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Queen Elizabeth leads tributes to the National Health Service for "the grief and loss felt by so many," as Britain pauses for a minute's silence, on the first anniversary of the lockdown of March 23, 2020. She offers flowers to St. Bart's hospital, after the recovery of Prince Phillip who was in hospital for one month for heart surgery and recovery. Pictures of a canon preparing for a outdoor garden service at Durham Cathedral, and lighting of candles at other cathedrals, offer glimpses of a solemn moment of silence, and the nurturing of hope for the recovery.

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About half of people in Britain in a recent poll taken during the second wave of coronavirus say they see a negative impact on mental health. Depression is affecting a fifth of the population in Britain. It has never been more important to be kind to each other and ourselves as the second wave hits a weary and fatigue stricken society.  People found many activities and hobbies to do during the 6 week lockdown period and there was an expectation that spring would bring better conditions. During the second wave of coronavirus there is a sense of a dreary period that goes on through Christmas. The uncertainty from the U.S. elections, Brexit in Britain, the reopening in countries such as India, the loss of jobs and income in countries that range from severe in Brazil, Mexico and Argentina to moderate in China, adds to the anxiety of daily life with surging cases. Creating what amounts to a low grade depressive effect during the second wave that needs to be addressed by the authorites, by health agencies, and in other ways, says this report in The Times. ...

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Hospitals in Europe are filling up quickly in the second wave of coronavirus. Coronavirus patients had to be transferred by helicopter to Germany from the Netherlands because of overburdened Dutch intensive care units. National Guard troops were flown in from the U.S. to the Czech Republic to help. In France as cases approach cumulative 1 million about 2000 patients are admitted to hospital for coronavirus every day on October 29. At some point French hospitals could be overwhelmed this winter, and doctors having to choose which patients to save, says president Macron. In the Czech Republic a collapse of the health system is expected by mid-November says the prime minister. No one expected this to be this severe, he says.  About 40,000 patients are hospitalized for coronavirus in the U.S. During the last week the case are increasing by over 40% in the U.S. and increase in hospitalizations are expected. Recovery rate is improving from the first wave. At NYU Langone hospital system in New York with 5000 coronavirus patients hospitalized recovery rate is improving from 25% in March to 7% in October. Better handling of cases and knowledge gained by doctors is a big part of this. ...

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German chancellor Merkel imposes a partial lockdown in Germany starting November 2. This is followed by an announcement of a lockdown across France by president Macron. On October 28 German daily cases went above 14,000. Only 25% of intensive care beds are now available, creating a very serious situation. Meetings in public will be restricted to just two households of up to 10 people total. No crowds at sports events. Restaurants and bars will close except for take away. Schools and kindergartens will remain open. Church services and protests will be allowed to continue. Shops will remain open with one customer for every 10 square meters or 108 square feet. Merkel called it a "very serious situation," and said "we must act now to avoid an acute national health emergency." She told Germans the number of people in intensive care units has doubled in last 10 days, and in many areas it was no longer possible to track and trace infection chains. In 75% of the cases the source of infection is unknown. People are encouraged to work from home and companies encouraged to make this happen. Companies with less than 50 employees and self-employed will get support from the government with  about 75%% of the income. Companies, institutions and clubs will also get federal aid. About $10 billion euros are set aside for this aid. ...

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The NYT  looks at how the world is coping- with pictures of a classroom in Denmark , blocks of apartments in Barcelona. One of the first countries to open schools with children 2 yards apart, washing hands every hour and not allowed to play with close touching, teachers staying apart in staff areas. Spain is one of the countries hit hardest and with strict lockdown not allowing children to step outside till now, as is allowed in Britain and France. Children in Barcelona are shown in block apartments with parents calling for letting children outside fdor short periods. Madrid is now letting children go outside home for one hour at a time.

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Efforts by the Physiology Society and Centre for Ageing Better (CAB), Make Movement Your Mission, and other groups in Britain to launch a national public health campaign. This effort is designed to get older people to exercize and form the contact with others that helps physical and mental health during the coronavirus restrictions and lockdown. It is a campaign for public health resilience.

