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Health

5 issues to know earlier than the inventory market opens Tuesday, June 1

Here are the key news, trends, and analysis investors need to start their trading day:

1. Dow jumps on the first day of June

The New York Stock Exchange welcomes Lightning eMotors (NYSE: ZEV) on May 24, 2021 to celebrate its transition to a public company.

NYSE

June was set for a positive start on Wall Street. Dow futures led on Tuesday with a gain of over 250 points of more than 0.7%. The Dow Jones Industrial Average and S&P 500 broke two-week losing streaks with weekly gains of around 1%. The Nasdaq rose 2% last week for its first two-week winning streak since mid-April. However, the Nasdaq bucked May’s uptrend, losing 1.5% and ending a six-month winning streak. Investors have their sights set on Friday’s May Labor Market Report, as well as the Federal Reserve Policy Makers’ Meeting on May 15-16. June.

A bitcoin logo displayed on a smartphone with stock market percentages in the background in this illustration dated April 26, 2021.

Omar Marques | SOPA Pictures | LightRakete | Getty Images

Bitcoin – less than 44% from April’s all-time high of $ 65,000 – traded below $ 36,000 on Tuesday. The world’s largest digital currency returned to levels not seen since February. Bitcoin crashed last month, tumbling more than 30% to around $ 30,000 on May 19. At Tuesday’s levels, however, it was still up 24% in 2021 and up 275% over the past 12 months.

2. AMC stocks add to last week’s strong rally

AMC Empire 25 in Times Square is open as New York City theaters reopen on March 5, 2021 for the first time in a year since the coronavirus shutdown.

Angela Weiss | AFP | Getty Images

AMC Entertainment rose again Tuesday, gaining 21% in pre-trading hours after selling more than 8 million shares to an investment firm. It is the latest in a series of capital increases for the ailing theater chain. AMC stock doubled last week on extremely high volume as retail investors re-piqued interest on Reddit’s WallStreetBets forum. AMC CEO Adam Aron tweeted early Tuesday in support of the stock sale.

3. Biden announces new efforts to narrow the racial wealth gap

U.S. President Joe Biden speaks with First Lady Jill Biden during a visit to Joint Base Langley-Eustis in Hampton, Va., Jan.

Ken Cedeno | Reuters

President Joe Biden will unveil new measures his administration is planning on Tuesday to address the racial wealth gap. During a trip to Oklahoma to commemorate 100 years since the Tulsa massacre, Biden will see an increase in the percentage of federal contracts for small, disadvantaged businesses, the repeal of two Trump-era housing rules, and an initiative to combat inequality in valuation announce of homes.

4. Elon Musk reveals the reason for the price increases for Tesla vehicles

5. SoFi will debut on Wall Street after the SPAC deal is closed

The Social Finance (SoFi) website on a laptop set up in the Brooklyn neighborhood of New York, United States on Friday, March 26, 2021.

Gabby Jones | Bloomberg | Getty Images

Social Finance is expected to debut as a publicly traded company on Tuesday after finalizing its merger with a SPAC backed by venture capital investor Chamath Palihapitiya last week. The transaction, announced in January with the special purpose vehicle Social Capital Hedosophia Corp V, valued SoFi at $ 8.65 billion. Palihapitiya, an early Facebook executive, recently took several companies public through SPACs, including Virgin Galactic.

– Reuters contributed to this report. Follow the whole market like a pro on CNBC Pro. Get the latest on the pandemic with coronavirus coverage from CNBC.

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Politics

Biden prohibits U.S. funding in 59 Chinese language firms

United States President Joe Biden speaks during a commemoration ceremony marking the 100th anniversary of the Tulsa Race Massacre at the Greenwood Cultural Center in Tulsa, Oklahoma, on June 1, 2021.

Almond Ngan | AFP | Getty Images

President Joe Biden on Thursday expanded restrictions on American investments in certain Chinese companies with alleged links to the country’s military and surveillance efforts, adding more companies to a growing blacklist.

In an executive order, Biden banned US investors for fear of ties to the Chinese government’s geopolitical ambitions, thereby continuing some parts of former President Donald Trump’s tough stance in talks with Beijing.

“This EO enables the United States to specifically and enrichingly prohibit US investments in Chinese companies that undermine the security or democratic values ​​of the United States and our allies,” a White House press release said.

The move will prevent US dollars from supporting the “Chinese defense sector” while expanding the US government’s ability to counter the threat posed by Chinese surveillance technology firms that – both inside and outside of China – monitor religious or ethnic minorities contribute to or otherwise facilitate repression and serious human rights violations, “added the government.

The 59 excluded companies include Aero Engine Corp. of China, Aerosun Corp., Fujian Torch Electron Technology and Huawei Technologies.

The bans go into effect on August 2 at 00:01 a.m. ET.

CNBC policy

Read more about CNBC’s political coverage:

The move is one of the strongest yet against its leading U.S. rival, and yet another sign that the Biden administration could adopt or advance many of the Trump administration’s tactics to stay competitive with China.

Biden and his economic advisors also need to decide what to do with a range of tariffs and whether to increase sanctions against Chinese officials involved in the mass incarceration of mainly Muslim ethnic minorities in the Xinjiang region.

A representative from the Chinese State Department challenged the move by the Biden administration, telling press officials that the Trump administration’s original order was carried out “in complete disregard for the facts.”

“The US should respect the rule of law and the market, correct its mistakes and stop actions that undermine the global financial market order and the legitimate rights and interests of investors,” said spokesman Wang Wenbin to reporters in Beijing.

The previous order of the Trump administration created a list of 48 companies.

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Health

We’ll In all probability Want Booster Photographs for Covid-19. However When? And Which Ones?

As the nation moves closer to President Biden’s goal of 70 percent vaccination rates, many people wonder how long their protection will last.

Right now, scientists are asking a lot of questions about Covid-19 booster vaccinations, but they don’t have many answers yet. The National Institutes of Health recently announced that they have started a new clinical trial of fully vaccinated people – with an approved vaccine – to see if a booster of the Moderna syringe increases their antibodies and protects against infection with the virus extended.

Although many scientists estimate that the US-approved vaccines Pfizer-BioNTech, Moderna, and Johnson & Johnson will last at least a year, no one knows exactly. It is also unclear whether emerging variants of the coronavirus will change our vaccination needs.

