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California is now the first state in the US to make vaccination mandatory for teachers. Teachers who turn down vaccination will need to undergo regular testing. This goes into effect Oct 15, 2021. California is also considering mandating eligible students to be vaccinated to attend school. Different states in the US are setting different rules for mask mandates for schools. California and Illinois require them, while 4 states have banned mask mandates in schools. 

The mandates and other action have pushed the fully vaccinated rate in California up to 64% for residents over 12 years, compared to 59% nationwide in US according to health data cited in the WSJ. Teachers unions in California support the rules. The largest union California Teachers Association, with 310,0000 educators, says 90% of its membership is vaccinated.

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As restrictions ease and the Delta variant makes up 83% of US cases, cases increase in the US. Stalled vaccination rates presents an added problem. On July 20 49% of the US population was fully vaccinated. Two thirds of counties in the US have less than 40% coverage, according to CDC director Walensky.

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The US booster vaccine drive is lagging behind as only 30% of Americans fully vaccinated have taken the booster vaccine, according to CDC. Only half of Americans over ager 65 have taken the booster shot. In New York City only 1.5 million Americans out of 8 million have taken the booster vaccine. This report in NYT shows Dr. Oshita's 3 urgent care clinics in Sacramento, California, and no rush of people to get the booster vaccine. It is scary, he says, of the lack of a rush of people into the vaccine centers. This is happening as the new omicron variant is spreading.

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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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With vaccine hesitancy in the US the goal of vaccinating a large part of the US population is still elusive. Less than half of the US population is fully vaccinated as of July 30. The vaccination rates in the US are now much slower than India even taking into account the population difference. The vaccination in India is at the rate of 4 to 5 million a day for the past week in India. In the US this report in The Guardian shows 4.7 million vaccinated in the past 2 weeks. On July 30 856,000 people were vaccinated in the US compared to over 5 million in India.  Newspaper reporting that encourages vaccine hesitancy people to delay getting vaccinated because of poorly reported headlines is adding to vaccine hesitancy in the US. This has led to much frustration at the White House. The threat of the Delta variant is making more people to take vaccination. Southern states are seeing a jump in vaccinations. Many prominent Republicans are now endorsing vaccination.  One of the problems in tackling the Delta variant is the confusing nature of the CDC guidance on masks. On May 13 CDC issued guidance saying masks were not necessary indoors and outdoors. Now 3 months later in July the CDC says the threat of Delta variant means mask wearing is essential particularly indoors because of the higher transmissibility of the delta variant.  ...

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The rule requiring health pass showing one is fully vaccinated goes into effect in France starting July 28 at restaurants, coffee shops, trains, and other public places. For the first week restaurants will not be fined. After this they can be fined 1500 euros for a single violation. The passe sanitaire in France is now required  for all public places where more than 50 people gather, such as events and museums including the Louvre in Paris. It will be extended to restaurants, cafes and shopping centres in August.

French premier Castex says 97% of the 18000  daily average new cases in France, up by 150% since the prior week, are from the unvaccinated. This has made health authorites and the government concerned about the delta variant high transmission rates and the high proportion of people still not vaccinated. For France this poses risk of a new kind of fourth wave, causing the government to take strong action to accelerate vaccinations.

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Indian health minister Mandaviya goes house to house in Palitana, Gujarat, to start India's Har Ghar Dastak, house to house vaccination drive. Indian government has identified 50 districts with vaccination rates below 50% for first shot, for efforts at house to house vaccination by visiting homes of the unvaccinated. PM Modi returning from Glasgow held a meeting with chief ministers of the worst affected states such as Maharastra,Tamilnadu, Karnataka and other states with officers at the district level also present, to start Har Ghar Dastak campaign. Modi told the chief ministers and district officials that his talks with leaders of developed countries had increased his awareness of the great risks in letting any slackness or loss of vigorous effort take place in the vaccination effort. Germany is today facing a pandemic of the unvaccinated with fully vaccinated stuck at 67% and facing resistance from unvaccinated and closing of vaccination centers. The US is also facing the same problem and the winter looks increasingly fraught with dangers for both US and Europe, when people go indoors. India seeks to avoid having to face the same problem by taking action in advance to get unvaccinated to enlist in the national effort. Only Spain and Portugal have rates of vaccination close to or over 80% for fully vaccinated, and this is because of the huge trust people in these two countries place in the health system, seeing vaccination as a gift of modernity, and seeing that it is important to not risk health of older family members with whom most young people live with in these countries. ...

