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France was exceptionally well prepared says France 24, citing a report in Le Monde, for the SARS crisis in 2002 and the H1N1 influenza in 2009. A billion masks were stockpiled by 2009. Following the H1N1 influenza not appearing in any significant way the media, political parties and the public shifted their attention away from public health crises preparation. For H1N1 the government spent 1 billion dollars some of it going to pharmaceutical labs. The eurozone financial crisis that followed the global financial crisis shifted policy to austerity measures. The entire preparation effort for influenza type health crises was abandoned as too costly.  The same pattern repeated in Britain which was also well prepared before 2010. Austerity budgets after 2010 had little room for public health investment.  One could say a similar pattern was seen in the U.S. Today the worst hit countries are U.S., Britain, France and other European countries. France which had 1 billion masks in 2009 to tackle a possible H1N1 epidemic finds itself with 150 million masks in March 2020 and scrambling to find masks. Some masks which were usable were even destroyed as expired, ministers and experts who had built up the prevention effort in 2009 were even demoted and forgotten, as was much of the preparation in these years. It wasn't just medical supplies pubic awareness had practically disappeared. In the U.S., in Europe, the same situation of a lack of public awareness so that experts, government, and the public could work together quickly, was clear to see. In countries such as Taiwan the preparation led to speedy response at all levels, making contact tracing, isolation of clusters effective. In the U.S. and Europe this early, early, period was lost leading to makeup mitigation measures and the growing sense of a loss of control over the virus. ...

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Cygnus is the rehearsal for a full blown pandemic that the British government conducted in 2016. After preparations accelerated following the SARS crisis in 2009 and the H1N1 pandemic in 2015, the British government accelerated its preparations for H2N2 the next pandemic. The exercize took place in October 2016 for 3 days, for a worst case scenario flu pandemic affecting 50% of the population and causing 400,000 extra deaths. For 3 days people were told to imagine being in the 7th week of the pandemic, facing peaks in demand for health and hospital care. Cobra meetings were to be held. This report in the Guardian gives details on the Cygnus exercize. It showed a lack of UK readiness.  By July 2016 prime minister Cameron was replaced by Theresa May in the Conservative Party and a full blown crisis emerged for Brexit. Britain lost interest in Cygnus or the pandemic prevention effort as Brexit consumed Britain's energies. Soon it was forgotten by the time Boris Johnson became prime minister and won the Brexit election. This shows how even a sincere effort and preparation over years of planning can result in nothing. This also happened in France. See France 24's coverage of this and our groups and links on this. One insight was that while every agency acted there was no coordinated response with someone in the central authority guiding the entire effort step by step. Care homes entirely privately run were also identified as a concern and anticipated significant pressures because of staff absenteeism at these social care centres in a pandemic, as reported in the Guardian ...

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Warnings to governments and leaders in industry and pharmaceutical research about epidemic preparedness by Bill Gates were ignored. He spent hundreds of millions of dollars to develop new vaccines and create disease tracking systems. But only governments could tackle this problem. He tells the WSJ in an interview that he feels terrible and that he wishes he had done more. His fear that a once in a century pandemic has come true. Governments did respond to the public health preparation needs as reported in France 24 to both SARS and the H1N1, both in Britain and France. It was the disbanding of this effort in the period of the global financial crisis and the eurozone financial crisis that led to the level of unpreparedness that Western Europe finds itself in today. This was caused by irresponsible banking practices. The response was austerity measures in Britain, France, Germany and Spain that led to leaving public health system investment being neglected, without fixing the original source of the problem. Misallocation of capital and lopsided priorities continued through most of the period leading up to the pandemic. There is a lot that Gates and other public spirited leaders could do now do in the new reordering of priorities and shifting the allocation of capital to public services and investments in infrastructure, and supply chain renewal to safeguard national interests. Today he is working with pharmaceutical executives and governments to produce billions of doses of vaccines while they are being tested. His foundation has reserved space in a manufacturing plant so that production can begin quickly once an effective vaccine is found. He says nobody has made 7 billion vaccines so that it will need all the help that it can get and international cooperation.  In an earlier interview with WSJ he told the interviewer in November 2014 that the world as a whole did not have preparedness. France and Britain prepared and then abandoned the effort for epidemic response by 2012 following the global financial and eurozone financial crises. Gates repeated the warning to 2016 presidential candidates in the U.S.  In 2017 at the Munich Security Conference he reminded people- "getting ready for a global pandemic is every bit as important as nuclear deterrence and avoiding a climate catastrophe." One focus of Gates was to come up with faster ways to a vaccine by using ready made components and then customizing it. This is an approach being adopted today by Oxford scientists and by Quidel Corp. in the U.S.   ...

