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Jeff Zients: the ‘Mr Fix It’ in charge of tackling the US Covid crisis

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Joe Biden has promised to put science back at the heart of the US government’s response to the pandemic. Yet the man he has chosen as his White House coronavirus tsar is not a scientist, but rather a management consultant and investor known to former Obama staffers as “Mr Fix It” for his ability to turn round failing government projects.

When Mr Biden takes over as president, Jeff Zients will be the co-ordinator of the president’s Covid-19 task force, a position that will give him oversight of everything being done across the federal government to tackle the virus, from deciding travel restrictions to managing the vaccine supply chain.

Unlike most of the others advising the new president on the virus, Mr Zients has no scientific or medical background. Still, his friends say the former consultant, entrepreneur and even deli owner is the perfect choice to fix the mess left behind by the Trump administration.

“What has been stunningly lacking over the past year is an organised response,” said Tom Frieden, the former head of the US Centers for Disease Control and Prevention, or CDC. “You need someone to be the conductor of the orchestra. They don’t need to know how to play every instrument, you just need to know what to do to get the best out of them.”

Mr Zients comes into the job at a critical point in the pandemic. The US has been hit harder by the disease than most other countries, with case numbers, hospitalisations and deaths rising throughout the autumn and early winter. A further 2,141 fatalities has taken the death toll to 392,428, according to the Covid Tracking Project, while an alternate methodology used by Johns Hopkins University puts the tally at more than 400,000.

The role of Mr Zients will be to revamp the entire pandemic response, a task that is likely to test his management skills as he tries to co-ordinate different federal, state and local organisations. 

One of his earliest jobs was working for Bain Consulting, where he later said he “fell in love with [the company’s] culture, teamwork . . . and analytical rigour”. It was there he met his wife Mary Menell, who comes from a South African family so well-connected that Nelson Mandela attended their wedding.

Mr Zients then helped to run Advisory Board, a healthcare research company, and its spin-off the Corporate Executive Board. He earned tens of millions of dollars when he helped to take both companies public. In 2002 Fortune Magazine estimated his wealth at $149m, then making him the 25th richest American under 40, one place above Julia Roberts and two behind Elon Musk.

In 2009 Barack Obama hired Mr Zients as the government’s first “chief performance officer”, before asking him to turn round the error-plagued launch of HealthCare.gov, the insurance exchange website used to distribute the policies offered under the Affordable Care Act.

Denis McDonough, who was Mr Obama’s chief of staff at the time, asked Mr Zients to take on that job during a walk on the White House south lawn. “He didn’t ask what the terms were, and wasn’t worried about the fact that it was an extraordinarily difficult job. He just wanted to get started,” Mr McDonough recalled.

Mr Zients’ answer was to bring in the private sector: he hired experts from Google and made Optum, a division of United Healthcare, the project’s main contractor. The strategy worked, and the technical glitches were fixed in time for people to begin signing up to the new state-backed health insurance policies in the following year.

Colleagues say Mr Zients was also a calm manager and excellent talent spotter.

Since leaving government Mr Zients has had an eclectic career, joining Facebook as a board member but also helping to start a popular Washington bagel shop Call Your Mother.

Andrew Dana, his partner in that venture, says Mr Zients helped him navigate the chaos of setting up a business and focus on just a few key questions, such as where the deli should be located. He said it was more than just an investment for the food-loving Mr Zients, who asked to sit in on smoked salmon tastings.

Mr Zients’ admiration for the private sector is viewed with suspicion by some on the left, with progressives asking whether he will be willing to give a prominent enough role to the government or risk upsetting the business community.

Max Moran, a research assistant at the Revolving Door Project, which monitors links between business and government, said: “I worry that his priority is not necessarily going to be doing what is going to help the most people immediately, but doing things that do not disrupt business as usual, whether that’s not upsetting the stock market or not creating regulatory uncertainty, or not expanding the state.”

