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Latin America is hit hard by the pandemic. About 20% of the region's companies will close down or about 2.7 million companies, and loss of 8.5 million jobs. GDP decline in 2020 of about 10% is expected.

All the statistics of a fall in poverty in Latin America that used to be cited by economists have proved to have no good foundations. Even before the pandemic the economies of Argentina and Brazil were in trouble. The pandemic has worsened the situation. It shows how important it is for countries in Latin America to build on strong foundations of education, health care and good governance. With fall in trade and in tax income the debt to GDP levels are expected to go up from 57% to 70% and 30% drop in earnings coming from relatives overseas to support families at home, resulting in great difficulties. 

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WSJ looks at the changes in the way medicine should be practiced in the light of what we have learned from the pandemic.  Medicine practiced before the pandemic and still today relies mainly on a visit to the doctor or specialist who is short of time. There is a shortage of doctors. Patients have many illnesses as a result of decades of neglect of proper nutrition, and exercize habits. Obesity is at about 40% in the U.S. about 30% in the UK and 17% in France, and high also in other parts of the world. These high rates were unknown throughout history and result in many illnesses and increase by four times the vulnerability to the coronavirus. One authority in medicine calls obesity pouring gasoline on a fire for effects of the virus.  A doctor's appointment with doctors short of time with no coordination around a whole range of factors related to obesity, illnesses, health checkups, mental health, is now seen as a heavily handicapped way to practice medicine or for patient healthcare and wellbeing. The alternative is discussed here as the way forward. A  team will be responsible for a patient's care not just an individual doctor. The team would care for general health after a patient's checkup, cover individual illnesses, weight issues, mental health, exercize nutritional needs and other good healthcare habits. Instead of relying on doctors at a time of shortages of doctors the team would be led by nurse practitioners.  A nurse practitioner is someone with a bachelors degree and a masters degree or doctoral degree in nursing with 1000 hours of clinical training. Studies have shown that they are effective and even more effective than individual doctors. Today particularly with the problem of doctors with limited time compounded by the built up problems of decades of bad habits in nutrition and exercize and poor "cultural" habits getting entrenched, there has never been a greater need for a better way to practice real healthcare for a person's wellbeing. Particularly in rural areas with an even larger shortage of doctors the health practitioner led team will play a big role. Patients will under this setting receive more care virtually and get more followup care by phone and video messaging. The numbers tell the story- there are shortages of doctors in USA, Europe, Africa, Latin America and Asia. In the U.S. shortage of doctors is 55,000 projected to 2033 by Association of American Medical Colleges. There are 290,000 nurse practitioners licensed in the U.S. and 131,0000 physician assistants. The goal will be to get an adequate number of nurse practitioners licensed in this decade to take care of these teams. The pandemic has made virtual visits to doctors and nurse practitioners popular. Medicine reimbursement should and would be practiced on the basis of how well a patient is doing not on a fee for each micro service that is delivered. For this to happen the teams led by the nurse practitioner have to commit to patient education of the benefits from good practices and good habits for nutrition, exercize, caring for oneself. A doctor short of time is hardly the person to carry on this patient education which is where the major opportunities for a new system arise. The virtual care also provides a new medium for patient education and awareness of the risks of getting illnesses, preventive actions to be taken in advance. One approach being tested in California and Texas is for a monthly fee for patients more payments by health plans to doctors or healthcare teams if the patient is healthier. Additional health professionals are added to the team including health coaches, dietitians and medical assistants to increase its effectiveness in counseling and education and monitoring.  The nurse practitioner team approach is already being practiced in parts of the U.S. including the example of New Hampshire shown here, and is predicted to be the approach for primary care in the next decade. ...

