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Future

Stock Futures Edge Down After S&P 500 Hits Record


U.S. stock futures edged lower Friday as investors assessed fresh waves of Covid-19 infections globally that could hamper global supply chains and drive up inflation.

Futures tied to the S&P 500 ticked down almost 0.3%, a day after it closed at a record. The broad market index remains on track for its best month since November. Nasdaq-100 futures declined 0.3%, suggesting that technology shares may be among the weakest performers after the opening bell.

Rising Covid-19 cases in Brazil and India and signs of weakening in China’s manufacturing sector are sapping some of the optimism that took the major indexes up to all-time highs earlier in the week. New variants are threatening to hobble global travel, convulse supply chains further and slow the recovery, investors say.

Signs that the U.S. growth is accelerating are also stoking concern that inflation may rise too much, driven by a persistent shortage of products like electronic chips and the prospect of more fiscal stimulus flooding markets. Persistent inflation can erode portfolio returns.

“That is where the market is, wrestling between those two,” said Edward Park, chief investment officer at Brooks Macdonald.

If the supply constraints and inflationary factors extend into next year, “the growth parts of the markets, which are supported by this ultra cheap money environment, will struggle,” he added.

New economic data from China weighed on sentiment, with official gauges for manufacturing falling short of expectations in April. China’s statistics bureau said global chip shortages, international logistics jams and rising delivery costs have weighed on factory operations.

Increased costs for businesses due to supply-chain issues could be passed on to consumers, boosting prices, investors said.

High cases of Covid-19 in India, Brazil and Japan have bolstered concerns that new variants could emerge and spread globally. A variant of the coronavirus first spotted in India has been detected in the U.S. and 18 other countries and territories. Another variant from Brazil that has been detected in more than 30 nations.

“The third wave is the big thing,” Mr. Park said. “The greater the case count, the greater the chance a new variant is created that unwinds a lot of the good work being done in the vaccine rollout program.”

In bond markets, optimism about U.S. growth prospects—stemming from better-than-expected corporate earnings, signs of the labor market’s recovery, and President Biden’s new $1.8 trillion spending proposal—have encouraged money managers to sell government bonds, considered the safest assets. There are also growing concerns that inflation could curtail the returns from fixed-income securities, and from stocks that are richly valued for their future cash flow.

The yield on the 10-year Treasury note ticked up to 1.645% from 1.639% Thursday, and is poised to extend its advance for five of the past six days. Yields rise when prices fall.

“You’re seeing a lot of companies reporting pricing pressures, supply chain disruptions, coupled with all this extra stimulus coming through from the U.S. that is why people are now really starting to focus on inflation,” said Edward Smith, head of asset allocation research at U.K. investment firm Rathbone Investment Management. “Persistent inflation beyond spring is the biggest risk to markets this year, because it could cause the Fed to taper and hike interest rates sooner than expected.”

Investors are likely to continue monitoring earnings, with energy giants

Chevron

and

Exxon Mobil

set to disclose results before the opening bell.

Fresh figures on U.S. consumer spending, due at 8:30 a.m. ET, are expected to show a rebound in March. Economists anticipate that Americans boosted spending as warmer weather and the vaccine rollout encouraged people to spend stimulus checks and savings.

Overseas, the pan-continental Stoxx Europe 600 edged 0.1% higher.

Most major indexes in Asia declined by the close of trading. Hong Kong’s Hang Seng shed almost 2%. The Shanghai Composite Index, South Korea’s Kospi and Japan’s Nikkei 225 each fell 0.8%.

Endeavor CEO Ariel Emanuel, fourth left, rang the New York Stock Exchange opening bell on Thursday to celebrate his company’s IPO.



Photo:

Courtney Crow/Associated Press

Write to Caitlin Ostroff at [email protected]

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8



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Stock Futures Waver Amid Rising Covid-19 Cases


U.S. stock futures wobbled Wednesday as an increase in global Covid-19 infection levels led to concerns about the pace of economic recovery.

