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There can be some comfort with the loss of the usual social contact during the period of lockdown and working from home. There are is the opportunity to slow down, pause and reflect in prayer or meditation. There is also time to spend in gardens or parks, a patio or balcony to be outside. As Adrian Higgins of the Washington Post- who has two books on gardening and covered it since the 1980's- points out here we are not apart from nature or above it, we are nature, and plants and birds outside are fellow beings of a sort. Most of us live in tight urban environments and this is a great opportunity to break away from all the noise and bustle and experience some time with nature and with ourselves. A time for renewal and listening to our inner voices, as the gods may be reminding us about living a better and slower life. Higgins reminds us that sometimes it is an experience that is alive in memory as there is a word for it in Japanese and in German, and in other languages. In Japan shinrin-yoku is about forest bathing, by finding a woodland or park and experiencing the stillness. Germans call it a forest walk or waldspaziergang. Plant gardens or parks will do, even landscaped areas in urban settings. The shades in a garden with sunlight falling in different ways on leaves and plants. We develop a capacity to notice things we stopped noticing as we grew up. Just walk or sit quietly and look. Plants and trees also take away some of the isolation and loneliness as they are fellow travelers of a sort. As anyone who has planted will know we can look forward to the new flowering, and the growth into next year, and the next. We have got too intertwined with the short term and the immediate fulfillment, and this draws us out of this in ways that enrich and nourish our lives.     ...

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The lessons from Italy, the epicenter now of the coronavirus pandemic, are clear- act early and decisively, impose quarantines and lockdown quickly to prevent intermingling. These steps need to be put early, with absolute clarity, and strictly enforced. This report in the NYT shows how decisive action early is the only way to prevent the crisis from becoming a large one that threatens the health system and millions. German states such as Bavaria and others now have a $25,000 euro and some have jail time. Singapore has jail time and fines for violating the stay home quarantine orders which it imposes after contact tracing. Taiwan has similar measures. Enforcement and strict control are part of the tools that have worked in these places and in China, South Korea.  Britain has still to close flights from Iran, Italy, which The Times reports on March 20 are still landing at Heathrow. This is after the U.S. weeks earlier banned flights from China, Iran, Italy, and last week from Europe after EU nations failed to take action early.  ...

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President Trump extends the U.S. lockdown for social distancing till April 30, on the advice of health experts. China meanwhile resumes industrial production and schools reopen. Factories, offices and retail outlets were shutdown for 2 months nearly nationwide in China. The U.S. has a social distancing lockdown not a complete quarantine of hotspots such as New York, New Jersey. Mr. Trump planned to quarantine New York but faced opposition from the governors of New York and New Jersey, including possible legal challenges. U.S. governors have acted imposing travel restrictions to their states from hotspots in other places in the country, forcing people traveling to self-isolate, stopping vehicles with out of state license plates and asking them to stay away. The U.S. cases have jumped from 100 in early March to 143,000 as of March 28, 2020, and 2514 deaths, according to John Hopkins. New estimates from president Trump and his team of experts are for the peak to be reached by April 15, and recovery gradually taking place by June 1, 2020. Based on the timeline in China shown below the time from the first set of 27 cases by December 15 to March 28 when China's factories were back to work and schools reopened across the country, is a period of 75 days. Based on this president Trump's timeline of June 1 for recovery has some foundation. China quarantined strictly compared to the U.S. yet in the early days it had no warning which the U.S. had in particular from Italy. The Trump administration by extending social distancing and lockdown restrictions till April 30 without a strict quarantine of the East coast areas yet with states outside imposing their own restrictions for outsiders, is doing what other countries such as China, South Korea, have to control this epidemic. The first coronavirus case was reported on November 17, 2019 according to the South China Morning Post, By December 15, the number of cases had reached 15. On December 27 on a single day 180 cases were recorded and the Head of the Respiratory Department at Hubei Provincial Hospital reported this to health authorites in China, according to the South China Morning Post, based on data collected in China.   ...

