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Public Health / Should you be grateful for a job?
« on: April 03, 2021, 11:50:14 AM »
It's natural to feel thankful that you're employed, especially when jobs are scarce. But is that gratitude actually a misguided emotion?

It's become a common refrain: “I’m just grateful to have a job”.

The last year has wreaked undeniable havoc on the working world. Globally, the working hours and income lost in 2020 added up to the equivalent of 255 million full-time jobs. Workplace closures, layoffs and a steep rise in unemployment are enough to make anyone who’s managed to hold onto their job feel some measure of gratitude – or, at least, pressure to be grateful.

That pressure pre-dates the pandemic. One of the most pervasive conversations around jobs is that we should be thankful to be hired, especially when competition for a position is fierce. Candidates are even expected to express the sentiment if they want to be hired in the first place: it’s hard to imagine leaving an interview without saying how much you appreciate being considered, or sending a thank-you email.

But it’s possible some of that gratitude is misplaced. Perhaps it’s not quite appropriate to be thankful that an employer is ‘letting you’ work for them. And while gratitude can be objectively good for you – research consistently associates giving thanks with increased happiness – it also has a darker side that can make you more willing to put up with a situation that makes you unhappy.

Differing obligations

Some workers may be much more inclined to feel grateful for their jobs than others.

Workers who expect to be hired or promoted may express less gratitude than those without systemic advantages. This is often the case for white men, who experience more upward mobility than other groups, and less bias that prevents them from securing jobs, or getting interviews in the first place. For instance, multiple studies have shown résumés with “white-sounding” names, and those that downplay racial cues, are significantly more likely to garner a response

Imposter syndrome may also play a part: workers who aren’t confident they deserve their roles may develop feelings of unworthiness, despite being qualified or skilled. Women are particularly vulnerable to imposter syndrome, and may find themselves giving outsize thanks for their jobs. And, in recent months, Latino and black Americans were significantly more likely to be affected by pandemic-related lay-offs than white Americans. Those among these groups who have kept their jobs are likely feeling pressure to express gratitude – even if they have to force it, and even if their workplace doesn’t inspire much to be thankful for.

Although this forced-gratitude problem can happen anywhere, Alex Wood, Centennial Chair in Psychology at the London School of Economics and Political Science, believes Americans particularly feel the obligation. In an individualistic culture like the US, the smallest favours may be taken as a huge boon. Studies show that Americans say “thank you” more often than people in other countries, and in situations others wouldn’t deem deserving of gratitude – like being employed.

“In the US, it seems unacceptable to say one isn’t a grateful person,” says Wood. “In the UK, people would laugh and say, ‘what is there to be grateful for?’ It’s a fair day’s pay for a fair day’s work. If you manage to get people feeling grateful, things have maybe gone a bit wrong. It should be an equitable exchange.”

The economic effects of the Covid-19 pandemic do alter the equation a bit, concedes Wood. It makes sense that an employer should be thankful for employees working more hours than usual to keep a suffering business afloat, and that employees would feel gratitude for a boss who didn’t let them go when profits fell.

“If it’s been costly to the employer to employ you,” he says, “then, yes, you’re going to feel grateful.” In that case, the gratitude between employer and employee is warranted, adds Wood. Globally, the pandemic has created that dynamic in some workplaces.

The problem with gratitude

Although some gratitude is genuine and spontaneous, other expressions of thanks – like the kind many workers feel pressured to exhibit right now – aren’t similarly authentic. And this forced, phony gratitude can backfire.

“If we’re asked to think about a time when we practiced forced gratitude, most of us can come up with one,” says Sarah Greenberg, a California-based psychotherapist and corporate mental-health consultant. “Like when we’re young and don’t want to eat our peas, and our parent says, ‘be grateful you have food!’. Well, we continue to do that to ourselves as adults. That forced gratitude becomes a social norm, and then it becomes our internal voice.”

An employee may start to think, “I really hate my boss”, then stifle that feeling by thinking, “but I’m so grateful just to have my job”
As adults, in social situations and at work, we start telling ourselves not to complain, to appreciate what we have. And once we start forcing ourselves to be grateful, we may begin using a tactic Greenberg calls “gratitude bypassing” to avoid other, negative emotions. For instance, she says, an employee may start to think, “I really hate my boss”, then stifle that feeling by thinking, “but I’m so grateful just to have my job”.

Suppressing or avoiding negative feelings isn’t healthy, says Greenberg. “If you’re calling emotional avoidance ‘gratitude’, you won’t see the positive effects of gratitude, and you will see the negative effects of emotion avoidance.”

Bypassing and avoidance only offer a temporary solution, she explains. Eventually, the negative emotions will catch up with us – and will likely be even more intense when they do. Rather than being annoyed or angry by something a manager said, then moving on, these feelings can build, and turn into resentment. But by masking those feelings, or substituting forced gratitude, we’re also missing out how those feelings can motivate us to improve our situations.

“Emotions have function,” she says. “So, we don’t want to cut that off.” If you’re telling yourself you feel grateful, when “actually what you’re feeling is stress, fear, complete exhaustion or sadness”, you could be ignoring the emotions that alert you that something is wrong.

In other words, if you’re too focused on why you should be grateful for your work, you may not realise that it’s become thankless. It’s a recipe, says Greenberg, for getting stuck in a job long after you should’ve left.

The employer advantage

Misplaced gratitude, adds Wood, could lead to mistreatment from employers who know their workers won’t complain or leave, due to job-shortage concerns.

“I have concerns with gratitude in the present climate,” says Wood. “In the time of Covid, one needs to be extra critical, because it might make us more exploitable. There are going to be many employers who will try to use it as an excuse to pay their workers less, or ‘cut down on expenses’ by having fewer employees doing more work. And if people are feeling grateful for having a job, that might dissuade them from standing up for their rights.”

The pressure to be ‘grateful’ for employment is inherently odd, according to Greenberg. A job, after all, is essentially a service a person performs to help a company make money.

“I think the old school of thought is, ‘well, I’m giving you a pay check, so you owe me’. It’s amazing what employers have come to expect in exchange for that pay check,” she says. “We work such long hours. We’re working remotely more than ever before, and as a result people are just working endless hours; we’re always on. That has such a big toll on wellbeing and health. Still, we’re getting the message that we’re supposed to feel grateful just to get to keep going to work.”

Embracing the ‘grey zone’

Greenburg explains that while it’s OK – and natural – to feel genuinely thankful to be employed, especially right now, the same person is also allowed to have valid complaints about their job. 

“We have these black-and-white ideas when it comes to emotions,” she says. “We might see it as these two poles: on the one hand is an ingrate curmudgeon. On the other is toxic positivity. We don’t always know how to be in that grey area, when often it’s fairly simple. It’s really OK to have more than one emotion at the same time. So yes, you’re grateful to have a job, and that can be true. You’re grateful to have security at an insecure time. But you hate your boss, and that’s also true. Between those polarities, there’s a grey zone.”

If you’re too focused on why you should be grateful for your work, you may not realise that it’s become thankless
That grey area is a good place for critically examining your gratitude, adds Wood. It’s only appropriate to feel grateful when a person or company is truly acting altruistically. And you can determine that using three basic criteria: “Ask yourself,” says Wood, “are they doing it for me? Is it valuable to me? Is it costly for them?”

When you begin to use this system of appraisal, the list of things you’re truly grateful for may get a bit shorter, but Wood says that by eliminating misplaced gratitude, you’re more likely to feel the powerful benefits of the real thing.

“Once you get your head around it, it’s a thing you can use practically,” he says. “Gratitude is extremely healthy if you’re correct in the appraisal. ”If your employer really does deserve your thanks, it’s likely to make you more content in your job overall. If they don’t, you’re in a better position to assess why not, and take steps to change your situation.

“When you’re more accurate, you can express your gratitude more authentically,” says Wood, “and that’s the kind that actually makes you happier.”Source: BBCWORKLIFE

Traditionally, we view reaching a good work-life balance as hitting a goal. But it may be more of a moving target than we realize.

Few topics have been so endlessly analysed, glorified and dissected as work-life balance. The quest to attain this somewhat nebulous state has dominated discourse around careers for years – especially for working parents. The concept is often presented as something to achieve, or a goal to reach. And once you’ve reached it, congratulations: you’ve made it; you’re a successful human being of the 21st Century.

But the problem is that we often tell ourselves: “’I’m going to put in eight hours’ worth of work, and then I’m going to put in eight hours’ worth of me time, which will include my family, my hobbies, my workout, my everything’,” says Anat Lechner, clinical associate professor of management at New York University. “I don’t think it’s such a simple formula.”

And, according to new findings, it may not be. Some researchers are now encouraging us to stop thinking about work-life balance as an achievement that you either hit or don’t. Instead, they suggest it may be more of a lifelong process – a continuous, never-ending exercise that requires vigilance, self-awareness and timely tweaks.

Not a one-time fix

Forget reaching that golden goal: researchers Ioana Lupu of ESSEC Business School in France, and Mayra Ruiz-Castro of the University of Roehampton in the UK argue that work-life balance is a “a cycle, not an achievement”.

In their 2020 study, the researchers interviewed nearly 80 employees at two London-based firms – an equal number of men and women between the ages of 30 and 50, all with at least one dependent child – who worked in middle or senior management roles.

Although it sounds like the respondents had a lot in common, here’s what separated them: about 30% of the men and 50% of the women reported resisting working long hours. The other respondents, meanwhile, all worked long hours because they thought that’s what successful professionals should do.

Once Lupu and Ruiz-Castro looked at those who rejected the long hours, they found that those workers actually had strikingly similar strategies for maintaining their work-life balance. They employed more “reflexivity” – or the ability to reflect and question assumptions in the name of self-awareness – and regularly took steps to adjust the things standing in their way of coveted work-life balance.

Workers stopped and questioned their circumstances – reflecting on their emotions and situations, then pinpointed their specific roadblocks to work-life balance. Taking stock and “claiming this mental space to gain clarity of what they want for themselves is the first step toward identifying and implementing alternative ways of working and living,” says Ruiz-Castro.

Lupu and Ruiz-Castro identified five steps that the respondents in the study who had better work-life balance used in their jobs.

First, they paused, de-normalised beliefs such as “I’m a professional, so I should work, work, work”, and asked themselves questions like, “What’s currently causing me stress?”. Second, after identifying the cause, they zeroed in on their resultant emotions – did they feel angry, sad, energised? Third, they reprioritised, asking, “Is working long hours really worth cutting back on family time?”, for example. Fourth, they considered their alternatives: is there anything at work that could be changed to accommodate these new priorities? And finally, they implemented changes, like asking their supervisor for greater flexibility, or deciding not to take on every project that comes their way.

The discussion of ‘work-life balance’ actually masks something else – Anat Lechner

This five-step process is something anyone can adopt. Going through the steps, and constantly checking in with yourself, can help you shift and adapt your professional life to something that will better harmonise with your personal one, their research suggests. “Awareness of your emotional state is essential in order to determine the changes you want to make in your work and in your life,” says Lupu.

New York University’s Lechner agrees that finding that balance is an ongoing pursuit. It’s not simply about divvying up the hours in your day between work, the gym, kids, chores and meditation. Because even if you do make sure the hours are evenly split, if the underlying emotional sources of stress are still there – the kinds of stress that the five-step cycle could help identify – then the time you actually spend at home may not be enjoyable.

“We come home and even though physically we are there, mentally we still may be processing things that happened at work. We’re not present,” she says. “I very often think the discussion of ‘work-life balance’ actually masks something else. What we call ‘work-life balance’ is actually just a proxy to having a sense of fulfilment and contentment.”

Other steps to take

Of course, finding that balance probably shouldn’t be something you have to do by yourself.

Research by Erin Kelly, professor of work and organisation studies at the Massachusetts Institute of Technology, shows companies and managers can play a key role in creating a better environment for workers. For her book, Overload: How Good Jobs Went Bad and What to Do About It, she and co-author Phyllis Moen split more than 1,000 employees at a Fortune 500 company into two groups: one that worked under a management redesign and one that continued working within the existing management structure.

Under the management redesign, many steps were taken to ensure better work-life balance for workers and prevent burnout. Managers were regularly reminded to explicitly support their employees, for example, and workers were allowed to make changes, like cancelling 0900 morning meetings.All of this was done in the name of increasing job satisfaction and giving workers greater flexibility, and to assure workers that it was something management was committed to.

