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Tara Parker Pope of the NYT has this advice about protecting yourself against coronavirus variants after talking to many infectious disease and other experts. Don't let your guard down she says and suggests some of the same precautions that were taken in earlier waves of the coronavirus, from masks to social distancing and prudent decisions about travel and shopping.

Vaccines offer protection against common coronavirus variants such as B.1.1.7  from UK. It is still wise to follow the prudent rules that were followed before.

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Slow progress of vaccination drives in the European Union has led to rising frustration. This is leading to action from the EU. The EU and Italy have halted export of 250,000 doses of vaccine bottled at a factory in Rome, that is part of the Astra Zeneca supply chain.

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US life expectancy dropped by 1.5 years to 77.3 years, the largest drop since 1943. This takes life expectancy back to the level in 2003. During the pandemic of 1918 the drop was 11.5 years, showing how much difference vaccines and modern medicine can make. The drop is a result of coronavirus, and added to this are the complications for people with other diseases including chronic liver disease, which is connected to use of alcohol. There was a decline in asthma and cancer related diseases. Delayed treatment for health conditions because of lockdowns and homicide increase were other causes of the drop.

Isolation, stress and disruption of normal diet and exercise will have effects still to be seen, say experts. 

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The Biden vaccination target of 70% of American adults at least partially vaccinated with one dose by July 4, 2021 remains elusive as vaccination rates have dropped. From a high of 2 million a day vaccinations have dropped to 400,000 a day during the first week of June 2021. Vaccination skepticism particularly in the south and western part of the US is making it harder to vaccinate the rest of the US population. This poses increasing risks as the new variants of the virus such as the Delta variant found in India, and now the most widely prevalent strain of virus in the UK, remain a serious problem. The unvaccinated population in the US is too large for any degree of safety in numbers vaccinated. Consider that at the press briefing given by the White House on June 3, 2021, only 28 states out of 51 states have fully vaccinated 50% or more of their population. There is a large variation between different states with states in the south such as Mississippi as low as 34% at least one dose and a similar situation in Alabama. In Arkansas, Georgia, Carolinas, and Louisiana  it is higher at about 50% with at least one dose. Even these figures are deceiving as in some parishes in Louisiana only 20% have even one dose. Studies show that only after the second dose are enough antibodies released to protect well against coronavirus. This is why vaccine experts at Baylor College of Medicine cited in NYT foresee a second wave in the southern US because of the South so underachieving in the case of vaccination.  ...

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Speaking for the Biden administration Anthony Blinken says that "on the current trajectory, if we don't do more, if the entire world doesn't do more, the entire world won't be vaccinated until 2024." What is needed he said is to "speed this up, and get that done, I think, in a much shorter time." Experts say the immediate impact of the Biden decision to give waivers on transfer of patents technologies is to get drug companies to cooperate with each other and for them to voluntarily join in the manufacture of vaccines globally. This would be done through global manufacturing alliances in major pharmaceutical manufacturing nations such as France, India and other countries that can quickly ramp up manufacturing if they have access to the technologies involved and the knowhow itself. The Biden decision is then the first of many decisions that would lead to voluntary action by pharmaceutical companies cooperating say Novartis and Sanofi in France and Switzerland with a Pfizer or Moderna in increasing manufacturing capacity or a Serum Institute or Reddy Labs in India working with Pfizer and Moderna or Novavax. These companies already have the basic structures to ramp up. This would take months yet the process has to start immediately. Today many companies such as Glaxo Smith Kline in UK and US are in a position to get involved in manufacturing but need access to the technologies and knowhow. Leadership by the US plays a huge part in making that happen.  ...

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Israel's vaccination drive shows the effectiveness of vaccination in controlling the pandemic. It also shows the vaccination using Pfizer vaccines achieving the trial results of 94% effectiveness in actual results with the Israeli population. Israeli experts in Tel Aviv and other places say vaccination is the best way to control the pandemic and encourage countries to move quickly with vaccination drives.