“We’re breaking new ground here when it comes to boosters,” said Dr. Edward Belongia, a physician and epidemiologist at the Marshfield Clinic Research Institute in Marshfield, Wisconsin.

Different pathogens affect our immune system in different ways. With some diseases, such as measles, a one-time illness leads to lifelong protection against further infection. But with other pathogens, our immune defense declines over time.

In some important ways, vaccines mimic natural infections – without actually getting sick. Measles vaccines can induce lifelong immunity. Tetanus vaccines, on the other hand, create defenses that fade year after year. The Centers for Disease Control and Prevention recommends getting a tetanus booster once every decade.

And sometimes the virus can change itself, so a booster is needed to create a new, bespoke defense. Influenza viruses are so changeable that they need a new vaccine every year.

The short answer is that we can’t be sure yet because people were vaccinated in large numbers just a few months ago.

“Even in the studies, we don’t know what the immune response is like a year later,” said Dr. Kirsten Lyke, vaccine expert at the University of Maryland School of Medicine and director of the NIH booster study.

But the first signs are encouraging. In vaccine trials, researchers have drawn blood from volunteers and measured their levels of antibodies and immune cells that target the coronavirus. The levels are going down, but gradually. It is possible that with this slow decline, vaccination protection will remain strong for a long time. People who were previously infected and then received the vaccine can enjoy even more permanent protection.

“I think there is a real possibility that immunity to the original strain could last for years,” said Dr. Belongia.

If this possibility is confirmed, Covid-19 boosters may not be required for years. But that’s a big if.

Possibly. Scientists have already established that vaccines with different technologies can vary in their effectiveness. The most powerful vaccines include Moderna and Pfizer-BioNTech, both of which are based on RNA molecules. Inactivated virus-based vaccines, such as those from Sinopharm in China and Bharat Biotech in India, have proven to be slightly less effective.

It’s not entirely clear why that is, said Scott Hensley, an immunologist at the University of Pennsylvania. RNA vaccines are relatively new and so the immunity they induce has not been thoroughly studied. In his own research on mice given different types of flu vaccines – some with RNA and others with inactivated viruses – Dr. Hensley made a similar difference. The amount of antibodies produced by the two vaccines was “grossly different,” he said.

It is possible that protection from the less effective Covid-19 vaccines may wear off faster. Sinopharm’s vaccine may already show signs of this decline. Clinical studies show an effectiveness of 78 percent. But the United Arab Emirates and Bahrain are already offering boosters to people who have received the Sinopharm vaccine to boost their declining immunity.

Scientists are looking for biological markers that could show when protection from a vaccine is no longer sufficient to hold back the coronavirus. It is possible that a certain level of antibody marks a threshold: if your blood is above this level you are in good shape, but if you are below you are at greater risk of infection.

Some preliminary studies suggest that these markers – known as correlates of protection – exist for Covid-19 vaccines. Research is being carried out to find them.

Updated

June 6, 2021, 2:38 p.m. ET

“That will teach us a lot,” says Dr. H. Clifford Lane, Associate Director, Clinical Research and Special Projects, National Institute of Allergy and Infectious Diseases.

We may need boosters to block variants, but that’s not yet clear.

The emergence of variants in recent months has accelerated research on boosters. Some variants have mutations that caused them to spread quickly. Others carry mutations that could affect the effectiveness of approved vaccines. But at this point in time, scientists have little evidence of how existing vaccines work against different variants.

Last month, for example, researchers in Qatar published a study of the Pfizer BioNTech vaccine, which was given to over a quarter of a million of the country’s residents between December and March.

Clinical studies showed that the vaccine was 95 percent effective against the original version of the coronavirus. But a variant called Alpha, which was first identified in the UK, cut its effectiveness to 89.5 percent. A variant first identified in South Africa, known as Beta, further reduced the vaccine’s effectiveness to 75 percent. However, against both variants, the vaccine was 100 percent effective in preventing serious, critical, or fatal illnesses.

Just because a variant can bypass existing vaccines doesn’t mean it becomes a widespread problem. Beta, for example, has remained rare in countries with strong vaccine programs like Israel, the UK, and the United States. If beta stays infrequent, it doesn’t pose a serious threat.

But evolution still has a lot of leeway to play with the coronavirus. Scientists cannot rule out the possibility that new variants will emerge in the coming months that will spread quickly and resist vaccines.

“It is clear that variants are inevitable,” said Dr. Grace Lee, Associate Chief Medical Officer, Practice Innovation and Infectious Disease Doctor at Stanford Children’s Health. “I think the question is how effective are they going to be?”

Its not clear yet. Some scientists suspect that a high immune response to the original version of the coronavirus also provides adequate protection against variants. But it is also possible that a vaccine that specifically thwarted one variant might be more effective.

Pfizer has made an attempt to test both options. Some volunteers who have already received two doses of their vaccine will be given a third dose of the same vaccination as a booster. In the same study, the researchers will give other volunteers an experimental booster designed to protect against the beta variant.

“Based on what we’ve learned so far, we currently think that until we see a decrease in SARS-CoV-2 circulation and Covid-19 disease, we think it likely that a third dose, a Increasing our vaccine, within 12 months of vaccine administration, will likely be needed to protect against Covid-19, “said Jerica Pitts, director of global media relations at Pfizer.

Possibly. In fact, much research on other diseases suggests that switching vaccines may increase the booster dose. “This is a proven concept from before Covid,” said Dr. Lyke.

Dr. Lyke and her colleagues are testing this mix-and-match option for boosters as part of their new study. They are recruiting volunteers who have been fully vaccinated with any of three US approved vaccines – Johnson & Johnson, Moderna, and Pfizer-BioNTech.

All volunteers receive a Moderna booster. The researchers will then observe how strong an immune response it creates.

It is possible that other vaccines that are still in clinical trials may work even better as Covid boosters. For example, Novavax and Sanofi are both conducting clinical trials of vaccines made from viral proteins in the United States. Dr. Lyke and her colleagues designed their study so that they could add more such vaccines later.

“We are working behind the scenes on other contracts so we can bring additional boosters into the study,” she said. These additional boosters can also include those tailored to variants, such as the one developed by Pfizer-BioNTech.

