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This WSJ report on critical analysis of coronavirus data has a very useful chart of Estimated Range of Symptomatic Cases Reported by Country. Complete coronavirus data for all symptomatic persons who have the coronavirus infection is lacking in most countries. Many people in large populations have symptoms and are positive but are not reflected in the official data collection. This is a big problem as the total number of cases are understated by a magnitude of twice to five times the numbers reported in official tally.   South Korea has done a good job of getting more of the symptomatic people with the infection in its data, as about 53% to 90% of such persons are reflected in official data. Next comes Germany at a range of 38% to 55%.  China comes third and has about 28% to about 38% of such persons reflected in its data, the U.S. currently on April 4 at about 14% to 19%, according to this chart in the WSJ. The source for this is Mathematical Modeling Center at the London School of Hygiene and Tropical Medicine. What this means is that the US. number of cases at 278,000  reported infected people with symptoms (April 4) is only 14% to 19% of the true number. Another way to say this is that the actual infected persons with symptoms is about 5 times what is reported, or over 1 million not the 278,000 reported.  As happens for China data collection agencies may never get the true number. To be comparable to the Chinese numbers, as the U.S. is a large country, the figure closer to the true numbers would be twice the 278,000 reported or over half a million symptomatic infections of coronavirus in the U.S. Why is this data important. With widespread testing as in South Korea one gets data that tells one how many people are infected (the size of the problem) and therefore the resources needed and the point of greatest impact. Also it tells one the typical transmission rate per person, and it helps hospitals in each area know what to expect and what resources are needed to prepare- not find people suddenly turn up in the E.R. in unpredictable numbers. The lack of widespread testing and better reporting in the data to get a grip on the pandemic is shown in this chart for countries hardest hit, less than 5-6% for Italy and Spain. The UK and France at 5-8%.   ...

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This report shows improvements in the situation for coronavirus in Pakistan. It is still to early to tell how the reopening of the economy is likely to affect the cases for coronavirus. Not enough testing is taking place. The Eid holiday taking place this weekend also could have repercussions later in August with more crowds and gatherings for the religious event. Pakistan has 278,000 cases of infection and 6000 reported deaths. At one point the situation seemed to be following the situation in Brazil but has stabilized recently.

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

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

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Italy is paying a heavy price for the delay in implementing a complete lockdown and other measures. The first delay was on Day 6 and Day 12 after the first coronavirus infection on Feb. 20, when the regional authorites in Milan region kept bars and cafes open and reopened Milan Cathedral to tourists as reported here in the NYT. This was happening even as the pandemic was surging in a case of ample denial. Then again on the 18th day after the detection of the first case on March 8, the lockdown announced was leaked leading to people leaving Milan and other towns for the south and other parts of Italy. This lockdown of March 8 was not specific enough and lacked details so that it was not properly implemented immediately. The final lockdown of the entire country came as the situation worsened on March 10. As a result the virus continued to spread leaving hospitals and health personnel overburdened and the country in severe crisis. The Veneto region fared better than the Lombardy region because of strict quarantines, higher rate of testing and contact tracing to enforce isolation of clusters. In towns such as Vo in Veneto the virus is under control as reported in the WSJ. ...

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Wuhan has announced  only 3 new confirmed cases since March 18. Restrictions on travel were lifted after a 77 day lockdown on the city, allowing inbound and outbound travel. Some restrictions on housing complexes have been tightened after reports of dozens of asymptomatic cases. The number of asymptomatic cases remains unknown. There is a fear of a second outbreak and authorites are staying vigilant, as it is feared that the first outbreak was worse than previously thought. Epidemiologists, intelligence agencies, and health experts believe the number of cases reported in Wuhan and China are undercounted. This could be they say a result of local officials wanting to present a better picture, of not enough testing in the early stages, not counting people who died at home, and including people who died of pneumonia under pneumonia instead of coronavirus. Dr Birx, head of the U.S. response effort,  says the U.S. lists people who died of pneumonia in New York as coronavirus deaths because of how widespread it is there, hitting seven people in a thousand. In addition there is a problem for all countries in counting people without symptoms. No one even knows how big that is, and Dr Birx in the U.S. says it is important to find out. ...

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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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So far 17 million people in the UK have received the Astra Zeneca vaccine.  35 cases of blood clots, 15 of pulmonary embolism and 22 of deep vein thrombosis have been reported across the UK and EU. In a normal year more than this number of cases of blood clots are seen say experts. These occur naturally in the population, including elderly population. Astra Zeneca's chief medical officer, Ann Taylor, says the number of blood clots in the 17 million people who have received the vaccine across Europe is actually lower than would be expected in the general population. The EU countries of Germany, France, Netherlands and Italy have temporarily stopped using it after 3 healthcare workers in Norway had blood clots. In Germany 7 out of 1.6 million had a rare condition of cerebral sinus thrombosis. Both EU and medical regulators say that there is no evidence that these blood clots are caused by the vaccine. The number of clots are similar to what was seen in the population before the coronavirus. Also this report in The Times says taken together there is no difference between the number of clots in the population that received the Pfizer vaccine or the Astra Zeneca vaccine.  The Daily Telegraph reports that one in 1000 people have blood clots every year, so that for 17 million people in vaccinated population with the Astra Zeneca vaccine there would be 17000 cases of blood clots over 12 months. During the clinical trials Astra Zeneca reported there were fewer people with blood clots who had been vaccinated than in the people who were not vaccinated. ...