Futures tied to the S&P 500 and the Dow Jones Industrial Average wavered between gains and losses after two straight days of declines. Technology-heavy Nasdaq-100 futures slid 0.3%.

A new wave of Covid-19 infections is sweeping through a number of countries including India and Japan, raising the prospect of fresh hurdles to the anticipated global economic rebound. Health authorities are also warning that new variants may emerge that are resistant to the existing batch of coronavirus vaccines. Given those concerns, investors are putting the brakes to what has been a furious rally in stocks in recent weeks, leaving the major indexes hovering near record highs.

“There are still risks in this market, particularly as it relates to the vaccine rollout and virus mutations,” said Shoqat Bunglawala, head of international multiasset investments at Goldman Sachs Asset Management. “We’re still likely to be in an environment with some volatility.”

Investors are also closely monitoring corporate earnings to see if the current valuations of expensive stocks can be justified.

Verizon Communications

and

NextEra Energy

are among a string of companies scheduled to report quarterly results before the market opens.

Chipotle Mexican Grill

will post earnings after the New York closing bell.

“We expect earnings to surprise on the upside, but the risks are asymmetric. In an environment where markets are at record highs, any company that doesn’t deliver is really punished,” said

Luca Paolini,

chief strategist at Pictet Asset Management. “Over the next few months the direction of earnings will determine the direction of the market.”

The retreat in U.S. stocks this week is simply a “normal pause” in a bull market, with investors taking the opportunity to book profits and reassess their risk appetite, Mr. Paolini said. “As long as the U.S. economy is strong, it’s not really worth the risk of betting against the equity market.”

Ahead of the market open, shares in

Netflix

fell almost 8% after the streaming giant said subscriber growth for the first quarter was weaker than expected.

In bond markets, the 10-year U.S. Treasury yield edged up to 1.575%, from 1.562% on Tuesday. Yields rise as prices fall.

Overseas, the pan-continental Stoxx Europe 600 climbed 0.5% after its biggest one-day drop since late December.

In Asia, most major stock indexes closed lower. Japan’s Nikkei 225 fell 2%, while Hong Kong’s Hang Seng declined 1.8%. The Shanghai Composite Index ended the day relatively flat.

Investors are looking to results to gauge whether high equity valuations are justified.



Photo:

Courtney Crow/Associated Press

Write to Caitlin Ostroff at [email protected]

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8



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Stocks Turn Higher After Fed Holds Steady


U.S. stocks rose Wednesday after the Federal Reserve vowed to keep its easy-money policies in place until the U.S. economy further recovers from the effects of the Covid-19 pandemic.

The S&P 500 added 0.3%, and the Dow Jones Industrial Average climbed 0.6%. The tech-heavy Nasdaq Composite advanced 0.4%, reversing losses earlier in the session.

All three indexes turned higher at the release of the central bank’s 2 p.m. ET statement. Investors are focused on any sign the monetary stimulus that has supported markets during the pandemic could begin to subside.

With unemployment still elevated, Fed officials are taking a cautious approach that supports the economy, said

George Catrambone,

head of Americas trading at asset manager DWS Group,

“Investors are taking some solace in that,” he said. “We’re going to make sure it’s there, that the recovery is sustainable and inflation is sustainable, before we really think about raising rates.”

The Fed also highlighted the brightening outlook for growth. Investors in recent weeks have trimmed bets on the technology stocks that soared earlier in the pandemic while adding shares of economically sensitive companies that should do well as the vaccine rollout progresses and more fiscal stimulus enters the financial system.

Shares of

Apple

and

Amazon.com

are down 5.6% and 3.1% this year, respectively, while the energy and financial sectors are leading the S&P 500.

“Tech is the funding source for reallocation,” said

Jamie Cox,

managing partner for Harris Financial Group. “You’re restoring the allocations that you had pre-pandemic.”

Money managers have started pricing in a rise in inflation, leading to a selloff in government bonds, and are betting that interest rates will start climbing by the end of next year. They have started exiting stocks that look to be too richly valued after last year’s rally.

