Why Amazon built a second headquarters and how the pandemic reshaped HQ2

Six years ago, Amazon kicked off a sweepstakes-style contest in search of where to build a second headquarters. The competition drew bids from 238 states, provinces and cities vying to be the next anchor for the nation’s dominant online retailer and second-largest private employer.

This week, Amazon formally opened the doors of the first part of its new East Coast headquarters, dubbed HQ2, in northern Virginia. The first phase, called Metropolitan Park, includes two 22-story office towers, which can accommodate 14,000 of the 25,000 employees Amazon plans to bring on in Arlington. About 2,900 employees have already moved in, and Met Park will be occupied by 8,000 employees in the fall.

Amazon built its headquarters in Seattle in 1994 partly because of the area’s deep pool of tech talent and the presence of Microsoft in nearby Redmond, Washington. The company’s Seattle campus now spans tens of millions of square feet across more than 40 office buildings, and the greater Puget Sound area has 65,000 corporate and technical Amazon employees.

It raises the question why Amazon, with its sprawling campus in Seattle and a growing real estate footprint globally, needed to build a second headquarters.

Around 2005, as Amazon’s business grew and its campus ballooned in Seattle, founder and then-CEO Jeff Bezos began to consider where the company should expand next.

At all-hands meetings, employees would ask Bezos “if we would ever be in one location at one time,” said John Schoettler, Amazon’s real estate chief, in an interview.

“I think that there was a romantic notion that we as a company would only be so big that we’d all fit inside one building,” Schoettler said. “[Bezos] had said, well, we have long-term leases and when those leases come up, I’ll work with John and the real estate team and we’ll figure out what to do next.”

John Schoettler, Amazon’s vice president of global real estate and facilities, walks Virginia Gov. Glenn Youngkin through HQ2.

Tasha Dooley

Originally, Bezos suggested Amazon stay around the Puget Sound area, but the conversation then shifted to recreating the “neighborhood” feel of its Seattle campus elsewhere, Schoettler said.

“We could have gone out to the suburbs and we could have taken some farmland and knocked some trees down, and we would’ve built a campus that would have been very inward-looking,” he said. “They generally have a north or south entrance and exit east or west. When you put yourself in the middle of the urban fabric and create a walkable neighborhood, an 18-hour district, you become very outward, and you become very part of the community, and that’s what we wanted.”

Holly Sullivan, Amazon’s vice president of economic development, said it would have been harder for Amazon to create that kind of environment had it “sprinkled these employees around 15 other tech hubs or 17 other tech hubs around North America.”

“So what HQ2 has provided is the opportunity for that more in-depth collaboration and being part of a neighborhood,” Sullivan said.

‘I don’t see us getting bigger in Seattle whatsoever’

Amazon’s highly publicized search for a second headquarters has faced some challenges. In 2018, Amazon announced it would split HQ2 between New York’s Long Island City neighborhood, and the Crystal City area of Arlington, Virginia. But after public and political outcry, Amazon canceled its plans to build a corporate campus in Long Island City.

The company’s arrival in Arlington has generated concerns of rising housing costs and displacement. The company said it has committed more than $1 billion to build and preserve affordable homes in the region.

Schoettler said Amazon intends to focus much of its future growth in Arlington and in Nashville, Tennessee, where the company’s logistics hub is based. It also plans to hire as many as 12,000 people in the Seattle suburb of Bellevue, he added.

“I don’t see us getting bigger in Seattle whatsoever,” Schoettler said. “I think that we’re pretty much tapped out there.”

HQ2 has some of the same quirks as Amazon’s Seattle campus. There’s a community banana stand staffed by “banistas” and white boards on the walls of building elevators. Amazon has a dog-friendly vibe at its Seattle office, which carried over to Metropolitan Park, where there’s a public dog park, and a gallery wall of the dogs of Amazon employees. The towers feature plant-filled terraces and a rooftop urban farm that echoes the feel of the “Spheres,” botanical gardenlike workspaces that anchor Amazon’s Seattle office.

Metropolitan Park is the first phase of Amazon’s new Arlington headquarters, called HQ2.

Tasha Dooley

Amazon is opening HQ2 at an uncertain time for the company and the broader tech sector. Many of the biggest companies in the industry, including Amazon, have eliminated thousands of jobs and reined in spending following periods of slowing revenue growth and fears of a recession ahead.

Companies have also been confronting questions about what work looks like in a post-pandemic environment. Many employees have grown accustomed to working from home and have been reluctant to return to the office. Amazon last month began requiring corporate employees to work from the office at least three days a week, which generated pushback from some workers who prefer greater flexibility.

Amazon tweaked the design of HQ2 around the expectation that employees wouldn’t be coming into the office every day.

Communal work spaces are more common, and there’s less assigned seating, Schoettler said. Employees may only be at a desk 30% of the day, with the rest of their time spent in conference rooms, or having casual coffee meetings with coworkers, he said.

