Tag Archives: Britain

Height of fashion? Clothes mountains build up as recycling breaks down

By Sonya Dowsett and George Obulutsa

MADRID/NAIROBI (Reuters) – Clothes recycling is the pressure-release valve of fast fashion, and it’s breaking under COVID-19 curbs.

The multi-billion-dollar trade in second-hand clothing helps prevent the global fashion industry’s growing pile of waste going straight to landfill, while keeping wardrobes clear for next season’s designs. But it’s facing a crisis.

Exporters are struggling, as are traders and customers in often poorer nations from Africa to Eastern Europe and Latin America who rely on a steady supply of used clothes.

The signs are everywhere.

From London to Los Angeles, many thrift shops and clothing banks outside stores and on streets have been deluged with more clothes than could be sold on, leading to mountains of garments building up in sorting warehouses.

Since the COVID-19 pandemic began early this year, textile recyclers and exporters have had to cut their prices to shift stock as lockdown measures restrict movement and business slows in end markets abroad. For many, it’s no longer commercially viable and they can’t afford to move merchandise.

“We are reaching the point where our warehouses are completely full,” Antonio de Carvalho, boss of a textile recycling company in Stourbridge, central England, wrote to a client in June, asking for a price cut for clothes he collects.

De Carvalho pays towns for clothing collected in his containers then sells it on at profit to traders overseas.

Since May, he said, the price he has been able to charge overseas buyers had dropped from 570 pounds ($726) a tonne to 400 pounds, making it hard for his company, Green World Recycling, to cover the costs of collecting and storing items.

Buyers were also asking to increase the credit periods before they had to pay from 15 days to 45-60 days, adding to cash-flow problems, de Carvalho wrote.

“We are losing … a huge amount of money, making a big loss for the operation.”

‘GOING OUT OF BUSINESS’

De Carvalho’s experience is mirrored across the sector, suggesting that, even once the pandemic passes, the battered trade could take a long time to recover.

Recyclers are removing clothes banks from streets, reducing the number of times they are emptied per week and looking at laying off workers to conserve cash, according to Reuters interviews with 16 market players in Britain, the United States, Germany and the Netherlands.

At the same time, in a bleak irony for such firms, donations have mounted as people stuck at home clear out their wardrobes – a boon in normal times.

“This is unlike any other recession in a century,” said Jackie King, executive director of U.S. trade body the Secondary Materials and Recycled Textiles Association (SMART). “I would anticipate there will be companies going out of business.”

The retreat of recyclers is having far-reaching consequences for an industry that has seen an annual average of more than $4 billion of used clothing exported globally over the five years to 2019, according to U.N. trade data.

Exports have shrunk this year.

In Britain, the weight of used clothing exported from March to July was around half what it was for the same period last year, official trade data shows. Exports improved in July – the latest month on record – as merchants rushed to shift stock as countries began to re-open, but were still down around 30%.

In the United States, the value of exports from March to July fell 45% compared with the same period last year, government data shows.

Up to a third of clothes donated in the United States – the world’s biggest exporter of used clothing – ends up for sale in markets in the developing world.

KENYAN WOES

The consequences of the decline can be seen in countries like Kenya, which imported 176,000 tonnes of second-hand clothing in 2018, equivalent to over 335 million pairs of jeans.

Business is sluggish in the open-air Gikomba market in Nairobi, one of the biggest second-hand clothes market in East Africa. Shop assistants stand idle while traders call out to shoppers asking them to try their garments

Traders have been hit with a double-whammy of the shrinking supply, exacerbated by the government banning the import of used textiles in March on concerns they could carry the novel coronavirus, and a drop in footfall due to people staying home.

“Before coronavirus came in, I would manage to sell at least 50 (pairs of) trousers a day,” said trader Nicholas Mutisya, who sells jeans and hats. “But now with coronavirus, even selling one a day has become difficult.”

“We cannot buy bales (of clothes) directly, so we buy our stock from those who have already bought them.”

The ban on used textiles imports was lifted in August after pushback from traders in Kenya and industry bodies in Europe and the United States who said second-hand clothes were safe as the virus could not survive the journey to Africa.

