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India reports over 300,000 cases for the fourth day in a row. German chancellor Merkel passes legislation that gives the federal government the power to set curfews to control the spread of coronavirus. Cases reach 166 per 100,000 in Germany and the government sees lockdowns to be in place till the end of May. Streets in Dusseldorf and other German cities are shown deserted at night.  The European Union deal signed with Pfizer for 1.8 billion doses including booster doses of the Pfizer vaccine, provides new hope for the vigorous vaccination drive needed in Germany and the rest of Europe. 

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About a third of recent coronavirus infections in the UK are from schoolchildren ages 10-19. The UK after a headstart in its vaccination drive has fallen behind other European countries and the US in the vaccination of children and teenagers. UK began vaccinating children in August far behind the US and Europe. On top of this UK under Boris Johnson decided to drop almost all public health restrictions during the summer. The change in Health Secretary happened on June 26, 2021 with Matt Hancock's resignation. The new Health Secretary Javid was to review the health restrictions in place till July 19. The sense of caution and preparedness that prevailed earlier as fallen short since July 2021 with the lack of coronavirus prevention measures such as masks, social distancing and vaccine mandates that were taken in Italy, France, Germany and other European countries, as well as in the US.

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A Kyodo News poll shows about 60% of Japanese want the Olympic games cancelled. Japan faces another wave of the pandemic with a surge in Osaka and other cities. The government's handling of the pandemic is disapproved by 71% of Japanese in a Kyodo News poll. Over 80% are unhappy with the slow vaccine rollout.   India faces a surge in cases public dissatisfaction that is similar to Japan and other countries in Europe. France and Germany have a slow vaccine rollout. In India vaccination drive is affected by a lack of supplies as in France and Germany with shortages of vaccine. The European Union in April signed contracts for over a billion doses with Pfizer and India has plans for ramped up supply of its Covishield and Covaxin vaccines to 2 billion doses by December 2021. This shows how difficult it is for advanced countries and major pharmaceutical producing countries such as as India to vaccinate their populations quickly in the initial stages of the vaccination effort. In July the vaccine effort would be in its 7th month and vaccine supply constraints are expected to ease as a result of aggressive action by governments in EU, France, Germany and India. This will also enable addressing needs in Latin America, Africa and South East Asia. ...

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New pictures released by NHS shows vaccination queues at Salisbury Cathedral near London, England. UK has reached 50% of people vaccinated or 33 million people, with July 31, 2021, the target date for all adults to be vaccinated. It took 136 days to do this for 64% of adults. Other parts of Europe are still struggling.

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Some local governments in China are making vaccination mandatory. China is setting a goal of getting 64%  of the population fully vaccinated by the end of 2021. In European Union countries mandatory vaccination by country or region is now being put in place to fight new coronavirus variants that spread faster in the population. The reopening of economy, business and tourism is increasing the risk from variants in summer 2021. The mandatory vaccination is a way to increase the percentage of the population that is vaccinated. Getting younger people who lag behind to get vaccinated is important to protect the percentage of the elderly population that is still not vaccinated. There are risks also to the younger population as seen in previous waves of the pandemic. The initial hesitation to make health pass showing a person is vaccinated mandatory was because only a small fraction of the population was vaccinated in Europe. Now that over 50% are vaccinated in most EU countries and UK, that hesitation thinking that it is discriminatory to those people who did not have access to vaccines no longer exists. Ample vaccine supplies and the misinformation spread about vaccines are making action on health pass necessary to protect the overall population. National governments in France, Denmark, Austria, Greece, and local governments in Germany, Portugal and other EU countries such as Ireland, Italy, see the danger from coronavirus variants that spread quickly as too big to take any risks a second time. ...

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Discussions at the cabinet level and with prime minister Johnson now include the possible use of annual covid jabs, the importance of getting the vaccine out before a new mutant strain of the virus that is hard to deal with a year from now. An annual covid jab could deal with new mutant strains of the virus. 

Prime minister Johnson is also having to deal with the issue of letting people in from overseas. If Britain's vaccination drive succeeds it will be all the more important to protect Britain from new mutant strains arriving with people coming from overseas. This will require strict control of people coming from other countries including Europe. The question of closing the borders to to reduce risks is now a serious one.