“If we don’t come in that day, no one else will utilize the space,” Schoettler said. “And so that way, you can come in, the desk is open and it’s not been personalized with family photos and that type of thing. You can sit down and absolutely utilize the space, and then go off about your day.”

Amazon’s HQ2 features some of the same quirks as its Seattle headquarters, like a community banana stand.

Tasha Dooley

The shift to a hybrid working environment has also influenced the further development of HQ2. Amazon in March said it had pushed out the groundbreaking of PenPlace, the second phase of its Arlington campus. PenPlace is expected to include three 22-story office buildings, more than 100,000 square feet of retail space and a 350-foot-tall tower, called “The Helix,” that features outdoor walkways and inside meeting areas for employees surrounded by vegetation.

Amazon will observe how employees work in the two new Metropolitan Park buildings to inform how it designs the offices at PenPlace, Schoettler said.

Amazon didn’t say when it expects to begin development of PenPlace, but it is continuing to move forward with the permitting and preconstruction process, Schoettler said.

“We just want to be really mindful, since we’re just opening these buildings, to make sure we’re doing it right,” Sullivan said. “These are large investments for us. We own these buildings, and we want to give them a long shelf life.”

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FDA advisors recommend that new Covid vaccines target an omicron XBB variant this fall

A woman receives a booster dose of the Moderna coronavirus disease (COVID-19) vaccine at a vaccination centre in Antwerp, Belgium, February 1, 2022.

Johanna Geron | Reuters

The U.S. Food and Drug Administration‘s independent panel of advisors on Thursday recommended that updated Covid shots for the fall and winter target one of the XBB variants, which are now the dominant strains of the virus nationwide. 

The committee unanimously voted that the new jabs should be monovalent — meaning they are designed to protect against one variant of Covid — and target a member of the XBB family.

Those strains of Covid are descendants of the omicron variant, which caused cases to surge to record levels early last year. They are some of the most immune-evasive strains to date.

Advisors also generally agreed that the new shots should specifically target a variant called XBB.1.5. The panel only discussed that specific strain selection and did not vote on the matter.

XBB.1.5 accounted for nearly 40% of all Covid cases in the U.S. as of early June, according to data from the Centers for Disease Control and Prevention. That proportion is slowly declining, and cases of the related XBB.1.16 and XBB.2.3 variants are on the rise. 

Advisors noted that XBB.1.5 appears most ideal for the fall since vaccine manufacturers Pfizer, Moderna and Novavax have already started to develop jabs targeting the strain.

“The 1.5 looks good. It seems like it’s the most feasible to get across the finish line early without resulting in delays and availability,” said Dr. Melinda Wharton, a senior official at the National Center for Immunization and Respiratory Diseases. “The vaccine we can use is the vaccine that we can get. And so it feels like this would be a good choice.”

The FDA typically follows the advice of its advisory committees, but is not required to do so. It’s unclear when the agency will make a final decision on strain selection.

There is also uncertainty about which age groups the FDA and CDC will advise to receive the updated shots this fall.

But the panel’s recommendation is already a win for Pfizer, Moderna and Novavax — all of which have been conducting early trials on their respective XBB.1.5 shots ahead of the meeting.

“Novavax expects to be ready for the commercial delivery of a protein-based monovalent XBB COVID vaccine this fall in line with today’s [advisory committee] recommendation,” said John Jacobs, the company’s president and CEO.

The U.S. is expected to shift vaccine distribution to the private sector this fall. That means the vaccine makers will start selling their new Covid products directly to health-care providers and vie for commercial market share. 

The panel’s recommendation coincides with a broader shift in how the pandemic impacts the country and the world at large. 

Covid cases and deaths have dropped to new lows, governments have rolled back stringent health mandates like masking and social distancing and many people believe the pandemic is over altogether.  

But Dr. Peter Marks, head of the FDA’s vaccine division, said the agency is concerned that the U.S. will have another Covid wave “during a time when the virus has further evolved, immunity of the population has waned further and we move indoors for wintertime.”

Updated Covid vaccines that are periodically updated to target a high circulating variant will restore protective immunity against the virus, said Dr. David Kaslow, a senior official in the FDA’s vaccine division. 

It’s a similar approach to how the strains are selected for the annual flu shot. Researchers assess strains of the virus in circulation and estimate which will be the most prevalent during the upcoming fall and winter.

But it’s unclear how many Americans will roll up their sleeves to take the updated shots later this year. 

Only about 17% of the U.S. population — around 56 million people —have received Pfizer and Moderna’s boosters since they were approved in September, according to the CDC.

More than 40% of adults 65 and older have been boosted with those shots, while the rate among younger adults and children ranges between 18% and 20%.

Those boosters were bivalent, meaning they targeted the original strain of Covid and the omicron subvariants BA.4 and BA.5. 

Pfizer, Moderna and Novavax shot data

During the meeting, Pfizer, Moderna and Novavax presented preliminary data on updated versions of their shots designed to target XBB variants. 

