Thursday, September 08, 2022

Study claiming that ivermectin reduces COVID-19 mortality by 92% has important methodological problems

CLAIM
“Ivermectin reduces COVID death risk by 92%, peer-reviewed study finds”; NIH now lists ivermectin as COVID-19 therapy
VERDICT 
DETAILS
Misleading: The study by Kerr et al. contains several critical flaws. Notably, it analyzed data in such a way that led people who developed COVID-19 to be excluded from the group of regular ivermectin users, regardless of their actual ivermectin use. Therefore, COVID-19 patients are underrepresented in the group of regular ivermectin users, making this group appear to have a lower risk of COVID-19 death compared to irregular users or non-users.
Factually inaccurate: The U.S. National Institutes of Health (NIH) didn’t add ivermectin to the list of approved COVID-19 treatments recently. The NIH continues to recommend against treating COVID-19 with ivermectin, except in a clinical trial.
KEY TAKE AWAY
The antiparasitic drug ivermectin has been subjected to many studies attempting to determine if it is effective at preventing or treating COVID-19. Large, randomized controlled trials so far haven’t detected benefits from ivermectin treatment in COVID-19 patients.

FULL CLAIM: “Ivermectin reduces COVID death risk by 92%, peer-reviewed study finds”; NIH now lists ivermectin as COVID-19 therapy

REVIEW


In early September 2022, many social media posts and articles circulated claiming that a study showed ivermectin reduced COVID-19 mortality by 92%. One example is this article by The Blaze, which received more than 20,000 engagements on social media, including more than 11,000 shares on Facebook, according to social media analytics tool CrowdTangle. The claim is based on a study by Kerr et al., published in the journal Cureus[1].

This claim sometimes went hand in hand with another claim that the U.S. National Institutes of Health (NIH) now considers ivermectin to be a COVID-19 therapy, as seen in this Facebook post by music video director Robby Starbuck and this tweet by mixed martial artist Jake Shields. Starbuck’s post referenced the NIH COVID-19 Treatment Guidelines webpage, which lists the drugs currently being evaluated for their effectiveness against COVID-19.

But as we will explain below, the first claim is unsubstantiated and misleading, while the second is inaccurate.

Study by Kerr et al. used methods that produced bias and led to significant limitations in the reliability of its conclusions

In the study, the authors evaluated whether regular ivermectin use influenced the risk of COVID-19 mortality, using data from a clinical database for a COVID-19 prevention program in the Brazilian city of Itajaí. The program ran from July to December 2020. The authors compared COVID-19 mortality between regular ivermectin users and people who used ivermectin irregularly or not at all. Based on their analysis, they concluded that the “[m]ortality rate was 92% lower in regular users than non-users”.

However, scientists who examined the study found that it wasn’t performed in a way that would enable reliable conclusions to be made about ivermectin’s effect on COVID-19 mortality risk.

In fact, the authors published a study on the same dataset in January 2022, claiming that ivermectin, when used in a preventative manner, reduced COVID-19 mortality and hospitalization by half[2]. That study was similarly panned for its methodological flaws. You can read comments by scientists about that study in this Health Feedback review.

One critical problem with the authors’ methods was pointed out by Greg Tucker-Kellogga professor of biology at the National University of Singapore, courtesy of physician Kyle Sheldrick. The authors had defined regular users of ivermectin as those who took “180 mg or more of ivermectin” in total throughout the program, and irregular users were those who took “up to 60 mg, in total, throughout the program”.

But one caveat is that if a participant in the program developed COVID-19, they were recommended not to use ivermectin. This detail about the Itajaí COVID-19 prevention program was stated in the authors’ first study that used the same dataset[2]:

In cases where a participating citizen of Itajaí became ill with COVID-19, they were recommended not to use ivermectin or any other medication in early outpatient treatment.

This detail is absent from the recent study.

Because of the way that the authors defined regular users (those who took a total of 180 mg or more of ivermectin by the end of the program), people who stopped taking ivermectin after developing COVID-19 during the study were very likely excluded from the group of regular users—even if they had been regularly taking ivermectin up until that point—and placed in the group of irregular users or the group of intermediate users (people who took between 60 to 180 mg of ivermectin by the end of the program) instead.

There are two issues with this. Firstly, excluding those with a COVID-19 diagnosis from the group of regular users—even if their ivermectin use up until that point had been regular—means that the group of regular users is overrepresented by those who didn’t catch COVID-19. As such, COVID-19 patients are overrepresented among ivermectin irregular and intermediate users. Indeed, the authors reported that of the 7,228 people who developed COVID-19 during the program, only 283 (3.9%) were considered as regular users.

This introduces a clear bias when calculating the risk of COVID-19 mortality based on ivermectin use, because only people who don’t develop COVID-19 at all are more likely to be included among regular users. And if someone doesn’t develop COVID-19, then they aren’t at risk of dying from COVID-19 in the first place. This bias would make it seem as if people who used ivermectin regularly are less likely to die from COVID-19 compared to those who took ivermectin irregularly or didn’t take it at all.

Secondly, based on the definitions of regular use and inclusion criteria set by the authors, those who took intermediate doses of ivermectin appear to have been excluded entirely from the study: “Of the 113,844 participants, 8,325 (7.3%) subjects used ivermectin regularly and 33,971 (29.8%) used ivermectin irregularly. In total, 88,012 subjects were included in the present analysis. The 71,548 (62.8%) remaining participants used intermediate doses between 60 mg and 180 mg and were not included in this analysis.” [emphasis added]

And of the 7,228 participants who were infected with COVID-19 during the study, 32.8% used intermediate doses of ivermectin, amounting to almost a third of COVID-19 patients who did use ivermectin.

Overall, the authors’ methods impose significant limitations that raise questions about what the authors’ conclusions would have been if they’d also considered the pattern of ivermectin use before infection and if the intermediate group’s outcomes had been included.