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Schools, shops, restaurants, cafes and offices are reopening and people are getting back to work and outdoors. What are the ways to reduce chances of getting the coronavirus and what is the latest advice from public health experts.  More attention is now being given by CDC and other experts to the aerosols, the smaller particles that are airborne that can spread the virus to people unawares in breathing, talking and singing activities. larger droplets come down to the ground, smaller droplets can be airborne for hours. This makes masks wearing very important, call it essential protection. Air filtration and proper ventilation is also important. What about social distancing? Experts now say 6 feet is good, 10 feet is better. This is from Joseph Allen director of the Healthy Buildings program at Harvard School of Public Health. No magic number but 6-10 feet or more is good for safety. Can one start expanding one's social circle? The fewer contacts the better says Dr. Allen. You can he says expand the circle but this depends a lot on how serious the other family is in taking precautions. Are elevators risky? If one can one should take stairs but do not board a crowded elevator unless the lobby is more crowded. Do not touch buttons, if you do use elbow or use sanitizer from your shirt pocket after pressing. This is where mask is essential. Here a tip is useful. Talking does not help as talking emits 10 times the particles than when you are quiet and this is true for small spaces such as elevators. Continual talk is not a good idea such as a long time spent talking, here watch that habit of getting into long conversations face to face.  Is it good to take a summer vacation. Here the answer is yes, as no one really knows how the winter will be. And remember outdoors is good for renewal of health, and one can look for places that are not crowded where the 10-12 feet or more can be easily done. One tip here is to take your own food and supplies from home so there is no need to go to crowded restaurants. Swimming in a lake or ocean is fine. Camping outdoors is fine and actually a good idea if you are with your own family. Try to use an empty restroom and one that is clean and wear the mask. While camping keep the 6-10 foot rule with people outside your immediate family, do not share food and drinks and try not to touch each other's supplies, and sanitize your hands or wash if you do. When hiking keep the mask in your pocket so you can wear it when you see others passing on trails. In hotels skip the cleaning service, in a rented property ask the owner to keep the windows open before you arrive, and put a day or two between your coming and the last person who rented the place. Renting a car is tricky allow a couple of hours to elapse between you and the last rental, open windows. Public restrooms. Always wear a mask many are poorly ventilated. Open the door without use of hands if possible,or use a paper towel to open and discard. Do not use air dryers. Is it safe for your house cleaning person to return. Keep the windows open to let in fresh air. Make sure your cleaner wears gloves. And all should wear masks. How to visit grandparents? Experts advise keeping visits outside and wearing masks when not 6-10 feet apart. Anyone not feeling healthy should avoid the visit. And bathrooms should be sanitized after people leave even wait a day if there is another bathroom. Experts advise against sharing food and buffet type meals. Ten feet distance is better than six feet. Can one use a gym? Here the advice is to exercize outdoors or at home if one can. It says be cautious unless your gym is limiting the number of people or spacing the equipment adequately. Ask about open windows, air filtration systems, ventilation.  This is excellent advice from experts with the latest information. Over the last few months from March to May most of the information was during lockdown, and a lot can be forgotten or seen as not necessary as things return to normal, as shops schools and cafes, office reopen, and cases remain steady and under control. Being vigilant is good for safely navigating this period through the summer and into winter till a vaccine is found. It is also about being a good civic minded person aware of one's own responsibilities, as when all take safety seriously and practice it everyday, it builds another layer of protection for everybody- because it creates a safer environment for all.     ...

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The low number of confirmed cases and small number of deaths in India and Pakistan is being analyzed for what to expect in the coming months from June to August. Some experts see this as just the beginning that the peak will come later on. India has about 75,000 cases and Pakistan 35,000. Testing has lagged behind with only 1.5 tests per thousand people compared to 26 per thousand in the U.S.  one reason the confirmed case count is lower. Some confidence is being drawn from the deaths- 2415 in India and 737 in Pakistan. This is because only 2.2% of cases in India and 3.3% in Pakistan led to deaths, compared to 14.3% in UK and 5.5% in China, 6% in U.S., using John Hopkins database. One reason given is that only 6.4% of India's population and 4.3% of Pakistan's is over 65 years age. Compare mean age in Italy 46 years to 27 in India and 23 in Pakistan. And there is plenty of sunlight which appear to destroy the virus. Other factors that may influence the virus- taking of the tuberculosis vaccine and routine exposure to more pathogens in both countries. Prime minister Modi in India is taking no chances considering the size of India's population. He has put forward a $280 billion economic package and is moving in deliberate carefully prepared steps to lift lockdowns with the current phase No. 4 allowing more reopening. The shift now is to a more self reliant economy in industrial production making "local more vocal."  During the lockdown the large rail network and postal networks with their millions of employees, IT technology driven banking with Aadhar identification for direct deposit to hundreds of millions of the most needy citizens, and farmers, proved to be the most reliable and supportive. ...