Others say they are worried about the most important coronavirus job in the White House being done by a non-scientist, especially if he undermines or interferes with the work being done by the CDC, which was frequently sidelined by the Trump administration.

Lawrence Gostin, a public health professor at Georgetown University, said: “Core functions, which were really served by the White House under the Trump administration, need to go back virtually exclusively to the CDC, without White House interference.”

Mr Gostin said Mr Zients had the executive experience needed to co-ordinate the rollout, but said he should avoid emulating the approach taken by outgoing vice-president Mike Pence, who chaired the White House coronavirus task force.

“If he starts to act more like Pence, reviewing and back-stabbing and overseeing the CDC’s response, it will be a disaster,” he said. 

Mr Zients’ first task will be to revamp the vaccine distribution plan, which has stumbled in its early days. But his early drafts reportedly failed to impress Mr Biden, who is said to have criticised Mr Zients’ team for failing to come up with detailed enough proposals. 

Mr Biden’s officials deny reports of tensions between the two, and the incoming administration has since released its blueprint for how to ramp up vaccinations. 

Announcing that plan, Mr Zients said last week it was “a fundamentally different approach” from that taken by the Trump administration. Critics point out, however, that many of the measures had already been taken by the outgoing government, such as releasing almost all available doses and calling for over-65s to be vaccinated straight away.

Others said the plan demonstrated Mr Zients’ reluctance to recommend radical policy solutions, such as asking the US National Guard to administer vaccinations.

But allies say the proposals show Mr Zients has identified the roadblocks in the existing rollout, which bodes well for his ability to overhaul the rest of the response. Mr McDonough said: “Jeff’s real skill is he can break down really complex problems into small and executable chunks.”

Mr Dana said: “I will sleep better knowing Jeff is in charge of tackling coronavirus.”

Additional reporting by Peter Wells in New York

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Analysis

Austria puts its faith in Covid testing above immunisations

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As lockdowns across Europe drag on into spring, the Austrian government says it has a strategy to get life back to normal in weeks rather than months — not with vaccines, but tests.

The country of 8.8m people will from Monday make 3.5m Covid tests available free to its citizens each week. The plan could allow restaurants and bars to start welcoming customers back by mid-March. Non-essential shops and schools are already open and many Austrians have returned to their workplaces.

“We are on the way to becoming the testing world champion,” said chancellor Sebastian Kurz. “Our goal is to be able to control the incidence of infection, or at least mitigate any growth in infection numbers, as best we can, by testing as much as possible.”

As Covid cases climb, Austria has grown frustrated with the EU’s slow vaccine rollout. The bloc’s performance particularly rankles because last May — in deference to EU solidarity — Kurz turned down a tentative offer from Benjamin Netanyahu to partner with Israel in its vaccination drive with Pfizer, two Austrian officials told the Financial Times.

Kurz has a close working relationship with the Israeli leader and the two regularly discuss the pandemic.

The missed opportunity for the kind of swift vaccination programme pioneered by Israel underscored the importance for smaller countries such as Austria to be flexible in their approach to the virus, a political adviser close to the chancellor said. 

Austria’s faith in testing has put it at odds with other European countries where the Covid policy is almost solely focused on immunisation as a means of escaping another wave of the pandemic.

That has left much of the continent languishing under stricter lockdown conditions than those enforced when the pandemic first hit a year ago.

Britain is Europe’s vaccine leader, with more than 28 doses of vaccine delivered per 100 residents. Austria has managed just 6 — slightly less than the 6.3 EU average. But last week the UK government said it still expected to impose four more months of restrictions to control the virus.

For critics, Vienna is walking a tightrope: cases in Austria have ticked up from the low of 14.9 per 100,000 residents a fortnight ago to a rolling seven-day average of 19.2. The next two weeks will be crucial: if numbers continue to rise Austria’s strategy will unravel.

But the focus on testing will also be closely watched. Chancellor Angela Merkel told lawmakers in her party last week she believed mass testing would be a critical in helping Germany ease its way back to normality.