Epidemiologist Gideon Meyerowitz-Katz also pointed out that while the authors accounted for certain confounding factors like pre-existing health conditions, such as type 2 diabetes and hypertension, they didn’t account for the potential effect of other confounding factors, like income.

Confounding factors are variables that affect the outcome of an experiment, but aren’t the variables being studied in the experiment. For example, scientists may wish to study the causes of heart disease. They may observe that red meat consumption is associated with a higher risk of heart disease. But it is possible that people who tend to eat more red meat might also be more likely to smoke cigarettes. In such a case, one possible explanation for the observation is that cigarette smoking, rather than red meat consumption, is the true influence behind that risk. This makes cigarette smoking a confounding factor.

This illustrates how failing to account for such confounding factors can lead scientists to draw erroneous conclusions about the cause of an effect that they observe in the study.

Meyerowitz-Katz also noted several inaccuracies in the title of the study. For instance, the study claimed to be a prospective, observational study, but is in fact a retrospective study.

Large, randomized controlled trials have already found that ivermectin was of no benefit to COVID-19 patients. In June 2022, a Cochrane Systematic Review that analyzed these trials reported[3]:

For outpatients, there is currently low- to high-certainty evidence that ivermectin has no beneficial effect for people with COVID‐19. Based on the very low‐certainty evidence for inpatients, we are still uncertain whether ivermectin prevents death or clinical worsening or increases serious adverse events, while there is low‐certainty evidence that it has no beneficial effect regarding clinical improvement, viral clearance and adverse events.

The TOGETHER trial, which was performed across 12 public health clinics in Brazil, compared 679 COVID-19 patients assigned to receive ivermectin [(400 microgram per kilogram of body weight) once daily for 3 days] with 679 others who received a placebo. It reported no difference in the study’s primary outcomes, defined as hospitalization due to COVID-19 or emergency room visit due to worsening of COVID-19 within 28 days of treatment assignment[4]:

Treatment with ivermectin did not result in a lower incidence of medical admission to a hospital due to progression of Covid-19 or of prolonged emergency department observation among outpatients with an early diagnosis of Covid-19.

The I-TECH trial, which was conducted in Malaysia, studied patients who were administered the standard of care together with oral doses of ivermectin for five days during the first week of illness. The researchers detected no difference in the likelihood of developing severe COVID-19 between patients given ivermectin and patients given standard of care only[5].

In summary, the available evidence so far, including clinical trials in humans, hasn’t indicated that the drug is effective against the disease. And the conclusions of the study by Kerr et al., owing to its methodological flaws, are unreliable and insufficient to overturn the current body of evidence indicating that ivermectin is ineffective against COVID-19.

The NIH recommends against treating COVID-19 with ivermectin; this recommendation hasn’t changed

Some social media posts claimed that the U.S. National Institutes of Health (NIH) recently added ivermectin as a COVID-19 treatment. For example, this Facebook post by Starbuck references the NIH COVID-19 Treatment Guidelines webpage, which lists the drugs currently being evaluated for their effectiveness against COVID-19.

However, ivermectin was listed on this page as early as June 2021 and isn’t a recent addition, as we can see if we compare archives of the webpage (see below).

How the NIH COVID-19 Treatment Guidelines page on antiviral therapy appeared at different points in time. Top: Archive from June 2021. Bottom: Archive from September 2022.

In fact, if one simply clicked on “Ivermectin” on the NIH page, the NIH makes it clear that they recommend against using ivermectin to treat COVID-19, except in a clinical trial.

 

REFERENCES

 

Published on: 07 Sep 2022 | Editor: 

Hong Kong is facing its worst-ever expat exodus.

Those leaving say the city is becoming no different from mainland China.

Matthew Loh,Weilun Soon
Sat, September 3, 2022 

Expats have been leaving Hong Kong en masse in 2022.
Anthony Kwan/Getty Images

Hong Kong-based expats told Insider they were frustrated by the city's response to the Omicron wave.


On top of facing daily disruptions and travel restrictions, they also feared a loss of freedoms.


During the pandemic, Hong Kong relied heavily on mainland China for policy responses and support.

After seven years of living in Hong Kong, New York native Marty Forth finally had it.

The academic arrived in the bustling city at the southern tip of China in 2015 and fell in love with its uniqueness. "It's a city with a very strong Chinese sense of place and history, yet still a very modern, progressive, clean, and safe city that's a hub for finance, travel, and innovation," he said.

Forth soaked up every minute of his first four years in Hong Kong. Even when a bout of turbulent mass protests in 2019 almost brought the city to its knees and sparked months of widespread chaos, Forth stayed on.

Then came the COVID-19 pandemic that ripped through Hong Kong in multiple waves. Over the last two years, the city has constantly oscillated between last-minute openings and closures of public venues, though caseloads stayed relatively few and far between.

And while other countries relaxed their Covid regulations to move toward co-existing with the virus, Hong Kong instead intensified its policies as the Omicron variant blew up in the city this year. Its rapid-fire introduction of restrictions prompted residents and experts to call the approach downright illogical.

"The government switched and changed its policy so many times and the decisions are made based on fear, not on evidence. Freedoms have been curtailed as a result," Forth told Insider.

So on March 8, Forth boarded a one-way flight to New York with his partner and their son. He's one of the hundreds of thousands of expatriates who have deserted the Chinese territory this year.

Once a paradise for foreigners looking to live and work in the heart of Asia, Hong Kong is now bleeding talent at a historic pace. In the first half of 2022, the city's total population fell by 110,000 – almost double the population loss from the entirety of last year.

Expats leaving Hong Kong told Insider that the government's haphazard response to Omicron was the final straw for them. They also said it made them realize how Hong Kong, a city that they once loved, was becoming just like any other urban hub in mainland China, which is why they bade it goodbye.

"You feel a little bit of guilt leaving your friends you've made over seven years behind," Forth said.

