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How FujiFilm pivoted fast to capture a key piece of the COVID treatment market

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You usually think of ultrasound machines as the devices used in hospital radiology labs to produce images of the fetus in pregnant women, or pinpoint damage from heart attacks. But one of the biggest advances in the fight against COVID-19 is repurposing portable, battery operated, bedside ultrasound scanners to instantaneously show which organs are hit by the disease, and display digital images of the ravages to the heart, lungs or kidneys. Those super-quick damage checks are fast-tracking the formerly slow walk of COVID patients from the ER to the ICU.

In the early days of the pandemic, hospitals were relying on full-body CT or CAT scans that took an hour or more to identify if and where a patient might need life-saving treatments. “Patients were dying in the machine, or in a resuscitation bay before we knew where the problems were,” says Dr. Diku Mandavia, chief medical officer at FujiFilm Sonosite, the unit of the Japanese document processing and healthcare giant that’s the world’s market leader in point-of-care ultrasound gear. “COVID-19 is so dangerous because it’s a multi-organ disease. Point-of-care ultrasound is like a flashlight inserted into the body. In the instant it takes to turn on a flashlight, you can survey all the organs and blood vessels.”

In early September, the FDA cleared Sonosite’s devices for aiding in the diagnosis of COVID-19 afflictions, and today, its machines are getting never-before-seen mileage zipping around ERs and ICUs from one newly-admitted patient to the next. The pandemic has helped make the scanners-on-wheels––also produced by such rivals as Philips and GE––as the fastest-growing segment in the medical imaging industry. Dr. Mandavia, who likes comparing Sonosite devices to staples in your garage toolbox, says that “for fixing COVID-19, they’re the hospitals’ Swiss Army knife.”

FujiFilm-Sonosite-PX-Product
FujiFilm Sonosite PX Ultrasound System.
Courtesy of FUJIFILM Sonosite

Today’s Sonosite modules are about the size of an open laptop, and weigh about ten pounds. They’re typically mounted at chest-height on a metal column attached to a 4-wheel base. Some super-miniaturized models are hand-held, so that a physician can move the scanning “needle” in one set of fingers, while reading the monitor held in the other hand. Those compact units are a world apart from the first cumbersome versions that Mandavia encountered. After graduating from med school in rural Canada, the young physician in the early 1990s took his first job L.A. County + U.S.C. Medical Center in downtown Los Angeles. “It was an urban battlefield, in some ways the same kind of battlefield we’re seeing for COVID,” he recalls. “It was the height of the gang epidemic. We had knifings, shootings, car accidents. It was like a wartime MASH unit.” When patients arrived suffering from internal bleeding, the only option for finding where the bleeding came from was running them through a CAT scanner. The imaging took so long, he recalls, that victims would die before doctors could determine the right operation to perform, foreshadowing today’s crisis.

At the time, ultrasound machines were huge, weighing about three hundred pounds, and limited to the radiology departments. “We tried moving them around, but they were the size of refrigerators,” says Mandavia. To make matters worse, the probes would break every week, sidelining the machines for days at a time. But in 1999, L.A. County got the first compact device that could speed through hospital corridors and provide the quick imaging that Mandavia sought. The Sonosite 180 originated from a Department of Defense grant for production of a portable ultrasound unit rugged enough for battlefield use. The big breakthrough was going from analog to digital by deploying ASIC chips, enabling Sonosite to create the first miniaturized, battery operated device.

Mandavia saw huge potential in spreading the use of scanners to diagnose a wide range of life-threatening conditions. Throughout the 2000s, he advised Sonosite on developing new models, and in 2009, joined the manufacturer full-time as chief medical officer. “We saw the benefits of miniaturization and bringing it to the bedside,” he says. “You think about babies and radiology, but not operating rooms or EMS transfers or use in helicopters. It was making the units smaller and reducing the cost that brought them to so many other specialties.” That versatility would pay off in the COVID crisis.