Yet the struggle continues for traders like Mutisya and Anthony Kang’ethe, who works as a driver for a shop selling second-hand clothes in bales shipped from Britain. He said the business had been hit hard by the supply crunch.

“Before we used to have five workers in our company,” Kang’ethe said. “We are left with two.”

DARK SIDE OF FASHION

Large-scale commercial trade in second-hand clothing from Europe and the United States to emerging markets took off in a big way in the 1990s due to growing African and Eastern European demand for Western fashion.

Such demand has provided a badly needed release value for a booming fashion market, where clothing production has approximately doubled over the past 15 years, according to sustainability charity the Ellen MacArthur Foundation.

The fashion industry is the second-biggest consumer of water and is responsible for up to 10% of global carbon emissions – more than all international flights and maritime shipping combined, the U.N.’s environment program said in March 2019.

Meanwhile, clothes account for a massive, and growing, pile of waste that ends up in landfills.

In Britain, shoppers buy more clothes per person than any other country in Europe, amounting to some five times more than what they bought in the 1980s, according to a 2019 UK parliamentary report by the Environmental Audit Committee.

About 300,000 tonnes of clothing goes to landfill or incineration per year, the report said.

The United States produces just under 17 million U.S. tons (15.4 tonnes) of textile waste per year, according to the Environmental Protection Agency – equivalent to around 29 billion pairs of jeans. Two-thirds of this ends up in landfills.

Many fashion retailers, including Zara owner Inditex and H&M, encourage shoppers to bring unwanted textiles to their stores for collection and, in the case of H&M, even offer discounts on new purchases in exchange.

Only a small proportion of clothes collected by Inditex end up for sale in international markets, a company spokesman said. H&M said clothing collected in its stores was processed by I:CO, a unit of German textile recycling company Soex.

“The whole problem is just getting bigger,” said Anna Smith, a doctoral researcher at King’s College London looking at a so-called circular economic system, which aims to eliminate waste.

“People are consuming more and more.”

(Additional reporting by Lisa Baertlein in Los Angeles and Anna Ringstrom in Stockholm; Editing by Pravin Char)

Most executives seek work-life balance after experiencing pandemic blues: survey

(Reuters) – Nearly eight out of 10 corporate executives have experienced poor mental health during the coronavirus crisis, prompting a number of them to re-evaluate and improve work-life balance, a survey showed on Monday.

Many top company officials in France and Egypt were most likely to have recalibrated their lives after experiencing the pandemic blues, followed by those in the United Arab Emirates, the United States and Britain, according to a survey of about 2,000 high net-worth individuals by health insurer Bupa Global.

The COVID-19 crisis has forced a vast majority of people, including top executives, to work remotely as governments imposed sweeping measures to curb the spread of the pandemic, putting a strain on physical and mental well-being.

Executives plan to exercise more regularly, eat a better diet, make time for meditation and spend more time with family and friends, the survey said.

“With the pandemic impacting mental health so heavily, it’s really important that business leaders work to address any issues both personally and at their organizations,” Bupa’s medical director Luke James said

The survey also found that less than a third of the participants intend to keep working from home primarily, and a quarter of them planned to trim working hours.

Women were more likely than men to opt for working from home, it showed, although those with children were less likely to take that option.

“Anyone who has been working from home around young children or trying to juggle work and home-schooling will know it can be challenging,” Bupa Managing Director Sheldon Kenton said.

As the line between work and personal space blurs, about a fifth of the high net-worth individuals surveyed said they would work remotely from their holiday homes as travel and face-to-face meetings decline.

(Reporting by Yadarisa Shabong in Bengaluru; Editing by Anil D’Silva)

Factbox: Latest on the worldwide spread of coronavirus

(Reuters) – Coronavirus infections slowed in Australia and New Zealand, while Britain said it was at a “tipping point” on COVID-19 as European countries mulled tightening restrictions to curb a sharp resurgence in cases.

EUROPE

* Britain is at a tipping point on COVID-19, health minister Matt Hancock said, warning that a second national lockdown could be imposed if people don’t follow government rules designed to stop the spread of the virus.