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A NYT video simulation that shows how early action is critical with decisive steps for quarantine and lockdown with enforcement, to control the spread of coronavirus. It shows the spread along a timeline of the coronavirus in the U.S.

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The Centres for Disease Control agency in the U.S. was unprepared for this pandemic in the early period from January to March. This report in the NYT shows how the agency failed to respond effectively in the early days leading to the loss of lives now past 100,000. When travelers arrived at U.S. airports in February from China carrying the virus with them these flights were diverted to selected airports with CDC conducted screening but the screening proved to be defective. Health officils desperate to set up isolation and quarantine could not act because the information provided was not accurate and missed many details resulting in the inability to quarantine early and isolate clusters as other countries Germany and South Korea have done.

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China reports no new coronavirus infections for the first time on March 19. The outbreak in Italy now surpasses that in China.  The U.S. government is now shifting to social distancing as the most effective way to control the spread and away from focus on widespread testing as a containment tool. The experience in China shows social distancing works, quarantine works. Countries and regions that have neglected to do this early are the ones worst hit, including most of Europe.  The reintroduction of the infection after its containment is addressed by quarantine and social distancing and use of masks, government disinfecting hard surfaces in all public areas, a program implemented strictly in Asian countries such as Singapore, China, Taiwan, and other Asian countries. Use of masks was common in Asian countries in earlier episodes of SARS and other epidemics, making it widely used long before this crisis. This is making a significant impact in addition to social distancing and other quarantine measures taken in China.   ...

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The testing shortages in the states and the lack of enough cartridges provided by the U.S. government for Abbott Labs testing machines is causing much frustration, as shown here in the WSJ. Illinois one hotspot is an example. Illinois governor Pritzker says he spoke to Abbott Labs a week ago and thought he had an agreement to conduct 3000 tests a day. He then learned that the U.S. government was taking over the purchasing and distribution of the tests.  He  received 15 Abbott machines and 120 cartridges for all of Illinois which would enable 120 tests from the U.S. government. Abbott currently is making 50,000 test cartridges a day for the rapid test. Detroit which had better experience with the Abbott machines says it has conducted 1000 Abbott rapid tests, shortly after Abbott got approval on March 27. With the 1000 tests Detroit was able to test first responders and bus drivers in quarantine. Detroit recently purchased another 4000 additional tests from Abbott which it wants to use in nursing homes and homeless shelters, vulnerable populations in the city. The Abbott test provides result in 15 minutes making it very effective in implementing fast quarantine action when the virus is spreading quickly in a specific population.  Other governors say they are banging their head against a wall trying to get more tests. ...

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Marco Rubio has shown an exceptional grasp of Latin America from his days representing Florida in the Senate, about a decade in the Senate when he has closely followed events and acquired a deep knowledge of Latin America. His answers at Congressional hearing were exceptionally good, and showed an ability and earnest desire to get good results for the Venezuelan people, sharing aninterest in the good for Latin America being a person of latin American origin who speaks fluent Spanish as a native language. Points made by Venezuela in answering questions from senators in the US Senate hearings- All of Latin America welcomed the US action to remove Maduro from Venezuela.  It affects Colombia and neighboring countries. Colombian rebel groups control parts of Venezuelan territory and operate from there.  Multiple administrations had deals with Maduro. Maduro kept none of the deals including the one with Biden for free and fair elections.  To be realistic in situations such as Spain, Paraguay, there were transitions before safe and fair return to normalcy and democratic government returned after decades of dictatorship. RUbio showed an exceptional grasp of the Latin Ameican situation and reminded senator Murphy that he had been in the Senate for decade and worked with the senators now on the other side to remove Maduro amd nothing had worked. Venezuela is a rich country , the most affluent in Latin America. It does not need money from the US. Before the Chavez dictatorship it was a country with democratic forms of government, and a country friendly to the US.  The action taken was a quarantine not a blockade. By controlling oil going out of Venezuela the lifeline for the country the US has control over its finances and the economy, budgets, the government finances. The immediate task was getting the oil out of the country as there was no place to put it and US had it sold at market prices not sent to China at a 20% discount for which Venezuela got nothing except paying off debt to China. The current authorites are cooperating with the US on the budget, they have to submit budget requests and the US approves it item by item and an audit agency is being set up including Ex-Im. Bank an other options to make sure the money is being spent on salaries and for the Venezuelan people. The money goes to an account for Venezuela at the US Treasury Department. In 4 weeks a lot has been accomplished. What happens in 6 months - for that actions are more important than words, it should be a marked improvement over today. Including setting up the US diplomatic presence in Caracas which means talking to the government on the ground, talking to civil society, talking to the Opposition.  ...