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All three countries in the South Asian neighborhood now face economic crisis of large proportions - Sri Lanka, Pakistan, and Bangladesh, all turning to the IMF for help. In the case of Sri Lanka there was help from the beginning from India. It was lack of jobs and not enough jobs generated even with a decade of 7% economic growth. It was in protests over job quotas reserved for independence soldiers that led to the ouster of Sheik Hasina's government. This report in NYT shows overdependence on garment exports which generated growth for decades under PM Hasina as having a drawback during Covid. The disruptions in the supply chain during Covid hurt Bangladesh when garment earnings dropped. At one point the industry was closed for months. India provided assistance including vaccines during Covid and India is the largest destination for Bangladesh exports with economic ties to 5 Indian states. The recovery from Covid has not been strong and has led to reduction in foreign exchange reserves. In 2022 Bangladesh turned to the IMF for assistance. Not enough jobs were being created for a large population. In 2000 the population was 129 million, in 2019 before pandemic 165 million. Today in 2024 it is 171 million, increasing by 33% from 2000. By contrast in a communist state Vietnam population increased by 22 million to 99 million or 29% in 2024 from 2000   Foreign exchange reserves dropped during the pandemic to $23 billion in July 2023, in the last 11 months it dropped by $4 billion to $19 billion. By comparison Pakistan's are at $13 billion, up $4 billion in 11 months. Foreign remittances from Bangladeshis overseas are another source of foreign exchange. The major problem of getting tax revenues with people and business not paying taxes due is a problem for Bangladesh and for Pakistan. India has made huge gains through GST and digitization of economy to get tax revenues to support economic growth and infrastructure. And under the leadership of prime minister Modi there is discipline, girt, a strategic focus, with good governance, that is similar to what helped transform Japan and China into industrialized nations. This is missing in Sri Lanka, Pakistan and Bangladesh and in Burma. This gives some idea why in the present budget north and eastern Indian states of Bihar, Orissa, Andhra Pradesh, with a combined population of 230 million people are in a specially designated region for development. It is a gathering momentum against centuries of foreign occupation and neglect similar to that seen in China. ...

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Merck's decision to organize R&D using four innovation hubs in Boston, San Francisco, London and Shanghai. Merck currently lacks a large R&D presence in London and it has commercial operations in Shanghai. Experts say innovation centers enable drug companies to take advantage of academic research at an early stage. Pfizer and other companies are also pursuing a similiar strategy. The new head of R&D at Merck, Dr, Perlmutter plans to shrink staff and focus on promising areas such as immunoterapies for treating cancer and vaccines. Perlmutter comes from Amgen and is bringing people who he worked with at Amgen. The focus is also shifting to tapping the new science behind dieseases.

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Changes Novartis CEO Daniel Vasella is making in the pharmaceutical business. He has hired Joe Jimenez, who is running Novartis's consumer health care business to be the new pharmaceutical division chief. Jimenez previously worked at packaged goods companies including H.J. Heinz Company. Jimenez is cutting 25% of the jobs at pharmaceutical division's headquarters in Basel to reduce bureaucracy and costs. In March he promoted Trevor Mundel and Andrin Oswald, 2 young executives, to head the drug developmet group which puts drugs through human testing and submits them for regulatory approval. This group had become too bureaucratic and slow to move and take initiative. To improve its functioning Jimenez is organizing it into small teams with each team assigned an experimental drug in Novartis's pipeline. Each team of 8 people including physicians, experts in regulatory affairs and marketing and toxicologists work together to spot potential safety issues early and discuss them with regulators to determine whether to put the drug through expensive clinical trials. Each team takes the responsibility to take its drug to the market. The pharmaceutical unit is also being organized to be more nimble. It solicits health systems early on whether its willing to pay for drugs. And Jimenez has startd 4 pilot projects in tough markets to improve relationships with payers, including the Pacific Northwest where Novartis has offered to train an HMO's nurses in aspects of heart disease. Vasella supports the generics division of Sandoz because the growth is in generics, with generics commanding 60% of the prescription volume in Germany and USA, and sales for generics up 25% this year in the generics division. And Novartis paid $39 billion for Alcon, a eye care company. Its also working aggressively in the vaccines business, which like generics enjoys double digit growth. ...