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Recognizing and being aware of the changes in our minds and thinking  with new waves of coronavirus actually helps us deal with it. This report says that fear or anxiety even if it is pushed to the periphery of consciousness produces a whole range of behavioural, emotional and physiological weirdness that most people have experienced themselves or noticed in others since March of 2020. Even if one gets used to the additional load one carries it still can weigh one down. We all have only this much mental energy, so that the effort required to ignore, repress, or shoulder this load of fear or anxiety reduces one's ability to be creative, connected or productive. By dealing with it constructively one can diminish the impact it has on us. This means being aware of it, acknowledging it and managing it in useful ways.  Experts cited here show that fear masquerades as other emotions including sadness, anger, irritation, or even excessive feel good behaviour. It can also be expressed in intolerant behaviours or hypersensitive. On the other side it could even be expressed in aloofness and being distant, or unfriendly. Fear can also show up in ways that reduce our ability to read social and emotional cues leading to improper or inept exchanges. Physiological changes can include muscle tension and fatigue, headaches, heart irregularities, dry mouth, hair loss, skin problems, and gastrointestinal symptoms. These symptoms are unrelated to pathology say health experts and are normal reactions to feeling threatened over a long period. Different people experience anxiety differently, and most people don't even know that this is what is making you feel this way. Instead of having unproductive exchanges with fear going back and forth one can have calmer, more useful exchanges. One should always ask say health experts- "So how are you and your family coping up in these weird times?" Mindfulness and spiritual ways of dealing with this are very useful. People slow down, calm their minds, and ask "what is going on in my head right now? Where in my body am I putting my tension?" Health experts say neurobiology supports this way of tackling it. Other useful ways are to set some predictable routine in your daily life- helps you think you are still in control of the parts of your life you can control. Thinking of others and helping others is a good way of keeping ourselves sane and healthy. Fear and anxiety may also serve some purpose- the negative emotion can be harnessed to do something positive and meaningful in our life, make changes in our lives for the better by helping others in society who are less fortunate or in difficulty. Just being larger than ourselves makes us feel a lot better day after day, till it becomes a part of us. ...

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The dangers to your back from Bend Lift and Twist as shown by expert doctors in orthopedics. How not to put stress on your spine- a few good tips to follow to be back healthy.

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Germany has shown that low tech contact tracing efforts work- no apps needed, a phone, a desktop computer with a centralized database, and most important the human relations skills of the person doing the calls. The  sensitivity to the situation facing each person being called, being able to talk to the person in the language they speak in a multilingual environment such as California, is shown here. A 40 person team operates in San Francisco consisting of public health officials, clinicians, medical students and librarians. They call the contacts of people with coronavirus, arrange tests, and as needed send packages of food and medicines to hotel rooms or homes. Every call is expected to last 15 minutes but all sorts of questions are handled.  English and Spanish are used. Here one of the persons doing the contact tracing says she does not use apps, just an open source software used in the fight against Ebola. Definitely low tech, no waiting, get going is the message to every city in the world. She says apps software such as what Google and Apple are putting out can tell you whether the person went to some place, but cannot tell you more about that person, cannot tell you about problems the person is having being tested, and how they are having difficulty providing for families. One of the big lessons from Germany and efforts such as this one in San Francisco, and in other places such as Paris, Singapore, Taiwan, is that there is a complex nature to contact tracing that cannot be solved by tech. In fact the best thing to do is to get started immediately, with a phone and a database on a computer, as long as you have a person who has the motivation and skills, empathy with people, a lot can be done. Waiting for apps is a dangerous waste of time is shown by the low tech German experience, and the experience in other places. Most important is starting immediately. The example shown here of working with migrant workers in contact tracing shows in the most vulnerable places it is these human relations skills that count, that no tech app can do. It requires detective skills to find out and get people to share their history of movements and contacts for 14 days . In Singapore crowded dormitories house 300,000 of 1.4 million migrant workers. Singapore using an app also but its use is secondary. Apps don't work in many situations but fail in the most critical situations such as these dormitories and other eccentric or atypical situations such as faced by South Korea with religious groups and gay communities, elderly people in Europe, that generate the worst dangers of spread and need to be cluster isolated quickly. Human contact tracing has a history of being an effective method and was used in China and South Korea during the 2003 SARS epidemic. More countries need to adopt the method used in Asia and in Germany, particularly Britain, the U.S., France and India. It is OK that Britain's NHS and India's national government with Aarogya Setu app have put out their own apps which balance privacy concerns with the need to act immediately and cover the entire country, but the hard slog of human contact tracing teams in each district is indispensable. This is why the former Health minister in Britain calls it Britain's national mission to do this. Speed is key- putting together teams across the country in every district from skilled volunteers or government workers, and pulling together the phone and a centralized database on a computer as basic equipment. The fact that this is easily doable and people with human skills needed can always be recruited as they have been in Germany- from public officials in local government who are less busy in lockdowns, medical students, clinicians, volunteers, people from different professions- makes it inexcusable not to learn from others experience and get going. Just Do It. You want to reopen business, professions, offices and public services- Just Do It, it makes this possible. You want to prevent spread of the virus- Just Do It, it makes this possible. You want to limit damage to the economy and get the recovery going- Just Do It, it makes this possible. People of all shades of opinion can agree on this- its the only thing that works, even when there is a lack of enough proper accurate testing. ...

