covid-19 pandemic impacts and response a novel strain of coronavirus disease ( “ covid-19 ” ) was officially declared a pandemic by the world health organization ( “ who ” ) in march 2020. in efforts to slow and control the spread of covid-19 , governments around the world issued stay at home orders , travel restrictions as well as recommendations or mandates to avoid large gatherings or to self-quarantine . many governments also instituted restrictions on certain businesses and their activities , particularly those that were deemed non-essential . these various measures led to a sudden and significant decline in economic activity within a number of countries worldwide . although the global economy has shown signs of recovery , current economic data indicates that full recovery has stalled in some major economies . as further discussed below , disruptions resulting from the ongoing covid-19 pandemic unfavorably impacted our results of operations in fiscal year 2020. while certain of our organizational units realized positive benefits to revenues from the pandemic , total consolidated revenues in 2020 were unfavorably impacted by an estimated net $ 600 million . our financial position has remained strong and we continue to generate operating cash flows that are sufficient to meet our short-term liquidity needs . we also further secured our financial flexibility during the economic downturn by increasing the commitments available under our revolving credit facility by $ 381 million and issuing $ 3.0 billion of equity securities . our fiscal year 2020 debt and equity transactions are further discussed in notes 3 and 16 to the consolidated financial statements contained in item 8. financial statements and supplementary data . we believe that given our debt ratings and our capital allocation strategy , we would have access to additional short-term and long-term capital should the need arise . we have not observed any impairments of our assets due to the covid-19 pandemic and its adverse impact on global economic activity in 2020. as noted above , due to government restrictions and a shift in healthcare priorities , there was a significant decline in medical procedures that resulted in weakened demand for our products in our fiscal year 2020. a decline in procedure volumes across acute and non-acute settings led to a decline in demand for general medical devices . we also saw a deferral in elective procedures and delays in instrument placements relating to our medication management solutions , including pyxis . there was also a decrease in routine diagnostic testing and specimen collections , which was offset by demand for covid-19 testing . additionally , there was a decrease in research activity due to laboratory closures , delays in clinical trial enrollment and reduced clinical testing . during the last half of our fiscal year 2020 , we noted moderate recovery in the demand for certain products , including those products that are driven by the volume of elective procedures . however , demand for our products has not yet fully recovered and due to the continued , significant uncertainty that exists relative to the duration and overall impact of the covid-19 pandemic , our future operating performance , particularly in the short-term , will be subject to volatility . the ultimate impact of the covid-19 pandemic on our business , results of operations , financial condition and cash flows is dependent on future developments , which are uncertain at this time , including : the preparedness and effectiveness of countries around the world in preventing or responding to the ongoing spread of covid-19 , or in countries where the spread has been controlled , any resurgence of the virus ; the degree to which covid-19 testing solutions continue to be made available and are utilized by governments , healthcare providers and institutions , retail pharmacies and the general public ; 24 the pace at which hospitals and clinical laboratories fully resume patient care that is not related to the covid-19 pandemic ; the timing of when research performed by research laboratories and institutions will resume to normal operations ; and the timing and strength of any global economic recovery and the degree of pressure that the weaker macroeconomic environment will put on future healthcare utilization and the global demand for our products . as part of our overall response to the covid-19 pandemic , we have deployed our capabilities , expertise and scale to address critical health needs related to covid-19 as follows : our covid-19 antigen detection test that can provide results in 15 minutes using a simple nasal swab and our portable bd veritor tm plus system was approved for emergency use authorization by the u.s. food and drug administration ( “ fda ” ) and received the ce marking for use in the european union . in addition to this immunoassay test , bd 's portfolio of molecular solutions for covid-19 testing includes three other tests that have been registered for use with our bd max tm molecular system . we have leveraged our category leading position as a manufacturer of needles and syringes to enter into partnerships with governments around the world to help prepare for a future covid-19 vaccination campaign . additionally , we have been adhering to guidance provided by the who , as well as by health officials in various countries affected by the covid-19 