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Business

‘Surprisingly resilient’: IMF lifts global growth forecasts | International Monetary Fund

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The International Monetary Fund (IMF) has raised its 2023 global growth outlook slightly due to “surprisingly resilient” demand in the United States and Europe and the reopening of China’s economy after Beijing abandoned its strict zero-COVID strategy.

The IMF said global growth would still fall to 2.9 percent in 2023 from 3.4 percent in 2022, but its latest World Economic Outlook forecasts mark an improvement over an October prediction of 2.7 percent growth this year, with warnings that the world could easily tip into recession.

For 2024, the IMF said global growth would accelerate slightly to 3.1 percent, but interest rate hikes by central banks around the world would slow demand.

IMF chief economist Pierre-Olivier Gourinchas said recession risks had subsided and central banks were making progress in controlling inflation, but more work was needed to curb prices, and new disruptions could come from further escalation of the war in Ukraine and China’s battle against COVID-19.

“We have to sort of be prepared to expect the unexpected, but it could well represent a turning point, with growth bottoming out and then inflation declining,” Gourinchas told reporters of the 2023 outlook.

Strong demand

In its 2023 gross domestic product (GDP) forecasts, the IMF said it now expected GDP growth in the US of 1.4 percent, up from the 1.0 percent predicted in October and following 2.0 percent growth in 2022.

The fund cited stronger-than-expected consumption and investment in the third quarter of 2022, a robust labour market and strong consumer balance sheets.

It said the eurozone had made similar gains, with 2023 growth for the bloc now forecast at 0.7 percent, compared with 0.5 percent in the October outlook, following 3.5 percent growth in 2022. The IMF said Europe had adapted to higher energy costs more quickly than expected, and an easing of energy prices had helped the region.

The United Kingdom was the only major advanced economy the IMF predicted to be in recession this year.

It forecast the British economy to shrink 0.6 percent this year, compared with a previous expectation for growth of 0.3 percent. People are struggling with higher interest rates, and government moves to further tighten spending are also squeezing growth, it said.

“These figures confirm we are not immune to the pressures hitting nearly all advanced economies,’’ Chancellor of the Exchequer Jeremy Hunt said in response to the IMF forecast. “Short-term challenges should not obscure our long-term prospects — the UK outperformed many forecasts last year, and if we stick to our plan to halve inflation, the UK is still predicted to grow faster than Germany and Japan over the coming years.”

China reopens

The IMF revised China’s growth outlook sharply higher for 2023, to 5.2 percent from 4.4 percent in the October forecast after its ‘zero-COVID’ strategy held back the economy. China’s growth rate was 3.0 percent in 2022, below the global average for the first time in more than 40 years.

Still, the fund added that China’s growth will “fall to 4.5 percent in 2024 before settling at below 4 percent over the medium term amid declining business dynamism and slow progress on structural reforms”.

At the same time, it maintained India’s outlook for a dip in 2023 growth to 6.1 percent but a rebound to 6.8 percent in 2024, matching its 2022 performance.

Gourinchas said together, the two Asian powerhouse economies will contribute more than 50 percent of global growth in 2023.

He acknowledged that China’s reopening would put some upward pressure on commodity prices, but “on balance, I think we view the reopening of China as a benefit to the global economy” as it will help ease production bottlenecks that have worsened inflation and by creating more demand from Chinese households.

Even with China’s reopening, the IMF is predicting that oil prices will fall in both 2023 and 2024 due to lower global growth compared with 2022.

Risks

The IMF said there were both upside and downside risks to the outlook, with built-up savings creating the possibility of sustained demand growth, particularly for tourism, and an easing of labour market pressures in some advanced economies helping to cool inflation, lessening the need for aggressive rate hikes.

But it detailed more and larger downside risks, including more widespread COVID-19 outbreaks in China and a worsening of the country’s property turmoil.

An escalation of the war in Ukraine could lead to a further spike in energy and food prices, as would a cold northern winter next year as Europe struggles to refill gas storage and competes with China for liquefied natural gas supplies, the fund said.

Gourinchas said central banks need to stay vigilant and be more certain that inflation is on a downward path, particularly in countries where real interest rates remain low, such as in Europe.

“So we’re just saying, look, bring monetary policy slightly above neutral at the very least and hold it there. And then assess what’s going on with price dynamics and how the economy is responding, and there will be plenty of time to adjust course, so that we avoid having overtightening,” Gourinchas said.

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World

China says COVID outbreak has infected 80 percent of population | Coronavirus pandemic News

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Prominent scientist says Lunar New Year travel rush unlikely to lead to a surge in COVID cases as most people have already been infected.

The possibility of a large-scale COVID-19 rebound in China over the next few months is remote as 80 percent of the country’s population has been infected, a prominent government scientist has said.

Wu Zunyou, the chief epidemiologist at the China Center for Disease Control and Prevention, said on Saturday that the mass movement of people during the ongoing Lunar New Year holiday period may spread the pandemic, boosting infections in some areas, but that a second COVID wave is unlikely in the next two to three months.

This is because the ongoing wave of the epidemic — driven mostly by multiple sub-branches of the Omicron strain — “has already infected 80 percent of the population”, he was quoted as saying on the Weibo social media platform.

Wu’s statement came as hundreds of millions of Chinese people travelled across the country for holiday reunions that had been suspended under recently eased COVID-19 curbs.

With some five billion passenger trips expected, fears have risen of new outbreaks in rural areas that are less equipped to manage large numbers of infections.

