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High levels of covid and RSV in the US are leading to health authorites saying wearing masks is needed to prevent it from spreading. Los Angles is likely to introduce a mask requirement for indoors by the end of December 2022. Carrying hand sanitizer and keeping wipes with you is a good idea because RSV spreads through touching infected surfaces. Vaccination for flu and covid is also a key prevention action. As most people are no longer wearing masks in the US the practice of wearing masks is becoming a good idea once again.

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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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The coronavirus variant surge has led to burnout for frontline medical workers in the US. It has been calamitous for the mental health of public health workers in the US. These are the data analysts, policy advisors and other workers in public health departments. Many have quit their job as reported here in The Guardian. A CDC survey of 26,000 public health workers in the US shows about half have problems of mental health. Public health workers have to face problems with elected officials as well as public resentment on issues such as vaccination.

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The European Commission says that 70% of adults in the European Union have now been vaccinated with 2 doses, about 256 million people in 27 countries. In the US this figure is 63% for persons 18 and over, in UK 77% are fully vaccinated for 16 and over. There is a wide variation between countries in Europe- with Portugal at the high end and Bulgaria at the low end for vaccination.

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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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India reports over 300,000 cases for the fourth day in a row. German chancellor Merkel passes legislation that gives the federal government the power to set curfews to control the spread of coronavirus. Cases reach 166 per 100,000 in Germany and the government sees lockdowns to be in place till the end of May. Streets in Dusseldorf and other German cities are shown deserted at night.  The European Union deal signed with Pfizer for 1.8 billion doses including booster doses of the Pfizer vaccine, provides new hope for the vigorous vaccination drive needed in Germany and the rest of Europe. 

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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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Parents and teachers in Germany are skeptical of school reopening because of the lax rules for mostly unvaccinated children. Teachers are not required to be vaccinated and show digital certificate of vaccination as is the case in Italy. Teachers and parents see the return to normalcy not lasting long  with the relaxed rules. Britain is also following school reopening with relaxed rules going so far as to not require social distancing or masks. Health experts question this policy.

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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 remarkable story of coronavirus vaccine given at 14,000 feet in the Himalayas of Arunachal Pradesh in India. A team trekked for 9 hours to reach a village in Tawang district so that 16 yak grazers could be given the vaccine. These grazers were away from home grazing their yaks and had missed an earlier vaccination camp. The village is aerially 30 miles from the Tibet border. The trek took them through dense forests, swampy stretches, and the Luguthang river, crossing two mountain peaks.

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How is it that Britain's regulatory agency approved the Pfizer vaccine before the U.S. FDA agency? This report in the NYT says FDA looks at the raw data. Britain's Medicine and Healthcare Products Regulatory Agency looks at the information provided by the company. It still does the testing batch by batch and has access to the data and looks at thousands of pages of data. What about the European Union? The European Union Medicines Agency meets on December 29. It takes days after it meets to get input of 27 countries so that vaccination cannot start till January. The U.S. president summoned the FDA to the White House to find out how soon the FDA could act. Both Britain and the U.S. are feeling the impact of the second wave of coronavirus.

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Kate Bingham, head of the Vaccine Task Force in Britain is commended for her intelligent approach in placing bets on vaccines in different technologies, "four buckets" as she calls them. This includes the Moderna and Pfizer in the mRNA technology and the viral vector Astra Zeneca, J&J vaccines. This approach made the British vaccination drive effective by being supported by a resilient supply system.

The Indian government has supported the effort to get several companies to make the Sputnik Russian vaccine in India in an effort to diversify supplies. Reddy Labs is one of the major manufacturers working on the Sputnik vaccine in 2021.

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Everyone over 50 years is to be given the vaccine in just a few months of 2021 by the NHS. A massive logistics and training effort is underway. The government changed the law to let student doctors, physiotherapists, and dental workers to give the vaccine. Retired doctors and nurses are called in. Britain has a war effort to counter antivaccine propaganda unlike other countries such as France and Germany. Compare that 79% of Britons are seeking the vaccine, 54% in France and 64% in the U.S. showing that the UK is doing a much better job. Vaccination starts next week for over 80 year old people. The world is watching.

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Why are home covid test kits harder to find in the US compared to Europe and other places? Part of the reason is that the FDA was more stringent in approving home tests than in Europe. During the focus on vaccination in mid 2021 there was less demand for home tests so that Abbott and other makers of home tests actually cut back on production. European governments continued buying them in bulk to distribute them free as the tests were required to enter restaurants and public transport in Europe. With Omicron in December 2021 pharmacies in the US quickly ran out of tests and prices were high at $25 for test kits.

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The new tiered system of tighter restrictions passed in the British parliament 291 to 78 with 51 Tory rebels voting against and 10 Tories abstaining. Labour abstained from the vote getting it to pass. Tory rebels are voting with their constituents in Tory seats in parliament that have lower rate from coronavirus and see the restrictions hurting the lives of people in their areas. The prime minister had to make a special plea to them to get it passed including promising to review in granular detail these areas which needed lifting restrictions because of low infection rates.