Unsurprisingly, Kelly and Moen found that employees in the redesign group reported less stress, less burnout, were less likely to quit their jobs and, over the next four years, were 40% less likely to quit than those who kept working under the old policies.

“Work-life balance is understood to be an individual’s response – so [people think] ‘it’s up to me to manage the craziness of my work life’,” says Kelly. But organisations need to examine the demands they’re placing on employees. “The root problem is not how the two pieces of work and life come together. It’s that we have unrealistic expectations of what we’re asked to do on the work side.”If your workplace isn’t an environment where work-life balance is possible in the first place, any strides you attempt to make toward it on a personal level will be in vain.

That’s a conversation that appears to be gathering pace since the pandemic ripped up the rule book for how we work as well as reshaped our working lives. The new prevalence of remote work, flexible work or even ‘hybrid’ working models will likely all play important roles in how we balance our professional and personal lives going forward.

And if it seems like finding that perfect balance remains elusive, the experts say that keeping some perspective can help. We’re in an era of catastrophic job loss; the pandemic alone has slashed 255 million jobs worldwide, and more jobs could be lost in the next decade as AI advances and more offices digitize. For millions of people, work is about being able to put food on the table. Talking about work-life balance “is a very privileged conversation”, says Lechner. “If we’re reflecting, maybe we should also reflect on that.”Source: BBC/Worklife.

Public Health / New coronavirus variant: What do we know?
« on: December 22, 2020, 12:09:46 PM »
So how has it gone from being non-existent to the most common form of the virus in parts of England in a matter of months?

The government's advisers on new infections now say they have "high" confidence that it is more able to transmit than other variants.

All the work is at an early stage, contains huge uncertainties and a long list of unanswered questions.

Why is this variant causing concern?

Three things are coming together that mean it is attracting attention:

*It is rapidly replacing other versions of the virus
*It has mutations that affect part of the virus likely to be important
*Some of those mutations have already been shown in the lab to increase the ability of the virus to infect cells

All of these come together to build a case for a virus that can spread more easily.

However, we do not have absolute certainty. New strains can become more common simply by being in the right place at the right time - such as London, which had only tier two restrictions until recently.

But already the justification for tier four restrictions is in part to reduce the spread of the variant.

"Laboratory experiments are required, but do you want to wait weeks or months [to see the results and take action to limit the spread]? Probably not in these circumstances," Prof Nick Loman, from the Covid-19 Genomics UK Consortium, told me.

How much faster is it spreading?

It was first detected in September. In November around a quarter of cases in London were the new variant. This reached nearly two-thirds of cases in mid-December.

You can see how the variant has come to dominate the results of testing in some centres such as the Milton Keynes Lighthouse Laboratory.

Mathematicians have been running the numbers on the spread of different variants in an attempt to calculate how much of an edge this one might have.

But teasing apart what is due to people's behaviour and what is due to the virus is hard.

The figure mentioned by Prime Minister Boris Johnson was that the variant may be up to 70% more transmissible. He said this may be increasing the R number - which indicates if an epidemic is growing or shrinking - by 0.4.

That 70% number appeared in a presentation by Dr Erik Volz, from Imperial College London, on Friday.

During the talk he said: "It is really too early to tell… but from what we see so far it is growing very quickly, it is growing faster than [a previous variant] ever grew, but it is important to keep an eye on this."

There is no "nailed on" figure for how much more infectious the variant may be. Scientists, whose work is not yet public, have told me figures both much higher and much lower than 70%.

But there remain questions about whether it is any more infectious at all.

"The amount of evidence in the public domain is woefully inadequate to draw strong or firm opinions on whether the virus has truly increased transmission," said Prof Jonathan Ball, a virologist at the University of Nottingham.

How far has it spread?

It is thought the variant either emerged in a patient in the UK or has been imported from a country with a lower ability to monitor coronavirus mutations.

The variant can be found across the UK, except Northern Ireland, but it is heavily concentrated in London, the South East and eastern England. Cases elsewhere in the country do not seem to have taken off.

Data from Nextstrain, which has been monitoring the genetic codes of the viral samples around the world, suggest cases in Denmark and Australia have come from the UK. The Netherlands has also reported cases.

Has this happened before?


The virus that was first detected in Wuhan, China, is not the same one you will find in most corners of the world.

The D614G mutation emerged in Europe in February and became the globally dominant form of the virus.

Another, called A222V, spread across Europe and was linked to people's summer holidays in Spain.

What do we know about the new mutations?

An initial analysis of the new variant has been published and identifies 17 potentially important alterations.

There have been changes to the spike protein - this is the key the virus uses to unlock the doorway to our body's cells.

One mutation called N501Y alters the most important part of the spike, known as the "receptor-binding domain".

This is where the spike makes first contact with the surface of our body's cells. Any changes that make it easier for the virus to get inside are likely to give it an edge.

"It looks and smells like an important adaptation," said Prof Loman.

The other mutation - a H69/V70 deletion, in which a small part of the spike is removed - has emerged several times before, including famously in infected mink.

Work by Prof Ravi Gupta at the University of Cambridge has suggested this mutation increases infectivity two-fold in lab experiments.

Studies by the same group suggest the deletion makes antibodies from the blood of survivors less effective at attacking the virus.

Prof Gupta told me: "It is rapidly increasing, that's what's worried government, we are worried, most scientists are worried."

Where has it come from?

The variant is unusually highly mutated.

The most likely explanation is the variant has emerged in a patient with a weakened immune system that was unable to beat the virus.

Instead their body became a breeding ground for the virus to mutate.

Does it make the infection more deadly?

There is no evidence to suggest that it does, although this will need to be monitored.

However, just increasing transmission would be enough to cause problems for hospitals.

If the new variant means more people are infected more quickly, that would in turn lead to more people needing hospital treatment.

Will the vaccines work against the new variant?

Almost certainly yes, or at least for now.

All three leading vaccines develop an immune response against the existing spike, which is why the question comes up.

Vaccines train the immune system to attack several different parts of the virus, so even though part of the spike has mutated, the vaccines should still work.

"But if we let it add more mutations, then you start worrying," said Prof Gupta.

"This virus is potentially on a pathway for vaccine escape, it has taken the first couple of steps towards that."

Vaccine escape happens when the virus changes so it dodges the full effect of the vaccine and continues to infect people.

This may be the most concerning element of what is happening with the virus.

This variant is just the latest to show the virus is continuing to adapt as it infects more and more of us.

A presentation by Prof David Robertson, from the University of Glasgow on Friday, concluded: "The virus will probably be able to generate vaccine escape mutants."

That would put us in a position similar to flu, where the vaccines need to be regularly updated. Fortunately the vaccines we have are very easy to tweak. Source: By James Gallagher, Health and science correspondent, BBC Health

Public Health / Is the Covid vaccine safe?
« on: December 09, 2020, 09:59:35 AM »
UK hospitals have started giving people the first doses of the Pfizer/BioNtech coronavirus vaccine.

But while many people want an injection as soon as possible, others are worried about putting something unknown into their bodies.

How do we know a vaccine is safe?

Safety trials begin in the lab, with tests and research on cells and animals, before moving on to human studies.

The principle is to start small and only move to the next stage of testing if there are no outstanding safety concerns.

What role do trials have?

As long as the safety data from the labs is good, scientists can check that the vaccine or treatment is effective too.

That means tests on large numbers of volunteers - around 40,000 individuals in the case of Pfizer/BioNTech.

Half the volunteers are given the vaccine and the other half a dummy or placebo jab. The researchers and participants are not told which group is which, until after the results have been analysed, to avoid bias.

All of the work and findings are checked and verified independently.

The Covid vaccine trials have happened at breakneck speed, but they haven't skipped any of these steps.

The Oxford/AstraZeneca Covid vaccine trial was voluntarily put on hold at one stage to investigate why one participant - out of many thousands - had died. It restarted once it was clear it was not related to the vaccine.

Who approves vaccines or treatments?

Approval will only be given for a vaccine in the UK if the government regulator, the Medicines & Healthcare products Regulatory Agency (MHRA), is happy that it's both safe and effective.

Checks on the vaccine will continue to make sure there are no further side effects or long-term risks.

Independent experts on the Joint Committee on Vaccination and Immunisation (JCVI) decide how best to use a vaccine and who should get it first.

What's in the Covid vaccines?

Pfizer/BioNTech's vaccine (and Moderna's) uses bits of genetic code to cause an immune response, and is called an mRNA vaccine.

It does not alter human cells, but merely presents the body with instructions to build immunity to Covid.

The Oxford AstraZeneca vaccine uses a harmless virus altered to look a lot more like Sars-CoV-2 - the virus that causes Covid-19.

Vaccines sometimes contain other ingredients, like aluminium, that make the vaccine stable or more effective.

Will a vaccine make me ill?

There is no evidence that any of these ingredients cause harm when used in such small amounts.

Vaccines do not give you a disease. Instead, they teach your body's immune system to recognise and fight the infection they have been designed to protect against.

Some people do suffer mild symptoms after being vaccinated, such as muscle aches or a raised temperature.

This is not the disease itself, but the body's response to the vaccine.

Allergic reactions to vaccines are rare. For any approved vaccine, the ingredients will be listed.

The MHRA says it hasn't identified any "serious adverse reactions" during the trial of the Pfizer/BioNTech vaccine.

Be aware that anti-vaccine stories are spread online through social media. These posts are not based on scientific advice (or blend facts with misinformation).

Is it safe for someone who had Covid to have the vaccine?

People will still be offered the jab even if they have had Covid-19 in the past.

That's because natural immunity may not be long-lived and immunisation could offer more protection.

Guidance from Public Health England says there are no safety concerns about giving jabs to people with "long" Covid either. But people who are currently unwell with Covid-19 should not receive the vaccine until they have recovered.

How animal-friendly are vaccines?

Some vaccines, such as the shingles vaccine and the children's nasal flu vaccine, can contain pork gelatine.

And some vaccines are grown on hen's eggs, or cells from chick embryos.

There are hundreds of Covid vaccines in development. We don't have details on every ingredient yet, but many of the Covid vaccines are expected to be vegetarian or vegan-friendly. Source: BBC Health

Public Health / Why investing in Early Stage Health Start-ups matters
« on: November 19, 2020, 01:25:38 PM »
We’ve all heard the statistic that 80% of new businesses fail. But it’s less well known why. The simple truth is, despite the multiple options for funding – venture capital, angel investing, crowdfunding, start-up accelerator programs to name a few – a great majority of businesses fail due to lack of capital.

In fact, raising capital and finding investors is one of the hardest parts of any new business venture. A 2019 start-up survey by Silicon Valley Bank found that 88% of participants found the current fundraising environment challenging. And that is because the funding pie is small and there is a long line of people wanting a slice.

2020, however, has put health and medtech start-ups in a unique position. Investment in health technology is surging with latest estimates around US$9.1B. The COVID-19 pandemic is highlighting the need for healthcare innovation and investors and entrepreneurs around the world are picking up the mantle (as I explored in a recent article).

But the road to commercialisation of medical devices, technology and pharmaceuticals is a long one. Securing intellectual property (IP), technical refinement, rigorous clinical validation and regulatory approval processes mean that healthcare start-ups need a steady stream of funding and capital to support the long-term work that goes into creating lifesaving, and industry-disrupting treatments and preventatives.

To explore just how critical early stage investment is to healthcare start-ups, I spoke to Professor John Knight, Managing Director of Ellen Medical Devices – The creators of the Affordable Dialysis System. His story details their journey from concept to clinical trials, demonstrates how important financial support was along the way.

So John, tell us about the Affordable Dialysis System and who it is designed to help?

The lives of millions of people each year are saved as a result of renal replacement therapy (also known as dialysis). Unfortunately, not everyone has access to this treatment.

In 2015, The George Institute for Global Health published research in the Lancet showing that in 2010 around 2.6 million people received dialysis worldwide to treat kidney failure. It also found that up to 7 million people died prematurely that year due to lack of access to dialysis.  Because of the world wide epidemic of obesity, high blood pressure and diabetes, which all carry a risk of kidney damage, the numbers are projected to now be 50% higher and to grow further into the future.