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The chief scientific adviser to the government of Britain says "go hard, and go early" to prevent a surge of coronavirus in Britain in the autumn and winter with more activity indoors. Things are flattish at the moment, but if hospitalizations pick up the government needs to quickly shift from Plan A without vaccine mandate and without mandatory mask use to requiring vaccinations and mask use, calling for working from home, as part of Plan B. Unlike France and other countries in Europe Britain has not taken the strong action that is necessary. Prime minister Boris Johnson is pushing for new efforts in getting the remaining people vaccinated.

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A second survey by the Indian Council of Medical Research shows an increase in the number of people estimated to be affected. The survey sampled people from 70 districts in 21 States in India. Overall prevalence using this method is high at about 21.5%. India has confirmed 10 million cases. Children and young are also affected.

Dr. Balaram Bhargava, Director General of ICMR, says "The message is that large proportion of the population remains vulnerable, Vaccines are necessary, and there can be no complacency with regards masks, social distancing and hand hygiene." India has so far not seen the kind of second wave happening in Europe and the US, yet the risks remain, showing the need for rapid implementation of the vaccine program for 300 million in the first part of the vaccination drive.

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A chaotic return of school children to school in September 2021 in most of Europe and America, because of a lack of clear statement on the rules to be followed for mask use, social distancing, and testing. Most children are also returning to school without vaccination.  It is also happening at this time in September when the Delta variant is spreading. US president Biden's decision for vaccine mandate for 100 million or two thirds of American workers comes at this time of uncertainty in schools about the future and coronavirus variant. In the US rules are being set school district by school district, at a time when vaccines are not approved for children under 12 years. One leading school administrator in the US says "it's as chaotic as you can get."

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Bellman and Dayal in WSJ give this amazing report of how vaccine travels from Pune to remote region of Mizoram hills in India's northeast near Burma. This is the story of the largest vaccination drive in the world that aims to have the vaccine supplies by July to vaccinate the entire population of 1.2 billion people by December 2021. It all began with Oxford University and Astra Zeneca with the decision to make the vaccine available to such a vast population and to people in all parts of the world not just Europe and the US. Bharat Biotech and India's pharmaceutical manufacturers have now joined efforts with the help of the Indian government to produce enough vaccine at affordable cost and make vaccine supplies ample and accessible. This will then be extended to all parts of the world.

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Just five prime ministers have remained in office for more than 5 years in Japan since 1945. Prime minister Yoshihide Suga's popularity dropped to 26% from high sixties since September 16 of last year. Five candidates are trying to lead the LDP party. Another period of uncertain revolving door politics appears to be the prospect. This would mean a weak effort in vaccinations and in tackling the coronavirus pandemic. 

Just as in Europe and the US, in Japan there are effects of the pandemic, economic downturn, widening social disparity, plus a contracting population. Yukio Hatoyama, Yoshhide Suga, and Shinzo Abe in his first term served for short periods of one year or less since 2012. There is a perceived need for the older leaders to retire from politics and let a younger generation tackle the problems the country faces as in Europe.

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About 85% of people in Portugal a country of 10 million people are fully vaccinated in October 2021, highest in Europe. Strict precautions for prevention such as social distancing and mask remained in place after the surge in January 2021 which led to deaths at a rate that was three times the peak rate in the US.

On October 1, 2021 the restrictions such as 30% limit on filling soccer stadiums were lifted. For the Benefica vs Bayern Munich soccer game restrictions were lifted leading to filled stadiums with vaccination pass mandatory. As people return to indoors in winter this could still result in increase in cases. Because Portugal depends on tourism and stadiums are filled to capacity there is the risk of a smaller surge. Cruise ships are back in Portuguese ports and tourists,are back in large numbers. Soccer fans, fill subways, leading to new concern about a limited spread of the coronavirus.