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Obama ACA subsidies to go directly to the people through Health Savings Accounts proposed by Republican Senators Graham, Scott and Cassidy in 2017, and again in 2025, and not to Insurance companies. In a post on his social media site DJT tells Congress that the ACA subsidies given directly to people rather than money sucking insurance companies would lead to a better result of people getting their own and better coverage for less money than under Obama type subsidies sent to insurance companies.  Much of Obamacare was done under a campaign from insurance companies and other health vested interests that undermined the original objectives so that however good the original objectives the watered down, disincentivising of reducing unproductive costs, led to a hotch potch band aid result. A common sense approach with the courage to get the right result that works for the people of the Nation to get good health care similar to Japan and other nations in Europe at reasonable cost is not a goal that an advanced nation like the US should see as unreachable or beyond our efforts, skills and wisdom. Obama and Bush failed, Bush in a major error to remove the negotiating power of government Medicare agency with pharmaceutical companies that Democrats failed to push back. ...

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The experience of Pintung county in Taiwan with a coronvirus outbreak is shown in The Guardian. Home quarantining of a couple from Peru leads to an outbreak. Community cooperation, a speedy response from local health authorities, testing and quarantining help to limit and control the outbreak. When it started this county on the coast, one of the poorest in the country, had limited health resources and no one was vaccinated. Most of the control response was through testing and quarantine, with vaccination assistance from the Taiwan government. Local people say strict quarantine is essential as the source of infections was from a couple who visited Peru and were allowed to home isolate. Taiwan government is now enforcing quarantine at hotels for all persons returning from overseas. WHO Emergencies program head, Dr Michael Ryan, says it is important to act quickly. He says "Be fast, have no regrets. You must be the first mover. The virus will always get you if you don't move quickly."  This happened in this Taiwan county as the local health authorites setup a soft lockdown of the two affected villages within 3 days of detecting the first case of Delta variant. This was announced over loudspeaker and food plus daily necessities were delivered to each household. A command centre was setup to take and coordinate the action daily. Taiwan authorites have enforced repeat testing and extended testing. ...

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How we age is up to us. You are able to do the plank at 70 because you are doing it at age 50. Dr. Norman Lazarus is a professor at Kings College, London, and is 84 years. It is all up to us, what we eat, how we get our exercize and aur work life balance. Dr. Norman Lazarus says about ageing that our appoach to it is totally inadequate and that ageing has not much to do with genetics. If one eats healthy food and exercizes well then many of the diseases we hear about at older age are just lifestyle diseases that one does not have to worry about, even if one gets one of the diseases the recovery will be faster. He says eat well, move a lot and also enjoy yourself. Enjoy yourself to keep cheerful which stimulates the brain. He is the author of "The Lazarus Strategy: How to Age Well and Wisely."  In Lazarus view the last 25 years can be miserable or without disease depending on what we do. Diseases of ageing are not inevitable he says, its rubbish he says and it makes him cry, it is just that it takes 25 years for all that neglect of exercize and not eating healthy to reach a critical point. It is also not that some people are better than others. Lazarus found himself at age 50 putting on weight till he made the decision one day at lunch with his wife.  A a non competitive long distance cyclist Lazarus has done studies which show cyclists over 70 years having the immunity and fat level of 20 year olds. Nothing is written, we have to write it ourselves. ...