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India's new vaccine policy and how it will vaccinate fully with 2 doses India's entire population by December 2021 is  outlined in the federal government's affidavit to the Supreme Court. The vaccine supplies of about 1880 million doses will be supplied by 5 Indian pharmaceutical vaccine manufacturers. 1350 million doses will be supplied by the manufacturers between August and December with 500 million doses made available by July 31 to the government. This is a monumental task for the vaccine manufacturers and the federal government which is being courageously tackled at every level. The new variants have shown how critical this task is and the challenge is being taken up vigorously.

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Graphs in this Washington Post report show the success or failure of vaccination drives around the world from the US and Canada to Europe, Brazil, Japan and Africa as of the first week of July 2021. Japan and Africa are far behind Europe and America. By July 4, 59% of Americans were fully vaccinated short of Biden's goal of 70%, according to CDC. Canada, Italy, Germany have passed the US. By making vaccinations mandatory France is working to catchup with Germany and Italy. Canada and UK lead in vaccination drives. 

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The first spread event for Omicron outside of South Africa is now known to be in Norwegian capital of Oslo. Some workers of renewable energy company Scatec SA returning from South Africa where the company has a solar panel project attended an annual holiday party. The party was at Louise an upscale Oslo restaurant, with 120 people all vaccinated, and tested the day before. More than half have tested positive for covid 19, with at least 13 having the new variant Omicron. Oslo municipal health department says it expects more Omicron cases among the 64 coronavirus cases as remaining workers get tested. The results so far are anecdotal and thin to be sure, yet they show none of the infected employees were seriously ill, says this report in WSJ, citing a company spokesman. The spokesman says people had different sysmptoms but none were severe. Tine Ravlo, assistant superintendent of the Oslo municipal government says- all of them are under isolation at home. And  for now they have what they describe as mild symptoms such as headache, cough, sore throat, and flulike symptoms.  Norway has 80% of population of 5.4 million people fully vaccinated. Mask mandates are in place again in Norway, private indoor gatherings limited to fewer than 100 people. ...

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European Union countries, Britain and the US face the risk of a resurgence of coronavirus through the Delta variant and other variants. The Delta variant detected in India is 40% to 80% more transmissible than the Alpha variant detected in the UK, with the Alpha variant 50% more transmissible than the original coronavirus that originated in Wuhan.    Virologists in Italy feel they are flying blind at this time because of the lack of genetic sequencing in Italy, Spain, France and across most European Union countries. The UK has done genetic sequencing on 27% of recent covid positive tests. The figure drops to 1% for Italy and is tiny for most of the EU countries including Spain and France. Without genetic sequencing it is hard to predict and take steps. Another problem in the EU is that the southern economies Spain, Portugal, Greece, Italy, Croatia are dependent on summer tourism for the economy. The UK economy can handle a delay to a full opening for 6 weeks without serious impact to the economy, says WSJ. Southern European economies can afford only short delays to full reopening. Croatia acted as a door to spread of coronavirus into central Europe when Germans and Austrians went to vacation spots in Croatia in summer 2020. This situation could be happening again in 2020 with British and other tourists visiting vacation areas in Portugal, and Germans visiting Greece and other summer tourism spots. Portugal's national health institute says the Delta variant represents 60% of new cases in the area around Lisbon based on early data. The government of Portugal is facing criticism for letting a Champions League soccer final to take place in Porto, Portugal between two English teams. Thousands of English fans watched the game at the stadium. Other problems are in relaxing of mask rules in France and Italy, last week in France and in the coming week in Italy. French nightclubs open July 9 without mask requirement. Germany is maintaining some social distancing measures and this includes mandating medical masks in closed public spaces and on public transport. Half of French, Italians, Germans are vaccinated and quarter fully vaccinated. Yet the gaps of unvaccinated people is large enough to cause serious concern of another wave. The relaxation of mask rules- the entire stadium in Budapest was packed for a recent game between Hungary and Italy for a soccer Euro 2021 game with no masks to be seen. Stadiums played a key role for the spread of the original coronavirus in Italy with a game in Bergamo, Italy, in the area near Milan. All this makes health officials concerned about the risks of still another wave of the coronavirus.   ...

