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The coronavirus pandemic death toll reaches 700,000 making it the deadliest in history. In 2021 the death toll increased with another wave now in the southern and western states such as Florida, Texas in the south, and California, Idaho in the west, with deaths concentrated among the unvaccinated.

The vaccination drive stalled by August 2021 leaving a large number of people between 18-35 unvaccinated mostly in the south and some in western states. States with large Republican support tended to show higher vaccination resistance though the reasons for not getting vaccinated were complex and some misinformation played apart in fear of vaccines. Vaccine supplies were ample in the US.

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States in America's Deep South have a much lower rate of people having taken one shot of vaccination, in the 30-40% range by May 2021. This report says states such as Alabama, Arkansas, Georgia, and others in the South are at risk of seeing a new wave of the coronavirus  because people will spend more time in airconditioned spaces in the summer. In contrast to the north with cold winters and indoor heated spaces people in the southern states can spend more time outdoors because of the warmer weather in winter. This may have protected southerners during the winter and spring months. This may reverse with more time spent in airconditioned indoor spaces in close proximity where the coronavirus infections can increase. This report comes as new reports show the Indian coronavirus variant becoming more prevalent in the UK and other countries. This variant spreads about 50% more rapidly than an earlier UK variant, say experts. Another analysis in The Times of London shows that the imperceptible rise phase of the new coronavirus variants is the most dangerous part of the coronavirus as it dulls the sense of danger in the population that makes it take notice and prepare countermeasures early enough. India is an example of how this can happen as the sudden rise actually started with a first imperceptible increase in March and early April 2021 that changed into a rapid escalation of the virus in the population by May 2021. The vaccinations give a strong sense of confidence, however the vaccination rates vary widely state by state in the US. ...

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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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Dr. Nancy Krieger of the Harvard School of Public Health says data on health risk -including which counties have high rates of health conditions such as obesity and other diseases- should inform targeted interventions and public messaging. This is important for administrators and health authorites in each county and state as they deal with a surge in coronavirus in parts of the U.S. which have so far been only slightly affected such as rural southern and western states. More recently places such as North Dakoa which the virus missed in the early stages are now seeing a jump in cases. This report shows counties in states such as Tennessee, Georgia, Alabama, Mississippi, North Carolina, particularly susceptible because of high rates of obesity and other health conditions. In all almost half of the U.S. population has one of these health conditions- obesity, diabetes, high blood pressure, lung disease and heart disease.  The high prevalence of obesity which worsens all other health conditions is a result of the lack of healthy food and nutrition, exercize and healthy living habits, that were neglected in the closing decades of the twentieth and early twenty first century. The shift to processed foods is only one of many bad practices that happened in these years. The lack of attention to healthy eating and nutrition, and outdoor exercize has marked this period and created conditions in which the virus could damage health. ...

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Already vaccination experts at the Baylor College of Medicine cited here say they foresee another wave of the coronavirus in the Southern US because of vaccine skepticism barriers to vaccination, and much of the population not being vaccinated. The percentage of the population in the Carolinas, Georgia, Georgia and Louisiana, that has both doses of vaccine is low. About 50% have had just one dose. In southern states Mississippi and Alabama the vaccination rates are much lower leaving large parts of the population unvaccinated. The widespread presence of the Delta variant in the UK and the R rate being between 1.00 and 1.2 in UK shows that the UK even with higher vaccination rates than the US is still facing a danger of another wave as it reopens.  The ominous aspect of this is that from just over 400,000 the vaccinations per day dropped to 316,000i n the US. This means there will be a period when vaccination drive is stalled while the reopening is fully underway with a new contagious variant twice as contagious as the original coronavirus. This leaves the US at risk of another wave, with the south and western US, younger people who are out more and unvaccinated, more at risk.  ...