* The Czech government could declare a state of emergency if a recent spike in cases continues in the coming days, Health Minister Adam Vojtech said.

* Protesters in some poorer areas of Madrid that are facing a lockdown to stem a soaring infection rate took to the streets on Sunday to call for better health provisions, complaining of discrimination by the authorities.

* Russia reported 6,148 new cases on Sunday, the second straight day when the daily number of cases exceeded 6,000.

* French health authorities reported 10,569 new confirmed COVID-19 cases on Sunday, down from the previous day’s record increase of 13,498.

ASIA-PACIFIC

* Schools in Seoul and nearby areas resumed in-person classes for the first time in almost a month after daily cases dropped to the lowest levels since mid-August.

* Australia’s coronavirus hotspot of Victoria reported on Monday its lowest daily rise in infections in three months, although state Premier Daniel Andrews said there were no plans yet to ease restrictions sooner than expected.

* New Zealand Prime Minister Jacinda Ardern lifted all coronavirus restrictions across the country, except in second-wave hotspot Auckland, as the number of new infections slowed to a trickle.

AMERICAS

* The United States set a one-day record with over 1 million coronavirus diagnostic tests being performed, but the country needs 6 million to 10 million a day to bring outbreaks under control, according to various experts.

* Brazil and Argentina, Latin American nations seeking more time to commit to the global COVID-19 vaccine facility known as COVAX, said they intend to do so as soon as possible after missing Friday’s deadline.

MIDDLE EAST AND AFRICA

* Morocco signed a deal with Russia’s R-Pharm to buy a COVID-19 vaccine produced under a license from Britain’s AstraZeneca, the health ministry said, as its total number of cases approached 100,000.

* Israel entered a second nationwide lockdown at the onset of the Jewish high-holiday season, forcing residents to stay mostly at home amid a resurgence in new cases.

MEDICAL DEVELOPMENTS

* Moderna Inc said it was on track to produce 20 million doses of its experimental coronavirus vaccine by the end of the year, while maintaining its goal of readying 500 million to 1 billion doses in 2021.

ECONOMIC IMPACT

* British manufacturers see no evidence of a ‘V’-shaped recovery from the pandemic underway and many are planning to slash investment, a business survey showed.

(Compiled by Devika Syamnath and Alex Richardson; Edited by Shounak Dasgupta)

Second UK lockdown? PM says second wave inevitable, new restrictions possible

By Guy Faulconbridge, Kate Holton and Andy Bruce

LONDON (Reuters) – British Prime Minister Boris Johnson said he did not want another national lockdown but that new restrictions may be needed because the country was facing an “inevitable” second wave of COVID-19.

Ministers were on Friday reported to be considering a second national lockdown, after new COVID-19 cases almost doubled to 6,000 per day, hospital admissions rose and infection rates soared across parts of northern England and London.

That rise in cases was part of a second wave that was now unstoppable, the prime minister said.

“We are now seeing a second wave coming in…It is absolutely, I’m afraid, inevitable, that we will see it in this country,” Johnson told UK media.

Asked about whether the whole of the country should brace for a new lockdown, rather than just local restrictions, he said: “I don’t want to get into a second national lockdown at all.”

But he did not rule out further national restrictions being brought in.

“When you look at what is happening, you’ve got to wonder whether we need to go further than the rule of six that we brought in on Monday,” he said, referring to the ban on gatherings of more than six people.

The United Kingdom has reported the fifth largest number of deaths from COVID-19 in the world, after the United States, Brazil, India and Mexico, according to data collected by Johns Hopkins University of Medicine.

The UK’s official number of new positive cases shot up by nearly a thousand on Friday to 4,322, the highest since May 8, after a separate ONS model pointed to about 6,000 new cases a day in England in the week to Sept. 10.

That was up from modelling of 3,200 cases per day in the previous week, with the North West and London seen as hotspots.

Health Minister Matt Hancock called a second national lockdown a last resort earlier on Friday and when he was asked about it said: “I can’t give you that answer now.”