Other mixed booster studies are also ongoing. In the UK, scientists are giving volunteers vaccines from AstraZeneca, CureVac, Johnson & Johnson, Moderna, Novavax, Pfizer-BioNTech and Valneva as boosters. ImmunityBio is testing its vaccine in South Africa as a booster for the Johnson & Johnson vaccine, while Sanofi prepares to test its vaccine as a booster for those of several other companies.

The NIH study could start delivering results as early as the next few weeks. If fading vaccines and rising variants lead to an outbreak of new infections this winter, Dr. Lyke have data to share with policy makers.

“It was vital for us to get a response as soon as possible,” she said. “We just don’t have this luxury of time.”

Dr. Hensley says it is wise to prepare for the possibility that boosters will be needed. But he hoped they didn’t detract from the urgent need to give billions of people around the world first doses.

“If more people are protected immediately, the virus will have fewer hosts to infect and fewer opportunities to develop into new variants,” he said.

“I want these vaccines to go global because I want to protect people all over the world,” added Dr. Hensley added. “But even if you only take care of yourself, you should also stand behind these efforts, because this is the only way to end the pandemic and limit the development of variants.”

Noah Weiland contributed the reporting.

Categories
Health

Amazon health-care menace? Teladoc CEO says it is ‘overrated’

The Amazon Pharmacy home screen on a smartphone arranged in the Brooklyn Borough of New York, U.S., on Tuesday, Nov. 17, 2020.

Gabby Jones | Bloomberg | Getty Images

Ask a sports star before a game whether their team is going to win and they’re likely to say yes with confidence. And then cue the headlines that will sensationalize the hubris. But would you expect an athlete to say — would you want them to think — they’re about to lose?

The heads of companies sometimes talk about the competition in a similar way, and they shouldn’t be in the CEO hot seat without confidence in their company’s ability to win.

Take Teladoc Health CEO Jason Gorevic, recently asked at the CNBC Healthy Returns Summit about the threat Amazon poses in health care.

“Based on the fact that it has one enterprise client of 385 employees, it is overrated,” Gorevic said, answering a question about Amazon Care, the retail and tech giant’s app-based primary care entry in Teladoc’s market, which signed up its first client, Peloton-owned fitness equipment company Precor, in May.

Should the Teladoc CEO be more worried? Even after Amazon’s deal with Berkshire Hathaway and J.P. Morgan to take on the status quo with its health care joint effort, Haven, fell apart, the merchandising giant still has a big market to exploit.

Amazon Care is expected to expand to its own employees in all 50 states this summer. It has been adding workers faster than any company in history, more than 500,000 in 2020. It also has had a deal with employer health provider Crossover Health for in-person employee health clinics that continues to expand across states with a goal of putting these clinics within a few miles of all Amazon employees, especially in light of the attention its workplace injury rates have received.

J.P. Morgan is moving on and deeper into health care after Haven, recently announcing it will move ahead with its own effort to invest in new health-care ideas, to be offered among its 165,000 employees and families.

Virtual health here to stay

As society has moved rapidly from the awareness phase of virtual care to the expectation phase, those expectations have increased, and Teladoc has added services like mental health treatment as part of what Gorevic tells CNBC is the future “unified experience” with patients.

“Virtual care is not a stay at home phenomenon,” Gorevic said. “The utilization we are seeing across multiple conditions all indicate it is here to stay.”

He cited first quarter 2021 results during which visit volume was up 69% year over year in spite of the fact that seasonal flu-related visits were down 90%.

Nevertheless, Teladoc shares have cratered, down from a peak earlier this year above $290 to roughly half that level, ending trading last week slightly above $146. But Gorevic says investors are missing the bigger picture, and overlooking improving numbers. The biggest quarterly number he cites: revenue per member, per month, which in Q1 2021 was $2.25, versus 87 cents a year ago.

Others cite the rapid M&A taking place in Teladoc’s market as reason to worry.

Walmart acquired MeMD in May; two other telemedicine competitors, Doctor on Demand and Grand Rounds, recently merged.

“Everyone feels like they have to have a press release that says something about telehealth to be relevant,” Gorevic told CNBC Healthy Returns. “I’m not surprised by any of these moves.”

“This pandemic has thrown the whole market into motion. As we looked at the market, we said we needed to be bold, and we see where it’s going,” the Teladoc CEO said, citing its $18 billion acquisition of chronic disease management company Livongo, which is focused on diabetes, and its expanding mental health services.

Gorevic says health-care consumers are overwhelmed by health-care websites and apps and want a unified experience, and the company is seeing that in multi-product bookings, which in 2020 represented two-thirds of bookings.

Amazon and the fear of disruption

Amazon’s ability to upend, or at least send waves of terror, through the health care industry has already been seen in the launch of its online pharmacy, which led to shares of Goodrx dropping from over $52 to roughly $33 after the announcement last October.

Wall Street analysts who cover Teladoc see Amazon’s presence as significant, yet not all agree it is an acute threat to Teladoc currently.

“Leery of Amazon’s initiatives here,” wrote Sean Wieland, managing director and a senior research analyst focusing on health-care information technology and health-care services at Piper Sandler, in response to an email.

“Even Amazon would have to get the enterprise market on board one employer at a time, as it’s a highly fragmented market and that would take years. Also, it’s a significant lift to go from offering urgent care visits on demand to whole person health care.”

More from CNBC’s Healthy Returns

Charles Rhyee, managing director and senior research analyst covering health-care technology and distribution at Cowen & Co., said Goodrx is a good example of how Amazon can disrupt health care, and it would be a mistake to ignore Amazon’s potential. But he thinks the threat in pharmacy is more direct than in telehealth.

“It’s is a mature market. There are tons of pharmacies out there and it is not a growth sector. In the truest sense, more of zero sum game,” Rhyee said, and that is something Amazon can afford to win at the expense of CVS or Goodrx.

Telehealth visits still a fraction of the market

Telehealth is still a nascent field and that may play to Teladoc’s favor in the years ahead.

“We are all talking about it because of Covid forcing everyone to seek virtual care, but if you think about how many visits Teladoc will do this year, it’s 12 million to 13 million visits,” Rhyee said.

That compares to a U.S. market in which there are one billion visits or more, annually, including mental health care.

Whether a Teladoc or American Well is growing in the telemedicine market, Rhyee says that amounts to about 2% to 3% of visits, a small fraction of what can be virtualized and an indicator that the market is going to expand.