“Markets across the board are expensive today, and that is pinned on central-bank support,” said

Hugh Gimber,

a strategist at J.P. Morgan Asset Management. “So this whole market is very, very sensitive to changes in central-bank policy.”

After the Fed’s reassurance that interest rates will stay low, shares of rapidly growing companies rebounded from earlier losses. The Russell 1000 Growth Index was recently up 0.3%, trailing a 0.4% gain by the Russell 1000 Value Index. Value stocks—which trade at low multiples of their book value, or net worth—have outperformed growth stocks in recent weeks.

“The resurgence of value investing has been the big story of the year,” said

Mace McCain,

chief investment officer at Frost Investment Advisors, noting that the rollout of coronavirus vaccines should help the economic recovery. “We expect tremendous growth this next year.”

In bond markets, the yield on the benchmark 10-year U.S. Treasury note rose to 1.641%, from 1.622% Tuesday. Yields rise as the price falls. The yield has climbed sharply from this year’s low of 0.915% on Jan. 4.

Traders worked on the floor of the New York Stock Exchange on Tuesday.



Photo:

Colin Ziemer/Associated Press

Among individual stocks,

NRG Energy

fell 17%. The company said it is withdrawing its 2021 financial guidance after the recent winter storm hit its results. Shares of

Plug Power

dropped 8% after the hydrogen and fuel-cell technology company said it would restate financial statements.

Brent crude, the international benchmark for oil, fell 0.6% to $68.00 a barrel.

In overseas markets, the Stoxx Europe 600 edged 0.4% lower. Most major indexes in Asia were little changed. South Korea’s Kospi index fell 0.6%, while the Shanghai Composite, Hang Seng and Nikkei 225 indexes all ended the day nearly flat.

Write to Karen Langley at [email protected] and Will Horner at William.Horner[email protected]

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8



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Reviews

J&J Single-Dose Covid-19 Vaccine Gains Backing From FDA Advisory Panel


Johnson & Johnson’s


JNJ -2.64%

single-dose Covid-19 vaccine worked safely and should be authorized for use in the U.S., a panel of experts advised federal health regulators Friday.

The advisory committee’s vote in support of the vaccine’s authorization is the last step before the U.S. Food and Drug Administration issues a decision, which is expected Saturday.

The panel, a group of 22 medical specialists in fields like internal medicine, pediatrics, vaccines and epidemiology, regularly advises the FDA about experimental vaccines. It voted to recommend shots from

Pfizer Inc.


PFE -0.98%

and partner

BioNTech


BNTX -2.94%

SE and

Moderna Inc.


MRNA 4.33%

before the agency authorized them in December.

During the all-day public meeting, representatives from the FDA and J&J discussed the safety and effectiveness of the company’s vaccine in a 44,000-plus subject study, as well as how effective the J&J vaccine is in preventing new cases caused by variants.

The give-and-take of questions and answers can be valuable in bolstering public confidence in the shot, according to FDA officials.

The vaccine was 66% effective at protecting people from moderate to severe Covid-19, an FDA review found, and even more effective at preventing severe disease alone.

“If authorized, Janssen’s vaccine candidate would play a pivotal role in the global effort to fight Covid-19,”

Johan Van Hoof,

global head of vaccines research at J&J’s Janssen pharmaceutical unit, said during the panel’s meeting. “A single-dose regimen offers the ability to vaccinate a population faster.”

As highly transmissible coronavirus variants sweep across the world, scientists are racing to understand why these new versions of the virus are spreading faster, and what this could mean for vaccine efforts. New research says the key may be the spike protein, which gives the coronavirus its unmistakable shape. Illustration: Nick Collingwood/WSJ

A rollout of the J&J vaccine could add enough shots in the U.S. by the end of March to boost the total number of people vaccinated by 20%. Health authorities are pushing to inoculate enough people as quickly as possible so that business, schools and other establishments can fully reopen.

