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    Bet against ‘superstar’ executives like Mark Zuckerberg and Tim Cook at your own peril, Jim Cramer warns

    Monday – Friday, 6:00 – 7:00 PM ET

    CNBC’s Jim Cramer on Thursday advised investors to trust big-name executives – especially those at the helm of the major companies that just reported quarterly earnings.
    “[They] don’t win every game, but over the long haul they win a lot more often than they lose, and counting them out is rarely a smart decision,” the “Mad Money” host said.

    CNBC’s Jim Cramer on Thursday advised investors to trust big-name executives – especially those at the helm of the major companies that just reported quarterly earnings.
    “You bet against these superstar CEOs and CFOs at your own peril. … [they] don’t win every game, but over the long haul they win a lot more often than they lose, and counting them out is rarely a smart decision,” the “Mad Money” host said.

    “Too often stocks go down because people who haven’t done the homework are knocking them down for reasons that make no sense. Just because a stock is down, that doesn’t mean the decline is justified,” he said.
    Cramer singled out five well-known business executives whose companies reported quarterly results recently, acknowledging that investors shouldn’t trust every business leader with a big reputation. 
    “The world’s complicated, people are fallible, no executive deserves your blind faith,” he said.
    Here are his thoughts on each company:
    Alphabet

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    “That’s [chief financial officer] Ruth Porat. Titan. If she says the quarter’s great and she explains it, you don’t just dismiss it. … You dismiss the clowns selling the stock,” Cramer said.
    Meta

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    “Facebook put aside billions to defeat TikTok; [CEO Mark] Zuckerberg only spent a fraction of that and he’s already created something better. … This is the guy the bears want to bet against? You can’t be serious,” he said.
    Ford

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    “Ford stock is one of the cheapest in the S&P 500. I’d be a buyer,” Cramer said.
    Microsoft

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    “Buying Microsoft into that foolish dip … was like stealing candy from an adult,” Cramer said.
    Apple

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    “A lot of people traded around the stock of Apple as usual because we heard bad things about supply problems, and China, and drab phones and slowing services. That’s people betting against [CEO] Tim Cook. … It’s Tim Cook, for heaven’s sake,” Cramer said.
    Disclosure: Cramer’s Charitable Trust owns shares of Alphabet, Apple, Ford, Meta and Microsoft.

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    Elon Musk will be the most indebted CEO in America if the Twitter deal goes through

    Two-thirds of Elon Musk’s financing for the $44 billion deal to take Twitter private will have to come out of his own pocket. He has a net worth of about $250 billion.
    Yet because much of his wealth is tied up in Tesla stock, Musk will have to sell millions of his shares and pledge millions more to raise the necessary cash.
    According to research firm Audit Analytics, Musk has more than $90 billion of shares pledged for loans.
    That makes him the largest stock-debtor in dollar terms among executives and directors, far surpassing second-ranked Larry Ellison, according to ISS Corporate Solutions.

    Tesla head Elon Musk talks to the press as he arrives to have a look at the construction site of the new Tesla Gigafactory near Berlin on September 03, 2020 near Gruenheide, Germany.
    Maja Hitij | Getty Images

    The world’s richest person could soon add another title to his name – America’s most leveraged CEO.
    Two-thirds of Elon Musk’s financing for the $44 billion deal to take Twitter private will have to come out of his own pocket. That pocket is deep. He has a net worth of about $250 billion.

    Yet because his wealth is tied up in Tesla stock, along with equity in his SpaceX and The Boring Co., Musk will have to sell millions of his shares and pledge millions more to raise the necessary cash.
    According to his SEC filings, Musk’s financing plan includes $13 billion in bank loans and $21 billion in cash, likely from selling Tesla shares. It also includes a $12.5 billion margin loan, using his Tesla stock as collateral. Because banks require more of a cushion for high-beta stocks like Tesla, Musk will need to pledge about $65 billion in Tesla shares, or about a quarter of his current total, for the loan, according to the documents.
    Even before the Twitter bid, Musk had pledged 88 million shares of the electric auto maker for margin loans, although it’s unclear how much cash he’s already borrowed from the facility.