Dialysis techniques currently available can cost as much as US$100,000 per patient per year. This cost puts them out of reach for patients in many of the countries where access to dialysis is lowest.  The research highlighted the need to develop new, simple and low-cost treatment alternative form of dialysis treatment for kidney failure.

The Ellen Medical Affordable Dialysis System addresses this need. It can deliver point of care peritoneal dialysis (PD) at a fraction of the cost of traditional dialysis. What’s more, it is portable, making access easier for people in regional and remote areas, rather than patients having to travel for treatment.

Our system is made up of a simple portable distiller which is used to sterilise water in places where the electricity supply is unreliable, and the water supply may be contaminated. The water is used to fill PD bags at the point of care. This costs just a few hundred dollars to manufacture, fits into a small suitcase and the running costs are just a few dollars a day. It has the potential to transform the way kidney disease is treated worldwide.

How did the idea for the Affordable Dialysis system come about?

After the research was publish in 2015, the George Institute announced the Affordable Dialysis Prize. It offered US$100,000 to the person or team who could create a new, simple and low-cost treatment alternative to RRT.

The competition attracted many entries, but it was won by Irish inventor and engineer Vincent Garvey. His prize-winning system stood out as having the potential to save millions of lives. Garvey partnered with The George Institute in December 2016 to establish Ellen Medical Devices. Our aim is to develop this technology and bring this innovative treatment system to kidney patients around the world.

Why was this seed funding so important for Ellen Medical?

The initial prize money was critically important for Ellen Medical. It allowed Vincent Garvey to secure our IP through hiring patent attorneys and filing global patents. IP has been protected in 10 key countries.

Early philanthropic seed funding from supportive individual private donors was used to build prototypes and create proof of concepts for our design. This was the essential first step in determining viability for the project.  These working prototypes were a key factor in our later successful larger scale funding applications

You’ve received several rounds of funding – how has that helped your team?

That’s right - we received substantial additional non-dilutive funding from the NSW government’s Medical Devices Fund and from the Paul Ramsay Foundation.  Both recognised the value of our innovation. This was very important as it allowed us to take several major steps forward in development. We were able to expand our team, hire the best IP, engineering and regulatory consultants and gain new expertise. We built specialised workshops and filled them with specialised equipment to build and test our prototypes. The next steps are to get ready to begin human trials and put together a regulatory approval submission.

Why is it important to invest in early stage start-ups, particular in the healthcare space?

Healthcare innovation takes a long time. It can take years for medical devices to be brought to market, and even longer for new drugs and pharmaceuticals. When they are successful, the rewards can be great. According to the team at the MedTech Actuator, the average commercial exit for Australian med tech start-ups is around AU$80M.   

There are many stages to commercialisation within healthcare – patent and IP protection, prototyping and testing, consumer research, clinical trials and meeting regulatory requirements. On top of that there are office spaces, IT, workshops and of course the salaries of the people working so hard to bring the vision to life.  All of this requires significant funds.

As could be expected, the medical devices industry is a highly regulated environment.  To be accepted by the regulators, engineering plans and regulatory packages must be prepared by teams with the right ISO certifications.  These consultants are highly experienced and sought after, and quite expensive.   

Another expensive part is protecting IP. And it is particularly important at the beginning of a project, when the stakes are high to protect the IP, create proof of concept and lay foundations for growth. Investment in early stage health start-ups is therefore critical. A healthy injection of cash at the beginning of a project provides a buffer for the inevitable delays and missteps inherent in innovation and prevents companies with marketable lifesaving ideas that could have lasting effects on global health from failing at the first few challenges due to lack of resources.

What is your advice for start-ups looking for funding?

It is important to consider four key business imperatives when searching for funding:

*You need to identify a clearly defined unmet medical need. This represents the market opportunity for your investors. You need to be able to quantify this opportunity, understand the competitive landscape and demonstrate the potential ROI.

*Your idea needs to be innovative: a value proposition with a unique competitive advantage.  You must also have early evidence of safety and efficacy and a robust plan to confirm it through clinical trials with patient-centered health care outcomes.

*You need a strong business case. Hard hitting potential investors are going to want to see pricing and distribution models, all backed up with a persuasive NPV analysis. This will help them understand the potential profitability of the project.

*Once these three key factors are in place, you need to secure your intellectual property. And it needs to be protected globally. The saying goes that no one should know about a new idea before your patent lawyer.

Ellen Medical Devices has seen consistent investor support over the last 5 years due to its clear patient need, innovative approach, and strong business case. But, among start-ups with similarly strong positions, their experience is not typical.  Without significant investment in early stages, health and med tech start-ups are at risk of failure, preventing potentially transformational health solutions from getting to the patients whose lives depend on it. Source:

Public Health / Coronavirus: Will our day-to-day ever be the same?
« on: November 10, 2020, 12:48:56 PM »
How will the way we live look different in the wake of the pandemic?

We don’t yet know the answer – and, in some respects, we don’t even know the right questions to ask. That’s why we’ve been surveying dozens of global thought leaders, doers and thinkers for our special Unknown Questions series, in which we’re unearthing the biggest questions we should be asking as we move toward a post-pandemic society.

In this edition, we look at how the virus will continue to change the way we live – from the way we build and live in cities to how we move between countries and continents.

Tony Wheeler: Co-Founder, Lonely Planet
Will only the wealthy be able to travel?

When it comes to the coronavirus pandemic, I keep repeating baseball player and philosopher Yogi Berra’s wise advice that “It's tough to make predictions, especially about the future.”

In the travel game, it’s tough even to understand what’s going on in the present. Some countries (Australia) won’t let people out, other countries (America) won’t let people in, even when they’re coming from a place with a better virus story. Or you can leave (the UK) and go somewhere else (the list changes daily) only to find (typically at 4 a.m.) all sorts of restrictions on your return.

None of this encourages travel, and it’s probably a safe bet that merely making the decision to head for the departure gate is going to be a fraught choice for some time to come. Quite apart from dealing with the bureaucracy and rules, I’m afraid that post-pandemic travel will be to a very different new world. Will we be welcomed? Will we be safe? And can we afford it? It will be a sad new world if travel becomes something only for the rich and gap-year travel becomes a rite of passage that ceases to exist.

Of course, a travel reassessment will give us the opportunity to tackle some of the industry’s inevitable drawbacks from a fresh perspective, but will we tackle overtourism and climate change, or just turn the power back on and hit restart?

Audrey Azoulay: Director-General, Unesco
How will AI shape our lives post-Covid?

Covid-19 is a test like no other. Never before have the lives of so many people around the world been affected at this scale or speed.

Over the past six months, thousands of AI innovations have sprung up in response to the challenges of life under lockdown. Governments are mobilising machine-learning in many ways, from contact-tracing apps to telemedicine and remote learning.

However, as the digital transformation accelerates exponentially, it is highlighting the challenges of AI. Ethical dilemmas are already a reality – including privacy risks and discriminatory bias.

It is up to us to decide what we want AI to look like: there is a legislative vacuum that needs to be filled now. Principles such as proportionality, inclusivity, human oversight and transparency can create a framework allowing us to anticipate these issues.

This is why Unesco is working to build consensus among 193 countries to lay the ethical foundations of AI. Building on these principles, countries will be able to develop national policies that ensure AI is designed, developed and deployed in compliance with fundamental human values.

As we face new, previously unimaginable challenges – like the pandemic – we must ensure that the tools we are developing work for us, and not against us.

Ezekiel Emanuel: Member, Biden-Harris Covid-19 Advisory Board and Chair of the Department of Medical Ethics and Health Policy, University of Pennsylvania
What will we be craving in a post-pandemic world?

There are three clear legacies from the Covid-19 pandemic. They all derive from the unnatural and unpleasant circumstances imposed by the pandemic and the necessary public health responses.

First, we all want security. The pandemic has filled us with uncertainty and insecurity. The natural response is to want security. This means security in having an income, child care, family leave and other things necessary to care for your family during a pandemic. Every country will have to critically evaluate its social safety net and shore it up.

Second, we all want sociabilities. Human are social animals. The isolation imposed by Covid-19 is debilitating. We want to have opportunities to be with other people, share meals, share a drink in the pub, and share activities. We see this when restrictions are eased how people run for parties and group settings. Opportunities and venues for sociabilities will become huge post-Covid.

Third, travel will explode after the pandemic. People like (safe) novelty and changes of scenery. We have all been locked down with the monotony of the same rooms, same walking routine, inability to see new things. When it is safe to travel, people will go, go, go.

Giuseppe Sala: Mayor of Milan and Chair of the C40 Mayors Covid-19 Recovery Task Force
How can we protect city dwellers?

Cities have already fundamentally changed as a result of the Covid crisis. By delivering a green and just recovery from the pandemic, we can create the cities and the future we want. Working closely with local communities and businesses, mayors around the world have taken urgent action to protect the health and wellbeing of our citizens.

We’re helping create good green jobs, supporting key workers, investing in safe, resilient mass transit, rapidly expanding bike lanes and increasing the amount of green space in our cities. The experience of lockdown has made clear the need for well resourced, local amenities, which is why many people are looking at 15-minute cities, where all city residents are able to meet most of their needs within a short walk or bicycle ride from their homes.

Many of these innovations have been introduced incredibly quickly, demonstrating just how fast things can change. And they are here to stay. A return to ‘business as usual’ would not just be a monumental failure of imagination, but lock in the inequities laid bare by the pandemic and the inevitability of more devastating crises due to climate breakdown. That could be the most hopeful legacy of this most challenging year.

Ma Yansong: Architect and Founder of MAD Architects, Beijing
What’s the role of public spaces in cities?

Covid-19 at the very beginning is a public health issue, and then was further developed as a political concern. It challenged the nature of urban design, and pushed us to reconsider the use architecture and city space.

“Sharing” used to be one of the most important agenda in urban design and planning. In our past architectural practices, we used to make a lot of efforts on providing more open space to stimulate social interactions, which was considered as a positive and revolutionary action. However, the pandemic led to more discussions on isolation and social distancing, rather than sharing and co-living. Our efforts on providing better public space is questioned, and they might be considered not that important anymore.

However, in the long run, public space will still be the foundation for sharing our cities. We can’t imagine the city as a perfectly functioning hospital, because the city should surpass functionality and reflect our ideal for living. Interpersonal communication is still essential, but in the post-pandemic era might be greatly challenged.

Maimunah Mohd Sharif: Executive Director, United Nations Human Settlements Programme
How could cities help solve pandemic inequalities?

With an estimated 90% of all reported Covid-19 cases recorded in urban areas, cities have become the epicentre of the pandemic. At the same time, I believe that the solutions to the socio-economic and health challenges will be found in cities.

Cities are already changing because residents have transformed the way they live and work. Governments have woken up to the urgent need to address issues around inequalities.

It is not the density of cities that leads to people being infected, it is unequal access to adequate housing, energy, water, sanitation, transport, green public spaces, healthcare and education. Cities will see dramatic changes because citizens will not put up with these inequalities. What we will look for in a home and in our living environment will be determined by where we find ourselves. My hope is that people will use their new-found political muscle to ensure that there is an equitable spread of resources in cities. As we build back better, we will need an empathy revolution to ensure we do not leave behind the most vulnerable groups.

Another major change for many is the discovery that we can work from home. We will seek to retrofit our homes to be able to maximise the opportunities and tackle the challenges this transformation presents to us all.

Ultimately, cities are made up of people and the pandemic has shown that infinite growth has its limits. We either need to adapt, or go the way of the dinosaurs. I believe we can and will change. This is our opportunity to plan and regenerate environmentally sustainable cities which power the Secretary-General’s vision of building back better and greener.

Janette Sadik-Khan: Former Commissioner, New York City Department of Transportation
What will transport look like?

Just a few months ago, the future of transportation was app-enabled mobility and visions of driverless cars. That version of the future crashed as the coronavirus advanced, and as car traffic vanished from city streets.

The transportation rescue hasn’t come in Ubers or robot cars. Cities on every continent responded by returning to old mobility and reclaiming roads for new uses. Milan, Paris and London are just some of the cities that have converted hundreds of miles of former driving and parking lanes into bus and bike lanes, and outdoor restaurant and café seating, allowing millions of residents to come outside safely simply by providing six feet of safe distance.

