Tag Archives: rise

Popularity of caravanning on the rise – expert shares staycation warning for families

CARAVANS are a fantastic option for Britons who want to go on a road trip, holidaymakers who like to be spontaneous with their trips and lovers of adventure. However, there are many options when it comes to choosing a caravan. Express.co.uk spoke to Camptoo’s Ed Bassett and found out his tips for choosing a vehicle.

Read more here Daily Express :: Travel News Feed

‘Positive’ news for savers as interest rates across accounts rise – ‘act quickly’

She continued: “A positive change to see has been a rise to the average easy access rate, encouraging for savers comparing deals but regardless of rate, it seems the popularly of having flexible access to cash remains a vital aspect to savers. 

“Indeed, savers are still storing their cash in sight deposits, with £6billion in deposits made in May – or £56billion so far this year – according to the Bank of England. 

“Considering the pandemic effects on financial vulnerability, savers may even choose a deal with a brand they trust and is completely flexible in the months ahead.”

The savings market, however, has yet to recover from the widespread impacts of the pandemic.

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This post originally posted here Daily Express :: Finance Feed

NHS staff demand decision on 1% pay rise this week and descend on Downing Street

NHS staff furious about the Government’s “pitiful” offer of a 1% pay hike will take their protest to Downing Street this week.

Boris Johnson will be told “claps don’t pay the bills” as a petition signed by 800,000 people calling for him to ditch the “pathetic” 1% – a real terms cut – and instead back a 15% rise will be handed to No10 on Tuesday.

Fears are growing that ministers will fail to back any rise before MPs disappear for their summer break next week, despite the rise being due some 100 days ago.

The Government raised hopes it could back a larger rise following a fierce backlash to its original plan, with ministers saying they would wait for the independent NHS pay review body (PRB) to make a recommendation.

But the body sent its report to ministers some three weeks ago and unions say exhausted NHS staff are “being treated as an afterthought”.

Matthew Tovey, the nurse working in Wales who organised the petition, said for healthcare staff, working during the pandemic “felt like running into a burning building – every single day”.

He added: “Our lives were turned upside down. We left our homes, our family, our children in order to work, to save lives.

“And instead of a pay rise, we get a pay restraint. It’s a kick in the teeth when we’re already down.”

He added: “We now live in a country where nurses are barely scraping by.

“Over a third skip meals to feed their families and over half work overtime to pay the bills. Pay cuts, freezes and caps have led to a 20% wage loss.

“The Government has a choice to restore this pay – and a meagre 1% is pathetic, pitiful and poor.”



NHS staff stage a protest outside St Thomas' Hospital in London
NHS staff stage a protest outside St Thomas’ Hospital in London

Chris Hopson, chief executive of NHS Providers, said on Sunday that a “reasonable” rise would be between 3% and 4%.

He told Times Radio: “That’s what I think where the Scottish Government were, at the higher end of that bracket. But interestingly nurses in Scotland weren’t particularly happy with that. So I do think there is an important issue here.

“The key point is our staff have been working incredibly hard and it feels to me it is right and proper that we should recognise the contribution that those staff have made.

“It was delightful for the NHS to receive the George Cross but actually we also need to ensure that hard working frontline NHS staff are also paid and remunerated at an appropriate rate and the effort they’ve put in over the last year is properly recognised.”

Healthcare union Unison, meanwhile, has called for a £2,000 increase for every NHS worker.

Head of health Sara Gorton said: “It’s in Boris Johnson’s gift to grant staff a fair deal. Yet he’s still making them wait.

“It’s 320 days since UNISON wrote to Boris Johnson asking for a £2,000 increase for every NHS worker. But health workers in England, Wales and Northern Ireland still don’t know what they’ll get nearly eleven months on.

“Staff who’ve done so much during the pandemic are being treated as an afterthought while MPs head off on their holidays. And infections are rising which means pressure is piling back on the whole health team once again.

“The least the government can do is confirm now that staff will get a decent pay rise.”

A Department of Health and Social Care spokesperson has said: “We are incredibly grateful to all our NHS staff. This year the Government has committed to providing NHS staff with a pay uplift, at a time when uplifts in the wider public sector have been paused. In doing so, the Government is acknowledging the extraordinary effort of NHS staff through the pandemic.