"But the Hong Kong we're leaving behind isn't the one we moved to anymore."
Daily disruptions and travel restrictions

Hong Kong's pandemic response has been guided by Beijing's COVID-zero strategy, with the aim of achieving "zero infections" in the city.

In mainland China, Beijing's tactic was to eliminate any trace of the virus through extreme restrictions. Local authorities would introduce sudden lockdowns on buildings, neighborhoods, or even entire cities to combat unexpected outbreaks.

These restrictions quickly turned into administrative and healthcare nightmares for hubs like Shanghai and Xi'an, where residents had to stay put in their homes for weeks while authorities scrambled to find ways to provide them with food and medicine, while also isolating the infected.

Meanwhile, Hong Kong residents were largely spared such harsh lockdowns in the first two years of the pandemic. With strict travel restrictions and widespread use of masks, the city enjoyed a relatively low number of COVID-19 infections for two years by acting quickly to suppress infections and snuffing out new clusters.

Then came Omicron, and cases in Hong Kong surged. More than 75,000 new infections were logged in a single day in February — nearly twice as many as New York City's worst-ever day of recorded Covid infections.

And so, Omicron and its deluge of infections sent Hong Kong's restriction cycle into overdrive.

Overwhelmed hospitals in Hong Kong had to treat patients
 on the street in March.
DALE DE LA REY/AFP via Getty Image


'There's a subtext here where it's more about control.'

The restrictions grew more and more haphazard. For instance, one couldn't gather in groups of more than two people — later changed to four — but could take group photos as long as everyone in them was masked. Breaking this rule could land an offender up to six months in prison. The authorities also instructed people to limit private gatherings to two households but said they wouldn't check on anyone.

Restaurants had to abide by a 6 p.m. dining curfew, later extended to 10 p.m. and then midnight. Only those who received at least one dose of recognized COVID-19 vaccines could dine in, even though authorities had already been giving out booster shots at the time. The rule was different for bars and clubs, where patrons had to take antigen rapid tests before entering them.

Hong Kong clamped down on travel, too. Returning residents would have to pay for hotel rooms to quarantine themselves for at least a week, or at times, up to three weeks, depending on the government's policies at the time. Flight routes into Hong Kong could be canceled at any time if a plane was found to have carried Covid-positive passengers. For Hong Kong-based expatriates thinking of visiting their family and friends elsewhere, such regulations meant having to prepare for the possibility of not returning to the city as planned.

There were also other one-off decisions by Hong Kong's government made that alarmed expatriates.

In an infamous move in January, Hong Kong ordered pet shops and owners to surrender their hamsters over fears that they might carry the coronavirus. This led to the culling of more than 2,000 hamsters.

For venture capital investor Belinda Pham, 26, the hamster culling was a reminder of the myriad stories she'd heard of mainland Chinese authorities killing Covid patients' pets — a grim hallmark of Beijing's bulldozer pandemic strategy.

"This is maddening, but it's unfortunately one of the many absurdities we saw in China," she told Insider. Originally from Paris, Pham left Hong Kong in the spring to further her career in Vietnam. She said she felt lucky to be able to leave the city and find another job elsewhere.

The situation worsened in February when Hong Kong authorities stoked controversy by deciding to isolate Covid-infected persons — including children — from their family members.


A child recovers from COVID-19 in a makeshift hospital ward.
Olivier CHOUCHANA/Gamma-Rapho via Getty Images

After separating around 2,000 children from their parents over six weeks, the city's Hospital Authority said in late March that it had scrapped the policy, per the Guardian.

James, a 37-year-old British marketing professional, told Insider that his circle of expatriate friends called the forced separation of children from their parents a "gulag move."

"That caused expats to spiral into a wave of panic and I started to see so many people leaving. " James said. He asked that Insider not use his full name to ensure his job security.

Even though Hong Kong's chief executive Carrie Lam announced in March that the city would lift some travel and domestic restrictions, her government also made it clear that the city would still stick closely to Beijing's "COVID-zero" plan.

"Quarantine will remain because that's still a very important tool… today we may have Omicron, who knows what's the next variant," Bernard Chan, who heads Lam's de facto cabinet, said in March of the relaxations, per the Financial Times.

Pham said she felt exhausted from listening to Hong Kong's government defend its position at a time when so many other countries chose to start living with the virus. "Now there's a political implication in everything. You can feel it day to day, it's all over the news," she said.

"It feels like we're all in a boat without a skipper, and China is driving us," she added.

James concurred. "There's a subtext here where many people don't think it's just about the virus, but more about control," he said.

"Hong Kong is not for expats anymore," he added. James relocated back to his hometown in the UK in early June.
The pandemic gave Beijing a chance to exert more control over Hong Kong, expats say

Beyond the Hong Kong government's Omicron response, expatriates said the pandemic also opened up a chance for Beijing to exert its authority over the territory.

Once a British colony, the UK ceded Hong Kong to Chinese control in 1997. The territory currently enjoys autonomy from Beijing but is expected to fully return to mainland Chinese rule in 2047.

English teacher Matthew Cox had always felt that Hong Kong was special. He arrived in the city in 2017 and was immediately taken by how the city was so cosmopolitan yet so traditionally Asian at heart.

This allure carried him through his toughest days in the city.

In 2019, a series of violent pro-democracy protests rocked the city. Hong Kong residents went onto the streets every weekend, bringing public transport to a standstill and forcing many commercial venues to close. They fought for pro-democracy ideals and urged Beijing to recognize Hong Kong's autonomy — at least until the territory fully returns to Chinese rule.

During the 2019 protests, Cox's only day off was on Sunday, and he went for weeks without being able to meet friends or unwind outside. But the turmoil didn't faze Cox. In fact, the protests were core to how he described Hong Kong — "a city with Chinese culture but with the freedoms of a European nation."

