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This Times leading article on UK government's coronavirus policy says it is inconsistent, and a muddled effort just as the third wave is accelerating. It asks the public to be cautious when going outside and still opens nightclubs with covid passports not required till the end of September. By August cases could reach 100,000 say experts so that the nightclub and bars reopening can only fuel the rise in cases. The British government must be aware that the Netherlands opened nightclubs and bars in June and this led to a sudden jump in cases with 40% of new cases coming from nightclubs.  The policy is undermining public confidence. It is doing this at the same time as it is asking people to self isolate for 10 days. The policy also does not require covid vaccination pass for all events and for shops and restaurants as is being done in France and in other countries on a regional basis as in Germany. 

 

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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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Arizona, Utah and South Carolina are 3 states that are cited by the US Labor Department for not adopting any portion of the Occupational and Health Safety Emergency Standard for health care workers. The Labor Department says that by not adopting these standards for social distancing, mask use and paid time off for vaccination, these states are risking the health and safety of health care workers. OSHA sent letters to these states revoking the states abilities to run their own occupational health safety programs.

Texas is one of the states where governors are opposing the Biden vaccine mandate. Airlines based in Texas, both Southwest Airlines and American Airlines, say they will follow the Biden vaccine mandate for federal contractors, as they are required by law to abide by the president's order.

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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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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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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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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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In his farewell speech Boris Johnson, with true British resilient spirit,  says "I will be giving fervent support to Liz Truss and her government every step of the way." Johnson likened his transfer of power to Ms Truss to a relay race. "The baton will be handed over," saying it "unexpectedly turned into a relay race, they changed the rules halfway through." But he expressed no feelings of regret, having come to terms with the arrangement in his own way. More likely Johnson is without saying it still determining the policies and direction of the government, perhaps more so now with Liz Truss and his loyalists the only persons in the cabinet and running the British government. Johnson addressed people's fears about the energy price increases- "the UK would continue to have the strength to give people cash they need to get through this energy crisis that is caused by Putin's vicious war."  He listed his government's achievements- the response to Covid. Some of this is forgotten as the UK not the EU leadership was first to move forward with vaccination plans. Johnson put his government's faith in the vaccine invented at Oxford University and committed early while the EU languished under Merkel and her protege Ursula Von der Leyen. The EU fell behind in providing vaccine leadership as Britain forged ahead early, giving hope to the rest of the world's population including India that adopted the Oxford vaccine. Johnson likened his role to the missions to the planets- "Let me say I am now like one of those booster rockets that has fulfilled its function and I will be re-entering the atmosphere and splashing down invisibly into some remote and obscure corner of the Pacific." Johnson has taken the situation in a truly British way without any rancor and gracefully. With Liz Truss in charge he even gets a break after the difficult period handling the once in a century pandemic, handing over to a younger member of his group, and yet deciding on many of the policies and guiding the government for the term it was elected for to 2024. History will look at him favorably for his handling of the pandemic and vaccination, and for his instincts about the Ukraine war and Britain's unwavering support, and now in guiding Truss to provide Britain with strong support for the cost of living crisis caused by the war. His failings stem partly from his exuberance and optimistic spirit, but nowhere near detract from these achievements. ...

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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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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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EU Commission president Leyen announces Pfizer will supply EU with 1.8 billion doses of Pfizer vaccine to 2023. The increased supplies will include booster shorts to increase immunity. Another change is the new date for 70% of European Union population to be vaccinated, which is now advanced to end of July instead of end of September. With new waves of the coronavirus affecting Europe, and criticism of the EU's earlier effort in securing vaccine supplies, more urgency has gone into the new effort in 2021. Leyen told Pfizer CEO Albert Bouria- "If I may say so, engineer the mRNA in a way that it can adapt to potential escape vaccines," at a joint press conference. Leyen thanked Pfizer for its enormous effort in boosting vaccine manufacture and delivery. This will help accelerate the vaccination effort in Europe after the slow start in March and April of 2021. Bringing much needed optimism and new hope of a lasting recovery both in economic activity, health and in the mood in Europe, which can then spread from the US and Europe to the rest of the world. ...

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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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US secretary of state Anthony Blinken meets Indian foreign minister Jaishankar, and prime minister Modi in New Delhi. India and the US are working together on how to make vaccine supplies accessible and affordable in Asia, Africa, and Latin America. To promote the vaccination drive in India the US announced an additional $25 million to the $200 million announced earlier, during Anthony Blinken's visit to New Delhi. Post pandemic economic recovery was also a subject of discussions. Blinken thanked Jaishankar for collaborative discussion on many points, including security in the Indo-Pacific region. He went on to say that "the US welcomes India's emergence as a leading global power." Blinken also said that the future in the 21st century will be written in the Indo-Pacific region.  Blinken thanked Jaishankar for the collaborative discussions on many topics, including trade and economy, and how to promote greater bilateral investments to deepen commercial ties. ...