SPREADING WIDELY ACROSS ALL AGES

The UK said its reproduction “R” number of infections has risen to a range of 1.1-1.4 from last week’s 1.0-1.2.

“We’re seeing clear signs this virus is now spreading widely across all age groups and I am particularly worried by the increase in rates of admission to hospital and intensive care among older people,” said Yvonne Doyle, Medical Director at Public Health England.

“This could be a warning of far worse things to come.”

Britain imposed new COVID regulations on the North West, Midlands and West Yorkshire from Tuesday. More than 10 million people in the United Kingdom are already in local lockdown, and restrictions for millions more could be on the way.

London Mayor Sadiq Khan said later on Friday that it was “increasingly likely” that additional measures would soon be required in Britain’s biggest city. He said he had seen evidence about the spread of the virus in London which was “extremely” concerning.

COVID-19 cases started to rise again in Britain in September, with between 3,000 and 4,000 positive tests recorded daily in the last week. This is still some way behind France, which is seeing more than 10,000 new cases a day.

“COVID-19 infection rates have increased in most regions, particularly the North West and London,” the ONS said.

The ONS said there had been clear evidence of an increase in the number of people testing positive aged 2 to 11 years, 17 to 24 years and 25 to 34 years.

Johnson was criticized by opposition politicians for his initial response to the outbreak and the government has struggled to ensure sufficient testing in recent weeks.

Asked by LBC radio why the testing system was such a “shambles”, Hancock said Dido Harding, who is in charge of the system, had done an “an extraordinary job.”

(Reporting by Guy Faulconbridge, Kate Holton and Sarah Young; Editing by Raissa Kasolowsky, Mike Collett-White, Philippa Fletcher, William Maclean)

What you need to know about the coronavirus right now

(Reuters) – Here’s what you need to know about the coronavirus right now:

Biden rejects Trump claim that vaccine is imminent

U.S. Democratic presidential candidate Joe Biden on Thursday bluntly contradicted President Donald Trump’s suggestion that a coronavirus vaccine may be only weeks away, warning Americans they cannot trust the president’s word.

“The idea that there’s going to be a vaccine and everything’s gonna be fine tomorrow – it’s just not rational,” Biden said during a CNN town hall in Moosic, Pennsylvania.

Trump again said on Wednesday that a vaccine for COVID-19 could be ready for distribution ahead of the Nov. 3 election.

Most health experts, including Robert Redfield, the director of the Centers for Disease Control and Prevention, have said a vaccine will likely not be widely available until mid-2021.

Israel imposes second lockdown

Israel will enter a second nationwide lockdown on Friday at the onset of the Jewish high-holiday season, forcing residents to stay mostly at home amid a resurgence in new coronavirus cases.

The country’s initial lockdown was imposed in late March and eased in May as new cases tapered off, reaching lows in the single digits.

But in the past week, new cases have reached daily highs of over 5,000, and Israeli leaders now acknowledge they lifted measures too soon.

The new lockdown will last three weeks and coincides with the start of the Jewish New Year, Rosh Hashana, traditionally a time for large family gatherings and group prayer.

UK COVID hospital admissions double every eight days

Britain’s health minister said that the novel coronavirus was accelerating across the country, with hospital admissions doubling every eight days, but he refused to say if another national lockdown would be imposed next month.

The United Kingdom has reported the fifth-highest number of deaths from COVID-19 in the world after the United States, Brazil, India and Mexico, according to data collected by Johns Hopkins University of Medicine.

COVID-19 cases started to rise again in Britain in September, with between 3,000 and 4,000 positive tests recorded daily in the last week. More than 10 million people are already in local lockdowns.

China reports highest new cases since Aug. 10

Mainland China reported 32 new COVID-19 cases on Thursday, marking the highest daily increase in more than a month and up sharply from nine cases reported a day earlier.

Although the latest increase still remains well below the peaks seen at the height of the outbreak in China early this year, it is the biggest since Aug. 10 and suggests continued COVID-19 risks stemming from overseas travelers coming into the country as the pandemic rages on in other parts of the world.