pandemic , to protect the health and safety of bd employees while ensuring continued availability of bd 's critical medical devices and technologies at this unprecedented time . we have worked closely with governmental officials to keep our manufacturing facilities ( and those of our suppliers ) open due to the essential nature of our products . due to our enactment of business continuity plans , we have not experienced any significant disruption to our operations and supply chain to date . we also enacted certain cost containment measures to mitigate the unfavorable impact of the covid-19 pandemic on our results of operations . story_separator_special_tag selling and administrative expense as a percentage of revenues in 2019 was relatively flat compared with 2018. lower research and development expense as a percentage of revenues in 2020 as compared with 2019 primarily reflected the prior-period impact of a write-down recorded by the surgery unit . this write-down drove higher research and development expense as a percentage of revenues in 2019 as compared with 2018. the interventional segment 's lower income in 2020 additionally reflected the expiration in 2019 of a royalty income stream acquired in the bard transaction . geographic revenues bd 's worldwide revenues by geography were as follows : replace_table_token_10_th u.s. revenues in 2020 were relatively flat compared with 2019 as the life sciences segment 's integrated diagnostic solutions unit 's sales related to covid-19 diagnostic testing largely offset the declines noted above for the medical segment 's medication management solutions and medication delivery solutions units , as well as for the interventional segment 's surgery and peripheral intervention units . u.s. revenues in 2019 reflected growth in all three segments . u.s. revenues in 2019 were favorably impacted by the inclusion of revenues associated with bard 's products in results for the first quarter of fiscal year 2019 , as noted above . revenue growth in 2019 was also attributable to sales in the medical segment 's medication management solutions unit as well as to sales in the interventional segment 's urology and critical care and surgery units . u.s. revenue growth in 2019 was unfavorably impacted by results in the medical 30 segment 's diabetes care unit , the life sciences segment 's diagnostic systems unit and the interventional segment 's peripheral intervention unit , as previously noted in the discussions above . international revenues in 2020 were favorably impacted by sales in the medical segment 's pharmaceutical systems and medication management solutions units as well as by sales in the life sciences segment 's integrated diagnostic solutions unit , as discussed further above . international revenues in 2020 were unfavorably impacted by revenue declines in china and europe for the medical segment 's medication delivery solutions unit , as previously discussed . international revenue growth in 2019 reflected growth in all three segments . international revenues in 2019 were favorably impacted by the inclusion of revenues associated with bard 's products in results for the first quarter of fiscal year 2019 , as noted above . fiscal year 2019 international revenue growth was also driven by sales in the medical segment 's medication delivery solutions and pharmaceutical systems units as well as by sales in the life sciences segment 's diagnostic systems and preanalytical systems units . emerging market revenues were $ 2.42 billion , $ 2.71 billion and $ 2.53 billion in 2020 , 2019 and 2018 , respectively . foreign currency translation unfavorably impacted emerging market revenues in 2020 and 2019 by an estimated $ 100 million and $ 155 million , respectively . revenues in emerging markets in 2020 were unfavorably impacted by a decline in healthcare utilization as a result of the covid-19 pandemic . as previously discussed above , revenues in our medication delivery solutions unit were also unfavorably impacted by a new volume-based procurement process which has been adopted by several of china 's provinces . to date , the impact of these procurement initiatives to our revenues in china has been limited to our medication delivery solutions unit . emerging market revenue growth in 2019 was favorably impacted by the inclusion of revenues associated with bard 's products in our results for the first quarter of fiscal year 2019 , as noted above . underlying growth in 2019 was particularly driven by sales in china and ema . specified items reflected in the financial results for 2020 , 2019 and 2018 were the following specified items : replace_table_token_11_th ( a ) represents integration , restructuring and transaction costs , recorded in acquisitions and other restructurings , which are further discussed below . ( b ) represents financing impacts associated with the bard acquisition , which were recorded in interest income and interest expense . ( c ) includes amortization and other adjustments related to the purchase accounting for acquisitions impacting identified intangible assets and valuation of fixed assets and debt . bd 's amortization expense is primarily recorded in cost of products sold . the amount in 2018 also included fair value step-up adjustments of $ 478 million relating to bard 's inventory on the acquisition date . ( d ) includes amounts recorded to other operating expense , net to record