    According to research firm Audit Analytics, Musk has more than $90 billion of shares pledged for loans. The total makes Musk the largest stock-debtor in dollar terms among executives and directors, far surpassing second-ranked Larry Ellison, Oracle’s chairman and chief technology officer, with $24 billion, according to ISS Corporate Solutions, the Rockville, Maryland-based provider of ESG data and analytics.
    Musk’s stock debt is outsized relative to the entire stock market. His shares pledged before the Twitter deal account for more than a third of the $240 billion of all shares pledged at all companies listed on the NYSE and Nasdaq, according to Audit Analytics. With the Twitter borrowing, that debt could soar even higher.

    Of course, Musk has plenty of cushion, especially since he continues to receive new stock options as part of his 2018 compensation plan. His 170 million in fully owned Tesla shares, combined with 73 million in options, give him a potential stake in Tesla of 23%, at a value of over $214 billion. The rest of his net worth comes from his more than 50% stake in SpaceX and his other ventures.
    He received another 25 million options as part of the plan this month as Tesla continued to meet its performance targets. While Musk can’t sell the newly received options for five years, he can borrow against them.
    Yet Musk’s 11-figure share loans represent an entirely new level of CEO leverage and risk. The risks were highlighted this week as Tesla’s share price slid 12% on Tuesday, chopping more than $20 billion from Musk’s net worth. Shares of Tesla were down less than 1% on Thursday afternoon.
    Musk’s bet also come as other companies are sharply cutting back or restricting share borrowing by executives. More than two-thirds of S&P 500 companies now have strict anti-pledging policies, prohibiting all executives and directors from pledging company shares for loans, according to data from ISS Corporate Solutions. Most other companies have anti-pledging policies but grant exceptions or waivers, like Oracle. Only 3% of companies in the S&P are similar to Tesla and allow share pledging by executives, according to ISS.
    Corporate concerns about excess stock leverage follow several high-profile blowups in which executives had to dump shares after margin calls from their lenders. Green Mountain Coffee Roasters in 2012 demoted its founder and chairman, Robert Stiller, and its lead director, William Davis, after the two men were forced to sell to meet margin calls. In 2015, Valeant CEO Michael Pearson was forced to sell shares held by Goldman Sachs as collateral when it called his $100 million loan.
    Jun Frank, managing director at ICS Advisory, ISS Corporate Solutions, said companies are now more aware of the risks of executive pledging, and face greater pressure from investors to limit executive borrowing.
    “Pledging of shares by executives is considered a significant corporate governance risk,” Frank said. “If an executive with significant pledged ownership position fails to meet the margin call, it could lead to sales of those shares, which can trigger a sharp share drop in stock price.”
    In its SEC filings, Tesla states that allowing executives and directors to borrow against their shares is key to the company’s compensation structure.
    “The ability of our directors and executive officers to pledge Tesla stock for personal loans and investments is inherently related to their compensation due to our use of equity awards and promotion of long-termism and an ownership culture,” Tesla said in its filings. “Moreover, providing these individuals flexibility in financial planning without having to rely on the sale of shares aligns their interests with those of our stockholders.”
    The exact amount that Musk has borrowing against his shares remains a mystery. Tesla’s SEC filings show his pledge of 88 million shares, but not how much cash he’s actually borrowed against them. If he pledged the shares in 2020 when Tesla stock was trading at $90, he would have been able to borrow about $2 billion at the time. Today, the borrowing power of those shares has increased tenfold, so he could have room to borrow an additional $20 billion or more against the 88 million shares already pledged. In that case, only about a third of his Tesla stake would be pledged after the Twitter deal.
    Yet if he’s increased his borrowing as Tesla shares have risen in value, he may have to pledge additional shares. Analysts say that if Musk has maxed out his borrowing on the 88 million shares (which is highly unlikely) and he has to pledge an additional 60 million shares to fund the Twitter deal, more than 80% of his Tesla fully owned shares would be pledged as collateral.
    That would leave him with about $25 billion in Tesla shares unpledged. If he also has to sell $21 billion of Tesla shares to pay the cash portion of the Twitter deal, as well as the accompanying capital gains taxes, virtually all of his remaining fully owned stock would be pledged.
    Either way, Musk will be putting a large share of his Tesla wealth at risk, which could make for a bumpy ride ahead for Tesla shareholders.
    Borrowing against shares, Frank said, “exposes shareholders to significant stock price risk due to an executive’s personal financing decisions.”