Medical experts warn that lack of activity even for a few days can build up into negative effects on muscle mass. Three "snack sized" breaks of exercize for 20 minutes each day are suggested as well as super bubbles of 4 people, and guidance on nutrition, mental well being.

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The lessons from Italy, the epicenter now of the coronavirus pandemic, are clear- act early and decisively, impose quarantines and lockdown quickly to prevent intermingling. These steps need to be put early, with absolute clarity, and strictly enforced. This report in the NYT shows how decisive action early is the only way to prevent the crisis from becoming a large one that threatens the health system and millions. German states such as Bavaria and others now have a $25,000 euro and some have jail time. Singapore has jail time and fines for violating the stay home quarantine orders which it imposes after contact tracing. Taiwan has similar measures. Enforcement and strict control are part of the tools that have worked in these places and in China, South Korea.  Britain has still to close flights from Iran, Italy, which The Times reports on March 20 are still landing at Heathrow. This is after the U.S. weeks earlier banned flights from China, Iran, Italy, and last week from Europe after EU nations failed to take action early.  ...

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Germany Economy Minister Peter Altmaier says Germany expects a shallower recession. GDP in 2020  is expected to be down by 5.8% much lower than the 10-15% in other countries. Exports in June were up by 15% to China and down by 20% to the U.S. Economies of Spain and the UK are expected to see twice the decline in GDP in 2020. Italy and Germany are seeing a increase in manufacturing output, Spain and France a decline. 

Still Germany remains exposed to other trading partners than China, such as the U.S. and Britain, total exports are expected to be down 12% in 2020. About 11% of workers are using short term work subsidies to stay at home. Cases of the virus are surging in France and Spain. In Germany there is a surge but it is slowing since last week. Mr. Altmaier thinks Germany can avoid a second lockdown.

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The second wave is here in Britain with Stage 4 "exponential" increase seen in Britain. Cases could rise four fold from over 4000 today, after rising four fold in the last month Aug 20- September 20, and that could make it reach 50,000 cases a day and 200 deaths a day. New restrictions include- Masks required in all retail stores and restaurants and public places. Businesses that breach rules could be closed or shut down. Pubs, bars and restaurants close by 10 pm and only table service. Weddings and receptions limited to 10 people. Individual fines for first time breaches doubled to 200 pounds. Adult indoor team sports not allowed. This is the first response. If infection rates are not down from the over 1 R rate and the transmission increases a national lockdown is considered as the next step. To not harm the economy and strike a delicate balance all who can work from home are encouraged to work from home.      ...

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Britain staged a rehearsal for a pandemic called Cygnus in 2016. Till that time the preparations for a pandemic that started years earlier during the SARS crisis were conducted vigorously. Yet the by this time Britain was becoming immersed in the Brexit struggles in the ruling Conservative Party. Prime minister Cameron resigned on July 13, 2016  and was replaced by Theresa May. From that time on the struggles with pro Brexit factions led by Boris Johnson consumed the COnservative Party and sucked the life out of the pandemic planning that Britain had conducted for years before. The recommendations to correct deficiencies from the pandemic rehearsal exercize were ignored. The second failure happened as the crisis approached. Again the Brexit date of January 31 intervened and the months long struggle to get Brexit had taken so much energy and tired out most of the British public including new prime minister and leader of the Conservative Party Boris Johnson. Johnson did not attend the first Cobra meeting of the highest level ministers and military, convened on January 25, 2020, as reported in the Times. Such meeting are convened only for a national threat. Only 5 weeks later on March 2 did the prime minister attend a Cobra meeting. During this time the situation was grave in Italy with rising cases and infections. The entire process was conducted during this time by the Health minister Mr. Hancock who had assured the public that the situation was under control. Britain now has the highest number of infections in Europe exceeding that in Italy- at 240,000 on May 15, 2020. The prime minister and his adviser Mr. Cummings, were also infected by the virus, and Mr. Johnson spent time in ICU before recovering. Queen Elizabeth addressed the nation on Easter day, the first such address since 1940, to boost Briain's spirits. Never had Britain been less prepared as in 2020 when earlier preparations were ditched for austerity plans and events such as Brexit fatigue conspired to strip the nation of the crucial 5-6 weeks of preparation since the first January 25 Cobra meeting of the highest people in government.  Never had such preparation even for 6 weeks been more crucial than in February and March as the infectivity ratio was determined by infectious disease specialists at the best British universities and scientific institutions to be between 2.6 and 3.4 compared to the Spanish flu pandemic of 1918 which was somewhere between 2.0 and 3.0. This means every one person infects another 3 persons, compared to about 1 person in a regular flu season. This reproduction ratio and the nature of coronavirus remain a threat today as Britain, Europe, the U.S. and the world reopens.  As reported in the Times the infectivity ratio was also the reason for the mindset that refused to believe that the virus was real because at 3.0 infectivity the only way to tackle it was a "lockdown," and this was itself an "apocalypse" scenario for many in the pro-Brexit Conservative party that won the election, which badly wanted to get back to economic activity after Brexit. ...