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The southern U.S. which was early to reopen the economy after the lockdown with some states having only partial lockdowns, is emerging from the coronavirus in much better shape than the rest of the U.S. The unemployment rate fell to 6.9% in August, the lowest of any region. The number of people employed was only 6% lower in August than in February, when most of the U.S. went into lockdown, compared with declines of 10.6% in the Northeast, 8.2% in the West, and 7% in the Midwest. Some of this was a result of aggressive reopening in Texas and other southern states. Overall deaths in the south were 60 per 100,000 people compared to 132 in the Northeast including New York and New Jersey, Midwest at 52, and West at 40. The Northeast numbers are high because of the elderly in nursing homes hit hard in New York and New Jersey.  In the southern states by comparison the deaths came later and among young people taking risks. The virus hit the northeast early and parts of the midwest, southern states had the advantage of some of the work already being initiated in March to fight the virus nationwide. Many of these states are also Republican and residents feared the virus much less. Republican Governors followed their instincts and aggressively reopened putting the economy first. The numbers tell the story. In South Carolina 44% of Republicans say they aren't afraid of the virus outbreak in the local area, compared to just 2% of Democrats, according to Civiqs poll. Georgia and Florida have similar numbers, all with Republican Governors. One factor favoring southerners is that cities in the south are much less dense and less populated than in the North and West. Smaller cities than Los Angeles and New York. ...

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It seems like good common sense -surely studies come later that masks can cut coronavirus cases by 40%- as Texas is learning the hard way. As coronavirus cases jump in Texas the governor makes wearing face coverings or masks mandatory in the state. Texas recorded over 8000 cases in a single day on July 3, 2020. "wearing a face covering will help us to keep Texas open for business." As a grim warning to Texans he said "we are now at a point where the virus is spreading so fast there is little margin for error." As the virus cases surged Mr. Abbott, the governor of Texas, ordered all bars shut and cut restaurant capacity by 75% last week and reversed step taken to open the economy. Another lesson learned the hard way when it seems like common sense- consider that on June 20 as reported in the WSJ a staggering 500,000 people went to bars in Los Angeles county the day after bars reopened. It is this type of activity that makes Dr. Fauci, say cases could reach 100,000 a day in the U.S. Infection rates are now increasing in 40 of 50 states with the southern states, western states doing badly.  A lot of it was plain common sense. A German study shows a 40% reduction of coronavirus cases when masks or face coverings are worn. For those arguing for the reopening so that economic hurt is mitigated there is even more reason to wear masks as it makes it possible to get back to work by following strict social distancing and mask guidelines. Everything in life is about adapting and making small changes for the larger good. Younger people have badly failed to show fellow feeling with lack of following social distancing guidelines on beaches and gatherings leading to the numbers now showing that people 18-34 are now equally at risk. ...

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The coronavirus surge in southern states in the U.S. is different from the surge earlier in the northeast including New York and New Jersey. More young people are getting the virus. About half of those testing positive are now 18-35 years of age in Texas and Florida. Social distancing and masks is not mandatory with young people not practicing these safety guidelines. Many took the reopening to mean they could go back to the usual summer routines. Not taking it seriously is leading to more infections of young people. Cultural issues with practicing the guidelines and a tendency to not take it seriously has been a problem in the U.S. and parts of Europe since the beginning of the crisis leading to larger number of cases.