Moderna has been evaluating shots targeting XBB.1.5 and XBB.1.16 — another transmissible omicron descendant, according to Rituparna Das, the company’s vice president of Covid vaccines. 

Preclinical trial data on mice suggests that a monovalent vaccine targeting XBB.1.5 produces a more robust immune response against the currently circulating XBB variants than the authorized bivalent shot targeting BA.4 and BA.5, according to Das. 

She added that clinical trial data on more than 100 people similarly demonstrates that the monovalent XBB.1.5 vaccine produces protective antibodies against all XBB variants. All trial participants had previously received four Covid vaccine doses.

Das said that comprehensive protection against XBB strains is likely due to the fewer unique mutations between the variants, which means their composition is similar.

There are only three unique mutations between the variants XBB.1.5 and XBB.1.16, according to Darin Edwards, Moderna’s Covid vaccine program leader. By comparison, there are 28 mutations between omicron BA.4 and BA.5.

That means the immune response an updated shot produces against XBB variants will likely be similar, regardless of which specific variant it targets, Edwards said.

Pfizer also presented early trial data indicating that a monovalent vaccine targeting an XBB variant offers improved immune responses against the XBB family. 

The company provided specific timelines for delivering an updated vaccine, depending on the strain the FDA selects. 

Pfizer will be able to deliver a monovalent shot targeting XBB.1.5 by July and a jab targeting XBB.1.16 by August, according to Kena Swanson, the company’s senior principal scientist.

Pfizer won’t be able to distribute a new shot until October if the FDA chooses a completely different strain, Swanson said.

Novavax did not provide a specific timeline for delivering a shot targeting XBB.1.5, but noted that an XBB.1.16 shot would take eight weeks longer.

Novavax unveiled preclinical trial data indicating that monovalent vaccines targeting XBB.1.5 and XBB.1.16 induce higher immune responses to XBB subvariants than bivalent vaccines do. 

Data also demonstrates that an XBB.1.5 shot produces antibodies that block XBB.2.3 from binding to and infecting human cells, according to Dr. Filip Dubovsky, Novavax’s chief medical officer.

Dubovsky said the trial results support the use of a monovalent XBB.1.5 shot in the fall.

Novavax’s jab uses protein-based technology, a decades-old method for fighting viruses used in routine vaccinations against hepatitis B and shingles.

The vaccine works differently than Pfizer’s and Moderna’s messenger RNA vaccines but achieves the same outcome: teaching your body how to fight Covid.

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It’s (Finally) Time to Stop Calling It a Pandemic: Experts

March 17, 2023 — It’s been 3 years since the World Health Organization officially declared the COVID-19 emergency a pandemic. Now, with health systems no longer overwhelmed and more than a year of no surprise variants, many infectious disease experts are declaring a shift in the crisis from pandemic to endemic.

Endemic, broadly, means the virus and its patterns are predictable and steady in designated regions. But not all experts agree that we’re there yet.

Eric Topol, MD, founder and director of the Scripps Research Translational Institute in La Jolla, CA, and editor in chief of Medscape, WebMD’s sister site for health professionals, said it’s time to call COVID endemic.

He wrote in his Substack, Ground Truth, that all indications — from genomic surveillance of the virus to wastewater to clinical outcomes that are still being tracked — point to a new reality: “[W]e’ve (finally) entered an endemic phase. “

No new SARS-CoV-2 variants have yet emerged with a growth advantage over XBB.1.5, which is dominant throughout much of the world, or XBB.1.9.1, wrote Topol. 

But he has two concerns. One is the number of daily hospitalizations and deaths – hovering at near 26,000 and 350, respectively, according to The New York Times COVID tracker. That’s far more than the daily number of deaths in a severe flu season.

“This is far beyond (double) where we were in June 2021,” he wrote.

Topol’s second concern is the chance that a new family of virus might evolve that is even more infectious or lethal – or both – than the recent Omicron variants.

Three Reasons to Call It Endemic

William Schaffner, MD, infectious disease expert at Vanderbilt University Medical Center in Nashville, is in the endemic camp as well for three reasons.

First, he said, “We have very high population immunity. We’re no longer seeing huge surges, but we’re seeing ongoing smoldering transmission.”

Also, though noting the concerning numbers of daily deaths and hospitalizations, Schaffner said, “it’s no longer causing crises in health care or, beyond that, into the community economically and socially anymore.”

“Number three, the variants causing illness are Omicron and its progeny, the Omicron subvariants. And whether because of population immunity or because they are inherently less virulent, they are causing milder disease,” Schaffner said. 

Changing societal norms are also a sign the U.S. is moving on, he said. “Look around. People are behaving endemically.”

They’re shedding masks, gathering in crowded spaces, and shrugging off additional vaccines, “which implies a certain tolerance of this infection. We tolerate the flu,” he noted.

Schaffner said he would limit his scope of where COVID is endemic or close to endemic to the developed world.

“I’m more cautious about the developing world because our surveillance system there isn’t as good,” he said.

He added a caveat to his endemic enthusiasm, conceding that a highly virulent new variant that can resist current vaccines could torpedo endemic status.