“We have received the reports from the independent Pay Review Bodies and are now carefully considering their recommendations before responding.”

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This post originally posted here United Kingdom News

Rheumatologists’ Industry Payments Rise; Small Minority Gets Most

Practicing rheumatologists in the United States received more than $ 220 million from pharmaceutical companies during 2014-2019, with payments increasing each year, according to findings from a descriptive study of the Centers for Medicare & Medicaid Services Open Payments Database.

Rheumatologists have identified conflicts of interest as an ethical concern, but the details of industry payments to rheumatologists have not been investigated, wrote Michael Putman, MD, of the Medical College of Wisconsin, Milwaukee, and colleagues in Arthritis & Rheumatology. “Payments among rheumatologists may be of particular interest,” given their frequent prescription of expensive and primarily on-patent biologic and targeted disease-modifying antirheumatic drugs (DMARDs), the researchers said.

Over the 2014-2019 study period, 5,723 rheumatologists received a total of $ 221,254,966 from 1,610,668 payments. Of these, 3,416 (59%) received less than $ 5,000; 368 (6%) received more than $ 100,000, accounting for 78% of the total payments. The yearly value of the payments increased from $ 29,755,133 in 2014 to $ 46,308,926 in 2019, a 56% increase.

The payments to individual rheumatologists during the study period ranged from $ 8 to $ 5,612,254, with a median individual payment of $ 2,818. However, most (81%) of the payments were less than $ 25, and only 4% were more than $ 1,000.

Physicians who received more than $ 100,000 were significantly more likely to be paid speakers’ fees, consulting fees, and travel and lodging fees, but significantly less likely to receive payments for food and beverage than were those who received less than $ 100,000.

Overall, women made up 43% of the study population and received 34% of the total payments.

However, the median payment to male rheumatologists was significantly higher than the median payment to female rheumatologists ($ 3,732 vs. $ 2,084). Female rheumatologists were significantly more likely to receive payments for food and beverage and significantly less likely to receive speakers’ fees or travel and lodging coverage.

When the data were analyzed by state, California had the highest amount of total payments ($ 27,769,124), followed by New York and Texas, while Arizona had the highest spending per rheumatologist ($ 143,559). By region, based on U.S. Census divisions, the highest spending occurred in the Middle Atlantic Division ($ 46,327,351) and the highest per rheumatologist spending occurred in the East-South Central Division ($ 49,605).

“These data suggest industry payments in rheumatology have followed two distinct patterns, which have been observed in other medical subspecialties,” specifically, that many small payments are made to a large number of physicians, and large-value payments are made to a small number of physicians, the researchers noted.

The impact of small payments cannot be discounted, they said, “as even small gifts may affect behavior and are associated with prescribing patterns.” The impact of large payments on behavior and practice deserve further investigation, “but it is notable that a recent evaluation of rheumatology clinical practice guidelines identified substantial involvement from rheumatologists who had accepted large values of industry payments,” the researchers added.

Approximately half the total value of payments came from three companies: Bristol-Myers Squibb (20%), Abbvie (17%), and Pfizer (12%). Medications associated with the highest spending included Otezla, Humira, and Xeljanz.

Of note, the data showed that H.P. Acthar gel was among the top 10 agents for total payments, and “over 90% of rheumatologists who frequently prescribe H.P. Acthar gel have also received H.P. Acthar–related payments, raising the possibility that such payments have influenced prescribing behavior,” given the lack of high-quality evidence to support its use and the availability of less expensive alternatives, the researchers said.

The study findings were limited by several factors, including the focus only on general payments to rheumatologists, and the lack of external sources to verify payments, the researchers noted. “Most importantly, this was a descriptive study, and the degree to which payments have influenced physician behavior lies outside the scope of this work. Future studies should investigate the degree to which industry payments have influenced prescribing in the field of rheumatology.”

Focus on Collaborations That Add Value

The study is important because previous data on the magnitude of payments or payment patterns from pharmaceutical companies to practicing rheumatologists were limited, lead author Putman said in an interview.