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This NYT report looks at the 20 counties within 5 battleground states in the midwestern states of Wisconsin, Michigan, eastern state of Pennsylvania, southern state of North Carolina and western state of Arizona. It shows the percentage of votes gained by the Republican and Democratic parties in the last 3 presidential elections. A look at the trend and direction of vote percentages gained by each party in each of the 20 counties in different states may be a better indication of the final result than polls alone as both parties are pushing hard in the 2020 election down to the last day. The Republicans strong in the ground game and organized effort, and Democrats in television advertising outspending the Republicans. Because of the clearly delineated positions the Democrats and Republicans stand in sharp contrast to each other both in image and substance.  Because of the Electoral College and states assigned electoral votes based on size the U.S. system is not based on the total vote count in the country. Who wins each state by vote count and gets the assigned electoral college votes assigned to that state, an builds up more than 270 Electoral College votes wins the election for president of the USA.  In Michigan there is the impact of the resurgence of the auto industry, with president Trump pulling out of TPP agreement and renegotiating NAFTA in favor of the U.S. auto industry bringing back jobs from Mexico. This puts the union vote in the auto industry- with Ford, GM and Chrysler located in Michigan- favoring these auto friendly policies from the current administration. The resilience of the auto industry sales during coronavirus is part of the economic story in Michigan. The renegotiated NAFTA treaty also helped dairy farmers of Wisconsin increase sales to Canada. In Pennsylvania the coronavirus and economic impact has hit harder than in Michigan with the decline in oil prices and effect on fracking industry. Closure of coal plants is also having a negative impact on the state. Tariffs on Chinese steel by the administration are helping the steel industry. Offsetting these economic stories is perception of how the coronavirus pandemic has been tackled by the administration. Added to this is the suburban women's vote and the shift of out of state liberal voters to suburbs in North Carolina (Wake county), and in Arizona (Maricopa county and Tucson area). States not covered here but also relevant are Minnesota which could be a battleground state in the midwest and Iowa. Racial protests in Minneapolis add another dimension with controversies about the policing in cities such as Minneapolis and recently Philadelphia. The sharp contrasts in image as well as policy, the coronavirus pandemic and the handling of the pandemic as well as the way rallies are being conducted differently by both candidates, and the economic stories, present an election like no other since the 1960's. The contrast is as sharp as between Gen. Dwight Eisenhower of the wartime allied effort and Adlai Stevenson a liberal and humanist in the 1952 election. That election saw some of the highest turnouts since the second world war, and this is now happening today. That election also determined the direction of postwar growth and dominance of American industry, the setting up of the National Highway system and important changes that were later continued under the Kennedy administration. It also marked the beginning of the Cold War following the Korean War under the Truman administration, a situation that is emerging in a different way today with the free world and the tension from relations with China. ...

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Data from India in a large study shown in Science magazine show useful findings. Only a small number of people cause the wide spread of the coronavirus. This study covers the two southern states of Tamilnadu and Andhra Pradesh with total population of 128 million. Contact tracers in the 2 states reached about 3 million contacts for the 435,000 coronavirus cases. Researchers analyzed data from 85000 of these cases where enough data was available with 600,000 contacts. Some interesting findings are- About 5300 children infected 2500 contacts among other school age children showing children in schools can spread the virus. About 5% of the people account for 80% of the infections detected by contact tracing. 71% of the people did not seem to have transferred the virus to someone else. Median hospital stay is only 5 days much less than in the U.S. The number of deaths in India is much smaller than the U.S. less than 100,000. 5.2 million people out of 6.2 million people have recovered.       ...

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Daily coronavirus cases dropped to the lowest level since March 30, 2021. Cases on June 19 were at 58,000 and deaths at 1154 for India's population of 1.2 billion people. The only state with cases over 10,000 was Kerala, and close to 9000 was Tamilnadu. Karnataka and Andhra Pradesh were at over 5000. All these states are in southern India. Only Maharashtra with about 9000 cases was in northern India. The positivity rate in Maharashtra state was 3% and in Mumbai 2%.  The Indian government has a clear vaccine policy and it is for vaccine supplies and vaccination drive to be under the federal government. This puts responsibility in one place and makes it possible to achieve the target of vaccinating 1.2 billion people by December 31, 2021, with the federal government putting all the resources it can muster into the effort. The economy is also linked to how the vaccination supply effort and vaccination drive progresses in the next 6 months, so that the goal of vaccination is closely linked to economic recovery and progress for India as a whole. A good monsoon rainy season would also help the rural economy recovery. ...