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The second lockdown in France that begins October 29 for 4 weeks is very different from the first. It incorporates many of the lessons learned during the first lockdown.  The construction industry will remain open after this made a large dent in the French economy during the first lockdown. Schools K-12 will now remain open, with children required to wear masks at age six, and stricter rules for masks and visiting parents. The universities will remain open with classes online, but physically closed. Buses metro and other transport will remain open. Churches will remain open but be limited to very small gatherings. Parks forests, gardens and beaches will remain open this time but one has to live within 1 kilometre to access them and limited to 1 hour. People are prohibited from travelling outside the region in which they are registered. People can exercize for 1 hour within 1 kilometre of their home. All are required to carry a signed form for any type of activity, including shopping, work, accessing essential services, or for their one hour exercize. Not having the signed form would lead to a fine of 135 euros. Because bars, restaurants will be closed people in these hard hit industries will get 100% of their pay from the government. In other industries companies will contribute 15% and the government 85% so that these people are covered. ...

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On October 28 France reported 36,000 daily coronavirus cases. French president Macron announced a new lockdown starting October 30 that last till December 1.  Under this second lockdown people can leave home only to go to work, to go to school, to give assistance to loved ones, for essential shopping and for 1 hour of physical exercize. People will have to show documentation when leaving home. Travel between regions is banned. Bars and restaurants and nonessential businesses will be closed. Universities and higher education will be done online. Schools will remain open, essential businesses will remain open. Most public services will be open. Factories, farms and construction sites can continue to operate. There will be extensive economic support for business and people. Small businesses will have access to 10,000 euros per month of assistance, employees get short term work assistance, and people having trouble with rent receive assistance. About half of intensive care beds are now taken in France. And Macron said transferring patients to other regions will not be possible as the virus is everywhere. ...

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French president Macron in a televised address with frankness and humility, the fourth for coronavirus, says the national lockdown will extend till May 11. As infected cases and deaths gradually level they are still very high. His main point- "There is new hope but nothing is won at the moment... the epidemic is not under control." "Were we prepared? No. Clearly not enough. There were failings, there was a lack of material." "These are difficult days and we are now feeling afraid and anxious for our parents and ourselves." In many ways he reflected the feeling in France, Britain and Spain, a sense of humility after the virus.  "We have to reinvent ourselves, and me first of all... We are vulnerable. When can we hope for an end to this? I understand you have many questions and I would like to answer all of them. But I say in all humility, I don't have definitive answers today."   ...

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Like the rest of the restaurant industry British pubs are affected by staffing shortages, inflation, higher energy bills, and supply chain problems. The UK lost around 3250 pubs and bars between March 2020 and September of this year. During lockdowns most were closed, as they reopen they face higher costs and are struggling to survive. New hires that earned 27,000 pounds now are offered 32,000 pounds, with few applications as people look for better work and working conditions than offered in the restaurant industry.

Fewer people are going to pubs for lunch as they work from home more. Older people are staying at home from virus related hesitancy. Pubs are passing on price increases of food of 20%. Once seen as part of Britain's cultural fabric this also is changing as people look for other sensible options.