No Huge Peaks

“I’m going to go with we’re endemic,” said Dennis Cunningham, MD, system medical director of infection prevention of the Henry Ford Health System in Detroit.

“I’m using the definition that we know there’s disease in the population. It occurs regularly at a consistent rate. In Michigan, we’re no longer having those huge peaks of cases,” he said.

Cunningham said though the deaths from COVID are disturbing, “I would call cardiovascular disease endemic in this country and we have far more than a few hundred deaths a day from that.”

He also noted that vaccines have resulted in high levels of control of the disease in terms of reducing hospitalizations and deaths. 

The discussion really becomes an academic argument, Cunningham said. 

“Even if we call it endemic, it’s still a serious virus that’s really putting a lot of a strain on our health care system.”

 Not So Fast

But not everyone is ready to go all-in with “endemic.”

Stuart Ray, MD, professor of medicine in the Division of Infectious Diseases at Johns Hopkins School of Medicine in Baltimore, said any endemic designation would be specific to a certain area.

“We don’t have much information about what’s happening in China, so I don’t know that we can say what state they’re in, for example,” he said.

Information in the U.S. is incomplete as well, Ray said, noting that while home testing in the U.S. has been a great tool, it has made true case counts difficult.

“Our visibility on the number of infections in the United States has, understandably, been degraded by home testing. We have to use other means to glean what’s happening with COVID,” he said.

“There are people with infections we don’t know about and something from that dynamic could surprise us,” he said.

There are also a growing number of young people who have not yet had COVID, and with low vaccination rates among young people, “we might see spikes in infections again,” Ray said.

Why No Official Endemic Declaration?

Some question why endemic hasn’t been declared by the WHO or CDC.

Ray said health authorities tend to declare emergencies, but are slower to make pronouncements that an emergency has ended if they make one at all.

President Joe Biden set May 11 as the end of the COVID emergency declaration in the U.S. after extending the deadline several times. The emergency status allowed millions to receive free tests, vaccines, and treatments. 

Ray said we will only truly know when the endemic started retrospectively. 

“Just like I think we’ll look back at March 9 and say that Baltimore is out of winter. But there may be a storm that will surprise me,” he aid.

Not Enough Time to Know

Epidemiologist Katelyn Jetelina, PhD, MPH, director of population health analytics at the Meadows Mental Health Policy Institute in Dallas, and a senior scientific consultant to the CDC, said we haven’t had enough time with COVID to call it endemic.

For influenza, she said, which is endemic, “It’s predictable and we know when we’ll have waves.”  

But COVID has too many unknowns, she said.

What we do know is that moving to endemic does not mean an end to the suffering, said Jetelina, who also publishes a Substack called Your Local Epidemiologist

“We see that with malaria and [tuberculosis] and flu. There’s going to be suffering,” she said.

Public expectations for tolerating illness and death with COVID are still widely debated. 

“We don’t have a metric for what is an acceptable level of mortality for an endemic. It’s defined more by our culture and our values and what we do end up accepting,” she said. “That’s why we’re seeing this tug of war between urgency and normalcy. We’re deciding where we place SARS-CoV-2 in our repertoire of threats.”

 She said in the U.S., people don’t know what these waves are going to look like — whether they will be seasonal or whether people can expect a summer wave in the South again or whether another variant of concern will come out of nowhere. 

“I can see a future where (COVID) is not a big deal in certain countries that have such high immunity through vaccinations and other places where it remains a crisis.

“We all hope we’re inching toward the endemic phase, but who knows? SARS-CoV-2 has taught me to approach it with humility,” Jetelina said. “We don’t ultimately know what’s going to happen.” 

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Long COVID Takes Toll on Already Stretched Health Care Workforce

March 6, 2023 — The impact of long COVID – and its sometimes-disabling symptoms that can persist for more than a year — has worsened health care’s already severe workforce shortage. 

Hospitals have turned to training programs, traveling nurses, and emergency room staffing services. While the shortage of clinical workers continues, support workers are also in short supply, with no end in sight.

“Our clinical staff is the front line, but behind them, several layers of people do jobs that allow them to do their jobs,” says Joanne Conroy, MD, president of Dartmouth-Hitchcock Medical Center, a 400-bed hospital in New Hampshire. “Lab and radiology and support people and IT and facilities and housekeeping … the list goes on and on.” 

Long COVID is contributing to the U.S. labor shortage overall, according to research. But with no test for the condition and a wide range of symptoms and severity – and with some workers attributing their symptoms to something else — it’s difficult to get a clear picture of the impacts on the health care system.

Emerging research suggests long COVID is hitting the health care system particularly hard.

 The system has lost 20% of its workforce over the course of the pandemic, with hospital understaffing at hospitals resulting in burnout and fatigue among frontline medical professionals, according to the U.S. Bureau of Labor Statistics.

