Cumberland Advisors Market Commentary – The CDC Foundation

Dear readers. The CDC Foundation is not widely known. It’s a 501(c)3 that was created by Congress as a special charitable agency. The Foundation works right alongside the CDC and other national health agencies but is an independent charity. It has a special-purpose charter. Its purpose is to respond rapidly to threats like COVID-19 or Ebola or Zika and not have to wait for the political appropriations system.

Market Commentary - Cumberland Advisors - A Discussion with Judith Monroe, MD - President & CEO CDC Foundation

I’ve supported the CDC Foundation with philanthropy in the past and will do so again. I’ve had the honor of working on a conference with Dr. Judy Monroe, who is the Foundation’s president. She is an accomplished medical professional and is very busy these days, as you can imagine. We were fortunate enough to have Judy as a special guest at Camp Kotok a few years ago. At that time, Zika was a hot topic and she enlightened us to the work of the Foundation as the world confronted that virus.

As part of our efforts to share information about COVID19, we want to bring attention to the CDC Foundation and ask readers to please consider supporting it. The details are contained in the following short Q&A with Judy Monroe. She was kind enough to take a few minutes to answer the questions I posed. We hope readers find this worthwhile. Please stay safe. Please forward this to anyone who might be willing to help the CDC Foundation at this critical moment in time. -David Kotok

Q&A with Judy Monroe. David Kotok questions/comments are in bold prefaced by DK and Judy’s responses are prefaced by JM.

DK – Judy, can the CDC Foundation put additional funding to work immediately during the COVID-19 crisis?

JM – Absolutely, there are incredible needs emerging, both on the public health front and in communities. While government support is absolutely essential to address this outbreak, no government, no organization and no individual can combat coronavirus alone.

Each of us can play a crucial role in ending the COVID-19 pandemic by providing support that can be used by frontline responders to meet rapidly emerging needs where government support may not be immediately available.

There are many immediate needs where the CDC Foundation, which is an independent nonprofit organization, and its donors can have true impact. Some of these include flexible support for:

– creating education and awareness campaigns to advance prevention and reduce stigma;
– deploying emergency staff with the skills required to meet needs at the state and local level;
– meeting essential needs, such as food and medical requirements, for quarantined and individuals in isolation;
– building capacity and infrastructure for global response efforts;
– And much more.

Right now, you can help by giving to the CDC Foundation through our crowdfunding campaign titled All of Us at give4cdcf.org. Or, to discuss giving opportunities, including an in-kind donation or forming a crowdfunding team through this campaign, contact Advancement at the CDC Foundation: by email at advancement@cdcfoundation.org or 404-523-1873.

DK – Judy, you’ve been through a number of these crises in the past. I recall our conversations about Ebola and Zika. How does this compare to them?

JM – While outbreaks have similar characteristics, each is very different. A primary difference with this outbreak is the nearly global-wide spread of this novel coronavirus in a short amount of time. The COVID-19 outbreak—which is now a pandemic—reminds us that a health threat anywhere is a health threat everywhere.

Comparing COVID-19 and Zika, the two most recent epidemics, shows these differences. You may recall that a key concern during the Zika epidemic, which was spread both through mosquitoes as well as person to person, was pregnant women who developed Zika during pregnancy. This infection could lead to birth defects in their unborn children. With COVID-19, many people have only mild symptoms. But based on the information we have, some people are at higher risk of getting very sick from this illness including older adults as well as people who have serious chronic medical conditions like heart disease, diabetes, and lung disease.

DK – We’ve talked together about prevention and personal responsibility and what a person can do. Is there any counsel you can offer?

JM – Yes. At this time, there is no vaccine to prevent COVID-19. The best way to prevent illness is to avoid being exposed to this virus, which is thought to spread mainly from person-to-person and to people in close contact with one another. Some basic tips include cleaning your hands often, avoiding close contact with others, protecting others by staying home if you are sick, covering your coughs and sneezes, wearing a facemask if you are sick, and cleaning and disinfecting surfaces. Also, follow the guidance from public health authorities, as guidance will continue to evolve as the pandemic evolves.

DK – Thank you, Judy, for a few moments during this hectic time and please be safe. When this is over, let’s go fishing again.

Dear readers. Please help the CDC Foundation. I encourage everyone to learn much more about COVID-19 and how to protect yourself by going to CDC’s website.

