co.

“This means that many of the reopening plays may be prone to flip flop and end up moving horizontally,” Liu said. “If anything, I think health-care does have potential, whichever way the tide turns in the short term, people are going to need treatment.”

https://finance.yahoo.com/news/china-traders-hunt-long-term-010000735.html

UnitedHealth, American Nurses Foundation team on pilot to tackle nurse burnout

 The United Health Foundation is teaming up with the American Nurses Foundation to address nurse burnout.

The foundation, which is the philanthropic arm of health insurance giant UnitedHealth Group, will partner with the nursing group in a three-year, $3.1 million grant program to pilot a stress and burnout prevention program. The initiative aims to overhaul organizational structure, address stigmas associated with seeking mental health care and encourage nurses to seek mental health services and support earlier.

A key focus in the pilot is elevating the voices of millennial and Generation Z nurses in the conversation around burnout, according to the announcement.

“Few could have predicted how unprecedented and demanding the past two and a half years have been for all of us, let alone our country’s nursing staff,” said Mary Jo Jerde, senior vice president of the UnitedHealth Group Center for Clinician Advancement, in the release. “Nurses have played a vital role throughout this critical period and we’re committed to ensuring they have the resources they need to deliver care across the country.”

The demands of the COVID-19 pandemic have put significant strain on the healthcare workforce, and many nurses are bearing the brunt of that stress. The most recent Pulse of the Nation's nurses survey found that 71% of nurses report feeling stressed, 69% said they are frustrated and 65% said they feel exhausted. Nearly half (49%) said they are burnt out, and 58% said they are feeling overwhelmed.

Those figures were higher among Gen Z and millennial nurses compared to their older counterparts, the foundations noted in the release, and these feelings were also commonly expressed among nurses of color.

A survey conducted by the American Nurses Foundation in August 2021 found that 34% of nurses do not feel emotionally healthy and 42% experienced trauma related to COVID-19.

“Given the complexity, intensity and intimacy of what nurses do every day, nurses’ need for mental health support has always existed. This has been exacerbated tenfold by the COVID-19 pandemic,” said Kate Judge, executive director of the American Nurses Foundation, in the release. “Burnout cannot just be addressed one nurse at a time. This new partnership addresses burnout at the systems level, especially for those most impacted including younger nurses and nurses of color.”

The American Nurses Foundation will pilot the program in four healthcare organizations that include more than 15,000 nurses across acute, primary and long-term care settings: BayCare Health System, Indiana University Health, University of South Alabama Health Hospital and Wayne Health Care. The pilot group represents both urban and rural sites of care.

The program takes a "train the trainer" approach originally developed for the military and later adapted to other demanding professions. The goal is to identify stress reactions before they grow into significant, lasting issues by empowering nurses to speak about their stress and burnout using common language and with peer support. Lessons from the pilot will be adapted into a national awareness campaign, including free anti-burnout resources for nurses and clinicians.

The partners plan to scale the pilot to reach more than 50,000 nurses nationwide over time.

In 2020, the United Health Foundation launched a similar pilot aimed at burnout among family physicians, in partnership with the American Academy of Family Physicians. The pilot is baked into UnitedHealth Group's broader efforts to target health equity, the company said.

https://www.fiercehealthcare.com/payers/unitedhealth-american-nurses-foundation-team-pilot-tackle-nurse-burnout

KFF: More large employers, unions turn to Medicare Advantage for retiree health benefits

 More and more employer and union-sponsored retiree health plans are offering Medicare-eligible coverage through Medicare Advantage (MA), a new analysis finds. 

The analysis from the Kaiser Family Foundation, released Thursday, comes as MA is expected to surpass traditional Medicare in total enrollment for 2023 and more insurers enter the lucrative market. Employers and unions are turning to MA in a bid to control retiree healthcare costs. 

“For some large employers, the shift to Medicare Advantage appears to be a strategy to maintain benefits for their retirees, without terminating coverage or adopting other changes that more directly shift costs onto retirees,” the analysis said. “However, the shift to Medicare Advantage has implications for retirees that extend beyond supplemental benefits.”

Kaiser relied on data from its 2022 employer health benefits survey of large private and nonfederal public employers. It showed that half of the large employers with 200 or more workers are offering health benefits to retirees through an MA contract, nearly double the 26% doing the same in 2017. Another 44% that offer MA coverage to retirees don’t give them another choice in coverage. 

Among the companies with 2,000 or more employers, 60% offered benefits through an MA plan. The top reason such companies turn to MA is to combat higher costs, with 42% citing it as a reason compared with 14% for flexibility for enrollees. 

Unlike traditional Medicare, MA relies on provider networks and cost management tools to cut down on costs. Kaiser warned that this shift toward MA has some unintended consequences for retirees. 

“This approach has potential to restrict retirees’ access to doctors and hospitals, depending on the plan’s provider network, and subject retirees to cost management tools, such as prior authorization, that may limit access to Medicare-covered services,” the analysis said. 

Kaiser cited a recent move by New York City to move its city worker retirees to an MA plan, a decision that is on hold after the insurers Elevance Health and Empire Blue Cross Blue Shield dropped out, according to a published report on The City news site. 

The MA market has grown in popularity among seniors in recent years. The program has also received heightened scrutiny surrounding overpayments to plans based on inaccurate risk scores and aggressive marketing tactics by agents and brokers.

https://www.fiercehealthcare.com/payers/kff-more-large-employers-and-unions-turn-medicare-advantage-offer-retiree-health-benefits