“I’m not concerned,” Rhyee said. “Where Teladoc sits is not what Amazon is doing. It’s not just basic video visits to speak to a doctor for a minor thing. It is increasingly in multiple specialities and second opinions and Livongo. You can argue right now very few, if any, have that broad capabilities, and that’s why Doctor on Demand is merging with Grand Rounds.”

He looks at Amazon in basic care and pharmacy in a similar way to his analysis of Walmart’s health care after its acquisition of MeMD. “They want to provide some basic connectivity and prescriptions that can be dispensed at Walmart.”  

Why Teladoc shares have been volatile

Stocks move up and down in discrete periods of time, and that doesn’t always correspond to the longer-term trend. That’s part of the challenge for investors with Teladoc right now, trying to figure out what its growth looks like post-Covid.

Membership growth guidance for this year may not be as strong as some investors wanted coming out of Covid, and app tracking firms have shown slowing momentum in daily usage. Yet people using Teladoc less now than April of last year does not mean they are using it less than they were in 2019. And last year was unusual.

“We don’t know what virtual will look like in the end,” Rhyee said. 

The Cowen analyst has a $240 price target on the stock and says at $140 it is trading at roughly 8 times forward revenue, which is up from where it traded before Covid, but that was when “people didn’t believe it was a real business.”

Rhyee says he will worry more about Amazon if it starts stringing together acquisitions in health care, including in the chronic condition management space. “That would tell me they are much more serious about it,” he said.

As long as Amazon Care is one enterprise client and its own employees, the Teladoc outlook will be based elsewhere.

The idea of competition between Teladoc and Amazon may be missing the real threat Amazon poses in health care, according to David Grossman, research manager director at Stifel. That includes disrupting the legacy providers in insurance and pharmacy benefits managers.

Teladoc is disrupting traditional providers by creating a virtual 24/7 network on demand that can offer a potentially lower-cost alternative. Those traditional providers now forced to offer telemedicine are more of a near-term threat to Teladoc, in Grossman’s view, as they evolve from starting telehealth “literally overnight” to incorporating virtual care as a permanent feature of their care delivery models.

“Virtual care is now table stakes for providers, while 15 months ago it was barely on the radar screen,” he said.

Setting up appointments online and having telehealth as an option may be one of the features Amazon offers, but that is a shortsighted way to view what Amazon is after in the health care system.

Amazon is saying we take over everything. It’s not lets go after Teladoc. That’s incidental.

David Gross, Stifel analyst

Grossman, who is concerned about Teladoc’s ability to grow revenue and margins, says Gorevic is a smart guy building a reasonable model. Now they can pitch health plans on using a provider network they have created at lower cost for employers, if employees agree to access services virtually as a first stop. That disintermediates the traditional provider network, but he does not see Amazon stopping there or even thinking in those terms specifically.

“Amazon is saying we take over everything,” Grossman said, looking at traditional health care market that is flawed in delivery and pricing and adds little value. “It’s not lets go after Teladoc. That’s incidental.”

Taking cost out of the system is what Amazon already has proven to be great at, squeezing out players that don’t offer value and shouldn’t be there. “I’m rooting for them in that sense,” the Stifel analyst said.

But whether it is Amazon’s or Walmart’s efforts that are emerging in health care, the models to watch do not exclude Teladoc. “There is no indication we should write it off,” Grossman said.

Teladoc shares are down for a lot of reasons, starting with the market rotation out of growth names and the market acknowledging that traditional providers are ramping up their own telemedicine products.

“Everyone points to Amazon, and let’s be fair, it was a high multiple stock and the market is getting out of the stay at home trade and pricing how high can utilization translate into pricing” Grossman said. He added that Teladoc has struggled to convince the street of its pricing power. “They have been opaque.”

The company is growing monthly revenue per member, as Gorevic noted, but the Stifel analyst was quick to point out the recent Q1 growth relied on the acquisition of Livongo. Livongo is the largest provider of virtual chronic care and that is top of mind for employers, but Teladoc has a lot of work left to do to prove demand for it is a secular driver of its business growth.

Behavioral health, meanwhile, is the fastest- growing incremental service but there is only so much that can be delivered on an automated basis, so it becomes a staffing platform to match supply and demand and help sole mental health practice proprietors fill their book of business like an Uber or Lyft.

While the 8 times revenue the company is trading at might seem less than rich, double-digit revenue multiple companies tend to be in sectors like software, where scalability comes fast and at high margins. Teladoc’s subscription-heavy sales model means a majority of revenue is fixed while the costs remain variable.

“Their claim all along has been as utilization goes up it’s good for them, but there is no pricing algorithm around that. We don’t know how to calculate that,” Grossman said.

Companies like Teladoc and American Well can grow members, and grow utilization among members, but how either of those growth measures factor into pricing power remains unpredictable. Utilization can go up, but revenue not match it. And that contributes to investor concerns about its scalability.

“It is factually correct they can get more per member with more services and there are lots of opportunities, but lots of competition for each module and booking,” Grossman said. The company’s scale and visibility give it an advantage, “but lots remains uncertain,” he said.

Gorevic told CNBC this is not a pandemic story. “Something else is going on here. People are reaching out for other things.”

Mental health, dermatology, and chronic conditions including diabetes, and health issues linked to it such as weight loss. “Not one and done things, and that’s why I am convinced,” the Teladoc CEO said.

Building the virtual primary care model and convincing payers and employers that it is most cost-effective to choose this option, and agree to have members enter the health system virtually as the first step, is the bigger opportunity to drive higher revenue per member, Grossman said, and longer-term it is the more sustainable way to disrupt the traditional provider network.

In that sense, Teladoc is taking market share just like Amazon would, and they can grow for a longer period of time. That may be a discrete disruption in health care that becomes permanent. The biggest disruption in health care, though, is not about telemedicine.

“All roads lead into the payers,” Grossman said. “That’s where the level of satisfaction is low and the control they have is high.”

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Categories
Politics

U.S. Help to Central America Hasn’t Slowed Migration. Can Kamala Harris?

SAN ANTONIO HUISTA, Guatemala — An American contractor went to a small town in the Guatemalan mountains with an ambitious goal: to ignite the local economy, and hopefully even persuade people not to migrate north to the United States.

Half an hour into his meeting with coffee growers, the contractor excitedly revealed the tool he had brought to change their lives: a pamphlet inviting the farmers to download an app to check coffee prices and “be a part of modern agriculture.”

