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Annalena Baerbock and Robert Habeck are the most popular leaders in Germany today. According to a survey by Insa polling institute in May Habeck ranks first and Baerbock second in popularity among Germans. Habeck is seen as very approachable by Germans and the Greens are exceeding expectations. Baerbock has taken a valiant stand for Germany in the face of Russia's invasion of Ukraine. Habeck has worked hard to reverse decades of neglect of German interests by Merkel and Schroeder and has set the foundations for German energy independence.

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New York Governor Kathy Hochul said Friday that the state recorded 21,027 new covid cases surpassing the previous record of 19,942 set in January. Of 263,000 tested about 8% were positive- health officials say positivity rate doubled over 3 day period through Sunday.

William Lee, vp science at Helix, population-genomics company that does surveillance and testing, says Omicron will likely be the dominant strain in the US within a week. He says it is growing so much faster as a proportion of cases, than any previous variants.

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US president Biden makes a pledge that the US will send vaccine doses overseas to other countries after it has met American needs. This is hugely important because the US has contracted with pharmaceutical companies for a major part of the world's vaccine supplies. It is part of the humanitarian assistance the US will soon be in a position to provide to African, Asian and Latin American countries. It is also in the American interest to reduce the potential for new variants and new sources of the virus entering the US through airline travel by helping vaccinate a large part of the world's population in 2021-2022.

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The need for a global response to a global problems not a lot of local solutions is the subject of this article by Dr. Larry Brilliant, who for 7 years 1973-80 worked with the World Health Organization to eradicate smallpox globally. 1. Action for a global response-The WHO can act as the vehicle for action globally-  restructure it and empower it to do the job. Put the right people in place who have the confidence globally. Set a new pandemic treaty and put it in place. 2.  Get a more advanced version of the mRNA vaccine which does not need a cold chain. India is reportedly working on one. Put funds and people in place for vaccine drives in poor countries.  Other action needed is learning from the situation in South Africa where the HIV patients are reported by Stephanie Nolan in NYT to have been more susceptible to mutations of the new variant. How can resources be put in place in poor countries so that patients in vulnerable populations get their medicines regularly, and are vaccinated. Overall how can these populations have the vaccine supplies needed- including ones without cold chain suggested by Larry Brilliant, potentially through vaccine work in India. Can international teams be developed with developed countries in Europe and US financing the effort and India offering its manpower and knowhow?   ...

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US health officials remain on high alert for one unfinished task of the fight against coronavirus- the unvaccinated people who could be a breeding ground for new variants of coronavirus. There is the danger that a new mutation of the virus in unvaccinated people could be more resistant to vaccines. This means everyone needs to get vaccinated, and one dose should be followed quickly with the second dose. One dose only has limited protection with strong level of antibodies resulting only after the second dose. In the US southern states such as Arkansas and Oklahoma lag behind in vaccination, and are seeing a large increase in cases.

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By dropping most coronavirus restrictions including masks, social distancing and size of gatherings, and opening night clubs, England is risking the same sudden rise in new cases from variants that hit the Netherlands last week. Analysis of what happened in the Netherlands shows nightclubs and bars as the origins of 40% of the new cases in the Netherlands. Prime minister Rutte of the Netherlands apologized for this kind of reopening after a big jump in cases in Netherlands.Seven day average in the UK is at 46,000 for the last week. With 40% of the UK population not fully vaccinated, the new variants can spread faster and mutate in the unvaccinated population.  There is a basic difference in priority- getting to work and doing essential shopping compared to going to nightclubs. The Dutch government shut its nightclubs after reopening them in June. At this point England is split in how to reopen. The Mayor of London says masks will be compulsory in all public transit in London. And 55% of the UK public in a recent survey from YouGov think reopening in this way is the wrong thing to do. Another poll by Ipsos shows 70% of people surveyed saying they wanted mask wearing to be compulsory indoors for another month. One bar club owner says that he thinks what they are doing is wrong. Some students think that this is a recipe for transmission to happen quickly. ...