But the government has moved to assuage concerns, with the National Health Commission saying on Thursday that China has passed the peak of COVID-19 patients in fever clinics, emergency rooms and with critical conditions.

Nearly 60,000 people with COVID-19 had died in hospital as of January 12, according to government data, roughly a month after China abruptly dismantled its zero-COVID policy.

But some experts said that figure probably vastly undercounts the full effect, as it excludes those who die at home and because many doctors have said they are discouraged from citing COVID-19 as a cause of death.

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World

Photos: Lunar New Year rush starts in China | Coronavirus pandemic News

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Hairdresser Wang Lidan is making an emotional Lunar New Year journey from Beijing to her hometown in northeastern China – her first such journey in three years – after the government lifted a strict “zero-COVID” policy that kept millions of people at home and sparked protests.

Referred to in China as the Spring Festival, the New Year holiday may be the only time of the year when urban workers return to their hometowns and see the family they have left behind.

The Chinese government expects about 2.1 billion journeys to be made during a 40-day travel period around the celebration as people rush back for the traditional reunion dinner on the eve of the new year. The first day of the Lunar New Year falls on Sunday.

“The restrictions are lifted, which made me relaxed. So I think it’s time to go home,” Wang said before heading into Beijing Train Station for a trip to the Heilongjiang province.

In December, China abruptly dropped near-daily coronavirus testing and QR code monitoring of residents after public frustration boiled over into protests in Shanghai and other cities. This month, it dropped most remaining restrictions, including the demand travellers from overseas go into lengthy and expensive quarantine.

Many local governments had also imposed their own quarantine on travellers coming into their areas, and it was those that Wang said had deterred her from leaving Beijing.

“If there was an outbreak in Beijing, I would have to be quarantined in my hometown. And when I came back to Beijing, I would be quarantined again,” she said.

“I would miss the Spring Festival and delay my return to work if I was quarantined twice. So inconvenient!”

Hu Jinyuan, from the eastern province of Shandong, had managed to return home each year despite the hassles. He says he plans to continue with regular COVID-19 testing and other measures given the high number of cases since the restrictions were lifted.

“I do nucleic acid tests every now and then. When I arrive in my hometown, I will surely do a test as a way of self-protection. Otherwise, I won’t know if I’m infected. If I’m infected, I will just isolate myself at home,” Hu said.

Wang Jingli said he decided to work through the holidays since his company would triple his overtime pay. With the COVID-19 restrictions cancelled, his children and wife will visit him in Beijing from their hometown in Henan province.

“With the reopening, everyone is very happy about the Spring Festival because we can reunite with our families. But because of my work, I would spend my Spring Festival here in Beijing.”

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Health

When young children test positive for Covid-19 and another respiratory virus, their illness is much more severe, a new study suggests

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CNN
 — 

When Covid-19 patients younger than 5 also test positive for another respiratory virus, they tend to become sicker and develop more severe disease, a new study suggests.

Among hospitalized children younger than 5, testing positive for both Covid-19 and another respiratory virus at the same time is associated with about twice the odds of severe respiratory illness than those who tested negative for other viruses, according to the study published Wednesday in the journal Pediatrics.

The study comes amid a harsh season of respiratory viruses, including RSV, flu, Covid-19 and other viruses that overwhelmed children’s hospitals. The findings demonstrate the impact respiratory viruses have on pediatric hospitals and how “continued surveillance” of circulating Covid-19 and other illnesses can help predict future surges in hospitalizations, wrote the researchers, from the US Centers for Disease Control and Prevention and various universities and health departments across the United States.

Caring for young children with overlapping respiratory illnesses was something Jenevieve Silva has experienced firsthand throughout the Covid-19 pandemic.

“The height of the illnesses was from September through mid-November, when our household just could not catch a break,” she said.

The mother of eight, based in San Jose, California, said that her toddler-age twin boys “have been battered by viruses” since they started preschool in May 2021.

Last October, Silva’s twins tested positive for Covid-19 and then developed what their pediatrician suspected was another respiratory viral infection, possibly respiratory syncytial virus or RSV, around the same time.

“Based on what the pediatrician told us, she said ‘I highly believe that they had these overlapping viruses,’” Silva said, adding that the boys’ symptoms included shortness of breath, cough, fatigue, and fever, with one twin having a 105-degree fever for four days straight.

Warm baths and massaging Vicks VapoRub onto their backs and chest helped ease their pain, but watching her boys battle these respiratory illnesses was “brutal,” Silva said.

“They had just looked so frail – they looked sick, like something deeper than just back-to-back viruses,” she said. “It was hell. I mean, it was really bad.”

The boys have recovered and are currently “doing great” and have gained healthy weight, Silva said, but she worries that they developed asthma following their illnesses.

Ever since October, when they had the overlapping viruses, “the doctor has now said it seems like that might have triggered asthma in them. And so now, ever since then, when they get a cold, they have asthma symptoms – violent episodes of coughing, sometimes throwing up,” Silva said.

“I can’t be the only mom dealing with virus after virus,” she said, adding that for other parents out there, she has a message of hope: “Be patient. Listen to your doctor.”

The new study included data on 4,372 children who were hospitalized with Covid-19. Among those who were tested for other respiratory viruses, 21% had a codetection, meaning another respiratory virus was also detected in their test results. The data came from the US Centers for Disease Control and Prevention’s Covid-19 hospitalization surveillance network called COVID-NET, with data from across 14 states.

The researchers noted that they focused on codetection, not coinfection, since testing wouldn’t necessarily show that a child was actively infected with both viruses just because they test positive.