SHARE YOUR THOUGHTS

How would you grade the vaccine rollout? Join the conversation below.

J&J has said it would deliver about 20 million doses for U.S. use by the end of March.

The FDA often convenes public meetings of outside experts to scrutinize experimental drugs, devices and vaccines up for agency approval, in part to boost public acceptance of the products should they be cleared for wide use.

J&J’s vaccine appeared to be safe in its pivotal study, the FDA found, aside from being effective.

“The known and potential benefits of Ad26 outweigh the known and potential risks,” Macaya Douoguih, head of clinical development and medical affairs at J&J’s Janssen unit, said during Friday’s meeting, using a code name for J&J’s vaccine.

FDA medical officer Yosefa Hefter said there are still unknowns about the vaccine, including the duration of immune protection and the safety and effectiveness in children.

An FDA analysis for the committee meeting also said rare cases of deep vein clots and of blockages in lung arteries were slightly more common in vaccine recipients than in placebo patients, and that the FDA considers these as “of clinical interest.”

The vaccine was effective “across demographic subgroups,” the FDA said. The demographic subgroups in the large study of J&J’s vaccines included racial and ethnic groups such as Black, Latino and Asian people, and age groups such as those 60 years and older.

Researchers also assessed efficacy in people who had underlying medical conditions including obesity and high blood pressure before entering the clinical trial. Sometimes vaccines don’t work as well in older people because of weakened immune systems.

One exception was that the vaccine appeared to be less effective in people 60 and older who had certain underlying medical conditions like diabetes and high blood pressure.

The Pfizer-BioNTech and Moderna vaccines also worked effectively across various demographic subgroups.

The vaccine was less effective in South Africa, where a more-transmissible Covid-19 variant has thrived, than in the U.S. J&J is among the companies working on new shots targeting the new strain, against which several current vaccines don’t appear to work as well.

J&J’s Covid-19 shot was, however, very effective against severe and critical cases in South Africa. The vaccine was 73.1% effective in preventing such cases occurring at least 14 days after vaccination, and 81.7% effective in preventing such cases at least 28 days after vaccination.

How Viral Vector Vaccines Work

Johnson & Johnson’s vaccine relies on a different mechanism for conferring immunity than traditional vaccines.

Traditional Vaccines

1. In classic vaccines, such as those against measles and polio, the patient is inoculated with weakened or inactivated versions of the virus. This triggers the immune system to produce specialized antibodies that are adapted to recognize the virus.

2. After vaccination, the antibodies remain in the body. If the patient later becomes infected with the actual virus, the antibodies can identify and help neutralize it.

Johnson & Johnson’s Vaccine

Scientists have isolated the genes in coronavirus responsible for producing these spike proteins. The genes are spliced into weakened, harmless versions of other viruses.

Instead of using the whole virus to generate an immune response, these vaccines use only coronavirus’s outer spike proteins, which are what antibodies use to recognize the virus.

Weakened virus with

spike protein genes

When injected into a patient, the genetically engineered viruses enter healthy cells where they produce coronavirus spike proteins.

The spike proteins produced by the cells prompt the immune system to mount a defense, just as with traditional vaccines.

Vaccine-generated antibody response

1. In classic vaccines, such as those against measles and polio, the patient is inoculated with weakened or inactivated versions of the virus. This triggers the immune system to produce specialized antibodies that are adapted to recognize the virus.

2. After vaccination, the antibodies remain in the body. If the patient later becomes infected with the actual virus, the antibodies can identify and help neutralize it.

Johnson & Johnson’s Vaccine

Scientists have isolated the genes in coronavirus responsible for producing these spike proteins. The genes are spliced into weakened, harmless versions of other viruses.

Instead of using the whole virus to generate an immune response, these vaccines use only coronavirus’s outer spike proteins, which are what antibodies use to recognize the virus.

Weakened virus with

spike protein genes

When injected into a patient, the genetically engineered viruses enter healthy cells where they produce coronavirus spike proteins.