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The head of South Korea's Disease Control committee says that patients with coronavirus can't relapse. About 277 patients tested positive after recovery. Looking at this the scientists found that there were harmless traces that were incorrectly detected by the RNA test which are not live so that patients are still in good health with no relapse. This is a very important bit of information for reopening different countries to modified normal life.

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So we need lobbyists and food producers and cola producers out of the schools. Here is an alarming fact- the current standards that govern whats served at all public and many private schools haven't been upsdated in 14 years. And the current standards don't even mention calories should be limited to 650-850 calories for lunch and 500-600 for breakfast. With the Institute of Medicine recommendations for more fruits and vegetables and healthy whole grain foods for school lunches comes cost its estimated that schools get $2.68 for the free lunches served to poor students, which cost $2.92 plus overhead and labor costs. The Obama administration is expected to add $1 billion but more is needed. Here s another place where money is needed at home that can be saved from expanding the war in South Asia-

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Research done by the WSJ shows people who sped time on fitness and are older are happier. More females than males by a wide margin. Community involvement rates are higher and faith in God is seen in people who are happier. Aaron Zitner shows the lives of 3 people including an 80 year old who ran a health clinic for 25 years who find happiness through community involvement and many projects including one that cut ten pregnancy in her county and is now writing grants to restore an old YWCA building in Cortland, N.Y.

A 77 year old civil engineer on a 7 acre farm in Chesapeake, Virgina, has good relationships, community involvement, and the same house for a generation, whose belief in God helps him be happy and find serenity in life.

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With the rushed approach adopted by the Trump administration not enough consideration was given to winning support in the House from 25 conservatives in the Freedom Caucus. Without their support the bill cannot be passed in the House of Representatives. The fight also includes one over what are essential health benefits including whether  maternity care would be included. As a result some moderate Republicans are also expressing opposition on the grounds that less people will be covered and fewer benefits will be provided under the Republican House plan called AHCA. President Trump has not involved himself in the details, and the bill comes very early in the first 100 days, leading to the perception that health care has become a partisan conflict without really grappling with the problems of high cost of health care and creating a solution that all can support. Democrats are seen as having made the same error early in Obama administration's first term. President Trump sees this as a much needed win with a drop in his approval ratings, making this even less of an effort to come out with a good plan.  ...

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Prostate cancer is becoming the most common cancer. Here are some useful tips for tackling this health problem men face today. 

Diet should include fresh fruits, nuts and vegetables. Reduce dairy to three portions (cheese, milk), limit calcium intake to daily requirement, and cut down on animal based protein and fat. 

Fat building up in the thighs and other parts of the body including waistline increases risk. This makes it essential to limit BMI to 30 and waist inches around 37 or close to this. Regular exercize lifts the mood and helps cut fatty tissue reducing the risk of prostate as well as other cancers.

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The first Quad Summit of leaders of US, Australia, India and Japan takes place on March 11, 2021. The Quad is a force for good says the Indian prime minister, with its focus on vaccines, climate change and emerging technologies. 

The leaders affirmed the need to ensure equitable access to the vaccines for speedy economic recovery and benefitting global health. Mr. Biden affirmed the need for the Indo-Pacific region to be "governed by international law, free of coercion and upholding universal values."

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Okere city, Uganda is revived with a school, solar energy, health clinic, and economy built on shea tree products. All done by someone who left the area as a child during the war decades ago and lost his father, a civil servant in Uganda. The graduate of London School of Economics, Mr. Ojok Okello, says he wanted it to generate its own income and grow from the ground up with local people building a better future. He did not want it to depend on the goodwill of some white person without the locals involved. To do this he put in his own money- $39,000. This is a heart warming story of what is possible in parts of British East Africa that are being revived with the good sense, hard work and, and positive spirit that was part of its history. It shows that with the will, self confidence and implementation a lot can be done that was thought to be impossible. A story that is seen in Indian villages and other parts of the world after decades of stagnation- clean water, electricity, schools, health care.   ...