Overall, “this study found that respiratory virus codetections were rare in the first year of the pandemic, RSV and rhinovirus or enterovirus codetections increased during the Delta-predominant period and influenza codetections were infrequent throughout the first 2 years of the pandemic,” the researchers wrote in their study.

The data also showed that children with codetections were more likely to be younger than 5, receive increased oxygen support, and be admitted to the intensive care unit. No significant associations were seen among children 5 and older.

Specifically for children younger than 2, testing positive for respiratory syncytial virus or RSV while having Covid-19 was significantly associated with severe illness.

More research is needed on the precise impact that two respiratory viruses can simultaneously have on the body, said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center and medical director of the National Foundation for Infectious Diseases, who was not involved in the new study.

“But we do think that being attacked by two viruses, particularly if you are less than five years of age, it’s been clearly demonstrated by this study, it does tend to make your illness more severe, more likely to be prolonged in the hospital, more likely to be in the pediatric intensive care unit,” Schaffner said. “And so clearly, having your lungs and your throat and your body – generally your immune system – attacked by two viruses simultaneously, understandably might make some young children more severely ill.”

Dr. Asuncion Mejias, associate professor of pediatric infectious diseases at Nationwide Children’s Hospital, said hospitalized children she has treated for Covid-19 and codetections of other respiratory viruses often require increased oxygen support and treatment in the intensive care unit.

“Covid is a very proinflammatory virus, so it really weakens your immune response,” said Mejias. “And when you haven’t recovered yet, and you get a second hit, in this case, RSV or rhinovirus, you develop a more severe disease.”

Overall, Schaffner said that these new study findings are more reason why it remains important to make sure children are up to date on their Covid-19 vaccinations as well as vaccinated against the flu.

Mejias agreed, emphasizing the importance of safe practices to prevent the spread of viruses to children too young to be vaccinated.

“The pandemic taught us how contagious these viruses are,” Mejias said about respiratory pathogens.

“If somebody is sick, try to avoid contact,” she said. “These viruses are not only transmitted by saliva and secretions but by hands. It can survive in your hands for more than 30 minutes. So if you touch your mouth and then touch a little baby, the baby can self inoculate the virus and become infected. So washing hands and all these measures are very important.”

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Business

From the unwinding of zero-Covid to economic recovery: What to watch in China in 2023

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Editor’s Note: A version of this story appeared in CNN’s Meanwhile in China newsletter, a three-times-a-week update exploring what you need to know about the country’s rise and how it impacts the world. Sign up here.


Hong Kong
CNN
 — 

After a tumultuous end to a momentous and challenging year, China heads into 2023 with a great deal of uncertainty – and potentially a glimpse of light at the end of the pandemic tunnel.

The chaos unleashed by leader Xi Jinping’s abrupt and ill-prepared exit from zero-Covid is spilling over into the new year, as large swathes of the country face an unprecedented Covid wave.

But the haphazard reopening also offers a glimmer of hope for many: after three years of stifling Covid restrictions and self-imposed global isolation, life in China may finally return to normal as the nation joins the rest of the world in learning to live with the virus.

“We have now entered a new phase of Covid response where tough challenges remain,” Xi said in a nationally televised New Year’s Eve speech. “Everyone is holding on with great fortitude, and the light of hope is right in front of us. Let’s make an extra effort to pull through, as perseverance and solidarity mean victory.”

Xi had previously staked his political legitimacy on zero-Covid. Now, as his costly strategy gets dismantled in an abrupt U-turn following nationwide protests against it, many are left questioning his wisdom. The protests, which in some places saw rare demands for Xi and the Communist Party to “step down,” may have ended, but the overriding sense of frustration has yet to dissipate.

His New Year speech comes as China’s lockdown-battered economy faces more immediate strain from a spiraling outbreak that has hit factories and businesses, ahead of what is likely to be a long and complicated road to economic recovery.

Its tightly-sealed borders are gradually opening up, and Chinese tourists are eager to explore the world again, but some countries appear cautious to receive them, imposing new requirements for a negative Covid test before travel. And just how quickly – or keenly – global visitors will return to China is another question.

Xi, who recently reemerged on the world stage after securing a third term in power, has signaled he hopes to mend frayed relations with the West, but his nationalist agenda and “no-limits friendship” with Russia is likely to complicate matters.

As 2023 begins, CNN takes a look at what to watch in China in the year ahead.

The most urgent and daunting task facing China in the new year is how to handle the fallout from its botched exit from zero-Covid, amid an outbreak that threatens to claim hundreds of thousands of lives and undermine the credibility of Xi and his Communist Party.

The sudden lifting of restrictions last month led to an explosion of cases, with little preparation in place to deal with the surging numbers of patients and deaths.

The country’s fragile heath system is scrambling to cope: fever and cold medicines are hard to find, hospitals are overwhelmed, doctors and nurses are stretched to the limit, while crematoriums are struggling to keep up with an influx of bodies.

And experts warn the worst is yet to come. While some major metropolises like Beijing may have seen the peak of the outbreak, less-developed cities and the vast rural hinterland are still bracing for more infections.

As the travel rush for the Lunar New Year – the most important festival for family reunion in China – begins this week, hundreds of millions of people are expected to return to their hometowns from big cities, bringing the virus to the vulnerable countryside where vaccination rates are lower and medical resources even scarcer.

The outlook is grim. Some studies estimate the death toll could be in excess of a million, if China fails to roll out booster shots and antiviral drugs fast enough.

The government has launched a booster campaign for the elderly, but many remain reluctant to take it due to concerns about side effects. Fighting vaccine hesitancy will require significant time and effort, when the country’s medical workers are already stretched thin.