David R. Kotok
Chairman of the Board & Chief Investment Officer
Email | Bio


Dr. Judy Monroe was a virtual guest of the Global Interdependence Center on May 7, 2020

View the interview at GIC’s website here: https://www.interdependence.org/events/browse/preparing-responding-and-preparing-again/


Judith Monroe from CDC Foundation & David Kotok
explore Zika & other initiatives of the CDC, August 2018

CDC Foundation Dr Judy Monroe & David Kotok

Here’s my first interview with Judy Monroe when she was a guest in Maine. -David

Link: https://youtu.be/rge2tC74kSc


Links to other websites or electronic media controlled or offered by Third-Parties (non-affiliates of Cumberland Advisors) are provided only as a reference and courtesy to our users. Cumberland Advisors has no control over such websites, does not recommend or endorse any opinions, ideas, products, information, or content of such sites, and makes no warranties as to the accuracy, completeness, reliability or suitability of their content. Cumberland Advisors hereby disclaims liability for any information, materials, products or services posted or offered at any of the Third-Party websites. The Third-Party may have a privacy and/or security policy different from that of Cumberland Advisors. Therefore, please refer to the specific privacy and security policies of the Third-Party when accessing their websites.

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Judith Monroe, MD of CDC Foundation, to speak during the “Health, Hunger, and Philanthropy” Panel

USF Sarasota-Manatee, Cumberland Advisors, and the Global Interdependence Center invite you to our third annual Financial Literacy Day, to be held April 11, 2019, from 8:30 AM to 4 PM in the Selby Auditorium of the USFSM campus.

FINANCIAL MARKETS & THE ECONOMY Financial Literacy Day III Judith Monroe, MD - President & CEO CDC Foundation

The theme this year is “Financial Markets and the Economy,” and the event will feature a number of panel discussions and special presentations, including the Session II panel, “Health, Hunger, and Philanthropy” bringing together Judith Monroe MD, President and CEO, CDC Foundation, Erin McLeod, CEO, Friendship Centers, Sarasota, Lisa Marsh Ryerson, President, AARP Foundation, and Gabriel Hament of Cumberland Advisors. The moderator will be Lisa Shaw, CFP, CIMA, managing partner, Cygnus Asset Management, LLC.

The CDC Foundation Judith Monroe leads has a mission to help the Centers for Disease Control and Prevention (CDC) do more, faster by forging effective partnerships between CDC and philanthropic and private sector organizations and individuals to build public health programs that make our world healthier and safer. The Foundation has over 300 active programs across the U.S. and 85 countries.

Prior to joining the CDC Foundation, Monroe worked for six years as a CDC deputy director and served as director of the Office for State, Tribal, Local and Territorial Support (OSTLTS). At CDC, Monroe oversaw key activities and technical assistance supporting the nation’s health departments and the public health system.

Feel free to ask questions of our panelists and connect with Dr. Monroe during “Financial Markets and the Economy.” Watch this video from the summer of 2018 where she talks with David Kotok about The CDC Foundation and the Zika virus.

Financial Literacy Day welcomes the participation of the general public. The cost is only $50 to register, and coffee, pastries, and lunch are included. Please reserve your spot soon – we expect to have a full auditorium. You can make your reservation online and learn more at http://USFSM.edu/FinancialLiteracy.




Venezuela Poses Health Risk in the Americas

The economic and political dimensions of Venezuela’s collapse have dominated headlines, but the country is also being undermined by a healthcare crisis that could spread to all of Latin America. The situation in Venezuela demonstrates how failed government and economic collapse can lead to the unchecked spread of infectious disease, creating headaches across a region and beyond.

Bandera_de_Venezuela_en_el_Waraira_Repano by Jonathan Alvarez C

In a report published in the journal Lancet Infectious Diseases, lead author Dr. Martin Llewellyn of the University of Glasgow and colleagues size up the problem:

“The re-emergence of diseases such as malaria in Venezuela has set in place an epidemic of unprecedented proportions, not only in the country but across the whole region….

“Based on the data we have collected we would urge national, regional and global authorities to take immediate action to address these worsening epidemics and prevent their expansion beyond Venezuelan borders….

“These diseases have already extended into neighboring Brazil and Colombia, and with increasing air travel and human migration, most of the Latin American and Caribbean region (as well as some US cities hosting the Venezuelan diaspora, including Miami and Houston) is at heightened risk for disease re-emergence.”

Malaria is the leading disease threat, but cases of Chagas disease and dengue fever have also risen drastically in Venezuela and the surrounding region in recent years. There is also the potential for epidemics of Chikungunya and Zika, the report’s authors say. In 2014 there were an estimated 2 million suspected cases of chikungunya in Venezuela, more than 12 times the official estimate.