FujiFilm-Sonosite-CMO-Diku-Mandavia
Diku Mandavia, CMO of FujiFilm Sonosite.
Courtesy of FUJIFILM Sonosite

In 2012, FujiFilm purchased Sonocare for $995 million. The deal was a landmark in the Japanese giant’s $9.5 billion, two-decade-long expansion in the U.S. FujiFilm has also made three major acquisitions in contract manufacturing for biologics. It’s currently partnering to produce two drugs for combatting COVID-19: a Novavax vaccine at its facilities in Texas and North Carolina, and an Eli Lilly therapeutic, developed in collaboration with the Gates Foundation, at its complex in Denmark. All told, healthcare now accounts for $4.6 billion of FujiFilm’s total sales of $21.2 billion.

The nearly ninety-year-old icon retains a strong presence in document processing and digital cameras. But FujiFilm saw the collapse in film coming early on, and diversified into expanding areas such as cosmetics and medical imaging. As a result, it now boasts sturdy growth and a $55 billion market cap. Its reinvention-on-the-fly stands in sharp contrast to the collapse of its one-time rival in film, Eastman Kodak.

Mandavia first received word of the mobile units’ effectiveness in fighting COVID from abroad. He got part of his intelligence on the COVID front lines, since he still works part-time as an ER physician at LA County + USC. “If you flash back to January and February, we had very little information in the U.S. on how serious the disease was,” he says. “Seldom in modern medicine have we faced something that’s not in the textbooks and baffles the experts.” But since Sonosite devices are plentiful in hospitals worldwide, Mandavia started getting reports from the outbreak’s first targets. “We were hearing from doctors first in China, then in Italy, that they were using point-of-care machines to image the lungs, heart, and blood vessels of patients struck by COVID-19,” he says.

The news from Milan, ground zero in Europe for the pandemic, that came over social media and emails to Mandavia from physicians on the ground, underscored the newfound power of ultrasound. “Hospitals in Milan were getting hundreds of COVID patients at a time,” recalls Mandavia, “so they couldn’t put them through CAT scanners.” Instead, doctors and nurses improvised by using a combination of ultrascans that expose damage to the organs, and pulse oximetry that deploys a sensor attached to a finger for measuring oxygen levels in the blood, to triage the severely ill from the less-sick patients.

“That told us we had a new use for the devices,” says Mandavia. In the Spring, orders for Sonosite machines surged, especially in Europe.

He notes that widespread use of the portable units makes hospitals far safer for the staff. “Constantly transferring patients from ICUs to radiology means lots of trips through the hallways where they can spread the virus so that doctors and nurses risk catching COVID,” he says. “With the portable devices, we can do the scans right at the patient’s bedside as the devices go from ICU bed to ICU bed, so the patients don’t need to move around nearly as much throughout the hospital.” Shifting to point-of-care imaging also frees up CAT scanners for essential uses such as identifying bone fractures, tumors or cancers. Every time a COVID patient goes through a CAT, the hospital staff must spend 30 to 40 minutes cleaning the machine to ensure it’s virus-free. That requirement shrinks the hours-a-day it’s scanning patients and generating revenue.

A COVID side effect plaguing hospitals: Administering the standard general anesthetics put operating room staff at risk, since the process requires running an airway tube down the patient’s trachea. Hospitals are cutting back on the elective surgeries where they make most of their money out of fear doctors and nurses will catch COVID from putting the airway tube place. Once again, ultrasound provides a solution, the use of nerve blocks in place of general anesthesia. “The scanner looks through the skin and to see the nerves, so that the anesthesiologist can pinpoint where to put the needle and inject the anesthetic around the nerve,” says Mandavia.

Mandavia describes the array of images that flash on the monitor during a COVID screening. “The devices show how well the heart is pumping,” he says. “They also signal kidney failure.” A crucial function is flagging blood clots that regularly threaten COVID patients’ lives. “The monitor shows clots in the blood vessels and in the legs that can go to the heart and kill you, and that need to be detected fast,” he adds. The images also guide physicians on where to precisely place the catheter that sends blood transfusions or drugs preventing cardiac-failure to the heart. “The catheter is like a plastic straw that goes into the neck and down the jugular vein into the heart,” explains Mandavia. “Ultrasound enables the doctor to pinpoint where the vein is, and where the catheter should go.”