Beijing’s Covid restrictions have put China out of sync with the rest of the world. Three years of lockdowns and border curbs have disrupted supply chains, damaged international businesses, and hurt flows of trade and investment between China and other countries.

As China joins the rest of the world in living with Covid, the implications for the global economy are potentially huge.

Any uptick in China’s growth will provide a vital boost to economies that rely on Chinese demand. There will be more international travel and production. But rising demand will also drive up prices of energy and raw materials, putting upward pressure on global inflation.

“In the short run, I believe China’s economy is likely to experience chaos rather than progress for a simple reason: China is poorly prepared to deal with Covid,” said Bo Zhuang, senior sovereign analyst at Loomis, Sayles & Company, an investment firm based in Boston.

Analysts from Capital Economics expect China’s economy to contract by 0.8% in the first quarter of 2023, before rebounding in the second quarter.

Other experts also expect the economy to recover after March. In a recent research report, HSBC economists projected a 0.5% contraction in the first quarter, but 5% growth for 2023.

Despite all this uncertainty, Chinese citizens are celebrating the partial reopening of the border after the end of quarantine for international arrivals and the resumption of outbound travel.

Though some residents voiced concern online about the rapid loosening of restrictions during the outbreak, many more are eagerly planning trips abroad – travel websites recorded massive spikes in traffic within minutes of the announcement on December 26.

Several Chinese nationals overseas told CNN they had been unable or unwilling to return home for the last few years while the lengthy quarantine was still in place. That stretch meant major life moments missed and spent apart: graduations, weddings, childbirths, deaths.

Some countries have offered a warm welcome back, with foreign embassies and tourism departments posting invitations to Chinese travelers on Chinese social media sites. But others are more cautious, with many countries imposing new testing requirements for travelers coming from China and its territories.

Officials from these countries have pointed to the risk of new variants emerging from China’s outbreak – though numerous health experts have criticized the targeted travel restrictions as scientifically ineffective and alarmist, with the risk of inciting further racism and xenophobia.

As China emerges from its self-imposed isolation, all eyes are on whether it will be able to repair its reputation and relations that soured during the pandemic.

China’s ties with the West and many of its neighbors plummeted significantly over the origins of the coronavirus, trade, territorial claims, Beijing’s human rights record and its close partnership with Russia despite the devastating war in Ukraine.

The lack of top-level face-to-face diplomacy certainly didn’t help, neither did the freeze on in-person exchanges among policy advisers, business groups and the wider public.

At the G20 and APEC summits, Xi signaled his willingness to repair relations with the United States and its allies in a flurry of bilateral meetings.

Communication lines are back open and more high-level exchanges are in the pipeline – with US Secretary of State Antony Blinken, French President Emmanuel Macron, Dutch Prime Minister Mark Rutte and Italy’s newly elected Prime Minister Giorgia Meloni all expected to visit Beijing this year.

But Xi also made clear his ambition to push back at American influence in the region, and there is no illusion that the world’s two superpowers will be able to work out their fundamental differences and cast aside their intensifying rivalry.

In the new year, tensions may again flare over Taiwan, technological containment, as well as China’s support for Russia – which Xi underlined during a virtual meeting with Russian President Vladimir Putin on December 30.

Both leaders expressed a message of unity, with Xi saying the two countries should “strengthen strategic coordination” and “inject more stability into the world,” according to Chinese state media Xinhua.

China is “ready to work” with Russia to “stand against hegemonism and power politics,” and to oppose unilateralism, protectionism and “bullying,” said Xi. Putin, meanwhile, invited Xi to visit Moscow in the spring of 2023.

Beijing has long refused to condemn Russia’s invasion of Ukraine, or even refer to it as such. It has instead decried Western sanctions and amplified Kremlin talking points blaming the US and NATO for the conflict.

As Russia suffered humiliating military setbacks in Ukraine in recent months, Chinese state media appeared to have somewhat dialed back its pro-Russia rhetoric, while Xi has agreed to oppose the use of nuclear weapons in Ukraine in meetings with Western leaders.

But few experts believe China will distance itself from Russia, with several telling CNN the two countries’ mutual reliance and geopolitical alignment remains strong – including their shared vision for a “new world order.”

“(The war) has been a nuisance for China this past year and has affected China’s interest in Europe,” said Yun Sun, director of the China Program at the Washington-based think tank Stimson Center. “But the damage is not significant enough that China will abandon Russia.”

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Health

Respiratory viruses could surge following the holidays, public health experts warn

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CNN
 — 

There is growing concern among infectious disease and public health experts that the US could face even more respiratory infections in January.

It is “highly likely” that respiratory viruses could spread even more following holiday gatherings and New Year’s Eve celebrations, Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center and medical director of the National Foundation for Infectious Diseases, told CNN on Monday.

“These are highly contagious viruses – and people have generally put Covid-19 and Covid vaccination behind them. They haven’t been all that attentive to flu. They’re not wearing masks,” Schaffner said. “And if you’re close together with other people, it’s an opportunity for all three of these viruses – flu, Covid, and even RSV – to spread from one person to another. So, we do expect a post-holiday surge in these viruses.”

At the same time, across the country, there has been a wave of flight cancellations and families stuck at the airport during their holiday travels.

When that happens, “People are together for very long periods of time, and they’re not wearing masks, and they’re weary and tired and stressed, and those are occasions where people are more apt to spread the virus,” Schaffner said, adding that his own granddaughter had four flights canceled over the holidays. He recommends masking up while in the airport and on an airplane.