Chagas disease is a leading cause of heart failure in regions where it occurs, and malaria and dengue can lead to death if left untreated. Zika can cause health complications such as nerve damage and spinal cord inflammation. During pregnancy, it can cause congenital abnormalities in the developing fetus. The most recent study estimated that there now over 2,000 cases of Zika virus per 100,000 people in Venezuela (2% of the population). (Source: “Life-threatening, insect-borne diseases spike in Venezuela, report says,” ABC News, Feb. 21, 2019,” https://www.nbcnews.com/news/latino/life-threatening-insect-borne-diseases-spike-venezuela-report-says-n974216)

(For the recommendations of the Centers for Disease Control and Prevention (CDC) on travel to Venezuela, see “Health Infrastructure Breakdown in Venezuela, https://wwwnc.cdc.gov/travel/notices/warning/health-infrastructure-breakdown-venezuela.)

The Llewellyn report also conveys a sense of the desperate lengths to which the failed Maduro government will go to stifle efforts to right the situation in the country:

“Venezuelan clinicians involved in this study have also been threatened with jail, while laboratories have been robbed by militias, hard drives removed from computers, microscopes and other medical equipment smashed.”

Venezuela used to be one of the wealthiest nations in Latin America and was a leader in the public-health arena – so much so that in 1961 the World Health Organization certified it as the first country to eradicate malaria.

However, from 2010 to 2015, cases of malaria rose by 359%, from 29,736 to 136,402. By the close of 2017 they had grown to 411,586, as mosquito control efforts went by the wayside, a shortage of antimalarial drugs became chronic, and there was a mass exodus of healthcare workers from the country. (Source: “Venezuela crisis threatens disease epidemic across continent – experts,” The Guardian, Feb. 21, 2019, https://www.theguardian.com/global-development/2019/feb/21/venezuela-crisis-threatens-disease-epidemic-across-continent-experts)

The malaria outbreak is a sobering example of how political and economic dislocation can trigger a public-health crisis. As the Venezuelan economy collapsed, people flocked to the region near the southern border with Brazil, in order to dig for gold in wildcat mines. Unfortunately, pockets of malaria had survived in the jungle there, despite its official elimination nationwide.

The mining camps, with their pits of stagnant water, were an ideal breeding ground for mosquitos, and malaria soon ran rampant at many of the mines. And because work in the mines was transitory, workers returned home with malaria, and wide areas of the country were reinfected with malaria.

If you’d like to read my personal accounts investigating the spread and threat of the Zika virus which includes visits to Cuba and Argentina’s three-country border region of Argentina, Brazil, and Paraguay, please download the the free monograph pamphlet, “Zika,” here: https://www.cumber.com/zika/

The Llewellyn report concludes with this call to action:

“We call on the members of the Organisation of American States and other international political bodies to apply more pressure to the Venezuelan government to accept the humanitarian assistance offered by the international community in order to strengthen the buckling health system. Without such efforts, the public health gains achieved over the past 18 years could soon be reversed.”

We still don’t know whether the Maduro government, with its military and bureaucratic backing, will continue to cling to power and take the country deeper into chaos, or whether Juan Guaidó, leader of the democratically elected National Assembly and “interim president,” will prevail. For a good backgrounder on the crisis in Venezuela and the options available to the international community to address it, read or view the testimony of Marcela Escobari, senior fellow of the Brookings Institute Center for Universal Education, before the US House of Representatives Committee on Foreign Affairs on Feb. 26, 2018, available here: https://www.brookings.edu/testimonies/made-by-maduro-the-humanitarian-crisis-in-venezuela-and-us-policy-responses/.

David R. Kotok
Chairman and Chief Investment Officer
Email | Bio


Links to other websites or electronic media controlled or offered by Third-Parties (non-affiliates of Cumberland Advisors) are provided only as a reference and courtesy to our users. Cumberland Advisors has no control over such websites, does not recommend or endorse any opinions, ideas, products, information, or content of such sites, and makes no warranties as to the accuracy, completeness, reliability or suitability of their content. Cumberland Advisors hereby disclaims liability for any information, materials, products or services posted or offered at any of the Third-Party websites. The Third-Party may have a privacy and/or security policy different from that of Cumberland Advisors. Therefore, please refer to the specific privacy and security policies of the Third-Party when accessing their websites.

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Cumberland Advisors Market Commentaries offer insights and analysis on upcoming, important economic issues that potentially impact global financial markets. Our team shares their thinking on global economic developments, market news and other factors that often influence investment opportunities and strategies.




Zika, Climate Change & January 25

On December 30, as 2018 drew to an end, NBC’s Meet the Press aired an entire program on the climate change crisis, well worth watching (https://www.nbc.com/meet-the-press/video/meet-the-press-1230/3850857). Host Chuck Todd gave no air time to climate change denialism. Instead, the episode plunged into analyzing the crisis at hand, what might be done, what impediments slow our time-critical response, and how to overcome those impediments. Florida Republican Representative Carlos Curbelo, among other program guests, called for constructive action. “We need to stop covering the debate and start covering the story, so that people see that this is real, and so that politicians take a more-pragmatic approach and find solutions that are actually achievable,” Curbelo said. The day after Thanksgiving, despite Mr. Trump’s personal dismissal of climate change, the Trump administration released Volume II of the Fourth National Climate Assessment (https://www.globalchange.gov/nca4), and we’ve been digesting its deeply concerning contents in the week since.