Other research spotlights the significant impacts on health care workers:

  • In New York, nearly 20% of long COVID patients are still out of work after a year, with high numbers among health care workers, according to a new study of workers compensation claims.  
  • A new study in the American Journal of Infection Control reports nurses in intensive care units and non-clinical workers are especially vulnerable. About 2% of nurses have not returned work after developing COVID-19, according to a 2022 survey by the National Nursing Association, which represents unionized workers.  
  • In the United Kingdom, long COVID symptoms impact the lives of 1.5 million people, according to the Office of National Statistics, which is monitoring the impact of COVID. Nearly 20% report their ability to engage in day-to-day activities had been “limited a lot,” according to data from February.

While long COVID brain fog, fatigue, and other symptoms can sometimes last just a few weeks or months, a percentage of those who develop the condition – on or off the job – go on to have chronic, long-lasting, disabling symptoms that may linger for years. 

Several recent research studies suggest the impacts of long COVID on health care workers, who interact more closely with COVID patients than others on the job, are greater than other occupations and are likely to have a continuing impact.

About 25% of those filing COVID-related workers compensation claims for lost time at work are health care workers, according to a study from the National Council on Compensation Insurance. That was more than any other industry. At the same time,  the study – which included data from nine states – found that worker compensation claims for acute COVID cases dropped from 11% in 2020 to 4% in 2021.  

Last year, Katie Bach wrote a study for the Brookings Institution on the impact of long COVID on the labor market. She said in an email that she still thinks it’s a problem for the health care workforce and the workforce in general. 

“It is clear that we have a persistent group of long COVID patients who aren’t getting better,” she says.

Hospitals Forced to Adapt

Dartmouth-Hitchcock Medical Center is the largest health system — and one of the largest employers — in New Hampshire with 400 beds and 1,000 employees at the flagship hospital and affiliate. Human resource staff here have been tracking COVID-19 infections among employees.

The hospital is treating fewer COVID cases, down from a high of about 500 a month to between 100 and 200 cases month. But at the same time, they are seeing an increase in staff are who calling in sick with a range of COVID-like symptoms or consulting with the occupational medicine department, says Aimee M. Claiborne, the head of human resources for the Dartmouth Health system. 

“Some of that might be due to long COVID; some if it might be due to flu or RSV or other viruses,” she says. “We are definitely looking at things like absenteeism and what people are calling in for.”

They are also looking at “presenteeism” – where workers show up when they are not feeling well and they are not as productive, she says. 

Those who return to work can access the company’s existing disability programs to get accommodations – allowing people with low energy or fatigue or another disability to, for example, work shorter shifts or from home. Dartmouth-Hitchcock is also building more remote work into its system after trying the approach during the height of the pandemic, Claiborne says. 

Ultimately, some workers will not be able to return to work. Those who were infected on the job can also seek workers’ compensation, but coverage varies from employer to employer and state to state. 

On the other side of the country, Annette Gillaspie, a nurse in a small Oregon hospital, says she caught COVID – like many other health care workers – early in the pandemic before vaccines were available and protective measure were in place. 

She says she still hasn’t fully recovered 3 years later – she still has a cough as well as POTS (postural orthostatic tachycardia syndrome), a common post-COVID-19 condition of the automatic nervous system that can cause dizziness and fatigue when a sitting person stands up.

But she’s back at work and the hospital has made accommodations for her, like a parking space closer to the building. 

She remembers being exposed — she forgot to put on protective glasses. A few days later she was in bed with COVID. She says she never quite recovered. Gillaspie says she sees a lot of other people at work who seem to have some long COVID symptoms. 

“Some of them know it’s COVID related,” she says. “They’re doing just like I do — pushing through.”

They do it because they love their work, she says. 

Shortages Span the Country

Millions of people are living in what the federal government calls “health practitioner shortage areas” without enough dental, primary, and mental health practitioners. At hospitals, vacancies for nurses and respiratory therapists went up 30% between 2019 and 2020, according to an American Hospital Association (AHA) survey

Hospitals will need to hire to 124,000 doctors and at least 200,000 nurses per year to meet increased demand and to replace retiring nurses, according to the AHA. 

When the pandemic hit, hospitals had to bring expensive traveling nurses in to deal with the shortages driven by wave after wave of COVID surges. But as the AHA notes, the staffing shortfalls in health care existed before the pandemic.

The federal government, states, and health care systems have programs to address the shortage. Some hospitals train their own staff, while others may be looking at expanding the “scope of care” for existing providers, like physician assistants. Still others are looking to support existing staff who may be suffering from burnout and fatigue – and now, long COVID.

Long COVID numbers  — like the condition itself — are hard to measure and ever-changing. Between 10% and 11% of those who have had COVID have long COVID, according to the Household Pulse Survey, an ongoing Census Bureau data project.

A doctor in the U.K. recently wrote that she and others initially carried on working, believing they could push through symptoms. 

“As a doctor, the system I worked in and the martyr complex instilled by medical culture enabled that view. In medicine, being ill, being human, and looking after ourselves is still too often seen as a kind of failure or weakness,” she wrote anonymously in February in the journal BMJ.