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A conflict is developing between Britain and the European Union over vaccine supplies as both sides try to get access to limited supplies. Britain and the US have moved ahead with their vaccination drives, causing alarm in Europe as Germany, France, member states of the EU lag behind. The problem comes from the delay in approving the vaccine by Astra Zeneca and Oxford University by the European Union. European Union prestige is at stake because its slower process of approving vaccine has led to a delay of 1 month in approving the Astra Zeneca vaccine. The Oxford vaccine is only now approved in Europe. Other problems have emerged. Astra Zeneca has announced that its vaccines made in Britain are now running short of supply and it can only provide 39 million doses to the EU instead of the 80 million originally arranged by EU. Soon after this announcement Pfizer said its factory in Puurs, Belgium, near Antwerp, is running into production issues. This would reduce supplies to the EU.  The EU has responded to this situation by saying it was being treated unfairly by Astra Zeneca. In response it has introduced new paperwork that would limit supply of Pfizer vaccines to Britain from the Belgian plant. Other countries are watching this situation with dismay as richer countries are fighting for the vaccine supplies. ...

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This report in The Guardian says what India urgently needs is for the US to lift export restrictions on supplies for India's vaccine factories, and tools such as genome sequencing to identify and control emerging variants of the coronavirus.

The report also points out that of the 1 billion vaccine jabs about half are in the US and Europe and the low income countries have only a tiny fraction of vaccinations. India which sent 64 million vaccine doses to countries including Brazil and Morocco, Bangladesh, in 3 months prior is reported to have sent only 1.2 million doses this month.

The crisis in India also shows the need says The Guardian for an international approach to the crisis no a country by country approach. It says the Bush plan for Aids and the the 2014 plan for Ebola in West Africa are models of an international approach that is needed now.

 

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IMF chief economist, Gita Gopinath, says multispeed recoveries are in place in regions and across income groups, linked to the differences in vaccine rollout, and extent of economic policy support. 

All regions in the world are expected to grow faster than estimated in January 2021 by IMF. 

US - forecast raised to 6.4% from 5.1%, this follows contraction of 3.5% in 2020. Rapid vaccination drive and large economic support under president Biden accelerating growth. About $5 trillion in economic support in the US by April 2021.

Europe- forecasts raised for growth in UK and Italy.

Latin America- growth forecast raised to 4.6% from 4.1%.

Africa- growth forecast raised to 3.4% from 3.2%.

Emerging and developing economies including India as a whole- growth forecast raised to 6.7% from 6.3%.

 

 

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The International Monetary Fund estimates global growth in 2021 at 5.5%. It also says that government support to support the economic recovery is essential calling for the strong stimulus being done in the U.S., Europe, Japan, India and other countries.

The IMF also cautions that everything depends on controlling the pandemic. There is special concern for countries in Africa and Latin America where vaccine supplies are needed.

The chief economist of the IMF, Gita Gopinathan, says India will see growth of 11.5% in 2021. The head of the IMF Kristalina Georgieva, says India has acted quickly to control the pandemic, considering the size of the population and its density.  The vaccination drive with 2.3 million healthcare workers vaccinated and 300 million to be vaccinated in the first part of the campaign, Georgieva says shows that steps are being taken for a strong recovery in 2021.

 

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 Edward Jenner invented the small pox vaccine in 1796. Before this a method called variolation was used. Pieces of fabric or threads moistened with a sick person's small pox postules were pulled through incisions in a person's arm. This was effective until Edward Jenner invented the vaccine itself for mass vaccination efforts. Tom Parfitt of The Times writes about how Catherine Empress of Russia invited Dr Dimsdale from Britain to give her the inoculation against smallpox. She became the first person to be inoculated in Russia and had the courage to do so after this method had been tried and successfully tested in Britain. Catherine writes in this letter to Count Rumyantsev that she had only mild discomfort. She then championed smallpox inoculation for the Russian people and says "it does not call for huge expenditure." Today the Russian government is making its best efforts to vaccinate the Russian people, yet only 38% are fully vaccinated. The example of a medical revolution 200 years ago and how it was handled in Europe is new inspiration for renewed efforts. ...

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Years of poor funding of public health departments in the US, Europe, and other countries have left public health departments lacking basics, lacking staff and resources. Here the WSJ shows how this has affected Alabama in the southern US. Alabama has the slowest vaccination program in the US with 10,000 doses given per 100,000 population. Positivity rate is very high at 29.1% for coronavirus, one of the highest for positive coronavirus tests in US in the past month of  Jan. 2021.

