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Merkel of Germany's approval rating for her handling of the coronavirus pandemic is up to 67%, in South Korea Moon won a landslide victory. In the U.S. Mr. Trump has 49% approval rating 6 points above his average. Boris Johnson in UK gets personal sympathy but his government's response is being questioned.

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The Trump administration will use the Defense production Act to procure 60,000 coronavirus test kits. China ramped up its production of test kits to 7000 a day in a few days after the crisis hit Wuhan. The U.S. Government is also using the DPA Act for procuring 500 million masks. FEMA is now coordinating the response to the crisis according to this report,

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What went wrong to get 100,000 deaths in the UK? A lot says this analysis in The Times. Don't need a big test and contact tracing effort was the early response, no quick decisions to build the infrastructure for this like South Korea or Taiwan. The Cheltenham Festival? Superspreader events a bad idea. Open Borders- another bad idea. After a break in the coronavirus weather by summer- relaxing vigilance and preventive steps, another bad idea. So on till a coronavirus variant stepped in through the open borders. You make your own luck, says this analysis in The Times of London.

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Coronavirus testing is being ramped up in the U.S. as the Food and Drug Administration new regulations allow commercial labs to manufacture and distribute  coronavirus tests. Now many players can now acquire and conduct tests including state and local governments, hospitals, universities, and private companies. so that tracking nationwide distribution is still difficult. Deborah Brx the response coordinator of the White House task force on coronavirus says U.S. has completed 220,000 tests in last 8 days.  In New York the scaled up efforts in a region with over half the coronavirus cases in the U.S., 13,000 were tested on Monday, March 23. Some hospitals in New York such as Mount Sinai expect to do double or triple the tests a day in a scaling up effort by March 30. In Los Angeles a city councilman negotiated with a South Korean company for delivery of 100,000 tests a week, having already secured 20,000 new tests. Additionally swabs and protective equipment are also needed to conduct tests and labs need to process results with speed. ...

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Boris Johnson has set up a unit in !0 Downing Street to coordinate a response  in the event of a "nightmare scenario" of spike in Coronavirus and a no deal Brexit added together with extreme flooding during the winter. Michael Gove, Cabinet Office minister is overseeing this effort.

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China is building a new hospital in Wuhan the center of the coronavirus outbreak, to contain the outbreak. The plan is to build it in just 6 days. China has taken a new approach to tackling this health crisis, isolating the area and speeding up action to find solutions to the virus. A shortage of hospital beds and resources in Wuhan led to the decision to build a new hospital rapidly. China's rapid response is the first high speed response and could be a model for future outbreaks. Before this during the SARS crisis in China, and other health crises worldwide, action was taken gradually by hospital and government authorites leading to more deaths and wider spread of disease.

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The head of the U.S. Department of Health and Human Services, Mr. Alex Azar, repeatedly assured the president as early as January 29, that there never had been a better interagency response to coronavirus, says the WSJ. This WSJ report says based on interviews with administration officials and others that Mr. Azar waited for weeks to brief the president on the threat from coronavirus, did not coordinate effectively across the health divisions,  failed to ramp up testing development, and oversold what had been done. Testing is one of the key issues raised at this time about the coronavirus effort. Mr. Trump tweeted on April 12 that Mr. Azar "told me nothing until later." The president was dissatisfied with Mr. Azar's handling of the flavored e-cigarettes ban. This report says Mr. Azar was slow in working with other agencies such as FEMA, and in involving directly the FDA, CDC, and other agencies, to create a strong and effective response to a fast developing public health crisis of enormous proportions. In February White House advisors were critical of Mr. Azar for delays in the testing program. As the delays progressed this report says Mr. Pence and the White House gave more responsibility to FEMA, and Dr. Hahn and CMS's Ms. Verma were made active members of the White House Task Force. FEMA also played a bigger role with greater funding.    ...

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Senay Boztas writes from Amsterdam, Netherlands, that the strict lockdown in the Netherlands is a result of a badly handled coronavirus policy response. The Dutch experience is offered as a lesson other countries can learn from. It too long to form a government after Dutch elections in March, 271 days so that it took too long to have a policy response. When a policy response was made it faltered badly with too relaxed a lifting of restrictions without essential distancing and mask use. Restrictions at super spreader events at night clubs and stadiums were lifted all at once. The government failed to develop a policy of anticipating the next wave from variants by planning early for a booster campaign. (Israel is already into its fourth booster shot as reported in NYT).  The result is that instead of a calibrated response, because infections make up 15% of tests, Netherlands is in a sharp lockdown. A policy of prime minister Rutte that put too much into the idea of freedoms with different meanings in the west calling Holland a "slightly anarchistic country that doesn't need a preachy government," rejected vaccine mandate of any kind as in France and Austria for public transport and restaurants.   ...