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The US has not yet approved the Astra Zeneca vaccine. Yet the US sits on large supplies of the Astra Zeneca vaccine. Europe badly needs the vaccine with its failure to procure enough vaccine doses. This is one of the paradoxes of the situation today. Italy faces a lockdown by Easter. 70% of cases in France are now variants, says the Health Minister Olivier Veran, and ICU's are 80% full. In Germany there are fears of a third wave. Yet vaccine supplies remain low and vaccination drives in Europe are slow, creating much frustration for the people.

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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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Genome sequencing is a way to tell if there are mutations in the virus. This is a very important part of the battle against the virus. About half of the genome sequencing in the world is done in Britain. 
Lessons learned are pointed out by the Science Editor of The Times.

During the first wave with the origins of the coronavirus in Wuhan, China, focus shifted to selected countries without much attention to Europe next door to Britain. Much of the mutated virus strains from Europe, from Italy, Spain and other countries cause the epidemic to get out of control. This is being repeated in the second wave.

When the epidemic surged in Kent British health authorites conducted genome sequencing for the virus to find out that there was a variant, a mutation of the virus that was causing a surge. This has helped Britain prepare to tackle the pandemic as it changes with new strains of the virus.

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Households and businesses have built up trillions of dollars in extra savings and the economic recovery looks strong says this report in the WSJ. Experts expect the economy to pass pre-pandemic levels in the second quarter of 2021. From this point the economy can recover the pre-pandemic trajectory of growth for 2022. There is a bit of caution about another wave of the coronavirus with new more contagious variants considering that about half the population still remains unvaccinated. The US has enough vaccine supplies, it is the anti-vax sentiment that could be the problem. Even with this bit of caution the economy appears resilient.

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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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The Oxford second generation vaccine is being developed to handle several strains of the mutating virus at the same time. The Oxford team developing the vaccine is following what the vaccine is doing, in the way it is mutating, to develop the new vaccine.

The Oxford vaccine uses a virus that has been modified to contain a piece of genetic code from the coronavirus. When injected it causes human cells to produce the coronavirus spike protein, which the immune system learns to recognize. A single vaccine would contain different lines of benign virus, each containing the genetic code for the spike protein of a different variant so that the immune system can recognize several mutated coronavirus strains at the same time. This is also how the flu vaccine works. 

Quick regulatory approval is expected with much smaller trials that would be followed by immunization shots given in September 2021 when winter arrives.

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Hospitals in New York City are coping better in the current wave of coronavirus variant in December 2021 as the symptoms of patients are milder and patients are going home quicker. This report covers NYU Langone, Northwell and Mt Sinai, Presbyterian  health systems. Only about 2% of healthcare workers were lost through dismissals because of the vaccine mandate at Northwell, which is the largest health system in New York City with about two dozen hospitals. About 400 covid patients turned up on Friday Dec. 17, a fraction of the 1350 last January and of the 3500 in early spring 2021. The head of integrated operations,, Dr. John D'Angelo says Northwell has enough staff to meet projected needs. Most covid patients had underlying health problems and a quarter are vaccinated up from 10-15% a month ago. Vaccinations and two years of experience make for a different picture now, though there will be challenges and I think we're going to have to think through a bit carefully, says Dr. D'Angelo. ...

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Greg Ip of the WSJ looks at the impact on the economy worldwide from the effects of variants of Covid-19 in 2022. He cites IMF estimates that global output will be 3% lower in 2022 than it had projected in 2019, with Western Europe and Latin America taking larger hits. US growth is distorted and disrupted with the effects of absence of workers from illness (5 million American workers not working in December 2021 because they were sick, or caring for someone sick or afraid of spreading it), supply shocks from supply chains, 7% inflation. The boost to productivity from digitization conceals the impact of an overworked and fatigue prone remote working workforce, says Greg Ip.