The impacts of climate change are myriad, affecting our world, our communities, our health, our food supply, and our investments. We will be taking a look at a number of climate-change-related issues impacting Florida and beyond, from sea level rise to red tide to hurricanes to fruitful adaptive strategies and the economic opportunities they present, when we convene on Friday, January 25, at the University of South Florida Sarasota-Manatee for our one-day event, “Adapting to a Changing Climate: Challenges & Opportunities.” See the full roster of speakers, including our own Patricia Healy, here: http://sar.usfsm.edu/event/adapting-to-a-changing-climate/. We hope to see you there.

In today’s commentary, however, I would like to zero in on the impact of climate change on vector-borne diseases, including Zika. Chapter 14 of the Fourth National Climate Assessment (https://www.globalchange.gov/nca4) addresses the adverse effects of climate change on human health, noting that “Climate change affects human health by altering exposures to heat waves, floods, droughts, and other extreme events; vector-, food- and waterborne infectious diseases; changes in the quality and safety of air, food, and water; and stresses to mental health and well-being” (p. 545 in the full report PDF). We have no trouble grasping the threats posed by heat waves, fires, floods, and storms that claim lives as well as property, along with droughts that parch crops and threaten water supplies, but we should not miss the implications of climate change for increased vector-borne disease risks. As the report points out, “Climate change is expected to alter the geographic range, seasonal distribution, and abundance of disease vectors, exposing more people in North America to ticks that carry Lyme disease or other bacterial and viral agents, and to mosquitoes that transmit West Nile, chikungunya, dengue, and Zika viruses” (p. 545).

The range of the Aedes aegypti mosquito, for example, a primary vector for dengue, chikungunya, Zika, and yellow fever, is expected to expand considerably worldwide, exposing far larger populations, particularly in Australia, Europe, and North America, to those viruses. According to one recent study, well before the end of the 21st century, 68%–80% of human populations may share their environments with Aedes aegypti and thus be vulnerable to the diseases that mosquito can carry, with the percentages depending on the climate change scenario that actually unfolds, (https://link.springer.com/article/10.1007%2Fs10584-016-1679-0). In general, lower greenhouse gas emissions translate to less risk for human health.

Risk of mosquito-borne diseases in general is to be understood not just in terms of the range of a particular mosquito species but also in terms of mosquito “disease danger days.” As an August 2018 report published at Climate Central points out, “there’s an elevated risk of disease transmission [assuming disease is present] when temperatures are between 61 degrees and 93 degrees Fahrenheit.” The report notes the circumstances required for disease transmission: “In addition to needing the proper climatological factors for the mosquito to survive and transmit disease, there needs to be the establishment of the disease in the first place — having the proper climatic conditions, a critical density of mosquitoes, and the conditions for the sustained cycle of disease transmission itself. And, in order to transmit disease, a mosquito must bite twice — once to acquire the disease [itself], and a second time to pass it on. The largest number of these twice-biting mosquitoes were produced at 75 degrees Fahrenheit.” (http://www.climatecentral.org/news/us-faces-a-rise-in-mosquito-disease-danger-days-21903)

Climate Central analyzed weather data for 244 US cities to determine the number of disease danger days each city faces now as the climate warms. They found that 94%, or 229, of the cities they studied are already seeing an increase in the number of days when average temperatures fall within the optimal range for mosquito-borne disease transmission. Some areas, however, may become too hot for the mosquitoes themselves. Phoenix, for example, actually has fewer disease transmission danger days than it did previously because of the number of extremely hot days the city must contend with. All in all, only 12 cities are experiencing a decrease in disease danger days. As the climate warms, the report concludes, Americans face heightened risks for dengue, Zika, chikungunya, and West Nile (http://www.climatecentral.org/news/us-faces-a-rise-in-mosquito-disease-danger-days-21903).

The 2015–2016 Zika outbreak drove home the hazards of mosquito-borne diseases, as Zika took a terrible toll on the development of one in seven unborn children whose mothers were exposed to the otherwise generally mild virus (https://www.contagionlive.com/publications/contagion/2018/october/zika-where-are-we-now). Babies were born with microcephaly and/or other birth defects such as vision problems, deafness, and epilepsy. Their lives and their family’s lives were forever changed from what might have been.