“I think all of us in infectious diseases and public health would recommend that masks are not perfect, but they are an additional layer of protection,” Schaffner said.

Some local health officials are bracing for a possible surge in respiratory illnesses following the winter holidays since that was seen recently following Thanksgiving, Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, said in an email to CNN on Monday.

“After the Thanksgiving holiday period, we saw an uptick in COVID cases by about 58% through the beginning of the Christmas holiday on December 21,” Freeman wrote. “Deaths from COVID also rose during that same time period by about 65%.”

Flu also surged after Thanksgiving, with more than a third of all flu hospitalizations and deaths at the time this season being reported in the first full week of data post-Thanksgiving, and cases also jumped nearly as much.

Currently, seasonal flu activity remains high in the US, but continues to decline in most parts of the country, according to data published Friday by the US Centers for Disease Control and Prevention. Despite improvements, flu may not have peaked yet.

CDC estimates that, so far this season, there have been at least 18 million illnesses, 190,000 hospitalizations and 12,000 deaths from flu.

As for the current state of Covid-19, increases appear to be relatively mild. Hospitalizations are ticking up in most states, although the overall rate is still just a fraction of what it was during other surges. New hospital admissions have jumped nearly 50% over the past month. Hospitalizations among seniors are nearing the peak from the Delta surge – and rising fast.

Freeman said it is expected that reports after the winter holidays will continue to show increases in Covid-19 cases and deaths, likely attributable to increased travel across the country, large family gatherings, fewer people being up to date on their Covid-19 vaccinations and flu shots, and fewer people following mitigation measures, such as masking and social distancing.

“Air travel is also back to pre-pandemic levels and there are no more restrictions on mask wearing on airplanes or in airports where viruses can easily circulate. Same for bussing,” Freeman said. “Fortunately, we are seeing less RSV in children from our high points earlier in December, so that respiratory illness is stabilizing and becoming less of a part of the triple threat of COVID, flu, and RSV.”

As health officials brace for a possible surge in respiratory viruses in the coming weeks, it might not be just flu, Covid-19 and RSV that sickens people, said Dr. Georges Benjamin, executive director of the American Public Health Association.

“We’re focusing on those three, but there are others out there – the common cold and others,” Benjamin said.

Overall, “we should expect more respiratory diseases,” he said. “The best way to reduce your risk is of course to get fully vaccinated for those that which we have a vaccine, so influenza and Covid, with the new bivalent version, are the two most important right now.”

Benjamin added that it also remains important to wash your hands often, wear a mask during holiday travels and stay home when sick.

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US

Title 42: Appeals court rejects bid by GOP-led states to keep Trump-era border policy in force

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CNN
 — 

A federal appeals court on Friday rejected a bid by several Republican-led states to keep the so-called Title 42 rule in force, after a district court struck the controversial Trump-era border policy down.

The new ruling from the DC Circuit US Court of Appeals sets the stage for the case to go to the Supreme Court. The Biden administration is set to stop enforcing Title 42 – which allows for the expulsion of migrants at the US-Mexico border – on Wednesday.

The Republican-led states previously indicated that if the appeals court ruled against them, they’d seek the intervention of the Supreme Court.

In the new order, the DC Circuit denied the states’ request to intervene in the case and dismissed as moot the states’ request that it put the lower court’s ruling on hold.

The unsigned order was handed down by a circuit panel made up of an Obama appointee, a Trump appointee and a Biden appointee.

They wrote that the “inordinate and unexplained untimeliness” of the states’ request to get involved in the case “weighs decisively against intervention.”

The case is a lawsuit the American Civil Liberties Union, representing several migrants brought In January 2021 challenging the program. The appeals court noted on Friday that the Republican-led states had long known that their interest in keeping the policy in force would diverge from the Biden administration’s approach to the case.

The appeals court wrote that “more than eight months ago, the federal government issued an order terminating the Title 42 policy.”

“Yet these long-known-about differing interests in preserving Title 42—a decision of indisputable consequence—are the only reasons the States now provide for wanting to intervene for the first time on appeal,” the DC Circuit said. “Nowhere in their papers do they explain why they waited eight to fourteen months to move to intervene.”

The ACLU attorney representing the migrants praised the court’s decision.

“The states are clearly and wrongly trying to use Title 42 to restrict asylum and not for the law’s intended public health purposes,” the attorney, Lee Gelernt, told CNN in an email. “Many of these states were vigorously opposed to past COVID restrictions but suddenly believe there is a need for restrictions when it comes to migrants fleeing danger.”

White House spokesperson Abdullah Hasan said after the ruling that the administration has a “robust effort underway” for managing the border following the policy’s expected lifting next week.

“To be clear: the lifting of the Title 42 public health order does not mean the border is open. Anyone who suggests otherwise is doing the work of smugglers spreading misinformation to make a quick buck off of vulnerable migrants,” Hasan said in a statement. “We will continue to fully enforce our immigration laws and work to expand legal pathways for migration while discouraging disorderly and unsafe migration. We have a robust effort underway to manage the border in a safe, orderly, and humane way when Title 42 lifts as required by court order.”

The White House also urged Republicans in Congress to agree to more border funding and work on comprehensive immigration reform. The Biden administration has asked Congress for more than $3 billion as it prepares for the end of Title 42 to help shore up resources for border management and technology.

The administration’s handling of Title 42, which the Trump administration put in place during the Covid-19 pandemic, has been the target of litigation from both supporters and opponents of the program.