The National Health Commission said that all new cases were imported infections. Mainland China has not reported any local COVID-19 infections since mid-August.

Canada’s Ontario clamps down on parties

Canada’s most populous province will clamp down on social gatherings to prevent “reckless careless people” from spreading the coronavirus at illegal parties, Ontario Premier Doug Ford said on Thursday.

His warning came as the nation’s top medical officer said authorities could potentially lose the ability to manage the pandemic.

Indoor social events in Toronto, Canada’s biggest city – along with Ontario’s Peel and Ottawa regions – would be authorized to include no more than 10 people, down from a previous limit of 50, Ford said.

“This is a serious situation, folks. We will throw the book at you if you break the rules,” he told a news conference.

(Compiled by Linda Noakes; Editing by Hugh Lawson)

Amazon bucks UK labor market gloom with 7,000 new jobs

LONDON (Reuters) – Amazon brought a little cheer to Britain’s troubled labor market on Thursday, saying it will create a further 7,000 permanent jobs in 2020, taking total new hires this year to 10,000.

Last month the number of people in work in Britain suffered the biggest drop since 2009 and the coronavirus is expected to take a much heavier toll on unemployment when the government winds down its huge job-protection scheme.

The one bright spot however has come from online retail and logistics as orders surged during lockdown. Amazon’s latest recruitment will take its total UK workforce to over 40,000 by the end of the year.

The U.S. internet giant said the 7,000 new roles will be for warehouse workers, as well as engineers, HR and IT professionals and health and safety and finance specialists.

The jobs will be in over 50 sites, including two new distribution centers in the north east and central England and at corporate offices.

It said it needed more staff to meet growing customer demand for its services and to enable small and medium sized enterprises selling on Amazon to scale their businesses.

Amazon has also started recruiting for more than 20,000 seasonal positions across the UK for the festive period.

Last month the Confederation of British Industry said British retailers had cut the most jobs since the depths of the financial crisis and expected the pace of losses to accelerate.

Well-known British retailers Marks & Spencer, John Lewis, Debenhams, WH Smith and Dixons Carphone have all announced job cuts in recent weeks, reflecting the rapid shift in demand to online sales.

Tesco, Britain’s biggest supermarket, said it would create 16,000 permanent roles to meet the surge in home deliveries.

(Reporting by James Davey; editing by Kate Holton)

Steroids cut death rates among critically ill COVID-19 patients, major study finds

By Kate Kelland

LONDON (Reuters) – Treating critically ill COVID-19 patients with corticosteroid drugs reduces the risk of death by 20%, an analysis of seven international trials found on Wednesday, prompting the World Health Organisation to update its advice on treatment.

The analysis – which pooled data from separate trials of low dose hydrocortisone, dexamethasone and methylprednisolone – found that steroids improve survival rates of COVID-19 patients sick enough to be in intensive care in hospital.

“This is equivalent to around 68% of (the sickest COVID-19) patients surviving after treatment with corticosteroids, compared to around 60% surviving in the absence of corticosteroids,” the researchers said in a statement.

The WHO’s clinical care lead, Janet Diaz, said the agency had updated its advice to include a “strong recommendation” for use of steroids in patients with severe and critical COVID-19.

“The evidence shows that if you give corticosteroids …(there are) 87 fewer deaths per 1,000 patients,” she told a WHO social media live event. “Those are lives … saved.”

“Steroids are a cheap and readily available medication, and our analysis has confirmed that they are effective in reducing deaths amongst the people most severely affected by COVID-19,” Jonathan Sterne, a professor of medical statistics and epidemiology at Britain’s Bristol University who worked on the analysis, told the briefing.

He said the trials – conducted by researchers in Britain, Brazil, Canada, China, France, Spain, and the United States – gave a consistent message throughout, showing the drugs were beneficial in the sickest patients regardless of age or sex or how long patients had been ill.

The findings, published in the Journal of the American Medical Association, reinforce results that were hailed as a major breakthrough and announced in June, when dexamethasone became the first drug shown to be able to reduce death rates among severely sick COVID-19 patients.

Dexamethasone has been in widespread use in intensive care wards treating COVID-19 patients in some countries since then.