product liability reserves , including related legal defense costs , as further discussed below . the amount in 2020 also includes net charges , which were recorded to cost of products sold and other income , net , related to the estimates of probable future product remediation costs . additional items recorded to other operating expense , net in 31 2019 included the estimated cumulative costs of a product recall , as well as the pre-tax gain related to bd 's sale of its advanced bioprocessing business . ( e ) the amounts in 2020 , 2019 and 2018 included total charges of $ 98 million , $ 30 million and $ 139 million , respectively , recorded in cost of products sold and research and development expense to write down the carrying value of certain assets , as previously noted in the segment operating income discussions above . the amount in 2019 also included an unrealized gain of $ 13 million recorded within other income , net relating to an investment . the amount in 2018 also included a net income amount of $ 303 million recorded to other income , net related to bd 's sale of its non-controlling interest in vyaire medical . ( f ) represents costs required to develop processes and systems to comply with emerging regulations such as the european union medical device regulation ( `` eumdr ``

net cash flows from investing activities capital expenditures our investments in capital expenditures are focused on projects that enhance our cost structure and manufacturing capabilities , and support our strategy of geographic expansion with select investments in growing markets . capital expenditures of $ 810 million , $ 957 million and $ 895 million in 2020 , 2019 and 2018 , respectively , primarily related to manufacturing capacity expansions . details of spending by segment are contained in note 7 to the consolidated financial statements contained in item 8. financial statements and supplementary data . acquisitions cash outflows for acquisitions in 2020 primarily reflected our acquisition of straub medical ag in the third quarter of 2020. cash outflows for acquisitions in 2018 primarily related to our acquisition of bard . for further discussion regarding the bard acquisition , refer to note 10 to the consolidated financial statements contained in item 8. financial statements and supplementary data . divestitures cash inflows relating to divestitures in 2019 and 2018 were $ 477 million and $ 534 million , respectively . for further discussion , refer to note 11 to the consolidated financial statements contained in item 8. financial statements and supplementary data . net cash flows from financing activities net cash from financing activities in 2020 , 2019 and 2018 included the following significant cash flows : replace_table_token_20_th additional disclosures regarding the equity and debt-related financing activities detailed above are provided in notes 3 and 16 to the consolidated financial statements contained in item 8. financial statements and supplementary data . debt-related activities certain measures relating to our total debt were as follows : replace_table_token_21_th ( a ) represents shareholders ' equity , net non-current deferred income tax liabilities , and debt .


 Write a concise suspicious activity report of the following text delimited by triple backquotes. Return your response as a formal report which covers the key points highlighting the location,dates,entity names and account holder information in chronological order of the text.
     ```net cash flows from investing activities capital expenditures our investments in capital expenditures are focused on projects that enhance our cost structure and manufacturing capabilities , and support our strategy of geographic expansion with select investments in growing markets . capital expenditures of $ 810 million , $ 957 million and $ 895 million in 2020 , 2019 and 2018 , respectively , primarily related to manufacturing capacity expansions . details of spending by segment are contained in note 7 to the consolidated financial statements contained in item 8. financial statements and supplementary data . acquisitions cash outflows for acquisitions in 2020 primarily reflected our acquisition of straub medical ag in the third quarter of 2020. cash outflows for acquisitions in 2018 primarily related to our acquisition of bard . for further discussion regarding the bard acquisition , refer to note 10 to the consolidated financial statements contained in item 8. financial statements and supplementary data . divestitures cash inflows relating to divestitures in 2019 and 2018 were $ 477 million and $ 534 million , respectively . for further discussion , refer to note 11 to the consolidated financial statements contained in item 8. financial statements and supplementary data . net cash flows from financing activities net cash from financing activities in 2020 , 2019 and 2018 included the following significant cash flows : replace_table_token_20_th additional disclosures regarding the equity and debt-related financing activities detailed above are provided in notes 3 and 16 to the consolidated financial statements contained in item 8. financial statements and supplementary data . debt-related activities certain measures relating to our total debt were as follows : replace_table_token_21_th ( a ) represents shareholders ' equity , net non-current deferred income tax liabilities , and debt .