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This editorial in The Guardian calls the new British Health Secretary Sajid Javid's actions after only 4 months on the job a bit of breathtaking cynicism, and a slap in the face of family physicians in the UK. In 2015 the Tory government promised to increase the number of family physicians by 5000, instead numbers have dropped today by 4.5% to 28096, even as demand has increased. The complete lack of sensitivity of the new Health Secretary to the level of burnout in family practice in the UK, and the difficulty attracting young doctors to family practice, has aroused a furious backlash in the UK. He has called for an end to social distancing and more face to face appointments when government policy had decreased face to face appointments following lockdowns. Britain has one of the lowest numbers of doctors per capita in Europe, says the Guardian, and that the government is tackling the wrong problem beggars belief.

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Steep drops in economic activity and loss of so many jobs is the reason why total lockdowns are not the best solution as seen from the experience gained by August. Selective lockdowns are now being applied across France, Germany and Britain in specific areas. About 400 million jobs have been lost, 13 million in the U.S.  Hospitals overwhelmed in northern Italy by March is what made the total lockdowns necessary.  These steps for total lockdown were made with very little known about the pandemic and the need to protect hospital and health systems. These decisions at that time are not questioned today. It is that now  with some treatments found, a vaccine close to being introduced, hospital system protocols established, health ministries and departments organized to respond quickly, and the public awareness at high levels,  it is now possible to impose these selective lockdowns effectively and quickly. As the WSJ now says the CDC had botched the initial development and distribution of tests in February- see WSJ analysis and our Lyrarc links of how 3 crucial weeks were lost in Feb with failure of the CDC and HHS in testing- making test and contact trace strategy window to be missed. China had not cooperated in letting a U.S. team quickly in the early days of February creating more uncertainty and risk. In that situation total lockdown suddenly became the reality to avoid a catastrophe. Today a carefully applied selective application of solutions can be done and is seen as the right way to protect jobs and livelihoods of people. ...

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This report in WSJ shows how European countries are maintaining salaries of employees who would otherwise be laid off. Governments have setup programs in France, Britain, Germany and other countries to provide employers with the money for 80-84% of salaries up to 2500 pounds ($3165) in Britain and 5330 euros a month in France. As a result 1 worker out of three in the private sector in France for subsidy applications for 6.9 million workers are already received. For the German program 2.4 million workers will get this benefit. About 1 million companies in Europe retain employees with this program of governments simply sending out the salaries with funds directly to households. This helps to keep out the stress for families, particularly families with children. It is as if the employees are not really laid off but asked to stay at home for manufacturing facilities and work from home in shorter hours where work can be done remotely.  Money is quickly deposited into the bank account of employees in these countries, though it is slower in Italy and Spain. It is as if the European approach is put the whole economy on pause for 2 months and restart it almost like before with only a small dent in employment once the coronavirus is pushed out with lockdowns and strict control actions. This will cap German unemployment at 5.9% compared with 5% last year, only a modest increase. The cost is not that much considering what it accomplishes. 10 billion euros is the cost in Germany where the state fund for this has 26 billion euros. 10 billion pounds in Britain. And 20 billion euros in France.  The U.S. adopts a similar approach also through its $349 billion program which provides loans to companies with less than 500 employees to meet payroll for 8 weeks and pay some overhead. Loans are forgiven based on job retention and employees on the payroll and only if the employees are retained. Another program is for companies larger than this. And a third program targets entire industries such as airlines, aerospace, and companies in other industries so that they do not have to layoff employees. U.S. unemployment insurance is modified to work along similar lines maintaining incomes of employees laid off because of the pandemic. Another program sends checks directly of $1200 to households with lower incomes to help them and to help people at poverty level or without jobs. The thrust of both the European and American efforts is the same, lose as few jobs as possible, keep people's incomes steady, and do this in a way that the economy can pick up quickly to the former level in as short a time as possible. Compared to Europe U.S. unemployment will be higher predicted at 9.8% with the expected rebound lowering the unemployment in 2021. ...