A large portion of the population of Alabama lives in rural areas. These rural areas are some of the worst hit in healthcare in the US. Since 2009 7 hospitals have closed in Alabama resulting from poverty of patient populations and population loss. This is part of the general erosion of rural healthcare infrastructure across the US in the last 20 years. A problem that now faces the Biden and future administrations. to tackle the problems of rural US communities.

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With more vaccines available from Pfizer and Moderna, and the poor SinoVac Chinese vaccine effectiveness against the Delta variant, Brazil and other countries in Latin America and Asia are shifting away from Chinese vaccines. Brazil's federal government has halted negotiations for additional doses of Chinese vaccines. In the early stages in 2020 Chinese vaccines helped Brazil cope with the devastating rise in cases. The slow pace of vaccinations in US and Europe has freed up more vaccine doses of Pfizer for other countries including Brazil. From accounting for 80% of vaccines in Brazil early in 2020, SinoVac vaccines now make up only 35% of Brazil's vaccine doses. At that time Brazil bought 100 million doses of SinoVac vaccine which were delivered. The local producer of SinoVac vaccine, the Butantan Institute will no longer make Chinese vaccines. While Sinovac vaccines are effective at preventing deaths, the vaccines have a low effectiveness rate for symptomatic infections. ...

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Jenny Medina looks at America's Biden 10 months into his presidency. Biden compared his presidency to that of FDR in his first years in office in 1933 with America in the depths of the Great Depression.  This report says FDR was better able to communicate how the New Deal would help families and workers in the face of distrust. Biden needs this today. During the ten months of the presidency Biden has already taken the tough decisions that are needed. For the vaccination drive, for the vaccine mandate on the coronavirus pandemic. On Afghanistan Biden took a similar tough decision to step away after learning the lessons of that conflict. He has quietly moved forward to build the alliance with Europe. On the infrastructure plan he has made the tough decision to make certain the essential components of spending on healthcare, education, childcare, support for mothers and older Americans are put in place, so that one bill for infrastructure is not passed without the bill for healthcare, childcare, mothers, elderly and education. Only this can provide the needed credibility for Republicans in states such as Tennessee who support community college open to all to come behind the overall Biden families and workers plan, and for working families throughout the whole country to support further spending for renewal of America.  ...

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South Africa feels a sense of relief as omicron cases follow a pattern of very steep upward increase, followed by a short period of a month, and then a very steep decrease. Cases in South Africa with a population of 60 million, about the size of Britain, dropped from 27,000 at the peak to about 15,000 on December 21, 2021. The area around Johannesburg was hardest hit. The median age is 27 years in South Africa, 40 in UK and 43 in Italy. With younger populations in India and parts of Asia South African population demographic is closer to India than it is to Europe where populations are much older. Scientists do not want to extrapolate from the South African experience with Omicron for this reason. Immunity from vaccination and prior infection could be contributory causes to the less severity of omicron say NCID scientists. "In South Africa this is the epidemiology. Omicron is behaving in a way that is less severe," says Dr. Cheryl Cohen, of the National Institute for Communicable Diseases (NCID). "Compellingly together our data really suggest a positive story of a reduced severity of omicron compared to other variants," he said at a conference with other scientists on Wednesday, Dec. 22.  ...

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For the first time in three decades US economic growth will be much faster than China's. Second quarter 2021 growth in the US was 12.2% compared to 7.9% in China, and will continue to be much higher for five consecutive quarters. This report in the WSJ says it is the result of the US response to the Covid pandemic. The US vaccination drive, massive fiscal stimulus and near zero interest rates have helped, including the confidence generated by the $1 trillion infrastructure investments planned for this decade. Over the longer term Capital Economic estimates China's GDP around 2030 will drop to 2% growth with demographic decline, just as the demographic factors favor Indian growth to levels that China has seen in the last two decades. This was the plan and vision set out by the Indian prime minister for 2047, on the 100th anniversary of independence. For the future government help has helped US households accumulate $2.6 trillion in excess household savings, which Moody's estimates is 7 times that in China.  In the longer term gaps will have narrowed between Asia and Europe, the US, which is a good thing. More will need to be done in Africa and Latin America. Much of the talk about who leads ignores the local needs in cities and towns across all parts of the world for a better quality of life, better education, better nutrition, better healthcare, meeting aspirations of young people, and supporting hope for a better future. ...