However, as the COVID-19 pandemic dragged on, he began to worry. In May 2020, as Hong Kong was combating the initial waves of the coronavirus, Beijing unilaterally passed the highly-controversial National Security Law to crush dissent in the territory. The legislation came into force on June 30, 2020, giving Hong Kong authorities the power to round up individuals they suspected of instigating secession from China or collusion with foreign forces.

Independent media outlets were forced to close, journalists became political prisoners, and China's infamous online censorship began creeping into Hong Kong. Local news companies also announced "partnerships" with Chinese state media.


Pro-democracy protestors thronged the streets of Causeway Bay in 2019. The same streets were completely empty in February as COVID-19 swept through the city.
Miguel Candela/SOPA Images/LightRocket via Getty Images, Peter PARKS / AFP via Getty Images

The timing of the law was key for Beijing, which "likely judged that the spread of COVID-19 would limit the risk of large-scale protests in Hong Kong in response to the new legislation," according to an analysis by public policy think-tank Brookings Institution in July 2020.

Cox assumed that Hong Kongers would fight back. "A lot of people felt that once Covid was over, they would really stick to this law and not push it aside. But people have forgotten it now, and once Covid is finished, Hong Kong won't return to how it used to be," he said.

As a foreigner in Hong Kong, Cox admits that the new law didn't have much of an impact on him personally. "But we see how it's affecting the locals, and how they don't have a voice anymore," he said.

"A lot of people see that it has become a Chinese city, already more and more freedoms are being taken," he said.
Hong Kong firms are trying to attract and retain talent, but some expats have already lost faith

Companies in Hong Kong have pledged more perks to lure and retain talent in an attempt to stem the expatriate exodus. Some firms are resorting to bumping salaries for new hires far past the usual rate, said John Mullally, regional director for human resource firm Robert Walters.

"The general usual kind of increase one gets when moving around is about 15%, now it's 25%, so it's quite the bomb," Mullally said. "You do obviously have salaries that have 35% or 40% increases as well. Realistically, it isn't that sustainable, but that's what companies have to do in order to populate their desks."

Mullally said maintaining Hong Kong's status as a financial hub while restricting travel will be a "difficult circle to square," but that the city's reputation is far from irretrievable.

"You underestimate Hong Kong at your peril. You should never underestimate its ability to adapt and change the world around it, and figure out a way to get things done," he said.

Some industries are already feeling the talent drain. A fifth of Hong Kong's international schools have struggled to hire enough teachers for the new academic year, and expat educators are reluctant to move to the island even with top-end salaries offered, the Financial Times reported.

Forth is not convinced that things will improve. Even though the Hong Kong government has pledged to ease restrictions, he said the city's constant flip-flopping over policies has eroded his trust in its ability to govern effectively. For now, Forth is content with staying in New York and sees no possibility of him moving back to Hong Kong.

When asked by reporters in April about the Hong Kong government's approach to controlling the spread of COVID-19, Lam said the government would not relent on the constant tweaking of policies so as to curb the spread.

"The right decisions have to be made trying to strike a balance between the public health considerations, the socio-economic development needs and the people's tolerance and acceptance level," said Lam, who stepped down on July 1 and passed leadership to her successor John Lee.

Lee, on the other hand, has promised to focus on reopening Hong Kong to travelers, and in early August cut hotel quarantine for incoming travelers from seven days to three, though arriving passengers still have to stay home for another four days after. He also axed the controversial travel ban on flights carrying passengers infected by COVID-19.

But his history as both a driving force behind the National Security Law and the security chief responsible for the crackdown on protests has eradicated hopes that the city's freedoms will return under him.

In his appointment speech on July 1, Lee promised to restore Hong Kong's status as a global financial hub but made no mention of how its COVID policies have dented its reputation.

More than a month after Lam stepped down, Beijing's policies under her remained mostly intact.

As of August, gatherings of more than four people are still prohibited, including in bars and clubs. Daily new COVID-19 cases continue to hover at around 4,000 — a far cry from the government's zero-case aspirations.

Before handing the reins to Lee, Lam said in June that the government would not give in "a single inch" to businesses' requests to ease restrictions, per the South China Morning Post.

To Forth, Lam's announcement means that the Hong Kong government would continue to be fickle-minded about its Covid regulations. "They keep changing the policies, you never know when they're going to clamp down again," he said.

"How can they come back and recover their reputation from this? How can I come back to Hong Kong with this?" he said.
North Korea hopes to build 'socialist fairyland' with new laws


By Reuters
Updated Wed September 7, 2022

A meeting of North Korea's Supreme People's Assembly in Pyongyang, North Korea, on September 7.

North Korea's rubber-stamp parliament convened this week to pass legislation aimed at turning the country into a "beautiful and civilized socialist fairyland," state media reported Thursday.

The North Korean Supreme People's Assembly met for its first session on Wednesday, and adopted laws on landscaping and rural development, state news agency KCNA reported.

The two laws will help advance the ruling party's efforts to bring about "a radical turn in the rural community and its policy on landscaping to achieve a rapid development of the Korean-style socialist rural community and spruce up the country into a beautiful and civilized socialist fairyland," KCNA said, citing a deputy's speech to the gathering.


North Korean leader Kim Jong Un, who did not attend the session, has vowed to improve people's livelihoods and boost rural development amid spiralling economic crises caused by self-imposed Covid-19 lockdowns, international sanctions over the country's nuclear weapons programme, and natural disasters.

Many of Kim's economic promises have yet to be fulfilled, analysts say, and aid organizations have warned of rampant food shortages and other hardships.

According to a report last month by 38 North, a US-based site that monitors North Korea, Kim's vow to rebuild a typhoon-ravaged province in the country's North and transform it into a "model" mining community has made little progress.

The United States has accused Kim of pouring resources into military projects at the expense of the country's people. It said this week Russia had approached North Korea about buying ammunition, potentially providing a windfall for the cash-strapped government in Pyongyang. Russia said the US report was "fake."