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Glaxo made a calculated bet on vaccines in 2004 with the spread of the bird flu H5N1 virus in Asia. THis flu killed half of the people infected. At the time Glaxo was told by the Department of Health and Human Services for its Relenza flu vaccine-"how much can you make and how fast?" It reflected the high level of concern among the public, and the need for governments to respond quickly or be seen negatively by the public. Chief Executive Jean-Pierrre Garnier tapped David Stout to put togethe a team to focus on pandemic flu. New production lines were opened for Relenza in Australia, France and the USA. By 2005 governments in the USA and other countries were placing large orders for Relenza.

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Questions may relate more to how these situations affected the role of Gates and similar individuals in protecting the interests of the US, Europe, India, Latin America and Africa in health organizations such as the World Health Organization. As globalization spread governments in the West surrendered some of the essential role they played in world health organizations to individuals and NGO's, and countries lacking experience needed for such an important task. The mishandling of the pandemic is partly a result of this retreat by western governments from the role that they have played during the nineteenth and twentieth century. In the US letter to the WHO by president Trump the role of Gro Harlem Brundtland of Norway was shown in handling an earlier virus epidemic that originated in Asia so that it would not spread and could be controlled. This is the H1N1 crisis in 2003 cited in Mr. Trump's letter to the World Health Organization. Brundtland took strong action that was missing during this pandemic after the US and western nations surrendered the essential role they have played for centuries based on role in medical science discovery for maintaining public health. Surrendering this role or seeing it erode is one of the biggest mistakes of our time and a mistaken form of globalized behaviour. It is only now being corrected as the realization dawns on major nations such as US, UK, France, Japan, Russia, India and other countries about the essential stability provided by western nations knowledge, experience and resources to this task of maintaining global health. Even a nation like India has to base its role on hundred or more years of work in medical science and commitment to public health that transcends political preferences or national interest to take on and be a worthy participant with the advanced nations that have played so great and beneficial role for the world in public health. What to speak of transient interest of nations in the developing world or countries where national interest or political preferences play a part in public health of the peoples of the world. This responsibility for world's public health can never be delegated to individuals, foundations or any one country, or small countries, or a combination of these, only to the collective experience of the last 300 years in medical science discovery and the role of Europe including Russia, and the US in leading the way.  The Biden administration has the same underlying concerns as the Trump administration about this mishandling of the pandemic and the disasters that followed bringing so much death and suffering This excerpt on Brundtland of Norway is from the letter the US sent to the World Health Organization- "In 2003, in response to the outbreak of the Severe Acute Respiratory Syndrome (SARS) in China, Director-General Harlem Brundtland boldly declared the World Health Organization’s first emergency travel advisory in 55 years, recommending against travel to and from the disease epicenter in southern China. She also did not hesitate to criticize China for endangering global health by attempting to cover up the outbreak through its usual playbook of arresting whistleblowers and censoring media. Many lives could have been saved had you followed Dr. Brundtland’s example." ...