Pedro Aguilar, a coffee farmer who hadn’t asked for the training and didn’t see how it would keep anyone from heading for the border, looked confused. Eyeing the U.S. government logo on the pamphlet, he began waving it around, asking if anyone had a phone number to call the Americans “and tell them what our needs really are.”

“They’ve never helped me,” Mr. Aguilar said after the training a few weeks ago, referring to American aid programs intended to spur the economy and prevent migration. “Where does all the money go? Where’s the aid? Who knows?”

As vice president, Joseph R. Biden Jr. led an enormous push to deter people from crossing into the United States by devoting hundreds of millions of dollars to Central America, hoping to make the region more tolerable for the poor — so that fewer would abandon it.

Now, as President Biden, he is doubling down on that strategy once again and assigning his own vice president, Kamala Harris, the prickly challenge of carrying out his plan to commit $4 billion in a remarkably similar approach as she travels to the region Sunday.

“When I was vice president, I focused on providing the help needed to address these root causes of migration,” Mr. Biden said in a recent speech to Congress. “It helped keep people in their own countries instead of being forced to leave. Our plan worked.”

But the numbers tell a different story. After years of the United States flooding Central America with aid, migration from the region soared in 2019 and is on the upswing once more.

Here in Guatemala, which has received more than $1.6 billion in American aid over the last decade, poverty rates have risen, malnutrition has become a national crisis, corruption is unbridled and the country is sending more unaccompanied children to the United States than anywhere else in the world.

That is the stark reality facing Ms. Harris as she assumes responsibility for expanding the same kind of aid programs that have struggled to stem migration in the past. It is a challenge that initially frustrated her top political aides, some of whom viewed the assignment from Mr. Biden as one that would inevitably set her up for failure in the first months of her tenure.

Her allies worried that she would be expected to solve the entire immigration crisis, irked that the early reports of her new duties appeared to hold her responsible for juggling the recent surge of children crossing the border without adults.

Ms. Harris, who has little foreign policy experience and no history in the region, has already been criticized for not visiting the border. At a recent news conference, a group of Republicans displayed a milk carton that had been mocked up to show a picture of Ms. Harris with the headline “MISSING AT THE BORDER,” even as she held a news conference with reporters detailing her plans to visit the region.

The political risks are evident, including the obvious pitfalls of investing billions in a region where the president of Honduras has been linked to drug traffickers and accused of embezzling American aid money, the leader of El Salvador has been denounced for trampling democratic norms and the government of Guatemala has been criticized for persecuting officials fighting corruption.

Even so, Ms. Harris and her advisers have warmed to the task, according to several people familiar with her thinking in the White House. They say it will give her a chance to dive squarely into foreign policy and prove that she can pass the commander-in-chief test, negotiating with world leaders on a global stage to confront one of America’s most intractable issues.

That test begins Sunday, when Ms. Harris embarks on her first international trip, to Guatemala and Mexico, where she is expected to detail efforts to reduce migration to the United States by seeking to improve conditions in those countries.

“Injustice is a root cause of migration,” Ms. Harris said during a White House meeting on May 19 with four women who fought corruption in Guatemala. “It is causing the people of the region to leave their homes involuntarily — meaning they don’t want to leave but they are fleeing.”

While White House officials say their push to help Central America can do a tremendous amount of good, there is growing recognition inside the Biden administration that all the money spent in the region has not made enough of a difference to keep people from migrating, according to several administration officials and others with knowledge of the discussions.

“We’ve looked extensively at different programs that have been approached,” said Nancy McEldowney, a longtime diplomat who serves as Ms. Harris’s national security adviser. “She obviously has learned a lot from what then-Vice President Biden did. And so we are very mindful of the need to learn of both positive and negative, what has happened in the past.”

Foreign aid is often a difficult, and at times flawed, tool for achieving American interests abroad, but it’s unclear whether there are any simple alternatives for the Biden administration. President Donald J. Trump’s solution to migration centered on draconian policies that critics denounced as unlawful and inhumane. Moreover, members of the current administration contend that Mr. Trump’s decision to freeze a portion of the aid to the region in 2019 ended up blunting the impact of the work being done to improve conditions there.

But experts say the reasons that years of aid have not curbed migration run far deeper than that. In particular, they note that much of the money is handed over to American companies, which swallow a lot of it for salaries, expenses and profits, often before any services are delivered.

From 2016 to 2020, 80 percent of the American-financed development projects in Central America were entrusted to American contractors, according to data provided by the U.S. Agency for International Development. The upside is that these companies have big offices capable of meeting the strict oversight requirements involved in handling millions of taxpayer dollars. The downside, critics say, is that a lot of the money disappears into those bureaucracies instead of reaching the people they’re trying to help.

Half a dozen development experts who have worked with or for the contractors said the companies could easily take about 50 percent of the aid money they receive and direct it toward overhead — including generous salaries for executives — and company profits. When asked about that figure, U.S.A.I.D. did not contest it.

“It’s a business,” said Carlos Ponce, a professor of nonprofit management at Columbia University who has worked for several U.S.-funded programs in the region. “And the same implementers win the contracts again and again, despite having implemented badly in the past, not showing any level of impact and not changing anything.”

U.S.A.I.D. would not provide an estimate of how much taxpayer money spent on specific projects in Central America gets eaten up by administrative costs, noting that the agency is “legally restricted” from sharing its partners’ “proprietary information.”

“It’s an incredibly not-transparent situation,” said Eric Olson, an expert on foreign aid to Central America at the Seattle International Foundation. “It’s like this is a national secret.”

Updated 

June 4, 2021, 7:27 p.m. ET

Ms. Harris’s aides say she wants to make absolutely sure that as much assistance as possible heads directly to the communities it’s intended for.

“She is concerned to make sure that we’re getting maximum benefit for every single dollar that we spend,” Ms. McEldowney said. Asked whether that included scrutinizing the money flowing to U.S. contractors, she said, “We are looking at that issue.”

Even when aid money reached Guatemala in recent years, it often brought little change, according to interviews with dozens who worked with or received assistance from U.S.-financed projects in the country’s western highlands.

One, called the Rural Value Chains Project, spent part of its $20 million in American aid building outhouses for potato farmers — many of which were quickly abandoned or torn apart for scrap metal.