In 2018, Zika has not made many headlines in the US, and the case count is down. As of December 4, 2018, the provisional case count for US States is 58 for the year, all travelers returning from affected areas. US territories have reported 116 Zika cases, with the virus presumably transmitted through local populations of infected mosquitoes (https://www.cdc.gov/zika/reporting/2018-case-counts.html). Case counts aside, the virus remains a threat – nothing has changed about its intrinsic potential to wreak havoc. It is still active throughout the South and Southeast Asia region, and some districts in India saw worrisome outbreaks in 2018 (https://www.hindustantimes.com/health/healthwise-new-outbreaks-need-better-disease-surveillance/story-2bSekn9rGCIbWADtk9p2TK.html).

While some experts hypothesize that “herd immunity” has been achieved in areas hardest hit in 2016, Carmen Zorilla, professor of obstetrics and gynecology at the University of Puerto Rico School of Medicine in San Juan, disagrees. She estimates that about 10.5% of pregnant women in Puerto Rico tested positive for Zika during the outbreak – an infection rate not nearly high enough to confer herd immunity. She observes that such viral outbreaks tend to happen in 3–5-year cycles. (https://www.contagionlive.com/publications/contagion/2018/october/zika-where-are-we-now).

Problematically, some 60–80% of Zika cases are asymptomatic, so Zika can readily go undetected and gain a foothold before it is identified in a particular area. Fewer than half of those infected actually seek medical care (https://www.contagionlive.com/publications/contagion/2018/october/zika-where-are-we-now). Most of the time, symptoms, when people do have them, are relatively mild and somewhat flu-like: fever, rash, headache, achy joints and muscles, and conjunctivitis, though in rare instances a Zika infection can lead to Guillain-Barré syndrome. Currently, the CDC recommends Zika testing for pregnant women with possible Zika exposure and for those who experience Zika symptoms after traveling to areas where they might have been exposed to the virus (https://www.cdc.gov/zika/hc-providers/testing-guidance.html).

Is there room in that surveillance net for a Zika outbreak to fire up before it is detected? Definitely so. In 2016, a research team led by Northeastern University professor Alessandro Vespignani and overseen by the Center for Inference and Dynamics of Infectious Diseases, projected the discrepancy between the number of reported Zika cases and the likely number of actual cases. The team’s models projected that the actual number of infections in July 2016 was likely 25 times the number of confirmed cases (https://www.sciencedaily.com/releases/2016/08/160802133703.htm).

Dr. Vespignani notes that major outbreaks are associated not only with the right air temperature but also with areas of standing water. In many instances, people educated to understand the risks can manage those, emptying the birdbath or flower pot saucers and the like at least once a week; but after major precipitation events magnified by climate change, when there is standing water everywhere, mosquito populations can spike. The sopping US Southeast, where rainfall records were handily broken in 2018, can testify that there is sometimes “water, water everywhere,” to borrow a phrase from Samuel Taylor Coleridge (https://www.accuweather.com/en/weather-news/2018-leaves-its-mark-in-the-rainfall-record-books-across-eastern-southern-us/70007024).

Furthermore, densely populated areas face elevated risk. Juanita Constible, a climate expert at the Natural Resources Defense Council, explains that, for mosquitoes, “extension of habitat is a combination of climate change and human behavior. Urbanization can expand habitats for some species of mosquito that prefer cities [Aedes egypti among them], so as people expand into natural areas, those species will go with them. Not only do urban settings have plenty of habitat and food, but in cities, mosquitoes lack natural predators.” (https://www.citylab.com/environment/2018/10/hurricane-florence-mosquitoes-north-carolina/571912/)

Kate Fowlie, spokesperson for the US CDC, warns, “Mosquito-borne disease outbreaks are difficult to predict. There will be future outbreaks, including large ones, as well as years with reduced transmission, but it is impossible to know when or where these transmission patterns will occur” (https://www.contagionlive.com/publications/contagion/2018/october/zika-where-are-we-now).

It seems obvious that surveillance is key to preventing outbreaks both in the present and in a warming future, but the CDC’s funding for expanded infectious disease surveillance is due to run out in 2019. The CDC is already planning to scale back its participation in the Global Health Security Agenda (GHSA), an early-warning system for infectious disease outbreaks, in 39 of 49 countries (http://www.ghtcoalition.org/blog/global-health-and-medical-research-saved-from-the-chopping-block-in-2018-spending-bill).

While the US will be assisting with infectious disease surveillance in 10 countries, the map of Zika-affected areas around the globe, courtesy of the CDC, is expansive (https://wwwnc.cdc.gov/travel/files/zika-areas-of-risk.pdf).