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About half of UK adults reported experiencing high levels of anxiety says the Office of National Statistics for the the first lockdown. During the second lockdown the fatigue coming from that period in March and the higher level of cases is likely to have increased the number of adults experiencing anxiety. Anxiety was experienced from the loneliness and the effect of the coronavirus on work. A quarter of all adults reported increased sleeplessness. Stockpiling, overworking, irritability, micro-managing, and alcohol consumption, are some of the erratic responses to this level of added anxiety. Experts suggest different responses. leadership and incremental change to put the problem into context. Such as in the case of coronavirus the important behaviours that one can control such as masking properly, social distancing properly, ventilating and cleaning the air with aircleaners, using necessary caution in outside exposure by limiting to the essential, and taking nutrients for defence against virus, other actions. After putting these in place the risks can be minimized.  At that point focusing on the present is seen by experts as the right way to respond. Get through this period or this week first, leave the next week or the next period for next time. To do this  baking, reading, hobbies, running, walking, yoga, gardening, and outdoors, a whole range of other activities including watching sports, listening to radio and music, all fall into this. Spending time doing things that make us happy. A good exercise is asking how does this make me feel, am I more relaxed? am I happier? Put things in perspective, is this catastrophising? Is this making it bigger than it is? Can I put away the illusion of control when control requires some higher power such as God. Can I leave that part to God, to the divine. Cognitive behavioural thinking modification is a way of tackling stress, loneliness, and the depression and anixety that feed on each other. Being aware that we may have wrong behavioural responses, asking questions about how accurate our thinking about things that pose threatening situations is, are helpful in tackling the anxiety.   Just breaking the pattern of behavioural responses of repetitive thinking is helpful by engaging in other activities. Meditation is helpful. Yoga is helpful. In this pandemic learning about nutrition and increasing one's knowledge of food, eating and exercizing right, of cooking, is a useful way of turning a negative into a positive.     ...

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Addressing the UN General Assembly in a virtual setting Mr. Trump tells delegates that China should be held accountable for certain actions in letting the coronavirus pandemic spread. He included the denial by China of human to human transmission very early before Feb-March, and its allowing Chinese flights to go overseas when it had completely banned flights domestically. He said flights were allowed to leave China after the virus spread from Wuhan even after Mr. Trump banned flights from China to the U.S. This spread the virus from China to Europe and to America.  Mr. Trump says the WHO is controlled by China. And this happened after foundations such as the Bill and Melinda Gates foundation and other foundations partly replaced the strong role played by the U.S. government at the world health agency during the post war period maintaining strong U.S. and European oversight in the earlier period. The lack of cooperation by China to let American experts into Wuhan immediately in January played a role in delaying the U.S. getting a first hand look at the coronavirus at the epicentre. Instead a 2-3 week delay left the U.S. Europe and India unprepared for the speed and havoc caused.  The only way to tackle the coronavirus was with speed and that speedy response was doubly needed because Europe and the U.S. had no recent experience with epidemics. Even India and rest of Asia, Latin America, Africa have no experience with this type of transmission and spread making time absolutely critical.  This speed was affected because China and the WHO acted as stumbling blocks in this view of what happened. The result was that in past pandemics were fought together, this pandemic was fought on a country by country basis, a bad precedent. ...

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The Blinken Wang Yi meeting at the G-2- in Indonesia is the first high level meeting between US and China since March when the Ukraine war started. In the press briefing after the meeting Blinken said "more than four months into this brutal invasion the PRC stands by Russia." He pointed to Beijing support of Russia at the United Nations, dissemination of Russian talking points through Chinese state media and joint military exercizes with Moscow. One aspect of the relations that is beyond the control or good intentions of the two countries top diplomats is the tit for tat response that began with the presidency of Donald Trump. Trump may have seen this as a way to talk to the voter base fed up with two decades of one sided trade with China with manufacturing shipped out to China and local communities of families and workers in regions across the US losing jobs and in decline. Much of this shift was done by US companies during the Clinton, Bush and Obama administrations over two decades. The strident tone adopted by Trump was met by tit for tat responses in Chinese media till the pandemic when it assumed a new aspect of Chinese origins of the coronavirus. The result is that Sinophobia in the US is met by a response in Chinese media and in the thinking of the Chinese leadership under Jinping that now sees the relationship as having already shifted during the pandemic. The paradox in this is that the US in its effort to get other countries on its side is only beginning to make an effort of get America's own companies and large business investors on its side. Most American companies are still continuing trade and business with China as before.  The same situation exists with the shift of manufacturing from Japan and the European Union to China, with the loss of jobs and decline of local communities that depended on manufacturing. Japanese and European companies are acting in ways that are similar to American companies. Having managed the shift of manufacturing from European Union and Japan to China these companies have done little to change this business situation in 2022 carrying on as before. This is the paradox of the current situation that business both in the US and EU, and Japan is not on the side of their governments, even as their governments attitude to China, particularly now after the pandemic and the Ukraine war has shifted drastically. Alongside this is the popular opinion that has shifted gradually over the last 10 years in the US and EU, first in these very local communities that lost manufacturing to China, and then across broader sections of the public, and now across whole regions of America, Britain, the EU and Japan. This shift in popular opinion has little interest in the way business conducts business overseas or governments conduct diplomacy in nuanced statements. As a result neither the governments of the US, EU and Japan or the business of the US, EU and Japan are in control of this shifting situation that has its momentum and pace operating quite independently of governments and business. And public opinion across America, Europe, Japan, and also in India is moving in an entirely new direction.     ...