'Employees will just say no': Bosses pushing staff back to the office could be fighting a losing battle

Staff are used to remote work, have different expectations about work-life balance and are now factoring in cost of inflation


Financial Times
Anjli Raval in London and Andrew Edgecliffe-Johnson in New York
Publishing date: Sep 06, 2022 

Commuters in Toronto's financial district in November. 
PHOTO BY COLE BURSTON/BLOOMBERG

Goldman Sachs Group Inc. boss David Solomon has long been a critic of remote work, describing the pandemic-related shift once as “an aberration.” This week he called time on the practice, scrapping most of the bank’s remaining COVID-19 restrictions for United States employees in a bid to get as many as possible back into the office.

For more than two years companies around the world embraced remote work and hybrid home-office arrangements as infections surged and the death toll escalated.

But as summer comes to an end in North America and Europe, some of the biggest companies are making a concerted push to get people to return to the office. They range from electric carmaker Tesla Inc., whose boss Elon Musk has demanded employees to be back at their desks 40 hours a week, to tech giant Apple Inc. and fitness company Peloton Interactive Inc., which are both pushing for at least three days a week.

It is not the first time big business has tried to reverse the shift to working from home. In the autumn of 2021, and even 2020, companies developed plans to initiate a broad comeback to eerie office buildings, only for new waves of infections to leave managers wary of butting heads with staff at an intensely fragile time.
This year is different, however. With people generally less fearful of virus spread, many bosses believe conditions are now as close as they are likely to get to pre-pandemic times. With Labour Day behind us and school terms starting across Europe, some executives are getting impatient and are taking a harder line.

Goldman Sachs chief executive David Solomon. 
PHOTO BY SIMON DAWSON/BLOOMBERG

According to one executive headhunter, business leaders are experiencing “do-gooder fatigue” — in reaction, in part, to the greater focus on employee wellbeing during the pandemic. “The feeling is, we need to get back to business.”

This could, however, lead to confrontations with staff who have grown used to remote working, have different expectations about work-life balance and are now weighing up the costs of going back to the office as inflation surges.

“People want to come into big cities to socialize, see friends and go to cultural events. But, for work, many people will say they can do it better at home,” says Ann Francke, chief executive of the Chartered Management Institute, a professional body in the U.K. “The pandemic forced people to ask…’Do we really need to organize work in this way?'” she adds. “This irks CEOs.”

That makes the coming weeks a critical moment for the future of the office — but also for all the industries that revolve around office workers, from the commercial property sector to sandwich shops and gyms.

If they're forcing us to commute, shouldn't they offset costs for us?

Hybrid work is here to stay,” Enrique Lores, chief executive of HP, which sells printers and laptops, said last week. The expected recovery in the company’s commercial revenues had been hit by the slower-than-expected return to workplaces and it now expects the office printer market to recover to only 80 per cent of its pre-pandemic size.

“I don’t know any company that has decided, or convinced their employees, that they need to be back in the office five days per week, every week of the month.”

For some employees — especially the less well paid — the pressure to return is also now wrapped up in the cost-of-living issues that many are grappling with, from higher energy bills if they stay at home to the expense of travelling to and from the office and child care.

The conundrum for workers was laid bare on Blind, the anonymous professional network. “If they’re forcing us to commute, shouldn’t they offset costs for us?” wrote one person posting about their company’s return-to-work policy. A second questioned the legality of mandates to push office working. “What happens if you refuse to return to office?” asked another.

The three-day model

Since the start of the pandemic, how someone chooses to work has been a personal decision for many office workers. Even for those chief executives who are not desperate to get everyone back into an office, the coming weeks are an opportunity to lay out formal policies on what the future of work will look like.

Some chief executives have emphasized the importance of face-to-face interaction for team work, company culture and junior employee training. But in many cases the explanations they have given about why the office is important have been vague.


If you ask for three days a week, you need to be able to explain why. To what end?
STEPHAN SCHOLL, CHIEF EXECUTIVE, ALIGHT SOLUTIONS

Stephan Scholl, chief executive of Alight Solutions, a cloud-based technology and services provider, says he had been reluctant to make office days compulsory. “If you ask for three days a week, you need to be able to explain why. To what end? This is what is frustrating ab
out some of my peers.”

1932






















“There is not one right way of working,” says Ethan Bernstein, an organizational behaviour expert at Harvard Business School. When everyone had to work at home full time it was easy for managers, as there was no other option. It is the hybrid model that is proving more difficult because of the endless ways work can take place. “This is a moment, yes, in trying to define what hybrid means,” he says. However, as there is little data to help companies chart a path, that often means the preferences of some — likely senior — staff will drive how a corporation behaves.

Amanda Cusdin, chief people officer at software company The Sage Group Plc, says that “human connection is still the most important thing” in many workplaces, especially for the 2,000 people the company recruited during lockdown who wanted to build connections.

The company has decided on a hybrid working model where each team determines the days they are in the office and staff are generally positive that they do not have to work five days a week in the office, she says. “At the same time, no one wants to come back to an empty building, so we need to have a critical mass present.”

Employees are welcomed back to work with breakfast 
in the cafeteria at the Chicago Google offices in April. 
PHOTO BY SCOTT OLSON/GETTY IMAGES

In the early stages of the pandemic, bosses focused on physical wellbeing, mental health and flexibility at work so employees could tend to the demands of sick relatives and home-schooling.

Then, after the rollout of vaccines, many tried to persuade workers back by offering perks — from free lunches and Uber rides to after-work drinks events, massages and employee discounts for local retailers. Goldman laid on afternoon concerts for its staff.

Envoy, a San Francisco workplace platform, now offers a shuttle service, a carpool program and a US$200 monthly commuting subsidy to persuade employees to come in for its desired three days a week. In the office, there are free bagel and fruit breakfasts, “snacks everywhere” and a happy hour once a month, says Annette Reavis, Envoy’s chief people officer, adding that dog owners are encouraged to bring their pets to work so they do not have to pay for dog walkers. “We’re trying to remove some of that financial burden,” she says, “but also build community.”