Jeffrey Siegelman, MD, a doctor at Emory University Medical Center in the Atlanta, also wrote a journal article about his experiences with long COVID in 2020 in JAMA. More than 2 years later, he still has long COVID. 

He was out of work for 5 months, returned to practice part-time, and was exempt from night work – “a big ask,” he says, for an emergency department doctor. 

In general,  he feels like the hospital “bent over backwards” to help him get back to work. He is just about to return to work full-time with accommodations.

“I’ve been really lucky in this job,” Siegelman says. “That’s not what most patients with long COVID deal with.”

He led a support group for hospital employees who had long COVID – including clerks, techs, nurses, and doctors. Many people were trying to push through their symptoms to do their jobs, he says. A couple of people who ran through their disability coverage were dismissed.

He acknowledges that as a doctor, he had better disability coverage than others. But with no diagnostic test to confirm long COVID, he’s not exempt from self-doubt and stigma. 

Siegelman was one of the doctors who questioned the physiological basis for ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), a condition that mirrors long COVID and commonly appears in those who have lingering symptoms of an infection. He doesn’t anymore. 

Researchers are beginning to link ME/CFS and other long-term problems to COVID and other infections, and research is underway to better understand what is known as post-infection illnesses. 

Hospitals are dealing with so much, Siegelman says, that he understands if there’s a hesitancy to acknowledge that people are working at a reduced capacity. 

“It’s important for managers in hospitals to talk about this with their employees and allow people to acknowledge if they are taking more time than expected to recover from an illness,” he says. 

In medicine, he says, you are expected to show up for work unless you are on a gurney yourself. Now, people are much more open to calling in if they have a fever – a good development, he says.

And while he prepared to return to work, symptoms linger. 

“I can’t taste still,” he says. “That’s a pretty constant reminder that there is something real going on here.” 

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Lebanon adopts ‘dollarization’ as currency, economy crumble

When Moheidein Bazazo opened his Beirut mini-market in 1986, during some of the fiercest fighting in Lebanon’s civil war, he didn’t expect it to thrive. But several years later, he had shelves full of food and needed 12 employees to help him manage a bustling business.

Those days are over. Bazazo now mostly works alone, often in the dark to reduce his electric bill. Regular customers are struggling to make ends meet, and as they buy less so does he, leaving some shelves and refrigerators bare.

Moheidein Bazazo changes price tags from Lebanese pound to the U.S. dollar in a shop in in Beirut, Lebanon, Wednesday, March 1, 2023. Lebanon began pricing consumer goods in supermarkets in U.S. dollars Wednesday as the value of the Lebanese pound hit new lows.
| Photo Credit:
AP

With the Lebanese economy in shambles and its currency in free fall, Bazazo spends much of his time trying to keep up with a fluctuating exchange rate. Businesses like his are increasingly leaning on one of the world’s most reliable assets — the U.S. dollar — as a way to cope with the worst financial crisis in its modern history.

“I once lived a comfortable life, and now I’m left with just about $100 after covering the shop’s expenses” at the end of the month, Bazazo said, crunching numbers into a calculator. “Sometimes it feels like you’re working for free.”

The Lebanese pound has lost 95% in value since late 2019, and now most restaurants and many stores are demanding to be paid in dollars. The government recently began allowing grocery stores like Bazazo’s to start doing the same.

While this “dollarization” aims to ease inflation and stabilize the economy, it also threatens to push more people into poverty and deepen the crisis.

That’s because few in Lebanon have access to dollars to pay for food and other essentials priced that way. But endemic corruption means political and financial leaders are resisting the alternative to dollarization: long-term reforms to banks and government agencies that would end wasteful spending and jump-start the economy.

Other countries like Zimbabwe and Ecuador have turned to the dollar to beat back hyperinflation and other economic woes, with mixed success. Pakistan and Egypt also are struggling with crashing currencies but their economic crises are largely tied to an outside event — Russia’s war in Ukraine, which has caused food and energy prices to soar.

Lebanon’s woes are much of its own making.

As the country felt the impacts of the COVID-19 pandemic, a deadly Beirut port explosion in 2020 and Russia’s invasion Ukraine, its central bank simply printed more currency, eroding its value and causing inflation to soar.

Prices are seen marked in U.S. dollar instead of the Lebanese pounds in a store in Beirut, Lebanon, Wednesday, March 1, 2023. Lebanon started pricing consumer goods in supermarkets in U.S. dollars Wednesday as the value of the Lebanese pound hit new lows.

Prices are seen marked in U.S. dollar instead of the Lebanese pounds in a store in Beirut, Lebanon, Wednesday, March 1, 2023. Lebanon started pricing consumer goods in supermarkets in U.S. dollars Wednesday as the value of the Lebanese pound hit new lows.
| Photo Credit:
AP

Three-quarters of Lebanon’s 6 million people have fallen into poverty since the 2019 crisis began. Crippling power cuts and medicine shortages have paralyzed much of public life.