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A slow and erratic response from the European Union and Britain following the lockdown in Italy on March 10. France went into lockdown on March 16, Germany and Britain on March 20. Over a week was lost when officials in the EU and governments in Europe did not take the situation unfolding in Italy as seriously as needed. The situation in South Korea was unfolding at the same time, and China was still facing the crisis at the time.

The response was coordinated quickly by March 20 and in the days before that.

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The British public is very conservative when it comes to reopening. 73% support prioritizing the health of citizens only 17% say prioritize the economy. This is the highest of industrialized nations, Japan being the next highest with 60% supporting prioritizing health only 16% in Japan saying the economy.  For Boris Johnson as he makes the speech on Sunday May 10 on reopening the political margin for error in decision is nonexistent. Britain's tabloid press and other media simply took the idea that to heck with it lets reopen reflecting a lack of caution in the headlines after Mr. Johnson expressed his intention to reopen. After seeing this Johnson and his closest advisers met without his hawkish ministers to reflect on what was happening in the country. The British government's scientific advisers say whether there are 100,000 deaths by the end of the year depends on many factors including testing, contact tracing, the way the lockdown is eased, the situation at nursing homes, and other government action  to prevent a resurgence in infections. At the meeting with Gove, Sunak Raab and Hancock, Mr Johnson stepped back and reversed any plans except for mild reopening- giving people more time outside for exercize, opening limited locations such as garden centres and advising strongly to wear masks on public transport. Both Johnson and Dominic Cummings his adviser had coronavirus, and Johnson spent some time in ICU. They know the impact of the coronavirus from their own personal experience.  For Johnson there is only one chance, Tory senior advisers say the public will forgive mistakes going into coronavirus, but will never forgive mistakes getting out of cotronavirus. He told Keir Starmer of Labour in parliament that he bitterly regrets what has happened in nursing homes. The scientists have warned him that the staff at nursing homes could seed communities once again. And that the coronavurus R ratio (1 being the level it starts growing again) could go up back to 1. This is the situation on May 10 as Johnson prepares to speak to the nation on Sunday at 7 pm, as he shifts to "maximum caution." ...

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Germany has shown that low tech contact tracing efforts work- no apps needed, a phone, a desktop computer with a centralized database, and most important the human relations skills of the person doing the calls. The  sensitivity to the situation facing each person being called, being able to talk to the person in the language they speak in a multilingual environment such as California, is shown here. A 40 person team operates in San Francisco consisting of public health officials, clinicians, medical students and librarians. They call the contacts of people with coronavirus, arrange tests, and as needed send packages of food and medicines to hotel rooms or homes. Every call is expected to last 15 minutes but all sorts of questions are handled.  English and Spanish are used. Here one of the persons doing the contact tracing says she does not use apps, just an open source software used in the fight against Ebola. Definitely low tech, no waiting, get going is the message to every city in the world. She says apps software such as what Google and Apple are putting out can tell you whether the person went to some place, but cannot tell you more about that person, cannot tell you about problems the person is having being tested, and how they are having difficulty providing for families. One of the big lessons from Germany and efforts such as this one in San Francisco, and in other places such as Paris, Singapore, Taiwan, is that there is a complex nature to contact tracing that cannot be solved by tech. In fact the best thing to do is to get started immediately, with a phone and a database on a computer, as long as you have a person who has the motivation and skills, empathy with people, a lot can be done. Waiting for apps is a dangerous waste of time is shown by the low tech German experience, and the experience in other places. Most important is starting immediately. The example shown here of working with migrant workers in contact tracing shows in the most vulnerable places it is these human relations skills that count, that no tech app can do. It requires detective skills to find out and get people to share their history of movements and contacts for 14 days . In Singapore crowded dormitories house 300,000 of 1.4 million migrant workers. Singapore using an app also but its use is secondary. Apps don't work in many situations but fail in the most critical situations such as these dormitories and other eccentric or atypical situations such as faced by South Korea with religious groups and gay communities, elderly people in Europe, that generate the worst dangers of spread and need to be cluster isolated quickly. Human contact tracing has a history of being an effective method and was used in China and South Korea during the 2003 SARS epidemic. More countries need to adopt the method used in Asia and in Germany, particularly Britain, the U.S., France and India. It is OK that Britain's NHS and India's national government with Aarogya Setu app have put out their own apps which balance privacy concerns with the need to act immediately and cover the entire country, but the hard slog of human contact tracing teams in each district is indispensable. This is why the former Health minister in Britain calls it Britain's national mission to do this. Speed is key- putting together teams across the country in every district from skilled volunteers or government workers, and pulling together the phone and a centralized database on a computer as basic equipment. The fact that this is easily doable and people with human skills needed can always be recruited as they have been in Germany- from public officials in local government who are less busy in lockdowns, medical students, clinicians, volunteers, people from different professions- makes it inexcusable not to learn from others experience and get going. Just Do It. You want to reopen business, professions, offices and public services- Just Do It, it makes this possible. You want to prevent spread of the virus- Just Do It, it makes this possible. You want to limit damage to the economy and get the recovery going- Just Do It, it makes this possible. People of all shades of opinion can agree on this- its the only thing that works, even when there is a lack of enough proper accurate testing. ...