However, while some employers continue to prioritize workplace benefits, others are taking a harder-nosed approach, which is coinciding with new budgetary constraints as companies prepare for a potential economic downturn.

Even Reavis acknowledges that those who remain at home should be thinking about the risk that managers are more likely to offer promotions and pay rises to the people closest to them. “Proximity bias is real,” she says, “and it’s only going to get worse in the next six to 12 months.”

Proximity bias is real and it's only going to get worse in the next six to 12 months
ANNETTE REAVIS, CHIEF PEOPLE OFFICER, ENVOY

 


The domino effect

Among the industries that depend heavily on filled corporate buildings, executives are watching the next few weeks closely, but many are cautious about predicting a surge in returning staff — especially after some made similar forecasts at the same time last year.

Sweetgreen, the U.S. salad chain which has two-thirds of its outlets in urban areas, has blamed “a slower-than-expected return to office and an erratic urban recovery” as it cut its full-year sales forecast. Traffic to stores such as its branch at the World Trade Center should pick up after Labour Day, says chief financial officer Mitch Reback, but “we felt that way a year ago, and the world felt that way two years ago.”

Huge shifts in office rents, occupancy and leases have already had a huge effect on office building cash flows, say academics from the NYU Stern School of Business and Columbia Business School. The one-third fall in the value of New York office buildings in the first year of the pandemic heralds a longer-term “office real estate apocalypse” equating to a US$50-billion cut to the value of New York’s offices and a US$500-billion blow to the industry nationwide.

   
A person stands outside the Bank of America Tower in New York City. 
PHOTO BY AMIR HAMJA/BLOOMBERG

Google’s Community Mobility Report, which charts movement trends across places such as offices, clothes shops, Tube stations, pharmacies and supermarkets found that compared to pre-pandemic levels, retail and recreation footfall was still down 26 per cent in the City of London. For the supermarket and pharmacy category it has fallen nearly 60 per cent. Both of these correspond to a 40 per cent reduction in travel to workplaces.

Yet despite the growing pressure from some bosses, many office workers seem to show little appetite for abandoning new ways of living they are rather enjoying. They are more available to their families, have eliminated hours of travel and found new freedoms through distance from their line managers.

The most recent report by Advanced Workplace Associates, a consultancy, on global hybrid working, which is based on nearly 80,000 employees across 80 offices in 13 countries, showed that on an average day two-thirds of desks are unused and just over a quarter of people are coming into the offices, with the attendance figure dropping to 12 per cent on Fridays.

In the U.S., a new Gallup poll suggests only 22 per cent of the employees surveyed who could work remotely are currently on site for most of the week and more than 90 per cent have no desire to return to full-time office work. Strikingly, the percentage of those currently on site who want to work exclusively from home has doubled since October 2021.

Some employers have already embraced the new reality by advertising fully virtual jobs or even opening up satellite offices to meet now-distributed workforces.

Industry observers say forcing people back to the office is a fruitless endeavour. The world has changed and companies need to adapt if they seek to retain talent in a tight labour market particularly in the U.S. and U.K. that, for now, will offer them alternatives if they walk away.

“Employees will just say no,” says Francke. “They know flexible working works and they will resent you for telling them they need to be at the office.”


Additional reporting by Joshua Franklin

© 2022 The Financial Times Ltd.



RETURN TO OFFICE


The Professional Try-Hard Is Dead, But You Still Need to Return to the Office

In the era of the Great Resignation, remote work, and “quiet quitting,” general disillusionment with white-collar striving has gone mainstream. The managerial set has yet to be CC’d.




BY 
DELIA CAI
 SEPTEMBER 6, 2022

PHOTO FROM SHUTTERSTOCK.

During my first job in media in the late 2010s, I was a glorified PowerPoint assembler on a magazine’s marketing team, where we spent our days figuring out what kinds of stories and topic areas corporate brands liked to put their advertising next to. One of the most popular themes was what we slickly called “The Future of Work”—a catchphrase cribbed from the marketing and MBA-swinging circles invested in forecasting all the exciting ways corporate life would change amidst peak millennialification of the workforce. We knew advertisers loved the idea of fashioning themselves as part of this revolution, and I still remember how I’d decorate those PowerPoints with stock images of ultramodern office spaces and stylish, suited figures in carefully varied skin tones. It never occurred to me, or my colleagues, or these brands, to wonder if the real future of work might actually look like something far more radical.

Roughly one pandemic later, there has been such an abrupt rupture in the way we work—not to mention how we think and talk about it—that we grasp at new taxonomies for the disillusionment with the hustle: It’s millennial burnout, it’s the “Age of Anti-Ambition,” it’s the Great Resignation. As the labor market has tightened and the labor movement regains cachet, living “under capitalism” has become a default punchline. The antiwork subreddit is the hottest club in town. Ambitious women are reportedly done with girlbossing (now in vogue: girlresting) and The Wing has officially crashed; it appears Kim Kardashian’s assessment that nobody wants to work these days was correct, because even Serena Williams can’t have it all. Of those who have given notice, there’s a predictable amount of regret: just not, it seems, amongst the clear majority.

Nowhere has this work-life reckoning been analyzed more obsessively than in the realm of white-collar work, where a confrontation with its privileges (being able to Zoom in to meetings from home) and indignities (having to grimace for the camera through all two hours of said Zoom meeting) has made for quite a lot of soul-searching. Consider the pandemic television shows that have elicited the buzziest (virtual) watercooler talk amongst the very-online class. Recent series like The Bear and Abbott Elementary depict workplaces that resist any administrative beveling of the messy realities of serving food and teaching children, which the Slack-dependent then watch with fetishistic awe. Meanwhile, we observe the infantilizing melon parties of Severance and the jargon-happy, nihilistic earners of Industry with an uneasy sense of identification. (Wait, is this fucking play about us?)