“I was most surprised by some of the medications that received high values of payments,” he said. “Many payments were linked to medications that we use commonly and that have high-quality data supporting their use. That was not surprising, and you could imagine dollars spent on [interleukin]-23 or IL-17 inhibitors being used in a way that is valuable to other physicians or to patients with rheumatic diseases. On the other hand, some medications – most notably H.P. Acthar gel – have no high-quality data supporting their use, are used by a very small cadre of physicians, and are extraordinarily expensive. At least in my opinion, there is no world where payments linked to H.P. Acthar gel provide any benefit for physicians or patients.”

Putman said he expected that the patterns and the increases observed in the study are likely to continue.

“Ultimately, I have a somewhat nuanced view of financial conflicts of interest,” he said. “Collaborations between the pharmaceutical industry and rheumatologists have provided extraordinary value to our field. I think rheumatologists should be much more involved in some areas. At the same time, I think we should be much less involved in marketing drugs that provide little value to patients and great cost to society. H.P. Acthar Gel is the classic example of this, but there are others as well. I think future research should focus on how these payments influence behavior and should seek to identify areas where they result in low-value care.” Going forward, valuable collaborations between rheumatologists and the pharmaceutical industry should be encouraged, but collaborations without value should be discouraged, he said.

Industry Payments Serve No Useful Purpose

The findings “highlight the overarching concern regarding the ability of industry payments to adversely affect care quality within the specific context of rheumatology practice,” Aaron P. Mitchell, MD, of Memorial Sloan Kettering Cancer Center, New York, wrote in an accompanying editorial.

Dr Aaron Mitchell

Mitchell emphasized several points, starting with the temporal trend showing an increase in industry payments beyond the rate of inflation that has not been universal across specialties. He also emphasized the “highly skewed distribution of payments,” with a large majority going to a relatively small number of rheumatologists. “This suggests an industry strategy of targeting ‘key opinion leaders,’ or KOLs, with higher payments,” and which was not surprising, as similar patterns have been seen in other specialties. Mitchell noted that 10 drugs accounted for more than half of the payments, and that “the unifying feature of these drugs is their high cost.”

“The picture of industry strategy that emerges from Putman et al. and other similar reports is that of intense, sustained KOL-focused marketing soon after the release of a new high-margin drug,” he wrote.

Despite the descriptive nature of the study, the findings have clinical implications based on other studies of the consequences of industry payments with respect to care quality, Mitchell said. “Hypothetically, industry spending to promote drugs to physicians could increase dissemination of new, superior drugs, improving patient outcomes.” However, physicians tend to opt for game-changing drugs without added incentive; “it is the less-innovative drugs that industry has to push harder.”

The practice of industry payments for physicians becomes even more difficult to rationalize given the potential for increased out-of-pocket costs and potentially avoidable toxicities for patients, Mitchell said. “Moreover, industry payments serve no unmet need; through our professional societies and other nonprofit sources, we physicians are fully capable of staying up-to-date on new treatments without relying on industry meals and sponsored events.”

Disclosure of Payments Is Important

The study is important because it is essential to understand how public disclosure of industry payments influences financial relationship between the biomedical industry and physicians, said Amarnath Annapureddy, MD, a clinical fellow in cardiology at Yale University, New Haven, Conn., who has studied and written about industry payments to physicians.

Annapureddy said in an interview that he was surprised by how the study findings were opposite to the assumption that public disclosure would dissuade continuation of financial ties between physicians and industry. “This study showed payments increased over time rather than decreasing due to public disclosure.”

However, Annapureddy said that he was not surprised at how few physicians received the bulk of industry payments. “These physicians are considered to be ‘key opinion leaders’ who could influence practicing patterns of other physicians. These findings are similar to payment patterns for other specialties, including cardiology.

“So far, no study has evaluated factors that drive changes in industry payment patterns,” Annapureddy said. “I anticipate the patterns noted in this study will continue at least in the short term. If health care systems mandate physicians to disclose potential conflicts of interest to the patients, it may reduce payments.”

However, “unless, there is a major health policy mandate by government, I anticipate public disclosure of payments through the open payments program will not impact industry-physician ties,” he said. “This study has not evaluated impact of payments on prescribing practices. There are overwhelming data from several studies that showed payments influence physicians practicing patterns, whether it is prescribing a medication or implanting a device.” However, as for additional research, Annapureddy said that it would interesting to see a randomized trial to show whether the way physicians disclose their financial ties with patients would impact their practicing patterns.