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    Stocks making the biggest moves after hours: Amazon, Apple, Robinhood and more

    An Amazon truck is seen entering the LDJ5 Amazon Sort Center on April 25, 2022 in New York City.
    Michael M. Santiago | Getty Images

    Check out the companies making headlines in extended trading.
    Amazon — Shares of the e-commerce giant tumbled by 10% after hours, after the company reported first-quarter results and issued weaker-than-expected revenue guidance for the second quarter. Amazon recorded a $7.6 billion loss on its Rivian investment after the EV maker’s shares lost more than half their value in the quarter.

    Apple — Apple shares initially got a lift after a big earnings beat but turned lower after CFO Luca Maestri said on the earnings call that supply chain constraints could hinder fiscal third-quarter revenue by between $4 billion and $8 billion. Shares were down more than 4% after hours.
    Robinhood — The investing app’s shares dropped more than 8% after reporting a wider-than-expected loss and shrinking revenue for the first quarter. The company also reported a decrease in monthly active users, to 15.9 million from 17.7 million a year ago.
    Intel — Tech firm Intel’s shares fell more than 4% after the company issued weak guidance for its fiscal second quarter. Intel called for adjusted second quarter-earnings per share of 70 cents, compared to the 83 cents per share expected by analysts polled by Refinitiv.
    Western Digital — The computer company’s shares rose more than 2% in extended trading following a strong earnings report for the company’s most recent quarter. Western Digital posted $1.65 per share in earnings for the quarter, compared to estimates of $1.49 per share, according to FactSet. It also topped revenue estimates and issued strong guidance for the next quarter.
    Roku — The streaming company saw shares jump more than 7% after reporting quarterly results. Despite recording an earnings miss and weak second-quarter revenue guidance, it brought in $734 million in revenue for the first quarter, while analysts were expecting $718 million, according to Refinitiv.
    Mohawk Industries — The flooring company’s shares jumped more than 10% after hours, following Mohawk’s quarterly results. Mohawk topped revenue estimates of $2.85 billion, according to FactSet, posting $3.02 billion for the quarter.

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    California subpoenas Exxon for details on role in global plastic pollution

    California’s attorney general on Thursday announced an investigation into the fossil fuel and petrochemical industries for allegedly overstating the role of recycling in curbing global plastic pollution and accelerating the crisis.
    Attorney Gen. Rob Bonta said his office has subpoenaed Exxon Mobil for information relating to the company’s alleged role in deceiving the public and worsening plastics pollution.
    The office didn’t specify what other companies it was investigating.

    A logo of the Exxon Mobil Corp is seen at the Rio Oil and Gas Expo and Conference in Rio de Janeiro, Brazil September 24, 2018.
    Sergio Moraes | Reuters

    California’s attorney general on Thursday announced an investigation into the fossil fuel and petrochemical industries for allegedly overstating the role of recycling in curbing global plastic pollution and exacerbating the crisis.
    Attorney Gen. Rob Bonta said his office has subpoenaed Exxon Mobil for information relating to the company’s alleged role in deceiving the public and worsening plastics pollution. The office didn’t specify what other companies it was investigating. Exxon did not immediately respond to a request for comment.

    As state legislatures and local governments in the 1980s began considering bills restricting or banning plastic products, fossil fuel and petrochemical companies began an “aggressive” and “deceptive” campaign to persuade the public that they could mitigate the waste problem by recycling, which the industry knew wasn’t true, Bonta alleged in a news release.
    “For more than half a century, the plastics industry has engaged in an aggressive campaign to deceive the public, perpetuating a myth that recycling can solve the plastics crisis,” Bonta said. “The truth is: The vast majority of plastic cannot be recycled.”

    More from CNBC Climate:

    “This first-of-its-kind investigation will examine the fossil fuel industry’s role in creating and exacerbating the plastics pollution crisis – and what laws, if any, have been broken in the process,” Bonta said.
    The world produces about 400 million tons of plastic waste each year, according to estimates from the United Nations. Plastics take hundreds of years to decompose, and the majority of plastics end up sitting in landfills or the ocean. The U.S. only recycles about 9% of its plastic, according to the Environmental Protection Agency.
    Plastics are also set to drive nearly half of oil demand growth by mid-century, according to the International Energy Agency. Fossil fuel and petrochemical companies recently invested more than $200 billion to expand plastic production worldwide.