There is a lot of purple on this map, but these are not all the places Zika can go; they are merely places where infection is already a risk. Infected travelers can fly all over the world, and disease-bearing mosquitoes know no borders other than inhospitable habitats. Climate change, as we have seen, will widen the range of vector-borne diseases, sharply increasing the percentage of the global population at risk. Viruses themselves, of course, are moving targets, as they mutate regularly – Zika posed no known risk to the unborn until this century, when a mutation changed what had been a mild pathogen (https://www.washingtonpost.com/news/speaking-of-science/wp/2017/09/28/zika-was-a-mild-bug-a-new-discovery-shows-how-it-turned-monstrous/?utm_term=.af60fd526a41). Scientists also warn us that we may soon be contending with disease-causing bacteria and viruses that have lain dormant for centuries or even millennia, frozen in permafrost that is now melting as the Arctic warms (www.bbc.com/earth/story/20170504-there-are-diseases-hidden-in-ice-and-they-are-waking-up).

As we look ahead, addressing climate change will clearly entail grappling with expanded threats to human health, and one of those threats will be elevated vector-borne disease risks, perhaps coupled with diseases modern medicine has yet to encounter. Climate change mitigation and adaptation, combined with vigilant surveillance, vaccine development, and mosquito population control strategies will all be keys to managing vector-borne disease risks posed by certain species of mosquitoes and ticks.

This commentary has been a deepish dive into just one of the secondary challenges climate change will pose to nations, states, cities, municipalities, and the well-being of Americans. In the instance of Zika, we know that the lifetime cost of caring for one child whose life is profoundly impacted by prenatal exposure to the Zika virus, beyond heartbreak, is likely to reach one to ten million dollars (https://wwwnc.cdc.gov/eid/article/23/1/16-1322_article). Human health is just one area in which proactively addressing climate change and adaptation makes both imminent sense and dollars and cents. Again, if you are in the Sarasota area on January 25, we hope you will join us at the University of South Florida Sarasota-Manatee for “Adapting to a Changing Climate: Challenges & Opportunities.” Find more information about this one-day event and register here: http://sar.usfsm.edu/event/adapting-to-a-changing-climate/.




CDC Foundation President Dr. Judy Monroe

“Is there a vaccine now for Zika?” I asked Dr. Judy Monroe, president-CEO of the CDC Foundation. “Not yet, but we’re working on it,” she answered. For a YouTube of my interview with Judy when she visited Camp Kotok, see https://youtu.be/rge2tC74kSc.

CDC Foundation Dr Judy Monroe & David Kotok

Judy was a special guest this year when we gathered in Maine. She told the assembled 50 folks about the CDC Foundation, a congressionally authorized 501c3 that operates in close cooperation with the Centers for Disease Control. The foundation’s efforts are entirely supported by philanthropy, while the CDC is, of course, a federal organization funded by taxpayers.

Judy explained that the foundation has a well-defined global healthcare role and can be reactive in crisis. The foundation has programs in 130 countries. The Ebola effort was an example of rapid foundation response. Early this month, the foundation was honored by the Puerto Rico Department of Health for emergency response support in the wake of Hurricane Maria.

We discussed Zika and the Caribbean and specifically Puerto Rico. Our group at Camp Kotok probably has over a billion dollars invested in PR debt, property, hotels, etc. Judy shared her findings and the foundation’s and CDC’s ongoing efforts for Zika prevention, treatment, and research.

Judy’s presentation was enlightening, as many in our group did not know about this philanthropic ally of the CDC. Now they better appreciate how many lives are saved globally and how 300 million Americans gain health safety through the work of the CDC and CDC Foundation. We thank Judy for making the trip to Maine to share her information with us.

Another attendee at Camp Kotok, Katie Darden, also spoke one-on-one with Dr. Monroe and you can find the link to her interview here:


Katie Darden interviews Dr Judy Monroe

For CDC Foundation Zika updates and current status, see their blog which gives a closer look at how the CDC Foundation brings together resources, people and ideas to advance the CDC’s work, https://www.cdcfoundation.org/blog

For Dr. Judy Monroe’s bio, see https://buff.ly/2Mn0AZR

For our previous commentaries on Zika, see the following links:
“Zika Update” July 13, 2018 (http://www.cumber.com/zika-update-july-13-2018/)
“Zika Update: Brace for a Resurgence,” Nov 1, 2017 (http://www.cumber.com/zika-update-brace-for-resurgence/)
“Zika Update,” July 1, 2017 (http://www.cumber.com/zika-update-3/)
“Zika Update,” March 8, 2017 (http://www.cumber.com/zika-update-2/)
“Cuba & Zika,” October 16, 2016 (http://www.cumber.com/cuba-zika)
“Zika, Cuba, and American Politics,” October 4, 2016 (http://www.cumber.com/zika-cuba-american-politics/)
“Answering a FAQ on Zika Vote,” September 7, 2016 (http://www.cumber.com/answering-a-faq-on-zika-vote/)
“Zika, Congress, and Damaged Lives,” September 7, 2016 (http://www.cumber.com/zika-congress-and-damaged-lives/)
“Zika 4,” September 6, 2016 (http://www.cumber.com/zika-4/)
“More of the Costs of Political Failure on Zika,” Aug 12, 2016 (http://www.cumber.com/more-on-the-costs-of-political-failure-on-zika/)
“Zika Politics: Democrats & Republicans,” August 2, 2016 (http://www.cumber.com/zika-politics-democrats-republicans/)
“Zika Update,” July 19, 2016 (http://www.cumber.com/zika-update/)
“The Zika Virus and the US Congress,” May 23, 2016 (http://www.cumber.com/the-zika-virus-and-the-us-congress/)