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 Suspicious Activity Report : covid-19 pandemic impacts and response a novel strain of coronavirus disease ( “ covid-19 ” ) was officially declared a pandemic by the world health organization ( “ who ” ) in march 2020. in efforts to slow and control the spread of covid-19 , governments around the world issued stay at home orders , travel restrictions as well as recommendations or mandates to avoid large gatherings or to self-quarantine . many governments also instituted restrictions on certain businesses and their activities , particularly those that were deemed non-essential . these various measures led to a sudden and significant decline in economic activity within a number of countries worldwide . although the global economy has shown signs of recovery , current economic data indicates that full recovery has stalled in some major economies . as further discussed below , disruptions resulting from the ongoing covid-19 pandemic unfavorably impacted our results of operations in fiscal year 2020. while certain of our organizational units realized positive benefits to revenues from the pandemic , total consolidated revenues in 2020 were unfavorably impacted by an estimated net $ 600 million . our financial position has remained strong and we continue to generate operating cash flows that are sufficient to meet our short-term liquidity needs . we also further secured our financial flexibility during the economic downturn by increasing the commitments available under our revolving credit facility by $ 381 million and issuing $ 3.0 billion of equity securities . our fiscal year 2020 debt and equity transactions are further discussed in notes 3 and 16 to the consolidated financial statements contained in item 8. financial statements and supplementary data . we believe that given our debt ratings and our capital allocation strategy , we would have access to additional short-term and long-term capital should the need arise . we have not observed any impairments of our assets due to the covid-19 pandemic and its adverse impact on global economic activity in 2020. as noted above , due to government restrictions and a shift in healthcare priorities , there was a significant decline in medical procedures that resulted in weakened demand for our products in our fiscal year 2020. a decline in procedure volumes across acute and non-acute settings led to a decline in demand for general medical devices . we also saw a deferral in elective procedures and delays in instrument placements relating to our medication management solutions , including pyxis . there was also a decrease in routine diagnostic testing and specimen collections , which was offset by demand for covid-19 testing . additionally , there was a decrease in research activity due to laboratory closures , delays in clinical trial enrollment and reduced clinical testing . during the last half of our fiscal year 2020 , we noted moderate recovery in the demand for certain products , including those products that are driven by the volume of elective procedures . however , demand for our products has not yet fully recovered and due to the continued , significant uncertainty that exists relative to the duration and overall impact of the covid-19 pandemic , our future operating performance , particularly in the short-term , will be subject to volatility . the ultimate impact of the covid-19 pandemic on our business , results of operations , financial condition and cash flows is dependent on future developments , which are uncertain at this time , including : the preparedness and effectiveness of countries around the world in preventing or responding to the ongoing spread of covid-19 , or in countries where the spread has been controlled , any resurgence of the virus ; the degree to which covid-19 testing solutions continue to be made available and are utilized by governments , healthcare providers and institutions , retail pharmacies and the general public ; 24 the pace at which hospitals and clinical laboratories fully resume patient care that is not related to the covid-19 pandemic ; the timing of when research performed by research laboratories and institutions will resume to normal operations ; and the timing and strength of any global economic recovery and the degree of pressure that the weaker macroeconomic environment will put on future healthcare utilization and the global demand for our products . as part of our overall response to the covid-19 pandemic , we have deployed our capabilities , expertise and scale to address critical health needs related to covid-19 as follows : our covid-19 antigen detection test that can provide results in 15 minutes using a simple nasal swab and our portable bd veritor tm plus system was approved for emergency use authorization by the u.s. food and drug administration ( “ fda ” ) and received the ce marking for use in the european union . in addition to this immunoassay test , bd 's portfolio of molecular solutions for covid-19 testing includes three other tests that have been registered for use with our bd max tm molecular system . we have leveraged our category leading position as a manufacturer of needles and syringes to enter into partnerships with governments around the world to help prepare for a future covid-19 vaccination campaign . additionally , we have been adhering to guidance provided by the who , as well as by health officials in various countries affected by the covid-19 pandemic , to protect the health and safety of bd employees while ensuring continued availability of bd 's critical medical devices and technologies at this unprecedented time . we have worked closely with governmental officials to keep our manufacturing facilities ( and those of our suppliers ) open due to the essential nature of our products . due to our enactment of business continuity plans , we have not experienced any significant disruption to our operations and supply chain to date . we also enacted certain cost containment measures to mitigate the unfavorable impact of the covid-19 pandemic on our