    Environmental activist groups on Thursday applauded the state’s investigation of the fossil fuel industry.
    “For too long, ExxonMobil and other corporate polluters have been allowed to mislead the public and harm people and the planet,” said Graham Forbes, plastics global campaign lead at Greenpeace USA. “The science has become crystal clear that we must move away from fossil fuels and throwaway plastic.”
    — CNBC’s Katie Brigham contributed reporting

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    Stocks making the biggest moves midday: Meta, McDonald's, Teladoc, Ford and more

    Pavlo Gonchar | LightRocket | Getty Images

    Check out the companies making headlines in midday trading.
    Meta Platforms — Shares of the company formerly known as Facebook surged 17.6% after reporting mixed first-quarter results. The company posted a beat in earnings but a disappointing revenue miss. It also saw daily active users grow following a decline in the fourth quarter.

    McDonald’s – Shares of the restaurant chain gained nearly 3% after first-quarter revenue topped expectations. McDonald’s reported first-quarter revenue of $5.67 billion versus the $5.59 billion expected by analysts, according to Refinitiv. The company saw same-store sales growth of 3.5% in the U.S. and even higher in international markets, ahead of estimates compiled by StreetAccount.
    Qualcomm — Qualcomm’s stock price surged more than 9.7% after its most recent earnings report showed all four of the company’s semiconductor businesses grew during the most recent quarter. Qualcomm posted adjusted earnings per share of $3.21 on revenue of $11.16 billion. Analysts surveyed by Refinitiv were forecasting earnings of $2.91 per share on revenue of $10.60 billion.
    Ford — The automaker’s shares fell 1.6% after the company said its stake in Rivian dragged profits lower in the recent quarter. Ford reported adjusted earnings per share of 38 cents on $32.1 billion in revenue. Analysts surveyed by Refinitiv anticipated earnings of 37 cents per share on $31.13 billion in revenue.  
    Caterpillar – Shares of the machinery company dropped 0.7% despite a first-quarter report that beat estimates on the top and bottom lines. Caterpillar reported an adjusted $2.88 in earnings per share on $13.59 billion of revenue. Analysts surveyed by Refinitiv had penciled in $2.60 in earnings per share on $13.40 billion of revenue. The company’s sales growth did slow relative to the fourth quarter, and operating profit margins shrank year over year.
    PayPal — PayPal shares jumped 11.5% following a beat on revenue in the first quarter. The stock rose even as the payments firm issued weak guidance for the second quarter and full year.

    Mastercard — Mastercard shares gained 4.8% following a beat on the top and bottom lines in the recent quarter. For the first time since the start of the pandemic, the company said cross-border travel ticked above 2019 levels.
    Comcast — Shares of Comcast plummeted more than 6.2% despite beating analysts’ expectations on the top and bottom lines as growth in broadband subscriptions slowed. The company beat analysts’ estimates on the metric but noted that roughly 80,000 of the subscribers were free internet customers.
    Southwest Airlines — Southwest Airlines’ stock rose 2.1% after reporting a wider-than-expected loss but a beat on revenue in the recent quarter. The company reaffirmed its second-quarter forecasts and said it expects revenue for that period to outpace 2019 despite fewer flights.
    Pinterest — Pinterest’s stock price jumped 13.6% following an earnings beat. On Wednesday, the image-sharing company reported adjusted earnings of 10 cents per share and revenues of $575 million. In comparison, analysts polled by Refinitiv expected earnings of 4 cents per share on revenues of $573 million.
    Eli Lilly — The drug maker’s shares 4.3% after the company reported results from a clinical trial showing its obesity drug tirzepatide helped patients lose up to 22.5% of their weight. Eli Lilly also reported better-than-expected earnings and revenue for the first quarter and boosted its full-year revenue guidance.
    Teladoc —  Shares of the telehealth service plummeted by 40.2% after the company reported an earnings miss for its most recent quarter and gave weaker-than-expected revenue guidance, after which at least six Wall Street firms issued downgrades of the stock.
    ServiceNow — Shares of ServiceNow added 8.1% following a beat on the top and bottom lines in the recent quarter. The company saw $1.73 adjusted earnings per share on $1.72 billion in revenue. Analysts expected $1.70 per share and $1.70 billion in revenue, according to FactSet’s StreetAccount.
    — CNBC’s Jesse Pound, Tanaya Macheel and Sarah Min contributed reporting
    Disclosure: Comcast owns CNBC’s parent NBCUniversal.