“This brings no value to people,” said Arturo Cabrera, a local government official, peeking into an unused outhouse. “It doesn’t generate income,” which is what people ultimately need, he added.

One achievement touted by Nexos Locales, a $31 million project administered by Development Alternatives Incorporated, a company based in Bethesda, Md., was creating an app to enable residents to see how their local government spent money. Aid workers said that many residents didn’t have smartphones, and that they couldn’t afford to pay for the data to use the app even if they did.

The company did not comment, directing questions to U.S.A.I.D. But several people who worked for or advised Nexos said they had grown frustrated at what they saw as wasted funding on dubious accomplishments. They described being pushed to count results like how many meetings they held and how many people attended, but had no idea whether those activities had any lasting impact.

“You felt impotent, knowing what young people or women needed, and we couldn’t do it,” said Alma López Mejía, a K’iche’ Maya Indigenous leader and a former manager at Nexos.

When aid workers started showing up one after another in the town of San Antonio Huista about six years ago, Elvia Monzón was relieved.

Then, it seemed that everyone Ms. Monzón knew had left the area, spread across a mountain range where coffee fields bask in a perfect mix of sun and rain. On clear days, you can see Mexico from the dirt road that snakes through town.

Ms. Monzón’s husband was already in the United States, and her son, then 14, begged her to take him there. When she wouldn’t, he left on his own and, his mother said, made it safely across the border.

For decades, migration to the United States followed a pattern: Aside from some spikes in migration from Central America after civil wars or natural disasters, it was mostly single Mexicans who headed north in search of better jobs and pay.

Then, in 2014, officials noticed the makings of a major shift: Record numbers of Central American children and families were crossing, fleeing gang violence and widespread hunger.

The Obama administration tackled the dicey politics of immigration in part by removing undocumented workers, earning the president the nickname “deporter in chief” from critics. But he also oversaw an infusion of new aid money that would, in theory, make countries like Guatemala more bearable for the poor. Mr. Biden was tapped to help disburse $750 million to the region.

Since then, at least three programs that won more than $100 million in U.S. funding in all have come to San Antonio Huista, hoping to make life better. Yet, in interviews, Ms. Monzón and more than a dozen other coffee farmers here could not point to many long-term benefits, despite the attention.

Aid workers kept coming to deliver lots of seminars on topics in which the farmers were already well versed, they said, such as planting new varieties of coffee beans, and then left.

“So many trainings, but at the end of the day where is the money?” asked Ms. Monzón. “The aid isn’t reaching the poor.”

U.S.A.I.D. said its programs in Central America “have had demonstrable success,” creating tens of thousands of jobs in the region in recent years, helping increase sales for small businesses and contributing to “declining migration intentions” from some Hondurans who received services.

The agency noted that American companies administering aid in the region subcontract part of their work to local groups, that no formal complaint had been filed against Nexos Locales, and that building outhouses or smartphone apps represented a small part of the efforts in Guatemala.

Some programs, like efforts to reduce violence in Honduras and El Salvador, have worked well, independent studies have found.

“All activities funded with U.S.A.I.D.’s foreign assistance benefit countries and people overseas, even if managed through agreements with U.S.-based organizations,” said Mileydi Guilarte, a deputy assistant administrator at U.S.A.I.D. working on Latin America funding.

But the government’s own assessments don’t always agree. After evaluating five years of aid spending in Central America, the Government Accountability Office rendered a blunt assessment in 2019: “Limited information is available about how U.S. assistance improved prosperity, governance, and security.”

One U.S.A.I.D. evaluation of programs intended to help Guatemalan farmers found that from 2006 to 2011, incomes rose less in the places that benefited from U.S. aid than in similar areas where there was no intervention.

Mexico has pushed for a more radical approach, urging the United States to give cash directly to Central Americans affected by two brutal hurricanes last year. But there’s also a clear possibility — that some may simply use the money to pay a smuggler for the trip across the border.

The farmers of San Antonio Huista say they know quite well what will keep their children from migrating. Right now, the vast majority of people here make their money by selling green, unprocessed coffee beans to a few giant Guatemalan companies. This is a fine way to put food on the table — assuming the weather cooperates — but it doesn’t offer much more than subsistence living.

Farmers here have long dreamed of escaping that cycle by roasting their own coffee and selling brown beans in bags to American businesses and consumers, which brings in more money.

“Instead of sending my brother, my father, my son to the United States, why not send my coffee there, and get paid in dollars?” said Esteban Lara, the leader of a local coffee cooperative.

But when they begged a U.S. government program for funding to help develop such a business, Ms. Monzón said, they were told “the money is not designed to be invested in projects like that.”

These days, groups of her neighbors are leaving for the United States every month or two. So many workers have abandoned this town that farmers are scrambling to find laborers to harvest their coffee.

One of Ms. Monzón’s oldest employees, Javier López Pérez, left with his 14-year-old son in 2019, during the last big wave of Central American migration to the United States. Mr. López said he was scaling the border wall with his son when he fell and broke his ankle.

“My son screamed, ‘Papi, no!’ and I said to him, ‘Keep going, my son,’” Mr. López said. He said his son made it to the United States, while he returned to San Antonio Huista alone.

His family was then kicked out of their home, which Mr. López had given as collateral to the person who smuggled him to the border. The house they moved into was destroyed by the two hurricanes that hit Guatemala late last year.

Ms. Monzón put Mr. López in one of her relatives’ houses, then got the community to cobble together money to pay for enough cinder blocks to build the family a place to live.

While mixing cement to bind the blocks together, one of Mr. López’s sons, Vidal, 19, confessed that he had been talking to a smuggler about making the same journey that felled his father, who was realistic at the prospect.

“I told him, ‘Son, we suffered hunger and thirst along the way, and then look at what happened to me, look at what I lost,’” Mr. López said, touching his still-mangled ankle. “But I can’t tell him what to do with his life — he’s a man now.”

Categories
World News

Larger rates of interest can be good for the nation, Treasury Secretary Yellen says

U.S. Treasury Secretary Janet Yellen speaks during a news conference, after attending the G7 finance ministers meeting, at Winfield House in London, Britain June 5, 2021.

Justin Tallis | Rueters

U.S. Treasury Secretary Janet Yellen said that President Joe Biden’s $4 trillion spending proposal would be positive for the country, even if it leads to a rise in interest rates.