David R. Kotok
Chairman & Chief Investment Officer
Email | Bio


Links to other websites or electronic media controlled or offered by Third-Parties (non-affiliates of Cumberland Advisors) are provided only as a reference and courtesy to our users. Cumberland Advisors has no control over such websites, does not recommend or endorse any opinions, ideas, products, information, or content of such sites, and makes no warranties as to the accuracy, completeness, reliability or suitability of their content. Cumberland Advisors hereby disclaims liability for any information, materials, products or services posted or offered at any of the Third-Party websites. The Third-Party may have a privacy and/or security policy different from that of Cumberland Advisors. Therefore, please refer to the specific privacy and security policies of the Third-Party when accessing their websites.

Sign up for our FREE Cumberland Market Commentaries

Cumberland Advisors Market Commentaries offer insights and analysis on upcoming, important economic issues that potentially impact global financial markets. Our team shares their thinking on global economic developments, market news and other factors that often influence investment opportunities and strategies.




Zika Update

With the summer mosquito season underway, Zika wings its way back into the news.

Cumberland Advisors Market Commentary - Zika

For the children of Zika and their parents, Zika’s impact will never abate. Journalist Mauricio Savarese reports for the AP from Brazil: “Today, some of the children born during the outbreak are trying school for the first time — in very limited capacities — while others have died or are struggling to survive, hindered by health and developmental problems.” He details some of their stories. Joaquim, who has microcephaly, can scribble with a pencil but cannot speak. He is fed through a tube, and his mother has to attend school with him to meet his nursing needs. In Brazil and elsewhere, including here in the US, schools face a steep learning curve as they begin to serve the special needs children whose lives have been forever altered by Zika. (http://www.santafenewmexican.com/news/some-of-brazil-s-zika-kids-try-school/article_14efc3b3-4afe-5fc4-b9e8-b3e2ca00de2c.html)

New research on nonhuman primates indicates that fully 26% of monkeys exposed to Zika early in their pregnancies miscarried. The findings suggest that human pregnancy losses resulting from Zika may in fact be higher than the data suggests. After all, Zika infections in adults may produce only mild symptoms or no symptoms at all and go undetected. (https://www.nih.gov/news-events/news-releases/pregnancy-loss-occurs-26-percent-zika-infected-monkeys)

But there is good news, too, on the Zika front. The number of Zika cases has fallen off dramatically in the past year. In areas hardest hit by Zika early on, the drop-off in cases seems to indicate that affected populations are developing “herd immunity.” A recent piece from PBS News Hour summarizes the numbers:

“Last summer, the virus declined sharply in its hotspots and all but disappeared in the U.S. In 2016, Puerto Rico, the U.S. Virgin Islands and American Samoa saw more than 36,000 cases of locally transmitted Zika virus. By 2017, the number had dropped to 665. In 2017, the continental U.S. saw only seven cases of local mosquito-borne Zika, down from 224 the previous year” (https://www.pbs.org/newshour/science/what-happened-to-zika).

The CDC’s pregnancy outcomes page reports totals that have grown more slowly in the past year, though there is always a lag time before updated numbers appear. Totals listed below are for December 1, 2015, to March 31, 2018.

(https://www.cdc.gov/pregnancy/zika/data/pregnancy-outcomes.html)

At this point, there are no reports of local Zika transmission in the continental US, though surveillance will continue to be key because travel-related cases crop up now and then – most recently, in Williamson County, Texas (https://www.kvue.com/article/news/local/two-zika-cases-confirmed-in-williamson-county-how-to-avoid-the-virus/269-571672784). Any travel-related case can, of course, lead to local transmission if a local mosquito bites the infected traveler and then bites someone else. The CDC maintains its Zika Risk Map for Travelers (https://wwwnc.cdc.gov/travel/page/zika-information), detailing precautions that help reduce the chance of infection.