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    1-800-Flowers shares sink as retailer cuts outlook over waning consumer demand

    1-800-Flowers on Thursday reported fiscal third-quarter results below analysts’ expectations and slashed its outlook for the year amid heightened inflation and waning demand for some of its gifts.
    CEO Chris McCann said that solid demand around Valentine’s Day was offset by “overall slower consumer demand for everyday gifting occasions.”

    Chris McCann, CEO, 1-800-Flowers
    Scott Mlyn | CNBC

    Valentine’s Day wasn’t enough for 1-800-Flowers last quarter.
    Shares of the company tumbled 15% Thursday and hit a fresh 52-week low of $9.13, after the online retailer reported fiscal third-quarter results below analysts’ expectations and slashed its outlook for the year amid heightened inflation and waning demand for some of its gifts.

    Chief Executive Officer Chris McCann said that solid demand around Valentine’s Day was offset by “overall slower consumer demand for everyday gifting occasions” during the three-month period ended March 27.
    1-800-Flowers also saw continued, and in some instances escalated, macroeconomic cost headwinds, he said.
    That was combined with waning demand from consumers, “reflecting growing consumer concerns with rapidly rising inflation and geopolitical unrest,” McCann said. The war in Ukraine, triggered by Russia’s invasion in late February, has created widespread economic turmoil.
    The CEO said in a press release that he sees cost obstacles to continue in the near term, too.
    1-800-Flowers, which also owns Harry & David, Shari’s Berries and PersonalizationMall.com, cited increased expenses for labor, shipping and marketing.

    The company reported a fiscal third-quarter net loss of $23.4 million, or 36 cents per share, compared with net income of $1.4 million, or 2 cents per share, a year earlier. Excluding one-time items, it lost 32 cents a share, bigger than the 28-cent loss that analysts polled by Refinitiv had been looking for.
    Revenue of $469.6 million was down 1% from the year-ago period. That was short of the $486.9 million that analysts were anticipating.
    For fiscal 2022, the company projected revenue growth of 3% to 5%, short of the 6.7% growth that analysts had expected. The company had been calling for revenue growth of 7% to 9% for fiscal 2022.
    The company has a market cap of $674.5 million, as of market close Thursday. Shares are down 55% year to date.
    “The current macroeconomy is highly unpredictable, with rising inflation and other factors impacting both costs and consumer demand,” said McCann. “However, it is important to note that we have faced challenging macro market conditions in the past and … we have emerged a bigger, better, and stronger company.”

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    How Headspace Health is tackling the global mental health crisis

    The 2022 CNBC Disruptor 50 list will be revealed Tuesday, May 17th

    Ginger.io was an original CNBC Disruptor 50 company, and growing out of an MIT Media Lab team, an early aggregator of digital health data and predictive analytics, and proponent of digital health care delivery.
    While its seed funding occurred back in 2011, it became a unicorn in 2021, and in the same year merged with Headspace Health to create a $3 billion digital mental health company as the scale of the global mental health crisis grew throughout Covid.
    Digital health and telehealth have high potential, and the space has seen a wave of consolidation to grow scale, but the sector has come crashing back down to earth this year, with some of the most prominent public companies, including Teladoc, Hims & Hers Health, and Amwell, seeing massive stock declines.

    In this weekly series, CNBC takes a look at companies that made the inaugural Disruptor 50 list, 10 years later.
    In 2013, the idea of an app for mental health-care may have seemed novel, if not monumental in terms of a global challenge for a disruptive start-up. But times have changed. A global pandemic that led to a massive spike in mental health challenges, and the acceleration in adoption of technology-based health care, make what start-ups like Ginger.io set out to do more than a decade ago seem ahead of their time.