Mandavia warns that the resurgence in COVID cases signals that we’re entering a scary new period. Hospitals must greatly boost capacity to handle the big surge to come. City parks may once again be sprouting tents sheltering makeshift ERs and ICUs. “When the wave hits, you can’t lug a CAT scanner to a tent, but it’s easy to use point-of-care ultrasound devices that weigh little and work on batteries,” he says. The innovation born of gang violence in L.A. is now combating a new wave of killing that’s as fast-moving and unpredictable as it is deadly. Fortunately, to every corner of a hospital overrun by COVID, the new mobile weapon can rush as well.

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Champagne is too special to be enjoyed only on special occasions. Here are 5 bottles to pop anytime this winter

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Along with almost every major celebration comes a call to pop open the bubbly. Champagne has a long-standing reputation for being the go-to drink to celebrate or toast to any special occasion and is even a defining drink for New Year’s Eve. But there’s more to Champagne than the big countdown or that rare milestone. After this year, a lesson worth taking away is that you shouldn’t wait for the special occasion. Instead, make the occasion special on your own. Champagne is a sublime way to do that.

First, let’s get a few requirements out of the way. Remember: For Champagne to be true Champagne, it has to be produced in the eponymous northeast region of France. Everything else is simply sparkling wine—although there are many, many equally satisfying and sophisticated sparkling wines out there that go by other names, such as Crémant (made in the same style as traditional Champagne but produced in other regions within France), Cava (Spain), and Franciacorta (Italy). And word to the wise: Officially, there is no such thing as “American Champagne” or “California Champagne.” It’s simply sparkling wine here, too. Anything else is just marketing.

And then there are three primary grapes used to produce Champagne: white Chardonnay grapes and red Pinot Noir and Pinot Meunier grapes; a blend of the three is what makes up most classic nonvintage bottles.

But there are many more styles of Champagne that deserve to be enjoyed just as often as any other wine. For those who are interested in the terroir (soil), a Blanc de Blancs is made using only Chardonnay grapes, a grape considered to be one of the most expressive of its terroir. While rosé has risen astronomically in popularity in the past decade, rosé Champagne has been produced since the 18th century. For the collectors, the Champagne houses also offer prestige cuvées, the finest Champagne the house produces and perfect for aging.

Here is a selection of certified Champagne wines in a variety of styles to consider popping open anytime this winter.

Beau Joie: Beau Joie specializes in zero dosage (no added sugar) Champagnes, aiming to appeal to a more health-conscious consumer. (That said, remember this is still an alcoholic beverage, and there is no such thing as a “clean wine” or a purely “healthy wine.”) Zero dosage allows the purity of the fruit to shine through without being masked by the addition of sugar. While it’s not easy to create such a delicately balanced bottle without adding sugar, as is common in the industry, consumer demand for this low-sugar approach has been on the rise for the past few years. Beau Joie’s bottles are extra special on the outside, too, as they are encased in an intricate suit of armor made from second-generation scrap copper, a functional design element that helps cool the Champagne quicker (ideal for impromptu celebrations) and keeps it colder for longer without the need for an ice bucket, which, shockingly, not everyone has at home. SRP: $69.

Champagne Henriot

Many wine lovers keep old bottles around for home decor, but Champagne Henriot takes it to the next level with its limited-edition Garden Box Rosé Kit: It not only includes a bottle of brut rosé but also can be used as a flowerpot. This copper pink–hued rosé blend showcases Pinot Noir grapes from the Montagne de Reims while retaining the fresh minerality of Chardonnay, with a palate of red berry fruits. SRP: $75.