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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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Sabrina Tavernise writes about vaccine skeptics in the US. She sees it as a problem about gut beliefs. It is prevalent among people of different political views, not just conservatives. The misinformation on vaccines has made people who normally would be open to getting vaccinated a bit leery. Because of the flood of information spread in today's hyper sensitive news environment, including misinformation. Tavernise describes how different people in the US tackle the decision to get vaccinated or not and how this leads some to simply postpone getting vaccinated. Britain tackled this problem of spreading misinformation on vaccine effectiveness or risks early. It also helped that in Britain there is a very high regard for the National Health Service, the NHS. In Germany and also in France there was increasing skepticism in the beginning, yet this is reversible as there is growing recognition of the benefit of taking the vaccine in Germany and France. Much can and needs to be done to create public confidence and limit the spread of misinformation that leads to postponement of vaccination at a time when variants are becoming more contagious. ...

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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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An India like surge is feared for Indonesia with the spread of the Delta variant and rising cases. Sudden spikes in Jakarta, central Java, and Bangkalan on the Java coast are straining hospitals. A nation of 270 million Indonesia has only a small vaccination program dependent on Sinovac vaccine from China, and only 5% are vaccinated.

Doctors say whether you are young or old have co-morbidities or not you can catch the coronavirus delta variant. Several members of a household can catch it and the deterioration happens quickly. Doctors in India made similar comments during the surge there in May 2021. Kudus region in central Java is typical. At first cases were declining from a January peak by May. Then cases jumped in June. A third of cases turned up positive for PCR tests.

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On some of the major issues today, competition with China, vaccination drive, infrastructure, both parties in Congress are working together in 2020 with president Trump and in 2021 with president Biden. During 2020 Congress passed laws on competition promoting US, in 2021 Congress passed first aid to the people for the pandemic, and recently a $1 trillion in spending on infrastructure. The was achieved with help from Senators from both parties who worked hard together to find solutions. Brooks says in the NYT that Congress worked better than the CDC during the pandemic. Though the politics made the headlines Congressmen worked quietly in the halls of Congress to craft reasonable solutions to the nation's challenges to help the country recover from the pandemic and point the way to a bright future ahead.

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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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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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 Biden's kickoff speech for president in 2024- "We've got a lot more work to do." Biden was able to get the US on track for huge investments in infrastructure, chips, climate change, renewable energy, cost of living help, of trillions of dollars. He told a union audience- "Under my predecessor (Mr. Trump), infrastructure week became a punchline. On my watch infrastructure has become a decade headline- a decade headline." (Not much was actually done for infrastructure by Trump.) What Baker in NYT says Biden was not able to do is where Republicans blocked his efforts- to cut student loan debt, for pre-school education assistance, for tuition free community college, for parental leave, and help to workers and families struggling with the cost of living. Biden also helped tackle the period of mass vaccination and exit from the pandemic, and bringing unemployment to below 4%.  Baker has covered 5 presidents for the Washington Post and the NYT. His book on Trump is- The Divider: Trump in the White House 2017-2021.  ...

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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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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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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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China's exports to all countries surged in November by 21% from a year earlier. Chinese made consumer goods and electronic goods were the main products with increased exports. According to WSJ calculations November exports were up 10% to the U.S. and 46% to Asian nations in ASEAN trade group of countries. Some of the exports to ASEAN including Vietnam and Malaysia find their way to the U.S. New tariffs by U.S. on China lead to some products diverted to Asian destinations and reexported to the U.S. China's imports of goods from the U.S. were up 33% from a year earlier but imports of farm, energy and other products and services were below what was expected under trade deals. Experts say Chinese imports of goods covered in the agreement were 55% of the year to date targets. The Biden administration will leave the tariffs on $370 billion in Chinese goods in place. China is not expected to make up the gap by the end of 2020. Experts also say the exports of Chinese goods has accelerated during the pandemic in 2020 and with the size of the second wave in the U.S. In 2021 U.S. imports from China should slow as the U.S. manufacturing recovers following the vaccination effort.  Also expect increased focus on the trade gap as U.S. trade policy continues to focus on closing the trade gap and continuing policy of the Trump administration. ...