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Asymptomatic people infected by coronavirus are acting as spreaders of the coronaavirus making it more essential than ever that everyone wear masks. This is a widely accepted practice in Asia- wearing masks to prevent others from getting a virus. This now needs badly to become the practice in the U.S. and Europe. The longer it is delayed the worse the crisis can get and the longer it takes to eradicate it. Even low grade cotton masks are useful as is the practice in Asian countries. It is now part of the new guidelines of the Centers for Disease Control in the U.S. This needs to be adopted as safe practice everywhere.

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Behaviours of young people going to beaches and bars, ignoring social distancing guidelines and not wearing masks is leading to a rise in the number of daily cases in Europe. This includes an illegal rave in a Berlin park. The incidence of coronavirus is now 19.6 per 100,000 people for persons ages 20 to 29 compared to 9.7 per 100,000 for the French population as a whole. Germany has recorded 900 new cases daily, France 1000, and Spain 2000 as a result of these youth behaviours during the last week.

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It took a week longer for each country to impose a lockdown. In China first Wuhan then the whole country went into lockdown and quarantine. The same process is repeated in Europe and in America as authorites see numbers of infections increasing rapidly without strict controls. First the Lombardy region in Italy around Milan, then the provinces in Northern Italy, followed by a complete lockdown in the country on March 10 as infection spread faster without lockdown and enforcement of lockdowns. Germany and Britain follow Spain and Italy on March 20. France followed Spain in the days after Italy's complete lockdown. Macron ordered the lockdown on March 16 with stringent enforcement. Infectious Disease specialists at Imperial College warned of "unintended consequences for the entire nation" if a lockdown of Britain did not take place. The goal is to limit the spread of infections from rapid to slow as public health systems and economic measures are ramped up in preparation for the crisis. Most countries were lacking the preparatory steps having lost time waiting to see what happens next or analyzing data in the vain hope the virus does not spread.  Bad economic results of lockdowns were initially a concern, but this concern became less important as the coronavirus spread rapidly in Europe. Decision makers in Europe decided that not acting forcefully would lead to equally or worse economic outcomes. Public health systems overwhelmed would diminish public confidence rapidly and lead to equally bad or much worse economic outcomes. The European Union executive body has supported state aid, stimulus action and border controls in this crisis. In America and in Europe the hope is that shoring up the safety net with massive aid to businesses and households would buy time to tackle and overcome the coronavirus through a combination of lockdowns, quarantines, contact tracing, large scale testing and medical technology measures. The examples of China, South Korea, Taiwan showed this pathway exists for phased control and reducing fatalities to zero. ...

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As the growth of coronavirus cases slows in the U.S. and Europe, cases in India surged by 9000 in a biggest single day increase with total cases passing 200,000. Deaths in New York dropped below 50 on June 2. Outdoor dining opens in upstate New York as this part of New York enters second phase of reopening- tables 6 feet apart and staff wearing masks at all times. Customers required to wear masks when not seated. New York City enters Phase 1 of reopening on June 8. New York City will distribute 1 million face masks and it will be mandatory to wear masks on mass transit. Hand sanitizer will be provided at stations. Every other seat will be blocked off on buses. 

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U.S. daily coronavirus cases reach a high of 88,000 on October 29. About 46,000 people are hospitalized in the U.S. Increases in following states - Illinois, North Carolina, Ohio, Michigan, Indiana, Minnesota, New Mexico, North Dakota and Maine. About 1000 daily deaths are reported.

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France, Spain, Austria and Belgium are seeing a second wave of the coronavirus.

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British prime minister Boris Johnson warns that the second wave of the pandemic is here. More countries face quarantine measures for travelers returning to England. 

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Hospitals in Europe are filling up quickly in the second wave of coronavirus. Coronavirus patients had to be transferred by helicopter to Germany from the Netherlands because of overburdened Dutch intensive care units. National Guard troops were flown in from the U.S. to the Czech Republic to help. In France as cases approach cumulative 1 million about 2000 patients are admitted to hospital for coronavirus every day on October 29. At some point French hospitals could be overwhelmed this winter, and doctors having to choose which patients to save, says president Macron. In the Czech Republic a collapse of the health system is expected by mid-November says the prime minister. No one expected this to be this severe, he says.  About 40,000 patients are hospitalized for coronavirus in the U.S. During the last week the case are increasing by over 40% in the U.S. and increase in hospitalizations are expected. Recovery rate is improving from the first wave. At NYU Langone hospital system in New York with 5000 coronavirus patients hospitalized recovery rate is improving from 25% in March to 7% in October. Better handling of cases and knowledge gained by doctors is a big part of this. ...