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India achieves an initial vaccination target of 3 million vaccinations in a single day on March 14, 2021. Much of recent increase is from people over 60 getting vaccinated. For healthcare workers the first priority group about 50% still need to be vaccinated. This sets the stage for taking the vaccination drive to the next level in India. Increasing number of people are now getting their second dose.

Health experts see not vaccinating the vulnerable population fast and wide enough as a missed opportunity. The need has never been greater to vaccinate with better organization, vaccinating staff, and supply of vaccines at locations, so that this beats any second surge.

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The chief political reporter for the German daily The Bild, says Ursula Von der Leyen EU Commission president's performance on ensuring vaccine supplies is a disgrace for the EU and Germany. For once Brexiteers are proved right he says with having negotiated a better deal with vaccine suppliers, not being stingy like the EU officials, paying good money and securing supplies as early as April.  He says the EU's bureaucracy, its sluggish response, miserly attitude is now being confirmed in this health crisis and Germany is not looking good at all. Tiede says Leyen failed at the German Defense ministry and like other ministers in this situation was shifted into the EU Commission bureaucracy,only to fail again. He suggests Merkel and the heads of France, and Italy, Spain take over negotiating directly from now on with pharmaceutical companies. The EU officials are under severe criticism in Europe, shown here for different EU countries. Leyen is shown to have blundered further by creating a spat with Astra Zeneca- either she did not read the contract or was ignorant of what it meant, say critics. The EU's deal with Astra Zeneca was not with binding provisions, making EU officials at fault. Der Tiegesspiegel called EU's failure to admit its mistakes "jaw dropping" and bordered on "shamelessness." Der Spiegel calls it the worst catastrophe of Leyen's career. This now means Germany will have only 70% of its population vaccinated by September 2021, say experts. ...

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Brazil held the Olympics and the World Soccer Cup, building new stadiums and living off the boom in oil and metals prices under previous governments. Today not only is there a lack of funding for infrastructure, healthcare, education and transportation.   This is now leading to lack of investment in healthcare services in a shocking way. The first full blown epidemic of yellow fever is hitting Brazil's cities of Rio de Janeiro and Sao Paulo. Officials fear that it will spread in an area that has 23 million people if it hits the slums where A.aegyoti mosquitoes are to be found in swarms. Rio and Sao Paulo are trying to tackle it by vaccinating 23 million people. Yellow fever kills about 3-8% of people affected. The economic crisis with lack of funds, and the political crisis that has affected Brazil with corruption scandals has led to a delayed response, according to experts at UCLA infectious disease center.  The disease is traced to loggers and monkeys in the Amazon region which usually remains contained in that region. SInce 2016 the lack of a strong official response has led to the crisis where monkeys carry it a mile a day all the way south to the Rio and Sao Paulo region. A effective government response would have included the use of media to educate people on the need for vaccination for all except newborns and pregnant mothers. Instead social media Facebook and You Tube spread the idea that the vaccination was dangerous, anti vaccine persons who normally got no audience trashed the vaccine. So that today public health authorites have to deal with this problem. The vaccination is highly effective and invented in the 1930's, was not started till November 2016, even though the spread southward from the Amazon region started in 2016. In fact says Dr Marquez, an expert at the University of Pittsburgh, only one in 100,000 gets a reaction and one in a million dies. He says compared to this 6% of 30 million people in the region affected could lose their lives, or  2 million deaths. ...