results of operations . story_separator_special_tag selling and administrative expense as a percentage of revenues in 2019 was relatively flat compared with 2018. lower research and development expense as a percentage of revenues in 2020 as compared with 2019 primarily reflected the prior-period impact of a write-down recorded by the surgery unit . this write-down drove higher research and development expense as a percentage of revenues in 2019 as compared with 2018. the interventional segment 's lower income in 2020 additionally reflected the expiration in 2019 of a royalty income stream acquired in the bard transaction . geographic revenues bd 's worldwide revenues by geography were as follows : replace_table_token_10_th u.s. revenues in 2020 were relatively flat compared with 2019 as the life sciences segment 's integrated diagnostic solutions unit 's sales related to covid-19 diagnostic testing largely offset the declines noted above for the medical segment 's medication management solutions and medication delivery solutions units , as well as for the interventional segment 's surgery and peripheral intervention units . u.s. revenues in 2019 reflected growth in all three segments . u.s. revenues in 2019 were favorably impacted by the inclusion of revenues associated with bard 's products in results for the first quarter of fiscal year 2019 , as noted above . revenue growth in 2019 was also attributable to sales in the medical segment 's medication management solutions unit as well as to sales in the interventional segment 's urology and critical care and surgery units . u.s. revenue growth in 2019 was unfavorably impacted by results in the medical 30 segment 's diabetes care unit , the life sciences segment 's diagnostic systems unit and the interventional segment 's peripheral intervention unit , as previously noted in the discussions above . international revenues in 2020 were favorably impacted by sales in the medical segment 's pharmaceutical systems and medication management solutions units as well as by sales in the life sciences segment 's integrated diagnostic solutions unit , as discussed further above . international revenues in 2020 were unfavorably impacted by revenue declines in china and europe for the medical segment 's medication delivery solutions unit , as previously discussed . international revenue growth in 2019 reflected growth in all three segments . international revenues in 2019 were favorably impacted by the inclusion of revenues associated with bard 's products in results for the first quarter of fiscal year 2019 , as noted above . fiscal year 2019 international revenue growth was also driven by sales in the medical segment 's medication delivery solutions and pharmaceutical systems units as well as by sales in the life sciences segment 's diagnostic systems and preanalytical systems units . emerging market revenues were $ 2.42 billion , $ 2.71 billion and $ 2.53 billion in 2020 , 2019 and 2018 , respectively . foreign currency translation unfavorably impacted emerging market revenues in 2020 and 2019 by an estimated $ 100 million and $ 155 million , respectively . revenues in emerging markets in 2020 were unfavorably impacted by a decline in healthcare utilization as a result of the covid-19 pandemic . as previously discussed above , revenues in our medication delivery solutions unit were also unfavorably impacted by a new volume-based procurement process which has been adopted by several of china 's provinces . to date , the impact of these procurement initiatives to our revenues in china has been limited to our medication delivery solutions unit . emerging market revenue growth in 2019 was favorably impacted by the inclusion of revenues associated with bard 's products in our results for the first quarter of fiscal year 2019 , as noted above . underlying growth in 2019 was particularly driven by sales in china and ema . specified items reflected in the financial results for 2020 , 2019 and 2018 were the following specified items : replace_table_token_11_th ( a ) represents integration , restructuring and transaction costs , recorded in acquisitions and other restructurings , which are further discussed below . ( b ) represents financing impacts associated with the bard acquisition , which were recorded in interest income and interest expense . ( c ) includes amortization and other adjustments related to the purchase accounting for acquisitions impacting identified intangible assets and valuation of fixed assets and debt . bd 's amortization expense is primarily recorded in cost of products sold . the amount in 2018 also included fair value step-up adjustments of $ 478 million relating to bard 's inventory on the acquisition date . ( d ) includes amounts recorded to other operating expense , net to record product liability reserves , including related legal defense costs , as further discussed below . the amount in 2020 also includes net charges , which were recorded to cost of products sold and other income , net , related to the estimates of probable future product remediation costs . additional items recorded to other operating expense , net in 31 2019 included the estimated cumulative costs of a product recall , as well as the pre-tax gain related to bd 's sale of its advanced bioprocessing business . ( e ) the amounts in 2020 , 2019 and 2018 included total charges of $ 98 million , $ 30 million and $ 139 million , respectively , recorded in cost of products sold and research and development expense to write down the carrying value of certain assets , as previously noted in the segment operating income discussions above . the amount in 2019 also included an unrealized gain of $ 13 million recorded within other income , net relating to an investment . the amount in 2018 also included a net income amount of $ 303 million recorded to other income , net related to bd 's sale of its non-controlling interest in vyaire medical . ( f ) represents costs required to develop processes and systems to comply with emerging regulations such as the european union medical device regulation ( `` eumdr ``