In the meantime, researchers have gotten a clearer, closer look at the virus itself, indeed the best image we have of any virus. Zika’s structure is intriguing (and rather beautiful), but getting a mugshot of the virus has practical utility. Michael Rossmann, a structural biologist at Purdue University, explains, “With the higher resolution, it is now possible to efficiently design vaccines and engineer anti-viral compounds that inhibit the virus.” (https://cosmosmagazine.com/biology/zooming-in-on-zika). That’s good news indeed.

Work on a Zika vaccine continues, of course (http://www.wfmz.com/health/health-beat/health-beat-vaccine-for-zika-virus/750067921), and other control measures are being explored. A new study finds that flea and tick meds some of us use on our pets (think NexGard and Bravecto) might protect populations from outbreaks of a number of mosquito-borne diseases, including Zika (https://www.sciencedaily.com/releases/2018/07/180702154731.htm). The effects that those drugs have had on some small percentage of pets, however, may raise safety concerns about their use on human beings.

More promising, perhaps, than dosing humans with flea meds is fighting nature with nature. In Australia, scientists have successfully deployed a bacteria called Wolbachia to dramatically reduce Aedes aegypti mosquito populations. CSIRO research director Paul De Barro explains, “What we were doing is releasing only males that had this wolbachia, and they would cross with mosquitoes in the field, the wild mosquitoes that didn’t have that same strain of wolbachia; and as a result the wild females would only lay sterile eggs, and so the population would crash.” Mosquito populations were reduced by 80% during the course of the experiment, sharply reducing risks of chikungunya, yellow fever, and, of course, Zika, all diseases carried by the Aedes aegypti mosquito. (http://www.abc.net.au/news/2018-07-10/zika-and-dengue-spreading-mosquito-largely-wiped-out-in-trial/9962294)

The good news about falling case counts aside, Zika still poses a threat and remains a concern as mosquito season enters full swing. Nothing about the virus has changed to make an outbreak less potentially disastrous for infants whose mothers are infected early in their pregnancies. Nothing has changed to reduce the financial and personal costs of dealing with Zika-related disabilities for a lifetime.
Vigilance is still the order of the day. Surveillance is still critical. Remarkably, smartphones may be deployed to get the job done (https://mhealthintelligence.com/news/mhealth-researchers-eye-the-smartphone-as-a-zika-detection-device).

Screening blood donations has turned out to be extraordinarily expensive, some $5.3 million per instance of Zika-infected blood found (https://www.statnews.com/2018/05/09/zika-testing-blood-donors/), so the FDA’s screening policy has recently changed so that pooled donations are tested rather than each individual donation. Given the small number of infected samples found, the idea is to continue ensuring that Zika will not be passed on in blood transfusions, while easing the testing burden and associated costs. (https://www.fda.gov/NewsEvents/Newsroom/FDAInBrief/ucm612702.htm)

Despite the good news about case counts and other progress, lifetime costs for Zika-impacted children and their education still loom. Zika has reinforced invaluable lessons about the crucial importance of both global and local disease surveillance and reporting. And it has made its own rock solid case for timely and adequate funding for effective prevention and research, particularly when the costs, in both human and monetary terms, of inaction are so high. Where infectious disease outbreaks are concerned, we can celebrate incremental victories and larger ones, but we can never let our guard down or be slow to detect and respond.

Our previous Zika updates are linked below:
“Zika Update: Brace for a Resurgence,” November 1, 2017 (http://www.cumber.com/zika-update-brace-for-resurgence/)
“Zika Update,” July 1, 2017 (http://www.cumber.com/zika-update-3/)
“Zika Update,” March 8, 2017 (http://www.cumber.com/zika-update-2/)
“Cuba & Zika,” October 16, 2016 (http://www.cumber.com/cuba-zika)
“Zika, Cuba, and American Politics,” October 4, 2016 (http://www.cumber.com/zika-cuba-american-politics/)
“Answering a FAQ on Zika Vote,” September 7, 2016 (http://www.cumber.com/answering-a-faq-on-zika-vote/)
“Zika, Congress, and Damaged Lives,” September 7, 2016
(http://www.cumber.com/zika-congress-and-damaged-lives/)
“Zika 4,” September 6, 2016 (http://www.cumber.com/zika-4/)
“More of the Costs of Political Failure on Zika,” August 12, 2016 (http://www.cumber.com/more-on-the-costs-of-political-failure-on-zika/)
“Zika Politics: Democrats & Republicans,” August 2, 2016 (http://www.cumber.com/zika-politics-democrats-republicans/)
“Zika Update,” July 19, 2016 (http://www.cumber.com/zika-update/)
“The Zika Virus and the US Congress,” May 23, 2016 (http://www.cumber.com/the-zika-virus-and-the-us-congress/)

David R. Kotok
Chairman & Chief Investment Officer
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