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The title may not reflect the content of this report on Admiral Giroir who heads the U.S. coronavirus testing effort. He is a pediatrician who worked for hospitals in Texas before heading a vaccine project at Texas A&M University.  Internal politics led to his resigning from the effort to build a vaccine development capability with pharmaceutical companies at Texas A&M. Most of the rest of this report shows a physician who is determined to pursue big projects such as the one he is tackling today. President Trump appointed him to lead FDA, and to be the Assistant Secretary of the Department of Health and Human Services. With the missteps of Secretary Azar testing suffered in the early months of the crisis as reported in the WSJ. Adm. Giroir has taken a leading role since  this period. He also heads the U.S. Public Health Service Commissioned Corps of 6200 staff playing a vital role. On March 13 he was asked to lead the effort in testing.  He comes to this role with experience in the field of vaccines realizing that "the challenges are not just biological but engineering." New technology would be needed to make massive amounts of vaccine. His idea is that transformational efforts are needed. His idea for a billion dose per month facility in Texas did not work, yet he worked on it for about 5 years from 2010 to 2015 at Texas A&M University, at one point being the vice chancellor. He was selected by Texas Governor Perry as chairman of the task force in Texas in 2014 to oversee the effort to fight the Ebola virus. He now is in a position to bring all his experience and aspirations to tackle the coronavirus, cutting through much of the red tape and bureaucracy, and pulling together the effort combining science of pharmaceutical companies with the technology of manufacturing billions of vaccine doses in a record time. Today he sees capacity for testing reaching 40-50 million tests a month by September 2020.   ...

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Contrast the slow US vaccine export response with that of India, Russia, EU and China. Only in May 2021 after India's daily Covid cases were close to 400,000 a day did the US make a serious offer of vaccines to other countries in need of assistance. U.S. president Biden says that 80 million vaccine doses would be exported by the end of June 2021. The WSJ says citing Airfinity, a London research firm, as of May 10 more than 333 million doses of vaccine were produced by the US and only 3 million vaccine doses were exported. Contrast that with the European Union which has shipped 111 million doses overseas one third of its total production, Russia which has exported 27 million doses.  India has exported 66 million doses according to the Ministry of External Affairs website as of May 17, 2021. This includes 4 million doses to Brazil, 4 million to Nigeria. Within its own region Bangladesh received 10 million and Sri Lanka 1.2 million doses, Afghanistan 1 million. Mexico received about 1 million doses. In Africa the Democratic Republic of the Congo which has suffered from many epidemics including Ebola virus received 1.7 million doses, Nigeria 4 million doses, Kenya 1 million, Uganda 1 million. Of the 66 million about half of it is a direct grant assistance and Brazil, Mexico, Morocco received all vaccine as grant assistance, 70% of Bangladesh's is grant assistance. The list on the Ministry of External Affairs site of the Government of India shows 95 countries including many of the most struggling nations of Latin America and Africa, bringing hope to countries which are struggling to hold onto hope for a better life beyond the pandemic. Sending help overseas through vaccine supplies is suspended for the moment but will resume in July after India has pulled in all of its pharmaceutical manufacturing industry under a government guided effort to go all out. Never has so much help bringing much needed hope gone to so many countries of the world in the twentieth or twenty first century from a nation that is struggling to meet its own needs. The US in pursuing a US first policy of vaccinating all its citizens has not taken into account the need to bring this evolving vaccine technology into the hands of as many qualified pharmaceutical manufacturers as possible. This in a rapid response to expand manufacturing capabilities to meet world wide demand. The risks of not doing so were not taken on early- the very same way the virus spread in January to March of 2020 can be repeated as people travel around the world particularly for tourism, business family reasons. This risk takes on anew dimension of contagious mutations of the virus which are 50% more- the Indian variant being 50% more contagious by some estimates than the UK variant, which itself was estimated to be 50% more contagious than the original one.  The result a pandemic that stretches out indefinitely unless billions of doses are made in a short timetable to beat the timetable of Nature through the coronavirus. India is doing this for the first time with plans to produce billions of doses by engaging the whole of the Indian pharmaceutical manufacturing industry in the effort in a rapid response so that July to December would see 1.2 billion people vaccinated. The US effort, the European effort is left to the individual effort of pharmaceutical makers in the US and Europe, not a government guided effort to engage the entire pharmaceutical industry of the US and Europe in a rapid response timetable of 2-6 months.  ...

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The World Trade Organization is about to choose a new director-general to succeed Mr. Azevedo, a career diplomat from Brazil. The two candidates are a former finance minister from Nigeria,  Ms. Okonjo-Iweala supported by the European Union and the trade minister of South Korea, Ms. Yoo Myung-hee, supported by the U.S. Japan supports the Nigerian candidate because of its trade disputes with South Korea. The role of head of WTO is important today because of trade issues between countries particularly the trade issues between China and the U.S., U.S. and other countries. And the sense that the WTO arrangement is not working for many countries in recent years without a level playing field in many industries from improper subsidies. Before the U.S. withdrawal from the World Health Organization not much attention was given by the U.S. to how it had changed after new elections. As a result non profit foundations like the Gates Foundation from the U.S. played a leading part in representation of American interests and China played a leading role leading to the crisis facing WHO today. During the coronavirus pandemic the WHO lacking adequate influence of U.S. or European Union countries was not able to act in a way that met the needs and concerns of these countries with advanced health systems. In the past pandemics were better addressed worldwide when the U.S. and EU played a major role from the beginning because of long experience and technological resources,  a role that was missing in the current pandemic. Ebola and other virus were tackled in Africa only when the U.S. or European countries played a leading and critical role. This role was sorely missed in the current crisis. This is why changes at the World Trade Organization matter. World trade is important for the world economy and can best operate when the concerns of U.S. and European Union about a level playing field and fair competition are met. This level playing field and fair competition also meet the interests of developing countries such as India which are industrializing rapidly and need to protect their own markets from unfair dumping, as well as Indonesia and other parts of Asia, Latin America and Africa that are part of the supply chain for the world economy. ...

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Berlin's most famous hospital. Half of Germany's Nobel prize winners for medicine and physiology worked at Berlin Charite Hospital. It was setup in 1710, by 1810 it was a medical university, and today a leading world medical centre. Mr. Navalny is being treated here. It is also a centre in the fight against the pandemic.

Here DW.com gives pictures of the hospital over the 300 years of history. It was part of the controversial period in Germany in the thirties and was part of the GDR after 1945. It was part of the fight against the Ebola virus in 2005 and now leads the fight in Germany against the coronavirus, showing how Germans can play a international role that brings dignity to the German people.

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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. ...