Valentin Leflaive

Valentin Leflaive is the culmination of prolific Burgundy producer Olivier Leflaive and Erick de Sousa of Champagne de Sousa, from Avize in la Côte des Blancs. The result is a Champagne with unique minerality and complexity thanks to the Burgundy barrels. This Champagne rosé is made from 100% Pinot Noir grapes from the Montagne de Reims. The base wine (70% of the blend) is aged for seven months in stainless-steel vats. The 30% of reserve wine added was aged in Burgundy barrels, those used to make grands crus wines from Olivier Leflaive. Following the secondary fermentation, the wine was aged for 20 months in a cellar. Elegant and bright with red fruit flavors, the Champagne offers a fine mousse that supports the fresh and complex citrus notes with distinct hints of lemon, cherry, and strawberry. SRP: $75.

Ayala

The boutique maison, led by chef de cave Caroline Latrive (one of the only female cellar masters in the region), produces Chardonnay-focused wines that deliver immediate pleasure, freshness, and elegance. Ayala is, for the most part, an under-the-radar Champagne brand. But the 2013 Blanc de Blancs could change minds on that one. Produced only in exceptional years, this 100% Chardonnay wine is the ultimate expression of Latrive’s winemaking style. It offers remarkable minerality and roundness. And the flavors build as it sits in the glass—becoming almost velvety—with notes including passion fruit, citrus, white peaches, and honey. SRP: $110.

Pol Roger:

Pol Roger is one of the few Grande Marque (most prestigious) Champagne houses that remains family-owned and operated. It is known for its tradition of aging and hand-riddling every bottle in the 4.66-mile-long cellars under the estate’s château, situated on the Avenue de Champagne in Epernay, France. The house’s rosé exhibits a deep salmon-pink color with a fine stream of small bubbles. The nose has aromas of ripe fruit with elements of citrus (blood orange), pomegranate, and small wild red berries. On the palate, a deep mineral character; a fine, creamy ripeness; and a hint of vanilla. The wine is tender and smooth, with a balance of delicate freshness and refined elegance. SRP: $123.

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Apple is forced to include iPhone charger for not demonstrating ‘environmental benefits’

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Brazilian users could purchase an iPhone with charger included.

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The young and unemployed need better networks

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“It comes in waves,” said Isabelle Risse, a recent graduate of St. Michael’s in Vermont. Risse has applied to more than seventy jobs since graduating in May—with no positive results yet. “One week I’ll send out fifteen applications. And then the next I am so hopeless.”

Risse is not alone. Close to one in four workers between the ages of 16 and 24 is unemployed, according to a recent study by the Economic Policy Institute. There is hope for young workers like Risse, but avoiding a career derailment and a lost generation will require young job-seekers and employers alike to focus more on connection.

More than half of the workforce finds jobs through personal connections. Decades of research has shown that people who use their personal contacts spend less time searching for jobs and end up in higher paying, more prestigious occupations. What’s more, while experienced workers are most likely to find their jobs through weaker ties—acquaintances, former colleagues, someone from the gym—that isn’t true for workers who are looking for their first real job.

Young workers are more likely to find a job through their closest connections, particularly their parents. This tendency is heightened during periods of increased unemployment, according to research by economists Francis Kramarz and Oskar Nordström Skans.

Still, despite the importance of turning to people who they know for help, young workers are less likely to use their personal contacts to look for work. A nationally representative study of unemployed workers by the Urban Institute found that only 23.6% of 16-to-24-year-olds looking for work reached out to family or friends for help, far less than older workers in a job search. There are at least three reasons why. 

The young are often reluctant to network

Risse eventually realized that if she wanted to find a job, she needed to do more than look on websites like Indeed and Idealist, but upon considering that notion, she says, she “was almost put off by it.” Similarly, Kaitlyn Zorilla, a 23-year-old living with her parents in Vista, Calif., said that between COVID, the election, and the holidays, “I’ve been reluctant to reach out to people that I know less. It’s just a burden to be asking people for help right now.”