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The new approach to tackle the coronavirus is to quarantine areas where it starts. The approach is being adopted in China, Italy, the U.S., Japan and other countries. Another part of this is closing of schools as in Japan and Hong Kong. Experts support this approach even though it was used in the 14th century.

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Delivering the mail by boat across Penobscot Bay, Maine in the northeast U.S. The mail has been delivered to six small and rugged islands here in Maine's coastal area by the same family since 1905. This could be the last year as Maine has a 14 day quarantine for visitors from outside. Maine has the largest median age in the country at 45. Known for its coastline it gets millions of visitors in the spring and summer months adding $6.5 billion to its economy. Depending on this tourism are thousands of small businesses. Coronavirus is changing the rhythm of life even here in a place which has known quieter rhythms.

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Travelers landing at Schipol airport in Amsterdam book their flights at the airport to fly right back to the U.S. after president Trump announces a ban on flights from 26 European countries. President Trump did not wait to coordinate with other European countries. Only Britain and Ireland flights are allowed at this time. The ban restricts European travelers from 26 countries for 30 days beginning March 13 at 11.59 pm. U.S. citizens coming from these 26 countries will be required to quarantine for 14 days upon arrival in the U.S.

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India imposes a travel ban for 30 days for visitors and overseas citizens of India in an effort to control spread of the coronavirus. The rule goes into effect on March 13, Friday. Visitors to India will face a quarantine of 14 days. The ban was announced on the same day that the U.S. president Trump announced a travel ban for 26 European countries for 30 days.

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The mistakes  and the right action done in Italy that the world can learn from as Italy tackles the coronavirus. The coronavirus is a dangerous pandemic yet there is one part of it that can be used to take the right action. The timeline of countries affected early in January and February and early March with information from these countries on what worked very effectively and what did not work with bad results is available. The mistakes were made in Bergamo, a town in Lombardy region of northern Italy with the highest number of infections and deaths in Italy. Bergamo had limited testing, no rigorous attitude for quarantining those who had come in contact with people testing positive, and lack of contact tracing. In Vo another town in northern Italy the situation is a complete contrast with resort to mass testing and isolation of clusters which has reduced infections to zero and made it a safe place. Vo is a small rural town 85 miles east of Bergamo in the Veneto region. This was the method used in South Korea, China, Taiwan and other Asian countries that have overcome the virus. Bergamo is an example of what failed in Italy with the worst number of fatalities. The health crisis worldwide has shown this  method of first general quarantine to buy time to build capabilities for testing  and preventing things spiralling out of control,  then mass testing, contact tracing and isolating the people who test positive, and repeating this process again and again till infections are way down,  is the only way to control this crisis. In the early days massive quarantine or stay at home strictly enforced is the best solution till production of tests accelerates to permit mass testing and isolating the clusters of infections. This mass quarantine buys time for accelerated production of tests and building up the capabilities of labs to process these tests, including use of a central national lab centre with national data on computers for microbiologists to monitor the entire country. This was done in South Korea reports in WSJ show. This is vital for everyone involved in the effort to control the virus to understand based on the experience of  countries that have successfully overcome coronavirus. It is the experience in South Korea and Italy that the U.S. White House response coordinator Dr. Brx is looking at and learning from as she and the White House team in the U.S., governors of all 51 states, health officials including CDC, are looking at as they execute their action plan in phases.  ...