The spike proteins produced by the cells prompt the immune system to mount a defense, just as with traditional vaccines.

Vaccine-generated antibody response

1. In classic vaccines, such as those against measles and polio, the patient is inoculated with weakened or inactivated versions of the virus. This triggers the immune system to produce specialized antibodies that are adapted to recognize the virus.

2. After vaccination, the antibodies remain in the body. If the patient later becomes infected with the actual virus, the antibodies can identify and help neutralize it.

Johnson & Johnson’s Vaccine

Scientists have isolated the genes in coronavirus responsible for producing these spike proteins. The genes are spliced into weakened, harmless versions of other viruses.

Instead of using the whole virus to generate an immune response, these vaccines use only coronavirus’s outer spike proteins, which are what antibodies use to recognize the virus.

Weakened virus with

spike protein genes

When injected into a patient, the genetically engineered viruses enter healthy cells where they produce coronavirus spike proteins.

The spike proteins produced by the cells prompt the immune system to mount a defense, just as with traditional vaccines.

Vaccine-generated antibody response

1. In classic vaccines, such as those against measles and polio, the patient is inoculated with weakened or inactivated versions of the virus. This triggers the immune system to produce specialized antibodies that are adapted to recognize the virus.

2. After vaccination, the antibodies remain in the body. If the patient later becomes infected with the actual virus, the antibodies can identify and help neutralize it.

Johnson & Johnson’s Vaccine

Instead of using the whole virus to generate an immune response, these vaccines use only coronavirus’s outer spike proteins, which are what antibodies use to recognize the virus.

Scientists have isolated the genes in coronavirus responsible for producing these

spike proteins. The genes are spliced into weakened, harmless versions of other viruses.

Weakened virus with

spike protein genes

When injected into a patient, the genetically engineered viruses enter healthy cells where they produce coronavirus spike proteins.

The spike proteins produced by the cells prompt the immune system to mount a defense, just as with traditional vaccines.

Vaccine-generated antibody response

J&J, citing preliminary evidence in an analysis released by the FDA, said the vaccine was 65.5% effective in preventing asymptomatic infections in a subset of study subjects.

Health authorities have been watching whether Covid-19 shots can stop people without symptoms from transmitting the virus. The virus has largely been spread by people who were infected but didn’t realize it because they had no symptoms.

The vaccine was less effective in South Africa, where a more-transmissible Covid-19 variant has thrived, than in the U.S. J&J is among the companies working on new shots targeting the new strain, which several current vaccines don’t appear to work as well against.

Write to Thomas M. Burton at [email protected] and Peter Loftus at [email protected]

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8



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Dow Slips Amid New Travel Curbs


The index of blue-chip stocks fell 200.94 points, or 0.7%, to 30015.51, marking its largest one-day point and percentage decline in December. The S&P 500 slid 7.66 points, or 0.2%, to 3687.26 to extend its losing streak to a third session.

The tech-heavy Nasdaq Composite, in contrast, rose 65.40 points, or 0.5%, to 12807.92, a new all-time high.

Much of the stock market has lost steam this week as some nations began taking steps to curtail travel in an effort to contain the emergence of a fast-spreading variant of coronavirus from England. The U.K. imposed stringent restrictions on social and business activity, prompting concern that more countries may be required to adopt measures that would hamper the global economic recovery.

“It would be a brave man to suggest this will just remain a U.K.-specific issue,” said

Derek Halpenny,

head of research for global markets in the European region at MUFG Bank. “Are we going back into another phase of more pronounced global lockdowns again?”

Oil prices slipped for a second day amid growing worries over the new restrictions imposed on travelers from the U.K. to other countries. Brent crude futures, the benchmark in international energy markets, dropped 1.6% to $50.08 a barrel.

Meanwhile, the yield on the 10-year note ticked down to 0.917%, from 0.941% Monday, as some investors looked to the relative safety of U.S. government bonds. Yields fall when prices rise.

Investors are trying to gauge whether the new strain of Covid-19 will impact the efficacy of vaccines that are being rolled out this month.