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The Editorial Board of the WSJ questions the lack of debate on the frequent lockdowns and the quashing by public health officials Fauci and Collins of an alternative point of view on lockdowns. That point of view by epidemiologists at three universities Oxford, Harvard and Stanford favored a policy of "focused protection" of high risk populations instead of snap response of blanket lockdowns. It cites statement by Dr. Fauci that people who criticize him are "really criticizing science, because I represent science. That's dangerous." And questions the idea that one man can by himself represent science, saying scientific debate over pandemic policy was and still is in the public interest. In some ways the Biden administration has adopted some of these ideas on a new pandemic policy that does respond with focused and selective lockdowns. Today shuttered businesses, lost livelihoods, untreated illnesses, mental illness, isolation effects are all taken into account in decisions throughout the US, and other countries in Europe, in Asia and the rest of the world. Some of the emails mentioned in this WSJ editorial were in October 2020 at the height of the first wave and second waves before the vaccination drive in 2021, when the fear of the coronavirus was the dominant response. Yet a spirited public scientific debate could have prevented some of the rancor and division that has led to high vaccine resistance in the US with fully vaccinated stalling at about 62% of the American population at the beginning of 2022. It did'nt have to be that way. America could have done a lot better with sincere scientific and public debate. ...

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China faces risk of a surge inthe coronavirus in June 2021. The area in and around Guangzhou appears to be seriously affected. The city tested almost its entire population of 18.7 million between June 6 Sunday and June 8 Tuesday. This report shows pictures of a deserted Beijing airport, strict restrictions on foreign travel. The SinoPharm vaccine effectiveness against the Delta variant in India and UK is unknown. The government is locking down entire neighborhoods rather than entire cities or provinces.  As the risks of the Delta variant and other new variants increases most of the population even in the US and Europe have either no dose or one dose. Researchers at the University of New South Wales in Australia show the Astra Zeneca vaccine effectiveness with one dose at only 30%, only after two weeks following the second dose does the vaccine effectiveness reach about 70%. The population of China and India are so large that much larger parts of the population remain unvaccinated. In China with 1.3 billion people and even if the figure of 800 million doses stated by the government is accepted- it could be an overestimate as the US has only managed 300 million doses with many vaccines- most of the population is unprotected. Vaccine skepticism is high in China making vaccination an uphill task. SinoPharmvaccine is not as effective as Pfizer, Moderna, Astra Zeneca, or Covaxin vaccines, making the task even more of an uphill kind. ...

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With better control over the coronavirus than U.S. and Europe, South Korea is not rushing to buy the vaccines developed by Pfizer or Moderna. It is waiting to see how the vaccine rollouts work in other countries before buying the vaccine. South Korea is also looking at getting better price from manufacturers after the rollouts in the U.S. and Europe. South Korea is moving cautiously and has said it wants to get 10 million doses through the Covax initiative the main global effort to provide broad access to vaccines. Another 20 million doses would be secured from private companies. This is in contrast to the approach in Japan where the government has signed deals for purchase of 290 million doses for 145 million people for its population of 126 million. The money allocated is $6.5 billion and the goal is to vaccinate everyone by first half of 2021.  If it works this would prepare Japan for the Tokyo Summer Olympics to open in July, after 1 year delay. South Korea has the freedom to do this and wait to see what vaccine works best with least long term effects because their are relatively fewer cases there. A total of 313 new daily cases on November 18, lower than daily cases in a single county in the state of Michigan in the U.S. Moderna and Pfizer vaccines use anew kind of gene based technology that has never been approved to prevent infectious diseases. Other competition is the vaccine from Oxford and Astra Zeneca which uses an existing technology that is used in existing vaccines modified for use in coronavirus. The Oxford vaccine and a vaccine from Johnson and Johnson are expected to have a lower price. Because life is functioning very close to normal South Korea is in the unusual position of saying that its people have no reason to be anxious for vaccine procurement, as indicated by its deputy director of Korea Disease Control and Prevention Agency. Only three fifths of the population is the target for vaccination by fall of 2021. ...