These steps, which would have been controversial before the pandemic, are today a first draft of what a new future of transportation could look like in post-Covid cities. Six feet of safe space on roads and sidewalks is all that cities need to transition from life shut indoors to a reopened, outside economy. There is six feet of space concealed within individual lanes on almost every street that can be readapted for safe, socially distant mobility, to create open-air commercial districts, and to make space for outdoor classrooms and civic activities like voting. The six-foot streets that the global economic recovery will be built upon are already within reach, and the outdoor, place-making activities that they make possible can make cities, safer, more resilient and more sustainable long after the pandemic. The six-foot city is already within reach on thousands of roads around the world, and wherever there are six feet, there is just enough space to hold us all together.

Michael Banissy: Professor of Psychology, Goldsmiths, University of London
How will we socialise?

Social interaction affects many areas of our lives impacting on the workplace, home life and many day-to-day activities. In many cases, one of the biggest predictors of mental and physical health is the quality of social relationships.

For me, the big questions linked to the pandemic therefore relate to how we can support social interaction as we move forward. With a variety of stages of lockdown there is no doubt that our opportunities for social interaction have reduced. Managing this reduction, whilst ensuring that we support social wellness across our communities is critical to how we live within, and recovery from, the pandemic. Will we be open to using technology and social robotics more? Will technology give us the same quality of social interactions that are important to social wellness, social innovation, and social productivity? Or will a craving for face-to-face interaction mean that we are less likely to engage with, and benefit from, these alternative forms of interaction?

There is no doubt that there will be many new social norms, but we can be sure that we’re likely to want to be social – to get together and talk about it all.

Rafat Ali: CEO and Founder, Skift
How much will the travel industry shrink?

The big question we at Skift are grappling with is this: is the future of travel smaller? As in, will be $3tn global travel sector become permanently smaller in the post-pandemic world? There are signs that the learnt behaviour of a world shut for months and maybe years to come will persist: the airline industry will most definitely be a smaller sector, with bankruptcies, layoffs and shutting down routes. Parts of business travel, the wanton criss-crossing of the global for a single meeting variety, for example, may be gone forever as we have become habituated to the good-enough world of Zoom, and lot more tech innovations to come that make video meetings lot better. The giant events industry that spawns a lot of travel may not return to its full physically glory of the past, as virtual events take hold and erode the economics of the till-now-very profitable sector.

As the international borders are shut in some form most likely till end of 2021, people are staying, driving and traveling locally, while short term rentals like Airbnb are doing better than hotels. There are some hopeful signs for future: domestic travel, in large part sustained by small locally owned businesses and usually ignored by the giant travel marketing machinery in favour of big ticket international trips, is getting a boost and if people begin to appreciate their local regions more in years to come, it would help with a smaller footprint on a planet that desperately needs it. Radical localism, as I call it.

Dani Simons: Head of Public Sector Partnerships, Waze
How will we get around?

Covid-19 has reshaped urban mobility. Instead of traveling to things, we’ve brought them to us, working from our living rooms, eating take-out at our tables. We’ve set new patterns that were unthinkable before. But most of us want to go out again. As that becomes possible, we have a once-in-a-lifetime opportunity to reshape how it’s done, to encourage new, more sustainable habits.

In some cities, traffic congestion has already crept back, exceeding pre-Covid levels. Transit budgets have been hit hard in big cities around the world, and service cuts loom. If we don’t act quickly, we could see more driving than pre-pandemic. Governments and businesses must consider how to optimise city infrastructure to keep traffic and pollution down, and ensure all residents – whether they can afford a car or not – can get around.

Data will play a vital role in helping us choose wise interventions. Some, already in progress, like expanding space for walking and cycling encourage a ‘new normal’ for our transportation network that will be better for our cities. Carpooling will also help. Once social distancing measures are loosened, cities and businesses can incentivise citizens and employees with longer trips to carpool to help reduce congestion and provide a flexible, affordable mode of transport.

Cities are made up of people and the pandemic has shown that infinite growth has its limits. We either need to adapt, or go the way of the dinosaurs - Maimunah Mohd Sharif
Sam Kling: Global Cities Fellow, Chicago Council on Global Affairs
How will cities weather economic challenges?

Big, crowded cities already faced especially disruptive changes during the Covid-19 pandemic. Now they face a set of economic challenges to match.

These challenges are unique in that they target many of the very same features that propelled big, global cities to new economic and cultural heights over the past decades. Law, finance and consulting – industries whose high-flying growth helped create the modern global city – have abandoned ritzy downtown offices for Zoom (surely temporary – but for how long?).

Bars, restaurants and retail, the essential amenities serving an affluent ‘creative class’, are withering. So is mass transit. Tourism declines have altered the face of meccas like Paris and London. In New York, word of an ultrawealthy exodus to the suburbs – tax dollars in tow – sparks even more budget panic.

Facing these challenges, cities will find pressure to do what they have in the past: target budget cuts to the vulnerable, direct resources to luring the wealthy to stay and prop up the existing system. But a pandemic which shows the costs of urban inequality also shows the dire need for a better system. Cities did not create these problems alone, and they won’t solve them alone either. But is there will to do it? If so, they might create a fairer, more resilient and more humane urban life.

Anjali Mahendra: Director of Research, World Resources Institute
Will cities emerge stronger after the virus?

Urban planning has been shaped by infectious disease outbreaks for centuries. Cities are at the frontlines of Covid-19 impact with the pandemic exposing existing fault lines related to lacking physical infrastructure and inequalities in access to public services. Large numbers of people do not have decent housing to self-isolate, basic water and sanitation for handwashing, access to adequate healthcare or transport options, as healthcare systems are overwhelmed and public transport systems are upended.

We are also seeing the fragility of jobs that underpin urban economies. Numerous low-wage formal sector jobs, as well as jobs in the informal and gig economy, lack a stable income or essential safety nets in the form of employment contracts and insurance. Almost 13 million people in the US are now unemployed, and 80% of India’s almost half-billion [person] workforce is in precarious informal jobs.

Cities have a major opportunity to build resilience to future such shocks in a way that is much more inclusive. Investing in public services and infrastructure, including health surveillance and testing systems, improved living conditions for low income people and supporting vulnerable workers, while enforcing guidelines to balance economic and public health concerns through collaboration between local and national governments – are some ways cities can emerge stronger from this crisis. Still, important questions remain around whether these measures will help address structural inequalities and whether the economic stimulus packages many countries are implementing will focus on making cities more inclusive, resilient and sustainable.

Amanda Levete: Principal, AL_A architecture, London
Can our community connections become more meaningful?

This pandemic has raised overwhelming existential issues – issues around race, inequality and the environment. But it has also revealed the breath-taking power of collective responsibility and shown that radical change is possible.

Adversity has reminded us that we all have a part to play in our interconnected world, to be more responsible, accountable and generous and to appreciate the importance of small things. We need to desire a more equitable society, and then design a more equitable model around that, to create places where we can live better together and better with nature. Places that promote a network of co-operation and where people can rediscover the art of living.

Cities are places of opportunity, and their success is the result of centuries of re-use and re-appropriation. Change is the one constant in cites, change is exciting and change is the engine of progress.

We need to get closer to nature in our cities, maximise not minimise space standards in our homes, re-purpose office buildings that people no longer want to work in and understand the importance of local.

Covid may attack our bodies, but distance and remoteness are threatening the very cultural foundation of our lives. More than ever we need to create better connectiveness in our communities to improve the quality of life for everyone.

Parag Khanna: Founding & Managing Partner, FutureMap
What will happen to our passports?

In recent years, we have grown accustomed to Asian passports climbing the ladder of global access – but not to Western passports tumbling down. The every-country-for-itself Covid-19 response has been particularly cruel to Americans, whose visa-free access plummeted from 183 to only 86 countries. And while those 86 included Canada and Mexico, America’s only two borders remained closed anyway.

Furthermore, the European Union kept the US off its ‘safe list’. Even with a vaccine, the system will not return to what it was before: nationality will not suffice to guarantee safe passage. Even for still-powerful passports such as Japan, Singapore, South Korea and the European Union, additional protocols will be required to re-attain relatively frictionless mobility.

For example, to avoid onerous quarantines, individuals will have to certify their health immunity through vaccination certificates and other special registrations. The new global mobility hierarchy may thus be tied much more to individual merit than nationality, with countries requiring significant checks on an individual’s financial, criminal and professional history. This may seem like an onerous new development, but it also levels the playing field for hard-working professionals from developing countries. There is no question that these trends in combination have boosted the appeal of investment migration and citizenship programs, whether for ‘digital nomad’, those looking to acquire second passports or those changing nationality altogether. Connected hubs offering hassle-free entrepreneur visas such as the UAE, Singapore and Thailand are likely to benefit. Every country for itself is also becoming every person for himself.

Donovan White: Director, Jamaica Tourism Board
How will ‘the post-Covid generation’ change the way we travel?

Without a doubt, the ways we used to explore and engage while travelling have changed drastically. As we are now living with Covid, it is imperative that destinations, hotels, attractions, airlines – really the entire global tourist industry – continuously innovate solutions to meet the needs of “Gen-C”, the post-Covid generation. Our communal experience is driving changes to lifestyle and safety requirements for the new way of travelling.

At the forefront is restoring traveller confidence and communicating how adjustments are impacting travel experiences at the local level. The heart of this is creating and marketing experiences that lend to stress-free travel within this new world.

We are seeing a growing number of bespoke and private experiences that allow travellers to more easily physically distance. We’ll also continue to see a growing number of extended stay experiences that cater to work-from-anywhere and remote learning circumstances. For example, most international leisure travellers can stay in Jamaica for up to 90 days. Our visa extension application is turnkey for travellers, enabling extended stays for further remote work.

As the way we socialise shifts drastically, so will the way we travel – but the comeback of travel has begun as more destinations open their doors and as Gen-C takes to the skies.

Sahil Gandhi: Visiting Fellow, Centre for Social and Economic Progress, India
How could Covid response improve housing quality?

It is now clear that densities were not the catalyst for the spread of Covid, but rather it was unmanaged densities, i.e., crowding. Slums in India and poorer neighbourhoods in US cities have been among the most affected areas in the Covid pandemic. Poor sanitation and lack of clean and adequate water supply, together with high indoor crowding and small dwelling spaces in Indian slums, have largely to be blamed for this.

City governments and health departments have struggled to control the spread of Covid in these areas. Besides suffering disproportionately from Covid outbreaks, slum dwellers have faced loss of livelihoods due to lockdowns and the ensuing economic slowdown. Historically slums have emerged due to the lack of formal housing for the urban poor. Slum settlements also tend to come up in core cities where there are sufficient employment opportunities for the poor since many cannot afford to commute long distances. However, their conditions have been neglected by policymakers. Efforts for slum improvement have been met with limited success and rehabilitation to areas in far-out suburbs has almost never worked.

Covid has brought to the fore the need to prioritise slum improvement and livelihood support for the poor. Housing policy solutions such as granting tenure security, upgrading amenities and services and folding decent-quality public housing within the remit of public health need to be explored.

It is imperative that destinations, hotels, attractions, airlines – really the entire global tourist industry – continuously innovate solutions to meet the needs of “Gen-C”, the post-Covid generation - Donovan White
Jerold Kayden: Professor of Urban Planning and Design, Harvard University
Will cities remain resilient?

What will happen to cities? The honest answer is, no one knows. To be sure, the pandemic has shaken the modern system in unprecedented ways, but there is a raison d’etre for cities not so easily dislodged. The human thirst for live engagement with people and place is not easily quenched. In the past, in crisis after crisis, urban resilience has proved the sceptics wrong.

Still, the pandemic has revealed, and in some cases, accelerated urban vulnerabilities. Many office-based businesses have come to appreciate that some work performed by employees can be done remotely. That means fewer employees at the office, fewer meal eaters in restaurants, fewer shoppers in stores. For some storefront retail, that could deliver a terminal blow to a patient already suffering from the inroads of ecommerce. Cultural attractions may suffer to the extent of a reduced worker population that previously stayed on into the evening. A less-dynamic city may be less alluring to tourists. Municipal finance and services could experience declining tax revenues. All in, the risks posed by knock-on effects cannot be easily dismissed.