BioNTech

Chief Executive

Ugur Sahin

said the vaccine developed by his company, in partnership with

Pfizer,

would likely work against the new variant and is being tested. If a new mutation would make the current vaccine ineffective, BioNTech can develop another tailored to the new variant in six weeks, he said.

Technology stocks traded higher on Nasdaq, in contrast to declines for the S&P and Dow.



Photo:

Michael Nagle/Bloomberg News

“The big unknown is to what degree could the new strain make the efficacy of the vaccine lower,” said

Peter Garnry,

head of equity strategy at Saxo Bank. “If it just turns out to be more infections, and it doesn’t have an effect on the vaccine, then the market will be less concerned.”

Late Monday, a fresh $900 billion fiscal stimulus package was passed by Congress, ending weeks of anticipation from investors about whether lawmakers could end their stalemate. The bill, which includes direct checks to households and relief for small businesses, is expected to be signed by

President Trump.

Even so, the bill’s passage wasn’t enough to propel the broader stock market higher.

“We’ve had the positive news on the vaccines and the fiscal deal, so there’s probably not a catalyst to drive stocks meaningfully higher in the next few weeks,” said

Brian Levitt,

global market strategist at Invesco.

When Is the Market on Holiday?

Select stock-market closures through year’s end

  • Thurs. Dec. 24: U.S. stock market closes at 1 p.m. ET
  • Fri. Dec. 25: Markets closed
  • Mon. Dec. 28: London stock market closed
  • Fri. Jan. 1: Markets closed

Still, Mr. Levitt noted that he maintains a positive outlook on equities.

“In my opinion, betting against stocks over the next year and beyond is betting against medicine, science and policy makers,” he said. “And I’m not willing to make those bets.”

In corporate news,

Apple

rose $3.65, or 2.9%, to $131.88 after Reuters reported that the iPhone maker intends to move forward with its own self-driving car technology.

Exercise-equipment maker

Peloton Interactive

gained $16.82, or 12%, to $161.21, hitting a new all-time-high, after it agreed to buy commercial fitness-equipment provider Precor for $420 million in cash.

Travel stocks and shares of energy companies tumbled.

Norwegian Cruise Line Holdings

slid $1.70, or 6.9%, to $23.08.

Chevron

fell for an eighth consecutive day, losing $1.73, or 2%, to $84.36. That marks the longest losing streak for the oil giant since October 2013.

Meanwhile,

Tesla

tumbled $9.52, or 1.5%, to $640.34, extending its losses for the week to nearly 8%. The electric-car maker made its S&P 500 debut Monday.

Moves in stocks could be big and markets may be especially choppy in coming days because fewer people are trading as the holiday period starts, said

Salman Ahmed,

global head of macro at Fidelity International.

The final stretch of trading in December is historically positive for the stock market. But this week’s losses may be a sign that investors are starting to take profits after a blockbuster year, especially as they consider the possibility of tax changes after President-elect

Joe Biden

takes office, said

JJ Kinahan,

chief market strategist at TD Ameritrade. The S&P 500 is up 14% in 2020, and the Nasdaq Composite has catapulted 43% higher.

Footage shows empty supermarket shelves while trucks bearing cargo get stuck at the border after France imposed a travel ban on Britain following the spread of a new coronavirus strain. Other countries have also barred passengers from the U.K. Photo: Neil Hall/EPA/Shutterstock

Additionally, Mr. Kinahan noted, Tuesday’s worse-than-expected consumer confidence report may also be weighing on markets.

The Conference Board, a private research group, said its index of consumer confidence dropped to 88.6 in the first two weeks of December, from a revised 92.9 in November. Economists surveyed by The Wall Street Journal had expected a level of 97.5.

Still, there were small signs of optimism. Data from the Commerce Department showed Tuesday that U.S. gross domestic product—the value of all goods and services produced across the economy—increased at an annualized rate of 33.4% in the third quarter, slightly stronger than the previous estimate issued last month.