Currency shortages prompted banks to limit withdrawals, trapping millions of people’s savings. It’s led some in desperation to hold up banks to forcibly take back their money.

The damage of the last few years was magnified by decades of economic mismanagement that allowed the government to spend well beyond its means. The head of the country’s Central Bank was recently charged with embezzling public funds and other crimes.

The pulverized Lebanese pound fluctuates almost hourly. Though officially pegged to the dollar since 1997, the pound’s value is dictated now by an opaque black market rate that has become standard for most goods and services.

Last month, its value fell from about 64,000 pounds to the dollar to 88,000 on the black market, while the official rate is 15,000. Making things worse for a country reliant on imported food, fuel and other products priced in dollars, the government recently tripled the amount of tax — in Lebanese pounds — that importers must pay on those goods.

This will likely lead to more price hikes. For small businesses, it could means selling products at a loss just minutes after stacking them on the shelves.

Dollarization could give the impression of greater financial stability, but it also will widen already vast economic inequalities, said Sami Zoughaib, an economist and research manager at Beirut-based think tank the Policy Initiative.

“We have a class that has access to dollars … (and) you have another portion of the population that earns in Lebanese pounds that have now seen their income completely decimated,” Zoughaib said.

The shift to a more dollar-dominated economy happened not by government decree, but by companies and individuals refusing to accept payment in a currency that relentlessly loses value.

First, luxury goods and services were priced in dollars for the wealthy, tourists and owners of private generators, who have to pay for imported diesel. Then it was most restaurants. And now grocery stores.

Caretaker Economy Minister Amin Salam said the Lebanese pound was “used and abused” over the past three years and that dollarizing grocery stores will bring some stability to fluctuating exchange rates.

As more people and businesses reject the local currency, the dollar gradually becomes the de facto currency. The lack of trust in the Lebanese pound has become irreversible, said Layal Mansour, an economist specializing in financial crises in dollarized countries.

“People are fed up with the fluctuation of the dollar rate, and having to spend lots of time changing it, so practically, on a societal level, it’s better to use dollars,” Mansour said. “This is the end of the Lebanese pound as we know it.”

Without a strategy to address the economy’s underlying problems, the government “is allowing this to happen,’’ said Lawrence White, an economics professor at George Mason University.

Dollarization means the Central Bank can’t keep printing currency that fuels inflation, and having a more reliable currency might create more confidence for businesses. But many people could be further squeezed if Beirut officially adopts the greenback as its currency.

Millions in Lebanon who tolerated the dollarization of luxury items may not respond similarly to groceries, whose prices were already surging at some of the highest rates globally.

Over 90% of the population earns their income in Lebanese pounds, according to a 2022 survey by the International Labor Organizaton and the Lebanese government’s statistics agency. Families that receive money from relatives abroad spend much of it keeping the lights on and covering medical expenses.

Moheidein Bazazo changes price tags from Lebanese pound to the U.S. dollar in a shop in in Beirut, Lebanon, Wednesday, March 1, 2023. Lebanon began pricing consumer goods in supermarkets in U.S. dollars Wednesday as the value of the Lebanese pound hit new lows.

Moheidein Bazazo changes price tags from Lebanese pound to the U.S. dollar in a shop in in Beirut, Lebanon, Wednesday, March 1, 2023. Lebanon began pricing consumer goods in supermarkets in U.S. dollars Wednesday as the value of the Lebanese pound hit new lows.
| Photo Credit:
AP

They would have to be paid in dollars to adequately adjust, which most businesses and employers, especially the Lebanese state, are short on.

Public school teachers have been on strike for three months because their salaries barely cover the cost of gasoline to commute. Telecom workers are threatening walkouts because their wages have not been adjusted to the Lebanese pound’s falling value.

Lebanon is nowhere near implementing the kinds of reforms needed for an International Monetary Fund bailout, such as restructuring banks and inefficient government agencies, reducing corruption, and establishing a credible and transparent exchange-rate system.

Zoughaib, the Beirut economist, said he fears the absence of sound policy and economic reforms means that dollarization will likely only deepen poverty, making it even more difficult for families to pay for health care, education and food.

Bazazo, the market owner, acknowledges that pricing in dollars will help him manage his finances and cut a small portion of his losses but worries it will drive away some customers.

“Let’s see what happens,” Bazazo said, sighing. “They’re already complaining.”

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China wants to reduce India’s influence in Indian Ocean region, say papers submitted at DGPs’ meet

Chinese activities and influence in India’s extended neighbourhood have grown increasingly with the sole purpose of keeping New Delhi constrained and occupied in facing the resultant challenges, according to papers submitted at a key security meeting in New Delhi.

The papers presented by Indian Police Service (IPS) officers at the just concluded conference of DGPs and IGPs submit that by providing huge amounts of money in the name of loans for developmental works in Southeast and South Asia, China wants to reduce India’s influence in the Indian Ocean region and force resolution of bilateral issues on Beijing’s terms.