Martin Landray, a professor of medicine and epidemiology at the University of Oxford who worked on the dexamethasone trial that was a key part of the pooled analysis published on Wednesday, said the results mean doctors in hospitals across the world can safely switch to using the drugs to save lives.

CLEAR BENEFITS

“These results are clear, and instantly usable in clinical practice,” he told reporters. “Among critically ill patients with COVID-19, low-dose corticosteroids … significantly reduce the risk of death.”

Researchers said the benefit was shown regardless of whether patients were on ventilation at the time they started treatment. They said the WHO would update its guidelines immediately to reflect the fresh results.

Until the June findings on dexamethasone, no effective treatment had been shown to reduce death rates in patients with COVID-19, the respiratory disease caused by the new coronavirus.

More than 25 million people have been infected with COVID-19 and 856,876​ have died, according to a Reuters tally.

Gilead Sciences Inc’s remdesivir was authorized by United States regulators in May for use in patients with severe COVID-19 after trial data showed the antiviral drug helped shorten hospital recovery time.

Anthony Gordon, an Imperial College London professor who also worked on the analysis, said its results were good news for patients who become critically ill with COVID-19, but would not be enough to end outbreaks or ease infection control measures.

“Impressive as these results are, this is not a cure. We now have something that will help, but it is not a cure, so it’s vital that we keep up all the prevention strategies.”

(Reporting by Kate Kelland; Editing by Mark Heinrich and Catherine Evans)

Britons rush home from France to beat new quarantine rules

By Alistair Smout and Tangi Salaün

LONDON/CALAIS, France (Reuters) – British travelers rushed home from summer holidays in France on Friday, booking planes, trains, boats and even private jets to get home before a 14-day quarantine comes into force in response to rising coronavirus infections there.

The government announced late on Thursday that it would impose a quarantine from 0300 GMT on Saturday on arrivals from France, giving an estimated 160,000 UK holidaymakers there just over 24 hours to get home or face self-isolation on return.

The sudden rule change dealt a fresh blow to tourists, airlines and tour operators. The pandemic has left many travel groups cash-strapped and fighting for survival.

Many British tourists headed towards the French port of Calais hoping to catch a ferry or a shuttle train home in time.

“We’ve changed our plans when we heard the news last night. We decided to head back home a day early to miss the quarantine,” one British woman at a service station on the motorway to Calais said after her week in southern France.

Queues of cars built up in Calais through Friday afternoon. Ferry companies were adding extra crossings to help more people get home, Jean-Marc Puissesseau, head of the Port of Calais, told Reuters.

PrivateFly, a British-based jet provider, said it had seen three times the normal number of enquiries and bookings.

The new quarantine rules apply to France, the second-most popular holiday destination for Britons, as well as to the Netherlands and the Mediterranean island of Malta.

Spain, Britons’ favorite holiday destination, came under British government quarantine rules on July 26.

“We’ve also had a number of enquiries from clients booked to travel to these destinations in the coming weeks to change their travel plans in order to avoid quarantine zones,” PrivateFly CEO Adam Twidell said.

France warned it would reciprocate, dealing a further blow to airlines’ hopes of an August recovery given they may have to cancel yet more flights.

Airline and travel shares tumbled. British Airways-owner IAG was down 6% and easyJet, which said it would operate its full schedule for the coming days, fell 7%.

TIGHTENING QUARANTINE

When Europe first went into lockdown in March, Britain was criticized for not restricting arrivals from abroad. But since June, it has introduced strict quarantine rules for arrivals from countries with infection rates above a certain level.

This contrasts with an easing of rules at home, where Prime Minister Boris Johnson has ordered the gradual reopening of the economy to resume, weeks after pausing it.

Transport minister Grant Shapps said the government needed to balance the need to open the economy and to contain the virus. The UK recorded 1,441 COVID-19 cases, the highest daily tally since June 14, official data showed on Friday.

Shapps told BBC Radio he sympathized with travelers but that they should not be entirely surprised, given the fluid situation around the pandemic.