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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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Stephanie Nolan's reports from Africa provide the few glimpses one can get today of the situation in Africa where variants are growing as a result of lack of vaccines (vaccine inequality) and the faltering vaccination drive, shortage of medicine and food supplies. Her report from South Africa showed how healthworkers and scientists in South Africa are working hard on the frontlines. This one from Zambia looks at the vaccination centers and vaccination workers as vaccination drives falter. The African continent with 1.4 billion people received 404 million doses. Today only 7% of the population is vaccinated in Zambia and the rest of Africa. People in Zambia do not have car transport so they have to walk 3-6 kilometres to get to a vaccination center, when they turn up at a center and it is out of vaccines they stop coming. Other problems are the social media accounts that show the vaccination drives as harmful to people, or CNN and other news that talk about blood clots that when carefully understood affect a tiny fraction of people. There are other issues also. Ida Musonda, a nurse in a clinic near Lusaka says after not many people turned up that she should go to markets and churches, but says there is no fuel for the vehicle to get clinic workers there. Bernadette Kawango is shown with her children. She works at an auto parts store and lives in a low income neighborhood in the edge of Lusaka. She ignores all the social media accounts that scare people from vaccines, yet she says she worries more about cholera, TB and malaria, and also HIV, AIDS. And she does not know anybody diagnosed with coronavirus.  The result is that there is vaccine shortage resulting in a kind of vaccine indifference (why walk miles to a center if it may not have vaccines), compounded by other problems such as the other diseases that also pose a threat in Africa, and the low incomes in a shrinking economy. And with about 8% vaccinated in Africa, the problem of variants can only be tackled by consistent and not erratic supply of vaccines. ...

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For the regions hardest hit by the coronavirus and its variants- the US, Brazil, India, Europe, Russia, China and Africa, the researchers and the frontline workers in South Africa are doing an incredible job. This report by Stephanie Nolan in the NYT shows the work of researchers at KRISPS advanced medical research center and the frontline workers in South Africa, who are making a difference. Shown are researchers and scientists at KwaZulu Natal Research Innovation and Sequencing Platform in Durban, South Africa on whom the world depends for stepping up the fight against the coronavirus- Dr Tulio de Oliveira, principal investigator of the national genetic monitoring network, and Saleem Abdul Karim, epidemiologist. On the frontline workers who visit patients homes to make sure immune compromised patients have access to their medications is Sizakele Mathe, community health worker. Stephanie Nolan has provided a much needed account of what work is being done on the frontlines to keep us all safe. ...

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AIIMS Director Randeep Guleria says it is critical to do three things to prevent a possible third wave from becoming a serious threat in India. The three steps are- to adopt covid appropriate behaviours such as mask wearing, social distancing and washing hands and to not fall into the habit of thinking that the virus has gone away when it is spreading and developing into new mutations. To do testing, tracing and micro containment zones quickly to isolate infection prone areas and prevent transmission. Gene sequencing analysis would enable understanding variants quickly to respond. And to vaccinate rapidly the entire Indian population, a program which is being tackled by the federal government.

These tasks are critical also to let the economy recover and let all segments of society recover soon from the pandemic. It is through mutual responsibility and fulfilling one's duty by every citizen that this becomes possible.

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Novax vaccine could be a game changer for the poor countries in Africa, Asia and Latin America. Novax has 90% efficacy overall and 93% effectiveness against the UK, South Africa and Brazil variants. The Delta variant was not there during the trials. Novavax has signed an agreement to provide 1.1 billion doses to Covax, the organization which is designed to send vaccines to poor countries. India has contracted through Serum Institute of India to make 100 million doses. UK has ordered 60 million doses that may be sent to the developing world.

Novavax vaccine goes for regulatory approval in the third quarter of 2021.

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Young people are the major source of transmission of coronavirus in the US with school sports as a major cause. Michigan, New York, Florida, New Jersey, Pennsylvania, makeup 42% of cases on April 11. Adults ages 20 to 39 are affected the most in Michigan. With cases for children under 19 quadrupling from a month ago. 301 reported school outbreaks in Michigan alone. A big problem is that the spread of the variant B.1.1.7  from the UK started in clusters earlier in February. It now has spread to the general population. India has seen a surge in the past 5 days and public health officials are learning from this experience in Europe and the US. The focus  should be on micro containment zones, prime minister Modi told state chief ministers in a virtual meeting on April 10, with screening, testing, tracking, and that health officials should not let higher numbers affect their persistent effort to screen, test and track as with the unceasing effort the results will come. ...