    Globally, the World Health Organization estimates approximately 1 billion people are living with a mental disorder, and that the vast majority of those in low- and middle-income countries where mental, neurological and substance abuse disorders receive no treatment at all. The supply-demand imbalance for mental health care surged since the Covid-19 pandemic. One Lancet study estimated that 53 million additional cases of major depressive disorders and 76 million additional cases of anxiety disorders globally in 2020.
    Ginger.io, which grew out of an MIT Media Lab team focused on aggregating and analyzing health care data, was featured on the inaugural CNBC Disruptor 50 list in 2013 for leading the way in creating a data-driven, on-demand digital mental health ecosystem. It became a unicorn in 2021 after a $100 million funding round led by Blackstone.
    At the time of the deal, Ginger reported revenue that had tripled year-over-year for three consecutive years and more than 500 employer customers including Paramount, Delta Air Lines, Domino’s, SurveyMonkey, Axon, 10x Genomics, and Sephora, as well as deals with corporate health-care concierge company Accolade and upstart online pharmacy Capsule.
    The company said demand for its services increased three-fold during the pandemic, but as the scale of the mental health-care issue has grown, the start-ups tackling it have had to scale, too. Late in 2021, Ginger merged with an app-based business many people looking for some calm during Covid had come to know: meditation app Headspace.
    The $3 billion merger of Headspace Health and Ginger was part of a larger consolidation trend within the digital health care space and movement by disparate health tech businesses to roll up a full suite of services under a model known as value-based care. Other original CNBC Disruptors — Castlight Health, which merged with Vera Whole Health, and Audax (now part of health giant UnitedHealth’s tech-based business Optum) — were among a recent wave of deals among some of the best known health tech start-ups. Virgin Pulse and Welltok. Accolade buying PlushCare. Grand Rounds and Doctors on Demand. Teladoc and chronic care company Livongo.

    The combined Headspace-Ginger entity reaches nearly 100 million lives across 190-plus countries through direct-to-consumer business and 3,500+ enterprise and health plan partners.
    “The increase in need is staggering,” said Russell Glass, CEO of Headspace Health. “You’ve gone from 20% of the [U.S.] population with a need to 40%, so a doubling of those with an acute anxiety, depression or other mental health need.” 
    Headspace Health clients include Starbucks, Adobe, Delta Air Lines and Cigna. 

    The original CNBC health care disruptors: Where are they now?

    “Mental health is clearly a global challenge,” said Karan Singh, COO of Headspace Health. And it is a challenge that includes business complexity, from varying regulations around the world to language-based needs. “Everyone may use a different language to describe things that they are going through, but this is something that most everyone is going through,” Singh said.  
    In the U.S., as the pandemic continues and regulations evolve, Headspace Health faces the challenge of getting lawmakers to view telehealth in the same category as traditional health care.
    The Biden administration is focusing on mental health among other health-care priorities, including plans to decrease restrictions to practice virtually across multiple states, a step Glass said is long overdue and critical in building a mental health infrastructure that is equitable economically, racially and geographically.
    “Solving this crisis should and can be our next JFK moonshot moment,” Glass said.
    “I do think we are going to need some structural changes to ensure that some of the gains we’ve seen over the past few years actually persist,” added Singh. 
    Virtual care has become a powerful and effective way for accessing care, and many people prefer it to in-person care, or at least to have the option.
    “The cat’s out of the bag,” Glass said. “As consumers realize just how amazing telehealth is, and as the government bodies hear more and more from those consumers, we’re going to see change happen.”
    Glass compares Headspace’s current regulatory struggle to the one faced by Uber, and cited how consumer preferences inspired regulatory change. 
    But the digital health space is facing more acute market challenges, with its post-pandemic playbook being questioned, highlighted by this week’s disastrous earnings results from Teladoc, which included a more than $6 billion write down related to its acquisition of Livongo. Some of the most prominent names to go public associated with digital health have seen their public market values decimated over the past year, including Teladoc, Hims and Hers Health, and American Well, as core telehealth services become commoditized and the market opportunity among corporate buyers and insurers willing to pay more for a full suite of digital health care seems less assured.
    Headspace Health sees room for both competitors, and more deal-making.
    “We want to transform mental health care to improve the health and happiness of the world. We’re not going to do it alone,” Glass said. “A healthy competitive environment is critical to accomplish what we want to accomplish.”
    Earlier this year, Headspace acquired Sayana, an AI-driven wellness company, further increasing the breadth of services and scope of care into its portfolio. 
    As it attempts to increase access to mental health care services, the ultimate goal is to drive costs lower.
    “How do we take the cost out of care? How do we keep people from needing higher levels of care?” Glass said.
    Singh provided the answer. “Focus on prevention. Ultimately, that’s the only way out of this,” he said.  
    —By Zachary DiRenzo, special to CNBC.com 