“Where we see countries breach a certain level of cases … then we have no real choice but to act,” he told Sky News.

Airlines UK, an industry body representing BA, easyJet and Ryanair, called on Britain to implement more targeted quarantines on the regions with the highest infection rates and to bring in a testing regime.

An EU study showed that imported cases of COVID typically only account for a small share of infections when a pandemic is at its peak, but are more significant once a country has the disease under control.

(Writing by Sarah Young; Additional reporting by Kate Holton; David Milliken and Richard Lough; Editing by Nick Macfie, Hugh Lawson and Frances Kerry)

Putin proposes seven-way online summit to avoid ‘confrontation’ over Iran: Kremlin

MOSCOW (Reuters) – Russian President Vladimir Putin on Friday proposed holding a seven-way online summit of the five permanent members of the U.N. Security Council together with Germany and Iran, to outline steps aimed at avoiding a confrontation over the Iran arms embargo.

In a Kremlin statement, Putin said discussions were becoming increasingly tense over the Iranian issue at the Security Council, which began voting on Thursday on a U.S. proposal to extend an arms embargo on Iran, which is opposed by veto-wielding Russia and China.

“The situation is escalating. Unfounded accusations against Iran are being put forward,” said Putin, adding that Russia remained fully committed to the Iran nuclear deal.

The 13-year-old arms embargo is due to expire in October under a 2015 nuclear deal between Iran, Germany, Russia, China, Britain, France and the United States that prevents Tehran from developing nuclear weapons in return for sanctions relief.

Russia suggested an online video conference to avoid aggravating the situation at the U.N. Security Council.

Putin described the matter as urgent and urged the other nations to carefully consider Russia’s offer, saying the alternative was further escalation of tensions and a growing risk of conflict.

(Reporting by Gabrielle Tétrault-Farber; Writing by Alexander Marrow; Editing by Toby Chopra and Hugh Lawson)

Long-term complications of COVID-19 signals billions in healthcare costs ahead

By Caroline Humer, Nick Brown and Emilio Parodi

NEW YORK (Reuters) – Late in March, Laura Gross, 72, was recovering from gall bladder surgery in her Fort Lee, New Jersey, home when she became sick again.

Her throat, head and eyes hurt, her muscles and joints ached and she felt like she was in a fog. Her diagnosis was COVID-19. Four months later, these symptoms remain.

Gross sees a primary care doctor and specialists including a cardiologist, pulmonologist, endocrinologist, neurologist, and gastroenterologist.

“I’ve had a headache since April. I’ve never stopped running a low-grade temperature,” she said.

Studies of COVID-19 patients keep uncovering new complications associated with the disease.

With mounting evidence that some COVID-19 survivors face months, or possibly years, of debilitating complications, healthcare experts are beginning to study possible long-term costs.

Bruce Lee of the City University of New York (CUNY) Public School of Health estimated that if 20% of the U.S. population contracts the virus, the one-year post-hospitalization costs would be at least $50 billion, before factoring in longer-term care for lingering health problems. Without a vaccine, if 80% of the population became infected, that cost would balloon to $204 billion.

Some countries hit hard by the new coronavirus – including the United States, Britain and Italy – are considering whether these long-term effects can be considered a “post-COVID syndrome,” according to Reuters interviews with about a dozen doctors and health economists.

Some U.S. and Italian hospitals have created centers devoted to the care of these patients and are standardizing follow-up measures.

Britain’s Department of Health and the U.S. Centers for Disease Control and Prevention are each leading national studies of COVID-19’s long-term impacts. An international panel of doctors will suggest standards for mid- and long-term care of recovered patients to the World Health Organization (WHO) in August.

YEARS BEFORE THE COST IS KNOWN

More than 17 million people have been infected by the new coronavirus worldwide, about a quarter of them in the United States.

Healthcare experts say it will be years before the costs for those who have recovered can be fully calculated, not unlike the slow recognition of HIV, or the health impacts to first responders of the Sept. 11, 2001 attacks on the World Trade Center in New York.

They stem from COVID-19’s toll on multiple organs, including heart, lung and kidney damage that will likely require costly care, such as regular scans and ultrasounds, as well as neurological deficits that are not yet fully understood.