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The Biden vaccination target of 70% of American adults at least partially vaccinated with one dose by July 4, 2021 remains elusive as vaccination rates have dropped. From a high of 2 million a day vaccinations have dropped to 400,000 a day during the first week of June 2021. Vaccination skepticism particularly in the south and western part of the US is making it harder to vaccinate the rest of the US population. This poses increasing risks as the new variants of the virus such as the Delta variant found in India, and now the most widely prevalent strain of virus in the UK, remain a serious problem. The unvaccinated population in the US is too large for any degree of safety in numbers vaccinated. Consider that at the press briefing given by the White House on June 3, 2021, only 28 states out of 51 states have fully vaccinated 50% or more of their population. There is a large variation between different states with states in the south such as Mississippi as low as 34% at least one dose and a similar situation in Alabama. In Arkansas, Georgia, Carolinas, and Louisiana  it is higher at about 50% with at least one dose. Even these figures are deceiving as in some parishes in Louisiana only 20% have even one dose. Studies show that only after the second dose are enough antibodies released to protect well against coronavirus. This is why vaccine experts at Baylor College of Medicine cited in NYT foresee a second wave in the southern US because of the South so underachieving in the case of vaccination.  ...

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The situation in California on December 12 is dire as its daily cases for coronavirus increase to over 25,000. For Los Angeles county the figure is over 10,000. California coped well with the first wave. As the summer arrived fatigue with lockdown restrictions had increased, social distancing and mask wearing were not followed. When bars and restaurants opened in Los Angeles county huge numbers of people gathered in close proximity. Beaches were crowded.  A further spike in cases is expected from the Thanksgiving period. LA officials are saying one person is dying every 20 minutes. ICU capacity is shrinking. In southern California it has dwindled to less than 10%.  In Santa Clara county in Bay area only 31 ICU beds remain for 2 million residents. San Francisco is expected to run out of ICU beds on December 27, 2020. A patchwork of restrictions varying by county means there is no uniform effort. Fatigue with restrictions means compliance is patchy with social distancing and mask wearing even at the height of this pandemic. Public officials have failed to convince the public to do their part including the governor of the state and the mayor of San Francisco, because of inconsistent messages. ...

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Kerala state of 35 million people who speak the language Malayalam, is one of the rare places today that has only 4 deaths from coronavirus, 524 cases confirmed and no community transmission. Here the Guardian looks at the reasons why. The Health minister KK Shailaja started very early on January 23, with a meeting of her rapid response team when the virus was still in China.  She setup a control room and instructed Kerala's 14 districts to do this on Jan. 24. When the first case arrived on Jan. 27 on a plane from Wuhan, Kerala had already adopted the WHO  protocol of test, trace, isolate and support. These passengers were checked for temperature, tested and quarantined. With some at a nearby hospital and others in home isolation. This is all the more amazing considering that Kerala is a state in southern India on the west coast that has a large number of people living and working overseas. Many are in the Gulf countries and the arrival of these refugees could have triggered a second outbreak. This was prevented by careful testing, and contact tracing of clusters.  When one group was evasive and concealed information from an airport surveillance team -arriving from Venice, Italy,  in late Feb- a case was detected back to them.  Contact tracers tracked down all of the hundreds whom they had been in contact with and quarantined them.  By 23 March all flights to 4 Kerala airports from overseas were stopped, including Cochin and Trivandrum. On March 25 India went into lockdown.  Some of the achievements in Kerala include quarantining 170,000 people early. with strict surveillance, which is now down to 21,000. Accomodating and feeding 150,000 migrant workers from other states, before returning them on charter trains to their home areas. A big reason for the success is the high literacy rate in the state. A big emphasis on education and healthcare is a part of the Kerala model. Shailaja is a secondary school teacher, and Health minister. From the days since independence of India in 1947 the state has a strong socialist tradition of taking care of the basics- health, education and public services. It also generates a part of its GDP with income from workers who are overseas.  Another reason for the success in dealing with coronavirus is experience. The state had a virus epidemic called Nipah in 2018 which has become the story for a movie called Virus in Malayalam. There is decentralized public health system in the state and people value their health care facilities, understand and trust the health care authorites. There are hospitals at every level of administration and 10 medical colleges. But trust and education, experience tackling the virus before, are key. Kerala is showing that poor countries can deal effectively with the virus, and create a better life by adopting the right model of creating good societies that value education, healthcare services, better economic structures and distribution of wealth, and  a degree of trust and responsibility found in a state that values public spiritedness. ...