Last month, US District Judge Emmet Sullivan struck down the program. But Sullivan put his ruling on hold for five weeks so that the Biden administration would have time to prepare for the policy’s wind down. The administration has also appealed the ruling, arguing that the program was lawful, even if federal public health authorities have determined it is no longer necessary.

As the December 21 deadline for Sullivan’s ruling to go into effect approaches, officials have been preparing for a surge of migrants. More than 1 million migrants have been expelled under the rule, which is a public health authority the Trump administration began using at start of the Covid-19 pandemic to expel migrants before they went through the asylum application process.

Republican-led states, in their attempts to intervene in the case, allege that allowing the policy to terminate would “cause an enormous disaster at the border.”

They have argued that the “greatly increased number of migrants that such a termination will occasion will necessarily increase the States’ law enforcement, education, and healthcare costs.”

The Biden administration opposed the states’ attempt to intervene and their request to keep the policy in place, calling the requests untimely and unjustified.

“The States could have sought to intervene after the CDC acted to terminate the Title 42 orders in April 2022,” the administration wrote.

The migrants who challenged the program in the case also opposed the states’ request, writing in a court filing that the states were “transparently interested in Title 42 as a restriction on immigration and asylum” rather than as a public health measure.

The Biden administration tried to wind down the Title 42 program in 2021, but a coalition of mostly GOP-led states – in a separate case filed in Louisiana – successfully sued to block the Department of Homeland Security from ending enforcement.

This story has been updated with additional details.

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Health

Covid, RSV and flu: A trifecta of respiratory viruses is taxing hospitals across the nation

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Los Angeles
CNN
 — 

Across the country, overflow health care workers are struggling to catch their breath as hospitals fill with sick patients battling a trifecta of respiratory illnesses – Covid-19, RSV and the flu.

“We’ve seen a real increase in cases … particularly since Thanksgiving,” said Dr. Christopher Longhurst, chief medical officer at UC San Diego Health, who added that the hospital is facing a respiratory surge. “Covid is up. The flu is up and other respiratory viruses are up as well.”

The situation is so overwhelming at UC San Diego Health, the hospital had to create space to triage patients by setting up tents in parking lots and using other unconventional spaces. The hallways in the emergency department are also full of temporary beds for patients who were admitted but are awaiting hospital beds.

“We have not had to reconfigure conference room space to care for patients even during the Covid pandemic,” said Longhurst, who explained that UC San Diego Health has experienced an equal number of Covid patients as patients with other respiratory viruses. “These are really unprecedented times.”

Last week, hospitals across the nation were the fullest they have been throughout the pandemic, reaching 80% capacity, which is an 8 percentage-point jump in two weeks. That’s also the highest level since the Omicron surge in January. This week, hospital capacity has improved slightly.

While RSV appears to have peaked in the US, both Covid and flu infections are on the rise.

All but seven states are experiencing high or very high respiratory virus activity, according to the Centers for Disease Control and Prevention. The CDC advises that people in areas with high Covid-19 community levels wear a mask.

Dr. Jeff Smith, executive vice president and chief operating officer for hospital operations at Cedars-Sinai Medical Center in Los Angeles, said the “extreme, rapid rise” of RSV from October into November was likely “the most RSV we’ve seen in the past decade.”

“And now we’ve seen a rapid decline (in RSV),” said Smith. “That has overlapped this Covid rise, which has happened a little bit slower and a little bit later, and then now is superimposed by this very rapid rise in influenza.”

Yet the surge of this virus trio is still not as bad as Covid was during the apex of the pandemic.

“The most powerful factor by far is probably the vaccines, but the other one is the cumulative number of infections we have all had which is now called natural immunity,” said Dr. Edward Jones-Lopez, an infectious disease specialist at Keck Medicine of the University of Southern California.

“Unfortunately, there’s still about a third of the country … where despite all the evidence of safety and efficacy, people are still not getting vaccinated,” he said.

There are vaccines for both Covid and the flu, but not for RSV. All three of the viruses present very similar symptoms – fever, cough and upper respiratory symptoms – so testing is required to determine which illness it is and recommend treatment.

And just because a patient has one virus doesn’t mean they can’t get the other two as well.

“I’ve seen one case of three infections occurring at the same time,” said Jones-Lopez. “These are independent viruses that can infect the same individual and, obviously, the more viruses, the more infections you have … the higher the risk of one of them leading to more serious disease.”

Mask mandates have not yet returned, but virus spikes in New York, Los Angeles and Seattle have led health departments to recommend people mask up indoor and in crowds.

But as friends and family gather this month, health officials are concerned.

“I certainly would recommend that if you are elderly or have an illness that makes you immunocompromised or particularly susceptible to infection, I would encourage wearing a mask now,” said Smith of Cedars-Sinai Medical Center. “It’s the best protection that we have for anyone else who is concerned about transmission.”

Or, as Longhurst put it, “Wear a mask during the holiday season and don’t kiss those sick babies.”

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Health

The triple threat of the influenza, Covid and RSV

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CNN
 — 

The United States is facing a triple threat, with a confluence of viral infections due to respiratory syncytial virus, influenza and Covid-19. Many children’s hospitals are overwhelmed after surges of RSV, while the level of influenza is the highest it has been at this point in the year for more than a decade. And after a lull in cases, new coronavirus infections are on the rise across the country as well.

All of this is happening as holiday season begins, with more people traveling and gathering indoors, likely with fewer precautions than in the previous two years.

How much should people be concerned? Which individuals should be the most cautious? Can people get all three viruses at the same time? What steps can be taken to reduce risk and stay safe? And should mandates such as masking and social distancing return?