Opportunities may arise elsewhere. If the locus of work becomes relatively more decentralised, then individuals at their remote locations may create a demand for new or enhanced local amenities. The pattern that emerges may include dispersed clusters of business, retail, cultural and public space offerings that serve dispersed populations.

Rachel Haot: Executive Director of Transit Innovation Partnership, New York City
How can the public and private sectors work together?

In the Covid era, innovation is not optional.

In New York, we’ve created a framework for collaboration and innovation in the Transit Tech Lab, a public-private initiative launched by the Partnership for New York City and the Metropolitan Transportation Authority, which moved more than 1 billion people per year via bus, subway and train pre-pandemic.

First, we define goals and publish an open challenge, inviting companies to pitch their solutions. Next, public and private sector experts evaluate applications. Transit agencies then select the most promising technologies for a rapid proof-of-concept and, if successful, a longer partnership. This approach encourages innovators to work with government, broadening competition. Transit partners report that Lab graduates have saved them millions of dollars by optimising planning and operations.

To restore confidence in public transit amid the pandemic, we announced the Covid-19 Response Challenge, which drew nearly 200 submissions internationally. Transit agencies are now testing eight technologies to create a healthier transit network, ranging from air filtration to digital monitoring.

Together, our partners are building a modern and efficient public transit system – and making New York more resilient in the process.

Chan Heng Chee: Chair of the Lee Kuan Yew Centre of Innovative Cities, Singapore University of Technology and Design
What will city centres look like?

I belong to the school that does not see great transformation post-Covid. We have exaggerated the changes that will take place. We should not underestimate how much people will revert to the norm and behaviours will not change substantially.

In advanced industrialised economies, there is great concern about the future of the office and the death of the city centre. Make no mistake, there will be massive job losses because of the pandemic. For those who have jobs, workers are embracing working from home and working digitally. Clearly, the digital economy will grow. So, there will be both an online and offline approach to work and our way of living. Some call this the emergence of the “blended city”.

But what will become of city centres? After all, what is a global city or a leading city without a vibrant city centre? Unused office space would be repurposed and ways of revitalising the city core will be seriously attempted. Online meetings via different platforms have ruled the day, but it is uncertain if Zoom meetings will produce the same trust and seal a deal with Asians. Business travel will return, but perhaps will be more prudential, at least at the start of the recovery. We can expect to see a greater adoption of automation and robots in factories in advanced economies. That was happening and will be accelerated.

But perhaps the city core will not lose its place. Leading companies and banks will always need a CBD (Central Business District) head office . In less developed economies, there will be severe job losses too and a society in greater distress but there will be little change. These cities are overwhelmed by the pandemic and are trying to create jobs and growth. A small segment will work from home, but given the competitiveness of the tight job market, many will choose to show up in the office. We will not see automation or use of robots accelerated as labour is cheap and resources are scarce, which may not be a bad thing.Source: BBCWorklife

Public Health / Science and Policy Collide During the Pandemic
« on: November 05, 2020, 09:54:06 AM »
Science has taken center stage during the COVID-19 pandemic. Early on, as SARS-CoV-2 started spreading around the globe, many researchers pivoted to focus on studying the virus. At the same time, some scientists and science advisors—experts responsible for providing scientific information to policymakers—gained celebrity status as they calmly and cautiously updated the public on the rapidly evolving situation and lent their expertise to help governments make critical decisions, such as those relating to lockdowns and other transmission-slowing measures.

“Academia, in the case of COVID, has done an amazing job of trying to get as much information relevant to COVID gathered and distributed into the policymaking process as possible,” says Chris Tyler, the director of research and policy in University College London’s Department of Science, Technology, Engineering and Public Policy (STEaPP).

But the pace at which COVID-related science has been conducted and disseminated during the pandemic has also revealed the challenges associated with translating fast-accumulating evidence for an audience not well versed in the process of science. As research findings are speedily posted to preprint servers, preliminary results have made headlines in major news outlets, sometimes without the appropriate dose of scrutiny.

Some politicians, such as Brazil’s President Jair Bolsonaro, have been quick to jump on premature findings, publicly touting the benefits of treatments such as hydroxychloroquine with minimal or no supporting evidence. Others have pointed to the flip-flopping of the current state of knowledge as a sign of scientists’ untrustworthiness or incompetence—as was seen, for example, in the backlash against Anthony Fauci, one of the US government’s top science advisors.

Some comments from world leaders have been even more concerning. “For me, the most shocking thing I saw,” Tyler says, “was Donald Trump suggesting the injection of disinfectant as a way of treating COVID—that was an eye-popping, mind-boggling moment.”

Still, Tyler notes that there are many countries in which the relationship between the scientific community and policymakers during the course of the pandemic has been “pretty impressive.” As an example, he points to Germany, where the government has both enlisted and heeded the advice of scientists across a range of disciplines, including epidemiology, virology, economics, public health, and the humanities.

Researchers will likely be assessing the response to the pandemic for years to come. In the meantime, for scientists interested in getting involved in policymaking, there are lessons to be learned, as well some preliminary insights from the pandemic that may help to improve interactions between scientists and policymakers and thereby pave the way to better evidence-based policy.

Cultural divisions between scientists and policymakers

Even in the absence of a public-health emergency, there are several obstacles to the smooth implementation of scientific advice into policy. One is simply that scientists and policymakers are generally beholden to different incentive systems. “Classically, a scientist wants to understand something for the sake of understanding, because they have a passion toward that topic—so discovery is driven by the value of discovery,” says Kai Ruggeri, a professor of health policy and management at Columbia University. “Whereas the policymaker has a much more utilitarian approach. . . . They have to come up with interventions that produce the best outcomes for the most people.”

Scientists and policymakers are operating on considerably different timescales, too. “Normally, research programs take months and years, whereas policy decisions take weeks and months, sometimes days,” Tyler says. “This discrepancy makes it much more difficult to get scientifically generated knowledge into the policymaking process.” Tyler adds that the two groups deal with uncertainty in very different ways: academics are comfortable with it, as measuring uncertainty is part of the scientific process, whereas policymakers tend to view it as something that can cloud what a “right” answer might be.

This cultural mismatch has been particularly pronounced during the COVID-19 pandemic. Even as scientists work at breakneck speeds, many crucial questions about COVID-19—such as how long immunity to the virus lasts, and how much of a role children play in the spread of infection—remain unresolved, and policy decisions have had to be addressed with limited evidence, with advice changing as new research emerges.

“We have seen the messy side of science, [that] not all studies are equally well-done and that they build over time to contribute to the weight of knowledge,” says Karen Akerlof, a professor of environmental science and policy at George Mason University. “The short timeframes needed for COVID-19 decisions have run straight into the much longer timeframes needed for robust scientific conclusions.”

Widespread mask use, for example, was initially discouraged by many politicians and public health officials due to concerns about a shortage of supplies for healthcare workers and limited data on whether mask use by the general public would help reduce the spread of the virus. At the time, there were few mask-wearing laws outside of East Asia, where such practices were commonplace long before the COVID-19 pandemic began. 

Gradually, however, as studies began to provide evidence to support the use of face coverings as a means of stemming transmission, scientists and public health officials started to recommend their use. This shift led local, state, and federal officials around the world to implement mandatory mask-wearing rules in certain public spaces. Some politicians, however, used this about-face in advice as a reason to criticize health experts. 

“We’re dealing with evidence that is changing very rapidly,” says Meghan Azad, a professor of pediatrics at the University of Manitoba. “I think there’s a risk of people perceiving that rapid evolution as science [being] a bad process, which is worrisome.” On the other hand, the spotlight the pandemic has put on scientists provides opportunities to educate the general public and policymakers about the scientific process, Azad adds. It’s important to help them understand that “it’s good that things are changing, because it means we’re paying attention to the new evidence as it comes out.”

Bringing science and policy closer together

Despite these challenges, science and policy experts say that there are both short- and long-term ways to improve the relationship between the two communities and to help policymakers arrive at decisions that are more evidence-based.

Better tools, for one, could help close the gap. Earlier this year, Ruggeri brought together a group of people from a range of disciplines, including medicine, engineering, economics, and policy, to develop the Theoretical, Empirical, Applicable, Replicable, Impact (THEARI) rating system, a five-tiered framework for evaluating the robustness of scientific evidence in the context of policy decisions. The ratings range from “theoretical” (the lowest level, where a scientifically viable idea has been proposed but not tested) to “impact” (the highest level, in which a concept has been successfully tested, replicated, applied, and validated in the real world).

The team developed THEARI partly to establish a “common language” across scientific disciplines, which Ruggeri says would be particularly useful to policymakers evaluating evidence from a field they may know little about. Ruggeri hopes to see the THEARI framework—or something like it—adopted by policymakers and policy advisors, and even by journals and preprint servers. “I don’t necessarily think [THEARI] will be used right away,” he says. “It’d be great if it was, but we . . . [developed] it as kind of a starting point.”

Other approaches to improve the communication between scientists and policymakers may require more resources and time. According to Akerlof, one method could include providing better incentives for both parties to engage with each other—by offering increased funding for academics who take part in this kind of activity, for instance—and boosting opportunities for such interactions to happen.

Akerlof points to the American Association for the Advancement of Science’s Science & Technology Policy Fellowships, which place scientists and engineers in various branches of the US government for a year, as an example of a way in which important ties between the two communities could be forged. “Many of those scientists either stay in government or continue to work in science policy in other organizations,” Akerlof says. “By understanding the language and culture of both the scientific and policy communities, they are able to bridge between them.” 

In Canada, such a program was established in 2018, when the Canadian Science Policy Center and Mona Nemer, Canada’s Chief Science Advisor, held the country’s first “Science Meets Parliament” event. The 28 scientists in attendance, including Azad, spent two days learning about effective communication and the policymaking process, and interacting with senators and members of parliament. “It was eye opening for me because I didn’t know how parliamentarians really live and work,” Azad says. “We hope it’ll grow and involve more scientists and continue on an annual basis . . . and also happen at the provincial level.”

There may also be insights from scientist-policymaker exchanges in other domains that experts can apply to the current pandemic. Maria Carmen Lemos, a social scientist focused on climate policy at the University of Michigan, says that one way to make those interactions more productive is by closing something she calls the “usability gap.”

“The usability gap highlights the fact that one of the reasons that research fails to connect is because [scientists] only pay attention to the [science],” Lemos explains. “We are putting everything out there in papers, in policy briefs, in reports, but rarely do we actually systematically and intentionally try to understand who is on the other side” receiving this information, and what they will do with it.

The way to deal with this usability gap, according to Lemos, is for more scientists to consult the people who actually make, influence, and implement policy changes early on in the scientific process. Lemos and her team, for example, have engaged in this way with city officials, farmers, forest managers, tribal leaders, and others whose decision making would directly benefit from their work. “We help with organization and funding, and we also work with them very closely to produce climate information that is tailored for them, for the problems that they are trying to solve,” she adds.

Azad applied this kind of approach in a study that involves assessing the effects of the pandemic on a cohort of children that her team has been following from infancy, starting in 2010. When she and her colleagues were putting together the proposal for the COVID-19 project this year, they reached out to public health decision makers across the Canadian provinces to find out what information would be most useful. “We have made sure to embed those decision makers in the project from the very beginning to ensure we’re asking the right questions, getting the most useful information, and getting it back to them in a very quick turnaround manner,” Azad says.

There will also likely be lessons to take away from the pandemic in the years to come, notes Noam Obermeister, a PhD student studying science policy at the University of Cambridge. These include insights from scientific advisors about how providing guidance to policymakers during COVID-19 compared to pre-pandemic times, and how scientists’ prominent role during the pandemic has affected how they are viewed by the public; efforts to collect this sort of information are already underway.

“I don’t think scientists anticipated that much power and visibility, or that [they] would be in [public] saying science is complicated and uncertain,” Obermeister says. “I think what that does to the authority of science in the public eye is still to be determined.”

Talking Science to Policymakers

For academics who have never engaged with policymakers, the thought of making contact may be daunting. Researchers with experience of these interactions share their tips for success.

1. Do your homework. Policymakers usually have many different people vying for their time and attention. When you get a meeting, make sure you make the most of it. “Find out which issues related to your research are a priority for the policymaker and which decisions are on the horizon,” says Karen Akerlof, a professor of environmental science and policy at George Mason University.