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Typical of so much of what is written about the World Health Organization and its role in the pandemic, this podcast in the WSJ fails to quickly convey the critical function of the WHO as an early warning system the world has depended on, including China. The H1N1 epidemic originated in Mexico. Asian countries including China and India depended on very quick response from the country where the epidemic originated  in allowing entry into the affected area for experts from advanced countries such as the U.S. The global response was then coordinated across countries quickly with complete transparency. The head of China's CDC himself faced a problem with transparency with the provincial authorites in Wuhan. 1.    Fundamentally this quick entry was denied the U.S. Request by U.S. to China was made on Jan. 6 for U.S. team to go to Wuhan, quick permission was denied and given only about 6 weeks later on Feb 16. This delay is the crux of the problem for the U.S.. Taiwan confirmed human to human transmission on Jan. 1, the WHO was saying this was not clear as late as Jan. 14. These costly delays are what the U.S.  letter is about.  The head of the CDC China Gao Fu called Dr. Redfield head of CDC in the U.S. on the next day after he suspected Wuhan provincial authorites were vague about what was happening. Gao Fu was alarmed when scanning the internet on December 30, 2019, about rumors of a vaguely worded lung disease in internal memos of Wuhan. He called Wuhan authorites and was not getting clear answers on that day, then deciding on December 31 to send his own team to Wuhan, as reported in German magazine Der Spiegel- Hackenbroch, Zand, 05/20/2020.  Der Spiegel says in its special report on the early period in Wuhan that Gao Fu was so alarmed about what was happening enough to be in tears in his series of calls with Dr. Redfield in the immediate days that followed. The date was shortly after the GAO Fu sent the team to Wuhan, December 31 and New Years Day 2020, as reported in Der Spiegel. See the link to Lyrarc gist of Der Spiegel's "A Failed Deception: The Early Days of the Coronavirus in Wuhan."  2.  President Trump points out the standards of the WHO- in the concluding point of his letter to WHO- when a three time prime minister of Norway, Gro Brundtland was head of the WHO during the SARS crisis of 2003. She acted quickly and decisively and no time was lost. It is this failure of the early warning system under the new president of the WHO after 2017 Dr. Tedros that alarms the U.S.  with about 100,000 deaths.  3.  This failure it can now be said was partly a result of a election in 2017 for the position of WHO president which was flawed. This was the first time a WHO head, an important position was put up for an election. The Executive Board was responsible for this appointment since the founding of the WHO as part of the UN, based in Geneva, Switzerland, after World War II. This system worked. The election was clearly a bad process for appointing the president of the WHO which should be done entirely on the capabilities of the person holding this position not on a flawed voting process. It is flawed because India and Bangladesh hit by a cyclone during the coronavirus have suffered greatly, as have other countries, but had only 2 votes for 1.5 billion people, when Barbados (385,000 population) and Laos (7 million) which had less than one  hundredth the population had the same number of votes. The U.S. had one vote. The election resulted in lobbying and a process in which many candidates stayed away because they simply would not go through such a process. The position was too important to the world- most of the advanced countries had forgotten about the danger of epidemics to let this happen by 2017, as shown in the way the austerity years led to cancellation of the preparations for pandemic in France and Britain. The austerity years and neglect of public health during these tech boom years in the western world made it possible for this to happen. 3.   Along with the 1 month ultimatum action is already being taken to restore the effectiveness of the importance of the Executive Board. The head of the health ministry in India, Dr. Harsh Vardhan, has been appointed the new chairman of the Executive Board on May 22. This restores the voice of billions of people in Asia in the process, and brings the major countries with the greatest risk in a pandemic into the decision process for tackling the pandemic, this includes the rest of the world.     ...

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1.2 million people left Paris just before the lockdown to places in the countryside from Brittany to Normandy. What happened to these people and the Paris they left behind? There are positive developments- for the first time many have experienced the quiet of the countryside and being close to nature in a way they never did before, realizing now how precious this is. Some families have decided to make a new beginning leaving Paris and starting a new life in another part of the country. This means less stress for the family trying to get their children to the right schools, less stress at work with the new rules on how work will be organized, and a chance to be closer to nature and away from the bustle of the city. Others are returning but aware of how they were perceived. Parisians who stayed say this Paris under lockdown is "everything we need." The city was quiet with an unusual calm, a peaceful environment and neighborhoods that were never like this before. Anne Hidalgo, the mayor of Paris is looking for ways to keep some of what was gained such as more cycling and a better lifestyle. She is putting in new bike lanes as quickly as possible for as many kilometres as can be done. Hidalgo vows to keep the city from being overcrowded with cars after reopening May 11. A journalist who was going around this quiet calm Paris says Paris has never been more pleasant than it is now. Who could have imagined that there is something to be learned from adamantine difficulties, from stumbles such as this one. Paris and France were stuck in a problem that they had prepared well for in 2002 with SARS and 2009 with H1N1, having afterwards abandoned the public health precautions during austerity policies and misplaced priorities.      ...