To guide us through these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician, public health expert and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”

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Seasonal flu: What you need to know


01:46

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CNN: Why should people be concerned about the convergence of RSV, influenza and Covid-19?

Dr. Leana Wen: There are several reasons to be concerned about this so-called tripledemic.

One is the impact at the societal level. Already, children’s hospitals across the United States are filled with kids infected with viruses, including RSV and influenza. Some experts speculate this is due to an immunity gap as a result of mitigation measures taken over the last two years. The situation is so bad that children’s health leaders have requested a formal declaration of emergency from the Biden administration to better assist these hospitals. (The administration has not declared an emergency, but the US Department of Health and Human Services sent a letter to governors last week saying it “stands ready to continue assisting you with resources, supplies, and personnel.”)

When hospitals exceed capacity, care for patients suffers. People who come to the emergency department end up waiting much longer because there isn’t enough staff to care for them. Patients who need to be hospitalized may wait for days for a bed to open up. Some patients, especially in rural areas, may need to be transferred hours away for the care they need.

These delays could be harmful, even deadly. And this doesn’t just affect patients with respiratory ailments; it leads to delays in care for broken bones, asthma attacks and appendicitis, too, among other medical emergencies.

Another is the consequence for particularly vulnerable individuals. While most people who contract RSV, influenza, Covid-19 and other respiratory illnesses will have mild symptoms, those most vulnerable could become severely ill, require intensive care and even die. The higher the rates of infection in their community, the more dangerous it becomes for vulnerable people.

Of course, no one wants to be sick. Even a minor viral illness can cause inconvenience, such as missed work and school. And even if someone does not need to be hospitalized, they could still feel unwell and be contagious to others. So a high level of infection of these viruses is something that concerns all of us.

CNN: Which people should be the most cautious during this period?

Wen: Individuals who should be most cautious are those are at the highest risk for severe illness. That includes older people, newborns and people with multiple chronic medical conditions. These are people most susceptible to viruses, and what is a mild infection to someone who is a healthy young adult could result in hospitalization for them.

Another group that should consider being cautious are those in direct contact with people at high risk. A spouse of someone who is immunocompromised, family members who live with elderly individuals, parents or caregivers to a newborn — these are all individuals who should reduce the risk of infection to themselves to prevent transmission to someone vulnerable in their immediate household.

CNN: Can people contract all three viruses?

Wen: In theory, yes. Someone can certainly, over the course of a year, contract all three viruses. Generally, though, they don’t get them all at the same time. The “tripledemic” phrase refers to all three viruses surging in the population at once, not necessarily (and not usually) in the same person simultaneously.

CNN: What steps can be taken to reduce risk and stay safe?

Wen: Vaccines exist for Covid-19 and for the flu to prevent severe disease and death. People should follow guidance from the US Centers for Disease Control and Prevention about staying up to date with their coronavirus and flu vaccine.

The coronavirus is airborne. Good ventilation helps to reduce spread, so gathering with others outdoors will be safer than indoors. Indoor settings can be lower risk if there is improved ventilation, for example, through open doors and windows and the use of HEPA filters.

Influenza and RSV are spread primarily through droplets. People should stay away from those who are coughing and sneezing (and individuals with symptoms should avoid public settings). Everyone should wash their hands frequently — and well. That is especially important for young children who often put their hands in their mouths.

There are other important tools, too, including testing and masking. Taking a Covid-19 test before gathering can reduce risk, as can wearing a high-quality N95 or equivalent mask (KN95 or KF94).

CNN: Is a cloth mask or regular medical mask enough?

Wen: No. The virus that causes Covid-19 is spread through microscopic droplets that can pass through cloth and regular medical masks. The N95 mask is the gold standard and will offer the best protection against respiratory viruses.

There will be some people who cannot tolerate an N95. Those individuals can wear two medical masks or a cloth mask on top of a medical mask. But these options are still not as protective as a well-fitting N95 or equivalent.

CNN: Should mandates like masking and social distancing return?

Wen: I think it will be very difficult to ask everyone to return to masking, distancing and avoiding indoor gatherings with loved ones — especially over the holidays. My view is that top-down mandates from the any level of government should be reserved for truly dire situations for which there are no other options — for example, if a new highly transmissible variant emerges that is far more dangerous and resistant to existing vaccines. That’s not the situation at the moment.

That said, just because mandates across the board aren’t likely doesn’t mean that people shouldn’t take care themselves. Individuals — especially those vulnerable to severe illness and their household contacts — should choose to wear well-fitting N95s or equivalent while in crowded indoor spaces. They can choose additional protective measures, including staying outdoors or in well-ventilated spaces when possible. And everyone should make sure, again, that they are vaccinated with the vaccines that currently are available against Covid-19 and influenza.

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Health

Face masks come back to forefront amid triple threat of Covid-19, flu, RSV

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CNN
 — 

Months after most mask requirements have come to an end and many people have stopped wearing them, some of the nation’s leading health experts are encouraging people to put their face masks back on – but this time, it’s not just because of Covid-19.

As a triple threat of respiratory illnesses – flu, RSV and Covid-19 – sweeps the nation this holiday season, health officials are urging people to take precautions to protect themselves: get vaccinated, wash hands frequently and even mask up in certain circumstances.

“There’s been a lot of attention directed to patients at higher risk of the complications of all of these illnesses – older persons, people who have any underlying illness, anyone who has immune compromise – I think, during this surge of this tridemic, if you will, there’s been a lot of ‘dust off your mask. Put your mask back on,’ ” said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center and medical director of the National Foundation for Infectious Diseases.