The study received no outside funding. Putman was supported by a Rheumatology Research grant, but he and the other researchers had no financial conflicts to disclose. Mitchell disclosed a merit award from the nonprofit Conquer Cancer Foundation, for which the Foundation received financial support from Merck. Annapureddy had no financial conflicts to disclose.

This article originally appeared on MDedge.com , part of the Medscape Professional Network.

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This post originally posted here Medscape Medical News

State pensions set to hit £10k as salaries rise after coronavirus pandemic

The safeguard guarantees that the payout will increase in line with inflation, earnings or 2.5 percent – whichever is higher. Salaries rose 7.3 percent in the three months to May and 8.6 percent annually as people return to work after the pandemic, say official figures. A 7.3 percent uprating would push the basic state pension up from £137.60 a week to £147.65.

Younger pensioners claiming the flat-rate payout will go from £179.60 a week (£9,339 a year) to £192.70.

But the bill for the overall rise will be an additional £6.7billion in 2022/23. This is £4.4billion more than if the pension increased by consumer price inflation or 2.5 percent only.

But experts warn the total cost could be even higher as the Office for Budget Responsibility has forecast that earnings growth could rise to eight percent in the next two months.

Tom Selby, senior analyst at AJ Bell, said it was “entirely plausible” average earnings could spike as more parts of the economy open up.

He said this could increase the value of the flat-rate payout by £746.20 to more than £10,000 a year.

Mr Selby said: “Chancellor Rishi Sunak faces being caught between the devil and the deep blue sea on the state pension triple lock.

“While the policy could add billions of pounds to public spending at a time of severe fiscal pressure, unpicking it would break a manifesto commitment.”

However, to reduce the cost, and maintain a link to real wages, Mr Sunak could temporarily tweak the safeguard by using a three-year rolling average figure for wage growth.

This would uprate the pension by 3.4 percent in 2022/23, said figures from Jon Greer, head of retirement policy at Quilter.

This would save the Government £3.5billion next year.

Mr Greer said: “Real wages aren’t really growing by 7.3 percent when you remove the distortionary impact of Covid. The Chancellor has said there must be fairness between taxpayers and pensioners in setting the state pension increase, and one way is by basing the earnings-growth element on a three-year rolling average figure.

“State pensions will still increase by a generous 3.4 percent next year, but the Exchequer will save £3.5billion and preserve some intergenerational fairness. Debates around the triple lock often get linked to the overall level of the state pension but that is another matter. Tweaking the triple lock doesn’t mean a state pension cut.

“This is about how it maintains its value fairly over time.”

Former pensions minister Sir Steve Webb said Mr Sunak could still “recommit” to building up the value of the pension long-term.

But an adjusted average earnings figure for the April 2022 uprating could get him “off the hook” this time round. Sir Steve, now at consultants Lane Clark & Peacock, said the triple lock “was not designed for a period when average earnings are as volatile as present”.

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This post originally posted here Daily Express :: Finance Feed

TIMES OF RISE AND DECLINE OF RELIGION AND MORALITY (2)

In the first volume of the magazine Strannik in 1901 appeared an extensive article by B. Titlinov devoted to the decline of religion and morality, a phenomenon we observe today – the beginning of the 21st century of the third millennium.

In the subsequent historical course, before us appears the chosen people of God – Israel. Although he was not destined to play a significant historical role, although he was one of the smallest peoples in Asia, but in religious terms, he had such an influence on all later centuries that the history of his religious life could not be silent. Despite Israel’s highly developed religious consciousness, the fluctuation of its religious sentiment cannot be ignored. Indeed, there was no room for skepticism or disbelief in the people of Israel; but his whole life is a story of turning away from Jehovah and returning to Him. And these retreats and returns testify to the decline, or rise, of religious inclinations. It is remarkable that what was observed in the later stages of human life can be seen in this case. The successes of external material life, external prosperity coincide with religious decline. Suffice it to recall the period of the judges. External enemies are defeated, peace comes to the country. Jehovah is forgotten and incense is burned before pagan deities. When troubles from the neighboring nations came and Israel groaned under the yoke of slavery, the priests again gathered at the altar, again Israel flocked to the sanctuary to pray for help and deliverance. A particularly strong rise in religious life took place after the Babylonian captivity. Foreign domination and the destruction of Jerusalem seemed to shatter all the national expectations of the Jewish people, and in this predicament, religion was the only consolation. On the banks of the mighty Euphrates, far from home, the full force of religious feeling awoke in the Jews. The people lived with him in the subsequent period of their existence.