Young or not, many people feel an aversion to the idea of “networking.” When 308 adults were asked to recall a time when they either networked for professional gain or just to socialize, participants who recalled a professional networking experience were twice as likely as their socializing counterparts to think of cleansing words like “wash” when presented with a word completion exercise (such as “w_sh”). The implication was that the sheer idea of networking made them feel dirty, according to the study conducted by Tiziana Casciaro of the University of Toronto, Francesca Gino of Harvard, and Maryam Kouchaki of Northwestern University. This difficult social moment we are all living through likely intensifies our moral aversion.

One way of overcoming this, according to the research trio, is to adopt a learning mindset and think of reaching out as an opportunity to grow. Another is to think of making these connections in terms of what you have to give. While the trio’s work suggests that less seasoned workers often feel as though they have little to offer, asking for help is giving someone else an opportunity to be of service and to tap into their own sense of expertise, even mastery.

Young people’s networks are limited in scope

But even when young professionals are able to overcome the drag of moral resistance, they face yet another challenge: Their networks often don’t have the reach that they need. “You’re on your own,” reflected Veronica Wells, 24, who had been working as a waitress prior to COVID. “I’ve been on my own for a while, since I was 17. I have to build up my own network.” 

Unsurprisingly, networks of the young and unemployed are often filled with other people who are the same age, also looking for a job. As Zorilla put it, “When all your other connections are also unemployed 22- or 23-year-olds, it doesn’t really help that much.” Moreover, in a recent study, my colleagues Balazs Kovacs, Nicholas Caplan, Samuel Grob and I found that networks have shrunk by more than 17% during COVID—shrinking just when young workers need them most.

The rate of joblessness among those under 24 is twice that of workers beyond this point, which is to say that if we want to lift the economy, young workers need help. Unemployment is “stunting social emotional learning and connectivity,” according to Marina Marmolejo, the executive director of Dream Kit, an organization that helps unstably housed youth find employment. “That means they don’t have people in their network that can help them to the next phase.”

Having a job makes you better at getting a job

This goes for recent college graduates as much as those who are low-income and job-insecure. Many of the skills that are essential for landing a job and succeeding in the workplace—the importance of listening, the power of knowing when to ask follow-up questions, the know-how to work in a team—are learned through social interactions on the job. This is where the young find more critical social connections as well. Mentors and sponsors are usually found at work.  

The network failures facing young people will have significant effects that extend far beyond the pandemic if they go unaddressed. Lisa Kahn, a professor at the University of Rochester, found that the economic consequences of graduating during a recession persist for more than 15 years—because young workers don’t have the opportunity to learn as they work.

Reasons for hope

Despite the seemingly grim circumstances, Marmolejo is “really excited about the future. Youth who weren’t able to access the job market can now access it through technology.” Young potential employees are bored and desperate to have the opportunity to contribute. “I sit in my room all day, sitting in the same position in bed, staring at my closet door for eight months,” said. Zorilla. “I’m willing to work as an office assistant now in a field that I’m not passionate about, just because I need a job.”

For companies struggling with online work, a large untapped pool of the digitally native should be viewed as a huge opportunity. Having Zoom meeting schedulers and greeters, talent who know how to market and deliver customer service online, and those with the creative drive to devise clever online alternatives to holiday parties or client mixers would make companies better and give young workers an opportunity to engage and keep growing. As Marmolejo argued, “There are opportunities to keep that learning cycle going. The virtual world is too accessible not to invite youth in.” 

Heading off the negative long-term implications of unemployment for young workers, starts with creating opportunities to connect. Young workers need an opportunity to meet people who can help them think through a career, not just give them a job. They need the chance to learn social skills that are critical for careers. For those who are firmly entrenched in a job, the young have a lot to teach employers too—about the virtual world and the real one as they see it. Solving this massive and multi-pronged problem begins with connection. If you are young and looking for work, I heartily recommend that you ask for help. If you are up the career ladder, stand ready to offer it.

Marissa King is professor of organizational behavior at the Yale School of Management, where she developed and teaches the course entitled Managing Strategic Networks. Her book, Social Chemistry: Decoding the Patterns of Human Connection, is coming out in January. Watch an interview with King here.

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