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WSJ looks at the changes in the way medicine should be practiced in the light of what we have learned from the pandemic.  Medicine practiced before the pandemic and still today relies mainly on a visit to the doctor or specialist who is short of time. There is a shortage of doctors. Patients have many illnesses as a result of decades of neglect of proper nutrition, and exercize habits. Obesity is at about 40% in the U.S. about 30% in the UK and 17% in France, and high also in other parts of the world. These high rates were unknown throughout history and result in many illnesses and increase by four times the vulnerability to the coronavirus. One authority in medicine calls obesity pouring gasoline on a fire for effects of the virus.  A doctor's appointment with doctors short of time with no coordination around a whole range of factors related to obesity, illnesses, health checkups, mental health, is now seen as a heavily handicapped way to practice medicine or for patient healthcare and wellbeing. The alternative is discussed here as the way forward. A  team will be responsible for a patient's care not just an individual doctor. The team would care for general health after a patient's checkup, cover individual illnesses, weight issues, mental health, exercize nutritional needs and other good healthcare habits. Instead of relying on doctors at a time of shortages of doctors the team would be led by nurse practitioners.  A nurse practitioner is someone with a bachelors degree and a masters degree or doctoral degree in nursing with 1000 hours of clinical training. Studies have shown that they are effective and even more effective than individual doctors. Today particularly with the problem of doctors with limited time compounded by the built up problems of decades of bad habits in nutrition and exercize and poor "cultural" habits getting entrenched, there has never been a greater need for a better way to practice real healthcare for a person's wellbeing. Particularly in rural areas with an even larger shortage of doctors the health practitioner led team will play a big role. Patients will under this setting receive more care virtually and get more followup care by phone and video messaging. The numbers tell the story- there are shortages of doctors in USA, Europe, Africa, Latin America and Asia. In the U.S. shortage of doctors is 55,000 projected to 2033 by Association of American Medical Colleges. There are 290,000 nurse practitioners licensed in the U.S. and 131,0000 physician assistants. The goal will be to get an adequate number of nurse practitioners licensed in this decade to take care of these teams. The pandemic has made virtual visits to doctors and nurse practitioners popular. Medicine reimbursement should and would be practiced on the basis of how well a patient is doing not on a fee for each micro service that is delivered. For this to happen the teams led by the nurse practitioner have to commit to patient education of the benefits from good practices and good habits for nutrition, exercize, caring for oneself. A doctor short of time is hardly the person to carry on this patient education which is where the major opportunities for a new system arise. The virtual care also provides a new medium for patient education and awareness of the risks of getting illnesses, preventive actions to be taken in advance. One approach being tested in California and Texas is for a monthly fee for patients more payments by health plans to doctors or healthcare teams if the patient is healthier. Additional health professionals are added to the team including health coaches, dietitians and medical assistants to increase its effectiveness in counseling and education and monitoring.  The nurse practitioner team approach is already being practiced in parts of the U.S. including the example of New Hampshire shown here, and is predicted to be the approach for primary care in the next decade. ...

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Much of the debate in Germany today is around the topic of reunification, was it good or bad for Germany, and why there is an issue of a separate identity in the East. Most East Germans feel they live in a separate country with a separate identity. This issue has social cultural and political consequences, says the Economist.    The CDU is increasingly facing questions about how it has turned out for East Germany. It is losing votes to the AfD in Saxony, Thuringia, and other places in the east. The migration crisis in 2015-2016 created new fault lines. When the Integration minister in a government in Saxony, which includes east German city of Leipzig, talked to people in her state why Germany was helping refugees, she was told to first integrate East Germans.  East Germans do not like resources being wasted on refugees when they feel left out themselves in their own country. After reunification of Germany by chancellor Kohl in 1990 about 8500 companies in the east were privatised or liquidated leading to a loss of jobs in old industries such as mining. Many of these older people ended up in odd jobs and then on Hartz IV, skimpy unemployment benefits. At unification 1 million people moved to the west from the east, predominantly younger people and predominantly women.  Over time one fourth of the population in the east 18-30 years moved to the west, two thirds of them women. Rural areas especially hit hard, with tax revenues slumping, shops and schools closed. Some estimates are that 80% of east Germans were out of work at one point. The humiliation their parents felt is only now being discussed as children in the east talk to their parents about what happened and the hardships their parents suffered 25 years ago. Was unification done the right way is a topic for discussion today. Today the east is much older than the west. Since 1990 over 60's increased by 1.1 million even as the overall population dropped by 2.2 million. In future some districts in the east will have 4 funerals for every birth say forecasters. So what could have been done differently in 1990 so that East Germans did not end up feeling like a "colonized people" by a biased western exploitative culture that portrayed them as culturally inferior and with very little that the west could learn from. Today it is said that the government agency Treuhand that handled closure of businesses could have moved slowly. The 1:1 transfer of west german currency for east german currency was to make east german companies uncompetitive overnight, and should have mitigating plans to tackle the problems of keeping these businesses in operation to keep local jobs. A new constitution and economic plans could have been written, a transition period for such a constitution and economic plan be put in place, so that changes could be studied and plans made to reduce the negative effects.  Culturally there was something the east did better. It had a culture of social solidarity that could have provided lessons for the west.  The good aspects in the east such as respect for women and encouraging them to work outside the home, free child care, the welfare state protecting vulnerable groups, could have lessons for the west to emulate and adopt practices. This would have given easterners a sense of self-respect as in some ways the German Democratic Republic (GDR) as the country was called in the east, had aspects that the west could learn from. For this to happen west Germans need to change their views- half of them see the reunification as a success, two thirds of east Germans see it as a failure culturally, and socially, and wrought with the economic impact of sudden shift in population and business, and loss of most productive young people to the west. ...