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A look at countries in Europe shows different strategies for tackling coronavirus Delta variant as schools reopen in September 2021. Italy requires all teachers to carry a covid digital certificate that shows vaccination or PCR test results. France, Germany and Spain do not require vaccination for teachers to go to schools, and rely mostly on social distancing and mask requirements in schools. Britain not only does not require vaccination digital certificate, but also has not made masks and social distancing mandatory. Health experts say there are serious risks in this approach with mass return to schools and offices after August 2021, and the fall weather with more time indoors. This could lead to a surge in coronavirus as in the US where the reopening of schools and Delta variant has led to surge particularly in states such as Texas, Florida, California. In UK 65% of total population is now fully vaccinated, in Italy 62%. Teachers in Italy fully support the new rules. In Lombardy region with Milan as the capital, only 300 out of 300,000 workers returned to schools without the green pass, according to regional officials. Britain remains an outlier says this report in the WSJ, taking more risks than is proper at this time, and simply hoping for the best. Not the best strategy in this situation.   ...

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Germany faces the possibility of a pandemic surge of the unvaccinated, something that is happening today in the southern United States.  For days the percentage of people that are fully vaccinated remains at 62%. Some vaccination centers are closed. A vaccination center outside the train station in Cologne offers passersby free vaccinations. Berlin's Social Democrat mayor Michael Muller is very frustrated. He says "I am now coming to a point where I think we have exhausted what we can do in politics."  At 62% the rate of fully vaccinated people in Germany is too low to prevent a surge of the Delta variant in the way that it has hit the southern US, and California. Vaccination rates of close to 85% are needed to tackle the risk of another surge in highly contagious delta variant. Not everyone remaining is die hard opposed to vaccines. The Robert Koch Institute estimate is that 5 to 10% of people are in that die hard category. The remaining 20-30 % are people who have various other concerns and fears, hesitancy, that may be changed.  The chairman of the World Medical Association Frank Ulrich Montgomery favors a vaccine mandate, what he calls a 2G rule, that should be introduced in Germany requiring vaccination to attend events, sports, restaurant visits, adopted nationwide. German government has rejected idea of mandatory vaccination of health personnel, that was adopted in France. Vaccination drives are regionally based. Some are ineffective such as the Deutsche Bahn train system vaccination drive for commuters that only had a few hundred doses of J&J vaccine and ran out quickly in Berlin. One prick J&J some say is better for vaccine skeptics. Vaccine skeptics think they may get away without getting covid infection. How does one get over this misconception? Others including members of the Greens party say vaccine needs to be delivered where people are- transit points, bus stops, doses offered in evening and early morning hours, trying new ways to reach people and inspire confidence. Germany now ranks behind France but ahead of Bulgaria in terms of vaccination percentage in September 2021, not a good situation. ...

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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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The problem facing Africa is whether vaccine supplies will run out before new vaccine supplies come from America, Britain and France. Only less than 1% of African people have been fully vaccinated out of a population of 1.3 billion people. US president Biden said America will provide 500 million doses of Pfizer vaccine to poor nations before the G-7 meeting in Cornwall, UK. Britain added 100 million and France 30 million doses. With new more transmissable variants out there Africa is in considerable danger today. The Delta variant from India has been shown to be about 70% more contagious than the Alpha variant from Kent UK. It is already the dominant variant for new cases in the UK. The new variants are now spreading in Africa. Cities such as Johannesburg, South Africa, and Kampala, Uganda are seeing a surge in cases. Another problem in Africa is that governments are increasingly reluctant to impose strong lockdowns because of the economy. Already it is believed that Africa's middle class has been severely affected during the last 18 months. ...

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The UK NHS is urgently tracking down parents of 35,000 children in London who are not fully vaccinated against polio, says this report in The Times. Health officials have detected the first outbreak since 1984. They are trying to trace it back to a "single household or street." London has lower rates of polio vaccination than the rest of England, dropping to levels that are seen as risky for the health of children. Vaccination rates are low in north and east London says this report in The Times. In London as a whole the vaccination rate for one year olds in 2021 is at 87%,  5 percentage points lower than that of the UK as a whole of 92%.  

Lack of investment in public health and services has weakened the public health system even as hundreds of billions of dollars were misallocated by capital markets gone astray. The pandemic exacerbated a bad situation in public health lowering vaccination rates even further.