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Both the Tories in Britain and the Democrats in the US were caught by surprise by the sudden surge after the pandemic of illegal migrations flows in 2023-2024 which dropped to all time lows in 2019-2021 with the covid lockdowns. Tories with factional infighting and Democrats falsely believing they were virtuous humane could not take effective decisive immediate action costing them the defeats in 2024. The size of the illegal migration problem to the UK was underestimated in 2023. Tory rhetoric alone failed to convince the British public. In the US Biden not confronting it head on also failed to reassure the American people as the US Border also meant destructive Mexico/China fentanyl flows. Even today the action proposed falls short and new US bipartisan legislation is needed to make it the law of the land, closing three decades of stealth in immigration policies. ONS now estimates that it missed 166,000 people. The real figure for the year ending June 2023 for net migration was 906,000 not 748,000 as previously estimated. In the year ending June 2024 this figure for net migration was 728,000. Labour party under Keir Starmer made setting up the new structures for tackling alarming rise in migration the top priority in 2024. That lesson was not learned in the US and the issue not confronted head on to win public confidence- the Biden support for Republican Senator Lankford's legislation on illegal migrants and the border came late in 2023 and the issue was left to fester for 2 years eroding public confidence. In the US the issue of illegal fentanyl flows at the US Border and from China makes the Border and China relations issues that required effective and immediate action overriding everything else. In the end Tories confusion and internal factions, other controversies, led to lack of vigilance and lack of effective action as net migration deceptively hit lows of 254,000, 111,000, and 254,000 in the pandemic years 2019, 2020, and 2021, only to surge tremendously to 634,000 and 906,00 in the years 2022 and 2023.  Labour's Starmer took action to make it No. 1 priority in the platform going into the 2024 election winning public confidence. A similar surge in migration happened in the US after a deceptive slowdown in the pandemic, compunded by Venezuela and central American states collapsing. ...

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The Survey published by Britain's Nationa Health Service (NHS) shows an increase by about half since 2017. The pandemic has made the problem severe with lockdowns, closure of schools and inequality in society leaving many children without access to online learning because of a lack of internet. What is seen early in this NHS Survey is probably true for many countries Mexico to Brazil, India to Indonesia, Egypt to South Africa, much of Europe and the US. This needs to be addressed quickly, for children. It also needs to be addressed for adults. 

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Prof. David Spiegelhalter of Cambridge University is critical of the British government for not finding out how many people may be infected by coronavirus. He says he is not telling how anybody should feel or what they should be worried about, but at least the people's anxiety should be proportional to the risks they actually face. His estimate is that based on the death rate of 1% its possible that there could be 3.5 million people in Britain who are infected with coronavirus or higher. Sir Spiegelhalter is professor at Cambridge University for the public understanding of science. He says this "basic information" is essential in making the decision such as how far and when to go out of lockdown, and that the British government has failed to do this in a timely manner required for tackling coronavirus without risking more lives.