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Massachusetts is moving into no. 3 or no. 4 position after New York and New Jersey and possibly Michigan in coronavirus cases with 34,000 reported. More than 3700 were hospitalized  in the state.

Massachusetts is close to hotspot New York. It also has a more aggressive testing strategy and is hiring hundreds of volunteers to do contract tracing, and uses Partners in Health, a nonprofit. Michigan and Massachusetts have followed a more aggressive strategy of testing compared to California which has taken a different approach of not doing aggressive testing and contact tracing leading to lower numbers in California now adjusted for population that could be different later on.

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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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Mr. Trump describes himself as a "wartime president" as he prepares to sign a Korean War era measure that allows the U.S. government to ramp up production of medical supplies.  Mr. Trump announced he was preparing to sign the 1950 Defense Production Act, which gives the president powers to direct civilian businesses to meet orders for products necessary for national security.

Mr. Trump is now holding daily news briefings on the emergency which can be seen on many television channels, including CSPAN.

In China factories producing mobil phones and other products were diverted to production of medical supplies and equipment as the coronavirus crisis escalated in February. The Chinese nation was on a war footing leading to the situation today when no new infection cases were reported. Only by doing this could 2 hospitals be built in 2 days in Wuhan to isolate patients. 

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Young people are the major source of transmission of coronavirus in the US with school sports as a major cause. Michigan, New York, Florida, New Jersey, Pennsylvania, makeup 42% of cases on April 11. Adults ages 20 to 39 are affected the most in Michigan. With cases for children under 19 quadrupling from a month ago. 301 reported school outbreaks in Michigan alone. A big problem is that the spread of the variant B.1.1.7  from the UK started in clusters earlier in February. It now has spread to the general population. India has seen a surge in the past 5 days and public health officials are learning from this experience in Europe and the US. The focus  should be on micro containment zones, prime minister Modi told state chief ministers in a virtual meeting on April 10, with screening, testing, tracking, and that health officials should not let higher numbers affect their persistent effort to screen, test and track as with the unceasing effort the results will come. ...

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New information from the recordings of the World Health Organization as reported by Associated Press, show that during the week of January 6 WHO's lead experts were having difficulty getting information about the coronavirus outbreak in Wuhan, China. Maria Van Kerkhove, an epidemiologist and the WHO technical lead for coronavirus says she was going on very minimal information. The WHO's top official in China, Gauden Galea, says in one of the recordings that they were in the situation where information was given to WHo officials in China only 15 minutes prior to it going on China's state television CCTV. In early January Michael Ryan, the WHO's chief of emergencies, says he feared a repeat of the SARS epidemic in 2002, which was initially covered up by Chinese officials, according to the AP report shown in the Guardian. Ryan says he found himself in the same situation as in 2002 SARS, endlessly trying to get updates from China about what was going on, and adds that WHO barely got out of the SARS with its reputation intact given the transparency issues, in the AP report shown in the Guardian. By June 1 about 6.3 million confirmed cases are reported of coronavirus in the world and 375,000 deaths, and huge losses to economies and people. China's authorites did not lockdown Wuhan till January 23, by which time this report in the Guardian says at least 5 million residents had left. China denied entry requested by the U.S.on January 6 for a team of experts into Wuhan, The team was not allowed into Wuhan for a crucial period of 6 weeks during which the virus had time to spread in the western world. This is taken up in Mr. Trump's letter to the WHO, and the work of Gro Harlem Brundtland is clearly stated in the conclusion of that letter. Brundtland was head of the WHO at the time of the SARS epidemic in 2003, and acted decisively with early warnings to prevent its spread.  Because of the extremely contagious nature of the coronavirus the failure of early warning systems resulted in enormous damage to lives and economic losses worldwide.  ...

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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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Mr. Trump says he will wear a mask on a visit to soldiers at Army's Walter Reed Hospital. Trump says its "a very appropriate thing. I have no problem with a mask." As cases hit 3 million in the U.S., close to 1 million in India and Russia, Mr. Trump joins the movement for masks worldwide. Early on Mr. Trump  took up the issue of transmission from Wuhan by banning flights from China, failed to get WHO and China to respond quickly to the pandemic requests from U.S. by providing information and allowing a team to visit Wuhan quickly in January. A stumbling block appeared within the health ministry in the U.S. with poor leadership which Trump had to overcome by relying on Vice President Pence to lead the stop coronavirus team at the White House.   Trump's reopening decision came under criticism and he says he had to balance the damage to jobs and economic well being that also affected health. Some of the states and young people responded in ways that led to public gatherings that have led to surges in the south and the western states such as Calfornia. The WSJ reported that in Los Angeles County on June 20 half a million people went to bars after they reopened, showing that culturally even counties in states like California lacked what is accepted good sense. For instance Tokyo bars were paid by the Japanese government not to reopen, according to one report. By wearing a mask Trump is simply acknowledging facts about transmission - a German study shows 40% reduction in cases with face coverings. ...