The first crisis in the religious life of historical humanity, which deserves serious attention, dates back to the last centuries of the pre-Christian era. This is an age that is unparalleled in later centuries. Even when there were periods of declining religion and a weakening of religious sentiment, the anti-religious movement never deeply affected the masses themselves, but rather attracted, for the most part, the upper classes. We should not consider this phenomenon as sudden, unrelated to the previous course of development. On the contrary, it has been prepared for centuries, and in recent times before Christmas, religious skepticism has manifested itself with particular force. Its origin can be traced to Greece, five centuries before our era, and only by tracing it to this source is it possible to understand the state of the world in the period under consideration. Greece, as is well known, is the birthplace of philosophy and science. Here, first after India, philosophical thought awoke. To Greece the world owes the grandiose creations of reason, the most beautiful works of art, but to it, too, unfortunately, owes the eternal disease of mankind, the disease of its spiritual organism – religious skepticism. “Once the spirit has reached itself, when the power of thought is already freed from authority and ever-reliable support, and by way of free conviction, to bring the mind to the ideal, the good, and the divine, as one fully approved by of reason. Then the seeking thought must be aroused against all prejudices, and usually opinions must be accepted only by faith, until everyone with his own mind generates and brings to himself the consciousness of universal truth ”(Carrier, Art in connection with the general development of culture, vol. .II, pp. 167-168). This is the task set by Greek philosophy – to build on the principles of reason a complete worldview, free from any influence of authority. By setting a goal in this way, she naturally came into conflict with religious beliefs. As diverse as the philosophical schools of Greece were, they all had one thing in common – the destructive influence on religion. The free development of thought required, above all, freedom in the religious sphere. Then the man was filled with faith in himself. He drove his adolescence, proud of his own strength, free himself from the shackles of authority. He hoped, indeed, to find his support in reason itself, he hoped to reach the truth completely. How great was Elina’s arrogant pride is clear from the fact that Greece deified man. Amazed by his beauty, first physical, then spiritual, she worshiped this beauty, and from that time man became the true deity of Greece. However, such self-deification could not be called religion. It satisfied the aesthetic rather than the religious needs of the human spirit. A kind of spontaneous indifference was the main characteristic of Greek life at that time. The Greek, as if he did not need a deity, was completely immersed in the world of poetry and beauty. In the beginning, we still see a desire to maintain a crumbling religion, and one of the victims of that desire was Socrates, but only a century later, this same Athenian people apparently completely lost their religious sense.

When Dimitar Poliorket settled in the temple of Athena Paladas, his people sang a hymn to one true deity with the words:

“O son of the supreme god, son of Poseidon

 And Aphrodite!

 Are the other gods without ears?

Or they are too far,

Do they exist at all, but in the end

They don’t care about us…

Here we see your face…

So we pray to you! ”

In these words there is not just indifference, but ridicule of religion, a mockery of careless frivolity, testifying to the complete decline of religious attraction among the people who composed such hymns. From Greece, the wave of disbelief spread to other countries, drawing more and more circles into society. Philosophy, completing its destructive work in the homeland, acquired more and more proselytes outside it. Rome, the lord of the world at that time, is known to have been completely under the spiritual influence of conquered Greece. Two philosophical schools in Greece attracted the most followers from Roman society, and both, although diverging in their basic principles, worked together to destroy the religious foundations of life. These two schools were the Epicurean and the Stoic.