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Germany's national broadcaster DW.com looks into the details of the vaccination drive in countries around the world, including Germany, and finds that there is more to the story than meets the eye in headlines about safety in vaccinations. Many headlines do not tell the whole story carefully. DW revewed reports from Italy, Austria, South Korea, Germany, Spain, the USA, Norway, Belgium and Peru, and found that in most cases health authorites have not found causal links between the vaccination and deaths.  As of March 15 it says 360 million people have been vaccinated in 120 countries, or about 9.25 million a day.  DW.com cites the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) which states: 'there is no indication that vaccination has caused these conditions, which are not listed as side effects with this vaccine. Information available so far indicates that the number of thromboembolic events in vaccinated people is no higher than that seen in the general population." As of March 10, 2021 30 cases of blood clots are recorded for 5 million people vaccinated with Astra Zeneca vaccine in the European Economic Area.  The Paul Ehrlich Institute which is in charge of vaccination in Germany has looked into 113 reported deaths in 46 years to 100 years old patients in Germany. Of these 113 deaths PEI finds that 20 died of the Covid 19 infection as it takes 14 days after the second dose for full protection, and 43 died of pre-existing conditions or other infections. For the patient population it says "they were seriously ill patients with many underlying diseases." PEI says "based on the data we have we assume they died of their underlying disease- in a coincidental time with the vaccination." A virologist at the Technical University of Munich, says that the deaths after vaccination are below the expected number of deaths without the vaccination.  ...

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Most of Kennedy's supporters who were Democrat leaning have gone back to the Democratic party and Harris. Only the ones remaining are likely to support Trump. Some of them are vaccine sceptics, the one issue on which Kennedy initially opposed Biden as he was against the vaccination campaign that Biden implemented to get America back on to recovery and on its feet again. The former president Trump also made light of the vaccination campaign and in doing so weakened the response to the Covid pandemic that destroyed 1 million American families. Only the vaccination campaign with full government support and educational effort on the importance of getting vaccinated made it possible for America to recover by 2021.  Hear this America- more lives could have been lost, million more without an effective vaccination campaign.

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Only about a third of the people in southeast Asia are fully vaccinated compared to 58% in the US. With growing inequality and a slowdown in production the supply chain in this region is hit hard. The region includes Malaysia, Vietnam, Philippines, Thailand and Indonesia. This region's growth rate is cut from 4.4% in April to 2.5% for 2021 by the World Bank. Manila based Asian Development Bank forecast is for 3.1% growth as coronavirus outbreaks lead to major lockdowns. This happened in Malaysia, Cambodia, and Indonesia. It has also worsened the global supply chain disruptions from clothes to cars and commodities.

As supply chains are restructured, and western countries increase manufacturing at home to avoid higher shipping costs, uncertainty of far flung supply chains, production is likely to decline.

World Bank sees 24 million more people below the poverty line in Asia this year than projected earlier.

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President Biden's scorecard for the first year- 3.9% unemployment down from 6.4% in January 2021. Created 6.1 million jobs the most since 1939. $ 1 trillion infrastructure building plan approved in Congress with support from Republicans, the money going quickly and directly to specific much needed rebuilding projects all over the USA for the first time.  73% of the population of American adults fully vaccinated with two shots. And $1.9 trillion relief to Americans to restore their finances. Suspended student loan payments during the pandemic. Action on climate change, children's education, help to women, held up in Congress by two Democratic senators joining the Republicans opposed to Biden. It could be said that more was accomplished in 1 year than at any time since the presidency of Franklin Delano Roosevelt in the thirties and forties. And this comes in the middle of the pandemic of coronavirus with 853,000 Americans dead from the virus. Biden puts is faith not in the polls but in getting things done.   ...