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On October 28 France reported 36,000 daily coronavirus cases. French president Macron announced a new lockdown starting October 30 that last till December 1.  Under this second lockdown people can leave home only to go to work, to go to school, to give assistance to loved ones, for essential shopping and for 1 hour of physical exercize. People will have to show documentation when leaving home. Travel between regions is banned. Bars and restaurants and nonessential businesses will be closed. Universities and higher education will be done online. Schools will remain open, essential businesses will remain open. Most public services will be open. Factories, farms and construction sites can continue to operate. There will be extensive economic support for business and people. Small businesses will have access to 10,000 euros per month of assistance, employees get short term work assistance, and people having trouble with rent receive assistance. About half of intensive care beds are now taken in France. And Macron said transferring patients to other regions will not be possible as the virus is everywhere. ...

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The P1 coronavirus variant from Brazil is seen in 200 of 877 cases in ski resort in Whistler, British Columbia. Helath officials have little knowledge of how this variant entered Canada's western province. This report says the housing shortage for hospitality workers is worsening the pandemic with 6-8 hospitality workers living together and no chance to limit the spread.   The decision by the state health officials not to screen with testing for which variant is responsible for an infection of covid is coming under criticism, as reported in The Guardian. This allows the variant to spread with no knowledge about where it is happening so that countermeasures can be taken. In the absence of this type of screening and testing one is flying blind, says this report. Recent steps to contain the spread in India advocated by prime minister Modi in India give micro-containment a big role, with screening and testing and detection of incidence of mutation becoming critical. To do this the health system has to be well prepared and have full support and direction from a unified authority bringing together every arm of government at the federal, state and local levels. Response has to be very quick and resource allocation proper from testing labs, people on the ground, vaccine supplies, and vaccination drive effective. ...

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Florida reported over 15,000 cases in one day on July 11, 2020, the highest recorded in U.S. in one day by any state. Many states are recording a climbing rate of positivity for coronavirus tests including California, and South Carolina is having about 22.3% positivity.

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Britain staged a rehearsal for a pandemic called Cygnus in 2016. Till that time the preparations for a pandemic that started years earlier during the SARS crisis were conducted vigorously. Yet the by this time Britain was becoming immersed in the Brexit struggles in the ruling Conservative Party. Prime minister Cameron resigned on July 13, 2016  and was replaced by Theresa May. From that time on the struggles with pro Brexit factions led by Boris Johnson consumed the COnservative Party and sucked the life out of the pandemic planning that Britain had conducted for years before. The recommendations to correct deficiencies from the pandemic rehearsal exercize were ignored. The second failure happened as the crisis approached. Again the Brexit date of January 31 intervened and the months long struggle to get Brexit had taken so much energy and tired out most of the British public including new prime minister and leader of the Conservative Party Boris Johnson. Johnson did not attend the first Cobra meeting of the highest level ministers and military, convened on January 25, 2020, as reported in the Times. Such meeting are convened only for a national threat. Only 5 weeks later on March 2 did the prime minister attend a Cobra meeting. During this time the situation was grave in Italy with rising cases and infections. The entire process was conducted during this time by the Health minister Mr. Hancock who had assured the public that the situation was under control. Britain now has the highest number of infections in Europe exceeding that in Italy- at 240,000 on May 15, 2020. The prime minister and his adviser Mr. Cummings, were also infected by the virus, and Mr. Johnson spent time in ICU before recovering. Queen Elizabeth addressed the nation on Easter day, the first such address since 1940, to boost Briain's spirits. Never had Britain been less prepared as in 2020 when earlier preparations were ditched for austerity plans and events such as Brexit fatigue conspired to strip the nation of the crucial 5-6 weeks of preparation since the first January 25 Cobra meeting of the highest people in government.  Never had such preparation even for 6 weeks been more crucial than in February and March as the infectivity ratio was determined by infectious disease specialists at the best British universities and scientific institutions to be between 2.6 and 3.4 compared to the Spanish flu pandemic of 1918 which was somewhere between 2.0 and 3.0. This means every one person infects another 3 persons, compared to about 1 person in a regular flu season. This reproduction ratio and the nature of coronavirus remain a threat today as Britain, Europe, the U.S. and the world reopens.  As reported in the Times the infectivity ratio was also the reason for the mindset that refused to believe that the virus was real because at 3.0 infectivity the only way to tackle it was a "lockdown," and this was itself an "apocalypse" scenario for many in the pro-Brexit Conservative party that won the election, which badly wanted to get back to economic activity after Brexit. ...