2. Get to the point, but don’t oversimplify. “I find policymakers tend to know a lot about the topics they work on, and when they don’t, they know what to ask about,” says Kai Ruggeri, a professor of health policy and management at Columbia University. “Finding a good balance in the communication goes a long way.”

3. Keep in mind that policymakers’ expertise differs from that of scientists. “Park your ego at the door and treat policymakers and their staff with respect,” Akerlof says. “Recognize that the skills, knowledge, and culture that translate to success in policy may seem very different than those in academia.”

4. Be persistent. “Don’t be discouraged if you don’t get a response immediately, or if promising communications don’t pan out,” says Meghan Azad, a professor of pediatrics at the University of Manitoba. “Policymakers are busy and their attention shifts rapidly. Meetings get cancelled. It’s not personal. Keep trying.”

5. Remember that not all policymakers are politicians, and vice versa. Politicians are usually elected and are affiliated with a political party, and they may not always be directly involved in creating new policies. This is not the case for the vast majority of policymakers—most are career civil servants whose decisions impact the daily living of constituents, Ruggeri explains. Source:TheScientist

Scientists have looked at death certificates to see if the cause could be linked up clearly to a storm, but it is easy to miss something in this type of data review. A person could have a heart attack brought on by stress from clearing tree limbs in a yard, following a storm.

An interdisciplinary team -- including epidemiologists, engineers, an atmospheric scientist and software developer -- led by Colorado State University (CSU) has created an open source data set that can be used for epidemiological research on tropical cyclones. The new tool also provides insights that can guide the design and analysis of this type of research.

The paper describing the new data set, "Assessing United States County-Level Exposure for Research on Tropical Cyclones and Human Health," is published Oct. 28 in Environmental Health Perspectives.

Interdisciplinary team tackles lack of data

Brooke Anderson, lead author of the paper and an associate professor in the Department of Environmental and Radiological Health Sciences at CSU, teamed up on this project with scientists including Andrea Schumacher, research associate with the Cooperative Institute for Research in the Atmosphere (CIRA) at CSU.

"For heatwaves, there has already been a lot of research on what the risks are for human health," said Anderson. Scientists can estimate community-wide deaths and illnesses associated with several types of climate-related disasters, including heat waves, floods and wildfires, she added.

Anderson said that with this new data set, scientists can now analyze multiple storms in different places and time periods, and drill down to see what happens in different health outcomes for people. Prior to the release of this new tool, most research has focused on data related to a single storm.

Schumacher said she's always been interested in looking at how counties across the country are affected by hurricane winds on a broad scale. And she found the perfect research partner in Anderson.

"Brooke and I found that we had a similar interest in characterizing hurricane winds," said Schumacher, who helps develop satellite-based products for hurricane forecasters.

Data set designed for others to build upon The team used what's known as the R programming language to create the data set, which will allow scientists from around the world to add new facets and enrich what the team has started.

Anderson said the concept is similar to when a child gets a toy train set, and it just comes with an oval. "Next, the grandparents come along, and you get a bridge or you get new roads that head off in different directions," she said.

The new tool -- maintained by an international group of volunteers on the Comprehensive R Archive Network, CRAN -- also provides very precise data. A scientist can look at rainfall during Hurricane Floyd from several days before (or after) the storm came, Anderson said.

CSU scientists are already using the new data set to look at Medicare hospitalizations following storms over a decade in the Eastern United States. Anderson said the team found that the number of people being hospitalized for respiratory conditions tended to increase when the storm hit, and a week after.

Another team she's part of used the dataset to look at how tropical cyclones affect different birth outcomes, including pre-term birth and pregnancy outcomes.

Schumacher said she sees lots of possibilities for where this research tool can go.

"From my end, there's still plenty of work to do," she said. "What we've created is a really good start. I can see all kinds of ways that we can improve on it, especially as we get better and better observations. "Source: ScienceDaily

Public Health / Healthcare as a climate solution
« on: November 01, 2020, 09:54:30 AM »
A new analysis reveals that accessible and affordable healthcare could be a key tool for addressing the climate crisis

Case in point: A new study by UC Santa Barbara's Andy MacDonald found that improving healthcare in rural Indonesia reduced incentives for illegal logging in a nearby national park, averting millions of dollars' worth of atmospheric carbon emissions.

The analysis, published in the Proceedings of the National Academy of Sciences, finds that deforestation in the national park declined 70% in the 10 years after an affordable health clinic opened in the area. This equates to more than $65 million worth of avoided carbon emissions when translated to the European carbon market, the study reports.

"The results illustrate a strong link between human health and conservation in tropical forests in the developing world," said MacDonald, an assistant researcher at the Earth Research Institute who coauthored the study with UC Santa Barbara's David Lopez-Carr and colleagues at Stanford University, North Carolina State University Raleigh, Oregon Health and Science University, Natural Capital Advisors, and two NGOs involved in the intervention.

The Indonesian clinic accepts barter as payment and gives discounts to villages based on community-wide reductions in logging. Given its success, it could provide a blueprint for preserving the world's biodiverse carbon sinks while reducing poverty and illness.

"This innovative model has clear global health implications," said coauthor Michele Barry, senior associate dean of global health at Stanford and director of the Center for Innovation in Global Health. "Health and climate can and should be addressed in unison, and done in coordination with and respect for local communities."

Every second, more than 100 trees disappear from tropical forests around the world. These forests, some of the world's most important carbon reservoirs, are crucial to slowing climate change and mass extinction.

The current paradigm for conserving tropical forests -- establishing protected areas -- often excludes and disenfranchises local communities. This failure to address people's needs can lead communities with few economic alternatives to illegally log and convert the land. Lack of access to high-quality, affordable healthcare can compound the problem by perpetuating cycles of poor health and expanding out-of-pocket costs.

With this in mind, the nonprofit organizations Alam Sehat Lestari and Health In Harmony in 2007 established a healthcare clinic adjacent to Gunung Palung National Park in West Kalimantan, Indonesia, with the support of the local government. The clinic was able to serve thousands of patients by accepting a range of alternative payments, such as tree seedlings, handicrafts and labor -- an approach that was created in collaboration with the communities themselves.

Through agreements with most of the region's district leaders, the clinic also provided discounts to villages that could show evidence of reductions in illegal logging. Between 1985 and 2001, this region had lost 60% of its forest to this activity. In addition to affordable health care, the intervention provided training in sustainable, organic agriculture and a chainsaw buyback program.

Researchers worked with the two non-profits to analyze more than 10 years of the clinic's patient health records, coupled with satellite observations of forest cover over that time. "Private foundations funded the interventions, but it's innovative new programs at Stanford and the University of California that are funding the research," MacDonald said.

The medical care led to a significant decline in a range of diseases such as malaria, tuberculosis and diabetes. At the same time, satellite images of the national park showed a 70% reduction in deforestation, compared to forest loss at control sites, an amount equivalent to more than 6,770 acres of rainforest.

"We didn't know what to expect when we started evaluating the program's health and conservation impacts, but we were continually amazed that the data suggested such a strong link between improvements in healthcare access and tropical forest conservation," said lead author Isabel Jones, who recently earned her doctorate in biology at Stanford. Looking more closely at community-level logging rates, the researchers found that the greatest drop-offs in logging occurred adjacent to villages with the highest rates of clinic usage.

A global blueprint

"This is a case study of how to design, implement and evaluate a planetary health intervention that addresses human health and the health of rainforests on which our health depends," said coauthor Susanne Sokolow, a senior research scientist at Stanford.

Globally, about 35% of protected areas are traditionally owned, managed, used or occupied by Indigenous and local communities. Yet the perspective and guidance of Indigenous peoples and local communities are rarely considered in the design of conservation and climate mitigation programs. By contrast, the Indonesian clinic's success grew out of the early and continued input of local communities who identified the mechanisms driving health and environmental problems as well as possible solutions.

Such holistic approaches can have greater long-term effects by preserving and restoring the ecosystem services that protect human health. These include natural filtering processes that reduce the risk of waterborne diseases and shade-providing forest canopies that reduce ground temperature and heat-related illnesses.

"The data support two important conclusions: human health is integral to the conservation of nature and vice versa, and we need to listen to the guidance of rainforest communities who know best how to live in balance with their forests," said Monica Nirmala, the executive director of the clinic from 2014 to 2018 and current board member of Health In Harmony.

The clinic in West Kalimantan is still active, and the researchers are currently working on a follow-up project to see whether it and similar interventions in Indonesia have alleviated some of the shock from COVID-19 both on human health and deforestation.

"We would expect illegal logging activity to respond to changes in timber market prices or loss of income associated with COVID-19," MacDonald said. "We want to know whether the interventions buffered communities against these effects, as well as whether they increased the communities' resilience in terms of health and wellbeing.

"Health in Harmony is also expanding to Madagascar and Brazil," he added, "and we want to be able to robustly evaluate the impacts of their interventions there."Source:ScienceDaily

Nature Medicine publishes findings of a 13,400-person survey in 19 countries hit hard by COVID-19

A research team from the City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), the Barcelona Institute for Global Health (ISGlobal), the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine (LSHTM), and Georgetown University Law School announced today that Nature Medicine has published their research revealing potential global hesitancy to accept a COVID-19 vaccine. Based on data collected with the previously validated COVID-SCORE survey of a sample of over 13,400 individuals from 19 countries that have been hard-hit by the virus, the investigators found that 72% of participants would likely take the vaccine. Of the remaining 28%, 14% would refuse, while 14% would hesitate, which translates into tens of millions of potential vaccine avoiders.

To date, more than 90 COVID-19 vaccines are in development, half of which are in human trials. In addition to addressing the formidable challenges of developing a safe and effective vaccine, producing it on a large scale, and distributing it equitably, health authorities worldwide must now consider the added obstacle of vaccine hesitancy.

"We found that the problem of vaccine hesitancy is strongly related with a lack of trust in government. Vaccine confidence was invariably higher in countries where trust was higher," said Jeffrey V. Lazarus, ISGlobal researcher and study coordinator.

"We need to increase vaccine confidence, and we need to improve the public's understanding of how they can help control the spread of COVID-19 in their families and their communities," adds Ayman El-Mohandes, Dean of CUNY SPH, and co-coordinator of the study.

The country with the highest score of positive responses to "taking a proven, safe and effective vaccine" was China (87%), which also had the lowest percentage of negative responses (0.7%). On the other end, Poland had the highest number of negative responses (27%), while the Russian respondents gave the lowest number of positive responses (55%). In the U.S., 76% of respondents answered positively, 11% were negative, and 13% had no opinion.

When asked if "you would accept a vaccine if it were recommended by your employer and was approved safe and effective by the government," 32% of respondents completely agreed, while 18% somewhat or completely disagreed. Again, a great variation between countries was observed -- China again had the highest percentage of positive responses (84%) and the lowest percentage of negative responses (4%). Russia had the highest percentage of negative responses (41%) and the lowest percentage of respondents (27%) who were likely to accept their employer's recommendation. In the U.S., 52% had confidence in an employer's recommendation, and 25% did not.

Vaccine acceptance also varied with age (with higher acceptance among older people as compared to those aged under 22), income (higher among people earning more than 32 dollars per day, as compared to those earning under two dollars per day), or education level. Curiously, people who had fallen sick with COVID-19, or whose relatives had fallen sick, were not more likely to respond positively.

"It will be tragic if we develop safe and effective vaccines and people refuse to take them. We need to develop a robust and sustained effort to address vaccine hesitancy and rebuild public confidence in the personal, family and community benefits of immunizations," warns Scott C. Ratzan, study co-author and Distinguished Lecturer at CUNY SPH. "Our findings are consistent with recent surveys in the US, which show diminished public trust in a COVID-19 vaccine," he concludes.

Heidi J. Larson, study co-author and Professor and Director of the Vaccine Confidence Project at LSHTM says, "These findings should be a call to action for the international health community. If we do not start building vaccine literacy and restoring public trust in science today, we cannot hope to contain this pandemic."

The authors also point out that people's decisions about vaccination depend on many factors and can change with time. In fact, since this survey was conducted in late June 2020, vaccine-related issues have become increasingly politicized and the antivaccine movement has become more aggressive, which suggests that vaccine hesitancy may be a greater threat today.