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Experts say wisdom is important for well-being the older you become. About 150,000 people are over 85 years age in New York City. This series in the NYT in Dec. 2015 looks at people in the city, their lives, and their attitudes to life. At this age as other physical abilities decline it is wisdom that makes up for this. By being positive about their aging and adapting to their limitations older people make better lives. Laura Carstensen, director Stanford Center on Longevity, says this period can be better than people think for seniors who have gratitude, forgiveness, calm and appreciation in greater degrees from 50 years to 70 years, continuing into the later years. Anger and stress being replaced by conveying gratitude. The positive attitudes to aging also affect memory and heart disease. One of the people covered Ping Wong, 90 years, plays mah-jongg with friends every day and does everyday activities that make her happy. Jonas Mekas, 93 years, is a filmmaker who continues his working activities- doing an exhibition in Brescia, Italy, publishing an anthology of his writings, and giving a lecture in Berlin on filmmaking. Mekas has an interesting philosophy of life- he says do what you are doing and don't think about it much, it will all end sometime, just do something good for humanity that someone else can pickup from you when you are gone, which is normal. A sense of optimism prevails in these lives. Says Mekas its important to not give up on the idea of paradise....

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Mangia is eat in Italian and this refers to eating less as away to longevity and health.The advantages of a Mediterranean diet with vegetables, nuts, legumes and fruits that unfortunately is less popular in Italy as diets have changed and obesity has increased, says this report from Italy. Another aspect of this is for wellness eating light and occasional days of very light food intake akin to fasting reduces effects of aging and increases healthy years of life past 60-70 years.

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It is a landmark agreement and more innovative than the GM and Chrysler agreeements, with the UAW getting a significant stake in Ford, something that is a first. UAW supported money going into creating 5 flexible body shops so that investment to get Ford new models and manufacturing capability is put in place in this agreement- showing union management unanimity in understanding Ford's situation. The UAW Ford Agreement details: UAW gets about 18% ownership of Ford and becomes Ford's largest shareholder with about 4 times the shares of the Ford family. Ford will build 5 new flexible body shops in unionized assembly plants, invest separately $200 million in new technology and equipment in unionized stamping plants, and make substantial new investments in engine operations. All new hires will get a starting rate of $14.20 an hour and a full rate of $15.34 an hour, nearly half the curtrent level and its good till Ford reaches 20% of the Ford UAW workforce. When this is reached for entry level positions Ford must first move those hired at the lower wage upto the higher wage before filling in more positions at the lower rate. The VEBA health trust will work this way. Ford will only put in $6.5 billion in cash into the trust and $450 million each year in current dollars. The rest is done innovatively to conserve cash and give the union a stake in Ford that will be a first time in such a deal. It may change the labor vs. management atmopsphere in the long run as Ford recovers. A $3.3 billion convertible debenture note will be issued giving the union a stake of about 18% at current share prices, which terms are still not clear. Ford will also issue a $3 billion secured note. And to cover retiree health obligations until the trust makes payments Ford will pay $2.2 billion. The Jobs Bank is restricted to 2 years. After 2 new job offers are declined the worker goes off the payroll. Ford will also trim about 10,000 to 14,000 workers with buyout packages. ...

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The head of Oxfam International shows how tackling problems such as clean water, health, daycare, can improve participation of women and generate additional employment. A major problem worldwide particularly in the developing world is the lack of enough good jobs. Investing 2% of GDP in healthcare in African, Asian and Latin American countries can generate additional 1-3%  employment. Higher levels of investment are needed in health and other services that improve the quality of life.

About $170 billion in taxes not paid to governments of developing countries because of tax dodging leaves governments short of the funds needed to invest in public services, schools and hospitals.