At this phase in the Covid-19 pandemic, even with other types of respiratory viruses circulating, masking recommendations based on an individual’s risk have been at the center of public health discussions, “rather than saying everyone in a community has got to put their masks back on,” Schaffner said.

“I don’t want to go to mandates because I think over much of the United States, you will get a lot of pushback, and people will ignore it. Public health recommendations have to be acceptable,” he added.

“The notion that during these kinds of viral surges, that people at risk should be wearing masks and being more cautious seems entirely reasonable – and I add to that, particularly in this part of the country, that we should be accepting, tolerant and indeed supporting people who do that, because they have a reason,” said Schaffner, who is based in Nashville.

“Don’t look at this as a political statement or a social statement. This is a purely health-related statement.”

Some communities across the country are considering bringing back certain masking recommendations as the wave of respiratory illnesses worsens.

The US Centers for Disease Control and Prevention offers specific guidance on when masking is recommended based on its Covid-19 community levels.

The agency says that people may choose to wear masks at any time but that a “high-quality mask or respirator” is recommended for everyone when a county has a “high” Covid-19 community level.

As of Thursday, about 5.66% of US counties have high community levels, including some places in Arizona, Wyoming, Oregon and the Dakotas.

Los Angeles County is at a high Covid-19 community level, but it hasn’t hit all three indicators that would trigger a mask mandate, Public Health Director Barbara Ferrer said Thursday.

The county has 258 new Covid-19 cases per 100,000 people and 14.8 hospitalizations per 100,000 people but continues to stay below the “high” level of staffed Covid patient beds, at 6.9%, she said.

Officials will consider masks again if that level goes over 10%, Ferrer said, but she’s hopeful that metrics might improve before then.

Even without a mandate, she emphasized community efforts like wearing masks inside when possible and getting Covid-19 vaccines or boosters.

“We haven’t reached that super dangerous threshold where CDC has said ‘you really need to start worrying about your hospital system,’ but we’ve reached a threshold, and all of the data shows this, where there is too much transmission, and it’s creating a lot of risk. And the time to mitigate the risk is actually now,” Ferrer said.

Throughout the Covid-19 pandemic, Los Angeles County has been at the forefront of implementing mitigation measures. In this case, officials would be following CDC guidance about masking and community levels.

“What L.A. County is doing is, they’re looking at their uptick in cases, hospitalizations and deaths, and they’re seeing a trending upwards toward that high community transmission level, and they’re preparing to reimplement the guidance that goes along with high community transmission, and that is to reimplement universal masking,” said Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials.

Every community has been looking at the same guidance, considering whether they are approaching high levels and might have to consider universal masking again, Freeman said.

“Now, I say all that based on the pure facts of the guidance, but I do think that has the possibility again of turning into a political divide in community by community where elected officials and others may or may not wish to see universal masking reimplemented. But we will have to see if that legal divide enters the picture again,” she said. “There’s not a lot of appetite for some of these original mitigation efforts to be reimplemented.”

In New York, state officials have encouraged schools and communities to take precautions such as indoor public masking as RSV, Covid-19 and the flu circulate, according to a letter from Health Commissioner Dr. Mary Bassett and Education Commissioner Betty Rosa.

The letter, issued Monday, warned of the multiple respiratory viruses that are straining the state’s health-care facilities.

Over the past three weeks, New York’s flu hospitalizations have more than doubled, and lab-confirmed flu cases have nearly tripled, according to the letter.

“In response, we are urging a community-wide approach, inclusive of schools, to again take precautions this holiday season and winter that can prevent the spread of respiratory viruses and protect young children, older individuals, and those with underlying health conditions,” the commissioners wrote.

The letter said schools and communities should encourage indoor public masking, vaccination and frequent hand-washing, among other measures.

“We encourage schools to utilize their local departments of health as a partner and resource in this work,” the commissioners said. “Together, we will ensure that all students in our state have a healthy and safe holiday season.”

The CDC’s Covid-19 community level metrics for US counties are based on three things: new Covid-19 hospitalizations, hospital capacity and new Covid-19 cases. But the agency is looking into revisiting these community levels, possibly to include data on other respiratory viruses such as flu and RSV, Director Dr. Rochelle Walensky said Monday.

“It’s something that we are actively looking into at CDC. In the meantime, what I do want to say is, one need not to wait for CDC action in order to put a mask on,” she said.

“We do know that 5% of the population is living in places with a high Covid-19 community level. We do encourage people to mask,” she said, adding that people should stay home when sick, practice good hygiene like washing hands frequently and improve air ventilation in indoor spaces.

Covid-19 hospitalizations are starting to tick up after Thanksgiving: More than 34,000 people were admitted to the hospital with Covid-19 in the past week, up 20% from the week prior, according to the CDC. Ensemble forecasts from the CDC predict continued increase over the next month or so.

About 1,800 Covid-19 deaths were reported to the CDC in the last week of November, and ensemble forecasts that predict Covid deaths will remain steady for the next month or so.

Dr. Anthony Fauci, who is stepping down this month as director of the National Institute of Allergy and Infectious Diseases, said he is not afraid to recommend a return to masking in some circumstances as the nation faces a triple threat of Covid-19, flu and RSV.

“I’m not talking about mandating anything,” Fauci said Wednesday on “NBC Nightly News.” “I’m talking about just common sense of saying, ‘You know, I really don’t want to take the risk of myself getting infected and, even moreso, spreading it to someone who’s a vulnerable member of my family.’ “

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