Explained | China’s moves in the Indian Ocean

The three-day annual conference was attended by Prime Minister Narendra Modi, Union Home Minister Amit Shah, National Security Adviser Ajit Doval and about 350 top police officers of the country.

China’s Belt and Road Initiative (BRI), China-Pakistan Economic Corridor (CPEC), infrastructure related investments in India’s neighbouring countries through easy loans, hot borders and Line of Actual Control (LAC) are some of the tools Beijing has been using effectively, the papers say.

The last two-and-a-half decades have seen Chinese economic and military growth at a massive scale and Chinese activities and influence in India’s extended neighbourhood have grown proportionately, they find.

“All this is being done with the aim to keep India constrained and occupied in facing the resultant challenges, force resolution of bilateral issues on its own terms, modulate India’s growth story, leaving it [China] free to achieve its aim of becoming not only Asia’s pre-eminent power, but a global superpower,” according to the papers.

The papers on the subject “Chinese influence in the neighbourhood and implications for India” were written by some top IPS officers of the country.

China has become far more attentive to its South Asian periphery, moving beyond commercial and development engagements to more far-reaching political and security ones, according to one of the papers.

China is investing huge amounts of money in the neighbouring countries of India mainly Pakistan, Nepal, Bangladesh, Myanmar and Sri Lanka in the name of infrastructure development and other financial assistance, it said.

Without exception, India’s neighbouring countries have described China as a crucial development partner, either as a funder or in providing technological and logistical support. Additionally, it is the biggest trading partner in goods for Bangladesh and Sri Lanka, and the second-largest for Nepal and the Maldives, it said.

“However, the economic element is increasingly intertwined with political, government, and people-to-people aspects of these relationships,” it said.

The COVID-19 pandemic has created opportunities for China to work directly with these countries in new ways such as the provision of medical equipment, biomedical expertise, and capital for coronavirus-related needs, it said.

These developments demonstrate that China’s presence in Southeast and South Asia is no longer predominantly economic but involves a greater, multidimensional effort to enhance its posture and further its long-term strategic interests in the region, the paper said.

“China is highly ambitious about achieving its regional power status in the Indian Ocean region. To do so Beijing wants to contain India which is the only threat before China in this region,” according to an analyst.

Radicalisation of Muslim youth a major challenge for national security

Radicalisation, particularly of the Muslim youth, is one of the key challenges for national security and it is important to take moderate Muslim leaders and clerics into confidence to counter radical organisations, according to papers submitted at the security meeting.

The papers noted that the rise in religious fundamentalism in India is primarily due to high level of indoctrination, easy availability of modern means of communication, including encrypted form, cross-border terrorism and Pakistan concentrating on encouraging these radical groups.

“Radicalisation, particularly of the Muslim youth, is one of the important challenges for national security of our country. Several radical Muslim organisations are active in India, which indulge in organised radicalisation of the Muslim youth. They have inherent tendency to corrupt minds of Muslim community, push them on the violent path and work against composite culture,” the papers noted.

In view of this, tackling radical organisations become imperative and priority in the interests of social harmony and national security.

These organisations are engaged in radical interpretation of Islamic scriptures and concepts.

They also create a sense of victimhood in Muslim psyche. In pursuit of puritanical Islam, their preaching go against modern values such as democracy and secularism.

In India, the papers revealed, the recently banned Popular Front of India (PFI), another banned group SIMI, Wahdat-e-Islami, Islamic Youth Federation, Hizb-ut Tahreer and Al-Ummah are some Muslim organisations, which fit in this category.

“Among these Muslim organisations, the PFI was the most potent radical organisation. It evolved as a national-level organisation since formation in 2006 by merging of three South India based outfits,” the papers noted.

Rise in religious fundamentalism is due to history and attending continuous religious programmes such as Dars-eQuran, Ahle-Hadith etc., high level of indoctrination, modern means of communication viz. internet, mail in coded and encrypted form, the papers said.

The cross-border terrorism and its post effects, Pakistan concentrating on encouraging these radical organisations, Muslim boys going to the Gulf countries and coming back with money and radical ideologies are some other reasons for the rise of radicalisation, according to the papers said.

The writers noted that terrorist radicalisation is a dynamic process whereby an individual comes to accept terrorist violence as a possible, perhaps even legitimate, course of action and each case of terrorist radicalisation results from the unique intersection of an enabling environment and the personal trajectory and psychology of a given individual.

Suggesting remedies, the papers noted that to tackle radical Organisations, multi-pronged approach is required, including monitoring of covert activities, creation of detailed databases on leaders and other entities of interests.

“Security agencies and state police need to be sensitised about threat to national security from radical organisations and in order to counter radical organisations, it is equally important to take moderate Muslim leaders and clerics into confidence.

“Emphasis should be given to identify and monitoring the hotspots of radicalisation and prior analysis must be done about the potentiality of a radical organisation in spreading extremism and involvement of its cadres in violent action and accordingly the plan of action should be initiated,” the papers noted.

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