A hairdresser and her customer in Vienna wear FFP2 protective face masks. © Alex Halada/AFP/Getty

Thomas Czypionka, head of health policy at the Institute of Higher Studies in Vienna, said “a tight net of testing” would provide the opportunity to reopen businesses and schools by controlling transmission of the virus. “This is a different kind of strategy. It’s not perfect, but its worth a try.”

The Austrian initiative should in part be understood in the context of the government’s poor handling of the second wave, according to Czypionka.

Feted for his nimble handling of the crisis last spring, Kurz has since faced criticism as the number of cases soars. In November, Austria recorded the highest number of new infections per million inhabitants in western Europe.

Testing is crucial, according to Czypionka, because people’s willingness to tolerate restrictions and their disastrous economic consequences had reached its limit. “People have lost faith. This is the real reason the government is having to open up.”

© Ronald Zak/AP

He was nevertheless confident that the testing strategy was a good one: “It’s cheaper than keeping a country in lockdown.”

While Austria’s first experiment with mass-testing began in December, with limited success, the latest drive is markedly different. Testing will be linked to the phased emergence from lockdown itself — using reliable PCR tests for entry into venues, and quick result lateral flow tests for home use. Officials at the chancellery said they believed this “nudge” approach — where even small incentives can prove powerful motivators for social change — has been highly successful.

Hair salons have been open in Austria since February 8. But their use is conditional on testing: customers must present proof of a negative test no later than 48 hours before an appointment.

The idea is now being thrashed out for the hospitality sector. An announcement is expected to be made this week, but the government is hopeful that entry tests at restaurants, bars and cafés could allow for a reopening of some — with strict hygiene measures also in place — as early as March 14.

“My heart bleeds because tens of thousands of businesses have not been allowed to open for months. We will do everything we can to ensure that the catering and hotel industry can welcome guests again soon. I’m on the side of the industry,” tourism minister Elisabeth Köstinger said last week.

Capacity for tests has been increased dramatically. There are now 800 pharmacies across Austria offering tests, and a further 650 specialist testing stations. From Monday, the government hopes to make up to five postal tests — which can be ordered by telephone hotline or online — available to every Austrian each week.

Schools are testing pupils twice a week and workplaces have been brought onboard. The government is subsidising more than 1,000 Austrian companies — representing a workforce of just under 500,000 — to provide them with free regular tests for those who want to return to the workplace.

Testing was the best way to avoid an “indefinite lockdown”, Kurz declared last week, as he promised Austrians the government would do whatever it could to safely reopen public life.



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Analysis

Rising interest rates cool sizzling rally in emerging markets

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The rush into emerging market assets since the depths of the coronavirus crisis a year ago is facing its first serious test as rising US interest rates revive memories of the “taper tantrum” of 2013.

Emerging market stocks sailed almost 90 per cent higher in US dollar terms from the nadir in March to a historic peak last week, according to MSCI’s broad index of equities in 27 countries. The surge stemmed in part from a ferocious hunt for returns after central bank stimulus depressed interest rates in developed markets to record lows.

But a sharp drop in developed-market government bond prices since the start of 2021 has sent borrowing costs sharply higher, and started to ripple into emerging markets. MSCI’s EM stock barometer has slipped about 5 per cent from last week’s high, reflecting drops in countries stretching from China to Turkey and Brazil.

“There’s no doubt that yield curve steepening worldwide is starting to spill over into other asset markets and the last thing we need right now is a full-blown bond and equity market sell-off,” said Win Thin, global head of currency strategy at Brown Brothers Harriman.

Line chart of % change in dollar terms showing EM stocks have slipped after a soaring start to 2021

To some analysts, the set-up this time around is similar to 2013, when investors fled EM assets as the US Federal Reserve signalled an end to the ultra-loose monetary policies that had given them such a boost.