Epicureanism is a system of an absolutely materialistic nature. For the philosophers of this trend, the world was a collection of atoms, infinitesimal indivisible particles, the various combinations of which explain all the phenomena of life. Man revolved entirely in this cycle of matter; both his body and his soul are no more and no less aggregates of material particles, whose ultimate destiny was the destruction, the decomposition of their constituent elements. The ultimate goal in this life was the enjoyment, the harmonious enjoyment of the world, to which the Epicurean assigned all his happiness. It is understandable in what relation to religion such a doctrine stood. There is no place for the deity in this world, since the latter is reduced to a simple conglomeration of matter. “Everything is a lie that the gods usually tell us,” Epicurus wrote in one of his letters, “and there is nothing just in the punishments that are supposed to be sent to the wicked, nor in the rewards provided for the good.” The students were faithful to their teacher. The derisive and contemptuous attitude towards religious beliefs was forever a hallmark of the Epicureans. Lucretius mocks the belief in variety. Heaven is powerless before fate and the laws of nature. There is no deity, no afterlife, no fear of punishment. Nature is the only deity worthy of worship, and only its sacred harmony is worthy of worship, because nature is the source of all life, it creates and develops everything according to its own laws. This deity of Epicurean philosophy needed no sacrifices, no worship, no prayers. Tears would be in vain here – the universe is eternally silent and no, because atoms are indifferent to human suffering. By the way, this circumstance did not bother the followers of Epicurus in the least. It seemed to them that they did not need a living deity, because the very need for a religious feeling had almost died out in their souls. On the contrary, even the very thought of a being above nature and beyond seemed unpleasant and disgusting to them, because it disturbed the clear and bright state of their spirit, disturbed his happy peace.

Stoic philosophy found its widest distribution in the ancient world on the border between the Old and New Testaments. But her influence is no less anti-religious than that of Epicurus. And if the latter was materialism in its purest form, then the former embodied the pantheistic worldview. There the world is seen as a collection of atoms, here descended from the deity, evolving from him according to certain laws, as from the grain grows a plant. There the deity was banished from the world, and his place was taken by the universe; here it merged with the universe, and, therefore, in the end, a lifeless, dead nature remained again. In this way, two different teachings merged into their final conclusions, and if the Epicureans suppressed any religious inclinations, their doctrine had the same effect on the Stoics.

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This post originally posted here The European Times News

Energy price rise warning: Cap to go up by more than £100

Britons should brace for a hard winter as energy prices look set to surge after a hike in wholesale gas prices, experts say. Energy analysts warn that regulator Ofgem may be forced to increase the energy cap by more than £100, pushing up bills for millions, many of whom are already struggling financially after the pandemic. The energy cap was designed to keep a lid on prices but this would mark the second big increase this year. 

In April, Ofgem lifted the price cap by £96 to £1,138 for 11 million default tariff customers, taking it back to pre-pandemic levels. Four million households on pre-payment meters saw the cap jump £87 to £1,156.

The next change is expected to be announced on August 7 and will come into force on October 1.

Dr Craig Lowrey, senior consultant at energy analysts Cornwall Insight, said rising wholesale energy and commodity prices are set to increase the cap by at least another £100.

He said: “That will push up this winter’s default tariff price cap to around £1,250 per year for a typical dual fuel direct debit customer.”

Wholesale energy prices collapsed during last year’s global lockdowns, but demand has now rebounded as the economy reopens.

Producers face higher costs as they invest in clean energy, while the cold winter across Europe and low levels of gas in storage facilities has also driven up gas prices.

Older people are likely to be hit hardest because they are less likely to switch energy supplier, with four in 10 aged 55 and over refusing to switch because they like their provider, according to a study by green energy supplier Pure Planet. 

Simon Francis, co-ordinator of the End Fuel Poverty Coalition, said more than four million people are already behind on their household bills.

He said: “The increase will be disastrous. The choice between heating or eating will become even starker.”

He said living in cold damp homes has health risks, and called on the Government to provide emergency financial support.

Higher energy costs will also hit small businesses as they battle to recover from repeated lockdowns, said Martin McTague, national vice chair of the Federation of Small Businesses.

And Will Owen of comparison site Uswitch.com, said a higher price cap in October will be bad timing – arriving as demand rises: “With many still working from home, usage remains high. The rising price cap may trap households on default tariffs into a vicious cycle of debt.”

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As Thailand hit by its worst COVID outbreak, economic risks rise

Thailand risks fueling its decade-high unemployment rate and household debt with the imposition of lockdown-like measures to contain the deadliest Covid outbreak to hit the nation.