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It depends- only if you look at it in actual millions of people. In percent of people Voice of America and this WSJ report show that US obesity rate is much higher with 22 states above 35% and the rate overall at about 25%, compared to China's at about 14%. The fact that this was reported in this way is happening as this issue is taken far too casually in the US, when the quality of life is largely dependent on health. And such high levels of obesity in the US, catastrophic levels in some southern and midwestern states, means one is not doing things right and heading for a poorer quality of life. This report in the WSJ cites estimates of obesity in China of as high as 200 million and likely to grow by another 100 million by 2034, about 14% of the population being obese today and obesity increasing to about 20%. In China the demand for weight loss drugs is growing. The government has a program to reduce the intake of salt, sugar and oil and increase health foods in the diet. Meat in the diet has tripled and there is a need for more health conscious attitudes in China, even more so and urgently in the US. Both the US and China are too auto centric in their culture, particularly the US where public transportation has not been given high priority leading to a lack of enough exercise getting to work. ...

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Trump at 77 has serious issues of age for the US presidency says Frank Bruni, professor of journalism and public policy at Duke University. Age is a very personal journey, says one expert, and it depends on how good you are taking care of yourself. On this score Trump has serious drawbacks. Nutrition matters, exercise matters. Bruni says Trump's diet is garbage, and he is overweight. Biden is only 3 years older than Trump, and he is known for healthy eating habits and regular exercise. This is a serious difference that the press has paid little attention to. Another factor in aging is doing something for a purpose in life that extends beyond one's self. Trump's obsessive attention to himself means there is a lack of purpose beyond one's own egoistic pursuit of office which acts as a negative factor in aging.

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What was established in Alaska meeting in Anchorage was the necessary rapport between two world powers. During the Bush, Obama, Biden administrations Russia was treated as a secondary economic power on Wall Street, with the focus shifted to China, which damaged relations with Russia which has always seen itself as a Northern European economic power. Some of the roots of the conflict go back to this period. In a nuclear world the size and historical relation in Northern Europe of Russia cannot be ignored purely on economic grounds about the size of it's economy in the way China could not be ignored in the 60's and 70's when it's economy was not what it is today. History and culture are not in Wall Street or Silicon Valley's understanding or grasp of international relations which go beyond economic and business considerations. On DJT and the first term, the survival of the US president- “When I came out of the plane and I said, ‘Good afternoon, dear neighbor. Good to see you in good health and to see you alive. I think that’s very neighborly and I think that’s some kind words that say to each other.” On Ukraine- “We have always considered and continue to consider the Ukrainian people our brothers and sisters. We share the same roots, and everything that is happening is a tragedy and a source of pain for us. Our country is interested in putting an end to this. But at the same time, we are convinced that for the settlement to be long-term, all the causes of the crisis must be eliminated." On DJT's assertion that if he was president there would have been no Ukraine war- Putin says "I can confirm that." “Today, we hear President Trump say that if he had been president, there would have been no war. I think that would have been the case. I can confirm that. Because, overall, President Trump and I had established a very good working relationship based on trust.”     ...

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The Jal Jeevan Mission of Indian prime minister Modi had the goal of bringing clean water by taps in every home. Of 190 million homes in 2023, 116 million homes now have clean tap water. This is 60% of homes in 2023 compared to 17% or 32 million homes when the program was started by prime minister Modi in 2019 just before the pandemic. Jal Jeevan's safe supply of drinking water to 1.2 billion people is closely connected to health of people and diseases, epidemics,  in villages and towns in India. In this way it ensures the health of the rural population in India, a must do of basics for development in India, that had never been tackled from 1947 to 2019. With much of it accomplished during the pandemic itself, and the target date set for 100% completion by 2024- the biggest achievement since independence. To day it is not just supply but how to maintain the supply of good fresh water using education of people in rural areas as part of the effort, and programs for preserving and storing fresh water. Programs are thought out in a broad context to include next generation technologies, water conservation and storage. ...