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A big surge in travel to mainland China from Asian countries and business travel from the US and Europe. Chinese travel outside of China to Hong Kong and Europe is also surging. Travel from China to Japan will face quarantines as Japan says there is no clarity on covid situation in China. A surge in cases and overcrowded hospitals is also causing much anxiety along with relief from the fatigue of lockdowns.

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The U.S. bans travel from most of  Europe and India imposes quarantine on visitors and overseas citizens entering the country for 14 days. Countries around the world reacted quickly to the situation in Italy, France and Germany. The strict measures taken by China are gradually being adopted by other countries. Quarantine done early has worked limiting the spread of the coronavirus. Countries with strong public health systems are better positioned to weather the health crisis. Where strong action is taken early and in anticipation, with a strong public health response, there is better control over the spread. This comes with some economic cost as it has hit the Chinese economy, yet the rebound is likely to be that much quicker and done with more confidence. For instance air travel in China declined by 85% in February from a year earlier to 8.3 million journeys according to Chinese aviation officials. Moves to keep social interactions to a minimum have yielded results. Only food stores and pharmacies remain open in China till March 25.  ...

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The people in the U.S. are shifting to widespread use of masks. There was some cultural resistance in Europe and the U.S. to use of masks, compared to Japan, South Korea and China where the use of masks in epidemics was common in earlier health crises. Europe changed first and now the U.S. is adopting masks as a way to avoid th spread of coronavirus. Health authorites in the U.S. now recommend use of masks to prevent asymptomatic people with infection from spreading the infection. Health experts say the widespread use of masks in Asia is one reason in addition to quarantines, contact tracing and isolation of clusters, is how China, South Korea, Taiwan and Singapore have controlled coronavirus to the point where it is no longer a serious danger.

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Take a a look at the moving BBC chart  "How the coronavirus spread" to see the dizzying speed at which the virus spread in America. In the beginning of March there are only about 200 confirmed infection cases in the U.S., by April 7 the number skyrocketed to 379,000. The public health experts were right including Dr. Fauci and Dr Birx. Even these experts may have been astounded at the speed with which it has spread, and going through a very difficult time convincing others including the skeptical public about the great danger to America. China's quarantine of the entire country of about 1 billion people, Italy's experience and data freely available from Italian doctors to American doctors, were warnings of what lay ahead for America. 

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The White House faces alarm as the U.S. president's valet and vice president Mike Pence's press secretary tests positive for the coronavirus. The cramped quarters at the White House and lack of the recommended social distancing at meetings of the U.S. president, most of the meetings being conducted maskless, are also cause for concern. 

Admiral Gilday of the Joint Chiefs will quarantine for one week. Self-isolating for 2 weeks are Dr. Fauci, Dr Redfield head of the CDC, and Dr. Hahn head of the FDA.

A senior economic adviser to president Trump, Kevin Hassett, says on CBS television program "Face the Nation" that it is scary to go to work now.

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Global update on the pandemic April 7, 2020. The U.S. has 368,000 confirmed infections, and over 10,000 deaths, as of April 6, based on John Hopkins University data.

Japanese prime minister Shinzo Abe issued an order for a month long state of emergency covering Tokyo, Osaka and five other prefectures.

Philippine president Duterte extended the quarantine for Luzon island to April 30.

The lockdown was placed on Wuhan, China, epicenter of the pandemic on January 23. On March 25 about 2 months later some travel restrictions were lifted. On April 6 trains were allowed to leave for several cities in China. 

Countries in Europe that stepped in early with restrictions such as Denmark and Czech Republic moved to ease them a bit. Czech Republic and Austria will require people to wear masks outside.