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The full text of the letter is given here. In this letter the U.S. sets out some important facts about events that happened during the coronavirus crisis during the crucial 4 month period from December 2019 to March 2020. Every week lost in this time due to reasons of a lack of transparency, openness meant hundreds of thousands of people more infected and tens of thousands of deaths worldwide. There are questions of transparency, of openness and this raises questions about the manner in which the World Health Assembly operates with hundreds of small countries in Africa and Asia having votes equal to that of the U.S., India, Brazil, Mexico with votes taken of over 200 countries. The entire election process can now be seen as questionable, when over a billion people in one country alone such as India or hundreds of millions in Brazil and Mexico would have to bear the consequences of poor decisions made by small countries that can be swayed in one direction or another based on political bias and other considerations that have nothing to do with global health.  At the conclusion of the letter by the U.S. to the current WHO shaped by a controversial election in 2017 the following is stated about the standards set by Gro Harlem Brundtland and which helped the world prevent the SARS crisis which originated in China in 2003 from spreading to the large countries of the world India, Brazil, Mexico, and other such countries in Asia and Africa, Latin America, and the U.S. European Union. "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." Even this does not come to grips with the flawed way in which the election of WHO head is done. It can no longer be relied on when there is the danger that lack of transparency can emerge in the WHO leadership itself because of a flawed process. It risks endangering the lives and livelihoods of hundreds of millions in countries such as India, Brazil, Mexico, as well as in the relatively small countries of Africa and Latin America where even basic water supplies are at risk but which could tilt elections at the World Health Assembly. Consider that a cyclone just hit the Indian state of West Bengal and Bangladesh on May 20 just as the coronavirus pandemic is spreading. That this region of 1.5 billion people had just 2 votes out of over 200 cast at the World Health Assembly in 2017 shocking. And even these votes cast based on old geopolitical considerations not how good the candidate is, and how good the country he is coming from is in terms of its record  on public health. The irony here is that private foundations in the advanced countries in the U.S. and Europe some of whom are major donors to WHO did not think that more experienced candidates in their own countries with a better record of public health such as in France or Germany are better qualified, in a flawed NGO support mentality left from the Clinton years. Basically the people in these large countries such as India, Brazil, Mexico were disenfranchised, when the austerity policies were consuming the European Union, and the U.S. had just elected a new administration itself groping for ways to reverse years of neglect of public services and infrastructure priorities. They would trust good leaders no matter where they come from, who have a record of transparency, leadership, and all the values we cherish together no matter where we come from. ...

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The southern and southwestern U.S. which were expected to peak late are now seeing a surge in the coronavirus cases. This includes Alabama, Florida, Texas and Arizona. New York imposes a quarantine of 14 days on residents of these states travelling to N.Y.