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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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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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The US vaccination drive appears to be stalling when it comes to getting younger people vaccinated. On a recent day 1.13 million persons were vaccinated. About 150 million Americans are fully vaccinated or about 47% of the population. About 53% of the population have one dose. This still leaves the rest of the population close to one half unvaccinated as the US is opening up fully and removing the social distancing and mask mandates that existed before. The problem is that the coronavirus delta variant is about twice as transmissible than the original coronavirus of March 2020. Vaccination is uneven across the US. Large parts of the southern states and the western states lag behind. In these areas as well as areas with large urban concentrations of population, the densely populated cities where social distancing and mask mandates are being lifted as if the coronavirus crisis is over, are at risk of seeing a more powerful virus spread quickly before gene sequencing catches up with new variants- making the response lag behind in terms of weeks. That lag in response could lead to another wave in the US. Consider also that tourism is opening up in Europe with removal of mask mandates, that gene sequencing to track variants is tiny in even countries such as Italy and France. A WSJ report on June 22 shows gene sequencing to track variants at 1% of positive tests in Italy, and virologists in Italy saying they feel as if they are flying blind. This report in the Washington Post says surveys show as many as one third of Americans have no immediate plans to get vaccinated. This is showing up in the low numbers for the vaccination drive, of around 1 million a day at this time in June 2021. In April this was 3 million vaccine doses adminstered on a single day on average. India where the new delta variant has had the most serious impact has stepped up its response with the federal government taking complete responsibility for vaccine supplies and vaccination drives. It is now vaccinating aggressively in the range of 6 million to 8 million doses a day during the last 7 days with a plan to ensure enough vaccine supplies for 1.2 billion people to get vaccinated by December 31.  The European Union and the US have  vaccinated just over 50% of their population for a variant that is more than twice as transmissible than the original virus. This leaves the unvaccinated at real risk because all the social distancing and mask mandates that existed earlier are being removed- in the US, in France, in Italy, and other countries. Soccer stadiums are filling up in Europe, the kind of sports events that later hit Bergamo, Italy, in March 2020. Summer tourism is back in Portugal and Greece. The best intentions will not be enough. Are mask and social distancing protocols being lifted too quickly especially in tourist locations reminiscent of last summer in Europe and elsewhere. Germany and Britain are holding on to them a bit longer. Will this be enough to tackle a new variant. ...

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Pfizer and Moderna's plans to make mRNA vaccines in Africa, Asia or Latin America may take much longer than 2022. The solution to producing an mRNA vaccine in Asia that could be mass manufactured and distributed throughout Africa, Asia and Latin America is now at hand. Gennova based in India, is partnering with Seattle startup HDT Bio to attack the problem of temperature and scalability in manufacturing for a mRNA vaccine that acts as a global solution using India's manufacturing capabilities. Dr Singh who founded Gennova, says- "We wanted to solve the problem of the scalability issue, and the temperature issue. If we can solve these problems, we are building a solution not just for India, but also a global solution." Gennova received seed funding from the Indian government. Other companies in Brazil and South Africa lack the manufacturing capabilities or financing needed that exist in India. The Indian government has achieved an initial goal of one billion vaccinated in just 6 months. The next step for India in its health infrastructure buildup is a mRNA vaccine that is an improvement over Pfizer and Moderna vaccines that can be stored easily, adapted for variants, and manufactured in large quantity as a global solution. ...

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Hit hard by the pandemic the people of Argentina, Brazil, Chile and Mexico are showing less vaccine hesitancy. This is enabling this region to catch up with the US in vaccinations. The difference is that people trust vaccinations. About two thirds of people in Chile and Uruguay are vaccinated. Supplies of vaccine are coming in from US, UK, Russia and China. Brazil is now doing 1.5 million vaccinations a day, compared to 750,000 in US daily. This report says that on a per capita basis taking into account the populations US is currently vaccinating at half the rate of Mexico and a third of the rate in Peru and Colombia, Argentina. With 8% of the population Latin America had one third the deaths making vaccination urgent and essential for this region. People are taking the threat of Delta variant seriously in the region. Astonishing as it may sound after all the publicity of deaths in Brazil this report in WSJ says 88% of people in Brazil want to get vaccinated, while 67% say this in the US, poll from Ipsos. Peru, Argentina, Mexico, Chile all top the US, says WSJ. ...