And so the future of white-collar work has morphed from an advertiser-friendly thought exercise to an existential question with a daily subset of moral riddles: Is that an illicit midday nap, or is it just work-life balance? Is it really the end of work friends, or is it just that a defensive herd mentality is no longer crucial to getting through the day? Is it worse to work on vacation, or to have a little vacation at work? Is the delivery bot lost in the woods, or is he finally free?

Take the latest debate on “quiet quitting” as a trendy, divisive term for what Anthony Klotz, the management professor who inadvertently coined “the great resignation” back in May 2021, links to the not-new concepts of worker disengagement and withdrawal. “All jobs have core elements of the job, which we call in-role performance…‘quiet quitting’ is quitting everything beyond that, which we call citizenship behaviors—going above and beyond the call of duty,” explains Klotz. Whatever moniker you give it, there’s now increasingly accepted room for the idea that you might step off the professional gas pedal in order to protect your well-being and even sense of identity. “People are talking about it as a mindset shift,” says Klotz, who has studied resignations for more than a decade. “Realizing like, I’ve become kind of a unidimensional person…I’m quiet quitting mentally to make room for me to be more than just a worker.” (Klotz allows for the record to show that he, too, was not immune to the Big Quittening’s reach; earlier this year, he resigned from his post at Texas A&M University for a new job teaching at University College London.)

Over the past months, as corporate employers attempt once more to marshall back-to-school sentimentality (not to mention a collective, CDC-sanctioned shrug re: coronavirus itself) to coax everyone back into those expensive real estate holdings, the fight over return-to-office is just one of the questions that foreground not only predictable tensions between worker and boss, but also between anyone who still believes in the physical office—and all its trappings—as a desired state of “normalcy,” versus everyone else who no longer does.

We can call the former, if you’re feeling derisive, the “professional try-hards;” I’d love to be flip and just say that, at this point in planetary decline, anyone who’s a little too interested in emails and Google Docs basically counts as a try-hard, but there’s a specific category of salaryfolk and company leadership provoking a justifiable kind of scorn. The professional try-hard I’m talking about is someone who, in the year 2022, still earnestly and performatively buys into the white-collar hustle and prides themselves on it. You know this person. They’re a cross between a teacher’s pet and a supply-room narc; if they’re not already a manager, they certainly aim to be one day. While everyone else got with the program that trying hard at work—against a political and national backdrop that feels like daily, endless crisis—is ridiculous, or worse, meaningless, these guys (it’s not exclusively a male thing, of course, but I’m not not being gendered on purpose) haven’t quite gotten with the program.

It’s Malcolm Gladwell waxing emotional about how much he loves return-to-office and pleading, “Don’t you want to feel part of something?” as if the man has never heard of, like, recreational softball. It’s Mark Zuckerberg reportedly getting mad about an employee asking if Meta Days (extra vacation days introduced during the pandemic) are still on this year because, shouldn’t the pleasure of working for Meta be enough? It’s any number of investor-type herbs who’ve been warning about how quiet quitting will cause you to lose out on x dollar amount of earnings later in life—that retirement yacht isn’t going to fund itself with the tears of your absent children, you know! It’s Braden Wallake, better known as the Crying CEO, who posted a photo of himself in tears on LinkedIn (of course it was on LinkedIn) in an attempt to score sympathy points for the vewy hward jwob of being in charge (chwarge?), only to turn himself into a viral joke. Let that tragic selfie tell you everything you need to know about how badly the try-hards are losing their grip.

“I don’t believe he was actually crying,” says public relations CEO and remote-work cheer captain Ed Zitron, when I ask for his take on the Wallake debacle. “I know exactly what he was doing there—this was his way of heading off layoff messaging at the pass. He was trying to make himself look good…he was obsessed with the aesthetics of all of it.” For Zitron, whose bylines at The AtlanticInsider, and his personal newsletter have made him the internet’s most unapologetic executive-class advocate of remote work, a regular torching of cringey professional-try-hard behavior has become something of a second career.

In Zitron’s view, as he wrote last summer in “Why Managers Fear a Remote-Work Future,” the battle over return-to-office is really about the way remote work rightfully disempowers a certain type of managerial creature—those who’ve gotten by on office diplomacy and the fine art of appearing busy and important, but not necessarily useful. As he sees it, the physical office space gave the advantage to anyone whose job was making sure you’re doing yours; no wonder professional try-hards are so obsessed with forcing everyone else back. “I believe there is a large chunk of extremely performative work that is having a midlife crisis right now,” Zitron says. “Executives are slowly realizing they don’t do as much and they may not be deserving of all of this. I think they want attention. They used to go into the office and be like, ‘Hello, peon! Look at me! You have to talk to me! You have to say things that make me happy, or I’ll fire you.’” (For the record, Zitron’s PR agency has been remote since 2012: “I’m in my pajamas right now, by the way,” he gleefully informs me over our midday call).

Though his views are far less pitchfork-and-torch-y, Klotz, the management professor, agrees that there is a sense of threat posed by the changed landscape of the workplace for the corner-office cohort. “I don’t think it’s nefarious or anything negative on the part of these leaders,” he explains. They’re just following the playbook that’s gotten them—and the economy—this far, reasoning, ‘If we would all just get back together, we can get back on track like it was in 2019’—which was a banner year for most companies, by the way,” Klotz says. “But you have workers who are saying, ‘All that’s good and well, but this is better for our lives.’” In an email, Klotz adds that, yes, of course employees resist having any workplace benefit (like the flexibility of remote work) taken away, but research has also shown that employees push back less if given a fair explanation. “I think that’s part of the tension right now,” he explains. “Employees who like working remotely but are being asked to return to the office are asking their leaders WHY.”