Funding was provided by the City University of New York Graduate School of Public Health and Health Policy Foundation, Bocconi University, J. Fielding, the United States Council for International Business Foundation and K. Rabin. Consensus Strategies was the funding recipient. J.V.L. acknowledges support to ISGlobal from the Spanish Ministry of Science, Innovation and Universities through the 'Centro de Excelencia Severo Ochoa 2019-2023' Programme (CEX2018-000806-S) and from the Government of Catalonia through the CERCA Programme.Source: ScienceDaily

Science and Information / The algorithm tackling the office space crunch
« on: October 22, 2020, 02:47:13 PM »
Companies are wrestling with how to bring staff back to the office in a safe and fair manner. One US firm has created an algorithm to try and solve the puzzle.

New York City-based start-up SquareFoot helps clients find office space in cities around the world. Today, however, the company faces a different real-estate problem: SquareFoot employs roughly 60 people, but its Manhattan office can safely hold only 27 people under the health and safety guidelines suggested by the city, state and US Centers for Disease Control. The old system of squeezing people in at open-plan tables just can’t work anymore.

The office “used to be a place you go”, says CEO Michael Colacino. “Now it’s like oil or fresh water. It’s a resource you have to conserve, allocate and think about as something totally different than a meeting place.”

As pandemic-hit nations tentatively evaluate returning to the office, thousands of companies face similar versions of SquareFoot’s conundrum. Some firms have already extended work-from-home policies for non-essential employees into 2021, while others have announced permanent cuts to physical office space. Many companies are adopting a ’hybrid’ model of office use, with employees dividing their time between remote work and in-person office time.

But that model presents a thorny scheduling challenge that demands answers to a host of questions: what’s more important – letting teams have in-person time together, or exposure to colleagues from other parts of the company? How do managers adjust schedules as different people start and finish group projects? Does everyone have equal access to face time with the boss, and to the kind of visibility that leads to promotions and choice assignments?

Is AI the answer?

SquareFoot’s business is building digital tools to help clients find office space in crowded cities. It’s now using those tools to find a workable solution to its own space crunch. It has come up with an algorithm that it hopes will allocate access to office resources in a way that best accommodates the needs of individuals, departments and the business as a whole.

The company started by surveying its department heads about the specific needs of each sector of the business. Questions focused on four key areas: amenities, location, communication and personal development. They dived into the details, taking inventory of the physical tools each team required to perform their jobs, from high-speed internet and limited-license software to whiteboards and access to mass transit.

The office ‘used to be a place you go. Now it’s like oil or fresh water. It’s a resource you have to conserve’ – Michael Colacino
They also dug into each department’s communications style and personnel make-up, tallying the amount of in-person discussion and passive information sharing each team engaged in, and their need to provide further training and relationship building for individual members.

With that data in hand, the company then built the AI tool that determines its scheduling. Employees who want office time submit a request to the system at least 24 hours in advance. If more people want to use the office than the space allows, the system evaluates each request based on factors like the employee’s job function and the amount of office time they’ve had that week.

The algorithm is reactive; it responds to employee’s requests for office time rather than calling particular individuals or departments into work. It’s also designed for situations when demand for office use exceeds supply, and at this point not that many people are ready to go back to the office, says Colacino.

“The hardest part is reconciling the perspectives of all the employees about what it means to be ‘safe’ when we have limited and conflicting data about the transmission of the disease in the office environment,” says Colacino. “When the studies have been completed correlating Covid transmission and office planning and design, we will have at least some basis for making decisions. Right now it’s mostly: ‘you do what you feel comfortable doing’, and even with a great workforce (like we have), you can’t run a business entirely through laissez faire.”

Reinvention, re-evaluation

Alex Alonso, an organisational psychologist and chief knowledge officer at the Virginia-based Society for Human Resource Management (SHRM), says the most popular question by far right now from HR managers is how to get everyone back to the office in a way that’s safe and fair. He says the right solution will look different for every company, and that innovation is key.

“If the intent is to reinstitute what you had, you’re going to find that that’s fool’s gold, because it doesn’t exist,” says Alonso. “What people who are thriving in this environment are doing is saying, ‘How do I make my culture succeed so I can reinvent my enterprise?’”

Algorithms aside, he suggests one option is to consider offering incentives to employees who are willing to work staggered or non-traditional schedules. And if the schedule can’t be flexible, companies could also consider getting creative with the space; after months of Zoom calls, a masked and socially distanced outdoor gathering could be a welcome alternative to more virtual work.

If the intent is to reinstitute what you had, you’re going to find that that’s fool’s gold, because it doesn’t exist – Alex Alonso
As Colacino points out, letting employees decide what works best for them may not be the ideal long-term outcome for businesses. Leaving the choice of whether to come to the office entirely up to staff could also have unintended consequences that can further workplace inequities. If children can’t go to school, one parent has to stay at home with them – a task that has disproportionately fallen to women in the pandemic. If employees in groups at high risk of Covid complications are told to stay at home, that disproportionately affects older workers and black and Latino workers. Yet in-person time in the office is correlated with promotions and advancement.

Companies grappling with how to assign limited office space should be sure that any system they come up with has input from all employee groups it might affect, says Karen Mangia, vice-president for customer and market insights at Salesforce and author of the book Working From Home: Making the New Normal Work for You. With things changing so rapidly, she recommends re-evaluating policies every quarter, so that they are more limber. “What’s critically important … is to have a variety of voices at the table helping to design those programmes,” says Mangia. “Even with the best of intentions, we only solve for what we know.”

At SquareFoot, the algorithm remains a work in progress. “We would be fooling ourselves if we thought we could design this a priori to be perfect. So we will be meeting up every couple of weeks as a management team to reassess and rebalance as needed,” says Colacino. “The beauty of this system is that the weighting can change without the algorithm having to change.”

With all the change that companies and employees have weathered in 2020, certainty about anything – even if it’s just knowing when a desk is free – could be a welcome fringe benefit. “Workers are admitting that the stress levels are higher than ever because they don’t know when they’ll go back and what it will look like when they go back,” says Alonso. “It’s a level of tolerance for ambiguity that quite honestly we have not had to deal with in quite some time.”Source: bbc worklife

Public Health / COVID-19 and a World Health Organization for you and me
« on: October 21, 2020, 10:54:01 AM »
A week on from the US decision to withdraw support from the World Health Organization (WHO), Distinguished Fellow Göran Tomson argues that the COVID-19 pandemic shows the need for a strengthened WHO, and that WHO is uniquely positioned to facilitate health security now and for the years to come, as we face future pandemics and continued challenges to global health.

“It really boils down to this: that all life is interrelated. We are all caught in an inescapable network of mutuality, tied into a single garment of destiny. Whatever affects one directly, affects all indirectly” Martin Luther King, Jr (1967)

Globalization is the growing interconnectedness between political, social, and economic systems beyond national or regional borders. The ‘COVID-19 moment’ is poised to be a turning point not only for addressing issues of pandemic preparedness, but also for major global challenges relating to geopolitics, population, technology, and climate change. The pandemic has underscored the importance of solidarity among nations and people. It has also underscored weaknesses in the existing global governance for health.

WHO, an agency responsible for international public health, is unique among global health organisations because of its treaty-making power, so is able to negotiate formal binding agreements entered into by member sovereign states. As a result, intergovernmental norms, standards, policies and strategies lie at the heart of WHO´s work. WHO´s strength and weakness is that it is a member organisation where democracy prevails – but serving the diverse needs and views of its constituent members is not easy. However, WHO navigates this through an approach based in evidence. These foundations are confirmed by the existence of a science division and an agreement with Institute of Health Metrics (IHME).

At 70 years old, WHO is often described as weak and ineffective but it has – and continues to – significantly strengthen global health. As well as providing guidance for the financing of health systems, WHO has delivered a number of Global Public Goods (GPGs). GPGs can be defined as: rules that apply across borders; institutions that supervise and enforce those rules; and benefits without distinction between countries. Examples include two WHO-negotiated treaties, the Framework Convention on Tobacco Control (FCTC), International Health Regulations (IHR). Good Pandemic Preparedness is another example of a GPG, one worth investing in, and one which WHO is uniquely positioned to deliver.

As a non-partisan body, WHO is uniquely positioned to oversee and coordinate state and non-state actors to address global public health challenges through ‘multi sectoral action’ which is critical to sustainable development. Commercial, socioeconomic and political determinants of health require major competencies in economy, ethics, law, political sciences in addition to the more “conventional” expertise in biomedicine and public health. WHO needs to strengthen its competence in some of these areas to meet the new challenges.

WHO´s General Programme of Work (2019-2023) (GPW13) is based on the Sustainable Development Goals (SDGs), with SDG3 (‘ensure healthy lives and promote well-being for all at all ages’) as its foundation. The three interconnected strategic priorities (“triple billion”) are: 1 billion more people benefitting from UHC; 1 billion more people better protected from health emergencies; 1 billion more people enjoying better health and wellbeing. The WHO constitution states the enjoyment of the highest standard of health as a fundamental right without distinction of race, religion, political belief, economic or social condition among its core principles. Unequal development in different countries in terms of the promotion of health and control of diseases, is a common danger. WHO is the only organisation in a position to improve health across the globe through working with member states, thereby contributing to improving peace and security.

The COVID-19 pandemic is a major health security issue and challenges the “triple billion” strategy in all its dimensions. COVID-19 is a ‘Pandora’s box’, exposing global and national problems relating to preparedness and inequity. This exposure must lead to global and national recognition of the economic, ethical and epidemiological consequences, and result in decisive progress.

WHO is best-placed to guide us all in the shape and effective delivery of strengthened global health action. An effective post-COVID-19 pandemic recovery requires a collective approach that is not solely confined to the health sector. It involves partnering with and empowering actors, sectors and the public.

A “whole of government” and “whole of society” approach should be applied nationally. Globally, the creation of a “multi-stakeholder platform for health” within WHO could develop GPGs including tools for inter-sectoral collaboration for transformative change.

The present crisis shows that we need a strengthened - not weakened – WHO, so that you, I, and every global citizen can benefit from the health, peace and security it works to secure and sustain.Source:

Public Health / Why older people are harder to vaccinate
« on: October 14, 2020, 10:06:20 AM »
The strategy for rolling out a Covid-19 vaccine might be undermined by older people’s immune systems.

In a hypothetical alternative universe where we already have a vaccine against Covid-19, world leaders will have a choice about how to deliver it to the population. The most vulnerable people, along with the nurses, doctors and care workers who look after them, are likely to be protected first.

If only it were that straightforward. The most vulnerable age group, the elderly, are particularly tricky to vaccinate.

“We have very few vaccines designed for older populations,” says Shayan Sharif, a professor of vaccinology at the University of Guelph, Canada. “More often than not in the last century, most vaccines have targeted childhood diseases.”

Shingles is one exception, usually given to patients in their 70s, and there are one or two other vaccines for diseases like meningitis or human papillomavirus developed for young adults. But otherwise immunology is skewed in favour of children.

“We have a tremendous amount of knowledge about childhood diseases,” says Sharif. “When it comes to young adults, middle age and old age, we don’t have a lot of experience.”

To understand why older people are harder to vaccinate, we have to look at the differences in their immune system. Many infectious diseases are more severe in older adults than younger adults. Older people have more risk factors – a lifetime of exposure to carcinogens or other infectious diseases will increase the risk of future disease from new infections. But they also undergo something called immunosenescence – ageing of the immune system.

Just like many other parts of the body, our immune system shows signs of our ageing. Some of the immune cells lose their function. The immune system is a very complex network of cell types that interact with each other. If something, somewhere within the system is not working, it interrupts the delicate balance of the immune response.

How does the aging immune system work?

When you are infected by a pathogen, the first layer of the immune system, the innate immune response, starts attacking the pathogen at the site of infection. For respiratory diseases, that could be the lungs, trachea or nose. White blood cells, or macrophages, attack the pathogen, swallowing it up before destroying it.

As those macrophages break apart the pathogen inside themselves, they present bits and pieces of it to another type of immune cell known as T cells. These serve as the “memory” of the immune system. T cells cannot see the pathogen by themselves and need certain macrophages, called antigen presenting cells, to show them the pathogen. That activates the next layer, the adaptive immune system.