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Germany is trying not to choose sides in the trade and security disputes between China and the U.S. Yet it owes a lot to the U.S. from the days of the Marshall Plan and U.S. taking on the role of defending Germany after the Berlin Wall. China was then a partner with the Soviet Union in the Cold War.  Today China is Germany's top market for its car industry. Yet the U.S. export market is much larger than China at $119 billion with China's at $96 billion. In Germany 28% of jobs are linked to exports, and in manufacturing this goes up to 56%, according to Germany Ministry of Economic Affairs. Germany supplied much of the factory  equipment from its engineering companies and the infrastructure that powered up the China transformation. A transformation now underway in India.  There are signs of a shift as engineering companies in Germany grew faster in the U.S. than China, increasing by 6-10% a year. India remains a key growth market for Germany over the next 10-15 years as growth in China slows and India accelerates with its younger demographics and investment in infrastructure. Much of the infrastructure in China is built and it is approaching the saturation Japan reached in the 1990's with additional investments adding little in the way of productivity. Longer term Germany has more potential for growth in countries in South and South East Asia  that will need to make huge investments in infrastructure and technology for manufacturing to meet the aspirations of the people there. Other issues related to freedom going back to the Berlin Wall and the rebuilding of Germany after World War II will emerge. German companies are running out of patience says this report in the WSJ with the bureaucratic obstacles, forced technology transfers, subsidies by state model to extinguish competition, and protectionist approach to home markets, even as state funded companies in China put other companies in Europe, Asia and the U.S. at a disadvantage. Germany will need to transition to a shift in its global relations, a process that is only now taking place. Just as with austerity policies in which it has now made the shift from going with the northern European countries (Sweden, Denmark, Netherlands, Finland) to the Southern European (France, Italy, Spain) in favor of common solidarity even at the short term cost of common debt, Germany now is facing the shift for solidarity with the U.S. for its support of Germany from the period of the Berlin Wall in the 1950's, for the U.S. and European solidarity in the face of the post-coronavirus world. The U.S. showing its generosity and openness to Germany and war torn Europe even as it took on the added responsibilities for creating a new alliance with Europe.   ...

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The US vaccination drive appears to be stalling when it comes to getting younger people vaccinated. On a recent day 1.13 million persons were vaccinated. About 150 million Americans are fully vaccinated or about 47% of the population. About 53% of the population have one dose. This still leaves the rest of the population close to one half unvaccinated as the US is opening up fully and removing the social distancing and mask mandates that existed before. The problem is that the coronavirus delta variant is about twice as transmissible than the original coronavirus of March 2020. Vaccination is uneven across the US. Large parts of the southern states and the western states lag behind. In these areas as well as areas with large urban concentrations of population, the densely populated cities where social distancing and mask mandates are being lifted as if the coronavirus crisis is over, are at risk of seeing a more powerful virus spread quickly before gene sequencing catches up with new variants- making the response lag behind in terms of weeks. That lag in response could lead to another wave in the US. Consider also that tourism is opening up in Europe with removal of mask mandates, that gene sequencing to track variants is tiny in even countries such as Italy and France. A WSJ report on June 22 shows gene sequencing to track variants at 1% of positive tests in Italy, and virologists in Italy saying they feel as if they are flying blind. This report in the Washington Post says surveys show as many as one third of Americans have no immediate plans to get vaccinated. This is showing up in the low numbers for the vaccination drive, of around 1 million a day at this time in June 2021. In April this was 3 million vaccine doses adminstered on a single day on average. India where the new delta variant has had the most serious impact has stepped up its response with the federal government taking complete responsibility for vaccine supplies and vaccination drives. It is now vaccinating aggressively in the range of 6 million to 8 million doses a day during the last 7 days with a plan to ensure enough vaccine supplies for 1.2 billion people to get vaccinated by December 31.  The European Union and the US have  vaccinated just over 50% of their population for a variant that is more than twice as transmissible than the original virus. This leaves the unvaccinated at real risk because all the social distancing and mask mandates that existed earlier are being removed- in the US, in France, in Italy, and other countries. Soccer stadiums are filling up in Europe, the kind of sports events that later hit Bergamo, Italy, in March 2020. Summer tourism is back in Portugal and Greece. The best intentions will not be enough. Are mask and social distancing protocols being lifted too quickly especially in tourist locations reminiscent of last summer in Europe and elsewhere. Germany and Britain are holding on to them a bit longer. Will this be enough to tackle a new variant. ...