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Prime minister Edouard Philippe of France sets out the detailed plan for reopening the country in phases starting April 28.

Key points-

Masks will be compulsory, travel between regions will be restricted.

New method of social distancing on subways operating at 70% of capacity- leaving an empty seat between 2 persons both wearing masks. Reduced trains scheduled between regions.

No gatherings of more than 10 people.

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Unions reject a 3% pay offer not enough to meet soaring inflation in UK. Boris Johnson calls for pay restraint. More than 50,000 members of the RMT union will walk out in Britain in a British rail strike, the largest in 30 years.

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Gender parity in higher education for women in India has suffered a serious setback says this report in The Indian Express. The burden of Covid pandemic has fallen disproportionately on women in India and enrollments in higher education have fallen for women.

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The toll in deaths and casualties on the Russian side has already reached 200,000 says this report in the NYT. The fighting in the eastern Donbas around Bakhmut is intense with hundreds of deaths and casualties a day says this report.

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The ancient city of Antakya in Hatay province in Turkey is wiped out, says this report in The New York Times. People are sleeping outside in a city in rubble, in the freezing cold. NYT gives pictures of the devastating earthquake.

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Fragmented and slow regulation by the SEC of financial activity that clearly needed regulation from the beginning. Charlie Munger Of Berkshire says in the WSJ that "wretched excess" has gone on in the cryptocurrency because of a gap in regulation.

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Tackling with resilience and patience the stormy display by Atletico Madrid, Pep Guardiola's team prevails in Madrid. A bandaged Phil Foden after some rough play continued to support Kevin de Bruyne in the field. Manchester City wins on aggregate.

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Supply chains are back to normal with better shipping rates, delivery capacity and retailer inventory. This should have a restraining effect on surging inflation and is a good sign for the US Fed's Jay Powell in his fight against inflation.

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The lockdowns and remote work have led to men spending more time taking care of children at home. The stereotype of the hapless dad as a second grade caregiver is now out of date. Dads have learned a lot during the pandemic.

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Joanathan Kanter is the Assistant Attorney General of the US. He was cleared to work on the Justice Department lawsuit against Google and antitrust matters. Kanter is critical of the way Google operates to act as a monopoly in its ad business.

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The increasing price of wheat and the failure to modernize Pakistan's agriculture is the subject of this report in The Indian Express. The floods and the Ukraine war, lack of development in agriculture, have created a food crisis in Pakistan.

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Companies in the US hiring older workers in the belief that older workers have a strong work ethic. WIth the Great Resignation and younger workers quick to quit jobs many companies are relying on older workers who are seen as more reliable.

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After it is turned off for maintenance will the Nordstream pipeline that takes Russian gas under the Baltic Sea to Germany come back on? Germany is not sure and preparing for a cutoff of gas supplies from Russia as the Ukraine war escalates.

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The US and Mexico launch a massive effort to welcome 100,000 refugees from Ukraine. FR24 gives this story on how Ukrainians already in Mexico and the US, who migrated many years earlier, are volunteering to help new refugees feel welcome.

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The stimulus agreement in the u.S. Congress will provide direct checks of $600 to many Americans and $300 a week in enhanced federal unemployment benefits, aid for schools, vaccine distribution, and small businesses. The package is for about $900 billion in aid.

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A look at graphs showing how much and where the $1.9 trillion aid for the pandemic is going for households, businesses, local governments and programs. This package of aid is ready to pass the US Congress in March 2021.

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Low interest rates are boosting the U.S. housing market. Lenders made $1.1 trillion in home loans in the second quarter 2020. Mortgage rates fell below 3% in July. About $2.5 trillion in home loans were made in 2019. Refinancings are up 200%.

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The failure to respond quickly with testing and contact tracing has been a major weakness of the response to the coronavirus in Europe and the U.S. Repeated fumbling in contact tracing has been common throughout Europe and in states in the U.S.

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The coronavirus pandemic has pushed New York into a $8.7 billion deficit for the fiscal year that began April 1, 2020. A bipartisan bill in Congress would have given $160 billion to state and local governments in the $908 billion bill. 

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The pandemic's effects on children with one in three going hungry and one in five growing up stunted, according to a report by UN agencies- UNICEF, FAO and the World Food Programme, is shown in this report in The Guardian.

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France's Health minister announces that health care workers will not be allowed to work after September 15, 2021 or receive a salary if they are not vaccinated. Health pass will be required to access bars, restaurants, trains and flights in France.

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No country has an elected parliament this big. Germany's Bundestag has 709 members of parliament. And this could swell to 900 says DW.com after September 26 elections. A look at the German parliament that reflects Germany's recent history.

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Even as China is investing more in the economy and workers are working fewer hours, the unemployment rate is increasing to 5.3% in Feb 2024, youth unemployment at 15% previously estimated at 22% in June 2023 before a new methodology was adopted.