A JAMA Cardiology study found that in one group of COVID-19 patients in Germany aged 45 to 53, more than 75% suffered from heart inflammation, raising the possibility of future heart failure.

A Kidney International study found that over a third of COVID-19 patients in a New York medical system developed acute kidney injury, and nearly 15% required dialysis.

Dr. Marco Rizzi in Bergamo, Italy, an early epicenter of the pandemic, said the Giovanni XXIII Hospital has seen close to 600 COVID-19 patients for follow-up. About 30% have lung issues, 10% have neurological problems, 10% have heart issues and about 9% have lingering motor skill problems. He co-chairs the WHO panel that will recommend long-term follow-up for patients.

“On a global level, nobody knows how many will still need checks and treatment in three months, six months, a year,” Rizzi said, adding that even those with mild COVID-19 “may have consequences in the future.”

Milan’s San Raffaele Hospital has seen more than 1,000 COVID-19 patients for follow-up. While major cardiology problems there were few, about 30% to 40% of patients have neurological problems and at least half suffer from respiratory conditions, according to Dr. Moreno Tresoldi.

Some of these long-term effects have only recently emerged, too soon for health economists to study medical claims and make accurate estimates of costs.

In Britain and Italy, those costs would be borne by their respective governments, which have committed to funding COVID-19 treatments but have offered few details on how much may be needed.

In the United States, more than half of the population is covered by private health insurers, an industry that is just beginning to estimate the cost of COVID-19.

CUNY’s Lee estimated the average one-year cost of a U.S. COVID-19 patient after they have been discharged from the hospital at $4,000, largely due to the lingering issues from acute respiratory distress syndrome (ARDS), which affects some 40% of patients, and sepsis.

The estimate spans patients who had been hospitalized with moderate illness to the most severe cases, but does not include other potential complications, such as heart and kidney damage.

Even those who do not require hospitalization have average one-year costs after their initial illness of $1,000, Lee estimated.

‘HARD JUST TO GET UP’

Extra costs from lingering effects of COVID-19 could mean higher health insurance premiums in the United States. Some health plans have already raised 2021 premiums on comprehensive coverage by up to 8% due to COVID-19, according to the Kaiser Family Foundation.

Anne McKee, 61, a retired psychologist who lives in Knoxville, Tennessee and Atlanta, had multiple sclerosis and asthma when she became infected nearly five months ago. She is still struggling to catch her breath.

“On good days, I can do a couple loads of laundry, but the last several days, it’s been hard just to get up and get a drink from the kitchen,” she said.

She has spent more than $5,000 on appointments, tests and prescription drugs during that time. Her insurance has paid more than $15,000 including $240 for a telehealth appointment and $455 for a lung scan.

“Many of the issues that arise from having a severe contraction of a disease could be 3, 5, 20 years down the road,” said Dale Hall, Managing Director of Research with the Society of Actuaries.

To understand the costs, U.S. actuaries compare insurance records of coronavirus patients against people with a similar health profile but no COVID-19, and follow them for years.

The United Kingdom aims to track the health of 10,000 hospitalized COVID-19 patients over the first 12 months after being discharged and potentially as long as 25 years. Scientists running the study see the potential for defining a long-term COVID-19 syndrome, as they found with Ebola survivors in Africa.

“Many people, we believe will have scarring in the lungs and fatigue … and perhaps vascular damage to the brain, perhaps, psychological distress as well,” said Professor Calum Semple from the University of Liverpool.

Margaret O’Hara, 50, who works at a Birmingham hospital is one of many COVID-19 patients who will not be included in the study because she had mild symptoms and was not hospitalized. But recurring health issues, including extreme shortness of breath, has kept her out of work.

O’Hara worries patients like her are not going to be included in the country’s long-term cost planning.

“We’re going to need … expensive follow-up for quite a long time,” she said.

(Reporting by Caroline Humer and Nick Brown in New York; Emilio Parodi in Milan and Alistair Smout in London; editing by Michele Gershberg and Bill Berkrot)