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Lessons can be learned about careful reopening in fighting the coronavirus from other countries. Here the Netherlands experienced a rise of cases by 500% within two weeks of reopening after some poor decisions. The Mark Rutte government decided to open all bars and nightclubs resulting in a twelve fold surge in these locations in one week. Most of the new coronavirus cases were in people 18-29. Data from Dutch public health institute shows 4 out of 10 new cases linked to bars and nightclubs with 262% surge in cases for young people 18-24 years. This goes to show that with the vaccination drive what we see is the cases shifting to younger people, the unvaccinated, and to activities like nightlife. People going to work, or doing hybrid remote work with trips to the office, workers in factories, people doing essential shopping, are not causing the rise in cases. Much can be learned from these examples in working out reopening that does not lead to new crises with surging cases in new waves of coronavirus. Earlier in 2020 summer tourists who ignored mask and social distancing restrictions in Croatia brought on a post summer coronavirus wave to Germany and Austria. This time Greece and Portugal are introducing restrictions. Greece plans to make vaccine health pass required effective July 21 to go into restaurants. Another lesson from Netherlands this week is that a 20,000 person music event of 2 days in Utrecht where QR codes were required showing vaccination or PCR tests failed. About 1000 cases were attributed to the Utrecht event alone. Reasons given are that people faked the QR codes, or that the covid testing system produced too many false results as much as 20%. The same QR code system was followed at nightclubs resulting in big problems. One can never be sure that things work as expected and the risks are great as this adds up. Even vaccines offer limited protection and only if fully vaccinated depending on the type of vaccine. One dose of the vaccine is simply inadequate, and obesity, other morbidities can lead to problems. Withdrawing the mandatory use of face masks in most situations is also a risky decision of the Dutch government. Face masks offer the added protection at a time of variants that spread quckly, and when large parts of the population have only one dose of the vaccine, some elderly are still not vaccinated, and young people have not been vaccinated in large numbers. ...

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Already vaccination experts at the Baylor College of Medicine cited here say they foresee another wave of the coronavirus in the Southern US because of vaccine skepticism barriers to vaccination, and much of the population not being vaccinated. The percentage of the population in the Carolinas, Georgia, Georgia and Louisiana, that has both doses of vaccine is low. About 50% have had just one dose. In southern states Mississippi and Alabama the vaccination rates are much lower leaving large parts of the population unvaccinated. The widespread presence of the Delta variant in the UK and the R rate being between 1.00 and 1.2 in UK shows that the UK even with higher vaccination rates than the US is still facing a danger of another wave as it reopens.  The ominous aspect of this is that from just over 400,000 the vaccinations per day dropped to 316,000i n the US. This means there will be a period when vaccination drive is stalled while the reopening is fully underway with a new contagious variant twice as contagious as the original coronavirus. This leaves the US at risk of another wave, with the south and western US, younger people who are out more and unvaccinated, more at risk.  ...

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India's vaccination drive which has passed one billion vaccinations is one of the great stories of our time. This report in DW.com looks at vaccination drive in a region that is densely forested. It is in central India in the state of Chhattisgarh with about 30 million people and about 7 million tribal people living in dense forests that make up 40% of the state's territory.  One such place is the Dandakaranya forest, Sukma district, 500 kilometres from the state captial of Raipur. It takes an arduous journey just to get to this place which has no electricity, no potable water and no road connectivity.  Block development officer Kapil Kashyap from Sukma tells DW.com how they worked hard, won trust among villagers and brought basic medical services to them. Astonishingly with such effort to overcome vaccine hesitancy, 95% of the people in the village here had their first shot, and 40% received two doses. It is such a kind of effort in every district that prime minister Modi has called for in the unrelenting effort needed to vaccinate fully 1.3 billion Indians. ...

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Vaccine mandates are becoming a favored action as companies and governments see the dangers of rapid spread of highly transmissible delta variant. Following the action by the French government to make vaccinations mandatory for all healthcare workers, and require health pass passe sanitaire showing one is fully vaccinated at restaurants, cafes, and trains, more governments are taking up this action. This is supported by French premier Castex showing that 97% of the 18000 average daily cases in France this week, up 150% from prior week, are from unvaccinated people. Similar situation prevails in the US making it critical that governments take action early, and not miss the right time for such action.

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In this interview in The Hindu with Public Health Foundation of India president Srinath Reddy, the importance of safe behaviours including masks and social distancing, public discipline to tackle a potential third wave. This was also pointed out separately by the Director AIIMS.  Mr. Reddy says study by Public Health England shows just one dose of Astra Zeneca vaccine is not very effective against the Delta variant- about 30% effective. As a result he suggests the need to reduce the spacing intervals which are at 8-12 weeks to a shorter interval now that adequate supplies of vaccine will be available starting in July and August till the end of the year. The initial spacing was 4 weeks when Astra Zeneca vaccine was first introduced and at which time the variants had not emerged. The Indian federal government affidavit to the Supreme Court shows that 1880 million doses of vaccine will be available by the end of the year 2021 to vaccinate fully with 2 doses the population of India over 18 years using 5 locally manufactured Made in India vaccines. This does not include the mRNA vaccines that will be made available from Moderna and Pfizer for which cold storage facilities are being prepared by the federal government.   ...