Thin at BBH notes that the Fed will probably seek this time to reassure markets it will only slowly withdraw the extraordinary stimulus measures it deployed during the depths of the Covid-19 crisis.

Nevertheless, some sectors are feeling the pressure. Chinese markets, which have been among the best performers due to the country’s rapid recovery from coronavirus, have dropped over the past week.

The CSI 300 index of Chinese equities has fallen about 6 per cent on a dollar basis from its February high, while Shenzhen’s technology-focused ChiNext market is down 13 per cent. Turkey, another large EM, has endured a roughly 8 per cent decline since February 15, according to an MSCI index.

Meanwhile, Brazilian markets have faced serious ructions after Jair Bolsonaro, the populist rightwing president, fired the boss of state oil company Petrobras for failing to keep pump prices low.

Still, some analysts and investors argue that expectations for a brighter economic outlook in many countries will help dull the risk posed by rising global interest rates.

With vaccines coming into sight, says Tom Clarke, partner and portfolio manager at William Blair Investment Management, “you can argue about how many quarters there will be of lost or much reduced income but it’s the kind of thing you can look through, even if it’s a long way into the future. That has caused a sea change in EM equities and currencies.”

This, he says, is part of a more fundamental change. Before the pandemic, several factors were weighing against emerging markets: protectionism in the US and elsewhere, rising tensions between the US and China, the uncertainty over Brexit — all of which have been resolved, to a greater or lesser extent. 

“There have been worries about a hard landing in China for several years and, lo and behold, it delivered positive growth, last year of all years,” Clarke said.

Not all EMs will come out of the pandemic in equally good shape, however. One factor crucial to their prospects will be their ability to deliver productive investment.

As recent FT analysis shows, foreign direct investment slumped around the world last year but held up remarkably well across Asia. In China and India, it grew in 2020 by 4 per cent and 13 per cent, respectively. In contrast, Africa and Latin America registered the largest contractions of any regions for many components of FDI including mergers and acquisitions, project finance and greenfield investment — the kind that generates new jobs.

Line chart of % change in dollar terms showing Growth potential has lifted India from pandemic lows, while Brazil still flounders

Investors have also welcomed domestic spending. Part of India’s response to the pandemic has been to increase public spending on infrastructure by 50 per cent over its 10-year average. Brazil, where such investment has been squeezed for decades, has concentrated its pandemic response on subsidies for consumption — popular in political terms but less good for building growth.

Paul Korngiebel, emerging markets portfolio manager at Boston Partners, describes coronavirus as “the massively distorting event that creates winners and losers by [country and] industry sector as policy differs in response to Covid”.

Just as in advanced economies, the focus of many EM investors has been on tech. Over the past 12 months, shares in electric vehicle maker Tesla are up 350 per cent in New York. Shares in Nio, its Chinese rival, also listed in New York, are up more than 1,000 per cent.

Korngiebel worries that, in some sectors, investors may have brought too much future growth into the present and that some valuations are getting stretched. Conversely, he sees opportunities in sectors, such as regional airlines, that have been crushed, as investors have perhaps prematurely written them off.

“We are really dealing with the aftershock of Covid right now,” he says. “It’s not over from an investor point of view — the pig in the python is only half digested.”



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Analysis

The UK mental health crisis coming in Covid’s wake

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Owen O’Kane grew up well-acquainted with the psychological damage that bombs and bullets inflict on communities long after their immediate impact, having witnessed first-hand the troubles in Northern Ireland.

Now a psychotherapist and author based in London, he is convinced that Covid-19 risks leaving similar long-term distress in its wake. In anticipation, he has given the phenomenon a name: “Post pandemic stress disorder.”

“A lot of people have been affected by trauma. Whether its PTSD (post-traumatic stress disorder) or PPSD you won’t see the full impact at the time. You only see it a few months later. If we don’t take this seriously we are going to have a very unwell group in the population for years to come,” said O’Kane, who was formerly mental health lead for the NHS in west London.