There are several types of T cells. Killer T cells, or cytotoxins, attack our own bodies’ cells in order to eliminate those already infected by the pathogen, reducing its proliferation. Helper T cells provide assistance to B cells, another part of the adaptive immune system.

B cells can see the pathogen on their own but for optimum function they need helper T cells. B cells produce antibodies. But to produce the most effective antibodies, they need this complex interaction with T cells.

The goal of a vaccination is to stimulate our immune systems to produce effective antibodies before we are exposed to the pathogen. Much has been made in the news of antibody tests as a way of proving who has had Covid-19. However, not all antibodies work, not everyone who has been infected with Sars-Cov-2 – the virus that causes Covid-19 – has antibodies and some antibodies have a limited lifespan.

The issue for vaccinologists is that the delicate balance between all of these cells in elderly people becomes disrupted. So, what happens in an older person’s immune system?

“Basically all of those cell types are impaired in their function,” says Birgit Weinberger, from the University of Innsbruck, who studies immunosenescence and vaccinations of the elderly. “They produce a different set of cytokines [proteins that aid communication between immune cells]. I think the important issue one has to keep in mind is that none of those cell types act on their own.”

You have to keep in mind how all those different parts of the immune system come together in concert – Birgit Weinberger

If antigen presentation by the macrophages is impaired in old age this could lead to a decrease in T cell activation, less help for the B cells and a lower antibody response. But it might be because of issues with the very first innate response.

“You have to keep in mind how all those different parts of the immune system come together in concert,” says Weinberger.

We also have a finite number of B cells and T cells in our adaptive immune system, says Sharif, and we lose some of them over time. That can create problems in later life.  “When we encounter a new pathogen our ability to respond becomes a lot more limited.”

Immunosenescence does not affect all people equally. As with other body parts, some people age better than others either by looking after themselves or being lucky enough to have the right genetic make-up. But it’s not all bad news. Some parts of our immune system improve with age, too.

“There are some cells in our immune system that become more vigorous as we age,” says Sharif. “If we have been exposed to a wide variety of pathogens, we have an immune memory to them so we don’t need to have an armoury of cells to respond to novel antigens.” But Sars-CoV-2 is one virus we have never been exposed to, so we do not have that memory.

This is the balance struck by our immune system: older people have a better immune memory for things they have already been exposed to, but have a more limited repertoire to respond to novel diseases. Ordinarily, this might be fine. But as humans come into contact with more pathogens that jump species (what’s called zoonotic disease) more frequently, our ability to handle novel disease might be more important.

What does this mean for vaccines?

When vaccines undergo in-human clinical trials, at stage one they are tested for safety (usually on only a few individuals), at stage two they are tested for efficacy (whether they produce the response that you intended) and stage three for effectiveness (if they do produce the right response, do they actually work at protecting against disease).

Vaccines have to compromise. While they might work well on one group of people, they might work less well on others. Currently there are a multitude of clinical trials for Covid-19 vaccines, many of which might make it all the way through development to approval. For Weinberger and Sharif, this is a good thing. Having a suite of vaccines that you can rely on means we can pick and choose the right one for the right scenario. One might work better for old people than others.

While all vaccines approved will need to show t they protect against disease, not all vaccines will prevent transmission.

No vaccine is going to be perfect. “There is not one vaccine that can provide 100% efficacy, not one, nada,” says Sharif.

While all vaccines approved will need to show they protect against disease, not all vaccines will prevent transmission. Most vaccines work by preventing the pathogen from causing disease, but they do not necessarily eliminate it from the body, meaning a vaccinated person might still shed viral particles, and so potentially infect others around them.

This has an important implication for how we choose to vaccinate the population. For those having to decide who gets the vaccines, the emphasis should be on the vulnerable. But if we vaccinate nurses, doctors and care workers without first vaccinating their patients, while those key workers might be protected, they might still pass on the pathogen to other vulnerable people.

“A vaccine could disrupt transmission, but it is unlikely we will find a vaccine that will completely stop transmission of the virus,” says Sharif. “Influenza vaccines are actually a good example: they do not do much to reduce transmission, but they reduce disease.”

Weinberger says that a strategy for vaccination is like a complex puzzle of social, medical, political and economic factors. But what should be clear is that while mortality is so much higher in some groups, they should be prioritised. Others need to get used to living with the virus.

How age affects the spread of the virus is still largely a mystery. Weinberger raises concerns about some of the early research that suggested children were less contagious. Those studies, she says, were not optimal for coming to that conclusion, because they were conducted when children in Europe were off school. Might those children now pick up the virus at school and spread it to grandparents when they come to collect them?

Sometimes we put on our blindfold and we say vaccines are the only saviour but that is not the case – Shayan Sharif

Better understanding the spread of the virus will reveal the best strategies for vaccinating the population. “We are doing a very good job to speed up the process [of developing a vaccine], but for some decisions we need the knowledge first,” says Weinberger.

Since we first started treating people for Covid-19, the medical knowledge about therapy drugs has significantly moved forward even if it has rarely been covered in the news – something Sharif finds puzzling. Fewer people may be aware of the progress with immunotherapeutics could be because they are a bit less glamorous, he says. We can all picture a vaccine, we should all be able to remember having one. But if you were asked to picture an immunotherapy, could you summon an image?

“Sometimes we put on our blindfold and we say vaccines are the only saviour, but that is not the case,” says Sharif. “Vaccines can take 14 to 28 days and require multiple injections and exposures. Immunotherapeutics can work in minutes and hours.”

"The most immediate hope for older people suffering with Covid-19 might be when we find a drug that reduces hospital time from weeks to days, says Sharif, or even one that negates the need for intensive care at all.

Hundreds of drugs are currently being researched as potential treatments for Covid-19. At the moment, one of the most promising drugs is Dexamethasone, a steroid proven to reduce the mortality rate of patients receiving oxygen which has been approved for use in the UK and Japan and was given to President Trump when he was hospitalised with the disease earlier this month.

At the moment, there are five drugs authorised for "emergency use", including Dexamethasone, in the US by the FDA. Of these, none have yet received FDA approval following a clinical trial so are used only in very specific cases. But the benefit of searching for a treatment among known drugs is that they have already received approval, and are proven to be safe in other contexts. Their approval following a successful clinical trial should therefore be relatively speedy – much quicker than the amount of approval a new vaccine requires.

Older people hospitalised with Covid-19 might benefit from this treatment research before seeing a vaccine. So, while vaccines might be a little way off, there are other reasons to be positive."Source:BBC FUTURE

Coronavirus is continuing its spread across the world, with nearly 37 million confirmed cases in 188 countries and more than one million deaths.

The virus is surging in many regions and some countries that had apparent success in suppressing initial outbreaks are also seeing infections rise again.

Public Health / Are we in the midst of a touch crisis?
« on: October 07, 2020, 03:48:46 PM »
Even as we have to keep our distance, the importance of human contact is becoming clearer.

The pandemic has forced us to think about who we touch more than ever before. For most of us it’s been more than six months since we have shaken hands, let alone hugged a friend who we don’t live with. In every human interaction we have outside our homes we are now forced to focus on keeping our distance from other people.

Even when we see family who we’ve been apart from for months, we have to consciously resist the temptation to kiss or embrace them in case it puts both them and us at risk. (Read more about Claudia Hammond’s own experience during lockdown.)

For many of us, the pandemic has brought home the importance of physical contact in our lives. Only in its absence have we noticed its worth. Is it possible that we are in the midst not only of a health crisis, but a crisis of touch?

And were some people missing out on the touch they wanted even before the coronavirus? Does society offer us enough opportunities for touch?

These are some of the questions that the Touch Test, a collaboration between BBC Radio 4 and the Wellcome Collection, set out to answer. A team of psychologists led by Michael Banissy at Goldsmiths University of London created an online study which was launched at the end of the January 2020. It included questions on where people liked to be touched on their bodies by friends or strangers, and whether they would be prepared to use a device to allow them to shake hands remotely. Two months later almost 40,000 people from 112 different countries have taken part in the study.

The results reveal a nuanced picture when it comes to human touch. Even before the pandemic it would be an oversimplification to say that we were in a “touch crisis” and that everyone was hungering for more. The situation is much more subtle, and in my view, more interesting than that.

The Touch Test found that people are divided over whether they personally get enough touch in their lives as well as over whether today’s society gives us enough opportunity to touch each other. Almost all the participants in this study completed the questionnaire in early 2020 before lockdowns were widespread and before social distancing became the norm. Just over half of people said they got too little touch in their lives, but 42% said they got about the right amount. And 43% of people thought that society does not enable them to touch enough, while 26% said society does provide them with enough opportunities for touch.

So, it’s clear that while some people hunger for more touch and think that modern life somehow prevents us from getting what we need, by no means everyone agrees. And not everyone wants it either.

While almost three quarters of people said that they like interpersonal touch, 27% do not. The team looked at age and gender along with a host of other factors to try to work out what separates those who like touch from those who don’t. Two key factors emerge.

For those who like touch, their well-being levels were higher if they had been touched recently

The first is personality. Extroverts feel more positive about interpersonal touch than introverts do. The second factor is how easy people find relationships with other adults. People who want to feel very independent in their relationships or who find it hard to get emotionally close to others tend not to like touch as much as those who find it easier. But people who feel anxious in their relationship value touch more.

Of those who crave more touch and believe that today’s world doesn’t provide enough opportunities for it, the most common reason they gave was the issue of consent. It’s possible that after #metoo came to the fore, some people are more cautious about physical contact with others. The next most common reason given was a lack of social interactions where touch was possible, followed by changes in society’s attitudes towards physical contact.

The Touch Test also gives us some indication of how powerful the right kind of touch can be. People with positive attitudes towards touch had higher levels of well-being and said they felt less lonely than those who don’t like it. And for those who like touch, their well-being levels were higher if they had been touched recently.

These results were obtained before lockdowns started in most parts of the world. The final week of the study, however, did coincide with the start of lockdown in the UK and some other countries, and there is a trend in the data towards more people that week saying they weren’t getting enough touch. But to discover what happened to people further into lockdown, we can look to two other studies.

In the US, Tiffany Field, a psychologist at the University of Miami’s School of Medicine, conducted an online study in April, where she found that by the end of the month 68% of people said they were experiencing low to high levels of touch deprivation. Preliminary results of an international study conducted in five countries in April by Merle Fairhurst, professor of biological psychology at the Bundeswehr University Munich, Germany, showed that in April, 61% of people were missing the touch of a stranger and 35% were missing touching family members.

If our skin is stroked at the ideal speed of 3cm per second then messages are sent via the nervous system to the brain

While you might expect families who spent a lot of time together in lockdown to have more opportunity than usual to comfort each other physically, Field found that only a fifth of parents said they were hugging, holding and kissing their children more.

It is no surprise that we miss touch when we are deprived of it. The human body even has a special system for detecting pleasant touch. As well as the receptors in the skin, which respond very quickly to pain, there are receptors called C-tactile afferent fibres, which respond more slowly.

If our skin is stroked at the ideal speed of 3cm (1.2 inches) per second, the kind of speed you would naturally use to try to soothe somebody, then messages are sent via the nervous system to the brain. Here they provoke a pleasurable chemical cocktail, where the stress hormone cortisol reduces and oxytocin increases.

Even thinking about the caress you are about to receive can trigger the release of dopamine in the reward system.

So, what can we do to about this lack of touch, when the threat of infection means we are likely to need to keep our distance from others for quite a while longer yet?

Field found during April that some people saw similar benefits to well-being and sleep if they substituted outdoor exercise for touch. Fairhurst is developing an app which trains you to stroke someone’s skin at the perfect speed. When I tried it, simply stroking the screen at that speed felt quite soothing. Her research has also shown that grooming yourself by applying lotions or creams, for example, can have some of the same impact as touch, as can eating nice food.

But she warns that eating for comfort is less sustainable than exercise in the long term. It’s also important to remember that the quality of touch matters, so it’s worth trying consciously to become more aware of touch and to make an effort to touch the people in your bubble in a caring way. And if this doesn’t work how about a self-hug? What you need to do is to think about a really good hug you experienced in the past, wrap your arms around your body and hold yourself. It’s not quite as good as the real thing, but it’s not bad.Source:BBC Future

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