Overseas, European shares rebounded after Monday’s losses. The pan-continental Stoxx Europe 600 gained 1.2%.

Major stock indexes in Asia closed lower. China’s Shanghai Composite fell 1.9%, and South Korea’s Kospi declined 1.6%.

Write to Caitlin Ostroff at [email protected] and Caitlin McCabe at [email protected]

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8



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Gadgets

It’s 2:30 a.m. in Wyoming: ‘You’re holding a smartphone to let a husband say goodbye to his wife via FaceTime after 60 years of marriage’


The first wave of the pandemic hit New York, and other cities with dense populations. As hospitals were overwhelmed with patients and struggled to access enough personal protective equipment and ventilators, the midwest and south were largely spared the worst of COVID-19.

Then, came the fall.

COVID-19, the disease caused by SARS-CoV-2, started disrupting families and ravaging lives far from the metropolitan counties, especially in the southern and midwestern states such as Texas, North Dakota, South Dakota, and Wyoming.

North Dakota has 167 COVID-19 cases per 100,000, while Wyoming has 140 coronavirus infections per 100,000, followed by South Dakota with 124,000 cases per 100K, according to the Center for Systems Science and Engineering at Johns Hopkins University.


‘You hear stories from Europe and China. You tell yourself it is not going to happen here.’


— Andy Dunn, chief of staff at the Wyoming Medical Center in Casper, Wyo.

As of Monday, there were 72,683 confirmed cases in North Dakota, and 846 deaths, and the population there has 7% positivity rate. New daily cases hit 1,143 over a seven-day period. Wyoming has 28,169 confirmed cases, 176 deaths and a 16.2% positivity rate, and 759 new daily cases.

“Everyone at the frontline has extra hours, extra shifts to keep up with the volume,” said Andy Dunn, chief of staff at the Wyoming Medical Center in Casper, Wyo. “We need more resources, we look for supplies from all over because we are seeing patients from South Dakota, too.”

But the extent of the crisis in Wyoming has still been a shock. A medical doctor from Colorado, Dunn moved to Casper ten years ago. In 2017, he took the role of chief of staff, and he is currently taking a hands-on role, treating COVID-19 patients at the center.

“You hear stories from Europe and China. You tell yourself it is not going to happen here,” he told MarketWatch. “And then, all of a sudden, it is 2:30 a.m., and you are holding a smartphone to let a husband say goodbye to his wife via FaceTime after 60 years of marriage.”

Andy Dunn, chief of staff at the Wyoming Medical Center in Casper, Wyo.

Patients in their 40s and 50s

“We all knew that it was coming, but you don’t get it until it is here, and it hits you. Things are rough at the hospital right now,” he said. Nor are his patients all elderly. At his hospital, several patients are now in their 40s, while numerous others are in their 50s, Dunn said.

The Wyoming Department of Health has recently approved requests from 15 counties to implement mask mandates to slow the spread of COVID-19. But a petition on Change.org asking for end restrictions in Wyoming was signed by 800 people just in a few days.

But some medical professionals in these midwestern states are not pro mask mandates. “If it is not an N95 mask, well, then you won’t be sure that it does protect you properly,” said Lisa Drylie, a nurse working in an operating-room division of the Sanford Hospital in Fargo, N.D.


‘A mask mandate has to be part of the mitigation of spread.’


— Adam Hohman, a 43-year-old nurse practitioner in Fargo, N.D.

“So, no, I don’t think that a mandatory masks mandate is going to help us,” she added. (In a review of studies on masks last month, the journal Nature concluded that “the science supports that face coverings are saving lives during the coronavirus pandemic.”)

It’s preferable to use a high-quality cloth or surgical masks of a plain design instead of face shields and masks with exhale valves, according to an experiment published in September by Physics of Fluids, a monthly peer-reviewed scientific journal covering fluid dynamics.