Other steps the government is taking are to seek emergency approval of vaccines with the first approval done for Pfizer vaccine. This means Britain will be the first country to start vaccinations in 24-48 hours- December 3 or December 4.

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In the first 6 months of 2020 about 21 million jobs were lost in the U.S., followed by a recovery following reopening with a third of the jobs regained by July 2020. Women and black people were disproportionately hit by job loss during the pandemic. Hispanics were hit the hardest but also recovered faster.

As the lockdowns dragged on in June, mental health, vaccinations  getting treatment for health conditions, and economic well being, became major objectives. This was accomplished through better incorporation of better practice such as social distancing and face coverings, ventilation, and healthy living practices including food, as more people went back to work. Bars and large gatherings remained a particularly vexing problem, with sports now being played in empty stadiums for television audiences. Offices were completely redesigned to be safe places for work and public transport featured empty seats.

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What is behind the anti-vaccine movement in the US? This NYT report looks at some of its unlikely origins- the anti-vaccine efforts of Robert Kennedy's son, Robert Kennedy Jr.. Mr. Kennedy is planning to run against Mr. Biden for the White House. Kennedy's opposition to vaccine's is traced back to his getting involved in cases as an environmental lawyer. Parents who had intellectually disabled children from other chemicals asked Kennedy to look into vaccines. Around 2010 Thimerosal, a mercury based preservative which been used for many years to prevent bacteria from growing in multiple dose vials of vaccine, was suspected to cause autism.  Already by 1999 the American Academy of Pediatrics, federal health agencies and pharmaceutical manufacturers agreed that thimerosal should be removed from childhood vaccines.  Yet it is still used, says this report.  This led to Mr. Kennedy's getting into vaccines in general by the time of the pandemic. He had a book out that was critical of Dr. Faucci, during the pandemic. Mr. Kennedy cautioned about the unintended effects of vaccines. He has another book out called the Wuhan Coverup that looks into the origins of the coronavirus. It refers to research conducted at the Wuhan Institute of Virology that was funded by the US. Mr. Kennedy believes that more transparency is needed on decisions made in the health care sector, and that critical views need to be aired for the public to be able to decide the right course of action. Vaccination is generally supported by people in America though there is a subsection of people who have concerns about side effects. On issues outside of vaccination there is a sense that America's health sector needs more transparency.     ...

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In Britain, in India and in the EU, the race is between the vaccination drive and the infection case growth, as each country and region takes steps to accelerate and organize production, distribution and administering of the vaccine to all parts of the population.

The latest late stage trial for Astra Zeneca vaccine in US, Chile and Peru, offers new hope. It is shown in that trial that it is 100% effective in prevention of hospitalization and deaths, and 79% effective in prevention of symptomatic illness from the coronavirus. It is also seen as safe by experts as it goes for FDA regulatory approval in the US. It is provided at cost, and storage is in ordinary refrigerators for long periods, with production in India of large quantities of the vaccine, making it a vaccine that could reach large parts of the world's population.

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The European Commission has proposed a 9 month limit for vaccination validity for travel to and within the EU. If approved by EU ministers non EU travelers and travelers within the EU will be required to show they had booster shots once original vaccination status is more than 9 months old. 

The current practice of countries being added and dropped from red lists will be dropped and instead of 27 countries in the EU having a confusing set of their own restrictions, a uniform set of rules will apply for the whole of the European Union. Six months are set for waning immunity from the vaccinations and three months were added to give countries more time to prepare their booster shot vaccine campaigns.

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US economic growth surged at a rate of 6.5% for the April to June period in 2021. This pushes the economy beyond its pre-pandemic size. Growth was lower than the 8.4% forecast of economists, yet strong enough to increase its size to exceed the pre pandemic level. It was powered by the business reopenings, vaccination drive, and the government infusion of pandemic aid to households and business. New restrictions after this summer for coronavirus following last year's pattern with extensive summer tourism and spread of coronavirus, could again slow the economy. Government infusions of aid aided consumer spending, and this could slow in the months ahead, and lockdown restrictions could limit growth.

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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 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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New pictures released by NHS shows vaccination queues at Salisbury Cathedral near London, England. UK has reached 50% of people vaccinated or 33 million people, with July 31, 2021, the target date for all adults to be vaccinated. It took 136 days to do this for 64% of adults. Other parts of Europe are still struggling.

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Discussions at the cabinet level and with prime minister Johnson now include the possible use of annual covid jabs, the importance of getting the vaccine out before a new mutant strain of the virus that is hard to deal with a year from now. An annual covid jab could deal with new mutant strains of the virus. 

Prime minister Johnson is also having to deal with the issue of letting people in from overseas. If Britain's vaccination drive succeeds it will be all the more important to protect Britain from new mutant strains arriving with people coming from overseas. This will require strict control of people coming from other countries including Europe. The question of closing the borders to to reduce risks is now a serious one.