During an interview with Bloomberg News, the former Federal Reserve chair said the president’s plans would total about $400 billion each year — a level of spending she argued was not enough to create an inflation over-run.

“If we ended up with a slightly higher interest rate environment it would actually be a plus for society’s point of view and the Fed’s point of view,” Yellen told Bloomberg.

“We’ve been fighting inflation that’s too low and interest rates that are too low now for a decade,” she said. She added that if the packages help at all to “alleviate things then that’s not a bad thing — that’s a good thing.”

Read the full Bloomberg report here.

Categories
Entertainment

Yoshi Wada, Ingenious Creator of Sound Worlds, Dies at 77

On the 18th Manhattan. He was 77.

His son and musical collaborator Tashi Wada confirmed the death but said the cause was unknown.

Yoshi Wada’s music was characterized by dense, persistent sounds that could create stunning acoustic effects. He absorbed much of various musical traditions – Indian ragas, Macedonian folk song, and Scottish bagpipes – while supporting his musical life by working in construction.

In an early technique, in the 1970s, he attached mouthpieces to pipes that could be over six feet long. In ritual concerts lasting several hours, he immersed the audience in the sonorous drones that emanated from this alphorn-like instrument, which he called the earth horn.

In combination with the electronics of the sound artist Liz Philips, the pulsating sounds of the pipes offered a new interpretation of the minimalist style that was then in fashion.

“The result was certainly one of the most coloristically attractive of the many recent examples of minimalist, stationary sound you hear today,” wrote John Rockwell of the New York Times of a Wada concert in 1974 at the Kitchen in Lower Manhattan, “more like an evening at the very beginning of Wagner’s ‘Rheingold’. “

Mr. Wada’s idiosyncratic singing and the use of bagpipes became the basis for two major albums released on free jazz labels in the 1980s. One, “Lamentation of the rise and fall of the Elephantine Crocodile,” was recorded in an empty swimming pool; To delve deeper into the project, Mr Wada slept in the pool. The other release, “Off the Wall”, made on a grant in West Berlin, combined bagpipes with a handcrafted organ and percussion.

“What I would like to have is a feeling for the endless space,” he said in a 1987 interview. “I want to create this feeling of infinity with sound.”

Mr. Wada also created elaborate sculptural sound installations. For “The Appointed Cloud” in 1987 he hung organ pipes and gongs in the Great Hall of the New York Hall of Science in Flushing Meadows Corona Park in Queens. Led by a computer program developed by David Rayna, visitors pressed buttons to change the sound of the composition in real time.

“Lots of young children came,” recalled Mr Wada in 2016, “and they went crazy pushing the buttons and it was a lot of fun.”

Yoshimasa Wada was born on November 11, 1943 in Kyoto, Japan, to the architect Shukitchi Wada and Kino Imakita. His father died in World War II and his childhood was marked by the rigors of the post-war period.

Yoshi had strong experiences early on in hearing monks sing in a local Zen temple. Enthusiastic about Sonny Rollins and Ornette Coleman, he started playing jazz saxophone as a teenager. He studied sculpture at the Kyoto City University of Fine Arts and searched Japan for avant-garde collectives such as the Gutai Group and the Hi-Red Center.

“It looked at the moon in a Zen garden for a whole night,” Mr. Wada later recalled of a “happening” presented by the artist and musician Yoko Ono. “That was a very nice feeling. I remember taking a bath afterwards and going home. “

After completing his Bachelor in Fine Arts, he moved to New York in 1967. George Maciunas, who is considered to be the founder of the Fluxus movement, lived in Mr. Wada’s building. Soon Mr. Wada was caught up in Fluxus’ high-minded absurdism, which made music out of cardboard tubes and syncopated sneezes.

Mr. Maciunas had begun buying abandoned buildings in the Manhattan area that would become known as SoHo and converting them into artists’ cooperatives, and he enlisted Mr. Wada to help with the carpentry and plumbing work.

Never having formal training in music, Mr. Wada took electronic music lessons from composer La Monte Young and in the early 1970s became a student of guru Pandit Pran Nath, who taught classical North Indian singing in Mr. Young’s studio.

“He tried to take everything in on a very high spiritual level,” said Mr. Young in an interview about Mr. Wada. “He was a very pure and noble person.”

His fascination with the microtonal inflections and hypnotic drones of Indian ragas, along with his dissatisfaction with standard instruments, led Mr. Wada to create the earth horns. But his musical interest continued to expand. He heard Macedonian folk singing at a festival and decided to study it, then formed a small choir to sing eerie modal improvisations. He attended Scottish Highland Games in the late 1970s and was impressed with the possibilities of the bagpipes.

After learning the solo bagpipe style known as “piobaireachd”, Mr. Wada built his own “customized” version of the instrument – with plumbing fixtures, pipes and air compressors – for evening performances that fused composition and improvisation.

“In studying all these different traditions, he always spoke of wanting to find ways to make them his own,” said his son Tashi in an interview.

Mr. Wada supported his family by continuing construction work and even starting his own construction company. He stored his menagerie of makeshift instruments in the basement of their building, one of the ones that Mr. Maciunas had developed. Tashi Wada remembered that a drum kit from his childhood found its way into one of his father’s sound installations.

Starting in 2007, Tashi Wada, who is also an experimental composer, helped reissue his father’s older recordings, which are now available on the Saltern label. In 2009, the Emily Harvey Foundation, which promotes the arts and had preserved some of Wada’s ear horns, invited him to repeat his performances from the 1970s. History lost the original electronic drone system; Instead, Tashi recreated the parts live. Father and son became regular musical collaborators.

Mr. Wada’s first wife was Barbara Stewart. In 1985 he married Marilyn Bogerd; they divorced in 2014. In addition to her son, he leaves behind her daughter Manon Bogerd Wada and a granddaughter.

In 2016, Tashi Wada interviewed his father for the art magazine BOMB and asked him about the hallucinatory effects he had experienced while practicing his music in a small studio in West Berlin in the 1980s.

“I didn’t use drugs at the time,” said Mr Wada. “It was not necessary. Sound pulls me into a dreamlike world when the sound is right. That is a very good effect and keeps me awake. “

Categories
Health

New York Turns to Good Thermometers for Illness Detection in Faculties

And then of course there are the inevitable privacy concerns. Kinsa emphasizes that all data made available to the city is aggregated and anonymized. “None of the individual data goes to anyone other than that person,” said Mr Singh. “You have the data, and we’re really persistent with it.”