Why, indeed. It’s the question of the hour raised with every morning alarm, every increasingly stern RTO email, every not-so-theoretical conversation I have had with my editor about this strange evolution of work, as my own office began to shift from pleasantly voluntary in-person meetings to required (part-time) attendance. Here I will risk a degree of try-hardist edging to say that I’d previously enjoyed spending Tuesdays at my Manhattan desk as a lifestyle choice, employer-grade air conditioning being one of the few things you can’t absorb over videoconference. But why did my feelings about the office shift from neutral to total disorientation the minute it became a fulfillment of some external requirement, some other decision-maker’s ruling, rather than an expression of my agency as a working adult?

I felt the dissonance on a visceral level when I was paging through an advance copy of Smart Brevity, a new handbook about “the power of saying more with less,” to be published September 20 by Jim VandeHei, Mike Allen, and Roy Schwartz, veterans of Politico and founders of Axios—two very good news outlets that have prided themselves on the particular formal innovations of blogging (Politico), bullet points (Axios), and constant exhortations for their audience to “be smart” (also Axios).

The book, which will now serve as something of a victory lap following last month’s $525 million sale of Axios to Cox Enterprises, touts the importance of direct, well-formatted communication for earning the trust and respect of your audience/employees, then promises to teach readers how to become miniature crusaders of clarity via a “revolutionary system and strategy” that the authors have dubbed “Smart Brevity.” It’s a well-timed hook: For anyone in the managerial set currently at a loss for how to wield influence sans in-person meetings, the chance to learn the secret to writing more powerful emails is certainly appealing. And you could do a lot worse than turning to three successful journalists for a primer on communication skills.

The problem, however, is that most corporate communications suck because most people simply aren’t professional writers, and in lieu of figuring out how to cram an MFA’s worth of actual writing advice into 200 pages, Smart Brevity resorts to consultant-class platitudes, like “singling out the person you want to reach clarifies things big-time,” and recommendations like “do a real gut check. Is this point or detail or concept essential?” Try as the authors might to rebrand a headline as a “tease” and bottom-line takeaways as an “axiom,” Smart Brevity’s attempts to pass off foundational concepts of good writing into some secret, proprietary technology often just feel silly; the exhortations on bullet point/GIF implementation and a whole chapter dedicated to emoji use veer toward insulting. A good portion of the book consists of before-and-after examples where some imagined long-winded paragraph gets made over in the Smart Brevity style; the resulting effect is not so much a lesson on succinctness as it is a clue about which types of people are socially encouraged to communicate in pings of authoritative masculine curtness.

I’d be lying if I didn’t emit the occasional juvenile laugh over lines like “Brevity is confidence. Length is fear,” and explanations for “STRONG” one-syllable words versus “WEAK” words (Do one of you guys want to tell me why the verb “bitch” is listed as an example of the former?). For a book obsessed with clarity, it’s hilariously redundant. But that isn’t the point, is it? (Who really thinks that the secret to workplace success lies in Slack’s Giphy library?) The irony, of course, is that Politico and Axios made their core business and reputation by providing subscribers news-making and actionable scoops—the snazzy, emoji-laden bullet-pointing of the news is merely branding. And that branding, apparently, is the actual point. This is a book with a snappy name and zippy catchphrases meant for white-collar strivers to carry around, or, as Zitron might say, a matter of aesthetics. It will do just as well to telegraph that you’re interested in solving the awesome mystery of effective communication as to actually bother with the work of it. It’s perfect professional-try-hard fare that concerns itself very little with how the wordiness of your speeches is probably not the biggest factor in how disgruntled your workplace feels about RTO.

What ties Smart Brevity, the Crying CEO, and general corporate try-hardism all together is this shared preoccupation with the appearance of hypercompetence over the actual thing. Why concern yourself with the complex factors causing employee burnout or worker disillusionment or midday napping when you’ve convinced yourself (and are attempting to reconvince your workers) that it’s just a matter of writing the most poetic (but also effective) LinkedIn post?

What’s clear—and what’s behind the reason that professional try-hards are flailing so fantastically—is that the very concept of corporate competence itself has become a joke. The ideals that white-collar striving is built upon have started to crumble: Imagine believing in true “innovation” in a world where Meta, formerly the most exciting company on earth, is reduced to hitting copy and paste. Imagine still buying into the corporate ladder in any sector where performance evaluations might be rife with racial disparities, or where the executives have essentially admitted on the stand that their entire industry is just a game of roulette. Imagine having faith at all in any idea of “corporate good” when the guy celebrated for years as the “one moral CEO in America” is now the subject of a rape investigation (that CEO has denied the allegations). Just last month, Adam Neumann, the disgraced WeWork founder whose implosion was so well-documented that it got turned into prestige television, reportedly received a $350 million second chance for pretty much the same idea he rode to ruin last time.

Imagine, in other words, believing anyone in charge knows what they’re doing. But okay, sure, sic the productivity-management software on everyone else to make sure we’re not online shopping a touch too much.

“People are waking up to this disenfranchisement, but I think it’s important to realize why,” Zitron sighs. “During COVID, we got to see that companies are more than willing to cut your asses out and reap massive profits a year later. The government treated companies better than they treated people. And what did people get? Maybe a check of $1,400.” He adds: “People turned around and were like, You know what? I’ve been working my ass off thinking it would get me somewhere. Why should I go above and beyond?”

So there may just be power in the disillusionment—for now:

“Usually in the world of work, organizational leaders change and followers are the ones who have to adjust,” says Klotz. “This is the moment where it flipped a little bit. A lot of employees and a lot of the world of work is saying to leaders, ‘We’ve gotten this glimpse into this world of work—this future of work—that is better for us. Could you please adjust?’” He pauses. “And that’s tough, because you’re asking the people with the power to adjust.”

And, mind you, this is all before the next economic downturn hits.




Delia Cai
SENIOR VANITIES CORRESPONDENT
Delia Cai is a senior Vanities correspondent at Vanity Fair, covering culture and celebrity. She joined V.F. after writing the “Deez Links” newsletter for five years. Delia lives in Brooklyn, and her forthcoming novel, Central Places, will be published with Ballantine Books.