The greater Bangkok area, accounting for about 50% of Thailand’s gross domestic product, will shutter shopping malls, spas, massage and beauty clinics for at least two weeks starting Monday. A mandatory work-from-home rule for most government employees, overnight curfews and curbs on domestic travel are set to hurt retailers, airlines and restaurant operators, already reeling from some form of Covid restrictions for more than a year.

Thailand is tightening restrictions to stem the spread of the more contagious delta variant of Covid that’s also fueled a surge in cases from Indonesia to Vietnam, and scuppered their plans to open up borders. The latest measures may further delay the Thai economy’s recovery from its worst slump in more than two decades and derail Prime Minister Prayuth Chan-Ocha’s target to welcome back vaccinated tourists by as early as mid-October.

“The economic hit will be increasingly bigger with each lockdown even if the length of the lockdown is the same,” said Maria Lapiz, managing director of Maybank Kim Eng Securities Thailand. “This is because many companies are already nearing the end of their tether after so many months of ever-shrinking revenues and stubbornly high cost of existence.”

Lapiz sees Thai households being hit hard and corporate earnings downgraded, while Radhika Rao, an economist at DBS Bank Ltd. in Singapore, says “downside risks are rising” for the growth forecast of Southeast Asia’s second-largest economy.

Here’s a look at what the latest Covid restrictions mean for the Thai economy:

GDP Growth:

Even before the announcement of the latest measures, Thailand’s central bank saw “significant downside risk” to its current 1.8% economic growth forecast for this year, saying a prolonged outbreak will squeeze business liquidity and hurt employment in the services sector. It expects the economy to return to pre-Covid levels only in early 2023 if herd immunity is delayed to the end of next year.

On Monday, the Bank of Thailand said it may slash its 2021 GDP forecast to factor in the worsening Covid outbreak, and will closely monitor the situation to see whether additional policy measures are required.

“While expectations were that this year would provide breathing room for the economy owing to vaccine availability, the economic impact is likely to mount until the rollout reaches critical mass,” Rao of DBS Bank said. “Rebound expectations hinge on public spending and exports, while a weak consumption clouds private sector investment trends.”

Unemployment, Debt:

The jobless rate is likely to rise from 1.96% at the end of the first quarter, the highest level since 2009, as more people will probably lose their jobs with a prolonged outbreak and curbs on businesses. The hit to the services industry in cities may drive more people into agriculture, a trend seen during a nationwide lockdown last year.

The Bank of Thailand last month predicted a “W-shaped” recovery in the labor market, slower than the past rebounds because of what it calls deep scars in the fragile services industry.

Thai household debt, which surged to an 18-year high of 90.5% of GDP, may further rise given the loss of jobs and income due to the tightening restrictions. That will seriously dent consumer spending, a key engine of economic growth.

Vaccinations:

Thailand has distributed about 12 million doses of vaccines, enough to cover about 9% of its population, ranking the country behind more than 120 other territories in inoculation rates. The government needs to ramp up vaccinations and consider spending the bulk of a planned 500 billion baht borrowing plan “to secure more quality vaccines rather than compensating those affected groups and stimulating economy,” according to Kampon Adireksombat, deputy managing director at SCB Securities’ Chief Investment Office.

“If we lock down without ramping up vaccinations, new cases may temporarily drop before rising again,” Kampon said. “We will be in the ugly cycle of lockdowns and compensation. This will hurt the economic outlook next year.”

Currency, Stocks:

Investors have already borne the brunt from the worsening pandemic in Thailand, with the nation’s currency and stocks both tumbling for four weeks in a row. While a strong dollar has contributed to the baht slumping to a near 15-month low, stocks have suffered from foreign investors pulling out a net $ 2.6 billion so far this year.

Earnings of consumer goods companies, retailers, airlines, hotels and shopping mall operators may be hurt by a weak economy and continued restrictions, while the baht may be more influenced by the U.S. dollar.

“Foreign investors are likely to avoid high-risk emerging markets including Thailand,” SCB’s Kampon said. “The baht will remain weak and the central bank will only step in to curb excessive moves. But it should be good for exports, which should support the economy.”