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The Editorial Board of the WSJ questions the lack of debate on the frequent lockdowns and the quashing by public health officials Fauci and Collins of an alternative point of view on lockdowns. That point of view by epidemiologists at three universities Oxford, Harvard and Stanford favored a policy of "focused protection" of high risk populations instead of snap response of blanket lockdowns. It cites statement by Dr. Fauci that people who criticize him are "really criticizing science, because I represent science. That's dangerous." And questions the idea that one man can by himself represent science, saying scientific debate over pandemic policy was and still is in the public interest. In some ways the Biden administration has adopted some of these ideas on a new pandemic policy that does respond with focused and selective lockdowns. Today shuttered businesses, lost livelihoods, untreated illnesses, mental illness, isolation effects are all taken into account in decisions throughout the US, and other countries in Europe, in Asia and the rest of the world. Some of the emails mentioned in this WSJ editorial were in October 2020 at the height of the first wave and second waves before the vaccination drive in 2021, when the fear of the coronavirus was the dominant response. Yet a spirited public scientific debate could have prevented some of the rancor and division that has led to high vaccine resistance in the US with fully vaccinated stalling at about 62% of the American population at the beginning of 2022. It did'nt have to be that way. America could have done a lot better with sincere scientific and public debate. ...

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The critical variable in knowing whether lockdowns of cities and countries are working is called the coronavirus RO, or reproduction ratio. This ratio measures the average number of people infected by a carrier A. It could be that he infects 1 person at work and transport call it B people , or in large gatherings call it C people he infects 2 persons, or in other surroundings such as restaurants he infects 1 person call it D people. The people A has infected B+C+D are the ones now not infected by A with the lockdowns such as in New York, Italy, Germany, UK and France. It is determined by global health experts that the number of B+C+D is about an average of 4 persons infected by 1 person A with coronavirus, though it may be much higher in practice in some areas. The natural rate of RO or reproduction ratio is considered by the European Centre for Disease Prevention and Control to be 3.86 or about 4, if no lockdown or social distancing or other prevention is practiced. This in a situation where people behaved as before unaware that the virus was around them. Governments such as New York and France, UK, Germany are including this key variable in their determination of how long a lockdown lasts, and for determining if the reopening is not going the right way or failing. In such situations the lockdown would be reinstated, or if it is a phased reopening such as in the U.S. and other countries go back to the previous phase. In Italy and Germany the RO reproduction ratio for coronavirus is estimated by official experts at 0.8. Germany's RO estimated by the Robert Koch Institute and Italy's by Franco Locatelli, scientific advisor to the government. In New York the margin is thin- with RO of 0.9, estimate from the state's governor. In France which has one of the tightest lockdowns of all with a document required to go outside it is at 0.6, the figure coming from the prime minister Mr. Philippe. In the UK it is below 1.0 but no accurate figure is reported. As Dr. Birx- leading the coordinated response in the U.S. - emphasizes over and over again this is a very contagious virus, about which not much is known. Social distancing, wearing masks, basic prevention measures such as frequent handwashing, and not gathering in large numbers of people, is essential for defeating this virus. This has to be followed up with extensive testing and contact tracing to win this fight.   ...