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The Trump administration suspended all flights from Europe on March 13, about one month after suspending all flights from China. This report in the NYT says there were about 10,000 estimated undetected infections in New York on March 1 when only 1 case of coronavirus was confirmed. It also says that researchers have tracked the mutations of the virus in all American states and found that most of it came from New York. Could the Trump administration have acted earlier than March 13 to stop flights from Europe? The state and city authorites in New York did not take the threat seriously by March 13, making it not clear that they would have acted earlier.   In places like Michigan which has Italian Fiat owned Chrysler operations, and automotive connections with Munich, Germany, reports show the virus coming from Europe. Munich based auto companies have extensive operations in China. In Louisiana the Mardi Gras celebrations around Feb. 25, received large numbers of visitors from New York, with research showing the virus mutations in Louisiana originated in New York. There was little awareness of the seriousness of the virus because of lack of past experience as happened in Asian countries. So that these kinds of public events bringing huge numbers of people in close contact were allowed to happen, and people who were cautious were likely to be ridiculed or shoved aside. New York continued to hold public gatherings at Madison Square Gardens and sports stadiums well into March, with complete disregard of the dangers, a decision made by local authorites.   ...

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Face masks become mandatory in over 100 congested areas of Paris, and in other French cities. A fine of 135 euros for not wearing a mask. 2288 new infections reported for France in last 24 hours for August 9. 

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The divergent approach to coronavirus taken in Asian societies and Europe.

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This beautiful DW.com video shows the use of face masks in vibrant colors and styles is in the hope that it will become popular. It is of great importance in the fight to stop the spread of coronavirus. A large part of people who have coronavirus are asymptomatic and are a big problem as spreaders of the virus, say health experts. The Robert Koch Institute in Germany recommends use of face masks. Jena is the first city in Germany making them mandatory. Other cities will follow, only not soon enough,

Face masks to prevent spreading the virus are a way of life in China, South Korea. Then why is it so difficult for Europe and the U.S.? Czech Republic and Slovakia have made face masks mandatory. The Center for Disease Control in the U.S. are now revising their guidelines to require people to wear face masks to avoid the spread of the virus, cloth masks or scarfs could be used also.

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A 35 year old Engineering professor from Texas who studies how transportation systems propagate infectious diseases and her 2 graduate students from China started and since January maintain the database of coronavirus confirmed cases and deaths. This is one of the widely used databases, also used by public health officials in the U.S. The database was started with a hunch from one of Lauren Gardner's students from China Ensheng Dong who comes from Shanxi province, north of Wuhan. A geography and mapping specialist he had studied in the U.S. since 2012, and spent many hours inputting data by hand following his classes. This WSJ report says the website was built in 1 day and was launched on January 22, when the coronavirus cases were practically nonexistent in the rest of the world and were concentrated in the Wuhan area. This report says behind the data reported in the media everyday is a complicated supply chain filled with challenges that come with data, what is reported, underreported and with what assumptions it is reported. Dr. Gardner says she is dealing with so much data on her dashboard, 4000 points of data, that its hard enough to pull all the data scraped together from different sources, its impossible for her to check the assumptions behind the data for consistency and trying to figure out facts underlying the data.  One of the ways the virus developed in the rest of the world is the surprise with which it caught western countries and then the rest of the world. As a result something that the government authorites would do such as the Centres of Disease Control is being done in a totally ad hoc manner. The U.S. government uses the University of Washington Health Metrics database, and in turn the University of Washington Health Metrics database takes some of the data from the John Hopkins database. Because a complacent population in the western countries were relying on numbers counted as cases to know how serious this epidemic was or whether there was an epidemic, the significance of data count from China assumed a signifcance far out of proportion to what it might normally be. This was because the western countries in Europe and America never encountered an epidemic of this kind in living memory, the last one forgotten from 1917 hundred years ago. Researchers in Gottingen University study in Germany conducted analysis of data in studies of cases published in Lancet Journal and found that only 6% of cases were being shown- that a much larger part of the population was infected. A researcher at Princeton University Ramanan Laxminarayan says countries tend to delay reporting until a problem becomes certain, because telling others comes with economic costs such as a rapid drop in trade and travel. Yet he says early warning systems are key to prevention. Early warning from the different publicly available data bases was not possible for many reasons. Relying on such ad hoc data was hazardous considering that as the NYT reported recently when there was the first confirmed detected case reported in New York there were already 10,000 persons estimated to be undetected. James Glanz and Benedict Carey, say in the NYT.com on May 7, that hidden outbreaks spread through U.S. cities far earlier than Americans knew, estimates show, which makes the publicly available databases giving a false sense of security, and not acting as an early warning because of the inadequacy of the resources for this task for individual researchers to handle. Not depending on  hurriedly put together databases with inadequate resources and having an independent sense of what the danger was as German chancellor Merkel described it in her first coronavirus address in March, was a better early warning signal than the databases in retrospect. And this too had come late. The reason is that the response had to be fast, very fast, and public perceptions had to be shaped quickly about the magnitude and speed of enormous proportions of the coronavirus, so that actions could be shaped quickly and executed quickly to stop it in its tracks.    ...

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This graphic report in NYT shows how the B.1.1.7 coronavirus variant spread in Europe and how dangerous it can be. It was first seen in Britain and is more contagious increasing the risk in the third and fourth wave of coronavirus in 2021.