    Sign up for our weekly, original newsletter that goes beyond the annual Disruptor 50 list, offering a closer look at companies like Headspace and entrepreneurs like Glass and Singh who continue to innovate across every sector of the economy. More

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    Severe hepatitis outbreak in healthy kids possibly linked to adenovirus infection, WHO officials say

    Eleven countries, including the U.S., have reported a total of 169 cases of severe acute hepatitis in healthy children aged 1 month to 16 years old, with the largest outbreak in the U.K.
    At least 17 children have required liver transplants and one patient has died, according to the WHO.
    The World Health Organization and the U.S. Centers for Disease Control and Prevention believe the outbreak might be linked to adenovirus, though investigations are continuing.
    In the past, adenoviruses have been rarely associated with hepatitis in children with weak immune systems but not in healthy ones.

    Adenovirus (highly contagious virus). Image made from a transmission electron microscopy view.
    Cavallini James | BSIP | Universal Images Group | Getty Images

    An outbreak of severe hepatitis in healthy children that has caused liver failure in some kids might be linked to adenovirus infection, though further investigation is needed, World Health Organization officials said on Thursday.
    Eleven countries, including the U.S., have reported at least 169 cases of severe acute hepatitis in children aged 1 month to 16 years old with the largest outbreak in the U.K, according to the latest WHO report. At least 17 children have required liver transplants and one patient has died.

    Hepatitis is an inflammation of the liver most commonly caused by viruses, but medications and toxins can also trigger the condition.
    “What is particularly unusual is that the majority of these children were previously healthy,” Dr. Philippa Easterbrook, a WHO official who monitors hepatitis, said during a question and answer session livestreamed on the global health agency’s social media Thursday.
    At least 74 of the children have tested positive for adenovirus, according to the WHO. Adenoviruses are common and usually cause respiratory illness but can also result in stomach pain, pink eye and bladder infections. The severe hepatitis outbreak in kids has coincided with increased transmission of adenovirus in countries such as the U.K., according to the WHO.
    “This doesn’t at this stage prove that there’s a causal link to these cases, but it is a promising interesting early signal that is being looked at in more detail,” Easterbrook said.
    Adenovirus has, in rare instances, been associated with hepatitis in children with weak immune systems, according to Dr. Richard Peabody, who leads WHO Europe’s high-threat pathogens team. However, adenovirus is not a known cause of hepatitis in healthy children, according to the WHO.

    “This is sort of an unusual phenomena that we’re seeing and that’s why we’re sort of alerting parents and public health authorities about this,” Peabody said.
    At least 20 of the children had Covid, with 19 of them testing positive for that virus as well as adenovirus, according WHO data. Peabody said it’s possible Covid also is playing a role in the hepatitis outbreak, though it’s not clear and more investigation is needed to determine if that’s the case.
    U.K. officials first notified the WHO about an outbreak of severe acute hepatitis in children earlier this month. The most common symptoms have been liver inflammation, stomach pain, diarrhea, vomiting and jaundice, according to the WHO.
    The U.S. Centers for Disease Control and Prevention last week issued a nationwide health alert after finding nine cases of hepatitis in children aged 1 to 6 years old in Alabama. They all had liver damage with some suffering liver failure, according to the CDC. The CDC also believes adenovirus may be the cause, though the public health agency said investigations are continuing.
    Easterbrook said health officials have largely ruled out the hepatitis A, B, C, D and E viruses as a possible cause. Hepatitis viruses have not been detected in any of the reported cases, according to the WHO. Other viruses such as CMV and Epstein Barr also don’t appear to account for the outbreak, Easterbrook said. Parents of the children so far have not reported a common exposure to a drug, toxin, food or travel destination, she said.
    The WHO has also largely ruled out Covid-19 vaccination as a possible cause because a majority of the children had not receive the shots, Easterbrook said.

    CNBC Health & Science

    Read CNBC’s latest global coverage of the Covid pandemic:

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