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Dr. Ezekiel Emmanuel of the University of Pennsylvania gives this early warning on the risks of the sudden U turn in China's zero covid policy to complete reopening. He says the switch from zero covid to population wide immunity via viral spread is coming on too suddenly without preparation. He says China made three mistakes. First, the economic cost of zero covid that dropped growth and created high youth unemployment of over 20%. Second, not procuring Pfizer and Moderna mRNA vaccines with newer technologies. Third, moving to abruptly end the zero covid policy 180 degrees in a sudden move that lacks preparation. Precipitiously ending the zero covid policy for 800 million people means rapid spread says Dr. Emmanuel. He says the key variable the R statistic that measures how many people get infected from one covid patient on average, has moved from 2 to 3 during the early stages of the pandemic to 10 with the omicron variant. Chinese officials report the R to be at 16 in China today, says Dr. Emmanuel. ...

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In a factory the size of 5 football fields located in Gurnee, Illinois, Abbott Labs makes its BinaxNow Covid-19 home tests. Abbott turned out 1 billion tests in 2021 and at one point had 80% of the market. Along with Pfizer vaccine, BinaxNow Home covid-19 tests are a dominant product during the pandemic. Abbott generated a fifth of its $43 billion in revenue from these home tests. Abbott faced several hurdles along the way. It gained when the US government authorized it to make the test. Yet after vaccination took off by mid 2021 the demand for tests declined and Abbott nearly idled its giant factory in Gurnee. Delta and Omicron variants led to a sudden reversal and surge in demand. Abbott developed its test based on an existing design it used in the US for flu tests, by a company it inherited by acquisition called Binax. To do that test one sends a swab up the nose, add that sample and a liquid mixture to a rectangular paper card, and close the card shut. The liquid then travels up the paper strip, revealing one or two pink lines, one for negative, two for positive. This is done in 15 minutes and the simple design described as a lollipop shape, put Abbott far ahead of competitors. The US FDA authorized Becton Dickinson and Quidel to make the tests before it authorized Abbott, but these rival companies had a poor and complex design. The Trump administration gave Abbott a $760 million contract to buy 150 million tests for distribution to health departments, long termcare facilities, nursing homes, and schools. And by October 2020 Abbott was already making 50 million tests a month. When it comes to distribution Abbott tapped into its pharmacy connections for baby products such as Similac baby formula. This gave it an advantage over Quidel and others who also lacked the manufacturing knowhow for large scale ramp up. The BinaxNow in pharmacies was sold at $24 for a box of two tests, while government paid $5 for one test. Abbott says it makes $ 7 per single consumer test. Yet there was one problem waiting to hit Abbott in 2021- demand dried up as the vaccination campaign took off. In fact the plant manager, Mr. Rodriguez, planned to move to another job inside Abbott as production declined. Then came the Delta variant and he was asked to ramp up production again. With Omicron demand soared. The Biden administration committed $3 billion to help boost test production and asked Kroger and Walmart to sell over the counter tests at cost for 3 months. Abbott had to lure workers from Amazon at $25 an hour for the Gurnee plant expansion. What was learned by the government and Abbott from this experience? The US government now looks for ideas in meeting demand volatility, supply challenges and production needs,. Sustaining production capacity is important for future virus flareups- a new government-industry partnership is required for maintaining test making infrastructure. With government help Abbott plans now to keep the facility at Gurnee operating indefinitely. ...

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Latin America has made a huge turnaround through successful vaccination drives. Today more people are vaccinated as a percentage of the population in Latin America at 62% than in the US at 56% or Europe at 60%, according to Our World in Data project at Oxford University. There is little resistance to vaccines in Latin America after successful vaccine campaigns against yellow fever and other diseases. During the first year of the pandemic Latin America had one third of the deaths in the world with 8% of the population. Deaths after vaccination drives have dropped to 8%.  Brazil with 617,000 deaths from coronavirus was second only to the US with 800,000 deaths. Brazil is now back to normal after a successful vaccination drive that has 66% of the population fully vaccinated, and 80% with one dose, some of the highest rates in the world, according to Our World in Data at Oxford University. In Colombia with 50 million population about 50% of people are fully vaccinated. Cases have dropped from 30,000 in June to 2000 a day and deaths from 700 daily that month to 50 a day in December 2021. In Buenos Aires, Argentina's capital, 83% of three million population are fully vaccinated, 14% have received a booster. Buenos Aires city health minister says Argentine society has an affinity for vaccination campaigns. "They rapidly accepted receiving them," he says. Yet from the point of view of new variants emerging there is a different situation in rural areas. In industrial states such as Sao Paulo 78% are fully vaccinated, yet less than 40% are fully vaccinated in poor Amazon state of Roraima.   We make it a point to honor the brave reporters in these countries who provide the reports in the WSJ, as we did earlier for NYT Stephanie Nolan's reports from South Africa and Zambia about frontline workers against Omicron in Africa.  Luciana Magalhaes in Sao Paulo, Jenny Carolina Gonzalez in Bogota, and Sylvina Frydlewsky in Buenos Aires and Kejal Vyas writing this report from San Salvador. ...

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Nationally the new Omicron offshoot variant, the XBB.1.5 represents 40.5% of the cases in the US by Dec. 31, according to the Centers for Disease Prevention and Control or CDC. In New England and New York it is about 75% of cases and is a rapidly rising variant in Europe also. Only 38% of persons over 65 years in the US have got the updated covid booster bivalent vaccine shot.