States like New York used the mandatory mask mandate as one of the main tools to stop the spread and to dodge the second wave in the fall. As of July, New York Gov. Andrew Cuomo, a Democrat, launched the national “Mask Up America” to promote is mask mandate.

But in North Dakota, there are moments of respite. Drylie sometimes hears joyful music from the lower floors of her hospital. It gives her hope. “It happens when they celebrate a patient who has recovered and dismissed,” she said.

Others disagree with Drylie. “A mask mandate has to be part of the mitigation of spread,” said Adam Hohman, a 43-year-old nurse practitioner who lives in Fargo, N.D. “A limited government is good, but we got to a point where we needed to do something more.”

Shortage of health-care workers

But beyond the masks, the shortage of actual health-care workers is another common issue that ties together North Dakota, South Dakota, and Wyoming, along with many other midwestern states across the U.S., according to local reports.

“The biggest problem I am hearing from my colleagues is that they don’t have enough nurses, said Hohman, originally from Minnesota, where he works at a hospital located in a rural area in North Dakota. He has worked 10 to 14 hours a day when the pandemic first hit.

Hohman said that hospitals in North Dakota are increasing their bed capacity by opening some units or converting other wards. “But they are having trouble in finding nurses to keep up with the work load, and to staff those beds,” he said.

Some hospitals in North Dakota even allowed health-care workers with COVID-19, when asymptomatic, to keep working in coronavirus units. And the U.S. Air Force has recently deployed 60 medical personal to help the state hospital staffing crisis.

The shortage of nurses across the U.S. is not a new problem, but the pandemic shed renewed light on the issue as the coronavirus pandemic hit. But North Dakota and Wyoming are actually among the best in the country in rankings of nurse-to-patients ratios.


The pandemic shed renewed light on the shortage of nurses across the U.S.

North Dakota has 16.4 nurses per 1,000 residents, making it the fourth-best equipped state in the country, while Wyoming is No. 1 with 19.9 nurses per 1,000 population, according to the Bureau of Health Workforce, an agency of the Department of Health and Human Services.

If even two of the best-ranked states for U.S. Nurse-to-State Population Ratio are struggling, others like Texas, California, or Montana are suffering even more, according to recent research by STAT, a media company focused on health, medicine, and scientific discovery.

“Public-health infrastructure and disaster planning in the United States remain underfunded and under-appreciated at all levels,”Hohman said. “We remain underprepared for protecting our nation’s health in the setting of current and future pandemics.”

When the pandemic hit New York in March and April, Hohman traveled to New York to help his colleagues. “I saw the worst of the worst up there. I think we underestimated our risk here in North Dakota due to our ruralness and a mentality that we are not New York,” he said.

Related:COVID-19 spread when 5 million people left Wuhan for Chinese New Year, yet 50 million Americans will still travel for Thanksgiving

As of Monday, there were at least 257,549 deaths due to COVID-19 in the U.S. and there have been 12.4 million reported infections of COVID-19 since the pandemic began, according to the John Hopkins University database. Worldwide, there are 59 million cases and almost 1.4 million deaths.

Texas and California both have over 1 million reported cases of COVID-19. Texas has 1,153,612 million cases, 21,013 deaths, and a 10.6% positivity rate, as of Monday. California has 1,114,524 reported infections and 18,726 deaths, with a 5% positivity rate.

New York, which was the epicenter of the pandemic in the U.S. during the early days of the first surge, has the most deaths of any U.S. state (34,319), followed by Texas, California, Florida (17,991), New Jersey (16,761), and Illinois (12,050).

With Thanksgiving weekend looming, the medical community fears that up to 50 million people traveling to see relatives and friends will create even more community transmission. The Centers for Disease Control and Prevention has asked Americans to stay home.

Medical doctors like the Wyoming Medical Center’s chief of staff, Andy Dunn, have one, reminder for Americans, one that will be more likely if they heed advice. “Be boring, stay put,” he said from his office in Casper, Wyo. “Thanksgiving will happen next year.”

This story is part of a MarketWatch series Dispatches from a Pandemic.



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