With Boris Johnson, UK prime minister, setting out England’s gradual and cautious exit from lockdown earlier this week and the rollout of the country’s vaccination programme still going well, there are some causes for optimism.

But O’Kane and his peers worry about the long term toll the pandemic is taking on the nation’s mental health.

Owen O’Kane: ‘If we don’t take this seriously we are going to have a very unwell group in the population for years to come’

By the middle of 2020, one in five people in the UK was suffering from depression, twice the number in 2019, according to the most recent data released by the Office for National Statistics.

The Centre for Mental Health, an independent UK charity, has predicted that this will translate into up to 10m people needing new or additional mental health support as a direct consequence of the pandemic. But that may be a conservative estimate given that these figures predate the latest and deadliest wave of the virus as well as a winter of intensified lockdown.

“Why I am on my soap box at the moment is that I feel all of the energy is still on getting the R (the disease’s rate of reproduction) down when we have this other pandemic brewing,” O’Kane said.

Part of the answer, he and other specialists argued, will be in allocating sufficient resources to deal with rising demands on services. Another part, argues O’Kane, will be clinical.

“A pandemic is invisible. It’s not like bombs dropping,” he said. But cumulatively its effects are no less traumatic. “If you don’t address the underlying trauma [in patients], they will relapse,” he said.

The stress associated with home-schooling children while sustaining work, of indebtedness, loneliness, or of being forced to confront at close quarters relationships that are fatally cracked, alongside the continuous threat of the virus itself, for many people has taken a grim toll.

“When you have 120,000 families who have lost someone, many of whom have not been able to say farewell; hundreds of thousands of doctors and nurses who have struggled . . . why would you not expect there to be a large number of people with psychological problems?” said Alastair Campbell, the writer and former director of communications to Britain’s former prime minister Tony Blair. “It would be very weird if you didn’t.”

Campbell, who published a book last year on his own experience of severe depression, is frustrated at the lack of preparation for this crisis in the making.

“It’s not just that services are terrible in some parts of the country. It is also that the government is missing a massive opportunity,” he said, arguing that the shock of the pandemic has brought mental wellbeing to the forefront of everybody’s minds except, apparently, those in government. “They still think that if you talk about mental health it makes it worse,” he said.

The government has pledged £500m of extra spending on mental health services this year to address waiting times for specialists, which can stretch to months and more, and to invest in the workforce.

“As part of the long-term plan we have committed an additional £2.3bn a year,” said Nadine Dorries, the minister for health, suicide prevention and patient safety.

Dr Adrian James, president of the Royal College of Psychiatrists, said that it was vital this funding sustained increases in trained psychiatrists, and other specialists while addressing a hangover from years in which mental health has been treated as the poor cousin to its physical relative.

“There is a huge backlog of investment in the mental health estate,” he said, adding: “We need to be on the front foot around mental health in relation to Covid rather than reactive.”

That means taking into account what’s to come. While Johnson’s plan for lifting lockdown aims to remove all restrictions by the end of June, the end of economic support for workers and businesses will cause fresh anxiety.

“As some of the measures that have protected employment security and finances of those in unemployment come to an end, we are facing a cliff edge,” said Catherine Seymour from the Mental Health Foundation, the think-tank. It is calling for temporary £20 weekly increases in welfare payments to be made permanent in next week’s Budget and for a ban on evictions to be extended.

The Samaritans, often the last resort charity for people in distress, has been making similar pleas, pointing to the proven link between recession and increased suicides,

Jacqui Morrissey, the charity’s assistant director of research, said 1.7m people had called on the Samaritans for emotional support between March and December last year, a period, she said, when many people had been deprived of their usual coping mechanisms.

It was imperative, she said, that the voluntary sector, which provides an essential supporting role to the state when it comes to mental health, remains afloat. “We need to make sure that there is a fully funded mental health renewal plan as we come out of that pandemic and that this is at the top of priorities with government working in collaboration with the sector to deliver it,” she said.





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