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Unlike the early waves of coronavirus the situation in November for coronavirus is that of being all over the country. This is true of Europe and also of the U.S. With the virus cases not restricted to any particular part of the country, but all over the country.

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The failure to respond quickly with testing and contact tracing has been a major weakness of the response to the coronavirus in Europe and the U.S. Repeated fumbling in contact tracing has been common throughout Europe and in states in the U.S.

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Young people in Europe are one of the hardest hit groups in this pandemic. They are overrepresented in sectors such as travel, retail and tourism. where loss of jobs is the highest, particularly now that a second wave of coronavirus is hitting Europe. The lockdowns in Europe shut down many of these same sectors again.

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A coronavirus map of the U.S. in November shows darkened areas in the midwest and the mountain states as the most hard hit regions. The U.S., India, Brazil, Russia and France, populous countries in Asia and Europe, and Americas, lead the way in the number of daily cases in the second wave as they did in the first wave of the coronavirus.

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The death toll from coronavirus reaches 200,000 in Mexico, the third highest after the US and Brazil. Vaccine supplies are low in Europe affecting the vaccination drive. 

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Julian Tang, a clinical virologist and professor at Leicester University looks at the risks of coronavirus variants. Variants from South Africa, B.1.1.7 variant and a variant from Brazil have complicated efforts of the vaccination drive in Britain, US and Europe. 

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The knowledge that the virus  caused human to human transmission and that it spreads to wide parts of the population very quickly were critical pieces of information that remained with Chinese epidemiologists, doctors and medical researchers, and were suppressed by local authorites in Wuhan.  Yet China's version of the U.S. CDC, China's Centre of Disease Control and Prevention, modeled on the U.S. control efforts worked effectively to identify the problem. Virologist Gao Fu, heads China's CDC. This report in Germany's Der Spiegel says Mr. Fu made it a habit to scan China's internet before bedtime for any signs of possible disease outbreaks. On the night of December 30 he came across rumors of an internal memo from the Wuhan Health Commission of an outbreak of a vaguely worded lung disease. When he called the Wuhan health authority he found their answers to be evasive which alarmed him. The next morning December 31 Mr. Fu sent the first of three teams to Wuhan which is how China was able to identify the problem, in the sense that Chinese authorites in Beijing were to rely on Dr Gao Fu to overcome the problem of Wuhan provincial authorites. He informed the World Health Organization Beijing office on that day. The Der Spiegel report says "shortly afterward," the Seattle Times in its report says this was about New Years Day 2020- Mr Fu made a call to Dr. Redfield, head of the U.S. Centre for Disease Control, who was on vacation. Redfield is deeply disturbed on hearing this from Fu and they have conversations over the next few days to the point that Dr. Gao Fu is in tears about what has happened. On January 1 Taiwanese public health authorites shared the information with WHO that the cornonavirus was a human to human transmission, would the Taiwanese authorites not have shared it with the U.S. the same week during calls from the U.S. CDC or other public health authorites alarmed about the situation. (The WHO was proving useless by Jan 14 when it contradicted Taiwan's more reliable assessment  on Jan 14 going by the letter from president Trump to WHO). On January 6 a few days later Dr Redfield and Dr. Azar head of Health and Human Services ask China for permission to send a team of CDC U.S. experts to China. This is cited in the U.S. letter to the World Health organization- the lack of human to human transmission information being given to the U.S. officially early by China. A risk that could have been a topic of conversation between the U.S. and China heads of CDC. That letter from president Trump also points out that the team of experts the U.S. planned to send was not accepted by China till Feb 16, one and half months after that series of conversations between Dr. Gao Fu of China CDC and Dr. Redfield of U.S. CDC in an alert message.  In effect removing one of the key defences for the U.S. and Europe in making their own defensive actions and plans, laying the basis of the worldwide coronavirus pandemic affecting millions of people. Dr Redfield is a AIDS researcher at the University of Maryland who spent most of his life trying to control spread of HIV and was appointed by president Trump to head CDC agency in 2018. He set a goal of eliminating AIDS by 2030 and is more comfortable with aids patients and research than the bureaucratic nature of agencies- CDC has about 11,000 employees. Once it was clear that a team of U.S. experts was not given permission to make its own assessment in Wuhan in the few days after January 6 offer to sent the team to China by Redfield of U.S. CDC and Dr. Azar, would it have alerted the U.S. that something was seriously heading the wrong way for a epidemic risk. That letter of president Trump cites how the head of WHO during the first SARS crisis in 2003, Dr. Harlem Brundtland acted when she faced China's lack of cooperation during that crisis by saying openly that this was a danger to world public health and millions. Could CDC in the U.S. and the other connected health authorites have taken the responsibility and filled Dr Brundtland's role in this crisis, that the WHO failed to perform?    ...

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Telemedicine is becoming normal and  extremely useful during the time of the coronavirus epidemic. Hospital systems are increasing its use in the U.S. Europe, and Asia.