 

 

 

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There are differences between the governors of 10 worst hit states and the president of the U.S. on when to reopen the economy. The seven on the East Coast including New York, New Jersey, Connecticut, Massachusetts, and three on the West Coast including California and Washington, all but one have Democrat governors and want to wait beyond May 1, till it is believed to be safe to reopen.190,000 of the 592,000 infected cases and over 10,000 of 25,000 cases of deaths are from New York alone. This is as though a third of the problem is in one state. The feeling in New York is that it should be the last to reopen, other states can go first in the middle of the country. The position in the U.S. Constitution is for states to maintain public order and safety. This was the basis of the president's position to work with the governors and continues to be the case, though there is pressure from economic advisers to the president to reopen earlier balanced by the opinion of health experts around the president.  Some states are taking action to reopen because the virus has not severely affected these states. President Trump says it is for governors to decide what is best for each state in consultation with the federal government. The U.S. government would step in if a state is taking risky action with the coronavirus. On the issue of whether the president could have acted quickly in February following his decision to stop flights from China and set up quarantines in January, the BBC has this to say. Dr. Fauci, the president's respected health expert was one of many public officials who did not see the magnitude of the crisis evolving with lack of good information from China. BBC North America Editor Jon Sopel cites Dr. Fauci's comments on February 13- that the coronavirus danger is "just miniscule" compared with the "real and present danger" of flu. As it happened the president acted alone in his sense of the danger from the outbreak in China through incoming flights and not relying on others. Here is what the situation of each country on reopening is- India -  has extended the lockdown to May 3. France - has extended the lockdown till May 11. U.S. - has extended the lockdown to May 1. States are taking the responsibility. UK - continues lockdown restrictions till May. The French president Macron had a simple answer to the question " when will we be able to get back to a normal, prior life?" Macron said "Quite frankly, humbly, I have no definitive answer to that." Some nurseries and schools will reopen May 11. Not restaurants, hotels, museums and theaters. By May 11 France will be able to test and quarantine anyone with symptoms and general public masks will be available to all. This is what Dr. Fauci in the U.S. also wants to see before being able to reopen, that testing and tracing, isolating, procedures be efficient and reliable. ...

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Massachusetts governor Charlie Baker gets an order in with a number of Chinese manufacturers for supply of over a million N95 masks. The hard hit east coast states of the U.S. face a critical shortage of N95 masks for health care workers in hospitals. The problem is getting them shipped from Shenzen, China to to Boston's Logan airport. Someone suggested using the Patriots football team's Boeing 767 jet. Robert Kraft, Patriot's owner agreed and the passenger plane was converted to carry cargo. The Chinese consulate in New York stays open over the weekend to process the flight crew's visas. Approval for landing without the crew being asked to quarantine for 14 days was another hurdle. Chinese authorites agreed to permit the landing for about 3 hours to pick up cargo only, with the flight crew staying on the plane. Chinese internet company Tencent sent some of its employees to help prepare the shipment and send it to Shenzen airport. The Boeing 767 makes a stop in Alaska before flying to Shenzen and completes the flight back to Logan airport in Boston. Governor Baker and the Patriot's Mr. Kraft send 300,000 of the masks to New York. ...

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This report shows the level of coronavirus testing as of March 27, 2020 in different states in the U.S. The U.S. testing program and supplies of tests are being ramped up quickly. About 65,000 tests are being done on Americans each day. The need is for 150,000 tests a day say public health officials. Testing is slow in California compared to aggressive testing in New York which has 60% of all coronavirus cases. California with twice the population of New York has done 77,000 tests compared to 122,000 in New York. Texas has done only 21,000 states by comparison. Every week new testing technology is being developed in different labs, medical companies, and universities. Including tests that can be conducted quickly and not requiring health workers or health workers with protective gear. Speed of processing test, least point of testing contact, and the protocol for quarantine, are all part of the testing and isolating of clusters mechanism to tackle the virus. This is critical in the coronavirus action plan being developed by Dr Brx of the U.S. White House team. ...

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This analysis from The Times of London provides critical information on the strategy for successfully tackling the coronavirus following the example of South Korea and progress in Britain.

The random community testing is key to getting an idea of the scale of infections in the community at large. The critical ratio called reproduction ratio tell one if the virus is under control and how lockdowns can be lifted. For Britain this 0.7 estimated by Imperial College. It has a 2 week lag. 1.0 or close to 1.0 is not good. Germany after being at about 0.7 has moved up to 1.0 with 2 week lag in information says the Robert Koch Institute. This means a lot of work ahead, it won't be easy.