While digital privacy experts say these are important safeguards, they also point out that information about children and health is particularly sensitive. “It’s really important to weigh the benefits and needs of public health against the social or societal risks,” said Rachele Hendricks-Sturrup, health policy advisor at the Future of Privacy Forum, a think tank focused on privacy.

For example, even anonymized data can sometimes be re-identified. “Even if it turns out to be ‘A fourth grader at this school in this neighborhood,’ that might narrow it down,” said Hayley Tsukayama, a legislative activist at the Electronic Frontier Foundation, a digital privacy group. “It doesn’t take a lot of data points to identify something new.”

The data, aggregated by zip code, will also feed into disease signals that Kinsa makes available on its public HealthWeather map. The company sometimes shares this information at the postal code level with pharmacies, vaccine distributors, and other companies. For example, Clorox used Kinsa’s data to determine where to target its ads. (Lysol won’t have special access to the data, says Kinsa.)

Both Kinsa and the city need to be transparent to families about how the data is used, stored and shared, and how long it is retained, experts said. City officials “are essentially putting their stamp on,” said Amelia Vance, director of youth and education privacy at the Future of Privacy Forum. “They need to make sure they are living up to parents’ trust that this program has been fully reviewed and is safe for their children and families.”

City officials will be closely monitoring how well the program is performing over the coming months, said Dr. Varma. How do families feel about the program? Is there enough intake to produce useful data? Can they actually spot outbreaks earlier – and slow the spread of disease?

“Our goal is to see if it really has the effect we hope in the real world,” said Dr. Varma. “It is also possible that the system does not detect anything conspicuous or unusual, but still proves successful because it provides people with useful information and increases their confidence that they have their children in school.”

Categories
Politics

Biden responds to the Could jobs report: ‘Our plan is working’

WASHINGTON — President Joe Biden responded to the May jobs report on Friday, saying the steady growth in jobs and the decline in unemployment is evidence his economic plan is working.

“None of this success is an accident,” said Biden, who spoke in Rehoboth Beach, Delaware. “It isn’t luck. It’s due in no small part to the cooperation of the American people,” who have worn masks and gotten vaccinated for Covid-19.

“And it’s due in no small part to the bold action we took with the American Rescue Plan,” said Biden, referring to the massive Covid relief bill Democrats passed in March.

“This is progress that’s pulling our economy out of the worst crisis in the last 100 years,” Biden said.

Nonfarm payrolls added a solid 559,000 jobs in May, the Labor Department reported. But the number fell short of the 671,000 jobs that economists surveyed by Dow Jones had anticipated.

The unemployment rate fell from 6.1% to 5.8%, which was better than the estimate of 5.9%. An alternative measure of unemployment that includes discouraged workers and those holding part-time jobs for economic reasons also edged lower, to 10.2%.

“Covid cases are down. Covid deaths are down. Unemployment filings are down. Hunger is down, and vaccinations are up,” said Biden. “Jobs are up. Wages are up. Manufacturing is up. Growth is up. People gaining health-care coverage is up. Small business confidence is up. America is finally on the move again.”

Despite the gains, the U.S. is still about 7.4 million jobs shy of where it was pre-pandemic.

Even though they’re called “May jobs numbers,” the actual figure is calculated during the second week of the month, based on that week’s data. This is especially relevant for understanding May’s numbers in the context of the pandemic recovery.

As Biden noted, in the three weeks since the May jobs figures were calculated, more than 21 million working-age adults have been fully vaccinated and are now more likely to return to jobs, spend money on leisure and consumer goods and plan summer travel.

Another milestone not fully captured by the May jobs numbers is the impact of the CDC’s announcement on May 13 that fully vaccinated adults no longer need to wear masks outdoors in crowds or in most indoor settings.

The announcement had a domino effect on state-level mask mandates, helping to draw Americans back to office buildings, health-care providers and other activities they had avoided during the past year.

As Biden prepares to meet with G-7 member nations next week in England, he noted that “no other major economy in the world is growing as fast as ours. No other major economy is gaining jobs as quickly as ours.”

U.S. President Joe Biden delivers remarks on the May jobs report after U.S. employers boosted hiring amid the easing coronavirus disease (COVID-19) pandemic, at the Rehoboth Beach Convention Center in Rehoboth Beach, Delaware, U.S., June 4, 2021.

Kevin Lemarque | Reuters

One notable part of the report was an acceleration in wage gains, which rose 2% year over year from being up just 0.4% in April.

Economists had largely been dismissive of average hourly earnings numbers for much of the post-pandemic period, noting that the bulk of hires came from higher-earning positions, which made wages look like they were rising for everyone but left many low-wage workers out of gains.

With the return of more hospitality workers in May, the numbers are more relevant now and indicative of rising wage pressures across the economy, not just for higher earners.

Some economists fear that increasing wages could lead to further inflation, and they blame enhanced unemployment benefits for causing a “labor shortage” that forced huge companies such as Bank of America and McDonald’s to raise their hourly minimum wage.

Biden rejects this view of the economy. “When it comes to the economy we’re building, rising wages aren’t a bug, they’re a feature,” he said during a speech in Ohio last week.

During the same speech, Biden renewed his call for Congress to raise the federal minimum wage to $15 an hour.

The May jobs report is the first full measure of the labor market since the shock of April’s numbers, which fell far short of economists’ initial expectations.

— CNBC’s Jeff Cox contributed to this report.

Categories
Health

Biden Covid group holds briefing as U.S. doubles down on vaccine efforts

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President Joe Biden’s Covid-19 Response Team holds a press conference Thursday on the country’s response to the coronavirus pandemic that infected more than 33.3 million Americans and killed at least 595,849 people.

On Wednesday, Biden said the government had redoubled efforts to get more Americans vaccinated against Covid-19 by July 4th

In early May, Biden announced his administration’s new goals in the fight against this virus: 70% of adults in the US should receive at least one dose of a vaccine and 160 million adults should be fully vaccinated by Independence Day.

In a White House speech on Wednesday, Biden announced June as “national month of action” to vaccinate more Americans. He urged unvaccinated Americans to get the shots and said they were still at risk of getting seriously ill, dying, and passing the disease on to others, especially as autumn approaches.