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Contrast the slow US vaccine export response with that of India, Russia, EU and China. Only in May 2021 after India's daily Covid cases were close to 400,000 a day did the US make a serious offer of vaccines to other countries in need of assistance. U.S. president Biden says that 80 million vaccine doses would be exported by the end of June 2021. The WSJ says citing Airfinity, a London research firm, as of May 10 more than 333 million doses of vaccine were produced by the US and only 3 million vaccine doses were exported. Contrast that with the European Union which has shipped 111 million doses overseas one third of its total production, Russia which has exported 27 million doses.  India has exported 66 million doses according to the Ministry of External Affairs website as of May 17, 2021. This includes 4 million doses to Brazil, 4 million to Nigeria. Within its own region Bangladesh received 10 million and Sri Lanka 1.2 million doses, Afghanistan 1 million. Mexico received about 1 million doses. In Africa the Democratic Republic of the Congo which has suffered from many epidemics including Ebola virus received 1.7 million doses, Nigeria 4 million doses, Kenya 1 million, Uganda 1 million. Of the 66 million about half of it is a direct grant assistance and Brazil, Mexico, Morocco received all vaccine as grant assistance, 70% of Bangladesh's is grant assistance. The list on the Ministry of External Affairs site of the Government of India shows 95 countries including many of the most struggling nations of Latin America and Africa, bringing hope to countries which are struggling to hold onto hope for a better life beyond the pandemic. Sending help overseas through vaccine supplies is suspended for the moment but will resume in July after India has pulled in all of its pharmaceutical manufacturing industry under a government guided effort to go all out. Never has so much help bringing much needed hope gone to so many countries of the world in the twentieth or twenty first century from a nation that is struggling to meet its own needs. The US in pursuing a US first policy of vaccinating all its citizens has not taken into account the need to bring this evolving vaccine technology into the hands of as many qualified pharmaceutical manufacturers as possible. This in a rapid response to expand manufacturing capabilities to meet world wide demand. The risks of not doing so were not taken on early- the very same way the virus spread in January to March of 2020 can be repeated as people travel around the world particularly for tourism, business family reasons. This risk takes on anew dimension of contagious mutations of the virus which are 50% more- the Indian variant being 50% more contagious by some estimates than the UK variant, which itself was estimated to be 50% more contagious than the original one.  The result a pandemic that stretches out indefinitely unless billions of doses are made in a short timetable to beat the timetable of Nature through the coronavirus. India is doing this for the first time with plans to produce billions of doses by engaging the whole of the Indian pharmaceutical manufacturing industry in the effort in a rapid response so that July to December would see 1.2 billion people vaccinated. The US effort, the European effort is left to the individual effort of pharmaceutical makers in the US and Europe, not a government guided effort to engage the entire pharmaceutical industry of the US and Europe in a rapid response timetable of 2-6 months.  ...

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Russian president Putin may have exacerbated the very thing he feared- a deepening demographic crisis in Russia. This report in the Financial Times says excess mortality was already one of the highest from the coronavirus- about 1 million compared to official figures of 360,000. During the 1990's Russia had gone through a demographic decline with fewer births after the fall of the Soviet Union and unstable conditions in the economy.  During the pandemic there was outward migration from Russia as a result of people wanting access to vaccines other than the local vaccine, says FT.  In an interview last November Mr. Putin talked about the dangers to Russian statehood and to the economy from a drop in births and falling population. The war has worsened this situation as the FT says about 70,000 highly educated people left the country in March and another 70,000 are expected to leave in April. The response of Europe and the US to the Ukraine invasion with moves that affect the Russian economy could lead to drop in jobs and living standards that lead to a further drop in births, says FT. This may be a more serious way in which Mr. Putin may have neglected to consider Russia's own long term interests in invading its neighbor.   ...

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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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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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The treaty of handover by Britain of Hong Kong under one country, two systems was flawed in the way it was negotiated. French commentators looking at the problem say the city is caught between its past in the British Empire and the new monolithic state that China represents. Under the British French visitors looked at the city and wondered how there was freedom but no democracy, people were just selfishly just interested in making money. Chris Patten, Britain's administrator of the territory tried but failed to get democratic process, During the negotiations in 1984 for handover the chief British negotiator, Percy Cradock, a former ambassador to China, tells the Australian Broadcasting Corporation that - In Hong Kong where there is such a disparity in strength between the two sides, you go for the best you can get, I take the simple view that half a loaf is better than no bread." Britain had very little leverage to secure a separate future for Hong Kong because it was small compared to much larger China resulting unequal negotiations. The same is true today as the best Britain could do is to get out a joint declaration with Australia and Canada saying that it did not approve the new security law, that it violated the treaty signed by Britain and China. The French view expressed by the editor of La Croix is that hasty poorly planned British exits- as happened in British India -have led to crises and conflicts for postcolonial generations, a legacy of British colonial rule. India and Pakistan still sorting out Kashmir, and India and China still fighting about the McMahon Line border area. The situation is very different for the U.S. which now has to respond in some way, and this comes as trade tensions and coronavirus tensions about its origins in China and the failure of Beijing to allow quick entry for an American team into Wuhan. This being for 7 weeks between Jan 6 request and February 16 permission. America sees this as losing 7 precious weeks to make up its own determination of the dangers when every week health experts say means saving or losing tens of thousands of lives. With loss of 100,000 lives the Trump administration has a sense of being misled. This French report in FR24 points out that the lack of a strong response from the U.S. would be something similar to letting the Berlin Wall happen without a response. Both sides in a situation where the territory of Hong Kong remained mostly about money and with a disproportionate influence of business interests similar to its founding under the unequal treaties of the 1850's. ...

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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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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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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. ...

LyrArc Article Gist
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. ...